Fascinating thoughts on the next technological wave by David Butler

Health workers can save the planet!!
Most of the public consider that health costs are a necessary financial drag on society and few health workers pause to consider their job as an economic driver or an invention which may be critical to the continuation of a way of life. Health as an economic driver in the format of labour markets, insurance and building new hospitals is quite obvious (imagine the unemployment if there were no health care jobs), but something deeper beckons if health workers are to be saviours of the planet...read on if you wish – it's time for a slightly heavy noinotes!!

Waves of economic activity – meet Nikolai Kondratieff
It is quite obvious in society, especially capitalist societies, that economic activity and prosperity often go in waves – the 10-12 year waves are most obvious, though many people in Europe and America are looking anxiously for the next wave! Other waves of economic activity have been described. Nikolai Kondratieff (Russian of course) proposed 60 year cycles of economic activity focussing on a particular invention which has led to enhanced productivity. Note the six waves of inventions in figure 1. Note also that the invention which underpins the current 6th Kondratieff wave is suggested as health and in particular biotechnologies and psychosocial health. The 5th Kondratieff was information technology. While the impact of IT is still strong, it is dwindling, at least in the West, where most people have access to a computer. Although, various estimates suggest that only 10% of the world population have access to a computer.



Image adapted from http://kondratieff.net/11.html

Health as economic driver?
Health as invention or economic driver may seem a bit odd. It is not really tangible like railways and steel which underpinned the 2nd Kondratieff wave. A good example of advances in biotechnologies includes the recent major steps towards a vaccine for malaria but it is the psychosocial health (perhaps it should be rephrased as biopsychosocial health) which is of interest here. Psychosocial health in regard to the 6th Kondratieff involves "attempts to better understand and tap into humans' internal information processes, and the wide field of mental and social potentials" with the suggestion that future successful economies and companies will rely on the health of their people and the health of the public health system as a whole – spiritually, bodily, socially, ecologically and mentally. [1] Wow! All this suggests, supports and encourages a powerful information medicine.

You have to think a bit laterally here to grasp it. Those of us who were not born with computers had to think in a different more systematic way to manage computers, but we seemed to manage. It will require quite a shift (eg resources to appropriate education, fair distribution of societal wealth) to access the untouched reserve of human mental potential to restructure a health care system into one where repairing disease continues but the focus is on health. This "information medicine" must be powerful.

The 6th Kondratieff, information medicine and the power of biology
We believe that the information medicine underpinning the 6th Kondratieff will emerge mainly from neurobiology and in particular recent neuroimmune science. For example, here is a pathway of knowledge that has only been available in the last decade... We know that altered use and pain experienced in a body part will lead to changes in the representation of that part in the brain. We know that this is a neuroimmune event most likely related to the activation of groups of glial cells which are essentially immune organs. We know that the immune system is, as Mick Thacker states, is "a system which can identify self from non self", i.e. it is a system that "knows who you are and will respond when you are not you". Responses could be fighting infection or altering the way the body is in the brain. However "you are not you" is not only a state which exists with a disease or injury, it also exists when you are socially dislocated, feel meaningless, have pain that you don't understand or don't have the means (cognitive, knowledge, finances etc) to even begin self-management of a problem. You "may not be you" if you are in a society yet to deal with ageism, racism, sexism and every other "ism". There must be neuroimmune effects leading to pain, disease and altered cognitions and emotions, all of which we now know that the immune system has a hand in [2].

Isn't it a bit too capitalist? 
My dear friend Mick Thacker, responsible for much of the neuroimmune mutterings above (and who now owns a stuffed badger) suggested a danger with the "health invention" falling into the hands of the capitalists, and he may be right. Growth theories don't appeal to everyone and well-being is not necessarily related to economic productivity and dollars. Nikolai Kondratieff certainly fell out with the Trotskyites in Moscow and he ended his days cooling his heels in a Siberian labour camp. But notions of linking a person's existing mental and spiritual powers to information medicine have great links to the health literacy movement, and you would hope that an awakening of these powers would limit misuse.

Some recent projects in Scotland have links to the 6th Kondratieff. (Scottish politics are usually left of the English) Here, the Chief Medical Officer [3] has launched an Assets Alliance for Scotland – health assets being any factor or resource which maintains the ability to sustain and maintain health and well-being. One of the greatest health assets is the still untapped productivity that we all have as part of our mental/spiritual/psychological makeup. Knowledge is the key to unlocking it and thus there are enormous links to the information medicine underpinning the 6th Kondratieff. 

Will you come on the trip?
One way to contribute to and benefit from the 6th Kondratieff is to reduce our own knowledge gaps as biopsychosocial knowledge races away from standard practice. So I am pushing the NOI conference here, a proactive conference on neuroimmune backed biopsychosocialism which pushes health as an economic driver. Check out the list of remarkable plenary and invited speakers – perhaps the best ever list of speakers at an Australian Rehabilitation conference and the massive "what to do about it" list of workshops and lunchtime events. There is a deep underlying theme here of informed self-management, professional and personal empowerment, information medicine and the critical neurobiology, in particular the engagement of the brain, which we see a vital to health as a successful 6th Kondratieff. -Davidwww.noi2012.com

References
Nefiodow, L.A.; Available from: http://kondratieff.net/11.html 
Fields, R.D., The Other Brain. 2009, New York: Simon and Schuster.
Burns, H.; Available from: http://www.scdc.org.uk/assets-alliance-scotland

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Psychosis isn't always pathological - BPS Research Digest 198, 6.10.11

Unusual, psychotic-like symptoms, such as hearing voices, are not as rare among the general population as you might think. For example, it's estimated that ten per cent of us hear voices that aren't there, with only a small minority likely to ever receive a clinical diagnosis. According to a new study, this means that the factors that cause psychotic-like symptoms are likely different from those that lead to a diagnosis of pathological psychosis. Charles Heriot-Maitland and his colleagues argue that this distinction has been missed by the majority of past studies that hunted the causes of psychosis by focusing only on patients, neglecting those who live happily with their psychotic-like experiences.

To make a start rectifying this situation, Heriot-Maitland's team interviewed six patients with psychosis (recruited via psychosis teams in SE England) and six "healthy" non-patients, who reported similar unusual experiences (recruited via UK networks involved with spiritual or psychic phenomena). Across both groups, these experiences included: receiving visions from God, hearing voices, and feeling that their body had been taken over. Based on their symptoms alone, you couldn't tell which group a participant belonged to - clinical or non-clinical. The researchers asked all the participants open-ended questions about the circumstances that led to the onset of their unusual experiences, how they felt about them and how their friends, relatives and other people had responded.

Using a qualitative method called Interpretative Phenomenological Analysis, the researchers looked for emerging themes in the participants' answers. Both similarities and differences emerged. In both groups, their unusual psychotic experiences had started after a period of negative emotion, most often accompanied by feelings of isolation and deep contemplation about the meaning of life. However, the groups differed in how they responded to and perceived their odd experiences. Members of the non-clinical group had been more aware of non-medical interpretations of their symptoms; they viewed them as transient and desirable; and people close to them shared this non-pathologising perspective. By contrast, the patients encountered invalidating, medical interpretations of their experiences and were themselves less able to accept their experiences and to incorporate them into their personal and social worlds.

From a theoretical point of view, Heriot-Maitland and his colleagues said there was a need for a more precise approach to the study of psychosis, which distinguishes risk factors for psychotic experiences from risk factors for actual clinical vulnerability. "It would seem that the more out-of-the-ordinary experiences are associated with clinical psychosis, the less chance people have of recognising their desirability, transiency, and psychological benefits, and the more chance they have of detrimental clinical consequences."

The researchers added that this has important clinical implications: "psychotic experiences should be normalised," they said, "and people with psychosis should be helped to re-connect the meaning of their out-of-the-ordinary experiences with the genuine emotional and existential concerns that preceded them." They also acknowledged that more studies, including quantitative investigations, are needed to build on this initial work.

Heriot-Maitland, C., Knight, M., and Peters, E. (2011). A qualitative comparison of psychotic-like phenomena in clinical and non-clinical populations. British Journal of Clinical Psychology DOI: http://dx.doi.org/10.1111/j.2044-8260.2011.02011.x

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