Richard G. Petty, MD

The Looming Crisis of Alzheimer’s

For those of us who lobby for resources, it is no overstatement to say that Alzheimer's disease has reached crisis proportions in the United States.

As we are getting older, the incidence, prevalence and mortality of Alzheimer’s disease are all rising.

The 2007 Alzheimer's Disease Facts and Figures report by the Alzheimer's Association makes sobering reading. Here are some of the headline facts:

• Alzheimer's disease is the most common cause of dementia
• At the present rate, one in 85 people will have the disease in 40 years
• There are now more than 5 million people suffering from Alzheimer's disease, and the report projects an increase of 16 million cases by 2050 unless preventive measures are taken and/or science is able to come up with a prevention or cure
• One person is now diagnosed with dementia every seven seconds
• One in every four American families is affected by dementia
• The incidence of dementia is one in 1,000 before age 65 and one in 20 after age 65.
• More than $100 billion is spent per year on dementia, which is about 10 percent of all healthcare expenditures

As we have discussed before, the symptoms of dementia may be delayed for 3 to 5 years through healthy lifestyles and behavior modification, and there are many new treatment approaches in the pipeline.

The huge issue is that statistic about one in four families being affected by the disease. And it is a disease: it is not part of normal aging.

Caregivers can suffer terribly.

The Alzheimer’s Association also has some information for those who care for people with Alzheimer’s.

There is also some food information here concerning caregiver stress.

I would also like to direct you to some of the things that I have written here about the wellness of caregivers.

And for everyone, don’t wait until you are thirsty before you dig that well. Work on building you personal resilience and follow the simple lifestyle guidelines that may significantly reduce your risk of developing Alzheimer’s disease.

Relationships, Conflict and Heart Disease

Robust, dynamic and balanced relationships can be the source of untold support and happiness in our lives. They can also provide us with the scaffolding on which to structure and maintain the health and meaning of our existence.

On the other hand, precisely because positive relationships can be such powerful forces for good, toxic, fractured and unbalanced interactions can create physical, emotional, social and spiritual havoc. Most of the evidence about the physical impact of negative relationships has concerned heart disease and disturbances of the immune system.

An article in this week’s issue of the Archives of Internal Medicine continues to flesh out the interaction between dysfunctional relationships and heart disease, suggesting that If you are in stuck in a close relationship with many negative characteristics, for instance conflict, you may well have a raised risk of heart disease, compared with somebody whose close relationship is more positive overall.

Roberto De Vogli and his colleagues from University College, London, looked at 9,011 British civil servants who filled in a questionnaire about negative aspects of their close relationships during two periods: 1989-1990 and 1985-1988. The main focus was on couples and participants also outlined how much regular emotional and practical support they received from their partners. They were followed up twelve years later to find out whether they had had a fatal or non-fatal coronary event, including chest pain of cardiac origin or a full-blown heart attack.

Of 8,499 people who were followed up and had provided enough information at the start of the study, quite a high number - 589 - had sustained a coronary heart disease event, although none of them had obvious coronary heart disease at the beginning of the study. The analysis took account of multiple potentially confounding risk factors including socioeconomic status and health habits. When they had all been stripped away, the researchers found that there was a 1.34 higher risk of coronary heart disease events among those who experienced a high level of negativity in their close relationships. This link was found in both men and women and in each social class. It could not be explained by depression or negative personality traits: it seemed to be the negative relationships itself that was to blame.

We already know that negative marital interactions are associated with depression, often in combination with reduced self-esteem and higher levels of anger. These are all emotions that can have both acute and chronic effects on the coronary arteries, through alterations in the normal balance of the autonomic nervous system, neuroendocrine changes, disturbances in coagulation and inflammatory and immune responses.

Many people are sensitive to any kind of negative interactions in the people around them, but the effects are particularly toxic if they involve the people closest to us. They are more likely to elicit strong emotions such as worry and anxiety that are the most likely to induce effects on our bodies.

Staying in a chronic negative relationship may be more than just masochistic.

It could kill you.

“Tenderness emerges from the fact that the two persons, longing, as all individuals do, to overcome the separateness and isolation to which we are all heir because we are individuals, can participate in a relationship that, for the moment, is not of two isolated selves but a union.”
--Rollo May (American Existential Psychologist, 1909-1994)

“Whenever you're in conflict with someone, there is one factor that can make the difference between damaging your relationship and deepening it. That factor is attitude.”
--Timothy Bentley (Canadian Family Therapist)

“Today the network of relationships linking the human race to itself and to the rest of the biosphere is so complex that all aspects affect all others to an extraordinary degree. Someone should be studying the whole system, however crudely that has to be done, because no gluing together of partial studies of a complex nonlinear system can give a good idea of the behavior of the whole.”
--Murray Gell-Mann American Physicist Noted for his Concept of Strangeness and the Discovery of Quarks, and, in 1969, Winner of the Nobel prize in Physics, 1929-

“We shield our heart with an armor woven out of very old habits of pushing away pain and grasping at pleasure. When we begin to breathe in the pain instead of pushing it away, we begin to open our hearts to what’s unwanted. When we relate directly in this way to the unwanted areas of our lives, the airless room of ego begins to be ventilated.”
--Pema Chodron (Formerly Deirdre Blomfield-Brown, American Buddhist Nun, 1936-)

Marriage Makes You…

A Chinese sage once said that if a woman took a pea and placed it in a large jar every time that she had sex in the first year of marriage, and then took out a pea every time that she had sex in the rest of her life, the jar would never be empty.

So many couples seem to think that a declining interest in sex I something to be expected, and agony columns and websites are crammed with complaints. Does it have to be that way? Is it just that people get bored with each other, or are too tired to bother?

Some intriguing new research suggests that there may also be a physical factor, reporting lower testosterone levels among married men compared with single, unmarried men.

The research is reported in this month’s issue of Current Anthropology by Peter B. Gray from the University of Nevada, Las Vegas, Peter T. Ellison from Harvard University and Benjamin C. Campbell from Boston University.

They investigated the links between male testosterone levels and marital status among modern-day cattle farmers from the Ariaal tribe in northern Kenya. Less than 1.5 percent of these men consider that their wives are a source of emotional support. The Ariaal males serve as herd boys until they reach puberty. They then undergo initiation, become warriors and begin to accumulate livestock. They do not marry and have children until around age 30. They value social bonds with male peers more than spousal or familial bonds. 

The researchers measured testosterone in morning and afternoon saliva samples of more than 200 Ariaal men over the age of twenty. They found that monogamously married men had lower testosterone levels than unmarried men in both the morning and afternoon. However polygynously married men with more than one wife had even lower levels of testosterone than the monogamously married men.

The data suggest that male testosterone levels might reflect variations in male mating efforts. It may also be that in the tribal setting, older men, who typically have lower testosterone levels, may have the social status and wealth to obtain more than one wife.

Given the increasing amount of data concerning the importance of testosterone for normal brain and arterial function, this may be a big wakeup call. If men do nothing once they are in a relationship, and their brains begin to think that the “hunt” is over, their testosterone levels can plummet.

And that can be fatal.

It is essential for couples to work to keep passion – and testosterone – alive.

It is not sexism, it is millions of years of evolution.

A Virus Linking Depression, Aging and Heart Disease

We have known for a long time that there are close links between depression, aging and heart disease, but the nature of the link has remained elusive. Most of the smart money has been on inflammation, but there could be other candidates.

New research in the journal Brain, Behavior and Immunity has linked an increase in two inflammatory proteins in the immune system with a latent viral infection and proposes a chain of events that might accelerate cardiovascular disease. It is possible that the same process may be involved in a number of other ailments that can afflict us, as we get older. The findings also suggest that chronic depression may play a key role in initiating the cascade that can lead to the development of coronary artery disease.

It has been known for some time that increased levels of the proinflammatory cytokines, TNF-α and IL-6, predict mortality and morbidity. High levels of each of them are found in the plasma and in atherosclerotic lesions of people with cardiovascular disease.

The levels of IL-6 in the body increase as the immune system ages. Some of the IL-6 is generated by immune cells - macrophages - that go to the site of an infection or injury. Earlier work by the team also showed that increases in psychological stress and depression could substantially raise the levels of IL-6 and TNF-α in the body.

Increased stress and depression can also trigger latent viruses to reactivate and begin reproducing inside cells. The viruses of greatest interest are some herpes viruses such as the Epstein-Barr virus (EBV). We know that up to 90% of the people in North America have been infected by EBV by the time they are adults.

If EBV begins to multiply in cells in the body, it produces a protein called dUTpase that, in turn, can stimulate macrophages to make yet more IL-6.

The researchers developed a model to test these linkages by using endothelial cells that line the inside of veins in umbilical cord tissue. I spent years working with these cells myself, and they provide an excellent substrate for examining vascular responses and the interaction between blood vessels and macrophages when exposed to the virus as well as the dUTpase protein.

As expected, the production of IL-6, as well as TNF-a, were increased just as they would be as part of the inflammatory process in the body. Such chronic incidents of inflammation are integral to the onset of atherosclerosis and an array of other diseases.

This work suggests a new way of thinking about how vascular diseases develop. We carry around these latent herpes viruses in our bodies virtually all our lives and periodically they can hurt us as we age, develop depression or, perhaps a nutritional imbalance.

Taken together with the recent data on the physical effects of loneliness, if you want to live a long and healthy life:

• Watch you mood: depression can kill you
• Stay socially engaged: loneliness can be fatal
• Maintain a balanced diet
• Take some physical exercise every day
• Learn – and practice! – some simple stress management techniques. You can obtain some at RichardGPettyMD.com

Deep Voices, Sexual Attraction and Children

I know that there are going to be a ton of exceptions, but I was extremely interested to see a study in the journal Biology Letters that seems to indicate that a deep male voice may attract women more than a great physique or an attractive face. Men with deep voices are also much more likely to have more children than men who do not have deep voices.

The investigators used an interesting analogy, sating that a man's deep voice is a bit like a peacock's tail: it has no survival value, but attracts the female of the species. Testosterone masculinizes the voice at puberty.

The research team interviewed 52 women and 49 men aged 18-55, from the Swahili–speaking Hadza tribe in Tanzania. They chose the Hadza tribe because their lifestyles reflect those of our hunter-gatherer ancestors. The females gather berries and search for wild plants. The males collect honey and hunt animals. Even though the Hadza are monogamous, extra-marital sex is common, but there is no birth control.

During the interviews, which took place in Swahili, the voices of the men and women were recorded. On studying the recording later they found that the deep voiced men had fathered more children than the non-deep voiced men. The man with the deepest voice had ten surviving children, while the one with the highest pitched voice had three.

Coren Apicella, the lead author, suggested that perhaps the males with the lower pitched voices had higher testosterone levels, which attracted them more to females or made them more attractive to them. It is also possible that men with higher testosterone levels start reproducing earlier in life. They may also be better hunters, since testosterone may have an impact on muscle mass, and  a better hunter would bring more food, allowing their wives to have shorter inter-birth intervals. 

It is possible that if vocal dimorphism evolved partly due to mate selection, then  in the past men and women may have had more similar voices.


I don’t suppose that anyone is going to be too interested to hear this, but your humble reporter has always had a very deep voice…

Molecules of Loneliness

It is well known that our social environment has a major impact on our health, wellness and longevity. Lonely, socially isolated adults have a higher mortality than those who are socially engaged.

There has been a lot of speculation about the factors involved, and there is a fascinating study published in the current issue of the journal Genome Biology.   

Researchers from UCLA identified a distinct pattern of gene expression in the white blood cells of people who experience chronically high levels of loneliness. The findings suggest that feelings of social isolation are linked to alterations in the activity of some of the genes that drive inflammation providing a molecular framework for understanding why social factors are linked to an increased risk of heart disease, viral infections and cancer.

Lonely people suffer from higher mortality than people who are not, and the debate has been whether that risk is a result of reduced social resources, or whether it is biological.

In this study the researchers used DNA microarrays to survey the activity of all known human genes in white blood cells from 14 individuals in the Chicago Health, Aging, and Social Relations Study. Six participants scored in the top 15% of the UCLA Loneliness Scale, a widely used measure of loneliness that was developed in the 1970s; the others scored in the bottom 15%. The researchers found 209 gene transcripts that were differentially expressed between the two groups, with 78 being over-expressed and 131 under-expressed. Genes over-expressed in lonely individuals included many involved in immune system activation and inflammation. At the same time, several other key gene sets were under-expressed, including those involved in antiviral responses and antibody production.

The first author on the study s Steve Cole, an associate professor of medicine in the division of Hematology-Oncology at the David Geffen School of Medicine, and a member of the UCLA Cousins Center for Psychoneuroimmunology, and he had this to say:

"What this study shows is that the biological impact of social isolation reaches down into some of our most basic internal processes the activity of our genes.
We found that changes in immune cell gene expression were specifically linked to the subjective experience of social distance. The differences we observed were independent of other known risk factors, such as health status, age, weight, and medication use. The changes were even independent of the objective size of a person's social network."

“We found that what counts at the level of gene expression is not how many people you know, it's how many you feel really close to over time.”

This study was supported by the National Institutes of Health, the Mind, Body, Brain and Health Initiative of the John D and Catherine T MacArthur Foundation, the Norman Cousins Center at UCLA, the John Templeton Foundation, and the James B Pendelton Charitable Trust.

Although small, this is remarkable and shows how much nature not only abhors a vacuum, but also dislikes isolation. We are social animals and anything that gets in the way of that will likely lead to a very poor outcome.

It is fitting that Norman Cousins, for whom the UCLA center is named, had this to say:
“The eternal quest of the individual human being is to shatter his loneliness.”

“The most terrible poverty is loneliness and the feeling of being unloved.”
-Mother Teresa of Calcutta (Albanian-born Indian Nun, Humanitarian and, in 1979, Winner of the Nobel Peace Prize, 1910-1997)

A Shocking Study

I have been teaching medical students and doctors since the 1970s. But there have recently been times when I have despaired about the way in which so many young doctors no longer engage in common courtesies with their patients.

I just spoke to someone who had visited a new family physician. She was fresh out of her residency, and her residency director has something to answer for. She did not make eye contact or shake hands, and could not remember the person’s name. When the patient extended her hand the doctor became confused because she was focused on her laptop.

I know that I can be accused of being old fashioned, but that shocked me, as did a recent report that medical students at a highly rated school are going to be getting classes in empathy and talking to people. This was announced with great fanfare. My question: why on earth do intelligent people need to be taught how to communicate? And if they have a problem in that area, first, how did they get accepted into that excellent medical school? During the years that I was involved in medical school admissions, I would have not have given a high score to someone with poor interpersonal skills. Second, why are the students’ teachers not modeling communication skills?

So first I heard about the extraordinary manner of the primary care physician. Then it was the self-congratulation that accompanied the announcement that students were going to be taught how to speak to people.

And then this.

A study in the Archives of Internal Medicine that left me shaking my head.

The researchers from Northwestern University's Feinberg School of Medicine found that Doctors do not address patients by name in half of first-time visits, even though nearly all patients want this common courtesy.   

There has been research on what doctors should wear but little about how they should greet patients or what patients actually expect. Most good physicians have relied upon empathy and common sense to guide them. This study focused on finding out what patients think is an appropriate greeting. He also analyzed a sample of interactions between doctors and patients during first-time visits.

The researchers collected information from 415 phone surveys in which people were asked how they expect to be greeted by a doctor. Researchers also viewed and analyzed more than 120 videos of primary care visits in which the doctor and patient met for the first time.

They found that 78 percent of survey respondents wanted the physician to shake their hands. Nearly all patients wanted to be greeted by name, including 50 percent by their first name, 17 percent by their last name and 24 percent by both their first and last name. Most patients, about 56 percent, wanted physicians to introduce themselves using first and last names, while 33 percent expected last name and 7 percent expected first name.

The researchers found a striking difference between expectations voiced in the phone surveys and the actual interaction between doctors and patients in the videos. While 83 percent of doctors shook hands in the videos, only half addressed the patient by name. 

Obviously everyone has their own communication style, but the researchers recommend that doctors should incorporate a greeting strategy that uses first and last names for both doctor and patient. Doctors also should plan to shake a patient's hand, but need to be sensitive to body language or other nonverbal cues that may indicate whether a patient does not want to or is not physically able to reciprocate or respond.

How we use names or handshakes will also change over time.

Why does this business of doctor-patient communication matter so much?

It is not simply a point of courtesy, though that would not go amiss. The real issue is that relationships are the heart of healing. Relationships might not be so important to the person performing some technical service, but for healing they are essential. If I need to get my car fixed, it is nice if the mechanic wants to talk, but it is not essential. He can treat my car as the hunk of metal and moving parts that it is.

But healing is different from treatment. Healing demands a relationship, intention and a shared vision. An interaction that will create something that is greater than the sum of the parts. A polite, personal greeting creates a first impression that can affect the chance of developing a therapeutic relationship. Ignoring the normal rules of social interaction sets the tone for everything that comes afterwards. It is respectful to use a person’s name and on a purely practical level, helps ensure that you are seeing the right person! More than once I have been given the wrong chart before meeting a person for the first time.

Interestingly, accrediting organization quite rightly emphasize that communication is a critical skill for physicians. Sadly many medical schools put such a huge emphasis on academic attainments that some people enter the medical profession without natural communication skills, and their training does little to help them get better at it. But this skill may not come naturally to all doctors, so it's important to offer guidance on different aspects of communication such as greetings

My students will tell you something that I have said a thousand times: “You have spent a lifetime developing people skills. You have learned how to talk to Aunt Mabel, how to feel when you are in a dangerous environment and how to deal with that guy at the bar who is becoming annoying. These are very valuable skills. Why did you check them at the door on the day that you entered medical school?”

One of my mentors once lamented, saying that 90% of medical students would have been better served by a technical college than a medical school, because they had no curiosity, no desire to move the field forward and no wish to engage with the people who came to see them. And that was in England, where there is socialized medicine. I did not want him to be right, but he probably was. In fact he was right about a great many things, which is why he was nominated for the Nobel Prize in Medicine on three occasions.

If medical schools want to turn out healers rather than technicians, then it is clear that medical students and doctors have to be helped to learn basic communication skills.

One of the many reasons that so many holistic therapists and practitioners of Integrated Medicine are popular is that they do understand the importance of good communication. Not because of research, but because that is their natural way of being.

What have your interactions with doctors been like?

How do you like them to greet you?

“True communication is remembering that everything is relationship --- that, regardless of the appearance, no one stands alone."
--Hugh Prather (American Spiritually-oriented Counselor and Writer in the Field of Personal Growth and Relationships)

“Once a human being has arrived on this earth, communication is the largest single factor determining what kinds of relationships he makes with others and what happens to him in the world about him.”
--Virginia Satir (American Family Therapist, 1916-1988)

Personal Mastery and the Wellness of Caregivers

Looking after aging relatives can be incredibly difficult, particularly if they have a chronic illness such as Alzheimer’s disease.

There is also evidence that the caregivers of people with Alzheimer’s disease have increased rates of cardiovascular disease and they die prematurely. It has been assumed that the cardiovascular problems are a result of stress causing overdrive of the sympathetic nervous system.

There was some interesting research (NR241) presented last month at the 2007 Annual Meeting of the American Psychiatric Association in San Diego. The investigators did not have to come far: they are from the University of California in San Diego.

The investigators looked at 70 spousal caregivers of people with Alzheimer’s disease and used an experimental task to measure the activity of their sympathetic nervous systems. They also measured the caregiver’s levels of “Mastery:” the belief that one is capable of handing one’s problems. Mastery is one of the components of resilience, a key characteristic of a person who can handle stress well.

What they found make very good sense: the caregivers with the highest levels of personal mastery had the lowest levels of sympathetic activity, suggesting that a sense of mastery may protect against the physiological effects of acute stress.

This provides us with yet more evidence that psychosocial interventions that increase mastery may reduce the risk of cardiovascular disease amongst the caregivers of people with dementia.

Successful Aging

One of the most promising changes in psychology is the ever-greater emphasis on what makes us healthy, rather than constantly looking at the things that make us sick. There is an important approach called Behavioral Activation (BA) Theory, which emphasizes environmental and behavioral factors as determinants of our overall well-being. According to the theory, reduced engagement in pleasurable activities may be an important precursor of reduced well-being. This makes good sense: it is estimated that as much as 90% of our higher cortical functions are designed for social interactions.

This is something that I wrote in Healing, Meaning and Purpose:

"Nothing in the Universe exists in isolation: We live in a Universe of relationships. It is inconceivable that anything can exist except in relationship to something else. The entire Universe is made up of integrated systems that function, develop and evolve together. A failure to construct and maintain healthy relationships can be a cause of much distress.

Several years ago I reported some interesting observations. At the time, I was doing a lot of research on diseases of blood vessels. I had developed a laboratory method for taking some of the cells that line blood vessels from volunteers and then growing them in a cell culture dish. We discovered that if we did not have enough cells in the dish, they would all die of “loneliness.” The exception is cancer cells, which in culture will grow on their own, like weeds."

As an example in a paper published in February in the Archives of General Psychiatry it was shown that lonely individuals may be twice as likely to develop the type of dementia linked to Alzheimer's disease in late life as those who are not lonely. The theory has been shown to predict psychiatric well-being in a number of populations, including the caregivers of people with Alzheimer’s disease, people with chronic pain, cancer patients and community-dwelling older people.

It is also known that psychiatric well-being, particularly emotional well-being, may play an important role in cardiovascular health. This may be due to an increase in the activity of the sympathetic nervous system that increases not only blood pressure, but also the levels of inflammatory mediators and coagulant factors in the blood.

In research from the University of California at La Jolla that was presented on Monday at the 2007 Annual Meeting of the American Psychiatric Association in San Diego, California, twenty two people with a mean age of 70 were studied, to see if there was a link between their behavioral activation, i.e. how satisfied they were with their leisure activities, their affective well-being and their blood pressure.

The findings were as expected: the less satisfied and engaged people were, the higher was their blood pressure.

This is only preliminary data, but it confirms something that we have said before: as we get older it is as important to stay socially engaged as it is to do mental exercise.

And if you known someone who is older and isolated, you might want to go and see them.

“The most terrible poverty is loneliness and the feeling of being unloved.”
--Mother Teresa of Calcutta (Albanian-born Indian Nun, Humanitarian and, in 1979, Winner of the Nobel Peace Prize, 1910-1997)

“What makes loneliness an anguish is not that I have no one to share my burden, but this: I have only my own burden to bear.”
--Dag Hammarskjöld (Swedish Statesman, Secretary-General of the United Nations from 1953-1961, and, in 1961, Winner of the Nobel Peace Prize, 1905-1961)

Attachment and Well-Being In the Elderly

Attachment theory is a psychological concept that was developed by John Bowlby in Britain and Harry Harlow in the United States in the late 1950s. The idea is that humans and many other animals have evolved an adaptive tendency to maintain proximity to an attachment figure.

Attachment is defined as an emotional bond that one person forms between himself or herself and another specific person. Originally the theory was developed to explain the relationship of a parent and child, but over tie it has become realized that attachments can occur throughout life, and if they become abnormal, they can lead to loneliness, isolation and psychopathology. There has recently been a resurgence of interest in attachment styles, and how they interact with emotional and behavioral expression during the development of dementia.

There was some interesting research presented today at the 2007 Annual Meeting of the American Psychiatric Association in San Diego, California. Investigators from Charlottesville, Virginia looked at 39 older patients (27 were women): 49% were aged between 65 and 74 and the remainder was over 74.

• 41% of women and 33% of the men said that their activities were limited by physical and/or emotional problems
• 41% of the women and 17% of the men endorsed at least two out of three indicators of depression
• When they examined their attachment styles, 28% were secure, 59% avoidant and 13% enmeshed
• An avoidant attachment pattern is more common among the elderly than it is among younger people
• Understanding attachment style could be very helpful in understanding how people react to their healthcare providers and their preferred coping styles

For anyone working or living with elderly people, attachment theory is well worth investigating. There is already some preliminary evidence that specific interventions may help older people with avoidant attachments.

Attachment theory is a psychological concept that was developed by John Bowlby in Britain and Harry Harlow in the United States in the late 1950s. The idea is that humans and many other animals have evolved an adaptive tendency to maintain proximity to an attachment figure.

Attachment is defined as an emotional bond that one person forms between himself or herself and another specific person. Originally the theory was developed to explain the relationship of a parent and child, but over tie it has become realized that attachments can occur throughout life, and if they become abnormal, they can lead to loneliness, isolation and psychopathology. There has recently been a resurgence of interest in attachment styles, and how they interact with emotional and behavioral expression during the development of dementia.

There was some interesting research presented today at the 2007 Annual Meeting of the American Psychiatric Association in San Diego, California. Investigators from Charlottesville, Virginia looked at 39 older patients (27 were women): 49% were aged between 65 and 74 and the remainder was over 74.

• 41% of women and 33% of the men said that their activities were limited by physical and/or emotional problems
• 41% of the women and 17% of the men endorsed at least two out of three indicators of depression
• When they examined their attachment styles, 28% were secure, 59% avoidant and 13% enmeshed
• An avoidant attachment pattern is more common among the elderly than it is among younger people
• Understanding attachment style could be very helpful in understanding how people react to their healthcare providers and their preferred coping styles

For anyone working or living with elderly people, attachment theory is well worth investigating. There is already some preliminary evidence that specific interventions may help older people with avoidant attachments.

A Pill for Every Ill?

Many of us have been becoming more and more worried by the idea that if we don’t like something, then we should take a pill, rather than trying to get to grips with the causes.

Can’t sleep? Take this pill. {Ahem, but why not try sleep hygiene first?)

Shy? No, you’re not allowed to be shy, you have social phobia, take this medicine.

Don’t like the size of your tummy? Don’t exercise; we have just the pill for you!

Not only does this approach undermine our responsibility and autonomy, it also minimizes the suffering of people with real clinical problems. When every headache gets labeled a “migraine” and every cold gets turned into “’flu,” it is easy to lose patience, empathy and understanding for people who are really suffering with the genuine article.

Here is a fine example of an announcement that has doubtless caught the attention of headline writers around the world. Researchers from the Medical Research Council's Human Reproduction Unit in Edinburgh in Scotland are reported to be working on a pill that would simultaneously boost a woman’s libido while at the same time reducing her appetite for food.

So what is this all about? Professor Robert Millar leads the Edinburgh team that has been looking at the properties type 2 gonadotropin-releasing hormone (GnRH), one of the hormones responsible for the release of sex hormones.

When it was given to monkeys, they displayed mating behavior such as tongue-flicking and eyebrow-raising to the males. When it was given female musk shrews, they displayed their feelings via "rump presentation and tail wagging.” These are two interesting visual images.

The thing is this. The tongue-flicking, eyebrow-raising tail wagers also ate around a third less food than they normally would. So now the search is on to find a pharmaceutical company that would like to make some kind of GnRH pill that would, presumably, produce libidinous skinny women.

Not only is this a frightful type of reductionism, but it raises all kinds of ethical issues.

The researchers in Edinburgh have been turning out a substantial body of very respectable data over the years, and this story looks very much like something that has been embellished.

Few people believe that eating or human sexuality are reducible to single chemicals in the brain. Low libido is a common problem, but it is usually a sign of stress, fatigue or relationship problems, rather than a chemical imbalance in the brain. And what, when and how we eat is an extraordinarily complex issue that is as much psychological and social as it is chemical. Stimulating the libido of someone in a lousy relationship is unlikely to lead to peace and harmony.

The whole concept also returns to the question of “what is normal?” when it comes to food, size or sex.

Heart Attacks, Meaning and Relationships

I am a doctor who has spent my career trying to empower people to take control of their lives, to fulfill and exceed their potential and to achieve and maintain vibrant good health. So I have worked my backside off to help people to deal with disease. But the curing of maladies is only half of our task. We also need to learn why things go wrong and what they are trying to teach us. So many of us have become wedded to the idea that illnesses are nuisances to be conquered rather than inevitable parts of life that can help us to grow and develop.

If our search just keeps turning up negatives, “I keep getting sick because I have bad luck/was born under a bad sign/have bad karma,” then you may need a little help from a therapist to help with those negative cognitions.

Here is a remarkably interesting study published in the current issue of the Journal of Advanced Nursing, that buttresses years of my own clinical observations: A third of people who suffer myocardial infarctions (heart attacks) discover new meaning to their lives and reconnect with their partner, but others see it as a threat to their well-ordered existence.

Researchers from Switzerland and the United States explored the experiences of 24 couples to see whether the one of them having had a heart attack changed their lives and their relationships. According to the researchers, three distinct behavioral patterns emerged as people tried to cope with a person’s heart attack:
Some said that the heart attack was an important and necessary event which had brought them closer together and transformed their lives.
Others felt fearful and threatened by the fact that they had no control over an unpredictable future.
The last group looked at various possibilities for positive change as a result of the heart attack. But they did not achieve them and felt that they had missed their chance to make things better.

It would be easy to pass off the people in the first group with the positive responses as “rationalizers:” people who are trying to make the best of a bad situation. But that would be a mistake. Severe, particularly life-threatening illness can often have a transformative effect on people an those around them. The key is to provide them with positive psychological and spiritual support.

This research strongly reaffirms the principle that successful recovery from a serious illness means more than eradicating it. It really means dealing not just with the physical, but also the psychological, social, subtle and spiritual aspects of what has happened.

In a cardiac rehabilitation program, if a person is in a stable relationship, it is essential to involve both partners in the program so that support can be tailored to their own individual relationship.

The lead researcher was Dr Romy Mahrer-Imhof, from the Institute of Nursing at the University of Basel in Switzerland, and she had this to say, “For example, counseling could provide these couples with more choices about how to negotiate more intimacy in a relationship in which each partner's needs and wants are respected…. Group session are also useful as they show people how other couples deal with similar situations, helping them to conquer fear and find new ways of living, despite the illness.”

One of the reasons that I’m so militant about aggressive rehabilitation and involving the family is this. As a very young freshly minted doctor, I was involved in the care of a man who suffered from a very small heart attack at the unusually early age of 28. He made an uneventful physical recovery, but announced to his family that he would never work again, and that sexual intimacy or any other kind of physical activity was now out of the question for him. Overnight, he had become a needless cardiac cripple. As he left the hospital he refused to get dressed in regular clothes, but instead wore pajamas and a bathrobe. He shuffled along like an old man despite the fact that his exercise tolerance was probably as good as mine. He refused all offers of help, would not go to rehabilitation and refused to see a psychologist or counselor. Despite the fact that his heart had recovered completely, he died within a year.

Nobody could have forced him into having treatment, and as a newly qualified doctor I was only the team tadpole.

But if I’d known then what I know now, I doubt that he would have had such a sad outcome.

Enabling the re-integration of the whole person - body, mind, spirit, subtle systems and relationships - is the central core of Integrated Medicine and Healing, Meaning and Purpose.

“No man is an Island, entire of it self; every man is a piece of the Continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friends or of thine own were; any man's death diminishes me, because I am involved in Mankind; And therefore never send to know for whom the bell tolls; It tolls for thee.”
--John Donne (English Metaphysical Poet and Divine, 1572-1631)

“Deep within himself man seeks meaning for his life, and tries to fulfill himself in accordance with that meaning.”
--Viktor Frankl (Austrian Psychiatrist and Holocaust Survivor, 1905-1997)

“When we are motivated by goals that have deep meaning, by dreams that need completion, by pure love that needs expressing, then we truly live.”
--Greg Anderson (American Author and Founder of the Cancer Conquerors Foundation, 1947-)

“Love is the ultimate meaning of everything around us”
-- Rabindranath Tagore (Indian Poet, Playwright, Essayist, Painter and, in 1913, Winner of the Nobel Prize for Literature, 1861-1941)

Women and the “Over-Attractive” Male

Here’s another one of those pieces of research that leave you thinking, “Didn’t I already know that?”

Researchers at the University of Central Lancashire in England have found that men who are good-looking, single and earn a large income are not as attractive as good-looking men with an average job and income. It may be important that the research was done in England: social status is still far more heavily engrained in society than it is in the United States or Australia.

The research was published in the journal Personality and Individual Differences, and examined how 186 heterosexual female students weighed up the male physical attractiveness and socioeconomic status when considering a long-term relationship. The average age of the test subjects was 23, and they were asked to look at personal ads of a number of men and to rank them in terms of attractiveness as a long-term partner. Each advertisement showed a photograph and provided basic information about the man’s age, occupation and what he was seeking in a partner.

The images of the men had previously been measured on a subjective scale of attractiveness. The men were randomly allocated to eighteen different occupations that varied from an architect and company director to a waiter, postman and gardener.

The researchers found that men who were rated as physically highly attractive but had medium social status, scored better than highly attractive men of high status. The authors speculated that the highly attractive high status men might have been thought to be more likely to be unfaithful in relationships or to be “too good to be true.” I was reminded here of a piece that I wrote in November: many people probably make mistakes in evaluating the potential of relationships simple because they under-estimate themselves.

Not only would it be good to repeat this research outside England, but it would also be a good idea to do similar experiments with women and people with different sexual orientations. There is some research that men at that age tend to make more superficial evaluations about potential partners.

The take home message: don’t try to make yourself look better than you are, it may backfire; don’t under-estimate yourself and look below the surface when making any important decision.

And Fabio, eat your heart out!

“Men in general judge more by the sense of sight than by the sense of touch, because everyone can see, but only a few can test by feeling. Everyone sees what you seem to be, few know what you really are, and those few do not dare take a stand against the general opinion.”
--Niccoló Machiavelli (Italian Writer and Philosopher, 1469-1527)

“Judgment and love are opposites. From one comes all the sorrows of the world. From the other comes the peace of God. Judgment will bind my eyes and make me blind.”
--A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

Arthritis and Sex

Today being Valentine's Day (you did remember didn't you?), Arthritis Care in the United Kingdom has taken the opportunity  to publicize its free booklet on sex, relationships, intimacy and arthritis, downloadable from its website (pdf).

Integrated Medicine is all about empowering and caring for the whole person, so I was very pleased to see this document. I spent some very happy times helping people with various types of arthritis, and I was astonished how infrequently anyone had ever asked them about the ways in which the illness impacted normal daily activities and had ever given them any advice on ways to work around problems.

Let me quote form the Arthritis Care news release:

"One of the reasons we produced the guide is to address issues people felt awkward discussing. It may be embarrassing to talk to your consultant rheumatologist, nurse or GP about emotional and sexual things, or matters of self-image and self-esteem - and they may be embarrassed to be asked. So where do you turn?' said Kate Llewelyn head of publications at Arthritis Care, who was diagnosed with rheumatoid arthritis at the age of thirteen.

The booklet provides a valuable insight for healthcare professionals and for the partners and families of people with arthritis, highlighting issues of concern to them, and suggesting practical and achievable solutions.

For people with arthritis, or other disabilities, difficulty can start before any relationship, pre-dating any date.

'Managing pain and other symptoms is exhausting, and it stops many people getting out and socializing. As a result, arthritis can be isolating, keeping you from making friends or seeing family, let alone dating and finding a partner. And maybe you are not very mobile, so can't dance, or play sport, or can't drink because of your medications. What's more, although anti-discrimination law means venues must now offer better access for disabled people, you still may find it harder to do things people without arthritis take for granted', said Kate Llewelyn.

Once a relationship has been formed, the challenges continue; the couple must work out ways of ensuring their personal and sexual relationship is sustained and developed, overcoming and working round the incurable and debilitating condition.

The report discusses a number of very practical matters: how pain and also medication can interfere with sex drive and some can cause weight gain. Many forms of arthritis are also associated with anemia and/or chronic fatigue.

It also discusses some of the psychological factors that can interfere with the sex lives of arthritis sufferers. For example, men may feel emasculated if they cannot perform their 'traditional' roles like playing sport or carrying heavy objects. Women may feel unfeminine if they put on weight with steroids, cannot do the housework or lift their children as a result of having arthritis. Others, with limited joint movement, or severe pain may be put off sex altogether, or find some of the traditional sex positions too uncomfortable.

'The book has got diagrams of lovemaking positions which people of differing physical abilities and limited movement have found useful. If you've got problems with your spine, or hips, or knees, it makes sense to experiment with positions that place least weight or strain on the rogue joints. Of course, after joint surgery or replacement, you may be advised to take a temporary break from sex, but, relationships are more than sex, and, with this guide, abstinence may make the heart grow fonder', said Kate Llewelyn.

Sex is rarely discussed with people strugglig with chronic illness, often because health care providers get embarassed about it.

It is essential for that to change, and I want to say a big thank you to Arthitis Care for having the courage to do this.

Why is Laughter Infectious?

When I was a very young student Monty Python’s Flying Circus was being shown on TV for the first time. The TV room in the halls of residence would normally be home to one or two sleeping stalwarts. But on Monty P. nights we would have seventy or eighty of us crammed into a small room: the sharing of laughter made the whole show ten times funnier.

I think that we’ve all had the experience of infectious laughter. It’s easy enough to see that it can be a social lubricant. But how does it work?

We have known for some time that when we are talking to someone, we often mirror their behavior, copying the words they use and mimicking their gestures. You may know that deliberately copying other people is a technique that we use when we are trying to influence others. It has seemed likely that the same applies to laughter.

Researchers at University College and Imperial College in London have shown that positive sounds such as laughter or a rousing and triumphant "woo hoo!" trigger a response in the listener's brain. This response occurs in the regions of the brain that are activated when we smile, as though preparing our facial muscles to laugh. The research, funded by the Wellcome Trust, Action Medical Research and the Barnwood House Trust, is published in the Journal of Neuroscience.

The research team played a series sounds to volunteers whilst measuring their brain's response using an fMRI scanner. Some of the sounds were positive, such as laughter or the triumphant woo hoo’s, while others were distinctly unpleasant, such as screaming or retching. All of the sounds triggered a response in the volunteer's brain in the region of the premotor cortex. This is part of the brain that prepares the facial muscles to respond to emotion. The response was greater for positive sounds, suggesting that these were more contagious than negative sounds. The researchers believe that this explains why we respond to laughter or cheering with an involuntary smile.

When we are in a group and encounter positive emotions, the brain responds by automatically priming us to smile or laugh. This gives us a way of mirroring the behavior of others, which in turn helps our social interactions. Presumably it plays an important role in building strong bonds between individuals in a group.

There is a global movement which started in India called the laughter clubs, in which people get together to have a really good belly laugh. It has been claimed that these group giggles reduce the chance of developing depression. The data is not good, but there’s one thing for sure: it’s unlikely to cause you much harm.

“Laugh and the world laughs with you; cry and you cry alone.”
--Horace (a.k.a. Quintus Horatius Flaccus, Roman Poet and Satirist, 65-8 B.C.E.)

“What a force is laughter.”
--Alexander Solzhenitsyn (Russian Writer and, in 1970, Winner of the  Nobel Prize in Literature, 1918-)

“The arrival in town of a good clown is of more benefit to the people than the arrival of 20 asses laden with medicine.”

--Thomas Sydenham (English Physician and a Founder of Modern Clinical Medicine and Epidemiology, 1624-1689)

Altruism and the Brain

There is a fascinating new study which will be out next month in the journal Nature.

Colleagues from Duke University Medical Center in Durham, North Carolina, believe that they have found a region of the brain that is associated with altruism: selfless concern for the well-being of others.

Some scientists have claimed that it is of no value because it has no survival advantage. I've never been able to agree with that extreme position. Another view is that the survival advantage comes from an ability to perceive the intention of others and therefore to anticipate their actions. I'm also not certain that this is genuine altruism, in the sense that altruism should be selfless.

45 volunteers were asked to play a computer game and also to watch the computer play the game. In some instances successful completion of the game resulted in the volunteers winning money for themselves, and in other instances it resulted in money being donated to a charity that each person had chosen at the beginning of the experiment. During these games the researchers took functional magnetic resonance imaging (fMRI) scans of the participants' brains.

According to the old fashioned - and false - theory that pleasure and pain are THE main drivers of behavior, it was assumed that altruistic acts would activate the reward systems in the brain.

They do not.

A region of the brain called the posterior superior temporal cortex (pSTC) is activated by altruism and is very sensitive to the difference between doing something for personal gain and doing it for someone else's gain. The pSTC appears to help us tune into perceiving and giving meaning to the actions of others. It is not focused on reward.

In the next stage of the research the participants were asked questions about the type and frequency of their altruistic or helping behaviors. The researchers then analyzed the responses to generate an estimate of a person's tendency to act altruistically and compared each person's level against their fMRI brain scan. The results showed that pSTC activity rose in proportion to a person's estimated level of altruism. Note that it was their estimated level rather than their actual altruistic acts.

The suggestion by the researchers is that the ability to perceive other people's actions as meaningful is critical for altruism.

I am going to be a Devil's advocate and interpret the data differently. I think it more likely that people who have a good understanding of social relationships are more likely to do things for other people. Helping other just makes sense to you. Both the tests and the imaging could be interpreted in terms of social understanding and empathy. In other words we are looking at an aspect of social cognition.

There may also be another correlation here. Some years ago we showed that in people with chronic schizophrenia there is a shift in the handedness of a particular region of the brain called the planum temporale, which lies on the top of the temporal lobe. This lead to the hypothesis that when people are hearing voices, they really are hearing something being generated in the right hemisphere of the brain. People with schizophrenia sometimes have trouble with reading other people's intentions and may attach meaning to random events. This new research mat help us understand why that can happen.

It also makes clinical sense: the best ways of helping people with mental illness who have these problems is to ensure that they are not on medicines that impair their social cognition, and to use social skills training.

“What we have done for ourselves alone dies with us; what we have done for others and the world remains and is immortal.”
--Albert Pike (American Lawyer, Masonic Author and Historian, 1809-1891)

“Spiritual energy flows in thankfulness and produces effects on the phenomenal world.”
--William James (American Psychologist and Philosopher, 1842-1910)

Healthy Aging

I have talked about the small number of simple steps that can dramatically reduce your risk of getting congnitive decline as your get older and some new evidence to show the benefits of non-drug treatments for dementia. I am pleased to say that my conclusions have just been supported by an editorial in the Journal of the American Medical Association.

I would like to let you know about another great resource: the International Council on Active Aging (ICAA) which has produced a great package of action items that are all rooted in good quality scientific research. The list is very similar to the ones that I have created for you here, and are very precise.

1. Invest in good shoes and socks
2. Play games
3. Walk
4. Increases your physical activity
5. Do exercises to improve your balance
6. Get regular eye checks, not only for corrective lenses, but to be checked for early evidence of diabetes or high blood pressure
7. Seek out friends family and neighbors
8. Modify your diet toward a "Mediterranean" one
9. Laugh
10. Get enought sleep

Whatever your age, I urge you to spend a few minutes working on a simple plan that will fit your schedule: your mind and body, family and friends will thank you forever.

Don’t Underestimate Your Attractiveness!

I wonder how many readers have ever been in a social setting and been a bit depressed by how good-looking everybody else seems to be? I’ve seen quite a number of people who by anyone’s standards were attractive individuals, but who were quite convinced that they were not.

At this point most proponents of pop psychology would jump in and say, “Well he’s got low self-esteem and we need to fix that.” They would probably recommend some exercise involving a mirror and telling him or herself how beautiful, attractive, valuable or special they are.

And they would be dead wrong.

This misperception about the attractiveness of other people is an evolutionary trick that will not be much helped by any number of affirmations.

A very interesting and well-executed study from the University of Texas will be published in next month’s issue of Evolution and Human Behavior. Sarah Hill, a psychologist in David Buss’ evolutionary psychology laboratory. Her research has shown that people of both sexes believe that the sexual competition that they face is stronger than it really is. She beieves that this is useful: it makes people try harder to attract or keep a mate.

What Sarah did was to show heterosexual men and women photographs of people. She asked them to rate both how attractive those of their own sex would be to members of the opposite sex, and also how attractive the members of the opposite sex were. She then compared the scores for the former with the scores for the latter, seen from the other side. Men thought that the men they were shown were more attractive to women than they really were, and women thought the same of the women.

She had predicted the outcome of the study based on a theory developed in the same laboratory by Martie Haselton and David Buss. It is called error-management theory:  the idea that when people make errors of judgment hey always tend to make the error that is going to be least costly. Research has shown something to which many women can attest: men often tend to misinterpret innocent friendliness as a sign that women are sexually interested in them. Haselton and Buss reasoned that men who are trying to decide if a woman is interested sexually could err in one of two ways. They can mistakenly believe that she is not interested, in which case they will not bother trying to have sex with her; or they can mistakenly believe she is interested, try, and be rejected. Trying and being rejected comes at relatively little cost. However, form an evolutionary perspective, not trying at all could lead the major cost of not being able to spread their DNA around.

The theory is that there is an opposite bias in women’s errors: They tend to undervalue signs that a man is interested in a committed relationship. The evolutionary argument would be that if she guesses wrongly about a man’s intentions, she might have to raise a child on her own.

However, when it comes to assessing physical attractiveness, man and women make the same errors.

We always need to be a bit wary about pushing the perspectives of evolutionary psychology too far. I think that they are valuable, but that we can get into trouble if we apply their insights too liberally: humans are complex creatures who are continuing to evolve rapidly. We are different in every way from the people of a thousand years ago.

But this is a very useful insight into why some many people feel to see themselves as they are.

The moral of the story: have courage in initiating new relationships, and look at the whole person: physical, psychological, social, subtle and spiritual.

And don’t forget to use your intuition: the surest guarantor of making the right steps in relationships.

“I never saw an ugly thing in my life: for let the form of an object be what it may,  light, shade, and perspective will always make it beautiful.”
--John Constable (English Landscape Painter, 1776-1837)

In Sickness and In Health

I recently talked about the importance of healthy relationships and some ways to establish and maintain them.

Here is an interesting study that was published in the Journal of Personality and Social Psychology.

The research into 111 coronary artery bypass patients showed that the partner's personality traits played a major role in how well they had recovered 18 months after their operation.

Pollyannas are probably the best sort of significant other when you’re sick. It is interesting to learn that their cheerful chatter might sound like the last thing an ill person needs but it is such a tonic that patients recover much better and faster.

A homeopath, acupuncturist or Integrated Practitioner would quickly identify who would like the Pollyanna and who would not.

What you definitely don’t want is a “generally neurotic and anxious” partner. These spouses increase the patients’ risk of developing clinical depression. Such depression is increasingly recognised as a significant risk factor in causing slow recovery and deaths from conditions such as coronary disease.

And most specialists recognize that depression and anxiety can be catching.

Healthy Relationships are Essential to Your Health

“All of life is relationship.”
--Swami Rama (Indian Spiritual Teacher and Writer, 1925-1996)

When I first started looking at the hundreds of different therapeutic systems that we have on offer, it was striking that they all have at their core the development of a relationship between two or more individuals. One is designated the patient or client and the other the therapist who is helping the patient cure himself or herself. Until the invention of the stethoscope, which was the first step toward separating patients from those treating them, the fundamental nature of a healing relationship was well understood. Sad to say, over the last century and a half orthodox medicine began to minimize the importance of relationship to cure.

Nothing in the Universe exists in isolation: We live in a Universe of relationships. It is inconceivable that anything can exist except in relationship to something else. The entire Universe is made up of integrated systems that function, develop and evolve together. A failure to construct and maintain healthy relationships can be a cause of much distress.

Several years ago I reported some interesting observations. At the time, I was doing a lot of research on diseases of blood vessels. I had developed a laboratory method for taking some of the cells that line blood vessels from volunteers and then growing them in a cell culture dish. We discovered that if we did not have enough cells in the dish, they would all die of “loneliness.”

The exception is cancer cells, which in culture will grow on their own like weeds.

Next, we made an accidental and remarkable discovery. We normally cleared out our cell cultures once a week, but on this occasion I found that I had accidentally nudged one of the dishes to the back of the incubator, where it had been sitting for three weeks. Looking at the cells under the microscope, we could see that they had formed little tubes. Now that might not sound like very much, but it was. The cells had, inside the body of the volunteer, been part of a microscopic tube called a capillary.

To prepare the culture, the cells had been cleaned with all sorts of biochemical treatments to strip them away from everything else so that we would have no contaminating cells. The teaching for years has been that the development of cells and organs is a result of biochemical interactions between different cells of the body driven by the DNA inside the nucleus of the cells. But my cultured cells had no such cells to guide them. How could they “remember” that their role was to make tubes? The most likely explanation is that they are responding to morphic fields. I published the observation in a paper 17 years ago, and others have now replicated it.

It is estimated that at least 80% of our higher cortical functions are directed toward social functions. It is little wonder that failing to use those vast tracts of evolutionary machinery might have sad consequences.

And they do. Social isolation increases the chance of substance abuse and scores of illnesses. And people who have no social supports are much less likely to recover from many major illnesses. On the other hand, being engaged in robust, dynamic relationships provides you with powerful protections against some illnesses.

Relationships are essential to your health.

There are tens of thousands of books on relationships and I have no intention of reiterating material that has been written about a hundred times before.
But based on our principles of physical, psychological, social, subtle and spiritual, let me make these suggestions for constructing and maintaining successful relationships:

1. Partnership: As I discuss in Healing, Meaning and Purpose, it is essential to examine every one of your relationships to see if it is a relationship of domination or partnership: is one person dominating and controlling the relationship, or are both people participating equally? And here is the trick. We are not only interested in the relationship between you and another person or persons, we are interested in ALL your relationships, from cell to soul.
2. Maintaining wellness: all the people in a relationship should do whatever they can to maintain their physical, psychological, social subtle and spiritual well being. Nobody can avoid everything: life will throw you some curve balls, but it is most unfair to burden a relationship with avoidable health worries
3. Responsibility: In the same way that you should not burden others in a relationship with avoidable health problems, you should also not burden them with needless concerns about money or other resources. Arguments about money are one of the main causes of turmoil in marriages, and it is not so much a matter of having insufficient, it is more often a matter of one person being irresponsible.
4. Attention: it is essential to give the other person or persons in a relationship the attention that they deserve.
5. Acceptance: This can be a hard one sometimes, and I am going to write more about acceptance shortly. Suffice to say that mature relationships require a good dose of acceptance. I have written before about an extreme case in which a woman was lamenting the fact that she could find nobody who matched her ideals in a mate. Her list of non-negotiable requirements in a partner ran to some ten pages
6. Kindness: Spontaneous acts of kindness are essential to healthy relationships. If you do not want to offer kindnesses to another person it implies that there is something seriously awry n the relationship. Kindness should not be planned; it should just be part of your normal modus operandi
7. Warmth and affection: Spontaneous warmth and affection are signs of a healthy relationship. But don’t think of that as holding hands and signing kumbaya, it also means being aware of the heart, the essence and the soul of the other person or persons in a relationship. If you have not recently shown some real gratitude for the other person, today might be a really good time to start.
8. Laughter: Do you and your partner(s) have fun together? Are you able to share laughter and to let go of pretence? It doesn’t mean that you have to spend all day watching Laurel and Hardy or telling each other sidesplitting jokes. It means being able to find a new and healthy perspective on life and to find time to enjoy the lighter side of life.
9. Conflict: do you have a healthy way of dealing with anger, conflict and resentment? All three may crop up from time to time, but the key is how you cope with them. It is simply not realistic to follow the advice that you should avoid all conflict. It’s as silly as saying the key to stress management is to avoid stress. You may as well try to avoid gravity. Stress and conflict are universal constants: the trick is learning how to deal with them. In the case of conflict the key – as always - is to communicate and to avoid toxic or corrosive habit patterns
10. Listening: Listening to another person is not a matter of sitting back and allowing sound waves to set up vibrations in your auditory nerve: listening is an active learned skill that involves watching, noticing and being aware of every aspect of a communication. (You may be interested in having a look at another piece that I wrote about communication). Listening involves giving space for a communication to unfold and then asking questions and checking to ensure that both people are understanding every aspect of the exchange
11. Trust: No relationship can be expected o flourish without a healthy dose of trust. Not just in the integrity of the relationship, integrity of the other person(s) involved in the relationship and trust that what you say or do will not be judged harshly
12. Freedom: I have seen more relationships flounder because of a lack of freedom than almost anything else. There is a good reason why freedom is such a powerful political force. For most people, freedom to be themselves and to determine their own destiny is as important as oxygen. Ensure that your relationships have plenty of space to breathe. 

“Relationships are the hallmark of the mature person.”
--Brian Tracy (Canadian-born American Author and Expert on Business and Personal Development, 1944-)

Eye Color: An Instant Paternity Test?

Most of us learned some genetics in high school. You were probably taught about sweet peas, height and eye color. If mom and dad have blue eyes and little Johnny has brown, then mom probably has some explaining to do.

Sweet peas, height and eye color are examples of genetic determinism: genes determine outcome. But as I have written before, many other genes are not so simple: in behavior and metabolism genes do not so much determine behavior as how the person will react to the environment.

Now there is some fascinating new research about eye color published in the current issue of the journal Behavioral Ecology and Sociobiology.

The color of the human iris is determined by a simple, predictable and reliable genetic pattern of inheritance.

Investigators from the University of Tromso in Norway have shown that blue-eyed men find blue-eyed women more attractive than brown-eyed women. The researchers have postulated that there could be an unconscious male adaptation for the detection of paternity based on eye color.

At first blush this look like a bit of a stretch, but it may not be.

Let’s do a quick revision from high school genetics:

1. If both parents have blue eyes, the children will have blue eyes.
2. If both parents have brown eyes, a quarter of the children will have blue eyes, and three quarters will have brown eyes.
3. The brown eye form of the eye color gene (or allele) is dominant, whereas the blue eye allele is recessive.

It then follows that if a child born to two blue-eyed parents does not have blue eyes, then the blue-eyed father is not the biological father. From an evolutionary perspective, males would be rather interested in knowing whether any children were theirs. So it is reasonable to expect that a man would be more attracted towards a woman displaying a trait that increases his “paternal confidence,” that any children would be his. If the mate also has blue eyes, it would be easy to uncover his partner's sexual infidelity.

In the study, eighty-eight male and female students were asked to rate the facial attractiveness of models. The pictures were displayed on a computer screen and were close-ups of young adult faces of people who were not known to the participants. The eye color of each model was manipulated, so that for each model's face two versions were shown, one with the natural eye color (blue/brown) and another with the other color (brown/blue). The participants' own eye color was also recorded.

Both blue-eyed and brown-eyed women showed no difference in their preferences for male models of either eye color. Similarly, brown-eyed men showed no preference for either blue-eyed or brown-eyed female models. However, blue-eyed men rated blue-eyed female models as more attractive than brown-eyed models.

In a second study, a group of 443 young adults of both sexes and different eye colors were asked to report the eye color of their romantic partners. Blue-eyed men were the group with the largest proportion of partners of the same eye color.

The lead investigator - Bruno Laeng – had this to say, "It is remarkable that blue-eyed men showed such a clear preference for women with the same eye color, given that the present experiment did not request participants to choose prospective sexual mates, but only to provide their aesthetic or attractiveness responses…based on face close-up photographs."

Blue-eyed men may have unconsciously learned to value a physical trait that can facilitate recognition of their own kin.

See if these findings ring true in your own relationships or in the people around you.

The Genetics of the Dancing Bees

When I was ten years old, I picked up one of my father’s old books. By the end of page one I was hooked, and I am sure that it was one of the pivotal points of my life that lead to my subsequent careers.

The book was the Dancing Bees: An Account of the Life and Senses of Honey Bee by Karl von Frisch. I still have it: my edition is now 51 years old, and showing its age.

The book may have faded but its brilliant ideas have not. In 1973, along with Nikolaas Tinbergen and Konrad Lorenz, Von Frisch won the Nobel Prize in Physiology or Medicine.

Honey bees are an ideal group of animals for studying behavior. When they are young, adult worker bees perform a number of tasks in the hive including caring for eggs and larvae. As they age, their job description changes and they shift to foraging for nectar and pollen. However, if the hive has a shortage of foragers, some of the young nurse bees will switch jobs early and go out foraging.

This job transition, whether it is triggered by age or social or environmental cues, involves changes in thousands of genes in the honey bee brain; some genes turning on, while others turning off.

The gene switching is achieved by short strings of DNA that lie close to and modulated each gene or set of genes. The strings serve as binding sites for particular molecules called transcription factors. When the correct transcription factor finds its the binding site, the accompanying gene may be switched on. If the transcription factor breaks away from the binding site, the gene is switched off.

New research funded by the University of Illinois and the National Science Foundation was published in two papers 1. 2. in this week’s Proceedings of the National Academy of Sciences. It used a new approach to try and understand the genetic underpinnings of some of this social behavior. Scientists have recently sequenced the genome of the honey bee, so the researchers’ strategy was to scan the binding sites of transcription factors known to function in the development of fruit flies from a single cell to an adult.

It is noteworthy that two of the researchers are computer scientists, showing us how often we need their help in designing and executing a lot of cutting edge research.

A computer algorithm that they wrote scanned nearly 3,000 genes. Statistical techniques were then used to investigate whether particular transcription factors correlated with genes that were turned on or off (what we call differentially expressed) between nurse bees and foragers.

The answer was the discovery of five different transcription factors that showed a statistically significant correlation with socially regulated genes. I sometimes wonder about the ponderous humor of some scientists: the five transcription factors – known, in fruit flies, to be involved in the development of the nervous system development, olfactory learning and hormone binding – have the names Hairy, GAGA, Adf1, Cf1, Snail, and Dri.

We also have another example of Mother Nature wasting nothing. Some of the same genes involved in the development of the nervous system of fruit flies are re-used for behavioral functions in adult honey bees. There are significant differences in the ways in which the honey bee and fruit fly genes are regulated. It is those regulatory processes that help to ensure that the genes end up producing honey bee behavior and not a fruit fly brain.

These findings suggest that honey bees may well turn out to be useful in elucidating the mechanisms by which social factors regulate gene expression in humans, as well as the effect of environmental factors on the expression of genes involved in social behavior.

There is every reason to believe that some of the same genes will be used in the human brain. The gene regulators will make all the difference in determining whether a bee becomes a nurse or a forager or a human becomes a sinner or a saint: they respond to a child’s environment, cognitions, attitudes, and perhaps even their spirituality.

If you are interested in a brief entree to the interactions between positive psychology and gene expression, together with some brief comments by yours truly, you may be interested to have a look here.

Premature Ejaculation

I was pleased to see an article in this week’s medical journal, The Lancet, that the drug dapoxetine lengthened the duration of intercourse by three to four times in an American study of 2,614 men, of whom 1958 completed the trial. There is currently no medication on the market for a condition that may affect up to a third of all men at some time in their lives. It can be frustrating for both partners in a relationship, and it can put a lot of strain on a family.

The researchers from University of Minnesota found that taking the drug increases the average duration of sex from less than a minute to three minutes 19 seconds. Up to now, many clinicians have used other medicines “off label,” to try and help the problem, but most of those treatments have carried many side effects with them.

This report leads to two other considerations.

First, is that the field of sexual health is being revolutionized by a new approach. One of the worst problems for many men has been the comparison culture, often fostered by the popular media. There used to be a joke that if a man wasn’t having 2.3 orgasms a week he would feel cheated. But what, exactly, is 0.3 of an orgasm anyway??

The “New View” of sexuality starts with a re-appraisal of what is normal in terms of sexual behavior and also in terms of aging. Trying to standardize sex is the cause of many problems for men and women because it leads to unhelpful comparisons. The “new view” asks a person quite different questions about their levels of happiness with their sex lives. This is a considerable advance on trying to medicalize everything.

The second point is this. For many centuries entire schools in China, India and Tibet have taught natural methods for delaying and enhancing ejaculation, primarily by strengthening and gaining control of the pubococcygeus muscle in the floor of the pelvis. Women have also been taught similar exercises to enhance their sexual pleasure, usually as part of a program of spiritual training. Some of these practices are included in this reading list that I put up at Amazon a few months ago.

It is not difficult to learn these exercises. There is surprisingly little research on these non-pharmacological approaches to improving people’s sex lives, so they are often dismissed by experts. But the fact remains that simple Kegel type exercise can often help people greatly.

I’ll happily detail some of these methods if people are interested.

Emanuel Swedenborg, Epigenetics, Sex and Marriage

Emanuel Swedenborg is without question one of the most remarkable people recorded by history. He was a scientist once described as the “last man to know everything.” Yet he was also a philosopher, mystic spiritual explorer and theologian. He has been called the “Buddha of the North.”

For people who worry that it may be too late in life to start on something new, he began his main work when he was fifty-six years old, and the next 28 years of his life generated an extraordinary number of books. As I am writing this, I can see his collected works that run to some 30 volumes.

Like most genuine spiritual teachers, Swedenborg has been much maligned, and some years ago a famous psychiatrist wrote a paper in which he “diagnosed” Swedenborg with a mental illness. A neat trick to do on someone whom he had never examined. On account of him having been dead for two centuries. Posthumous diagnosis is fraught with difficulty, and there was a glaring problem with the psychiatrist’s theory: very few men develop a psychotic illness in their fifties, and it is almost unheard of for them to remain highly functional.

Oh yes, and there’s also the fact that Swedenborg made some remarkable predictions that have proven to be true.

One of them was this. He said that during sexual intercourse between a married couple there is a soul linkage and a transfer of some soul essence between the couple. That was one of the reasons why he was against casual sex for both men and women. In those days there was little talk about the reality of same-sex unions.

Was he just a child of his puritanical times, or was there something more to it?

Soul linkage may be just that. But if that is uncomfortable, try this: For “soul linkage,” read, first, subtle systems. One of the most convincing pieces of evidence for the existence of these systems is the subjective experience of couples who feel energized after spending intimate moments together. While others feel totally drained, as if a psychic vampire has sucked their essential essence from them.

Second, let’s read epigenetic transfer. We are all used to the transfer of maternal and paternal DNA during sex. We are also uncomfortably aware of the extraordinarily high rates of sexually transmitted diseases. One of the most extraordinary of the new findings if that environment may have effects down through the generations, and that these effects must clearly be transmitted during sexual intercourse. Sex transmits not just DNA, but epigenetic codes and perhaps also passenger genes that may enter each partner.

Perhaps we should consider that before dismissing Swedenborg’s ideas as the fruits of an outdated moral and ethical system. Forget for just one moment about religious, spiritual and moral conventions: perhaps there are also biological reasons and subtle system explanations for restricting the numbers of partners that we have.

Marilyn Monroe is said to have once made the remark that, “I don’t see anything wrong with having lots of sex, after all, it doesn’t give you cancer.” Well, as thousands of young women have found, it can do just that, and what other damage may it do to a person?

People Dangerous to Your Health

I found a terrific blog with the title “Warning: Bores and buffoons may endanger your health.”

Our ability to self-regulate is a limited resource that fluctuates markedly, depending on our prior use of willpower, tiredness, stress and our personal resilience.

A new study by a team lead by Professor Eli Finkel of Northwestern University has shown that poor social coordination impairs self-regulation. What does this mean? If you are forced to work or interact with difficult individuals you may be left mentally exhausted and far less able to do anything useful for a significant period of time. In other words, draining social dynamics, in which an individual is trying so hard to regulate his or her behavior, can impair success on subsequent unrelated tasks.

In the research, volunteers were asked to work in pairs to maneuver an icon around a computer maze, with one volunteer giving the instructions, the other moving the joystick. Those operating the joysticks were actors, primed to respond to instructions in slow, stupid, inefficient and generally irritating ways. What was interesting was that the effects were not mediated through participants' conscious processes: they were almost entirely going on below the level of conscious awareness.

There is extensive literature on the consequences of social conflict. But until now, very little research has been conducted on the effects of ineffective social coordination. That has been a big gap in the research literature, particularly given the fact that most of the higher systems in our brains are dedicated to social functions, and since the earliest days of our hunter-gatherer ancestors, tasks requiring social coordination have been the norm. In our day-to-day activities we have to cooperate with other people. Ineffective social coordination consumes a great deal of mental resources and has high costs for subsequent self-regulation. This is so important, because self-regulation is essential to living life well. It is also essential to the existence of a well functioning society.

What to do with this new information?

Identify people who drain you. If you need to work with them, do it in short bursts, and give yourself plenty of time outs.

And continue to build your resilience.

There's also one other piece, that we'll look at another time. Some people may also drain your energy directly. You may have come across "energy" or "psychic vampires." They really do exist, though there is nothing supernatural about them, and they don't have fangs or an aversion to garlic. In another post I'll show you some techniques for dealing with those people as well.

The researchers have done us a great service by putting the entire paper on the departmental website. Access is free.

A Gene for Infidelity?

Last January I wrote about the link between creativity and promiscuity.

I’ve just picked up this month’s copy of the Mensa Magazine, published by British Mensa  and there’s an interesting article by Dr. Desmond Morris entitled “Why brilliant men betray their wives.” Desmond is a national institution in Britain. A zoologist, ethnologist and surrealist painter, he always used to be on television and gained considerable notoriety for his book The Naked Ape that tried to explain human behavior by analogy with apes.

In his latest article Desmond follows some of the same reasoning that I did in my article: many intensely creative people also enjoy risk taking. He just talks about males, but I think that the same principles apply equally to many intensely creative and successful women, who also enjoy taking extreme risks.

Every act of creation demands that we see, feel or think differently about something. Desmond says that every piece of innovation or creativity is an act of rebellion. I only half agree with that: the truly creative person is busily establishing a new level of order. The creative rebel is a stereotype that’s not born out by experimental work on genius and creativity. The creative or innovative act is one of making new connections and in a sense it is also a moment of risk-taking, for the new technique, formula or invention may fail. We recently discussed the way in which resilience is a key to creativity: to keep going in the face of failure or adversity. Even the most highly creative are not every single day: I have known many Nobel Prize winners and award winning artists, and they all have their off days.

Desmond’s article highlights the multiple extra-marital affairs of Albert Einstein, John F. Kennedy, Charlie Chaplin and Bertrand Russell.

He argues that it is the innate compulsion to take risks that leads both to creative brilliance and an inability to remain with just one partner. He pursues the idea that our distant hunting ancestors required a new personality trait: bravery. The successful needed to take risks and be courageous. Desmond then again excludes women from his equation, saying that their reproductive contributions to the tribe made them too important to risk on the hunt. He now fast-forwards to the present, saying that the offspring of the adventurous males could either engage in physical risk-taking or explore new ideas. And that their curiosity leads them to explore not just ideas but novel sexual experiences. Once a “conquest” has been made, the risk-taking adventurer moves on to a new target.

It is certainly true that men are far more likely to die in accidents than are women, but it’s a bit of a stretch to attribute all of that to risk-taking. What about the male difficulties with multi-tasking and to resist peer pressure, to say nothing of much higher rates of substance abuse?

And yes, fame, power and wealth can be powerful aphrodisiacs. But to reduce immoral, dangerous and disrespectful behavior to a risk-taking gene from our distant ancestors seems to me to a wild extrapolation based on a very selective use of a small amount of information.

Because infidelity surely has many more strands to it that just a genetic “itch.” Many highly successful people are enormously narcissistic and so fail to take into account the damage that their infidelity might do to their spouse and children.

Seeing sex as no more than a branch of gymnastics is also off the mark. Even a casual encounter will likely contain emotional, subtle and even spiritual components. If a relationship is failing because those are all missing, it is no surprise if a spouse investigates divorce and other options. But that is not risk taking: it is fulfilling a need that is not being met by the current partner.

Clarity of Communication

One of the major reasons for the failure of relationships or of businesses is a failure to communicate clearly. There are also powerful reasons for thinking that much ill health is rooted in “blockages:” inadequate communication between your body, your mind, your emotions, subtle systems and spirituality.

Any communication consists of ten essential components:

1. The integrity and mental state of the sender
2. The intent of the sender
3. The expectation of the sender
4. The information
5. The medium
6. The context
7. The receiver
8. The mental state of the receiver
9. The reaction or response of the receiver
10. The meta-text and meta-communication of the exchange

Naturally, in a healthy communication, everyone involved takes turns being the sender and the receiver, and this interaction between you creates the overall message. I must be very clear that I’m not just talking about verbal communication, but also physical and intimate interactions, business and family discourses.

I’d also like to take the whole notion of communication a step further: meaningful communication needs for us to be consciously aware of the interaction, and we should see it not just as an exchange of information, but of energy. A charismatic individual may communicate a lot more than mere words and his or her impact may last long after the words have been forgotten. On the other hand, there is actually a technical term – phatic communion - for empty language that is purely used for social lubrication: “How are you?” “You’re welcome,” “Have a nice day.”

It really is important to be aware of all of these components of communication. A problem in any one of them can make a mess of any attempt for people to connect. Too often I see people think only of the sender, the message and the recipient, without realizing that it is the other aspects of communication that are the keys to success or failure. This is often very important in therapy: people may ruminate on something said to them, when they should be considering the context of whatever was said.

Meta-text and meta-communication refer to the whole spectrum of other components of our interactions that stretch beyond the message itself. These include the types of language that we use as well as prosodic cues. And if people are in close proximity, body language and gesture. You may well know that it is possible to tell a great deal about someone’s intentions by studying changes in the tone of their facial muscles, changes in the color of their skin and the directions I which they move their eyes when speaking. How we use certain words to fill in our communication can be as important as the main body of a communication. Something that we do all the time is to try to understand the underlying meaning or meta-text, that is often quite different form the actual words being spoken.

Whether dealing with an individual in therapy or a business that wants to perform better, there is a series of critical questions that will uncover communication problems:

1. Do you have any communication problems?
2. Who is responsible for it?
3. Is there a disconnection between the mental state of any message sender and the message itself?
4. Does the sender have a clear purpose in communicating?
5. Are people able to understand the sender? (T.E. Lawrence (of Arabia fame) was said to have one of the largest vocabularies at the University of Oxford. So large that many people didn’t have a clue what he was talking about!)
6. Is information being communicated appropriately?
7. Is the environment conducive to communication?
8. What is interfering with communication?
9. How long has this been a problem?
10. Why has the problem not been solved?

If there is a communication problem, consider starting from scratch:

1. Any communication contains information and energy: are they both clear and pure?
2. Is there congruence between what is being communicated and the intent of the communicator?
3. Is there a culture of integrity in communications?
4. Are people striving for the greater good or personal aggrandizement?
5. What people, policies or procedures are interfering with communication?
6. How are communications becoming degraded?
7. What and who's emotions are interfering with the informatyion and the energy of any communications?
8. What might lead to the misunderstanding of a message?
9. What systems are in place to ensure that communications are being received and understood correctly?
10. What system of questioning is in place?

Once we understand each of the phases of communication, and that it is a dynamic exchange of energy and not just information transfer. And that ANY message or communication is subject to degradation, and that there are ways to check for and correct it, you are well on your way to abolishing many of the problems that can wreck relationships, capsize companies and ruin a therapeutic alliance.

“Once a human being has arrived on this earth, communication is the largest single factor determining what kinds of relationships he makes with others and what happens to him in the world about him.”
-- Virginia Satir (American Family Therapist, 1916-1988)

“Skill in the art of communication is crucial to a leader's success. He can accomplish nothing unless he can communicate effectively.”
-- Norman Allen (American Playwright, Recipient of a Charles MacArthur Award for Outstanding New Play)

“A world community can exist only with world communication, which means something more than extensive shortwave facilities scattered about the globe. It means common understanding, a common tradition, common ideas, and common ideals.”
--Robert M. Hutchins (American Educator, and, from 1929-1945, President of the University of Chicago, 1899-1977)

Friendship and Psychological Distress

“To lose a friend is the greatest of all losses.”
Publilius Syrus (Syrian-born Latin Writer, 1st Century B.C.E.)

Severe and persistent mental illnesses are one thing, but there are many, many more people who are miserable and unhappy, without that unhappiness necessarily getting to the level of an “illness.” The offices of primary care physicians and therapists are full of people in genuine distress for all kinds of reasons.

I first began to think about this many years ago when a woman came to see me and promptly announced, “I’ve come for psychotherapy. I’ve been in therapy for seventeen years, and I want some more.” I wasn’t being in the slightest bit flippant when I responded by asking her if, after seventeen years, she really felt that it had offered her anything? She looked at me blankly, and it soon became very clear that what she needed was not more therapy, but a friend to talk to.

There has been another puzzle: why is it that women are more likely to develop depression than men? The most profound gender difference in mood disorders begins to emerge after puberty, so it would be easy to attribute it all to hormones. But that would be a mistake.

I recently pointed out that there are some fundamental differences in the ways in which men and women interact: women tending to be more relational and men tending to be more transactional. The female sense of self tends to be more entangled with her relationships, while a man’s self-worth and sense of self is more often associated with his achievements. Most of these differences begin to emerge in early puberty: when girls talk to their friends, their conversation tends to be more emotional and to be concerned primarily with relationships, while boys tend to be more reserved and to discuss facts, statistics and achievements. There is some evidence from research in different cultures that these different styles seem to be the norm throughout the world. Yes, there are of course plenty of people of both genders who behave differently, and so it is more accurate to relate these differences to the male and female factor or essence, rather than getting it confused with anatomical differences.

Emotional language tends to put more strain on a relationship, and it is well-recognized that girls’ relationships turn over much more rapidly than boys’ ones. An interesting hypothesis proposed some years ago by Professor Sir David Goldberg, is that this high turnover in relationships may lead girls to experience more disappointing experiences in their social networks, and it is this string of disappointments that predisposes young women to depression.

A happy, healthy, dynamic network of friends is a cornerstone of developing and maintaining psychological resilience. Without them you become progressively more vulnerable to the reversals that affect all of us from time to time.

“A friend might well be reckoned the masterpiece of nature.”
--Ralph Waldo Emerson (American Poet and Essayist, 1803-1882)

“To know how to live in a brotherly way with those around us is to be rich, for each of us, with our face, eyes, voice and thoughts, contributes something alive, something warm, which nourishes everyone.”
Omraam Mikhaël Aïvanhov (Bulgarian Spiritual Master, 1900-1986)

Resilience, Misfortune, and Mortality

Much of the development of the ideas of Integrated Medicine has been driven by the idea that a truly effective holistic medicine does not simply integrate different modalities to achieve health and wellness, but is also aimed at integrating all the different aspects of a person into a coherent whole. That was the real reason for choosing the term “Integrated” medicine in the United Kingdom, though “Integrative” and “Integral” medicine are ultimately all aiming for the same thing.

This is quite different from simply adding some acupuncture, an herb or some relaxation therapy to a conventional medical program. Its aim is not so much getting someone better, as to give the whole person – physical, psychological, social, subtle and spiritual - what he or she needs to be able to get themselves back on an even keel, so as to be able to deal with future challenges as they arise. And not just deal with them, but to use challenges as springboards to growth and development.

The whole idea of this system of medicine included an extra dimension that had often been left out: the interaction between the person in trouble and the practitioner. We are social animals, but even more than that it looks as if we are highly interconnected from cell to soul. We have to take into account the impact of a therapeutic interaction on the clinician, as well as the influence of the clinician’s psychological, subtle and spiritual makeup on the individual.

The development of this system of medicine had many parents. One was the American-born Israeli sociologist Professor Aaron Antonovsky who first generated the idea of salutogenesis: the study of the factors that support human health and wellness. He was one of the first to show that people who were relatively unstressed were far more likely to be able to resist illness, compared with stressed people. His interest was not just in what causes disease, but what are the roots of health.

He returned to and discussed, developed and applied an idea that had been around since the work of Sigmund Freud and Roberto Assagioli: that was that our experience of well-being constitutes a Sense of Coherence (SOC). He defined the sense of coherence like this:

"A global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that one's internal and external environments are predictable and that there is a high probability that things will work out as well as can reasonably be expected."

Two recent studies seem to indicate that this concept of coherence is fundamentally correct.

Researchers in Cambridge in the United Kingdom have reported a population-based cohort of 20,921 men and women completed a postal assessment of their lifetime experience of specific adverse events and a measure of their sense of coherence. Those with a weak SOC reported significantly slower adaptation to the adverse effects of life experiences, compared with those with a string SOC, and were more likely to die prematurely. Although the size of the effect was not large, the results suggest that SOC is a potential marker of an individual's adaptive capacity to deal with social stress, which is predictive of mortality

The second study was a systematic review from Finland. I like the way in which the study was done, and it came to this conclusion:

“SOC seems to be a health promoting resource, which strengthens resilience and develops a positive subjective state of health. Salutogenesis is a valuable approach for health promotion.”

So what does this mean for you?

Developing a sense of coherence is a most critical factor in creating and maintaining robust health and ability to adapt to change, be it in health, stress, your relationship or at work.

How do you do that? Healing, Meaning and Purpose spends over a hundred pages or several CDs explaining the most up to date ways of doing exactly that using a process known as Creative Self-Integration.

I do hope that you take the opportunity to sample some of the techniques for yourself.

Exploring the Web of Life

“When we try to pick out anything by itself, we find it hitched to everything else in the Universe.”
--John Muir (Scottish-born American Naturalist, Writer, Founder of the Sierra Club, and “The Father of the National Park System,” 1838-1914)

One of the most significant discoveries during my lifetime has been the gradual understanding that at the most basic levels we are all inextricably interlinked. Long thought to be nothing more than an occasional curiosity concerning the behavior of elementary particles, there is more and more evidence that this interconnectedness is constantly present in our lives.

The work of people like the late David Bohm, Rupert Sheldrake, Dean Radin, Ervin Laszlo and many others has gradually begun to put these essential ideas on a much firmer footing. That’s not to say that every scientist in the world accepts these concepts: they certainly do not. But science grows by slow steps. Each observation adding to the one before, like grains of sand being heaped onto a giant ant heap. Sometimes things turn out to be wrong, and then it’s back to the drawing board. Or the ant heap gets re-arranged.

But rather than argue about the theory, I would like to suggest that you try an experiment. It is particularly effective if you are in a close relationship with another person.

If you are at work or away from the other person for some other reason, spend every free moment during the day thinking kind, loving thoughts about the other person. Feel a sense of gratitude that they are in your life. Do nothing else. Don’t specially call, email or IM them. Just do the thinking and feeling about them. And when next you see them, have a look at their initial reaction toward you. It’s extraordinary how often people find that when they next meet up, the person who’s been thought about in this way is particularly warm and loving.

I don’t recommend doing the converse, and thinking mean thoughts about someone and waiting for the fallout. But if the other person is tired, dispirited or distant when you meet, it’s a good idea to see if your thoughts about them may be factored into the equation.

Clearly there are a hundred things that will determine how people react toward each other. Is it a new relationship or a mature one? Are people tired or distracted by work or children? Has there been an argument, illness or trouble with relatives or neighbors? The list is almost endless.

But I would suggest that you try this experiment for yourself and see what you come up with. If you send them, I’ll publish any interesting observations, with the usual guarantee of anonymity.

And by the way, there are some rigorous scientific experiments being conducted right now to test this phenomenon.

“Your life and my life flow into each other as wave flows into wave, and unless there is peace and joy and freedom for you, there can be no real peace or joy or freedom for me. To see reality--not as we expect it to be but as it is--is to see that unless we live for each other and in and through each other, we do not really live very satisfactorily; that there can really be life only where there really is, in just this sense, love.”
-- Frederick Buechner (American Presbyterian Minister and Writer, 1926-)

Sex Drive and Relationships

The BBC is reporting on an article published in the journal Human Nature.

According to the report - and I haven't yet seen a copy of the original research - investigators from the Hamburg-Eppendorf University in Germany found that the sex drive of many women begins to plummet once they are in a secure relationship. They found that four years into a relationship, less than half of 30-year-old women wanted regular sex.

Conversely, they found that a man's libido remained the same regardless of how long he had been in a relationship. The researchers interviewed 530 men and women about their relationships.

They found 60% of 30-year-old women wanted sex "often" at the beginning of a relationship, but that within four years of the relationship this figure fell to under 50%, and after 20 years it dropped to about 20%.

And here's a shock: The study also revealed tenderness was important for women in a relationship. About 90% of women wanted tenderness, regardless of how long they had been in a relationship, but only 25% of men who had been in a relationship for 10 years said they were still seeking tenderness from their partner.

The researchers then start talking about the evolutionary implications of all this: that women evolved to have a high sex drive when they are initially in a relationship in order to form a "pair bond" with their partner.

That is all quite plausible, but it is a usually a mistake to try and reduce human behavior to hormones, neurotransmitters and evolutionary drives.

Most men and most women may well have different sex drives, and the duration of a relationship may play a part. But it is just as likely that we are seeing the effects of having children who need lots of a couple's attention and a natural reaction to one or both partners focusing more on their careers and outside activities rather than on the relationship.

In Healing, Meaning and Purpose I talk about the best solution to tired relationships: it's not a matter of trying every variation in the Kama Sutra. The most valuable thing to ensure the viability of intimate relationships is not so much to try to learn lots of different techniques, but instead to make the time together really count. There is nothing quite as attractive as an intimate occasion marked by complete focus on and awareness of the other person. Feeling the dance of the duality, focusing on all your senses, and, if you can, feeling the subtle systems of the other person.

Simple things that have rescued countless relationships. And a lot cheaper than hours of therapy.

Gender, Culture and Communication

Regular readers will know that I’m very interested in gender differences. More and more evidence is confirming what most of us have always known: men and women tend to think and behave differently. Some of the differences are clearly neurological and some social. It is sometimes difficult to sort out which is more important: some research findings on gender differences have produced mixed results because of some of the assumptions of male investigators!

But notice that I emphasize the word “tend” to think differently. We are always dealing with statistical differences. My Y-chromosome should enable me to navigate from A to B without difficulty. In fact, I am seriously directionally challenged: I should probably have a GPS system with me when I go down to the shops!

I have spoken about my admiration for the work of Deborah Tannen, and I have also written about Christina Robb’s marvelous book, in which she charts the development of new insights into gender differences in psychology.

This weekend I was at the annual meeting of the National Speakers Association in Orlando, and I learned something very interesting that fits in with all of our previous discussions. I learned it from one of the speakers, named Julia Hubbel. I already knew that women tend to be more relational in their interactions and men are more transactional. Most women tend to spend a lot more time on the maintenance and development of relationships and most men are more interested in the bottom line: What is the solution? What’s the deal going to be? What I did not know is that there is some data to indicate that non-White males tend also to emphasize relationships over transaction. As soon as I heard that, I was sure that it was right: I have had a lot of dealings with people from the Indian subcontinent, and most would consider it very rude to get straight down to business before we had taken tea or eaten something while discussing family and other personal matters. Julia teaches networking skills that integrate gender and ethnic considerations.

As she was explaining her insights and methods, I was reminded of the work of the anthropologist and cross-cultural researcher Edward T. Hall, who wrote a series of excellent books on cultural factors and thought.

Gender and cultural differences in communication are of such importance that I plan to return to the topic in the near future. In the meantime, you might be interested in a book by Richard Nisbett, entitled The Geography of Thought: How Asians and Westerners Think Differently and Why. After multiple trips to Japan, during which I learned a lot about cultural differences, I gave a copy to a friend who is a Canadian in a senior management position in the Japanese affiliate of a US-based company. He told me that he was astonished by the accuracy of the insights.

Some of the political misunderstandings that you see on the news every morning are often a consequence of different thinking styles. Learning how men and women and people in different cultures think and operate is not just interesting.

It is essential.

“Skill in the art of communication is crucial to a leader's success. He can accomplish nothing unless he can communicate effectively.”
-- Norman Allen (American Playwright, Recipient of a Charles MacArthur Award for Outstanding New Play)

Technorati tags: Communication Gender differences Deborah Tannen Cross-cultural communication

Stress, Depression and Resilience

“Patience in calamity, mercy in greatness, fortitude in adversity; these are the self-attained perfections of great saints.”
--The Hitopodesa (Sanskrit fable from the Panchatantra, the “Five Chapters,” Translated as the “Good Advice” c.1100 A.D.)

We are all different in the way that we respond to emotional and physical stress. It is not enough to focus on one single reason why one person handles it and another does not. I have often made the point that we need to consider the physical, psychological, social, subtle and spiritual contributions to any illness or challenge.

New research is shedding light on the interaction between two of these: genes and environment. A multinational research effort assessed the impact of stressor on mood in 275 pairs of female twins. 170 sets of twins were identical: they have exactly the same genetic makeup.

The research indicates that only 12% of individual differences in reactions to stress can be attributed to genetic influences. This is stunning, and should have been reported far more widely: 88% of the differences in the way a person reacts to stress are not genetic, but personal and environmental. This is of great importance in problems such as depression. If genetic factors play such a small role, then paying attention to the development of personal resilience - as well as dealing with social factors – is more likely to be effective than anything else. And, as has been discussed elsewhere one of the ways in which some medicines help people with depression, bipolar disorder and schizophrenia is probably by increasing their resilience.

I have already started showing you some of the techniques for improving psychological resilience and in a future publication we are also going to start work on physical, subtle and spiritual resilience and how to develop more resilient and dynamic relationships.

"Never allow anyone to rain on your parade and thus cast a pall of gloom and defeat on the entire day. Remember that no talent, no self-denial, no brains, no character, are required to set up in the faultfinding business. Nothing external can have any power over you unless you permit it. Your time is too precious to be sacrificed in wasted days combating the menial forces of hate, jealously, and envy. Guard your fragile life carefully. Only God can shape a flower, but any foolish child can pull it to pieces."
--Og Mandino (American Motivational Speaker and Author, 1923-1996)

Technorati tags: Resilience Depression Stress Environment Genetics

Convergence

One of the many things differentiating complementary and alternative medicine from the more conventional type, is that complementary practitioners are not much interested in a pathological diagnosis, and instead focus far more on the whole person. There are more than 500 types of complementary and alternative medicine, and virtually all work on the principle that they want to stimulate the body to heal itself.

It is not so well-known that in recent years some of the most cutting edge academic research in medicine has been breaking down artificial organs-based barriers, and focusing instead on the whole person, and look at research in a more holistic way. So a cardiologist and liver expert may be working together on the same problem.

Someone was asking me why this blog has so many categories? The reasons is that artificial barriers between illnesses, health, wellness, consciousness and spirituality are breaking down, and this blog reflects that. I was asked, “So are you interested in self-help or health and wellness?” the answer to that one is “Yes.” All of these are inextricably linked.

A second conceptual change, that is not much known outside of research centers, is that much of the current thrust in pharmacology is based on modulating the body’s responses, rather than simply blocking diseases processes.

Despite this apparent convergence, there are still some enormous differences in approach:
1.    The medical research enterprise remains profoundly reductionist, and so it tends to ignore some key aspects of what it is to be human: we are a great deal more than sets of biochemical reactions.
2.    Dismissing the social and psychological aspects of health and illness remains an Achilles’ heel of most academic research. When I was working in academia, a distinguished colleague came over form the England to give a lecture. An expert in brain imaging, he spoke a lot about consciousness and free will. As one of my American friends said afterward: he sound just like you in our research meetings!
3.    Complementary, alterative and now integrated medicine remains firmly focused on relationships as a key to healing. Not just the relationship of a client and their family, but the relationship between client and therapist. And there is a third arm to this. When, in the mind-1980s, we first started putting together the principles of this new Information Medicine known as Integrated Medicine in the United Kingdom or Integrative or Integral Medicine in the United States, a key component of it was the insistence that the therapeutic encounter would require the therapist to do more than just show up and do something technical. But that the therapist would also be aware of the impact of the encounter on them, and the importance for the therapist to be involved in growth work themselves. There was a time when psychotherapists would remain in therapy throughout their careers. That may not now be feasible. But it is entirely feasible for a therapist to take a bit of time each day to calm themselves; to reflect on what is going on inside them and in the subtle currents of the interactions between them, the person who has come to them for help and guidance, and all the other people involved in the situation. This is the way in which medicine is going to develop in the future.

The extraordinary advances of biomedical research can be an incredible boon to humanity, but they need to be leavened by an understanding of the context within which they are developing.

“A physicist who rejects the testimony of saints and mystics is no better than a tone-deaf man deriding the power of music.”
--Sir Sarvepalli Radhakrishnan (Indian Philosopher and, from 1962-67 President of India, 1888-1975)

Technorati tags: Alternative medicine Complementary medicine Integrated medicine

Capacity

There’s a nice article at a website that I like a lot. This one recommends adopting an approach of examining our capacity for work in four different ways: physical, intellectual, emotional, and spiritual.

There are powerful reasons for using multidimensional perspectives to help people not just function at their best, but also to be resilient in the face of adversity. I would like to add two things to this article.

First is an exceedingly useful concept is the “complexity quotient” (CQ), which measures our ability to adapt to changing complexity. It is another way of thinking about a person’s “capacity.” Successful leaders, winning athletes and healthy individuals are extremely flexible and have a high CQ. They can raise their game and adapt quickly. On the other hand, they also have the ability to let go when the pressure is off. After recovering from a mental breakdown, the psychologist Carl Jung was known not only for his remarkable scholarship, but also for his extraordinary ability to relax and to become childlike and to think up all sorts of games for his children. These are signs of a well-rounded, balanced and integrated personality. Sometimes we see people in whom this ability goes haywire, and they overcompensate with drugs, alcohol or risky sexual behavior.

Second, I think that it’s valuable to also add the capacity of your relationships and your energy. Robust, dynamic and supportive relationships can enhance your capacity for work and play, and they buffer you from the slings and arrows of outrageous fortune. We do not usually think about the capacity of the subtle systems of the body, but they are there and very real. Strengthening them with techniques such as breathing, yoga or qigong, can dramatically improve your quality of life and capacity for effectiveness and enjoyment.

Technorati tags: Capacity Complexity quotient Subtle systems Biofield

The End of Life As We Know It?

Your humble reporter was discombobulated to read a recent report from E3: the Electronic Entertainment Expo in Los Angeles.

It appears that hordes of young men – yes they were virtually all young and male – were far more interested in the electronic games on display than they were in a number of quite attractive young dancers and models who graced the event. Though we have not one iota of interest in the orientation of the assembled company, on statistical grounds alone we would expect that at least some of these young men should be wired to take an interest in presumably intelligent members of the opposite sex. Yet they seemed to prefer playing with their silicon monsters and joysticks.

Perhaps the gamers are all too cerebral to be interested in young models who may be unable to tell a bit from a byte. But in the midst of all the sage commentary about the expanding gaming market and the ready accessibility of computer games to people who have access to not much else in the way of entertainment, our thoughts meandered off in a different direction: we have been wondering if we are here witnessing some form of natural selection at work….

Technorati tags: Evolution Relationships Sexual attraction

Presence and Charisma

I was reading a heart-warming story reported by the BBC of a unique case of a young woman who had a heart transplant at the age of two, and when, ten years later, her adolescent body began to reject the heart, the transplant was removed, and her original heart, which had been resting for ten years, was able to take over. A medical first, but that was not what attracted my attention. Neither was it the lymphoma that she developed several years ago, perhaps because of the original illness that damaged her heart, or perhaps because of the anti-rejection medicines that she has had to take all these years.

It was instead the smiling face of Professor Sir Magdi Yacoub (I just love the pictures of him here.) who did the original operation and who consulted on this new operation. He recently turned 70 and no longer operates himself. I cast my mind back almost 25 years, when I was working at the National Heart Hospital in London and first met him. There are two things that I remember about him. The first is that he was the person who allowed me to show the successful use of acupuncture to treat people who had gone through open-heart surgery, and still had pain in their chests. And the second is the reason for today’s item: Magdi had the most extraordinary personal “Presence.” When he walked in a room, everyone would notice him. Most had no idea who he was, or his extraordinary achievements; they were just drawn to him.

I have met many people who have this “presence” or “aura.” In the Eastern world it is often thought of as another manifestation of “Qi.” Closely related to “presence” is charisma: a compelling attractiveness or charm that can inspire devotion in others. In the ancient world charisma was thought to be a divine power or talent, and the word comes from the Greek word kharis meaning “grace” or “favor.” There is a small scientific literature on this phenomenon of charisma, which often flows from having a strong presence. Some of the research is summarized here.

There are clearly many types of charisma: Political, sports, performance, business, spiritual, literary. scientific and so on. The only two people whom I’ve met who knew Einstein told me that people would usually all stand up when he entered the room. Charisma is more than just a personal characteristic; it can also be conceptualized as the way in which certain groups interact with each other. There is a fascinating book entitled Charisma and Social Structure by Raymond Trevor Bradley, that has a fascinating discussion of the transformative and transcendent power of charisma. It must also not be forgotten that there are those who have used charisma for evil ends: three of the most wicked people of the last century were also possessed of extraordinary personal charisma.

Clearly some people have presence and charisma. The question is whether theses characteristics can also be developed. The answer is yes, they can be. Presence is created by an overall impression constituted of posture, eye contact, stillness, silence, self-confidence, competence and serenity. People with a strong presence are often a little mysterious, in the sense that they tend not to reveal much about themselves or their accomplishments. I have also felt if very strongly in people who have worked to develop the subtle systems of their bodies. One of the most potent examples was a Korean Ki-Master who spoke not a word of English, but whose presence could be felt the moment he entered a packed room. Work on your subtle systems will likely cause you to be more still and serene and to have a better posture and that's a great start.

There are a number of things that you can do to improve your own charisma:

1. Create a strong first impression by developing your presence
2. Develop a good impression when you speak
3. Be a good active empathic listener who connects with other people and asks pertinent questions
4. Be supportive of other people and their aspirations
5. Be persuasive
6. Be resilient and adaptable
7. Expand your vision of what is possible
8. Practice thinking creatively
9. Use humor
10. Be committed and courageous
11. Initiate persistent action
12. Instill hope in the people around you

Technorati tags: Sir Magdi Yacoub, Charisma, presence, empathy, acupuncture

Cell Phones and Relationships

In a recent post I commented on the dangers of multi-tasking, and cited Linda Stone’s excellent term “Continuous Partial Attention.” A little over three weeks ago, Marianne Richmond wrote an excellent post on "Attention: Giving it and Getting It" that discusses, among many things, the role of attention in our relationships.

I have just come across a study that supports everything that we have been saying. It was published in the Journal of Marriage and Family in December and examined cell phone usage over a two-year period in 1,367 couples from the Cornell Couples and Careers Study. Increased cell phone use was linked to increased distress and lower family satisfaction. Being constantly available blurs the boundaries between work and family time.

Be very careful that you are not becoming a slave to that device on your belt.

“The waste of life occasioned by trying to do too many things at once is appalling.” --Orison Swett Marden (American Writer and Founder of Success Magazine, 1850-1924)

Technorati tags: continuous partial attention, relationships, cell phone

Sex, Time and Energy

I was taking a long flight yesterday, which gave me the chance to read through the results of a large survey  done by Men’s Health and Cosmopolitan Magazines. You will see, gentle reader, how widely I spread my net in my ceaseless efforts to bring you important new materials to enrich your life….

The results of this survey of 6,000 men and women seemed at first to make interesting reading. More than half of men and women surveyed saying that they wanted to have sex at least once a day; around half of the women saying that they wanted to have more adventurous sex, and so the list went on. But then I started thinking: “Who are these people?” They certainly don’t sound much like the people that I know, or people with whom I’ve worked professionally.

So I showed the survey to She Who Must Be Obeyed, and she immediately agreed: “How old are they? And how many of them have children?”

Most healthy adults are interested in having intimate relationships, but how many people are too tired and too distracted to do everything that they want to? And how many people are busily multitasking their lives away to the exclusion of everything else? I was recently talking to a married couple who had packed the children off for the evening and had a date night all organized. The restaurant was booked, the theater tickets in hand, and they both fell fast asleep on the couch and missed both.

I’m sorry to disappoint some of my readers, but the world is not quite the way that it is portrayed in some magazines. At least not once you take on responsibilities. The problem with surveys like this is that it can make some people very dissatisfied, for it leads them into the trap of comparison: “If that’s what the survey says, then what’s wrong with me?” The answer is, of course, that there is no such thing as “normal behavior.” What you and your partner like and feel comfortable with is all that really matters, so long as it isn’t infringing on anyone else. Every time another survey like this comes out, every one of my therapist friends sees an increased number of people worried that they aren’t performing up to par.

Sexual mismatches can create a lot of difficulties in relationships, but let me make a suggestion: the most valuable thing to ensure the viability of intimate relationships is not so much to try to learn lots of different techniques, and it is sometimes just not realistic to put aside as much time for each other as you would like. So instead make the time together really count. There is nothing quite as attractive as an intimate occasion marked by complete focus on and awareness of the other person. Feeling the dance of the duality, focusing on all your senses, and, if you can, feeling the subtle systems of the other person. You already know that our experience of the passage of time is highly elastic. Focused awareness of another person can make even five minutes seem like a lot longer, and remember what I have said before, and is an important theme of Healing, Meaning and Purpose: time management is far less important than energy management.

And remember this: you will never be free so long as you are concerned about the opinions of others.

Technorati tags: sex, relationships, time management

Testing for Telepathy

“By means of thought, we are able to obtain all the elements we need from the universe and to reach all the beings we want to contact. Yes, through the law of affinity, thought takes charge of seeking out these elements or these beings. Even if the person you have in mind is on the other side of the world, out of the six billion people on earth, your thought will go directly to him or her and to no one else, as if it had been magnetized to make contact with precisely this person. So from now on, when you want to acquire an element from the universe or to contact someone, think about this element or this person without concern for their whereabouts. Provided your thought is intense, it will go straight to its target.”
--Omraam Mikhaël Aïvanhov (Bulgarian Spiritual Master, 1900-1986)

Of all the subjects that I’ve discussed, one of the most difficult is telepathy. It is difficult not because of a lack of empirical data, but because it is such a polarizing topic. Some people believe in it, and others claim it is impossible, that any research that says otherwise must be wrong and if you believe in it, you will believe in anything. Yet it is an important subject, and the research data keep on coming.

The English biologist and writer Rupert Sheldrake has just published a study in a well known and peer reviewed journal. Perceptual and Motor Skills is a journal with a reputation to protect, so you can be sure that this study was scrutinized particularly carefully. This study investigated possible telepathic communication in connection with emails. In the study there were four potential email senders, and for each trial one of them was selected at random, and there were 50 email receivers, who had to guess who was going to send them an email one minute before it was sent. Further experiments were done with a small number of people who were videotaped continuously. All the experiments generated results that were significantly above chance.

What this means is that we have another piece of evidence to add to the overall body of knowledge about telepathic interactions between people and animals.

Part of the difficulty about telepathy is in understanding how it could happen. When people are in close physical proximity they can pick up on subtle physical cues like body language and dilation of the pupils. I am also persuaded by the data from the HeartMath Institute, indicating that the electrical field generated by the heart can be detected by other people at a range of several feet, and that it can lead to entrainment of the electrical rhythms two people’s brains. But the email experiment is important because none of these factors come into play. My own take on this is that we are all constantly and inextricably interlinked with one another. Most of the time we don’t notice it because of the constant chatter of the mind and the efforts of the ego to protect our individuality. But under certain circumstances – shock, meditation, deep relaxation, sex, and near-death experiences - the walls come tumbling down and we experience our connection for what it truly is. And then we see the non-dual reality of the world.

The other point is this: I have made the point that the Laws of Healing have been gradually changing and evolving over the last century, and our individual and cultural consciousness is evolving and adapting. Because of that, more and more people are having first-hand experience of the interconnected web of life.

“The web of our life is of a mingled yarn, good and ill together . . .” {All’s Well that Ends Well, Act IV, Sc. Iii} --William Shakespeare English Poet and Dramatist, 1564-1616

Technorati tags: Intuition, Rupert Sheldrake, Telepathy Omraam Mikhaël Aïvanhov

Gender and Relationships

I sometimes review interesting or important books at Amazon.com. I’ve just done that with a book entitled This Changes Everything: The Relational Revolution in Psychology by Christina Robb that is important for us on several levels. The book reviews the work of three remarkable individuals – Carol Gilligan, Jean Baker Miller and Judith Lewis Herman - who between them changed the way in which we think about some important gender differences.

The philosopher Ken Wilber first alerted me to Carol Gilligan’s work several years ago. In the mid-1970s, she wrote an essay entitled "In a Different Voice," that was subsequently expanded into a book that I recommend highly. She described the marked discrepancies in moral development processes and self-expression between men and women.

According to Gilligan, the whole notion of a woman's self tends to be inextricably bound up in a web of close relationships. Women tend to be more diligent about maintaining and nurturing these relationships, and inter-personal details tend to be far more important to most of them, than they are for most men. I remember someone sending me a little joke about gender differences, in that mothers know the names of all their children’s friends, their parents’ names, birthdays, favorite music, likes and dislikes in people, food and clothes. While fathers may or may not notice the small people in the house. That was, of course, a joke. But like all jokes it had within it a grain of truth. But notice that I keep using words like “tend to,” when describing gender differences, because there are plenty of men who are into all these interpersonal details and women who are not remotely interested.

At the time that Carol Gilligan started writing about this, much psychological thinking in the United States had not yet dragged itself out of the confines of the post-Freudian theorizing that had dominated American psychology for decades. Gilligan and her co-workers identified relationships as the foundation of psychological and physical states. At the time, the idea that men and women might tend to think and relate in different ways was anathema. I worked in Boston around that time, and it was clear what could and could not be thought about and discussed. Gilligan's work was courageous, and taken together with the findings of psychiatrists Judith Lewis Herman and Jean Baker Miller, would ultimately lead to radical alterations in the way that we understand the psychology of women. Are these gender differences social, political or biological? The answer is, I think, yes: all of the above.

It is surprising how often discussions of gender differences are still omitted from much work on self-psychology. In an otherwise wonderful book - The Self in Neuroscience and Psychiatry, edited by Tilo Kircher and Anthony David - there is scarcely any mention of gender.

I am not much of a fan of trying neatly to cleave men and women’s thinking styles in two. There will always be a great deal of overlap, and the key is not so much biological gender, but the style normally associated with a gender. The research of these three pioneers and of another pioneer – Deborah Tannen - is teaching us that the roots of many problems in our lives may be a consequence of misunderstandings about what men and women consider to be the most important things in their lives. It is also important to recognize that the amount of “maleness” or “femaleness” that we bring to our relationships and to our sense of self will change and evolve over time. Have you ever watched a relationship between a dominant career oriented male and a passive female gradually change into one in which the male takes the more passive role? This is a good example of a shift in “maleness” and “femaleness.”

I have been impressed by some of the recent work of David Deida, who has done a lot to explore the interplay of male and female essences in our lives. I have already mentioned in some of my other postings the importance of moving from a dominator to a partnership model in all of our relationships.

Consider whether problems in any of your relationships may be a result of misunderstanding gender needs.

Technorati tags: gender differences, psychology, relationships, gender

More on Chess and the Mind

After my last article about some of the things that one can learn from chess, a blogger in Australia added “patience” to my list. And he is quite right. Except that I have, sad to say, never mastered the art of patience. It's a character flaw. Maybe I would have had more success at the Royal Game if I had been just a bit more patient. I suppose a few extra IQ points might have helped too...

There is a nice article on Susan Polgar’s blog : Susan is the oldest of three remarkable Hungarian sisters who were trained to be geniuses from early childhood by their father László Polgár. She now lives in New York, and she is an International Chess Grandmaster who also happens to be fluent in seven languages. She is doing a great deal to promote the enormous benefits of chess, particularly in the United States. Clearly the sisters had “good genes,” but it is inspiring to see what can be done for youngsters if they are exposed to a highly enriched environment early in life. But there is something else to the Polgar story. Despite the stereotype that over-education might lead people to be unbalanced eggheads, all three have turned out to be remarkably normal and charming young women with children of their own. One sister – Judit – is the highest rated female chess player of all time, and the third sister – Sofia – is an International Master living in Israel.

The normalcy of the sisters is in stark contrast to the situation of many children that I have seen in Japan, who are already having extra tuition in Kindergarten. Scholastic failure is a recognized cause of suicide in Japan, and the Japanese actually have a word for death from overwork: Karoshi.

I wish Susan well in her efforts to promote chess, but I would also love her to share with the world how she and her sisters managed the balancing act of marrying extreme intellectual development with normal emotional and interpersonal relationships. That is in many ways even more remarkable than the sisters’ extraordinary accomplishments.

Technorati tags:  chess, balance, Susan Polgar,

Marital Conflict and Hardening of the Arteries

The Bible contains at least three references to the undesirability of hardening one’s heart:

“And the Lord said unto Moses, When thou goest to return into Egypt, see that thou do all those wonders before Pharaoh, which I have put in thine hand: but I will harden his heart, that he shall not let the people go.” -- Exodus 4: 21

The BBC is carrying a report of a paper presented to the American Psychosomatic Society meeting in Denver Colorado. Researchers from the University of Utah have added another piece of evidence that marital conflict bad for you. In a previous posting I discussed the evidence that marital conflict can compromise the immune system. Now we have confirmation that marital conflict can also have an adverse effect on the coronary arteries, leading to hardening and calcification of these crucial blood vessels.

The researchers studied 150 married couples, with at least one partner in their sixties. None of the people in the study had ever been diagnosed with cardiovascular disease. Each couple was asked to pick a topic that caused disagreements in their marriage: topics included money, disagreements about in-laws, children, vacations and household chores. They were then videoed while they discussed the topic, and the videos were watched by psychology students who coded comments as friendly or hostile, submissive, or dominant or controlling. Cardiac scans were then done to look for signs of disease.

Wives who made the most hostile comments during the discussion had a greater degree of calcification of their coronary arteries, indicating the build up of plaque in these crucial arteries. It is not just the behavior of one person: the highest levels of calcification were found in women who behaved in a hostile and unfriendly way and who were interacting with husbands who were also hostile and unfriendly. Husbands who were more controlling, or who were more dominating, or whose wives were controlling or dominating, were also more likely to have more severe hardening of their arteries than other men.

These findings are in line with everything that I have been writing about looking at all the five dimensions or domains of a person: physical, psychological, social, subtle and spiritual. If you ask most people what they are doing to protect themselves against heart disease, they will probably talk about not smoking, taking exercise and healthy eating. That response is correct, but inadequate. Toxic relationships are just as dangerous, as are certain psychological response styles. For many years it was thought that the so-called “Type A personality,” was a risk factor for coronary artery disease, but research has shown that it is just two aspects of this response style that are responsible for the increased risk of coronary artery disease: anger and hostility.

Disagreements are bound to come up in any relationship, but the way that we communicate gives us a great opportunity to do something healthier for both people. In my book Healing, Meaning and Purpose I discuss the wonderful work of Riane Eisler, and I talk a lot about methods of transforming relationships from an unhealthy dominator model into a healthy partnership model.

Particularly if you are in a relationship, I urge you to take some action today to move towards greater heart health.

Technorati tags: marriage, heart disease, Riane Eisler, bad relationships

Sexuality and Spirituality

The talk shows and multiple Internet sites have picked up on a story about a controversial website  that is pulling a great many people to a progressive church in Granger, Indiana. Some people have been getting very hot under the collar, and saying that there’s no place for frank advertising and for discussions of sex in a church, or a church-based website.

To be honest, I fail to see what all the fuss is about. It is self- evident that no two people are ever going to agree about everything to do with religion. And just as obvious that there are some clearly different schools of psychological and spiritual development. Some are by their very nature sexually repressive while others, and I am thinking here primarily of Tantric and Taoist traditions, have actively used sex for spiritual enlightenment. But there has also been an important study that has shown that many people who are not following any particular spiritual tradition have spiritual, mystical or transcendent experiences during sex. This is reported in a very fine book by developmental psychologist Jenny Wade.

In the introduction to Jenny’s book, the philosopher Ken Wilber makes an important point, that leads us straight back to the controversy over the website. He asks why so many people laugh at or snigger about sex? And his answer is superficially astonishing, but, I think, quite correct. He says that we laugh at sex because it can kill us.

Many psychologists and philosophers have examined the basis of laughter, and have all, in their different ways come to the conclusion that it has something to do with an event that we find unnervingly significant. I think that is was Freud who pointed out that laughing when someone slips on banana peel causes laughter because it is a reminder that anybody can fall victim to the same thing.

So what does Ken mean by that statement? He means that sex can kill the “everyday you,” your normal personal ego, and sometimes enable people to experience the depths of their own spirituality. And that can be very scary. Clinicians still see a great many people who have developed problems because of conflicts over their own sexuality and their beliefs; In particular their religious beliefs. Yet here is the paradox: sex may not be conducive to religious belief but it can be highly conducive to spiritual experience. Yet Jenny Wade’s study also showed that 80% of the people who had these experiences never told a single person about them. Presumably because they fear that they will be laughed at.

For the people who felt upset about the Church in Indiana, I think that it’s important to realize that sex is not going to go away. Everybody knows that sex sells, and if people are drawn into hearing a balanced message to help them re-establish their moral compass, isn’t that a good thing?

Technorati tags: sexuality, Jenny Wade, spirituality, Ken Wilber

Prairie Voles Again!

I do hope that we are all properly appreciative of the scientific contribution of these cute little creatures. I mentioned them in one of my Valentine’s Day posts, but you will find a picture and an accompanying story here.

Thomas Insel’s group at the National Institute of Mental Heath in Bethesda have spent years working on pair formation and partner preference in these little fur balls.

It seems that pouring dopamine into a region of their brains known as the nucleus accumbens makes male prairie voles seek out girlfriends. There are at least seven major subgroups of dopamine receptors. But in these little creatures D2 receptors are involved in approach behavior that is associated with the formation of a pair-bond, and D1 receptors maintain the bond. While forming a relationship the little vole’s brain actually changes.

I am always a bit worried about trying to read too much into these experiments, because human behavior really is a great deal more complicated. But I have a couple of thoughts:

1. Dopamine receptors are proteins, so they are products of genes that get switched on by the formation of a relationship. Might some people have a genetic reason for having difficulties in relationship formation, and how would that play with environmental factors? You may well know some people who seem cold and uninterested in relationships, and indeed, there are some personality disorders in which people have chronic difficulties in forming relationships. Yet certain types of psychological therapy can help them.

2. Some antipsychotic medications block D2 receptors. Is that a further explanation for the relationship difficulties of some people receiving these medicines?

3. I think that we should thank the Prairie Vole Kingdom for their help…..

Technorati tags: relationships, dopamine, love, science of love

Love, Sex and Cupid’s Chemicals?

Well, once again some of my colleagues would like to reduce everything about love to a series of chemical reactions in the brain. The BBC recently reported a study from Pavia in Italy that actually came out at the end of last year in the Journal Psychoneuroendocrinology. The Italian researchers measured the levels of a group of hormones known as neurotrophins that stimulate the brain to produce new connections or, under certain circumstances, new cells. This research contributes to a chemical scheme that says that there are three stages of love, and that they run something like this:

1. Lust: This is supposed to be driven by the sex hormones testosterone and estrogen and happens together with rises in the nerve growth factor (NGF). So the idea is that we learn to enjoy lust. I don’t think that we needed millions of dollars of research to tell us that!

2. Attraction: This is the phase when we are supposed to be thinking of nothing else but the new significant other, and even reduce our need for food and sleep. The NGF is still lurking around here, but now there are supposed to be other chemicals coming into the picture: Serotonin, that makes us feel good; Dopamine, that is involved with emotion and the important facility of salience: deciding what is important in the environment; and norepinephrine, that cranks up our metabolism and also gets involved in the formation of memories and behavioral responses.

3. Attachment: This is supposed to be what happens after the initial stage of attraction, if a relationship is going to last. This is said to be mediated by the hormones vasopressin, which is involved in memory and fluid balance, and oxytocin, that is produced during childbirth and during breast feeding, and is thought to be involved in cementing a bond between mother and child. Oxytocin is also released during sexual orgasm, so it has been thought that oxytocin is the reason why having a lot of sex brings a couple closer.

Well, that all sounds good. But can it really explain the vast panoply of behaviors and emotions that are going on today all over the world?

The answer is, of course, a resounding “NO.”

I admire and respect this type of research work. It is difficult and takes enormous patience and persistence. But we know that this research is in its infancy.

To try and “explain” human love and human sexual experience on the basis of half a dozen chemicals is about the same of looking at a street map of New York and pretending that you can then understand the experience of living in Brooklyn. Yet some people have looked at some of this research and said that we should expect to fall out of lust after a year or two and instead be content with coexistence and cuddles. Whichever way you look at that interpretation, it is dead wrong. The more so, because I have seen people suggest that these chemical discoveries present a ready made license for seeking new partners who will stimulate their testosterone, NGF or whatever.

The Italian studies had the virtue of being done in human beings, but a lot of the studies have been done in animals. There is one species that has been studied hundreds of times: The Prairie Vole. This tiny creature has many attributes important to the research scientist. But very few that are applicable to human beings.

Let me give a concise Valentine’s Day summary about love, sex and chemicals:

1. Yes, there is a chemical contribution to many of our experiences, but it is a contributor, and not the explanation for them

2. We have huge amounts of data to prove that our emotional and psychological reactions cannot be reduced to chemicals alone. There is a human mystery that is way beyond such reductionist notions

3. These chemical studies will eventually need to include not just our subjective experiences, but also the role of other individuals: our relationships

4. None of the studies is yet ready to deal with the subtle systems that pervade our world. Let me ask you a question: Have you ever had an intimate partner who drained your energy and another who flooded it with positive energy? That’s pretty good evidence!

5. Have you ever felt that you had a soul connection to your partner? If you have, you know that it cannot be reduced to chemicals. It affects every part of your being.

Happy Valentine’s Day!

Addendum:  CNN has just published a similar article:  please click here to read it.

Technorati tags: love, science of love, 

Sit and Smell the Roses

“O, my love’s like a red red rose That’s newly sprung in June.”
--Robert Burns (Scottish Poet, 1759-1796)

Just in time for Valentine’s day, comes some research from McGill University in Montreal, Canada, that may have important implications for many people. Researchers discovered that the sensitivity to the smell of roses was greater in people sitting than in those who were lying down.

This is consistent with other research that has found that many of our senses are less acute when we lie down. It is not simply that when we lie down our noses are less exposed to wind drafts carrying odors, it is likely part of a complex series of partial shut downs of the senses that take place as we prepare for sleep.

There are two messages from this research:

1. Most brain imaging studies are done when people are lying down in a scanner, so when we are doing experiments involving the senses, we may need to rethink that, and see if we can re-arrange things so that subjects can be seated.

2. If you are planning on scattering rose petals, or giving someone special a bouquet of roses, perhaps you should wait until they have got out of bed.....

Stressful Marriages Can be Damaging to Your Health

There is an extremely interesting article in the month’s Archives of General Psychiatry, which was picked up by the media that examined how marital stress effects healing.

Most people now accept that the mind has powerful effects on the body, though as recently as the 1970s this was still regarded as rank heresy by many in the medical community. This new study is important for our understanding of the relationship between stress and physical health, and gives us further insights into how we can help ourselves stay well.

The study was done at Ohio State University and examines 42 married couples. Each person was given small skin lesions, and the startling finding was that in hostile couples, the wounds healed 60% more slowly than they did in non-hostile couples. The investigators even identified an inflammatory mediator called interleukin-6 (IL-6), as the biochemical link between hostility and slow wound healing. IL-6 levels are linked to long-term inflammation, which is in turn implicated in a number of illnesses, including diabetes mellitus, arthritis and cardiovascular disease.

A thirty-minute disagreement with a spouse could push back wound healing for 24 hours. The skin is the largest organ in the body and is exquisitely sensitive to stress: just thing of blushing and getting zits when under stress. So it is difficult to extrapolate from these findings in the skin, to try and predict what would happen with healing of internal organs. But we do have enough information already to say the following:

1. Allowing yourself to become involved in an argument may have long-term physical effects on you.

2. Some years ago I worked with a group of fine people who did just one thing that I did not like: they were wedded to the idea that it is a really good idea to vent your feelings. They would go as far as allowing patients to hit walls and other inanimate objects. I was never keen on this, feeling that expressing a lot of negative emotion could be counter-productive. After a patient broke bones in his hand after striking the wall, I quietly put an end to the practice. This new research indicates that I was correct to do so.

3. If you are going to have surgery, it is a good idea to be in a calm and peaceful frame of mind.

4. Stress is often unpredictable so it is a really good idea to be engaged in some ongoing stress management practice, so that you are better able to deal with the "slings and arrows of outrageous fortune," as Shakespeare put it over four hundred years ago. Clearly this doesn’t mean that you have to walk around like a burned out hippy on Quaaludes. Unless you really want to…. The best techniques that I know of for dealing with stress are the Sixty Second Peace Technique, Qigong and Yoga Breathing. If you have your own method, then stick with it. Otherwise you may want to check out some of the materials that I have written and recorded.

Technorati tags: stress, marriage, arguments, healing