Friday, November 18, 2011

Functional medicine: A systems approach to medicine

Mark Hyman, MD has dedicated his career to identifying and addressing the root causes of chronic illness through a groundbreaking whole-systems medicine approach known as Functional Medicine

Friday, October 28, 2011

Individualism and Collectivism: Schismogenesis and #occupywallstreet

Most social systems require a balance between symmetrical and complementary relationships or patterns.

A symmetrical pattern is characterised by ‘tit for tat’.  You hit me, I’ll hit you back. Obviously, this pattern has its uses, but unchecked would lead to the destruction of one of the parties in the relationship, and thus end the relationship too.

A complementary relationship is characterised, crudely, by a sadist and masochist, where the behaviour of one party complements that of the other. Again, this type of relationship can be useful, but unchecked, this pattern can lead to destruction as the sadist becomes increasingly sadistic and the masochist becomes increasingly masochistic.

Gregory Bateson (1972) referred to these runaway patterns that lead to destruction as ‘schismogenesis’ and argued that most relationships need to have a balance between complementarity and symmetry patterns. This balance could be thought of as a form of homeostasis. For example if a relationship is tending towards more ‘tit for tat’ (symmetrical) patterns, for example both partners becoming more violent, if one party becomes submissive (complementary), this would disrupt the runaway pattern and lead to a balance. Of course this new complementary pattern will, in time, need to be balanced by more symmetrical behaviour and so on.

In an earlier post (I seem to have deleted by accident) I wrote about how privileging personal gain over co-operation can ultimately become self-defeating, and I wonder if there are parallels in the current political context where we might think of balancing patterns of behaviour on a societal level.

Short term, personal gain seems to be the raison d'ĂȘtre of the individualist culture; characterised by politicians whose policies are influenced by terms of office, popularity and benefitting themselves and where corporations are motivated by keeping profits up and shareholders happy. It has become increasingly evident with recent revelations regarding News International and the scandal involving Liam Fox and his friend Adam Werritty that politics and corporate desires are intimately connected, adding more weight to suspicions that there is small elite of people who conspire to serve their own needs.

The benefits of this culture are of course, competition (although sometimes this is faux), comparatively cheap prices and a reasonable standard of living for many people (in the developed world).

The downside to this type of culture is that the addiction to short term gains for the few is leading to future consequences that are self-defeating and destructive.

Cheap, unhealthy processed food has led to phenomenal numbers of people becoming obese, and diabetes is likely to be a massive burden on future health care services.

The environment is exploited without regard to the long term consequences of pollution and deforestation. The fact that global corporations sponsor climate change deniers is significant. Their addiction to short term profits over-rides any responsibility for future generations.  Automobile manufacturers and oil companies have a vested interest in lobbying governments to keep citizens dependant on cars rather than other forms of mass transit.

The developed world’s addiction to oil is almost certainly the reason for US intervention in the Middle East, with countless dead and injured. The concept of transgenerational trauma (Shevlin & McGuigan, 2003) indicates that relatives of people affected by trauma, including those born after traumatic events, have symptoms of post traumatic stress. This does not bode well for the future health of states so significantly impacted upon by conflict.  A dominant narrative of the developed world’s rapacity is likely to feed the emergence of more dissent and violence from poorer states.

A balance is required to counter what I believe is a runaway pattern of individualism, where a more collectivist, long term approach might privilege and prioritise differently, considering more closely the long term ethical and environmental consequences of behaviour. I hope that the #occupywallstreet movement is the beginning of this counter-balance. It is, so far, a peaceful and determined protest and it is to be hoped that it remains so.

I’d like to close with these words from Gregory Bateson’s daughter, Nora; words which I believe offer a wider understanding of the situation:

“When you peel back all of the lovely accomplishments of the great revolutionaries what do you find? At the center there is this: They did the impossible. They risked everything, and changed the unchangeable. Occupy Wall St...This is the exhale we have been waiting for. This movement is the release of all we have held back, and all we have deferred: the fatal complications of poverty, ecological disaster, and political injustice against. Until now, we have been betting away our futures to keep this monster from tipping over; we have been covering for it, nursing it, convincing ourselves we were even proud of it. Like children of abusive alcoholic parents-- we have been silenced for so long. Finally the unsayable is being said, giving the unmovable boulders of this illusion of subservience to economic structures an opportunity to crumble. We were as my father said, “double binded” by the loop of needing the corporate body to both employ us and then relieve us of our earnings for what we thought was survival, but is actually destroying our real survival in our environment and with each other. Now, the thing that has kept us rapt and bound is grotesque: oozing greed, eating its young, poisoning us, the earth and even itself. If we can remember, that these structures are constructs of our imagination, not forged in nature, we can begin to re-imagine the system. Ideas... are what we are working with, and they can grow, change, evolve. We can live better, but first, we occupy. Don’t be distracted by the deeds of the change-makers, the “what” in what they changed, really, the key is THAT they did not wrap themselves in the practicalities of reason. Of course it’s impossible, that is why we have to do it.”  Nora Bateson

 Shevlin, M. & McGuigan, K. (2003) The long-term psychological impact of Bloody Sunday on families of the victims as measured by The Revised Impact of Event Scale.
British Journal of Clinical Psychology, 42: 4, 427–432.

Wednesday, October 26, 2011

Fixing a 'broken society'

“Something is profoundly wrong with the way we live today. For 30 years we have made a virtue out of the pursuit of material self-interest: indeed, this very pursuit now constitutes whatever remains of our sense of collective purpose”. Tony Judt; Ill fares the Land

Salvador Minuchin, the originator of structural family therapy, considered that, in order to function healthily, a family needs structures, boundaries and rules.

Within the wider family system, sub-systems work together, and complement each others roles.  The boundaries of a subsystem are the rules defining who participates, and how. For example, the boundary of a parental subsystem is defined when a parent tells an older child, “You are not your brother’s parent. If he is watching something on TV he shouldn’t, tell me and I will take care of it”.

For proper family functioning, the boundaries of subsystems must be clear and defined well enough to allow subsystem members to carry out their functions without undue interference, but they must allow contact between the members of the subsystem and others.

In addition to clarity of boundaries, most families can be conceived of as falling somewhere along a continuum of whose poles are the two extremes of diffuse boundaries and overly rigid boundaries. These two extremes of boundary functioning are typically called enmeshment and disengagement.

Members of enmeshed subsystems or families may be handicapped in that the heightened sense of belonging requires a major yielding of autonomy.  In contrast, members of disengaged subsystems or families may function autonomously but have a skewed sense of independence and lack feelings of loyalty and belonging and the capacity for interdependence and for requesting support when needed.

The clarity and range of boundaries within a family are useful parameters for the evaluation of family functioning, but is this the case in a broader society?

Where does a society begin and end?  What sort of boundaries delineate any given society and its sub-systems and are they permeable or rigid?

If our society was a family, my sense is that we have an extremely small subsystem that is very much disengaged from the remaining subsystems. The extreme level of disengagement, along with the disparity in size and wealth between this subsystem and the remaining societal sub-systems is toxic.

This toxicity leads to what David Cameron described as a 'broken society'; lack of social cohesion, poor health, increased dependency on drugs and alcohol and crime. In contrast, societies that have more equality seem to do better.Richard Wilkinson   a researcher in social inequalities in health and the social determinants of health in a 1997 paper published in the British Medical Journal suggested that “one reason why greater income equality is associated with better health seems to be that it tends to improve social cohesion and reduce the social divisions”.

He later went on to suggest that “the psychosocial effects of relative deprivation are unlikely to be confined to health… where death rates from accidents, violence, and alcohol related causes seem to be particularly closely related to wider income inequalities, the predominance of behavioural causes may reflect changes in social cohesion”.

From a structural therapy point of view, a family that has serious problems needs to be restructured. If we think at a societal level, this would involve changing the structure of the society, making it more functional by altering the existing hierarchy and interaction patterns.In a recent TED lecture, Wilkinson argues for a fairer, progressive tax system to address inequalities.

However, a more comprehensive solution to the problem of restructuring our society has been addressed by Tony Judt, who argued that the whittled-down Left squandered a huge opportunity to show the mainstream that new ways of seeing and thinking are desirable. In the aftermath of recent financial crises, it’s pretty much impossible to argue that financial markets properly regulate themselves.

Judt advocates a revival of the central values of American liberalism or European social democracy. He calls for the beneficent authority of a welfare state (in one form or another) to redress the excesses of unregulated market forces; a course that emphatically rejects both dogmatic socialism and unrestrained capitalism.

His version of social democracy (or, for Americans, liberalism) envisages a society less materialistic, less individualistic and more community-minded than the present one, based on an economy in which capitalism, while by no means abolished, is on the other hand firmly tamed and regulated.

In light of these great upward shifts of wealth, Judt (who died in 2010) felt that, at that time, no civic movement had gained mainstream influence. Perhaps the #occupy protests are the beginning of this very movement?

Judt. T. (2010). Ill fares the land. London; Penguin.

Minuchin, S. & Fishman, H. C. (2004). Family Therapy Techniques. Harvard: Harvard University Press

Wilkinson, R. G. (1997). Socioeconomic determinants of health: Health inequalities: relative or absolute material standards? BMJ 314: 591

Monday, October 24, 2011

Mong: Language, Ricky Gervais, Wittgenstein and Humpty Dumpty

'When I use a word,' Humpty Dumpty said in a rather scornful tone, 'it means just what I choose it to mean - neither more nor less.' - Lewis Carroll, Through the Looking-Glass

As Lewis Carroll wryly noted, words require a shared meaning rather than an idiosyncratic meaning chosen by the speaker.  Wittgenstein argued that definitions of words emerge from what he termed ‘forms of life’, roughly the culture and society in which they are used, although he might have observed that this emergence is a process; sometimes words have different resonances and meanings to different generations or groups within a broader culture. A recent example of this unfixed meaning of words was evident in the use of the word ‘mong’ by the comedian Ricky Gervais on twitter, which caused a polarised response in some media.

In popular, current usage, the word ‘mong’ refers to a state of being messed up, and ‘monged’ was often used as an equivalent term in the north West of the UK for being ‘stoned’ on cannabis. However, the word ‘mong’ derives from the term ‘Mongolism’ or, more accurately ‘Mongolian Idiocy’ used (formally) to describe people with Down’s syndrome up until 1961, and formally dropped by the World Health Organisation in 1965.

Having grown up with an older sister who, since the early 1960’s has been formally described and diagnosed as ‘mentally handicapped’, ‘autistic’ and ‘learning disabled’, I frequently had to endure my peers and strangers calling her ‘mongy’, ‘spaz’ or ‘retard’, or our family being stared at when my sister made some unusual (to others) gestures and movements when she was feeling happy. It was not pleasant, and was sometimes quite distressing, especially when I was very young.

Gervais’ casual use of the word ‘mong’ suggests that, in popular culture, language that is derogatory to people with learning disabilities is more acceptable (or can be used with less sensitivity) than words that are derogatory about race, or other differences.  Black people can protest about (or even appropriate) the offensive word ‘nigger’, Asians can do likewise with the offensive term ‘Paki'.  People with learning disabilities cannot protest as easily; in a sense they are more vulnerable, and make easier targets for bullies but we all have a responsibility to challenge derogatory and hate language, no matter who the target.

Gervais and his sidekick Stephen Merchant previously insulted the actress Victoria Wright who has cherubism, and they seem happy to push the limits of post modern, ironic comedy to teeter on the edge of being bullies rather than funny. Which is a shame. Whilst Gervais may not have meant to cause offence by using the term 'mong', how he positions his comedy in relation to disability and derogatory language in the future will be the acid test.

Thursday, August 11, 2011

Robbing from the vulnerable

The above video is from recent events in London. It shows a young Malaysian being simultaneously helped and robbed by a group of youths. The video was shown on the BBC news and understandably provoked quite a lot of reaction.

I felt this is quite an interesting motif to reflect upon from a broader perspective, thinking about how what was perpetrated in the video above models behaviour at other levels of society; from politics, corporate business and finance, healthcare, education and of course, the media.

Most corporations want our money, usually in exchange for junk.

Junk food that is full of additives, junk equipment that has obsolescence built in, junk insurance that is full of small print to minimise pay-outs and junk clothes, with a limited life and manufactured by people living in poverty.

Meanwhile, on a larger stage, the same deceits continue...

Children blown to pieces by  cluster bombs as democracy is forced upon populaces.

Troops killed in the name of war on an abstract concept - terror - which is in reality serving the interests of oil companies.

The muggers in the above video are simply replicating what happens routinely to us all. That young man being mugged is you. He is all of us who are being robbed under the pretext of being helped.

All the time, the rich get richer  -  last year, according to Mary Ridell writing in the Telegraph, the combined fortunes of the 1,000 richest people in Britain rose by 30 per cent to £333.5 billion.

Monday, July 18, 2011

News International and the myth of power

Lord Acton famously said that power corrupts, and absolute power corrupts absolutely. The English anthropologist and social scientist Gregory Bateson argued that power does not exist in relationship and that, in fact, it is a myth. He said, in Steps to an ecology of mind (1978) that

‘…the myth of power is, of course, a very powerful myth, and probably most people in this world more or less believe in it. It is a myth, which, if everybody believes in it, becomes to that extent self-validating. But it is still epistemological lunacy and leads inevitably to various sorts of disaster’.

Bateson’s view on power was critiqued at the time, particularly by other social scientists and therapists who felt that to deny power was to deny the experiences of abused people, particularly women. On the surface, this seemed a reasonable critique; what reasonable person could deny that an abuser has power over the abused? However, this critique misses the wider point of Bateson’s argument, which is that the conventional (erroneous) use of the term power is that of a metaphor drawn from the language of physics (along with terms like energy, force, impact and so on), which have no place in a biological, social world of information, context and meaning. Instead of thinking of power in human relationships, we would be better served by reflexive dialogue about the metaphor of power, and see ourselves as simply parts of a larger situation. For this to be necessary, both sides in a conflict would need to be proud and humble rather than arrogant.

The sort of disaster that Bateson alluded to, and that humanity is facing is, in part, linked to the self perpetuating pursuit of the myth of power. Hand in hand with the myth of power is the concept of profit. To be rich, in the conventional epistemology, is to be powerful, and therefore, to control resources is seen as an imperative by states that wish to maintain and increase power.

Noam Chomsky recently wrote (available here) ‘there is every reason to suppose that today's policy-makers basically adhere to the judgment of President Franklin Delano Roosevelt’s influential advisor A.A. Berle that control of the incomparable energy reserves of the Middle East would yield "substantial control of the world." And correspondingly, that loss of control would threaten the project of global dominance that was clearly articulated during World War II, and that has been sustained in the face of major changes in world order since that day’.

Later in this article Chomsky writes:

‘Systemic risk in the financial system can be remedied by the taxpayer, but no one will come to the rescue if the environment is destroyed. That it must be destroyed is close to an institutional imperative. Business leaders who are conducting propaganda campaigns to convince the population that anthropogenic global warming is a liberal hoax understand full well how grave is the threat, but they must maximize short-term profit and market share. If they don't, someone else will.

This vicious cycle could well turn out to be lethal. To see how grave the danger is, simply have a look at the new Congress in the U.S., propelled into power by business funding and propaganda. Almost all are climate deniers. They have already begun to cut funding for measures that might mitigate environmental catastrophe. Worse, some are true believers; for example, the new head of a subcommittee on the environment who explained that global warming cannot be a problem because God promised Noah that there will not be another flood’.

 In short, the pursuit of the myth of power with its attendant need to maintain profits and control resources has led to the loss of countless lives in the Middle East, active denial of the reality of global warming, and as I have indicated elsewhere, the abuse and misuse of ‘evidence’ in rushing through incompletely trialled medicines for the sake of short-term gain.

Relevant to the current situation with News International, Bateson (1978) also wrote

‘What is true is that the idea of power corrupts. Power corrupts most rapidly those who believe in it, and it is they who will want it most. Obviously, our democratic system tends to give power to those who hunger for it and gives every opportunity to those who don’t want power to avoid getting it. Not a very satisfactory arrangement if power corrupts those who believe in it and want it…Perhaps there is no such thing as unilateral power. After all, the man ‘in power’ depends on receiving information all the time from outside. He responds to that information just as much as he ’causes’ things to happen… it is an interaction, and not a lineal situation’.

 Clearly the Murdoch entertainment/propaganda machine has been intimately linked with, and and has been a mouthpiece for, the political/corporate elite who routinely have been committing crimes against humanity. The stone that has been lifted by the telephone hacking scandal has shed light on some worrying relationships between the elite and the media and sent all sorts of people scurrying for cover. Perhaps now is the time to challenge the world order typified by the pursuit of power by the elites.

Bateson discussed how Goebbels, the Nazi Minister for Propaganda, believed he was powerful and in control of the Nazi propaganda machine when in reality he was guided by informants (effectively Goebbels was dependent on feedback) and ultimately his belief in his control of the system ultimately led to its destruction. The arrogance and confidence of a mileau where the hacking of telephones and bribery of police was condoned (or even encouraged) would indicate that News International, like Goebbels, was lured into believing in its own 'power'.

Let us not fall into the same fallacious trap that power can be overcome with more power, but instead through humility, dialogue, persistence and by recognising our own part in this very dangerous situation.


Bateson, G. (1978) Steps to an ecology of mind. London: Paladin.
Chomsky, N. (2011) Is the world too big to fail? The contours of global order. accessed 18th July 2011.