April Blog 2011


By Clive Lindley-Jones | April 5, 2011 11:31 am

Dear Friends,

We live in interesting times. No sooner has the new elbowed out the old…. then we look back with regret at the unintended consequences and try to salvage some of that loss in our otherwise headlong surge towards the new. Perhaps, just as the twentieth century was an unprecedented explosion of technological change so the twenty first century will, at least in part, be about how we balance those gains with the need to restore some of those intangible yet vital losses.  As we all live longer and there are so many more of us in the world, how will we share out the benefits equitably and find ways of paying for the advantages?

Truly a time of great promise, but deeply unsettling.

Therapist Free Therapy

Two interesting and contrasting pieces caught my eye recently… One, a piece in the Economist, on an interested future possibility for  psychological change opening up for those suffering from certain debilitating  psychological conditions, but who don’t want talking therapy or drug treatment.  Psychiatry: Therapist-free therapy As they point out;”treating disorders of the psyche is still a hit-and-miss affair, and not everyone wishes to bare his soul or take mind-altering drugs to deal with his problems. A new kind of treatment may, though, mean he does not have to. Cognitive-bias modification (CBM) appears to be effective after only a few 15-minute sessions, and involves neither drugs nor the discussion of feelings. It does not even need a therapist. All it requires is sitting in front of a computer and using a program that subtly alters harmful thought patterns“.

This seems an approach that has promise for certain conditions like anxiety and addiction, but will not replace the subtle opening up and healing that can be so beneficial in good psychotherapy for so many deep and lasting conditions.

The other piece that caught my eye was on an osteopathic web site. This was a lecture by my long time colleague and former lecturer Mervyn Waldman DO.  Now working  in two hospital pain clinics and in private practice in Israel.

His subject,  The Tragic Emasculation of British Osteopathy. Here he outlined the potentially powerful role that osteopathy can have at the bedside in acute conditions such as pneumonia or otitis media and how before the introduction of antibiotics, the osteopathic founding fathers made their considerable name from their effectiveness, not so much in minor orthopaedics but in the osteopathic treatment of acute illnesses, at a time when there was little else at hand. How they flourished and how this kind of bedside osteopathy has been tragically neglected in modern schools of osteopathy was his controversial theme. He makes a powerful case, supported by resent research,  for this, often overlooked, somatic component of disease and the mistake we make in ignoring and neglecting its full potential.

These two contrasting pieces in some ways typify our early twenty first century predicament.

On the one hand all sorts of exciting new possibilities are appearing, often released from the helms of science fiction by the new power of the micro chip to allow us to do more with technology than we could ever even imagine only a short while ago.

Smart-phone anxiety

If you had shown me, as a student,  a telephone no smaller than a pack of cards, that could, with no visible wire, connect me instantly to a map and photograph of the world that could zoom in and go right down to actual pictures of almost any street I care to look at in the world, I would not have believe such a thing possible… not even for James Bond! And yet today we have such technology.It is not surprising, nor necessarily undesirable, that Harvard university is doing a trial on smartphone anxiety treatment, iPod Touch and Android smartphones to help with social anxiety and worry.

Waldman reminds us not to neglect and forget the skills of our forefathers as we are swept along by the magic of pharmaceutical  breakthroughs. Perhaps the real challenge for us today is to balance on the middle way, welcoming the new and yet respecting and not neglecting  the old. Too often responses fall too easily into ‘all for’ or ‘all against’ camps.

Empathetic Innovation

If you can make the time, and it will be more thought provoking than many TV programmes you might spend an hour on, invest an hour of your life with innovations expert Charlie Leadbeater.  Watch his lecture, On the Secrets of Social Innovation at Scale.

He looks at our social structures and ways of doing business and suppling services and outlines the future for us where we are able to combine high systems with high empathy, just as these two examples above point to. We are at a time when we all want to mix and match the benefits of high systems such as aeroplanes, but often to give us more empathy such as in the huge success of social networks such as Facebook.

As Leadbeater points out we wobble between deep dread and great hope. A time when powerful dictatorships are crashing to the ground, in part through the use of social media. A time when so many people are desperate for a good education and yet the educational system is dysfunctional.

The same can be said for health care. We have grown up with systems that do things for us and to us. Can we envision, or create, systems that do things with us. While we all want some systems such as hospitals, most of us also want to die at home, and yet at the moment 85% of us die, too often alone, in hospitals or care homes. There is today this wobbling between monolithic systems that struggle to meet some of our needs and yet leave us with little empathy. Little of the true intangibles; which are participatory and contributory and have respect, care, relationship built into them.

The People’s Supermarket

One example is the The People’s Supermarket – Channel 4.Where people are trying to better the monolithic success of the four major supermarkets that dominate the UK food market and have come to ruthlessly shape our agriculture. The People’s Supermarket – A Supermarket For The People By The People. It is a struggle to find the balance between the fiercely efficient cost cutting of the giants and the empathy and value of the small cooperative.

So we can hope that the true future of medicine, as the old innovation model of the pharmaceutical industry is bust, is less about the new wonder drug to help diabetes but rather systems of support, supply and education that help us avoid diabetes in the first place. In other words, not just delivering stuff, in this example drugs, to people, but helping us lead better lives and have more empathetic deaths.

Film of the Month

Inside Job

Directed by Charles Ferguson

This month we eschew books and befitting this months theme, we focus on this years Oscar winning documentary about the recent banking crisis.

It is, as Philip French says in The Observer, truly jaw dropping. With no gimmick , and mostly talking heads, somehow this powerful film managed to go over the miserable ground of the great crash of 2008 and still turn up new ground and insight. Ferguson has chosen to focus mostly on the shenanigans of the New York side of he crash, and the peccadilloes and evils of Wall Street, no doubt much the same film could have been made in London.

Most potent of Ferguson’s  careful analysis is the way that he so expertly eviscerates those well paid, in his case US based, economists, from ivy league colleges like Harvard and Columbia, who for an undisclosed price lent their names, prestige and supposed academic objectivity, to shore up the unpardonable, reckless and unsustainable things that were being done with trillions of dollars of your, mine and everyone else’s money. Everyone else that is, who wasn’t a highly paid senior banker or economist.

And so Ferguson expertly and surgically exposes the colluding and colliding elites who when they were willing to go on camera like Glenn Hubbard, Bush’s former economic advisor, became irritable and secretive when questioned deeply as to their role and their profits from this gargantuan cock up.

It is not for nothing this has been called one of the most entertaining, as well as important, pictures of the year.