paper presented to the 9th Conference 'MEDICINE and CULTURE', the European Society of Philosophy of Medicine and Health care, at the International Hippocratic Foundation of KOS, Greece, Sept. 20-24, 1995
(**) Note
The correct spelling for LFS is "Low Flexibility Syndrome".
Yet I maintain the original title as it has been already officially registered.
Key Words
Positive
Placebo Effect
Immuno-modulating Power
Environmental Pressure
Family Communication Patterns
As Hippocrates
taught, health care is intimately connected to cultural patterns prevailing
in society and the influence of the social environment is capable either
of increasing or decreasing the gravity of each illness. 'Today's Science'
classifies these influences of self-defending power within the ambit of
the so-called "Placebo Effect". Its mechanism shows that these influences
are acquired and not genetic; and that these emanate from a pathological
lowering of the organic immuno modulating level which is linked to the
existence of a rigid psycho dependent suggestible personality.
Hence a new illness should be identified which can be called the 'Low
Flexibility Syndrome', LFS. Lack of flexibility linked to the decrease
in self-defending power is characteristic of LFS and finds its origin
in the environmental pressure present in the family educative pattern.
Therefore, even if its therapy could be only symptomatic, the prevention
of LFS becomes possible once the inappropriate elements present in the
usual pattern of family communication are pointed out and can then be
eliminated.
So, now it is surely time that Hippocratic Medicine provided for the connections
between health and the cultural patterns prevailing in our society, the
first being the Family communication relationship. Is the ESPMH and the
IHFK ready to accept this challenge?
Already 2.500
years ago, Hippocrates taught us how to search in nature for causes of
illnesses and for principles of healing. The treatments He provided to
the sick were, moreover, warnings to them to change their living habits
and their relations with the environment:
"It is necessary for the physician not only to provide the needed treatment,
but to provide for the patient himself and for those beside him and to
provide for his outside affairs," said the Father of scientific medicine.
Now, at the beginning of the Third Millennium, today's medicine is looking
at the interrelations between humans' knowing, acting and valuing and
the cultural patterns prevailing in society as they connect with health
care[1].
Thanks to
Hippocrates, we know today that the influence of the environment on human
health can be as important as human influence on the social and natural
environment, and those who know how they interact with the environment
also know themselves and this makes their environment and their health
mutually supportive. This precise knowledge should lead Hippocrates' followers
to study the particular environment where the individual's knowing, acting
and valuing are first formed: in the Family.
Much more than teachers, Hippocrates' followers should indeed be concerned
with the very likely link between Family educative communication and health.
This is because the Family is where some social and cultural bases of
primary prevention and of health care can be found. My attempt to stress
the connection between words and health at this 'Medicine and Culture'
Conference in Kos could achieve this goal.
But, how does the connection between the social environment and human
health develop? Is it possible to systematize this very complex matter
in the light of today's knowledge, in accordance with the Laws of science
and the parameters of modern medicine? If Hippocrates' soul will help
me, I will answer this question by defining the parameters of a new illness.
The connection between social environment and human diseases is not specific. This means that the influence of the socio- environmental elements on a sick person can either increase or decrease the gravity of their eventual sickness irrespective of the type of illness. Thus the physical functions affected by the socio- environment elements belong to the general system on which the power of the organism's self-defense against any illness depends. This general self-defending power is commonly known as the "immuno modulating" power.
Magicians and Shamans have always practised the magic art of influencing for good or evil the immuno modulating level of their more vulnerable patients, and it was thanks to Hippocrates that we knew that this important factor in health defence depends on the patient and his/her environment, and not on magic or supernatural forces. Today's scientific medicine classifies such connections between self-defending power and suggestive factors within the ambit of the so-called "Placebo Effect". In the last fifty years the properties of Placebo and its negative or positive effects on the subject's physical defences were described by students like Wolf, Lasagna and Beker, Graber, Claridge, and others. Their work definitely demonstrated that the immuno power of the human body can be lowered not only by action from outside factors like HIV, but also by the action of psychological factors relating to the involvement of the subject in his/her environment [2] where negative results may include the pathological decrease of self- defending power known as the "Negative Placebo Effect".
Nevertheless, modern scientific medicine has failed to undertake a systematic study of the mechanisms which underpin the Placebo Effect, perhaps considering this as something likely to be of interest only to magicians. So our knowledge of what happens to the body when its self- defending power is decreased, comes more from studies on AIDS than from those on the Negative Placebo Effect. In particular, we still don't know clearly enough what happens when this self-defence is increased by a Positive Placebo Effect. I shall attempt to investigate this question here:
In this case,
we must first exclude the possibility that one's self-defending power
can be lifted above its natural level, because if that were possible,
we would be obliged to admit the intervention of just those supernatural
forces which Hippocrates taught us to avoid. Yet the fact of increasing
a subject's self-defending power has been conclusively demonstrated [3].
Thus it must have its source in a pre-existing condition of having first
been decreased to a level beneath its natural level. Furthermore, such
a pathological condition must be as widespread in humans as is the human
capacity to react positively to a Placebo. In western civilization, the
possibility of a positive answer to Placebo is present in nearly 70 %
of people [4], and we are drawn to believe
that this percentage could be even higher in less civilized countries.
Also, from the research of the above quoted Authors, we also know that
the more common psychological characteristics of the interested subjects
are emotionality, anxiety, suggestibility, and psycho-dependence in the
form of an unconscious aptitude for acting in conformity with others'
wishes. These behavioural characteristics mark the rigid fundamentalist
psycho-dependent personality, in opposition to the autonomous and flexible
one.
A personality which is rigidly dependent on others' consent to perform
its behavioural and believing procedures, incapable of self-realization
and self-consciousness, lacking in autonomy and adaptive flexibility,
therefore goes hand-in-hand with a decrease of the body's physical defences,
and it is just in this context that the Positive Placebo Effect can have
its effect. Thus, this definite kind of mental structure must be considered
as symptomatic of a real pathological condition, whose immediate effect
on the body is a lowering of the natural level of self-defending power.
It therefore constitutes a potential factor which underpins and aggravates
each illness in humans.
The above exposed elements allow us to determine the parameters of a definite
pathological condition. I call it "the Less Flexibility Syndrome" because
its most important symptom is a decrease in the immuno and relational
flexibility linked to a rigid psycho-dependent personality.
The origins of the Low Flexibility Syndrome are clearly of an acquired, non-genetic, nature. This assertion can be proven by the same existence of the Positive Placebo Effect which demonstrates how the decrease of the immuno level peculiar to the LFS is reversible. This could not be compatible with a genetic origin. Thus we must look for the origin of LFS in the outside environment; that is, in the acquired cultural factors ruling the formation and the strengthening of the human personality. In this way, because the neuro-psychical structure starts to take form from the beginning of life relations, the cultural factors responsible can be traced back to the first relations of educative communication; that is, to the family environment surrounding the child in its first years of life.
From my studies, I elucidate the characteristics of two different patterns in family educational communication and their function in framing the brain of the young individual. The variant which allows us to distinguish between them is provided by the more or less strong and rigid request of consent in the assistance - dependence relationship upon which the family bases itself [5].
The most
common educational pattern, which thereby must be considered responsible
for the high percentage of positive answers to Placebo, is characterized
by a strong and peremptory request for consent by the family authority
from the child; and this at the time when his/her personality is in the
process of fixing its final psychic structure. Such a request, if systematically
practiced by the parents with intense, seductive strength in that delicate
period when the child's brain is fixing its structure, constitutes the
environmental pressure which can condition the preferential recourse in
the brain to those nervous connections and circuits that are responsible
for the treatment and the execution of behavioural lines aimed rigidly
at obtaining the consent of the parental authority. And the same, vice
versa, to exclude or block the nervous channels and circuits responsible
for enforcing autonomous and dialectical - i.e. more flexible - behaviour.
Therefore we can consider LFS as the result of a definite educational
conditioning which took selective action in the beginning of the child's
life by giving rise to a particular trait in his/her brain framework.
On a behavioural level, this "brain frame" corresponds to a rigidly psycho
dependent personality, and on a physical level it corresponds to a pathological
decrease to beneath the maximum natural potential of the immuno power
of the person concerned.
Because LFS consists in a lowering of the subject's physical defences, we must first of all consider that it acts more on the intensity of the symptoms rather than on their quality.
On an individual physical level, the symptoms of LFS are therefore those of all the common illnesses whose establishment can be aided or whose course can be aggravated by the more or less immuno- depression due to the same syndrome; and that means practically every symptom of every illness.
On a psychical level, the symptoms of LFS are the manifestations of the emotional and relational sphere typical of dependent personalities and, above all, of personalities which are open to suggestion. Schizophrenia too, since it seems to have its origin in an educative conditioning based on a child's consensus answer to a parent's paradoxical requests [6], can be considered a symptom of LFS.
Finally, the psycho dependent personality is a contributory factor to drugs and medicine addiction and, indeed, of addictive consumerism [7].
The most
important effects of LFS act, however, on a social level. Here the syndrome
involves - together with the relationship of the single individual in
his environment - also the social environment because it is the sum of
single individuals' behaviour. The variety of these symptoms, the descriptions
of which can be found on the daily local and international news, is boundless,
and it is made up of a collective attitude. As we have seen, LFS concerns
about 70 % of people [4]. This collective
attitude is characterized by a sizable degree of suggestibility and a
lack of rationality in assuming all the information needed to manage collective
behaviour properly.
On a social level therefore, the presence of LFS in 70 % of people seems
to manifest itself in a rigidly conservative group which closed to inner
dialectics and to any innovative proposal even if it possesses great accordance
with reality. Obviously, the inability to give adequate and flexible answers
to the more complex environmental adaptive issues arises in such a group
and the hardening of intolerance and extreme fundamentalist positions
will result. This will inevitably accompany unsolved social issues and
a consequent decay in individual and collective health. Now the recognition
of LFS should cause this social issue to become a topic of health care
by Hippocratic Medicine.
A true aetiological
therapy of LFS cannot be proposed because it is the result of an educative
conditioning which took root in the formation of the child's brain frames
in his formative years, thus causing it to imprint itself on the childs
definitive personality and culture.
On an individual level, therapy for LFS is therefore similar to that of
current medical practice in the treating of the symptoms of different
illnesses of which the Low Flexibility Syndrome can constitute an aggravating
factor.
On a relational level, the effects of LFS are epitomized by the existential
crisis in today's society. Here, a symptomatic therapy should be applied
through culture, science and politics: it should consist of leading collective
choices towards flexible believing and behavioural attitudes which better
align with adaptation and tolerance. Furthermore, such a therapy would
be the subject of a collective choice. Now this sounds impossible because
the syndrome acts precisely upon the inter-relational system of humans'
knowing, acting and valuing by influencing the collective choices towards
fundamentalist positions of a wholly insufficient rationality and acceptance
of reality. Therefore, as regards its social effects on a collective level,
LFS in itself does not seem to be compatible with a rational symptomatic
therapy that may have any solid probability of becoming successful.
Once recognised, the substantial identity between some aspects of the educational pattern of family communication and the environmental pressure which conditions the fixing of a rigid psycho-dependent brain structure and is responsible for LFS, this conditioning can be avoided simply by the correction or the removal of the identified items. To this end, the provision of appropriate information regarding the nature and characteristics of family communication patterns which condition the building of the child's brain frame, seems to be sufficient to allow parents a better choice of pattern on which the building of a flexible personality depends [5].
The spreading of this information could obtain the twofold result of preventing the effects of LFS, both on the individual and collective levels. Indeed, the adoption of a better educative pattern seems destined to increase mental flexibility in future generations and to protect against fundamentalism and an overall tendency to addiction. This definite information would also draw the attention of the present generation to the role of flexibility in the interrelations of human knowing, acting and valuing, thus opening a path to the collective adoption of more flexible lines of behaviour and adaptation in both the natural and the social environment.
Hippocrates' teachings have never been more topical than at the current time. The human today is ill. We are traversing a very deep crisis of which we are unable to see either the beginning or the end.
This illness is due, without any shadow of doubt, to the all too scarce flexibility in humans of the use of educational means and in ignoring cultural and scientific warnings; too scarce a flexibility in performing communication relationships between people and among peoples; too scarce a flexibility in observance of the adaptive laws of the natural and social environment starting from that of the Family.
Hippocrates
taught us to look at illnesses with the eye of a naturalist. The causes
of our existential sickness, the crisis in adaptation we are facing at
the beginning of the third millennium, must also be observed in the same
way. Thus we need to recognise the nature of humankind in its relations
with the environment, and in the educational and cultural patterns of
our societies and of our families, leaving nothing to mystery, to magic,
or to the supernatural.
My proposal of defining a new pathology, the "Low Flexibility Syndrome",
according to parameters of modern scientific medicine, might perhaps give
an outline to the understanding of today's existential sickness of humankind.
At any rate, my attempt should represent a call to the Hippocratic Physician
who, in his daily healing practice, looks not only at the required treatment
but also at his patient's social environment; that is, the interrelations
of knowing, acting and valuing and the cultural patterns prevailing in
our societies which form the same nature of the individual, and his/her
health.
I would like to suggest that everybody observe more deeply the first of
these cultural patterns: the family educational one. Because of its function
as the environmental pressure which occurs just at the delicate time when
the young individual begins to build both its brain frame and its future
flexibility, the educative communication family pattern is intimately
connected with health care.
That is all.
All throughout my work, I have always tried to make more rational the
tie between health care and the family pattern of educative communication
so as to bring us towards flexibility as Primary Prevention. I would be
very pleased to consider this small contribution as my personal respect
to Hippocrates' memory. But above all, I am pleased to have been allowed
to present my concept of a connection between family communication and
human health to this ESPMH 'Medicine and Culture' 9th Annual Conference
here at Kos, where Hippocrates himself taught.
Thank you.
Antonio Rossin - at Kos on Sept. 23, 1995
1
- Marketos S.: Medicine is an aspect of civilisation, Lessons from the
Hippocratic Medicine, Microsurgery, 4-5, 1993
2 - Wolf S.: Effects on suggestion
and conditioning on the action of chemical agents in human subjects. The
Pharmacology of Placebo, J. Cl. Invest., 29, 100, 1950
3 - Bourne, R.H.: The Placebo.
A therapeutical means with scarse use and difficult understanding (Italian
transl. by S. Luciani: Le basi razionali della terapia Vol.2 n.1 pag.5,
Piccin Padova)
4 - Lasagna and Becker, A
study of the Placebo response, Am. J. Med., 16, 770, 1954.
5 - Rossin A.: Droga&Famiglia,
Zielo ed., Padova 1990.
6 - Bateson G.: Double Bind.
Toward a Theory of Schizophrenia, Steps to an Ecology of Mind, Chandler
publ., S.Francisco 1972
7 - Rossin A.: Sul nesso
tra Farmacodipendenza, Effetto Placebo e dipendenza psicologica, Bollettino
Farmacotossicodipendenze e Alcoolismo n 5/1988, Ministero della Sanità,
Roma.
Note
At the present time Antonio Rossin is working to realize an Objective-
Project aimed at improving the educative communication, focusing on parenting,
to increase flexibility in children's minds as the opposite of fundamentalism
since the Family framework.
Antonio
Rossin
Neurologist - Family Doctor
45010, Ca' Vendramin (RO)
Italy
www.flexible-learning.org
Last update: 06/17/03
