Tag Archives: doctor

The power of trust

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“If you want to go fast, go alone. If you want to go far, go in a team.” ~ African Proverb

Melbourne … rain.  It’s so cliché, but here I am in Melbourne, staring out at the dismal misty greyness enveloping the city, displacing all warmth and joy.

Perhaps it was the dreariness combined with the light stupor that comes from being in a meeting all day, but as I was watching the incessant drizzling, I drifted into a contemplative trance, pondering the power of water.

By itself, one drop of water can do very little.  No one notices the effect of one drop of rain.  Though with more and more drops comes more and more change.  Wet ground grows puddles, then tiny rivulets, then streams of water which, when they combine, can form a raging torrent strong enough to change entire landscapes in a day.

And then I wondered, what allows something so individually weak to be so forceful en masse?  I don’t want to sound like a B-grade motivational speaker, but I think this is so important for any single person or organisation that wants to achieve anything of significance.

There are two properties that give a stream of water its power.
* A common direction
* A strong bond

As the sheer might of a violent surge so aptly demonstrates, there is immense power when small drops all combine to move together in one direction.  Yet the former property is only possible because of the latter.  Without the strong molecular bonds between them, water molecules would simply dissipate, along with all of their power.

So how can we apply this analogy to an organisation?  Well, if an organisation wants to be successful in achieving whatever plans it has, each part of that organisation needs to be moving together in the same direction.

Ok, that’s rather trite, but bear with me, because my cathartic discourse isn’t about the power of common direction, but about the bonds that confer the power to the forward momentum.

The molecular bond of any powerful organisation is trust.

Stephen Covey wrote that, “Trust is the glue of life. It’s the most essential ingredient in effective communication. It’s the foundational principle that holds all relationships.”

Peg Streep, writing in Psychology Today, wrote, “Trust is the foundation of all human connections, from chance encounters to friendships and intimate relationships. It governs all the interactions we have with each other. No one would drive a car or walk down a sidewalk, or board a train or an airplane, if we didn’t ‘trust’ that other people took their responsibilities seriously, and would obey whatever rules applied to the endeavour at hand. We trust that other drivers will stay in their lanes, that conductors and pilots will be sober and alert. And that people will generally do their best to discharge their obligations toward us. Culture, civilization, and community all depend on such trust.”

Trust means that we have confidence in the intentions and motives of others.  For example, patients trust doctors because they have confidence that the doctor knows what they’re doing and has the patient’s best interest at heart.  A recent meta-analysis showed that patients were more likely to have more beneficial health behaviours, less symptoms, higher satisfaction with treatment and a higher quality of life when they had higher trust in their doctor.  Trust enables positive progress.

Trust brings cohesiveness organizationally as well as socially.  If employees don’t trust each other or their managers then all sorts of problems start to arise: collaboration and communication stagnates, innovation ceases, employee engagement declines, productivity falls, and in general the workplace becomes unsuitable to be around.

Paul J. Zak is a neuroscientist that has studied the neuroscience and value of trust in the employees of Fortune 500 companies and in mountain tribesman.  His data shows that employees who feel trusted perform better at work, stay with employers longer, and are significantly more innovative.

In order to foster trust, organisations have to build confidence in the intentions and motives of others – between workers and managers and between the workers themselves.  When you have the confidence that your co-workers are going to pull their weight and do their jobs, it makes it easier to get on with yours.  When you know management aren’t going to make arbitrary, selfish or irrational decisions, it’s much easier to follow their lead.

So how do you build trust within a relationship or an organisation?  There are many ways to inspire confidence, but conflict resolution expert, Dr Aldo Civico suggests five different strategies:

  1. Trust generously – or in other words, trust first.
  2. Be patient and flexible. Trust is built over time.
  3. Be dependable and be reliable. Take your own words very seriously. Don’t make up excuses, take responsibility for mistakes.  Don’t be afraid to apologise.
  4. Be consistent.
  5. Be open and transparent in your communication. Don’t undermine or backstab.

The rain has stopped here, now it’s just cold!  I hope that you can grow trust in within your organisation so that you and your team can move forward with strength and purpose.

Bibliography

Streep, P., (2014) “The Trouble With Trust”, Psychology Today, https://www.psychologytoday.com/blog/tech-support/201403/the-trouble-trust

Birkhäuer J, Gaab J, Kossowsky J, Hasler S, Krummenacher P, et al. (2017) “Trust in the health care professional and health outcome: A meta-analysis”, PLOS ONE 12(2): e0170988. https://doi.org/10.1371/journal.pone.0170988

Smallwood, A., (2017) “This neuroscientist says work culture can’t thrive without trust”, Collective Hub. https://collectivehub.com/2017/06/this-neuroscientist-says-work-culture-cant-thrive-without-trust/

Civico, A., (2014) “5 Strategies to Build Trust and Increase Confidence”, Psychology Today, https://www.psychologytoday.com/blog/turning-point/201404/5-strategies-build-trust-and-increase-confidence

 

Dr Caroline Leaf and Testimonials – Good marketing, poor evidence

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Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. She is a pseudoscientist of the highest order. She once wrote a PhD. Now she has episodes of her TV show titled “Surviving cancer by using the Mind”.

This weeks edition of her newsletter started off with some subtle boasting:

“We have received many E-mails over the past years asking for Testimonies with regards to Dr Leaf’s research and teachings. We have summarized eight pages of testimonies received at TESTIMONIES. Be encouraged and feel free to refer them to friends, family, acquaintances, and work colleagues struggling with Mind issues.”

Testimonials are an empty box wrapped in shiny paper and trimmed with a bow. They look really good but offer nothing of substance. They’re simply an old advertising trick.

According to the Market Science Institute, “Testimonial solicitations – in which firms solicit consumers’ personal endorsements of a product or service – represent a popular marketing practice. Testimonials are thought to offer several benefits to firms, among them that participating consumers may strengthen their positive attitudes toward a brand, through the act of writing testimonials.” [1]

Who can argue with a person who says that Dr Leaf helped turn their life around? Saying anything negative just makes you sound like a cynical old boot.

And that’s the real problem, because while publishing a whole bunch of positive stories is good for marketing, it makes it very hard for those who had a genuinely bad experience to say anything. No one wants to listen to those people whom Dr Leaf has confused or mislead – it makes for terrible PR. Those people feel devalued, and sometimes worse, because it seems like everyone else had a good result from Dr Leaf’s teaching, except them.

Testimonials also make for very poor scientific evidence. Indeed, testimonials are considered the lowest form of scientific evidence [2]. It’s all very well and good for a bunch of people to share their positive experiences, but as life changing as the experience may have been, they are not evidence of the effectiveness of Dr Leaf’s teaching. Without specific, well-designed research, no one can say if the testimonials Dr Leaf is publishing are the norm. Recent research demonstrates that self-help literature for depression may not have any benefit over a placebo treatment [3]. So it may be that any improvement attributed to Dr Leaf’s teaching was actually the placebo effect. Dr Leaf can list testimonials until she’s blue in the face, but that doesn’t prove that her work is scientific or therapeutic.

Indeed, selectively publishing testimonials is duplicitous, telling half-truths, positively spinning her own story. How many e-mails has Dr Leaf gotten from people who have found her teaching inaccurate, ineffective, unbiblical or harmful? Dr Leaf’s social media minions deliberately delete any negative comments and block anyone from her sites that disagree with her. And over the years, many people have shared with me how arrogant and dismissive her team has been to polite, genuine concern or criticism. I can personally attest to the same treatment. If Dr Leaf was honest with her followers, she would be openly publishing the brickbats as well as the bouquets.

For her readers and followers, the testimonials need to be seen for what they are: just individual stories. Sure, we should rejoice with those who are rejoicing (Romans 12:15), and so good for those who feel Dr Leaf has helped them. But they do not constitute evidence for the therapeutic efficacy or scientific integrity of the work of Dr Leaf.

For people genuinely struggling with “mind issues”, the last thing they need is testimonials collated by Dr Leaf’s marketing team.  They don’t need to be referred to Dr Leaf’s work, they need to be referred to psychologists and doctors.

And if Dr Leaf really wanted to prove her legitimacy, she would rely on independent peer-reviewed published research, not on the list of vacuous, self-serving cherry-picked testimonials that she is currently offering.

References

[1] Marketing Science Institute. Consumer Testimonials as Self-Generated Advertisements: Evaluative Reconstruction Following Product Usage. [cited 2014, Aug 3]; Available from: http://www.msi.org/reports/consumer-testimonials-as-self-generated-advertisements-evaluative-reconstru/.
[2] Fowler, G., Evidence-based practice: Tools and techniques. Systems, settings, people: Workforce development challenges for the alcohol and other drugs field, 2001: 93-107
[3] Moldovan, R., et al., Cognitive bibliotherapy for mild depressive symptomatology: randomized clinical trial of efficacy and mechanisms of change. Clinical psychology & psychotherapy, 2013. 20(6): 482-93

The confused teaching of Dr Caroline Leaf

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Dr Leaf released her latest e-mail newsletter today.  I decided to follow up with a brief review of this week’s instalment after her last e-mail newsletter completely misrepresented Ephesians 4:16, the function of the hypothalamus and the effect of stress on the population,

Dr Leaf was true to her usual form.  Her fundamental assumptions remain subtly skewed, forcing each layer of argument into an unbalanced and unstable alignment, and the more she tried to justify herself, the more unstable her arguments became, until eventually they toppled.

There was the obligatory dig at the medical profession, another smug ad hominem dismissal claiming that doctors have ‘negligible training in nutrition’, so doctors don’t understand the ‘whole approach’ that Dr Leaf and other so-called ‘progressive’ food thinkers have.  In reality, doctors have a lot of nutritional training, a darn-sight more than communication pathologists and self-titled cognitive neuroscientists.

And again, Dr Leaf demonstrates her paucity of knowledge or respect for the scripture by again misquoting Proverbs 23:7.  You don’t need to be a Biblical scholar to be able to read a verse of scripture in context, and in context, “as he thinks in his heart [mind], so is he” has got nothing to do with our mind or our thoughts (as I’ve discussed before https://cedwardpitt.com/2015/05/30/dr-caroline-leaf-manhandling-scriptures-again/).

But the critical error which invalidates Dr Leaf’s essay this week is the intellectual dissonance she creates by making two paradoxical claims.

“Your mind, or soul, has one foot in the door of the spirit and one foot in the door of the body. The mind creates coherence between the spirit of man and the body of man, and therefore influences and controls brain/body function and health, and influences spiritual development. Your mind, with its intellectual ability to choose and its emotional authority, controls all physical aspects.”

and

“Fasting has been shown to enhance brain function, and reduce the risk factors for coronary artery disease, stroke, insulin sensitivity and blood pressure. For instance, restricting calories can support the induction of sirtuin-1 (SIRT1), an enzyme that regulates gene expression and enhances learning and memory.”

Essentially, Dr Leaf is saying in one breath that the mind is separate to the physical brain but controls all of the function of the physical brain and the body, but then moments later says that changes in the body alters the function of the brain which then alters the function of the mind.

So which is it?  You can’t have it both ways?  It’s impossible for the mind to control all physical aspects of the brain if the mind is vulnerable to changes in the brain and body.

The dilemma of Dr Leaf’s mind-brain paradox stems from her defective set of assumptions on the triune being.

“You are intrinsically, brilliantly, and intricately designed with a spirit, soul and body (Genesis 1:26; 1 Thessalonians 5:23). This is known as our triune nature.  Our triune nature is divided into different components. Your spirit is your ‘true you’, or what I call your PerfectlyYou. The spirit has three parts: intuition, conscience and communion (worship). Your soul, which is your mind, also has three parts: intellect, will and emotions. Lastly, your body has three parts: the ectoderm, mesoderm and endoderm, from which the brain and the body form.”

Dr Leaf’s ideas about the triune being are Biblically and scientifically tenuous—more conjecture on Dr Leaf’s part than hard science or solid theology (Read here for more information on this https://cedwardpitt.com/2014/07/25/dr-caroline-leaf-dualism-and-the-triune-being-hypothesis/)  Yet she bases her entire ministry on these shaky assumptions, cherry picking studies and manipulating facts to suit her arguments and ignoring the glaring contradictions that inevitably arise.

So Dr Leaf’s latest offering to her followers again demonstrates the confusion and contradiction that plagues her teaching—layer upon layer of cherry-picked factoids manipulated to prop up her tenuous assumptions. Dr Leaf would do better by listening to scientists and doctors rather than arrogantly dismissing them.

Dr Caroline Leaf and the Myth of Mind Domination

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“You control your brain … your brain does not control you!”

So says Dr Caroline Leaf, Communication Pathologist and self-titled Cognitive Neuroscientist.

You’d hope that Dr Leaf would know. She says on her website that “Since the early 1980‘s she has studied and researched the Mind-Brain connection.” And if you take what she says at face value, it sure sounds right. Of course we’re in control. My brain does what I tell it to do. Except that it actually doesn’t. Our brain has a lot more control over us than we realize.

First of all, our “free” will isn’t actually free at all, but constrained by a number of unseen, subconscious processes that are entirely dependent on our brain. It may seem like we’re in complete control of our choices, but our subconscious brain has already done most of the work for us. Even if we had complete freedom over our choices, our “free” will would still require an intact brain in order to carry out its wishes.

The “control” of our brain is very similar to our “control” when we drive a car. When we say that we’re “controlling” the car, what we actually mean is that we are controlling the speed and direction of the car. But there are thousands of electrical and mechanical actions that take place each second that are vital for the running of the car, and that we have absolutely no direct control over. It just takes one loose nut or faulty fuse to make the car steer wildly out of control, or stop functioning entirely, and then we’re not in control at all.

In the same way, various diseases or lesions in the brain show that brain is really in control. The fact we don’t see all of the underlying processes in a fully functional brain simply provides the illusion of control.

For example, there are a number of lesions of the parietal lobes within the brain that give rise to some unusual but intriguing conditions. One of which is a condition called “Alien Hand Syndrome”. Wegner describes two patients with Alien Hand Syndrome, a lady whose “left hand would tenaciously grope for and grasp any nearby object, pick and pull at her clothes, and even grasp her throat during sleep … She slept with the arm tied to prevent nocturnal misbehavior”, and a man who, “While playing checkers on one occasion, the left hand made a move he did not wish to make, and he corrected the move with the right hand; however, the left hand, to the patient’s frustration, repeated the false move. On other occasions, he turned the pages of the book with one hand while the other tried to close it; he shaved with the right hand while the left one unzipped his jacket” [1]. Alien Hand Syndrome demonstrates that our decision-making and our action sequences are controlled by two separate systems in our brains.

There are other conditions that also show that our brains control us more than we control them. A more common example are the tic disorders, such as simple motor tics (sudden involuntary movements) and complex tic disorders, such as Tourette’s (best known for the involuntary tendencies to utter obscenities). Even more common are parasomnias – a group of disorders in which people perform complex behaviours during their sleep – sleep talking, sleep walking, sleep eating. One of my patients once drove her car while asleep (Honestly, that’s no exaggeration!).

So at best, we only have partial control of our brain. Our brain is driving, our mind just steers it a little, but it doesn’t take much for that veneer of control that we think we possess.

The other way in which we appear to have control over our brain is through free will. Free will has been debated for years on philosophical grounds, but over three decades ago, Libet performed an experiment that demonstrated measurable and predictable brain activity occurring up to a full second before a test subject was consciously aware of the intention to act [2]. More recently, a study by Soon et al showed that predictable brain activity occurred up to eight seconds before a person was aware of their intention to act [3]. As Bonn says, “the gist of these findings is that our feeling of having consciously willed an act is illusory in many ways. It seems that the conscious awareness of intention that we place so much weight upon, that we naively think of as causal, is, in fact, a narrative construction that is formed well after the train of causation has been set in motion.” [4]

The Oracle explained it to Neo, “… you didn’t come here to make the choice. You’ve already made it. You’re here to try to understand why you made it.” (Matrix Reloaded, 2003)

Haggard concludes, “Modern neuroscience rejects the traditional dualist view of volition as a causal chain from the conscious mind or ‘soul’ to the brain and body. Rather, volition involves brain networks making a series of complex, open decisions between alternative actions.” [5]

This does not eliminate our capacity to choose, but frames it in a more realistic fashion. As Bonn points out, “Although we are not consciously aware of what is going on at every stage of the chain of neural events leading to action, there is room for a degree of conscious involvement if only to pull the emergency brake before it is too late. Thus, although it may not be the initial source of motivations and behavioral impulses, the part of the mind that is self-reflective; that can envision the self in causal and narrative contexts, may serve important monitoring and control functions.” [4]

Again, we have less control over our brain than we realize. We feel like we have made a choice, but more often than not, our brain already made the choice for us up to eight seconds beforehand, and the feeling of intention that we have is simply our conscious mind catching up – not making the choice, but finding a reason for why we made the choice.

It’s always nice when people who call themselves neuroscientists tell us what feels intuitively correct. In the cold, hard light of day, actual neuroscientists don’t tell us what’s intuitively correct, but what’s actually correct. It may seem like our mind is in control of our brain, but modern neuroscience confirms that our brain is the dominant force, while our mind just helps to steer a little.

References

  1. Wegner, D.M., Precis of the illusion of conscious will. Behavioral and Brain Sciences, 2004. 27(5): 649-59
  2. Libet, B., et al., Time of conscious intention to act in relation to onset of cerebral activity (readiness-potential). The unconscious initiation of a freely voluntary act. Brain, 1983. 106 (Pt 3): 623-42 http://www.ncbi.nlm.nih.gov/pubmed/6640273
  3. Soon, C.S., et al., Unconscious determinants of free decisions in the human brain. Nat Neurosci, 2008. 11(5): 543-5 doi: 10.1038/nn.2112
  4. Bonn, G.B., Re-conceptualizing free will for the 21st century: acting independently with a limited role for consciousness. Front Psychol, 2013. 4: 920 doi: 10.3389/fpsyg.2013.00920
  5. Haggard, P., Human volition: towards a neuroscience of will. Nat Rev Neurosci, 2008. 9(12): 934-46 doi: 10.1038/nrn2497

 

The end of the sugar obsession?

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I was flicking through Facebook this evening as I usually do, hoping to vicariously share someone else’s joy in life, when I came across this little tidbit, “You know what? Don’t quit sugar.”

The link was to a blog on mamamia.com.au (http://www.mamamia.com.au/health-wellbeing/you-know-what-dont-quit-sugar/) which asked if the tide of the quit sugar obsession was starting to recede.  It discussed the recent post of Sarah Wilson, a journalist for Fairfax and the author of several books on quitting sugar, which have become immensely popular by tagging on the coat-tails of David Gillespie’s “Sweet Poison” books.

In her blog, Wilson confessed to a barely forgivable sin of giving in to peer pressure and eating two chocolate croissants, then emotionally self-flagellating for the rest of the day.  That the symptoms that she described fitted nicely into the category of an anxiety neurosis didn’t seem to register with Wilson, who carried on like she had ingested a large goblet of hemlock.

Credit to the mammamia team who published some of the comments of real nutritionists like Cassie Platt, and eating-disorder counsellors like Paula Kotowitz, who said,

“Being harsh on ourselves, not only does not help, but makes us feel so much worse in the long run because it deconstructs our sense of self and causes us to beat up on ourselves. Isn’t it possible that there is a happy medium in there somewhere? It’s not crack. Just food.”

Platt, who is about to release a book titled, “Don’t Quit Sugar”, says,

“Your food choices should be based on biological and metabolic needs. What we eat should fuel our cells, facilitate growth, repair and reproduction and, most importantly, enable your body to function at its very best.”

Platt said that she has previously tried removing sugar from her diet and that she had to “claw” her way back to health.

The mamamia writing team summed up by saying,

“The benefits of reducing sugar intake are widely accepted in the scientific community but the idea of avoiding it altogether remains an issue of serious contention. And the possibility that these sorts of diet programs can mask dangerous eating disorders, is particularly worrying.”

They asked the question, “Has the sugar-quitting backlash begun?”  For the love of all things sacred, I seriously hope so.

About a month ago I wrote a piece about the quit sugar fad, and posted evidence that eating an extremely low carbohydrate diet is no better than eating a low fat diet, because it’s calories, not sugar, that makes all the difference to weight gain or loss.

A balanced, low calorie diet has been pushed by nutritionists and doctors ad nauseum for decades, but consistently neglecting to use words like “poison”, “toxin” or “death” has meant that the message is nowhere near as stimulating as the current whim.

Is it possible to have your cake and eat it too?  Absolutely.  My hero of nutritional science, Dr Rosemary Stanton, spoke at a Brisbane conference a couple of years ago and succinctly debunked Gillespie, Wilson and their ilk.  She also explained the concept of feasting, the long forgotten art form of having exceptionally good food once in a while, and enjoy it with friends, rather than eating substandard food every day by yourself, which is the modern trend.

Rather than gorging on sugar every day to compensate for your loneliness and despair, Dr Stanton advocated a diet high in vegetables and little or no processed food on a daily basis.  But then once a month or two, she advised to enjoy your favourite food, no matter what it might happen to be – cheesecake, ice cream, chocolate croissants – anything you like.  The only rules were to make sure that it is really good quality, the best that you can afford, so that it is worth savouring and looking forward to next time, and enjoy it with friends, since the social aspects of the food we eat are as important as the nutritional value.  Sage advice from someone who has been researching nutrition for longer than I’ve been alive.

I’m sure that by now, Sarah Wilson will have got over her sugar intoxication.  She may not have enjoyed it, but I hope that ends up being a pivotal moment in correcting the imbalance in our relationship to sugar, and living by the facts, not the latest fad.