Leonardo Da Vinci - View Of A Skull c.1489 (Pen and Ink), Galleria dell’Accademia, Venezia

I spend a lot of time talking at schools about life, money, careers, and yes, health. I know it is next to useless to say to a teenager “Don’t Do Drugs!” - however, show then MRI scans of damage to the hippocampus from ecstasy use, or current statistics of early onset Alzheimer’s in chronic cannabis users, or psychiatric statistics of drug involvement in teenage schizophrenia and manic / depressive behaviour, or finally, amputees testimonies from collapsed veins cutting off circulation and how they just got started with gateway drugs, and yes, you get some interest.

So a little science regarding the incredible dangers of anorexia on the system is justified occasionally. The research lead by Dr Miriam Bredella, and presented at the Radiological Society of North America last weekend is compelling. Bone isn’t just there to hold up the muscle and stop us looking like a big pancake; it is essential for disease management, renewal of red and white blood cells, and for posture.

The damage to looks as well as the immune system is seriously dangerous, and even irreversible. Given that the largest source of fat in the human body is not our behinds but our brains. The body must have fat to survive and grow. It will take it from the last available source: the brain. Teenage brains are plastic; this means they are growing and changing, depriving the brain of its base composite has horrific effects on intelligence, IQ, careers, and emotional lives. Awful. Now we are seeing that the same is true for bone structure.

We need to find a way to get beyond media imaging into pictures of health and that starts with education. Hope it helps.

Children and teenagers with even mild cases of anorexia exhibit abnormal bone structure, according to a new study appearing in the December issue of Radiology and presented at the annual meeting of the Radiological Society of North America (RSNA).

“Adolescence is the most critical period for growth of bone mass, and the onset of anorexia interferes with that process,” said Miriam A. Bredella, M.D., musculoskeletal radiologist at Massachusetts General Hospital and assistant professor of radiology at Harvard Medical School in Boston. “Impairment of bone development may permanently alter bone structure and increase the risk of fractures and osteoporosis in adult life.”

Anorexia is an eating disorder characterized by emaciation, distorted body image and intense fear of gaining weight. People with the disorder are obsessed with weight control and often perceive themselves as overweight, even when they are dangerously thin. The disorder primarily occurs among young women and affects one in 100 adolescent girls, according to the National Women’s Health Information Center.

Among the many health problems associated with anorexia is bone loss. Typically, dual energy x-ray absorptiometry (DXA) is used to test bone mineral density in adolescents with anorexia.

Dr. Bredella and colleagues set out to determine if alterations in bone structure occur before significant decreases in bone mineral density become evident.

The researchers used high-resolution, flat-panel volume computed tomography (CT) and DXA to study 10 adolescent girls, age 13 to 18, with mild anorexia and 10 age-matched girls without the disorder. The new, high-resolution CT exam allowed the researchers to identify differences in bone structure between the patients with anorexia and the healthy controls, whereas bone mineral density measurements obtained using DXA did not.

The results showed that while there was not a significant difference in bone mineral density between the anorexic patients and the healthy control group, there were significant structural differences, indicating that changes in bone structure begin to occur in anorexic patients well before decreases in bone density.

“Our data suggest that reassuring values of bone mineral density obtained using DXA may not reflect the true status of bone structure in this undernourished population,” Dr. Bredella said. “In patients with anorexia, bone structure should be analyzed to detect abnormal bone health. Flat-panel volume CT allows the examination of bone at high resolution with relatively low radiation exposure making it a suitable technique for evaluation of bone structure in adolescent patients.”

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Article adapted by Medical News Today from original press release.
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“Distal Radius in Adolescent Girls with Anorexia Nervosa: Trabecular Structure Analysis with Very High Resolution Flat-Panel Volume CT.” Collaborating with Dr. Bredella on this paper were Madhusmita Misra, M.D., Karen K. Miller, M.D., Ijad Madisch, M.D., Ammar Sarwar, M.D., Arnold Cheung, M.D., Anne Klibanski, M.D., and Rajiv Gupta, M.D., Ph.D.

It is good to be asked back again.

When the people asking are a branch of the United Nations then it is a definite privilege and an honour.

I had a great morning with 85 post-graduate students, from a very wide range of nations including China and Hong Kong, South Korea, Thailand, Vietnam, Cambodia, Tanzania, Gambia, Nigeria, Lebanon, Palestine, Egypt, Malawi, Mauritius, Sri Lanka, India, Pakistan, Ecuador, Peru, Latvia, and even from here in Sweden. (My apologies to those who represent countries I may have left out). Many are women. And all are exceptional.

All have been chosen by their governments, companies, and organizations to do the courses in advanced marine management. I was invited to compliment the academic with a healthy dose of leadership training. Rather tahn adopting a command-control or technical model I talked on Authentic Leadership. We had a blast.

I am very grateful to academic dean, Prof. Patrick Donner, and to all his students, for their efforts. Honestly this is why I work: to have so many people from so many nations on one site like the World Maritime University is a wonderful opportunity to talk about what leadership is becoming and how we achieve changes that will improve both work and life in the modern world.

You may think that you’re a pretty positive person. But we’re betting no matter how hard you try, you wouldn’t be able to out-happy Matthieu Ricard, a French Buddhist monk who’s been nicknamed “the happiest man on earth.”

Seem like a stretch? We’re not just claiming that title based on the fact that Ricard is never seen without a smile, or that monks are generally a pretty beatific bunch – he’s got science on his side, too. In 2004, researchers at University of Wisconsin conducted a study on the brain patterns of hundreds of volunteers from different walks of life. The bell curve of the MRI measurements fell between +0.3 (a Sylvia Plath acolyte, no doubt) to -0.3 (Richard Simmons, perhaps?). But Ricard alone achieved an astonishing score of -0.45 – a level of joy so far above the others that his score was nearly off the chart.

So how did Ricard become the world’s happiest man? The 60-year-old monk didn’t always live a quiet life in the Himalayan mountains – as a young man, he was lauded as one of the world’s most promising biologists. But in 1972, he dropped out of the stressful world of French academia, trading in his laboratory for a monastery in Darjeeling, India, where he studied under Tibetan master Kangyur Rinpoche. In the years since, he has become well known as an author and photographer, and he serves as the Dalai Lama’s personal translator in France. He has devoted his life to the study of Buddhist philosophy and the art of happiness – and he firmly believes that the rest of us can achieve his incredible level of joy, too.

“The mind is malleable,” Ricard told The Independent. “Our life can be greatly transformed by even a minimal change in how we manage our thoughts and perceive and interpret the world. Happiness is a skill. It requires effort and time.”

To fill your life with joy, he said, you must recognize what already makes you happy, and work to change your mental balance. “You have to identify what it is in that situation that makes you happy. It’s as though you’re making a journey, and you look in your rucksack to find it half filled with provisions, half with stones. You need to take out the stones and put in more provisions.”

In his new book, Happiness, Ricard serves as your own personal cross-trainer in the art of happiness, with advice on meditative exercises to increase peace of mind, and his own philosophies on how to fill your life with joy. With his help, you might just be able to tune out your noisy neighbor’s Metallica cover band for a few minutes, and imagine you’re relaxing on a private beach instead. If you can’t make it out to visit a Buddhist monastery any time soon, his book might just be the relief you need.

<a href=http://www.ted.com/index.php/talks/view/id/191>Here</a> is video of Ricard speaking at the 2004 TED conference.

Day Two: Expectations And Realities - Getting To Grounded Work

Having seen on Day One that psychology could be applied successfully in organizations, today I want to look at a couple of the biggest movements in work psychology that arose out of work psychology rather than management thinking.

The first led to the OD movement, Organization Development began with action. Two types of action: Action Research and Action Learning. In a sentence both emphasize self-awareness as the key to organizations developing a strategic edge over the competition and to sustained growth and the strength to cope with change and when things go wrong.

Kurt Lewin [1890 - 1947]

Action Research was the child of one of the most brilliant minds ever in psychology, Kurt Lewin. Lewin was simply a brilliant mind, and a very good scientist. Many attribute the growth and impetus of social psychology and organizational psychology to him, and he influenced many outside of his specialist areas with his ideas and thinking.

The most famous example being his work on genidentity, also known as counterpart theory, that looks a the commonality between physics and biology to explain how objects arrive to be as they are - and whether they remain the same when the original materials are gone - for example, new cells in the human body, or the famous logic puzzle of the Ship of Thesus, where all parts of the ship are replaced - is it still the same ship? Fpr physicists these are important questions. It was no doubt this line of thought that seems to have turned Lewin from being a behavorist to a gestalt psychologist.

Behavorism initally looks very promising in psychology. It was, by far, the most influential movement in lab and experimental psychology in the early parts of the twentieth century, especially in America. Behavorism relies on scientific evidence, observation, and denies subjective experience. It you can’t produce the same result again it ain’t valid.

The only problem with this is that much of what psychology deals with: why do we think about things differently, what is the mind, why do we make decisions differently etc; are subjective.

Franz Brentano [1838 - 1917]

This gave rise to the Gestalt school in Berlin with its roots in Franz Brentano’s very influential lectures in Vienna from 1874 - 1895. Among Brentano’s circle that he is known to have directly influence include his most famous student Sigmund Freud, as well as the founder of anthroposophy Rudolph Steiner, the originator of the phemenology school, Edmund Husserl, which stated that all we know about the world is how our mind’s experience them, and the originator of the idea of the Gestalt, Christian von Ehrenfels. Bretano’s idea that the relation between the mind and the outside world is the relationship of the human condition was a hugely influential one.

Christian Von Ehrenfels [1859 - 1932]

Von Ehrenfels’ idea of the gestalt, along with Husserl phenomenology, found a champion of his cause in Max Wertheimer with is two of his colleagues Wolfgang Köhler and Kurt Koffka at the University of Frankfurt in 1912. Wertheimer began by looking at the phenomenon of human sight and light and kept wondering how we are able to piece together images from patterns rather than the whole.

Max Wertheimer [1880 - 1943]

These three went on to establish the Gestalt movement in Berlin. (Not to be confused with gestalt therapy also called empty chair therapy.) Wertheimer has read Ehrenfels’ work where the term gestalt (Literally: form) was coined to mean that sum of the whole is not only greater than its parts, but is also not simply put together in sequence, like say a computer, but rather arises organically from all directions. While juxtaposed to this, but in conjunction, structure does make up wholeness. It was influential thinking that and eventually would lead to cognitive psychology replacing behavorism..

In his own words:

“The basic thesis of gestalt theory might be formulated thus: there are contexts in which what is happening in the whole cannot be deduced from the characteristics of the separate pieces, but conversely; what happens to a part of the whole is, in clearcut cases, determined by the laws of the inner structure of its whole.”
Social Research, 11 (translation of lecture at the Kant Society, Berlin, 1924).

Gestalt was obviously a pretty useful way to think about how the mind and brain work. It was also a way to think about synergy and our social interactions in groups and organizations as surely the whole idea of the effect of an organization is to achieve something greater than the sum of the parts. It is also very sueful in problem solving as it asks who the parts relate to the whole, and how the whole relates to the parts; it also considers the gaps to be important

So back to Kurt Lewin.

Lewin had begun as a behavorist, but found in Gestalt what he had been missing: why groups work. He argued that group work should be better than it was, that group work should produce results, and that with self-awareness the group should get better and better at what they do.

Lewin began by looking at what stops us achieving our goals. He developed the idea and called it force field analysis. Asking what forces were stopping or helping us to go from our current state to our desired state helped groups to see the invisible problems more clearly - but identifying the problems alone wasn’t enough.

Lewin had the gumption to ask what about the people themselves? Aren’t we as often as not ourselves responsible for creating the force fields, for putting barriers in the way and making life difficult for the group?

Here, force field analysis helped, but the fact remained that though we see the fault in others easily we are slow to acknowledge it in ourselves.

The issue is not just how to tell someone what they need to do to change, or even get them to listen and understand that, the problem is to keep working with them effectively afterwards.

So Action Research.

Action research is a way of framing group work that allows people to create a learning environment, or in Lewin’s phrase a “community of practice”, it is both problem solving and a strategical tool that allows organizations to become more self-aware.

How does it work?

Well, it works on a learning loop. Loops are common in quality: plan, act, check, re-evaluate, we learn as we’re doing. They range from a simple plan-check-do cycle to more advanced cycles like Six Sigma and OODA loops. The latter helped fighter pilots to predict likely behavior of enemy pilots in Vietnam, six sigma developed by motorola reduces error to six parts or less in a million, handy in manufacturing.

Lewin coined the term feedback from electrical engineering to mean constructive criticism. More than that though action research is about building a non-judgemental culture in an organization where people genuinely listen to each other rather than simply pushing their viewpoint.

From the IDEAS site

Let us now cross the Atlantic to Britain.

And Reg Revans.

Reg Revans [1907 - 2003]

Revans was originally an astrophysicist studying with both Rutherford and Thompson at the Cavendish Laboratories at Cambridge University. I am lucky enough to have met those who knew Revans well, and the most common trait I have heard is that he was genuinely a humble man. He chose to leave his work in Cambridge to move instead to the Essex education board as he was convinced that he was an educator. He went on to beome the director of education between 1945-1950 of one of Britain’s largest employees: the National Coal Board.

While there he developed his ideas around Action Learning.

He developed a simple formula to express why people don’t succeed at work, and what they needed to do to remedy that:

L = P + Q

L is for learning. P = programmed knowledge (What we have been taught) and Q is for insightful questioning. So learning is a combination of knowledge and good questions. There are four major questions Who? Where? What? When? which should cover most aspects of the Q part of the equation.

Revans’ and Lewin’s point is entirely valid: we would rather damage our relationships in an organization rather than use some simple tools to acquire the wherewithal to learn how to genuinely learn and develop that organization effectively.

While it helps to have a practioner as an impartial facilitator the point is to find the heart and willingness to genuinely learn from each other. Management philosophy has picked up on this as we move more and more away from command and control structures to praticipative work.

Work psychology seeks to bring out the best in the organization, and Lewin and Revans both spent their lives dedicated to the idea that work should not be grey, crushing, or boring.

The other major point of the Action schools is that it moved work psychology into the workplace as a strategic tool to help individuals and companies develop strategies for excellence.

Day Three: Moving Beyond Humanistic Psychologies To The Modern Workplace

Day Two: Deeper Down The Rabbit-Hole.

The Physiology Of Stress

So let’s build on yesterday’s post and ask what is happening at various levels biologically in the body? What is going on? What will help to really understand the physiology of stress?

Today, we’ll look at how the body gets stressed, step by step.

Tomorrow, we will definitely be through the looking glass, and begin looking at moods, emotions, the limbic pathway, and the neuropsychology of stress.

We approach the rabbit hole. Deep breath folk. Ready? Let’s go!

On the first day of the course we saw that proteins called hormones are produced by your glands (Endocrine system). These not only keep your body’s internal environment in balance (Homeostasis) but also can knock it out of balance as a reaction to internal and external counterproductive stress (The HTA axis).

Here we need to switch attention to an overall picture and take into account along with hormones. the real main signaler of what happening in the body: the nervous system, or more accurately, the nervous systems. In addition to the hormones the complex array of nerves throughout the system send signals to the brain and stomach.

The body is dvided into two main nervous systems. The Central Nervous System (CNS) and The Peripheral Nervous Systems (PNS). The one deals with stimuli, the other manages the automatic functions. In banking terms, the front office and back office as it were; the public face and the administration. Without either, like any good organization, the organization will cease to function. CNS and PNS are fine for anatomy. But we want function.

So for function we call the CNS The Somatic Nervous System (SNS) and the PNS The Autonomic Nervous System (ANS).

As their names suggest the somatic deals with bodily movement (Soma=body Gk) stimuli (Skin, eyes (optic nerve), taste etc;). And the autonomic with those responses which are automatic.

You would not want to have to think about making your heart beat, or lungs work etc; but, along when need the heart beat increases or decreases, the stomach works or relaxes the autonomic nervous system (ANS) send the necessary instructions.

The ANS is further divided into three: sympathetic, parasympathetic, and enteric divisions. The enteric system is found in all life with a nervous system and handles the digestive tract.

The Parasympathetic Nervous System (PNS) can be seen at work when we relax, switch off, and calm down. Look for things like smaller pupils, slower breathing, even signs of hunger as it works on the digestive system too.

The human body also has The Sympathetic Nervous System (SNS) that give us, in the famous words of Walter B Cannon in 1915, the fight or flight response. Considering, as we discussed on day one, he also coined the term hoeostasis, you could say he was onto a good thing in terms of the history of medicine.

As we are all too much aware with the fight/flight response the heart rate speeds up, blood pressure increases, adrenalin (epinephrine) from the adrenal glands floods the system and gets our bodies ready for action. At what do we do? We sit still in our office chairs and have a meltdown.

Flight in the shape of a pair of running shoes and an MP3 player is a much better deal.

So, the SNS is our bad boy here. It triggers the limbic pathway, which runs throughout the brain and handles emotions, (More on this on day three), and this in turn releases the Hypothalamus-Pituitary-Andrenalin (HPA axis) reaction (Discussed yesterday) that floods the body with cortisol.

It doesn’t even take, literally, a second to upset us.

Experiments have shown that before the eye can consciously register a bad image, (By flashing for a microsecond a group of photos that would create discomfort in a normal person faster than then the eye can register them), the body at the HPA axis is working. This means it begins to react to danger even before we are truly aware of it. It is one of the biggest problems in the workplace and modern society is that we are constantly stimulating these responses through noise and time demands.

Anyway, the HPA axis combines to releases protein hormones called glucocortisoids from the adrenal gland.

The two most important glucocortisoids are cortisol, (also called hydrocortisone), which is really important to our discussion, and we will return to in detail in a short while and dexamethasone, which is absolutely the saint and good guy here.

Dexamethasone is used to help rheumatoid, cancer, and brain tumors. You may even have had some if you had a bad facial reaction if your wisdom teeth have been taken out. Dexamethasone simply reduces swelling. It can even be used to control the pituary-hypothalamus and reduce cortisol, but this in only currently recommended for extreme measure, such as Cushing’s disease, where the cortisol is out of control and results in growth in the pituatary gland. This is outside the realm of accepted variances for normative stress, and is rare. It can be caused by taking steroids. I am looking at its use as a anti-inflammatory medicine for daily stess and will report back on that, better is to avoid adrenal cortisol overload in the first place. More on that below.

Cortisol

11,17,21-trihydroxy-,(11beta)-
pregn-4-ene-3,20-dione

Cortisol is, in our current understanding, the most important hormone that regulates homeostatis, our inner state.

Now cortisol in moderation is vital for life, without it you die. It stimulates the conversion of proteins to glucose (So foods to energy, for example), raises blood sugar, and promotes glycogen, a super-sized polymer of glucose as it were, which is essential for the liver to function and control metabolism, the release of energy (in conjunction with the thyroid and the hormone, thyroxine).

The liver is the power station then converting the fuel into electricity. It also, with the kidneys, detoxes the body. Obviously, this is all good.

And very, very bad when it’s goes wrong.

If the adrenal gland receives messages from the brain via the pituitary gland to overproduce then the trouble begins.

You may recall that one of our symptoms of stress from yesterday was an enlarged liver or spleen.

In view of what we’ve just said about the liver, let’s make a scientific observations - Oops.

For as the liver regulates the body’s need for energy, and the spleen, produces the lymphocytes, or white cells, necessary to combat disease, we begin to see that stress literally shuts down the body’s immune system. And the handy helper in crime?

Cortisol and the corticosteroids, of course. (Which does sound dangerously like the name of a third year medical school cover band?).

So, first we need to understand, in more detail, how cortisol is produced, and what it normally does. Then we can see what it does to us when it goes haywire. Then we’ll ask what controls are known.

Firstly as we said yesterday all hormone processes start in the brain.

In the hypothalamus, above the brain stem, there lies The Paraventricular Nucleus (PVN). It is small (Well, tiny actually: the brain is absolutely amazing!) area near the optic chiasm.

It contains bundles of neurons, one is called The Magnocellular, and the other, The Parvocellular.

They both produce those protein hormones.

These then move to the pituitary gland.

The magnocellalar produces two hormones, the oxcytocin and vasopressin.

Oxytocin is sometimes called the love/social hormone as it is released when we feel friendly. It is also the neurotransmitter released during sex. (No, I’m not getting into the research parameters on the discovery of that one here either). It is also crucial in neuopsychology for pairing, bondin,g and friendship overtures.

Vasopression, which helps the body retain and dispel water through the kidneys, also contracts blood vessels and caillaries.

Both, when you stop and think about it are important in stress control.

Firstly, we need to look at the more important, for the purposes of toady’s discussion, the parvocellular region.

It produces three main hormones: CRH (Corticotrpin-releasing hormone), and vasopressin. The third, TRH (Thytropin-releasing hormone) that stimulates the thyroid. It is the first two we are interested in.

CRH and vasopressin combine to produce ACTH (Adrenocortiotropic hormone), which we talked about yesterday. ACTH causes the reaction in the pituitary gland that then talks to the adrenal gland, which then responds by releasing cortisol.

So can we do anything about this. Well, firstly, try to restore homeostasis. Highly effective and recommended non-pharmaceutical actions include deep sleep, long walks, calm, calm, calm, breath, and avoid caffeine. Caffiene aggrevates cortisol, which is actually at is strongest surge first thing in the morning. So that early morning cup of coffee is a jolt rather than a help. The cortisol comes in at around 30 minutes after waking, often making us think it’s the coffee.

Alternatively, you can be a woman. This helps enormously.

Professor Shelly E Taylor, UCLA.

Professor Shelly E Taylor, of UCLA, who was awarded the William James Fellow Award in 2001 by the American Psychology Society, and is the author of the marvellous “The Tending Instinct” says “Woman show more often a “tend-befriend” rather fight-flight response”. This can easily be proven: at the end of working day a woman will lose her stress by talking, or getting involved with her close relationships. Men, on the other hand, put on their iron masks and withdraw for as long as it takes, or allowed. Or explode.

There is evidence to suggest that oxytocin (mentioned earlier), which calms us, is negated by male hormones, but amplified by estrogen (the female hormone) meaning woman are born calmer.

Secondly, a visit to a doctor is recommended: missing annual cholesterol and blood pressure checks are a pretty good reason as to why doctors can’t cure people. GO!

Finally, for people showing the physical symptoms of stress a Cort-Stim (Cortrosyn Stimulation) blood test, which tests the adrenal response with an injection of ACTH and looks for an appropriate cortisol response. It’s taken from the elbow or hand, and generally a high-carb diet is recommended the day before followed by six hours of fasting before the test itself.

For most cases, steps one and two are enough.

Now that we have an overview of the biology of stress we are ready to move into the more commonly understood meanings of stress, as both positive in negative, in the moods, emotions,and the limbic pathway and the neuropsychology of that.

Day Three: Yeah Baby, Yeah! Moods, Emotions, the Limbic Pathway and Neuropsychology

I went in for a day at a school in a pretty tough area and as always got feedback. One week later I got this email from a 17 year old:

I just been waiting for this opportunity to thank you for the lesson you gave us for about a week ago. It was amazing. Every word you say makes me more inspired, and my self-confidence isn’t so good, not at all actually, but when you speak and tell us all these things, it all feels so much better.

I guess I just want to thank you, because you give me such an inspiration and you make me feel that studying is really fun, it’s fun to learn. I really do hope that you come back soon I really do.

And that’s why I do what I do: if it makes a difference, and can help one teenager see life as possible instead of impossible, as hopeful instead of hopelesss, as having a future that might actually lead somewhere. It’s always fun to work with those who already understand how life works and just need better tools, but to make a real difference you need to work with those who see it as gray, boring, and crushing…

I look forward to return visit in February very much…

It’s always good to see the future of work - and going to schools and doing the Way of Intelegance for schools is always rewarding.

I had a fantastic day at Bladins.

Bladins is one of the best International Baccalaureate schools in the Nordic region. The pupils are bright and have every chance of success. We had a great time together - and they were kind enough to give me a huge cheer and a standing ovation at the end - some of them even came up at the end to say how they enjoyed it - never easy for teenagers! I look forward to more visits - thanks to all involved!

I had a great day at Copenhagen International School, and look forward to another in February. Thanks to all involved.

Ben Ward, who instigated the process during our meeting at the excellent ECCN networking club in central Copenhagen, also co-ordinates and raises funds for Team Peru who work with Kiya Survivors, a charity for special needs, abused, and abandoned children in Peru.

Here is a wonderful video of the pupils’ trip in 2006

and a great fun video that sums up nicely their great attitude:

Thanks to all involved and I look forward to the return visit next month.