Welcome to SkillsBeforePills, Bo von Scheele, Ph D, professor
At this web I try to write as easy as possible about biopsychosocial medicine and how lifestyle related diseases and mental problem can be subjected to assessment, interventional measures as well as evaluation based on a lifestyle related medicine paradigm.
This web site is so far not quite ready – so please, be careful, something below might be not well written and be misunderstood. Only I, Bo von Schéele, am responsible for this kind of thinking discussed here – so far!
Summarizing; Lifestyle related diseases and (including mental problems/disorders) problem concerns … lifestyle behaviors – of course! Genes as well as epigenics and their expressions does play a crucial role in individuals´ real life which vary very much and as we understand more and more they constitute mostly dispositions (seldom completely responsible for individuals´ lifestyle behaviors influence on health). A child can understand that lifestyle related diseases and mental problems concern individual ways of living in a their socio-cultural context! But obviously not Big Pharma, and all those manipulated by their interests – pills are not only mostly completely wrong (given not life threatening states – but also even really bad in many respects, where one is it can mask, as in hypertension, the development of the real causes for the elevated blood pressure, which in turn opens the door even more for severe chronic lifestyle diseases (pills only temporary sometimes can influence, decrease symptoms but mostly not the real causes). Again, changing/modifying individuals´ lifestyle behaviors are crucial for restore health as well as further on support health development and prevent development of unhealth and disease.
As still a simplistic, reductionistic medical paradigm (see http://skillsbeforepills.com/our-scientific-approach/) control school medicine supported by Big Pharma (otherwise they would not be counted on), we need to find other ways for development of lifestyle medicine (Biopsychosocial medicine) and that is the reason we start up www.healthcreators.com after 25 years clinical work moving out of the clinic to argue “lifestyle medicine for all – by us all” suggesting education from zero. People are invited to learn step by step. To quote Allen Frances on psychiatry; ”Psychiatric diagnosis is too important to be left to the psychiatrics” (page 218) – Frances, Allen. (2013) “Saving normal. An insider´s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life” HarperCollinsPublisher.
As I have no money to pay people working with me I try also to start a foundation – first focusing on ADHD http://skillsbeforepills.com/foundation/ while this might be the most urgent problem (of very many) to try save children (And also older people) from Big Pharma interest.
Below are a few reflections/arguments developed during the years – and more will come.
Thoughts accumulating for 20 years might now be meaningful to discuss related to changes in scientific Zeitgeist. The below is also motivation while I focus on development a lifestyle medicine tool box and super vision of individuals tailored use of it
Thinking about years – in Emery, F.E. (1969). Systems Thinking. Perguin Books Ltd, Harmondsowrth, Middlesex; England presents an overview of systems thinking which shows that the fight for a human integrating perspective has been very clearly and convincingly discussed by many lats 100 years, even 1865we have below a quotation which in real is not yet started within school medicine. It is not possible to understand by scientific rational reasons why not a biopsychosocial systems integrating medicine has been developed, if focus is on human health. Gratefully appreciated if anyone can give a reason why medicine still has not yet – 2013! – with outmost energy adopted and intentionally promote a real systems integrating medicine which can deal with lifestyle related diseases and problems. The absence of this is so impossible for “normal” individuals that a political and humanistic investigation committee should investigate this! To medicate children motivated by they “have” a neuropsychiatric disorder is not only without any ground at all in most cases but also a huge treat against their further health which pharmacological substances (most not even permitted by lack of research) which mask the development of further dysfunctions. That people who are regarded as experts can do such harm to children´s health is unbelievable – a night mare. Se more during “ADHD” at this website (much not yet translated from Swedish)
Are pills the solution for peoples’ health?
We can hardly se absence of health, development of illness/diseases as a function of absence of pills although markets are close to succeed towards such believes. Medicine is defined as “art of healing” and not pills what most people refer to.
I do agree with Bernard [see below] that simplistic perspective is not acceptable and worthy medical science. My not very nice metaphor is: Conductor “Medicine” shall conduct the piece Homo sapiens sapiens but has no (conductor’s) score. Instead s/he has only the one for first violin (played by pharmacological people). Alternative and complementary medicine is allowed to play at the backyard (alternative and complement to WHAT?). Simplistic medicine makes actually no sense for sciences, societies and individuals but for pharmacological interests. I would like to be very wrong here but my 20 years in science indicate that this is not the case. NB enthusiastic health care providers are not to blame with the above while they follow what medicinal science prescribes.
How this simplistic process can proceed as it does is impossible but still do, probably resting on that nowadays scientific knowledge and paradigms are not discussed as before – not time for it and it does not support ones career. Another reason is that we scientists fight for money and thereby perhaps not emphasize our short comings and lack of (multidisciplinary) knowledge. Absence of biopsychosocial environment related knowledge is more discussed at www.stressmedcenter.com)
On the psychological side it is not much better. A agree with Fiske [see blow] (also in general for sciences) and Amadeo [see below]. Much is not well understood concerning brain/psychological processes and to call some of this not understood “silent thought” does not solve anything – especially as those silent thought probably has salient effects on our biological systems, e.g. part of components in operational condition in terms of state dependent learning. Without a more elaborated knowledge platform (functioning at both at individual and group levels) psychological and psychiatric intervention cannot be effective, which is highly needed also in traditional medicine fields.
So what can we do when official science let us down?
1. Collect knowledge which has high scientific power (defined) and make it available for individuals (not just let the internet take over from a biopsychosocial, not yet existing, health care systems)
2. Learn how to use this information in an individual useful way validated by best possible validation approaches/systems
3. Focus on innovation, knowledge development, validating research at normative and individual levels – focus on what is needed by individuals and societies and not for the profits benefits
4. Reconstruct parts of health care systems to become knowledge implementing at individual levels in cooperation with people – patients or not.
In sum; Increasing number of “us” within sciences and health care systems request urgently focuses on the development of a real, concrete and useful, well functioning biopsychosocial medicine approach which can deal effectively with individuals´ lifestyle related disease and problem! We are not yet there but must get started to come there. As long we do not basically change theoretical paradigm, methodology, data analysis tools, clinical approaches nothing will happens – which promote the continuation of the extreme dominance of pharmacological medicine also for life style- and society related diseases! Pills before skills – skills as alternative and complement to pills is of course a very wrong, not scientific acceptable and very, very wrong way to approach to health and diseases – at least for man and societies!
In my professor presentation I discuss solutions to the above – http://skillsbeforepills.com/lifestyle-medicine/
Bo von Schéele, Ph D, in psychology and professor in medical engineering
Brief summarizing arguments
Human medicine concerns biopsychosocial humans living in a complex context which medical diseases/problems related to life style- and society related factors hardly can be analyzed and treated with a simplistic paradigm (motivating patients to be subjected to pharmacological interventions) as Bernard observes
“.. If we break up a living organism by isolating its different parts it is only for the sake of ease in analysis and by no means in order to conceive them separately. Indeed when we wish to ascribe to a physiological quality its values and true significance we must always refer it to this whole and draw our final conclusions only in relation to its effects in the whole” (Bernard, 1865) in A Despopoulos & Silbernagl (1991) Color Atlas of Physiology: N.Y.: Thieme.
Concerning scientific knowledge and scientific paradigm situation within medicine “there are no signs of progress toward sufficient consensus, …. the nature of the subject matter (paradigm with mighty and main) “appearance of more agreement than actually exists” (Fiske 1978). Fiskes argument is highly valid concerning medicine today
“Our theories, beginning with primitive myths and evolving into the theories of science, are indeed man-made, as Kant said. We try to impose them on the world, and we can always stick to them dogmatically if we so wish, even if they are false (as are not only religious myths, it seems, but also Newton’s theory, which is the one Kant had in mind). But although at first we have to stick to our theories – without theories we cannot even begin, for we have nothing else to go by – we can, in the course of time, adopt a more critical attitude towards them. We can try to replace them by something better if we learned, with their help, where they let us down. Thus there may arise a scientific or critical phase of thinking, which is necessary proceeded by an uncritical phase” Popper, 1976, p. 59-60) .. and “Paradigmatic thinking often lead man (as e g scientists) to exclude areas of research/relevance, including particular findings and/or theories/rational that does not easily fit into the paradigms of today. A paradigm is a set of believes about reality that seem self-evident and un-changeable. This is the more or less explicit platform where theories and hypotheses are generated-/extracted/emerging. Paradigms are needed for effective work but if regarded as “facts” and the scientific truth it can lead individuals (e g scientists) to defend their view-point against rational evidence or fight back new evidence while not fitting into the own paradigm” Kuhn 1957, The Structure of scientific Revolution p.??)
To be able to be effective, medicine fields must be able to adopt a biopsychosocial system integrating paradigm – there is no other way while we cannot “make” humans simplistic to fit the simplistic/pharmacological dominating paradigm of medicine of today. George Kelly (1955) developed an axiomatic system for personal psychology. If our present knowledge is not functional enough we must be able to construe an axiomatic system, perhaps not like Euklides did but a biopsychosocial systems integrating approach which also can be used for individual assessment and multifaceted interventions.
As very little is done concerning a real systems integrating development of biopsychosocial medicine (hard to understand why it is not while the need is increasingly urgent for individuals and societies) most work is ahead of us – and hopefully “us” will become an expanding number of hard working people – scientist, clinicians, laymen and particularly those in the position of patient patients – as said above.
Responsible for this web site is Professor Bo von Schéele