2018-06-26 Dear reader, please see the below as a starter, where most is still to come. Trying to also include a generalist perspective is for me like (a) trying to integrate real world with different scientific/clinical paradigms but (b) like elaboration/thinking/ … is like preparation and elaboration of “fish, to taste good, must swim three times: in water, in butter, and in wine”, that is; real world goings-on, science (biopsychosocial-cultural) systems integration and empirical experiences (Poppers world 1, 3 and 2). Concerning my dyslexia, I hope some of my writings will be understood as intended! So, more is to come and I appreciate constructive feedback (for AAPB members direct to me) and I respond ASAP – when possible!
A working draft:
Basically, in general dynamic cancer cell dysfunctions concern mainly down regulation of preprogrammed cell death, Apoptosis. Nocebo and placebo, although not well understood, is assumed to be biopsychosocial-cultural behavioral dynamic processes at different time aspects which can influence via processes which in some well-known cases hardy can be understood otherwise then largely associated with Limbic*/Gut/Immune/Autonomic Nervous Systems related. Mainly spatial not verbal, not conscious, “Irrational” processes of which we rationally have little insight into.
Base on the above paradigm point of departure, my question is; “the above seems to be something to be addressed from systems integrated (not reductionistic) psychophysiological behavioral medicine approach, where we at least can in some cases can consciously, using integrated biofeedback, can influence not conscious systems/parameters validate (we do not Popperian falsify individuals behaviors?) in our parameters, e.g. autonomic nervous systems behaviors. Not enough? No, but as a “starter”, if we include etCo2 and SpO2 we may also have some, not very much, but some association with mitochondria metabolism (which is more and more regarded as critical for down-regulation of Apoptosis) and if we include skin conductance we may, in line with Karl Jung´s (1906); “Aha, a looking glass into the unconscious!” when he used skin conductance and word processing.
What do I indicate? Applied, systems integrated psychophysiology work is urgently needed also in severe diseases as different kinds of cancer. In a scientific reductionistic controlled medical world where different “Besserwisser Big Brothers” fighting about their own way (Sinatra, 19??) as the only very road to use, forgetting we are not using absolute, secure knowledge how cleaver we than regard our self to “be” as well as (what I call) Thales and Protagoras principle*!
Summarizing, let join our forces and go head and try to integrate a basic integrating consensus based on our different psychophysiological approach – see it as a asset not a problem – using our basic knowledge platform to address the dynamic of cell behaviors where metabolism, autonomic and Limbic precognitive strategies together with diet (a wasp´s nest of those who know how “it is”) have the potentials to first bring patients into the “patient as educated, active resources and coworkers” (Our manual since 1986 in stress medicine) position adding to now quite fast improvements which in the future may be traditional intervention down-regulated and gradually more and more up-regulated becoming an integrated psychophysiological behavioral medicine (including integrated individual tailored biofeedback!) field!
Since I learned about http://stressmedcenter.com/projekt/om-placebo/placebo-case 1979, I have been on the informal road elaborating the noncebo-placebo issue, especially last two years, when I suddenly become a patient myself May 3, (very aggressive Prostate cancer behaviors) motivating be to move on with my toolbox version http://biopsychosocialmedicine.com/projects/rd-international-projects-2/placebo-rd/the-cancer-patient-as-an-educated-resource-an-coworker-in-own-rehab/
Those of you who know about any attempt to address the cancer behavior problem from our psychophysiological systems integrating paradigm, I would appreciate very much if you notify me!
* When considering Limbic (preferably not conscious, spatial, precognitive) information processing, I build/construct my theoretical and practical paradigm on George Kelly´s Personal Construct Theory (As I see, not yet well understood and partly therefore not used approach), in combination with other biopsychosocial tools). To be formally published 2019 when I have some illustrative cases empirical (ideographic) to refer to. See also http://biopsychosocialmedicine.com/projects/rd-international-projects-2/placebo-rd/the-cancer-patient-as-an-educated-resource-an-coworker-in-own-rehab/
** About mitochondria: “Mitochondria originate from a bacterium, meaning they have their own DNA molecule in which the structure of several proteins is recorded. An OXA-like machinery (oxidase assembly machinery) already existed in the bacterial precursor of mitochondria and has been conserved throughout evolution” including human of today! “The imported OXA-dependent proteins play important functions that range from cellular respiration, the exchange of metal ions, and biochemical reactions, to the integration of proteins enabling the transfer of metabolic products across the inner membrane. When the integration or function of these respiratory proteins is blocked, this can cause mitochondrial-based neuromuscular diseases or cancer. The OXA-dependent integration of inner membrane proteins, which has been conserved throughout evolution, is thus fundamental for the formation of the mitochondrial inner membrane and for the energy supply of human cells” https://phys.org/news/2016-05-evolution-mitochondria.html.
As our “Mitochondria in addition to energy production, have a second major function related to programmed cell death by apoptosis.” https://cellbiology.med.unsw.edu.au/cellbiology/index.php/Cell_Mitochondria#Apoptosis, its functions and dysfunctions are decisive for metabolic disorders where we now also with high probability can include different forms of cancer.
This means that human lifestyle metabolic related behaviors, how we breathe and eat biological functional become of priority for our health development! Moreover, based e.g. on – “Guyton (1991) discusses the relationship between respiration and normal exercise, which is not well understood but he suggests that the increase in respiration actually occurs too rapidly (in regard to the chemo-receptor feedback system) in the beginning of exercise. ´Anticipatory´ … stimulation of respiration from the higher centers of the brain which leads to an increase in ventilation which actually decreases arterial PCO2 below normal level under normal biological reaction during the (first) 30-40 seconds of normal exercise. This adequate reaction is a “learned response” (Guyton, 1991, p. 452). “The chemical factors play a significant role in bringing about the final adjustment in respiration to keep the carbon dioxide and hydrogen ion concentrations of the body as close to normal as possible .. The nervous signals are either too strong or too weak in their stimulation of the respiratory center” (p. 451). https://link.springer.com/article/10.1023%2FA%3A1023484513455 – we really need to dynamically approach mitochondria “health” and its preferably decisive influence on e.g. cell dysfunctions cancer behaviors, from a integrated psychophysiological perspective. Especially if we try to get a ideographic biopsychosocial perspective on cancer patients.
Much more is to say, although we are in the beginning to understand basics in cancer dynamic (not static) behaviors! I do think we are approaching enabling to develop a methodology which can a priori predict, based on more advanced understanding of basic mechanisms of relevance, outcome validated not only in our data (like etCO2, SpO2, RSA/HRV, FT and also EDA – NB its transmitter!) but also more traditional cancer parameters as PSA and also a new kind of, easier used, biopsy. Until then we can do well controlled case studies that increase our knowledge and then gradually move into normative studies, which often do not give very much information diagnostics and tailored interventions on Adam and Eve!
Again – most diseases are dynamic, with variation in the time domain, but also vary between and sometimes within individuals over time and situations or “”Since appraisal, emotions, and coping patterns ebb and flow in a person’s changing commerce with the environment, a new type of assessment is needed that measures process and variation within individuals and across situations, as well as structure and stability” (Lazarus, Cohen, Folkman, Kanner & Schaefer’s, 1980, p. 113).
Some basics to be considered
- Thales-principle (in my words): Not to be blinded by our own excellence and wisdom, we should work for improve intellectual, knowledge and practice developing in a “win-win” at human kind levels like Thales call for and initiated; in my words “criticize our own precognitive/spatial and cognitive/verbal thinking, arguments and values as well as others enabling together move into a united increase/improve of our (man-kind but individually tailored) insight and views theoretically as well as practically.
- Protagoras-principle (in my words): Every person has their own subjective view of reality. Can be called subjective appraisal/ belief/behavior/private opinion corridor of “individuals´ world”. https://en.wikipedia.org/wiki/Opinion_corridor. Stephen Pepper (1942) coined the concept the World Hypothesis: (https://en.wikipedia.org/wiki/World_Hypotheses). Stephen Covey https://en.wikipedia.org/wiki/Stephen_Covey describes the concept very well as also George Kelly in his Personal Construct Theory http://kellysociety.org/kelly.html. Some realize this, but not all, especially Besser-wiser. This is usually a source of confusion at all levels. Protagoras is considered to be the first humanist. Because he also represented the rhetoric evolution, he warns of abusing it – which today appears to be normal, especially in the power and profit interests/areas. Not political areas to be forgetting! Not forgetting is also put our own House in order!
* Opinion corridors (see above) can be both one person anchored or at the group level, for example: What is politically correct in a given party.
Let the forces be with us!
Bo von Scheele, Ph. D. Professor