I have recently been thinking about the idea that wisdom is connected to knowing that we don't know anything. I was aware of this idea from reading that after Socrates was called the wisest person in ancient Greece he at first doubted this until he realized that his wisdom was because he knew that he didn't know anything. The socalled Socratic method involves asking quesions and listening to the answers until an understanding happens. The person asking is not reacting to what is being said or correcting, giving advice, but merely asking questions to clarify the responses that are being given. There are no conclusions drawn based on previous experience nor any judgement made about what is being said. So, it is like knowing that you don't know anything as you are listening to learn about someone and refusing to think you know them. Thinking you know them allows you to judge or criticize them. 

So, if you listen to someone without your own reactions, judgments or criticisms, isn't this being empathic? Isn't this like being with someone and sharing their experience without substituting your own experience. Isn't it hard or even impossible to do this and also judge them or compete with them or reject them. So if we all listen to each other without judging or criticizing then we will all feel and be connected to each other and will all get along.

What do you think?



The nocebo effect is the opposite of a placebo effect, so it is a negative response to a sham treatment where the person believes that they are getting the treatment but actually are not. What is amazing is how powerful expectations and outlook are as the placebo response is often close to that for those who actually received the treatment.  This has been true for studies of antidepressants used for depression. This has led some researchers to conclude that the antidepressants are not effective because the placebo response is so strong. What seems to be not understood is that for a placebo response to occur people have to believe they are getting the treatment. So, you can only have a placebo or a nocebo response if there is also treatment occuring.  

What is critical is to understand what happens in our brains when we have either a placebo or a nocebo response.  Nocebo responses are especially concerning. To understand these reponses researchers have looked at expectations and beliefs and their impact on treatment responses and overall health. Years ago a large study by the National Heart Association was conducted in Framingham, Massachusetts on 5290 men and women ages 30-62. They found that women who thought that they were "prone" to heart disease were four times more likely to die from heart disease than those women who did not feel that they were at risk for heart disease. So, is it possible that feeling prone to heart disease can kill you? It seems like it. It is as if we can create our own reality regarding our health in amazing and potentially frightening ways.

There is plenty of evidence from research that chronic stress increases negative outcomes for illnesses that we might have. Stress does not create illnesses such as heart disease or cancer but will make them worse and make for a worse prognosis. This reflects increased negative health outcomes related to the impact of chronic stress as this stress contributed to both a negative outlook and a feeling of hopelessness. This makes it similar to a nocebo effect. Turning to a positive outcome, a study by Crestwell in 2007 showed that breast cancer survivors who wrote affirming statements about their life had fewer side-effects and better overall outcomes compared to those who wrote negative statements. So, a more positive outlook as demonstrated by more positive statements without any prompts, leads to better outcomes. 

Since what we believe and expect can have significant impact on our lives why not be positive and hopeful?



These are three things that the leader of the "Butterfly Circus" said to the limbless man.  I have recently blogged again about this wonderful short film called "Butterfly Circus." I was discussing this film with some of my patients who had watched it, at my encouragement. We discussed the statement "of course you have an advantage" and I mentioned that I felt that the statement was true but I did not know why it was. I then heard one of my patient's say that they were more open about themselves with others and more comfortable with themselves, since they had started to react less to past experiences and therefore had less anxiety and paranoid thinking. I wonder if my patient's struggles with anxiety and paranoia helped to push them to learn to react less to the past and that this was their "advantage" that helped them to "manage" their lives better. Hopefully some day soon they will realize that they are "magnificent."  

I also wonder if we all have an advantage and we all can manage and we all are magnificent? Don't we all have doubts and struggles and feel stressed based on past worries that we keep experiencing? So, doesn't that mean that we have the advantage of feeling more and more compelled to risk changing our lives by managing to be responsible for ourselves and our choices? Doesn't this then help us to be who we were meant to be versus being who we are when we succomb to worries and fears? And, when we are who we were meant to be isn't that magnificent?

What do you think?




A few years ago as part of a course that focused on spiritual journey's, I watched a short film called "The Butterfly Circus." The film is about encouraging people to believe in themselves and take responsibility for themselves. It is not about enabling people by acting like they can't do things themselves. The circus performers are connected by all having struggled to believe that they could manage and have meaning in their lives. The circus leader was able to see that these people can manage and then he encouraged them to discover this for themselves.  

The hero of the film was born without limbs. He was part of a side show at an amusement park when the circus leader met him.  The circus leader said "you are magnificent".  The limbless man then spit on him.  The next thing the circus leader said to the limbless man was "of course you have an advantage." The third and last thing we hear the circus leader telling the limbless man is "I think you can manage."  This was when the limbless man was asking for help crossing an area next to water that was uneven. He wanted to be carried over it. The next second the limbless man fell into the water.  After a few seconds, when other members of the circus were getting ready to pull him out, he surfaced with a smile as he had discovered that he could swim. From this point he was able to choose to discover what other things he could do that seemed impossible before.  The transformation was the transformation of the caterpillar into the butterfly.

The transformation of caterpillars into butterflies involves caterpillars forming highly organized groups of cells called "imaginal discs" that hold the genetic information that then forms the butterfly. During the chrysalis or cocoon stage, the caterpillar seems to digest itself and the digested part becomes the food for the imaginal discs to form the butterfly. Totally amazing!

Well, I believe that all of us [homo sapiens, sapiens] also experience amazing transformations when we learn to believe in ourselves and take responsibility for our lives and the choices that we make. That is why it is so important that we do not make the mistake of caring for others by taking over for them and reinforcing their fears that they can not manage.  It is often [maybe always] hard to encourage and support but not take can look like someone must be carried to safely make it through a difficult time in their lives, but we must not give in to their fears but instead be strong enough to see their abilities and be encouraging as they struggle to be who they were meant to be. 

What do you think?



The first amendment to our constitution prohibits the making of any law abridging the freedom of speech.  The supreme court has clarified the extent of the protection for free speech.  This applies only to speech against the government and more recently has been broadened to allow for more political dissent.  Of significance lately is concern about protests on college campuses that are against certain speakers that the students disagree with.  This has involved violence at times.  The concern is that the stuent protests will have the impact of supressing free speech. This then has led to concern about any effort to restrict speech such as those who are spreading hate comments on the internet and those who bully others on the internet via social media. There has been increasing concern expressed about bullying as it is connected to increased risk of suicide [many studies indicate an increased risk for suicide in children and adolescents who are being bullied although it is difficult to be precise about the impact of bullying on suicides].  So is it free speech vs increased risk of suicide?  Or is it free speech vs chronic stress traumatizing our brain cells that can lead to cell death. [This will be clarified below.]

Dr. Lisa Feldman Barrett, a professor of psychology at Northeastern University, wrote an opinion piece in the July 16, 2017 edition of the New York Times, entitled: "When is Speech Violence?' She makes the point that some speech is abusive while other speech is offensive but not abusive.  She considers bullying to be abusive as well as when people trade insults with each other over and over. Dr. Barrett considers prejudiced and judgmental views to be offensive but not abusive as these views do not create a prolonged stress for people and therefore do not trigger brain reactions that can be destructive.  It is like the difference between acute, temporary stress where the brain copes without leading to any damage to the brain.  On the other hand, abusive stresses lead to prolonged stress in people who are traumatized by these speech patterns and this leads to challenges to their immune systems that can compromise their DNA and even lead to neuron [brain cell] death. This repetitive abusive speech can lead to someone developing a post traumatic stress disorder [PTSD]. They often cope by blaming themselves and trying to keep things from getting worse. This on going stress reaction damages their immune systems. In addition, since they feel hopeless and like they have no control over their lives, they are at risk for suicidal behavior.

So, some speech is violent in the way other people respond to it. The abusive nature of the speech seems connected to it being repetitive and ongoing even if intermittant. So, free speech would not seem to include this type of speech.  What do you think?

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