Dr. Frisch

HAPPY NEW YEAR!

I hope that each of you had a nice holiday season and are ready to ring in the new year.  This year will likely bring new and exciting changes in your life.  Some of the changes will be a direct result of what you do and other changes will be the result of what others do that influences your life!

Changes that occur may be desirable or undesirable, but we need to realize that changes are inevitable and how we react to them is what is important.

In the new year, I would like for you to remember this statement:

"I am in control of my future.  I may be forced to react to unpleasant events, but how I react is up to me."

This simple statement packs a punch.  You are acknowledging that change will happen, but how you respond to that change is your responsibility. 

When you think that you have no choice over situations or events it is disheartening and demoralizing.  It is liberating when you realize that the event or situation can still occur, BUT that your response is up to you!

Taking charge of a situation does not means that you control it.  Taking charge means that you are able to respond to an event or situation in any number of ways and be comfortable doing so.

When you learn to stop trying to control everything around you and understand how to respond to everything around you, YOU GAIN TRUE CONTROL!

My wish is that each of you think of 2 things in your life  which you desire change, stop trying to figure out how to change it.  Instead,  think of 3 possible responses to that situation, and then DO ONE OF THEM!

This first step will add a degree of freedom and personal control that you may not have experienced before.  The more you practice this technique. the easier it becomes.

Have a great start to your New Year!

Dr. Frisch

NEW CHEMICAL MARKERS  

The health care industry is forever changing, most of it for the good.  New advances in technology have reveal new 'chemical markers' to determine if we have sustained trauma that may have been missed by standard testing.

Standard testing with illness or after trauma might include traditional examinations,  X-rays, lab work, CT scans, MRI and maybe even a PET scan.  These are all good tests and have served both doctors and patients faithfully for many years, but like any test, none of these is 'all-inclusive' for finding every malady.

A recent Swedish study has found that there are 'markers' that are found in spinal fluid after trauma that may determine if damage was sustained to the spinal cord and/or spinal nerves after injury.  The markers have weird names that may become household names in the future. They are:

• Glial Fibrillary Acidic protein (GFAp).  This is released when there is an injury to specific nerve components.  
• Neurofilament protein.  This protein is released when there is injury to nerve axons.  Axons are the portion of a nerve that takes signals to the periphery of your body.

This current study looked at the cerebrospinal fluid levels of these two protein markers after trauma injuries.  The injury types were limited to falls and whiplash injuries from automobile crashes.  The levels of the proteins were evaluated in all participants.

The authors noted, "In the present study, there seems to be a relationship between the levels of tissue markers and clinical findings."  All levels of markers improved over the following 18 months, which indicates the release of the proteins were trauma-based and not randomly appearing findings.  The authors further stated that, "Both experimental and clinical studies support the hypothesis that a portion of the cases with severe whiplash may have axonal injury."

Testing such as this is important.  Anyone who has sustained serious injury from an automobile accident knows that the symptoms of pain, numbing and physical disability may not surface right away.  If only traditional testing is available, a number of 'real' injuries may be missed or passed off as being insignificant.  "Go home, rest and you'll be fine", may be replaced with, "We had no early positive orthopedic or neurological findings, but we did determine from your lab work that you did sustain trauma to your spine and nervous system." 

Instead of being told that there is nothing wrong, patients of the future may be told that something is wrong before they even feel the pain associated with the problem!  Being able to document 'invisible trauma' means that necessary care can begin before improper healing starts.  It would be much like your mechanic telling you that it is time to change the oil because there are indicators that are signaling engine failure.

The documentation that results from this type of definitive testing means that everyone HAS TO BELIEVE YOU when you say that you are hurt.  Often, the hardest thing to do is to convince someone you are significantly injured because they can't see what you are talking about and there is rarely visible blood!  When the injured person can see documentation that explains what they are feeling, they are able to stop doubting themselves as well.   It is very common that the injured person begins to believe that a problem it must be 'all in their head' because the doctor(s) can't find anything wrong.  What a shame.

Establishing documentation like this also keeps insurance companies honest as well.  When documentation is 'irrefutable' is will be hard (not impossible) for an insure to say nothing is wrong with you.  You will have an honest leg to stand on!

Change is good, even though somewhat awkward at first.  New advances like GFAp and NFL will open up a diagnostic future that is truly exciting.

Guez, M., Hildingsson, C., Rosengren, L., Karlsson, K., Toolanen, G. (2003). Nervous tissue damage markers in cerebrospinal fluid after cervical spine injuries and whiplash trauma. Journal of Neurotrauma 20 (9),  853-858.

Eileen's Corner

This is a simple salad that I make often.  It is always good, especially  if guests are coming.  They often call and ask for the recipe a couple of days later or when their next 'event' is happening!  I think you'll like this one.

Enjoy!

Eileen

MOST THINGS DON'T HAPPEN!

I may get yelled at for saying this, but it is true.  Most things don't happen!

When was the last time you broke a bone?  How often do you herniate discs, once a month?  Have you ever had Rheumatoid arthritis, gout or a brain tumor?

We have several hundred million people living in this country, but since most things don't happen, you would be hard pressed to find a group of people who have all had the same disorder.  This 'selectivity' of diseases or trauma makes us feel unique and sometimes, quite alone.  

It would be easy for me to say that everyone in the world needs chiropractic care because I see physical trauma and ailments every day, but what about the people I don't see?  Can I say that all of them need chiropractic care as well?  No I can't!

  There Are So Many Of Us! 

With the New Year upon us, I thought you might enjoy reading this topic paper on world sustainability.  In other words, how can we all live together without doing each other in?  This might be a good paper to read to ring in the New Year!  Parts of this paper apply to each of us.  It is quite lengthy, but I think that you'll enjoy it.

  Is Sustainability Enough?

Glenn Frisch  

Augsburg College

Sustainability is becoming an increasing topic of concern in all circles of influence.  Sustainability can be described as the ability of the world’s population to live and thrive within the confines that our planet can sustain an ever-expanding population.  If a point is reached where the world can no longer support the people living on the planet the population is not sustainable.  At that point we face the real possibility of extinction.  Political, academic and social leaders are steadily becoming educated on the limitations that our planet affords us. They in turn are beginning to take steps to insure that the general public understands what is needed to promote local and world safety and longevity.  When presented with the facts that our planet has limited resources most people would agree that it is our responsibility to care for the planet we live on.  Long-term wishes and ideals are, however, often interrupted by short-term desires and needs.  There are individual needs of sustenance, community needs for growth and cohesiveness and finally, world needs for cooperative existence.  Within these parameters are entities that hold individuals, communities and countries apart.  These include personal beliefs and biases, lack of community structure and responsibility and inhibited of world balance for a common goal.

There are countless areas that need control and change, but our immediate focus should be on environmental preservation and sustainability.  On a personal level this would encompass our use of natural resources like coal, gasoline and oil and the impact that it has on our environment.  We have also stripped the land for farming and mining and continue to deplete our oceans of food banks.  Unchecked, these practices will make our planet unable to sustain the existing and growing population.  Our ideology can be partitioned into two categories of thought; do we unabashedly consume or are we conservation conscious?

The Erlich & Holdren (1971) I=P-A-T Model is a good example of personal responsibility that is still valid today.  Human activity on the planet (I)= the population (P) X the level of affluence (A) X technologies that produce affluence.  This means that we are often the direct cause of our own demise.  When the population steadily increases our needs increase.  As those needs increase, so does our creativity and resulting affluence.  Both affluence and population, however, may be controlled by technology.  Technology means more than just new advancements for society.  It also influences how we use what we already possess.  This may include birth control, medical control of diseases, farming techniques that increase food supply and even our ability to find greater reserves of fossil fuels.  How we use technology will determine our level of affluence and population expansion.  These three factors combined decide what our current and future world impact will be.  The formula seems so simplistic, but it applies to nearly every situation that I can think of on a personal level.  When considering global warming due to our use of fossil fuels and ozone depletion from irresponsible fluorocarbon use, it is easy to accurately apply the I=P-A-T formula.  We used our technology to create an affluent lifestyle for a larger population and our impact on the planet was destructive.  With deforestation of the rainforests in South America and over fishing of the Alaskan (Brown, 1985) and Atlantic waters we are not alone in our destruction of Earth’s resources.  Other societies suffer with the same moral dilemma; do we restrict growth and remain regressed in the world or do we strive for a superior quality of life and a degree of self-empowerment?

This Tragedy of the Commons (Hardin, 1968) is described as a behavior that makes sense for one or a few people, but when implemented by enough people actually prove damaging to society.  Community thought engulfs and expands individual ideas and beliefs.  A community agreement of deforestation and resource use reaches a damaging threshold much quicker and with less chance of recovery than a sole individual action.  The reverse of this, however, is also true.  A focused effort by a community to conserve resources (fuels, energy, food supplies), become efficient in resources they do use, and limit the number of people who use the resources is a positive step in sustaining a population and a planet.  These are necessary steps to survival and sustainability, but are they enough?  Human nature seems to draw us toward coveting and excessive use of what we desire.  To what degree must the individual influence a community to realize growth and expansion without abuse and destruction of available resources and technology?  This is a difficult question to answer without expanding our groups of influence from individuals and communities to include the world cultures.  I use the words ‘world cultures’ rather than ‘peoples of the world’ because we are not all the same.  The needs and desires of people around the world are not the same as those of in the United States.  We are an exceptionally affluent society comprising only 5% of the world’s population, but we consume 25% of all resources (Oskamp, 2000).  There are African nations in dire draught and starvation.  Their immediate needs for survival will outweigh world social and environmental concerns.  Their ‘community’ is not poised to make competent decisions for everyone else.  This may fly in the face of those individuals who would like to believe that everyone is the same and equal, but it is unfortunately, not true.  Their community ideals have a self-serving role that would enhance the Tragedy of the Commons.  I would classify world political powers in the same category of world culture.  A political government is typically established to control and operate an existing country and population, and to also set standards for expansionism that benefits that country.  As long as this model exists, there will be problems.  Safety and prosperity for all cannot occur when there is first, economic disparity between cultures and secondly, conflicting ideology of how to obtain prosperity using established, cultural differences and biases.  A simple parallel to this idea would be the current war in Iraq.  Although Saddam Hussein is a murderous tyrant in much of the world’s eyes, what is the interpretation by the people in Iraq?  If the opportunity for power arose, would another sect be just as bad or worse?  Do they understand the purpose of U.S. involvement in their country or do they believe this to be a war for oil and that we are trying to steal what is rightfully theirs?  Their culture is very old and established, but do they know or care about world good when they are focused in a direction that defers all outcomes, good and bad, to the will of Allah.  Can there be reasoning with a culture that demands a religious, ‘god-given birth right’ that may include our extinction?  This may be somewhat dramatic, but I believe that it does make my point regarding world cultures.  Interaction of world cultures requires more than just communication or education.  To move beyond the ideals of personal conservation and positive community action we need to establish a workable interaction between world cultures. This would include educational awareness of environmental problems, a realization that they are part of both the problem and the solution, and finally, incentives and penalties for not achieving goals for sustainability and prosperity. 

To this point, I have focused on three areas that influence world sustainability, personal, community and world culture interaction.  Within these three areas exist barriers due to economic, political, religious, and educational patterns.  These direct patterns of bias restrict positive interaction and environmental security, preservation and advancement.  I will dedicate the remainder of this paper to discussing existing theories for environmental and social sustainability and imparting some of my own ideas for social success.

Four basic solution types have been proposed (Ophuls, 1973, 1977) to promote environmental and social sustainability.  Governmental laws that establish regulations, incentives and penalties are coupled with education regarding societal problems.  These first two are promoted through small groups in a community setting to bring a sense of belonging to individuals within that community.  Religious ideals and a moral code of ethics are also stressed.  This imparts a sense of responsibility in each member of that community.  Researchers and educators may differ on the importance of any one of these four areas alone. I think, however, that they would agree on the need to establish both legal and moral principles to achieve their goal of environmental protection and social sustainability.  It has been proposed that implementing laws allows moral choices to occur, rather than trying to force opinions without a legal standing.  I believe that this idea holds merit.  Asking someone to do the right thing does not insure that they will comply.  By enacting a law, however, that same person understands there is a legal obligation to perform an activity.  He or she will likely perform the activity willingly and voluntarily without being told what is expected.  This method of societal compliance allows laws to establish a base of expected behavior that is willingly followed because people know it is the right thing to do.  I feel that enacting basic laws regarding social behavior is a good thing.  An expected level of behavior insures that my neighbor won’t be using poisons on his yard that will affect my family’s health.  Basic laws insure that the environment is protected and not destroyed by others.  Laws also force me to comply with what is best for my neighbor and community.  Establishing incentives helps to solidify compliance of laws and moral obligations regarding society and the environment.  Incentives are technique approaches that are used to eliminate barriers for a desired result.  People would likely drive more fuel-efficient cars if they were compensated in some fashion for giving up what they already possess.  Compensation could be in the form of a monetary rebate, a vehicle of equal quality or a realized, direct benefit to them by driving a fuel-efficient, environmentally friendly vehicle.  An example could be the new British Mini Cooper.  The car is stylish, affordable and has great performance.  The marketing campaign was directed at the 25-45 year old age bracket and has been highly successful.  The marketing campaign did not use a ‘green theme’ and targeted everyone equally. 

Other incentives for change are directed at corporations and business.  When a business can make financial gains in the form of loans, rebates and tax strategies they will take notice of a desired social change.  The business world will fight change that costs them money and does not realize direct benefits to the business itself, employees or customers.  No matter what the incentive, unless it is explained in clear terms to the desired person, community or business, action is unlikely.  Strategies must also be applied because an incentive that seems too good to be true may actually be counterproductive to change (Gardner & Stern).  Incentives seem to work best in combination with other influencing techniques.  Offering an energy company property tax relief may be incentive enough for them to implement cleaner air standards.  Laws without incentives or direct benefit to the business entity will probably not achieve successful compliance of the desired behaviors. 

The limitation of laws is evident when interacting globally.  Other countries often do not respect the laws we have enacted in this country and have no intention of replicating them in their country.  The economic windfall that they realize from American business relocation may insure that their standards remain low.  This will price fix products for the American consumer and give the foreign worker a temporary betterment in their quality of life.  The social and environmental devastation will likely go unchecked until there are laws passed and incentives in place not to go overseas for labor.  The political machine in this country will, however, erode locally and globally when we lose our production base that business affords us.  A shift in production out of this country makes us greater users than producers and weakens our social structure.  The average American may not notice the slow economic erosion until it is too late.  They are thinking locally when they should be paying attention globally.  These thoughts parallel Forester’s (1969,1980, 1987) ideas of counterintuitive behavior.  His four principles detail human ineffectiveness to realize the cause of problems.  He proposes that the symptom of a social problem dominates the cause, resulting in an ineffective resolution of a problem.  He further states that short-term gain often overrides long-term solutions and that we are often unable to determine what the leverage points are that could make a significant change.  He also notes that an immediate, local solution may have broader consequences.  This could be explained as bringing in a host animal to contain another animal population only to end up with the eradication of an unexpected, desirable species.  Socially it could be described as soliciting Wal-Mart to a small town in the hopes of cheap goods and more jobs only to realize that 5 downtown businesses closed their doors because they were unable to compete with the large retailer.  Former business owners and taxpayers will become cheap employees for a large retailer who gets tax incentives and uses Third-world labor.  This reveals to us that the problem of social responsibility and planetary sustainability are intertwined.  They are not separate entities.  Problems need to first, be addressed individually and then within our communities so as to affect change globally. 

I do believe that there are steps that we can take as individuals and specifically, as health care professionals to benefit the world around us.  I propose that personal accountability be stressed at home and in our schools.  This is paramount.  Parents have an obligation to teach their children social right from wrong.  This begins at home and must carry over into the educational system.  When parents take a stance for social responsibility the educational system will follow.  As educators, the psychology profession needs to directly target the parents for change.  Social awareness of environmental changes that must occur often meets with initial resistance.  Rather than attempting to battle resistance one-on-one, a direct campaign needs to be implemented through media outlets like newspapers, radio and television.  Instead of asking for social change, the attitude should be one of already occurring change.  If people are led to believe that change is happening whether or not they do anything, the resistance will be less than if they think they have a choice in the matter.  Once people think that an action is being taken, they will want to be a part of it.  Everyone wants to be associated with a winner.  Enacting appropriate laws at a later date would be an unemotional afterthought.  The public won’t care because change is already happening.  I believe that to enact a social change, the emotional aspect of the issue must be removed.  Social and environment psychologists need to develop marketing techniques that eliminate bias for change by making the issues emotionless.  An example of this would be the ongoing issue of fossil fuel consumption.  When fossil fuel use is interpreted as merely an evolutional nuisance to future energy advancements, the emotional dependence will wane.  If we look back 40 years, we can see societal change that was a direct result of the space program.  Even the fins on automobiles were a result of pending space flight.  No one even doubted that progress was immanent. Anything seemed possible.  To doubt it was to be ignorant and backward.  That type of thinking needs to return if we are to be successful in our attempts to make social change that will advance individuals, protect our environment and provide sustainability.  This can all begin on the individual level through personal interpretation that will be reinforced by community action and implementation. 

Community change may have a better chance of success if leaders within the community focus on the community as a whole and reduce their own bias.  The lure of money and power often inhibits a community leader from implementing change that would deprive him or her of that benefit.  We need to elect officials that will work on behalf of the community and not for entities within the community.  With the surge of immigration to this country, the decisions are not black or white, but every color in-between as well.  Social and environmental psychologists need to be involved in these communities.  Immigrants need to realize that they need to assimilate.  I think that some of the seemingly important distinctions of the past 30 years need a revision.  The terms African-American, Asian-American, Mexican-American and others need to be eradicated from our social vocabulary.  We all know what our genetic background is and what cultures we came from.  To impart cohesiveness we need to continually stress the idea that we are all Americans.  What we do in our communities is based on our acceptance of being Americans.  We cannot expect a racially mixed society to function as one if divisions are stressed and encouraged.  These divisions, however, are often encouraged when officials run for office or money benefits are at stake.  The social and environmental psychologists need to be involved in merging the cultures that make up a community.  This will influence thought and behavior for change.  Schools also need to be concerted in their efforts to stress Americanism and cohesive unity.  This will develop responsible behavior toward our neighbors because they, like us, are Americans.  When individual thoughts and actions are unemotionally changed by cohesive education and sublime action, the demands of the community in which each of us live will change.  This is an evolutionary process that will take more than one generation to succeed. Positive perseverance is the key.

The social and environmental psychologists will have a more difficult task when trying to change worldviews of environmental protection and population sustainability.  This is largely our own fault.  Not because we don’t care, but because we have not shown the world that we do care.  Telling a poverty stricken nation that they are wrong for stripping away their natural resources of wood, farm land or ore deposits is ineffective for change when they see the apparent riches of our country.  What they don’t see is the technological advancements that make our appearance of wealth possible.  There are environmentally safer ways of obtaining oil and natural resources without decimating the land itself.  Our state and federal pollution agencies restrict certain harmful pollution practices. This may be inconvenient and expensive in some instances, but it is better for long-term sustainability of our society and that of the world.  Our leaders need to share technology with other countries that will allow them to become viable and successful.  Technology may be specific designs or equipment that improves their quality of lives, but they need to realize that technology demands responsibility.  The use of technology has consequences.  Supplying technology to developing nations means education, support and a demand of responsibility from each nation.  When a developing nation believes they have the ability to compete on a world market level they are no longer in a survivalist mode.  It is at that moment when they realize they have responsibilities.  It is irresponsible to tell a homeless man that eating from a dumpster is unhealthy.  By giving that man a job with demands and expectations you will have a productive member of society.  The world stage is similar.  We must control the current devastation to our planet, the overuse of its resources and the exploding population of those who use those resources.  We do not have a choice.  The outcome is obvious when presented with the current data.

I hope that you enjoyed this piece.  Even if you don't agree with all of the ideas, it forces everyone to think about 'what they do believe in'.  This country was established by intelligent and educated people (89-95% could write and write) who made choices.  Most countries around the world were not established in such a manner.  We may be somewhat spoiled and complacent in our local and global attitude.  I think that with the events of recent years, we have lost the luxury of complacency.

Have a great month and I will see you in February!

Take care,

Dr. Frisch