Homeostasis Theory of Well-being

Homeostasis is a singular unifying principle for all living beings. Homeostasis operates at all levels of nature in every living system: in molecules, cells, tissues, organs, organisms, societies, ecosystems and the planet as a whole (Lovelock, 2009). Tissue homeostasis regulates the birth (mitosis) and death of cells (apoptosis); many diseases are directly attributable to defective homeostasis leading to over production or under production of new cells relative to cell deletion (Fadeel & Orrenius, 2005).

Biochemical and physiological feedback loops regulate billions of cells and thousands of compounds and reactions in the human body to maintain body temperature, metabolism, blood pH, fluid levels, blood glucose and insulin concentrations inside the body (Matthews et al., 1985). A body in good physical health is in biochemical and physiological homeostasis. Severe disruptions of homeostasis cause illnesses or can be fatal.

The General Theory of Behaviour (GTB) (Marks, 2018) extends the principle of homeostasis to behaviour, experience and psychological well-being.

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A basic structure for homeostasis. Homeostasis involves several interacting processes in a causal network. A homeostatic adjustment in one process necessitates a compensatory adjustment in one or more of the other interacting processes.

Illustration credit: Graham McPhee.

The General Theory proposes that all behaviour and experience follow the principle of homeostasis. The GTB distinguishes between Physiological or ‘Type I’ Homeostasis and Psychological or ‘Type II’ Homeostasis. Homeostasis also operates at lower levels of organisation including the cellular level (Type O Homeostasis) and higher levels of organisation including the social (Type III Homeostasis) and ecological levels (Type IV Homeostasis).

A person in good health is in a state of homeostatic balance that operates across all five systems of cellular, physiological, psychological, social and ecological homeostasis. Outward and inward stability in any living being is only possible with continuous accommodation and adaptation. All living beings strive to maintain equilibrium and stability within themselves and the surrounding environment through millions of micro-adjustments and adaptations to continuously changing circumstances. In any conscious being, adjustments and adaptations can be both conscious and unconscious. However, the majority of fine adjustments occur at an unconscious level, hidden from both external observers and the individual actor.

The General Theory can be illustrated using the moderately complex system that regulates well-being. The Homeostasis Theory of Well-being utilises the fact that human beings are natural agents of change. Humans adapt, accommodate and ameliorate under continuously changing conditions, both external and internal, to maximise the stability and equilibrium of physical and mental well-being. A diagram describing the Homeostasis Theory of Well-being (HTW) is shown below.

Screen Shot 2018-08-22 at 14.38.20The Homeostasis Theory of Well-being  (Marks, 2015)

In this theory, well-being is the outcome of a multiplex of continuously changing feedback loops in a system with four component processes: well-being; cognitive appraisal; emotion; and action. Homeostasis maintain both physical and psychological equilibrium with the ever-changing external and internal environments courtesy of an infinitude of micro-feedback-systems that fall within four macro-systems.

Psychological homeostasis regulates through feedback loops that control thought, emotion and action. Continuously flexible micro-adjustments of activity within feedback loops maintain equilibrium from moment to moment. Psychological homeostasis occurs in response to the infinite variety of circumstances that can affect well-being, including both internal adjustments (e.g. emotional regulation) and external adjustments using deliberate behavioural regulation (e.g. communicating, working, eating and drinking). In synchrony and synergy with all of the body’s other homeostatic mechanisms, psychological homeostasis operates throughout life during both waking and sleep.

In prevention and treatment of clinical conditions, individuals can be helped by technological aids designed to feedback physiological data using behavioural homeostasis, e.g. in diabetes, metabolic syndrome, hypertension, thyroid problems, skin disorders such as urticaria, or obesity. Cellular, physiological and psychological homeostasis are of similar complexity. Behavioural forms of homeostasis occur in actions designed to support neural systems of regulation. Social homeostasis in supportive actions by other humans, requested or volunteered, provides another way to support and protect an individual’s well-being.

Inputs to homeostasis include technological systems such as: (1) scales for measuring body weight; (2) thermometers to measure body temperature; (3) pulse measurements; (4) electro-mechanical homeostasis, developed by engineers to enhance human control systems such as heating (thermostat), driving (cruise control), navigation (automatic pilot), and space exploration (computer navigation systems); (5) life support systems (e.g. artificial respirators, drip feeding, kidney dialysis, intensive care units); (6) medical and surgical interventions; (7) pharmaceutics; (8) alternative and complementary therapies; (9) yoga and meditation.

People are social and affective beings and these are qualities that must be included in any theory of behaviour. The Homeostasis Theory of Well-being needs to be tested in randomised controlled trials and prospective studies to determine its scientific validity and applicability to health care.

Reasons To Avoid Nicotine Replacement Therapy

We all know that tobacco is the world’s number one killer. The tobacco plant itself is not unattractive. It’s the nasty nicotine inside and all the other s**t that ends up in the smokers’ lungs that is the problem.

Big Pharma wishes the world to believe that their drug-based therapies are effective methods to stop smoking. Smokers are offered nicotine in a less risky manner than inhaling smoke from burning tobacco. Or they are offered a medicine as a method of ‘weaning’ off smoking, using one drug to help stop using another.

The effectiveness of drugs is tested in clinical trials. Clinical trials are studies in which people volunteer to test new drugs or devices. All new treatments (drugs and medical devices) must go through clinical trials before being approved by the Food and Drugs Administration (FDA) in the US, the European Medicines Agency (EMA), and the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK.

One would like to imagine that the conclusions reached by these agencies are based on the best information science has to offer. Unfortunately clinical trials and reports can be cleverly manipulated so that drugs appear in a positive light. The area of clinical trials is a minefield of dubious practices, commercial skullduggery and misleading information.

Unfortunately clinical trials are often twisted abominations of science designed to trick people into thinking drugs are safe and efficacious when oftentimes they are the exact opposite.

What can appear on the surface to be well-controlled scientific clinical trials may have a dubious pedigree. There are many reasons for this. Like many other businesses, universities depend upon funds from other industries to increase cashflow. There is pressure on university professors in medicine and psychology to accept research funds from diverse sources including drug companies who need universities to run clinical trials.

For a variety of different reasons the evidence collected from some elements of this research can be tainted and untrustworthy. In order to cross the hurdle of FDA/EMA/MHRA approval, drug companies require positive results from clinical trials that follow rigorous scientific methods. The influence of commercial interests and the need for industrial income flows can lead to outcomes that are not always ideal.

The influence of Big Pharma on governments, regulatory bodies and the professions cannot be underestimated. Its influence on the medical profession begins from the moment a student starts at medical school. Offers of textbooks, study grants, and other incentives start in Year One. The ‘grooming’ process continues throughout a doctor’s career, with many attractive incentives and offers designed to recruit doctors and their patients into clinical trials.

One doctor I know was offered a free flight on Concord and three days of paid holiday in return for recruiting five patients into a trial. University professors who direct the trials are equally well rewarded, as are those who put their names on the papers that report positive clinical findings.

We end up in a situation where the health service and the general public are fooled into accepting expensive drugs that are ineffective or less effective than drug companies claim. Quite often drugs prescribed by doctors on the advice of the ‘authorities’ are nothing more than active placebos with unpleasant side effects.

Unfortunately, this situation exists with the principle method used by smokers to kick the habit, Nicotine Replacement Therapy (NRT). NRT is heavily promoted by companies, endorsed by expert committees, and university professors, yet the evidence on its real world effectiveness is totally lacking. This evidence suggests that it is no better than a placebo or a simple sugar pill.

SMOKING TREATMENT WOMAN

Model.
Nicotine substitutes in the form of chewing gums.


The Sweetener Effect

At first sight, the pharmacy approach to smoking seems a bit nuts. Why would you want to replace one form of an addictive drug by another? You wouldn’t help an alcoholic by drip-feeding them alcohol. That would be absolutely crazy. Ditto, heroin cocaine or ecstacy. So why should experts have us all believe that the best way to cure nicotine addiction is by giving people nicotine?

The answer is simple: it’s the Sweetener Effect. These experts have been bought. That’s right, the leading advocates of NRT have all received payments from the companies selling the product. Big Pharma has big pockets and plays willing academics like puppets on a string. It’s a very old saying that “he who pays the piper calls the tune.” In the field of medicines, there are plenty of willing pipers playing the company’s tune.

I discuss briefly below a few examples of research on NRT and other treatments can never be accepted as trustworthy. The scientists robustly deny that they have been influenced. They are disingenuous or naïve or wrong. Bear in mind that ‘conflicts of interest’ don’t need to be conscious. Financial connections can influence investigators at an unconscious level which can leave them in a state of complete denial. Let’s consider a few examples.

Case 1: Michael C Fiore, a University of Wisconsin Professor of Medicine, in charge of revising US federal guidelines on how to get smokers to quit.
Dr Fiore runs an academic research centre funded in part by drug companies that make quit-smoking aids. Dr. Fiore personally has received tens of thousands of dollars in speaking and consulting fees from those companies.

John R. Polito, founder of WhyQuit published a Press Release on November 12, 2009, containing the following interesting facts:

“After spending millions on the University of Wisconsin’s (UW) studies since 1992, the smoking cessation arm of the pharmaceutical industry expects its money’s worth. Welcome to pay day!
A University of Wisconsin quit smoking study press release told smokers that they needed to purchase and suck on a nicotine lozenge while at the same time wearing a nicotine patch. The spin by Professor GlaxoSmithKline (Dr. Michael C. Fiore) and his staff at UW’s Center for Tobacco Research and Intervention (UW-CTRI) was masterful.
The University’s press release claims to announce key findings from a UW-CTRI study published in the November 2009 issue of Archives of General Psychiatry entitled, “A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies.”
Used in three of five active group study arms, the nicotine lozenge was clearly the study’s focus. GlaxoSmithKline’s Commit nicotine lozenge was the only lozenge sold when the study was commenced in September 2004.
Arguably, no man on earth has done more to promote use of replacement nicotine products (NRT) than Dr. Michael C. Fiore. In 1992 he was lead author of a nicotine patch review published in the Journal of the American Medical Association (JAMA). He subtitled his paper “Clinical Guidelines for Effective Use.” It foretold his future in serving as lead author and panel chairman in coining official U.S. quit smoking policy in 1996, 2000 and 2008. It’s called the PHS “Clinical Practice Guideline,” and each time was written and updated by expert panels drowning in pharmaceutical industry financial influence.
Dr. Michael C. Fiore founded and has served as director of UW-CTRI since its creation in 1992. He co-authored this new study along with six UW-CTRI staff members.
In 1998, GlaxoSmithKline (then Glaxo Wellcome) spent $1 million to establish a University of Wisconsin Foundation “named chair” for Dr. Fiore to occupy. According to Dr. Fiore’s sworn testimony, the endowed chair made available to him unrestricted grants of up to $50,000 per year.” (Slightly edited by the author).

Case 2: A review of the effectiveness of Nicotine Replacement Therapy published by Drs. Silagy, Lancaster, Stead, Mant and Fowler in 2004 by the Cochrane Library.
The Cochrane Library is held up to be the repository of ‘Gold Standard’ scientific reviews of therapies and medicines. The information in the Cochrane Library influences decision-making by authorities who approve new medicines and technologies such as the ‘NICE’. The authors concluded: “All forms of nicotine replacement therapy (NRT) can help people quit smoking, almost doubling long term success rates.”

Yet there was a massive conflict of interest among the authors. A footnote to the publication states: “C. Silagy received funds for consultancy work undertaken (at various times) on behalf of Pharmacia and Upjohn, Marion Merrell Dow, Glaxo Wellcome and SmithKline Beecham. G. Fowler and D. Mant were involved in a trial of transdermal nicotine (ICRF 1994).” One of the reviewers of the paper was Professor Robert J West of University College London (see Case 3 next). It really is like putting the foxes in charge of the henhouse.

Case 3: Professor Robert West, Editor of the journal Addiction. He is also the world’s most vocal advocate of NRT.
Professor Robert ‘NRT’ West has published dozens of papers suggesting positive results from NRT but not a single paper showing zero results. The journal Addiction and Professor West openly admit to conflicts of interest. The journal Addiction has an “Ethical Policy” which states: “ADDICTION has asked its senior editors to provide brief statements on any interests which might be seen as having a potential bearing on the independence of their editorial judgements”. Editor West states: “Robert West has received travel funds and hospitality from, and undertaken research and consultancy for pharmaceutical companies that manufacture or research products aimed at helping smokers to stop. These products include nicotine replacement therapies, Champix (varenicline) and Zyban (bupropion). This has led to payments to him personally and to his institution….”

The trouble is that we simply don’t know how much of an influence there has been. There can be no doubt that travel funds, hospitality, research grants and consultancy payments over a long period of time must have an influence. If a journal editor is a paid consultancy fees by Big Pharma, it is sensible to question the reliability of reports published in his/her name, especially those that advance products made by the sponsoring companies. I have some experiences of my own to draw upon.

In the 1990s I did a piece of research on stress experienced by carers of people with dementia. I do not understand how but Big Pharma has very long tentacles and somehow or another a major drug company got wind of of our results. I certainly did not approach them. However, the company began a charm offensive that was, to put it bluntly, quite inappropriate. My team were invited to give a talk in a symposium at an international conference at a well-known resort in Switzerland. The whole process was quite incredible. From the moment I said I would consider it, the phone hardly stopped ringing.

All kinds of sweet little deals were on offer: business class air tickets, a five-star hotel, a chauffeur-driven limo to the airport, and goodness knows what else. I could hardly believe it when the company offered to prepare our PowerPoint slides for us! This was the moment that I ‘smelt a rat’. We attended the symposium, but my co-presenter and I paid our own fares, booked our own hotel, and prepared our own slides. The symposium team were all “old-hands” who had stayed at a luxury hotel for several days as guests of the company. All had slides showing the company logo.

I wonder what happens to the values of academics as supporters of independent thinking and freedom of speech when the almighty dollar appears on the conference table. I had known the chair of the symposium many years before as a PhD student. I found his role as Big Pharma’s spokesperson a little disconcerting. He told me his hobby consisted of flying his own aeroplane.

There is no limit to Big Pharma’s antics in influencing opinion. One of the key tricks from its tool-bag is to employ ghost-writers to produce the reports of their clinical trials. From the company’s viewpoint, it’s a ‘win-win’, intellectually-lazy-but-enriched academics get their names on papers that they don’t need to write, and, it’s another positive finding, and another cheque in the bank account. Another dollar, another day, and nobody needs to know.

The collaboration between universities and industries has led to an erosion of standards and a distrust of science. Worse, millions of patients are being offered ineffective treatments. The only way to gather trustworthy evidence is to ensure that the clinical trials are independent, unbiased, and free of strings and sweeteners. Sadly, in today’s world, where everything is about profit, that rarely happens.

Reports on clinical trials conducted by the pawns of the pharmaceutical industry too often a sham – exercises in propoganda nothing to do with natural science. And guess who pays? You, me, patients and consumers!

To be continued...

Stopping the Obesity Crisis

The two people illustrated above, Claude Bernard and Walter B Cannon, discovered and named the phenomenon of ‘homeostasis’.  They couldn’t possibly have ever guessed this, but their ideas could ultimately help to stop the current obesity crisis.

Homeostasis is a universal principle of living beings, a necessary requirement for life. Homeostasis maintains equilibrium at set-points using feedback loops for optimum functioning of the organism. Long-term disruptions of homeostasis or ‘dyshomeostasis’ arise through genetic, environmental and biopsychosocial mechanisms causing illness and loss of well-being including obesity, the addictions, and chronic conditions. These and many other phenomena of Psychological Homeostasis are explained in A General Theory of Behaviour.

Obesity dyshomeostasis is associated with a self-reinforcing activity of a vicious Circle of Discontent in which hedonic reward overrides weight homeostasis in an obesogenic and chronically stressful environment. Over-consumption of processed, high-caloric, low-nutrient foods, combined with stressful living and working conditions, have caused loss of equilibrium, overweight and obesity in more than two billion people.

The prevalence of obesity is higher in women and low-income groups who are more exposed to chronic stress and low purchasing power including some ethnic minority groups.

Research on different diets suggests that a plant-based diet containing low amounts of sugar, little or no red meat and the minimum of fats promotes weight-loss and prevents obesity, diabetes, metabolic syndrome, coronary heart disease, and cancer. A vegan diet with no meat, fish or dairy is especially anti-obesogenic.

The ‘thin ideal’ pervades popular culture with narratives and images of thinness which has an entirely negative effect on youth the world over. Legislation should be enacted to ban the use of artificially enhanced images of ultra-thin models in magazines and media.

Discrimination against people who are overweight or obese causes stress and socio-economic disadvantage. Approaches to the epidemic that invoke a narrative of ‘blame-and-shame’ exacerbate the problem. There are very few people who deliberately become obese through conscious effort or who would not like to avoid it if they possibly could.

Homeostatic imbalance in obesity includes a ‘Circle of Discontent’ (COD) a system of feedback loops linking weight gain, body dissatisfaction, negative affect and over-consumption. This homeostatic COD theory is consistent with a large evidence-base of cross-sectional and prospective studies.

A preliminary model suggests that obesity dyshomeostasis is mediated by the prefrontal cortex, amygdala and HPA axis with signalling by the peptide hormone ghrelin, which simultaneously controls feeding, affect and hedonic reward.

The totality of evidence within current knowledge suggests that obesity is a persistent, intractable condition. Prevention and treatment efforts targeting sources of dyshomeostasis provide ways of reducing adiposity, ameliorating addiction, and raising the quality of life in people suffering chronic stress.

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Vigorous and uncompromising Governmental actions are required, independent of corporate interests, at all levels of society to reduce the prevalence of obesity and related conditions. A four-armed strategy to halt the obesity epidemic is necessary.

There is an immediate need to enact anti-discrimination legislation to protect people with obesity and improve their quality of life. Anti-discrimination laws are necessary to eliminate one of the primary causes of obesity which fuels the Circle of Discontent. PLWO need legal protection from discrimination which has been shown to be detrimental to the mental health of the victims of obesity.

Legislation to enforce a mandatory code of practice is needed to resist and devalorize the thin-ideal. Precedents have been set in Israel and France to ban models with extremely low BMI, examples which should be followed in all countries. The retouching of pictures in fashion magazines to make the human subjects appear slimmer or more attractive should be controlled. Consumers should be informed when images of people have been manipulated.

Generic legislation is necessary to curb the widespread consumption of energy-dense, low nutrient foods and drinks. Mexico, France, Finland and Hungary and, most recently, the UK have set charges for a levy on sugary drinks, a step in the right direction. More generic taxation is necessary to incentivize producers and retailers to reformulate products. An ‘Unhealthy Commodities Tax’ which would yield revenue and improve the diet of a large segment of the at-risk population.

Improving the access to plant-based diets is an effective strategy for producing weight loss. The example of the WIC in the US indicates that increasing access to fruit and vegetables has a positive effect on food consumption towards a healthier diet. Following the WIC model, legislation should be considered in every state and country to improve F/V intake. Proceeds from a UCT could be used to subsidise the organic production of F/V with payments to growers and sellers to enable lower retail prices of organic F/V. Interventions to increase access and affordability of F/V would help to slow the obesity epidemic.

Huge resources have been invested on the monitoring of the epidemic and on the treatment of PLWO. The major part of future investment should be re-directed towards containment and control by legislating strategies for obesity prevention as was previously the case in tobacco control. No more kowtowing to industry. Let’s cease the “shock-horror” narrative of obesity at all levels of society and replace it by concrete actions.

We know what is required. Can our national governments show the necessary leadership and do what is necessary? The survival of the planet and the human race requires nothing less.

Stop Smoking Now

If you’re a smoker and want to give up the habit, then Stop Smoking Now is designed for you. The approach involves restoration of homeostasis without nicotine in the body or nicotine replacement, e-cigarettes or any other kind of crutch in the form of medication.

The truth is Stop Smoking Now could not only save your life, it offers you a healthier and longer life as well. It also could save you a shed-load of money. A new car every year, fabulous holidays, and a much higher quality of life are all yours if you really want them. But it isn’t really about the money. It’s about your health and well-being.

To gain these benefits, all you need to do for the next 7-10 days is to follow the process. Yes, that’s right, it really is that simple. Hard to believe, right?

Well consider this. I have spent the last forty years fine-tuning the best possible ways for smokers to overcome the habit. My role as a Health Psychologist has brought me into contact with people from all backgrounds and cultures who have been at all the different stages of stopping smoking. In many cases, the smokers started out as desperate and hopeless cases, feeling that nothing could work for them. They had tried almost everything to stop smoking, but nothing had succeeded. Instead of blaming the faulty and futile systems they had been using to stop smoking, including most of all, their own willpower, they typically blamed themselves. They blamed themselves for being “weak”. Sounds familiar?

All a person needs to stop smoking is a system that actually works. A week or two weeks of serious application and, bingo, you will hit the jackpot, stop smoking, and remain a smoker for the rest of your life. Like many ex-smokers, you will experience feelings of joy and empowerment, hugely increased self-control and life satisfaction by achieving what previously seemed impossible – to stop smoking. Nothing can offer you a greater boost to your self-esteem than to stop smoking, absolutely nothing. It’s better than winning the lottery. Because it’s not just about the money you’ll save, it’s about a Whole New You.

Stop Smoking Now gives you the most effective method of stopping smoking. The processes described here will enable you to bring about the change.

I know – I have been there!

In my twenties virtually everybody was smoking. Smoking was the natural and normal thing to do. You could smoke almost anywhere. In shops, cafes, pubs, clubs, cinemas, theatres, absolutely everywhere. It seems crazy now, but that’s how it was. I was a pack-a-day smoker and guess what, I actually thought I was enjoying it. Sound familiar?

Cigarette advertising was everywhere. In newspapers, magazines, on TV, at the movies and on huge billboards all over the place. People would literally drive along motorways and freeways smoking cigarettes and crash their cars gawping at the billboards. It seems a different reality now, but that’s exactly how it was. All kinds of subtle and clever messages designed to get everybody to smoke a particular brand. Brands for ladies, brands for teens, brands for minorities, brands for everyone.

My brand was XXXXX. I don’t really know why. I can’t explain it. As far as I was aware, it had nothing to do with the evocative brand imagery. But at a pre-conscious level, it almost certainly had a lot to do with it. Of course, I tried other brands too, but I usually drifted back to XXXXX. I had probably been smoking for about 10-11 years when something happened that stopped me in my tracks and got me thinking. I switched to the low tar version of XXXXX, called XXXXX Ultra Lites.

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I was living in the US when I switched to this ‘sleek’ low-tar brand, a supposedly ‘safer’ method of smoking – ‘safer’ according to the the big tobacco companies, that is. My grey-and-white pack of XXXXX looked smooth and on-trend, the perfect thing for a ‘Man-about-Town’. Like millions of others all over the world, I was one ‘cool dude’ making the switch to ‘low tar’. Until I discovered the truth, that is…

Little did I realize at first what a complete sham these ‘lights’ really were. The tobacco companies had discovered the sneaky idea of making tiny holes in the sides of the filters so when you inhaled you got extra air mixed in with the smoke. This fooled the machines used for measuring cigarette tar levels into assigning lower tar levels inside the cigarettes. Millions of ‘cool dudes’ all over the world were being taken for a ride because the cigarettes contained the exact same chemical concoction of tobacco as the regular, high tar brands. And you paid extra for the privilege! When the government scientists finally figured out what was going on, the terms “light,” “low,” and “mild” in product labeling and advertisements were banned in the USA.

A week or two after I had made the switch I woke up one morning with an unexplained headache and began to notice I was having to inhale ever more deeply to get any real ‘satisfaction’ from my Ultra Lites. This was in 1976 when I was working at the University of Oregon with Professor Ray Hyman. Ray Hyman remains one of the tiny number of people to have one of Psychology’s few real ‘laws’ named after him: the ‘Hick-Hyman Law’.

One evening over dinner Ray gave me a penetrating stare and said: Given all you know about the ill-effects of smoking, why the heck are you still smoking? He stopped me dead, so to speak. I really couldn’t give a rational answer. It was at that very moment that I decided to give up smoking. Within a few days of preparation, I did it. I destroyed my remaining cigarettes and never smoked again.

As I sit at my laptop, forty years later, I can honestly say that I gave up smoking thanks to the headaches from my XXXXX Ultra Lites and the pep talk from my friend. My thanks go out to them both. This was the best health-related decision that I took in the whole of my life. Thanks Ray! Thanks XXXXX Ultra Lites! It’s now forty short years since I quit smoking.

Once I took the decision to quit smoking, however, it was far from plain sailing. I discovered how very difficult it can be. I was crotchety with the whole world. I couldn’t sleep properly. I was sharing my woes with the inside of a beer bottle. There was an inexplicable gap in my life. A vacuum of nothingness that was difficult to fill.

This was how it all started, the main reason I decided to write books and run programmes and campaigns to help other people to stop smoking. After I returned from my visit to the US, a very smart PhD student called Paul Sulzberger came to me with the idea. He and I started running Stop Smoking courses. We put together a course of five sessions that groups of people attended over a period of eight days. The sessions started on a Tuesday and finished the following Wednesday. It was highly successful. Eighty-five percent of smokers had given up by the end of the eight days. The remaining 15 percent had all reduced their consumption significantly.

News of our Stop Smoking programme spread like wildfire and we took the programme all over New Zealand and into Australia. We must have helped 20,000-plus smokers give up the habit. Our research and an independent research organisation told us that we were producing some very exciting results, the highest cessation rates ever recorded. We did ads on TV and in the major papers and franchised the system internationally and it is still running under various umbrellas to this day.

In the mid-80s I returned to London as Head and the first Professor of Psychology at the School of Psychology at Middlesex Polytechnic. The busy London lifestyle felt a bit different to more laid-back New Zealand. In my efforts to continue the march against smoking, I needed a more efficient approach so I converted the method into a self-help pack I called the QUIT FOR LIFE Programme, which was published by the British Psychological Society.

The BPS QFL Book Cover

In 2005, the first edition of the version you are now reading was published. In its current edition, Stop Smoking Now has proved to be the most successful stop smoking method ever invented. Yes, that’s right, ever invented.

I have the results of scientific trials prove this. One of my most memorable moments was when I returned on a visit to the beautiful South Island of New Zealand on holiday with my son, Michael. While in Dunedin we visited a friend who lived in the suburb of St Clair. It was a warm and sunny afternoon. A person who, at first I did not remember, had taken my smoking cessation programme many years before came over, looked me straight in the eye, and said: “You saved my life. You helped me stop smoking 25 years ago. Now I’m 75 and fit as a fiddle, thanks to you, I wouldn’t still be here if you hadn’t helped me stop smoking.” This is not the only time I have received the heart-warming announcement: “You saved my life”. Many others have said exactly the same thing.

On the other side of the coin, a friend of a friend in New Zealand just died of cancer and told my friend on the phone to me just before he died, “I should’ve taken more notice of Dave’s ant-smoking programme”.

I too probably wouldn’t still be alive today if I hadn’t stopped smoking. I know from bitter experience. I watched my one-and-only brother Jon die from throat cancer caused by smoking. Jon had only just reached his sixtieth birthday.

But that’s all history now. Let’s return to the present…You are on a different path, a path that can lead to health, increased quality of life, and happiness.

What You Need To Stop Smoking Now
If you have the book, you have already taken the first precious step on the path to changing your smoking habit. You will have within your hands a powerful and unique system designed to enable you to reach this important goal to stop smoking. You have the desire. You have the motivation. You have the ability. In this book, you have the strategies, the know-how you need to do it, to Stop Smoking Now. Follow the guidance in this book, and you will stop smoking in just a few days, and, think about it, you will never need to smoke again!

This will be the most important step to improve your health that you can take in the whole of your life. Experiencing the process from beginning to end is something you will never forget. You will be a changed person, a New You.

You already realize that smoking is the most stupid, addictive and harmful habit known to humankind. It is predicted that one billion people will die in the 21st Century as a consequence of smoking. One way of solving the world’s population explosion, I suppose… But a smoking-related death it’s not normally a quick death. Smoking-related illnesses are nasty, protracted and painful and require thousands of health care dollars. Having watched my brother slowly die in great pain, it’s something I wouldn’t wish on anybody.

Stop Smoking Now offers you the best chance to overcome your smoking habit without any help from Big Pharma. It offers you a way to extinguish the habit, once and for all. And that’s without taking a shed load of gut-busting drugs. The methods in this book have been evaluated with hundreds of smokers in randomized controlled trials. Tens of thousands of people like you have successfully overcome their smoking habit using these methods.

If you use all of the procedures with commitment and perseverance, you will overcome your smoking habit for ever. You twill be a Calm and Confident Non-Smoker.

An addicted smoker is always, to a degree, dysfunctional. The changes that make you will make will help you to be a fully functional human being again. Like you used to be before you took up the habit, or rather, before the habit took over you.

Drinking, eating, Internet surfing, shopping, chilling, watching TV, gaming, gambling – anything to excess can quickly turn into an addiction. Smoking is a habit which seems extremely difficult to change. As an ex-smoker I know. But smoking can be brought under control easily and permanently by applying this systematic programme.

The book can be used as a stand-alone, self-help, how-to method of quitting or it can be combined with the treatment offered by your local health service providers. Two or more smokers can also Stop Smoking Now together to generate an element of cooperation, or even competition. Who gets there first, is always an interesting challenge, as is Who stays there the longest?

I wish you absolute and complete success in becoming a happy and successful non-smoker.

A General Theory of Obesity

Inside every one us there exists a tension between comfort and discontent. When we assuage the discontent, we find comfort. When we resist comfort, the discontent builds stronger. This eternal struggle is an aspect of the human condition that creates a vicious and unforgiving circle. Within it lies a significant key to human nature, and to the nature of all sentient beings, the ‘Yin and Yang’ of life…it helps to explain the human struggle with overweight, obesity and the addictions.

Once the causes of obesity are fully understood, the obesity epidemic can be stopped. My book on obesity takes a step towards that goal. I propose an explanatory theory of an objective issue of undeniable importance to human beings – the obesity epidemic. The ideas are drawn from a range of disciplines including economics, endocrinology, epidemiology, neurobiology, nutrition, physiology, policy studies and psychology. The theory focuses on a universal feature of living beings, homeostasis, and the potential for its disruption, dyshomeostasis.

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The evidence points to ‘Obesity Dyshomeostasis’ as a problematic human response to contemporary conditions of living. Similar to racism, sexism and ageism, the current trend towards ‘blaming and shaming’ individual sufferers of obesity and overweight contributes to the problem. Only by reversing this form of prejudice, and the associated environmental conditions, will the obesity epidemic have any chance of being resolved (Marks, 2015a, 2016).

Summary of argument:

Health is regulated by homeostasis, a property of all living things. Homeostasis maintains equilibrium using feedback loops for optimum functioning of the organism. Dyshomeostasis, a disturbance of homeostasis, causes overweight and obesity, is estimated to be present today in more than two billion people world-wide.

Obesity Dyshomeostasis is associated with a ‘Circle of Discontent’, a system of feedback loops connecting weight gain, body dissatisfaction, negative affect and over-consumption. The Circle of Discontent is consistent with an extensive evidence-base.

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Obesity Dyshomeostasis occurs when homeostatic control of eating is overridden by hedonic reward. Appetitive hedonic reward is a natural response to an obesogenic environment containing endemic stress and easily accessible, high-energy foods and beverages. In a time of plentiful and cheap food, people eat more to comfort their discontents than purely for hunger. The comfort foods and beverages that are snacked on almost limitlessly are nutritionally deleterious to the health.

The objectives are: (i) To define, describe and discuss the concepts of psychological homeostasis and dyshomeostasis and their relevance to overweight, obesity, the addictions and chronic stress; (ii) To propose a General Theory of Well-Being founded on the construct of psychological homeostasis; (iii) Within the general theory, to specify the Obesity Dyshomeostasis Theory (ODT) of overweight and obesity; (iv) To summarize the body of evidence that is supportive of the general theory and the ODT; (v) To describe interventions for preventing overweight and obesity based on the ODT.

Obesity dyshomeostasis is mediated by the prefrontal cortex, amygdala and HPA axis with ghrelin providing the signalling for feeding dyshomeostasis, affect control and hedonic reward. Dyshomeostasis plays a causal role in obesity, the addictions and chronic conditions and is fueled by negative affect and chronic stress. Prevention and treatment efforts that target dyshomeostasis provide strategies for reducing adiposity, ameliorating the health impacts of addiction, and raising the quality of life in people suffering from chronic conditions and stress.

A four-armed strategy to halt the obesity epidemic consists of eliminating the causes of overweight and obesity: (1) Resisting and putting a stop to a culture of victim-blaming, stigma and discrimination; (2) Resisting and devalorizing the thin-ideal; (3) Resisting and reducing consumption of energy-dense, low nutrient foods and drinks; (4) Improving access to plant-based diets. If fully implemented, these interventions should be competent to restore the conditions for homeostasis in billions of people and the obesity epidemic could be halted.

Extracted from Obesity. Comfort vs Discontent

Psychology as a Natural Science. Part II: Theory

Psychology begins by identifying, observing and taking measures of natural phenomena that can be investigated experimentally and then modelling the findings using theories. Identification of natural phenomena requires terminology and definitions to refer to the same set of psychological processes. Unfortunately, as noted by others, scholars often use such terms in diverse and idiosyncratic ways which has led to a state of “conceptual and definitional chaos” (Buck, 1990, p. 330). Different phenomena and different schools working from different foundations share little or no common theoretical concepts, experimental techniques, or phenomenal entities to work on. This lack of consensus has led to a multitude of empirical papers reporting data as ‘facts’ and near-random fact-gathering has becomes a mainstream activity in Psychology.

Theories, such as Reference Point Theory (Marks, 1972, described in the previous article) provide models for understanding basic processes in thinking, emotion, and behaviour. No theory exists in a vacuum. Theories are like plants grown from seed in a well-designed, ornamental garden. The garden has a structure, a harmonious pattern of colours, textures and patterns, replicated over years of planning and pruning, pleasing to the eye and lasting through all seasons and weather. Illuminated by theory, information is beautiful. Examples of such ‘scientific gardens’ abound in other natural sciences: Evolutionary theory and Mendelian genetics in Biology; Uniformitarianism in Geology; bonding, reaction, valence, molecular orbitals, orbital interactions and molecule activation in Chemistry; Newtonian mechanics, conservation of energy, dynamics, electromagnetism, general relativity and quantum theory in physics. These theories are evidenced by millions of corroborating observations by scientists in these disciplines. To date, Psychology has produced many disparate findings, but few generally accepted theories or laws, and there is consequently hardly any accretion of knowledge.

Psychology has been considered a natural science since the eighteenth century (Hatfield, 1995). Yet in the twentieth century, there was a ‘fall from grace’, for reasons that remain obscure. Perhaps it was the rapid progress of all of the other sciences leaving Psychology to pale in comparison. Philosopher of science, Thomas Kuhn, did not consider that his concept of a scientific ‘paradigm’ as a standard, perspective, or set of ideas, could be applied to any existing social science including Psychology.

A necessary condition for Psychology to be considered a natural science is the existence of an explanatory principle for psychological phenomena across the board that is capable of unifying the discipline.

Paradigms

The construct of ‘scientific paradigms’ was introduced by Thomas Kuhn (1968). The General Theory of Behaviour (Marks, 2018) is based on the classical ideas of balance and equilibrium. Galen (CE 129–200), the early Roman physician, followed the Hippocratic tradition with hygieia (health) or euexia (soundness) as a balance between the four bodily humours of black bile, yellow bile, phlegm and blood. Galen believed that the body’s ‘constitution’, ‘temperament’ or ‘state’ could be put out of equilibrium by excessive heat, cold, dryness or wetness. Such imbalances might be caused by fatigue, insomnia, distress, anxiety, or by food residues resulting from eating the wrong quantity or quality of food. Human moods are viewed as a consequence of imbalances in one of the four bodily fluids. Imbalances of humour corresponded to particular temperaments (blood—sanguine, black bile—melancholic, yellow bile—choleric, and phlegm—phlegmatic). The Theory of Humours was related to the four elements: earth, fire, water and air. It is remarkable that some common beliefs and expressions today are linked to Greek and Roman thought of 2,000-plus years ago.

The idea that there are universal processes of body and mind to restore balance remains as much a principle in contemporary thought as in Classical times. We talk of a person ‘losing equilibrium’, being ‘well balanced’, ‘stable’, or ‘unbalanced’ or ‘unstable’ and so forth, all of which hark back to the idea of keeping oneself in balance. When applied to behaviour, the terms ‘equilibrium’ and ‘balance’ are analogous to the same terms used in mechanics. An object is said to be in a state of mechanical equilibrium when it is stable with equal forces on top and underneath, and when two objects are weighed against each other are said to be ‘in balance’ when the weights on the two sides of the balance are equal.

The related concepts of balance, equilibrium and homeostasis are occasionally used in personality theory (e.g. Stagner, 1951) and in work psychology (e.g. the family/work balance; Aryee, Srinivas & Tan, 2005) but only rarely found in other areas of Psychology. Maslow’s (1943) ‘hierarchy of needs’ assumed a foundation of basic biological needs for air, food, water, sex, sleep, homeostasis and excretion. As need satisfaction moves upwards towards the top of the pyramid, a person becomes more ‘satisfied’, eventually reaching a pinnacle of ‘self-actualization’, which Maslow defined as the epitome of need satisfaction. In asserting that homeostasis is a need, Maslow makes an insightful discovery. We can assume that the need for equilibrium, balance and stability is as fundamental a human need as any other. Internal or external conditions that change the state of an individual, group or population away from equilibrium or balance are normally described as ‘stress’. The concepts of equilibrium, homeostasis and stress are important for the Reset Equilibrium Function proposed in the General Theory.

In Physiology homeostasis is a regulating property wherein the stability of the internal environment is actively maintained. The term was coined by Walter B. Cannon in 1932 in his classic text, The Wisdom of the Body:

“The constant conditions which are maintained in the body might be termed equilibria. That word, however, has come to have fairly exact meaning as applied to relatively simple physico-chemical states, in closed systems, where known forces are balanced. The coordinated physiological processes which maintain most of the steady states in the organism are so complex and so peculiar to living beings – involving, as they may, the brain and nerves, the heart, lungs, kidneys and spleen, all working cooperatively – that I have suggested a special designation for these states, homeostasis. The word does not imply something set and immobile, a stagnation. It means a condition – a condition which may vary, but which is relatively constant.” (Cannon, 1932/1963, p. 24).

“The constant conditions which are maintained in the body might be termed equilibria. That word, however, has come to have fairly exact meaning as applied to relatively simple physico-chemical states, in closed systems, where known forces are balanced. The coordinated physiological processes which maintain most of the steady states in the organism are so complex and so peculiar to living beings – involving, as they may, the brain and nerves, the heart, lungs, kidneys and spleen, all working cooperatively – that I have suggested a special designation for these states, homeostasis. The word does not imply something set and immobile, a stagnation. It means a condition – a condition which may vary, but which is relatively constant.” (Cannon, 1932/1963, p. 24).

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Homeostasis regulates the function of cells, tissues and organs using organised negative feedback systems. Examples at an organismic level include regulation of core body temperature and the levels of pH, sodium, potassium and calcium, glucose, water, carbon dioxide and oxygen in the body. This core principle of Physiology is of equal importance, I wish to argue, for Psychology. Moreover, if a path towards unity across sciences is to be found, then homeostasis provides one valuable stepping stone.

It is argued that a healthy and happy person is a person who is functioning in equilibrium across internal and external domains. To use a colloquial expression, they are a person who ‘has their act together’. A condition of near-perfect well-being, balance and equilibrium is only rarely and momentarily achieved. Many sources of chronic stress including poor work-life balance, social jet lag caused by chronobiological asynchronies, relative poverty, and perceived or real imbalances in wealth, justice and equality, or what has been termed “The Spirit Level’ (Wilkinson & Pickett, 2009)all continuously conspire to make dyshomeostasis a new norm.

When dyshomeostasis occurs, people suffer negative affect, unmet needs such as hunger, thirst, insomnia, and possibly cardiovascular disease, metabolic syndrome or diabetes (Marks, 2015, 2016). Homeostasis, or its lack, is an organizing principle of broad generality throughout the psychological universe of thought, feeling and action. Improved understanding of ‘Psychological homeostasis’ will contribute towards the prevention and treatments of ill-health and dis-ease.

Psychology as a Natural Science. Part I: Measurement

I wished, by treating Psychology like a natural science, to help her to become one.

William James

The Problem

For more than a century, Psychologists have struggled to make their discipline a ‘proper science’.  From introspection, to behaviorism and then to cognitivism, Psychology has fallen somewhat awkwardly between the biological and social sciences. Suffering existential doubt, and always looking over their shoulders, Psychologists never quite found a place of comfort at the high table of Science. Contributing to this liminal status have been three issues, measurement, theory, and paradigm.

In this article, I discuss measurement in Academic Psychology. The branch of Academic Psychology that is usually held up to be the most ‘scientific’ is Psychometrics, otherwise known as ‘Psychological Measurement’. Bizarrely, it is also the largest thorn in the side of Academic Psychology considered as a science. I explain some of the reasons for this curious state of affairs below.

S. S. Stevens – “Mass Delusion”

Attributes of the physical world are measured quantitatively. Attributes of the psychological world are more ‘sticky’ to deal with. For good reason, psychologists are unable to measure many of the most interesting psychological attributes in any direct and objective manner. Unfortunately, measurement in Psychology is an ‘Emperor’s clothes’ story.  The early years as an infant science were spent paddling at the shallow end of the pool with attempts to make psychophysics and ability testing the showcases of a new quantitative science. But it was all downhill from there on.

In spite of limited successes, Psychology’s ‘measurement problem’ has never been satisfactorily resolved. S.S. Stevens’ Handbook of Experimental Psychology (1951) invoked ‘operationism’ as a potential solution and, since that time, Psychologists have assumed as an act of faith that measurement is the assignment of numbers to attributes according to rules. Sadly, Stevens’ solution is a mass delusion, a sleight of mind.

Joel Michell: “Thought Disorder”

Among his many in-depth writings about Psychological measurement, Joel Michell (1997) summarized the situation thus: “…establishing quantitative science involves two research tasks: the scientific one of showing that the relevant attribute is quantitative; and the instrumental one of constructing procedures for numerically estimating magnitudes. From Fechner onwards, the dominant tradition in quantitative Psychology ignored this task. Stevens’ definition rationalized this neglect. The widespread acceptance of this definition within Psychology made this neglect systemic, with the consequence that the implications of contemporary research in measurement theory for undertaking the scientific task are not appreciated…when the ideological support structures of a science sustain serious blind spots like this, then that science is in the grip of some kind of thought disorder.” (Michell, 1997).

A ‘kind of thought disorder’ – strong terms but it is true.

It is apparent that numbers can be readily allocated to attributes using a non-random rule (the operational definition of measurement) that would generate ‘measurements’ that are not quantitatively meaningful. For example, numerals can be allocated to colours: red = 1, blue = 2, green = 3, etc. The rule used to allocate the numbers is clearly not random, and the allocation therefore counts as measurement, according to Stevens. However, it would be patent nonsense to assert that ‘green is 3 × red’ or that ‘blue is 2 × red’, or that ‘green minus blue equals red’. Intervals and ratios cannot be inferred from a simple ordering of scores along a scale. Yet this is how psychological measurement is usually carried out.

Stevens’ oxymoronic approach aimed to circumvent the requirement that only quantitative attributes can be measured in spite of the self-evident fact that psychological constructs such as subjective well-being are nothing like physical variables (Michell, 1999, Measurement in Psychology). However, positivist psychometricians blithely treat qualitative psychological constructs as if they are quantitative in nature and as amenable to measurement as physical characteristics without ever demonstrating so. For more than 60 years many psychologists have lived in a make-believe world where ‘measurement’ consists of numbers allocated to stimuli on ordinal or Likert-type scales. This feature alone cuts off at its roots the claim that Psychology is a quantitative science on a par with the natural sciences.

Measurement can be defined as the estimation of the magnitude of a quantitative attribute relative to a unit (Michell, 2003). Before quantification can happen, it is first necessary to obtain evidence that the relevant attribute is quantitative in structure. This has rarely, if ever, been carried out in Psychology. Unfortunately, it is arguably the case that the definition of measurement within Psychology since Stevens’ (1951) operationism is incorrect and Psychologists’ claims about being able to measure psychological attributes can be questioned (Michell, 1999, 2002). Contrary to common beliefs within the discipline, psychological attributes may not actually be quantitative at all, and hence not amenable to coherent numerical measurement and statistical analyses that make unwarranted assumptions about the numbers collected as data.

Psychometric Myth

Psychometricians often make the precarious assumption that ordinal scales constitute a valid description of underlying quantitative attributes, that psychological attributes are measurable on interval scales.  Otherwise there can be no basis for quantitative measurement across large domains of the discipline. Michell (2012) argued that: “the most plausible hypothesis is that the kinds of attributes psychometricians aspire to measure are merely ordinal attributes with impure differences of degree, a feature logically incompatible with quantitative structure. If so, psychometrics is built upon a myth (p. 255).

This view is supported by Klaas Sijtsma (2012) who argues that the real measurement problem in Psychology is the absence of well-developed theories about psychological attributes and a lack of any evidence to support the assumption that psychological attributes are continuous and quantitative in nature.

Scientific Psychosis

A person with delusions of grandeur can be labeled as suffering from psychosis. But what if a whole discipline has delusions of grandeur? In this case the term ‘Scientific Psychosis’ would not seem inappropriate.

Using ordinal data as if they are interval or ratio scale data leads to incorrect inferences and false conclusions. Using totals and averages requires data to be on an interval scale. Performing parametric analyses on ordinal data can produce biased estimates of variances, covariances, and correlations and spurious interaction effects.

Yet these practices are regular, everyday occurrences in Academic Psychology. I am not talking about first year undergraduate lab classes. I am talking about people at all levels from illustrious professors at Harvard, Yale, Princeton, Oxford and Cambridge.  They not only regularly break the basic rules of measurement themselves on a wholesale basis, they negligently train their students to do it also.

If the received wisdom about measurement in Academic Psychology is characterised as mass delusional, thought disordered and confused, we have a serious problem, a very serious problem. And the problem seems to be getting worse. We can quite justifiably call this syndrome: ‘Scientific Psychosis’.

Thurstone: Ratio Scaling

To be consistent with its claim to be a science, psychologists must use measures that preserve the requirements of a ratio scale, namely, that there are meaningful ratios between measurements. For example, if you have a cold and took three paracetamol tablets today and four yesterday, you could say that the frequency today was ¾ or .75 of what it was yesterday. Measuring objects by using a known scale and comparing the measurements works well for properties for which scales of measurement exist. L L Thurstone (1927) used the method of pair comparisons to derive scale values for any set of stimulus objects with the Law of Comparative Judgement which states:

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In his ‘Analytic Hierarchy Process’, Saaty (2008) also uses direct comparisons between pairs of objects to establish measurements for intangible properties that have no scales of measurement. The value derived for each element depends on what other elements are in the set.  Relative scales are derived by making pairwise comparisons using numerical judgments from an absolute scale of numbers (e.g. 0-9). Measurements to represent comparisons define a cardinal scale of absolute numbers that is stronger than a ratio scale.

Intuitive measurement is something that we take for granted in everyday life. However the way intuitive measurement works may be far from intuitive.  Consider how we are able estimate and compare magnitudes of objects, even when we have never actually seen these objects. For example, how do we compare the sizes of animals such as lions and hippos and judge which is larger or which is smaller? One theory of this process that appears to be especially accurate is described below.

Reference Point Theory

One theory of the estimation and comparison of magnitudes assumes there are implicit minimal and maximal reference points at the extreme ends of the distribution. As a special case of the Law of Comparative Judgement, the theory assumes that stimulus objects are represented by distributions with variances that increase with distance from the reference point contained in the question (Marks, 1972).

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DM with JL PhDThis photo from 1969 shows the author and ‘subject’ with the basic apparatus and stimuli from Experiments 7 and 8 of the author’s doctoral research at Sheffield University, ‘An Investigation of Subjective Probability Judgements’.

Keith J Holyoak

In 2014, Reference Point Theory received strong empirical support from a team at UCLA under the leadership of Keith J Holyoak.  Keith is not only a Distinguished Professor but he is Editor of Psychological Review.  Chen, Lu and Holyoak (2014) present a model of how magnitudes can be acquired and compared based on BARTlet, a simpler version of ‘Bayesian Analogy with Relational Transformations’ (BART, Lu, Chen, & Holyoak, 2012). The authors concluded that Reference Point Theory provided the best fit to their data:

“BARTlet provides a computational realization of a qualitative hypothesis proposed four decades ago by Marks (1972)…The reference-point hypothesis implies that the congruity effect results from differences in the discriminability of magnitudes represented in working memory, rather than a bias in encoding (e.g., Marschark & Paivio, 1979) or a linguistic influence (Banks et al., 1975). BARTlet provides a well-specified mechanism by which reference points can alter discriminability in direct judgments of discriminability (Holyoak & Mah, 1982) as well as speeded tasks (p. 46).”

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As well as being a Distinguished Professor at UCLA, and editing Psychological Review, Keith J Holyoak is also a poet and translator of classical Chinese poetry.  Kudos!

“The greatest scientists are artists as well.” (Albert Einstein).

“The greatest scientists are artists as well,” said Albert Einstein

Homeostasis, Balance, Stability

The fixity of the milieu supposes a perfection of the organism such that the external variations are at each instant compensated for and equilibrated…. All of the vital mechanisms, however varied they may be, have always one goal, to maintain the uniformity of the conditions of life in the internal environment…. The stability of the internal environment is the condition for the free and independent life. Claude Bernard

The central principle of the General Theory of Behaviour is the construct of ‘Psychological Homeostasis’. It was 61 years after Claude Bernard (1865) first wrote about the ‘internal milieu’ that Walter B. Cannon (1926) coined the term ‘homeostasis’. Then, 16 years later, psychobiologist Curt Richter (1942) expanded the homeostasis construct to include behavioural or ‘ total organism regulators’ in the context of feeding. From this viewpoint, ‘external’ behaviours that are responses to environmental stimuli lie on a continuum with ‘internal’ physiological events. For Richter, ‘behaviour’ includes all aspects of feeding necessary to maintain the internal environment. However Bernard, Cannon and Richter all focused on a purely physiological form of homeostasis, ‘H[Φ]’. In my new General Theory of Behaviour, I propose that the ‘external milieu’, the proximal world of socio-physical action, is equally important.

The General Theory extends homeostasis to all forms of behaviour. Psychological homeostasis can be explained in two stages, starting with the classic version of homeostasis in Physiology, H[Φ], followed by the operating features of its psychological sister, H[Ψ]. The essential features are illustrated in Figure 1.

Screen Shot 2018-08-17 at 15.09.57Figure  1: Upper panel: A representation of Physiological (Type I) Homeostasis (H[Φ]). Adapted from Modell et al. (2015). Lower panel: A representation of Psychological (Type II) Homeostasis (H[Ψ]).

To be counted as homeostasis, H[Φ], a system is required to have five features:
1. It must contain a sensor that measures the value of the regulated variable.
2. It must contain a mechanism for establishing the “normal range” of values for the regulated variable. In the model shown in Figure 2.1, this mechanism is represented by the “Set point Y”.
3. It must contain an “error detector” that compares the signal being transmitted by the sensor (representing the actual value of the regulated variable) with the set range. The result of this comparison is an error signal that is interpreted by the controller.
4. The controller interprets the error signal and determines the value of the outputs of the effectors.
5. The effectors are those elements that determine the value of the regulated variable. The effectors may not be the same for upward and downward changes in the regulated variable.

Identical principles apply to Psychological (Type II) Homeostasis (H[Ψ] with two notable differences (Figure 1, lower panel). In Psychological Homeostasis, there are two sets of effectors, inward and outward, and the conceptual boundary between the internal and external environments lies between the controller and the outward effectors of the somatic nervous system, i.e. the muscles that control speech and action. Furthermore, Psychological Homeostasis operates with intention, purpose, and desire.

The individual organism extends its ability to thrive in nature with Type II homeostasis. Self-extension by niche construction creates zones of safety, one of the primary goals of Type II homeostasis. Niche construction amplifies the organism’s ability to occupy and control the environment proximally and distally. The use of tools for hunting, weapons for aggression, fire for cooking, domestication of animals, the use of language, money, goods for trade and commodification, agriculture, science, technology, engineering, medicine, culture, music literature and social media are all methods of expanding and projecting niches of safety, well-being and control.

Individual ownership of assets such as land, buildings, companies, stocks and shares reflect a universal need to extend occupation, power and control but these possessions do not necessarily increase the subjective well-being of the owner [Auxiliary Proposition 007].

Initiated by the brain and other organs, homeostasis of either type can often act in anticipatory or predictive mode. One principal function of any conscious system is prediction of rewards and dangers. A simple example is the pre-prandial secretion of insulin, ghrelin and other hormones that enable the consumption of a larger nutrient load with minimal postprandial homeostatic consequences. When a meal containing carbohydrates is to be consumed, a variety of hormones is secreted by the gut that elicit the secretion of insulin from the pancreas before the blood sugar level has actually started to rise. The blood sugar level starts lowering in anticipation of the influx of glucose from the gut into the blood. This has the effect of blunting the blood glucose concentration spike that would otherwise occur. Daily variations in dietary potassium intake are compensated by anticipative adjustments of renal potassium excretion capacity. That urinary potassium excretion is rhythmic and largely independent on feeding and activity patterns indicates that this homeostatic mechanism behaves predictively.

Similar principles operate in Type II homeostasis acting together with the brain as a “prediction machine”. When we anticipate a pleasant event such as a birthday party, there is a preparatory ‘glow’ which can change one’s mood in a positive direction, or thinking about an impending visit to the dentist may be likely to produce feelings of anxiety, or the receipt of a prescription of medicines from one’s physician may lead to improvements in symptoms, even before the medicines are taken.

At societal level, anticipation enables rational mitigation, e.g. anticipation of demographic changes influences policy, threat from hostile countries influences expenditure on defence, and the threat of a new epidemic influences programmes of prevention. [Auxiliary Proposition 008].

Homeostasis involves several interacting processes in a causal network. A homeostatic adjustment in one process necessitates a compensatory adjustment in one or more of the other interacting processes. To illustrate this situation, consider what happens in phosphate homeostasis (Figure 2). Many REF-behaviours that we shall refer to are isomorphic with the 4-process structure in Figure 2. However, in nature there is no restriction on the number of interconnected processes and any process can belong to multiple homeostatic networks.

Screen Shot 2018-08-17 at 15.10.23Figure 2: Phosphate homeostasis. A decrease in the serum phosphorus level causes a decrease in FGF23 and parathyroid hormone (PTH) levels. Increase in serum phosphorus leads to opposite changes. Calcitriol increases serum phosphorus and FGF23, while it decreases PTH. Increase in FGF23 leads to decrease in PTH and calcitriol levels. PTH increases calcitriol and FGF23 levels. Reproduced from Jagtap et al. (2012) with permission.

Homeostasis never rests. It is continuous, comprehensive and thorough. With each round of the REF, all of the major processes in a network are reset to maintain stability of the whole system. The REF process goes through a continuous series of ‘reset’ cycles each of which stabilizes the system until the next occasion one of the processes falls outside its set range and another reset is required.
Processes in Type II homeostasis may vary along quantitative axes or they can have discrete categorical values. For example, values, beliefs, preferences and goals can have discrete values, as does the state of sleep or waking.

Any change in a categorical process involves change throughout the network to which is belongs. [Auxiliary Proposition 009].

Such changes may be rapid, in the millisecond range, e.g. a changed preference from chocolate chip cookie flavoured ice cream to Madagascar vanilla that may occurs an instant after arriving at the ice-cream kiosk. At the other end of the spectrum of importance, in buying a new apartment, the final choice might also occur in the instant the preferred option is first sighted. Or the decision could take months or years even though it is of precious little consequence, e.g. deciding that one is a republican rather than a monarchist, or it may never occur because we simply do not care one way or the other. These considerations lead to a surprising proposition that:

The speed of a decision is independent of its subjective utility [Auxiliary Proposition 010].

One objective of A General Theory of Behaviour is to explain the relevance of the REF system to Psychology. We know already that the regulation of action is guided by three fundamental systems: (i) the brain and central nervous system (CNS), (ii) the endocrine system (ES) and (iii) the immune system (IS). It is proposed that, as a ‘meta-system’ of homeostatic control, these systems collectively govern both physiology and behaviour using two types of homeostasis, H[Φ] and H[Ψ], respectively. We can understand how this might be possible in light of a recently discovered ‘central homeostatic network’.

An extract from: A General Theory of Behaviour.

Hierarchy of Needs

The General Theory incorporates an amended form of Abraham Maslow’s (1943) motivational needs hierarchy. The diagram shows the hierarchy amended by Douglas T. Kenrick and colleagues  to which in the General Theory of Behaviour is added the process of Type II homeostasis. The first level of the hierarchy for Immediate Physiological Needs already incorporates homeostasis (Type I).  In discussing the second level for “Safety Needs”, Maslow states:

“The safety needs.—If the physiological needs are relatively well gratified, there then emerges a new set of needs, which we may categorize roughly as the safety needs. All that has been said of the physiological needs is equally true, although in lesser degree, of these desires. The organism may equally well be wholly dominated by them. They may serve as the almost exclusive organizers of behaviour, recruiting all the capacities of the organism in their service, and we may then fairly describe the whole organism as a safety-seeking mechanism.” (p.376).

In describing this need in detail, Maslow turned to the needs of children for a predictable, orderly world, a world which is reliable, safe and predictable:

“Another indication of the child’s need for safety is his preference for some kind of undisrupted routine or rhythm. He seems to want a predictable, orderly world. For instance, injustice, unfairness, or inconsistency in the parents seems to make a child feel anxious and unsafe. This attitude may be not so much because of the injustice per se or any particular pains involved, but rather because this treatment threatens to make the world look unreliable, or unsafe, or unpredictable. Young children seem to thrive better under a system which has at least a skeletal outline of rigidity, in which there is a schedule of a kind, some sort of routine, something that can be counted upon, not only for the present but also far into the future. Perhaps one could express this more accurately by saying that the child needs an organized world rather than an unorganized or unstructured one.”  (p. 377)

Maslow specifically links safety with ‘stability’:

“we can perceive the expressions of safety needs only in such phenomena as, for instance, the common preference for a job with tenure and protection, the desire for a savings account, and for insurance of various kinds (medical, dental, unemployment, disability, old age). Other broader aspects of the attempt to seek safety and stability in the world are seen in the very common preference for familiar rather than unfamiliar things, or for the known rather than the unknown.”(p. 379).

Maslow’s bracketing of safety with stability connects the needs pyramid with Type II homeostasis. It is noted that, in the amended pyramid, “Safety Needs” has been relabelled as “Self-Protection”. Thus all motives above level I are part and parcel of the striving for stability and equilibrium that is the function of homeostasis Type II. (Figure 1).

Screen Shot 2018-08-17 at 15.00.28Figure 1. The Hierarchy of Fundamental Human Needs. This figure integrates ideas from life-history development with Maslow’s needs hierarchy. This scheme adds reproductive goals, in the order they are likely to first appear developmentally. The model also depicts the later developing goal systems as overlapping with, rather than completely replacing, earlier developing systems. Once a goal system has developed, its activation is triggered whenever relevant environmental cues are salient. Type I homeostasis operates at level 1. All motives from self-protection at level 2 and above engage Type II homeostasis.  This figure is reproduced by permission from Kenrick, Griskevicius, Neuberg and Schaller (2010).

The amended Hierarchy is Principle II (Needs Hierarchy) of the General Theory, which is stated as follows: In the hierarchy of needs, Physiological Homeostasis Type I is active at level I (Immediate Physiological Needs) and Psychological Homeostasis Type II is active at all higher levels from II (Self-Protection) to level VI (Parenting).

 As priorities shift from lower to higher in the hierarchy we see a progression in developmental priority as each individual matures.  In fact, it is possible to apply the motivational hierarchy at three different levels of analysis: evolutionary function, developmental sequencing, and current cognitive priority (the proximate level). In agreement with Douglas T. Kenrick et al. (2010), the basic foundational structure of Maslow’s pyramid, buttressed with a few architectural extensions, remains perfectly valid.  Need satisfaction is allowed to be a goal at more than one level simultaneously. In light of the amended pyramid, three auxiliary propositions are stated as follows:

Individuals unable to meet their immediate physiological needs at level I of the hierarchy are at a disadvantage in meeting needs at higher levels in the hierarchy. [Auxiliary Proposition, AP, 004].

People with unmet needs for self-protection (level 2) are at a disadvantage in meeting their needs for affiliation (level 3). [AP 005].

In general, people with higher than average unmet needs at any level (n) are at a disadvantage in meeting higher level needs at levels n+m. [AP 006].

The universality of Abraham Maslow’s original needs hierarchy is supported by a survey of well-being across 123 countries. Louis Tay and Ed Diener (2011) examined the fulfilment of needs and subjective well-being (SWB), including life evaluation, positive feelings, and negative feelings.[2] Need fulfilment was consistently associated with SWB across all world regions. Type II homeostasis defined within the General Theory provides a close fit to the natural striving of conscious organisms for security, stability and well-being, described in later chapters. The needs hierarchy amended by Douglas T. Kenrick et al. (2010) is expected to be a close fit to nature.

An extract from: A General Theory of Behaviour.

A Dangerous Idea

“The stability of the internal environment is the condition for the free and independent life.” Claude Bernard’s statement about the ‘milieu intérior’.

The starting point for ‘A General Theory of Behaviour‘ is Claude Bernard’s ‘dangerous idea’, quoted above, the concept of the ‘milieu intérior‘. This idea was put on the back burner for several decades because nobody quite knew what to do with it. It looked too dangerous.

Then, in the early Twentieth Century it was taken up by J.S. Haldane, C.S Sherrington, J. Barcroft and a few others. In 1926 the concept gained currency when Harvard physiologist Walter B Cannon coined the term homeostasis for milieu intérior. In Cannon’s view, his book The Wisdom of the Body had presented a modern interpretation of vis medicatrix naturae, the healing power of nature posited by Hippocrates. Cannon also believed he had shown how the automatic function of homeostasis freed the brain for the more intellectual functions of intelligence, imagination and insight.

At this point, the homeostasis story picks up apace. Add to the mix of Bernard and Cannon, spice the pot with the work of Wiener (1948), Von Bertalanffy (1968) and season it with the work of biologist J Scott Turner (2017) and we have a ‘stew’ to die for. As the contents of the pot bubble and coalesce, we sense that homeostasis is not only advantageous for any living system, but it could even be  one of the defining characteristics of life itself.

At every level of existence, from the cell to the organism, from the individual to the population, and from the local ecosystem to the entire planet, homeostasis is a drive towards stability, security and adaptation to change. In an infinite variety of forms, omnipresent in living beings, is an inbuilt function with the sole purpose of striving for equilibrium, not only in the milieu intérieur but in the milieu extérieur also.

We take a gigantic leap…but that’s why we are here – even if we feel we are at the edge of a cliff – we must go for it…

Cliff edge

On the other side of Bernard’s scientific coin, we imagine we find the following:

“The stability of the external environment is the condition for the free and independent life.”

By changing a single word ‘internal’ to its antonym, a whole new theoretical perspective for the Science of Behaviour is created.

Voila! –  “A General Theory of Behaviour” is born.

Striving for balance and equilibrium is the guiding force in all that we – and all other conscious beings – do, think and feel. This newly defined type of  homeostasis deserves a descriptive name: “Reset Equilibrium Function” (REF). This term describes exactly what the process does: it is a function that resets every runaway process to equilibrium.

All organisms automatically regulate essential physiological functions by homeostasis and it is a matter of everyday observation that drives are maintained in equilibrium by comportment, e.g. eating, drinking, fornicating, sleeping, excreting, etc. This type of homeostasis has been established since the time of Bernard. Far more than this, and as a matter of routine, without any special reflection in most instances, all conscious beings reconcile discrepancies among their thoughts, behaviours, and feelings and in the differences with those with whom they have social relationships.

Conscious organisms strive to achieve their goals while maximizing cohesion and cooperation with both kith and kin and, at the same time, striving to take away or to minimize the suffering and pain of others. [Auxiliary Proposition (AP) 001].

The goal is to minimize all forms of eyeball-to-eyeball confrontation and tooth-and-claw competition and to live in a culture where the thriving of all is in the self-interest of every individual. The hypothesis has been described by Antonio Damasio thus: “cultural instruments first developed in relation to the homeostatic needs of individuals and of groups as small as nuclear families and tribes. The extension to wider human circles was not and could not have been contemplated. Within wider human circles, cultural groups, countries, even geopolitical blocs, often operate as individual organisms, not as parts of one larger organism, subject to a single homeostatic control. Each uses the respective homeostatic controls to defend the interests of its organism” (Damasio, 2018, p. 32).

Whether we are aware of it or not, the REF is omnipresent, wherever we go, whatever we are doing and whatever our feelings. The process is not something we need normally focus attention on, the process through which our behavioural systems are perpetually striving to maintain balance, safety and stability in our physical and social surroundings. Competing drives, conflicts, and inconsistencies all can pull the flow of events ‘off balance’, triggering this innate striving to restore equilibrium. The majority of people for the majority of time strive to calm and quieten local disturbances of equilibrium rather than to exacerbate them. [AP 002]. It is not a battle that we can always win; there is always the possibility of instability, error, calamity or catastrophe even.

There are abundant links to other theories inside and outside of Psychology. Piaget’s notion of equilibration was concerned with the attempt to balance psychological schemas when new information is encountered. In equilibration, children accommodate new information by changing their psychological schemas in a process of assimilation. This same idea applies to other psychological domains when there is a departure from a set range of equilibrium. Advocates of Buddhist philosophy, for example, the Dalai Lama, have identified a need for inner peace.

Body and mind continuously regulate and control many domains and levels simultaneously, with multiple adjustments to voluntary and involuntary behaviour guided by two types of homeostasis: Type I – inwardly striving or physiological homeostasis, H[Φ], and Type II – outwardly striving or psychological homeostasis, H[Ψ]. Physiological regulation involves drives such as hunger, thirst, sex, elimination and sleep. Influenced by Cannon, Clark Hull (1943) suggested a drive theory of regulatory mechanisms in which an organism can only rest when it is in a state of equilibrium. When a need such as hunger or thirst develops, the organism engages in need-satisfying behaviour. However, ‘drive’ can be mental as well as physical so that misery, fear and worry – often lumped together as ‘stress’ – create a state of unrest that prevents calmness, relaxation and sleep. Whenever we feel unrest, there is a need to ‘press the reset button’ and restore equilibrium. The ‘Reset Equilibrium Function’ (REF) operates across all behavioural systems and processes of relevance to the Science of Psychology.

A General Theory of Behaviour pivots on the Reset Equilibrium Function (or ‘REF’) by integrating the principle of homeostasis with our understanding of psychological processes and behaviour. We employ systems theory with cyclical negative feedback loops as a central feature. Feedback loops in Cybernetics and Control Theory mirror homeostasis within Biology and Neuroscience. Claude Bernard’s ‘milieu intérnal’, Cannon’s (1932) ‘homeostasis’, Wiener’s (1948) Cybernetics and von Bertalanffy’s (1968) general systems theory all converge toward the ubiquitous role of feedback in self-regulating systems. Psychologists have employed control theory as a conceptual tool for large areas of Psychology (e.g. Carver and Scheier, 1982) and, notably, one objective of control theory has been to provide a “Unified Theory of Human Behaviour”.

A General Theory of Behaviour employs systems of homeostasis in networks of interconnected processes with values that are reset by the REF. This hypothesis is founded on principles in Biology, Engineering and Cybenetics which have compelling isomorphisms with phenomena in Psychology.

The Reset Equilibrium Function extends the reach of homeostasis to a general control function that automatically restores psychological processes to equilibrium and stability. The REF is triggered when any processes within a system strays outside of its set range. The REF is innate and can exist only in conscious organisms, which all have Type I and II homeostasis. Non-conscious organisms have one type of homeostasis (Type I).

Figure 1 shows Type II homeostasis in a system of four processes, each with its own set range, making a series of resets. Any set of processes such as the four in Figure 1 is a sub-set of thousands of interconnected processes responsible for coding, communicating and controlling inside the body and the brain. Any process can be connected to hundreds or thousands of others in one huge lattice structure. Potentially any single one of these processes can push any other process out of its set range requiring it to reset. When any process resets, a ‘domino-effect’ is possible when other interconnected processes require a reset also. The two types of homeostasis work in synergy. Psychological and physiological processes operate in tandem to maximize equilibrium for each particular set of functions. [AP 003].

Many examples of the REF featured in this book have a similar structure to that shown in Figure 1. However, there is no restriction on the number of participating processes or interconnected networks.

figure1still

Figure 1 The Reset Equilibrium Function (REF) in a system with four interconnected processes.

My main objective here is to demonstrate that the REF is relevant to numerous psychological functions. These include functions where frequent reset is a condition for stability, e.g. cognition, affect, chronic stress, and subjective well-being, and also where out-of-control behaviour, such as addiction or insomnia, is in need of correction. For all psychological functions, conscious awareness of the state of equilibrium being preserved is not necessary, e.g. subjective well-being. However, when there is goal to change behaviour, conscious awareness of the goal and full engagement of resources are necessary preconditions for purposeful striving, e.g. addiction to alcohol.

In Psychology, biological approaches automatically fall under the suspicion that material reductionism is required. This suspicion is widespread among psychologists who are anti-reductive. With good reason, mind and behaviour are viewed as having properties that extend beyond ‘cogs and flywheels’ or other physico-chemical energy exchanges. We do not doubt the basic ‘clockwork’ model of homeostasis is the dominant one; witness the frequent use of the domestic heating thermostat as the prototypical example of homeostasis in Biology, Physiology and Psychology textbooks. However, the ‘clockwork’ approach is a simplistic caricature and the hypothesis that all behaviour is reducible to physico-chemical reactions is robustly rejected:

Principle I (Agency): The voluntary behaviour of conscious organisms is guided by universal striving for equilibrium with purpose, desire and intentionality.

Following G.E.M. Anscombe, we assert that agents act intentionally if they know what they are doing, i.e. they are aware of the purpose of the act and the reasons for doing it. Type 2 homeostasis, which is associated with the REF, falls into this category. In arguing that homeostasis (Type II) is intentional and purposeful, we adopt two non-reductionist principles, holism and critical realism. In applying the General Theory it is never necessary to assume that mental processes and behaviours are reducible to physico-chemical reactions. We only require that the mind/body system as a whole can be studied using objective methods. Von Bertalanffy (1968) sums up the issue thus:

“We cannot reduce the biological, behavioural, and social levels to the lowest level, that of the constructs and laws of physics. We can, however, find constructs and possibly laws within the individual levels. The world is, as Aldous Huxley once put it, like a Neapolitan ice cream cake where the levels-the physical, the biological, the social and the moral universe-represent the chocolate, strawberry, and vanilla layers. We cannot reduce strawberry to chocolate – the most we can say is that possibly in the last resort, all is vanilla, all mind or spirit. The unifying principle is that we find organizational levels. The mechanistic world view, taking the play of physical particles as ultimate reality, found its expression in a civilization which glorifies physical technology that has led eventually to the catastrophes of our time. Possibly the model of the world as a great organization can help to reinforce the sense of reverence for the living which we have almost lost in the last sanguinary decades of human history.” Von Bertalanffy, 1968, p. 49.

Bene dictum.

There are connections and overlaps with other theories of motivation. For example, there is almost complete convergence between the General Theory and Stevan E Hobfoll’s Conservation of Resources (COR) theory, which holds the basic tenet that “Individuals (and groups) strive to obtain, retain, foster, and protect those things they centrally value.”. Principle I (Agency) concerning the universal striving for equilibrium requires the basic COR tenet to be true or equilibrium could never be attained.

An extract from: A General Theory of Behaviour.

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