Monthly Archives: January 2015

Zeitgebers – External Processes That Generate Structure In Our Daily Lives

A conversation earlier this week where I discussed with a colleague that I had only been in my current job for ten months, and was looking forward to having a full year cycle in my new job complete, so I could be aware of the year-round structure and key dates associated with the work I do, got me thinking of zeitgebers and their influence on our lives. Most of my research work in my career to date has examined our brain and body’s physiological system regulatory control mechanisms, in order to understand what regulates our basic human functions and how they are controlled. Most of this work, like in most laboratories around the world, has examined systems within the body, or a specific organ or physiological system in the body, to try and understand its regulation. But of course the activities of our body and our behaviour are not just regulated by internal processes, but also by the need to respond to external environmental or social influences, and zeitgebers are one such important external controller.

A zeitgeber is defined as any external environmental or social cue that ‘entrain’ and synchronizes our body’s functions in a rhythmical way, and therefore ultimately controls its function over a period of time. Examples of zeitgebers include light, temperature, and social interactions. A potent cyclical zeitgeber is the day/night light cycle which sets our 24 hour (circadian) cycle of physiological activity. At a physiological level, the alternating presence or absence of light which is part of the day / night cycle appears to regulate biological ‘clocks’ in our body via receptors in the eye which transmit this information from the external environment to key regulatory areas of the brain, which then adjust our body systems level of activity – usually higher in times of light (daytime), and lower in times of darkness (night). There is also a social zeitgeber ‘loop’ that is induced by the day / night cycle, namely that when it is dark we lie down and sleep, which in an indirect way also slows down our body’s physiological activity levels, and when it is light we become more active and perform our activities of daily living, including routine exercise, and therefore our body’s physiological activity levels increases during the day. Each new day and night cycle causes this increased and decreased physiological activity to be repeated, and therefore becomes a cyclical / rhythmical activity in an ongoing, repetitive manner. Therefore, the day light cycle ultimately ‘enslaves’ or ‘entrains’ our body and social life functions, without us being aware of it’s supreme influence.

Social activity, such as feeding cycles have also been proposed to another important zeitgeber. Daily scheduled feeding, such as eating three regular meals at the same time point each day, induces cyclical changes in the activity of our physiological systems which are required to absorb and use the ingested food. Scheduled feeding also induces anticipatory habituated changes to allow these feeding bouts to occur, such as planning a space in our work day to have a lunch break, and these social changes which allow an individual to feed at similar time points in the day become potent zeitgebers themselves. Zeitgebers do not just work over daily cycles, but can operate over a longer (and shorter) ranges of time. For example, seasonal changes in temperature will cause adjustments in our behaviour at different times of the year, and social activities such as long holidays at specific times of year create different patterns of activity and eating patterns during those specific times of year, in a repetitive and cyclical manner at the same time of year over decades of our lives.

There are also likely to be long term zeitgebers over the course of our entire life cycle. For example, social circumstances and how different stages of our life are ‘regulated’ and ‘marketed’ by our societal infrastructure and expectations are likely to influence how we behave as children, young adults, middle aged or old folk. How active we are and how we change how we behave as we move through our life span may not be related just to the physical ageing processes slowing down the function of our bodies, but may also be related to us ‘fitting into’ the behaviour and behavioural patterns acceptable for each period of our lives as so eloquently described in the the poem by William Shakespeare about the ‘seven stages of man’. So in effect a social zeitgeber may exist which regulates our social and physical behaviour over our entire life cycle, which is not just related to our own body’s age related changes, but also due to society’s expectations and behavioural norms for each specific age we pass through during our lifetime.

Zeitgebers don’t seem to be just a human specific phenomenon. For many years each Sunday morning when I woke up I drove to our local village shop to buy the newspapers and supplies, and took my dog for the drive. After a while doing this, each Sunday morning he (the dog) would be waiting patiently by the door before I arrived for this weekly drive to the shop, which was always astonishing to me from an academic perspective. This example obviously highlights the importance of the need for an awareness of the passing of time / the presence of internal clocks as being essential for the function of social zeitgebers, but in a typical ‘chicken and egg’ scenario, it is not clear if the zeitgebers set the internal clocks that allowed my dog to be aware that it was Sunday morning and therefore time to wait by the door for his weekly drive, or if internal clocks set the social zeitgeber activities by supplying the information to the dog that it was time for him to go and wait for the expected drive. Perhaps like everything, both of these are correct and both the zeitgeber and the internal clock play an interactive role in my dog’s routine weekly behaviour, as it does mine.

So going back to my discussion about looking forward in a few months time to understanding the entire year of my work cycle, the zeitgeber concept would indicate that firstly I / we are perhaps ‘entrained’ by our work cycles in a zeitgeber manner we don’t realize, and secondly that we actually need or want to be so ‘entrained’, and feel somewhat ‘adrift’ if we don’t have the knowledge and security that come with the awareness of being immersed in the yearly patterns of our work / holiday cycles, and therefore that zeitgebers maintain not just our body’s physiological activity, but also our social wellbeing. There is evidence that disruption of zeitgebers / our cyclical routines can lead to psychopathology such as mood disorders and even depression. Equally, there is evidence that psychopathology is also inherent in some of the zeitgeber cycles themselves, for example in the Northern hemisphere there is increased incidence of seasonal affective disorder (depression) during the dark months of winter, and that most folk find the last week before payday in January to be the most depressing time of the year for several obvious reasons. So roll on the completion of my first full year in my current job, so both consciously and perhaps subconsciously I can understand and adjust to the zeitgeber function my work life creates for me, even if this security does come with the worry about who actually is in control of my life, myself or all the zeitgebers that ‘entrain’ me in either daily, monthly, seasonal, yearly, and even lifelong cycles that one just cannot escape from, and from which it perhaps would not be optimal indeed to do so!


A Career in Medicine – The Sisyphus Paradox

Our new first year Medicine students attended their welcome ceremony at our University yesterday, and it was wonderful to witness and experience their excitement at starting studying the career of their dreams. Watching them and being involved in the ceremony got me thinking about medicine as a career, and I was reminded of an excellent piece of philosophical writing published at the time I was training to be a medical doctor myself, by Professor Johan Koeslag, a Physiology Professor at the University of Cape Town whose teaching had a profound positive effect on me. In this article he compared a career in medicine to the Myth of Sisyphus, with the role of clinician being likened to that of Sisyphus in the myth.

In Greek Mythology, Sisyphus, who was King of Ephyra (modern day Corinth), attempted to cheat death, and for this and other roguish behaviour he exhibited during his reign as king, Zeus punished him by forcing him to roll a heavy boulder up to the top of a hill. Each time he reached the top of the hill, the boulder rolled down again, and the task had to be repeated continuously for eternity. Therefore, Zeus by this punishment had consigned Sisyphus to performing what was an inherently useless action for eternity, the goal of which was to create an eternity of frustration for the miscreant Sisyphus. With time the Myth of Sisyphus became representative of any activity that is inherently pointless, repetitive and interminable. An analogy was drawn by Johan from this to the daily work of a medical doctor, namely that no matter what a clinician does, they can never ‘cheat death’ / permanently cure anyone, as even if they cure a patient of one disease, they will eventually die of something else. From this perspective, if saving life is the job description of a clinician, then medicine must represent the ultimate failure as a profession, with a one hundred percent long term mortality and therefore failure rate. As in the Myth of Sisyphus, clinicians are thus caught in an absurdist paradigm, as they are ‘saving’ people to face certain death. In his article Johan described this as the Sisyphus Paradox of Medicine, namely that because they wage a losing battle against death in all those that they treat, all clinicians resemble Sisyphus, eternally condemned to perform an impossible task in a repetitive manner until their own point of eternity, or to be more moderate, their retirement day.

This may sound a somewhat depressing view of medicine, but Johan did not stop there. He (and others who have taken forward these ideas) then went on to clarify what clinicians should do to maintain ‘faith’ while having awareness of this Sisyphus paradox in their daily working life. He suggested that clinicians need to accept this perspective, and understand that their ‘lot in life’ is to maintain commitment to their work, and to their patients, even with this awareness of its ultimate futility, and by doing so they would make themselves as clinicians more balanced and more close to their own state of perfect grace. Second, the clinician would need to focus more on creating a pain or illness free environment for their patients, to the best of the clinician’s ability. While there may be a teleological reason for pain and suffering, possibly in the context of learning some perspective or self-understanding that would not occur in pain-free routine existence, there would clearly be comfort produced in a clinician’s patients by reduction of their pain and suffering, even if at some point in the future the patient’s death is inevitable. Thirdly, there would perhaps be benefit in clinicians incorporating scientific analysis into their work life, in order to try and understand better (if possible) such difficult concepts as ‘life’ or ‘death’. Science, as opposed to medicine, philosophy or theology, is likely to be the only method we have which can potentially explain such complex issues as life and death in a ‘material’ manner, or at least the physiological and anatomical mechanisms related to these ‘big’ concepts. Fourthly, and finally, clinicians perhaps need to concern themselves more with educating their patients on the certainty of death, in order to better prepare them for this inevitability. In modern times death and dying are almost ‘taboo’ subjects, and death occurs usually ‘behind closed doors’, which may in effect be creating an increased fear of death and dying either due to ignorance or avoidance of the issue. if clinicians educated patients (and healthy individuals) about their own inevitable mortality, and that dying is in itself the culmination of life, however paradoxical this observation may be, they may potentially remove their patients fear of death, or at least make them be more comfortable with their own dying, when their time eventually comes, as it does for all of us.

So watching those folk yesterday at the start of their medical careers, with my own awareness of the Sisyphus paradox inculcated in me by Johan’s thought-provoking work, that would likely be an absolute contradiction to the inherent reason most of them probably chose medicine as their preferred career choice, I wished them luck on their own clinical journey, and hoped that by working daily rolling their own ‘boulder up the hill’ in a never-ending way, that they would all eventually understand the Sisyphus nature of their work, and by doing so attain their own state of perfect grace, and become the best doctor they can be, doing medicine for the right reasons in the best possible way.

Self Talk And Mentors – Our Inner Soliloquies Tell What We Want and Who We Are

Doing some work getting going both mentorship structures and leadership courses in my work environment got me thinking about self-talk in a circuitous way. Self-talk is the dialogue between the voices which we hear ‘in’ our mind throughout most of our waking lives. It has also been described as private speech, inner dialogue, soliloquy, or sub-vocal speech, amongst other definitions. Different categories of self-talk have been described. Regressive self-talk occurs where there is the release of emotional energy, which is not directed at any specific target or person, as when one hurts oneself and curses to oneself because of the pain. Intrapersonal self-talk is related to structuring and sustaining cognitive capacity, such as repeating a telephone number or reminding oneself to remember someone’s name after meeting them. Interpersonal self-talk is self-talk which is directed towards communicating with others in the future, such as researching a speech for future delivery, or planning what one will say in a future meeting. While these categories provide structure in describing our self-talk, a lot of time our own self-talk seems to be idle chatter, which ‘bounces’ between topics, and crucially usually ‘sounds’ like a dialogue between two, or occasionally more voices when one is consciously focussing on / listening to the discussions in one’s own mind.

It has also been suggested that self-talk may be a crucial component of conscious perception of one’s environment and self-awareness, by alerting the ‘mind’ to changes in emotional and physical state, and creating an understanding of whether these changes and the cause of them are relevant or are of concern to the individual, by allowing the individual to take the ‘perspective of the other’ in their own mind. Associated with this concept, it has been pointed out that self-talk cannot occur as a single voice, and is by definition a soliloquy that occurs between at least two inner voices. There is an ‘I’ voice’, representing the voice urging one to act or describing a current activity, and a ‘Me’ voice which takes the perspective of the ‘other’ and with which the ‘I’ voice is assessed.

It has been suggested that previous social interactions with other individuals allows one to gain a viewpoint of oneself by becoming aware of that person’s perspectives of our actions or thoughts. Therefore, taking the perspective of the ‘other’ is the ability to understand that a person’s viewpoint may be different to one’s own, and potentially to use this information to change one’s behaviour or viewpoint. Self-talk allows, or is in itself, the end result of the internalization of this mechanism of taking another person’s perspective, as one can describe to ones ‘Me’ voice (a real or imagined person) in one’s own mind the reasons for behaving in a certain manner during a previous experience, or for planning behaviour in future similar based on how the ‘other’ would respond to it. When one engages in self-talk with the ‘Me’ voice therefore, which takes the perspective of the other, we can tell ourselves what others expect of us. This ‘Me’ voice can be the opinion of a single individual who has had a positive impression on us as a wise counsel in the past, or of a ‘generalized other’, which would be the perceived expectations of what the person believes their community would do in the situation being described by their ‘I’ voice. These different perspectives may have been learnt or adapted from previous social interactions with other individuals, groups of individuals, or from writings and media excerpts that describe community values or expectations that are internalized and become the content of the ‘Me’ voice. Therefore, we have a soliloquy going on in our minds the whole time, and this self-talk is a discussion between the desires of the individual during a particular experience, and the learned social expectations derived previously from external discussions or interactions with an individual, group or community.

So how does all this relate to mentorship and leadership as I described earlier was occurring in my own thoughts the last while (personal self-talk!). Well, clearly mentors are crucial for supplying the information that has the potential, if they are respected, to become the ‘Me’ voice in our minds. I have noticed from my own experiences and becoming aware of my own self-talk (and doing some research and reading on it) that my inner soliloquies often occur with mentors from the past that I have respected – for example my PhD supervisor, a wise family friend, a senior leader at the University I work at – and when I am confronted with a situation that angers or concerns me, I find myself in my mind ‘communicating’ with these respected folk from my past, and by doing so come to a way forward through the problem I am facing. As I grow older, more respected folk are added to my community of ‘others’, and situations seem to become easier to deal with as I age, as they generally do for most folk as they get older and who all are going through a similar process of incorporating mentors as “Me’ voices as is happening to me. So obviously, getting the right mentors, and right potential folk to supply the text for one’s ‘other’ perspective (the ‘Me’ voice in our head) is crucial, and perhaps our best chance, of moderating our own behaviour in a way that will make ourselves leaders and role models for those around us and for the next generation following us, who look to us to provide their own ‘perspective of the other’.

Of course a person can have a problem if their ‘Me’ voice is not wise but is rather self-damaging, or is generated from a negative role model which becomes unwittingly introduced into ones panel of ‘others’ which one uses as an action frame of reference. Whether these voices can be consciously altered over a short period of time is not clear either. Obviously with time given that ‘Me’ voices are added means that our self-talk protagonists can be altered, but in many ways self-talk and the outcome of the dialogue create our personality / view of life (however one wishes to define our core way of viewing and interacting with life), and to alter completely all the voices one has accumulated would create a completely different personality or way of thinking. Such major self-talk does not seem to occur unless there are catastrophic changes in one’s environment or personal life, such as divorce, death of a loved one, or natural disaster, which one’s ‘Me’ voices cannot provide a frame of reference or good advice for. When this occurs the inner ‘Me’ voices can become fragmented and in the end be replaced by other ‘Me’ voices which are able to make sense of the current crisis or trauma, and therefore would potentially create a very different personality as an outcome to the catastrophic trauma. But for most folk, as the old saying goes, the passing of time is the only healer and thing that will change a damaging ‘Me’ voice.

So we need to be aware that we have the potential as parents, mentors or leaders to end up as ‘voices’ in those we interact with and take an interest in what we say and do. To be successful we surely need to manage the ‘I’ voice – psychology folk would find resonance with these concepts described above with those of Freud’s ‘Id and Ego’ theory or Steve Peters’s classic description of our ‘Inner Chimp’ which the ‘Human’ in us needs to control to be successful – but also we need to get the right blend of ‘Me’ voices (the ‘others’) which are generated by mentors of our past, which will see us through all the complex situations we face in our daily life. Being aware of our own self-talk, and the make-up of it, is perhaps crucial for the success or failure we make of our lives, and of course, the mentors we choose and who become ingrained in minds as ‘Me’ voices surely make all the difference.

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