Science and real world – where we scientists also are human beings and also do not have access of the 100% truth?
George Kelly (personal constructs theory, 1955) shows (at least me) that science concerns real world (or should do it if not about basic research) and real world concerns science.
At the same time perhaps one of the most important “thing” for us in real world is that life style related diseases and mental problems is very little understood in clinical science/medicine/psychology/psychiatry. How come? Not of interests? For whom? Science? Man?
For those of us who live a health and peaceful life?
For those of us who are suffering from/of emotional driving forces which are not by individual or science well understood. Something that health care services face – in confusion.
Life style medicine concerns not only the above at normative levels, but “all if it” – variations between and within individuals over situations and time in real world.
We do need a more effective focus on life quality, health promotion and prevention/rehabilitation of life style related diseases.
The field is enormous complex not well understood until now and mostly exploited/misued of commercial interests, especially for pharmacology interest. But gradually, we are pleased to see emerging an interests similar to the democratic forces against other profits power interest.
Our aim is to promote a humanistic attitude to medicine where knowledge implementation and its individual implementation are of priority concern! Medicine is too important to only leave for reductionistic specialists who are not also generalists while medicine needs get rid of simplistic, naïve reductionistic way of thinking (paradigm) and focus on understanding human real world complexity – a biological, psychological, social-cultural and ecological one. To complex you might say – but that is real world.
Following in the footsteps of Bernard, Engel, R.S. Lazarus and many other I will try after 30 years of work according to their argument (below) for a substantial change in health care services for a development as below.
In principle is it
- A biopsychosocial knowledge medical platform (although not much developed since 1977) where applied psychophysiology is foundation pillar
- Life style analysis and interventions (we have called it stress medicine during 20 years not to confuse physicians) are based on a multifaceted perspective (part of my Ph D title 1986)
- Intervention strategy is education and self activities (food, breathing, movements, psychosocial strategies) and supervision where therapy is only done when education and supervised self acitivites are not enough to meet IBED (see below) predicted development.
- Documentation is based on AI (case based reasoning and other AI-tools) which become a reference library for life style diseases (not yet ready and need much, much work – and before we will try to do it manually as good as possible
|Philosophic paradigm||Critical rationalism||Different paradigms get different consequences|
|Scientific paradigm||Biopsychosocial medicine||Different paradigms get different consequences|
|Focus||Idiographic AND nomotetic||Need to go from specific to general – see e.g. Donald Fiske´s argument|
|Method||Traditional AND IBED*||Needed * Individual. Biological Evidence based Documentation|
|Data analysis||Sophisticated, systems integrated||Human brain based analysis must be integrated with Artificial intelligence based|
|Focus for analysis||Biopsychosocial reality||Man is living in real world|
|Intervention focus||Biopsychosocial tool box||Craftsmen need education and training, a manual and supervision|
|Documentation||Traditional and IBED||A prerequisite for a sound knowledge and empirical development|
Different paradigms can be compared with different ideologies behind different political parties. In at least medical sciences science is discussed as something unified which is not the case – at least not outside pharmacological medicine.
Some examples on the above:
A few quotations if relevance;
“There may well be no definitive characteristics of science and, indeed, if there were they would probably change from one time to another. Strictly, ´science´ means ´knowledge´ but what has come to mean in the modern western world is knowledge acquired as a result of employing empirical methods (Valentine, 1982, p. 6). Specifically about observation, measurement and experimentation as well as experimenter bias effect, “Rosenthal (1967) has argued that unintended covert communications from the experimenter to the subject, which affects the subject’s responses, is the norm rather than the exception (Valentine, 1982, p. 69). Vallentine, E. R. (1982). Conceptual issues in psychology. London: Allen & Unvin.
“Our theories, beginning with primitive myths and evolving into the theories of science, are indeed man-made, as Kant said. We try to impose them on the world, and we can always stick to them dogmatically if we so wish, even if they are false (as are not only religious myths, is seems, but also Newton’s theory, which is the one Kant had in mind). But although at first we have to stick to our theories – without theories we cannot even begin, for we have nothing else to go by – we can, in the course of time, adopt a more critical attitude towards them. We can try to replace them by something better if we learned, with their help, where they let us down. Thus there may arise a scientific or critical phase of thinking, which is necessary preceded by an uncritical phase” Karl Popper, “Unended Quest”
ISBN: 9780415285896, Routledge, London, 1976, p. 64).
“Data without a theory is empty. Theory without data is blind” (I. Kant)
“Paradigmatic thinking often lead man (as e g scientists) to exclude areas of research/relevance, including particular findings and/or theories/rational that does not easily fit into the paradigms of today. A paradigm is a set of believes about reality that seem self-evident and un-changeable. This is the more or less explicit platform where theories and hypotheses are generated/extracted/emerging. Paradigms are needed for effective work but if regarded as “facts” and the scientific truth it can lead individuals (e g scientists) to defend their view-point against rational evidence or fight back new evidence while not fitting into the own paradigm (Kuhn 1957, The Structure of scientific Revolution)
Bernard: “..“.. If we break up a living organism by isolating its different parts it is only for the sake of ease in analysis and by no means in order to conceive them separately. Indeed when we wish to ascribe to a physiological quality its values and true significance we must always refer it to this whole and draw our final conclusions only in relation to its effects in the whole” (Bernard, 1865) in A Despopoulos & Silbernagl (1991) Color Atlas of Physiology: N.Y.: Thieme.
Engel, G.L. (1977).The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136
If we do not change the focus, the paradigm, the methodology, … and follow Lazarus, et. al suggestion; “Since appraisal, emotions, and coping patterns ebb and flow in a person’s changing commerce with the environment, a new type of assessment is needed that measures process and variation within individuals and across situations, as well as structure and stability” (Lazarus, Cohen, Folkman, Kanner & Schaefer’s, 1980, p. 113)” and use applied psychophysiology as a platform, we will not increase efficacy in health promotion, stress prevention, differential diagnostic analysis and biobehavioral treatment of negative stress – indeed , a disaster for society and man!