August 2008

Commercial tests for food allergy exploit the fears of vulnerable individuals.  None of them has diagnostic value and what’s more, restricting the diet according to the results of the tests may lead to serious health problems.  Those were the damning conclusions from ‘Which’, the consumer organization, in a report released today.     


‘Which’ carried out its own research.  Four researchers, one with a serious peanut allergy, another with lactose intolerance and two more who had no symptoms of food intolerance assessed 4 different tests.  None of them was experiencing any symptoms of food intolerance at the time of testing.  


The tests used widely differing techniques.  They included analysis of hair samples for vibrational energy (Bionetics) or hair root DNA (Integral Health),  assessment the measurement of changes in muscle resistance caused the proximity of vials containing certain food extracts (kinaesthesiology),  measurement assessment of changes in body conductance when essences of foods are placed in the circuit (Vega),  and analysis of blood samples for circulating antibodies (IgG) to a range of different foods.  They are not cheap.  The cost varies between £45 for the cheapest session of kinaesthesiology to £275 for a full IgG food scan of 113 different substances.      


Each test was evaluated by two researchers, who compared results from two different laboratories or practitioners and in some cases sent duplicate samples under an assumed name.  The results were alarming.  Not only were the tests not replicated by the two different laboratories or practitioners, but analysis of duplicate hair and blood failed to achieve agreement.  None of the tests detected the researcher who had peanut allergy and only one detected the person who was intolerant to milk.  The tests did, however, pick up a whole range of other intolerances.  Kinaesthesiology even claimed evidence for a severe peanut allergy in one of the researchers who ate peanuts with impunity.  The diets recommended by the blood tests excluded up to 39 foods, creating the risk of nutritional deficiency.


The results for hair analysis, kinaesthesiology and body conductance are hardly surprising.  These are exercises in pseudo-science, they have no evidence base and their exponents deserve to be exposed as confidence tricksters, extorting money from vulnerable people under false pretences.  


The data  from the Yorktest and Cambridge Nutritional Services are, however, more worrying.  They measure circulating antibodies to a variety of food substances, their metholodology (ELISA) is scientifically valid, the technicians are trained and, as far is the Yorktest is concerned,  qualified nutritionists are available to offer advice on dietary modification.  The rationale and methods look good, but if they are that good, why is IgG testing not available on the NHS? 



Antibodies did not evolve to protect us against food – they are essential components in our cell wars system against invasion by microorganisms.  Food intolerance is like injury by ‘friendly fire’.    


Antibodies come in various classes.  IgA is secreted into the gut and acts like a fire blanket to immobilize and destroy bacteria before they have a chance to invade.  They are not directly implicated in allergies. 


IgG antibodies circulate in the blood stream.  They recognize and combine with the foreign organism,  tagging it, immobilizing it and rendering it  vulnerable to destruction by the body’s white cells.  They work quietly away all the time, ridding our body of invaders that could take over and damage it.  They, too, for the most part are not implicated in allergies.


IgE exists in the gut wall and attaches itself to highly reactive white cells called mast cells.  Mast cells function like grenades.  The combination of the IgE with a foreign organism pulls the pin on the grenade and the mast cell explodes releasing a cocktail of powerful chemicals, which causes spasms, secretion, inflammation, diarrhea and vomiting – an immediate reaction, which can make the subject feel very ill.  The battle itself is highly destructive, rather like the destruction of Gori in the recent  conflict in the Caucasus.  It is this damaging reaction – the immediate hypersensitivity – that can cause severe allergies.  NHS allergy clinics and immunological laboratories test for immediate hypersensitivity either by injecting small amounts of the food protein under the skin, where, if positive, it causes a wheal and flare or by examining the blood for specific IgE antibodies. 


IgE reactions are highly dangerous and are not deployed often.  Over a lifetime, the body develops a tolerance to most of the foreign substances that it encounters and can deal with these using a quiet combination of IgA and IgG.   The more extreme IgE response is only deployed when the body encounters some rare organism (or protein), that has caused damage before and it has not become tolerant to – like meeting somebody who has previously abused you.  IgE  elicits a rapid protective response that evicts the invader forthwith.  But the body, like a nation state with experience of dealing with other potentially threatening states, usually tends to quieter and more diplomatic means of dealing with the problem. 


Allergies might therefore be regarded as failure of tolerance – the persistent activation of an attack response (in immunological terms a Th2 response), even to food proteins that carry no threat to the body.  Allergy is like an extreme or dysfunctional attitude.  The hygiene hypothesis suggests allergies may be becoming more common because in our sanitized environment, we are less likely to encounter and develop tolerance to the whole range of parasites, bacteria and viruses early in life.  In other words we lack experience, see everything as a threat and over-react – even to the food we eat.   Recent research has shown that worms and helminthes turn the IgE system off.  This allows them to exist in symbiosis with us in our guts, but at the same time, they protect us against allergy.  This has led some to advocate administering worms as a treatment for food allergies.     


But hospital testing reveals that less than 2% of people with symptoms of food intolerance,  have evidence of immunological hypersensitivity – IgE activation.  So there must be something else going on.  So the focus has again swung to IgG. 


The rationale for IgG testing is as follows.  If, for any reason, in a normally tolerant person,  too many proteins get into the body, because – say – the gut has become inflamed and too permeable or the IgA system is defective,  then a  massive IgG response may join with the proteins to produce large clumps which may lodge in the tissues of the joints, the guts, the lungs or the skin causing local inflammation.  An elevation of IgG antibodies to specific foods, therefore, might indicate that enough food proteins are getting across to elicit this type of allergic response.


For the most part, however, raised IgG levels probably indicate quite the reverse – that the body is dealing with the invading protein with normal ‘tolerance’.  This would explain why the York and Cambridge tests detect so many ‘intolerances’ to foods that their subjects can eat without any risk at all.  It would also explain why the most common intolerances are to foods that are most commonly eaten  – there’s just more of them about – and why the results vary according to how much has been consumed.  Finally it would explain why subjects with no symptoms of food intolerance have elevated IgG.           


Several recent studies have shown that raised IgG levels are associated with the development of tolerance to flour in Baker’s asthma,  eggs in egg allergy and foods reintroduced after an exclusion diet. 


The dreadful paradox of all this is that Yorktest and Cambridge Nutritional Services may actually have a test for food tolerance rather than food intolerance.  If that is the case then dietary restriction based on the advice of this test would not only deprive people of what they like to eat but also may risk nutritional deficiency.

Read tomorrow’s blog for a discussion of what food allergies mean.

Dear Dr Dawkins, 


Congratulations.  You succeeded in presenting an authoritative, passionate and convincing account of evolution to a television audience.  ‘The Genius of Charles Darwin’ will stimulate an interest in biological sciences and cause some to reassess their beliefs.  


In last night’s episode, the last in the series, your adversaries were not sixth formers, but their teachers, self styled evangelicals and The Primate of All England, Dr Rowan Williams.  Like you, I was shocked to hear the chemistry teacher declare that he believed that the world was definitely created within the last 10,000 years and saddened at Rowan Williams’ remark that God created the laws of physics.  


There is no doubt in my mind about evolution.  The evidence you presented is quite overwhelming.  Recent investigations in molecular biology have built on Darwin’s observation to create a beautiful and inspiring theory, which is as near to scientific truth as we can possibly get.  John Mackay’s argument that he can’t believe in evolution because he can’t see it happening is patently ridiculous.  Has Mr Mackay seen God?  The sad thing is he might probably say he has! 


But I still feel slightly disturbed by your attack – not so much on belief in God, but on people’s right to believe in their Gods – and even on the belief  in anything that we can’t actually measure.  


I am a also a scientist – and an atheist.  I spent 30 years in medical science.  I published over 500 papers, most of them peer reviewed by other scientists.  I learnt to evaluate evidence and construct a scientific argument.  I, like you, feel passionately about a search for truth, but I am nevertheless all too aware, as you must be, of the limitations of science. 


It all hinges on the nature of evidence.  As I see it, our existence, from a scientific viewpoint, is constructed from three categories of knowledge.  First there are those  aspects we have hard evidence for, like evolution, plate tectonics, the biochemical structure of living matter,  the Laws of Physics, electromagnetism, the benefits of immunisation,  the actions of drugs.   The second category contains knowledge for which the evidence is indirect and much softer, depending often on assumptions and measurements that are in themselves unsubstantiated.  This includes many aspects of theoretical physics – the nature of  subatomic particles, the structure of the universe, the nature of time.  It also includes much psychological theory,  medical epidemiology and even the efficacy of medical treatments since all of these are based on observations of populations and predicated on the assumptions we make in order to group and  separate them and the statistical tests that we apply.  Then, there is a third category, one of acceptance and belief.   This includes many of the cultural and abstract ideas that form our view of the world and condition our social existence, notions like beauty, truth, meaning, love, happiness and belief itself.  This is more the realm of literature, art and music. 


You are a man of culture.  You admitted to Rowan Williams that you love poetry, but… love? ….. poetry?  How do you measure these?  If you are as dyed-in-the-wool a scientist as you can appear to be,  then you must believe that love doesn’t exist and poetry is meaningless,  but I guess you aren’t.   Oh, if challenged, you would bluster on about levels of oxytocin and connections between the limbic system and prefrontal cortex – but this would be sterile and limiting.  It doesn’t capture the essence of human experience in the same way as poetry does.  You might even say that some day we will be able to define the experience of love, or the nature of beauty  by certain types of neurohumoral activity in the brain.  I would have my doubts.      


You may have boxed yourself into a corner by your almost evangelical stance against the creationists, but I would guess that you, like most scientists, hold a balance of knowledge and belief in your mind.  You would have to.  Otherwise you could never say, ‘I love poetry’ or ‘evolution is beautiful’ or ‘that’s patently ridiculous’, because that would immediately challenge your view of love, beauty and meaning – leading you to question the origins of your own beliefs.  Indeed, if I can be so bold, you could never function as Oxford Professor for the Public Understanding of  Science, unless you could use metaphor, yet the very use of metaphor depends on shared cultural narrative, mythology and belief.     


What would you regard as the most important attribute for a scientist – education, perseverance, dedication, a detailed knowledge of statistical method?   I think it is imagination – the ability to dream with your head in the clouds while your feet are firmly planted in terra firma.   Imagination is not about the way things are, it’s about the way they might be.  It’s the stuff of hypothesis, the process scientists use to  convert a belief into a scientific fact,  to make sense of what they can’t understand.    But imagination, surely, is abstract, like beauty or love.  Scientists too have to believe in their mythologies – even though they spend their lives trying to destroy them.            


I am a scientist and a doctor.  I have spent a large part of my life trying to understand the illnesses that medicine has no clear explanation for.  I’ve even written a book on it.  I held professorships in physiology, nutrition and integrated medicine at Sheffield University.   But my epiphany came not with some brilliant physiological breakthough, but with the opportunity to take a Masters degree in psychoanalytical psychotherapy and investigate the meanings of illness.   For years, I had struggled to help my patients, devising new systems of investigation, new methods of treatment, but nothing really worked. 


I am now a better physician.  I integrate the hard facts of  physiology and the softer evidence from psychology and sociology with the meanings, my patients express with their symptoms and ascribe to their treatment.  So, even though there is no scientific evidence that I know of, to support the use of homeopathy, for example, I know that that belief is important to some of my patients and therefore try to work alongside it to bring about the insight that will give confidence and effect a cure.  On the other hand,  I do suggest that they stop taking the drugs that are doing them harm, even though they might be evidence based.  Good medicine, I believe, lies at the hinterland between art and science.  The same applies to good philosophy.    


We all need meaning in our lives, some belief and code of ethics that directs the way we live.  We each need a narrative to make sense of our own lives and a shared cultural mythology to live together in harmony with other people.  Our narratives may well be informed by evidence, but they may not.  But does this really matter – as long as the meaning makes sense to us and our society and doesn’t cause harm.  I suspect – but I have no evidence for it, that the need to create stories, may be part of our genetic heritage – a vital component of our humanity.  


So when I witness you berating recalcitrant sixth formers, beating John Mackay about the head with your arguments or even crossing words with Rowan Williams, I can’t help thinking that you are being a bit of a bully.  After all, you have selected the rules and chosen the weapons.  It is no competition.  They don’t have a chance.  They are coming from a different place.  To be honest,  I find it rather sad that Dr Williams was made to appear as wispy and woolly as his own beard.  I had faith in him as a spiritual leader – but such is the nature of television.        


There is danger in mounting a campaign to disabuse people of their cultural beliefs.  To them, science is as much an abstraction as their belief in God.  Yes, they should be better informed.  By all means educate people about evolution.  Everybody has the right to know where they came from.  But don’t tell them their religious beliefs are rubbish and their Gods don’t exist.  To do that is to be destructive to their soul; it robs them of the meaning of their lives, just like the Christian missionaries were doing in Africa in Darwin’s time.  Freedom of belief is enshrined in all the constitutions of the free world.  Belief is what holds societies together, whether this is belief in God, Allah, Buddah, Oprah Winfrey or Team GB.  It is the variety and quality of our beliefs, irrespective of whether we have evidence for them that enrich our lives.  Science and The Arts work best when they work together.    

The tuna is a magnificent fish.  It has a beautiful streamline shape with sharp serrated dorsal fins and a tail like a scimitar.  The Atlantic Bluefin (Thunnus thynnus) is a dark blue on top shading to a white underneath and can grow to a size of several metres.  It is related to the Swordfish and is much appreciated as a sporting fish by deep sea anglers. 


The tuna is not a single fish but a family, the Thunnuni,  which includes the Skipjack, Yellowfin,  Bigeye, Bluefin and Albacore.  They are pelagic; they range the upper layers of the ocean feeling on smaller fish, crustaceans and squid.  For most of the year, the Atlantic Bluefin forages off the continental shelves of North America and Europe.  When it comes time to spawn, the populations split, one group goes west to the Gulf of Mexico, the other goes east into the Mediterranean.  Once, when they were more widespread and large numbers of tuna fed in the North Sea, schools several miles long could be seen passing through the channel en-route to the spawning grounds. This made them easy to spot and to fish.


But it is in the spawning grounds where the fish are in shallower waters and closer to  human habitation, that most fishing occurs.  This has devastating effects on populations.  A ban of tuna fishing has been imposed in the Mediterranean, but this is difficult to police.  Illegal hunting for tuna still goes on, encouraged by soaring prices.  


As travellers on a continental scale, tuna are strong active fish.  They have to keep on the move; it is their raison d’etre.  If they stop, they die – literally.  Tunas have no mechanism for pumping water over their gills.  Instead, they swim with their mouths open and their forward movement forces water through the gill arches.    


Tuna are able by a combination of muscle activity and swimming in warmer surface waters to keep their muscles at a constant temperature of 30 degrees Centigrade.  Warmer muscles allow the tuna to maintain high swimming speeds for long periods of time and recover quickly after prolonged exertion.  Their dark muscle contains a combination of large numbers of slow twitch fibres adapted for endurance as well as some fast twitch fibres, which provide the necessary burst of speed for the hunter.  It’s perhaps that mix that creates such a tender yet tasty meat.   


Tuna is one of the most delicious fish to eat – so tender with a clean, slightly acidic taste.  It is delicious raw.  Try thin steaks,  basted with spices, coriander seed, cumin, finely chopped garlic and chilli, pepper and sea salt, and seared in a hot cast iron frying pan, until the outside is a light pink, leaving a core of dark red meat inside.  Serve with pok-choi, steamed for a few minutes so that it retains its crisp texture and mustardy flavour, some oriental mushrooms, lightly fried, and a spoon of rice basmati rice with a little soy sauce dribbled over it.  Other recipes recommend marinating the fish in soy and fish sauce and serving with a rocket and parmesan salad with slices of mango, but it is important not to drown the delicate flavour of the meat.  At £4 a steak, this is a meal of rare delicacy, a meal to savour, and you have the added satisfaction of knowing that Tuna contains large amounts of omega-3 fatty acids, which keep your brain, your joints and your arteries flexible.  


At one time, this fish occurred in abundance.  It speed and wide range meant that it was largely fished locally near the spawning grounds. Stocks were sustainable.  For the last thirty years, the demand for tuna in sushi bars and sandwiches has been so high that it is fished on an industrial scale.  According to the World Wide Trust for Nature, the Atlantic Bluefin is on the verge of extinction. 


Had I realised that before I shopped for last nights’ meal, perhaps I would have chosen something else. Gordon Ramsey has taken tuna off the menu in his London restaurants. I also feel slightly guilty at contributing in some miniscule way to the demand for tuna and being prepared to pay the price. But at least I feel that by respecting savouring this beautiful fish, cooking it carefully with the spices and ingredients to set off its unique flavour, I have honoured it. 


Surely it is better to appreciate an endangered fish in this way than to buy it in cans, mash it up in vinegar and pepper and spread it between two slices of plastic bread or to char it to extinction on barbecues.  Does that sound reasonable to you?.  I am not sure I am convinced.  I still feel guilty.        

Oh dear; there he goes again – off on another hobby horse, attacking windmills with sharpened consonants and strangulated vowels. And, surprise, surprise – the  experts have become frustrated and annoyed.    


A decade ago, Prince Charles accused GM scientists of meddling in ‘realms that belong to God and God alone’.  This week, in an interview to The Daily Telegraph, he asserts that ‘Gigantic corporations’  are conducting a ‘gigantic experiment with nature and the whole of humanity, which has gone seriously wrong. Why else’, he adds, warming to his cause, ‘do you think we are facing all these challenges, climate change and everything?’ 


‘This new technology is driving small farmers off their land into ‘unsustainable , unmanageable, degraded and dysfunctional conurbations of unimagineable awfulness’.    


‘And if they think that it’s somehow going to work because they are going to have one form of clever genetic engineering after another, then count me out, because that will be guaranteed to cause the biggest environmental disaster of all time.  It will destroy our environment.  It will cause hunger throughout the world.’  



Wow, sir – that’s telling them!  But, just one little point – is it all true?   Can we really blame genetic modification for all the ills associated with modernity?    



The fact is that genetic modification has been with us for centuries, ever since men discovered that they could enrich the productivity of food crops by selective breeding and hybridisation. Wheat, legumes, barley, potatoes, maize, beetroot, grasses – they are all products of genetic engineering.   GM just takes it one stage further by making direct modifications to the genes. 


Cash crops have also been with us for a long time. They offer employment and a more affluent lifestyle for the local population, but they do expose them to competition and the downturns of a global economy while discouraging the subsistence farming that might provide a buffer against starvation.  But is it really GM that is driving small farmers off their land or just the fact that irrespective of the underlying technology, food supply is big business and large industrial style farms are here to stay?    


And what is the evidence that GM technology causes climate change?  Climate change had been occurring for decades before the first GM foods were grown commercially in 1996.   Moreover, it seems that genetic modification could help to withstand climate change by developing new crop varieties that could withstand warmer temperatures and drought.  GM might even produce plants that consume more carbon and yield more food.   And since many GM crops need no tilling, their growth  releases less CO2 into the atmosphere from both the soil and from tractors.   


It is of concern that genetic modification might reduce biodiversity, but then surely any food crop discourages biodiversity.  Fields of oil seed rape, maize, wheat or barley are ecological deserts with only the hedgerows and coppices providing  corridors and islands of biodiversity.  But GM, by reducing the use of herbicides and pesticides, might well encourage biodiversity. 


Will GM encourage widespread hunger?  The 1970s Green Revolution in India was based on the conventional propagation of hybrid dwarf crops, allowing more energy to be diverted into the seed heads.  This brought spectacular gains in agricultural yields and all but abolished the famines in that country.  Genetic engineering now offers the possibility of further increased yields for a rapidly expanding population through the development of crops that can that resist viruses and pests, and tolerate hot, saline, or otherwise inhospitable conditions. 


So the evidence suggests that GM technology might well benefit human societies.   GM foods have been grown commercially for 12 years now and there is little evidence to suggest that it is responsible for global hunger, climate change or any kind of environmental disaster – yet.  


But Prince Charles, as self appointed social conscience for the nation, gives voice to our fears of innovation.  In 1830, the ‘Captain Swing’ rioters in Dorset expressed their fears by direct action and began smashing the new agricultural machinery.  They were transported for it.  Charles can express similar reactionary views but people respect his unique, albeit somewhat isolated perspective.  HRH is a champion of the nostalgic, the vernacular, the romantic view of English heritage.  It relates to a time when the King was in his palace and all was well with the world.  His perspective is one of privilege.   The ghost town of Poundisbury on the outskirts of Dorchester,  and the range of Duchy originals suit a particular life style,  affluent, country, sophisticated – certainly not the inhabitants of ‘the degraded and dysfunctional conurbations of unimagineable awfulness’.  We could therefore be forgiven for thinking that he is perhaps just a bit out of touch.  


But aren’t we all a little in thrall with his world?  Don’t we enjoy visiting stately homes and country houses?  Isn’t the National Trust one of our richest charities?  Don’t we all feel some sense of ownership with a view of country living that is forever England?   Isn’t it part of our collective identity, like William Shakespeare,  John Betjman and Bath buns.  In his passion to conserve his family’s heritage, doesn’t The Prince speak for all of us?   So when he condemns the Sainsbury wing of the National Gallery as a monstrous carbuncle on the face of a well loved friend, don’t we all secretly applaud?  And when he describes modern medical practice as like the Tower of Pisa, leaning too much in one direction, don’t we nod wisely?    


I once met Prince Charles.  It was at a reception given for his Foundation for Integrated Medicine at Highgrove – not the house, but the barn at the rear – a new build in the style of baronial hall with kitchens and a minstrels gallery and, if I remember correctly, tapestries on the wall.  I was impressed by HRH’s ability to engage with each of his 70 guests and then disengage, leaving them feeling heard and special.  His speech was amusing – charmingly self effacing with a touch of goonery about it. 


‘Oh, I know the experts get annoyed with me,’ he told us, ‘But it’s very strange that when I talk to medics they all agree with my views on architecture and when I talk to the architects, they all applaud my views on medicine. So perhaps I should talk to you about organic farming.  


It’s as if Charles doesn’t expect to be taken seriously.  It’s all a bit of a surprise.  That may be the problem, because as a prominent public figure and our future King, he has a responsibility to check his sources and present a reflective and balanced argument. 


Don’t misunderstand me.  I think Prince Charles does a tremendous job.  He works tirelessly for the good of the nation.  His various trusts are a major force for good.  I applaud his work.  I also support his right to say what he believes.  But he should choose his advisers more carefully.  As moral philosopher for the nation by Royal appointment, he would be better advised to present a more responsible view. An ill considered rant on GM foods brings the institution of the monarchy into disrepute because it doesn’t recognise either how GM might help to alleviate poverty and suffering throughout the world or the dedication of the scientists who are working on it.  It doesn’t exhibit Kingship. 


Charles has an opportunity to be both a social conscience and a moral leader, but he needs to demonstrate a scrupulous disinterest.  If he can rein in his passion and take himself seriously as a voice of reason, he will ensure the monarchy’s continued relevance as a moral lynchpin for a changing and unstable society.    



If I don’t post any more blogs for some time, you will know that I am banged up in The Tower.         

In yesterday’s blog,  I argued that television might contribute to the recent epidemic of emotional and unexplained physical illness because it makes us immediately aware of the threats to our existence,  it offers the most exciting but most dysfunctional responses to emotional dilemmas and it cuts us off  from the community that might help us resolve difficult situations.  These factors create a rise in emotional tension while failing to offer any means of resolution.  


So if television is bad for our health, what about personal computers and the internet.  Do they also contribute to illness for similar reasons or might they actually have a more healthy influence?  


The ability to obtain detailed and for the most part reliable information on any topic,  the increase ease of written communication, the ability to organise our lives from our desktop – paying bills, sending letters, selling items on eBay, arranging finances and investments, having meetings, watching films, even dating   all of this has transformed the efficiency of our lives.  In theory this must make life easier and and by reducing the hassle and frustration, diminish emotional tension and allow us more time to pursue a more healthy lifestyle. 


The internet is a much more interactive medium than television. We are not just passive recipients. We choose, out of millions of possibilities, the sites we interact with . We can have a dialogue, construct virtual relationships, engage with a virtual community.  


It appears that the internet will be the medium through which we will all communicate in the future.  Face to face interaction with suppliers, colleagues, friends, our bank manager, estate agent, lawyer, doctor, the person at the post office, will no longer be necessary.  That will certainly be more efficient, but will it keep us happy or healthy? 


The internet offers a virtual, as if, existence, a substitute for the real relationships.  Will that be enough?   


It may well be enough to pay bills, but can you have a satisfactory consultation with a doctor or a lawyer on the net.  Can you have a useful session with a psychotherapist via a webcam.  Can anybody have a satisfactory sexual experience on the world wide web?  


Human relationships have to be conducted person to person.  It is said that 93% of human communication is non-verbal using all of our senses, touch, smell, hearing, as well as vision.   We can pick up cues, attitudes, character, beliefs , personality through gestures, facial expressions, eye contact, tone of voice, body language.  This comprehensive communication eases our fears of separation and abandonment,  provide that  essential sense of belonging.  Loneliness is probably the more prevalent illness of our time.   


Isn’t there something important about the chance relationship who live close to us, that everyday discussion about the weather, our family, what the council are doing to our local services, that induces a sense of belonging, community that we can’t get from the internet?       


But at the same time, we are so skilled at making ‘as if’ relationships.  It is part of the human condition to imagine relationships and stories, often from relatively few cues.  Isn’t this enough to sustain us?   Don’t we all imagine that we know Gordon Brown, or George Bush?   Don’t we feel that we belong to Team GB at the Olympics.  I think we do, just as I believe that people who are isolated and lonely – the infirm and the elderly – derive a real sense of connection from The Archers or Coronation Street.  It is something, it is a kind of connection, but it can never be a substitute.    


How would we feel if our children were brought up by some interactive internet programme.  It wouldn’t work, would it?  There is more to bringing up children that vision.  Telly tubbies may keep children entranced for a bit, but this is not a whole care package.  Children left to their play stations and televisions, can never grow up with the necessary interactive social skills that will allow them to deal with all the situations that modern life throws at them while remaining healthy.


So, while I think that our computer and internet are better than nothing, especially for those suffering from the most prevalent sickness of our society – loneliness, it can never be a substitute for community, family, that essential sense of belonging that we need and share with all other social species. 

In the corner of the living room is a television. There is another one in the master  bedroom, a small one in the kitchen and one in each of the children’s bedrooms. This is probably typical of many family houses in Britain.  The television has taken over and yet, one might argue, it constitutes one of our most serious public health hazards.    


That’s a bit strong, you might think.  Surely, television is one of the wonders of the age.  At the touch of a button, it keeps us informed what is happening throughout the world twenty four hours a day.  It provides a rich choice of drama and entertainment without ever leaving our armchair. It allows us to watch major sporting events whenever and wherever they are taking place.  It provides information and commentary on every conceivable topic. It instructs us how to cook, how to decorate our homes, how to create the most interesting and productive gardens. 


Ownership of television sets did not really start to escalate in Britain until the 1960s. Since then, there has been a progressive increase in emotional illness and those physical conditions that have no obvious medical physical explanation.  The same association is seen throughout the world.  For example,  disordered eating was almost unknown in Fiji before the introduction of western television.  Within a few years, dieting and self induced vomiting had become commonplace among young Fijian women.  The same association was observed in  Czechoslovakia and the Republic of Georgia.  And tellingly, the close knit Amish community, that forbids the use of television in their houses, has been spared the depression epidemic. But association does not constitute proof.  It is not possible to isolate ownership of television sets from other fundamental changes in society, such as the decline in ‘community’, the increase in social isolation and rise in single parent families.        


Anxiety, depression and bodily illnesses that have no obvious physical cause are due, at least in part to difficult life situations and traumatic events that people cannot resolve.  The resultant tensions remain in the body where they tighten the muscles, raises the blood pressure, alters the activity of the immune system, increase sensitivity, wrench the gut out of kilter and generally exhaust and demoralize us.  The reason these illnesses have been getting more common are, I believe, the result of a combination of culture shock caused by changing social attitudes towards entitlement and narcissism and a decline in community and social interaction. This has created new social dilemmas, which are increasingly difficult to resolve without lasting shame and guilt. (See ‘Shameful acts, guilty secrets and enduring sickness; a moral for our times’ – August 7th, 2008).  


Television is also the most pervasive influence on how we feel and react to situations.   In a society where there is an erosion of the authority of our institutions and a decline in social interaction, it is television that directs attitudes and sets standards of social behaviour.  Soap operas, the most popular television programmes, are scripted to deal with modern dilemmas.  They encourage us  to seek fun rather than act responsibly,  to confront rather than negotiate, to protest rather than understand, to demand our rights rather find ways of living together,  and to fret about minor issues rather than view things in perspective.  Such programmes reinforce  the distorted perceptions of a narcissistic society,  in which image and self actuation take priority over community values.         


News programmes bring the dramatic intensity of disasters anywhere in the world right into our living rooms.  There is rarely any good news.   Television journalists are not paid to inform, instruct and reassure,  but to excite and arouse us.  So while distant events like the invasion of Georgia by Russian troops may not generate a deep personal grief reaction, they stir up the topsoil of insecurity,  which cannot but fail to make the lonely and vulnerable feel anxious and unwell. Vicarious exposure to emotional trauma upsets us, but does not allow us to engage with it, resolve our emotions,  learn from it and grow.

Quiz shows,  reality programmes  and advertisements seduce us into believing  we can all be famous and live in a fantasy land of happiness and comfort.  But fame and affluence are ephemeral; they can be easily snatched away,  leaving us with nothing.   With such an unreliable world, how can we build up a healthy sense of confidence and trust?   


But surely, we don’t have to be affected by what we see on television.   That’s true,  but television is a hypnotic medium.  Audiences peak in the early evening when we have finished the days work, eaten an evening meal, perhaps had a drink or two and are settled in an armchair.   This relaxed but focused state of mind is highly receptive to evocative images.   They influence the way we feel and think,  directing our attitudes, conditioning our beliefs,  creating aspirations,  destroying reputations,  determining fashion and setting trends.   It is not the rhetoric of our politicians that convinces us to vote in a particular way,  but the way the television commentators  interpret what they say.   It is not the quality of a new product that makes us buy it,  it is advertiser’s skill in persuading us that we need it.  And it is not always our physical symptoms that make us go to the doctor, but the fears of what the documentaries on health tell us it might be. Every day, we hear of some new threat to our health, creating another worry that we cannot resolve.     


We resolve our tensions by thinking, reflecting and talking to other people.  Television induces passive involvement rather than resolution, it erodes time and space for reflection and it has facilitated a loss of community. Beamed into our homes 24 hours a day, television occupies the time we might communicate productively with others.  People go out much less than they used to.


So if television does not actually cause illness, it makes it more likely by  encouraging the behaviour that creates complex moral dilemmas while reducing opportunities for resolution. 


Finally and perhaps most important, television is watched more by children than their parents.  In Britain children watch at least 3 hours television every day and many teenagers spend more time alone in front of their television and play station than with family and friends. This is not so much a training for life as an escape into fantasy.  Deprived of normal social interaction, such children may grow up unable to deal with the complex emotional dilemmas of modern life without becoming ill.



He certainly appears good – young, slim, sculpted, incisive, statesmanlike, eloquent and, an advantage these days, of mixed race.  Barack Obama is the man for our time – or at least that is what his sponsors would have us think.  America is ready for a black president, a man with the credentials not only to represent his country, but to lead the world. This will be a new dawn.  The clichés roll.  By comparison,  John McCain, his senior by 25 years, looks old and slow, yesterday’s man, a hero in a long past war that his country would rather forget.   


It is already being proclaimed as the most expensive election in history.  For this is not about electing a competent administrator, a clever economic investor or even a skillful personel manager;   it’s about the installation of a God. 


The positions, Barack Obama is in contention for, are the paramount leader of the richest country in the world, a diverse and complex nation of 225 million people, the  commander in chief of the world’s most powerful and well equipped army,  and the de facto guiding force for the western world.  If elected, he would be the most powerful influence on the stability of a planet in crisis.  He has to be a God.    


He has to be a God because, to be President of the United States of America, he must appear to embody superhuman strength, the wisdom of Solomon, steely authority, unflinching resolve and unquestioning dedication.  He must show himself willing and strong enough to accept absolute responsibility.  Yet he must also possess a humility that goes with understanding, a charisma that inspires loyalty, and a basic humanity that guarantees trust.  He has to be all things to all men.  Only a God can do that, because Gods, as our own creations, are the virtual embodiment of all of our projections.  Obama is not a God, but he has to create the illusion that he is. 


We don’t really know Barack the man – only what his public relations team choose to tell us,  but he starts with the advantage of not having a political history.  Unlike Clinton, he doesn’t have shadows to air brush out.  Unlike Bush, he doesn’t have relatives.  Unlike McCain, he is not tarnished by an unpopular war and the failure of a  previous republican nomination.  His is a blank canvas – an opportunity to create a public relations masterpiece, a dazzling image that will propel him to apotheosis.   


So everything is strategy,  a PR opportunity;  a visit to a factory in Detroit,  a school in Texas, a film set in Los Angeles,  a tour of European cities,  a speech in Berlin reminiscent of JFK,  a meeting with Sarkozy, a photograph with Gordon Brown – a useful contrast!  He doesn’t have to say that much.  In fact the less he says the better – every utterance will be picked over by the media vultures.  He just has to look the part. And so far, he has done it very well. 


It should be a foregone conclusion.  Obama looks like a God – McCain looks like grandpa.  But public opinion is so fickle.  Would-be Gods can be destroyed by one unfortunate error.  Maybe the timing of his European visit was presumptuous,  but the biggest area of risk concerns his attitude to The Middle East.  Hilary Clinton wanted to bomb Iran,  Obama wants to talk.  Obama got the nomination, but did he really capture the mood of his country?  The difficulty is that whatever Gods-elect say will be used by their detractors to undermine the image.  The cartoon in The New Yorker brilliantly captured brilliantly the fears of the waverers.  It showed Obama in the Oval Office, dressed in an Arab robe and turban, exchanging a fist bump with Michelle, who is dressed in the battle fatigues of The Black Power movement.  The stars and stripes are burning in the grate. 


Obama sounds awfully like Osama – just change one letter.  It anything stalls his campaign, that will.  It is so unfair.  Obama has been so measured in his comments about The Middle East. The man has shown the qualities of a statesman.  But this isn’t about the real man.  The election of Gods is all about image. 


We confer so much power on our leaders, they cannot appear anything other than Gods if they are to retain support.  They may well be elected on a wave of adoration, but it is so difficult to maintain that level once the reality of everyday politics sets in.  How can you appear like a God, when you trying to broker a deal between the unions and the public sector, or when you are having to make concessions with China on carbon emissions, or when you feel forced for diplomatic reasons to ignore violations of human rights in Chile? 


It is easier if there is a crisis.  JFK exhibited God-like invincibility s in his dangerous but successful brinkmanship over the delivery of nuclear missiles to Cuba.    Margaret Thatcher had her great symbolic victory in The Falkland Islands.  ‘Rejoice, rejoice!’, the warrior goddess cried at the moment of victory.  And then she faced down the miners, whose leader, King Arthur was overburdened with the clay of hubris.  Her success was in choosing who to pick a fight with.  Gods and Goddesses must appear invincible if they are to last.  Their God-like reputation is but a veneer.  Scratch it and the image is lost forever. 


Remember the broken statue of Saddam after the last Iraq war.   It was shock to see that it was …. H O L L O W !    I first heard of Saddam when I was invited to my then research fellow to attend a reception organised by the Iraqi students.  It was an elaborate PR exercise.  A film depicted smiling images of a be-whiskered, beneficent leader holding babies, talking to farmers, visiting a power station, greeting other Arab leaders. Yet just months before, he had committed genocide against the Kurds in the far north of his country – though of course we didn’t know that then. 


I fear that in the excitement to get him elected,  Obama is being built up too high.  How can he possibly hold all the hopes, aspirations and projections that people are heaping on him?  With America about to lose its status as the sole world superpower,  Obama is seen as its saviour.  But if he is elected, sooner or hopefully later, people will see Barack Obama for what he is, a clever young lawyer of mixed race and underprivileged background, who has worked hard, showed a degree of political cunning and knows how to present himself.  And they will feel deceived and hate him for his humanity.  Even one as gifted as Barack Obama will not be able to solve the credit crunch or prevent terrorism and with every apparent failure, some of the gold leaf will flake off his image.  He will begin to look – well ordinary.   


The election of a political leader is like falling in love. It is a state of idealisation. We imbue our leaders with all our hopes and aspirations. We make of them everything we have ever desired.  They are the one. But after we have committed to them, we gradually come to realise that they are not perfect; they are perhaps a touch too arrogant.  We begin to notice a few disagreeable habits.  They might not even be as scrupulous and honest as we thought they were.  And they seem to care more for remaining in power than they do for our concerns. 


We demand absolute standards from our Gods.  If they are too human and they let us down, we hate them. And so, column inch by column inch, they have, as Gods, to be destroyed.  


So Obama must fail.  They all do.  It is inevitable.  One can only hope that his fall of grace, when it happens, is a long decline into boredom and inconsequence – with the machinery of state being competently managed by the administrators.  It is unlikely that American democracy would permit their leaders to act out the myth of their own omnipotence and become tyrants, but there is a danger is that the edifice that is Obama may be so high and excite so much fear among his more reactionary opponents, that when it falls to earth, the damage will extend far and wide.   


Despite that,  I do hope he gets elected.  The inauguration of America’s first non pure white president will send a powerful message of racial integration thoughout the world, affirming the United States as a dominant moral force for peace and stability throughout the world.  My wish is that he won’t be forced to compromise his basic humanity and will prove a great leader.   

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