A Cybernetic Approach to Controlling Health Problems

For several decades, health issues have increased by more than 8.5% each year. According to a recent study conducted by the center for Disease Control and Prevention, 65% of US adults are either overweight or obese. The rate of diabetes are increasing in the United States, with a 27 percent increase seen in the last five years. The high cost of health care also poses a major threat to the nation's economy. However, health problems can be prevented to a large extent by controlling people's lifestyle. Group discussions and conversations may help people to adopt a healthy way of living. Therefore, Cybernetics which is the study of conversation/communication and control/regulation can be used to help solve this problems. This study aims at using cybernetics as a model for controlling health problems. Addiction In developed countries of the world like USA, where the literacy rate is above 95%, people know that leading a healthy lifestyle removes the risk of chronic health issues to a considerable margin. However they most times do not adopt a healthy way of living. Why? Addiction has ruined the healthy life style of people. For example- people may be addicted to sleeping and do not exercise, addicted to eating foods with high calories that causes them obesity and make them prone to heart problems. Addiction is a condition in which a consistent desire/craving to repeat an addicted behavior exceeds the ability to rationally stop doing so. When the more you have, the more you seem to need to achieve the same effect or result. This effect can be displayed as a positive feedback loop where the want continues expanding within the loop.Some background about feedback loops – Feedback loops are of two forms: negative feedback loop and positive feedback loop. Negative feedback loops strives towards balance and stasis by subtracting error with each cycle. A good example of negative feedback loop is homeostasis, the body's system for keeping itself chemically and temperature balanced. Positive feedback loops, by comparison, add the variations of each cycle. As a result they can become potentially dangerous as their effect mount with each event. Hypothermia, shock, heatstroke are examples of positive feedback.Figure-1 models addiction (nicotine addiction) as a positive feedback. The desire for smoking continues to increase in the loop for achieving the same level of satisfaction. The first day, Bob needs to smoke once and get satisfied. The second day, he needs to smoke twice to get the same level of satisfaction. Gradually, his cravings and urge to smoke increases along with the frequency.Controlling the Uncontrollable(addiction)The graph above (Figure-1) indicates how the addiction continue to expand in a positive feedback loop. Also, Bateson's examination of alcohol addiction contended that the very attempt to regain discretion, to be a â€Å"commander of one's own spirit†, added to the heightening of the alcoholism. Moreover, the Twelve Step Program of Alcoholics Anonymous-which has been effectively adjusted to a huge number of addictive practices, offers recuperation by â€Å"surrendering† that is, by stopping to deliberately try to stop the addiction. Subsequently, the person who is addicted does not have an essential variety to control addiction.At the point when Addiction becomes uncontrollable, how can it be controlled? Ludwig's research on Alcoholics mind demonstrates that â€Å"developing the right mind frame† (sufficient inspiration) for sobriety improves the probability that an individual can figure out how to resist his addiction .Sufficient inspiration or adequate motivation can solve the puzzle of addiction as an uncontrollable event. The diagram beneath demonstrates the cybernetic approach to deal with controlling health issues by inspiring individuals to follow a sound way of life (work out, yoga, healthy food and so on.), that is abstaining from an unhealthy way of life.Reward/Incentive SystemPeople have various needs including monetary needs, physiological needs, safety needs and esteem needs. An individual can be motivated for performing an activity using proper incentives which may help in fulfilling some of his needs. A reward system could be a web application like Weight Watchers or an organization such as a health club. Below is a model of an incentive system used in motivating a person to exercise regularly. The model also shows that the system can keep refining or modifying the incentive system to make sure that the user is always motivated.Group Affiliation/FriendsGroups, friends and circle of relatives assist in controlling addictions and regulating the manner people live. People develop trust, care and similarity in a group that offer intellectual strength for controlling their cravings. It has additionally been proved that the group association programs offer long- term remedy for addiction in comparison to short-term remedy provided through medication therapy. Self-assist programs like Alcoholics anonymous, rational healing or women for Sobriety, assist in gaining control over addiction through assisting the affected person to integrate into a self-assist group. Trust Trust is a system-related concept and that is a constantly evolving state of information acquisition, processing and feedback. Figure-4 demonstrates the system model of trust between two actors (trustor and trustee). The trustor continually accesses the behavior of the trustee against his mental model of trustworthiness, which results in increased trust if the behavior matches with his mental model otherwise decreased trust. Trustworthiness relies on three variables which relate to perception about the person to be relied on: competence, integrity and benevolence. ‘Competence' is the perceived potential of the trustee, as measured through indicators which includes training or credentials, experience, and reliable past performance. ‘Integrity' is the degree to which the trustee is considered to perform with honesty, fairness, and consistency of actions and words. ‘Benevolence' concerns the extent to which the trustee demonstrates care and consideration for people he or she interacts directly or indirectly. In addition to the above-recognized antecedent variables, trust also relies on the ‘context' within which the trustor and trustee are embedded. It could affect the extent to which the trustee is rated on antecedent variables particularly competence. For instance, a person may be perceived as competent in one context but no longer in another. Furthermore, it is essential to differentiate between Interactions among unfamiliar others and ongoing interactions among familiar others for trust. In a social system, trust could be unidirectional or bi-directional. Also, trust may be commutative.After the developement of trust, the trustor (Alice) feels confident and becomes willing to take actions based on the suggestions, actions and decisions of the trustee (Bob) to an extent proportional to the trust level in the trustee. Now, when Bob says that he controlled his blood sugar level by following the recipes from the diabetic cook-book, Alice feels confident the same recipes in the diabetic cook-book works and she is now motivated to follow them too. It also gives her a social proof of the reliability of the recipes from the diabetic cook-book. Figure-6 is the conversation model of this trust and social proof scenario between Alice and Bob.CareCare is also a continously evolving state of information aquisition, processing and feedback.Similarity, trust, understanding and reciprocity make the important variables. It is also dependent on context and familiarity/relationship between individuals. Below is a figure which shows a model of care between Alice and Bob and how care helps them for abstinence. Bob's behavior is matched to Alice's mental model of a person she would like to care for. If there is a positive match,then the care for Bob increases otherwise it decreases. When there is a match, she cares about what Bob's expectations are from her. She feels a sense of responsibility/accountability for Bob's expectations because she does not want to disappoint him. Similarly, Bob also does a behavior assessment of Alice against a mental model of a person she would like to care for. Its also important to note that both may have different perceptions or mental models of the persons they may like to care for. Also, care may be unidirectional as well. Now when Bob makes a suggestion to Alice about losing weight, she feels responsible/ accountable for losing weight as she cares about Bob. Similarly, Bob feels responsible/accountable for not smoking when Alice asks him to quit smoking.Figure 7: Care/Accountability/ResponsibilitySimilarityIn comparism to trust and care, similarity also is a constantly evolving state of information acquisition, processing and feedback. The antecedent variables for similarity might include mental attitude, behavior, hobbies, age gender and race.The figure below shows how similarity motivates Bob for exercising frequently because he gets competitive and inspired by Alice.The table below summarizes Trust, care and similarity. Antecedent Variables MotivationTrust Competence, Integrity, Benevolence Willing to act on the basis of words, actions anddecisions of anotherCare Similarity, Understanding, Trust, Reciprocity Accountability,ResponsibilitySimilarity Mindset, hobbies, age, gender, race Competitiveness,InspirationFigure 9: Summary for Trust, Care and SimilarityAlternative model for Accountability, Responsibility, Competitiveness and collaboration in a self-help group.