Friday, December 30, 2011

Development During Infancy and Childhood


Most scientists eventually decided that child development is not a mini replay of evolution and but most continue to believe that studying children and how they develop can tell us a lot about human beings in general. This belief helped to spark a scientific field now known as developmental psychology. Developmental psychologists study the changes that occur during all or part of the life span in  the processes of perception, learning, thinking, social activity and other aspects of human behavior.


Three major issues in developmental psychology have stimulated recurring conflicts.

NATURE VERSUS NURTURE

The nurture side of the nature –nurture debate had its strong advocates too – people who believed that environmental forces have a more powerful influence on our development than does heredity. The nature-nurture debate really concerns the relative impact of heredity and environment. Virtually no one believes that nature alone, or nurture alone, completely determines the course of our development. Psychologists agree that development is shaped by the interaction of heredity and environment.

PASSIVITY VERSUS ACTIVITY

Some psychologists picture as fairly passive, doing what we do largely because of the environmental forces around us. Jean Piaget attacked the view that the developing person merely “submits passively to the environment”. Instead Piaget argued that people actively manipulate the objects and  events around them. They don’t merely copy or learn about reality as they develop. Instead, they construct their own ways of understanding the world; psychologically speaking they all invent their own reality.

CONTINUOUS VERSUS DISCONTINOUS

Some psychologists see development as a sort of continuous progression – that is a steady accumulation of skills, knowledge and maturity. According to this view, development is best viewed as a smooth curve, it can be measured in quantitative ways – that is ways that tell us how much of a particular ability the child has. Other psychologists see development as a discontinuous progression – that is as a sequence of leaps from one stage to another. Here it measures developmental changes in qualitative ways – that is in terms of the characteristics of people’s behavior.

 

Methods of Studying Development


Development psychologists focus on time and transformation. They study the changes that occur as the developing individual unfolds – changes in processes as basic as perception and as complex as forming a self concept. The psychologists rely on research methods geared specifically to the study of development. Two of the most important are the longitudinal method and the cross sectional method.

THE LONGITUDINAL MEHTOD

A psychologist using the longitudinal method observes the same individuals at different points in time. The individuals may be the children of oil barons and migrant workers studied at yearly intervals from birth. This research can be much more difficult. People who enlist in a study may move away, lose interest, or for other reasons be unavailable for later observation or testing. This is a logistical problem for the investigator, and it is a source of bias, it might mean that the findings of the completed study would apply only to people who rarely move and who are interested in research. Another risk of this research is that a study will seem less important or sophisticated at its end than it did at its beginning; this is because the central issued and the preferred research methods of psychology are continually shifting.

Carefully conducted longitudinal research, despite its problems, is highly regarded by most developmental psychologists, who recognize the value of repeatedly observing ithe same individuals as they mature.

THE CROSS-SECTIONAL METHOD

Most developmental research involves the cross-sectional method. In studying dependency, for example, many investigators simply compare representative samples of youngsters at two or more age levels on the same measures. They found large group differences, with dependency most pronounced in the youngest children and least pronounced in the oldest. This of course, suggests that dependency as measured by these researchers probably declines from the early to the mid elementary years. Such cross sectional research is an efficient way of spotting age group differences as such. It has its disadvantages, though because it does not involve repeated measurements of the same individuals, it cannot tell us how stable people’s characteristics are as they mature.

Infancy: Early steps in the March to Maturity

For centuries, the deeply private world of the infant was cloaked in mystery. Because babies could not talk, the adults in their world were reduced to guesswork and speculation about them. In recent decades, however, ingenious investigators have figured out ways of peering into the infant’s world. The neonatal (newborn) period is the first 4 weeks after birth. This is the time of transition from the total dependency of prenatal life to a more independent, creative existence. It is a time when rhythms of breathing, feeding, sleeping, and elimination are established and when babies and parents make some critical adaptations to one another. 

THE NEONATE:
Most of the psychologists agree that neonates are born with abilities to perceive and respond to some parts of their world in an organized and effective way. For example, reflexes that are in place at birth permit the neonate to grope, or ‘root’ for the breast, to suck when a object is placed in its mouth and to swallow milk and other liquids.

Neonates show perceptual abilities that would surprise most people. They show positive reactions to certain sweet tastes and negative reactions to certain sour, bitter or salty taste. They turn in the direction of certain sounds, including human speech. Some of the most exciting findings about neonates involve their visual abilities. They not only orient toward light but they can under the right conditions, actually follow a light.

Some surprising findings of a study conducted by Meltzoff and Moore suggested that neonates are even capable of imitation. The research appeared to show that babies as young as 2 to 3 weeks can mimic certain adult behaviors such as facial expressions.

Some researchers now suspect that the apparent imitation may be most pronounced among very young infants and that it may be reflexive – something like the early rooting.

MOTOR DEVELOPMENT

The development of motor activity in the period of infancy has been studied extenisively. Investigators have built up a rich fund of normative data on the ages at which certain motor milestones are attained.   The below mentioned chart shows the norms for several such milestones. It shows that there is a fairly broad age range within which individual infants may reach each milestone, the order in which the milestones are reached rearely differs.






Age (in months)                               Mile stones

At 1 level                                           arms and legs thrust in play
At 2 level                                           hands erect and steady
At 3 level                                           hand predominantly open
At 4 level                                           turns back to side
At 5 level                                           one handed reaching                                             
At 6 level                                           sits alone steadily
At 7 level                                           crawls or creeps
At 8 level                                           pulls up by furniture
At 9 level                                           Neat pincer ( thumb)
At 10 level                                        Pat –a – cake
At 11 level                                        stand alone
At 12 level                                        walks alone
At 13 level                                        throws ball forward


The order of events is quite consistent, but the age at which each milestone will be reached is hard to predict for a given child. For example, 5% of the infants walk alone by the age of 9 months but that another 5% percent do not walk alone until after their sixteenth month. Walking is another good example of the interaction of nature and nurture; although it seems to be a wired in developmental sequence, it can be speeded up or slowed down by variations in the infant’s experience.

Prehension - the use of the hands as tools, shows another predictable developmental sequence. It begins with infants thrusting their hands in the direction of a target object, essentially “taking a swipe” at the object. This is followed by crude grasping involving only the palm of the hand. Then there is a sequence of increasingly well-coordinated finger and thumb movements. Later in the first year of life, most infants can combine thumb and finger action into a pincer motion that allows them to pick up a single chocolate chip from a tabletop.

What they will then do with the chocolate chip depends upon the state of yet another motor system, mouthing. The most common form of mouthing in infancy is sucking.

DEVELOPMENT OF PERCEPTION

The past two decades have seen an explosion of research on infant perception, particularly visual perception. There are lot of ways in which infants organize and interpret what they see. For example – a kind of research is a study of depth perception conducted by Gibson and Walk. To judge whether infants can read the perceptual cues that adults use to judge depth, these researchers used the visual cliff. It involved an apparent drop-off made safe by a clear glass cover. Despite the cover, Gibson and Walk found that none of the 6-14 month old infants they tested would cross the “deep” area to get to their mothers.  Yet all 36 of them eagerly crawled to their mothers when the moms were stationed on the “shallow” side. This strongly suggests  that even 6 month old infants have depth perception.

Investigators have traced significant development changes in face watching. One month olds show only a moderate interest in real human faces; when they do focus on a face they focus mostly on edges and points of light dark contrast. Two month olds, by contrast, spend more time looking at the interior of the face, especially the eyes, than at the outer edges. Most researchers agree that by the fourth or fifth month, infants can ‘assemble’ parts of a face into a meaningful whole. By five months, for instance, babies can distinguish between two dissimilar faces.

COGINITIVE DEVELOPMENT – PIAGET’S THEORY

For the infant, the cognitive development is expressed through perceptual and motor activity. When a baby looks intently at the points and contrasts of a triangle or inspects her father’s face, she is manifesting one of her few means of “thinking about” or “knowing” the triangle or the face. When another infants sucks on the handle of his rattle, this motor activity is his way of knowing, or understanding that rattle.

This point has been emphasized by Jean Piaget, a Swiss biologist, philosopher, and psychologist who has developed the most detailed and comprehensive theory of cognitive development. Piaget called his approach genetic epistemology. In Piaget’s view, the development of knowledge is a form of adaptation and as such involves the interplay of two processes, assimilation and accommodation.  Assimilation  means modifying ones environment so that it fits into one’s already developed ways of thinking and acting.
Accommodation means modifying oneself so as to fit in with existing characterisitics of the environment.

According to Piaget, the processes of assimilation, accommodation and equilibrium operate in different ways at different age levels.

Piaget called the period of infancy the sensorimotor stage. This label reflects something as the infant’s ways of knowing the world are sensory, perceptual and motoric. Piaget called each specific ‘way of knowing’ a scheme. A scheme is an action sequence guided by thought. For example, when infants suck, they are exercising a suckling scheme. Their first sucking is primitive and not very flexible in style being sucked.  In making the necessary adjustments, they accommodate their sucking scheme to the shape of the nipple. This allows them to assimilate the nipple into their sucking scheme. This combination of assimilation and accommodation results in adaptive behavior that helps the infant survive.

Piaget described many specific cognitive changes that take place during the sensorimotor stage.  When young infants sees the object and the object is hidden, they seem unaware that the object continues to exist.  For example, hold an object within view of the baby until he or she is clearly interested and is reaching for it, and then quickly cover the object with a cloth. Chances are that the baby will stop in mid reach and will not search for the object at all. If we repeat the same with an younger age level (14-16mth)  we will see that the baby search for the hidden object. The search suggests that the baby has attained what Piaget called Object permanence – the idea that objects continue to exist even when we can no longer see them.

SOCIAL DEVELOPMENT

The first ‘social’ relationship most infants form is with a parent and in most cultures that parent is the mother. Various theorists have offered various ideas about the psychological significance of that relationship.

Piaget emphasized the cognitive aspects of infancy. In the infant’s ways of “relating” to parents and others, Piaget saw signs of sensorimotor intelligence. Freud’s view was quite different. He saw infancy, the oral stage, as a time when issues of dependency were being dealt with and when physical satisfaction was derived from stimulation in the oral region of the body.  Erik-Erikson argued that mother-infant interaction is a context for the baby’s basic conflict between trust and distrust of the world.

Despite their differences, all three theorists agreed that infants typically form intimate attachments to their mothers.

Attachments :
Attachment is an early, stable, affectional relationship between a child and another person, usually a parent. Early efforts to study this relationship were clinical and somewhat informal. Various researchers studied attachment in a structured way. Their work yielded a surprisingly consistent picture

1.      Initially, the infant develops an attraction to social objects in general and to humans in particular; the baby shows proximity – maintaining behaviors (crying, clinging, and other behaviors that serve to keep humans nearby)
2.      Next, the baby distinguishes familiar from unfamiliar people and the primary caretaker (usually the mother) from other familiar people; then proximity – maintaining behaviors begin to be aimed more directly at familiar persons, particularly at the primary caretaker.
3.      By the second half of their first year, most infants develop a true attachment to the primary caretaker; they recognize that person and direct proximity maintaining behaviors toward that person and not toward others.
4.      By the first birthday, the attachment is so strong that children react negatively to separation from the primary caretaker, they grow fearful and tearful, for example, when their parent leave them with a sitter.


EMOTIONAL DEVELOPMENT

When babies smile, does it mean they are happy? This seemingly simple question is actually very complicated because what looks like an emotion may not always be one. Evidently smiling happens for different reasons at different ages. Some smiling is seen even in new borns, but much of this seems automatic and hardly emotional. For example, some smiling seems to be triggered merely by the infant’s bodily state, as when babies break in to grin during REM sleep in the first few days after their birth. In the second month, smiles can be brought on by events in the environment – particularly the sound of human voice or the sight of a human face. A powerful smile evokes is a combination of a voice and a moving face, particularly if the voice is high-pitched. By the third or fourth month, babies smile more for their mothers than for an equally encouraging female stranger. By the beginning of the fifth month most babies have begun to combine smiling with laughing.  By their first birthdays, tactile fun evokes fewer laughs; but interesting visual displays like a human mask, get more laughs.

ADJUSTMENT PROBLEMS IN INFANCY

In an ideal world, infancy would be a time when baby and parent would quickly adjust to one another and develop a smooth harmony of styles that is called a “Waltz”. Quite common in the first year of life are infant feeding problems – especially a digestive discomfort known as colic and vomiting. Constipation and diarrhea, irregular sleep patterns, and mystifying bursts of crying also occur very often in the first year. Near the end of the first year and well into the second, the problems most often involve a conflict between the baby’s growing physical and mental processes and the parents efforts to regulate behavior that seems to them to be aggressive or dangerous.

A number of clinical disorders make their first appearance during infancy. Among these are several that are known to be caused by genetic or other biological factors. Down syndrome for example, involves mental retardation and a characteristic physical appearance noticeable even in the newborn.

Early signs of the disorder known as infantile autism make their appearance during the first year and a half of life. Autistic youngsters fail to show several of the landmark features of infancy. They fail to focus on other people’s eyes, they do not smile regularly in response to people’s voice or faces, they do not show key signs of attachment as protest when a parent leaves them. Infants suffering from a failure to thrive show apathy, lack of normal social interest, and stunted growth despite seemingly adequate nutrition.

ADJUSTMENT PROBLEMS IN EARLY CHILDHOOD

In the  preschool year, children acquire a risky combination: mobility, language, and immature judgement. Their limited powers of reasoning make it hard for them to foresee the consequences of their physical activity. They are physically able to cross the street but unable to envision all the dangers that crossing the street poses. Preschoolers also use their newfound language skills with a distinct lack of restraint. Their cognitive egocentrism prevents them from taking the perspective of their listener; the result can be painfully honest comments such as “Hello, fat lady” or “you have ugly teeth.

Preschoolers pay a price for their powers of representational thought. That price is a lively imagination that can careen out of control at times. Shadows on the wall at bedtime can become burglars, kidnappers or ghosts. There is a perpetual tension between the rational and irrational uses of imagination.  A common fear among preschoolers is that something under the bed will grab a hand if it hangs free. Surveys of parents show that fears are amoung the most common behaviors problems of early childhood, but what children fear changes markedly during this period.

Problems such as temper tantrums decline over the preschool years.

Early Childhood : Play, Preschool, and Preoperations

From the age of about 18 mths through the age of 6, the comfortable confines of the child’s family give way to the world of peers. The play that goes on in that world may seem frivolous to many adults, but we are now coming to recognize it as , to use Piaget’s expression, “the work of the child”. In the context of play, children make the transition from sensorimotor thinking to thinking that involves internal manipulatiohn of symbols. The elegant symbol system is known as language takes shape at a pace that leaves even experienced parents dazzled. The frequency and intensity of peer interaction force the child to deal with interpersonal issues, such as coping with aggressive impulses and learning how to help.

COGNITIVE DEVELOPMENT

The period between about the ages of 2 and 7 was labeled the preoperational stage by Piaget. By this label, he meant that these years are preliminary to the development of truly logical operations.

Operations are flexible mental actions that can be combined with one another to solve the problems.

The primitive identity concept is an important milestone. One reasons is that it enters into the way children think about their gender identity. Another reason is that identity concepts seem to be necessary steps on the way to concentration, a defining feature of the next major Piagetian stage, concrete operations. Finally these early object-identity concepts may be linked to a more personal sense of identity – that is the self concept.

Another important development in the preoperational period is representational thought – the ability to form mental symbols to represent objects or events that are not present. As early evidence of representational thought, Piaget cites delayed imitation.

Early in the preoperational stage, reasoning is not truly deductive nor is it truly inductive. Instead very young children show transductive reasoning; that is they reason from the particular to the particular, often in ways that are influenced by their desires.

Some other characteristics of preoperational thought can be surveyed briefly. Egocentrism, means an inability to take the point of view of another person. Preoperational children tend to assume that others see the world just as they themselves see it. Egocentrism as thus defined, does not mean selfishness; instead , it refers to an intellectual limitation. Preoperational children also display animism, the belief that inanimate objects which have certain characteristics of living things are in fact alive. Finally, preoperational children do not understand cause effect relationships very well. They tend to see unrelated events and objects as causally related to one another. Infact, they tend to believe that each event has a clearly identifiable cause, and thus they often fail to recognize the operation of chance and luck.

LANGUAGE DEVELOPMENT

Achieving mature thought requires achieving a mature use of language.  One can view the course of language development as either continous or discontinuous . vocabulary development appears to be a fairly smooth, continuous process. The infant’s first legitimate English word usually appears around the time of the first birthday. By the age of 2 , the vocabulary has usually expanded to about 50 words, and by age 3, it consists of about 1000 words.

Language development looks more discontinous or stagelike, when we focus on syntax, the formation of grammatical rules for assembling words into sentences. There are large differences among children in their rate of development and because children do not always use their most advanced forms of language. In many children, syntactic development actually begins before stage 1 (12-18 mths)

The recurring conflict between active and passive views of the developing person canbe seen in the study of language development. Some theorists, have argued that children learn language by trying  various combinations of sounds and being rewarded by their parents and other for those sounds that represent true language. Others, such as Piaget have argued that children create their language by constructing their own rules and revising them as needed. There can be little doubt that some of children’s language acquisition  comes from being rewarded or encouraged by others; all of us have seen this process in action. Yet it also is hard to deny that children are active builders of their own language. One line of evidence often used to support this view is the erroneous language that children use – language that reveals rules the children have constructed but that is not likely to have  been rewarded.

SOCIAL DEVELOPMENT

Along with the increasing mobility and accelerating language skills of the preschool child comes an expanding social world. The process by which the child’s behavior and attitudes are brought into harmony with that world is called socialization.

Freud’s theory focused mainly on the child’s socialization with respect to parents during this period. Freud believed that during the anal stage, roughly the second year of life, key interactions center around toilet training. The child takes physical satisfaction from stimulation in the anal region of the body and social issued including self control and orderliness are confronted. Freud believed that children forge a lasting identity with their same sex parent.

Freud and erikson did theirs, with a focus on the parent-child relationship.

The parent –child relationship: The first part of early childhood has been dubbed “the terrible 2s. one reason for this label is that the child’s increasing physical prowess, intellectual power, and language skill transform the nature of the parent child relationship, the child becomes less compliant and manageable than before.

In teaching specific skills to their children, parents may profit from the work of behavioral psychologists. In addition to teaching specific skills, the parent during this period is called upon to be disciplination.

First a combination of general parental warmth and specific explanations for specific prohibitions seems to promote effective discipline. Parental warmth seems to make the child eager to maintain the parent’s approval and to understand the parent’s reason for the prohibition.  Parental style may influence the way these patterns are expressed, but parental style is also partly a response to the child’s style.

Sex roles : children’s identification with their parents influence their ideas about sex roles. Children of both sexes may initially adopt may traditionally feminine and maternal behavior patterns but by the age of 4 or 5, boys have already begun to show traditional male types of behavior. One reason for the divergence of boys and girls is that children pick up sex-typed behavior through observational learning – that is boys observe and imitate males, particularly their mothers. There is a large differential imitation of males and females not shown up strongly until children are 4 or 5 years old. The reason seems to be that children’s awareness of sex differences is influenced by their cognitive development.
- Cognitive development and environmental factors, there seem also to be biological causes for sex role development.

Peers and Play : As children mature, their relationships with their parents are increasingly rivaled by their relationships with their peers. The nature of child to child interaction in the context of play change sin predictable ways over the early childhood years.

Initially children engage in solitary play, they may show a preference for being near other children and show some interest in what those others are doing. Solitary  play us eventually replaced by parallel play in which children use similar materials and engage in similar activity; typically near one another, but they hardly interact at all. By age 3, most children show at least some co-operative play a form that involves direct child-to-child interaction and requires some complementary role taking. Additional signs of youngster’s growing awareness of peers can be seen at about age 3 or 4. at this age, at least some children beign showing a special faithfulness to one other child. At the age of 4 or 5 they step on the way to the stable sense of gender identity.

Aggression: In early childhood, boys and girls face an important new task: learning to express unpleasant feelings in socially acceptable ways. Often the feelings are vented in the form of aggressive behavior. Studies show that aggressive behavior, across many cultures, is more common in boys and girls ; also more common in early childhood.

Aggressive behavior may be fostered not only by observational learning but also by direct reinforcement, or reward. In many settings where children play, the aggressive children play, the aggressive children often triumph over others, have easier access to preferred toys, and even get extra attention from adults who are encouraging them to be less combative. Social influences such as television may, through modeling, encourage aggression.  Parent often respond to such behavior by paying special attention to the child and even by giving in to the child’s demands “just to get a little peace and quiet”.

Prosocial behavior: Preschoolers can be aggressive, but they can also be touchingly helpful, generous, and comforting. Such behavior is called presocial. Some have argued that these children are motivated to be involved with other children; and whether the involvement is aggressive or prosocial will depend upon the situation. Others argue that aggressive children, who themselves are easily upset, finds it easier to empathize with others who are upset.

According to Hoffman, children pass through four predictable stages in the development of the empathy that makes prodocial behavior possible. In the first stage, infants have trouble differentiating self from others. Their behavior is triggered by and often looks like, the strong emotional displays of others. After the first year, children gradually develops a sense of self as different from others, and at that point they enter a second stage. Although they have come to recognize that another person is, in fact another person, their egocentric thinking leads them to “help” the other person in ways that they themselves would want to be helped. In the third stage children recognize that a distressed person may have feelings and needs that are different from their own. In the fourth stage the children are likely to empathize  with and seek to help, say an unpopular child  who seems generally morose or withdrawn.

ADJUSTMENT PROBLEMS IN EARLY CHILDHOOD
In the  preschool year, children acquire a risky combination: mobility, language, and immature judgement. Their limited powers of reasoning make it hard for them to foresee the consequences of their physical activity. They are physically able to cross the street but unable to envision all the dangers that crossing the street poses. Preschoolers also use their newfound language skills with a distinct lack of restraint. Their cognitive egocentrism prevents them from taking the perspective of their listener; the result can be painfully honest comments such as “Hello, fat lady” or “you have ugly teeth.

Preschoolers pay a price for their powers of representational thought. That price is a lively imagination that can careen out of control at times. Shadows on the wall at bedtime can become burglars, kidnappers or ghosts. There is a perpetual tension between the rational and irrational uses of imagination.  A common fear among preschoolers is that something under the bed will grab a hand if it hangs free. Surveys of parents show that fears are amoung the most common behaviors problems of early childhood, but what children fear changes markedly during this period.
- Problems such as temper tantrums decline over the preschool years.

- Later Childhood : Cognitive Tools, Social Rules , Schools


COGNITIVE DEVELOPMENT

The intellectual tools that children develop in this period were labeled concrete operations by Piaget, and that is also the name he has given to this stage of development. This stage involves a major advance in the power of the child’s reasoning.

With the advent of these operations, children’s awareness of the ways the world is organized begins to mushroom. They understand not only conversation of length but conservation of other physical entities – like mass, number and area.

In many ways the concrete-operational child’s thinking shows a power and versatility that would have been literally unthinkable in the preoperational period. But even this more advanced level of thought has its limitations. The operations are concrete in the sense that they are tied to the real world of objects and events. It is also hard for the concrete-operational child to grasp the broad meaning of abstract concepts such as freedom, integrity or truth.

SOCIAL DEVELOPMENT

As their social world expands to include classmates and teachers, children’s ways of thinking about people show a corresponding change. Studies of “person perception” show that a child even as old as 6 or 7 will describe others in egocentric ways, referring to what the other people do to or for the child. Descriptions at this age also focus on concrete, observable characteristics of others, such as their physical appearance or their outward behavior.

During the next few years, children begin to use more and more descriptive statements involving psychological characteristics – statements that require some inference about the other person.

Friendship:  The development of “person perception” goes hand in hand with changes in the nature of friendship. Their first friendships tend to be self-serving; a friend is someone who “does what I want”. Later during the elementary school years, friendships become not only outgoing but reciprocal as well; friends are seen as people who “do things for each other”. Quality of exclusion or possessiveness goes along with many friendships in the middle and late elementary years, and also in adolescence.

Groups:  At the same time that children are learning to form one to one relationships with friends, they are learning to organize themselves into groups. Groups have certain defining characterisitics: goals shared by its members, rules conduct and a hierarchical structure.

Peers versus Adult influence : During the elementary school years, as we have just seen, friends and groups of peers take on central importance in a child’s social life, parents also influence . by the late elementary school period, there are many situations in which American youngster prefer relying on peers to relying on parents. Perhaps more importantly, there are many situations in which children, if forced to choose, will opt for behavior approved by their peers rather than behavior approved by their parents and other adults.
- Later Childhood : Cognitive Tools, Social Rules , Schools

COGNITIVE DEVELOPMENT
The intellectual tools that children develop in this period were labeled concrete operations by Piaget, and that is also the name he has given to this stage of development. This stage involves a major advance in the power of the child’s reasoning.

With the advent of these operations, children’s awareness of the ways the world is organized begins to mushroom. They understand not only conversation of length but conservation of other physical entities – like mass, number and area.

In many ways the concrete-operational child’s thinking shows a power and versatility that would have been literally unthinkable in the preoperational period. But even this more advanced level of thought has its limitations. The operations are concrete in the sense that they are tied to the real world of objects and events. It is also hard for the concrete-operational child to grasp the broad meaning of abstract concepts such as freedom, integrity or truth.

SOCIAL DEVELOPMENT

As their social world expands to include classmates and teachers, children’s ways of thinking about people show a corresponding change. Studies of “person perception” show that a child even as old as 6 or 7 will describe others in egocentric ways, referring to what the other people do to or for the child. Descriptions at this age also focus on concrete, observable characteristics of others, such as their physical appearance or their outward behavior.

During the next few years, children begin to use more and more descriptive statements involving psychological characteristics – statements that require some inference about the other person.

Friendship:  The development of “person perception” goes hand in hand with changes in the nature of friendship. Their first friendships tend to be self-serving; a friend is someone who “does what I want”. Later during the elementary school years, friendships become not only outgoing but reciprocal as well; friends are seen as people who “do things for each other”. Quality of exclusion or possessiveness goes along with many friendships in the middle and late elementary years, and also in adolescence.

Groups:  At the same time that children are learning to form one to one relationships with friends, they are learning to organize themselves into groups. Groups have certain defining characterisitics: goals shared by its members, rules conduct and a hierarchical structure.

Peers versus Adult influence : During the elementary school years, as we have just seen, friends and groups of peers take on central importance in a child’s social life, parents also influence . by the late elementary school period, there are many situations in which American youngster prefer relying on peers to relying on parents. Perhaps more importantly, there are many situations in which children, if forced to choose, will opt for behavior approved by their peers rather than behavior approved by their parents and other adults.

Sunday, October 9, 2011

An Interview


MANU KOTHARI
An interview
June 2000


Dr. Manu Kothari (1935) is Professor of Anatomy, at the Seth G.S. Medical College, in Mumbai, India. He is the author of eight books including: The Nature of Cancer (Vol. One), Bombay, 1973. Cancer: Myths and Realities of Cause and Cure, London, 1979. The Other Face of Cancer, Goa, 1994. Human Genetics, Bombay, 1986. Essentials of Human Embryology, Bombay, 1983. Death: A new perspective on the phenomena of disease and dying, London, 1986. Living and Dying, Goa, 1996. Violence in Modern Medicine: In, Violence and Science, 1988. Next to these books he published numerous articles in the Journal of Postgraduate Medicine.

The meeting that took place in Pretoria at the behest of President Mbeki, was to decide whether the orthodox group is right mainly that HIV causes AIDS, that AIDS is a fatal disease and must be treated as an emergency measure - or that there is not much substance in the entire hypothesis, as a very small group on the other side thinks.

And I think it is very bold of the President, to, intellectualise the issue and that is how we met there. You see, one of the key points which has been used by the media that AIDS is a curent catastrophe, and one point which Peter Duesberg pointed out, who is the pioneer dissident as you might say, who doesn't believe that there is an HIV virus, who doesn't believe that that it causes AIDS, who doesn't believe that AIDS should be treated like the way we are treating, you know. He was the person who said "Here we have a situation, where what is most important is that, as in his opinion, the orthodox group seems to be poorly read, and the dissident group which is very well read, is not listened to for whatever reason."

Now the question is what really is bygging this issue, and therefore, I want to use this as a platform to discuss medicine's failure, or otherwise in such leading areas as cancer, heart attack, hypertension, stroke, diabetes, arthritis, peptic ulcers. Just consider these, and you realise that you've got to fall back on a very important book which came out from Rockefeller Foundation called 'Doing better and feeling worse, Health in the United States'. This was in 1977. Now what is "Doing Better"? Until the '60s, the United States used to spend about 8 billion dollars a year on health. Now it is spending worth 1.25 billion dollars a day. Moral of the story.. doctors, hospitals, manufacturers are having a gala time! And who's "Feeling worse"? Oviously the patient!

The 1977 decision that we are feeling worse, patients are feeling worse, remains unchanged as of May 2000 A.D. Now the questionis "Why so"? If you go into that book, in the first chapter written by Lewis Thomas, a Yale, philosopher, physician, and who was lately the Director of Sloan Kettering Institute, he says, "..When it comes to these major issues like cancer, heart attack, hypertension, stroke, diabetes, arthritis and peptic ulcer.. medicine knows next to nothing"! And in the same book, there is another medical physician Wildarsky, who says that in 9 problems out of 10, medicine can do precious little. In fact, there is a global survey that 9 prescriptions and procedures, 9 investigations and whatever out of 10 are not onyl unneccesary but unwarranted!

Now why have we come to this? We have come to this because, I think, beginning 1930, technology started taking over thinking. And therefore, circa 1930 Betrand Russel said, that Modern Education teaches how to do, but not how to think. And since a common person wants things to be done, like it is in court, that Justice should not only be done but seen to be done, so therapy not only should be done, but seen to be done.

Assertive action has become a priority issue in medicine, however wrong it may be. Now with regard to AIDS, let me point out a few epistemological principles which come to the fore. Epistemology is the science of knowledge. It is a science which takes any piece of information and weighs its worthwhileness, its possiblity, its impossibilty,.. uselessness, its worthwhileness. Now consider that about 300 years ago, an apple fell on the bald pate of Newton and gravitation was born. Since then we have been studying gravitation left, right and centre! We know everything about it from the 10th decimal point.. but one thing remains certain, we can't alter gravity. As Robert Arturu says," apple must fall down"! Therefore, supposing we know everything about cancer cell, that in no way will allow you to alter the cancer cell. Therefore, in fact, Lyall Watson on the European side and Lewis Thomas on the American side, both have generalised that the biggest discovery of the 20th century is the discovery of Human Ignorance!

In 1996, the KEM Hospital, the institution where I work, celebrated its 50th year. And the Dean told me I should suggest to him a rather unusual, offbeat topic for a conference to be held. So I said, Sir, why don't you hold a first ever conference on Medical ignorance. And he started laughing. He didn't take up the issue for the simple reason, he said, that if this conference is held, money flowing in from pharmaceutical firms will close down. So I said, O.K. sir. I give you a guarantee that I will organise the conference, but not talk at the conference. But somehow it never came to pass. And lo and behold in 1977, I get a book from America sent to me by one of my students, Encyclopedia Scientific Ignorance. This was followed up by Pergaman Oxford in 1979 with Encyclopedia of Medical Ignorance. Now these two encyclopedias more than underscore what Lyall Watson and Lewis Thomas said. Let us go back in the hoary past and Shankaracharya. He said in 9th century, that if "Gyaan"(knowledge) is "Aananth"(happiness), so is "Agyaan"(ignorance). And much later Blaise Pascal said that knowledge is the inner surface of the sphere, whose outer surface is painted with ignorance. And therefore, sometimes when somebody calls me that I am well read, then I tell them that I know that I am very very ignorant, because the more you know, the more exponentially you become ignorant. And that explains to you why some of the greatest people who are very learned, are almost painfully humble. You almost get irritated that this man knows so much and yet he pretends to be humble. But in the depths of his heart you see, he knows that he doesn't know!

I am a teacher, and so I've got to teach my students. And I often think of my role. What is my role here? And then I realise that I am a resident of "the democracy of intellect". This is a phrase used by Jacob Bronowski in one of his small books titled 'Democracy and Intellect'. There is neither dissidence nor proponence. There is only a democracy of intellect. And what is my task? The task of any teacher is to take the student to the outer limits of knowledge and to the beginning of his ignorance, thereby establishing an epistemological equality which must be at the heart of any democracy. So thinking along these lines, our own department where I have been teaching for the last forty years, we have very cardinal principles. That on the first day, the student must learn to have a healthy disrespect for the three T's.. teacher, what is taught and the textbook. And towards that end we encourage them to take an oath which was supposed to be a ritual in early Europe, especially in particular universities. You take an oath, that here I have come not to worship what is known, but to question! Question, question and question! And therefore, the issue of HIV/AIDS also demands questioning.

Now to help our questioning on HIV/AIDS, or rather, to have a moral right on this issue, let us take other areas where things appear so pretty clear. 1946 Augustus Bier wrote, that all you know about cancer can be written down on a visiting card, we don't know! And till today it remains unchanged. Around 1983, James Watson of the double helix fame, characterised cancer research as intellectually bankrupt, financially ex invigorating and therapeutically useless. And he said cancer establishments are a lot of shit.. that is the term he used. Sir Meg McFarlen, the Nobel Laureate,summoned up the entire Nobel scene, and he said that after a thousand main years work, the outcome is precisely nil. And today what has happened is, cancer cell no longer is taken as a structural entity. Cancer cell is taken as one more form of normal cello. Now the question is what is cancer cell and what is normal cell?

So Albert Szent-gyorgii, the Nobel Laureate for the discovery of vitamon C and actin myocine, while chairing a session in America at the 69th Ciba Symposium on Sub molecular biology and cancer, on the last page, he is asked, Sir, can you define what is a cancer cell?. And he says, typically of a humble person,"My dear sir, how can I tell you what's a cancer cell when I don't know what's a normal cell?" Yet in the cancer establishment, the bogey of cancer cell as being a vicious, savage cell is being sustained. Another unholy humbug which thet are sustaining, is that chemotherapy and radiotherapy are useful because they tend to kill the more fast multiplying cells as compared to normal cells. So we went on till cytokinetics arrived. And cytokinetics arrived to destroy two illusions. Cytokinetics showed that if at all cancer cells multiply painfully slowly with the result that when you give radio therapy and chemo therapy, before you kill a single cancer cell, you will destroy a million normal cells. That is the trade off, okay? And the other illusion which it destroyed was that of early diagnosis, we still drumbeat early diagnosis. From 1802 through the 19th and 20th century, some of the most leading thinkers have shown that early diagnosis is not possible. This was said intuitively. Then came cytokinetics. And Cytokinetics has shown that before a tumour assumes one milligram of weight, which no scan ever can detect, it's a billion cell strong! And to arrive at that it will take a few years. Which means that by the time a cancer is diagnosed, a symptomatic silent cancer is diagnosed and detected by the most sensitive scan, it has been in the patient's body from 5-20 years. And therefore, when I think about this bogey of early cancer, I say, quoting, almost paraphrasing Churchill.."Never in the history of science has so much untruth been told, by so few, to so many, for so long".

Right, and therefore you know... go furthur! We wrote the 10th chapter of our smaller book, because Ivan Illich realised that the larger volume 'Nature of Cancer', 1000 pages, nobody will read. So he said. Manu, bring it to one tenth, and we brought it! And at that time we wrote the 10th chapter,'Cancer is unresearchable'. When I sent it to England, my publisher said, Manu, you are in the habit of joking, but this is carrying a joke too far!. So I said, what you do is circulate this chapter among top cancer specialists in England, and if they ask me to modify it. I'll do it. If they ask me to drop it, I'll drop it. On purely intellectual grounds they could do neither. And now that chapter has stayed in the series of additions and transalations and we have shown that cancer is unresearchable.

1979, 14th March was the 100th birth anniversary of my beloved Einstein, And therefore, Lopa and I decided to pay a tribute to him. Why pay a tribute to him? Let it be known to the whole world that in the word of J.B.S. Harding, Einstein has been the greatest Jew after Jesus Christ! So Lopa and I wrote an article, On Time, Uncertainity, Relativity and Normality in medicine. And that was published in Chicago. The title was "Trans science aspect of disease and death". That from the common cold to cancer, basically science can do nothing about its cause, about its course, about its cure. So some friend tod me, I'm a Luddite. I don't know what are technological advances. There is MRI. There is CT Scan and therefore, he says, just see. And therefore the next chapter was, Trans technique aspects of diseases and death. Believe me, till today, about cause, course and cure of common cold, cancer, coronary, heart attack, hypertension, stroke, diabetes, HIV and AIDS, medicine knows next to nothing. And medicine must accept that it knows next to nothing. okay?

About diabetes. We seem to know that there is diabetes and anti diabetic drugs. But I think we are kidding! Diabetes is a multi faceted problem. Protein metabolism is disturbed, fat metabolism is disturbed, sugar metabolism is disturbed, arterial health is disturbed. At the moment we have only one parameter, glucose level. So we give a drug to bring the glucose to the doctor's desired level not neccessarily to the patient's comfort. And you call it curing diabetes, treating diabetes! You're kidding.

I think, some years ago, there was a Conference held only to define Diabetes mellitus. And at the end of 3 days, they gave it up that it can't be defined. Medecine has not defined hypertension, medecine has not defined heart attack, medecine has not defined cancer, medecine can't define arthritis, medecine can't define HIV and AIDS! It Can't! when you are so grossly deficient, how can you research? At the moment writing the ABC of cardiolopgy. A for artery, B for blood, C for codium or heart. And what is my revelation? i thought that cardiologists must be knowledgeable people, but there is profound ignorance! there is not a single genuine anti cardiac drug, not a single one.

And I must wax eloquent on angiography, angioplasty and bypass. It was in 1993 that Renu Varmani, trained here. but now is a big person in America, majestically declared"we no longer trust coronary angiogram in the USA. We go for intra coronary ultra sonogram". So I said," Madam, should I put an obituary in the Times of India tomorrow, that coronary angiography is dead?" She said" You must pay, you must do that" And then she said "When you do angioplasty, the coronary arteries are invariably torn". So I said, " Shall I announce tomorrow that coronary tear is part of coronary care?" She said "Yes". And what is the bottomline today? That angioplasty does not lengthen life, creates many complications. And if you put stent inside, stent induced stenosis of the arteries today described as the most common iatrogenic, malignant disorder.

Okay! I have just a download from American college of cardiology and American Heart Association, which says angiography is unreliable! Therefore you do intracoronary ultra sonogram which is unreliable, therefore you do thalium optic study which is unreliable, therefore you do coronary angioscopy! All four together are unreliable. Now the fact that they are unreliable, I transalated into the fact that if you do angioplasty and bypass, nobody's life is lengthened. No one!

Let's go to bypass. Let's take Harrison's Textbook of Medecine. Large volumes, Volume One and Two.. nearly two and a half thousand pages, which i have followed from 10th to 14th edition, 1983 to 1998! Fifteen years and Five editions! And you go to the section, coronary bypass... and what does it say? We don't know how bypass works! But the following are the three theories. 1)Placebo is effective 64%! This 64% i got from another book, but no wonder N.Y.Times once described coronary bypass as the costliest Aspirin!

Okay, you spend a lot of money, and you are convinced that the right thing has been done. (2) Sensory neurectomy. Because the pericardium is cut, nerves are cut, the heart is botched upas ever, but because the fellow doesn't feel the pain, he does not build up an alarm reaction. And probably the worst is in cold print."Bypass probably works by infarcting the ischaemic segment", transalated into ordinary language, it means, bypass-by killing the complaining segment. So the segment is killed. it's nerves are killed and the fellow is pain free immediately on the operating table. But moral of the story... bypass is a surgery which is very very unscientific, to say the least. And I have a book, History of Coronary Revascularization, by Richard Preston, one of the Brooklyn cardiologists. And he has stated from 1890 till today, and this is a book around 1978, and he asked her, his cardiologist friend, as to why they were selling an operation which had very poor rational. And the reply was that the consideration of the economy. This is a marketplace, my client wants to buy, so I want to sell! Moral of the story, what do we do in cancerology or cardiology? We cannot attack the primary problem, precisely because there is no problem! It's a part of growing. okay? Everybody gets it.

So you can't treat everybody, but what do we do? Whenever there is a symptom, when cancer causes lump, in case the lump is bothering the contours and the beauty of the person, remove it! If it is blocking a tube, remove it. Moral of the story, Tata hospital has to ease, provided there is dis-ease! Presence of cancer means nothing, okay?

In fact, I may read out to you from Boyd's Pathology, that cancer is one of the classical examples where the person may be totally at peace with himself, therefore there is a lump, he has no disease, he has got cancer, but he has no disease. In a similar fashion, you may take my coronary angiogram and find it awfully diseased, but I have no symptoms. Because I have no symptoms, I am not dis-eased. There is no need for an easer called physician. And therefore, there is no need for the physician to violate what is called Heal's Law. He says that it is impossible to make an asymptomatic person feel better, therefore it is very much possible to make an asymptomatic patient feel worse1 You go to Hinduja (hospital). You go up well dressed, pay a large amount. You walk in as a person, you walk out as a patient! Because what do they do? They do investigate, and as Rousseau says, implant into your brain a worm of suspicion which starts crawling. From that day you start thinking that it's not hunky- dory with you, and this particular preempting a disease, has not paid off to anybody in any field. And therefore, my bottom line about cancer, my bottom line about coronaryu, my bottom line about diabetes and hypertension is, if they are silent, do nothing! And as and when you treat, treat the symptom, warning the individual that this will worsen his condition. One symptom will disappear, other will arrive! Just to give you an example, Lawrence Clinical Pharmacology is now in its 8th celebrated edition. You go under the section of cardiac failure. You go to the summarizing box at the end of chapter, and there is a very profound statement "Relief of symptoms does not improve prognosis and vice versa". You go to the 1956 Transactions of the N.Y. Academy of Medical Sciences, vol 6. There is a fifty page article by Hardin Jones of National Cancer Institute of Bethesda, Maryland. He surveyed global cancer of all types and compared the untreated and the treated, to conclude that the untreated out lives the treated, both in terms of quality and in terms of quantity. Secondly he said, "Cancer does not cure". Third he said"There is a physiological mechanism which finishes off an individual".

Which brings me to Bertrand Russel's 1918 article on Causation. He said, Causalism has died in all advanced sciences, but in some sciences it survived. Because like the King of England, the king of England and the king of Egypt, it's supposed to do no harm. Okay?

Wednesday, May 11, 2011

Susceptibility
The various recurrent symptoms people experience throughout their lives (chronic diseases) arise from individual susceptibility, from enduring 'constitutional' weakness. Likewise, in order to determine the 'cause' of an infectious (acute) disease, it is necessary to take into account both the virulence of the infectious agent and the resistance offered by the patient's defense mechanism. The resistance to contagion is based upon the susceptibility or 'host resistance' of the organism; it is largely determined by the miasmatic inheritance of the individual.

The Susceptibility of Plants and Animals
Plants and animals are susceptible to their environment, as, of course, is the human organism. Certain plants require certain kinds of soil in order to thrive. They also need certain kinds of climatic and atmospheric conditions. You wouldn't see a banana tree growing at the North Pole, for example! Plants will attempt to adapt to changing environment but some adaptation is too extreme.
Animals also adapt to their habitat in order to survive and in so doing they develop a protective immunity.
"Animals from certain parts of the earth's surface develop peculiarities of their own which are entirely different from their close relatives elsewhere. They can withstand certain influences and hold their own under adverse conditions which would be fatal to another of the same species developed under differing circumstances. In other words they develop a protective immunity against their environmental conditions.
The polar bear is immune to the rigors of the Arctic, but is susceptible and soon succumbs to the influence of warm climates. The Bengal tiger thrives in the humidity of the Indian jungles: other members of the tiger family have adapted themselves to the latitude and rarefied atmosphere of the slopes of the Himalayas and searching winds of those heights; either is susceptible to the ravages incident to a change in temperature."
H.A. Roberts M.D.

The Susceptibility of the Human Organism
The human organism may react to influences in its environment, on a mental, emotional or physical level.
If a person is not assimilating salt within his body, or if he is, in fact, healthy but sweating profusely in a very hot climate to which he is not accustomed, he may well develop a craving for salt, as his body is crying out for that need (or lack) to be met.
Some people thrive on pressure and react well in a situation of continual stress, e.g. the business tycoon who does not have ulcers or heart pathology! In him there is a need for excitement, and he is exhilarated by the thrill and uncertainty of his profession rather than daunted by it. Some of us can play three sets of tennis in the scorching heat, whilst others of us wilt in the shade on a warm summer day.
It has been noted that some people have such a strong constitution that they can smoke 60 cigarettes a day, drink half a bottle of whisky, burn the candle at both ends and still live to be ninety!
H.A. Roberts wrote "Everything that has life is more or less influenced by circumstances and environment." Disease or disharmony results when the organism cannot readily adapt to morbific agents (viruses, environmental pollution, grief, jealousy, etc.) and where that organism, because of constitutional weakness, is open or susceptible to adverse effects from the external influences.

The Morbific Agent
We have learned that as dynamic organisms we are affected initially on a dynamic level, and this original disturbance eventually results in the production of symptoms on the mental, emotional or physical levels of the organism.
"The one who is made sick is susceptible to the disease cause in accordance with the plane he is in and the degree of attenuation that happens to be present at the time of the contagion. The degree of the disease cause fits his susceptibility at the moment he is made sick."
J. T. Kent

It could be said that any living organism, including bacteria and viruses, has a dynamic energy or quality, a level of vibration or frequency which so far cannot be measured by scientific instruments. When this frequency is within the range or frequency of any given human organism (and therefore compliments it) it is able to produce an effect on the dynamic level of the organism. In health, no symptoms of any consequence will be produced.

H.A. Roberts describes it as a vacuum in the individual which attracts and pulls to it things which are most needed that are on the same plane of vibration as the want (or deficit) in the organism. (If the body is deficient in a substance it will crave that substance in order to fill the need.) He says that "in analysing susceptibility we find it is very largely an expression of a vacuum in the individual. The vacuum attracts and pulls for the things most needed, that are in the same plane of vibration as the want in the body ... the vibrations of the sick individual call aloud for something to meet the need." In this state of lowered resistance the body attracts that which may fulfil an inner need.
Let us illustrate the point by considering the emotional needs of children. For example:
A child presents with dreadful behavioural problems. His behaviour is so bad that his parents must keep close watch on him in order to prevent his outbursts of anger and destruction, but as busy professional people they find it hard to do this.
It is not hard to see in some cases that some children do not receive the love and attention they need and crave , and so some way is masterfully found by the inner being to fill the need (the lack). It is not uncommon for attention seeking behaviour to develop in such cases as a means , at least, of getting some attention. Any attention is better than none, and so an attempt is made to satisfy the emotional need in the best way possible in the given circumstances. This is merely a generalisation and is used simply to illustrate a point.
Childhood Contagious Diseases
Once the vacuum has been filled, the need is met and the system is satisfied. This can be well illustrated by using the example of childhood contagious diseases.
In childhood, before contagion, the state of health in constitutional terms displays a need or lack. This need may be because of the child's inherited tendencies to disease.

Roberts says that:
"The human economy has inherited many tendencies from the accumulations of its ancestral heritage. These tendencies show themselves in childhood in the great number of so called children's diseases, which are nothing more or less than an inward turmoil of bringing to the surface and expelling certain conditions; again, these eruptions are a lack of ability on the part of the patient to create a similar state within his own economy to satisfy the susceptibility ... Nature steps in with the laws of susceptibility and an influence is attracted which blooms forth as an infectious or contagious disease, so as to most fully satisfy this susceptibility."

Kent describes the meeting of a constitutional need as "stemming the influx". He says:
"Now at the beginning of disease, i.e. in the stage of contagion, there is a limit to influx, for if man continued to receive the cause of disease (if there were no limits to its influx) he would receive enough to kill him, for it would run a continuous course until death. But when susceptibility is satisfied, there is a cessation of cause and when cause ceases to flow into ultimates, not only do the ultimates cease but cause itself has already ceased."
Susceptibility to Maintaining Causes

An individual can be merely indisposed by the effects of business failure, unrequited love, stress, overeating, poisoning, etc., but as soon as the maintaining cause is removed the individual returns to health. A maintaining cause will lead to indisposition; prolonged indisposition will require treatment, and symptoms will reveal themselves according to the idiosyncrasies of the individual patient.

Constitutional Weakness
Some people can lead an orderly existence, eat good wholesome food, have no obvious maintaining causes, yet display symptoms that express a serious inner disorder. We must now consider the element of constitutional weakness with regard to susceptibility. The human economy does not start afresh at the time of conception; it is the product of imperfect parents, each with his and her own susceptibility and maintaining causes.
Not only the physical impediments of the parents, but also their mental dispositions at the time of conception, their diets, whether they are under the influence of alcohol, drugs or suppressive medication, etc., are all possible ways in which an invisible weakness can be cultivated in the economy of the foetus. So, even at that early stage, it is only able to make imperfect, ineffectual resistance to some morbific influences. In other words, for those reasons alone, it may not be a potentially healthy human being, with the ability to adapt to its environment effectively.
Furthermore, some weaknesses may be transmitted from previous generations. Hahnemann called these transmitted weaknesses MIASMS, which means a taint or pollution an inherited tendency to the deviation of flow of the vital force from its normal state. (Miasms will be considered in detail in Unit 8)
Family Susceptibility
Whole families can be susceptible to certain diseases. Our ancestors are connected to us like links in a chain, the first being connected to the last by the intermediary connecting links.
The tendencies towards cancer, tuberculosis, epilepsy, heart disease, arthritis, schizophrenia, etc., are frequently seen to span the generations of a family. Ambition, the desire for power, for excitement or adventure, can also often follow this course (although the polar opposite may present instead, and the business tycoon may have a 'drop out' son or daughter.)

Racial Susceptibility
Racial groups can be susceptible to particular diseases and have immunity to others. Roberts says "It is because the similar condition has remained unsupplied through generations and the laws of attraction and susceptibility are manifesting their powers." When eventually satisfied, immunity will be established which will produce changes in the economy that bar out any more influx.

Conclusion
Inherited constitutional weakness will render the individual susceptible to a deviation in flow of his vital energy, which is then open to the possible attraction of morbific agents, as there is not the vital power with which to resist them.
Maintaining causes will further debilitate the organism's dynamic energy, increasing its susceptibility and lowering the resistance to attack. This in itself weakens the organism's ability to adapt to its ever changing environment.

Susceptibility to Medicines
We are all susceptible to external and internal influences and have suffered suppression of one kind or another. A health inducing therapy would strive to lower the patient's level of susceptibility to any given morbific agent, rather than to merely try and remove the symptoms that might appear as the result of the original constitutional weakness, thereby rendering the patient susceptible to the maintaining factor.
Morbific agents do not produce symptoms in all people at all times, but it is quite a different case with artificial morbific agents, i.e. orthodox medicines.
"Every real medicine, namely, acts at all times, under all circumstances, on every living human being, and produces in him its peculiar symptoms (distinctly perceptible, if the dose be large enough) so that evidently every human organism is liable to be affected, and, as it were, inoculated with the medicinal disease at all times, and absolutely (unconditionally), which, as before said, is by no means the case with the natural diseases."
Aphorism 32
Furthermore, it must be remembered that the greatest susceptibility to influence is to the simillimum!