The following originally appeared on Explore: The Journal of Science and Healing.
No economic, political, or military power can compare with the power of a change of mind. By deliberately changing their images of reality, people are changing the world.[i] — Willis Harman, Institute of Noetic Sciences
Over the years, many of us periodically bump into experiments in healthcare that cause us to think, “This changes everything!” Such studies are convincing not only because of the empirical evidence they offer, but also because they feel important to us personally. These findings strike a nerve. They often rattle our worldview, our fundamental concepts of how things work. They send us back to the drawing board of reality and make us re-think.
THE POTTED-PLANT STUDY
This was my experience decades ago when I read a report that is often referred to as “the potted-plant study.” Published in 1976, the experiment was devised by social psychologists Ellen Langer and Judith Rodin.[ii] Langer and Rodin wanted to see if nursing-home residents could improve their wellbeing if they were given the responsibility of taking care of a plant. The residents were divided into two groups. One group was encouraged to make more decisions for themselves. Each of these individuals chose a houseplant to care for, and they made their own decisions about where to place it in their room and when and how much to water it. They were allowed to choose where and when to receive visitors, and when to watch the movies that were shown at the home. “Our intent,” says Langer, “was to make these nursing-home residents more mindful, to help them engage with the world and live their lives more fully.”[iii] The individuals in the second, control group were also given houseplants but were told that the nursing home staff would take care of them. They received no instructions to make their own decisions about anything; the staff, as usual, would decide such matters.
At the start, both groups were quite elderly and frail. But within only three weeks differences began to emerge. The self-responsibility group began to show an increase in levels of activity, confidence, and group participation as assessed by staff nurses. The incidence of illness dropped. By 18 months, the death rate in the self-responsibility group, compared to the control group, was reduced by 50 percent.[iv] How did this happen? Langer says, “It’s not well understood. Even we had been surprised: it seemed odd that simply asking people to make choices would result in the powerful consequences that our study showed.” (3, pp 4-5)
When I discovered Langer and Rodin’s study soon after it was published, I was well aware of the growing evidence for mind-body connectedness. I was also personally acquainted with biofeedback, a mind-body therapy that is highly effective for certain maladies. Moreover, most physicians are well aware of the placebo effect, a mind-body phenomenon that is present when almost any therapy is employed. But what I found stunning in Langer and Rodin’s study was the 50 percent reduction in mortality in the group responsible for their potted plant. I was not aware of any intervention that could achieve a 50 percent reduction in mortality over 18 months in nursing homes.
This finding should have been front-page news around the world, but it has yet to fully sink into our materialistically oriented healing professions. Why the resistance? Although we say we accept that the mind affects the body, much of this is lip service. Langer believes there are unconscious factors that operate within science and medicine to keep mind and body separate in our thinking. A major reason is that the actual pathways of an intrinsic mind-body unity are still largely unknown.[v] Since we don’t fully know how mind-body unity can occur, it is tempting to say it doesn’t occur to any significant degree. Langer was not dissuaded, however. She says:
I began to realize that ideas about mind/body dualism were just that, ideas, and a different, nondualist view of the mind and the body could be more useful. If we put the mind and the body back together so that we are just one person again, then wherever we put the mind, we would also put the body. If the mind is in a truly healthy place, the body would be as well — and so we could change our physical health by changing our minds. (3, p 5)
This possibility led to a series of daring experiments to test her premise — that if the mind is in a healthy place, the body will also be healthy.
THE COUNTERCLOCKWISE STUDY
In 1979 Langer and her students devised an experiment they would later call the “counterclockwise study.” (3, pp 5-11), [vi] This experiment would test her premise that if mind and body were indeed united, then “young” thoughts would be accompanied by a younger, healthier body.
The plan was for elderly subjects to reside at a retreat center for one week, where the researchers would re-create the world twenty years earlier, the world of 1959. The subjects would be asked to live as though 1959 were real. This was not pretense, not “as if” it were 1959; rather, they were asked to let themselves go, be just who they were in 1959, and have fun. They would speak in the present tense as if 1959 were actually happening, and they would not bring up anything that happened after 1959.
Langer recruited men in their late seventies or early eighties who were not ill. The control group spent the week simply reminiscing about the past. The experimental group spent the week not merely reminiscing, but making the twenty-year past as real as possible. Their rooms were retrofitted with paraphernalia from 1959. They listened to news, radio shows, and music from that period. They met once a day to discuss “current” events that had “recently” happened, such as the launch of America’s first satellite, Explorer 1, and Castro’s activities in Cuba. They discussed the Russians, communism, Nikita Khrushchev, the need for home bomb shelters, and how the Baltimore Colts defeated the New York Giants for the NFL championship. They watched the Ed Sullivan Show and Sgt. Bilko on black-and-white television. They discussed books popular at the time, such as Ian Fleming’s Goldfinger, Leon Uris’s Exodus, and Philip Roth’s Goodbye Columbus. They listened to radio shows featuring Jack Benny, Jackie Gleason, Perry Como, Rosemary Clooney, and Nat “King” Cole. The movies they watched included The Diary of Anne Frank, Ben Hur, North by Northwest, and Some Like It Hot (3, pp 9-10)
What happened? Langer states, “[We] found that indeed, the mind has enormous control over the body. …On many of the measures, the participants got ‘younger.’” The results were especially notable, considering that the study was devised in 1979 and conducted in 1981 before there was much mind-body research and before 80 became the new 60. Despite how enfeebled these men were at the start of the study, both groups improved significantly from where they started. Hearing, vision, memory and grip strength were significantly improved by the end of the study. The improvements in the experimental group were significantly greater than those of the comparison group with respect to manual dexterity, increase in IQ, height, gait, posture, joint flexibility, and diminished symptoms of arthritis. Langer’s team photographed everyone before and after the week and found that all the experimental participants looked noticeably younger at the end of the study. In addition, the experimental group walked away from the retreat without the aid of canes. They carried their own suitcases without the help of family who had assisted them before the study.
Elders are not supposed to improve their hearing and vision or any of the indicators Langer and her team evaluated. Yet the overall results contradicted the widespread belief that aging equals deterioration. Aging, it seemed, did not have to be a one-way decline. It could run counterclockwise, the name of Langer’s 2009 book on the subject.3
This study shaped Langer’s view of aging and the limits of mind-body unity for the next few decades. She now says, “I have come to believe less and less that biology is destiny. It is not primarily our physical selves that limit us but rather our mindset about our physical limits. Now I accept none of the medical wisdom regarding the courses our diseases must take as necessarily true.” (3, pp 10-11) For Langer, our customary biological dictates are not inviolable. The wildcard is consciousness and one’s mindset.
Hollywood is interested. According to Harvard Magazine, a film tentatively titled “Counter Clockwise” is in the works, with Jennifer Aniston playing the role of a 34-year old Ellen Langer.6
THE CHAMBERMAID STUDY
Almost no one disputes the value of physical exercise in health. Exercise results in a lower incidence of stress and depression, as well as lower risks of coronary artery disease, cancer, hypertension, obesity, osteoarthritis, and diabetes. Evidence suggests, however, that physical exercise is not completely physical. As in aging, the mind appears to play a major role in the benefits we derive from physical activity.
Some people who exercise a great deal, however, are not healthy. Among these are hotel room attendants or chambermaids, who attracted the attention of Langer and her colleague Ali Crum. Although they have high levels of physical activity that meet or exceed the surgeon general’s requirements for a healthy lifestyle, their health is exceedingly poor. Langer and Crum asked, why is it that these women, who clean on average fifteen rooms a day, each taking twenty to thirty minutes and requiring considerable pushing, reaching, bending, and lifting, have elevated risks of high blood pressure, body mass index, and body fat percentage? While not denying the importance of diet, low pay, psychological stress, and genetics, Langer and Crum suspected that the mindset of the attendants toward exercise might be important, as with the elders in the potted-plant and counterclockwise studies.[vii]
At the outset of their study of these women in 2007, Langer and Crum found that most of them did not view their work as exercise. Two-thirds of them reported not exercising regularly, and one-third said they got no exercise at all. Langer and Crum asked, “If we change the attitudes of room attendants who are getting the required amount of physical activity but do not perceive it as exercise, will they reap the benefits?” (3, p 114)
Seven hotels agreed to participate in the study, which involved 84 female room attendants. Women in four of these hotels were informed that their regular work met the requirements for a healthy, active lifestyle as judged by the CDC, the United States Centers for Disease Control and Prevention. They were given explanations on how their work is good exercise, similar to gym workouts. The control group, the women in the other three hotels, were treated in the same way as the informed group, except they did not receive information about work as exercise (although they were informed of such at the end of the study). To prevent participants in the two groups from sharing information, all room attendants within a hotel were placed in the same group. Several baseline health measurements were made at the outset. Care was taken to monitor whether the women changed any behaviors during the study, either at home or at work.
Although neither group changed their exercise levels, diet, or other habits, the informed experimental group increased their perceived level of activity, whereas the control group did not. After only four weeks of knowing that their work was excellent exercise, the informed participants lost an average of two pounds, showed a significant reduction in body fat percentage, and showed a reduction of ten points systolic and five points diastolic in their blood pressure, all of which were statistically significant. The control group actually gained weight and body fat. Langer and Crum concluded, “The changes in reported physical activity are attributable not to actual increases in physical activity but to a shift in mindset initiated by the information given to them in the intervention.” (3, p 117)
There were no physical explanations for the health improvements in the experimental group. This, of course, violates conventional wisdom about what is required for a reduction in weight and body fat. Skeptics of the study argued that, although the experimental group experienced a change in attitude toward exercise, this must have been accompanied by a change in diet, activity, or some other physical factor. Not so, assert Langer and Crum. They say, “The search for [physical] explanations for findings such as these results from mind/body dualism that simply denies the direct influence of the mind on the body…. As to what was happening simultaneously on the physiological level in our hotel room attendant study, we do not know.” (3, p 118)
Neither does anyone else. During the past two decades, there has been a flurry of research activity to illuminate the actual pathways between mind and body. That a mind-body connection exists appears irrefutable; specifically how the connections play out largely remains a mystery. For example, a blizzard of fMRI brain scans and other sensitive measurements have been employed to uncover some subtle, sneaky physical mechanism that might explain the events that Langer and others have demonstrated. Various hormonal and neural pathways are recognized as links in these connections. Yet the actual nature of the interface of all these physical mediators with the mind remains a bottomless mystery. In philosophy, this is known as the venerable mind-body problem. The futility of this search has led Langer to flatly repudiate mind-body dualism. For her, the mind-body problem is not a problem. The reason, she maintains, is that there are not two separate entities, mind and body, operating on one another, but only one entity: the non-dual body-mind.
A COUCH POTATO’S DREAM
Interest in mindset is not confined to psychology. Dr. Guang Yue, an exercise physiologist at the Cleveland Clinic Foundation, found that merely visualizing moving a little finger sideways was enough to increase the strength in the muscle responsible for this motion.[viii]
In a follow-up study, he devised a fitness regime in which he asked ten volunteers aged 20 to 35 to engage in a fifteen-minute mental workout five times a week for 12 weeks, in which they imagined flexing one of their biceps as hard as possible. Yue and his team recorded the electrical brain activity during these mental workouts and also monitored electrical impulses in the motor neurons of their biceps to make sure the volunteers were not tensing their arms isometrically. Bicep strength was tested every two weeks. By the end of the study the subjects had increased their bicep strength by 13.5 percent. The improvement lasted for three months after they stopped their mental workout. Control subjects who did not do the mental imagery demonstrated no improvement in muscle strength.
Yue states, “[This] suggests you can increase muscle strength solely by sending a larger signal to motor neurons from the brain. …All you have to do is sit in a quiet place where you can concentrate. You don’t need any equipment. You don’t need to spend a cent.”
Yue suggests that his discovery, now replicated by others, could help patients too weak to exercise to recuperate from stroke or injuries, and could help elderly individuals maintain or increase their strength. [ix], [x], [xi]
PUT ON A HAPPY FACE
The nexus between our emotions, thoughts, and body was the subject of a flurry of studies in the 1970s and 1980s looking at the relationship between smiling and happiness. These studies produced surprisingly consistent results. Briefly, they showed that there could actually be a benefit to producing a fake smile. As journalist Julia Layton says in her review of these experiments, “According to many experts, smiling may not only be an outward manifestation of a happy feeling. It may actually be able to cause happiness. It’s the exact opposite of how most people see the smile-happiness connection….”[xii] In effect, these studies turn the assumed arrow of causation in reverse.[xiii]
One of the most influential smile-happiness studies was that of social psychologist Robert Zajonc in 1989. He asked subjects to produce vowel sounds that forced their face into various expressions. To mimic a smile, they made the sound of a long “e,” causing the corners of the mouth to turn outward. Among the other vowel sounds tested was the long “u,” which forces the mouth into a pouty configuration. Subjects said they felt good after making the long “e” sound, and feeling bad after the long “u.” Zajonc fleshed out his findings with a detailed physiological hypothesis involving brain changes triggered by facial expressions. [xiv]
Many complex studies, too numerous to be reviewed here, built on this simple experiment. They overwhelmingly showed that subjects felt happier after smiling, even though the smile was forced. One study showed an opposite effect: when individuals contorted their faces to indicate fear, their pulse rate increased and their body temperature rose.
Researchers in this area invoked Charles Darwin as a kind of patron saint of their premise, pointing out that in the 19th century Darwin proposed that facial expressions didn’t only reflect emotions, but also caused them.[xv] Psychologist William James also asserted that facial expressions are not just the visible sign of an emotion, but actually contribute to the feeling itself. 24, [xvi]
These findings have been trivialized in popular media, but none of the investigators in this field suggested that fake smiles could put us in a state of perpetual bliss or make unhappiness go away. As Layton says, “The theory basically states that in a state of emotional neutrality, putting a smile on your face can tip you in the direction of a positive feeling. So don’t walk into a funeral and make everybody smile as big as they can.”24
Both the smile-happiness experiments and the counterclockwise studies in elders are pixels in the evolving picture of mind-body unity. If you smile, or if you think, act, and behave as if you are young, this can tip you in the direction of being happier or younger. But there is this difference: the counterclockwise studies involve end points that reflect more than an emotion such as happiness, but actual fatality rates.
OUR AGING SCRIPT
Based on the above findings, a conservative conclusion would seem to be: To the influence of genetic, metabolic, environmental, neural, humoral, and nutritional factors in aging must be added the evidence, gathered over nearly four decades, that what we think about aging is often played out in our life, as if we are following a script that we ourselves have written.
In 1975, several years prior to the counterclockwise study, psychologist Becca Levy and her colleagues asked a group of about 650 people in Oxford, Ohio, to agree or disagree with statements about aging. Among them were items such as “Things keep getting worse as I get older,” “As you get older, you are less useful,” and “I am as happy now as I was when I was younger.” When Levy and her colleagues checked the records of the participants 23 years later, they found that those who viewed aging more positively lived, on average, 7.5 years longer than those who were negative about it.[xvii], [xviii]
A recent study by Levy and her colleagues showed that perceptions of age are as good as actual age when it comes to physical functioning in elders whose average calendar age was 81.[xix] Subjects participated in 15-minute sessions once a week for four weeks. In an “implicit” intervention, they were shown a variety of words like “wise,” “creative,” and “spry and fit,” coupled with words like “senior” and “old.” These words were flashed on a laptop screen so briefly that while the brain registered them, the individuals could not tell what they said. Other subjects engaged in “explicit” intervention, such as writing about fit, active older people. After four sessions and follow-up at one and three weeks, they were given physical tests such as their ability to walk, balance and get up from a chair. There were no improvements in the explicit intervention group, but the implicit intervention group showed considerable improvements in their fitness. Compared to studies involving physical exercise, the implicit intervention was more effective on physical abilities than six months of exercise. Currently, however, no one knows how long the positive improvements will last, or how often the elderly participants might need a tune-up through re-exposure to the implicit messages. [xx], [xxi]
Positive attitudes toward aging reflect optimism about health in general. Cardiologist Daniel B. Mark, of Duke University School of Medicine, followed the progress of 1,719 men and women after cardiac catheterization. After one year, twelve percent of people who were initially pessimistic about their health had died, compared to only five percent of the optimists.[xxii] Dr. Nancy Frasure-Smith, of the Montreal Heart Institute, found that heart patients who scored high on pessimism were eight times more likely than optimists to die over the course of eighteen months.13 Dr. Geoffrey Reed, of the University of California, Los Angeles, showed that fatalism, optimism’s polar opposite, and the loss of friends predicted negative outcomes in patients with HIV disease. 13
Many people find it difficult to follow an optimistic personal script about aging. It’s understandable. In view of the attention currently given to Alzheimer’s disease, arthritis, and other degenerative ailments, many see their future as a one-way ticket to disability, senility, and custodial care. Yet there are solid grounds for optimism. In a recent survey of those 65 to 74 years of age, 89 percent reported no disability. After age 85, 40 percent of individuals are fully functional.[xxiii] Disability among the elderly has declined by 1 percent or more per year for the past several decades, and experts are optimistic that this trend will continue.[xxiv]
CONSCIOUSNESS AS FUNDAMENTAL
What of Langer’s claim that there is an inseparable unity between an individual’s mind and body? As mentioned, this assertion collides with the so-called mind-body problem in Western philosophy (which is not considered a problem in most Eastern philosophical traditions). Briefly the problem is this: how could the mind, which seems so immaterial and ethereal, be connected or unified with the body, which we experience as overwhelmingly solid and material? How could such dissimilar entities interact, let alone unite as one? For centuries Western philosophers of the highest caliber have labored unsuccessfully toward a solution to this enigma.
Along comes Langer, who denies that there is a problem at all. She insists that her experiments could not turn out the way they did unless mind-body unity were a reality. As we’ve seen, she attempts to solve the mind-body problem by demolishing mind-body dualism.[xxv] Langer is not alone. Mary Midgley, the eminent English moral philosopher, launches a similar assault:
The real trouble with the mind-body problem centers on the word “materialism.” This word is itself a relic of dualism: it suggests that there are two rival stuffs — mind and matter — competing to be seen as basic to the world. It tells us to choose one of these and reduce the other to it. There are not two such separate stuffs: There is just a complex world containing complex creatures…. But actually our thoughts are quite as real as our coffee cups, and “matter” is every bit as obscure a concept as mind.[xxvi]
Similar conclusions have emerged in twentieth-century physics. An example is Nobel Prize-winning physicist Erwin Schrödinger. In discussing the relationship between mind and matter, subject and object, he says, “Subject and object are only one. The barrier between them cannot be said to have broken down as a result of recent experiments in the physical sciences, for this barrier does not exist.”[xxvii]
Langer is not a philosopher but a grounded empiricist. Her many experiments have lead her to believe that mindset is ultimately beyond philosophy and is of practical, everyday, life-and-death importance, as we saw in her potted-plant study in nursing home residents, in which mindset was correlated with a 50 percent reduction in deaths over an 18-month period.
Materialistically inclined skeptics insist that mindset is overrated. They suggest there were unrecognized, naturalistic factors that shaped the outcome of the various mindset studies. Therefore mindset should be regarded as a placeholder until these physical factors are identified.
Many materialists furthermore insist that, even if mindset is conceded to be a factor in these experimental outcomes, this is actually an affirmation, not disproof, of materialism. Why? Because mind, they insist, is itself material; it is produced by the physical brain in a manner yet to be discovered. Philosopher of science Karl Popper has criticized this position as “promissory materialism,” because it is a promise that is never fulfilled. Popper considers this stance as an ideological, unscientific, faith-based belief that rests on no substantial proof. [xxviii]
Langer’s studies are a skirmish in the unending war over the origins and nature of consciousness. I am on Langer’s side. But I also believe that Langer’s case is much more solid than even she seems to realize, because the evidence for the action of consciousness on matter is extraordinarily robust.
For one thing, many eminent scientists are convinced that consciousness is not material in origin, not derived from the physical brain and body. If this is so, Langer’s “mindset” cannot be held hostage to matter by zealous materialists. The following statements are representative of this view.
Erwin Schrödinger, winner of the Nobel Prize in Physics, 1933:
Consciousness cannot be accounted for in physical terms. For consciousness is absolutely fundamental. It cannot be accounted for in terms of anything else.[xxix] If we have to decide to have only one sphere, it has got to be the psychic one, since that exists anyway.[xxx]
Max Planck, winner of the Nobel Prize in Physics, 1918, and the founder of quantum physics:
I regard consciousness as fundamental. I regard matter as derivative from consciousness. We cannot ge[t behind consciousness. Everything that we talk about, everything that we regard as existing, postulates consciousness.xxxi]
Carl G. Jung, psychiatrist:
It is almost an absurd prejudice to suppose that existence can only be physical. As a matter of fact, the only form of existence of which we have immediate knowledge is psychic. We might as well say, on the contrary, that physical existence is a mere inference, since we know of matter only in so far as we perceive psychic images mediated by the senses.[xxxii]
Donald D. Hoffman, cognitive psychologist, University of California, Irvine:
I believe that consciousness and its contents are all that exists. Space-time, matter and fields never were the fundamental denizens of the universe but have always been, from their beginning, among the humbler contents of consciousness, dependent on it for their very being…. If this is right, if consciousness is fundamental, then we should not be surprised that, despite centuries of effort by the most brilliant of minds, there is as yet no physicalist theory of consciousness, no theory that explains how mindless matter or energy or fields could be, or cause, conscious experience.[xxxiii] The scientific study of consciousness is in the embarrassing position of having no scientific theory of consciousness.[xxxiv]
The premise that consciousness is fundamental in the world does not rest on opinion, but is buttressed by a body of evidence little known to those outside the world of formal consciousness research that focuses on the nonlocal, distant ways in which consciousness manifests in the world. Experiments in six areas of consciousness research pointing in this direction have been replicated in labs around the world, each area giving odds against chance of around a billion to one. The combined odds against chance of all six areas are 1054 to one, a truly astronomical number. These six areas are remote viewing, random event generator influence, the Global Consciousness Project, ganzfeld experiments, presentiment studies, and experiments in precognition.[xxxv], [xxxvi] These areas are too extensive to be discussed here, but are examined in detail in several authoritative books, including The Conscious Universe and Entangled Minds by consciousness researcher Dean Radin.[xxxvii], [xxxviii]
Against the backdrop of this growing body of evidence, Langer’s view that mindset can influence the body is hardly radical. Indeed, it does not go far enough.
There is abundant evidence that consciousness is capable of doing things that the physical brain and body cannot do — an observation that immediately suggests some sort of dualism. We now know that consciousness can act remotely from the physical brain and body, evidenced in the six categories of consciousness research mentioned above. In addition to these categories, many researchers are convinced that consciousness can exist apart from the body — mind-body disunity — as suggested in thousands of reports of near-death experiences[xxxix] and reports of children who appear to have experienced previous lives.[xl] If these reports are valid, Langer’s premise that mind and body always constitute a unity is not a sufficient model for the operations of consciousness in the world.
Psychiatrist Ian Stevenson (1918-2007), of the University of Virginia, investigated thousands of cases in which children appear to have lived a previous life.40 His research is considered important even by some materialists such as the late astronomer Carl Sagan.[xli] Stevenson’s research suggests that consciousness exists without a living body between the death of the individual and his or her rebirth or reincarnation. During this period, dualism reigns because there is no living body with which consciousness could associate. But upon rebirth or reincarnation, mind and body might resume behaving in a non-dual, Langer-like way. Stevenson therefore declared himself a proponent of interactional dualism — a kind of both/and, rather than an either/or view of the mind-body relationship.[xlii]
Interactional dualism is an idea that has a respectable history. Two of its eminent proponents were William James, the father of American psychology, and the Nobel Prize-winning philosopher Henri Bergson. The main idea of interactional dualism is that body and consciousness interact, but are not the same. The brain processes sensory stimuli and affects the content of consciousness, but it does not “make” consciousness, any more than a TV set makes the image it displays. How mind and brain actually interface with one another remains a mystery, as we’ve noted. As Stevenson put it, this puzzle “is part of the agenda for future research; but that is equally true of the claims confidently made by many neuroscientists who assert that minds are reducible to brain activity.”42
Let us bow in gratitude to those brave psychologists — Langer, Rodin, Crum, and others — whose counterclockwise studies have bucked the materialistic tide of their profession. Their experiments are a tremendous contribution to the interaction of mind and body. But they are not a stopping point. They are pointers toward a more majestic, genuinely nonlocal view of consciousness that includes but transcends the intrapersonal, local, mind-body perspective.
A recurring temptation in psychology is to consider the latest discoveries as something of a final achievement: what could possibly lie beyond mind-body unity? This attitude, however, is deadly for progress, particularly at present when we already possess the building blocks for a nonlocal view of consciousness, in which it is infinite in space and time, therefore immortal, eternal, and one.[xliii]
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[xviii] Graham J. Older people become what they think, study shows. Nytimes.com.. http://newoldage.blogs.nytimes.com/2012/12/19/older-people-are-what-they-think-study-shows/. 19 December, 2012Accessed 19 November, 2014.
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