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Robin de Cartaret Living Systems Approach

Robin de Carteret: A Living Systems Approach to Sustainable Healthcare

I’m seeing a pattern. We currently face multiple crises:

  • A crisis in healthcare, with rapidly rising demand for expensive high tech treatments and an increasingly elderly population.
  • A financial crisis, with banks, businesses and whole countries facing bankruptcy.
  • A resource crisis, with many of the key resources we currently depend on, like oil and rare earth metals, approaching peak production, where many analysts say prices will rise dramatically.
  • An ecological crisis, with strong scientific consensus that climate change, biodiversity, and our effects on the nitrogen cycle are way past safe limits.

So is it a coincidence that we face all these crises together, at this moment in time, or are they all linked to something more fundamental? I believe a key factor in creating these problems is our mainstream culture’s linear, mechanistic view of the world; our society has been seduced by the simplicity and clarity we find in analytical, linear thinking. It’s understandable, as this kind of thinking has given us incredibly powerful and useful technologies, including engines, electricity, and much of modern medicine. However many of the systems we deal with, such as living things, communities, cultures and economies are not mechanisms; they are dynamic, interconnected, Complex Systems. If you treat Complex Systems as if they are machines you’ll find yourself in trouble when unacknowledged feedback loops create unintended effects. We are trying to control nature, people and economies, acting as if they are predictable mechanisms rather than inherently unpredictable but creative living systems.

I’m inspired by a new, and also ancient, view of the world as a living, interdependent set of nested systems. Understanding the emergent behaviour in ant colonies, for example, or how river deltas form, can inform our understanding of embryo development, genetic networks, and how we influence and are influenced by the ecosystems we live in.

In my workshop ‘Complex Adaptive Systems’ I will use interactive activities to explore ideas from complexity theory and a Living Systems approach to offer new perspectives of systems at multiple levels - the way human bodies work, how we organise in teams and organisations, social and economic dynamics, and our impacts and dependence on ecological systems.

I am not a medical practitioner, but work in Complex Systems Education. Its encouraging to see the work already mentioned in this blog, such as the SHE network who are already teaching medical students about a Living Systems approach. I think everyone, including healthcare professionals, could benefit from applying systemic concepts in their work and I’m keen to hear your views on how they can be and are already being applied. Are there systems you work with that can’t be understood by breaking them down into their constituent parts? Where do you notice self-regulating, or amplifying feedback loops and do you see signs of tipping points where the state of a patient or system goes past a point where it suddenly changes and is hard to bring back to the original state? How resilient is the system you work in to shocks and changes. Have you got the right balance of efficiency and redundancy to allow for responsiveness to the unexpected?

We are involved in complex dynamic interactions all the time, and I believe seeing the world more explicitly in these terms will give us new perspectives and offer creative, deeper, more interconnected solutions to many of the problems we face.

When we look at our current crises in isolation they can seem hopelessly insoluble. But something that really gives me hope is that when we look at them together, and as part of the same dynamic, there is evidence that the very same things that make people healthy and happy - meaningful work, being part of a supportive community, high self-esteem, sense of belonging, connection to nature - are also ones that reduce our ecological impact, and our dependence on high energy and resource use. They help create resilient, more self-reliant communities of people, who look after each other and are less dependent on a global financial system. That’s a vision of a future that I am excited to work towards!

Robin de Carteret is a freelance educator and consultant in complexity science and sustainability, see