3rdo.org | Ecology of Health: What are the patterns that connect?
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  • russellgundry

    08/06/2017 at 9:43 am Reply

    Comments and reflections from Benjamin Taylor, RedQuadrant Managing Partner

    This is not a skilful plucking out of patterns, it is a jagged and jetlagged spewing of notes, which might be fun for some. At an event that was in one way very grounded – and where ‘woo’ was mentioned more than once – it seems appropriate.

    ‘Ill health’ is culturally defined.

    (e.g. Understanding of ‘health’ and illness very different in high and low context cultures – in South Korea, you are never told that you’re terminal. But because you keep going to the doctor and your daughter is crying in the waiting room, you kind of pick it up. Americans need to be told ‘straight’, but in very carefully defined euphemisms: you says someone ‘passed away because they lost their battle’ – though of course that means not only are they dead, they’re dead because they’re a loser. He’s dead, Jim!)

    An individual’s agency is constrained by context, language, roles and appropriate behaviours (culture).
    ‘If you want good personal healthcare, see a vet’ – book by David Zigmond:
    https://www.theguardian.com/society/2016/sep/18/the-ousted-doctor-my-patients-souls-matter-most

    Most of our healthcare is based on royal rituals – you make an appointment at the pleasure of the Doctor, attend his pleasure in the waiting room, approach the chamber, knock and are bid enter, then you sit in the subservient position.

    This is not a collaborative paradigm.

    Most of our healthcare is colonialism of the self.

    Research analysing interviews in health contexts was able to be highly predictive of health outcomes. Listening is hugely powerful.

    To learn our way to better health, we have to see the assumptions limiting us and move towards a bigger context.
    Most professionals are able to assume the (false) mantle of confidence, because the parameters and success of their work are defined in context.

    As always, cutting off the reality of the world affects the world (negatively).

    For those who perceive this sort of thing (but are in the system), it’s soul-destroying.

    The pattern of the Poor, Sick, Miserable Person (the victim patient) provides great comfort to both patient and physician, and all around – but is possibly the worst possible culture to promote a return to health. It disable both actors and the whole system. Learning to see a bigger picture is the only way out of this, but again, for an individual in the system, this is a constant battle.

    And most of the time, the actual prescription to achieve ‘wellness’ is clear and simple, but is the one thing the physician cannot prescribe, or usually even discuss. I choose to suffer from migraines and they are very pleased to give me (more and more) pills and potions, even though I’ve voiced the fact that a super-healthy diet, and no sugar, coffee, stress or lack of sleep would reduce them to almost nothing. We carry on playing our roles. We are all naked, but in the world of the nudist colony, all glances are veiled:

    https://model.report/s/5j27zh/audio_erving_goffman_and_the_performed_self_philosopher_jules_evans_on_jung_and_the_mind

    One algedonic signal is the doctors starting to notice how much they are suffering – their ill-health, their pain. They might need to shift to anger to break out of a shut-down, overwhelmed mental state. But is acting the victim or becoming the angry campaigner fundamentally changing anything?

    All this cultural impact – ask “is that the only way it can be seen?” – try to see the limitations, blindspots, and biases.
    Epistemology and power are deeply intertwingled: https://www.google.co.uk/search?q=intertwingled

    Gregory Bateson spoke about the limitations of “conscious purpose” because it defines a filtered version of things, since conscious is limited. But unknowing and the unfiltered can be terrifying.

    The setup of the day, with free-floating discussions around a set of ‘contexts’ (medicine, education, work etc), generating interest in other ‘contexts’ and actually stopped conversation being limited to a single context.

    But still, in the first discussions, we introduced ourselves with a filtered version of our identities, and established our credentials. We also quickly established some norms, and flinched when these were challenged (I saw you, Nora!) 🙂
    There was a claim that ethnography might identify differences from assumptions which might generate curiosity to hear more.

    But, again, assumptions drive and are driven by epistemology which limits the possible variants of the underlying systems. I’m reminded of Ev Williams, founder of twitter, remarking that everyone turns to watch a car crash: the internet interprets this as ‘more car crashes, please!’, and supplies them:

    https://iapp.org/news/a/twitter-founder-tries-to-fix-broken-internet

    Aren’t some other aspects of life like that? Healthcare probably is.

    Nobody mentioned the POSIWID of a hospital as being ‘a place for surgeons to improve their craft’.

    https://books.google.co.uk/books?id=4PjbXwzrnh8C&pg=PA155&lpg=PA155&dq=POSIWID+of+a+hospital&source=bl&ots=4TtJxecQEP&sig=tmDeg5U2Tghz5Jn8fdt4Lu56rME&hl=en&sa=X&ved=0ahUKEwiQt_Wagq3UAhVEFMAKHcasAbcQ6AEILDAB#v=onepage&q=POSIWID%20of%20a%20hospital&f=false and https://books.google.co.uk/books?id=of_OQGAhfs8C&pg=PT244&lpg=PT244&dq=POSIWID+of+a+hospital&source=bl&ots=sPFnThxmCk&sig=SKzFPCdulP3msZW-Rxwx1POMUtY&hl=en&sa=X&ved=0ahUKEwiQt_Wagq3UAhVEFMAKHcasAbcQ6AEIMDAC#v=onepage&q=POSIWID%20of%20a%20hospital&f=false

    But towards the two thirds mark in the summarising conversation, things got very cybernetic with mention of the management of the emergent properties of the system, and identifying and acting on the algedonic signals. The suffering of the doctors and other healthcare workers isn’t their suffering, it’s the suffering of the system.

    Still, you find what you look for, and asking ‘what’s wrong’ in a ‘health system’ context gets you illness. Asking ‘what’s wrong’ about the system gets you labelled negative (in fact, it is negative) – you have to have a vantage point outside the system to get somewhere.

    We thought that the education system had very parallel pathologies to the health system – and the health education system (for healthcare workers) had them squared.

    The core model could be defined as an anti-ecology patter: ‘objectify and exploit’ – cross-categorise and separate. This pathology drives harm not health. Leadership is then of parts and trying to lead this ‘as a system’ is a… challenge, given that it’s counter-paradigmatic.

    A liminal space, like ours for the day, can form a community (as can the Bromley by Bow Centre) – but our community was out of time, and doesn’t fit back into any context.

    The strongest answer to ‘what is health’ offered was ‘health is found in self-organisation’. Accept that or not, but maybe we have to accept a lot of ‘ill-health’ at the moment as health – including premature deaths. Symptoms of a deeper system, or the healthiest resolution of a deeper malaise?

    If health is ‘autonomy or freedom’, as also ventured, we have an even bigger challenge, since most definitions of freedom generate a lot of what we currently call ill-health.

    Or is health to be ‘fulfilled and complete as a human being’?

    Or are health and illness two imposters we should treat just the same?

    We had no actions. Should we have had?

    But we had enthusiastic discussion, wine, and all the kombucha scobies were captured to colonise Sweden. The graphic recorder captured an inspiring, upbeat, landscape of hero leaders pointing towards the future 🙂

    We also had bread, cakes, and coffee for lunch as well as salad, herbal teas and water. Actually, was there water freely available? How healthy were we?

  • Patterns from our Warm Data on The Ecology of Health:

    Separation looses vitality.

    The attenuators of context and complexity have an exponential impact.

    Actions follow attitudes: “As you think, so you become.”

    Thinking is increasingly endangered in our world. Making time out of time to nurture it is catastrophically important.

    Having the courage to venture from certainty into the world of the unknown enables us to find liberation.

    Learning is a complex idea and can only be efficacious through trans-disciplinary contexts and connections.

    Connections made with open hearts and minds enable emergence in our selves and others.

  • Liam Ream

    17/06/2017 at 2:31 pm Reply

    Fascinating exchanges! Sharing with a surgeon friend.

    My take on health is that it “issues from purpose” with the qualities of survival a means rather than an end.

    Also, all “aspects of being” must be addressed for health to be holistic and put at less risk.

    Though this may be seen and communicated differently from culture to culture and soul to soul, for me, “health” means the purifying and enlightening of each aspect of my being (body, heart, mind, will & soul) through the loving action of assisting others likewise (core purpose).

    Cheers,
    Liam

  • russadmin

    11/04/2018 at 3:27 pm Reply

    Ecology of Health: Questions that need to be asked

    Richard Feynman said he would rather have questions that can’t be answered than answers that can’t be questioned.

    We finished our Ecology of Health conference with more questions than we did answers.

    In fact, we deliberately drew together our discussions, asking what are the questions are that now need to be asked?

    This is what was said:

    What is the epistemology? How can we work with people’s perceptions?

    Do we want to be cured, or do we want to be complex?

    What are the patterns of language?

    What makes the health? How can we imagine health in communities, and how can we make it happen?

    How do we reframe the idea of genomics?

    What does health mean when you’re dying?

    Who is talking about ‘health’ – and how?

    The next generation is already working in a radically different way. Some reference Esalen and Big Sur – but many probably see them as irrelevant

    How can we help medical students deal with complexity and humanity?

    Can we have an ethnographic process that enables us to put one foot in front of another… That helps guide us rather than defining itself absolutely, and making itself defunct in the process of doing that?

    How does symbology affect the shape of this discussion? Bill Tate – is this what you meant?

    Significant change is already happening, it is not positive, and we are not necessarily in sync. What does a healthy society look like in this context?

    What care is conducive to health? How does care provide connection?

    What is a healthy ecology? We’re losing species on a daily basis? A healthy society is not the same thing as a healthy ecosystem.

    What do we mean by ‘we’? The West? The World? Living Things? We need to step back and look at this question with compassion.

    How do we design health in an increasingly technological context?

    The process of overcoming problems is fundamental – rushing towards the solution is really missing the point.

    The two sides (at least) of this debate need to connect.

    We’re going to lose 30-40% of existing jobs to technology in the next two decades or so. How do we support communities to be healthy in this context?

    Can the intelligence of the people building artificial intelligence be trusted with its’ consequences?

    Predictions of the world being encompassed by technology seem too all encompassing.

    Is the wisdom of this context, knowing what not to do?

    What have we missed?

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