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					Complexity Science
           A Tantalizingly Brief Introduction

           Academic Forum
           Department of Family Medicine
           February 7. 2006



           Cathy Risdon
           Dale Guenter
What we will do…
          Explain the natural universe

          …by describing advanced
           mathematical principles

            …that will help to understand
            everyday challenges in clinical
            care
               …and to transform
               organizations
Paradox
          Seeming contradiction

          Defies intuition



          …usually sparks an emotional
           response…surprise, intrigue,
           humour, anger, and…is there
           energy in paradox?
Heart Rate Variability
Newton
         A body at rest

         Tends to stay at rest

         Unless acted upon by an
          outside force

         IS THIS TRUE?
Linear (Predictable) Phenomena
           Order results from rules

           Change and disorder from lack
            of rules, or outside force that
            disrupts a system
Population Size Example
           Order (final population size)
           Is not specified by the rule
           But dynamically by repeated
              reapplication of the rule (iteration)
           One cannot tell the future from the
              present, it must evolve
              (EMERGENCE)
           ‘Homeostasis’ is a dynamically
              maintained order, not static
           Autonomy (internally determined
              variability) is possible
Non-Linear Phenomena
          Slightly different starting values
            can lead to enormously
            different outcomes

          Non-Linear Rules can create
           unpredictability AND order
           (paradox?)
Mathematical Chaos
          Shapes and patters do form, but
            not predictably
          Not Random
          Rather order within disorder
          Cannot tell from history what will
            come next
          Paradoxically regular and
            irregular, stable and unstable,
            predictable and unpredictable
          (consider the weather)
Fractal
          Self-similar patterns

          That follow chaos, non-linear
            mathematics
Heart Rate Variability
Heart Rate Variability
Fractal in the Body
Other clinical fractals
             Gait patterns
             Neurobehavioural observations
             Insulin levels
So What?
           Clinical Research…does seeking
             predictable responses to
             medical interventions make
             sense?
           Treatment…do most of our drugs
             enhance or inhibit inherent
             variability?
           Health…a stable state… or
             paradox…a dynamical order
             and disorder
           Chaos.. the signature of health?
Complexity Science
           http://www.fractal-
             recursions.com/files/anim/060
             405v4651a.mpg

           http://serendip.brynmawr.edu/co
             mplexity/newton/
 Self-Organization/Emergence
• Self-organization is an
  inherent property of …….
• Patterns emerge in local
  interaction without there
  having to be a blueprint,
  external observer or
  controller
• The patterning is the result
  of “bounded instability” –
  paradoxically stable and
  unstable; amplifying and
  dampening AT THE SAME
  TIME
   Coherence Without Control
• Meaning is patterned by
  interaction
• Everything we do matters!
• Attention is focused not on
  abstract wholes- but on the
  actual micro, local interaction
  between people in the living
  present
• We are simultaneously
  forming and being formed in
  moment to moment
  interaction – there is no
  meaningful way to stand
  apart from that or to
  design/control
   Implications of Emergence
• Everything we do
  matters – outcomes
  are the co-creation of all
  interactions and are
  under perpetual
  construction
• Can’t locate “blame”
  within an individual –
  “agency” lies
  simultaneously with
  individuals and the
  group since they form
  and are formed by each
  other
 Adaptability=Surviving/Thriving=
              Anxiety
• Groups of people are
  creative only when their
  behaviour displays the
  paradoxical dynamics of
  stability and instability at the
  same time
• Creative process is also
  destructive – involves
  cooperation AND
  competition (and because
  we’re human – conflict,
  fantasy, power, anger, envy
  as well as joy and
  excitement). Removal of
  conflict (or the move to
  “harmonize values” or “share
  the same culture") is to
  remove the raw material of
  creative activity
                        Anxiety
• Focusing on the quality of
  anxiety and how it is lived
  with
• Shifting patterns of
  conversation lead to
  uncertainty which threatens
  how people understand
  themselves – their personal
  and collective identities
• Of course, very anxiety
  provoking
• “What is it that we are doing
  that enable us or disables us
  from living with the anxiety
  that change creates?”
                       Diversity
• (note – focus is away from
  consensus, vision
  commitment, cohesiveness)
• Paradox:
• – if we have nothing in
  common at all – joint action
  is impossible
• - if we conform too much,
  emergence of new forms of
  behaviour is blocked
• Attending to deviance
  (rumors, gossip, and
  subversiveness) is
  important- especially as they
  might be sustaining
  “legitimate” themes and
  make change impossible
Paradox: Letting Go of Control
• Difficult having a limit to
  control and certainty
• Being able to cope with
  knowing and not knowing
  (and the arousing feelings of
  shame and incompetence)
• Avoiding the pattern of
  blame when the unexpected
  arises
• Perhaps spend less time and
  energy on ‘high control”
  activities
   Implications for Leadership
• Managers/leaders do not
  stand alone/apart – they are
  also participants in emergent
  enquiry
• Attention needs to be
  focused on the unexpected
  and complex patterning of
  the responses of
  organizational members to
  manager’s intentions
• Focus attention away from
  how to make a choice –
  toward the quality of
  participation in self
  organizing conversations
  from which the choices and
  the responses to them
  emerge
              Leadership Skills
• Increased attention to the
  quality of our own
  experience of relating and
  managing in relation to
  others – including an
  understanding of our own
  part in what is happening
  around us
• Skills: capacity for self
  reflection, facilitating free
  flowing conversation, ability
  to articulate what is
  emerging in conversation,
  sensitivity to group dynamics

				
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