2. Complexity Science A Tantalizingly Brief Introduction Academic Forum Department of Family Medicine February 7. 2006 Cathy Risdon Dale Guenter

3. 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

4. Paradox Seeming contradiction Defies intuition …usually sparks an emotional response…surprise, intrigue, humour, anger, and…is there energy in paradox?

5. Heart Rate Variability

6. Newton A body at rest Tends to stay at rest Unless acted upon by an outside force IS THIS TRUE?

7. Linear (Predictable) Phenomena Order results from rules Change and disorder from lack of rules, or outside force that disrupts a system

8. 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

9. Non-Linear Phenomena Slightly different starting values can lead to enormously different outcomes Non-Linear Rules can create unpredictability AND order (paradox?)

10. 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)

11. Fractal Self-similar patterns That follow chaos, non-linear mathematics

12. Heart Rate Variability

14. Fractal in the Body

15. Other clinical fractals Gait patterns Neurobehavioural observations Insulin levels

16. 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?

17. Complexity Science http://www.fractal- recursions.com/files/anim/060 405v4651a.mpg http://serendip.brynmawr.edu/co mplexity/newton/

18. 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

19. 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

20. 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

21. 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

22. 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?”

23. 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

24. 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

25. 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

26. 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