Paradigms, and Paradigm Shifts as Broad Context
for the Transition to "Health Care"
"This document was prepared by Janet M. Eaton under
contract with the Nova Scotia Department of Health. It does not, however,
necessarily represent the views, opinion or policy of this Department"
August, 1996
Introduction
The primary purpose of this paper is to provide a conceptual
basis for viewing the new "health care" policy within the broader
context of the current shift, occurring globally, from an industrial, rational,
mechanistic, reductionist paradigm to an emerging integrated, evolutionary,
systemic paradigm. To understand that shift it is helpful to be aware of
how the boundaries which shape our thoughts or our "paradigms" from the
past sometimes prevent us from seeing new trends and knowledge which do
not fit the old ways of thinking.
In the new kinds of decision-making structures and partnerships
emerging in our province, like the new Community Health Boards, it is important
to work together to "transcend" old paradigms so that it is possible to
move on together to develop a new vision of a future health care system
co-created by community based participation.
This paper discusses the concepts of paradigms, paradigm
shifts and contrasts features of the new systemic paradigm with the older
one, all of which can assist in "paradigm shifting".
Finally, it concludes by examining the transition from
a medical to health model as a shift from a reductionist to a systemic
paradigm.
1) Global Transformation or Dominant Paradigm Shift:
There seems to be a consensus amongst thinkers and writers
from every field of knowledge that society, indeed civilization as
a whole, is undergoing a massive transformation or "paradigm shift"
that is occurring with far greater rapidity than at any corresponding transition
period in the history of the human race. Since the late 1950's, philosophers,
futurists, sociologists, management consultants and the like, have been
predicting, warning , tracking and describing trends during this global
transformation.
Daniel Bell (1958) first wrote of a new "post-industrial"
era, Lewis Mumford (1956) of a "new age", Marilyn Ferguson (1982),
in her landmark book, The Aquarian Conspiracy of a "new historic age",
and Rosebeth Moss Kanter, in "The Change Masters” spoke of
a "transforming era" where the assumptions upon which people have depended
become so inappropriate that they break down and must be replaced by another
set (Kanter, 1983).
Alvin Toffler's landmark book, The Third Wave (1980),
provided yet another innovative look at this major paradigm shift
to a new era and John Naisbett (1982) described 10 Megatrends which
were beginning to reshape a new paradigm- included were the shift from
an Industrial to Information Society; from a National to Global Economy,
from a Representative to Participatory Democracy; from Centralization to
Decentralization; from Institutional to Self-help; and from Hierarchies
to Networking.
The interpretation most authors bring to the recent paradigm
shift is to describe computers and telecommunications as the triggers of
massive economic restructuring which, then, creates subsequent changes
in all our social structures and relationships. Arthur Cordell, the former
Chairman of the Science Council of Canada, in The Uneasy Eighties - The
Transformation to an Information Society, reflected this new direction.
The advent of microelectronics is rapidly and irreversibly
leading to a major and fundamental transformation of western society, with
implications not only for the nature and organization of the economic
infrastructure, but also for the quality of life, social organizations
and relationships among individuals, private institutions, and government...
An information society will test and challenge traditional values and norms
related to work; ... an information society will involve restructuring
of the very concept of work and of the relationships between skilled and
unskilled workers... The uneasy eighties are a time of transition and uncertainty....
the early part of the Industrial Revolution was, similarly, a time of confusion
and dislocation. (Cordell, 198--) Governments, in all industrialized
countries, had to scramble to adapt policies to these shifts and, not surprisingly,
the initial emphasis was on attempting to maintain or increase competitiveness
in the global economy. Technology, human resource development, new organizational
design and management, niche marketing and other "levers for competitiveness
were policies adopted by federal and provincial governments. Nova Scotia,
after a major consultation and planning process, adopted 'Creating
Our Own Future" which articulated these kinds of policy initiatives. (Province
of Nova Scotia, 1992)
Social policy, as we had come to know it since it began
in post -war years, were also challenged to change. Canada followed
other OECD countries in attempting to shift from a "passive to active"
social security policy. The results of Social Security Reform,
the largest public consultation process in Canada's history, has led to
dramatic changes which Nova Scotia is beginning to experience in the form
of severely reduced payments combined in block funding and new responsibilities
devolved from federal government ( Phillips, [Ed] 1995; HRDCanada,
1994).
Around the same time, all of our values and beliefs
were being challenged to change. Canadian academic and futurist,
Norman Henchey (1986) noted :" Canada, along with most countries in the
world today, is experiencing the effects of rapid economic and social change
and deeper alterations in structures, values, and assumptions. Expectations
developed in the post-war era, of progress, anticipated success in academic
achievement, a good job, a general climate of stability and security, have
begun to crumble. As our expectations overwhelm our abilities to
satisfy them, basic assumptions and values have been challenged to change.'
(Henchey, 1986)
Fundamental changes in values along with economic necessity,
new heights of information access, and failure of old paradigm structures
to function adequately in an information age, fuelled major changes
in the nature of organizations, human resource management, marketing,
participatory democracy and new forms of public policy which emphasized
decentralization of decision making and community economic development
among other things.
Since that time the continuing shifting of human values
has continued to reshape organizational change, as well as our views
of economic development, politics, citizenship, the family, community,
friendship, and our own basic development throughout the lifespan.
The latter trend is witnessed in the new emerging but pervasive emphasis
on holistic health, wholeness, spiritual development, and interest in aboriginal
and Eastern philosophies.
Today's information age, technologically literate,
citizens have begun to assimilate knowledge in new, inclusive ways which
is moving us away from the fragmented knowledge paradigm of the recent
past to a new "wisdom" paradigm which moves toward wholeness, connectedness,
a sense of community both locally and globally and compassion for the human
condition.
From the developments described in this section of the
paper we can see that the new "Health Care " policies fall within
this framework of changing patterns in global economics, and public
policy shifts in social security programs, and basic value shifts
in the population. They also reflect a broader contextual shift in our
fundamental underlying view of the world which is described in this paper
as a dominant paradigm shift or transformation from an industrial, scientific,
rational, mechanistic paradigm to a new emerging, integrated, evolutionary,
systemic paradigm.
2) Paradigms and Paradigm Shifts
a) What is a paradigm? (pronounced pair
a dime)
The term "paradigm" came into usage as a result of the
landmark intellectual work in the early 1960's of Thomas Kuhn, Professor
Emeritus of Philosophy, Massachusetts Institute of Technology. In his Structure
of Scientific Revolutions he used the term "paradigm" to attempt to delineate
the core essence of a scientific community's "shared examples" of
what they believed and understood their science to be (Kuhn, 1962).
In this respect paradigms were equivalent to what present
day systems thinkers are calling "shared mental models". Since the time
of Kuhn many scholars, thinkers, consultants of organizational change,
and futurists continue to use the term "paradigm" because of its usefulness..
Stephen Covey, leadership consultant and author of Seven Habits of
Effective People (1989) and Principle-Centred Leadership (1992) describes
paradigms thus:
"Paradigm which comes from the Greek was originally a
scientific term but now is more commonly used to mean model,
theory, perception, assumption, or frame of references. In the more
general sense it is "the way we see" the world---not in terms of our visual
sense of sight, but in terms of perceiving, understanding, interpreting.
A simple way to understand paradigms is to see them as "maps".(Covey, 1989)
Joel Barker, management consultant who has developed
training strategies and audio and video tapes and book based on Kuhn's
discoveries about paradigms, defines “paradigm” as:
"A set of rules or regulations that do two things;
i) help to establish boundaries around our thoughts,
giving edges or borders and defining patterns, and
ii) show us how to be successful by solving problems
within these boundaries." (Barker, 1994)”
Jack Mezirow, Adult Education Professor from Columbia
University, in his Transformative Dimensions of Adult Learning
reviews a range of interpretations from many other fields of study and
finds the following terms which provide parallel meanings - horizons of
expectation, perceptual filters, frames, ideologies or schemas, personal
constructs in addition to "paradigms" of Kuhn. (Mezirow, 1993)
b) What is a paradigm shift?
Stephen Covey suggests that a "paradigm shift" is what
we might call the "AHA !" experience when someone finally "sees" the composite
picture in another way or finally "sees the light". . Jack Mezirow, refers
to this shift as a "perspective transformation" which he suggests could
be caused by experiences or dilemmas which shake us out of our usual way
of thinking about things- anything from a death in the family, to the kids
leaving home, to a poem, visit to a foreign culture, a death of a loved
one or losing a job suddenly. (Mezirow, 1993)
Another term for “paradigm shift”, which is commonly used
by evolutionary systems thinkers, is "transcendence". Ken Wilber,
who has developed a framework of human consciousness which includes
Piaget's five stages of cognitive development as well as several transpersonal
stages, describes how we "transcend" stages of human consciousness throughout
a lifetime in a series of "paradigm shifts ". He notes the importance of
arriving, at least, at Piaget's fifth stage of "formal operations" where
you can operate or reflect upon your own thought process, or transcend
them, take a different perspective or become highly introspective. This
is akin to "executive thinking","critical thinking", and metacognition.
(Wilber, 1995)
c) Why is it so important to know about paradigms?
Stephen Covey notes that, while many of us have
maps or paradigms in our heads, we seldom question their accuracy
and, in fact, we're usually unaware that we have them. Since our attitudes
and behaviours grow out of these assumptions, the way we see things is
the source of the way we think and the way we act. Canadian Economist,
Dian Cohn, confirmed this reality for Canadians:
"... a way of thinking, a way of interpreting events--
a paradigm--dies invisibly.......establishing a new vision has been stunningly
difficult for Canadians, as a whole, to absorb." (Cohn, 1993).
Another reason for attention to the idea of “transcending
paradigms” is because of Kuhn's findings with the scientists he studied
that their paradigms literally acted as “physiological filters" which prevented
them from seeing data right before their very eyes. It seemed to him that:
"professionalization leads, on the one hand, to an immense
restriction of the scientist's vision and to a considerable resistance
to paradigm change.” (Kuhn, 1962: 64)
Peter Drucker bemoans the fact that third wave progress
has been blocked by an entrenched bureaucracy resistant to change- within
government, the research community, academia and big business all with
a vested interest in the old way of doing things. (Drucker, 1994)
Fortunately, there is a growing awareness within
the field of "social systems design" that "transcending" or "leaping out"
of old paradigms is essential for organizations that are moving to a whole
new "open systems " approach. Bela Banathy, in a recent review of the “social
systems design” literature, shows that there are a growing number of strategies
and methodologies for assisting groups to “transcend” their old paradigms
including Hammer and Champy (1993), Bridges, (1993) and his own "leaping
out" methods. (Banathy, 1995, Personal Communication)
For all these reasons and others, it is crucial
that new policies, programs and new kinds of organizational
and decision- making structures like partnerships, and community boards,
be informed by knowledge, about the potential of old paradigms to block
the goals of their initiative in predictable ways and to have the
opportunity to transcend old paradigms, before attempting to develop new
visions or shared mental models of a desired future.
Albert Einstein, whose stunning research was
in fact a scientific revolution which created the foundation of the new
science which proscribes the new systemic paradigm, knew well the nature
and importance of paradigms.
"No problem can ever be solved by the consciousness
that created it . We must learn to see the world anew."
3) Dominant Paradigms of Civilization - and Paradigm
Shift in a Global Context:
In the first section the concept of a "paradigm
shift" as a major transformation of civilization was introduced.
When we apply the concept of paradigm to the history of humankind we attempt
to describe why cultures change, we are dealing with very powerful high-level
theories, the kind that are referred to as grand theories, dominant
paradigms, and conceptual frameworks. During the 19th century several
powerful grand theories were developed including the theory of "cultural
materialism", sometimes called "economic determinism". The view of the
world offered by this theory is one where economics and technology determine
the success and spread of the culture and social relationships and institutions
are adapted to the productive and technological requirements of communities.
Ideologies and values are adapted to useful behaviours in both, the social
and economic realms. (Hayden , 1993)
Most social scientists, who view the world through the
lens of "cultural materialism” or "economic determinism", have described
four dominant paradigms. As shown in the chart below, technological
innovations at three major transition periods in the history of human civilization,
resulted in entirely new ways of making a living, doing business or, what
we might call, work. Heilbroner (1962), Toffler (1980), Banathy
(1994), Cohen (1993) are just a few of the many authors who describe
this dominant economic paradigm.
Figure 1: Dominant Economic Paradigms showing
technological triggers
Time Period
|
Dominant Paradigm
|
Technological Triggers
|
1950's Onward |
Information Age Paradigm |
Computers and Telecommunications |
mid 1700's |
Industrial Paradigm |
Gasoline Engine Electricity |
3,500 B.C. |
Agricultural Paradigm |
Domestication of animals
Planting crops Plow |
35,000 B.C. |
Nomadic or Hunter/gatherer Paradigm |
|
Ken Wilber, evolutionary systems thinker, points out that
there were actually two different types of farming cultures - Horticultural
(9,000 B.C.) and Agrarian, the first based on the hoe or simple digging
stick and the agrarian period based on a heavy, animal-drawn plow. (Wilber,
1996) In the earlier horticultural societies the majority of food
stuffs were produced by women (while men still hunted); many of these
societies worshipped female deities as "Mother Earth" and evidence shows
that men and women lived in partnership. (Eisler, 1987; Wilber, 1995).
In the agrarian societies which developed, men worked the fields
with the heavier plows, worship turned to male Gods,
and a dominant social paradigm emerged based on the myth of the male
hero questing and conquering in a society based on power rather
than partnership. (Wilber, 1996; NFB, 1992).
In a synthesis based on evolutionary systems theory, new
archaeological evidence of earlier "Mother Earth" cultures, and an
enlarged vision of history, Rhiane Eisler developed yet another world
view of "Cultural Transformation". In this theory, she proposed that there
are only two major forms of social organization in regard to how power
is distributed in a society - partnership relationships based on linking
and dominator hierarchies based on ranking and power. (Eisler, 1987).
d) Why Learn About Major Periods of
History or Dominant Paradigms of Civilization?
Examining dominant paradigms of history encourages us
to see the patterns or larger frames of reference which shaped each of
these periods. In recognizing these patterns we are encouraged to
"transcend" old paradigms and to view the world from a higher vantage
point. We can also find insights and principles from the past which can
guide us into the future, e.g. in the earlier horticultural partnership
societies and the perennial wisdom of earlier aboriginal cultures.
In the same way, the stark contrast and sharp discontinuity
between the characteristics of the industrial, mechanistic, reductionist
paradigm in juxtaposition or along side those of the integrated systemic
paradigm world which is emerging implies the need to develop new perspectives,
and new intelligent technologies in designing and redesigning social systems.
(Banathy, 1994).
The next section focuses on the underlying basis of the
distinction between the world views of these two utterly different
paradigms.
4) The Nature and Implications of the Rational/Scientific/Mechanistic/Fragmented
Paradigm
Scholars agree that, throughout most of history, the world
view which saw matter, body and mind as a vast network of mutually interlocking
orders subsisting in Spirit, with each node in the continuum of being,
each link in the chain, being absolutely necessary and intrinsically valuable.
These three great domains were all one continuous and interrelated
manifestation of Spirit, one Great Chain of Being. With the rise
of modern science--associated with the names of Copernicus, Galileo, Bacon,
Newton, and Descartes-- this great unified and holistic view of the
world began to fall apart, in ways that none of these pioneering scientists
themselves either foresaw or intended. (Wilber, 1996) This new science
later became exemplified by Sir Isaac Newton's mathematical discoveries
which allowed him to postulate a clockwork universe with parts that functioned
like a machine. This metaphor of a clock or machine, which was synonymous
with a closed system, was adopted in almost every field of knowledge.
Figure 2
Scientific/Mechanistic/Reductionist
Paradigm |
Scientific/Evolutionary/Systemic
Paradigm
|
Metaphor of Clockworks, machine. |
Metaphor of network. |
The whole is the sum of the parts. The parts are more
significant than the whole. |
The whole is greater than the parts. |
Observer separate from observed. Complete
objectivity assumed. |
Observer is connected to the observed.
Subjectivity assumed. |
Rational knowledge and cerebral thinking separate from
and superior to emotional, intuitive, spiritual ? limiting potential. |
Rational, cerebral, emotional, intuitive and spiritual
in balance maximizing potential of human mind. |
Preference for analysis, reduction and convergent focus. |
Peference for synthesis and divergent focus. |
Problems seen in linear problem/solution and cause/effect
terms. Assumption a “technical fix” is possible. |
Problems seen as systemic and therefore in multidimensional
terms; no quick fixes; multidisciplinary, systemic, creative solutions. |
Knowledge is divided into separate subjects/disciplines
and into separate modes of experience (economic, environmental, political,
social, etc.). Bureaucratization of knowledge. |
Recognizes need for interrelated knowledge; importance
of interdisciplinary, transdiscipli-nary, new evolutionary systemic theory
which seeks general systems principles overarching all disciplines and
systems. |
Humans are separate from natural world and natural systems;
they can control and dominate both. |
Humans are part of the natural world and do not control
or dominate either in nature or in human systems. |
The fragmented nature of reality and our own body, mind
and spirit has reduced the individual and communities to a need for the
knowledge/skills of professional/experts. |
Interconnectedness of nature and everything in it leads
to wholeness of the individual, importance of community support and less
need for experts. |
Reference to Figure 2 provides an overview of the
major characteristics of this older paradigm. In this machine-like
paradigm the different parts were seen as more significant than the whole.
They were seen clearly in relation to one another, and could be separated
out and studied to determine cause and effect relationships. This
lead to a tendency to study the parts while abandoning the whole.
In this view of the world the observer was separated from the observed
which tended to isolate people from their environment. Complete objectivity
was assumed and events were seen in isolation. (Hutchins, 1995) Rational,
knowledge with a preference for analysis, reduction, and a convergent focus
became the dominant mode of thinking about and studying the world and the
intuitive and spiritual was diminished and devalued. (Banathy, 1992) Problems
came to be seen as something which could be isolated, as variables
in linear problem/solution and cause and effect terms where a "quick technical
fix" was possible.
Consequences of this reductionist mode of thinking included
the separation of knowledge into separate disciplines or modes of
experience. This has led to the development of unidisciplinary
and single perspective theories in academia which have shaped the economic,
political, social and organizational world for the past two centuries.
This fragmentation of knowledge also in a growth of applied social sciences
or professions which arose to offer services to fragmented humans, families,
organizations, businesses isolated from that which provides the essence
of humanity.
The results of this fragmentation led to a dominant economic
paradigm which has taken us to the edge of environmental catastrophe because
of its failure to view the whole; the factory model of piecemeal
production and scientific management; schools, universities, social and
health services which offered partial services to parts of a system.
It is interesting to note the growing use of the concept of "ignorance"
in academe as witness to this growing awareness of the great void of knowledge
missing in a fragmented knowledge paradigm. We could also cite the situation
in education, psychology and training where the science of behaviour shaped
and limited thinking about human potential for many years.
The mechanistic, reductionist paradigm changed the
maps of the world that each person carried unconsciously within them. This
loss of the interior dimension of human nature reduced individuals to two-dimensional
beings cast about by events on the physical surface of reality and
it terminated our intimate bond with the rest of the cosmos, environment,
community, and humanity. (Coombes and Holland, 1996) Thus science discouraged
us from looking below the surface to our inner self where we find creativity,
intuition, self-knowledge, compassion and will to act -- the very stuff
that had formed much of the perennial wisdom of the ages. This result
of this loss to the human psyche is eloquently expressed by new physicist,
David Bohm, discoverer of "holography":
" For fragmentation is now very widespread, not only throughout
society, but also in each individual; and this is leading to a kind of
general confusion of the mind, which creates an endless series of
problems and interferes with our clarity of perception so seriously as
to prevent us from being able to solve most of them.....The notion that
all these fragments are separately existent is evidently an illusion, and
this illusion cannot do other than lead to endless conflict and confusion."
David Bohm (in Capra, 1991) From a human consciousness perspective the
rational state allowed the human species to move from a rule/role mind
state of earlier mythical cultures and move to a new ego state where
self-esteem replaced the need for belonging, abstract reasoning replaced
concrete thought and moral development shifted beyond the approval of others
to that of individual rights i.e. form conformist to individualistic.
(Wilber, 1996)
5) The New Integrated/ Evolutionary Systemic/Holistic/
Paradigm
Fritjof Capra, in "The Turning Point" challenged
the Newtonian world machine of closed systems with a description
of a new world view which emerged from quantum physics as a universe
as dynamic, even restless, and a web of interconnected relationships.
(Capra, 1975, 1991) New physics embodied by the Einstein's general theory
of relativity and Heisenberg's Quantum Theory together showed Newtonian
physics to be a mere approximation of reality. (Coombes and Holland,
1996) According to David Bohm both relativity and quantum physics
share the common perspective of wholeness. Relativity views space
not as a void of nothingness between solid atoms-- but returns to a vision
of the universe as continuous, unbroken fabric. Quantum theory is holistic
in quite another sense viewing all action as continuous and unbroken, where
the particles have no individual existence.
New physics evolved and incorporated new theories to become
"new science" which Wilber, in his latest synthesis of knowledge, describes
collectively as the "sciences of complexity” ---including General Systems
Theory (Bertalanffy, Weiss) , cybernetics (Weiner), non equilibrium
thermodynamics which includes self -organizing theory (Prigogine
), autopoetic system theory ( Maturana and Varela) dynamic systems theory
(Shaw, Abraham) and chaos theories, among others." (Wilber, 1996).
He refers to them all collectively as systems theory, dynamic systems theory
or evolutionary systems theory.
The general claim of evolutionary systems theory is that
there have now been discovered basic regularities, patterns or laws, that
apply in broad fashion to all three great realms of evolution, the physical,
biological and social spheres and that a unity of science --a coherent
and unified world view--is now possible. These general systems theories
claim in other words that "everything is connected to everything else"--
the web of life as a scientific and not just religious conclusion as it
had been in period prior to the Rational Scientific Paradigm. (Wilber,
1996).
In contrast to the old paradigm the new systems sciences
have provided evidence of a very different fundamental basis of the universe
one which is much more akin to the perennial wisdom of the ages. The world
is seen as an integrated whole instead of a dissociated collection of parts,
i.e. the system is greater than the sum of its parts, with any events that
occur being viewed as linked or interconnected. (Capra, 1991) The systemic,
or systems approach, examines the world in terms of relationships and integration's.
Systems are treated as integrated wholes which properties
cannot be reduced to those of smaller units. In this, the observer is connected
to the observed- and subjectivity is assumed impossible to avoid
(Hutchins, 1995). Recent research in the fields of 'bioenergy" and
morphic field analysis of Rupert Sheldrake (Coombes and Holland,
1996) is bringing greater understanding to this area of energy fields which
surround all living matter and connect us, research which has until recently
been shunned because it did not fit the dominant paradigm. At the same
time the Jungian psychologists are rejoicing with the discoveries which
bring Jung's theory of "synchronicity" more perspective and credence within
the new paradigm.
There is a preference for synthesis and divergent focus
as opposed to the analytical and reductionist thinking of the old
paradigm (Banathy, 1993). Within individuals there is a balance between
the rational knowledge and cerebral thinking abilities and intuitive and
spiritual abilities. This balancing of the human psyche or integration
is the essence of the new paradigm, as described by Wilber and Gebser,
who saw the link with the evolution of human consciousness and that of
cultural evolution. Hence, transcendence, by a critical number of individuals
from the rational paradigm to an integrated paradigm, could signal a dominant
paradigm shift of civilization. What is of particular interest in connection
with this paper, as context for a new health care policy, is the fact that
"health" is defined as "wholeness" or "wellness" which is "integration"
or transcendence of the "rational" paradigm which, as we have seen above,
fragmented the human psyche and world view to such disastrous consequences.
Whereas the reductionist paradigm led to fragmentation
of knowledge there is a growing awareness that all learning must be contextual
to be effective:
" we need to end the travesty of the educator that is
removed from context. Real life experiences, and therefore knowledge,
do not come chopped up in discrete subjects, but are invariably interdisciplinary."
(Hutchins, 1996)
The systems thinkers go a step further in recognizing
that knowledge of life is not in fact interdisciplinary but is better understood
as systemic knowledge, the understanding of social systems, ecological
communities, and hundreds of other systems that provide the context for
carrying out our purpose - survival. Systemic thinking provides that
means of discovering systemic knowledge for systemic thinking is holistic
and, therefore, contextual. It asks you to examine complex phenomena from
many perspectives in order to understand that all system's functions interact
in response to its environment. (Hutchins, 1995)
Contrary to the old paradigm, the new one would enable
us to solve more of our own problems, either individually or in communities,
without being dependent upon an expert or professional, i.e. there is a
diversification of an individuals knowledge base, resulting in a less reductionist,
more holistic understanding of all issues.
Evolutionary systems theory is providing an alternative
to steady-state and equilibrium approaches for the design of socio-cultural
systems. Within the evolutionary vision, old static theories of social
change are being replaced by theories that are truly expressive of the
full range of human potential . They recognize "evolutionary consciousness
which stems from our capacity to direct our own evolution in a self-transcendent
mode, our unique human ability to be self-aware, "to view a situation in
a new light, or ..to jump over one's own shadow." (Bach, 1993). And
new social systems design research and practice is developing new methodologies
for assisting groups in "transcending old paradigms" to move on to co-create
new open systems based on the knowledge of new science (Figure 3) contrast
old closed and new open systems.
Figure 3
The Old Paradigm
|
The New Paradigm
|
Fixed bureaucratic structure. |
Open, dynamic, organic, flexible. |
Status-laden, rigid hierarchy. |
Functional and evolutionary. |
Power resides at top. |
Power shared by empowerment. |
Motivate and manipulate people. |
Inspire, care for each other. |
Value productivity |
Value overall contribution |
Solving problems. |
Creating opportunities |
Blame for failure. |
Learning from failure. |
Short term focus. |
Long term perspectives. |
Past regimen reinforced. |
Creativity and freedom nurtured. |
Work within constraint. |
Seek the ideal. |
Progress by increments. |
Progress by leaps |
Technology/capital based. |
People/knowledge based. |
Linear/logical/reductionist. |
Dynamic/creativity/synthesizing. |
Emphasis on quantity. |
Emphasis on quality |
Insisting on the “right way”. |
Learning, exploring, questioning. |
Need for external acknowledgement. |
Acknowledgement from Self. |
Adversarial, competitive. |
Cooperative and supportive |
The goal is to beat the competition and be ahead of others. |
The goal is integrity and individual and collective identity. |
Motivated by production |
Motivated by satisfaction. |
Figure 3b
First Generation Systems Design
(Closed Systems)
|
New Systems Design
(Open Systems)
|
Systematic |
Systemic |
Systems engineering |
Systems design |
Design of Closed Engineering or “Hard Systems” |
Design of open social systems and corresponding “soft
system” approaches. |
A “how-oriented” activity that designs named systems
with defined objectives and specifications by developing and testing (and
selecting from) models of alternative systems based on carefully defined
criteria. |
Seeks to understand the design situation as a system
of inter-connected, interdept, and interacting issues; and seeks to create
a design solution as an interconnected, interdept, interacting and internally
consistent solution ideas. |
Attempts to apply engineering principles to social systems
(under the labels social engineering” and “operations research” in the
1960's and 70's were not successful in resolving complex, open systems
design problems. (Ackoff, 1979) |
Seeks to envision the entity to be designed asa whole,
as one that emerges and is designed from the synthesis of the interaction
of its parts. |
A central thesis of evolutionary systems theory, derived
from Chaos Theory and Self- Organizing theory of Ilya Prigogine, is that
all manner of systems - chemical, biological, physical- enter states of
turbulence, reach a bifurcation point, and eventually either self- destruct
or self-transcend. Most evolutionary theorists and humanitarians in general
are now saying that human civilization has reached a bifurcation point
and that the need to "transcend" old ways has never been more evident or
imperative. From this theoretical vantage point moving to an integrated
state, either as an individual or society, is synonymous with wholeness,
or wellness which begins with integration of the human psyche.
Although there is not time in this paper to further pursue
the new paradigm thinking, evidence of the pervasive imperative to "transcend"
the old paradigm is shown in Figures 4 and 5.
Figure 4
“The world truly is at a cross roads. We face many complex
problems whose solutions will take more than just physical resources and
financial expenditures... The roots of the current crisis of civilization
lie within humanity itself. Our intellectual and moral development is lagging
behind the rapidly changing conditions of our existence, and we are finding
it difficult to adjust psychologically to the pace of change. Only be renouncing
selfishness and attempts to outsmart one another to gain an advantage at
the expense of one another can we hope to ensure the survival of human
kind and the further development of civilization.”
(Michail Gorbachev, 1995) |
“We are standing at the threshold of a new era on the
frontier of two centuries and two millennia. Wherever we live, we all feel
that we are at some kind of watershed and that we must change a great deal,
both within our own countries and in relations between nations.”(Gorbachev,
1995) |
"Our current evolutionary stage has brought forth the
potential of global human society, but out collective conscious is still
locked within ethnocentric, racial, and national boundaries thus creating
an evolutionary consciousness gap. (Banathy, 1989) |
“There is another course which, as co-creators of our
own evolution, is still ours to chose. This is the alternative of breakthrough
rather than breakdown: how through new ways of structuring politics, economics,
science and spirituality we can move into the new era of a partnership
world.”(Eisler, 1987) |
Figure 5
Beyond the Information Age
New Paradigm Thinking
“Age of Compassion” |
Robert Theobald, 1996 Draft Massey Lectures, CBC Website |
"Age of Humanity” |
H.B. Danesh, Canadian Psychiatrist and World Baha’i Leader
in Psychology of Spirituality, 1994 |
“Age of Light” |
Hazel Henderson, in The Age of Light, in The New Paradigm
of Business, 1993. |
“Age of Partnership” |
Riane Eisler, in The Chalice and the Blade, 1987 |
“Systemic Paradigm” |
Fritjof Capra in Tao of Physics, 1901 Willis Harman,
Global Mind Change, 1988 |
“Evolutionary System" |
Eric Jantzch, 1980, Bela Banathy, 1989; Ken Wilber, 1995,
Ralph Abrahams, 1994 |
"The Natural Step” |
Karl Henrik Robert, 1995 and Paul Hawkin, 1993 |
Figure 6
Medical Paradigm
|
Health Paradigm
|
Decision-making government and profession-driven |
Decision making devolved to those closest to the source
of the problem |
Decision-making government and profession-driven |
Decision making devolved to those closest to the source
of the problem |
The whole is the sum of the parts |
The whole is seen as more than the parts |
Foundation is scientifically developed knowledge |
Foundation is culturally acquired wisdom |
Emphasis on rational scientifically knowable where professional
is expert |
Emphasis on blance of rational and intuitive where health
care giver/healer is in relationship to patient/client |
Tendency toward problem solving within closed system
of knowledge specialty |
Tendency to view the whole system |
Focuses on illness and treatment, pharmaceuticals and
surgery |
Focuses on prevention and learning and healthy life style |
Professional and institutional provision |
Community based |
Disease centered |
Health centered-Quality of Life focused- Emphasis prevention |
Fragmented services -focus on institutions |
Integrated services focus on client |
Professional view patient as having a problem which science
and solve |
Community based care givers see patient as an asset to
themselves and the community |
Decision-making government and profession-driven |
Decision making devolved to those closest to the source
of the problem |
6) The Medical to Health Care Paradigm
Shift and some implications
Observation of Figure 6 provides a breakdown of
the medical to health care shift as a rational scientific mechanistic to
integrated systemic paradigm. In medicine the systemic of holistic approach
suggests that we shift our focus from treating illness in specific parts
of the body to preventing illness by focusing on the whole person and by
promoting a healthy life style. We are now starting to understand
health in a new light as one Native American Healer puts it:
" We now understand our own health as something created
thorough the pattern of our lives and we are beginning to understand disease
not as something bad or evil, that "comes to get us" but as a symptom of
an imbalanced way of life in which we walk on Mother Earth. With this understanding
we can begin the process of healing ourselves through proper nutrition,
physical exercise, new beliefs, and a more healthy environment,
as well as through the balancing of energies and the
right use of medicines that stimulate the body's innate healing capacities."
(Eagle, in Carlson & Shield, 1994).
By interpreting health in this broader paradigm perspective
we can see a benefit in a shift to a health paradigm beyond simply economic
savings, community empowerment and a healthier population. Health
as wholeness, as a natural state of integration, is what the evolutionary
systems theorists suggest is the essence of the new paradigm and the only
thing which will enable an imperative shift to a healthier planet and new
stage of humanity.
Another systemic trend found within medical education
- is the shift toward problem centred learning as opposed to system
by system descriptive approaches and the recognition of the importance
of Eastern approaches which are based on the new science appreciation of
energy fields in and around the body and the need to create balance therein.
The emergence of new schools in naturopathic and holopathic medicine, acupuncture,
reflex ology, bioenergy healing, psyhosynthesis among others, are all trends
which are becoming more entrenched as the paradigm shifts.
The implications of this systemic shift for Community
Health Boards are many and include such things as the possibility of continued
growth and demand for alternative health care services to be recognized
as publicly approved services, the imperative of creating broad awareness
amongst the general population of the importance of this shift,
and of the need for boards to abandon old paradigms and to adopt new paradigm
methods to carry out the function of planning for a new health care paradigm.
In a systemic paradigm individuals are assumed to be self-aware,
in touch with their inner resources, moving to personal mastery, awakened
to a creative life force, to feel a life purpose, and to feel connected
to their community and environment around them.
This value shift corresponds with the economic and political
necessity of devolving responsibility of decision making to those
most affected by the decision, a basic tenet of democracy. Seen in
this light, the shift to Community Health Boards is a serious responsibility
and testing ground for new paradigm ideas and methodologies. Along with
a shift to community comes a de-emphasis on professionals and a reliance
on wisdom of the community . John McKnight's Careless Society, which is
a diatribe against professionalism and a celebration of a return to community
involvement as a basis for all social services, provides an excellent
insight into this paradigm shift. (McKnight, 1995; McKnight & Kretzman,
1993). Another systemic characteristic is the shift in the new "health
care" policy to more integrated and user - friendly services.
Finally, a few of the implications of new paradigm thinking
which are relevant for Community Health Boards functioning: Board development
will be enhanced by an awareness of the concept of a paradigm, paradigm
shift and of the differences between the dominant paradigms discussed.
In the same manner, board function will be further enhanced by opportunities
to "transcend" old paradigms.
Learning more about open systems and evolutionary
systems theory can be an asset in a community based approach that is decentralized
and working in an open environmental system. In the new systems paradigm
the planning behaviour of humans is another example of learning to adapt
to an ever changing environment. Planning , which is the projection
of what we will do to change, is less a product or road map to further
action than it is a tool by which people and organizations learn.
The shift to a new paradigm suggests the need to contrast
old knowledge, skills and attitudes needed with new ones. In fact, this
will be equivalent to shifting from a "knowledge" to a "wisdom" or
"systemic" paradigm. Systemic thinking, the most important attribute
in the new systemic paradigm, becomes essential and would helps us to see,
among many other things, the parallels between school councils, community
economic development boards and community health boards; the parallels
between human systems, ecological systems and social systems; and
would assist us in the realization that knowledge and skills we learn in
working together on a board and planning for the future are generic skills
which we take, apply and share in our families, our communities and our
workplaces. It also shows us how global thinking and local action are interrelated
in a unique and holistic manner.
Finally as we become aware of "evolutionary systems theory"
and all its implications we will find ourselves "leaping out of old
paradigms. As Eric Jantsch has said:
"Evolutionary consciousness stems from our capacity to
direct our own evolution in a self-transcendent mode, our uniquely human
ability to be self-aware, to view a situation in a new light, or.. to jump
over one's shadow." (Jantsch, 1980)
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Dr. Janet M. Eaton
J.M. Eaton Associates
P.O. Box 1525/ 89 Main St.,
Wolfville, Nova Scotia,
CANADA, B0P 1X0
Ph. 902) 542- 1631 (h)
Ph./Fax 902) 542- 1673 (o)
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