The concept of systems thinking refers to a mode of understanding phenomena and processes in the context of the interdependent connections. We can use systems thinking to understand how a present situation emerged from a constellation of other situations, which were themselves contingent on their relationship to other situations, and so on. A situation here refers to any process, object, or system manifest in reality. Systems thinking helps get a more complete perspective on how phenomena unfold over time based on what was, what is, and what can be—the web of interconnection from which we always interact and live.
Thinking from a systems perspective can be counter-intuitive or even uncomfortable because of our dominant perceived experience of life playing out in a sequential manner, one situation after another—what we could call linear. However, the actual reality of any experience is only possible from a field of profound non-linearity. In other words, in addition to thinking about anything as a chain of causality one after another, systems thinking also recognizes the coming together of simultaneously occurring activities of parts to create greater, more complex wholes. Hence the saying, “the whole is greater than the sum of its parts.” Aspects of daily life that may be considered simple or taken for granted are unfathomably complex. Just think for a moment of all the innumerable processes that must be occurring and had to have occurred over your lifetime and millennia before you to have the ability to read and understand this article. This type of inquiry is systems thinking.
Systems Thinking and Health
So how is this abstract concept relevant to health? To start, we are alive and are a part of nature. Therefore, the question becomes, how does nature inherently sustain life? Every living organism (human, non-human animal, plant, fungi, microorganism, etc.) is an integrated and coherent whole, but they are also a part of a broader system. These are examples of a holon: a system that is whole and autonomous unto itself, but integrated and interrelated to the systems above and below them in levels of complexity (e.g., atom, molecule, organelle, cell, tissue, organ, physical body, ecosystem, planet, sun, galaxy, cosmos). It is important to realize that parts of wholes are also living systems. For instance, the leaf of a plant is a living system in and of itself nested within the larger system of the whole physical plant. Then going beyond the individual living system, they can be organized higher still, manifest as communities of organisms such as societies and ecosystems.
Throughout the living world, without exception, we find systems nesting within other systems. You, the individual reading this now, are part of a particular social system, and you yourself are an integrated whole living system, which contains your organ systems, composed of individual anatomical organs which are themselves living systems, continuing down to their tissues and cells—all nested and all necessary. The maintenance of life, in what philosophers and poets throughout the ages have referred to as “the breath of life”, is based on the ceaseless flow of energy through the living system, known as metabolism. The difference between something that is dead/non-living versus alive is the process of metabolism, i.e., its “breath of life”.
When we look at an individual person form clinical perspective, or a group of people from a public health perspective, we can begin to ask questions regarding the make up of their nested systems. Where you came from, your childhood, your health history, your relationships with the social and natural environment, your activities—the whole unique and vivid personal story is completely clinically relevant. When we think of people and populations this way, we move closer to seeing them as a whole.
Systems Thinking in Integrative Medicine
Integrative medicine in its ideal form would utilize systems thinking when approaching diagnosis and treatment. Established and codified systems of medicine like Chinese medicine, Endobiogeny, eastern and western herbalism, homeopathy, Ayurveda, body based therapy, psychology, and conventional medicine all offer a particular perspective that describes an individual’s unique story in an effort to understand how best to guide them towards health. When we don’t think systemically, or excessively focus on systems that are too reduced (genome, biochemical pathways, etc.), we can lose sight of the whole. Medical researchers and clinicians often limit themselves to understanding the mechanisms through which a disease operates, so they can interfere with those mechanisms drugs or surgery in an attempt to suppress a symptom.
There is no problem with this as a scientific endeavor or as a clinical approach—it is a valid way to find important answers to important question, and is highly useful for keeping people alive an functioning. However, it is very important and interesting, when dealing with complex systems, to wonder how a person (a whole system) developed a particular disease at a particular time and a particular place. Such a broad yet systematic perspective will enable our health professionals to better understand chronic, complex diseases and the phenomenon of healing. If a clinician does not have the time or training to make such an inquiry, it is important to refer to someone who can. Otherwise, we do a disservice to our patients.