When a child has a diagnosis, everyone involved – parents, educators, and service providers – have concerns; and all those various concerns generally boil down to a desire for their child to be happy and to do things with more ease.
For some, being happy and doing things with more ease may feel difficult or even unattainable. Often times families, educators, and service providers engage in strategies – perhaps several – only to find that the results they were looking for were not achieved and things are still not easier. Additionally, when a child has serious illness/diagnosis, parents often experience stress and unhappiness and often blame themselves.
Why is it that things don’t get easier? And how can families, educators, service providers and children be happy no matter what the condition or situation?
This article will illuminate a paradigm shift for the health care system. Being a system, health care includes everyone involved – physicians, therapists and services, patients and clients, and government. We often think of health care as medical professionals and other health providers. But without patients and clients, these professionals don’t have a job. And without government support, many people can’t afford services. So we need to look at the health care system from a systems thinking approach, and an iceberg model an effective way to do this1.
Above the surface, what is visible, in this example a family’s current reality is represented. The current reality includes the ways individuals do things, their behaviours and ways of dealing with situations, and their emotional responses and reactions. Below the surface are many of the areas that support and influence everyone in the family and support the family’s situation, such as development, gut health, diet, neurology, biochemistry, environment, toxicity, sensory & motor systems, immune system, education, health care, services, family, society, funding/finances and government. This is where disconnects and disruptions can occur, which result in stress, unhappiness, and challenges in the current reality.
For example, a diet high in processed foods may affect gut health, which typically results in poor assimilation and nutrient deficiencies; this in turn may have an impact on the immune system, potentially causing additional health issues.
If a child misses the developmental milestone of crawling due to hospitalisation, development of muscle tone may be affected, possibly resulting in developmental delays and academic challenges.
Sensitivity to touch may impact medical interventions, such as needle and tube insertions, resulting in resistance and possibly fear regarding much needed interventions.
An educational model based comparison and scoring may result in a feeling of isolation.
High treatment costs may result in parents needing to work long hours or go into debt, putting strain on the family system, and possibly resulting in limited treatment options.
Judgement from members of society based on the appearance of a diagnosed child may result in low self esteem.
Often times, as you saw in some of the examples above, several disruptions are interrelated and interconnected, forming the complex behaviours, compensations, and stress in a family’s life.
When we focus above the surface in an attempt to address the current reality, we simply focus on the things that are already hard and on the resultant stress. Additionally, trying to change or extinguish a behaviour without addressing it’s root causes generally results in another behaviour taking its place. This is because the behaviour is serving a purpose.
Alternatively, we can focus below the surface to address the disconnects and disruptions. We can do this by seeking many different interventions and strategies that each look at one disconnect, such as occupational therapy, physiotherapy, nutritional guidance, family counselling, biomedicine, medical interventions, speech therapy, education support, etc. All of these are valid and useful interventions.The problem with seeking each of them is that we end up with the silo effect – each intervention seeing and addressing the situation as separate. This is not so effective because the disconnects are interrelated and influence each other. Additionally, families get exhausted. And, their child is constantly engaged in therapy, treatments and interventions, which often results in him thinking that he is not ok like he is. We need therapies and interventions to see and address all of the disconnects – even seemingly unrelated ones – in an interconnected way so the family’s unique patterns of behaviours and interactions are discovered and understood, and the whole family’s quality of life is supported.
But there is yet another layer that is important to address, because it is the deeper driving force that perpetuates the disconnects and disruptions. This layer is thought; what we think about these areas below the surface that influence who we are; what we believe and assume to be true about them; and what we believe to be true about ourselves. This is the layer that is largely missing from the system of health care.
Looking at our thoughts, assumptions, and beliefs is important for several reasons. It is important because most of us are not consciously aware of our thoughts – rather we are on autopilot, making decisions according to our own conditioned beliefs and assumptions about how things “should” be, what we should do or shouldn’t have done, etc. Conditioned mind judges, and judgement separates. It is important because if we assume or believe any of these areas below the iceberg need to look a certain way, we will be unhappy if they don’t. It is important because when things don’t look like we think they should, we experience stress; when stressed, we see things through a narrow constricted view; research4 shows that when stressed we are 50% less creative, which limits potential solutions. it is important because how we see things affects how much energy we have for doing things and it affects our choices about where to channel what energy we do have. It is important because where we put our attention determines the quality of our lives. Attending to any of these disconnects as stressful, sad, worrisome, or frustrating gets us more stress, sadness, worry, and frustration. And finally, it is important because our children adopt our beliefs.They too live by them and therefore assume they need to be a certain way in order to have love and acceptance. They assume there is something wrong with them, because otherwise their parents would not be unhappy.
As Cheri Huber so clearly states, “Whether life is seen as an opportunity, a delightful garden of possibility, or a burden, depends on our point of view, not on our circumstances.”
This is important on a personal family level and on a societal level. For example, if a parent believes diet is unrelated, she may therefore offer treats high in sugars and low in nutrients, which in turn may perpetuate poor gut health and lowered immune functions.
If a child with physical challenges gives up on playing sport due to fear of being laughed at by his peers, his physical challenges may be perpetuated due to limited practice and experience.
On a societal level, if members of society have strong beliefs about what normal looks like, discrimination will likely be perpetuated.
If a mainstream school believes it can’t meet the needs of individuals with serious illness, this may lead to children being excluded and segregated; this in turn may perpetuate limited educational opportunities.
If Government believes that only certain interventions should be funded, families may not have access to effective services.
If service providers and/or educators believe a child can’t do something, it will likely be a self fulfilling prophecy.
Henry Ford said, “Whether you think you can, or you think you can’t, you’re right.”
This is a brief introduction to systems thinking as we see it in the field of health care. You can read further by clicking the links below.
Scharmer, C. Otto 2009, Theory U: Leading from the future as it Emerges, 1st Ed. Berrett-Koehler Publishers, San Francisco Book Introduction
Kaeufer, K., Scharmer, C. Otto,Versteegen, U. 2003 ‘Breathing Life into a Dying System, Recreating Healthcare from Within’, Reflections, The SoL Journal on Knowledge, Learning, and Change, vol. 5, no. 3, pp1-12.
Scharmer, O., “8 institutional innovations that could update the economic system,” the guardian, September 26, 2014,.