The root ideas in dealing with change.

Sun Tzu, in the 2,500-year-old classic, The Art Of War, declares that "there is no invariable strategic advantage (shih), no invariable position (hsing), which can be relied upon at all times." Warfare is an extreme example of human turbulence. As in warfare, there is no cookbook method for dealing with change, no fixed and reliable strategy - and yet there are certain fundamental ideas that can help us think about our situations. These ideas come from a wide variety of sources, including:

* Theories dealing with chaos and complexity

* Systems thinking and complex adaptive systems theory

* Family dynamics

* Organizational development

* Eastern mystical thought (especially Taoism)

* The martial arts (especially Aikido)

None of these are simple ideas. There is no "60-Second Change Manager" checklist, no three simple thoughts that can make us masters of turbulence. But we have to start somewhere, and the best place might well be a quick discussion of some of these fundamental ideas.

Systems thinking

Traditionally, science has studied objects in isolation, and broken them down further to study their parts, dissecting a frog, for instance, to discover how it works. This is called "reductionist thinking," and it can be very powerful. Starting in the late 1940s, springing from the studies of communications, computation, and game theory during World War II, and especially from the work of John von Neumann and Norbert Weiner, some scientists began to look in the other direction. If we want to understand a frog, they would say, we need to learn about the world in which it lives - the pond, with its lily pads, fish, and flies.

This "systems thinking" proved equally powerful in almost every field. Gregory Bateson, for instance, pointed out that if we want to understand a mentally ill person, it helps to look at the web of family communications in which that person lives. In the biosciences, this spawned the whole idea of an "ecology." In health and city planning, it led to the "Healthy Cities" movement. Rather than analyzing the pieces of the whole, systems thinking focuses on the interaction between the pieces, in terms of control, communication, a nd feedback. An understanding of systems thinking has turned out to be fundamental to any study of change.

Chaos theory 

Science has traditionally made things simple in order to study them. For instance, a scientist might try to approximate the mass of a mountain by imagining that it was a pyramid of equal size. But of course, few things in nature are truly that simple. In recent years, scientists have found ways to mimic and study the real complexity of natural structures such as ferns, mountains, and the rings of Saturn, as well as chaotic surges in the power grid and interactions within families. This body of "chaos theory" has arisen from many sources, including quantum mechanics, probability, systems thinking, and the study of communications. It focuses on how complexity is generated, especially in iterative processes, in which the output of one phase is the input of the next phase. It tries to discern what is theoretically predictable, and what is fundamentally unpredictable, no matter how much we know about the present. It provides a powerful new way of thinking about complex change.

Linear versus non-linear

The solutions to a linear equation, plotted on a graph, make a line. Changes are proportional: Change one variable (increase plant capacity a small amount), and other variables change with it (production rises, as does the payroll, and the need for raw material). Changes are smooth and continuous. Non-linear equations do not produce a line on a graph, but rather weird clouds, rills, and whirlpools. Changes can be sudden, paradoxical, and chaotic: increase plant capacity a small amount, and production doubles. Or falls drastically. Or flips from one to the other. As managers, of course, we try to keep things linear and predictable. But the systems we manage are complex and tend to be non-linear.

Complex adaptive systems

Any system with more than a few variables or inputs can be said to be complex. A simple system reacts in a "linear" fashion. The outcomes of a complex system are non-linear, and cannot be predicted with any certainty, no matter how much information we have about them. They are less like machines and more like hurricanes, or families, or ant colonies. They are adaptive in that they interact with their environment. For instance, an ant colony will react to a hard winter by adding insulation, sealing ventilation holes, abandoning parts of the anthill, and even allowing many of its individual members to die, so that the colony will be preserved in all its functions - it adapts to its environment. Complex adaptive systems take in and dissipate energy; they "learn" in one way or another, in order to preserve themselves. Health care systems are complex adaptive systems. So are you.

Possibility space

In such a complex, non-linear space, the possibilities of the future are not predictable - but they are also not infinite. The future possibilities of a health care system include merger, liquidation, growth, and even transformation of parts of it into, say, office buildings, insurance organizations, or substance abuse clinics. It is far less likely that a health care system will turn into, say, a small tropical country, a brother-in-law, or an ice cream bar. The cloud of outcomes that have a greater-than-trivial probability of happening are the "possibility space" for the future of that system.

Sensitivity of initial conditions

No matter how, much information we have about a complex interaction, we cannot predict its outcome. However, there is something we can do by gathering enough information and analyzing it: We can determine which of the "initial conditions" are important to the outcome. A landing airplane has little sensitivity to whether the runway is asphalt or concrete, but a lot of sensitivity to the presence of ice on the wings or wind-shear in the descent path.

Emergence

No ant knows how to make an anthill. The anthill "emerges" from the much simpler interactions of the ants. No one decides which way the stock market will go. Its activity emerges from millions of decisions made by stockholders. An organization's leaders make the decisions, yet the organization's actual behavior can surprise its leaders. The organization can seem to resist its leaders, even when it doesn't seem that anyone in particular is resisting. As John Holland, of the University of Michigan, puts it, "the control of a complex adaptive system tends to be highly dispersed."

Hive mind 

In common parlance, "hive mind" conjures legions of yes-men and yes-women working with cult-like unanimity of thought, like the Borg of the "Star Trek" TV series, with its mantra: "You will be assimilated. Resistance is futile." In the context of biosystems theory, "hive mind" refers to something quite different: The intelligence that emerges from the intricate, multiple connections of units that themselves have little or no intelligence, the way a beehive, for instance, "decides" that it is time to split in two, make a new queen, and send half of the workers off with her to a new home. Experts in bee behavior insist that the decision is clearly not made by the queen, who must be coaxed and sometimes dragged and pushed out of the hive, but by the hive itself, in the interaction of the workers.

Every organization, community, and family has a hive mind, that makes decisions and expresses them in action (or inaction) - often not consciously, often not overtly expressed, and often opposed to, or at right angles to, the decisions of the official leadership. Managing this hive mind, speaking to its needs, fears, and expectations, is a major part of leadership.

Feedback loops

Feedback loops are the cycles by which we influence each other's actions. They come in two flavors, positive and negative. The words "positive" and "negative" have nothing to do with whether the outcome is good or bad. A stock market crash is a positive feedback loop. A thermostat, which keeps a room at a pleasant temperature, is a negative feedback loop. A positive feedback loop re-enforces itself at each turn: A falling market in Tokyo causes London stockholders to sell, which causes New York stockholders to panic, and so forth. A negative loop folds back on itself, each turn countering the previous one: A thermostat responds to a cool room by turning on the heater, the heater warms the room, the thermostat responds to the warm room by turning off the heater, the room cools, and so on, around and around. Homeostasis, the body's way of keeping itself on an even keel, at optimal temperature and chemical balance, is a complex tangle of negative feedback loops. Shock, on the other hand, is a positive feedback loop.

Both kinds exist in organizations. Quality control, for instance, is a negative feedback loop: A mistake or problem results in an improvement to the system that will prevent that mistake. Labor trouble, a divorce, or an addiction is usually the result of a positive feedback loop: Each step in the process pushes the next one further from the optimal, feeds it, magnifies it - each accusation gives the other side more ammunition and makes it harder to back down, each drink makes it harder to remember why it was important not to drink, and harder to summon the will to stop.

Scale

The fundamental nature of change is fractal: It is the same at different scales, much like a slice through a small piece of a cauliflower looks identical to a slice through the whole cauliflower. The observations we are making here about feedback and chaotic unpredictability, for instance, apply equally well to families, communities, organizations, industries, and nations.

Paradoxically, questions of scale are of great importance in attempting change. For instance, debate over "family values" has raged on the U.S. political landscape for over a decade. Certainly our national laws and policies can be better or worse in their influence on values, but it is equally clear that no federal legislation will fundamentally change our values. Values are not generated at that scale. They are generated at the scale of church, community, family, and school.

Attempting to solve a problem at the wrong scale makes it more difficult. Most pollution problems, for instance, need to be solved over entire bioregions - it doesn't work to clean up the stream that is crossing my back yard if the stream drains a mine tailing a mile upstream. Trade problems have an unalterably global nature, while health problems are fundamentally local (since they occur in individual bodies) and community-based (since so many of the vectors of individual health arise out of community and family).

Taoism

Of all the world's great spiritual books, the Tao Te Ching ("The Classic of the Way and its Power") is perhaps the most mysterious, from its first sentence ("The way of which we can speak is not the true way") to its last ("The path of the wise is to act for others, not to compete"), some 5,000 characters later. This book, attributed to Lao Tzu, along with the works of Chuang Tzu and others, form the basis of philosophical Taoism, for 2,500 years one of the two poles of Chinese intellectual life: Confucianism (practical, hierarchical, interested in relationship, rules, and duty) and Taoism (evocative, paradoxical, interested in the nature of chaos, and change).

It will take considerable unpacking to show the relevance of this ancient text to modern business decisions and personal dilemmas, but its assumptions and themes show a deep wisdom about the nature of change: the interrelated, systemic nature of things; the way strength arises from weakness, and vice versa; how a retreat can be an advance, and an advance, a defeat; the paradoxical nature of knowledge; and the importance of true listening ("The wise one constantly has no set mind; he takes the mind of the common people as his mind").

Martial arts

All martial arts attempt to study human conflict and the way the human body moves in the midst of turbulence. When we are dealing with change, the conflicts we face are rarely physical - yet the insights of the martial arts can be very useful. In restructuring a clinic, for instance, it's not much use to know how to knock someone to the floor, but it can be very useful to know the advantages of being a target, the importance of setting the rhythm of the action, and the power of discovering and attracting your opponent's ki, their true inner strength.

Anamnesis 

The goal of medieval Christian mystics was not to discover something new, but to end their amnesia, to get back to something they had always known, their oneness with the Divine. They called this "anamnesis," the end of forgetting. Watch a master martial artist, a champion sprinter, a great soprano. Under pressure, they do not attempt to add something new, something more. Rather they reach back to what is deep and constant for them - what the martial artist would call her "ground" or "base." In dealing with change, we can be flexible, rapid, and welcoming to new things only when we have the strongest possible connection to that which is deep and constant - our values, our place in the universe, who we are.

Over the coming months, we will play with these ideas and others, showing how they relate to real-world situations, such as competition, price-cutting, motivation, and team-building. If any of them resonate with your experience, drop me a line at The Physician Executive, or to [e-mail] the Internet.