In recent times there has been a flurry of publications, within academia and clinical research, pointing to the relevance of systems thinking in physical therapy and our understanding of factors that contribute to injury and health.
Systems thinking is a general conceptual orientation concerned with the interrelationships between parts and their relationships to a functioning whole, often understood within the context of an even greater whole. It is ancient in origin and familiar to us all, but it is also something very modern Trochim et al. (2006).
Emergence is a key feature of the systems approach. Emergence is not readily predicted – since the interactions within a system and between seemingly ‘unrelated’ factors generates often unanticipated change. Emergence is most often non-linear.
Systems are characterised by the following features:
(i) complexity in the system arises from multiple webs, relationships, and interactions between a large number of heterogeneous factors
(ii) the knowledge associated with a given actor, agent or factor in the system is limited and localised to its respective sub-system or level
(iii) history, plays an important role in the system, and past events explain present and future behaviour
(iv) interactions in the system can include non-linear self-reinforcing and self-correcting feedback loops (i.e. reciprocity), which might produce an emergent effect (i.e. small initial events can reverberate exponentially and produce a disproportionately larger consequence in time, otherwise known as ‘sensitivity on initial conditions’)
(v) complex systems are homeostatic: they persist, adapt, and are continually in flux to enable reconfiguration in response to internal or external influence and change
(vi) systems are counterintuitive, and aetiological processes can be vastly distant in time and space
(vii) systems can be resistant to obvious solutions (i.e. seemingly reasonable strategies can actually worsen the issue).
The corollary of these characteristics is that emergent phenomena arise from the many perceptions, decisions, actions and interactions between actors and agents across the entire system. On the individual and clinical level, subtle changes in resting states, breathing and posture reverberate exponentially through the organism driving emergence which transform embodiment. These ideas inform my osteopathic approach and find full expression in our online course MESHWORK Fundamentals.