A Conversation About… Navigating Complexity in Mental Health through Systems Theory

Disclaimer: The following transcript has been autogenerated and may contain occasional errors or inaccuracies resulting from the automated transcription process.

Host (00:01):

Hi there. Welcome to Mental Health Professionals Network podcast series MHPN’s aim is to promote and celebrate interdisciplinary collaborative mental health care.

Dana Shen (00:18):

Welcome to this episode of MHPN Presents, and today we have a conversation about systems theory. Before we get started, I’d like to acknowledge all of the countries that we are listening from today. I’m currently on Kaurna Country and I want to pay my respects to the Elders past and present of Kaurna Country, but also all the countries that we’re on. I also wanted to hand over to my wonderful friend Seanna Davidson, who we will be chatting today. Seanna, was there something you’d like to say regarding an acknowledgement today

Seanna Davidson (00:53):

I’m joining from the Kabi Kabi / Gubbi Gubbi lands, and pay my respects to Elders past and present from these lands as well and the land skies and beautiful waters.

Dana Shen (01:06):

Thank you so much, Seanna, and it’s so lovely to have you here, and it was an easy decision for me to do this. We’ve known each other for a number of years now, and we joined together in a programme called The System Sanctuary run by two wonderful people, Tatiana and Rachel. And this was actually really what brought us together in a place of reflection and bringing together our practises. Was there anything else you wanted to share, Seanna, about how we got together and why it’s been good for you? For our connection?

Seanna Davidson (01:39):

I think just a bit of serendipity and beauty really, and to appreciate that in our time of knowing each other, it went from kind of this formal programme into catchups and conversations about the work that we do and planting these little seeds of wanting to do something together and it was all about the right timing and the right thing, and so just, a little bit of appreciation for those moments and so grateful for them too.

Dana Shen (02:07):

Fantastic. And I think the final thing for me to say is that I’m Aboriginal / Chinese. I’m a descendant of the Ngarrindjeri Nation and also the Kaurna people through my grandmother. And a really important part of meeting Seanna and connecting with her was actually having someone who I really trust as an ally in this work. So I just wanted to add that before we get started. So let’s talk about systems theory. So what is this all about? I’ll open up with my thoughts and I’d love your additions to this, Seanna. So when I think about systems theory, an important part of that is first of all, it’s very ancient. We’ll be talking in referring to ideas that come through a range of different places, including the western academic route. But actually this is ancient Indigenous teachings because what deeply underpins these ideas is that we are all interconnected.

(03:05):

And so one of the core things I think is first of all, I like to think about systems theory through the lens of it being an organism. So as a human being, I’m made up of all these wonderful elements, my organs, my skin, blood, all of the things that make me Dana. And it’s this complex relationship between these things that creates something bigger than any individual part. So I’m not only blood, I’m not only organs, it is all of those things together that make me, me, Dana. So that’s at its core what sits at the center of systems thinking. And Seanna, I thought I’d hand over to you just to add your views about that.

Seanna Davidson (03:52):

Yeah, well, just picking up on that, I think it’s of course such a great example that our organs, our blood, our hair, those are really physical, tangible things in the system. Something that can really easily point to things that we can measure, make sense of, show to somebody else. But of course, we’ve had this huge exploration into what is our brain and our thinking and our mind and our soul, parts that we know to also make up who you are as Dana. And they are of course, far less tangible. We can’t really point to them. We know that something is happening there, but they’re absolutely, particularly in a case of mental health, we know that they’re a big influence on this system. They’re an interconnective interrelated part of that system. So systems in their best and most challenging ways are these things that can be seen and known and understood, but also all of these elements that bring in such complexity because we can’t see them, but we know that they’re connected and we know that they’re influencing things, influencing the whole. So just those two sides of it, I suppose, what can be seen and what is unseen, but still part of the system?

Dana Shen (05:09):

Absolutely. And I’m glad that we’ve taken that step towards thinking about the mental health system because I’d like to talk a bit about that. What is the mental health system? What are the elements of it? My background is that I’ve worked primarily in social services and health services most of my career in the public sector. And now as a consultant, and maybe I can start this, what makes this system, we’ve got lots of different layers to it, and they’re all interconnected. Of course, we have the human beings that work in these systems. We have the structures and processes that they are guided by. So for instance, we have procedure, we have rules, and we have things that are measured. We have things that are acted upon in relationship to others. For example, the consumers in a system, there are many different elements that are interconnected and they have a purpose.

(06:16):

They’re working towards a particular type of goal. Now, this is where things start to get more complicated because sometimes different systems can have different kinds of goals and different parts of a system inside a system can have different kinds of goals. So it can be complicated. As we think about this, I imagine that as people are listening, they’re going, yeah, okay, I’m experiencing this sometimes where in my team I’m working towards something, but maybe the broader system is doing something else. So it starts to introduce what Seanna referred to as complexity, the complex nature of the way this works. Seanna, do you want to speak a little bit more about your perspectives on the mental health system and what that might be?

Seanna Davidson (07:06):

Yeah. Well, just in terms of me on my work, my job and my role is often to support whether it be teams or collaborations who are trying to improve systems. So that goal that you were just talking about, maybe something doesn’t feel like it’s working very well. So I often help them to think about and name and kind of identify system parts and relationships and what is that new goal that they’re working towards. And so I share that because even naming what the system is, we think, oh, well the mental health system, but you can talk to even five people who are in the same profession and they might define it differently and then talk to another five in completely different professions and they might name it differently. And so I think that’s one of the first things that’s so fascinating about it is there’s not this one definition, there’s not this one boundary that makes it up, but oftentimes in terms of where we’re situated, how we might experience something that actually will shift and change what we decided is included or not included.

(08:13):

So for example, one piece of work in community, they wanted to improve mental wellbeing outcomes, but they used that word wellbeing instead of the mental health system because language mattered to them in terms of how they defined it. And so that complexity can even be about, well, what are you talking about? Because I’m talking about this mental health system, but which one are you talking about? So we have to remember that a definition is totally subjective to each of us. And part of our work in making sense of it is actually checking in with others and how they’re defining what the mental health system is. And one of the thought I just wanted to add here is that things like mental models, values and biases that we might have, and particularly in the mental health system, things like that might be particular to one group or another.

(09:09):

And of course there are some change over time, just like we have seen shifting attitudes and different types of treatment for mental wellbeing. So all of these are playing into that complexity about how we conceive of our mental wellbeing or our mental health system, who has a role, what shapes it and what defines it. And then as you were speaking to Dana, you started to recognise that nested nature, that there’s systems within systems. And so I just wanted to put some context to that where someone might decide that our mental health system for themselves is actually the boundaries of their home because that’s where they feel safe, that’s where they might be able to control their day-to-day activities that might be able to be where they seek out their supports and get comfort. That might be someone who’s experiencing a mental health crisis, but if you might be a professional supporting and offering mental health services, you might think of it much more in the policy domain, the funding domain, the service delivery. And so of course, none of these are exclusive to each other. They’re all interconnected, but you can start to see how they’re all nested within each other. And then as you were saying, that kind of meta system, the system at large, is it at the state level? Is it the national level? Again, we’re making decisions about makes up that system and that influences what we think it to be and what those goals might be and who define them.

Dana Shen (10:43):

And what I love about what you’ve just said is that because we see things in different ways, and this could be individuals, teams, groups of people, communities, the nature of this means that we’re actually creating ourselves the systems that we’re in. And what I love about this is that it means that they can change. Because what can happen is that because something looks a particular way for a period of time, we think that it can’t change. And sometimes that can feel very heavy for us that work in these social service and health system, it feels really heavy, but it is possible to change things. It doesn’t mean it’s easy to change things. It can be quite difficult, but it is possible. And it’s here, Seanna, that I wondered if we could talk a little bit about some of the behaviours and things within systems that can make things easier to change or harder to change sometimes. I wonder if you could start the ball rolling on that conversation.

Seanna Davidson (11:49):

Yeah, yeah. Well, you know what, let’s do what makes it harder to get them out of the way. Because you know what, I think a lot of people know those things already and they’re what makes it feel so heavy. So a few of them might be, well, and you named one already, right? That different groups, different subsystems might have different ideas about how the system is supposed to work. So is it about that service delivery is the only thing that we need? Is it about that? What we actually need is really healthy physical environments that we live in, and that’s a better mental health system. So we can have these competing purposes. Sometimes what can happen as well is that there are feedback loops in the system that are holding a problem in place until we start to see them name them and then break them.

(12:42):

That can really make it challenging to change. We’ve also got this thing complex systems that we talk about is resilience or kind of snapback, which is like we make some progress. And then it’s kind of like that system at large feels like it’s coming back down and pushing back against us and one step forward, two step back kind of thing. So there are all of these things about this complexity being how it pushes back, but there’s also the good isn’t there? And one of the things that I’ve certainly learned is the way that which, whether it be collaborations, whether it be that there’s diverse types of effort at different levels and scales in a system, it’s kind of like attacking the problem from multiple angles and from multiple perspectives. That’s one of the best ways that we can work towards change. So it could be consumers being active, it might be health professional services being active.

(13:43):

It might be our government being active, it might be our funding structures changing our values and beliefs. Beliefs also shifting and changing, but that’s a lot of different groups doing and making their unique contribution from where they are in the system. And so there’s something about that collective goal, getting greater momentum behind that collective goal, but lots of diversity and at multiple levels. And I think we’re starting to understand that more through processes like collective impact. But Dana, what about you? When you are doing this work, what have you seen? I know there’s the hard, but what is the good?

Dana Shen (14:23):

So I think there’s a couple of things that I’ll be touching on a little bit later. Actually. Some, I think important practises that are useful at multiple levels, but I think one of the first things is that you really want to ensure that you’re bringing in really different perspectives into the work that you’re in, that you’re doing. We feel like we always want the allies for this. That is the thing that’s going to help us change things. And yes, allies are wonderful. I wouldn’t be where I am without the allies that have been beside me for many, many years since I was a young person. But you really do want to bring in other people that see the world in a different way and have a different potential definition of the systems that we’re talking about. Because actually it’s bringing along many different people that give a greater likelihood of creating change and not having that pullback, the tension where things come back.

(15:19):

It can also help you to find ways, gentle ways to move forward, if I can put it that way. Because for us to actually make systemic change that lasts over time, what I’ve seen is that you’ve got to be able to bring people along with you. And you taught me this, Seanna, one of the things when I was feeling at my most frustrated, I think it was a couple of years ago, and I said, this is so hard sometimes. And you said you’ve got to meet people where they’re at. You’ve actually got to meet people where they’re at. Because if we don’t do that, we can’t make change occur in the ways that we want to. And that’s called working to a collective, but it’s not an easy thing to do because the collective has different views. That’s why we’re bringing people together to move forward.

(16:09):

So I think that that’s one thing that’s been important. It works when you can do that. And if you can take the time to do that, it’s really important. Other things I’ve seen is where you start to look for wins that may not be the things you always want all the time. Some people might call them smaller wins, others might be, oh, I didn’t think that was going to be your win, but something’s happened and it’s created something else. So you’re looking for places where change is created that actually could create other things that are unexpected in the system. And I’ve actually noticed that sometimes that happens when something occurs that you didn’t want to happen in the first place. And what happens when you get that it generates an energy that creates something new and different. So it’s okay, we can have things that step back sometimes those couple of steps back, couple of steps forward, some great positive stuff can come out of that. It’s how you see it and use it as an opportunity for the next step.

Seanna Davidson (17:18):

Well, I was just going to say my energy is starting to feel even better just as we say that listening to you talk and I think you’re so right and it reminds me to share here, I think one of those things that maybe you and I live it and breathe it so much, but it’s such an important reminder, which is that uncertainty, complexity is all about uncertainty and a lack of knowing. We can’t plan in and anticipate 10 steps ahead of us because the system is always changing, even though we think, oh God, nothing’s changing. It is absolutely changing all the time. And so we need to be in a place where we have a little bit of trust leaning into that trust that there are also things happening where there’s good coming forward when we’re putting good things in, good things can come out and the trust and to look for those.

(18:09):

But that part around uncertainty is also about no one holding the ultimate truth. Going back to that what you’re talking about, the people we might not want to have conversation with, the people that we disagree with who have a different goal for the system or have a different purpose for it. And part of our ways of being able to engage with them that’s so fundamental is letting a little bit go of our ego and that we know what is right. And I’m not saying that we don’t know some right things, but we can’t enter it with a position of I know everything there is to know and I’m the only voice that’s important. So that talking with diverse perspectives, talking with those challenging perspectives, there’s always something for us to learn about what’s happening in a system from that. So that little bit of sitting with the uncertainty, letting go of what we think we know or letting go of what we think to be right helps us to engage with those difficult conversations and also as you said, helps us to find that energy and momentum of where good is happening and then amplify that when we see that happening.

Dana Shen (19:24):

So part of my background as you know Seanna, I’m a meditation teacher and actually a lot of the aims of meditation is really about being able to be present in the moment that you are within now at any time.

Seanna Davidson (19:42):

Yes, I’ve had to learn a lot from you about that.

Dana Shen (19:46):

And so we can bring that same way of seeing the world into how we observe ourselves and the systems in which we are in. Now, a core part of the teachings are also about non-judgment. It doesn’t mean that we’re not discerning and that we’re not thoughtful about what’s happening. What it means is that we’re trying to bring a gentle approach to how we see ourselves in a system, but also how we see others in a system. So two things I think can be very useful. First of all, whenever we can be really present, whenever we can minimise distraction and really be connected with people, there’s a much greater likelihood of positive things occurring from that. Even if you disagree with people or they disagree with you or they’re angry at you or whatever it is that’s happening, the greater the presence we can bring the better.

(20:37):

And I thought it might be a nice time too to think about some other practises that people can consider that I mentioned earlier in a range of different ways in a system. So I call these the courageous heart and head practises, and I think the name you also gave them, Seanna, was the Gentle Warrior skills because we are being bold and we are being strong, but we’re also coming at it with self-compassion and compassion with others. So I just wanted to talk this through to see how it resonates with people that are listening and part of the mental health and care system. The first one is an unconditional friendliness, an unconditional friendliness towards ourselves and other people. And what could that look like on an individual level? It’s about how we keep an open mind with people, we assume a basic goodness and that we’re going to listen even if the views could be a bit different.

(21:41):

So that helps us to maintain an openness in terms of a systemic thing. If we think about it at other levels, is it the way in which we give people a chance to try things, try things new? We support people to give it a go, we’re open to try new things because we’ve listened to somebody with a different view that has a different perspective. So it’s about having an openness on an individual level and in relationship as well as what that might mean to what we do in a system and how we act. So I want to go to the next one, Seanna, but just wanted to check in. Was there anything in particular that comes up for you when I talk about this?

Seanna Davidson (22:22):

I just thought what you were saying about compassion, the unconditional friendliness have a systems level. That’s a great place to remember about experimenting and that reminder of what we don’t know. And sometimes that looks like big projects that have a lot of big questions about how’s this going to go? But when we don’t know, because a system is complex, we have to have that period of experimentation now, just to be really clear and really safe when we’re talking about individuals and mental health, we’re not saying be wild and experiment with what might happen to humans. But I’m saying when we’re trying to shift systems, sometimes we have to try something that we don’t know how it’s going to land. And we need friendliness in that approach just as you’re saying, to give that space. And when it doesn’t go as planned or how we hoped to still look for the lessons in that, and all of that has to come from that place of friendliness. And just on the individual level, I thought to really recognise here, particularly in this profession, I think we can often feel like we’re not doing enough when we care so much. Maybe the thing today is to say to each of you who might be listening, that you’re doing enough. When you show up with your whole heart trying your best and for you or yourselves to recognise that, give yourself that unconditional friendliness and remember that you’re doing enough.

Dana Shen (23:47):

I think that’s a nice segue into the next courageous practise, and that is the practise of compassion. And I want to really differentiate compassion with empathy. So empathy is where we get to literally feel another person’s pain. We can be inside someone’s shoes and we experience that pain. Compassion is noticing the suffering of someone else or other beings and wanting that to end and acting in ways to help that to end. So you can see one can be quite painful while we sit inside something, one has a little bit of distance, but it helps us to maintain an open mind and an open heart with people. I think that’s a really important thing, particularly in these practises, in the work that you do in mental health, is being able to maintain a level of distance in order to keep our heart and our minds open to the human beings in front of us and the suffering that they’re going through.

(24:51):

The next one is around sympathetic joy. And what that means is that when we see people are happy, we actually want their happiness to continue. So we’re going to make sure that jealousy or we want that or we’re going to put those things aside and we want other people to really benefit and to do well. And I imagine that as people are listening, they’re thinking, yeah, how can I do that? In the systems that we’re in, there’s so much competitiveness and things getting in the way of other things, but if we see people doing well, we really want that to continue and to support them. Finally, a really important one is equanimity, to be economists. This means that we want to be able to maintain a balanced approach to how we see things, no matter whether there are ups or downs. And notice what I’m saying here, it’s not just the downs, it’s when there’s the ups too.

(25:49):

We’re still wanting to maintain a level of equanimity, whatever the emotion or the situation is arising that we seek to find balance. So we’re seeking to find levels of balance in the work that we are doing in these systems as well. How do we do that to ensure that we can maintain care for people and that we’re not rocketing up and down inside ourselves, nor in the way in which our teams or organisations behave. So overall, these are some of the things that you can consider and we are hoping to talk to you again, of course, to maybe look at each of these in a little bit more detail and to think about what this could look like in practise as well. So one of the things I thought would be really important, I think Seanna, for us to kind of begin to wrap up in our conversation that we’re having together is maybe to put forward some of the things that we really think are important for people to take away from today. Were there two or three things, Seanna, that you’d really in particular like to emphasise before we leave this session?

Seanna Davidson (26:55):

It’s like I probably answered that question a hundred times, but just now I go, oh man, I don’t know. Actually, I think what I’ll say here is that a little bit of bringing us back to where we started, Dana, when you reminded us that our bodies are a system. We exist in a system, and I think one of the things that I’ve learned in terms of taking care of yourself when you’re doing this big work is to find folks like yourself. And I don’t necessarily mean that you are working on a project together, but it’s somebody who is kind of interested in thinking about the system. They’re having some challenges, but they’re also having some wins. What I really mean there, you’ve got fellow travellers with you on the journey, so you’ve shared these beautiful practises and where are people that you can practise them with? We can’t just talk about them and then put them into practise perfectly tomorrow. And so I think finding your like-minded travellers, the people who want to travel this journey so you can support each other in going down these hard roads that sometimes open to these beautiful meadows and we get these wonderful winds and sometimes it’s a little bit more rocky and we’re clamouring over in and trying to make our way through in terms of how can take care doing this big important arc.

Dana Shen (28:19):

Thanks you, Seanna. And I think for me, the most important thing I think I’d like to have people leave here today is a couple of things. First of all, systems thinking, when we put it into words can actually become quite complicated because we are trying to find words for something that’s so deeply living and connected and related and creating things. It’s quite hard to talk about, but I want to assure people that each one of us actually knows this intuitively. We actually know our connections and we know it in the moments when we give space for it, whether that’s a connection with the natural world or we deeply connect with a consumer, or we really feel like we’ve worked together with our team in a particular way that’s been incredibly positive. We actually do intuitively know. So some of this is about putting intuition into words and I just want people to know that so that people don’t feel like, oh, this is all a bit too hard or anything like that. Actually, as a human being, you know this well,

Seanna Davidson (29:31):

The wisdom within, isn’t it, Dana?

Dana Shen (29:33):

It certainly is. So we’ve covered a lot of territory today, so I just really wanted to thank Seanna Davidson for joining me today about this, and we hope that it’s been a value to you. We think we’ll be returning to the airways to continue the conversation with you and maybe to think a bit more about the practises of this. And next time with a mental health clinician, we’ll apply systems theories to mental health practise at the coalface. We would greatly appreciate if you could fill out the exit survey. You’ll find a link to it on this episode’s landing page to let us know what you thought of this episode, and if a follow-up episode is a good idea. In the meantime, if you want to stay up to date with MHPN podcasts, make sure you subscribe to MHPN Presents. Thank you for your commitment to ongoing learning and to multidisciplinary mental health care.

Host (30:24):

Visit mhpn.org.au to find out more about our online professional programme, including podcasts, webinars, as well as our face-to-face interdisciplinary mental health networks across Australia.