Central to systems science is the idea of integration, an idea that Siegel works to capture in principle and use in practice. Central to Siegel’s thesis is the idea that well-being is a function of the interdependence between mind, brain, and relationships. He draws upon systems science in an effort to explain how an embodied mind is shaped by evolved biological structures, processes, and functions that influence the ongoing ebb and flow of emotion, cognition, and behaviour; and he describes how interpersonal dynamics co-function in this context to shape patterns of physical, mental, and relational health. Siegel highlights how an awareness and understanding of system interdependencies and system dynamics can be used to alter the flow of information and energy in the system and thus refashion the biological, psychological, and relational structures, processes, and functions that influence patterns of physical, mental, and relational health. In broad terms, then, his goal is the goal of applied systems science.
The image borrowed from John O’Donohue is the image of a river with an emergent flow. O’Donohue said that he’d love to live like a river, carried by the surprise of his own unfolding. The metaphor borrowed from systems science (Bertalanffy, 1968) is one of life as a self-organizing process. Siegal notes how a complex system is said to regulate its own emergence. Living systems move toward higher levels of complexity and integration, that is, unless they are moving away from this state toward disequilibrium, instability, disorder, and death. Upon first reading systems science Siegal grappled with how to apply these ideas to further our understanding of health and well-being:
“If these ideas were relevant and true, then perhaps this was an argument for the idea that we too are capable of self-organization. It seemed to me that our triangle of well-being, the system of mind, brain, and relationships, might be more fully understood in these terms, and we might apply the principles of complexity and integration to creating health across each of these three aspects of our lives”. (p. 69).
The healthy system is a system that somehow masters, or at least regulates, its own self-organizing process—it is a system that somehow maintains integration and complexity and avoids the extremes of rigidity and chaos. Elaborating upon the metaphor of the river, Siegel ask us to consider rigidity and chaos as the left and right bank of the river, respectively. The ideal position for the self-organizing person is in the centre of the river—in the flow—where matter and energy move freely and where there is scope to maximize complexity and integration. The central flow of the river is the place where the five FACES of optimal health and well-being can flourish. More specifically, a healthy complex and integrated system is marked by a Flexible, Adaptive, Coherent, Energized, and Stable (FACES) flow.
Of course, Siegel is not the first psychologist to grapple with how best to apply systems science metaphors to our understanding of health and well-being: Csikszentmihalyi grappled to operationally define flow (Csikszentmihalyi, 1990); Labouvie-Vief grappled to articulate her vision of dynamic integration in personality functioning (Labouvie-Vief & Márquez González, 2004); Lewis wrestled with the system dynamics of emotion (Lewis, 2005); Fischer worked to clarify the skill structures involved in regulatory control of action (Fischer & Bidell, 2006), and so on. But Siegel is somewhat unique: he relies less on operational definitions and measurement of system dynamics and more on mindsight, that is, the ability of an individual to monitor and alter the flow of information and energy in their system in a principled manner that is informed in part by their understanding of biological and psychological science.
Siegel uses clinical case studies to argue that mindsight can be cultivated and used to enhance well-being. While some might argue that Siegel’s mindsight offers little more than existing mindfulness perspectives (Langer, 1991, 2009), and that the science of personal transformation Siegel points to might be somewhat dependent on the dubious mindsight abilities of a clinician who would, at least initially, point out to clients which aspect of their ongoing system flow they need to work on, it is possible that some new scientific insights will might emerge from Siegel’s perspective, the outcome of which may be useful. Judging from the success Siegel reports with his clients, it is possible that his new mindsight therapy methods may withstand the test of randomized controlled trials. Finally, it is possible that some people reading Seigel’s book will assimilate useful knowledge and new therapeutic strategies that help them in some way. All of this implies that possibilities become reality.
Applied Systems Science
Arguably, people can cultivate some mindful awareness of the flow of information in their system, and perhaps this can liberate them in certain respects from medical and psychological constraints and open them instead to the possibilities of mindful control over their own health – ideally, mindful control that is informed both by science and personal observation (Langer, 2009). This case has been well argued by Ellen Langer. Nevertheless, it is a view which assumes that these mindful skills can be cultivated, and the issue as to how best to foster skill development in this context opens up a large set of applied systems science challenges.
Consistent with the available research evidence, Siegel enters this skill development territory with the view that mindfulness meditation is a useful skill to cultivate. Siegel describes how mindfulness meditation can help people to regulate their emotions and cultivate a more flexible and stable mind that fosters higher levels of integration. But Siegel builds upon this mindful base to highlight a variety of different forms of integration, each of which are different dimensions of skill that can be cultivated.
Mindfulness is at the core of the first of eight domains of integration Siegel describes as keys to personal transformation and well-being. He calls this first domain of integration the integration of consciousness. In most of the clinical cases Siegel presents, some skill in the integration of consciousness, acquired in large part via mindfulness meditation, is needed before clients can work on other domains of integration.
Siegel describes seven additional domains of integration: horizontal integration of the left and right side of the brain; vertical integration of the body, brainstem, limbic areas, and cortex; memory integration, including the integration of implicit and explicit memory; narrative integration of “our left hemisphere’s narrator function with the autobiographical memory storage of our right hemisphere” (p. 74); state integration of the “distinct states of being that embody our fundamental drives and needs: closeness and solitude, autonomy and independence, caregiving and mastery, among others.” (p. 74); interpersonal integration of self with others; and temporal integration in the context of existential doubts associated with uncertainty, impermanence, and mortality.
Siegel presents a case study to illustrate how functions associated with each of the eight domains of integration represented a problem for different clients. He then describes how he used his unique mindsight knowledge and therapeutic practices to help his clients achieve greater integration and greater well-being.
First, there is the case of Jonathan, a boy who suffered from bouts of rage and depression. Jonathan learns to control his mood swings by developing mindful awareness of his emotions and how they change in response to contextual cues. Jonathan achieves better integration of consciousness and, ultimately, greater well-being.
There is the case of Stuart, a ninety-two year old man who is prickly and lacking in feeling, presumably from excessive left relative to right hemisphere activation. Siegel works to activate the right hemisphere via body scan, non-verbal connection, and imagery exercises, and then to integrate left and right hemisphere functions in the context of diary writing work, which ultimately leads to horizontal integration of thinking and feeling and higher well-being for Stuart at age ninety-four.
There is the case of Anne, who lost her mother to lung cancer when she was three years old and who was raised by a depressed father and a harsh step-mother. In response to a painful dressing down from her stepmother at the age of eleven, Anne promised herself she would never feel anything again. She later became a successful radiologist but recently she suffered panic attacks and was feeling empty and disconnected from her children. Siegel worked to reconnect Anne with the feelings in her body, the ultimate outcome of which was increased vertical integration that manifested as less panic and anxiety, greater connection with her daughters, and less of a feeling of emptiness.
There is the case of Allison, who presented with back pain that turns out to resolve itself when an implicit memory of sexual assault is explicitly recalled. The memory implicitly impacted Allison’s functional state, causing her not only back pain but also persistent relationship problems, including significant sexual difficulty. Siegel helped Allison to achieve memory integration, integrating the implicit memory and explicit memory systems.
Then there are the many cases who in response to the adult attachment interview demonstrate dismissing, preoccupied, or disorganized narratives that reflect insecure attachments established during childhood and maintained in adulthood. The challenge here it to achieve narrative integration, that is, to gain awareness of insecure attachment patterns and thus moderate their negative influence; and ideally, to reconfigure interpersonal dynamics toward secure attachment patterns, the benefits of which are now well established (Mikulincer & Shaver, 2007).
The case studies in relation to state integration, interpersonal integration, and temporal integration highlight other challenges and illustrate how insightful and effective Siegel is as a therapist. However, a critical reading highlights a few key challenges for Siegel moving forward. First, can he map his eight-domain model of integration onto existing biopsychosocial models of health to construct a theory that is comprehensive, testable, parsimonious, possessing clarity of constructs, internal consistency, and which is open to disconfirmation? Second, and related, is his view of health and well-being designed to be a useful heuristic tool for clinicians or a model that shapes basic systems science research? Siegel does not make his theoretical position clear, and as it stands his theory amounts to little more than a heuristic tool that may -- possibly -- be more or less useful in the hands of different practitioners. Third, how might people acquire mindsight skills using this heuristic tool, and how might we test the efficacy of this multifaceted tool in practice? The issue here is one of how best to design training programmes for clinical psychologists and how to educate them in best practice; or alternatively, how best to design evidence-based healthcare training to people who wish to develop mindful skill over their own mindsight abilities. Finally, there is the issue of how best to construct an applied systems science which includes all the elements needed for social system change, without which Siegel’s mindsight theory and mindsight skills will never be developed in the population at large.
Specifically, to bring about coherent, integrated change, we need an applied system science that incorporates at least five elements. According to John Warfield, systems science is best seen as a science that consists of nested sub-sciences. It is presented most compactly using the notation of set theory. Let A represent a science of description. Let B represent a science of design. Let C represent a science of complexity. Let D represent a science of action (praxiology). Let E represent systems science. Then
A ( B ( C ( D ( E
We can learn something of systems science by first learning a science of description. Then we can learn a science of design which includes a science of description. The science of design is fundamental if our goal is to redesign systems. Next we can learn a science of complexity which includes a science of description and a science of design. The science of complexity is fundamental if our goal is to integrate the knowledge and perspective that different people have in relation to key problematic design issues. Next we can learn a science of action which includes a science of description, a science of design, and a science of complexity. The science of action is fundamental if our goal is to catalyze collective action for the purpose of bringing about system changes that are grounded in the science of description, design, and complexity. Effective applied systems science needs to embed these elements, one within the other.
As it stands, Siegel’s view teeters on the edge of the science of description. It teeters on the edge of psychological and biological science, drawing selectively from both. Siegel currently works with a heuristic he has found useful. He needs to expand his heuristic and transform it into a theory that is increasingly informed by the relevant sciences of description -- biological, psychological, and social science. He then needs to consider the issues of design, complexity, and action, such that he can transform the science of personal transformation into the new science his book title implies.
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