The More Beautiful World Our Hearts Know is Possible. Charles Eisenstein (2013) North Atlantic Books. Berkeley.
This book should be required reading for all. Student nurses especially interested in health should read and discuss the implications. It will appeal to a wide range of people and is written in a very accessible style. This is not a book that would interest Donald Trump, Boris Johnson or the ‘Masters of the financial Universe.’ It would be too ‘fluffy’ for hard line leftists mired in economic determinism. It draws upon a re-emerging world view: a ‘systems view’, of life central to ecological and sustainability discourse. It has a long history; one crushed by the forces of colonialism, genocide, imperialism, extractive and other form of capitalism, patriarchy, Abrahamic religion and scientism. Its roots are to be found in the three social movements for social justice, indigenous rights and ecology.
A ‘Systems view of Life’ challenges the fragmentary, mechanistic, individualist view of life. Charles Eisenstein thinks, along with writers such as Fritjof Capra (the ‘rising culture’) and Paul Hawken (the ‘blessed unrest’) that we are in transition from one to the other. Stephen Sterling suggests that the sustainability transition cannot be made without adopting a ‘systems view’. Nurse education and practice has not fully caught up with the implications of such thinking.
Much of nurse education is founded on the old view; and thus we learn to reduce the human body to its constitutive parts (reductionism), that the most important knowledge is anatomy, physiology, biology, that health is about disease processes, specific aetiology, cure (biomedicine), that the focus of diagnosis is the individual apart from their social and ecological context, and we can understand illness and health in a cause and effect manner. There are of course exceptions to this overly simplistic description yet it is probably the case that when in clinical practice the focus is on acquiring skills, knowledge and attitudes to undertake a certain role. This is done with the implicit acceptance of a fragmentary, mechanistic worldview. Up to a point that is as it should be. However, if nurses in their personal as well as their professional lives are to join in creating that transition then they need to be critically reflexive (challenging ourselves, our own thoughts, our own sense of self) and critically reflective:
In ‘An Invitation to Social Construction’ (2009) Kenneth Gergen introduces this concept with the following explanation:
‘Critical reflectivity is the attempt to place one’s premises into question, to suspend the ‘obvious’, to listen to alternative framings of reality and to grapple with the comparative outcomes of multiple standpoints…this means an unrelenting concern with the blinding potential of the ‘taken for granted’…we must be prepared to doubt everything we have accepted as real, true, right, necessary or essential’.
Eisenstein poses some key questions to assist with this process (p4):
- Who am I?
- Why do things happen?
- What is the purpose of life?
- What is human nature?
- What is sacred?
- Who are we as people?
- Where did we come from and where are we going?
These questions may come across as a bit ‘new agey’ but are of course questions scientists and philosophers have asked. They are not questions often found explicitly in nurse education.
The following answers to those questions have been the dominant discourse leading to our fragmented, reductionist and dualist paradigm. Eisenstein calls this the ‘Story of the World’, while Capra and Luisi (2014) outline its origins in western philosophy, locating it with the giants of science and philosophy: Newton, Descartes, Hobbes, Locke and Mill to name just a few. A passing note: they are all white men. Much of today’s science, including some medical practice, and philosophy has moved on, but has not yet reached into our emerging worldview as practical activity in the social, economic and political worlds dominated still by the neoliberal imaginary in the Anglo-American world view, and by other various forms of materialist capitalism elsewhere (e.g. Russia, China, India).
- Who are you? The liberal humanist self of the sovereign individual; a separate individual among other separate individuals in a material universe that is separate from you. There are clear boundaries between us and the material world. You are ‘skin encapsulated ego’. You are a ‘flesh robot’ programmed by genes to maximise your reproductive self- interest. Your mind is a separate ‘bubble of psychology’, separate from other minds and materiality. A ‘soul encased in flesh’ or a mass of particles operating according to the laws of physics. A separate biological, anatomical, physiological you.
- Why do things happen? The impersonal forces of physics (gravity, light, mass) act upon all particles including you. All phenomena are a result of mathematically determined interactions. There is no purpose, intelligence or design behind it all. There are only impersonal forces and masses. This is life, the sum of the interaction of force and mass.
- What is the purpose of life? There is only cause. The universe is blind and dead, inanimate and uncaring about your existence. There is nothing that can ‘care’. Life exists and reproduces itself. Thought is only electromechanical impulses; love is a ’hormonal cascade’. Life is based on the self interest of the reproducing unit, its self interest is in conflict with the self interest of other units, everything that is not self is either indifferent or hostile. Dog eat dog, survival of the fittest.
- What is human nature? As we live in a hostile universe of competing individuals and impersonal forces, we have to protect ourselves and this means exercising control. Anything that assists with control: money, power, status, security, information, is valuable and must be acquired. We are at heart ruthless maximisers of self interest. Economically we are utility maximising rational actors, ‘homo economicus’.
- What is sacred? As the ruthless pursuit of self interest is anti-social we must aspire to ‘higher things’. This means controlling the desires of the flesh, engaging in self denial and self discipline. We must ‘ascend’ into the spiritual realm if religious, or into the realm of reason, principles and ethics, if secular.
- Who are we as people? Anthropocentric: The apex of evolution, the highest form of life, a special kind of animal. We are unique created in the image of God (if religious) or unique in having a rational mind (if scientific). We alone possess consciousness, we alone can design the world.
- Where have we come from and where are we going? We started out as naked, ignorant animals barely able to survive in a hostile environment; lives were ‘nasty, brutish and short’. Our brains enabled the transition to be the lords and possessors of nature, having ‘dominion over all we survey’, our destiny is to free ourselves from work, from disease, even from death itself.
These answers are the ‘old story’ that are still somehow the, albeit torn, fabric of much of our reality. The answers are changing, the old is emerging into the new but the transition is not complete. The new story has no coherent programme, no powerful political party, no country, no organising principles. It does have a movement however. This movement is not to be found in the mass media, filled as it is with mass culture. The movement is not to be found in the palaces, the parliaments or in presidential residences. The movement does not have a giant multi-national corporation, trade agreement or is backed by a military-industrial complex. It faces the forces of the old story, of capital flows, of religious fundamentalism and of scientism. It is not an ‘it’.
As you read this, consider your own world view and answer for yourself the above questions. In addition reflect on what this means for nursing practice. To what degree are we still in the old story in actual practice? Put aside the espoused theory of ‘holistic practice’ and look for what the ‘theory in action’ is. Are there clinical areas which heavily depend on individualising, separating, fragmenting, reducing human experiences to biomedical and scientific processes? Are you able to discern what assumptions and values underpin the daily work?
Finally, consider the issue of care and support for older people: what assumptions, values and interests are at play here? Have we separated the old from the rest of us? Do we feel their pain? Have we created a system that integrates and values their existence? What priorities drive the whole system of care? A clue is that in the UK’s parliament, the needs of older people for care and support is seen as a huge ‘commercial opportunity’.