Process philosophy in healthcare

Part 1: Introduction

Adapted from photo by Shruti Singh on Unsplash

Try this quick experiment: stop what you’re doing. Just for a moment sit or stand completely still. Don’t move, twitch or blink. Stop breathing. Stop digesting, pulsing and synapsing, too. Stop thinking. Suspend ageing. Don’t decay or replenish anything. Don’t change. Stay just as you were a minute ago when this experiment began.

Of course, we all know this isn’t possible. We can never be truly still. Because even when we think we are being still, we are still|moving.

And yet, almost all of the structures that shape our life in the West are governed by this photograph-like framing of reality. We live in a universe of names and identities; things, objects and matter; fixed processes, systems and structures; conventions that can be learned and passed along. The world is a kind of ‘container’ — as George Lakoff and Mark Johnson described it (Lakoff & Johnson, 1980) — full of objects that continually bump into one another making things happen.

We have ordered the world in this way in part because it makes thinking and communicating easier. (Try describing anything to someone else without using nouns, for instance.) It’s also easier to measure something when it has clearly defined properties. And if you can measure something, you can isolate it from everything it is not: measure its relative distance — both figurative and spatial — and give it a discrete, bounded, finite identity. You can group like things together, assign differences, and rank them in order. And, in time, when you have enough of these things, you can engineer a Great Chain of Being.

But is this a true reflection of reality, or merely a convenient projection: an abstraction; an artificial construct superimposed on the world by human minds and human sense(s)? Is this really how the cosmos rocks?

In recent years, a host of theorists and philosophers have critiqued the kinds of substance philosophies that have underpinned Western modes of thinking since the Renaissance. We’ve seen critiques emerge from existentialism and post-structural linguistics, from Marxism and critical theory, and in recent years we’ve seen it in the rise of post-qualitative research and the new materialisms. And most of these owe some allegiance to process philosophy.

Process philosophy is the most widely known alternative to substance philosophy and it extends back to the writings of pre-Socratic philosophers in 6th century BCE. It can also be found in the ancient Eastern traditions of Hinduism and Buddhism as well as being the metaphysical basis of many indigenous cosmologies.

Perhaps the most widely known process philosophers today are Gilles Deleuze, Henri Bergson and Alfred North Whitehead. But there is process philosophy in the writings of Gottfried Wilhelm Leibniz and Baruch Spinoza, Karen Barad, Jane Bennett, Mark Bickhard, and Manuel De Landa, John Dupré, Antony Galton, Graham Harman, Charles Hartshorne, Erin Manning, and Quentin Meillassoux, Timothy Morton, Nicholas Rescher, Johannes Seibt and Helen Steward.

All of these are fundamentally process philosophers whose work tries to think through the implications of Heraclitus’s famous process dictum that you can never step in the same river twice.

So, if it is that you can never repeat a breath, feel anything the same way twice, think anything again, or, indeed, stop anything, even for a moment, what does it mean for the way we have systematised and ordered the furniture of our universe thus far? If everything is a process and everything flows, how can we live like that?

But even asking this question suggests an error, because process philosophy tells us that we already are living like that. Life doesn’t stop because we’ve suddenly noticed that we’re in constant motion. The earth won’t stop spinning because we’re suddenly thinking about it. No, the problem is not how to live ‘in process’ — we already are — the problem is how we can know the world in process. How can we understand, use, and make good in a world which rejects the reality of objects, things, identities, being, reduction, and finitude?

Over the course of the next few weeks I’m going to dig into process philosophy a little and explore what it is, how it’s being used, how we might do it well, and how it might be being misapplied. I want to see if I can tease out some of its implications for the way we think about health and healthcare, and how it might offers us some radical new ways to research and practice.

If this is something you yourself have dug into, have some knowledge of, or some materials you’re happy to share, please add them in the comments below. As always, it’s lovely to hear from you.

Reference

Lakoff, G. and M. Johnson (1980). Metaphors we live by. University of Chicago Press.