- “For every complex problem there is an answer that is clear, simple, and wrong” -H.L. Menken
Keeping “it” simple is important at times. It prevents us from becoming overwhelmed, clarifies concepts, aids in general understanding, and directs the focus towards a single goal. Most importantly, keeping it simple is necessary when communicating new topics or concepts to others. However, the problem occurs when keeping it simple is used a substitute for understanding the complexity.
When we oversimplify complexity it increases the chances of a blunder occurring. Assumptions, cognitive biases, and ignorance all become more prevalent when we start to overlook the dynamic and intricate patterns of problems, situations, and systems. This can be seen in everything from politics to healthcare. Even everyday discussions are often plagued with people over simplifying a topic to support their perspective (whether they know it or not).
Thus, to avoid these cognitive traps and mental errors it is important to embrace complexity and attempt to identify and study it, not to ignore or eliminate it.
One way to understand complexity is through the Dynamic Systems Theory. More specifically, I have found the following metaphor from Esther Thelen to be an interesting thought experiment. She invites you to become aware of the ever-changing complexity of something as “simple” as a mountain stream.
The Mountain Stream Metaphor
“The metaphor is of a fast-moving mountain stream. At some places, the water flows smoothly in small ripples. Nearby may be a small whirlpool or a large turbulent eddy. Still other places may show waves or spray. These patterns persist hour after hour and even day after day, but after a storm or a long dry spell, new patterns may appear. Where do they come from? Why do they persist and why do they change?
No one would assign any geological plan or grand hydraulic design to the patterns in a mountain stream. Rather, the regularities patently emerge from multiple factors: The rate of flow of the water downstream, the configuration of the stream bed, the current weather conditions that determine evaporation rate and rainfall, and the important quality of water molecules under particular constraints to self-organize into different patterns of flow. But what we see in the here-and-now is just part of the picture. The particular patterns evident are also produced by unseen constraints, acting over many different scales of time. The geological history of the mountains determined the incline of the stream bed and the erosion of the rocks. The long-range climate of the region led to particular vegetation on the mountain and the consequent patterns of water absorption and runoff. The climate during the past year or two affected the snow on the mountain and the rate of melting. The configuration of the mountain just upstream influenced the flow rate downstream. And so on. Moreover, we can see the relative importance of these constraints in maintaining a stable pattern. If a small rock falls into a pool, nothing may change. As falling rocks get larger and larger, at some point, the stream may split into two, or create a new, faster channel. What endures and what changes?”
It’s important to look at the big picture (photo credit)
A Movement Assessment Example
Let’s take the example of someone who can’t touch their toes.
It may be useful to give this person a specific, simple exercise (ex. KB ASLR) and education (ex. thought viruses) to help cause an immediate shift in their movement pattern – kind of like a rain storm quickly altering the way the stream runs. The benefit of this approach is that it offers control and predictability, which are two main factors when working with stressed and painful systems.
However, as many of us have experienced in the clinic, these quick changes are usually temporary and are neither complete nor permanent fixes in themselves. The rain storm passes and the stream returns to it’s former pattern. To truly affect the path of the stream it’s important to direct some attention to the entire mountain system.
In the example of someone who can’t touch her toes it is important to acknowledge the mountainous (sorry, couldn’t resist) complexity of “why”…
Maybe she can’t touch her toes because she has a stiffer body that lays down more collagen – her parents can’t touch her toes and their parents’ parents couldn’t touch their toes (epigenetics?). Maybe her allostatic load is too high because she’s overstressed from her job or relationships. Maybe she’s not motivated. Maybe she has a psychological issue – depression, anxiety, history of trauma, etc. Maybe it’s behavioral. Maybe she grew up in a very sedentary lifestyle and prefered to read or play video games for the first 26 years of her life. Maybe she was taught to lift weights or perform athletic techniques improperly and hammered those patterns into her body over many years. Maybe she believes that rounding her back or lengthening her hamstring is dangerous. Maybe she has a cold (neuro-immune connection). Maybe her microbiome is a mess. Maybe she doesn’t sleep well and has a circadian mismatch. Maybe it’s her vestibular system, stomatognathic system, or vision. Maybe it’s neurodynamics. Maybe it’s her respiration. Maybe it’s an osseous abnormality. Maybe she can’t IR her femur because of her pelvis position. Maybe a joint is tight in her cervical spine that decentrates the rest of the body. Maybe it’s a forefoot varus. Maybe it’s her posterior hip capsule. Maybe her paraspinals are unable to eccentrically control the movement. Maybe it’s her core. Or maybe it’s one of the other many things that could prevent any human from touching their toes.
It’s important to acknowledge the intricate, evolving interaction of these variables, which then becomes another variable in and of itself. It’s the perspective of “the whole is greater than the sum of its parts”.
Once all this is considered it will be easier to determine which variables can act as a control parameter to cause the desired phase shift of the system. In other words, maybe for the aforementioned patient a neurodynamic exercise would provide an adequate stimulus to shift her system into a place where she can perform a full, pain free toe touch. Or maybe it will require a combination of stimuli such as a core strengthening program, improved sleep hygiene, and graded exposure. Or maybe…
The success does not lie in the intervention, but how the system responds as a whole.
This complexity is why one exercise, manual technique, or communication style will work well with one patient, but have no effect on another “similar” patient. Or why someone may not do well with physical therapy, but feels better after going to a dietician or getting a new job.
Some people may be able to alter their stream easily with a simple passing weather pattern, while others will need a long-term tectonic shift. The art is finding where the change needs to come from.
Simple will work at times, but it is not a solution for all. The human species is far too complex to be simple.
Bottom Line
It’s great to keep it simple on some levels. But don’t make the blunder of convincing yourself that it is simple. Instead, embrace the complexity.
How do you do this?
Dig deeper. Try to gain a better understanding. Always look to learn more. Learn to enjoy the state of not knowing – curiosity. Find the quality. Never be satisfied. Always ask why. Then ask why several more times. And dedicate yourself to the lifelong effort of finding the elusive truth.
Again, to reiterate, this isn’t to say simple is bad. It’s just that oftentimes I find the beauty of simplicity comes from understanding its complexity.
- “A philosopher is a person who knows less and less about more and more, until he knows nothing about everything.” -John Ziman
Thelen, E. and Smith, L. B. 2007. Dynamic Systems Theories. Handbook of Child Psychology. I:6.
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The main reason I do this blog is to share knowledge and to help people become better clinicians/coaches. I want our profession to grow and for our patients to have better outcomes. Regardless of your specific title (PT, Chiro, Trainer, Coach, etc.), we all have the same goal of trying to empower people to fix their problems through movement. I hope the content of this website helps you in doing so.
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Aaron, I just graduated from PTA school yesterday and I have been following your blog through school. I love it. We think so much alike. Keep up the great work. And I love this line from the article, “The success does not lie in the intervention, but how the system responds as a whole.” I was glad to read this because I have taken this approach many times as a student and have seen great success with it. Thank you!
Embracing complexity is important in all aspects of life. We normally look for over-simplified answers that don’t really address the underlying problems. Thank you for your article!