Felix Tretter

Nach kurzen persönlichen Vorbemerkungen der Autoren zum Bezug zu den Arbeiten von F. Vester führen diese (a) Grundlegendes zur den Systemwissenschaften im Allgemeinen, (b) zur Begrifflichkeit, sowie (c) zu Modellierungsansätzen aus. Der Beitrag demonstriert systemisches Denken zu Gesundheitsfragen durch Anwendungen u. a. im Bereich Umwelt und Gesundheit, der Gehirnforschung und zum Verhältnis soziologischer Systemtheorien. Eingangs wird auf die Vielfalt an praktizierten Systemansätzen hingewiesen, die aber in wesentlichen Grundkonzepten übereinstimmen, wie etwa einer „quasi-ontologischen“ Sicht auf die bearbeiteten Problembereiche. Und das ungeachtet von „Konjunkturen“, wo etwa das „Regelkreis-Paradigma“ durch Gleichgewichtsfragen und dem Blick auf Nichtlinearitäten teilweise abgelöst wurde. Dies wird dargelegt, und schließlich wird die Bedeutung einer „ganzheitlichen“ Sicht auf Gesundheitsfragen betont, was systemtheoretisch differenziert wird und in ein bio-psycho-sozialökologisches Krankheitsmodell mündet.

Neuroscience is a multidisciplinary effort to understand the structures and functions of the brain and brain-mind relations. This effort results in an increasing amount of data, generated by sophisticated technologies. However, these data enhance our descriptive knowledge, rather than improve our understanding of brain functions. This is caused by methodological gaps both within and between subdisciplines constituting neuroscience, and the atomistic approach that limits the study of macro- and mesoscopic issues. Whole-brain measurement technologies do not resolve these issues, but rather aggravate them by the complexity problem. The present article is devoted to methodological and epistemic problems that obstruct the development of human neuroscience. We neither discuss ontological questions nor review data, except when it is necessary to demonstrate a methodological issue. As regards intradisciplinary methodological problems, we concentrate on those within neurobiology and psychology. As regards interdisciplinary problems, we suggest that core disciplines of neuroscience can be integrated using systemic concepts that also entail human-environment relations. We emphasize the necessity of a meta-discussion that should entail a closer cooperation with philosophy as a discipline of systematic reflection. The atomistic reduction should be complemented by the explicit consideration of the embodiedness of the brain and the embeddedness of humans. The discussion is aimed at the development of an explicit methodology of integrative human neuroscience, which will not only link different fields and levels, but also help in understanding clinical phenomena.

The Covid-19 pandemic has challenged both medicine and governments as they have strived to confront the pandemic and its consequences. One major challenge is that evidence-based medicine has struggled to provide timely and necessary evidence to guide medical practice and public policy formulation. We propose an extension of evidence-based corona medicine to an organismic systems corona medicine as a multilevel conceptual framework to develop a robust concept-oriented medical system. The proposed organismic systems corona medicine could help to prevent or mitigate future pandemics by transitioning to a bifocal medicine that extends an empirical evidence-based medicine to a theory-oriented organismic systems medicine.

„Sinn“ ist vor allem im Kontext der Psychotherapie und der Psychiatrie von besonderer praktischer Bedeutung, insofern manche Menschen, insbesondere mit depressiven Syndromen, eine Sinnkrise zeigen. Und umgekehrt: der Verlust von „Bezugsobjekten“, insbesondere im sozialen Bereich, wie etwa durch den Verlust der Arbeit oder gar durch Verlust eines geliebten Menschen, kann bei jedem Menschen zu depressiven Symptomen und Sinnkrisen im Leben führen, mit der Frage „Wozu das alles, was soll ich tun?“ In dem Beitrag wird vorgeschlagen, einen grundlegenden „ökosystemischen“ Blick auf das Sinnphänomen zu werfen, bei dem Umweltbeziehungen der Person und deren systemische Struktur betrachtet werden. Wenngleich der Sinnbegriff sehr heterogen konstruiert ist, wird unter Bezug auf das Sinnkonzept von Viktor Frankl versucht,wegen der Situationsbezogenheit von Sinnphänomenen und der Situiertheit des Menschen, einen humanökologischen Rahmen aufzuzeigen. Für detailliertere strukturtheoretische Betrachtungen erscheinen im Anschluss daran Ansätze der Systemwissenschaft nützlich: Sinn wird demnach zunächst auf den erlebten Konsistenzgrad der Struktur des Netzwerks der Elemente affektiv-kognitiver Repräsentationen zurückgeführt. Sinnfindung und Sinnverlust werden daran anknüpfend, aber globaler als nichtlineare Dynamik in der synergetischen Potenziallandschaft von Systemzuständen interpretiert. Schließlich wird ein für die Praxis nutzbares einfaches Regelkreismodell von Sinn als Wertesystem vorgeschlagen, das psychische Störungen, wie Depressionen, besser verstehen lässt. Weitere interdisziplinäre Fachdiskurse müssten allerdings die Adäquatheit, die Relevanz und die Grenzen dieser „ökosystemischen Perspektive“ überprüfen. “Meaning” is of particular and practical importance, especially in the context of psychotherapy and psychiatry, insofar as some people, especially with depressive syndromes, exhibit a crisis of meaning. And vice versa: the loss of “objects of reference”, especially in the social sphere, such as the loss of work or even the loss of a loved one, can lead to depressive symptoms and crises of meaning in life in any person, with the question “Why all this, what should I do?” The paper proposes to take a basic “ecosystemic” view of the meaning phenomenon, looking at environmental relationships of the person and their systemic structure. Although the concept of meaning is constructed in a very heterogeneous way, with reference to Viktor Frankl’s concept of meaning, an attempt is made to show a human ecological framework because of the situationality of meaning phenomena and the situatedness of the person. For more detailed structural theoretical considerations, approaches of systems science appear useful afterwards: According to this, meaning is first traced back to the experienced degree of consistency of the structure of the network of elements of affective-cognitive representations. Following on from this, but more globally, sense-making and senseloss are interpreted as nonlinear dynamics in the synergetic potential landscape of system states. Finally, a simple closed-loop model of meaning as a value system that can be used in practice is proposed to better understand mental disorders, such as depression. However, further interdisciplinary professional discourse would need to examine the adequacy, relevance, and limitations of this “ecosystemic perspective.”

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the limits of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum.

Clinical fields of the “sciences of the mind” (psychotherapy, psychiatry, etc.) lack integrative conceptual frameworks that have explanatory power. Mainly descriptive-classificatory taxonomies like DSM dominate the field. New taxonomies such as Research Domain Criteria (RDoC) aim to collect scientific knowledge regarding “systems” for “processes” of the brain. These terms have a supradisciplinary” meaning if they are considered in context of Systems Science. This field emerges as a platform of theories like general systems theory, catastrophe theory, synergetics, chaos theory, etc. It provides a lot of abstract concepts, constructs, methods and models. We assume that these tools also enable theoretical integration in the diversified field of clinical practice in the sciences of the mind. Additionally, systems thinking in clinical psychology improves conceptual links to currently network-oriented neurobiology. However, clear definitions of systemic terms are necessary to emerge from their mainly metaphorical use. Here we revise mainly terms like “structure”, “process” and “dynamics” as they are used already in psychology, psychoanalysis, psychopathology and psychiatry in an ill-defined way. For instance, affective-cognitive structures like “life space” or “object representations” can be seen as products of mental processing. These structures, in turn, modulate dynamics of mental processes. Additionally, we suggest a coupled network concept of emotions and motivations as the main subsystem that modulates mental dynamics that results in a qualitative systemic model of the mind. Finally, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental. ystem for mental dynamics. In this context, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental.