Kissing Descartes good bye.

of the approaches used by complementary and alternative medicine (CAM), and indeed by all therapeutic models that offer a complex package of care – physical therapies, surgery, general practice and family medicine, psychotherapy, psychosomatic treatments, mind-body medicine – cannot be modeled along the lines laid out by the mechanistic paradigm. Not only cannot they be modeled along those lines, they should not. They require a completely different model, one that can handle those complex interactions among the various aspects of treatment, the various aspects of a patient and his or her individual way of looking at the world, of experiencing the illness, and his or her reactions to those experiences including the package of care applied. But how, if not mechanistically, can this be modeled? Enter ‘Complexity Theory’, a bastard child of Aristotle and more recently of modern science. Indeed, it was Aristotle who coined the phrase: ‘The whole is larger than the sum of its parts’, which has become the center piece of general systems theory (GST). Introduced by Ludwig von Bertalanffy [3] and like-minded colleagues like Albert Szent-Gyoergyi [4] in the 1960s, following earlier and similar attempts by Gestalt psychologists like Max Wertheimer and Kurt Lewin, GST was a first major theoretical revolt within the biological sciences against the mainstream of mechanistic thinking. GST became quite popular and successful in biology and the modeling therein. Some great minds like Gregory Bateson exported the thinking of systems theory into psychology [5, 6], epistemolgoy and social theory, where Niklas Luhmann and others made use of it [7]. But medicine did not really take much notice, apart from a few minor exceptions. In came chemists, like Eigen [8] and Prigogine [9]. They discovered that chemical processes can self-organize, and once they do, exhibit strange collective behavior. Ilya Prigogine won the Nobel prize for his discovery that complex systems involved in the exchange of energy, information, or matter can display irreversible second-order transformations. Such chemical dynamics defy mechanistic assumptions, as parts lose their modular nature and cease to function as parts, while global system Make no mistake: Descartes was a genius and probably one of the most influential writers since Aristotle. His greatest achievement was that he had the – then – brilliant idea that organisms, and humans at that, can be conceptualized as mechanical automatons, machines that function through the conveyance of hydraulic force, just like mechanical clocks. What was extraordinarily daring at Descartes’ time has become the mainstream metaphor of the modern scientific age. Organisms have been and are being viewed as machines. The whole analytical power of our modern scientific enterprise in medicine is built on that metaphor. If you have a machine, you can analyze its parts, study their functioning, put it back together, and if something breaks, you can repair it or fit in spares. Emergency medicine, surgery, infection control, and a load of other biomedical achievements testify to the power of this metaphor and to the usefulness of applying it. However, what many people have started to notice is that this metaphor only works well for analytical purposes and in medicine for acute care problems. It is quite at a loss with most complex medical conditions, functional problems, psychotherapeutic challenges, and chronic diseases. These constitute roughly 70 to 80% of a patient load in a normal general practitioner clinic, and up to 100% of the patient load in all psychotherapeutic, counseling, psychosomatic, and probably even complementary practitioners’ clinics. Hence, and quite surreptitiously, a lot of patients have sought out these alternatives, because they instinctively see that their problems need a more holistic approach than the mainstream mechanical model affords. This has created a tectonic shift in power and put some strain on the seemingly smooth division line between conventional medicine and alternative practitioners. Patients are deserting conventional treatments and are putting money and effort into complementary ones [1]. Mainstream scientists bark back: ‘not scientific, not according to our standards anyway’ [2]. Now the point is: what exactly is meant by ‘scientific’? If you mean by ‘scientific’ capable of being modeled according to the mechanistic metaphor, then this is quite correct. Most