What does it mean to think in systems? On multi-level thinking in arts and health

Emily Carlson, PhD, co-founder of MTFI, reflects on a recent MTFI event

At our first online MTFI Friday Get-Together, we heard from doctoral researcher Saoirse Finn about, well, a lot of things. Saoirse’s work, along with that of her supervisor Daisy Fancourt, is tied together by a focus on big-picture thinking about the relationship between arts (and, more broadly, leisure activities) and health and wellbeing. One of the things that impressed me most, personally, was the way her work shows a consciousness of how phenomena related to arts and health are always imbedded within complex systems.

I first encountered the world of systems science when I began learning about computer programming, when my sister (a pro software developer) recommended the book Thinking in Systems by Donella Meadows. The principles of systems science are surprisingly simple don’t require a lot of mathematical gymnastics to understand. An easy example of a system is a bathtub; water can flow in via the tap or out via the drain, and how much water is in the bathtub at a given moment is a function of the rate at which water is flowing in and flowing out of the tub. That simple system can be affected in many ways; maybe the tap is designed to shut off automatically when the water reaches a certain level, leaving the tub in a stable state (until enough water has evaporated to lower the water level). But maybe the tap, the drain, or both are imperfect such that there are drips going in and out constantly, causing the system to be in a state of constant flux. Or maybe, if you’re really unlucky, the tub is designed so that the more water that flows in, the more water flows out, giving you a really expensive and environmentally un-friendly positive reinforcement loop.

Systems thinking applies to economics (think supply and demand), biology (think calories consumed and expended), and, once you think about it for a while, pretty much everything. Including how engagement with music, arts and other leisure activities relates to health and wellbeing. In their paper How leisure activities affect health: a narrative review and multi-level theoretical framework of mechanisms of action (2021), Fancourt, Aughterson, Finn, Walker and Steptoe have done absolutley huge work in documenting and categorizing over 600 potential mechanisms by which leisure–including arts engagement–might affect health and wellbeing. They include psychological, biological, social, behavioural and health processes, each of which operates on micro meso and macro levels, that is individual, small group, and large group/whole societal levels.

For instance, on the micro psychological level, playing the guitar as a hobby may have a positive impact on an individual’s affective state, such as increasing her positive emotions or decreasing her negative emotions (changes which take place as the behaviour affects nervous system stress, neurohormonal responses, subsequent cognition, etc.). On the meso level, playing music together in a small group such as a band or orchestra may increase group cohesion (which in turn may provide individual affect regulation to the players). On the macro level, there may be decrease in collective stress and the formation of collective memories, even a decrease in social prejudice, for example for those who attend gigs or concerts.

The authors make several systems-theory informed points about their model, which they call the Multi-Level Leisure Mechanisms Framework. Firstly, all leisure activities involve multiple components; playing the guitar may not only improve mood, but increase cognitive skills like attention, physical skills of fine-motor control, singing while playing may cause one to take deep breaths, activating automatic nervous system responses for relaxation, etc. Secondly, such mechanisms interact with each other systemically and dynamically, increasing and decreasing in response to one another. Thirdly, context is always important; practicing guitar with no goal in mind compared to practicing guitar for a gig or concert may activate different processes. Fourth, systems are always changing, especially when they are as complex as humans and human behaviours, and finally, while the framework they have presented is extensive it is not exhausting–there will probably always be more mechanisms to uncover.

The appendex to this article is a goldmine not only for researchers, but for therapists who want to broaden their thinking and find new ways to communicate the benefits of engagement with the arts. Although particularly relevant to Community Music Therapy models, many mechanisms and their descriptions will sound familiar to music therapists working with individuals who have had to try to articulate their goals: increase self-confidence, increased tolerance of uncertainty, formation and affirmation of self-identity. Nevertheless, I would encourage anyone who reads this fantastic article not to merely gather useful phrases or come up with isolated new ideas, but to think more deeply about how each mechanism may be connected to dozen if not hundreds of others. The goals we write on our forms and therapists and the hypothsis we put in our papers as researchers necessarily put a magnifying glass to one or two moving parts in a huge, complex, dynamic system, which in music includes everything from the firing of a single auditory neuron to the full breadth of the musical cultures within which we exist. We’re so glad to have had Saoirse’s talk to remind us about this big, big picture and plan to keep it in mind for MTFI Get-Togethers to come…. Including our next one! Register for our April 30th 2021 MTFI Friday Get-Together with our friend, music therapist Angie Snell. We hope to see you there!