UPSTREAM FOCUS

This is blog dedicated to exploring options for sorting some of our big challenges, making use of an 'upstream' focus.

'Upstream' here does not mean that we're swimming up a river or even going back in time. An Upstream Focus means that we seek to be aware of and to respect PROCESSES. Processes flow through time in powerful ways. They continually create our world and us, for we human beings and other creatures on this planet are all lives-in-process as well. Processes create the beauty and abundance that we appreciate, and processes also contribute to tragic outcomes and destruction. We all encounter problems- environmental problems, social problems, human problems- that in the moment can be inexorable and unrelenting. It can seem like whatever we try do is futile.

But a close examination shows us often that, however firm and final a particular process may be in this moment, there was a time or times in that process when a small change could lead to a completely different outcome- perhaps a much better outcome from our point of view. An UPSTREAM FOCUS means we are looking for those opportunities to influence major processes at the natural inflection points in useful ways- the points in the process where a small effort by a few can make a big difference.

Why do we need an UPSTREAM FOCUS? Why is this critical in our time? With all of our knowledge and science and technology, why do we need to work upstream? Why can't we just use our technology and our economic productivity to force systems and processes to give us what we want?

The short answer is, while much of our culture and our institutions and our stories about ourselves is about overcoming nature and natural processes, we rarely succeed in overcoming forceful processes and we never succeed for long. We may all find certain stories reassuring, but in the process of growing up most of us learn that in the end our resources and options are always limited. Bad things happen that we can't prevent or end. We of course cheer when a single survivor is rescued from a collapsed residential building but we don't usually dwell as long on each of the scores of lives lost in the same calamity.

One of the things that makes us human is "Loss Aversion"- a way of saying we tend to really value what we already have at a given moment- what we've grown to know and of which we've become fond. Loss Aversion must have been a great strategy for us mammals and primates, because we're still around. But in our modern interactions with powerful processes, Loss Aversion can lead us in dangerous directions. In a coming post I will write on how "Loss Aversion" can sometimes move us, individually and culturally, to invest in goals and strategic priorities that are not realistic. Again, because in our world, resources are always limited, Loss Aversion presses us to invest all we have in maintaining threatened status quo goals against overwhelming forces. Unfortunately this leads us to turn a blind eye towards upstream opportunities- where a small effort could make a big difference for us.

This blog is about opening up a space for considering the opportunities for a better future that an UPSTREAM FOCUS can provide.

As a physician and psychiatrist, I have spent the largest part of my career helping to care for those impacted by disease and loss, much of it we now know developing in the wake of upstream events in infancy and childhood (see future section below on Adverse Childhood Experience or ACE). The suffering and disability these people experience is very real and pressing. While it is not easy to meet their needs and with current methods we rarely restore them to full health and potential, these people need and deserve our concern and help. At the same time I am very concerned about our lack of attention to effective UPSTREAM approaches that could shield future generations from these harms. In my state of Maine this year we see more children impacted by poverty, hunger, abuse and neglect than last year. On our current course many will grow up limited and scarred for the rest of their lives by these upstream events. Humanity faces great challenges in coming decades- climate change, ecosystem failures, mass extinctions, pandemics, regional and global instability with the threat of planet-withering conflict. However my position is that pessimism is a lazy person's game. As a relentless optimist, I believe that there is much we can do to improve our chances on this planet. One of the most important is to begin to focus efforts UPSTREAM, where we can have the most impact, to ensure that the largest part of future generations grows up not only free from the need for intensive support and care, but also has is in a position to bring their energy and talent to the challenges ahead.

Following posts will consider absolutely some of the overwhelming problems that humankind has faced, and finally overcame only after developing an effective UPSTREAM strategy. I will also offer posts suggeting UPSTREAM strategies that could help us address some of the chief challenges of our time.

I invite you, reading this, to consider: What problems do we face- stubborn, challenging problems that refuse to get beter year after year- that may be viewed as consequences of UPSTREAM events? What processes do we need to attend to, what natural inflection points can be used? Let's begin a conversation, bringing together our insight and our experience. Let's go UPSTREAM together, and make a better world.

EP

Edward Pontius MD, DLFAPA, DNBPAS
Portland, Maine