The healthcare continuum revised

My own STIR societal research foundation, together with AiREAS (air quality and healthy city) and the University of Technology of Eindhoven, apply participative learning with a group of 25 international students. We are looking for ways to use technology in the healthcare system within the challenges of Sustainocracy. We introduce a whole new way of thinking that can eventually transform the entire healthcare chain.


In the picture above on the “continuum of care” we see the entire healthcare chain and how it develops itself from prevention via early discovery of a health problem, all the way up to the last phases of anyone’s life.

But we miss something….

When we review our current society we notice that in terms of prevention there is little we can do since our political and economic structure, together with the lifestyle that belongs to it, contributes to our health reduction. In AiREAS for instance we look at our exposure to air pollution in relation to our lifestyle. Research revealed that 50% of the responsibility is of our own as we deal with our lifestyle and pollution in an unaware way. But the other 50% is caused by our surroundings and societal cultural management. This causes the enormous cost development of the healthcare chain.

Before we enter the care continuum we need to ask ourselves in what societal context it is placed and how we could dispute this reality from our evolving self and collective awareness?  In Sustainocracy we determined 5 leading core values for sustainable human evolution and progress, such as health and the quality of our air, food and what we drink. When we design society using those core values it will have a direct impact on the entire care chain but also the quality of our life and the related overall productivity of the community.

The students have been invited to the challenge to see how they can use techological instruments (such as games) to persuade citizens to participate in the health driven society. The students need to consider the fact that most citizens, and especially those who live their lives well before any preventive actions are considered, have totally different priorities than making time free for their health. What motivation will trigger them to participate? Are there target groups that are more inclined to participate than others?

A second part of the challenge is to find economic continuïty for the application of the technology by positioning it as proof of concept with measurable social, environmental and economic impact that is taken over by the consumer.

Our basic needs are in jeopardy

In Sustainocracy we defined our core values in terms of health, safety, regional cocreation, awareness and fullfilment of our basic needs (water, food, warmth and air). All our core values are at stake but when our basic needs are in jeopardy we have little evolutionary perspectives to look for. Life turns into a daily quest for survival. On a global scale the examples I use are small but when we look carefully we see them repeating themselves across the globe, affecting many billions of people. Often I am asked if Sustainocracy can help. It sure can but needs local commitment.

Water: In Bolivia 1000’s of persons queue up for their watersupplies as entire cities are running out of this basic need.


Bolivia, Peru and the rest of the Andes areas have severe water shortage

Worried scientists and local residents from the region have contacted me to see if the introduction of Sustainocratic processes could help overcome the problems by joining the hands of local governance, innovation, science and citizens. We believe it can but again needs local willingness to build the groups around water, health and cocreation. We can help with level 4 regional development but cannot take over responsibility.

Air: Over 476.000 yearly premature death are counted in Europe alone due to poor air quality, especially in urban city environments. In New Delhi (India) one of the worst ever periods of smog was lived through these weeks. The local government declares air pollution an emergency but continues developing their cities based on economic growth rather than health. Sustainocracy was explained in februari 2016 in New Delhi upon invitation of the Indian government but no proactive attitude has been seen sofar. We have AiREAS to help out but need local commitment.

Food: Today in Dutch newspaper: Over 30.000 plants are good for human consumption but our food supplies have fallen into the hands of speculative industrial food processes that concentrate on 4 mainstreams that provide 75% of our daily calories: wheat, corn, soja and rice. Our landscapes are ruined due to manipulated monocultures of this type of food, often with patented seeds controlled by multinationals ruining also our farmers, using pesticides, fertilizers, etc. Worried scientists admit that we leave the soil behind for our kids in worse shape than ever.

Warmth: Rosa, an elderly lady of 81 in the township of Reus (Spain) has become the example of heartless policies and unjust inequality in the capitalist communities. Rosa had no money to pay for her electricity bills and dies when her matress caught fire when she forgot to blow out a candle. Local sources say that a law had passed that prohibited energy suppliers to cut off poor people from supplies during winter time. The gas company had done so anyway claimen their unaware nest of her poor situation. Whatever the background and reasoning behind all this it shows us and the world how vulnerable we all are of external supplies and the behaviour based on self interest of enterprises and money driven governance.

It always happens to someone else, until one day it happens to you…….


Co-authors and enablers celebrate their AiREAS publication

Phase 3 of the healthy city project named AiREAS was focused on getting civilian engagement with the challenge of reducing the air pollution in town and improving the integral environmental and human health of the community.  The results of nearly 2 years of investigation by scientists, civilians, civil servants and social entrepreneurs has been written down in this open access publication. It has become common practice in AiREAS that those who had a leading role in the process also co-author the publication of the findings. For some it is the first time their name is attached to a global manuscript. Others are already being referenced as authorities in their field of (scientific) expertise. It is also common practice that successes are being celebrated together with the enablers of the project. These enablers coauthored phase 1 of AiREAS which was published earlier this year. On the group photo, from left to right: Jaap Ham, Hans Verhoeven, Eric de Groot, Nicolette Meeder, Dilek Demir, Jean-Paul Close, Rüstem Demir, Edwin Weijtmans, Marco van Lochem and John Schmeitz. Missing are Mary-Ann Schreurs and Pierre Cluitmans who were bot travelling.


Hardship and Posttraumatic Growth

By chance I received a copy of the booklet titled “Exploring the Psychological Benefits of Hardship” and  subtitled “A Critical Reassessment of Posttraumatic Growth”. This combination of possible benefits of diffulties people endure combined with the idea of some kind of posttraumatic “growth” triggered my curiosity. Both authors are academically related to psychology one in the UK, thè other in the USA.

My own contribution to this analysis of human reaction to hardships is based primarily on my own personal experiences and subsequent analysis of my own path ahead, the intense changes that I went through and finally the introduction of a totally new societal resonance named “Sustainocracy”. My reaction to my hardship may be less common and extreem but nevertheless one to take into account. I took the positive drive forward but equally imagine people taking the other way and lay their hands on themselves or others in the purest of frustration, sense of impotence and desire to make a statement.

Subsequently I encountered many people who had gone through similar processes and had adjusted their lifestyle enormously ever since. In a way it has become so common now that we are even looking at a global new type of energetic resonance with meaning that is emerging. It is good to see that academic attention is paid even though maybe some extra orientation is needed to get to more useful and practical insights.

First I would like to come to terms with the science of psychology. What is this?

Psychology, according to the definition in Wikipedia, is the study of behavior and mind. In my own interpretation I’d like to refer to psychology as the analysis of the huge diversity of ways we human beings (and communities) process consious and subconsciously, and react to, sensorial stimulus we receive.

The conscious perception of our surroundings is highly conditioned by the way we grew up and received input from our parents and surrounding culture in early family life. This also determines the way we tend to learn how to behave through external advice (parents, grandparents, school, on the street, in clubs) as a kind of do’s and don’t list of behavior. Our level of interpretation of reality is hence colored after birth by our human surroundings as we grow up. It determines what we sense as normal and abnormal. Gradually our field of perception broadens as our mobility into the world expands. Still we interpret our perception largely against the molding of our childhood. This has provided us with our behavioral spinal cord against we measure our interpretation of what is good or bad. 

Through trial and error we experiment with life with the comfort of adult guidance helping us forward, including when we make “mistakes”. I parenthesize the word “mistake” because it is often measured against a cultural standard of right and wrong which is always subject again to interpretation. In modern times of television, internet and travel our views on cultural differences, languages and alternative ways of interpreting the same reality have become accessible to all human beings. At any stage in our lifetime we can get confused by such diversity and have to somehow try to make up our mind.

The moral and ethical challenges today of interpreting the inputs we receive while defining our standpoints is affecting us all, some much more than others.

Hardship and trauma are states of mind that are very common, even necessary and usefull in living our lives. They always affect our way of looking at reality, in fact, without it we would probably never learn or progress. Let us try to define these terms:

Hardship means the sense of trouble or difficulty.

Trauma refers to someone being psychologically, physically or emotionally hurt or damaged. Some specialized websites segment a trauma further as:

a :  an injury (as a wound) to living tissue caused by an extrinsic agent

b :  a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury

c :  an emotional upset  

The psychological benefits of hardship are not just obvious, it is a fact of life and sustainable progress through a permanent learning curve. A child that wants to stand up to walk, because of a genetic impuls in the unconscious or through semi-conscious emulation of the behaviour of it’s parents, will encounter hardship. It is tough to stand up, to balance, to start walking, avoid falling down and not bump into all kinds of obstacles. The hardship is obvious as the child experiments and the joy of achievements is not just of the child but shared as encouragement by all involved.

When the new born child wants to communicate hardship is encountered too. For instance when a baby is hungry it does not experience it as hardship but as a trauma. The baby has no sensitivity yet to overcome a difficulty consciously because it is totally dependent on help from its surroundings. Hardship is not yet a state of mind, yet trauma is, in the sense of perceiving an immediate biological need that cannot be obtained or solved by oneself. The baby cries or screams to get attention for its needs and learns how to use these communication skills effectively through action and response. A young child that falls and hurts its knee will react again from trauma rather than hardship. The screaming and crying are a reflection of its state of mind after the incident. The child is in shock and the pain extends to much more that just the knee. As the event repeats itself the child builds experience and self confidence. It gradually converts trauma into hardship and eventually as nothing at all once it has learned to be cautious, careful and persistent.

As we grow up we learn to become more self-sufficient over time, helping us to convert trauma into hardship. We reduce our screaming and enhance in our dialogue. As we become more and more experienced we tend to live life as a chain of daily events that are under a kind of automated control, providing us with our basic needs (and possible extras) without the perception of hardship or trauma. In such cases, as common in our modern western lives of wealth, we tend to look for artificial ways to stimulate our needs for drama and excitment through adventurous holidays, our visits to funfares and attraction parks, by watching scary movies or through use of drugs.

Elimination of fear

In essence we tend to build our adult securities around the elimination of our fears and risks. The natural basic benefit of hardship is that it motivates us to do something in a new and different way while learning along the way through the accumulation of experiences. Hardship, in the sense of overcoming trouble and difficulties, or creating a sense of sustainable elimination of fear, is hence a motivator for innovation, especially when the size of the trouble or difficulty to solve is sensed within the scope of feasibility (Yes I can) of the individual or group (Yes we can). Over decades national governance evolved into risk avoiding care systems that eliminated nearly all hardship for it citizens surrouding them with social securities and services. With such environment the psychology of behaviour and state of mind of the people involved is one that considers peace of mind as a civil right, not something born out of severe hardship and trauma in the past. It is not something to work for as a commitment to sustain such wealth, it is something you can demand for as consumable right. The psychology to address life through a learning process of trial and error is replaced by a psychology of apathy, greed, fear and risk avoidance.

Trauma as cause of personality change?
The book of reference had triggered my own reflection about hardship and trauma based on my own experiences, resulting in years of anthropological and sociological experimentation and analysis as a consequence. Unfortunately the goes into a great diversity of trauma’s of different degrees of intensitie with the intention to find potential indicators or a common denominator that leads to a possible and significant change of personality. The authors had evidence of such change of personality in a large variety of situations and wanted to see if there could be a scientifically valid explanation of such change.

My own description of what seems to be a change of personality is the moment of an individual breaking through into a new resonance with our surrounding reality. In my experience it does not change a personality, it changes behaviour due to newly acquired and deepening insights after the trauma of making intense personal decisions. The choices are a voluntary exercize even through the situation one goes through may not be voluntary. Think of a divorce, leaving a job, setting off towards a new place to live as a refugee, supporting an abortion or euthanasia, a near death experience, loosing a loved one, etc.

The process of making the intense choices is usually experienced as extremely traumatic and hurtful. This is caused mainly because one is on the verge of leaving a way of life that offered a particular level of security and enters a twilight zone of insecurities that seem necessary but highly emotionally conflictive, risky and fearful. When we then position ourselves beyond the trauma of making the decision, survived and made a new living, the person in question seems to be totally different from the one before the event. 

The trauma lived through and that marked the person has three stages: the reason why, the choice and the process after the choice. This I tend to refer to as “the context”. Without proper context definition when using the three stages the analyses of the psychological change of personality is impossible. Why would a person leave a particular lifestyle to upset his or her life dramatically and then set out to build a life based on totally new criteria? This why question therefor always leads to a context, not just the trauma.The book lifted one specific situation out, the possible traumas of refugees.

The psychological trauma refers to a voluntary, often self inflicted or unavoidable state of mental and painful chaos in which there is no way back while the way forward is full of insecurities. 

Analysis of the different types of context (war, divorce, near death, severe injustice, etc) may even show the unlying commonality of them all. It can lead to the finding of common denominators that were still left open ended in the book. The sense of mental, physical, emotional chaos between the life that one lets go and the one that lies ahead yet remains undefined, is a commonality I found among many people like myself. At one stage we were part of a mainstream of post war adults living life on the bubble of societal mainstream reality. Once that bubble was burst we needed to come to terms with our new interpretation of reality, not the one imposed on us by history and our surroundings. A severe inner burst of emotions got us to redefine our own core values. The process of letting go of our previous set of values and the acceptance of the new is also the explanation why we suddenly seem to be reborn as different persons. We are not of course. We are still the same as before, we now simply process the stimulus from our surroundings in a totally different way. The trauma is sensed as an awakening, an illumination, a liberation of all types of blockages. In essence we have transformed from half dead wired robot into a living human being. A lot can happen in between that can be sensed as injustice, immoral, ethical wrong or as personal drama. All this needs to be processed mentally and emotionally. If one succeeds, without leaving behind a sense of hatred or blame, one may discover a new level of inner empathy, love and forgiveness.

Many people are now populating the emerging world of emotional and spiritual freedom encountering again the unmanipulated reality of hardship after the trauma of re-birth while building up again new securities based on love and strength. For us the traumas and hardships have had indeed a tremendous psychological effect. It enhanced rather than changed our personality as we all sense now our true human self leadership of our choices instead of a manipulated reality of interests of others.

The only word of this book that still remains to be valued is “growth” in relation to our postraumatic reality. What does growth mean? It tends to refer to something getting bigger, but what would get bigger? In the book I could not find a clear understanding of what the authors were looking for. In the reality change that I refer to growth may apply to a level of “understanding” the realities of life. Or the possible new growth into a sense of self sufficiency. But growth as what? Full human beings? Recovery of what we once were or the full establishment of what we become afterwards? 

Our levels of interpretation of what we perceive and process have changed. It is difficult to accept this as growth as it is better defined maybe as a deepening process. We do not see it anymore as an individual “curiosity” but an evolutionary progression that affects many people and even entire communities. 

People who are still functioning in the “other” structured reality tend to look at growth from an economic perspective and accumulation of material possessions. That sense of material wealth has been replaced by the personality changed individuals into the wealth of trust and cocreation. There is no need to have anything when we have lost everything once before and learned to trust the ability to create whatever we need in close and productive relationship with our environment. This provides this sense of freedom and inner rest while we see all those others still absorbed by anxiety and fears. The word “growth” in psychological sense after such traumatic experience hence only has relevance when accepting the evolutionary voyage of which we may have been pioneers and now become a new mainstream.  

Those who have gone through the intense process have a sense of gratitude that it happened even though we all had to cope with intense suffering. At hindsight this suffering is easily placed in perspective as our new reality grows in presence and networked encounters with others. Giving it a proper position is also a matter of time and evolution. In the beginning we would still “blame” the past and its manipulative players of our misfortune. Then we evolve in understanding and “embrase” the present and future through self leadership. The past becomes an essential part of what we became as if we transformed from catepillar to butterfly, the same species but in a new jacket and reality, we don’t crawl anymore, we fly.

The book leads to new discussions and this is always positive. It is of course an analytical choice to weigh the convergence of trauma and growth more than context and psychological transformation. The first has the tendency of throwing all possible traumas into a bucket and see if we can find evidence of personality changes and even some types of growth if we care to define what growth means. From a scientific point of view this type of generalized work in progress is valid but it does not get us any further than the overall conclusion that “there is something there, we still don’t know the details, more study is necessary”. The latter requires choices of scientific focus that delivers more usefull conclusions through context definitions yet requires the need to explain the focus. This is only possible when the researchers themselves understand the practical circumstances, maybe from personal experiences, rather than merely theorizing observations.

The evolution of society through Sustainocracy displayed at city hall Eindhoven during Dutch Design Week 2016

It may seem a paradox to show an emerging, new governance and societal interaction model in the midst of the 160 year old party political democratic system of the city hall of Eindhoven. But that is what evolution is all about. The symbolism of progress, even if the new replaces the old, simply because it is better suited to address the challenges of our era, is worth contemplating with joy and sense of opportunity and faith. Just look at the pictures below. On the wall we see the portraits of all mayors of the city of Eindhoven since 1850. They look over the exposition as a reflective token of the evolution of time, from the military uniforms of a non-disputable hierarchy, up to the new era, on a new wall, of the emerging participation society…..

Our demonstration was simple. A table at the center of the exposition remained empty, symbolizing the challenge of dealing with reality without prejudism, hierarchies, stacks of money or power positions. We place the core human and natural values on this table as defined in our new democracy referred to as Sustainocracy. Together with the four pillars of any society (government, citizens, scientific knowledge and innovative entrepreneurship) we look at our reality from a core values perspective and define our priorities for changes together. Visitors could experience such values driven interaction by simulating it using their own local priorities and issues of great concern.

Around the table, in the hall we then show some of the spin-offs of such innovative drive, each changing our society and its functioning while inspiring the world through its cocreative progession and measureable results. This was the layout of the central table and the surrounding spin offs.


The city council room was left aside as a symbol of the past in which party politics and economic priorities took our attention away from our core values. A new center of debat had emerged, the sustainocratic, multidisciplinary table of shared responsibilities…..

During the 9 days of exposure we received over 1000 visitors from our own citizen’s collective and from many other local and international communities. These visitors from across the world joined our sustainocratic table and got inspired to take the ideas home with them. We organized a civilian participation debat in the council’s room. This also evolved with international presence (Spain, Turkey and Afganistan). Six points of attention were joinedly defined and drawn up as a manifest to our community level 4 leadership (awareness driven eco-system) to enhance our progress even further:

  • Acknowlegde and value social entrepreneurship,
  • Find ways to make the huge impact social entrepreneurship indexed and measureable,
  • Engage citizens to the core values at city neighborhood level
  • Dare to be ambitious when dealing with the core values. The silent majority needs to be considered in the progressive plans, not just the strongly heared conservative voices,
  • Involve the younger generations through participative learning processes,
  • Exchange inspiration, experiences and best practice among the other communities in the world which too are engaged in this evolutionary challenge…..

Many visitors reacted both suprised and committed: “It exists, you are showing it here in Eindhoven, so now we want this too!”

Dutch Design Week 2017 goes global. Contact me by reacting to this blog if you want to engage with Sustainocratic progress and join this week in october 2017 with innovative initiatives, seminar or congress participation, etc.

You cannot buy responsibility


Current generations don’t decide on our future anymore, we decide our survival

We live in a very special timeframe within the evolution of our human species of the last 200.000 years. We used be worry about our future but now, in a very short space of time (years rather than decades), we need to decide collectively about the survival of our species.


My view of the minimum time we have to redefine our human attitude towards life, expressed in years rather than centuries

We have clearly passed the survival threshold while holding on to a consumer mentality within a speculative economics environment of capitalism. The only way out is awareness driven interaction based on core human values as well as redefining our material dependencies. Remedial response does not work anymore. It is like mopping the floods with the taps still open. It is however still the policy of our funds driven governance, lobbied ahead by the unjustifiable promises of heavily subsidized semi-government structures and powerful materialistic organizations of individualized material greed.

Proactive living labs such as sustainocratic STIR, AiREAS, FRE2SH etc have the solutions at hand while proving concepts over and over again in yearly timeframes rather than decades. The main obstacle is the type of society created after the World Wars, which was thought to be the best solution ever from that early awareness breakthrough. It now is the representing the biggest obstacle for transformative change.

Time is pressing.   80 years ago we still had decades to find and implement solutions, now we have years at the most. BUT: We have solutions now that we did not have 80 years ago. It ‘s time to evolve through awareness driven living labs while using the findings fast. Question is: can we do it fast enough?