Nouns and verbs

Innovation      Leadership    Competition     Efficiency    Choice    Resources    Strategy     Quality

Scholars tell us that 3000 years ago our vocabulary included far more verbs than nouns – we talked in much more fluid ways than we do now of processes, behaviours and actions. Now we refer to what we see around us in terms that are more static and rigid – as nouns. What does this difference reflect? And is it helpful to review our own use of language?

I think it may be crucial.

Something seems to happen when we describe activities as nouns instead of verbs, the energy levels change for a start, but thre’s more than that – see for yourself whether that’s what you find.

Think, for example, of ‘leadership’ and then about ‘leading’.

Typically, I find people’s lists look like this:

Leading:

•   relating and connecting
•   talking and listening
•   supporting and challenging
•   caring

Leadership:

•   creating a compelling vision
•   developing and delivering a successful strategy
•   managing performance
•   effective communication strategies

Leading feels active and fleetfooted, leadership somehow feels heavy and more pedestrian. And this seems to happen whatever example you choose – its quite fun to try it with any verb and its associated noun.   Nouns seem to beget nouns, and verbs more verbs. Nouns give us more things to think about, more nouns – like vision, strategy, and performance – and indeed they can keep our brains happily occupied for hours. Verbs give us a sense of action and energy, of fluidity, contingency, flexibility, of possibility. Verbs keep us interacting with others, having to draw on our courage, judgement, integrity and discretion as we do so. Nouns rely on brainpower alone.

The simple hard and the complicated easy

Years ago I came across the distinction between what its author (an ex US Marine) described as the simple tough and the complex easy. Translating them into a UK usage and reserving the term ‘complex’ for the more specific meaning it has within complexity theory, I’ve called them the complicated easy (activities which use lots of  brain power but little else – doing an analysis for example)  and the simple hard (simple to describe, hard to implement because they require all the rest of you, your courage, judgement, integrity …..  For example having a constructive conversation with someone about something they won’t want to hear).

For a long time I said that both were needed, but increasingly, as the complicated easy steadily drives out the simple hard in all our large bureaucracies, I wonder whether it is needed at all, whether the simple hard is enough. And over the years I’ve come to see, too, that thinking in verbs is one way of helping us stick to the simple hard and not be seduced ( as we so easily are) into the complicated easy.

Do all nouns fall into the complicated easy class? No, I think concrete nouns (like ‘leader’) while not as active as ‘lead’ and ‘leading’, convey a sense of sold reality  in a way that ‘leadership’ doesn’t. So while its helpful to rethink our phrases to include as many verbs as we can, a few concrete nouns won’t mislead us. It’s the abstract nouns that do  – so it’s here that danger lies.

I suggest abstract nouns always tend to lead us towards the complicated easy: away from real personal engagement and towards logical arguments. More than this, I suggest that they fuel our fears, and that because we become more fearful when we think in those terms. we all too often devise strategies that turn those fears into self fulfilling prophecies.

Lets look at an example

If we think of the NHS in terms of abstract nouns like money (one of the most powerful abstract nouns we have), and structure, we can quickly convince ourselves that we don’t have enough of the former and that we must therefore reconfigure the latter, and we begin to talk of rationing. (And interestingly we use rationing here as a noun rather than a verb.)

If, instead, we focus on what it is that money buys, we talk of people: people doing things, people caring for and about other people. And instead of structures we see connections between people, the conversations that support and challenge people, that give them freedom within boundaries, that hold them gently and firmly to account.

Then we begin to see possibilities as welll as worries, and we behave differently. We aren’t cavalier about connections and conversations in the way we are with structures. We don’t leap immediately to rationing, we are thoughtful instead about how we and others can use our time and talents wisely and with care, and we find all sorts of other ways of meeting the needs we know are there and care about meeting.

So abstract nouns are dangerous

Think of innovation, competition, efficiency, choice, strategy. All nouns that economists and Business Schools have loved to formalise for us, think about logically, and develop new theory about.
(Right now, as I write this, the NHS is strongly influenced by the work of two Harvard professors, Clay Christensen’s thinking on innovation, and Michael Porter’s on competition and strategy.)

Typically management consultancies then sell us implementation programmes based around the ideas – all very logical, very appealing to brains – less so to our emotions. They will also help Inspection Regimes devise monitoring tools, to see how well management teams are implementing  the concept.

As an historical example, think of World Class Commissioning – a McKinsey product. Think of all those descriptions, all those competences, all those lists, all those kinds of evidence…
Compare that with the early days of Primary Care Groups when commissioning was new and still a verb, when there was real energy on the ground.

‘But, but, but …’ you are expostulating, ‘commissioning is so much more advanced now, we’re so much further forward, and we’re well on the way to being able to really change things ……, we just need more ………’.
But that is always the cry of the advocates of complicated easy programmes: it is always ‘going ‘ to work, with a little more …. something…….

If you think about your history in the NHS, I think you may find you have come across that? And not just the NHS, think how austerity programmes were/are going to resolve the problems of Greece, Portugal and so on – tomorrow, always tomorrow, (this has been described as the standard  ‘sado-monetarism! of the neoliberals!

Theories not facts

We must remember that these theories based on academic thinking about abstract nouns are just that: theories, ideas. And we should hold them lightly, test them our, always keep them under review. After all, we are not in  territory here where evidence is abundant or helpful.

No? You think there is evidence that will  help? Time for another distinction.

Puzzles, problems and messes

In the 1970s, systems theorist Russell Ackoff defined a puzzle as a situation or conundrum in which there is a right and a wrong answer. He saw a problem as a situation in which there is no right or wrong, just better or worse ways of proceeding. And a mess is when you have a complex system of interacting and interdependent problems.

For a puzzle we can establish clear cause and effect links straightforwardly and  use RCTs to help us choose between diffferent ways of resoloving our dilemma. A problem is not quite so straightforward but there will be experts who have formed judgements about better and worse ways forward and we can consult them. But in a mess the system is so complex with so many different puzzles and problems interacting with each other that the situation will be different every time, and the best we can do is ‘muddle through elegantly’.  And most of the time we are operating in a mess!

(Dave Snowdon of Cognitive Edge is very helpful on the different kinds of evidence and leadership that is needed in these different situations.)

Let me say that again:  in a mess we can be actively misled by the kind of evidence that can be established and used in a puzzle, and by the professional expertise that can help guide us through a problem. Here we are in the territory where ‘muddling through elegantly’ is the only way.

Of course this will be anathema to those who see the world only as a series of puzzles and problems. David Nicholson, for example, always decried ‘muddling through’ as a solution to the future of the NHS, preferring instead to treat this as a puzzle.

The importance of remembering that theories are not facts

So let me say it again: in complex systems (messes) theories/ideas can only be that – they aren’t facts, there is no proven link between cause and effect. And it might be worth remembering some of the ideas we’ve acted upon as though they were facts:

• the calorie theory of obesity (now under challenge)
• the cholesterol/saturated fat theory of cardio vascular disease ( now ditto)
• that merging back office functions saves money  (almost always followed 6-7 years later by the fact that disentangling shared services is much more cost effective)
• increasing efficiency reduces costs (it doesn’t, some defined parts of the system are done quicker or cheaper but inevitably cause higher costs overall)
• the wholesale introduction in many businesses of Business Process Re-engineering (now widely seen as a total and hugely expensive failure)
• the Washington Consensus as the means of preparing  developing countries for globalisation (widely castigated)
• choice and competition lead to increased quality and affordability ……

If we look at these initiatives  we can notice that we often measure their success by looking at a proxy outcome rather than the one we care about. For example we don’t measure the reduction in cardiovascular incidents but cholesterol levels. We don’t look at whether public services are increasing in quality and affordability but whether we have introduced choice and competition.

If we treated them as theories instead of as facts we would behave differently wouldn’t we? We would proceed with care, we’d measure the outcomes we truly cared about, we’d assume that in different circumstances things may be different and adjust an implementation accordingly. We might stop top down change and allow local teams to make decisions based on an understanding of the theory and of their local setting.

The future is as messy and complex as the present

A large part of the problem is that reality, the complex world around us of which we are a part, is so vastly, mind-bogglingly complex we cannot grasp it logically, cannot describe it, cannot fully understand it. We can usually sense more than we can describe, but muddling through is all we can do, that is after all what living is all about.

We can build islands of puzzles in this swamp of mess, and for each island we can establish evidence of some cause and effect relationship. But then are tempted to string these isolated islands together into a logical argument that we find very appealing – perhaps because it renders that complex mystifying reality tame and amenable.
Pursuing the logical ideas developed in Business Schools is attractive because it avoid us having to understand the mess around us and allows us to focus instead on a simple, logically described, imaginary future. When we get there of course it is not like that at all, it is just as much a mess as the present.

What do I mean? let’s look at an example, let’s think of the current ‘solution’ to the financial problems of the NHS: closure of local hospitals in favour of increasing care closer to home and the development of much larger specialist centres.

It’s an idea. Based on just the kind of ‘islands’ of evidence I’ve just described. There is a logic to it, and if the only things driving the behaviour of this massively complex system (relations between the NHS and the UK public) were logical choices within a few carefully described situations then this might work. But reality is SO much more complex than that, behaviours aren’t logical, situations are never as straightforward as they seem in prospect,  and there is simply no chance at all that what happens in practice will look anything at all like the picture described by the planners.

So what can we do instead?

Suppose that instead of using logic to try to  build a nice (logical) attractive but unattainable future we attended to understanding and responding to the present? Suppose we used a simple hard approach rather than a complicated easy one? Suppose we used verbs instead of abstract nouns?

For example: instead of lots of theoretical thinking about ‘innovation’ (abstract noun) we might talk of real people wanting to offer the greatest help to their patients and constantly looking for better ways of doing so (lots of verbs and concrete nouns here).

Then instead of setting up Institutes and developing Diffusion Strategies and Programmes to address the ‘Gap’ between research findings and uptake (all of which are not only complicated easy but hugely expensive), we would talk with people, make sure everyone had regular ongoing conversations with people more experienced than they, about how they are doing, about new ideas, about what is valuable about existing practices as well as what can be done better and differently. This is simple and hard, and it can happen alongside other activities so it doesn’t cost money, what it needs willingness, courage, interest, and judgement.

If we really attended to the present, we would look (really look) at what stopped people being more proactive, and we would find all sorts of things. We would realise that one of the biggest barriers is the status differences between different professions, and the fear of speaking out that this engenders. When we understood that we could teach people how to use their status wisely and well, and not unwittingly abuse it, and we could help people know how to recognise the difference when they see it in others, and give them permission and support to challenge if they choose. You see? paying attention to the proesent takes us in different directions from thinking about the future.

These sound like semantic differnces but if we change our language, we stay with the simple hard, and if we stick ot the simple hard we attend to the present rather than the future, and   we change what we see as important,

Try it for yourself
Think of something you know needs improving. Take a piece of paper and write the heading ‘innovations to improve X’. Make your list.

Now put that on one side and think about what it is you really care about here. Picture it in as much detail as you can. Why X needs to be better. What good kinds of better might look like. How much you want it to be different, what is getting in the way of it being different, and what you value about the way it is at the moment. Try and use verbs to describe things.
And then see what happens. See if often over the next few hours and days you come across all sorts of ideas, snippets of ideas, thoughts, ways forward, in all sorts of unexpected places. See if these build into something very different from the list of innovations you made. Often when we clearly understand the problem and care about it being resolved we become a sort of fertile ground and we find and grow all sorts of seeds!

Is that what you find???

Valerie Iles

1 September 2014