1
Introduction
Many of the major players in health and wellbeing research have made multi- and interdisciplinary research a priority. These include: the World Health Organization (1986), as stated in The Ottawa Charter; and the European Commission (2014), as stated in Horizon 2020, a framework for health research and technology. In the fields of health and wellbeing, this acknowledged need for interdisciplinarity is often framed as a call for interventions guided by the biopsychosocial model, originally developed by George Engel in 1977. However, as we explain in the section on the antinomies of contemporary interdisciplinarity, despite the extravagant lip service paid to interdisciplinarity, there is little sophisticated analysis in the literature that explains its philosophical necessity. Neither can it be said that interdisciplinarity has, to date, been an unqualified success. In this book, we aim to repair these shortcomings by addressing two overriding questions:
1. Why is interdisciplinarity necessary?
2. How is it possible in practice?
To answer these questions, we approach interdisciplinarity from the perspective of ontology, using a critical realist epistemology. For example, we suggest how sophisticated research procedures can be designed to enable scientists to integrate the knowledge gained from various individual disciplines. This metatheoretical approach avoids unilinear reductionism, additive atomism, and naĂŻve eclecticism alike. We also discuss the practical issues involved in achieving interdisciplinarity, such as how to encourage co-operation among researchers. We answer the question asked by some â whether there should be disciplines at all â with a resounding âyesâ. This is because the complexity required by interdisciplinarity is best achieved by an efficient division of labour, enabled by well-defined disciplines with clearly differentiated tasks. However, the existence of well-defined disciplines does not prevent the transdisciplinary processes that eventually transcend the disciplines and result in interdisciplinarity.
The essence of our argument is that the need for interdisciplinarity is an unavoidable consequence of the open-systemic character within which practically all events occur. Critical realists, the present authors included, have begun to theorize the concepts essential for the understanding of interdisciplinary work in this open system context, such as stratification and emergence, absence and contradiction, internal relationality and holistic causality (see e.g. Bhaskar and Danermark, 2006; Høyer and Naess, 2008; Bhaskar et al., 2010; Holland, 2014; Price 2014a). However, there is, to date, no major treatment within the critical realist genre exploring the rationale or implications of the necessity for interdisciplinary work.
Finkenthal (2001) posed the question: âWhat makes interdisciplinarity possible and/or desirable?â This question can be addressed from at least three perspectives. The first, and probably the most common, is from a practical perspective, for instance, how to educate students in interdisciplinary research and how to nurture interdisciplinary milieus. The second perspective is epistemological and focuses on the conditions, possibilities, nature, and limits of knowledge production that stems from interdisciplinarity, for instance this perspective considers the challenges faced by researchers when they attempt to integrate elements in the interdisciplinary process. A third perspective is to bring ontological questions â that is, questions about reality â to the fore. From this perspective, the question posed by Finkenthal can be sharpened and becomes, âWhat must the nature of reality be like for interdisciplinarity to be possible, and necessary, and such a strikingly pervasive (and talked about) feature of our experience?â
Therefore, in this book, our argument for interdisciplinarity starts from ontology, namely, multimechanismicity (a multiplicity of mechanisms) in open systems; and moves to epistemology, namely multidisciplinarity, interdisciplinarity, intradisciplinarity, crossdisciplinarity, and transdisciplinarity. We assume the presence of a necessary laminated system, which is a stratified totality, constituted by emergent levels. Any explanation will need reference to each level, hence the need for anti-reductionism and interdisciplinarity alike. The necessary laminated system involves an internal relation between the levels or elements of a system, constituting a specific form of holistic causality. This suggests the existence of polymorphous presence, where the effects of a change or an intervention in one part of a system can be detected in all the other parts of the system, at all its levels. These effects may be of varying weight or import and contrary to one another. We are therefore concerned to pay attention to:
⢠irreducible emergence â implying levels of reality
⢠internal relations â implying holistic causality
⢠laminated systems â implying internal relations between levels of a system
⢠polymorphous presence â implying internal relations between all elements at all levels of a system.
If critical realism pinpoints the necessity for integrative pluralism, what integrates the plurality, i.e. what unifies the specific field of inquiry, preventing an eclectic empiricism of effects? It is not possible to fall back on philosophy, geo-history, political economy, art, literature, the history of Western Civilization, or reconstruction in terms of some grand narrative such as was once provided by e.g. Jean-Jacques Rousseau or Karl Marx. Conceptually concordant heuristics such as âfour-planar social beingâ â i.e. the human being in (a) material transactions with nature; (b) social interactions between agents; (c) social structure proper; and (d) the stratification of the embodied personality, including mental, emotional, and physical being (Bhaskar, 2008b: 160) â can play an important role in relating apparently discrepant but connected fields of inquiry. But it is ultimately only ex post and at a relatively late stage in any complex of investigations that we can begin to identify, in a real definition, what integrates or unifies the field. That is, it is only at a relatively late stage that we can identify the nature of the specific articulation of the mechanisms in their laminated system. Therefore, in this book, we engage in a double polemic: against both reductionism and eclecticism.
Interdisciplinarity, health, and wellbeing
Nowhere is the need for genuine interdisciplinarity more evident than in research related to health and wellbeing. For a human being is patently a totality and cannot be studied as a congeries of distinct and separable parts. Thus, a person cannot be perceived as being made up of a number of parts that relate to distinct disciplines. (S)he is a totality and therefore requires treatment in a thoroughly interdisciplinary way. The problem is that traditional medicine is dominated by a worldview that is both empiricist, which prevents interdisciplinarity since it omits the non-empirical parts of reality that are necessary for disciplinary integration, and physicalist, which reduces health and wellbeing issues to the biophysical. In order to overcome such barriers, the underlying metatheoretical presuppositions about reality need to be explicit and subject to critical reflection. In short, the rationale for this book on interdisciplinarity and wellbeing is that there is a worrying lack of metatheory in discussions on interdisciplinarity. This translates into inadequate health and wellbeing research and ultimately inadequate health practice. As an alternative, we offer a version of health and wellbeing research and practice that we call the âseven enigmas of healingâ. These enigmas are related to fundamental questions about certain health issues such as: What is it? What are its signs and symptoms? What causes it? All of these enigmas must be re-theorized once the emergence and holistic character of the processes at work are recognized. The seven enigmas offer advice on how to achieve the two functions of contemporary medicine: its scientific function, oriented to the understanding of deep (explanatory) causality; and its healing function, oriented to the well-functionality of the human being-in-activity in his or her natural and social context. Both require that we understand human beings as a âbio-psycho-social mixâ (Sharfstein, 2005).
Fully appreciating the pervasive nature of the real interdisciplinary context radicalizes the practice of health professionals. This is because it implies that a new job or location, or the working through of a fractured relationship with a parent or child, may be the answer to a physical ailment such as a skin complaint, and that a purely physical treatment may need to be complemented by a battery of other measures. For human beings are evolving laminated systems within larger laminated systems. Given our conviction that critical realism is uniquely capable of providing a sound basis for interdisciplinary research, our first aim for this book is to present critical realism. We then elaborate the critical realist implications for interdisciplinarity, which leads to recommendations for researchers, practitioners, and policy-makers.
Outline of the book contents
In Part I of this book, consisting of Chapters 2 and 3, we consider the contradictions â the antinomies â present in contemporary interdisciplinary literature. In Chapter 2, we discuss six features of interdisciplinarity commonly found in the literature, namely: its discussions of the forces driving researchers towards interdisciplinarity; its preoccupation with definitions; its reporting of the failures of interdisciplinarity; its personalistic approach; its comments on the institutional and administrative organization of the interdisciplinary process; and its bibliometric analysis. In Chapter 3 we discuss a seventh characteristic of the interdisciplinarity literature, which is that â in the absence of an adequate metatheoretical justification for interdisciplinarity â researchers characteristically approach interdisciplinary research from the perspective of their particular disciplinary focus.
Part II of this book, which consists of Chapters 4âChapter 8, is based on a series of lectures delivered by Roy Bhaskar in 2009 at Ărebro University, Sweden. These provide a general theory of interdisciplinarity from the standpoint of critical realism. Here we outline the basic concepts of critical realism and consider the theoretical arguments necessary to make applied critical realism (that is, interdisciplinarity) possible. We assume that the relevant object of inquiry is a âlaminated systemâ of a specific type. In Chapter 4, we outline the main concepts of critical realism. However, when we apply basic critical realism to social science, it is necessary to adjust its categories since these were originally developed for the natural sciences. This is done in Chapter 5. In Chapter 6, we develop the basic or core argument for interdisciplinarity. Reference is made to several contexts of interdisciplinarity, such as disability studies, anorexia nervosa, coronary heart disease and HIV education. Starting from the conditions for explanation in open systems, the argument moves through a series of ratchets from multimechanismicity through multidisciplinarity to interdisciplinarity and beyond, developing the notion of a laminated system. The basic argument involves a critique of the reductionism and/or atomism which flows from the actualist presuppositions and implications of orthodox philosophy of science. In this way, the argument is oriented against reductionism and atomism in the context of inquiry. However, it is equally oriented against eclecticism in the research cycle, in that it shows how the resultant laminated system can be progressively articulated in the process of science under the influence of empirical, or more generally a posteriori (i.e. so as to include qualitative, e.g. hermeneutic), investigations. If the phenomenon of open systems necessitates reference to several distinct mechanisms, of potentially radically different kinds, we indicate the way in which these distinct mechanisms can be intricated in a unitary explanation through the epistemic articulation of the appropriate laminated system, in a real definition of the field of inquiry. In Chapter 7, we focus on the development of critical realism by describing the seven phases of the development of understanding âbeingâ. We consider âbeingâ as such, as changing, as whole, as human action, as reflexive, as meaningful, and lastly as unity. In the last chapter of this section, Chapter 8, we further sharpen the characteristics of critical realism by comparing it with other metatheoretical positions and argue that critical realism, in its endeavour to give âthe whole pictureâ, embraces the insights of other metatheoretical positions.
In Part III, consisting of Chapters 9âChapter 15, we illustrate how interdisciplinarity can be applied in practice. Here, we are interested in the social organization of interdisciplinary research and cooperation. Methodologically speaking, we emphasize integrative pluralism which necessitates a theory of inter-professional cooperation. Specifically, we consider the development of a special theory of interdisciplinarity in health and wellbeing. In Chapter 9, âBiophysical interventions are not enoughâ, we consider those components of health care that are often disregarded because they cannot be reduced to the empirical and/or physical, such as the well-documented placebo effect, which we call the hidden (holistic) healing ensemble. In Chapter 10, âThe seven enigmas of healingâ, we refer to certain illnesses/conditions to illustrate the need for the systematic use of interdisciplinarity. In this chapter, the concept of causality moves to the fore, with its complexity in applied/concrete work being stressed. In many ways, this chapter provides the culmination of the thesis so far developed, as we attempt to show how the metatheory of critical realism can be applied in practice. Thus, in the context of each of the enigmas, we are faced simultaneously with the spectre of a disjunctive plurality of possible resolutions (e.g. in the case of Enigma 3, diachronically considered, causal aetiologies), each of which is itself composed by another kind of plurality, a conjunctive multiplicity of constituent features or facets (e.g. causes), marking the point of application of interdisciplinarity. Methodological and conceptual sophistication is an important prerequisite to clarity here. We are concerned to relate abstract questions of philosophy to the concrete concerns of healing and care. Thus, the intertwined needs for both a multi- and interdisciplinary approach and a methodologically self-conscious critical realism are brought to the fore. When we integrate our knowledge about mechanisms at different levels into a higher order of knowledge to gain holistic understanding of the totality, the interdisciplinary work becomes itself a new discipline. In principle, this new discipline can be complemented by other disciplines in a new interdisciplinary research programme. For instance, when Darwin came up with his interdisciplinary idea of evolution, this became a new discipline, namely, evolutionary biology. This discipline has been complemented by other disciplines, such as genetics, geomorphology, anthropology, and linguistics. In Chapter 11, âThe biopsychosocial approach, with special reference to the International Classification of Functioning, Disability and Healthâ, we analyse and constructively critique the World Health Organization (WHO)âs International Classification of Functioning, Disability and Health (ICF) as a concrete example of how research in health and wellbeing can be approached in an interdisciplinary way. In Chapter 12, âThe practical organization of interdisciplinary co-operationâ, we consider how best to do multi- and interdisciplinary research. While the difference between multidisciplinary and interdisciplinary research is in principle clear, in general the interdisciplinary research project will be conducted by researchers drawn from a multiplicity of disciplines. This raises important questions for the practical implementation of the programmes described in the book. In Chapter 13, âUnderstanding methodological imperialismâ, we try to explain the social mechanisms that uphold the problematic but ubiquitous assumption that some methods or methodologies are considered to be âproperâ science, while others are considered to be less scientific or even not scientific at all. Specifically, we attempt to understand some of the language-based mechanisms by which methodological imperialism is maintained. In Chapter 14, âInterdisciplinarity in action: explaining the epidemiology of HIVâ, we illustrate the use of the description, retroduction, elimination, identification, and correction (DREI(C)) dialectic in interdisciplinarity research in a context of HIV education. In the final chapter, Chapter 15, âConcluding considerationsâ, we summarize the main arguments of the book.
The audience of the book
This book will benefit people interested in studying philosophy or the metatheory of interdisciplinarity, and people interested in or seeking to apply critical realism. Therefore, a whole range of applied researchers are likely to find it useful, from advanced undergraduates to postgraduates, to professional researchers in fields such as social work, health, disability research, and indeed any researcher interested in understanding more fully the concrete object of their investigation. However, this book is not only relevant to researchers, but to those people who apply research findings. Therefore, it will prove useful to those concerned with policy an...
