How Does Change Happen?

Tom Guarriello recalls moving patients at a 1968 hospital by geographic location, which unexpectedly shrank the patient load and helped people return home. He argues small structural changes, like the internet or microloans, can trigger massive shifts. Real happiness comes from meaning and connection, not purchases.
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Mm. Well, hi, good morning, it's Tom Guarriello. You know, as far as we know, we are the only species that has the capability of reflecting on its own existence. It's New Year's Eve Day. As a species, we have this characteristic, this pattern of reflecting at moments that mark big transitions. And for us, because our lives are so short, minuscule in the scheme of time, years passing are opportunities for reflection. So we all, many, many, many of us, take a minute and stop to do some reflection as the year changes. And the thing I wanted to reflect about a little bit today is about some things that I heard in a video by The Red Skull. Interesting video called Haters, Hunger, and Happiness. And I'm going to deal with the latter two of those in my reflections here. First, I want to start by telling you a story because this story has meaning for me in terms of how change happens, at least my experience of seeing change happen. When I was a young man in training to be a psychologist, I worked in an institution for the seriously mentally ill. This was Dayton State Hospital in Dayton, Ohio. And it was 1964, and in 1964, the mentally ill, seriously mentally ill, were in the main institutionalized, kept in these large state-run institutions where, um, conditions varied a great deal from state to state, from the most modern to the most horrible. And even within institutions, conditions varied from progressive to essentially warehousing kinds of conditions. And so in 1964— I mean, I'm sorry, 1968— here I am, a young psychologist in training working on my master's degree at the time, and a young chief psychologist, relatively young man, and his wife came in to institute some new programs that were in line with President Kennedy's, at that time, of course, the late President Kennedy's vision of the changing of the mental health system had dictated. President John Kennedy had instituted a whole new system of providing mental health care in America by dividing the country up into geographical areas, uh, which then had, uh, agencies and organizations, uh, within them which were responsible for providing care for the residents of that area. They were called catchment areas. And, um, that law had come into effect in '66. After Kennedy's death. Lyndon Johnson had continued Kennedy's vision. It came into law in, in Ohio and in Pennsylvania, places that I knew of, and around that time. Others were earlier. But anyway, at Dayton State Hospital in 1968, what we were doing was we were taking the population of the hospital, which at that time— I don't remember the exact number, but I'm going to say it was about, uh, 6 or 7,000 patients in this huge institution. And what we were going to do was instead of having them housed on their, uh, according to the chronicity of their illness, in other words, the length of stay in the institution, instead of housing them that way, we were going to change their physical distribution according to the catchment areas that they would live in where that they came from according to this new scheme, this new way of dividing the country. So one day, and probably one of the most remarkable days of my life, on one day, what we did was the entire population of the institution, anybody who was ambulatory, anybody who could walk, and see, even some who couldn't, there were people in wheelchairs, were going to move, and they were going to move from their old bed, their old ward, to a new place in the institution where they were going to be living. And that day was an incredible day to watch, you know, 7 or so thousand seriously mentally ill people gather their own belongings, you know, with lots and lots of supervision from everybody in the institution, gather their own belongings, and then move themselves to their new unit and their new bed and their new surroundings was a remarkable experience. It's something, you know, I mean, it was frightening because we didn't know what was going to happen. It was— well, it was a remarkable day. Now, what that— here's what happened. Within a year The population of that institution decreased by about a third, and within 3 years— 2 years, I was gone, then 2 years later— it was reduced by about half. Now, many, many, many of the people who I saw on that day moving from one part of the institution to another, many of those people had been in the institution for literally 20 years, some of them longer. And nobody had— nobody— it would have been naive to believe that any of those people were going to ever be able to get out of that institution. It didn't look like it. The prognosis was poor. What happened was that in their new surroundings, many of these people reconnected with themselves and with others in their environment, in their community. Of course, we did a lot of work to establish a network of support and care that would be able to enable people to to get out of the institution and to live in the community. And many, many did. Many did. And it was remarkable. Now, there was no good reason to believe that those events would really lead to the kinds of outcomes that they led to. Red Skull says that the internet and YouTube, it's naïve to believe that these kinds of connecting media will change the world, will open up the world. And it's— there's no good reason to believe that it will. There is no good reason to believe that it will. However, if you believe that change can emanate from unexpected sources and that we all have a theory of change somewhere in our mind that we carry around with us. Change on a small scale, personal change. Change on a larger scale, family kind of change. Change on a macro scale, societal change. We all have an implicit theory of that that we carry around with us. Some of us believe that change will only come as a matter of overwhelming force and energy. That you have to pour tremendous amounts of energy into a system in order to change it. Others of us believe that change is— that systems, living human systems, are inherently complex and unpredictable. That change takes place as a result of events that on their face did not look as if they had the potential to create that change. Small things. And I think that I experienced that in this day and the years that ensued, that what looked like an exercise in bizarre, naive futility, moving these people around, simply moving them around from one place to another, and and all of the ensuing things that happened— we didn't just move them around from one place to another, after all, we treated them differently— that perhaps the kind of connectivity that is enabled by what goes on here, not just on YouTube, but the connectivity among people that internet, um, that the internet is enabling perhaps can be a part of a non-predictable kind of change that can take place in the world. And by the way, people are not going to need computers in order to connect with one another in this sort of way very soon. Cell phones are the fastest growing technology on the planet, and connectivity with cell phones is already transforming cultures. It's transforming the economics of a place like Bangladesh. If you go take a look at the recent Nobel Prize, Peace Prize winner Muhammad Yunus's organization, the Grameen Bank. You'll see that Grameen Bank has changed the way the economy of large portions of Bangladesh work on the virtue of microloans. And microloans are, again, from a change perspective, it's naive to believe that loaning a woman $20 was going to be able to have any impact at all on her, on her family, on her village, or on Bangladesh. But the fact is, they are— it is having dramatic impact on those places. So I certainly understand the Red Skull's questioning of whether or not it's naive to believe this, and perhaps it is naive to believe it, but this is something that I believe. I've had experience seeing change take place in this kind of fashion, I believe it's possible for it to happen again. And that relates to the second— the third of Red Skull's three parts of his video, and that is happiness, in which he says, look, you know, he was describing a wealthy person who was angry and obviously unhappy. And so, you know, his question is, well, what makes a person happy? It's become kind of common parlance to say, you know, money can't buy you happiness. Well, you know, money can buy you happiness. There is a certain kind of happiness that money can buy. You buy a— you get a new bigger house. Are you happy? Yes, you're happy. You get a new car. Are you happy? Yes, you're happy. You're really happy. You're not fakely happy. You're really happy. But there is a kind of happiness that money can't buy. For me, that kind of happiness emerges from meaning and from understanding. Things mean something on the basis of a set of beliefs and a set of values. Money can't buy you beliefs and values. Money can't determine whether or not you you're going to develop understanding and compassion towards others. I think connectivity can— is a great invitation to understanding, meaning, and happiness. And so I think that for me, at this point in thinking about the new year, 2007, what I hope happens in 2007 is that we increase the degree of understanding the degree of compassion, the depth of meaning that each one of us has for one another in our lives by virtue of connectivity, and that that connectivity is taking place here, it's taking place on the internet, it's taking place face-to-face. And so I think it's important that we think about how we're gonna contribute to that greater overall personal happiness and happiness for others at this kind of moment when we stop to reflect. So, Retsuko, thanks. That was an interesting video to think about. And everybody, Happy New Year. It's been a great experience for me getting to know you all and watching and listening to you all, and I look forward to much, much more in 2007. So, thanks again.










