Abstract

In his thoughtful commentary, De Bruin invites us to say more about the notion of causation in our two-dimensional model of self-management in health care. In particular, he thinks there is a tension between 1) self-management-as-facilitation being causally efficacious and 2) “surgical” self-management interventions on specific variables being practically impossible in psychiatric conditions due to their complex dynamic nature. In particular, he asks us: “How can we establish the causal efficacy of these intentions if we are dealing with complex dynamic systems that do not allow for precise surgical interventions?”. The assumption seems to be that one can only...