We can learn a lot about observations from quantum mechanics. At the quantum level it becomes clear that during an observation – an interaction – both the observer and the object change. You can see both as an observer, and both as an object. Observer and object change, and the outcome depends on the input of all participants and their environment, via entanglements. The coherence, the context, thereby contributes to the outcome.

When you check the tire pressure of a car tire, you let a small amount of air out of the tire, thereby lowering the tire pressure a bit. The observer, in this case the tire pressure gauge, also changes. The pressure in the device gets higher, after which both the pressure gauge and the tire share the same pressure, the same information. The observation does something to both.

The coherence we see at the quantum level can also be seen in our daily environment. In Chapter 1 we discussed the example of the container with water and the thermometer. When measuring the temperature of the water, the thermometer and the water share the same information. They are a whole for a moment, until they interact with other systems. Consider what happens when people make observations. The image we form of a situation is partly determined by our background. It is colored by ourselves, by how we have been shaped by our lives. And we keep changing with each subsequent observation.

Try to define ‘objective reality’ knowing that during an observation, both the observer and the object that is being observed change. How can it be defined?

Reality depends on our perception
In More Than Matter?  the English philosopher and theologian Keith Ward provides us with a philosophical description of the role of the observer [1]. He argues that there are no colors, sounds, smells or tastes if there is no observer to perceive them.

“Any physicist will say that brains are mostly empty space, in which molecules, atoms, electrons, quarks, and other strange particles buzz about in complicated ways. It seems as though physical objects, when not being observed, have no colours, and no sounds, smells or tastes either. Sounds, like colours, are not physical events. Neither are smells, tastes, or sensations. Things do not smell like, taste like or feel like anything, when nobody is smelling, tasting, or feeling them. The physical world, it seems, is totally vacuous. No colours, sounds, smells, tastes, or sensations. What on earth is left?”

Ward uses this reasoning in a larger story about the existence of a God. But it can also be interpreted as an argument which states that that color, sound, smell and feeling, only has meaning when there is an observer.

In closed-ended questions
Many things in our daily environment are so stable that we experience the world as an objective reality. This shapes the way we think. That’s how the analysis paradigm became the dominant mindset. The language of this paradigm is a language that, just by using words, makes divisions into categories and collections. It defines categories for things that are difficult to classify because of their irregularity or changeability. The questions associated with this paradigm are questions that are meant to classify. They are closed-ended questions. The questioner gives limited options, often only yes or no, or at the most a weighted answer, but the person being asked is never invited to give every conceivable answer. This analytical approach can be useful in many cases. This route of decision trees is also very suitable for digital processing in automated systems. But consider the perspective from which this is being viewed. Is a closed-ended question neutral? Who plays the leading role here? The questioner or the person who answers the questions?

Automated systems are appealing and inexpensive. You can even use them for free in many occasions. But when using these systems please keep in mind who or what plays a central part: “If a service is free, then you are the product.”

Open-ended questions
When we take the subjectivity of our experiences into account, we need a different language with different questions. Sensations and emotions like smell, color, pain, sadness and gratitude are not objective, after all.
In everyday life we ​​have to deal with these things, things that are not the sum of building blocks, and where cause and effect are not clear. But there is language to describe those things. They are words that convey that the whole is more than the sum of its parts (“football is not bookkeeping”), and that new things can arise (“the chemistry in the process”). These words are part of a language that acknowledges that emotions and visions are subjective (“You can’t feel another person’s pain”, “I see it very differently” or “There is no accounting for good taste”). The questions also have to be different from those for the reductionist model. One way you can use language to do justice to the perspective of the interviewee is to ask open-ended questions. Those questions start with ‘who’, ‘what’, ‘where’, ‘when’ and ‘how’. By asking open-ended questions many outcomes become possible. All possible outcomes of an open-ended question are in ‘superposition’. Only when an answer is given the indeterminacy of all conceivable possibilities fall to one of them. The person being asked judges and describes his own observation and can share this by answering. This is different from decision trees with closed-ended questions. In decision trees, hypotheses (opinions, choices) of the questioner are tested. Using the solution-focused approach discussed in this book, people are invited to become curious about their own answers. This approach has already proven itself in practice. Only the open-ended question ‘why’ is not used in the solution-focused approach, because this is intended to identify causes and therefore belongs within the analysis paradigm (Chapter 2).

In our introduction we stated that we want to show you the forest and the trees, i.e. analysis and synthesis. Reduction is the way of analysis, which inherently leads to the loss of connecting information. Instead of reducing, we can also combine, and thus create new things. Add information, so to speak. That is the way of synthesis. It will come as no surprise that we are in favor of employing both paradigms.

Respect the views of others
When you let go of the idea of ​​an objective reality, it is easier to accept the ideas and views of others. We all know the golden rule: “Do unto others as you would have them do unto you” from the Bible. Similar proverbs appear in many other religious and philosophical texts.  When you acknowledge subjective realities, you automatically arrive at the even more beautiful platinum rule: “Treat others as they want to be treated.”

In an objective reality, the world is the same for everyone. This matches well with stable subjects, because they look the same to every observer. But this does not apply to changing subjects. Translated into patient care, this is a good reason to follow the patient’s perspective. Huber et al. [2] found striking differences in their views on health in their research among various healthcare stakeholders (patients, practitioners, policy makers, insurers, public health actors, citizens and researchers). The way we see, value and judge health and healthcare apparently depends on the observer. This is an argument to align with the patient’s point of view. Treat them the way they want to be treated.