Iatrogenics, Naive Intervention, Coddling, Safetyism, & the Family Office: “First, do no harm”

Are the interventions you’re making, the support and education you’re offering, the forms of assistance to the family that you’re providing, examples of iatrogenics–harm more than help, treatments in which the healer (unintentionally) causes more damage than good?

I’ve recently read two books in close succession that have resonated off of each other and made me really wonder about the unintended consequences of the work done by many family offices, family advisors, and trustees: Antifragile, by Nassim Taleb, and The Coddling of the American Mind, by Greg Lukianoff and Jonathan Haidt. There is a lot one could say about each book, and I will undoubtedly return to some of their themes in other posts. (I have some reservations about each book, but will hold those for later as well.) But for now, each raises a fundamental question for family office professionals and advisors: are the interventions you’re making, the support and education you’re offering, the forms of assistance to the family that you’re providing, examples of iatrogenics–harm more than help, treatments in which the healer (unintentionally) causes more damage than good?

Antifragility, Iatrogenics, and Naive Intervention

As background, the basic idea of Antifragile is simple but profound: whereas fragile organisms and entities (and societies) weaken or break when subjected to randomness or stress, antifragile organisms thrive when stressed. They do better, not worse, when shocked by random or unexpected events. They grow, evolve, and overcome. Like the mythical Hydra that grew two heads every time one was chopped off, they naturally get better in response to hardship. It is known in psychology that some people exhibit post-traumatic growth, not post-traumatic stress disorder. Similarly, the old adage of “if you want something done, give it to a busy person” is suggestive: stress on the system isn’t always a bad thing–sometimes it is generative.

[D]epriving stress-hungry antifragile systems of stressors brings a great deal of fragility …

Taleb is convinced that life itself exhibits antifragility, as do most thriving people and systems. That’s the good news. The bad news is the modern tendency to ignore that fact, and to systematically attempt to intervene, make things “safer” and “stronger,” smooth out the bumps in the road, and in the process, unintentionally weaken an otherwise resilient, antifragile person or entity by making them more, rather than less, fragile. According to Taleb, this modern tendency is the “systematic removal of uncertainty and randomness from things, trying to make matters highly predictable in their smallest details. All that for the sake of comfort, convenience, and efficiency.” As he puts it, “[m]y definition of modernity is humans’ large-scale domination of the environment, the systematic smoothing of the world’s jaggedness, and the stifling of volatility and stressors.“

Taleb brings up the idea of iatrogenics in Chapter 7, which is titled “Naive Intervention.” Iatrogenics occurs when the healer harms the patient. The treatment unintentionally exacerbates the ailment. In the context of fragility and antifragility, “the source of harm lies in the denial of antifragility, and [in] the impression that we humans are so necessary to making things function.” There are lots of examples:

  • Suppressing forest fires over a long period of time (nominally to make the forest “more safe”) makes the next large fire far worse (and the forest overall less safe);
  • Propping up weak banks, rather than letting them fail (nominally to make the banking system “more stable”) makes the next financial crisis far worse;
  • Suppressing political dissent for a long period of time, by, for example, supporting a dictator (nominally to make the region “more stable”), makes the next political revolution far worse.

As Taleb argues, “we need to avoid being blind to the natural antifragility of systems, their ability to take care of themselves, and fight our tendency to harm and fragilize them by not giving them a chance to do so.” As a counterpoint, he mentions the Drachten effect: when the town of Drachten in the Netherlands removed all street signs as an experiment, drivers drove more safely–the increased sense of danger and responsibility improved things, rather than the expected opposite.

When heaven is about to confer a great responsibility on any man, it will exercise his mind with suffering, subject his sinews and bones to hard work, expose his body to hunger, put him to poverty, place obstacles in the paths of his deeds, so as to stimulate his mind, harden his nature, and improve wherever he is incompetent.
Meng Tzu (Mencius), 4th century BCE (quoted by Lukianoff and Haidt)

Coddling and Safetyism

In The Coddling of the American Mind, Lukianoff and Haidt borrow (explicitly) from Taleb’s anti-fragile argument to talk more generally about the rise of “safetyism” in American culture and on American campuses. They argue that we have gone through a safety revolution in the last thirty years, particularly aimed at keeping children safe. In many cases, this has been positive: between 1978 and 1985, all fifty states made car seats mandatory. Schools and homes and toys and children’s clothing have been childproofed or safety tested. All of this has helped dramatically decrease death rates for children.

But they fear that we have allowed “concept creep” to broaden our understanding of what “safety” is and what it requires. Safety, including emotional safety, has become the dominant goal of parents and educators. “We believe that efforts to protect children from environmental hazards and vehicular accidents have been very good for children. [B]eing in a car crash without a seat belt does not make kids more resilient to future car crashes. But efforts to protect kids from risk by preventing them from gaining experience–such as walking to school, climbing a tree, or using sharp scissors–are different. Such protections come with costs, as kids miss out on opportunities to learn skills, independence, and risk assessment.” Parents are now shamed–or arrested–for letting their kids have even moderate amounts of independence. They argue that the “bureaucracy of safetyism” dominates in many K-12 schools and on college campuses, and that this has created both more anxiety among students and a culture of moral dependency.

Lukianoff and Haidt focus much of their book on campus free speech issues, and on the ongoing battles over how students and college campuses should handle politically-charged speech and events. I will sidestep those themes, because my interest here is in the unintended consequences of “coddling”–or, as the authors reframe it, “overprotecting.” Like Antifragile, these authors demonstrate repeatedly how safetyism produces the opposite of its intended effect: rather than decreasing harm, it unintentionally causes it.

Antifragility in a Family Enterprise System: “First, do no harm.”

And so, to family enterprise systems. Each of these books has many profound implications for these systems. Here I want to focus on one set of questions: are family office professionals, advisors, and trustees unintentionally making family members and systems more fragile by coddling? When are family system interventions “naive”? The family enterprise advisory world is full of well-intentioned discussions of how to promote resilience and “grit,” and how to avoid wealth insulating family members from learning how to overcome difficulty. But are the very family meetings, learning sessions, retreats, and family office services that are designed to teach these lessons then doing the exact opposite–making the family more fragile, not more antifragile?

I don’t know.

To put the question more positively, how can family learning, support, and services be crafted to promote antifragility, rather than fragility?

Again, I don’t know. But I’m sure that we should be asking this question.

That, in itself, will undoubtedly help. Asking whether interventions are likely to produce unintended consequences–to weaken, rather than strengthen, family members or beneficiaries–will likely change the intention behind those interventions, and this should be a good thing. Intentions matter. If a family enterprise system (whether the family members, family office professionals, trustees, etc.) is designing a family meeting, creating a learning curriculum, or providing services, setting the dual intention to (1) avoid weakening and (2) preferably strengthen each family member will fight against the threat of coddling or iatrogenic fragility.

It is also important to carefully consider this question through the lens of impact and intent. (For the best discussion I know of on this question, see Patton, Stone, & Heen, Difficult Conversations.) Despite our good intentions, the impact can be harmful. Put differently, we may intend for a family meeting or family service to be helpful to the family, keep them “safe,” or help them learn … but the impact may be the opposite. The working session at a family meeting may focus on “building resiliency,” but behind the scenes, the office staff has arranged all the hotel rooms, transportation, and meals, dealt with lost luggage, and arranged for child care. The implicit message: the family members are fragile, they need tending and care, and the family office’s purpose is to protect them from life’s inevitable difficulties. This is a very easy trap to fall into–I have felt the pull of it in my own work with family enterprise systems. But it promotes fragility, not growth and antifragility. The message received–the impact–weakens, not strengthens.

Consider another simple example: travel services. Many large family offices help with international travel arrangements for beneficiaries. Particularly if a family member is considering travel in a remote or risky part of the world, family office staff may make security or tour arrangements to mitigate risk.

For some families–particularly those in the press or spotlight–this can be critical. But it can be taken to extremes. I know of a wealthy father who panicked when his high school daughter signed up for a summer foreign exchange program in an African country. His condition for allowing her to participate? He sent a security guard with her, who was stationed outside the hut in the village she lived in. (This was not a well-known family likely to run kidnapping risk.) This father loves his daughter. His intention is to keep her safe. But is he making her more fragile–and thus less safe–over time? By smoothing the rough edges of her experiences, how is she supposed to learn to cope with life’s difficulties?

I have heard parents describe their desire to teach their children to love travel–and to love exploring and learning about other cultures, demographics, and countries. Often, however, those same parents take their children only to exclusive resorts, and only on private aircraft or in first class seats. As a result, their children never learn to wait for a late plane, find their way through customs and immigration, or deal with a foreign bus system to make it from the airport to a city center. They become “fragile travelers,” not confident ones. When asked, many of these parents describe their own somewhat harrowing but thrilling adventures traveling in Europe, South America, or elsewhere in their late teens, often with a friend and a backpack as their only support. No cell phones, no texting Mom and Dad–often for months on end. Their eyes glitter when recounting these experiences. And yet … their children have nothing similar. The rough edges that their parents dealt with–and remember fondly–have been entirely sanded away.

Again, the intention may be good–but the impact less so.

Many family office professionals describe their fundamental role as risk mitigation. They are risk professionals–looking for and systematically reducing financial, legal, PR, cyber, interpersonal, security, travel, insurance, and other risks for the family they serve. And yet–the families they serve say they want their children to be resilient and tough, and that their primary goal is to avoid creating dependence. If the family office’s interventions in the lives of these family members create a bubble of protection around them, how can that really serve the family’s resiliency and independence goals? How do family members grow strong if life’s challenges are professionally managed for them?

Fragility and antifragility exist not just in individuals but at the level of systems. One can weaken the family enterprise system as a whole by treating it as weak, and therefore depriving it of opportunities to grow stronger. Too much quiet handling of family conflict by advisors can atrophy the family’s conflict management muscles over time. Too much assistance with decision-making can help get decisions made in the short term, but may sacrifice building long-term decision-making skills. Like suppressing forest fires, interventions to increase safety can actually make a system less safe, resilient, or able.

I am not saying that all of these services should stop, nor that a family office shouldn’t be obsessively focused on risk. But I will end with a simple conjecture: families want and need their advisors to think carefully about fragility and antifragility as they craft interventions and support, to talk openly about these issues, and to wrestle with the threat of unintended consequences. For many years, Jay Hughes has argued that family advisors must first do no harm. Avoiding iatrogenics, naive interventions, coddling, and safetyism must be at least a very basic part of what “first do no harm” means.

Scott Peppet

Scott Peppet is striving to create the enlightened family office. He writes about the challenges and joys of managing the family enterprise with the hope of sharing ideas with like minded people

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