Debating the utility of ‘ambivalence’ for human-centric strategy formulation

Alexander Spalding

In many ways, the notion that ‘ambivalence’ or ‘self-contradiction’ might, in fact, be part-and-parcel of business strategy formulation seems perfectly sensible. After all, the idea that humans possess the propensity to act in ways that seem to go against their ethical modi operandi or ‘objective’ self-interests seems well-evidenced within our industry. Yet, while the self-contradictory tendencies of humans-as-users/consumers seem to have become entrenched in our industry’s conceptual toolkit, relatively little attention has been paid to the ambivalence with which we as innovation practitioners formulate ‘human-centric’ strategy. 

In the spirit of anthropological self-reflexivity, I would like to suggest two things. Firstly, there is something inherently ambivalent about the way in which human-centric strategy is currently formulated. Secondly, problematising the potential beneficiality of this ambivalence is also worthwhile.

To debate the ambivalence of human-centric strategy making, one must first be convinced that there is something ambivalent about this industry in the first place. I became particularly interested in this idea during my Master’s degree. During this time, I was conducting ethnographic research within an organisation called ‘CareX’*, a small health-tech startup that develops remote patient monitoring software for people living with, amongst other conditions, Major Depressive Disorder (or, as it is oftentimes simply referred to as, ‘depression’).

I was drawn to this research because I was particularly interested in understanding how the people working on these kinds of software products not only think about ‘depression’, but also how their worldviews impact the innovation pipelines of the companies within which they work. What I soon realised was that ‘depression’ doesn’t exist as a stable conceptual category at CareX. It is, instead, an amorphous notion that the firm’s stakeholders all seem to adopt a slightly different stance on.

For the pharmaceutical companies that support CareX’s product development initiatives, ‘depression’ is a condition defined by the psychopharmacological action mechanisms of the drugs within their product portfolios. For the software engineers, it is a condition that is heavily tempered by how many psychopharmaceutical medications (and their related side-effects) contemporary digital software can reliably track. For the firm’s user researchers, it is a condition for which psychopharmaceutical treatments are not necessarily seen to be the only (nor optimal) means with which people’s symptoms of suffering can be treated.

And for the startup’s management, it is a condition heavily tempered by the amount of legal liability that CareX can comfortably take on when it comes to designing (amongst other kinds of capabilities) suicidality mitigation measures. It thus goes without saying that ‘depression’ has taken on a mystifyingly nebulous, and oftentimes contradictory, existence at CareX.

What I think makes this ethnographic detail particularly fascinating is that the quantum-like qualities of ‘depression’ at CareX are not lost on its employees. In fact, while these people don’t necessarily agree, in principle, with conceptualisations of ‘depression’ that are different to their own, they ultimately think that it is more important to reconcile these different ideas than it is to lock horns over whose definition is the most accurate and ‘human centric’. The people who work at CareX have thus learnt how to see the firm’s strategic decision-making in an ambivalent way so as to be able to ultimately build a product that can, in some capacity, help those living with ‘depression’.

Although this ethnographic detail is situated within a small startup organisation, I believe that the ambivalence required to work at CareX is not unique to this organisation alone. As such, I think it’s important for us to think about how this phenomenon scales across organisations of different shapes and sizes.

How do we visibilise the different worldviews that must inevitably come together when innovation strategy is formulated? How do we define the amount of reconciliation that we are willing to do when different worldviews and agendas clash in the strategy making process? And how do we go about challenging orientations that we think compromise the worlds that we attempt to bring to life through our work? 

While I do not, by any stretch of the imagination, possess definitive answers to these questions, I think that questions like these enhance the ethical reflexivity and self-awareness of our work. For example, although CareX’s employees have learnt to orientate themselves to ‘depression’ in an ambivalent way, this can arguably be interpreted as an inevitable byproduct of structural power imbalances in the product strategy formulation process.

As a result, one cannot help but wonder what kinds of alternative worlds could become possible if ‘depression’ were to take on a different (and perchance less ambivalent) form within CareX’s overarching product development work. By thus working through these kinds of questions on a collective basis for our own industries, we as innovation practitioners can create constructive affordances for tracing how ambivalence tempers both the micro as well as the macro effects of our work.

*‘CareX’ is a pseudonym for the organisation in which my dissertation research was conducted.


Alexander Spalding, a member of Human Sciences in Strategy, is a digital health specialist and medical anthropologist. Alex is passionate about integrating knowledge of the lived experiences of patients, caregivers, and care team members into healthcare product innovation work.

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