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In thinking about the usefulness of systems psychodynamic theory, this paper argues that innovation and creativity often involve a revisiting of traditional concepts and practices—as evidenced by the current interest in mindfulness. It makes a defence for subjectivity and explores the creative tension this evokes in the discussion of evidence, and then describes a reflective stance that is useful, necessary even, in understanding intractable issues of social policy and organisational stress—taking the example of the delivery of care in a national health service, seventy years after the making of the welfare state in post-war Britain.