About Afternow

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AFTERnow is a collaborative enquiry into the impact of modern culture on health involving Professor Phil Hanlon, Dr. Sandra Carlisle, Dr. David Reilly, Dr. Andrew Lyon and Dr. Margaret Hannah. Our work was funded for six years by the National Programme for Improving Mental Health and Well-being in Scotland and supported by the Glasgow Centre for Population Health. 

To better understand our motivation in this work, it may be helpful if we provide a brief sketch of our life paths.


Phil Hanlon

Phil’s medical degree led first to clinical work and then to the leadership of a vaccine trial in The Gambia. That experience persuaded him that public health approaches were needed not just in Africa but also at home in the West of Scotland. That insight led in time to a leadership role in Health Promotion in Greater Glasgow and research in public health at Glasgow University. Although he pursued all of these activities with energy and enthusiasm and he was enormously impressed by the commitment of staff and communities, his experiences led him to the conclusion that the approaches that were being used were insufficient to meet the scale and complexity of Scotland’s public health challenges.

Andrew Lyon

Andrew began his career in anthropology, deriving insights and contributing to writing from rural India. Returning to Scotland he moved into public health and made an enormous contribution by leading the Glasgow Healthy Cities project. By the year 2000, he was working on sustainability issues with Forward Scotland and was building extensive and diverse networks while experimenting with fresh ways of working with communities.  Andrew considers it a privilege to have worked on these important projects and is proud of much that was achieved but he began to observe that outcomes always turned out to be less than what was aspirated for and he began to ask profound questions about why that should be.

Margaret Hannah

Margaret came to Scotland not long before the turn of the Millennium. By this stage she had established a considerable reputation in three important and synergistic spheres. Margaret qualified in medicine and by 2000 had worked first in clinical medicine and then in most of the wide range of public health activities delivered by the NHS. She had also been active in politics and social action and had stood as a parliamentary candidate in the 1997 general election.   The third sphere is more difficult to label. Margaret is a thinker and a doer. Through her travels in South America and Asia and her innovative work with think tanks like the Scottish Council Foundation she had been exploring fresh ways of engaging with the whole person and to foster healing and creativity.

David Reilly

David graduated in medicine and pursued a rigorous conventional training in Adult Medicine and General Practice. However, he judged the ‘treatment factory’ mindset that junior doctors encounter failed, in many cases, to meet many of the complex needs of patients and even tended to brutalise staff. At this point he considered giving up medicine altogether, but then concluded that he had to find a different way of being a doctor. He began by seeking to learn from his own patients and from this approach developed a distinctive approach to healing, innovation and change. At the core of it lies a shift in the practitioner - away from engagement shaped by the questionable old map of - ‘What can we do to fix you/ your situation?’ - to a map that asks ‘What can we do to help you release your own self-sustaining capacity?’

Sandra Carlisle

Sandra is an anthropologist and qualitative researcher. As such, she brought a vitally important additional dimension to the team. Sandra studied English language and literature, and medical social anthropology and sociology at Keele University: the latter led to a life-long love of research in this field. Over the years since then she has been involved in numerous health- and policy-related research and evaluation projects. Through these experiences Sandra developed a very strong awareness of the importance of cultural influences on health and wellbeing (Sandra joined the collaboration as a full time researcher in 2006 and moved to a new post at Aberdeen University in 2012).


In short, each of us was experiencing what Thomas Homer Dixon calls the ingenuity gap: this is the gap between what is needed to solve many problems in the modern world and our capacity to respond. Through collaboration, we have tried to improve our understanding and move our practice forward. Some milestones on this journey will give an impression of our direction of travel.

In 2001, Phil led the establishment of a new organisation – the Public Health Institute for Scotland (PHIS). He did this as a secondment from Glasgow University because the new organisation provided an opportunity to understand Scotland’s problems better. During its relatively short existence (PHIS was merged with another health organisation) it provided a setting for innovative thinking and was energised by a staff that constantly explored new solutions. One PHIS project involved Andrew, David and Margaret as collaborators and led to the publication in 2003 of ‘The Fifth Wave’, which was the first expression of the ideas that are presented in a more developed form on this website.

In 2002 Andrew became one of the founder members of a new venture – International Futures Forum (IFF). Margaret, while continuing her work for NHS Fife has also been a key member of the IFF team. IFF seeks to address the ‘conceptual emergency’ which they perceived to be a consequence of living in the modern world. The mission of IFF is to “restore practical hope and provoke wise initiative in challenging circumstances” and to “address complex, messy, seemingly intractable issues – local, global and all levels in between”. Their aim is to help develop the capacity for transformative innovation rather than simply propping up the old system.

Meanwhile David had been leading the creation of the NHS Centre for Integrative Care, which was formally the Glasgow Homeopathic Hospital. As part of this, a new building was created to house the Centre. The design of the hospital, with its emphasis on natural daylight, art displays and gardens is integral to the process of healing. The purpose of art in a hospital setting is to reflect the idea that healing itself is a creative process: inherent in this notion is the idea that underneath our suffering and illness as human beings, we are fundamentally whole.  Healing is the re-discovery of that wholeness.  The change they experienced – a ‘healing shift’ - leads towards greater self-care and self-compassion and a greater sense of empowering responsibility. Whilst AFTERnow explored the impact of external (but internalised) cultural shifts on our well-being, David’s work explores (and put into practise) the human potential for self-healing, resilience and well-being.

In his role as an academic, Phil became increasingly aware that reductionist methods in disciplines like epidemiology were not providing the insights needed to meet the gap between the scale of the public health challenge and our capacity to provide solutions. This led to the AFTERnow project.   The AFTERnow project made the dis-eases of modern Scotland it’s starting point and asked the question ‘is there something about modern culture that makes us vulnerable to these problems’? We explored a massive variety of literatures from which key themes have emerged.

During a series of ‘learning journeys’ across Scotland, as part of our fieldwork, we held many fascinating conversations with diverse people and organisations.  As a result we can report that new ways of thinking, being and doing are now emerging: we have seen examples of transformational change.

Each of us in their own way is helping to explore new ‘maps’ of reality. It is our contention, however, that the future will emerge through collective action – the activities of many and the new web of meaning that we create among ourselves.