*2.2. Theory*

In the present study, we adopt the theoretical position that every person observing his or her own unique environment is observing something slightly di fferent from what everyone else is observing. This is important to bear in mind in relation to COVID-19 risk communication, as every person will be observing this in a slightly di fferent way, and the messages will therefore mean something di fferent in the context of di fferent environments [23].

Luhmann's systems theory is, in essence, a grand theory about communication and the individual person's observation and meaning-making of this communication. The theory introduces a distinction between psychological and social systems, which is an important aspect of our present approach to studying life with diabetes during lockdown. What Luhmann called psychological systems, in fact, constitute the consciousness of persons, individuals or subjects, and for Luhmann, social systems can be either interactions, organizations or societies [23].

The consciousness of psychological systems and the communication of social systems do not have direct access to each other. They basically speak di fferent languages, and this means that the psychological systems cannot communicate, but are instead restricted to observing the communicative social systems. The systems are closed and autopoietic, which means that each system continually self-interprets and self-reflects on the basis of its own contents. This inability to fully understand the other kind of system is Luhmann's way of addressing the classical sociological issue of the co-evolution of the social and the individual [22].

The notion that the systems are closed means that the consciousness that continually recreates the way we (as psychological systems) interpret and understand ourselves, in the context of our own unique environment, always comes from within the system itself. Consciousness never comes from the outside, because we never acquire consciousness from other psychological or social systems. We are therefore closed in terms of this operational element. It is this self-reference that enables systems to continually distinguish themselves from their environment. The concept of self-reference is therefore essential in understanding how each system is able to maintain its own horizon of meaning despite the complexity of the environment [21].

The psychological system continues to produce the consciousness needed to maintain a sense of meaning, while at the same time observing and trying to understand the environment. In this sense, we arrive at a paradox: While the systems are closed in terms of their self-reference, they are in fact at the same time open with regard to observing the environment. The concept of observation is therefore essential to how systems evolve and change. To actively try to understand and make sense of the environment, the psychological system needs to continually recreate its own self-understanding and sense of meaning. It is on the basis of this self-understanding and sense of meaning that the actual observations are made [22].

For the social systems to influence the psychological systems, and vice versa, the systems need to create noise or distortion in order for the other system to observe and try to make sense of it all. For the psychological system of a person with diabetes to be influenced by the COVID-19 risk communication, it has to see it as relevant to observe–and observing it has to make sense for the self-reproducing meaning-making processes within the psychological system itself. Observing communication from

di fferent social systems represents a high level of complexity, as the individual psychological system is exposed to numerous social systems on a daily basis [23].

The basic operation of observing is making a distinction. When a system observes something, it is automatically not observing something else. Rather, it is not observing the rest of the environment. When people with diabetes are observing anything health-related in any given setting, they are automatically not observing something else in relation to the health-related issue and/or the setting. By analyzing how, where and why these distinctions are made, we can analytically sharpen our focus on why people observe what they observe and, perhaps more importantly, why they do not observe what they do not observe [22].

To understand how systems navigate in the complex environment of possible observations, it is necessary to move on from the concept of observations to what Luhmann called expectational structures. By ascribing expected meaning to di fferent contexts or relations, a person will acquire a sense of where he or she will be able to observe meaning in relation to him- or herself or in relation to any given prior observation [23].
