Have you ever seen an attempt at process improvement backfire? If so, you’re not alone. Back in 2001 Elisabeth wrote about a case where better testing led to worse quality but that example is hardly unique. Examples abound. An organization trying to tighten up release timelines ended up with ever-increasing planning horizons. Yet another organization that rolled AI tooling to speed up development ended up slowing down. Best intentions go astray because software development organizations are non-linear adaptive systems. Attempting to control outcomes as a straightforward chain of cause and effect doesn’t work. When you face a big challenge—poor quality releases, slow delivery, or missed commitments—there is no single dial to turn. You can influence the system, but first you have to understand how it works. In this talk we show you how to see your context as a system, and reason about it so you can find the possibly counter-intuitive approaches to solve hard problems.