“We tend to rely for the most part on the verbal-intellectual mode of apprehension, because this is what is developed through education in modern western culture. The verbal-intellectual mind functions in terms of abstract generalities that take us away from the richness and diversity of sensory experience – this is both its strength and its weakness.” Henri Bortoft.
I argue that the Biodynamic Model of Osteopathy in the Cranial Field (BOCF) is reductionist and a counterfeit holism. While it is in no way wrong (whatever that means) its claims to be wholistic are unfounded. If anything, it is a deepening of the Platonic-Cartesian-Newtonian mind-body Substance (separation) which is the foundation of the spectator-consciousness where awareness is awareness of something and developed from a collection of abstract generalities.
Obviously within the space I will keep this post as short as possible. I will try and get to the point as soon as I can. Naturally, your comments and questions are always welcome.
The main paper I am going to use to argue my point is by McPartland and Skinner (M&S). This is not because I feel the need to attack them, on the contrary, I feel they have in combination written the best work on the subject. I also recognise the roots of this approach in relation to the work of James Jealous, D.O.
The Biodynamic approach to health care, education, and agriculture originated from Rudolf Steiner, above, (1861 – 1925) in 1924. Steiner’s approach was influenced by Johann Wolfgang von Goethe as a form of spiritual-science in the disciplines mentioned. It seems that a group of osteopaths have recognised the Steiner origins of Biomechanics and returned it to its reductionist roots.
The claim by M&S that, “BOCF’s legacy extends back to Hippocrates, as reflected in the Hippocratic Oath’s axiom ‘do no harm’ and it’s concern for our triune (body-mind-spirit) integrity,” could be claimed by all Western medicine. Nothing new there.
When Still wrote, “I love my patients” and “I see God in their form,” the key word is not love or God it’s form. It is through form that we can sense movement. The only tissue to show this movement, on an evolutionary foundation, is bone; the slowest and deepest movement. He also wrote, “the cerebrospinal fluid is the highest known element that is contained in the human body.” And more, “the rule of the artery is supreme,” “we live an die by the fascia,” etc etc. I could go on. This is a typical and unfortunately common example of cherry picking from the work of Still. What’s common amongst osteopaths is the inability to stand back and see the bigger picture. Still wrote in a way that no part could be taken out of the whole philosophy. He was consistent with the works of Georg Wilhelm Hegel, below, (1770 – 1831) who, as with Steiner, was influenced by Goethe.
The Hegelian system regarded nature as a contradiction in motion. This contradiction was seen as the source of motion in nature; day/night, hot/cold, wet/dry. In addition he placed an emphasis on the ‘mind’s eye’:
“Knowledge for Hegel is holistic, in the sense that it is something grasped, not in isolation, but in relation to pictorial forms of thought, out of which it emerges in the long historical process leading natural consciousness to conceptual knowledge, as represented by the progression of shapes of consciousness in the Phenomenology… (Hegel used, my addition) this artistic mode of cognition or “picture-thinking” (das vorstellende Denken) and “picture-thoughts” (Vorstellungen), as he calls it, yields a kind of knowledge.” Hahn, S. S. (2007)
This is exactly Still’s method of seeing more deeply in the experience of examination and treatment not visualisation.
“Another interesting incident which Dr. Charlie related to me was the case of a young man who had injured his knee. This boy came from a family in Kirksville who were great friends of Dr. Still. At a time when Dr. Still was out of town, this young man who was working with an adz in a cooper shop, through some misstroke, dropped his tool and it struck his knee, resulting in a deep cut. A nearby doctor was called and examined the boy. He said that the accident had resulted in the escape of joint fluid from the knee. Very soon afterwards, the limb became inflamed, blood poisoning set in and three of the local doctors were called in consultation. They decided that the limb would have to be amputated. The mother of the boy would not consent to the amputation until Dr. Still returned home. Two of the physicians insisted that the limb should come off immediately and not later than the next day or the boy’s life would be lost. The third man of the three, Dr. F. A. Gore, one of the finest men I have ever known and one who was a personal friend of Dr. Still, said to the other doctors, in the presence of the mother, that he was in favour of waiting, that Dr. Still had secured some very marvellous results in the past and he himself would like Dr. Still to see this patient before the operation was performed.
“Dr. Still unexpectedly returned to town that evening, and, even before hearing of the case, while out in the east end of Kirksville where the boy’s people lived, he called upon them and was surprised to learn of the son’s condition. The mother, describing this visit to Dr. Charlie, said that he went into the room, looked at the boy and examined his knee for a few minutes. Then he sat down in a chair by the side of the bed, put his feet up on another chair, and pulled his hat down over his eyes. He sat there so long in contemplation that the family became alarmed, and they were afraid he was not going to do anything. Evidently having satisfied himself as to procedure, he arose and went to work. He manipulated the thigh and the pelvic bone on that side, gently rotating the thigh, and stretching the limb a little, thus causing relaxation of the contracted and inflamed tissues around the knee. Then he went away. By morning the swelling had materially decreased and by afternoon, when the doctors who had advised amputation came, they found there was absolutely no necessity for an operation.” Hildreth, A. (1942)
“Dr. Sutherland was a student of Still and became imbued with Still’s thinking, methods and practice.” (M&S) He never even spoke to Still but Charlotte Weaver, D. O. , spoke to him.
“Charlotte Weaver was at the American School of Osteopathy in Kirksville, Missouri, from 1909 to 1912, when she was personally encouraged by Dr. Still to investigate circulation from the head through the spinal cord. In contrast to her personal communications with Dr Still, William Garner Sutherland, DO, according to his wife, never had any private conversation with Dr Still. It was not clear to Dr Still’s students how he had envisioned applying the concepts of structure and function to the cranium. Both Dr Weaver and Dr Sutherland spent many years developing their ideas about cranial osteopathy, although they had only minimal interaction.” (Jones, J. M., 2012)
“Sutherland formulated his first cranial hypothesis as a student in 1899 while examining a temporal bone from a disarticulated skull. The thought struck him that its edges were bevelled like the gills of a fish, as if part of a respiratory system.” (M&S) This tenuous link was not related to Still’s ideas. If Sutherland had a more dynamic holistic approach he would have realised that the temporal bone is one form (here’s that word) of the three-foldness of mammalian form (and again) known as metamorphosis. This triadic skeletal system is One (not numerical) bone differencing. So, the temporal, scapular and innominate bones are all One component of the mammalian limb system. We have three sets of limbs comprised of a flat bone, a long bone and a bridge: 1. Innominate, femur and ischium, 2. scapular, humerus and clavicle, 3. temporal, mandible and zygoma. It’s known as the Inner Lawfulness of Metamorphic Form and is only shown in the bone. Hence the word, “Osteopathy.”
Sutherland’s approach is Darwinian and an abstraction giving no credit to this Inner Lawfulness.
Dr. Jealous’s “…’work with the elders’ enabled Jealous to complete an authoritative chronology of Sutherland’s journey. Thus BOCF dedicates itself to the perceptual odyssey where Sutherland left off at the end of his life.” That’s all good but don’t credit Still with having anything to do with it.
Metaphor and Archetype.
That nobody understood what Still was on about was a common thread amongst those closest to him. McConnell complained about this as did Hildreth:
“It seems to me that my failure to understand in every instance the connection between the lesion, which was claimed by him to be the causative factor, and the diseased condition, is due to the fact that Dr. Still was a much better student of natural law than I. My hope is that the student of osteopathy today who studies and masters anatomy, physiology, and other kindred fundamental sciences will be better able than I to fathom the relationship between the various nerve origins and centres as given by Dr. Still and the functions they involved.” Hildreth, A. (1942)
“What Still saw and understood, and Sutherland came to refine in his later writings, was the universal principle that the natural world is constantly changing and what is fixed (or without motion) becomes out of balance with its environment.” (M&S) How can parts of the natural world be “constantly changing” and at the same time “what is fixed becomes out of balance”? Here’s a contradiction in the common use. Even in disease states movement is still happening. How can anything in the natural world be “out of balance” when all phenomena are expressing themselves through their differences? Where is this balance?
“Still considered osteopathy a science but when Still’s osteopathy extended beyond known science and rational explanation, he imparted his lessons by using metaphorical language.” (M&S) Still spoke in metaphor because science in the nineteenth century was literature and poetic based as in the works of Emerson and Thoreau.
“Metaphor provides a verbal bridge over the space between the speaker’s intention and the listeners interpretation. This transformational space, metaphorically speaking, characterises the learning space between teacher and student, the theatre space between actor and audience and the healing space between the practitioner and patient, where at a certain moment during an exchange something greater than the sum of the parts emerges.” (M&S)
A metaphor is only a “verbal bridge” if you approach language as symbolic signs in the reductionist intellectual model. This is an attempt at unity through unification. Language in this instance is seen as re-presentative of meaning to be linked by a “bridge” so that as metaphor language and meaning ‘belong together’. This is akin to Plato’s Two World Metaphysics where direct experience is only an Opinion and indirect experience is Form or true knowledge; it’s a dualism.
In the wholistic dynamic consciousness there is no separation and hence language is disclosive; hence language and meaning ‘belong together’ and metaphor is an attempt to deepen the experience by non-rational unfinished speaking or writing. It is the unfinished open dynamic aspect of metaphor that allows the unity, without unification, of the practitioner and patient to deepen the experience.
“The way the whole emerges is by coming into presence within parts. The whole comes to presence part-ially because it is within parts, and it is by im-part-ation, by coming into presence within parts, that the whole can be whole.” (Bortoft, H. 1971) The whole is not by putting or “bridging” parts together; this is the rationalist intellectual approach and is counterfeit holism. In effect this approach is the sum of the parts!
“The man-as-triune truths that lay behind Still’s osteopathy become the victims of medical reductionism, casualties of our Western way of emphasising the intellectual and eschewing the intuitive and instinctual. Reductionism limits our view of reality and our faculty of awareness (sense of consciousness).” (M&S) The intuitive means to “see more deeply immediately” and is not an instinct. As for awareness as a sense of consciousness; awareness is always of something. The whole can’t be subject to awareness as it would become a thing among things and therefore not whole but a part. The whole is not nothing but no-thing and therefore can’t be subject to awareness.
“As OCF has led to BOCF, the use of metaphor has led to the use of archetype… Archetypes symbolically embody basic human experiences and their meaning is instinctually and intuitively understood. Jealous’s concept of ‘the embryo’ as ever present in the living organism is a key BOCF archetype.” (M&S)
The archetype arises out of attention to self-differencing. Rather than reducing the patient to a lowest common denominator, in this case the embryo, so that we are all the same, instead we should be attending to differences. As a result the experience happens as a sense of wholeness in the process of coming-into-knowing of the practitioner. It is not in the patient.
“The archetype is not an individual ‘primal’ organism, but an experience of the unity that presents itself through multiple manifestations in organisms.” Ebach, M. C. (2005)
“The embryo, as an archetype of perfect form, serves as a blueprint for our body’s ability to heal itself. The formative, restorative and regenerative fluid forces that organise embryological development are present throughout our life span, ready for our co-operation in harnessing their therapeutic potency.” (M&S)
Placing the embryo and it’s ‘perfect form’ as the ‘blueprint’ for healing is an abstract generalisation reducing the patient, again, to a lowest common denominator. Cars and houses have blue prints not living phenomena. As for ‘formative, restorative and regenerative fluid forces’ these are end product presuppositions.
“Among BOCF practitioners, every event within the the therapeutic arena has a name. The importance of naming is shared by primal cultures worldwide, notably the Bushman of the Kalahari. According to the Bushman, an individual’s separation from that part of themselves that is connected to ‘everything else’ leads to fear and a sense of aloneness and this facilitates the disease process.” (M&S)
Naming is an intellectual-verbal activity classically Cartesian. By naming we experience as a re-presentation and we are too late in the presencing of experience. We name in the awareness of something as an end-product. The dear Bushman of the Kalahari don’t use language in the same way as we do. While we re-present through our symbolic approach they, as do other cultures, use a sensuous-intuitive approach of presencing; attending to the act (process) of languaging not language.
Evolution of Thought
M&S now go into the evolution of thought moving through bones, dura, CSF and then fluid body. These are generalised abstractions. None of my patients come as either bones, dura, CSF or a fluid body; they come as a whole patient.
In the bones section M&S cite Charlotte Weaver who we know spoke to Still.
“Sutherland’s deductive observations were confirmed by research completed by his osteopathic contemporary, Charlotte Weaver. She conducted experiments that led her to regard the bones of the cranium as modified vertebrae. Foetal dissections supported her theory that the spinal column and the cranium are embryologically homologous . Weaver characterised the sphenobasilar symphysis as a modified disc between occiput and sphenoid – plastic and capable of motion.” (M&S)
Weaver was doing something completely different. She emphasised the upper thorax as the place to start any investigation and treatment. Unfortunately, Weaver, as did many at the time, misunderstood the idea of metamorphosis thinking it as sameness rather than differentness. The error continued into embryonic homology where sameness of form between body parts was compared for similarities; the wing of a bird, the wing of a bat, the fin of a whale, and the human forearm. Metamorphosis and homology originated from the works of Johann Wolfgang von Goethe. He saw differences in these forms seeing One (not numerical one) limb arising out of all the limbs in the consciousness of the observer, the whole arising out of the parts. Not a physical limb but the Archetype limb which gave rise to the physical forms. Again, the idea of three cranial vertebrae originated from Goethe. This triadic (3), three-fold, gesturing is present in all mammalian forms as I have mentioned above.
Under dura “Sutherland accessed the dura by gently gripping the cranium. The external periosteum is contiguous with the internal dura. Sutherland visualised the continuous web of connective tissue, from the cranium down to the sacrum – which he characterised as the tadpole-shaped ‘core-link’.” (M&S)
All approaches of this kind rely on an act of exclusion. The body is a whole so you would have to exclude the whole patient and reduce them to a part. Visualisation is an end-product re-representation of the experience; too late.
Moving to CSF the Primary Respiratory Mechanism (PRM) consists of five phenomena, fragmentation. Leading to the Cranial Rhythmic Impulse (CRI) which apparently is palpable at a rate of 6-12 cycles/min, which is “…independent of cardiac or diaphragmatic rhythms.” (M&S). How can anything be independent of anything else in the organic world?!!! With the recognition of cycles this again reduces the patient to a numerical lowest common denominator. This is reductionism at its worst.
In fluid body, M&S quote Jealous:
“Sutherland arrived at a conceptual transition, leaving those who followed with a bridge to the depth of osteopathic research and practice that places us upon a new and deeply challenging renewal of the ultimate truths of our profession.”
What! The only bridge I know of in philosophy is Plato’s bridge in his Two World Metaphysics. As for the concept of depth, there is no depth in the organic world just direct Appearance as a whole expression as in Aristotle who was against Plato’s idea. Jealous goes beyond the phenomena into reductionism.
Evolution of Perceptual Skills
In the section on Evolution of Perceptual Skills again there are sections: bones, dura, CSF and fluid body. I’m not going to go into depth as this is all getting a little tiring!
“The dural model of OCF…” (M&S) Yes, it’s a model and as we know from some of my previous posts any model can only show its limitations.
“The practitioner visualises ‘a state of rapport in the fluid continuity between the physician and the patient’ by ‘melding the hands with the head’.” (M&S) Really!!!
Leaping forward to the CSF section under the mentioning of CV-4 technique:
“The CV-4 induces therapeutic changes around the body, possibly via periaqueductal gray (PAG) tissue, which surrounds the fourth ventricle… The PAG is homuncular, like the somatosensory cortex, so the topography of the PAG corresponds to different parts of the body.” (M&S)
This idea of the homunculus came from René Descartes’s Cartesian theatre. Leading to what in philosophy is termed the Infinite Regress. The homunculus is a small man in the head viewing what the person is seeing. Problem being who’s seeing what the little man is seeing? Another man! The whole body corresponds to different parts of the body, not a part of the body.
There was a slight glimmer of hope that they were getting it but alas it slipped away as fast as it had arrived. Under the often hijacked claims of quantum physics M&S wrote, “The role of consciousness in quantum theory is a radical departure from classic physics. The outcome of any experiment depends upon the consciousness of the observer.” Not quite true, it’s more of an influence rather than a dependancy. “Indeed, the term observer should be replaced by the term participator.” Yes, fantastic. “We cannot observe the universe, we are a participator in it.” No, we can observe it and we are a participator. It’s all slipping away. “Our individual consciousness is a small hologram of the universal consciousness shared by all living things. Capra named consciousness (‘the process of knowing’) as a key feature of life, including life forms such as plants and protozoans that lack a central nervous system.” Further slipping away. Oh, by the way these protozoans lack a central nervous system but they have a skeleton! “Many forms of motile single cells lead their own independent lives. Some of them are free single-celled animals. They all are tiny but their motor behaviour can be watched with the microscope. They swim and crawl, they secure food, they conjugate, multiply… Sense-organs, beyond a pigment spot, seem to inspection wanting. Of nerve there is no trace. But the cell framework, the cytoskeleton, might serve… There are, however, observers of skill who after devoting patient study to the motor behaviour of such single-cells conclude that microscopic single-cell life, without sense-organ and with out nervous system, can learn.” (Sherrington, C., 1955)
“Newtonian physics has undergone a paradigm shift to quantum physics, thanks to relativistic studies addressing subatomic phenomena and consciousness. Still’s writings suggest he had undergone a quantum paradigm shift. He knew instinctively that the healing events in his patients happened at the subatomic level but he did not have the words or the concepts of quantum physics to draw upon, to express the transformation he was experiencing in his treatments.” (M&S)
Here, a paradigm shift is confused with a new model in the Newtonian paradigm. Talking of subatomic (spacial locality) is not quantum. Poor Still didn’t have the words. Yes he did it’s called poetry! And as for dragging the late David Bohm into the discussion: “Sutherland’s BoL (Breath of Life) exits characteristics that can only be explained by quantum theory (e.g. the theory of implicate order by Bohm)” (M&S)
I’ve had enough!
BOCF is not a direct experience as a dynamic wholeness. It is reductionist and dualistic as is physical therapy and composed entirely of theories and presuppositions. This is the re-presentational theory of knowledge and as such is indirect experience clouded by theories and models. A lack of understanding of Western philosophy and the history of science has made the osteopathic profession vulnerable to Pied Piper of Hamelin (Browning was a genius) characters with what they present as the Emperor’s New Clothes ( Anderson was no less a genius).
Unfortunately this is the usual shallow out of context study of Still. So, why does BOCF seem to work? Because one person is doing it to another. It’s a theory and Still had no theories. If this is a better way why aren’t we treating malaria and typhoid; Still did.
“Andrew Taylor Still was not simply curing headaches and stiff necks at this time. Epidemics of serious infectious diseases regularly swept through frontier settlements of the period, and Still took on these problems without hesitation. He used manipulation to treat cases of pneumonia, erysipelas (a bacterial infection of the skin), typhoid fever, and the often-fatal, infectious diarrhoea’s of children, then called the flux… An inspired medical heretic and prophet is often able to produce dramatic cures of many kinds of illness. Samuel Hahnemann, Andrew Taylor Still, Mary Baker Eddy, and Edgar Cayce all could. These people may be able to communicate their skills to one or two generations of students but over time, and especially after their deaths, the overall efficacy of their systems declines, even though the same methods remain in use, applied according to the master’s directions.” Dr. Andrew Weil, (1995) Health and Healing
Advanced Osteopathic Manipulation, 2018, http://www.pro-osteo.com/
Bortoft, H. (1971) The Whole: Counterfeit and Authentic. Systemics. Vol. 9. No. 2 September, p. 1 – 26.
Ebach, M. C. (2005) Anschauung and the Archetype: The Role of Goethe’s Delicate Empiricism in Comparative Biology. Janus Head 8(1), 254 – 270.
Hahn, S. S. (2007) Contradiction in Motion: Hegel’s Organic Concept of Life and Value. Cornell University Press, Ithaca.
Hildreth, A. (1942) The Lengthening Shadow of Dr. Andrew Taylor Still. Mrs A. G. Hildreth, Macon, Missouri and Mrs A. E. Van Vleck.
Jones, J. M. (2012) Charlotte Weaver: Pioneer in Cranial Osteopathy. Book Review in The Journal of the American Osteopathic Association, March, Vol. 112, p. 143 – 144.
McPartland, J. M. & Skinner, E. (2005) The Biodynamic Model of Osteopathy in the Cranial Field. Explore: The Journal of Science and Healing. January, Vol.1, No.1, p.21 – 32.
Sherrington, C. (1955) Man on his Nature. Pelican, Middlesex.