The UK Cranial Osteopathic Profession - Strengths and Weaknesses.
Originally published in Sutherland Cranial Magazine Summer 2012
In a previous article “One Leap Forwards or Two Steps Apart” the argument was stressed for a comprehensive and tangibly taught osteopathic training in the cranial field to be integrated into the 4/5 year UK osteopathic undergraduate programme.1 The rationale behind this argument would be to encourage a greater depth of knowledge in anatomy combined with the practical development of listening skills and the using of indirect techniques. These skills, in themselves, promote the need of the student to apply an osteopathic philosophy in their patient approach. The current UK undergraduate programme currently neglects and undervalues these skills.
In anticipation, it was suggested that the UK osteopathic profession working in the cranial field would need to identify their strengths and weaknesses. By acting on their strengths and addressing their weaknesses it may be possible to integrate into their work into the undergraduate programmes, achieve equal credence to other all other osteopathic approaches and contribute more to the development and forward drive osteopathic profession as a whole.
The osteopathic profession practising in the cranial field can stand accused of a number of weaknesses; namely of being ,unscientific,, ,clinically ineffective, and ‘magical thinking’. It is high time that these points are aired one by one, analysed and discussed. The strengths of this osteopathic approach, not least its popularity and success as a sadly secular part of the profession, also needs discussion and some analysis.
For the purpose of this article the description 'Cranial Osteopath' is chosen as the name commonly used by both patients and practitioners to describe osteopaths who work using Sutherlands’ concept of the Primary Respiratory Mechanism (PRM) in their osteopathic therapeutic approach. It is a title that is a misnomer. Osteopaths who practice in the cranial field treat the whole body including the head. They have the training of a structural osteopath and many use both direct and indirect techniques, work with both voluntary and involuntary motion and do not like to be secularised. However UK osteopaths have to gain their 'cranial osteopathic' skills and training through post graduate study and therefore need some title to distinguish them from those untrained in this approach. It is high time we were all trained to the same high standard in all approaches – structural, cranial and visceral. This eliminates the need to secularise and the use of this unpopular title.
'Unscientific'
Jung spoke of four main psychological functions common to all humanity: thinking, feeling, sensing and intuition. He arranged these as two pairs of opposites: “Thinking interprets, feeling evaluates, whilst sensation and intuition are perceptive in that they make us aware of what is happening without interpretation or evaluations..... Jung observed that each person has an innate conscious orientation towards one of the four functions, whilst the opposite function remains largely unconscious and undeveloped...... Jung’s therapeutic approach required the conscious development of the neglected function, together with an awareness of the four functions in oneself, so as to achieve a well rounded personality.” 2
Historically great scientists, artists, geographers, religious experts and astrologers coexisted and communicated with one another. Together they attempted to offer a complete understanding of the microcosm, body, world and universe within a hierarchic system, respecting and embracing all of the four psychological functions as described by Jung. In the 17th century the scientific revolution critically took science away from the other disciplines, travelling along the 'thinking' dimension and consciously dismissing 'feeling', 'intuition' and 'sensing' as scientifically unworthy.
In order for an osteopath to assess and treat his patient he uses the skill that is the premise of being an osteopath. He palpates. It is subjective, a feeling and therefore of no scientific value. To make matters worse, 'cranial osteopaths' use perception (intuition and sensing) and actively encourage themselves not to analyse or interpret at the point of trying to engage and interact with the PRM.
The therapeutic rationale of a 'cranial osteopath' is to find a point of balance from where the body has the potential to reorganise. On talking of balance it is possible to think beyond the 3 dimensions. There is front to back, left to right, top to bottom, deep to superficial, psyche to soma, the secular parts to the whole in the fractal sense, the whole body to its surroundings and the dimension of time in terms of past, present and future. A 'cranial osteopath' will use the principles of treatment – exaggeration, direct action, decompression- in a suggestive, supportive way rather than an assertive manner, to help the body to find that point of balance. Having done that, the practitioner is passive as it is time to witness the body at work. It is astounding to witness. The practitioner is guided by the PRM and for this to happen he must relinquish control and a full understanding of what is happening and why. Diagnosis and treatments merge.
Although a 'cranial osteopath' can examine his patients structurally before and after treatment and is competent in clinical screening procedures, the actual methods of diagnosis and treatment are scientifically unworthy. They must hold their hands up to this fact. It needs to be acknowledged publically, clearly and subsequently overcome. It is a fact that severely hampers any contribution that cranial osteopathy can make towards science in terms of an allopathically orientated diagnosis and treatment.
However, this is far from meaning that science cannot contribute towards this approach in osteopathy.
In his book The Grand Design Stephen Hawking points out how great thinkers of Ancient Greece, such as Democritus, Archimedes and Aristotle, were insightful but they were not scientists.3 He explains that the tools or scientific methods needed to back up their ideas were not available in their era. This author would suggest that Sutherland was insightful and the science emerging in this 21st century is starting to give credence to his concepts and the PRM.
Sutherland dedicated a lifetime of study to an absolutely fascinating and nearly original concept, constantly disparaged by the majority of his colleagues. He tried to describe his understanding of the PRM by breaking it down into 5 concepts, as a means of explaining. These concepts have been pulled apart and individually criticised without the understanding that they come as a package to explain a very simple phenomenon of a rhythmic shape change that occurs at all levels from the molecules, nucleus, cells, organs, limbs, whole body – an expression of health in motion in a hierarchal system. That expression of health in motion, through the whole body as a unit, relies on a functional midline. It was this functional midline he compartmentalised to rationalise the physical body (cranial bones and sacrum), the shape it holds (membranes) and the fields of force operating within it (fluid motion and embryological development within the CNS).4 This rhythmic shape change, the involuntary motion (IVM), is the first thing “cranial osteopaths” need to be able to explain in scientific terms. It is no good calling themselves osteopaths who work with the IVM if they cannot explain IVM in rational terms. “Cellular breathing” (although this author uses this descriptor herself) is not sufficient. 'Cranial osteopaths' regard this Involuntary Motion (IVM) as an indicator of health and where absent, as an indicator of dis-ease. However it is not the tool with which they work to effect a change. They claim to interact with the Primary Respiratory Mechanism (PRM) and initiate a therapeutic response within their patients.
What is it that they are interacting with and how are they initiating a therapeutic response?
These are fundamental questions. Cranial osteopaths may not have the answers in their complete form but, as Colin Dove has promoted both verbally and in writing, they need to be practising their skills around a modern day theory. 5,6 It is not a case of exchanging Sutherlands theory for anything else; rather bringing it into the 21st century. Until the osteopathic profession working in the cranial field attempt to answer these questions and develop a modernised theory around which their therapeutic approach is based, the profession is not in a position to develop a modern day language and be able to communicate with others.
Using the analogy of a jigsaw, where the finished picture represents the rationale behind working with the PRM, it seems to this author that pieces of that jigsaw are emerging from different fields of science and, on gathering the pieces together, it is possible to see the start of that picture emerging.
What is relevant is that science today is changing tack. Up until recently thought processes were based on logic and sequential analysis of what we can see and what we can measure, but now quantum science is telling us that we have to come away from preconceived ideas, and think in far more dimensions – to think beyond reason. The biomechanical models set in 3 dimensions are very helpful for those that are biomechanical practitioners, however the more subtle involuntary motion and palpatory experience of the response of the PRM to clinical intervention requires a different scientific reasoning and one that is starting to emerge today. Hawking also explains that it is not necessarily a singular explanation for a singular theory. Rather there can be a number of explanations that merge towards a more complete understanding.3 Where previously, different scientific specialisms have isolated themselves from one another they are now realising that if they come together, pictures rather than facts emerge. “There is a wholesale merging of minds between the life, engineering and physical sciences – billed as critical to helping researchers answer the most profound questions..... ... The Convergent Revolution is a paradigm shift”. 7 Osteopathy is rooted around the laws of nature and to understand the laws of nature requires the asking of the most profound questions.
Where biomechanical colleagues are sharing in and benefitting from scientific advances developing in medicine and manual therapy, “cranial osteopaths” need to and they are embracing developments along alternative avenues. Cell biology, quantum physics, evolutionary biology, neurology, psychology, embryology, mathematics, philosophy and socioecomonics all bear relevance when looking at complex systems and their emergent behaviours. Various osteopaths with enquiring minds have looked at a number of these disciplines individually or in combination and used knowledge and advances made in these fields to try and explain the IVM and the inexplicable forces, natural forces, with which a cranial osteopath interacts and initiates a response via the PRM.8,9,10,11,12,13,14,15,16. They have looked at pieces of the jigsaw. Nick Handoll wrote his ground breaking book, The Anatomy of Potency. Those pieces of the jigsaws need to come together. Dr Paul Lee has made an outstanding contribution in writing his book Interface.16 Dr Lee stresses the need to ‘not stop there’ but ‘keep digging’. Patrick van den Heede17 talks of integrated morphology incorporating breathtaking detailed and extensive knowledge from many scientific arenas to show us a way of considering body, mind and matter as one. A group called the EvOst group in Belgium are currently gathering force in small but collective numbers of key thinkers from around the world and studying the implications of this convergent revolution. They are gathering momentum in their efforts to embrace the philosophy of osteopathy as proposed by AT Still within a current and convergent scientific, philosophical and socioeconomical model. This is what is needed: a meeting of some great minds from across the globe, a picture borne and a consensus of opinion formed.
A Piece of the Jigsaw
Ingber is a cell biologist exploring tensegrity within the DNA, nucleus, cell and extracellular matrix. “Tensegrity is a building principle that was first described by the architect R. Buckminster Fuller(1961)...... Fuller describes tensegrity systems as structures that stabilize their shape by continuous tension.” At the same time as concentrating on tensegrity at the cellular level, Ingber appreciates the relevance of the hierarchical structure of life and discusses how his findings should mirror themselves at levels of higher organisation, namely tissues, organs and whole body; maybe higher. 18
Biological tensegrity has had its critics amongst cell biologists.19 Many biomechanics believe tensegrity should remain in the realms of sculpture, physics and engineering from whence it started.20 However it is relevant here to point out that Ingber is the founding member of the Wyss Institute for Biologically Inspired Engineering at Harvard. The Institute has been awarded the biggest grant of $125 million dollars in the history of Harvard. His team are representative of the Convergent Revolution.21
Ingber and his team work from a functional perspective in understanding how structure governs function within life processes. They have demonstrated how physical forces applied to the surface of the cell can affect chemical outcomes both within that cell and in cells distal to it; a phenomenon Ingber explains through connectivity via the extracellular matrix. However the positioning and the angle from which those physical forces are applied is relevant. 22 If it is possible to consider the body and the cell as sharing hierarchal properties does this explain that if a cranial osteopath provides a point of contact to the surface of his patients body, at the correct angle and in the correct position he seemingly has influence on further physical and chemical outcomes distal to the point of contact?
Ingber highlights studies demonstrating how living cells forced to take on different shapes, spherical or flattened, can switch between different genetic programmes.23 Cells spread flat become more likely to divide, whereas round cell activate a death program known as apoptosis. In between these two extremes, normal tissue function is established and maintained. This bears huge implications to cranial osteopaths in terms of the rhythmic shape change between flexion (short and fat) and extension (long and thin) that we see as representative of health; the IVM. Patients unable to express one range of the rhythmic cycle bear the signs of dis-ease.
One of Ingber’s most recent papers describes not only that physical forces play a large part in influencing embryological development but that these same physical forces are potentially responsible for the maintenance of health.24 'Cranial osteopaths' discuss the embryological fields of force persisting on through life as our self healing and self regulating mechanism. Is it these morphogenetic forces that the osteopath interacts with and is guided by. Is this representative of the PRM?
Moving briefly across to quantum science here is a quote from an article in New Scientist Feb 2012. “Last year Wilson and his team at the Chalmers University of Technology in Gothenburg, Sweden, provided what seems a particularly egregious case of something for nothing. They claimed to have conjured up light from nowhere simply by squeezing down empty space. That would be the latest manifestation of a quantum quirk known as the Casimir effect: the notion that a perfect vacuum, the very definition of nothingness in the physical world, contains a latent power that can harnessed to move objects and make stuff.”25 AT Still talks of ‘Spirit’26 (in terms of life force rather than deity) or the ‘Unknowable’ and Sutherland talks of ‘liquid light’27. Is the Casimir Effect representative of the ‘unknowable’ or the ‘liquid light’ exerting its influence through mind and matter in the form of motion?
The whole of the osteopathic profession should be embracing these discoveries. The jigsaw analogy applies to osteopathy in its whole intended format.
In anticipation, it was suggested that the UK osteopathic profession working in the cranial field would need to identify their strengths and weaknesses. By acting on their strengths and addressing their weaknesses it may be possible to integrate into their work into the undergraduate programmes, achieve equal credence to other all other osteopathic approaches and contribute more to the development and forward drive osteopathic profession as a whole.
The osteopathic profession practising in the cranial field can stand accused of a number of weaknesses; namely of being ,unscientific,, ,clinically ineffective, and ‘magical thinking’. It is high time that these points are aired one by one, analysed and discussed. The strengths of this osteopathic approach, not least its popularity and success as a sadly secular part of the profession, also needs discussion and some analysis.
For the purpose of this article the description 'Cranial Osteopath' is chosen as the name commonly used by both patients and practitioners to describe osteopaths who work using Sutherlands’ concept of the Primary Respiratory Mechanism (PRM) in their osteopathic therapeutic approach. It is a title that is a misnomer. Osteopaths who practice in the cranial field treat the whole body including the head. They have the training of a structural osteopath and many use both direct and indirect techniques, work with both voluntary and involuntary motion and do not like to be secularised. However UK osteopaths have to gain their 'cranial osteopathic' skills and training through post graduate study and therefore need some title to distinguish them from those untrained in this approach. It is high time we were all trained to the same high standard in all approaches – structural, cranial and visceral. This eliminates the need to secularise and the use of this unpopular title.
'Unscientific'
Jung spoke of four main psychological functions common to all humanity: thinking, feeling, sensing and intuition. He arranged these as two pairs of opposites: “Thinking interprets, feeling evaluates, whilst sensation and intuition are perceptive in that they make us aware of what is happening without interpretation or evaluations..... Jung observed that each person has an innate conscious orientation towards one of the four functions, whilst the opposite function remains largely unconscious and undeveloped...... Jung’s therapeutic approach required the conscious development of the neglected function, together with an awareness of the four functions in oneself, so as to achieve a well rounded personality.” 2
Historically great scientists, artists, geographers, religious experts and astrologers coexisted and communicated with one another. Together they attempted to offer a complete understanding of the microcosm, body, world and universe within a hierarchic system, respecting and embracing all of the four psychological functions as described by Jung. In the 17th century the scientific revolution critically took science away from the other disciplines, travelling along the 'thinking' dimension and consciously dismissing 'feeling', 'intuition' and 'sensing' as scientifically unworthy.
In order for an osteopath to assess and treat his patient he uses the skill that is the premise of being an osteopath. He palpates. It is subjective, a feeling and therefore of no scientific value. To make matters worse, 'cranial osteopaths' use perception (intuition and sensing) and actively encourage themselves not to analyse or interpret at the point of trying to engage and interact with the PRM.
The therapeutic rationale of a 'cranial osteopath' is to find a point of balance from where the body has the potential to reorganise. On talking of balance it is possible to think beyond the 3 dimensions. There is front to back, left to right, top to bottom, deep to superficial, psyche to soma, the secular parts to the whole in the fractal sense, the whole body to its surroundings and the dimension of time in terms of past, present and future. A 'cranial osteopath' will use the principles of treatment – exaggeration, direct action, decompression- in a suggestive, supportive way rather than an assertive manner, to help the body to find that point of balance. Having done that, the practitioner is passive as it is time to witness the body at work. It is astounding to witness. The practitioner is guided by the PRM and for this to happen he must relinquish control and a full understanding of what is happening and why. Diagnosis and treatments merge.
Although a 'cranial osteopath' can examine his patients structurally before and after treatment and is competent in clinical screening procedures, the actual methods of diagnosis and treatment are scientifically unworthy. They must hold their hands up to this fact. It needs to be acknowledged publically, clearly and subsequently overcome. It is a fact that severely hampers any contribution that cranial osteopathy can make towards science in terms of an allopathically orientated diagnosis and treatment.
However, this is far from meaning that science cannot contribute towards this approach in osteopathy.
In his book The Grand Design Stephen Hawking points out how great thinkers of Ancient Greece, such as Democritus, Archimedes and Aristotle, were insightful but they were not scientists.3 He explains that the tools or scientific methods needed to back up their ideas were not available in their era. This author would suggest that Sutherland was insightful and the science emerging in this 21st century is starting to give credence to his concepts and the PRM.
Sutherland dedicated a lifetime of study to an absolutely fascinating and nearly original concept, constantly disparaged by the majority of his colleagues. He tried to describe his understanding of the PRM by breaking it down into 5 concepts, as a means of explaining. These concepts have been pulled apart and individually criticised without the understanding that they come as a package to explain a very simple phenomenon of a rhythmic shape change that occurs at all levels from the molecules, nucleus, cells, organs, limbs, whole body – an expression of health in motion in a hierarchal system. That expression of health in motion, through the whole body as a unit, relies on a functional midline. It was this functional midline he compartmentalised to rationalise the physical body (cranial bones and sacrum), the shape it holds (membranes) and the fields of force operating within it (fluid motion and embryological development within the CNS).4 This rhythmic shape change, the involuntary motion (IVM), is the first thing “cranial osteopaths” need to be able to explain in scientific terms. It is no good calling themselves osteopaths who work with the IVM if they cannot explain IVM in rational terms. “Cellular breathing” (although this author uses this descriptor herself) is not sufficient. 'Cranial osteopaths' regard this Involuntary Motion (IVM) as an indicator of health and where absent, as an indicator of dis-ease. However it is not the tool with which they work to effect a change. They claim to interact with the Primary Respiratory Mechanism (PRM) and initiate a therapeutic response within their patients.
What is it that they are interacting with and how are they initiating a therapeutic response?
These are fundamental questions. Cranial osteopaths may not have the answers in their complete form but, as Colin Dove has promoted both verbally and in writing, they need to be practising their skills around a modern day theory. 5,6 It is not a case of exchanging Sutherlands theory for anything else; rather bringing it into the 21st century. Until the osteopathic profession working in the cranial field attempt to answer these questions and develop a modernised theory around which their therapeutic approach is based, the profession is not in a position to develop a modern day language and be able to communicate with others.
Using the analogy of a jigsaw, where the finished picture represents the rationale behind working with the PRM, it seems to this author that pieces of that jigsaw are emerging from different fields of science and, on gathering the pieces together, it is possible to see the start of that picture emerging.
What is relevant is that science today is changing tack. Up until recently thought processes were based on logic and sequential analysis of what we can see and what we can measure, but now quantum science is telling us that we have to come away from preconceived ideas, and think in far more dimensions – to think beyond reason. The biomechanical models set in 3 dimensions are very helpful for those that are biomechanical practitioners, however the more subtle involuntary motion and palpatory experience of the response of the PRM to clinical intervention requires a different scientific reasoning and one that is starting to emerge today. Hawking also explains that it is not necessarily a singular explanation for a singular theory. Rather there can be a number of explanations that merge towards a more complete understanding.3 Where previously, different scientific specialisms have isolated themselves from one another they are now realising that if they come together, pictures rather than facts emerge. “There is a wholesale merging of minds between the life, engineering and physical sciences – billed as critical to helping researchers answer the most profound questions..... ... The Convergent Revolution is a paradigm shift”. 7 Osteopathy is rooted around the laws of nature and to understand the laws of nature requires the asking of the most profound questions.
Where biomechanical colleagues are sharing in and benefitting from scientific advances developing in medicine and manual therapy, “cranial osteopaths” need to and they are embracing developments along alternative avenues. Cell biology, quantum physics, evolutionary biology, neurology, psychology, embryology, mathematics, philosophy and socioecomonics all bear relevance when looking at complex systems and their emergent behaviours. Various osteopaths with enquiring minds have looked at a number of these disciplines individually or in combination and used knowledge and advances made in these fields to try and explain the IVM and the inexplicable forces, natural forces, with which a cranial osteopath interacts and initiates a response via the PRM.8,9,10,11,12,13,14,15,16. They have looked at pieces of the jigsaw. Nick Handoll wrote his ground breaking book, The Anatomy of Potency. Those pieces of the jigsaws need to come together. Dr Paul Lee has made an outstanding contribution in writing his book Interface.16 Dr Lee stresses the need to ‘not stop there’ but ‘keep digging’. Patrick van den Heede17 talks of integrated morphology incorporating breathtaking detailed and extensive knowledge from many scientific arenas to show us a way of considering body, mind and matter as one. A group called the EvOst group in Belgium are currently gathering force in small but collective numbers of key thinkers from around the world and studying the implications of this convergent revolution. They are gathering momentum in their efforts to embrace the philosophy of osteopathy as proposed by AT Still within a current and convergent scientific, philosophical and socioeconomical model. This is what is needed: a meeting of some great minds from across the globe, a picture borne and a consensus of opinion formed.
A Piece of the Jigsaw
Ingber is a cell biologist exploring tensegrity within the DNA, nucleus, cell and extracellular matrix. “Tensegrity is a building principle that was first described by the architect R. Buckminster Fuller(1961)...... Fuller describes tensegrity systems as structures that stabilize their shape by continuous tension.” At the same time as concentrating on tensegrity at the cellular level, Ingber appreciates the relevance of the hierarchical structure of life and discusses how his findings should mirror themselves at levels of higher organisation, namely tissues, organs and whole body; maybe higher. 18
Biological tensegrity has had its critics amongst cell biologists.19 Many biomechanics believe tensegrity should remain in the realms of sculpture, physics and engineering from whence it started.20 However it is relevant here to point out that Ingber is the founding member of the Wyss Institute for Biologically Inspired Engineering at Harvard. The Institute has been awarded the biggest grant of $125 million dollars in the history of Harvard. His team are representative of the Convergent Revolution.21
Ingber and his team work from a functional perspective in understanding how structure governs function within life processes. They have demonstrated how physical forces applied to the surface of the cell can affect chemical outcomes both within that cell and in cells distal to it; a phenomenon Ingber explains through connectivity via the extracellular matrix. However the positioning and the angle from which those physical forces are applied is relevant. 22 If it is possible to consider the body and the cell as sharing hierarchal properties does this explain that if a cranial osteopath provides a point of contact to the surface of his patients body, at the correct angle and in the correct position he seemingly has influence on further physical and chemical outcomes distal to the point of contact?
Ingber highlights studies demonstrating how living cells forced to take on different shapes, spherical or flattened, can switch between different genetic programmes.23 Cells spread flat become more likely to divide, whereas round cell activate a death program known as apoptosis. In between these two extremes, normal tissue function is established and maintained. This bears huge implications to cranial osteopaths in terms of the rhythmic shape change between flexion (short and fat) and extension (long and thin) that we see as representative of health; the IVM. Patients unable to express one range of the rhythmic cycle bear the signs of dis-ease.
One of Ingber’s most recent papers describes not only that physical forces play a large part in influencing embryological development but that these same physical forces are potentially responsible for the maintenance of health.24 'Cranial osteopaths' discuss the embryological fields of force persisting on through life as our self healing and self regulating mechanism. Is it these morphogenetic forces that the osteopath interacts with and is guided by. Is this representative of the PRM?
Moving briefly across to quantum science here is a quote from an article in New Scientist Feb 2012. “Last year Wilson and his team at the Chalmers University of Technology in Gothenburg, Sweden, provided what seems a particularly egregious case of something for nothing. They claimed to have conjured up light from nowhere simply by squeezing down empty space. That would be the latest manifestation of a quantum quirk known as the Casimir effect: the notion that a perfect vacuum, the very definition of nothingness in the physical world, contains a latent power that can harnessed to move objects and make stuff.”25 AT Still talks of ‘Spirit’26 (in terms of life force rather than deity) or the ‘Unknowable’ and Sutherland talks of ‘liquid light’27. Is the Casimir Effect representative of the ‘unknowable’ or the ‘liquid light’ exerting its influence through mind and matter in the form of motion?
The whole of the osteopathic profession should be embracing these discoveries. The jigsaw analogy applies to osteopathy in its whole intended format.
In this author’s opinion, controversial as this may be, it is not possible to take osteopathy into science without losing what osteopathy is. However it is possible to bring science into osteopathy and preserve what is vital; an osteopathic philosophy of health and the skills that stand alongside this. It is important to be clear about which way around this is done.
'Clinically Ineffective'
An osteopath trained in the cranial field is trying to achieve something different from those practising an allopathic approach and therefore cannot be judged by allopathic criteria.
This picture is worth a thousand words in trying to get a point across here: identical twins, same genetics, same nurturing (assumed) yet so different. In a very simplistic scenario an osteopath could diagnose the twin on the left as having a nonphysiological cranial base pattern; an inferior vertical and torsion sphenobasilar (SBS) strain. It is structural diagnosis using a nomenclature system. 28
Unnamed twins: Artist – Clare Cullen
Children with this SBS pattern tend to suffer with ear, nose and throat problems. These strain patterns are clearly recognisable and frequent attendants to a cranial osteopathic practice, often presenting with ear, nose and throat problems. They have high narrow palates, their tongue sits on the floor of the mouth due to lack of space. The children develop poor swallowing and breathing habits and turn into mouth breathers. The air hits the lungs cold and oxygen uptake is compromised. Accessory muscles of breathing are activated on a regular if not constant basis affecting posture. The narrow palate leads to teeth crowding, orthodontics and subsequent potential conflict of patterns between the viscerocranium (face) and neurocranium. 29 This brings another host of problems with it. These individuals can be recognised by the development of dark rings under their eyes, thin lips and anterior head postures. The aging process is visibly as well as systemically accelerated.30
An osteopath will treat a baby with an aim to minimise these strain patterns and to prevent such eventualities, amongst many others. He will aim to minimise the distortions and compressions taken up by the membranes and cartilage prenatally, perinatally and postnatally before such patterns become ossified in bone and reflect far beyond the local trauma. As a bi-product, the osteopath may ‘settle’ the baby; symptomatic conditions may improve, eg. colic, reflux, feeding, sleeping and breathing difficulties. The parents assume the osteopath to be treating the symptoms. The cranial osteopath is not treating symptoms; he is treating the baby and the potential for health – something far more profound. The osteopathic professions are not getting this message across and need to develop a consensus on this; a means of communication with the patients.
There is a passage in the book Black Swans by N. N. Taleb, describing the imaginary situation that some clever person, with inside knowledge and foresight, warned that there was going to be an air terrorist attack on the USA and all aeroplane cockpit doors must be reinforced with steel. If that had happened the day before 9/11 no one would have thanked or even acknowledged him because no one would ever have known what eventualities he had prevented. That is what an osteopath trained in the cranial field does. The parents and the babies do not have any idea how the osteopath has helped, beyond a settled baby. The osteopath can only theorise as the health is reflected in the future of that child.
If the twin on the left, as a baby, had come to a suitably trained osteopath he or she would have worked with the PRM in an effort to minimise the non physiological SBS strain. Untreated the effects of that SBS strain pattern would have manifested over the decades in the twin on the left. Various conditions would have been itemised and treated allopathically. This author would guess that he experienced pain and stiffness in his upper back if not the whole spine and, perhaps recurrent shoulder problems; he had less energy than his brother; perhaps a heart condition through the strain of poor breathing over the decades31 and even early onset neurological issues, perhaps Parkinsons or Alzheimers , through sleep apnoea and lack of oxygen to the brain.32
No one would have predicted such a picture evolving from birth over the decades and noone could have prevented it – except an osteopath with the correct training.
There was a study carried out to measure whether “cranial osteopathy” was effective at treating Cerebral Palsy – commissioned by Cerebra, a charity that helps to improve the lives of children with brain conditions.33 After a 6 month interval physiotherapists that were carrying out the study noted that there were no observable benefits in the children that had received “cranial osteopathic treatment”, except one finding that their sense of well being was measurably affected. Interestingly this was dismissed as irrelevant. This author would suggest that they look at those children in 5 year or 10 years time. This author would look at their “life” rather than some constructed measure of cerebral palsy and its severity. She would also question who or what they will stand against in comparison as whatever they are standing against is a variable in itself. This author believes that if “cranial osteopaths” expose themselves to the allopathic way of evaluating effectiveness, they will fail.
This is, of course, a huge problem if the profession wants osteopathy to be comprehensively covered by the medical insurance companies who place their main emphasis on evidence base and outcome measurement. As a profession it is important to ask the bigger question of whether osteopaths want to sit in pockets of the insurance companies and become part of a huge machine over which they have no influence; forget about the laws of nature (intelligent as they are) and a philosophy on which we rely for our identity. It is a similar problem if the profession want to be incorporated under the NHS who seek the same criteria.
The desire for osteopathic treatment to become available to everyone no matter how rich or poor is shared by all. Stuart Korth thought of a different way around this; the Osteopathic Centre for Children (OCC). This is a renowned institution treating hundreds of babies and children every week, free of charge or for a small donation. These children represent the osteopathic future. This author does not understand the feasibility of repeating this model nationwide, to diversify away from just children and for the profession to stay in control of its own destiny, but if it is feasible then she would propose it. She would at least propose that there was a monthly update from the OCC published in Osteopathy Today to push a very important point.
So if someone asks whether cranial osteopaths are clinically effective this author would question, in turn, under what criteria are they asking that question? In truth cranial osteopaths cannot claim to be successful at treating low back pain, migraines, colic, insomnia, depression, sinusitis, vertigo, cerebral palsy? They don’t treat a condition, they initiate a therapeutic response the outcome of which is uncertain. The human body and mind is a complex system and emergence from this system is beyond the control of the osteopath; nature is in charge. Incredibly their practices are full of patients with all the above complaints, and more, asking for “cranial osteopathic treatment”. This leads on to the question of whether osteopaths trained in the cranial field are busy.
In the Osteopathy Today Jan- Dec 2011, approximately 50% of job advertisements for associates or locum positions specify “experience working with the IVM”, or some similar phrase; incredible - considering it is a peripheral, voluntary and miniscule part of the syllabus of our undergraduate programme. The General Osteopathic Council (GOsC) are apparently bemused by the number of patients who ring up asking how to find a “Cranial Osteopath”. Yet the GOsC pay no attention whatsoever to the standards or enforcement of training in this realm of treatment which leads onto the next point.
“Is the cranial osteopathic approach effective?” is a different question to “is an individual cranial osteopath effective?”
The effectiveness of the individual practitioner relies on a combination of training and experience. This author has already covered the fact that many osteopaths who say that they treat patients cranially are woefully uniformed and some lack any training at all. 1 This is clearly wrong and the only solution to this problem is for a comprehensive cranial osteopathic syllabus to be taught at undergraduate level. An extensive knowledge base with practical training in osteopathy in the cranial field should be a prerequisite for qualifying as an osteopath, as it is in parts of Europe.
In terms of experience, osteopaths only have the opportunity to specialise in the cranial and visceral field at postgraduate level so their clinical introduction is on full fee paying patients. In 1991, following this author’s 5 day introduction to cranial osteopathy course, she applied her newly learnt principles of treatment to her patients. She had the most basic of knowledge, no concept of what she was interacting with or any palpatory skill with which to apply the above. She failed markedly to impress her patients or the principal of the osteopathic practice and reflected badly on the cranial osteopathic profession and the osteopathic profession as a whole. She is sure that she has not been alone in this situation.
This is another strong argument for osteopaths to master their skills in listening and indirect techniques at undergraduate level, with supervision and with patients that are aware they are paying a reduced price for an unqualified practitioner.
“Magical Thinkers” Are osteopaths working in the cranial field “magical thinkers” in terms of what they do and what they say?
It is only after decades of working with the PRM that this author has developed an overwhelming confidence in it; not in herself. Confidence in this system of treating does not come instantly or easily, and nor should it. This author has undergone the monumental task of showing the intangible PRM to the reluctant learners. They make challenging students but less so than the self professed healers who believe that “cranial osteopathy” will provide their vehicle for accreditation. An important point here is that a student might be reluctant to explore this avenue of osteopathy, but that has no correlation with how good they might be at this work and vice versa.
There are students that naturally palpate at the bony level and apply effectively functional techniques. There are students who palpate at the level of the membranes and exert their influence by feeling the patterns and the pull and easing them towards a point of balance. There are other students who instinctively palpate at the level of the fluids and work with the formative forces driving the fluids.
All these students should share the same confidences.
When one observes the development of Sutherland, Becker and others through their literature there is a recurrent pattern where they start with the bones, moving onto the membranes, and over further time exploring the fluids and the formative forces that drive them. It seems to be a natural progression and one that assumes that when the practitioner reaches the fluid/energetic level he is advanced or an expert. There is a tendency to accelerate or rush cranial osteopathic students to an advanced fluid/energetic level way ahead of their years or even decades and this can create ‘magical thinking’. It is important to come away from imposing the idea that palpating at this level is the norm and anything less as a failure. That is not to say that this level of diagnosing and treating is invalid. It can be omnipotent but it is the extreme end of a spectrum of different osteopathic approaches many of which could still be classified as “cranial”. AT Still spoke of mind, matter and motion. They come as an ‘osteopathic package’. Too much focus on one aspect with neglect of the others destroys the package. The physical body should not be neglected just as mind and motion should not be neglected. Matter matters!
It is impossible to understand work with the PRM through explanation alone. A practitioner has to experience it and to subsequently evolve. If the UK cranial osteopathic profession wants to become inclusive rather than exclusive they need all osteopaths to experience it, to get their hands on a model and explore the fantastic anatomy with their hands and initiate an interaction with the self healing, self regulating mechanism using indirect techniques. Many osteopaths will be irritated and alienated immediately if expected to fast track to the fluid/energetic level. Rumours abound of students being told that they cannot be a “proper osteopaths” until they achieve the “biodynamic level” whilst being table tutored on post graduate cranial courses. There are a few other quite major alienating traits that cranial osteopathic table tutors have acquired that do not help integrate the profession. This author would request that these be identified and discussed.
Going back to the subject of being ‘magical thinkers’, there are two questions still lingering.
1. Does PRM exists at all? 2. Can be interacted with in a way that initiates a therapeutic response that is of benefit to our patient?’ This authors answers are categorically, yes and yes. There is no magic thinking going on, however there is the overwhelming wonder at the human body, its very existence and the life giving force that exists within, that maintains it and that surrounds it.
Conclusion Science Cranial osteopaths need science to back up a modern day theory if they want to communicate and integrate themselves with their structural colleagues.
Osteopaths working in the cranial field need to take notice of the convergent scientific revolution. This is separate to ‘evaluating the outcomes of cranial treatment’, ‘finding evidence of pulsed cranial fluid affecting physiological parameters’, ‘data collection from practices’. 34 This is completely different. It is about bringing science into osteopathy but being absolutely clear that it is not about making osteopathy scientific.
The osteopathic profession needs to push for the study of the cranium and development of listening skills and the use of indirect techniques to be taken seriously at undergraduate level? If there was a full training programme for osteopaths in the cranial field at undergraduate level, it would encourage research projects into investigating some of the more structural reasoning behind their treatment rationale. Some examples might be the relationships between SBS strain patterns and long term health – both psychological and physical; the relevance of dental occlusion and head and spinal posture; the implications of orthodontic intervention and the effect on long term health; the development of the upper, middle and lower face and the effect on breathing. If this was integrated research with a number of students contributing to different aspects of the same study over years, or even decades, it could gather some impact. It would require osteopaths with a comprehensive anatomical knowledge of the cranium, scientifically trained, within educational institutions to oversee these structurally biased studies. Most research that gathers any credence emerges from teams within educational or corporate organisations, working over years, if not decades.
Effectivity If osteopaths working in the cranial field profess to be clinically effective it should be only with the understanding that all osteopaths practising cranially are fully trained. In training the students it is important to reinforce the fact that they do not approach their patients in an allopathic way and therefore cannot justify what they do by allopathic criteria. If the profession do not do this it would be to their inevitable demise.
Rationale If the profession want to be inclusive rather than exclusive and avoid accusations of being magical thinkers this author would suggest that they stop fast tracking students onto the fluid/energetic level and respect and encourage students that apply their applied functional anatomy of the cranium at all levels of palpation and who use all treatment approaches.
Final Word: This author would encourage all members of the osteopathic profession to consider Jung’s analysis of the healthy balance between the 4 psychological functions. An osteopath interacting with the PRM may rely intently on intuition, feeling and sensing for a therapeutic intervention, but when his hands are off the patient, he should be thinking, thinking, thinking.
“Reason flows from the blending of rational thought and feeling. If the two functions are torn apart, thinking deteriorates into schizoid intellectual activity and feelings deteriorate into neurotic life-damaging passions”. Eric Fromm.
References
1. Wildy J Feb 2012 One Leap Forwards or Two Steps Apart. OT
2. Harding S 2009 Animate Earth p36
3 .Hawking S 2010 The Grand Design p32, p77
4. Sutherland WG 1990 Teachings in the Science of osteopathy Ch2
5. Dove C 2004 Rollin Becker memorial Lecture,
6. Dove C 2011 SCC Magazine 33:31-32 5
7 .Nelson B July 2011 Scientific American p12
8. Handoll N 2000 The anatomy of potency
9. Draeger K, van den Heede P, Klessen H 2011 OSTEOPATHIE- ARCHITECTUR DER BALANCE
10. Nelson KE, Sergueef N, Glonek T 2001 JAOA. 101(3):163-173, 2006 JAOA 106(6):337-341
11. Ferguson A 2003 A review of the physiology of cranial anatomy. IJOM 6(2): 74-84,
12. Girardin 2005 Evolutionary Medicine in the Osteopathic Field IJOM 85-93
13. Girardin 2012 Handouts for the EvOst
14. Hamm D 2011 A Hypothesis to explain the palpatory experience and therapeutic claims in the practice of osteopathy in the cranial field. IJOM 14(4)p149-165
15. Oschmann J 2009 Energy Medicine: The Scientific Basis
17. Lee P 2005 Interface: Mechanisms of Spirit in Osteopathy
18. Ingber DE 1998 The architecture of life. ScientificAmerican:1:48-57
19. Brookes M 1999 Hard cell, soft cell. New Scientist 164:41-46
20. Pflueger C 2008 The meaning of tensegrity principles for osteopathic medicine. Masterthesis www.osteopathicresearch.com/paper_pdf/Pflueger
21. Ingber DE May 2011 ubergeek316.fr/2011/05donald-ingber-serendipitous-science.html
22. Ingber DE 2003 Tensegrity1. Cell structure and hierarchical systems in biology J Cell Sci 116: 1157-1173
23. Pienta KJ Coffey DS 1991 Cellular harmonic information transfer through a tissue tensegrity matrix system. Medical Hypothesis 34:88-95
24. Ingber DE 2010 The mechanical control of tissue and organ development. Development 137(9):1407-1420
www.childrenshospital.org/research/ingber
25. Harris D Feb2012 Vacuum Packed. New Scientist p34
26. Lee P 2005 Interface: Mechanisms of Spirit in Osteopathy p44
27. Sutherland WG 1990 Teachings in the Science of osteopathy p34,228
28. Magoun 1976 Osteopathy in the Cranial Field 3rd Ed Ch 7
29. Sergueef N 2007 Cranial Osteopathy for Infants, children and adolescents Ch 7.3,7.4,7.6,7.7
30. Iyer SR & RR. 2010 Sleep, ageing and stroke. J Assoc Physicians India 58:442-6
31. Mirrakhimov AE 2012 Non drowsy obstructive sleep apnoea as a potential cause of resistant hypertension: a case report. BMC Pulm Med 12(1)p16
32. Diedrierich NJ et al. 2005 Sleep Apnoea syndrome in Parkinson’s disease. A case control study . Movement Disorders 20 (11) p1413-1418 35.
33. www.sciencedaily.com/releases/2011/03/1103150093247.htm
34.ICRA Newsletter October 2011
'Clinically Ineffective'
An osteopath trained in the cranial field is trying to achieve something different from those practising an allopathic approach and therefore cannot be judged by allopathic criteria.
This picture is worth a thousand words in trying to get a point across here: identical twins, same genetics, same nurturing (assumed) yet so different. In a very simplistic scenario an osteopath could diagnose the twin on the left as having a nonphysiological cranial base pattern; an inferior vertical and torsion sphenobasilar (SBS) strain. It is structural diagnosis using a nomenclature system. 28
Unnamed twins: Artist – Clare Cullen
Children with this SBS pattern tend to suffer with ear, nose and throat problems. These strain patterns are clearly recognisable and frequent attendants to a cranial osteopathic practice, often presenting with ear, nose and throat problems. They have high narrow palates, their tongue sits on the floor of the mouth due to lack of space. The children develop poor swallowing and breathing habits and turn into mouth breathers. The air hits the lungs cold and oxygen uptake is compromised. Accessory muscles of breathing are activated on a regular if not constant basis affecting posture. The narrow palate leads to teeth crowding, orthodontics and subsequent potential conflict of patterns between the viscerocranium (face) and neurocranium. 29 This brings another host of problems with it. These individuals can be recognised by the development of dark rings under their eyes, thin lips and anterior head postures. The aging process is visibly as well as systemically accelerated.30
An osteopath will treat a baby with an aim to minimise these strain patterns and to prevent such eventualities, amongst many others. He will aim to minimise the distortions and compressions taken up by the membranes and cartilage prenatally, perinatally and postnatally before such patterns become ossified in bone and reflect far beyond the local trauma. As a bi-product, the osteopath may ‘settle’ the baby; symptomatic conditions may improve, eg. colic, reflux, feeding, sleeping and breathing difficulties. The parents assume the osteopath to be treating the symptoms. The cranial osteopath is not treating symptoms; he is treating the baby and the potential for health – something far more profound. The osteopathic professions are not getting this message across and need to develop a consensus on this; a means of communication with the patients.
There is a passage in the book Black Swans by N. N. Taleb, describing the imaginary situation that some clever person, with inside knowledge and foresight, warned that there was going to be an air terrorist attack on the USA and all aeroplane cockpit doors must be reinforced with steel. If that had happened the day before 9/11 no one would have thanked or even acknowledged him because no one would ever have known what eventualities he had prevented. That is what an osteopath trained in the cranial field does. The parents and the babies do not have any idea how the osteopath has helped, beyond a settled baby. The osteopath can only theorise as the health is reflected in the future of that child.
If the twin on the left, as a baby, had come to a suitably trained osteopath he or she would have worked with the PRM in an effort to minimise the non physiological SBS strain. Untreated the effects of that SBS strain pattern would have manifested over the decades in the twin on the left. Various conditions would have been itemised and treated allopathically. This author would guess that he experienced pain and stiffness in his upper back if not the whole spine and, perhaps recurrent shoulder problems; he had less energy than his brother; perhaps a heart condition through the strain of poor breathing over the decades31 and even early onset neurological issues, perhaps Parkinsons or Alzheimers , through sleep apnoea and lack of oxygen to the brain.32
No one would have predicted such a picture evolving from birth over the decades and noone could have prevented it – except an osteopath with the correct training.
There was a study carried out to measure whether “cranial osteopathy” was effective at treating Cerebral Palsy – commissioned by Cerebra, a charity that helps to improve the lives of children with brain conditions.33 After a 6 month interval physiotherapists that were carrying out the study noted that there were no observable benefits in the children that had received “cranial osteopathic treatment”, except one finding that their sense of well being was measurably affected. Interestingly this was dismissed as irrelevant. This author would suggest that they look at those children in 5 year or 10 years time. This author would look at their “life” rather than some constructed measure of cerebral palsy and its severity. She would also question who or what they will stand against in comparison as whatever they are standing against is a variable in itself. This author believes that if “cranial osteopaths” expose themselves to the allopathic way of evaluating effectiveness, they will fail.
This is, of course, a huge problem if the profession wants osteopathy to be comprehensively covered by the medical insurance companies who place their main emphasis on evidence base and outcome measurement. As a profession it is important to ask the bigger question of whether osteopaths want to sit in pockets of the insurance companies and become part of a huge machine over which they have no influence; forget about the laws of nature (intelligent as they are) and a philosophy on which we rely for our identity. It is a similar problem if the profession want to be incorporated under the NHS who seek the same criteria.
The desire for osteopathic treatment to become available to everyone no matter how rich or poor is shared by all. Stuart Korth thought of a different way around this; the Osteopathic Centre for Children (OCC). This is a renowned institution treating hundreds of babies and children every week, free of charge or for a small donation. These children represent the osteopathic future. This author does not understand the feasibility of repeating this model nationwide, to diversify away from just children and for the profession to stay in control of its own destiny, but if it is feasible then she would propose it. She would at least propose that there was a monthly update from the OCC published in Osteopathy Today to push a very important point.
So if someone asks whether cranial osteopaths are clinically effective this author would question, in turn, under what criteria are they asking that question? In truth cranial osteopaths cannot claim to be successful at treating low back pain, migraines, colic, insomnia, depression, sinusitis, vertigo, cerebral palsy? They don’t treat a condition, they initiate a therapeutic response the outcome of which is uncertain. The human body and mind is a complex system and emergence from this system is beyond the control of the osteopath; nature is in charge. Incredibly their practices are full of patients with all the above complaints, and more, asking for “cranial osteopathic treatment”. This leads on to the question of whether osteopaths trained in the cranial field are busy.
In the Osteopathy Today Jan- Dec 2011, approximately 50% of job advertisements for associates or locum positions specify “experience working with the IVM”, or some similar phrase; incredible - considering it is a peripheral, voluntary and miniscule part of the syllabus of our undergraduate programme. The General Osteopathic Council (GOsC) are apparently bemused by the number of patients who ring up asking how to find a “Cranial Osteopath”. Yet the GOsC pay no attention whatsoever to the standards or enforcement of training in this realm of treatment which leads onto the next point.
“Is the cranial osteopathic approach effective?” is a different question to “is an individual cranial osteopath effective?”
The effectiveness of the individual practitioner relies on a combination of training and experience. This author has already covered the fact that many osteopaths who say that they treat patients cranially are woefully uniformed and some lack any training at all. 1 This is clearly wrong and the only solution to this problem is for a comprehensive cranial osteopathic syllabus to be taught at undergraduate level. An extensive knowledge base with practical training in osteopathy in the cranial field should be a prerequisite for qualifying as an osteopath, as it is in parts of Europe.
In terms of experience, osteopaths only have the opportunity to specialise in the cranial and visceral field at postgraduate level so their clinical introduction is on full fee paying patients. In 1991, following this author’s 5 day introduction to cranial osteopathy course, she applied her newly learnt principles of treatment to her patients. She had the most basic of knowledge, no concept of what she was interacting with or any palpatory skill with which to apply the above. She failed markedly to impress her patients or the principal of the osteopathic practice and reflected badly on the cranial osteopathic profession and the osteopathic profession as a whole. She is sure that she has not been alone in this situation.
This is another strong argument for osteopaths to master their skills in listening and indirect techniques at undergraduate level, with supervision and with patients that are aware they are paying a reduced price for an unqualified practitioner.
“Magical Thinkers” Are osteopaths working in the cranial field “magical thinkers” in terms of what they do and what they say?
It is only after decades of working with the PRM that this author has developed an overwhelming confidence in it; not in herself. Confidence in this system of treating does not come instantly or easily, and nor should it. This author has undergone the monumental task of showing the intangible PRM to the reluctant learners. They make challenging students but less so than the self professed healers who believe that “cranial osteopathy” will provide their vehicle for accreditation. An important point here is that a student might be reluctant to explore this avenue of osteopathy, but that has no correlation with how good they might be at this work and vice versa.
There are students that naturally palpate at the bony level and apply effectively functional techniques. There are students who palpate at the level of the membranes and exert their influence by feeling the patterns and the pull and easing them towards a point of balance. There are other students who instinctively palpate at the level of the fluids and work with the formative forces driving the fluids.
All these students should share the same confidences.
When one observes the development of Sutherland, Becker and others through their literature there is a recurrent pattern where they start with the bones, moving onto the membranes, and over further time exploring the fluids and the formative forces that drive them. It seems to be a natural progression and one that assumes that when the practitioner reaches the fluid/energetic level he is advanced or an expert. There is a tendency to accelerate or rush cranial osteopathic students to an advanced fluid/energetic level way ahead of their years or even decades and this can create ‘magical thinking’. It is important to come away from imposing the idea that palpating at this level is the norm and anything less as a failure. That is not to say that this level of diagnosing and treating is invalid. It can be omnipotent but it is the extreme end of a spectrum of different osteopathic approaches many of which could still be classified as “cranial”. AT Still spoke of mind, matter and motion. They come as an ‘osteopathic package’. Too much focus on one aspect with neglect of the others destroys the package. The physical body should not be neglected just as mind and motion should not be neglected. Matter matters!
It is impossible to understand work with the PRM through explanation alone. A practitioner has to experience it and to subsequently evolve. If the UK cranial osteopathic profession wants to become inclusive rather than exclusive they need all osteopaths to experience it, to get their hands on a model and explore the fantastic anatomy with their hands and initiate an interaction with the self healing, self regulating mechanism using indirect techniques. Many osteopaths will be irritated and alienated immediately if expected to fast track to the fluid/energetic level. Rumours abound of students being told that they cannot be a “proper osteopaths” until they achieve the “biodynamic level” whilst being table tutored on post graduate cranial courses. There are a few other quite major alienating traits that cranial osteopathic table tutors have acquired that do not help integrate the profession. This author would request that these be identified and discussed.
Going back to the subject of being ‘magical thinkers’, there are two questions still lingering.
1. Does PRM exists at all? 2. Can be interacted with in a way that initiates a therapeutic response that is of benefit to our patient?’ This authors answers are categorically, yes and yes. There is no magic thinking going on, however there is the overwhelming wonder at the human body, its very existence and the life giving force that exists within, that maintains it and that surrounds it.
Conclusion Science Cranial osteopaths need science to back up a modern day theory if they want to communicate and integrate themselves with their structural colleagues.
Osteopaths working in the cranial field need to take notice of the convergent scientific revolution. This is separate to ‘evaluating the outcomes of cranial treatment’, ‘finding evidence of pulsed cranial fluid affecting physiological parameters’, ‘data collection from practices’. 34 This is completely different. It is about bringing science into osteopathy but being absolutely clear that it is not about making osteopathy scientific.
The osteopathic profession needs to push for the study of the cranium and development of listening skills and the use of indirect techniques to be taken seriously at undergraduate level? If there was a full training programme for osteopaths in the cranial field at undergraduate level, it would encourage research projects into investigating some of the more structural reasoning behind their treatment rationale. Some examples might be the relationships between SBS strain patterns and long term health – both psychological and physical; the relevance of dental occlusion and head and spinal posture; the implications of orthodontic intervention and the effect on long term health; the development of the upper, middle and lower face and the effect on breathing. If this was integrated research with a number of students contributing to different aspects of the same study over years, or even decades, it could gather some impact. It would require osteopaths with a comprehensive anatomical knowledge of the cranium, scientifically trained, within educational institutions to oversee these structurally biased studies. Most research that gathers any credence emerges from teams within educational or corporate organisations, working over years, if not decades.
Effectivity If osteopaths working in the cranial field profess to be clinically effective it should be only with the understanding that all osteopaths practising cranially are fully trained. In training the students it is important to reinforce the fact that they do not approach their patients in an allopathic way and therefore cannot justify what they do by allopathic criteria. If the profession do not do this it would be to their inevitable demise.
Rationale If the profession want to be inclusive rather than exclusive and avoid accusations of being magical thinkers this author would suggest that they stop fast tracking students onto the fluid/energetic level and respect and encourage students that apply their applied functional anatomy of the cranium at all levels of palpation and who use all treatment approaches.
Final Word: This author would encourage all members of the osteopathic profession to consider Jung’s analysis of the healthy balance between the 4 psychological functions. An osteopath interacting with the PRM may rely intently on intuition, feeling and sensing for a therapeutic intervention, but when his hands are off the patient, he should be thinking, thinking, thinking.
“Reason flows from the blending of rational thought and feeling. If the two functions are torn apart, thinking deteriorates into schizoid intellectual activity and feelings deteriorate into neurotic life-damaging passions”. Eric Fromm.
References
1. Wildy J Feb 2012 One Leap Forwards or Two Steps Apart. OT
2. Harding S 2009 Animate Earth p36
3 .Hawking S 2010 The Grand Design p32, p77
4. Sutherland WG 1990 Teachings in the Science of osteopathy Ch2
5. Dove C 2004 Rollin Becker memorial Lecture,
6. Dove C 2011 SCC Magazine 33:31-32 5
7 .Nelson B July 2011 Scientific American p12
8. Handoll N 2000 The anatomy of potency
9. Draeger K, van den Heede P, Klessen H 2011 OSTEOPATHIE- ARCHITECTUR DER BALANCE
10. Nelson KE, Sergueef N, Glonek T 2001 JAOA. 101(3):163-173, 2006 JAOA 106(6):337-341
11. Ferguson A 2003 A review of the physiology of cranial anatomy. IJOM 6(2): 74-84,
12. Girardin 2005 Evolutionary Medicine in the Osteopathic Field IJOM 85-93
13. Girardin 2012 Handouts for the EvOst
14. Hamm D 2011 A Hypothesis to explain the palpatory experience and therapeutic claims in the practice of osteopathy in the cranial field. IJOM 14(4)p149-165
15. Oschmann J 2009 Energy Medicine: The Scientific Basis
17. Lee P 2005 Interface: Mechanisms of Spirit in Osteopathy
18. Ingber DE 1998 The architecture of life. ScientificAmerican:1:48-57
19. Brookes M 1999 Hard cell, soft cell. New Scientist 164:41-46
20. Pflueger C 2008 The meaning of tensegrity principles for osteopathic medicine. Masterthesis www.osteopathicresearch.com/paper_pdf/Pflueger
21. Ingber DE May 2011 ubergeek316.fr/2011/05donald-ingber-serendipitous-science.html
22. Ingber DE 2003 Tensegrity1. Cell structure and hierarchical systems in biology J Cell Sci 116: 1157-1173
23. Pienta KJ Coffey DS 1991 Cellular harmonic information transfer through a tissue tensegrity matrix system. Medical Hypothesis 34:88-95
24. Ingber DE 2010 The mechanical control of tissue and organ development. Development 137(9):1407-1420
www.childrenshospital.org/research/ingber
25. Harris D Feb2012 Vacuum Packed. New Scientist p34
26. Lee P 2005 Interface: Mechanisms of Spirit in Osteopathy p44
27. Sutherland WG 1990 Teachings in the Science of osteopathy p34,228
28. Magoun 1976 Osteopathy in the Cranial Field 3rd Ed Ch 7
29. Sergueef N 2007 Cranial Osteopathy for Infants, children and adolescents Ch 7.3,7.4,7.6,7.7
30. Iyer SR & RR. 2010 Sleep, ageing and stroke. J Assoc Physicians India 58:442-6
31. Mirrakhimov AE 2012 Non drowsy obstructive sleep apnoea as a potential cause of resistant hypertension: a case report. BMC Pulm Med 12(1)p16
32. Diedrierich NJ et al. 2005 Sleep Apnoea syndrome in Parkinson’s disease. A case control study . Movement Disorders 20 (11) p1413-1418 35.
33. www.sciencedaily.com/releases/2011/03/1103150093247.htm
34.ICRA Newsletter October 2011
