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Health and the Therapeutic Processby Stephen Paulus, DO Every inquiring individual who has ever been injured or suffered an illness wonders what triggers the process of healing. Each person who struggles with a chronic disease or persistent pain deeply ponders the question of why the mechanisms of healing have not manifested in their body so that a correction, alleviation, or a cure is achieved. Cause and EffectOne of the other fundamental and classic Osteopathic principles is to seek out a precise diagnosis. We must find the source of disease (or the inciting cause) then offer a specific and appropriate treatment. It was A. T. Still, who implored Osteopaths to seek the cause of disease, rather than treating the effects. Dr. Still demanded that we treat the unseen cause of disease, which he likened to fire; rather than wasting our time dallying with the conspicuous effects, or the smoke.3 The effects of a disease are only the symptoms and he wanted us to understand that treating the cause of illness was the priority of every well-trained Osteopath.The laws of cause and effect can also be applied to the living human being in a more dynamic and physiologic manner. We can employ the word effect, not as a symptom of disease or as the product of a lesion, but as the result of something normal. We can trace the production of a creative category of effect back to its origin, which is not pathologic. In this way of thinking, effect is not an antonym of cause but is a consequence. Neither is effect a counterfeit representation of cause. It is intimately connected and is continuous with its origin. In this line of reasoning, it may be better to say that effect is the progeny of cause. A. T. Still, once said, “To find health should be the object of the doctor. Anyone can find disease.”4 What we call the Health in Osteopathy is an effect of Original Cause, or the Divinity within us. This is what William Sutherland, DO (the Osteopath who developed the Cranial Concept) called the Breath of Life. It is the spark of creation provided by the Breath of Life which transforms us into living, breathing, feeling human beings rather than a cadaveric sack of tissue, lifeless fluids, and chemicals. In other words, our Health originates from the Divinity, or the Divine Inspiration that gives us life. When A. T. Still said, “ I love my [i] [ii] [iii] [iv] fellow man, because I see God in his face and in his form,” [v] he was seeing the Original Cause in each patient he treated Osteopathically! Orthodox and Atypical Mechanisms of SensingHealth is, for the Osteopath, the most basic and accessible phenomenon available for any person who hopes to help another individual who is unable to self-heal or engage a Therapeutic Process. The Health is a characteristic of every living creature and can be perceived by an atypical category of sensing. When we utilize our known senses we engage our nervous system and that which we sense can be measured and confirmed scientifically. Our traditional five senses include that which we see, hear, smell, taste, or touch. They are faculties, which require a neurologic end-organ to receive physical stimuli (information) via the peripheral nervous system. Other physical senses, related to touch, include having a sense perception of movement (kinesthesia) or knowing our position in space via receptors in the muscles, tendons, and joints (proprioception). In addition, involuntary physical senses are involved in neurologic, hormonal, and biochemical integrations, which regulate variations in temperature, oxygen, blood sugar, blood flow, and all of the unconscious or vegetative functions of the living human body; those functions are measured by scientific/material instruments, which are simply mechanical extensions of our sensory end-organs. The Health, is not measured physically or mechanically and must be “sensed” by a different route. We must use an unorthodox system of appreciation that does not access the traditional five senses via the soma.In publicly discussing the experiences surrounding an Osteopathic treatment we come up against a wall created by structural limitations in the English language. We must be careful when utilizing words with a fixed definition to imply something new or different. There are some within the Osteopathic profession who use the word perception loosely, to mean something different and opposite to that of sensation. Or sometimes we apply an overly simplistic description of the subtle, non-mechanical phenomena appreciated in an Osteopathic treatment and generically refer to it as a “sensory experience” or as a “sensory perception.” Often, in that hazy gray zone of conversational language, a word becomes utilized in numerous ways by differing individuals and thus becomes a source of confusion rather than clarification. What is sensing, and how is perception defined? Webster’s Unabridged Dictionary defines sense as, “any of the faculties, as sight, hearing, smell, taste, or touch, by which humans or animals perceive stimuli, originating from outside or inside the body.” [vi] It primarily defines perception as, “The act of apprehending and understanding by means of the senses or of the mind using cognition.” [vii] But it also gives as a definition, “the immediate or intuitive recognition or appreciation of moral, psychological, or aesthetic qualities. It includes the qualities of insight, intuition, or discernment.” [viii] Whereas the word sense has a clear definition, perception has a divided and divergent meaning. When we look etymologically, for additional explanative roots of the word perception, we are left without inspiration. The root of perception comes from the Latin word, capio, which means to take hold, grasp, or to seize. [ix] Stedman’s Medical Dictionary calls perception, “the mental process of becoming aware of or recognizing an object. The process is primarily cognitive rather than affective (pertaining to emotion or feeling).” [x] To put it simply, sensing is the neurologic stimulation of sensory end-organs. Perception is the cognitive processing, understanding, and interpretation of information received by means of the senses. When William Sutherland, DO asked us to use, “Thinking, seeing, feeling, [and] knowing fingers” [xi] he did not imply that we use physical palpation engaging the end-organs of touch. Sutherland clarified his description of knowing fingers when he said, “By knowing, I mean not information gained by physical senses but a knowledge that comes from getting as far as one can from the physical sense.” [xii] When Dr. Sutherland referred to the breath of air as “material” or as secondary respiration, he by default supposed that the Primary Respiratory Mechanism, the Potency, and the Tides were all non-material. [xiii] Within the spirit of Sutherland’s work, I have extrapolated his classification and categorized mechanical events as material (this includes all anatomic and physiologic functions that can be measured) and all of the non-mechanical phenomena (which includes the Breath of Life, the Health, all the Tides, and other subtle forces) as non-material. What do we call the system that receives the information and knowledge that comes from the non-physical realm? What do we call the atypical, unorthodox afferent system that is accessed by our “thinking, seeing, feeling, [and] knowing fingers?” [xiv] Unfortunately, the closest term we have to capture the real meaning of our non-material, non-physical sensations during an Osteopathic treatment is Extrasensory Perception or ESP. The problem with utilizing ESP as a descriptive expression is that its connotations and associations are with occult and paranormal practitioners. Extrasensory Perception is associated with mind reading, thought transference, clairvoyance, and telepathy. The Osteopathic experience that I refer to has nothing to do with the traditional use of ESP and has no associations with the occult. Another interesting term used to describe information received through non-physical pathways is that of the “sixth sense.” This faculty is considered a special ability to perceive something by not using any of the traditional five senses. It is typically associated with powers of intuition. [xv] It is not enough to say that the “thinking, seeing, feeling, [and] knowing fingers” [xvi] are just based upon intuition. Using the term “sixth sense” is too vague and is already interwoven into the colloquial language of everyday speech, and is therefore potentially misleading. I have the daily experience of using my “knowing fingers” to gain entry to a parallel system of other-sensory perceptions that are not associated with the definitions for ESP or sixth sense and, at the same time, are a form of knowledge gained by “getting as far as one can from the physical sense[s].” These other-sensory perceptions are founded in awareness, are beyond the gross material senses, and are unavailable to a mechanical instrument. Perhaps this expanded category of other-sensory perceptions are what A. T. Still meant by the five hundred kinds of senses beyond the traditional five senses. [xvii] Other-sensory perceptions, may be the best term (for now) to describe the experiences; the knowledge that comes from getting as far as one can from the physical senses; or the non-emotional “feelings” of a non-mechanical subtle, elegant, and graceful Osteopathic treatment. There is an other-sensory field, system, or a complex set of afferent receivers that gives the human organism information not transported via the end-organs of the five traditional senses. This form of receptive awareness primarily utilizes a fulcrum within our consciousness. Consciousness is the seat of integration and the locus of internal knowledge. [xviii] However, other-sensory perceptions also include the senses utilized within the unconscious. The unconscious is the totality of all phenomena within psyche that lack the quality of consciousness. [xix] This is where intuition, instinct, and the mysterious senses reside. The unconscious is the entry point where we integrate and bring into our being the nameless “something other” of transcendent experience. Engaging the other-sensory system does not utilize the mechanical and neurological functions of the nervous system, especially the proprioceptors (end-organs) of touch. In fact to utilize this additional, unorthodox sensory system, we must drop from our conventional sensory field all that we palpate. While sensations measure the material, the other-sensory perceptions involve and engage the non-material. The field of the other-sensory perceptions is a receptive, afferent system, which gathers and processes information that is different than the data inputted via the five orthodox senses. Instead of using our mind to sense, we utilize our “mind’s eye” to perceive—or perhaps it is more accurate metaphorically to say our mind’s eye, or ear, or hand, etc. So, when we talk Osteopathically of having a sensory experience, technically we are referring to a material, proprioceptive event based upon a mechanical model. If we want to speak of the expanded experience that includes information received by the other-sensory system, then we must either use different language or carefully, in advance, redefine and qualify generic phrases to unmistakably make our presentation understandable. HealthThe Health is one of the subtle biologic forces that is accessed by using the other-sensory system. To actively engage the Health (which is non-material) we must drop from our orthodox sensory field the material sensations based upon palpation—which are mediated via the physical sense of touch. To detect the Health, we must also drop from the perceptual process our vectorial ego and our need to do something or to fix a lesion. Jim Jealous, DO describes how our observer must become receiving (afferent) rather than looking (efferently) to search for something. [xx] We must yield or let go, in order to engage the Health. The Health is powerful and welcoming but only in the presence of inner quiet and true patience. If we try to aggressively seek and find the Health, we are often left empty handed. Health comes to us when we are receptive yet humble.Is Health something mystical or inaccessible? No, it is fully available in every moment as one of the most accessible of Life’s biologic forces. Rather than ask, “What is Health?” perhaps it is better to ask how does Health feel? What is its texture? To me the Health has a “feeling” of basic and fundamental goodness, wholeness, and uncompromising strength. The Health is also, expectant. It is pregnant with potential and promise. Perhaps Henry David Thoreau was referring to the Health when he said, “ We must learn to reawaken and keep ourselves awake, not by mechanical aids, but by an infinite expectation of the dawn, which does not forsake us in our soundest sleep.” [xxi] Health is best described as a distinctive biologic matrix within a living being that interfaces with every aspect of structure, with the integrated physiologic systems, and with the totality of all psychological processes (both conscious and unconscious). It is the milieu, the growth medium, or the nutritional source of the Therapeutic Process. Health is engaged by means of the other-sensory perceptions. Rollin Becker, DO once called Health, “the Living Principle in a living body.” [xxii] Health does not exist in non-living, inorganic, or inert matter. Health does not originate from any single location within the anatomy of an individual, but emerges from each cell, permeates every fluid in the body (e.g., cerebrospinal fluid, extracellular fluid, and lymphatic fluid), and is present in the interstitial ground substance of connective tissue. Health does not come from outside the body, but comes from the inside (of a living being) and expresses its biologic actions from the fulcrum of Life. It is one of the reliably repeatable experiences in Osteopathy of what we call “wholeness.” Whereas God, or the Infinite is ineffable, the Health is not. We can put words to our direct experience of Health; however the language we utilize is often not concrete. Sometimes my perception of Health is small and quite commonplace and at other times it is vast and extraordinary. Therapeutic ProcessAs the true living matrix, the Health generates all of the fundamental forces involved with healing. Health is undifferentiated, non-directional, and unorganized. The Health provides the raw material for healing. From the coalescing of this original biologic healing force comes the Therapeutic Process‑‑a healing process that is directional, purposeful, and has potency. We can say that the Therapeutic Process is an effect of the Health. Once the Therapeutic Process is generated it contains an inherent intelligence that gives it purpose and direction. The Therapeutic Process is translated into many divergent yet complementary purposeful forces of healing. The types, manifestations, and layers of the Therapeutic Processes are numerous. What we call “healing” is the consequence of the Therapeutic Process. Sometimes the Therapeutic Process is superficial and mechanical, i.e., the healing of a laceration (which involves the local production of specialized cells involved in tissue repair), or in the resolution of an episode of influenza where the immune system produces specific substances and cells, to fight the infection and ultimately rid the body of the invader. In other situations the Therapeutic Process is subtle and more complicated, dealing with less obvious issues, i.e., the healing of a broken heart or the multifaceted process of healing a cancer. The same Therapeutic Process that heals the body (soma) heals the mind/emotions (psyche). Many people are surprised to learn that the Therapeutic Process does not differentiate between psychological ills and physical ills. Why would the Infinite Mind [xxiii] create separate systems of healing for the, so-called, mental and physical aspects of a human being?Instinctually we all know that to separate the mental/emotional from the physical only prevents us from experiencing the totality of healing in the presence of an illness. If we believe that the mind and body are separate then the split will become evident during an incomplete process of healing (just one of the many processes that create disease). It is through the building of barriers between the psyche and soma that incomplete healing occurs. Some of the barriers are erected by our divisive and dualistic western culture, others by our own habit to separate rather than unify. Additional barriers are created, between soma and psyche, by our own protective or defense mechanisms that have become dysfunctional or out of proportion to our functional needs. Illness, Disease, Injury, and DysfunctionWhy do we have illness, persistent pain, or dysfunctions that do not heal? Too often that question cannot be answered and it remains a mystery. Some injuries or illnesses cause extensive tissue damage and the anatomy is permanently altered beyond repair. Sometimes, we must have an illness in order to learn and grow so we can gain insight and wisdom. Other times the cause of our illness is more accessible, yet we become stuck, unable to heal ourselves by engaging the Therapeutic Process. In this situation we seek the help of another human being, in the form of an Osteopath, or another health care professional, or in a gifted and sensitive friend.I have found that the Therapeutic Process can get diverted by a number of potential dysfunctional processes. One of the most common causes of illness or pathology, that I see, is when the body begins to act as a collection of parts rather than as a unified whole. We all know that the sum of the parts never even comes close to equaling the whole. The “whole” of us as human beings is intricately and synergistically interconnected. When the connections become dysfunctional (damaged or diseased), a “part” develops and it becomes difficult for the Therapeutic Process to find the fragment that requires healing. When a particular anatomic region, a physiologic system, or an aspect of the psyche becomes diseased or injured, the natural defense mechanisms of the organism are activated. These defense mechanisms are an aspect of the Therapeutic Process. If the intelligence of healing is not able to completely resolve the dysfunction, then the body will wall off the offending region—thus creating a part not fully or adequately connected to the whole. One of the goals of an Osteopathic treatment is to restore communication of the part to the whole (or vice versa). This means restoring the Health to the part so a specific Therapeutic Process can be generated. Sometimes, we re-establish better communication by using a mechanical approach of physically enhancing circulation, allowing unobstructed flow of lymphatic and extracellular fluids, by treating myofascial and skeletal strains, or by removing any compressive forces that result in altered nerve flow and function. There is no doubt that using a mechanical approach can restore better functioning of the entire organism by specifically removing the physical barriers that create material dysfunctional components. We can also utilize a non-material, non-mechanical approach to help restore the organism to a higher level of functioning. The Health, Tides and other non- material forces of healing can be applied to physical or non-physical lesions/dysfunctions. Many Osteopaths do not know that normal function can be perverted in the non-material field, outside of what is termed soma. Lesions do not just occur in the bones, muscles, connective tissues, and nerves. Dysfunction is also found in the living fluids and other subtle aspects of the human being. We can use the forces of healing generated by Original Cause to motivate changes in the physical or non-physical manifestations of a patient. We are not required to “correct” a lesion or dysfunction by only using the mechanical principles of applied bioengineering and neuromuscular medicine. A non-material Osteopathic Treatment uses the other sensory system in the diagnosis and treatment process. Wholistic OsteopathyThe beauty of Osteopathy, as a healing system, is the built in recognition that both mechanical and non-mechanical approaches to patient care are essential and complementary methods of assisting a person who does not have the ability to initiate a specific Therapeutic Process for a particular illness. Many Osteopaths have forgotten (or perhaps never knew) that Andrew Taylor Still offered the perfect philosophical and therapeutic blend of mechanical and non-mechanical methods as well as material and non-material skills. He was and continues to be the perfect role model for all of Osteopathy.Unfortunately, within the Osteopathic profession the mechanical approach, to the near exclusion of the non-material, prevails and has taken an imbalanced priority. The use of the orthodox five senses predominates in supporting a biomechanical model of treating only the neuromusculoskeletal system, rather than the entirety of the organism. As human beings we are much more than somatic neuromuscular and biomechanical appliances. Dr. Still and Dr. Sutherland did not want us to become therapeutic bigots, practicing the philosophy of dualism. They asked us to use all of our resources. When A. T. Still said, “To find health is the object of the doctor. Anyone can find disease,” [xxiv] I believe he was giving us a clue to the method of his non-material treatment philosophy. Even when we actively engage the Health as a non-mechanical force of healing and drop the physical senses from our awareness, we do not “turn off” the proprioceptors of touch; the material data gaining entry into our psyche comes in through the unconscious rather than via our awareness based in consciousness. We don’t separate ourselves to the point of refusing potentially helpful input. We just allow the material sensations to enter by way of the back door, instead of through the front door of consciousness. As Osteopaths practicing in a wholistic way, we not only look at the human organism as being indivisible but also the method of our touch must be wholistic and non-dualistic. We refuse to deny any knowledge given to us that will help our patients achieve their highest level of wellness. Sometimes during a treatment, I will have dropped from my field of awareness all physical or material manifestations of the organism. Then something shifts in the physical body and I will instantly transfer my attentiveness back to the orthodox sense of touch and engage the patient from the material perspective. An Osteopathic treatment is an exquisite and wonderful dance between the inseparable worlds of physical and subtle, material and non-material, plus mechanical and non-mechanical. When we follow Dr. Still’s advice and find the Health or when we recognize that, “the health holds dominion over the body by laws an immutable as the laws of gravity.” [xxv] Then we have at our disposal the most biologically accessible force for healing. I call my attention based in conscious awareness my “third hand.” I can maintain a physical contact on a dysfunctional part and at the same time using my awareness—or my third hand—hold the texture of the Health. A remedial process occurs when the dysfunctional part is held at the exact same time as something wholistic, i.e., the Health. It is difficult to find the words to describe what occurs when the two come together. However, the effect is the production of a Therapeutic Process. It is sometimes naively said that health is the absence of disease. This overly simplistic statement cannot be farther from the truth. However, the corollary may be practically utilized. Disease is the diminished presence of Health. So, when we bring the Health to a diseased section of the body a remarkable event is set free—the person begins to function as a unified whole and a Therapeutic Process is generated. I often refer to the cause of disease, or the most accessible dysfunctional effect as the “necessity.” During an Osteopathic Treatment the patient unconsciously shows me their necessity, which is the most important issue to treat that day. It is our duty as Osteopaths to listen very carefully, to understand, to patiently wait, and to use all of the diverse integrative functions of perception available in our consciousness. When the necessity of a patient is matched with the Health, it is not a magical or mystical event that occurs but it is the simplest and most profound effect available to any human being . . . healing. [ii] Andrew Taylor Still used many euphemisms to refer to God or The Divine. The preceding two sentences contain three of the 23 euphemisms that Dr. Still used in his published writings. See Inter Linea: The Journal of Osteopathic Philosophy, Vol. 2, No. 4 page 8. |
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Copyright (c) 2004, 2005 by Stephen Paulus, DO. All Rights Reserved.
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