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Holism is this an underpinning concept of Osteopathy?

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Erica Winters

on 10 January 2014

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Transcript of Holism is this an underpinning concept of Osteopathy?

Holism: Underpinning Osteopathic Concepts?
Tensegrity
"The body working as a tensegrous system"
Tensegrity is a system of balance between compressional and tensional forces
Conclusion
"The treating of the whole person, taking into account mental and social factors, rather than just the physical symptoms of a disease"
So Does Holism Underpin Osteopathic Concepts?
Whilst 'osteopathy' was created prior to 'holism', I think it is fair to say that both concepts stem from much earlier times and both share very similar values.
I feel that of the concepts that I have been able to explore, the concept of holism does feature.
In addition, with the multitude of tools to an osteopaths hands, I think it could be considered as holistic in the way an Osteopath is able to pick and choose the most effective tool. As such for any student or established osteopaths, I think it would be naive to shut their minds to any certain techniques. As there may come an occasion when their patient requires more than their favoured technique and therefore their ability will be limited.
Holism?
"The theory that parts of a whole are in intimate interconnection, such that they cannot exist independently of the whole, or cannot be understood without reference to the whole, which is thus regarded as greater than the sum of its parts"
"As Osteopathic machinists we go no further than to adjust the abnormal conditions back to the normal. Nature will do the rest"
Still's Founding Principles
Balance
This applies to our body as a
whole
both internally and externally!
As well as being able to take a holistic approach to diagnosing, can this be applied to treatment?
How do these tools relate to holism?
The Body Is A Unit
Structure Governs Function
The Rule Of The Artery Is Supreme
The Body Possesses Self-Regulatory & Self-Healing Mechanisms
Abnormal
Homeostasis
Normal
What is Normal?
Function
Health
One persons 'normal' is not anothers
This is a very subjective term and should be used retrospectively.
Osteopaths need to understand what their patients 'normal' can be and strive towards this.
It is important to note that normal is not necessarily 100% function. As we age or due to trauma this is likely to reduce and as such our 'normal' will constantly adapt to our surrounding stressors.
(homeo, unchanging + stasis, standing)

refers to the existence of a stable
internal environment regardless to the changes in
the external environment
Somatic Dysfunction
When bodily structure / function is compromised and therefore the body's defences
When stressors from all sources become overwhelming and cause an imbalance
Disease as a result of one or all of the above
A movement that is made at one point of the body transmits and will be felt at other levels due to the synergy of the body
The body is a unit
Holism
A tensegrity structure works as a whole unit rather than independent subunits creating one. As such if you apply a force local to one area this force will be distributed distally to the rest of the entire unit.

The frame of a tent is the easiest structure to imagine - should you apply pressure local to one area. that force is transmitted through the entire structure to keep the tent standing.
The spinal curves are balanced between the curves
There must also be balance within the spinal curves themselves
Physical balance - Eye level - your body strives to keep this level
Homeostasis - physiological process of maintaining internal balance
Psychological balance
Nutritional / Dietary balance
Standing alone requires a balance of these forces due to the compressional force of gravity which our body' is constantly exposed to. Gravity is met by a resistance / tensional force coming up through our body from our feet.
So far holism is proving to be a key part of Osteopathy!
External forces are transmitted equally through the structure resulting in balanced distortion rather than allowing the structure to crumble
There are however other forces that impact the body which tensegrity cannot account for...
The below are just a few examples:
OK, so how does this relate to Osteopathy
Right so these principles all seem pretty encompassing of the whole body ---> holism

But what do these actually mean...

So it looks reasonable that the founding principles of osteopathy could be considered as being holistic in nature. However how is this being applied in today's practice and are there any other concepts that support or oppose this?
With this presentation I have only been able to scratch the surface of Osteopathic concepts. However this exploration into holism and those concepts has been revealing. I had always thought I fully understood what holism was, however it is a much larger concept than I had anticipated and can explore.
Balance is vital in all elements of living
Balance not just within the body, but in the mind, in the spirit with balance between each of these. Caroline Stone describes these as being the 'triad of health', Which when we think back to the definition of ' holism' it is to look at a patient as a whole person to include their mind and social & environmental factors.
However, can we as aspiring and established Osteopaths ever truly be holistic when so many factors are out of our hands?
Although as much as we have good intentions for our patients, with so many aspects of their lives out of our hands (quite rightly too!) we will never be able to achieve the results we truly desire. Unless a patient makes every effort to follow advice given, however even then some contributing factors are even out of their hands and as such I think it is not always possible to truly treat holistically.
Holism in osteopathy is not just about the way we look at a person when we form our differential diagnosis but it is also the way of accessing and selecting the most appropriate of our osteopathic tools for our patient at that time.
However, like with everything there are limitations!
I hope this presentation has been as insightful to read as it has been to create. For a student osteopath it has certainly raised some questions for me, which over time with experience may or may not become answered. But for now I will settle for having an open mind, learning what I can and question as I go along.
As a student I am still learning about all the tools of the trade however from what I can gather through research, an osteopath has many tools at their disposal.
No.1 being our
HANDS
&
EYES

There are many techniques which can be considered as being either direct or indirect:
Soft tissue
Myofascial release
Muscle energy techniques (MET)
High velocity techniques (HVT)
Lymphatic
General articulatory technique (GAT)
Facilitated positional release
Balancing ligamentous techniques (BLT)
Visceral techniques
General osteopathic treatment (GOT)
Cranial
The approach to the initial consultation and differential diagnosis, an osteopath uses their key tools,
EYES
&
HANDS
, to enable them to look at their patient as a
WHOLE,
in addition
EARS
are used to listen to the patient to understand the social and environmental factors but also to assess the patients mind --->
Holism!
Once a diagnosis has been formed, then an osteopath is able to select the most appropriate 'tools' to treat said patient. This selection process will take into account the patients needs and any contraindications.
Within the application of a 'tool' an osteopath will need to understand the implications of the effect of a technique on the rest of the patients body.
TENSEGRITY ---> WHOLE ---> Holism!
However, can one truly treat holistically?
Honestly, as I am only a student I can't really say. However theoretically I'm not so you can be, even though all of the osteopathic concepts that I have explored suggest otherwise.
I query this as, Holism, as we know is the 'whole'. However in order to treat a patient as a 'whole' we would need to treat all aspects of their lives, however in order to do this we would need to have some form of control on their external environmental factors. Such as stress from work, family, friends, smoking, alcohol / drug abuse, obesity, inactivity and the list goes on. There are so many aspects of a patients life that we will never have control over. This leaves us to all we can do and that is to give advice and treat the patient within our limits.
Unfortunately this conundrum will always exist and therefore it would be difficult for anyone to state that they truly treat holistically.
That being said I still believe and hope, that if one had a truly receptive patient, who really made the effort to implement the changes suggested then this could be considered as treating holistically.
Medical Definition:
Definition:
Origins of Holism
The term holis,m was created by Jan Christian Smuts in 1925, to describe the understanding of "whole systems" rather than individual elements.
IIn Ancient Greek 'holism' derives from word "holos," meaning "whole"
(Oxford Dictionary Press, 2013)
(Parsons and Marcer, 2006)
(Parsons Marcer, 2006)
(Stone, 1999)
(Stefano, 2006)
(SOUKYA, 2013)
Origins of Osteopathy
Founded by Andrew Taylor Still in 1874 when he lost faith in orthodox medicine and searched for a more natural way of healing.
The term 'Osteopathy'' wasn't coined until 1885. It derives from Ancient Greek, 'osteon' meaning bone and 'pathos' meaning suffering. However this translation is not true to exactly what Osteopathy is.
(Chila, 2011)
Just from this small amount of information it is clear that the concept of Osteopathy was born prior to the creation of the word 'holism'.

However when we look back at the history of medicine it is clear that the concept of 'holism' has been around far longer, For example if we look at Hippocratic Medicine, which views disease as an imbalance of the four humours, with treatment aimed to facilitate the body's own ability to restore health by restoring the humoural balance. Where dietary and sanitary considerations were also made which is suggestive of the concept of holism. It is also evident that the osteopathic belief of the body's self healing mechanisms predates its creation.
(Stefano, 2006)
(Stone, 1999)
The body, mind and spirit are all interrelated, and all are affected by internal and external factors, not all of which an osteopath has control over. As such can osteopaths truly treat holistically?
Realistically, I am not so sure, as whilst an osteopath can treat the body, which will have knock on effects to the mind and spirit, if the patients issues are being contributed by external factors, then these are out of an osteopaths hands. Therefore an osteopath is reduced to only being able to offer advice in ways in which a patient can make improvements to their lifestyle in order to help themselves.

(Still, 1902)
(Sherwood, 2012)
This cycle is continuous throughout life, most of the time your body is able to complete this itself and sometimes it requires a helping hand.
(Nicholas and Nicholas, 2012)
References
(Parsons Marcer, 2006)
(Parsons Marcer, 2006)
(Parsons Marcer, 2006)
(Parsons Marcer, 2006)
(Nicholas and Nicholas, 2012)
Understand Your Patient
General Osteopathic Treatment
When we consider GOT it is an all encompassing technique which does not treat individual elements but the entire body. This technique is also known as the Total Body Adjustment (TBA).

GOT works through the use of articulatory forces to correct the bodily structure whilst having an affect on the physiological functions

The approach to GOT is holistic, as with all of the techniques, however the treatment itself is to the
whole body
and therefore could be considered as the most holistic technique available to an Osteopath.
Full transcript