Holism

The osteopathic ideas can be summarized
into three values or principles. Firstly, there is the aspect that describes
the self-regulation mechanism, that keeps the human body in balance. An
osteopathic therapist is educated to stimulate this mechanism of the body. Furthermore,
there is another principle that is used in osteopathic medicine. It describes
the correlation between function and structure. A functional problem in the
human body can affect the structure, but a structural problem can also affect
the function (Kuchera, 1994). There is one more osteopathic principle left, that
describes the necessity to see the human body as one undivided unit. The body
is subdivided into many parts, but every part of it works for the aim of other
parts (Kuchera, 2007). This last osteopathic principle is better known as
holism. The founder of holism is JC Smuts. He saw this word as a unit where
matter and mind became fluid (Parsons and Marcer, 2006).

The human body is subdivided
into four systems including the craniosacral system, visceral system, parietal
system and the psychosocial system. An osteopathic therapist has to integrate
all four of these units because alterations in one system can affect another
system (Parsons and Marcer, 2006). The cause of a medical issue can sometimes
be located in another system of the body, which makes it necessary to integrate
all systems. On top of that, the human body has several communication systems, so
that makes it possible for one system to influence another system. That aspect
as well makes it fundamental to integrate all systems of the human body to have
an effect on the patients’ complaint (Seffinger, 2003).

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Apparently, it is incomplete to
limit this aspect of the osteopathic philosophy to the physical aspect. The
patient is more than just a body with various units, but it has its own mind as
well. Mind and body are inseparable and need to be treated as one undivided
unit (Seffinger, 2003).  

1.     Founder (written by Marthe
de Saedeleir)

2.1 Jan Smuts: short biography

 

Jan Smuts (°24 May 1870 – +11 September 1950) was an
important politician who contributed in an important way to the history of
South Africa and the world. His work on holism is just a part of his large
legacy. It is not the intention of this course work to discuss his political
and other pursuits, but it is useful to place Smuts’ holistic thoughts in a
historical context (Tate, 1947).

 

Jan Smuts was born in South Africa, in what was then
called the Cape Colony. He grew up on the family farm, in Bovenplaats, in the
Afrikaner Calvinistic tradition, which was very strict and placed a great
importance on hard labor, moral rectitude, individualism, … (norms which still
stand in the Calvinistic way of living) but was also based on the separation
from the non-Whites at that time.  His
childhood was marked by long lonely walks and exploring the surrounding
countryside. During these walks his lifelong passion for nature was created (Smuts Hon J.C., 1927):

 

“An
early awakening of the feelings and faculties that were shaping him as a person
and would one day shape his thought about the atom, the cell, mind,
personality, the whole universe”(Stokes, 1963,p.8).

 

When he was twelve years old his elder brother died,
now it was his duty to go to school. He was a very talented student and made a
big impression on his professors. For example, at Victoria College, he won the
Ebden scholarship for Christ’s College Cambridge University, where he studied
Law, and became the only person ever to have written both parts of the Law
Tripos in one year and achieve a Double First. When he studied at Cambridge,
Smuts was described by his Professor Maitland, a leading figure among English
legal historians, as the most brilliant student he had ever met. He was also
considered to be one of the most outstanding students in the 500 years of the
College’s history together with John Milton, Charles Darwin (Tate, 1947).

2.2 Smuts’ vision on holism

 

The term holism, as an academic terminology, was first
introduced by Smuts in his book: “Holism
and evolution”.

 

Smuts’ book is based on two important mechanisms: the
unity and continuity in nature. The concept holism is derived from the Greek holos,
the “entire”, the “whole”. His holism is a synthesis between Darwin’s theory of
evolution, as described in his “The
origin of species”, Einstein’s theory of relativity and Smuts’ own
reflections on the evolution of matter, life and mind (Wilber, 2001). Smuts’ holism goes beyond this and states that the
parts of any whole cannot exist and cannot be understood except in relation to
the whole. In this context, a whole is the equivalent of a system. All the
properties of a given system (biological, personality, social, cultural) cannot
be determined or explained by the sum of its component parts alone.

Smuts (1927) defined Holism as:

 “the ultimate synthetic, ordering,
organizing, regulative activity in the universe which accounts for all the
structural groupings and syntheses in it, from the atom and the physic-chemical
structures, through the cell and organisms, through Mind in animals, to
Personality in man”(Smuts Hon J.C.,
1927,p.326).

Smuts’ idea of holism was a response to the
reductionistic view of reality in the 1920’s, which failed to recognize: 

A)  
The countless synergies
which exist in the natural and human lifeworlds

B)   
The process of creative
evolution (Smuts Hon J.C., 1927).

 

Reductionism refers to the viewpoint:

A)  
That all explanations
of the actions of systems could be mathematically calculated from those of the
component parts of the universe;

B)   
That
all explanations of social behavior are psychologically reducible (Wilber, 2001).

 

Smuts brought his philosophy of life as developed in
his Holism and Evolution to practice
in his political career: he merged the former four provinces of South Africa
(Cape Province, Free State, Transvaal, Natal) into the larger and better whole
of the Union of South Africa. And he merged The Union of South Africa into the
larger and better whole of the British Commonwealth of Nations. After the First
World War he eventually merged it to the better whole of the United Nations (Tate, 1947).

2.    
Influences on the
musculoskeletal system

 

2.1.  Psychological system (written by Marthe de Saedeleir)

The biopsychosocial
model is the interaction of biological
factors (genetic,
biochemical, etc), psychological factors
(mood, personality, behavior, etc.), and social factors
(cultural, familial, socioeconomic, medical, etc.) these aspects attributes to
the person health (Mayer and Saper, 2000;
Borrell-Carrió, Suchman and Epstein, 2004).

 

At the practical level, it is a way of understanding
the patient’s subjective thoughts as an essential contributor to accurate
diagnosis, health outcomes, and humane care (Engel, 1977).

 

A wide range of psychological and socioeconomic
factors will interact with physical pathology to modulate a patient’s report of
symptoms and subsequent disability (DiGiovanna, Schiowitz
and Dowling, 2005). Thus, “knowing the whole person” is important in
this model as well as in the osteopathic approach. In general, this
biopsychosocial model is in some way congruent with the osteopathic principles
and that the biopsychosocial model provides a great deal of actual evidence
that supports the osteopathic approach (Penney, 2010).

 

(Gatchel et al., 2007) noted that the emergence of this biopsychosocial
approach has paralleled the evolution of scientific thought in medicine:

 

“During the
Renaissance, increased scientific knowledge in the areas of anatomy, biology,
and physiology was accompanied by a biomedical reductionism, or a ‘dualistic’
viewpoint, that mind and body function separately and independently. This
perspective dominated medicine until quite recently and affected the
understanding of the relationships between mental health and pain. The gate control
theory of pain introduced by Melzack and Wall (1965), however, began to
highlight the potentially significant role that psychosocial factors play in
the perception of pain. Pain is now viewed as a complex set of phenomena rather
than as a simple, specific, or discrete entity.”(Gatchel et al., 2007, p.796).

2.2.  Visceral system (written by Magali Desmidt)

It is
fundamental in the osteopathic practice to use the concept of a viscerosomatic
and somatovisceral reflex. Various difficulties located in the internal organs
of the human body can cause problems in the segmental related parietal region. This
concept is well known as a viscerosomatic reflex. It is the somatic reflection
of an interruption located in the internal organs (DiGiovanna et al., 2005). Additionally,
somatic dysfunctions that are located in the axial spine can also affect the
segmentally related visceral structures. This concept is known as a
somatovisceral reflex. Both, visceral and parietal systems, can influence each
other (Nelson and Glonek, 2007).

Irritation
or disruption located in visceral structures result in an increased afferent
activity through the viscerosensory fibres that will arrive at the spinal cord.
The increased afferent activity has an effect on the anterior and lateral
column of the grey matter of the spinal cord. This results in an increased
sensibility, asymmetry, restriction and trophic disorders which indicates a
somatic dysfunction in the musculoskeletal system. The increased afferent
activity has also an effect on the anterior column of the grey matter which
results in hypertonicity of the segmental related muscles and especially along
the axial spine, the muscles become tense. Osteopathic therapists will evaluate
all these symptoms on patients’ body to identify somatic dysfunctions (Mayer
and Saper, 2000). These elements show that it is necessary to
link all the different systems in the human body. It is futile to only focus on
the musculoskeletal system, or only on the visceral organs. The systems are
related to each other.

Based
on these viscerosomatic and somatovisceral reflexes it is necessary to see the
human body as one unit that cannot be divided into various compositions. All
the structures are working together to create a healthy condition. It is
useless to treat the axial spine from several somatic dysfunctions if the cause
of these difficulties is located in the visceral structures, or vice versa
(Chila, 2010).

 

2.3.  Craniosacral system (written by Magali Desmidt)

According to William Garner Sutherland,
the liquor cerebrospinal fluctuation is responsible for the cranial rhythmic
impulse. The expansion of the ventricular system, due to the emission of liquor
cerebrospinalis, causes an impact on the membranous system around the
synchondrosis sphenobasilaris. This causes a transmission on the joint, and can
be handed over through other structures such as the sacrum (Nelson, 2002). That
implies the important to connect all different system in the human body,
because it can result in problems in the musculoskeletal system.  

3.    
Conclusion (written by Marthe de Saedeleir)

The whole is made up of parts or units that influence
it and vice versa. The whole has a function or identity of its own. The
parts/units are influenced /affected by the whole. Alteration of one part /
unit will alter the whole. A change in the whole will affect each part/unit to
a greater or lesser extend (Smuts Hon J.C., 1927).

 

Osteopathic medicine is holistic as it looks at all
parts/units (visceral, craniosacral, musculoskeletal and the biopsychosocial
aspect) of the human form/structure before deciding how to treat a certain
problem rather than confining attention to the symptomatic area. Symptoms
(failure) within a body system are likely to have come in some part from
dysfunction in another system, requiring that the other system is treated in
order to resolve the presenting symptoms in the first system (Stone, 1999). This differentiates us (osteopaths) from other
manual therapies. 

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