The often heard statement from Brandon Stevens, Vice-Principal at the CAO is “Osteopaths are optimists – we name things for what they like to do”. This is extremely important, in treatment as well as in having an understanding of the world itself. Robert Johnston, the Principal with Principles, has been speaking to students of the CAO quite a bit about his deepening understanding of Dr. Still with special emphasis as to understanding WHY Dr. Still used certain words (and, by extension, concepts) when he wrote. Dr. Still apparently did not like words much as they did no justice to the reality of the situation, experience mattered more. Word construction has challenges…I will go through some here to make a point!
Identity formation is an exclusionary process in most cases (ie, a rabbit is a rabbit because it is not a snake). This is generally related to the common social method of thinking which is binary (one thing or the other, not a mix of both…aka 1,0,1,0). This is not the only way to identify something. In a natural sense identity is more accurately portrayed by what something IS. This can be done by looking at the characteristics present. As an example: ants possess respiration, limbs, eyes, a head,and articulations while humans possess respiration, limbs, eyes, a head, and articulations. Clearly there is more that makes up a human and an ant, however, if we only look at certain parameters then humans and ants are the same. Here is where the divergence can happen between positive and negative identity formation – I can continue to name all of the parts that make a human which will eventually add up to a human while doing the same thing for an ant to create a positive identity for both (a human is a human due to the totality of the being in all facets) or I can find the differences and say that an ant is not a human simply because an ant does not have skin. Both methods work and both methods have merits. What I want to stress here is that one takes in to account EVERYTHING that is present and important (or as much as can be comprehended in a given moment) while the other focuses on the DIFFERENCES between things that are being considered. This process also allows us to recognize that the similarities between different things are there for a reason as are the differences (the reason is how those entities respond to and interact with the laws of nature!).
In Osteopathy the treatment is based on the Operator’s ability to identify what is present as an issue for the patient in mind/body/spirit and provide correction towards what is natural and normal. The role of the Operator is to know what a patient is built to be like (anatomy and physiology) so that they can recognize the abnormalities present to then direct the patient towards the normal. Osteopathy does this primarily through manual therapeutics while considering things such as environment (gravity, atmosphere, living conditions) to help the patient. Osteopathy may be referred to as constitutional. If an Operator were to concern themselves with medical conditions they would never get any work done! Taking time to test something and then run it against an infinite number of names removes the ability to FIND IT, FIX IT, AND LEAVE IT ALONE. Dr. Still wanted us to be familiar with the normal (anatomy and physiology) that we may recognize the abnormal when present. There are 2 positive identities here : 1. What a human ideally is (“normal” anatomy and physiology) 2. What the human on your table is (the total of what is “normal” and “abnormal”) – the space between these is where the solution lives (bringing the abnormal closer to the normal).
If an Osteopath were to work off of a diagnosis that was not created with Osteopathic principles they would not be doing Osteopathy – this is a definitional reality. The work that needs to be done to support a human requires that the Operator ask the question “why?” and be able to answer it! The connections matter both within the patient’s body and outside of the patient’s body. The Operator must then be realistic – you can’t take a hammer away from someone that frames houses, however, you can provide as much balance as possible so that the repetitive movement strains their body less.
After all of that rambling I want to say identity is important! The Osteopath is required to to call a spade a spade, call it what it is. This requires HONESTY. This requires that the Osteopath not GUESS. The honesty is important because if you don’t know…you don’t go. You can help a patient on whatever level you can conceptualize – your intention will be where you are able to have your effect. Identify what you as an Operator are capable of doing, identify what the patient is, identify if you are able to provide the necessary help, and then do the work. Dr. Still wanted us to see things as they are – this is how it is done in nature.
Ps. in case it is not clear, the Operator must do a lot of work on themselves to ensure that they are ready, capable, and honest enough with themselves to treat effectively (you have to know what/who YOU are).