Torsten Liem, Patrick Van Den Heede, Geist-Körper-Interdependenz in der osteopathischen Behandlung, Osteopathische Medizin. 2021; 22 3: 28-32,
In dysfunctions, disturbances in the physical adaptability of a biological system impair the ability to maintain homeostasis, e.g. in the case of physical, viral, bacterial or chemical stresses. The significance of disturbed physical regulation as a possible cause of physical symptoms is the subject of much discussion in osteopathy. The role of the mind as a possible cause of physical disorders, on the other hand, is less studied in osteopathy and not infrequently interpreted metaphysically. In the following we will discuss interactions in the mind-body interdependence that are essential to consider for treatment.
Body-mind interdependence, mind-body interdependence, dysfunction, treatment interaction, body concept, psychosomatic osteopathy
In dysfunctions, disturbances in the physical adaptability of a biological system impair the ability to maintain homeostasis, e.g. in case of physical, viral, bacterial or chemical loads. The importance of disturbed physical regulation as a possible cause of physical symptoms is the subject of many a debate in osteopathy. The role of the mind as a possible cause of bodily disorders, however, is less studied in osteopathy and often metaphysically interpreted. In this article, we want to discuss the interactions in mind-body interdependence that are essential for treatment.
body-mind interdependencemind-body interdependence, dysfunction, treatment interaction, body concept, psychosomatic osteopathy
We define mind as an interdependence of thoughts, ideas, expectations, memories, etc. with the physical source of conscious functioning through which it is expressed (e.g. the body as a physiological entity). What is meant by this is that we consider the mind as a function that has two different properties or modes of expression:
- one in which the mind is dependent on physical parameters, and
- one in which the mind has acquired a relatively independent quality of information that can in turn interfere with physical factors.
Information, in our view, can be conceptualised as both a physical and a conceptual, abstract unit of exchange that constellates and interferes with modalities of form (appearance) in certain time scales of evolution. We postulate that these processes are accompanied by an associated, fluctuating process of consciousness in all kinds of forms and evolutions, which at the same time also reveals a relative autonomy. The respective therapeutic competence, the interferences and interactions of mind and form, taking into account ontogenetic and organogenetic aspects of - as well as phylogenetic and evolutionary influences in - the respective patient, have in our experience an influence on the processes taking place in the here and now of a treatment interaction.
We understand the concept of "body" or "embodiment" as an adaptive process of increasing complexity, integrating information into matter and exposing this integrated information to an evolutionary wave pattern of adaptability to an ever-changing and integrative refinement of increasing complexity. In particular, evolutionary brain development (as a body substrate) comes to the fore in human development.
In the course of human development, the concept of the body has itself undergone evolutionary changes, e.g. from an abstract construct to an increasingly concrete body that enables meaningful experiences. from an abstract construct to an increasingly concrete body that enables meaningful experiences, accompanied by increasing integration of the perception of both states and processes, also beyond mechanistic perspectives, from the external to the internal, from states to processes, from analysis to holism, from mechanical isolated wholeness to a consideration of systemic interactive contextual dynamics (, following Levin and Solomon 1990).
Depending on evolutionary and ontogenetic evidence, we believe that body-mind interaction and mind-body interaction should be considered as two successive episodes of ontogenetic differentiation.
Ontogeny refers to the development of an individual being, in distinction to the term phylogenesis.
Body-mind medicine and mind-body medicine accordingly appear as two facets of the same coin, their depth and healing potential increasing with the identification, differentiation and integration of "bottom-up" as well as "top-down" information and processes.
In this sense, the specificity of the spirit seems to be related to a specific transformation of the implied matter, the spirit begins to become or appear quasi "personalised" when it is associated with a specific form of matter.
The following interactions are significant for us in understanding the development of disease and the osteopathic approach in the treatment setting:
When energy and matter interact, they create an evolutionary pattern of space-time relationship specific to that particular form. Mind can be conceived as an interactive expression between these two components, creating an increasing probability of consciousness and eventually awareness, depending on the evolutionary stage.
Especially in the treatment of human beings, it is essential to us that the mind starts from specified and specialised consciousness and creates consciousness as well as being able to change it.
As a final result, we see the emergence of a constantly self-renewing mind that begins to live its own life with increasing relative autonomy (an "original" informed part that now begins to connect with an abstracting tendency of the mind setting, relativising and emancipating itself from bodily limitations). This new potential of the mind also has the capacity - albeit always dependent on interacting dynamics to corporeality and life contexts - to influence and reorganise the "matter" of the body.
We observe in our osteopathic treatment that as the mind first evolves by means of as well as in interaction with an increasing complexity of the physical to increase in depth and meaning and become concrete and expressive, it begins to inform and transform the body through changing space-time units of consciousness and awareness in the "subtlest and finest components of its constituents".
Accordingly, we see the ontology of mind as a history of the construction and maturation of mind on a genetic and epigenetic landscape of the proto-ontogenesis of the body (pre-informed ontogeny), while the phenomenology of mind appears as a history of the condensation of space-time into the finest fractals of body consciousness.
In this sense, the body substance first potentiates the maturation of the spirit, while later the spirit substance reorganises the body substance.
In fact, in our view, there is no separation of mind and body (matter) in the end. There is no such thing as separate mind-stuff and body-stuff, i.e. information transformation is never only body-related, never only mind-related, but dependent on environmental contexts in which the mind-body unity evolves.
This means that each living system depends on how it has developed and evolved in relation to its context. It also means that the possibilities for transformational processes in treatment are determined by a common and combined pattern of interference and expression of the components of body-mind and mind-body interactions that can be traced back to the past on the one hand and relate to the likelihood of an evolving future on the other.
Morphodynamics in osteopathy
On the one hand, evolution is a process of self-transcendence that leads beyond the existing , whereby each new emergence transcends and incorporates its precursors, and in the process the lower sets the possibilities of the higher and the higher sets the probabilities of the lower, and each further evolutionary stage generates greater depth. On the other hand, in its form as a (relatively) autonomous whole, there exists a defined telos of that whole. In its capacity as part of another wholeness, however, it is influenced by a telos outside itself. Thus, attractors exert, as it were, patterns of increased probability and as formative traits, a kind of drive for development or a kind of pull that "pulls" development in a certain direction.
An ascending causality of increasing complexity of the material world is accompanied by an equally descending causality of consciousness. Both are expressions of a constantly changing information that simultaneously acts as an impulse generator for these ascending and descending causalities.
In this sense, spirit has "chosen" a very select tissue (ectoderm) on which to create its mental stuff. Embryologically, the brain was virtually built on two other tissues (entoderm and mesoderm) to represent its final form and function. In this respect, the brain acts as a kind of transformer from body tissue to spirit tissue. It was created and constructed by an "evidence" of afference. Several pathways of afference were constructed during its ontogeny and continue to do so until full maturation. The neurological pathways seem the most obvious, but the vascular pathways, for example, are at least as informative, if not initially more essential.
During neurological maturation (up to the first 22 years of life), a synergistic interference field is established with the maturing immunological field (up to the 10th year of life). So it is also not surprising that the neurology and the immune system are functionally related in the distinction between self and non-self.
In this process, evolution shows a direction that is characterised by increasing differentiation, multiformity, complexity and organisation . This can be seen, for example, in the way in which all the information just mentioned is initially stacked in ordered and subordinate brain areas and later gradually combined in a more complex way and is expressed, among other things, in an increasing internalisation of the extra-worldly as well as the inhibition and relativisation of older brain structures by younger ones, such as the limbic system by the prefrontal cortex or the brain stem by the midbrain. Regulative or dysfunctional influences of social systems, norms, rules and culture on prefrontal activities and functions must also be taken into account, which can be studied in an increasingly differentiated way (which was not yet possible at the time osteopathy was developed).
Neuronal networks are themselves combined and form networks upon networks until an enactive brain is formed. What is meant by this is that brain, body and context (environment) form in dynamic interaction with each other and are constantly related to each other and can only be understood from this. Finally, neural activity is so complexly wired that its activity generates a subtle field coherence of frequency waves capable of creating images of representations of the mind. The mind emerges on the basis of frequency coherence, which in turn depends on subtle electrical and electromagnetic brain field organisation.
Thus, in our view, the brain field organisation is characterised by various properties:
- It organises a memory field.
- It progressively creates a memory of the "self".
- It creates the possibility or probability of free will.
- It begins to control the "intention" that leads to the cognitive competence of creating probabilities about the world.
The brain has developed in different levels of functionality. We distinguish
- a survival brain,
- an emotional brain and
- a cognitive brain.
The net expression of "free will" is probably a subtle combination of these three qualities.
Sometimes intention is charged more strongly by unconscious drives than by conscious ones, even though we have the impression that our interaction takes place in the conscious field. Intention seems to be a "thought movement" based on a subtle combination of unconscious drives that align with the conscious field of actual interaction.
In this sense, the neurocognitive brain and its functional organisation are dependent on a variety of influences.
The frontal brain field of intention and decision-making is constantly informed by the limbic integrative brain field, while at the same time being able to relativise and inhibit them. This field interferes reciprocally with all convergence zones scattered across and within the brain surfaces and with all sensory, sensorimotor and interoceptive inputs entering the limbic system.
In our view, it is particularly important to consider therapeutically that patterns that have existed for a long time - be they tissue, psychological, neuroendocrine, metabolic, immunitary or postural and behavioural patterns - become new stabilities and dysfunctions that do not dissolve simply because the conditions for their emergence have disappeared! Specific strategies are needed to resolve them.
Border experiences as triggers for mind-body desynchronisations
Challenges and stress and other borderline experiences in life can, on the one hand, enable growth as we acquire new skills, new circuitry forms in the brain and new ways of seeing things develop. However, challenges can be too fast, intense or complex and overwhelm us and we are not able to respond appropriately, but on the contrary, the experience may be one of loss of control, helplessness and hopelessness, leaving lasting effects in the mind-body interdependence.
Mind-body influence in treatment
It is important to note that free will and intention are "controlled" by subconscious levels of consciousness. The part that could be defined as free will is the seemingly conscious part of intention, which one quasi interprets as being organised by the "self".
The same consideration can be made about "thinking". If one knows that the part one thinks during a thought process is only the "visible" part of the complete thought that already started half a second earlier, then one should consider the possibility that at least parts of a thought take place on an unconscious or preconscious level.
This provides for two possibilities:
- The unconscious part of a thought process is related to the organisation of the body field and its subsequent afferent tonality (e.g. what organises the final coherence of certain brain areas). Repeated experiences, family socialisations and attachment patterns, socio-culturally shaped interpretations, pre-, peri- and postnatal experiences, to what extent we have been confronted with positive, tolerable or toxic stress in life, neuroendocrine and neurovegetative stress axes etc. influence these unconscious processes.
- The conscious part of thinking actively interacts with the body field organisation, partly through the unconscious drives that are hidden behind "free will" and "intention".
It is now clear that "thinking" is not as free as one might "think". However, this has the advantage of saving energy and resources by not having to analyse every experience by means of complex reflection.
In our view, the mind process has two ways of influencing what happens in the body.
- First, by the body actively participating in the mind process by offering the supportive cues for all the cognitive and physiological levels necessary for a sharp expression of the mind's "free will".
- Secondly, the subconscious undercurrent - including the storage of information by the cellular system, which functions, among other things, as a tensegrity structure - through which unconscious parts of the mind influence the vegetative and neuroendocrine balance of the body.
It is precisely this interference that affects the body's balance and its homeostatic adaptability.
In this sense, somato-energetic-psychic dysfunctions go hand in hand with physiological changes, energetic phenomena, physical experience incl. neurovegetative signs as well as emotional stirrings and mental interpretations. For example, emotional stress in childhood, especially in early childhood (for example in the form of abuse, neglect, injury or boundary violating events), can lead to certain strategies whereby loyalty laws are applied to ensure survival and to be able to continue to receive the unconditional love of the parents, while at the same time subordinating bodily needs (= survival at the expense of relative mind-body synchronisation).
Clinically relevant conclusion
One's own inner awareness, coupled with the ability to co-regulate, is closely linked to the perception, understanding, confrontation, acceptance and integration of these awarenesses, experiences and somato-energetic-psychic dysfunction patterns, as well as to the competence to support patients in approaches of psychosomatic osteopathy. This includes the perception of multiple dynamic interactions of tissue patterns, body sensations, neurovegetative arousal, endocrine, metabolic and immune activity, emotions, mentalisations and belief patterns in the concrete everyday life of our numerous relationships . Thus, by means of osteopathic treatment, a state of equilibrium, a release of the bound forces in somato-energetic-psychic tension patterns could be favoured by enabling the "mind-body stuff" to clarify its relationship to each other .
By "inviting" in certain ways the aspects, forces and worlds of experience associated with the dysfunction - which previously led a relatively separate life of their own from the wholeness or were disregarded, suppressed, repressed or only fragmented and incompletely integrated - an osteopathic approach can be used to allow deeper resonance and healing spaces to emerge.
When the dysfunctional pattern in a temporally and spatially limited mind-body interaction changes in the patient, the relationship of the whole as well as the contextual dynamics can change. This in turn can potentially lead to further changes in the organism. This process begins during the therapeutic interaction, but also takes place especially after the consultation, in the treatment-free interval.
V.d. Heede, P: The emotional landscape in the osteopathic field. (expected early 2022)
Liem T. Psychosomatic osteopathy. Munich: Elsevier; in press (expected early 2022).
Course series: Psychosomatic Osteopathy:
Basic 1: 29.04.-01.05.2022, Basic 2: 24.06.-26.06.2022 at the OSD in Hamburg
Psychosomatic Osteopathy, advanced: 15-18.09.2022 at the OSD in Hamburg
- Jantsch E. The self-organisation of the universe. Munich: Hanser; 1992
- Liem T. Paradigms of healing. In: Liem T. Van den Heede P (eds) Foundations of morphodynamics in osteopathy: an integrative approach to cranium, nervous system, and emotions; 1st ed.Pencaitland: Handspring Publishing Limited; 2017.
- Liem T. Psychosomatic osteopathy. Munich: Elsevier; in press (expected early 2022).