Psychology of the tissue

Replies to This Discussion

Permalink Reply by Clement Rhein on January 20, 2008 at 7:31pm

umm, It tells me "page untrouvable"

▶ Reply to This

Permalink Reply by David Bekaert on January 21, 2008 at 6:26am

Hi Clement,

This is the correct URL:
http://pierreosteopath.blogspot.com/

Pierre has a great blog. Keep on posting!

Gr,
D

▶ Reply to This

Permalink Reply by Ronan O'Brien on January 21, 2008 at 3:36pm

Hi Pierre

I enjoyed reading your article and look forward to more. I'm speaking at the Advancing Osteopathy 08 conference in February on the topic of using Internet technologies to further osteopathic education and foster collaboration. Your blog is a great example of this.

Keep up the good work.

▶ Reply to This

Permalink Reply by Austin on January 21, 2008 at 8:27pm

Hi Pierre. Great to read an osteopathy blog, very thought-provoking.

Is there any distinction between "somato-psychologic" and "psycho-somatic"? It seems that in either, the dysfunction occurs under a particular set of circumstances, and is exacerbated or recreated by replaying or reinforcing those circumstances. In your examples, the only difference appears to be that one is traumatic (somato-psychologic) and the other is chronic (psycho-somatic).

Also, the label "memory" applied to the tissue seems misleading to me. "Structural change" would seem more appropriate. Of course, what we usually refer to as "memory" is rooted in structural changes in the brain, but we don't usually refer to a particular memory as a "structural change". So why refer to structural changes as memories?

Maybe there is actually no distinction between "structural change" and "memory". The human organism could simply be viewed as constantly changing in response to the stimuli it receives. Currently, we partition these responses into "physical" (or somatic etc), "mental" (or psychological etc), and other realms. This provides convenient distinctions which give us a frame of reference that allows clear context. For example, if I say I have problems "remembering" names, most people will agree what I mean by this, and I can be confident that whoever I say this to will have the same concept that I do of "memory" in this context.

So while it may be very worthwhile exploring the interactions between the various domains (bio/psycho/social/etc) perhaps it would be better to use language appropriate to each domain? At their intersection - for example, psycho-somatic dysfunction - we could discuss the interaction of the attributes of each domain using an appropriate language. This would ensure clarity and consistency. (This isn't to say our terminology or language is currently perfect, just to suggest we use an appropriate tool for each job).

The interfaces between these domains may be hugely complex. Perhaps the language doesn't yet exist to define what happens at the interfaces, but borrowing terminology from each domain to describe what happens at their boundaries seems arbitrary to me. Using terms like "tissue psychology" and "tissue memory" seem to muddy the water. Can we not discuss the examples you mention in terms of psychology, hormone secretion, cellular response, trauma... and other well-defined terms? To say that "tissue has memory" seems a conflation. The phenomena you describe can be accounted for more simply by saying "psychology affects somatic sytems", or "physical changes affect psychology" etc. This phraseology has the benefit of being easily understood and uncontroversial - there are many studies that confirm what we understand by these phrases.

But then, maybe I just didn't get it :-) Or maybe I'm splitting hairs. Regardless, I'd also say that Sheldon's somatotypology is, at best, controversial.

▶ Reply to This

Permalink Reply by pierre de lasteyrie on January 25, 2008 at 5:37am

Hi Austin,
Thanks for your long and interesting reply.

Concerning the psycho-somatic,and somato-psycho memory :
In fact my understanding was that, in one case the trauma was coming from the soma while in the other the trauma was first affecting the psycho. of course both have an effect on the psycho an on the soma but not in the same order and for the same reason.

Concerning the term memory, I understand that it can be misleading (that could have been my point), I couldn't say that a tissue had a psychology if it hadn't a memory, because the memory will affect the stimulation response.
Now, the term "memory" is applied to a tissue (this is disturbing indeed); If you drop your mobile phone on the floor the impact will leave a mark of this impact :this is a memory of this impact. The term memory is also used in the metallurgic field to talk about the memory of certain alloy. when you warm them up they recover their initial form ! So the term memory is not only used for a vague souvenir in our brain but it is also used for a piece of alloy, it seems reasonable for me to use it for a living cell (which is a fractale of ourself ?)

My point within this article was to try to make a correlation between the techniques used and a psychological approach to the body of the patient; you are right in saying that we should use political correct sentence or terms such as psycho-somatic/ somato-psycho link reflex or even psycho/psycho, somato-somatic reflexes. In this case if I express, following your term, a technique it would look like :
"the practitioner acts from his psycho to his soma by touching the patient who suffers from a somatic dysfunction creating some somato-psycho reflexes, having an effect on his limbic system (psycho-psycho reflex) which in return change the way the muscles behave through the psycho-somatic reflexes. On a local level, the structural changes influences on the proprioception and the function of the structures influencing once more on the somato-somatic reflexes and on the somato-psycho reflexes. This change of muscle behaviour influence the practitioner's proprioception through the somato-psycho link, remembering him certain simila sensation (psycho-psycho) then influencing him on the technique or movement to use (psycho-somatic)..."
Sorry but I find easier to understand that the hand of the practitioner should use the appropriate technique to talk and listen to the patient body.

Actually In our Osteopathic language we already use the verb listen for cranial techniques. It shouldn't be appropriate because we still don't have ears in our palms, but still we do use it. Why could only mute people speak and talk with their hands ? couldn't we, practitioners, speak and talk to a patient body as well with our hands ?
Don't you ever feel that you converse to your patient when you treat him/her ?

Regardless, Sheldon might be controversial, so is Darwin, Gandhi, Bush, Jesus, the local surgeon...
Sheldon was not the only one talking the different body types. Kretschmer was talking about the athletic, Athenic, and Pyknic types, Vannier was talking about phosphoric carbonic and fluoric types, and Goldthwait about slender,intermediate, and stocky types. Between each one of these groups there are correletaion. So Sheldon was not the only one to divide people in three different classifications and to associate gross psychological profile to each of them. I understand that it might be contrversial to divide individuals in categories, but in practice don't you find that this classification "talks" to you ? Even if a lot of the patients tend to be a mixture of the "three" types, we can still from time to time observe a "real" meso, endo , or ecto.

What do you find controversial about sheldon classification by the way ?

Thank you again for your reply,

Perre

▶ Reply to This

Permalink Reply by Austin on January 27, 2008 at 12:42am

Bonjour!

Regarding psycho-initiated or somato-initiated trauma, it seems that the traffic flows both ways: psychology affects physiology, and vice versa. Very few people would disagree with that. It's difficult, and possibly useless, to attempt to state whether a somatic or psychological effect is at the root of any problem. Whichever we pick, the other is just as viable.

So, let's say we arrive at somato-psychologic situation, i.e. a physical trauma which affects the psychology of the patient, such as that suffered by the person who twists his ankle on TV. Well, if we look deeper, we may say that a healthy psychology would have bounced back from such an event unscathed. So the psychology must be dysfunctional. So perhaps this is not a somato-psychological case at all, but a psycho-somatic case. But, go further back: why is the psychology dysfunctional? Maybe a physical event in the past! So.. wait, is it psycho-somatic, or somato-psychologic..?

And so on. It seems odd to attempt distinguishing a causal path. There may be one, but it will arbitrarily complex for any given patient or situation. Soma and psyche are inter-dependent, that's the simplest statement: it caters for all eventualities. That's not to say we shouldn't bother researching the past: we should. But will the treatment differ?

The jump from metallic alloys having "memory", to cells having "memory"... If this is a series of analogies, that's all fine. However, to say a cell has memory, or a tissue has a psychology, is to state.... what exactly? It seems to be a case of:

1. Metallic alloys are things.
2. Cells are things.
3. Metallic alloys are said to have "memory" (although it would be clearer to say that they return to their original form when heat is applied).
4. Therefore cells have "memory" (although this is a different type of memory).

It doesn't seem to follow. It would be fair to state that certain cells return to their initial state after mechanical stress is removed (is this memory?); or that other types of cells follow an identical response to an identical stimulus (is this memory?); and so on. So, just as psychology can be reasonably accurately described in the language of its domain, and cellular response likewise, can we not simply state that psychology and physiology interact?

Analogy is a wonderful and powerful tool, but it should always be clear that any example is just that: an analogy. Context sometimes does this for us. So to state that a deaf person speaks with their hands is reasonably unambivalent, given the context of deaf communication. To state the "cells have memory" or "tissue has psychology" seems to require a thorough setting of context, which I haven't so far followed. Statements such as "Can a tissue have a memory by itself without involving the brain ? Some may disagree but I will say : ' Yes, of course !' " seem to be unambiguously couched in the context of biology. So the meaning of "memory","tissues" etc are the biological meanings; in which case it seems this isn't analogy, it's some statement of biological fact. If this is the case, I haven't followed the evidence.

Regarding describing the interaction between a patient and an osteopath, yes, I think that the language should be absolutely unambiguous, if it's intended for a 3rd party - and if such description is at all possible (which I doubt).

In terms of what it **feels like**.... I'd prefer to read a poet's account. It would be far more evocative.

Regarding Sheldon: Just because other people have been controversial and yet correct, it doesn't follow that just because he is controversial that he was correct. Is there really a correlation between gross phenotype and character? Let's say that, for predicting character, instead of endo/ecto/meso, we chose hair colour; or cranium size; or BMI; or.... any other feature. Doubtless there are studies to suggest each one is related to character, or health, or anything else we choose to relate it to. So why choose Sheldon (

▶ Reply to This

Permalink Reply by pierre de lasteyrie on January 28, 2008 at 2:09pm

Dear Austin,

Thanks for your stimulationg conversation, yet a bit brain picking...

If you reread my post you will notice that I do state that it is hard to differentiate somato-psycho and psycho-somatic and that they are intimately related, but maybe I was not clear enough.

I doubt that any individual is psychologically healthy (I certainly here project my own inner conflicts),
When I wrote this part of the post, I didn't have any concrete, clinical experience examples to write down but since I had: I was testing a patient and found a restriction in one of her knee, I asked the patient if he recalled any injuries affecting his knee. After a first denial, he started to become flushed and giggly and told me that he dislocated his patella having sex, a few years ago...
I let you the choice to put whatever neurological link you want in this.

Actually knowing the past is very important and I am intrigued that you ask such a question as an osteopathic practitioner. the order of traumatic events can affect the order and treatment plan, It may give you some contra-indication to your treatment, and affect completely the type of techniques you will use. I'll give an example: One day I took over a patient who has been sexually assaulted a few years previously. Whaterever joint you tested, you could find some resrictions and potentially correct it. She received from a previous practitioner more than 20 treatments (mostly structural, HVT, STW, GOT..) she had a limited and temporary relief from each treatment but was still suffering from various pain and discomfort and was still feeling depressed ... I saw her once, and knowing her past history, and past treatment I decided to use a different approach and to "talk" to her body differently using a cranio-sacral approach. After one session she told me that she hasn't felt that good for the last 3 years... Obviously knowing her past history and past treatment influenced greatly my choice of treatment.

Concerning the memory of the cell,we may disagree on the vocabulary to use, you call it structural changes, I call it memory. Actually there is something quite interesting in the "memory" of a trauma. After a trauma your tissue may be more dense inone area than in another. "Kyst of residual energy" as described by Dr Upledger. I don't know if you are aware of the adaptation of the tensegrity model to the human body. they did some experiment with some indifferentiate kidney cells: Apparently when they were compressing theses cells, the cells were dying until there were enough space for the others. When they were stretching these cells they were multiplying. When they arrived at the good ration number/compression these same cells were secreting some hormones !

Concerning the alloy, I don't invent it ! it is called Shape Memory Alloy. If you disagree with the fact that "scientists" use the term "memory" instead of saying "alloys that return to their original form when heat is applied" I suggest that you comment a few of their post !
Effectively my explanation was a bit dubious, but it is clear for me that since we are composed from cells, and that we are capable of memory, it seems reasonable to assume that a part of this memory is within our cells.

Concerning a memory without involving the brain again , I believe it. if you are paraplegic and that I break one of your leg, your bone will still heal, and 10 years later on the Xray we will still see a mark of this impact. you call it structural change, I call it memory. If I had used a war hammer instead of a base ball bat, the damage wouldn't have been the same, 10 years later the structural damage wouln't have been the same, the memory of these two different impacts different ! Again you call it structural changes, I call it memory. Not too hard to understand is it ?
Please don't try this at home as it may be painful and particularly invalidating...

Concerning these statements, there are mine and represent my point of view, I never said that they were proven or were the absolute truth. We call this a blog, a space were you an express your point of view without proving everything you say. The aim of this post was to see differently the physical connection between a practitioner and his/her patient, we call this philosophy of Osteopathy.

I hope you don't wait for evidences before using a technique, as most of osteopathic field and techniques have not been proven effective yet, even the HVT ! Do you still use these techniques in practice knowing that they are still not proven effective ? Even if studies show they are, some others will show the opposite to be true. If they are effective on the low back are they effective on the neck ?
If you wait for the evidence, you will have to wait for long !
Do you practice cranial techniques ? This field is even more controversial...

If the term "feels like" put you off, you better rethink your osteopathic approach in this case, as our job is to feel things with our hands and to be as sure about what we feel, than about what we ear,or what we see, or what we taste, or smell.

When I was asking you if you never felt the sensation of communicating with your patient, I meant manually, through your palpation with cranio-sacral techniques, inhibition, fascial techniques...
What kind of techniques do you use in practice ?

About Sheldon, I took this example as I have been tought at school his classification and that I found in practice that generally functional techniques were more effective on ecto than on meso, and structural techniques more effective on meso than endo. Please accept my apologies if my lack of experience showed me wrong.

It is said that: "criticism is a tax that jealousy takes on the merit".

Thanks,
Take care
Pierre

▶ Reply to This

Permalink Reply by in8 on January 28, 2008 at 3:41pm

Way to go,Pierre! :)
{Every cell in your body is eavesdropping on your thoughts, make
those thoughts good ones.}

▶ Reply to This

Permalink Reply by Austin on January 29, 2008 at 5:00pm

Hi Pierre. I'll email you personally... debate on the internet is a little daft. Feel free to post anything I say here if you want, but I should probably have taken this up with you privately in the first place.

▶ Reply to This

Permalink Reply by Ronan O'Brien on January 29, 2008 at 7:59pm

Guys - a plea if I may - I am really enjoying reading this discussion and I am sure others are too. Please re-consider taking it offline. It's not often these things are discussed in public forums and I think that's a shame. Everyone has something to learn from you having this visible conversation.

▶ Reply to This

Permalink Reply by Clement Rhein on January 30, 2008 at 8:46pm

I agree with Ronan.
please

▶ Reply to This

Permalink Reply by Austin on January 30, 2008 at 9:26pm

Well, okay. I have the feeling it's getting a touch personal though, which I'm sure neither Pierre nor I intended. But that's the nature of debate :-)

I've emailed Pierre, if he's happy to carry on here then that's cool with me... though I'd prefer to edit what I sent to him rather than post it here. Discussion in private can be a little more... "frank" ;-)

• 1
• 2