Principles of Connective Therapy II
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Principles and Practice of Connective Therapy II
Principles of Connective Therapy II Dr Alain Abraham Abehsera Do MD
A. Pedagogy of Connective Therapy Recently, I watched a movie called “Excalibur”, a beautifully made, intelligent movie with splendid colors. It was also full of extreme feelings, hate and love, honor and deceit. Its setting was in Medieval England, the legendary times of King Arthur and the Knights of the Round Table. Its main theme was “chivalry”, that state of extreme self-consciousness about fidelity and honor. It was, as all good movies about Knights, extremely inspiring. One comes out entirely identifying with the “good knights”. That same evening, I was called to treat my hosts, they both had a feeling of “Flu”, feeling freezing cold, the bedcovers being of no help. There was also diffuse pain in all the peripheral joints and along the spine. I felt so inspired by the movie that I decided that I would treat as “a knight” would, dealing with the “viruses” as a knight would deal with the Evil Forces which fight his King or his Lady. I first proceeded to restore warmth, something quickly achieved, and then to remove the pain. It worked fairly fast on my two hosts and both got up the next day, weak, but symptomless. The purpose of this story is as follows. Connective Therapy is, and must not be, a stereotyped technique. It is entirely inspired by the moments you live. But more than that, it allows the therapist to apply his feelings, those that cannot be translated into words. In this case, the feeling of Knighthood that led my technique cannot be explained into words. I could certainly detail some of the steps I took (to create warmth, to fight the infection, to alleviate the pains etc.). No words can express, however, the basic “drive” behind all these steps. The anatomy was secondary in this case. The feeling was primary. During this course, you have heard other lecturers propose their model of living systems. The Chinese model, for instance, offers a very detailed description of the cycles of energy in the body. The Chinese have supplied us with an anatomy and a physiology that do not correspond to our anatomy and physiology. I believe that their information can be added to and processed into connective thinking, i.e., transformed into technique, without using needle, moxa or electrical stimulator. To achieve this, you will have to understand and feel, use reason and emotion. My general purpose, in this course, is to give you the “audacity” to create techniques of your own according to your understanding and your feelings about reality. The stronger your feelings, the more sophisticated your approach of the problem (in terms of the model used, such as Western or Eastern anatomy), the better the technique will be. It must be clear, however, that although you can learn anatomy from me or anybody else, you cannot learn your feelings from me or anybody else. I can only teach you how to turn your feelings into a concrete tool, how to make them external and effective through visualization.
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In other words, visualization is a form of expression not only of dry, objective, information, but also of “feeling”, a material that words generally cannot convey. Indeed, visualization is silent, wordless, and as such, can transfer, with minimal loss, the indescribable feelings of your thoughts. I repeat: an anatomical visualization is made of “thought” (the information gained from books, dissection, patients etc.) but also of “feeling” (about the anatomy, the needs of the patient, your relationship to him, your emotional state at that moment etc.). For me, to teach effective visualization, is to teach how to transmit facts and feelings. I believe this can be achieved in three ways. So far, I have used models mainly drawn from philosophy, ancient physics or history. Although they seem to be made of dry facts, these models are full of the “feelings” about reality of some key characters of the past, whether Plato, Aristotle or Still. These models generally agree with what the eyes see, the ears hear etc. but do not agree with each other. This is acceptable since they reflect the feelings of different persons (Plato, Aristotle etc. ). They are, however, archetypal feelings about reality, about health and disease, about matter, space, motion etc. This material can be turned into technique in three ways: • The first and ideal way would consist in learning each philosopher’s main lines of thought and then let you devise the visualization based on his “feelings about reality”. Ie, I would select a given amount of information in a philosopher or a piece of physics and then ask you to devise the relevant visualizations on reality. This would be ideal since it would respect your independence and creative ability. You would be able to invent visualizations that I have not thought of. We would then share mine and yours. • The second way would consist of learning the ideas and then the visualizations drawn from them. This is the approach we have used. It is not as good (but there probably is no other pedagogic choice at this point) since I force you into particular directions of understanding which are reflections of the teacher’s, i.e., my feelings on reality. • The third and lowest level would be to teach philosophical or physical concepts, the relevant visualizations and then the detailed application of these visualizations on a particular clinical case or problem. This the poorest model, the most reductive since it turns you into imitators, it closes your creative possibility and worse, it entirely disturbs your ability to visualize as you should: i.e., the ability to transfer your own feelings with the “dry” information. Example: Step I: Philosophical piece Parmenides believes that motion is illusory, that what is not, cannot be. Movement means that something was there and is now somewhere else, it is not anymore where it was at the beginning. The notion of “it is not” is impossible, since what is not, doesnot exist, only that that is, can exist. This is Parmenides explanation on reality (ie his rational thinking) but also his feeling about reality.
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Step II: Visualization You visualize an intensely moving system, such as a bee-hive, an ant’s nest, a busy street. After you have “visualized” the hectic motion of all the individuals, you visualize that no motion really occurs, that behind these random motions stands a noble, beautiful stillness. The order of the Bee-hive, the deep reality of the bee-hive is motionless. It is that stillness that drives all bee-hives in the Universe, that make bees unique. Step III: Treatment You visualize the circulation of the uterus, you see the organ teeming with blood vessels that pulsate, and blood vessels teem with blood corpuscles. You visualize this intense motion and then you try to reach the deep stillness, tranquillity behind all this “noise”. You have reached the true state of the blood circulation (this technique is to be developed later). The third stage is superfluous and negative at this point of our teaching. Thousands of possibilities lie between stage I and stage II, or between stage II and stage III. These must not be closed through a dogmatic form of teaching. It is unfortunate that dogmatic teaching is very much wanted by students since it takes much less time to transfer information. It almost invariably leads to students being pale copies of their teachers (since he cannot transfer his feelings). We shall thus keep away from going into the third stage although it is our final aim (the actual treatment procedure). We must concentrate on all the procedures that encourage the transfer of our thoughts (“dry” information as in anatomy) and feelings into our visualizations.
B. General Remarks on the “Sense” of Visualization
In our last lecture, we defined the two basic elements of Connective therapy: it is a thought process with a physical effect. We have to further define the nature of this thought process and of this physical effect (not in psychological/philosophical or physical terms, since this is the objective of the relevant courses). The thought process is defined as an act of visualization. As the name implies, this favors one aspect of our perception of the world, that of vision. It seems that during the technique, we are working with our vision, although our eyes may be closed or open We may also call this: “imagination”, but imagination contains the word “image”, one that also depends on the sense of sight. Do we then work only with images? No, if images are to be understood as the perceptions acquired only through the sense of vision. In our visualization, we will introduce perceptions learned through the senses of hearing, touch, taste and smell. Our visualization will thus be defined as crossroads where a sound, a taste, a texture, a form meet and fuse into a “vision”. I am touching here on one of the main “traps” of visualization. If it is considered only as the use of mental images, then it is dangerously close to what we call “imagination”, i.e., completely uncontrolled and unrealistic mental exercises. The
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trouble with our sense of vision is that it is the least physical of the senses: light is soft, it seems to flow into our eyes and evokes images without any resistance. This is very much unlike the sense of touch which is accompanied with the greatest sense of “reality”, of concreteness, of resistance. Hearing, taste, smell are all more “concrete” than sight. Only very strong light becomes somehow palpable, i.e., it hurts. Light is carried by photons, a particle that has almost no mass. This physical lightness goes well with the feeling of weightlessness when we use our eyes. Only using images, derived from pure vision, can thus be a weightless experience, ie one without physical effects. Here lies the difference between the type of images we will try to construct in CTh and those generally designated as “imagination”. For instance: confronted with a painful knee, you will have to create the image of a femur, tibia etc. The obvious procedure will be to try and remember the image from a book or the skeleton and then use that image. This is generally a useless procedure in CTh. Images remembered from books are weightless images and as such will have no physical effect. Indeed, if all our mental images had an external physical effect, the world would be a difficult place to live. The streets would be full of corpses and pregnant women as the French poet said. We would be terrorized by the Evil Eye, spell casting etc. This is indeed the principle of magic thinking: to act on someone through various manipulations on his image or his name as if his image or name were equivalent to him (cf. Voodo, Evil Eye etc.). Thank goodness, looking at someone or at some image, and trying to send some information to that person, is theoretically not an effective procedure. There possibly is, however, an external physical effect of pure vision. Generally, vision is described as a passive phenomenon: light enters our eyes and reacts with pigments in our retina to give the sensation of color. From the outside to the inside, the world to the brain. The Ancients did not think that way. They believed that vision also (or only) had an “outgoing”, “centrifugal” element. Ie, vision is accompanied by the emission of some “ray” out of our eyes. This would sound crazy nowadays. But there may be something to it. Vision is possibly both centrifugal and centripetal. Hasn’t everyone felt the strange, undefined sensation that someone is looking at him? The physical basis of this strange feeling is difficult to establish, but it is certainly common. Some research is even being conducted on this phenomenon. CTh seems to rest on the assumption that there is such a phenomenon, that vision is not just the passive reception and evocation (as in imagination) of images. It is a twoway phenomenon. Images of this kind are “active”, they are centrifugal. They may be considered as thought “radiation”. But they do not carry exclusively “images”, they can also carry sounds, textures, smells or tastes. These other senses are also passive (we receive sounds through the ears, touch through the skin etc.) but no less than “centrifugal visions”, we can send “centrifugal sounds”, tastes etc. I have not been able to prove this even to myself but occasional experiences seem to indicate that this is possible. I am positive about two things: we can send centrifugal images that convey centrifugal ideas or feelings. Through visualization, we are therefore able to send more than “images”, we radiate “information complexes”. This reminds us of the phrase in the Bible (Exodus), where the people of Israel “saw the thunder” and “heard the lightning”.
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Shamans deliberately seek this level of perception, where there are no clear limits between senses. The ear sees, the eye hears, the hand perceives colors etc. Some try to achieve this through drugs (LSD, mushrooms etc.). These lead, however, to a “confusion of senses” which seems completely ineffective. What we propose here is to learn a carefully controlled use of visualization, one that is able to “export” our perceptions and ideas to external reality.
Three-dimensionality of senses We have two eyes and two ears that perceive the world in “stereoscopic” and “stereophonic” fashion. The sense of “depth” or perspective whether in sound or sight is due to the apprehension of images through both ears and eyes. An image, as seen through our eyes, is not a simple reproduction or copy of reality. When we hear a complex sound, such as a symphony, we do not just copy the sounds from the outside in our brains. Seeing and listening does not consist in making photocopies or sound copies of reality. Light strikes our eyes and is transformed into a complex of electrical impulses transmitted through the optic nerves. This set of electrical impulses has a highly organized pattern, which is re-built into an image which seems to correspond to reality. The brain re-builds the image introducing color, depth or 3D etc. This is an active process on our part. Children that are born blind and recover sight only at a later age (as in congenital syphilis) demonstrate the “intellectual” aspect of vision. They have difficulty in perceiving depth. When they see a window (even if it is 6 meters away) they will reach for it with their hands. Their world is flatter than ours (although basic depth perception seems innate). It is only with experience that they will learn precise depth. For instance, through the combined use of touch and sight, they learn that this particular image of a window is linked to them having to walk 6 meters, another one is linked to them having to walk 3 meters etc.). It takes some time until they reach a visual perception that is similar to ours, including the perception of the differences between a square and a triangle. For a newly seeing child, they both look like an assembly of lines and they have to count “three” or “four” corners to decide which one is what. Seeing is thus a constructive activity of the brain and not a passive color photocopy of reality. Seeing is an intelligent act no less than any other thought process. The same goes for listening or touching. With regard to CTh, the most interesting characteristic of this re-building activity is the notion of 3D. The three dimensions of perceived reality appear in two types of pictures those obtained when seeing (and listening, where it is less obvious) with the eyes open those obtained through drawing or sculpting In other words, I see with depth (images seen with normal vision) and I can reproduce with depth on paper or on a solid (drawn image or sculpture). We speak of 3D drawing, a very ancient ability, since prehistoric drawings already resort to it. Sculpture is by definition 3D. Our hands and eyes can confirm the volumes and contours. Drawing is an ‘”illusory” 3D since only our eyes can confirm it. Drawing is not a natural activity, it is a cultural one.
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Man has thus the ability to see in 3D and to reproduce in 3D what has been seen in 3D on a flat surface (as in drawing). Something external (the object) has become internal (the image of the object) and again external (the drawing) without losing much information. There is a continuity between these three images (the model, the internal image of the artist and the external image or sculpture). The drawn image is a convention about reality that is unique to our visual sense. But how is it then, that only very few people can draw in 3D, ie, reproduce reality? It should be a natural process: I see something and my hands, with the help of colors, reproduces it. But this is not the case. A portrait or a flower drawn by a gifted artist is light years away from the type of drawings we would make of the same person or flower. One of the main differences is the loss of 3D. A gifted painter is able to reproduce not just the contours, but also the precise hues and color nuances of reality, something completely impossible to most of us. This ability reaches often that of the camera: the painter is able to make a faithful picture of reality. How is this done? And why is this a rare gift? In most of us, something is “lost” during the process described above: when I want to reproduce something, I take an external image (the object or model), then create an internal image (the perceived object) which is then externalized (the drawing itself). It seems that during this procedure, the three-dimensions of reality are lost. Indeed, for most people, imagination (with eyes closed) of a given object, is a 2D experience. If I am asked to put it down on paper, I will draw a 2D image because that is what is contained in my imagination. This is a crucial point, one of the most fundamental and relevant to CTh. We will have to struggle with this throughout our learning process and during our therapeutic exercise. At this point, I may affirm that a 2D visualization is useless or almost completely so. Reality is naturally 3D and our imagination is 2D, something made obvious when we try and draw. There is a major discrepancy between our images of reality and reality itself. Where does this discrepancy come from? The answer is easy. Our standard vision is itself not truly 3D. Indeed, no one has ever seen a complete object. There is a “dark side” to every object. For instance, a cube is only perceived partially. When it lies on a table, I cannot see its base or its back. To see them, I must turn them around and then, I cease to see the top and the front. This inability of man to see anything whole constitutes one of the arguments about G-d’s necessary existence or perfection (cf George Berkeley). Only He can see the entire object : He is the place of this world but the world is not His place (for instance, if we take a given object, like a glass, we can say that He is the place of the glass, but the glass is not His place). In some ways, we are outside of this world, we are excluded from it (exiled, alienated, Galut in Hebrew) since we are not able to see anything in its entirety. Our normal vision is thus only partially 3D, it has depth but not wholeness. A further loss of 3D occurs in our imagination. Some people seem to suffer less from this, like the artistically inclined. Indeed, the fact that they can reproduce depth on a flat surface supposes that in their minds there is some form of 3D plan of the image, of how they will proceed to reproduce it. I believe that this ability is not just an external, technical gift, a “trick” about reproducing reality. It is a deep-seated mental ability.
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We may thus say that in most of us some ability is missing or inhibited, repressed.
The Companions of the Tour de France There is an old and beautiful tradition in France, a few hundred years old, which still continues -although on a smaller scale- until this day. It is called the “Tour de France”. It has to do with learning crafts like carpentry, wrought-iron, masonry, pottery, blacksmiths etc. In the old days, youngsters that wanted to learn these trades had to be apprentices to well-established craftsmen for a few years. After having learned the basics of the trade, they would have to start a “Tour de France” , ie they would have to go from one craftsman to the other, around France, and learn from each one for a few months. Then, at the end of this voyage, they would have to make a “chef d’oeuvre” (masterpiece) that, upon acceptation, would allow them to become full-fledged craftsmen (this is supposedly the origin of the Free-Masons). I had the privilege of seeing “chef d’oeuvre” made by contemporary companions. I also have met some. For instance, blacksmiths that, upon looking at a horse’s way of walking, would know exactly what type of irons should be nailed, what width, weight and on which legs. It is extremely impressive to see these people at work. For instance, a carpenter, with a few strokes on a piece of wood or a piece of furniture, will tell you how old was the tree when it was cut, how long it stayed outside before it was worked etc. These are humble achievements but no less impressive that those who claim that they have psychic power. This craftsmanship reminds me, in osteopathy, of Fryette’s claim that he could recognize staphylococcal from streptococcal infection by touching the skin of his patient. I believe that some of these osteopaths were true companions. I would like you to read some of the pieces written by Sutherland on what he felt, on his amazing knowledge of the anatomy of the cranium, on how he could distinguish the abnormal pull of some tiny group of fibers in the meninges on some tiny little articulation deep in the cranium. Still, Fryette and Sutherland have certainly achieved their “chef d’oeuvre”. I believe that some contemporary osteopaths have continued this tradition of excellence. I wish we could embark on such a road of excellence, everyone according to his abilities. It would be sad to aim at less than that, even if that is only an aim, if that has only a “heuristic value”. Four Colors of Reality As I have said several times, CTh is a pure thought process. Even when we will use our hands, all the information that will pass between you and the patient will be thought. No motion from the hand will be necessary. This is an Osteopathic tradition born with Still, purified by Sutherland, even more so by Becker and, I believe that it has reached its fullness with the method we call “connective therapy”. Although I feel completely connected and indebted to these masters, I have been very much preoccupied by the following question. Should connective therapy be considered as a form of osteopathy? Or is it a distinct system of practice?
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A change of name (in this case, from Osteopathy to Connective therapy) is justified only when • the name is not appropriate anymore • the accepted teaching and methods of the previous approach would have a negative effect on the student trying to learn the new approach. I believe this is the case here. The usual teaching of osteopathy would have a deeply negative effect on your ability to perform Cth, a point that will become clearer as we proceed. A change of name for a given method would still not be justified if Cth were a generally less effective form of therapy than osteopathy, if it was more restricted in its indications, if, in other words, something important was lost in the passage between Osteopathy and CTh. I believe again that this is not the case, that not only little is lost, but that it opens doors, potentialities that did not exist in Osteopathy. It took me a very long time to reach that conclusion (much like the time taken by Sutherland before he began to propose his Cranio-Sacral concept) and I came to it through clinical experience, through comparisons with colleagues and their achievements. CTh is fundamentally different from Osteopathy. The latter is just an important source of Cth but not the exclusive one. The same goes for Still who derived Osteopathy from three or four sources but none can be said to be primary or exclusive. What are then the sources of CTh? Apart from Osteopathy, we have mentioned basic models of reality which have been described by others in Philosophy and Physics. There are other sources, however, and I would like to present them in an orderly fashion. I would consider that there are four basic approaches to reality. By approach, I mean, ways of thinking reality. CTh is nothing else than thinking that piece of reality called the patient. Moreover, the patient is a human being, possibly the most complex piece of reality that exists. These four ways of thinking are the four fundamental colors through which any human being perceives reality. They are the philosophical (analytical, logical, rational, non-empirical) way the scientific (empirical/rational) way the artistic way (sensory) the mystical way (faith/empirical) Everyone of us here, thinks and thus paints reality with a mixture of these four colors. Each of us adds to his perceptions, one or more of the fours spices above. None of them can be considered as more important than the other. You cannot reduce their number. The philosophical perception of reality is fundamentally different from the mystical or artistic one. None of these four approaches can be considered as being “truer” than the others. As children of the XXth century, one would be tempted to say that only the “scientific” approach is justified since it is based on facts seen objectively. But the last hundred years of scientific reflection has shown that science is in no way more rational than mysticism (supposedly the least rational). We find, at the root of
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sciences, no fewer “acts of faith” than in mysticism (cf. materialism, Darwinism etc.). As we enter the XXIst century, we hear of more and more scientists of high level with a “mystical approach” to reality; we cannot resist making parallels between quantum physics and Pythagoreanism, the most mystical of all trends in Greek philosophy and in human rational thinking. At least from an empirical point of view, no one can claim to know the ultimate color of reality. I personally belief that this color, if it exists, partakes of the four colors together. Reality is made of the four colors but is fundamentally different from each one. Very much like white light is made of the six primary colors but fundamentally different from each one. I have always considered myself a faithful disciple of all four schools, the scientific, the philosophical, the mystical and artistic. At a younger age, I would become an enthusiastic follower or one or the other model. With maturity, I surrendered my dialectic weapons, and accepted that all four are real, but only partial views of reality. CTh is clearly the result of a synthesis between these four colors. The printed material you receive may sound chaotic simply because they have to convey the diversity of their origins. I will mention, for instance, the possible existence of “knots” that “strangle” your patients from the outside world. My belief in the existence of such knots stems from my mystical inclinations. But my scientific tendencies are no less strong, and they force me to interpret these knots not in terms of dibbuks, angels or devils, but in terms of physical fields of torsion, of immobile motions, of formless matter or matterless forms, notions that have been thoroughly explored over the centuries by philosophers and scientists. These four colors of reality are at play in all the fields of our individual and collective existence: political, economical, cultural, ideological etc. Early on, I felt attracted to one human activity where all these colors appear bright and shiny: Medicine or Therapy. To me, this seemed the only field where, immediately, I could check the validity of my assumptions, of the colors I had chosen. I can make the most beautiful synthesis from the most beautiful theories in the world, but how do I know that what I have conceived corresponds to any reality? Medicine is one field where any theory of reality can be tested immediately. In acts as simple as : can I relieve this pain? Can I alleviate this suffering, this handicap? If one model succeeds in alleviating pains in certain situations but not in others, the model is incomplete and has to be reworked, enlarged etc. Or sometime, you discover that a given suffering cannot be changed and possibly will never be changed. I have spent the last twenty years doing just that: going from practice to theory and back. Trying never to claim in theory more than I have succeeded in practice. This world has known many remarkable thinkers : scientists, mystics, artists etc. But none of them, has this remarkable opportunity: check your beliefs in practice, on suffering. I have had remarkable experiences in this field, experiences that can only be described as “mystical-medical” where I would feel complete oneness with the patient (a mystical experience by definition) and where I felt anything could be achieved. These experiences were rare but they have acted as “light-houses” in the darkness of my search. They became models for research. My professional quest has mainly consisted in trying to reproduce on a day to day basis what had been experienced in a state of “grace”, i.e., turn grace into an empirical fact.
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I have always interpreted my failure to change serious pathological states (even if we have to accept that some of them cannot be changed), such as cancer or diabetes, as an obvious sign that my premises or theories are incorrect, or better, incomplete, that I have missed some fundamental aspect. From this point of view, I have acted differently from other practitioners of unconventional medicine, for whom failure of treatment is always a failure of the patient, sometimes of the practitioner, but never of the principles.
How can we hope to progress then? From my past experience, I believe that we do not achieve major leaps in our abilities or understanding by increasing the amount of details known. Major leaps occur through changes of paradigm, of principles. For the student wanting to learn CTh, such a change in paradigm, a true leap, has to occur and the very day of the leap, I hope he will feel the image particular to Cth in his thought or between his hands. After having acquired the basic feeling of Cth, he will have to make further leaps which will turn him every time into a better practitioner. These leaps, however, do not occur as a function of the number of pages of anatomy read and remembered. Learning more anatomy or physiology will generally not make me able to treat types of diseases that I could not treat before I read the books. In other words, a better knowledge of anatomy can only make you treat better what you could treat less well before. But if you had no effect on thyroiditis before, reading the anatomy of the thyroid gland will not turn you overnight into a specialist of inflammatory diseases of the thyroid gland. Another example: knowledge of the anatomy of the elbow will make you a better therapist of “tennis elbow”, but knowledge of the anatomy of the pancreas will not make you a better therapist of diabetes. To treat diabetes needs a change of principle, or better, a choice of a wider principle that is able to include the treatment of both elbow pain and diabetes.
Treacherous analogies The search for wider, more inclusive principles and practice has been my obsession. I have developed hundreds of techniques of visualization and never bothered to write them down. I forget them as they come although some of them were very effective. I repeat, techniques, better techniques allow for the better treatment of the same conditions, generally not of other conditions. Time and again, I have seen that the difficulties met by students in applying their technical knowledge to a particular clinical case was due to their ignorance about principles. Or more precisely, students do not know that technique is applied principle1. How do we use principles in osteopathy or Cth? We saw that philosophy, by definition, is characterized by the search for unity behind plurality. Confronted with animals of all kinds, I will try to distinguish if there is any
But the reverse is also true: principles are theoretical techniques. There is a free movement of information between technique and principles, going in both directions. Israel School of Connective Osteopathy Jerusalem
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pattern. For instance, after a few minutes, I will see that, although all of them are of very different appearance, they seem to belong to two basic types: those with hair and fur, and those with feathers. Instead of three hundred types of animals, I end up with two types. Confronted with the untold number of clinical cases, I must act the same. I must reduce the number of facts presented by the patient. For instance, a patient comes with tiredness, sore throat, left foot pain and occasional itching on the left hand. Can I make some connection between all these symptoms? Is there a pathological principle at work here? The same principle can be at work in another patient with different symptoms. Can I recognize it every time or most of the time? A principle is really known when it can be recognized everywhere it is at play. When you can recognize a principle under its thousands of disguises, you may say that you “know” this principle and how it acts. Our brain is somehow able to recognize similarity of principles when confronted with, apparently, different situations. Recent research has attributed this capacity to the right part of the brain2. For instance, let us say you are confronted with two objects as different as a “wick” and a “wicked” person, and then asked to find if they have something in common, possibly justifying the fact that they sound very close. In the case of these two objects, they seem to express and contain the same idea, that of being “twisted”. The notion of torsion is part of the essence of each one. One cannot conceive of a cotton wick or of a wicked person, without torsion. After having recognized the presence of “twistedness” in those two entities, you will be able to recognize it everywhere it occurs: for instance, in the muscles you will have to treat, in connective tissue, in the “knots” you will feel inside or outside the body etc. If I want to treat a muscle, his tendons and his insertions on a given set of bones, I must look for the image, the essence that is common to all three structures. I find that connective tissue is present in all three structures, but beyond that, that connective tissue is made of a network of fibers that are twisted, that criss-cross each other. Using an image like “twisted meshwork of fibers which criss-cross each other in all kinds of directions” will be an effective way of treating in one single visualized field a muscle (or group of muscles), its tendons, related bones and ligaments. After you have recognized the principle of torsion behind many different entities (wicks, muscles, ligaments, wickedness etc.), you may find other principles of this kind that are common to apparently different objects. For instance, entities that are characterized by the notion of conflict, transport or pregnancy etc. I have considerably expanded on this concept in my book Babel. There I make the hypothesis that man has two basic visions (possibly in parallel to the two sides of our brain, but I think that a much wider phenomenon is at play). His left vision looks for differences between any object and any other. It will strongly protest, for instance, that wicks and wicked persons are totally different, that their differences are far more important than their similarities. For the right vision, the opposite is true, for it considers the essence of things and, from that point of view, wicks and wicked people are very similar if not identical. The right vision makes constant analogies of this kind, looking for similar objects or entities in our reality. The left vision does just the
We have to be weary of the so called differences between right and left brain perception. They no doubt exist but one should be careful not to divide the brain into two distinct boxes. The brain works as a field. Israel School of Connective Osteopathy Jerusalem
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opposite, it looks for differences. In Babel, I have shown the effect of these forces on the formation of words. In our work in CTh, we constantly have to • know the detailed constitution of any given tissue (left vision), for instance a muscle • know the analogies of structure and function between that tissue and surrounding tissues (right vision), for instance, that muscle and the bones, ligaments etc. Use of left vision is not particular to CTh. Learning and knowing details is encouraged throughout our schooling. Looking for and using analogies between detailed structures is quite unique to CTh. The use of detailed knowledge makes it a precise technique, the use of analogies, a very versatile technique. We must be very careful with those two poles: excessive details or excessive analogies make the technique ineffective. Making analogies, for instance, is both inspiring and dangerous. Inspiring because it is one of the main creative forces in art (poetry, painting, music etc). Dangerous because it knows no limits and may end up comparing anything to anything else. I will ask you to make analogies, to create your own analogies, always bearing in mind that this does not consist in just comparing anything to anything else in any way and at any time. Analogies are effective if they are fed by precise details. The more detail you know about two structures, the more effective your analogy will be. Vague knowledge about muscles and bones, vague images of how they are made of fibers, will lead to a weak treatment. CTh therefore implies: • the constitution of a detailed data base (anatomy, physiology etc.) where data are well delimited, differentiated. The more you know about the differences between two given structures (two muscles, a muscle and a bone, a viscus and a blood vessel), the more effective you will be. You set precise limits around each tissue, defining what makes it unique. • The abolition of the limits above, in search for analogies, common features etc. For instance, the notion of torsion common to all connective tissue fibers present in all the tissues of the body. A true connective therapeutic act occurs when this paradox has been realized: the creation of an analogy between two distinct structures. You can acquire most of the detailed knowledge on your own, in textbooks. In this course, I will have to help you create your analogies, something not found in textbooks. We have already experienced these analogies through the various exercises drawn from physics, history and philosophy. Please understand a crucial point: I cannot teach you analogies by telling you how to make analogies or which analogies are right or wrong. Proceeding this way would be destructive. By definition, the making of analogies must be a living process, a constantly creative one, not a predefined technique. Analogies must be a live constituent of your total visualization. So that the best thing I can do is to teach the principle of making analogies, or better, teach analogies by making myself analogies. In other words, to teach analogies, I have to speak analogically. And this is why I have chosen to teach CTh through other subjects, through philosophy or history. These are related to CTh by analogy. They teach technique by analogy, not directly.
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When we learn about a given philosopher, we have to find the essence of his view and apply it by analogy to therapeutics. It is the very act of visualizing the analogy (the transfer of information from one subject to another, apparently not related, one) that is effective and creative. Let us take a concrete example. A patient comes with elbow pain and another one comes with digestive problems. Apparently, there is no connection between them, one is an “articulatory”, osteo-muscular problem, the other is a “visceral” problem. One concerns soft tissues (viscera) the other harder tissues (bones, ligaments). What would be the best way for me to teach their treatment? Either teach “techniques for the elbow” and then “techniques for the viscera”, or “ principles of treatment of both soft and hard tissues”? Once we have learned that principle, shouldn’t we learn also the principle of connectivity, whereby an elbow has to be treated in correlation to the gut or the liver and vice versa? It is obvious to me, and not obvious to most of the people in charge of osteopathic education, that the common principles must be taught first, since they will make room for your independence and creativity. If not, you will have to find for every single problem, the book or seminar where the technique is described. Knowing the analogic principles will allow you to go from any tissue to any other, and thus tackle any pathology. Over the years, through clinical experience, I have found a limited number of analogies or analogical principles. But, I have to repeat it, do not ask me to teach them directly. When used during visualization, they are alive, like fish in water. To describe them to you, is to bring the fish out of the water. It may be beautiful but dead. What I mean is that no word can exactly describe the analogies used in visualization. Nothing can be said that describes them directly. But much can be said indirectly. By analogy, I can say that a given feeling typical of CTh looks likes this but does not look like that. I can never define, I can only compare, i.e., make analogies. The description of what should or could be perceived is actually so difficult that I have felt obliged to take the widest possible basis of comparison. The use of philosophy, physics or history supplies me with a varied and contrasted material from which I can make extensive comparisons. I can thus say that spontaneous tissue motion produces a perception evocative of the notion of field seen in physics but also akin to the notion of fluidity described by Thales. It is neither one nor the other but something in between and in between many other concepts. The wider our data base is, the better the description will be, always using the key phrase “it looks like that” “ it does not look like that”.
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Yoshev BeSeter Elion I had one teacher in Qabala, Rabbi Shmuel Toledano. He taught us one very fundamental concept of Qabala. Truth is only found when the two contraries fuse into one whole. Neither black nor white is true, and certainly not gray. Gray is a mixture where black and white have disappeared. Truth occurs when something is seen as absolutely black and white at the same time. Rabbi Toledano taught us that this was the deep meaning of the verse from the Psalms: Yoshev Beseter Elion. Speaking about G-d, this verse describes Him as “He who sits in the highest (ultimate) contradiction (Seter – Setira, a word which has the ambiguous meaning of hidden residence and contradiction)”. This truly impressed me and has been one of my main quests ever since. How can I visualize something and its opposite at the same time? How can I visualize that some articulation is bending towards the right and towards the left at the same time? I believe, from limited experience, that here lies a fundamental “secret” of visualization. Something we shall try to train in. One cannot think of making these types of visualization from reading anatomy books. When principles are clearly understood and identified, it becomes possible to find true contradictions. Having found a true contradiction between two concepts, we can then try and fuse them into one. It is unfortunate that people are so vague in their definitions that they fail to see the differences or oppositions between two concepts when they should see them, and vice versa, they see contradictions when there are none. This ability is crucial in therapy. We will have to possess our principles and bring them to a degree as close as possible to crystal clarity. My teacher in osteopathy, SJG Wernham, a student of Littlejohn, one of the main students of Still, and the founder of European Osteopathy, used to say that osteopathy is ninety percent principle and ten percent practice. His teaching consisted in having us sit for three hours on end and read from texts completely incomprehensible to us. We hated that. I find myself doing this with you although I hope the texts are a little more comprehensible. But CTh, a pure thought process, is nothing but “projected principles”.
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Principles of Connective Therapy II Dr Alain Abraham Abehsera Do MD
A. Pedagogy of Connective Therapy Recently, I watched a movie called “Excalibur”, a beautifully made, intelligent movie with splendid colors. It was also full of extreme feelings, hate and love, honor and deceit. Its setting was in Medieval England, the legendary times of King Arthur and the Knights of the Round Table. Its main theme was “chivalry”, that state of extreme self-consciousness about fidelity and honor. It was, as all good movies about Knights, extremely inspiring. One comes out entirely identifying with the “good knights”. That same evening, I was called to treat my hosts, they both had a feeling of “Flu”, feeling freezing cold, the bedcovers being of no help. There was also diffuse pain in all the peripheral joints and along the spine. I felt so inspired by the movie that I decided that I would treat as “a knight” would, dealing with the “viruses” as a knight would deal with the Evil Forces which fight his King or his Lady. I first proceeded to restore warmth, something quickly achieved, and then to remove the pain. It worked fairly fast on my two hosts and both got up the next day, weak, but symptomless. The purpose of this story is as follows. Connective Therapy is, and must not be, a stereotyped technique. It is entirely inspired by the moments you live. But more than that, it allows the therapist to apply his feelings, those that cannot be translated into words. In this case, the feeling of Knighthood that led my technique cannot be explained into words. I could certainly detail some of the steps I took (to create warmth, to fight the infection, to alleviate the pains etc.). No words can express, however, the basic “drive” behind all these steps. The anatomy was secondary in this case. The feeling was primary. During this course, you have heard other lecturers propose their model of living systems. The Chinese model, for instance, offers a very detailed description of the cycles of energy in the body. The Chinese have supplied us with an anatomy and a physiology that do not correspond to our anatomy and physiology. I believe that their information can be added to and processed into connective thinking, i.e., transformed into technique, without using needle, moxa or electrical stimulator. To achieve this, you will have to understand and feel, use reason and emotion. My general purpose, in this course, is to give you the “audacity” to create techniques of your own according to your understanding and your feelings about reality. The stronger your feelings, the more sophisticated your approach of the problem (in terms of the model used, such as Western or Eastern anatomy), the better the technique will be. It must be clear, however, that although you can learn anatomy from me or anybody else, you cannot learn your feelings from me or anybody else. I can only teach you how to turn your feelings into a concrete tool, how to make them external and effective through visualization.
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In other words, visualization is a form of expression not only of dry, objective, information, but also of “feeling”, a material that words generally cannot convey. Indeed, visualization is silent, wordless, and as such, can transfer, with minimal loss, the indescribable feelings of your thoughts. I repeat: an anatomical visualization is made of “thought” (the information gained from books, dissection, patients etc.) but also of “feeling” (about the anatomy, the needs of the patient, your relationship to him, your emotional state at that moment etc.). For me, to teach effective visualization, is to teach how to transmit facts and feelings. I believe this can be achieved in three ways. So far, I have used models mainly drawn from philosophy, ancient physics or history. Although they seem to be made of dry facts, these models are full of the “feelings” about reality of some key characters of the past, whether Plato, Aristotle or Still. These models generally agree with what the eyes see, the ears hear etc. but do not agree with each other. This is acceptable since they reflect the feelings of different persons (Plato, Aristotle etc. ). They are, however, archetypal feelings about reality, about health and disease, about matter, space, motion etc. This material can be turned into technique in three ways: • The first and ideal way would consist in learning each philosopher’s main lines of thought and then let you devise the visualization based on his “feelings about reality”. Ie, I would select a given amount of information in a philosopher or a piece of physics and then ask you to devise the relevant visualizations on reality. This would be ideal since it would respect your independence and creative ability. You would be able to invent visualizations that I have not thought of. We would then share mine and yours. • The second way would consist of learning the ideas and then the visualizations drawn from them. This is the approach we have used. It is not as good (but there probably is no other pedagogic choice at this point) since I force you into particular directions of understanding which are reflections of the teacher’s, i.e., my feelings on reality. • The third and lowest level would be to teach philosophical or physical concepts, the relevant visualizations and then the detailed application of these visualizations on a particular clinical case or problem. This the poorest model, the most reductive since it turns you into imitators, it closes your creative possibility and worse, it entirely disturbs your ability to visualize as you should: i.e., the ability to transfer your own feelings with the “dry” information. Example: Step I: Philosophical piece Parmenides believes that motion is illusory, that what is not, cannot be. Movement means that something was there and is now somewhere else, it is not anymore where it was at the beginning. The notion of “it is not” is impossible, since what is not, doesnot exist, only that that is, can exist. This is Parmenides explanation on reality (ie his rational thinking) but also his feeling about reality.
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Step II: Visualization You visualize an intensely moving system, such as a bee-hive, an ant’s nest, a busy street. After you have “visualized” the hectic motion of all the individuals, you visualize that no motion really occurs, that behind these random motions stands a noble, beautiful stillness. The order of the Bee-hive, the deep reality of the bee-hive is motionless. It is that stillness that drives all bee-hives in the Universe, that make bees unique. Step III: Treatment You visualize the circulation of the uterus, you see the organ teeming with blood vessels that pulsate, and blood vessels teem with blood corpuscles. You visualize this intense motion and then you try to reach the deep stillness, tranquillity behind all this “noise”. You have reached the true state of the blood circulation (this technique is to be developed later). The third stage is superfluous and negative at this point of our teaching. Thousands of possibilities lie between stage I and stage II, or between stage II and stage III. These must not be closed through a dogmatic form of teaching. It is unfortunate that dogmatic teaching is very much wanted by students since it takes much less time to transfer information. It almost invariably leads to students being pale copies of their teachers (since he cannot transfer his feelings). We shall thus keep away from going into the third stage although it is our final aim (the actual treatment procedure). We must concentrate on all the procedures that encourage the transfer of our thoughts (“dry” information as in anatomy) and feelings into our visualizations.
B. General Remarks on the “Sense” of Visualization
In our last lecture, we defined the two basic elements of Connective therapy: it is a thought process with a physical effect. We have to further define the nature of this thought process and of this physical effect (not in psychological/philosophical or physical terms, since this is the objective of the relevant courses). The thought process is defined as an act of visualization. As the name implies, this favors one aspect of our perception of the world, that of vision. It seems that during the technique, we are working with our vision, although our eyes may be closed or open We may also call this: “imagination”, but imagination contains the word “image”, one that also depends on the sense of sight. Do we then work only with images? No, if images are to be understood as the perceptions acquired only through the sense of vision. In our visualization, we will introduce perceptions learned through the senses of hearing, touch, taste and smell. Our visualization will thus be defined as crossroads where a sound, a taste, a texture, a form meet and fuse into a “vision”. I am touching here on one of the main “traps” of visualization. If it is considered only as the use of mental images, then it is dangerously close to what we call “imagination”, i.e., completely uncontrolled and unrealistic mental exercises. The
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trouble with our sense of vision is that it is the least physical of the senses: light is soft, it seems to flow into our eyes and evokes images without any resistance. This is very much unlike the sense of touch which is accompanied with the greatest sense of “reality”, of concreteness, of resistance. Hearing, taste, smell are all more “concrete” than sight. Only very strong light becomes somehow palpable, i.e., it hurts. Light is carried by photons, a particle that has almost no mass. This physical lightness goes well with the feeling of weightlessness when we use our eyes. Only using images, derived from pure vision, can thus be a weightless experience, ie one without physical effects. Here lies the difference between the type of images we will try to construct in CTh and those generally designated as “imagination”. For instance: confronted with a painful knee, you will have to create the image of a femur, tibia etc. The obvious procedure will be to try and remember the image from a book or the skeleton and then use that image. This is generally a useless procedure in CTh. Images remembered from books are weightless images and as such will have no physical effect. Indeed, if all our mental images had an external physical effect, the world would be a difficult place to live. The streets would be full of corpses and pregnant women as the French poet said. We would be terrorized by the Evil Eye, spell casting etc. This is indeed the principle of magic thinking: to act on someone through various manipulations on his image or his name as if his image or name were equivalent to him (cf. Voodo, Evil Eye etc.). Thank goodness, looking at someone or at some image, and trying to send some information to that person, is theoretically not an effective procedure. There possibly is, however, an external physical effect of pure vision. Generally, vision is described as a passive phenomenon: light enters our eyes and reacts with pigments in our retina to give the sensation of color. From the outside to the inside, the world to the brain. The Ancients did not think that way. They believed that vision also (or only) had an “outgoing”, “centrifugal” element. Ie, vision is accompanied by the emission of some “ray” out of our eyes. This would sound crazy nowadays. But there may be something to it. Vision is possibly both centrifugal and centripetal. Hasn’t everyone felt the strange, undefined sensation that someone is looking at him? The physical basis of this strange feeling is difficult to establish, but it is certainly common. Some research is even being conducted on this phenomenon. CTh seems to rest on the assumption that there is such a phenomenon, that vision is not just the passive reception and evocation (as in imagination) of images. It is a twoway phenomenon. Images of this kind are “active”, they are centrifugal. They may be considered as thought “radiation”. But they do not carry exclusively “images”, they can also carry sounds, textures, smells or tastes. These other senses are also passive (we receive sounds through the ears, touch through the skin etc.) but no less than “centrifugal visions”, we can send “centrifugal sounds”, tastes etc. I have not been able to prove this even to myself but occasional experiences seem to indicate that this is possible. I am positive about two things: we can send centrifugal images that convey centrifugal ideas or feelings. Through visualization, we are therefore able to send more than “images”, we radiate “information complexes”. This reminds us of the phrase in the Bible (Exodus), where the people of Israel “saw the thunder” and “heard the lightning”.
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Shamans deliberately seek this level of perception, where there are no clear limits between senses. The ear sees, the eye hears, the hand perceives colors etc. Some try to achieve this through drugs (LSD, mushrooms etc.). These lead, however, to a “confusion of senses” which seems completely ineffective. What we propose here is to learn a carefully controlled use of visualization, one that is able to “export” our perceptions and ideas to external reality.
Three-dimensionality of senses We have two eyes and two ears that perceive the world in “stereoscopic” and “stereophonic” fashion. The sense of “depth” or perspective whether in sound or sight is due to the apprehension of images through both ears and eyes. An image, as seen through our eyes, is not a simple reproduction or copy of reality. When we hear a complex sound, such as a symphony, we do not just copy the sounds from the outside in our brains. Seeing and listening does not consist in making photocopies or sound copies of reality. Light strikes our eyes and is transformed into a complex of electrical impulses transmitted through the optic nerves. This set of electrical impulses has a highly organized pattern, which is re-built into an image which seems to correspond to reality. The brain re-builds the image introducing color, depth or 3D etc. This is an active process on our part. Children that are born blind and recover sight only at a later age (as in congenital syphilis) demonstrate the “intellectual” aspect of vision. They have difficulty in perceiving depth. When they see a window (even if it is 6 meters away) they will reach for it with their hands. Their world is flatter than ours (although basic depth perception seems innate). It is only with experience that they will learn precise depth. For instance, through the combined use of touch and sight, they learn that this particular image of a window is linked to them having to walk 6 meters, another one is linked to them having to walk 3 meters etc.). It takes some time until they reach a visual perception that is similar to ours, including the perception of the differences between a square and a triangle. For a newly seeing child, they both look like an assembly of lines and they have to count “three” or “four” corners to decide which one is what. Seeing is thus a constructive activity of the brain and not a passive color photocopy of reality. Seeing is an intelligent act no less than any other thought process. The same goes for listening or touching. With regard to CTh, the most interesting characteristic of this re-building activity is the notion of 3D. The three dimensions of perceived reality appear in two types of pictures those obtained when seeing (and listening, where it is less obvious) with the eyes open those obtained through drawing or sculpting In other words, I see with depth (images seen with normal vision) and I can reproduce with depth on paper or on a solid (drawn image or sculpture). We speak of 3D drawing, a very ancient ability, since prehistoric drawings already resort to it. Sculpture is by definition 3D. Our hands and eyes can confirm the volumes and contours. Drawing is an ‘”illusory” 3D since only our eyes can confirm it. Drawing is not a natural activity, it is a cultural one.
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Man has thus the ability to see in 3D and to reproduce in 3D what has been seen in 3D on a flat surface (as in drawing). Something external (the object) has become internal (the image of the object) and again external (the drawing) without losing much information. There is a continuity between these three images (the model, the internal image of the artist and the external image or sculpture). The drawn image is a convention about reality that is unique to our visual sense. But how is it then, that only very few people can draw in 3D, ie, reproduce reality? It should be a natural process: I see something and my hands, with the help of colors, reproduces it. But this is not the case. A portrait or a flower drawn by a gifted artist is light years away from the type of drawings we would make of the same person or flower. One of the main differences is the loss of 3D. A gifted painter is able to reproduce not just the contours, but also the precise hues and color nuances of reality, something completely impossible to most of us. This ability reaches often that of the camera: the painter is able to make a faithful picture of reality. How is this done? And why is this a rare gift? In most of us, something is “lost” during the process described above: when I want to reproduce something, I take an external image (the object or model), then create an internal image (the perceived object) which is then externalized (the drawing itself). It seems that during this procedure, the three-dimensions of reality are lost. Indeed, for most people, imagination (with eyes closed) of a given object, is a 2D experience. If I am asked to put it down on paper, I will draw a 2D image because that is what is contained in my imagination. This is a crucial point, one of the most fundamental and relevant to CTh. We will have to struggle with this throughout our learning process and during our therapeutic exercise. At this point, I may affirm that a 2D visualization is useless or almost completely so. Reality is naturally 3D and our imagination is 2D, something made obvious when we try and draw. There is a major discrepancy between our images of reality and reality itself. Where does this discrepancy come from? The answer is easy. Our standard vision is itself not truly 3D. Indeed, no one has ever seen a complete object. There is a “dark side” to every object. For instance, a cube is only perceived partially. When it lies on a table, I cannot see its base or its back. To see them, I must turn them around and then, I cease to see the top and the front. This inability of man to see anything whole constitutes one of the arguments about G-d’s necessary existence or perfection (cf George Berkeley). Only He can see the entire object : He is the place of this world but the world is not His place (for instance, if we take a given object, like a glass, we can say that He is the place of the glass, but the glass is not His place). In some ways, we are outside of this world, we are excluded from it (exiled, alienated, Galut in Hebrew) since we are not able to see anything in its entirety. Our normal vision is thus only partially 3D, it has depth but not wholeness. A further loss of 3D occurs in our imagination. Some people seem to suffer less from this, like the artistically inclined. Indeed, the fact that they can reproduce depth on a flat surface supposes that in their minds there is some form of 3D plan of the image, of how they will proceed to reproduce it. I believe that this ability is not just an external, technical gift, a “trick” about reproducing reality. It is a deep-seated mental ability.
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We may thus say that in most of us some ability is missing or inhibited, repressed.
The Companions of the Tour de France There is an old and beautiful tradition in France, a few hundred years old, which still continues -although on a smaller scale- until this day. It is called the “Tour de France”. It has to do with learning crafts like carpentry, wrought-iron, masonry, pottery, blacksmiths etc. In the old days, youngsters that wanted to learn these trades had to be apprentices to well-established craftsmen for a few years. After having learned the basics of the trade, they would have to start a “Tour de France” , ie they would have to go from one craftsman to the other, around France, and learn from each one for a few months. Then, at the end of this voyage, they would have to make a “chef d’oeuvre” (masterpiece) that, upon acceptation, would allow them to become full-fledged craftsmen (this is supposedly the origin of the Free-Masons). I had the privilege of seeing “chef d’oeuvre” made by contemporary companions. I also have met some. For instance, blacksmiths that, upon looking at a horse’s way of walking, would know exactly what type of irons should be nailed, what width, weight and on which legs. It is extremely impressive to see these people at work. For instance, a carpenter, with a few strokes on a piece of wood or a piece of furniture, will tell you how old was the tree when it was cut, how long it stayed outside before it was worked etc. These are humble achievements but no less impressive that those who claim that they have psychic power. This craftsmanship reminds me, in osteopathy, of Fryette’s claim that he could recognize staphylococcal from streptococcal infection by touching the skin of his patient. I believe that some of these osteopaths were true companions. I would like you to read some of the pieces written by Sutherland on what he felt, on his amazing knowledge of the anatomy of the cranium, on how he could distinguish the abnormal pull of some tiny group of fibers in the meninges on some tiny little articulation deep in the cranium. Still, Fryette and Sutherland have certainly achieved their “chef d’oeuvre”. I believe that some contemporary osteopaths have continued this tradition of excellence. I wish we could embark on such a road of excellence, everyone according to his abilities. It would be sad to aim at less than that, even if that is only an aim, if that has only a “heuristic value”. Four Colors of Reality As I have said several times, CTh is a pure thought process. Even when we will use our hands, all the information that will pass between you and the patient will be thought. No motion from the hand will be necessary. This is an Osteopathic tradition born with Still, purified by Sutherland, even more so by Becker and, I believe that it has reached its fullness with the method we call “connective therapy”. Although I feel completely connected and indebted to these masters, I have been very much preoccupied by the following question. Should connective therapy be considered as a form of osteopathy? Or is it a distinct system of practice?
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A change of name (in this case, from Osteopathy to Connective therapy) is justified only when • the name is not appropriate anymore • the accepted teaching and methods of the previous approach would have a negative effect on the student trying to learn the new approach. I believe this is the case here. The usual teaching of osteopathy would have a deeply negative effect on your ability to perform Cth, a point that will become clearer as we proceed. A change of name for a given method would still not be justified if Cth were a generally less effective form of therapy than osteopathy, if it was more restricted in its indications, if, in other words, something important was lost in the passage between Osteopathy and CTh. I believe again that this is not the case, that not only little is lost, but that it opens doors, potentialities that did not exist in Osteopathy. It took me a very long time to reach that conclusion (much like the time taken by Sutherland before he began to propose his Cranio-Sacral concept) and I came to it through clinical experience, through comparisons with colleagues and their achievements. CTh is fundamentally different from Osteopathy. The latter is just an important source of Cth but not the exclusive one. The same goes for Still who derived Osteopathy from three or four sources but none can be said to be primary or exclusive. What are then the sources of CTh? Apart from Osteopathy, we have mentioned basic models of reality which have been described by others in Philosophy and Physics. There are other sources, however, and I would like to present them in an orderly fashion. I would consider that there are four basic approaches to reality. By approach, I mean, ways of thinking reality. CTh is nothing else than thinking that piece of reality called the patient. Moreover, the patient is a human being, possibly the most complex piece of reality that exists. These four ways of thinking are the four fundamental colors through which any human being perceives reality. They are the philosophical (analytical, logical, rational, non-empirical) way the scientific (empirical/rational) way the artistic way (sensory) the mystical way (faith/empirical) Everyone of us here, thinks and thus paints reality with a mixture of these four colors. Each of us adds to his perceptions, one or more of the fours spices above. None of them can be considered as more important than the other. You cannot reduce their number. The philosophical perception of reality is fundamentally different from the mystical or artistic one. None of these four approaches can be considered as being “truer” than the others. As children of the XXth century, one would be tempted to say that only the “scientific” approach is justified since it is based on facts seen objectively. But the last hundred years of scientific reflection has shown that science is in no way more rational than mysticism (supposedly the least rational). We find, at the root of
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sciences, no fewer “acts of faith” than in mysticism (cf. materialism, Darwinism etc.). As we enter the XXIst century, we hear of more and more scientists of high level with a “mystical approach” to reality; we cannot resist making parallels between quantum physics and Pythagoreanism, the most mystical of all trends in Greek philosophy and in human rational thinking. At least from an empirical point of view, no one can claim to know the ultimate color of reality. I personally belief that this color, if it exists, partakes of the four colors together. Reality is made of the four colors but is fundamentally different from each one. Very much like white light is made of the six primary colors but fundamentally different from each one. I have always considered myself a faithful disciple of all four schools, the scientific, the philosophical, the mystical and artistic. At a younger age, I would become an enthusiastic follower or one or the other model. With maturity, I surrendered my dialectic weapons, and accepted that all four are real, but only partial views of reality. CTh is clearly the result of a synthesis between these four colors. The printed material you receive may sound chaotic simply because they have to convey the diversity of their origins. I will mention, for instance, the possible existence of “knots” that “strangle” your patients from the outside world. My belief in the existence of such knots stems from my mystical inclinations. But my scientific tendencies are no less strong, and they force me to interpret these knots not in terms of dibbuks, angels or devils, but in terms of physical fields of torsion, of immobile motions, of formless matter or matterless forms, notions that have been thoroughly explored over the centuries by philosophers and scientists. These four colors of reality are at play in all the fields of our individual and collective existence: political, economical, cultural, ideological etc. Early on, I felt attracted to one human activity where all these colors appear bright and shiny: Medicine or Therapy. To me, this seemed the only field where, immediately, I could check the validity of my assumptions, of the colors I had chosen. I can make the most beautiful synthesis from the most beautiful theories in the world, but how do I know that what I have conceived corresponds to any reality? Medicine is one field where any theory of reality can be tested immediately. In acts as simple as : can I relieve this pain? Can I alleviate this suffering, this handicap? If one model succeeds in alleviating pains in certain situations but not in others, the model is incomplete and has to be reworked, enlarged etc. Or sometime, you discover that a given suffering cannot be changed and possibly will never be changed. I have spent the last twenty years doing just that: going from practice to theory and back. Trying never to claim in theory more than I have succeeded in practice. This world has known many remarkable thinkers : scientists, mystics, artists etc. But none of them, has this remarkable opportunity: check your beliefs in practice, on suffering. I have had remarkable experiences in this field, experiences that can only be described as “mystical-medical” where I would feel complete oneness with the patient (a mystical experience by definition) and where I felt anything could be achieved. These experiences were rare but they have acted as “light-houses” in the darkness of my search. They became models for research. My professional quest has mainly consisted in trying to reproduce on a day to day basis what had been experienced in a state of “grace”, i.e., turn grace into an empirical fact.
Israel School of Connective Osteopathy Jerusalem
ISCO
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I have always interpreted my failure to change serious pathological states (even if we have to accept that some of them cannot be changed), such as cancer or diabetes, as an obvious sign that my premises or theories are incorrect, or better, incomplete, that I have missed some fundamental aspect. From this point of view, I have acted differently from other practitioners of unconventional medicine, for whom failure of treatment is always a failure of the patient, sometimes of the practitioner, but never of the principles.
How can we hope to progress then? From my past experience, I believe that we do not achieve major leaps in our abilities or understanding by increasing the amount of details known. Major leaps occur through changes of paradigm, of principles. For the student wanting to learn CTh, such a change in paradigm, a true leap, has to occur and the very day of the leap, I hope he will feel the image particular to Cth in his thought or between his hands. After having acquired the basic feeling of Cth, he will have to make further leaps which will turn him every time into a better practitioner. These leaps, however, do not occur as a function of the number of pages of anatomy read and remembered. Learning more anatomy or physiology will generally not make me able to treat types of diseases that I could not treat before I read the books. In other words, a better knowledge of anatomy can only make you treat better what you could treat less well before. But if you had no effect on thyroiditis before, reading the anatomy of the thyroid gland will not turn you overnight into a specialist of inflammatory diseases of the thyroid gland. Another example: knowledge of the anatomy of the elbow will make you a better therapist of “tennis elbow”, but knowledge of the anatomy of the pancreas will not make you a better therapist of diabetes. To treat diabetes needs a change of principle, or better, a choice of a wider principle that is able to include the treatment of both elbow pain and diabetes.
Treacherous analogies The search for wider, more inclusive principles and practice has been my obsession. I have developed hundreds of techniques of visualization and never bothered to write them down. I forget them as they come although some of them were very effective. I repeat, techniques, better techniques allow for the better treatment of the same conditions, generally not of other conditions. Time and again, I have seen that the difficulties met by students in applying their technical knowledge to a particular clinical case was due to their ignorance about principles. Or more precisely, students do not know that technique is applied principle1. How do we use principles in osteopathy or Cth? We saw that philosophy, by definition, is characterized by the search for unity behind plurality. Confronted with animals of all kinds, I will try to distinguish if there is any
But the reverse is also true: principles are theoretical techniques. There is a free movement of information between technique and principles, going in both directions. Israel School of Connective Osteopathy Jerusalem
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pattern. For instance, after a few minutes, I will see that, although all of them are of very different appearance, they seem to belong to two basic types: those with hair and fur, and those with feathers. Instead of three hundred types of animals, I end up with two types. Confronted with the untold number of clinical cases, I must act the same. I must reduce the number of facts presented by the patient. For instance, a patient comes with tiredness, sore throat, left foot pain and occasional itching on the left hand. Can I make some connection between all these symptoms? Is there a pathological principle at work here? The same principle can be at work in another patient with different symptoms. Can I recognize it every time or most of the time? A principle is really known when it can be recognized everywhere it is at play. When you can recognize a principle under its thousands of disguises, you may say that you “know” this principle and how it acts. Our brain is somehow able to recognize similarity of principles when confronted with, apparently, different situations. Recent research has attributed this capacity to the right part of the brain2. For instance, let us say you are confronted with two objects as different as a “wick” and a “wicked” person, and then asked to find if they have something in common, possibly justifying the fact that they sound very close. In the case of these two objects, they seem to express and contain the same idea, that of being “twisted”. The notion of torsion is part of the essence of each one. One cannot conceive of a cotton wick or of a wicked person, without torsion. After having recognized the presence of “twistedness” in those two entities, you will be able to recognize it everywhere it occurs: for instance, in the muscles you will have to treat, in connective tissue, in the “knots” you will feel inside or outside the body etc. If I want to treat a muscle, his tendons and his insertions on a given set of bones, I must look for the image, the essence that is common to all three structures. I find that connective tissue is present in all three structures, but beyond that, that connective tissue is made of a network of fibers that are twisted, that criss-cross each other. Using an image like “twisted meshwork of fibers which criss-cross each other in all kinds of directions” will be an effective way of treating in one single visualized field a muscle (or group of muscles), its tendons, related bones and ligaments. After you have recognized the principle of torsion behind many different entities (wicks, muscles, ligaments, wickedness etc.), you may find other principles of this kind that are common to apparently different objects. For instance, entities that are characterized by the notion of conflict, transport or pregnancy etc. I have considerably expanded on this concept in my book Babel. There I make the hypothesis that man has two basic visions (possibly in parallel to the two sides of our brain, but I think that a much wider phenomenon is at play). His left vision looks for differences between any object and any other. It will strongly protest, for instance, that wicks and wicked persons are totally different, that their differences are far more important than their similarities. For the right vision, the opposite is true, for it considers the essence of things and, from that point of view, wicks and wicked people are very similar if not identical. The right vision makes constant analogies of this kind, looking for similar objects or entities in our reality. The left vision does just the
We have to be weary of the so called differences between right and left brain perception. They no doubt exist but one should be careful not to divide the brain into two distinct boxes. The brain works as a field. Israel School of Connective Osteopathy Jerusalem
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opposite, it looks for differences. In Babel, I have shown the effect of these forces on the formation of words. In our work in CTh, we constantly have to • know the detailed constitution of any given tissue (left vision), for instance a muscle • know the analogies of structure and function between that tissue and surrounding tissues (right vision), for instance, that muscle and the bones, ligaments etc. Use of left vision is not particular to CTh. Learning and knowing details is encouraged throughout our schooling. Looking for and using analogies between detailed structures is quite unique to CTh. The use of detailed knowledge makes it a precise technique, the use of analogies, a very versatile technique. We must be very careful with those two poles: excessive details or excessive analogies make the technique ineffective. Making analogies, for instance, is both inspiring and dangerous. Inspiring because it is one of the main creative forces in art (poetry, painting, music etc). Dangerous because it knows no limits and may end up comparing anything to anything else. I will ask you to make analogies, to create your own analogies, always bearing in mind that this does not consist in just comparing anything to anything else in any way and at any time. Analogies are effective if they are fed by precise details. The more detail you know about two structures, the more effective your analogy will be. Vague knowledge about muscles and bones, vague images of how they are made of fibers, will lead to a weak treatment. CTh therefore implies: • the constitution of a detailed data base (anatomy, physiology etc.) where data are well delimited, differentiated. The more you know about the differences between two given structures (two muscles, a muscle and a bone, a viscus and a blood vessel), the more effective you will be. You set precise limits around each tissue, defining what makes it unique. • The abolition of the limits above, in search for analogies, common features etc. For instance, the notion of torsion common to all connective tissue fibers present in all the tissues of the body. A true connective therapeutic act occurs when this paradox has been realized: the creation of an analogy between two distinct structures. You can acquire most of the detailed knowledge on your own, in textbooks. In this course, I will have to help you create your analogies, something not found in textbooks. We have already experienced these analogies through the various exercises drawn from physics, history and philosophy. Please understand a crucial point: I cannot teach you analogies by telling you how to make analogies or which analogies are right or wrong. Proceeding this way would be destructive. By definition, the making of analogies must be a living process, a constantly creative one, not a predefined technique. Analogies must be a live constituent of your total visualization. So that the best thing I can do is to teach the principle of making analogies, or better, teach analogies by making myself analogies. In other words, to teach analogies, I have to speak analogically. And this is why I have chosen to teach CTh through other subjects, through philosophy or history. These are related to CTh by analogy. They teach technique by analogy, not directly.
Israel School of Connective Osteopathy Jerusalem
ISCO
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When we learn about a given philosopher, we have to find the essence of his view and apply it by analogy to therapeutics. It is the very act of visualizing the analogy (the transfer of information from one subject to another, apparently not related, one) that is effective and creative. Let us take a concrete example. A patient comes with elbow pain and another one comes with digestive problems. Apparently, there is no connection between them, one is an “articulatory”, osteo-muscular problem, the other is a “visceral” problem. One concerns soft tissues (viscera) the other harder tissues (bones, ligaments). What would be the best way for me to teach their treatment? Either teach “techniques for the elbow” and then “techniques for the viscera”, or “ principles of treatment of both soft and hard tissues”? Once we have learned that principle, shouldn’t we learn also the principle of connectivity, whereby an elbow has to be treated in correlation to the gut or the liver and vice versa? It is obvious to me, and not obvious to most of the people in charge of osteopathic education, that the common principles must be taught first, since they will make room for your independence and creativity. If not, you will have to find for every single problem, the book or seminar where the technique is described. Knowing the analogic principles will allow you to go from any tissue to any other, and thus tackle any pathology. Over the years, through clinical experience, I have found a limited number of analogies or analogical principles. But, I have to repeat it, do not ask me to teach them directly. When used during visualization, they are alive, like fish in water. To describe them to you, is to bring the fish out of the water. It may be beautiful but dead. What I mean is that no word can exactly describe the analogies used in visualization. Nothing can be said that describes them directly. But much can be said indirectly. By analogy, I can say that a given feeling typical of CTh looks likes this but does not look like that. I can never define, I can only compare, i.e., make analogies. The description of what should or could be perceived is actually so difficult that I have felt obliged to take the widest possible basis of comparison. The use of philosophy, physics or history supplies me with a varied and contrasted material from which I can make extensive comparisons. I can thus say that spontaneous tissue motion produces a perception evocative of the notion of field seen in physics but also akin to the notion of fluidity described by Thales. It is neither one nor the other but something in between and in between many other concepts. The wider our data base is, the better the description will be, always using the key phrase “it looks like that” “ it does not look like that”.
Israel School of Connective Osteopathy
Jerusalem
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Yoshev BeSeter Elion I had one teacher in Qabala, Rabbi Shmuel Toledano. He taught us one very fundamental concept of Qabala. Truth is only found when the two contraries fuse into one whole. Neither black nor white is true, and certainly not gray. Gray is a mixture where black and white have disappeared. Truth occurs when something is seen as absolutely black and white at the same time. Rabbi Toledano taught us that this was the deep meaning of the verse from the Psalms: Yoshev Beseter Elion. Speaking about G-d, this verse describes Him as “He who sits in the highest (ultimate) contradiction (Seter – Setira, a word which has the ambiguous meaning of hidden residence and contradiction)”. This truly impressed me and has been one of my main quests ever since. How can I visualize something and its opposite at the same time? How can I visualize that some articulation is bending towards the right and towards the left at the same time? I believe, from limited experience, that here lies a fundamental “secret” of visualization. Something we shall try to train in. One cannot think of making these types of visualization from reading anatomy books. When principles are clearly understood and identified, it becomes possible to find true contradictions. Having found a true contradiction between two concepts, we can then try and fuse them into one. It is unfortunate that people are so vague in their definitions that they fail to see the differences or oppositions between two concepts when they should see them, and vice versa, they see contradictions when there are none. This ability is crucial in therapy. We will have to possess our principles and bring them to a degree as close as possible to crystal clarity. My teacher in osteopathy, SJG Wernham, a student of Littlejohn, one of the main students of Still, and the founder of European Osteopathy, used to say that osteopathy is ninety percent principle and ten percent practice. His teaching consisted in having us sit for three hours on end and read from texts completely incomprehensible to us. We hated that. I find myself doing this with you although I hope the texts are a little more comprehensible. But CTh, a pure thought process, is nothing but “projected principles”.
Israel School of Connective Osteopathy
Jerusalem
| קובץ מצורף | גודל |
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| Principles of CTh 2.pdf | 184.92 ק"ב |
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