tag:blogger.com,1999:blog-25505250852152046662024-02-20T12:30:17.865-08:00Osteopathie AmsterdamSander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-2550525085215204666.post-45499263419901481032020-03-15T02:58:00.002-07:002022-03-05T06:51:52.597-08:00Long live the placebo effect?<div dir="ltr" style="text-align: left;" trbidi="on">
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<strong><span style="background-color: white; color: black;">Long live the placebo effect?</span></strong></div>
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<strong><span style="background-color: white; color: black;">The placebo effect has a negative reputation, but that is not entirely justified. In complementary and alternative medicine (CAM) it is also seen as the self-healing capacity of the body. What exactly is the placebo effect and how can we osteopaths make good use of it?</span></strong></div>
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<span style="background-color: white; color: black;">By Sander Kales</span></div>
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<span style="background-color: white; color: black;">Much of the effect of an osteopathic treatment is due to what we unknowingly do. Up to 75 percent of the relief of pain and depression complaints after a biomedical treatment is due to the placebo effect (Dieppe 2016).</span></div>
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<span style="background-color: white; color: black;">The placebo is often seen as an inert substance; a pill that contains nothing effective. The placebo effect is that which follows the administration of a substance or a procedure. A placebo treatment is therefore not only about fake pills, but also about symbols, rituals and interactions.</span></div>
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<span style="background-color: white; color: black;">McQueen reviewed placebo effects and postulates that the effect decreases as disease and depression worsen (2013). Placebo effects also appeared to vary enormously with different diseases.</span></div>
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<span style="background-color: white; color: black;">The reverse also applies: the same placebo effect appears to be found for treatments from different healthcare providers. That was the opinion of doctor John Lie during the NVO Migraine congress of 2018. The effect of acupuncture versus a dummy treatment in the treatment of migraine turned out to be just as large as that of osteopathy versus a dummy treatment. Lie therefore concluded that the same underlying treatment mechanisms must be at work. That there is indeed an influence of placebo on physical functioning is also apparent from the negative “placebo” effect: the nocebo (Kaptchuk 2015). In short, not the treatment but something else improves the complaints of patients.</span></div>
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<span style="background-color: white; color: black;">The placebo effect can partially explained by distinguishing between disease and illness. Disease is a biological dysfunction that can be explained pathophysiologically, a disorder is a condition. A placebo treatment primarily affects the condition and not the disease, McQueen states.</span></div>
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<span style="background-color: white; color: black;">Although it can do a lot for the patient, a placebo treatment only provides relief and not a cure. What is at the origin of the pain complaints, such as tumors, is not reduced.</span></div>
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<span style="color: black; font-size: 14pt;"><em style="background-color: white;"> “The severity of the symptoms is partly determined by the experience of the patient”</em></span></div>
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<strong><span style="background-color: white; color: black;">The healing relationship</span></strong></div>
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<span style="background-color: white; color: black;">Apparently there is such a thing as effective medication and a healing relationship. In ancient times the phenomenon of healing was already known, and often it was mostly the intention to relieve another person of his suffering. Over time this developed into Complementary and Alternative Medicine (CAM) with rituals, beliefs and treatments. Today, according to the American National Institute of Health, CAM can be subdivided into five subareas: alternative medical systems (such as acupuncture, homeopathy), biologically based therapies (dietetics, phytotherapy), manipulative and body-oriented therapies (chiropractic, osteopathy, massage), energetic therapies (therapeutic touch, Reiki) and body-mind interventions (meditation, hypnotherapy) (Staud 2011).</span></div>
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<span style="background-color: white; color: black;">With the development of the medical sciences, CAM developed further as well. In its search for the effective treatments, the medical sciences eventually left behind “bloodletting” and mercury treatments, and with that healing was also forgotten. Placebo got a bad name.</span></div>
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<span style="background-color: white; color: black;">The word placebo literally means: to satisfy. It comes from a Latin psalm from the 14th century the Placebo Domino: I will satisfy the Lord. Henry Beecher made this concept popular in 1955 with his book “the Placebo effect.” He stated that the placebo is a threat to medical science and is therefore unethical. In randomized controlled studies (RCTs) today, the effect of placebo’s is not measured but filtered out (Staud 2011).</span></div>
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<em><span style="background-color: white; color: black; font-size: 14pt;"> “The placebo effect van be seen as the self-healing capacity of the patient”</span></em></div>
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<strong><span style="background-color: white; color: black;">CAM</span></strong></div>
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<span style="background-color: white; color: black;">But what applies to regular medicine does not apply to Complementary and Alternative Medicine. After all, CAM is not related to tumor treatment, but more often to the experience of complaints. Because the severity of complaints is also partly determined by the experience of the patient. In CAM, the placebo effect is therefore seen as the self-healing capacity of the patient, the third principle in osteopathy.</span></div>
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<span style="background-color: white; color: black;">According to renowned CAM researcher Ernst (1995), the effect of a CAM intervention does not only consist of a specific treatment effect, but also of non-specific effects such as the placebo effect, a natural healing effect and various other phenomena. But what exactly does the placebo (treatment plus effect) consist of? Or vice versa: how is it that CAM practitioners score so well on placebo effects?</span></div>
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<span style="background-color: white; color: black;">According to Stub (2017) researcher at the Integrative Health Care center in Norway, CAM is provided by health care practitioners who listen, confirm, give hope – and do this in a pleasant environment. They generally have more time than their colleagues from mainstream medicine. In addition, these health care providers believe in the effectiveness of their approach. All of these factors influence the placebo effect.</span></div>
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<span style="background-color: white; color: black;">The placebo effect is therefore achieved by having faith and belief in the healing process. Patients undergoing CAM therapy experience being seen as a whole. This holistic approach is perceived by patients as empowering and instructive with regard to their own recovery capacity. This contextual healing is seen as the placebo treatment. Dieppe (2016) states that mainstream medicine should applaud the ability of CAM practitioners to achieve a strong placebo and learn from it.</span></div>
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<span style="background-color: white; color: black;">There is also a demonstrable neurophysiological effect with placebo effect. When undergoing a placebo treatment, Finness (2010) measured changes in brain activity. It is therefore clearer to replace placebo treatment as a concept with “mental attunement to the context of treatment”. This mental tuning gives the relief of pain.</span></div>
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<span style="background-color: white; color: black;">According to Harvard brain researcher Hashmi (2018), mental attunement consists of internal (expectation) factors within the patient and external (relational) factors, regarding the therapist and the patient.</span></div>
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<span style="background-color: white; color: black;">The internal relational factors consist of: patient expectations, pain beliefs, satisfaction and health beliefs. The external relational treatment factors, also referred to as non-specific factors, consist of beliefs from the osteopath, the therapeutic relationship and feedback, rituals, conditioning. Together they are also called “common factors”.</span></div>
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<span style="background-color: white; color: black;">As an osteopath, how do I optimize the process of mentally tuning in?</span></div>
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<strong><span style="background-color: white; color: black;">The osteopathic therapist-patient relationship</span></strong></div>
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<span style="background-color: white; color: black;">The professional competence profile for osteopaths in the Netherlands (NVO 2014) states that an osteopath communicates effectively verbally and non-verbally to build a relationship, to conduct a conversation and to be able to report. An osteopath must learn to build a good relationship by listening, recognizing verbal and non-verbal communication, giving space, learning to recognize feelings and, in the meantime, taking into account the uniqueness of the patient.</span></div>
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<span style="background-color: white; color: black;">The British Osteopathic Association (G.O.C. Standards, 2000) states that the osteopath enters into an empathetic relationship with the patient. They believe that the osteopath should be critical and able to reflect on himself. Touching creates an intimate contact and non-verbal communication is therefore important.</span></div>
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<span style="background-color: white; color: black;">The German osteopath Mayer (20165) describes in her thesis that the osteopath-patient relationship consists of the following five components: the work agreement, transference-countertransference relationship, the restorative development-oriented relationship, the congruence I-other (empathic capacity) and the transpersonal relationship (self-awareness, third-person perspective). It is important to keep all five components in mind during the treatment process.</span></div>
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<span style="background-color: white; color: black;">Professor Sturmberg (2013), specialist in the field of complex systems in health care, summarizes these relationships by stating that a healing relationship consists of three components: competencies (clinical wisdom, mindful, emotional self-regulation and self-confidence), processes (appreciation, connecting and surrendering) and outcomes (hope, trust, being known, PROM and PREM). You can train the competencies, observe the processes and try to get feedback (for example through peer review) and evaluate the outcomes.</span></div>
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<span style="background-color: white; color: black;">In summary, one can state that an osteopathic relationship must contain a number of aspects: competencies of the osteopath, good processes (working relationship, non-verbal communication, transfer-versus-transfer, affect regulating and subject relationship) and of course the desired outcomes. These aspects may then result in an improvement of the non-specific/general treatment factors. What do these skills look like in the osteopathic process?</span></div>
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<strong><span style="background-color: white; color: black;">The diagnostic phase</span></strong></div>
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<span style="background-color: white; color: black;">The osteopath-patient relationship starts with a diagnostic phase. Within osteopathy we work with the five explanatory models of complaints according to the ECOP (Hruby, 2019). The fifth model is the biopsychosocial model. The definition according to Romano is: “The biopsychosocial approach systematically takes into account biological, psychological and social factors and their complex interaction in understanding health, disease and healthcare.”</span></div>
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<span style="background-color: white; color: black;">It appears that the osteopath is inclined to focus primarily on a biomedical and a structural analysis of the demand for help in everyday practice. They are much less inclined to approach the demand for help from the biopsychosocial model (Sampath 2020). According to osteopath Abrosimoff, this leads to osteopaths having a paternalistic attitude towards their clients (“I’ll fix it”). And that attitude has a negative effect on all relational aspects that would actually increase the effect of a treatment (2020).</span></div>
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<span style="background-color: white; color: black;">Thus, the concept of somatic dysfunction in osteopathy does not take into account the psychosocial dimensions of complaints. Fryer even states that this notion is outdated and reinforces the belief in a structural biomedical cause of pain. The osteopath “makes or heals” instead of “guiding the change” (2016). Osteopath and clinical psychologist Calsius notes that there is a latent danger of reducing the psychological reality of the patient to the somatic explanation paradigm of osteopathy (2018).</span></div>
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<strong><span style="background-color: white; color: black;">The treatment phase</span></strong></div>
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<span style="background-color: white; color: black;">The biopsychosocial model is non-theoretical and purely descriptive. It provides a framework for the diagnostic phase, but doesn’t give a guideline for the treatment phase. However, various osteopaths have also looked into the treatment phase.</span></div>
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<span style="background-color: white; color: black;">The osteopath can modulate the autonomic nervous system, based on tone and lifestyle stressors change (Kolb 2020). However, this falls within the biomedical paternalistic “I will make it” approach.</span></div>
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<span style="background-color: white; color: black;">According to the osteopath Barrington, touching during an osteopathic treatment has a number of facets: supportive, preparatory, informative, caring, therapeutic intervention, awareness of information, safety and exchange (2014). Touching therefore contains many relational aspects that can promote the treatment relationship and thus also ensure the non-specific treatment effect.</span></div>
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<span style="background-color: white; color: black;">It is then necessary to integrate osteopathic touching with verbal communication, to make transference and resistance phenomena transparent. Mayer (2015) conducted qualitative interviews with osteopaths and showed that the person who sees himself as a mediator between the patient and his “healthy” parts, places less emphasis on verbal communication than the therapist who sees himself as a supervisor of the process.</span></div>
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<span style="color: black; font-size: 14pt;"><em style="background-color: white;"> “By paying more attention to the factors that contribute to the osteopath-patient relationship, we can increase our effectiveness”</em></span></div>
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<strong><span style="background-color: white; color: black;">Resume</span></strong></div>
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<span style="background-color: white; color: black;">The osteopathic intervention has a number of effects, including the placebo, or the mental alignment with the treatment. The osteopathic treatment does not contain a separate biopsychosocial approach, but it does arise from the treatment relationship. Touch is an important aspect of this. This touch requires more verbal communication and awareness of the relational factors. By paying more attention to the factors that contribute to the osteopath-patient relationship, we can increase our effectiveness.</span></div>
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<span style="background-color: white; color: black;">The NVO congress will elaborate on the biopsychosocial working method of the osteopath, and includes the following speakers:</span></div>
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<li style="line-height: 20px;"><span style="background-color: white;">Joeri Calsius, osteopath and clinical psychologist, presents a conceptual model for integrated bodywork from a somato-psychic perspective.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Hedda Lausberg, neurologist and psychiatrist, has worked out non-verbal communication so that there are concrete tools that contribute to improved patient contact.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Eva Banninger, professor of clinical psychology, shows through video contribution what happens in transfer-opposite transfer phenomena (see recent newsletter).</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">From the Mental Health Care (GGZ), Rogier Hoenders will show the limits but especially the possibilities for an integrated approach.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Red flags: disorder or serious pathology.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Yellow flags: psychosocial indicators that show an increased risk for progression to longer-term distress, inability and pain.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Blue flags: work and employer perception of health and work.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Black flags: context and environment, such as other people, systems and policies</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Orange flags: psychiatric symptoms.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Abrosimoff M, Rajendran De, “Tell me your story” – How osteopaths apply the BPD model when managing low back pain – A qualitative study, International Journal of Osteopathic Medicine (2020).</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Barrington, Contacting with Clarity – The communicative purposes of osteopathic touch, 2014, Master of Osteopathy, Unitec New Zealand.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Bialosky 2017, Placebo Mechanisms or Manual Therapy: A Sheep in Wolf’s Clothing? J Orthop Sports Phys Ther 2017; 47 (5): 301-304. doi: 10.2519 / jospt.2017.0604.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Calsius, Experiential Bodywork Course, Panta Rhei, 2018.</span></li>
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<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Clarke, R.J., Depression, Anxiety and Positive Outlook among patients presenting to an osteopathic training clinic: A prospective survey, Master of Osteopathy, Unitec Institute of Technology, 2010.</span></li>
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<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Dieppe, P., & Rahtz, E. (2016). Placebos, CAM and Healing: P + X + Y. Int J Complement Alt Med, 4 (2), 00114.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Dugailly, P.M., Fassin, S., Maroye, L., Evers, L., Klein, P., & Feipel, V. (2014). Effect of a general osteopathic treatment on body satisfaction, global self-perception and anxiety: A randomized trial in asymptomatic female students. International journal of Osteopathic medicine, 17 (2), 94-101.</span></li>
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<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Ernst, E., & Resch, K. L. (1995). Concept of true and perceived placebo effects. Bmj, 311 (7004), 551-553.</span></li>
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<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Finniss, D.G., Kaptchuk, T.J., Miller, F., & Benedetti, F. (2010). Placebo effects: biological, clinical and ethical advances. Lancet, 375 (9715), 686.</span></li>
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<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">General Osteopathic Council, Standard of Proficiency, 2000.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Greco, C.M., Yu, L., Johnston, K.L., Dodds, N.E., Morone, N.E., Glick, R.M., & Colditz, J. (2016). Measuring nonspecific factors in treatment: item banks that assess the healthcare experience and attitudes from the patient’s perspective. Quality of Life Research, 25 (7), 1625-1634.</span></li>
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<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Hall AM, Ferreira PH, Maher CG, et al. The influence of the therapist-patient relationship on treatment outcome in physical rehabilitation: a systematic review. 2010; 90: 1099–1110.] Phys Ther.</span></li>
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<li style="line-height: 20px;"><span style="background-color: white;">Hashmi, J.A. (2018). Placebo effect: Theory, mechanisms and teleological roots. In International review of neurobiology (Vol. 139, pp. 233-253). Academic Press.</span></li>
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<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Hruby, R.J., Tozzi, P., (2017). The five osteopathic models: Rationale, application, integration: from an evidence-based to a person-centered osteopathy.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Kaptchuk, T. J., & Miller, F. G. (2015). Placebo effects in medicine. N Engl J Med, 373 (1), 8-9.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Kendall, N., Linton, S.J., and Main, C.J. 1997 Guide to assessing psychosocial yellow flags in acute low back pain: Risk factors for long term disability and work loss. Accident rehabilitation and Compensation Insurance of New Zealand and the National Health Committee, Wellington, New Zealand.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Kolb, W.H., McDevitt, A.W., Young, J., & Shamus, E. (2020). The evolution of manual therapy education: what are we waiting for?</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Mayer, Sharon, Towards a relational understanding of embodied therapeutic relationships: a qualitative study of body-focused practitioner’s experiences, 2015.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">McQueen, D., Cohen, S., St John-Smith, P., & Rampes, H. (2013). Rethinking placebo in psychiatry: the range of placebo effects. Advances in psychiatric treatment, 19 (3), 162-170.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Miciak, Maxi, A review of the psychotherapeutic common factor model and its application in physical therapy: the need to consider general effects in physical therapy practice; Scand J Caring Sci; 2012; 26; 394–403.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">NFP, Professional Competence Profile of Psychomatic Physical Therapy, KNGF-NFP, May 2009 edition.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Novy, Regina, Therapist-Patient-Relationship in Osteopathy; How do osteopaths form their relationship to patients? A qualitative study, Master Thesis Danube University Krems at the Wiener Schule für Osteopathy (Vienna School of Osteopathy), Vienna, May 2007.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">NVO, Professional profile Osteopathy, version 2014.</span></li>
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<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Sampath, K.K., Darlow, B., Tumilty, S., Shillito, W., Hanses, M., Devan, H., & Thomson, O. P. (2020). Barriers and facilitators experienced by osteopaths in implementing a biopsychosocial (BPD) framework of care when managing people with musculoskeletal pain – A mixed methods systematic review protocol. International Journal of Osteopathic Medicine.</span></li>
</ol>
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<li style="line-height: 20px;"><span style="background-color: white;">Staud, R. (2011). Effectiveness of CAM therapy: understanding the evidence. Rheumatic Disease Clinics, 37 (1), 9-17.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Stub, T., Foss, N., & Liodden, I. (2017). “Placebo effect is probably what we refer to as patient healing power”: A qualitative pilot study examining how Norwegian complementary therapists reflect on their practice. BMC complementary and alternative medicine, 17 (1), 1-10.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Sturmberg, Joachim P., and Carmel Martin, eds. Handbook of systems and complexity in health. Springer Science & Business Media, 2013.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Association of Haptotherapists (VVH) Professional competence profile GZ-Haptotherapeut version 2010.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Zellner, Katrin, Übertragung und Gegenübertragung – Phänomene einer gegenseitigen therapeutischen Beziehung! Eine Hinführung auf das Theme Patients-Therapists-Beziehung mit Bezug zur Osteopathy, Thesis Osteopathy Schule Deutschland, Berlin, 31.08.2014</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Zhang, W., & Doherty, M. (2018). Efficacy paradox and proportional contextual effect (PCE). Clinical Immunology, 186, 82-86.</span></li>
</ol>
<ol style="font-family: chaparral; font-size: 15px; margin: 0px 0px 10px 25px; padding: 0px 5px;">
<li style="line-height: 20px;"><span style="background-color: white;">Zilcha-Mano, S., Roose, S. P., Brown, P. J., & Rutherford, B. R. (2019). Not just nonspecific factors: the roles of alliance and expectancy in treatment, and their neurobiological underpinnings. Frontiers in behavioral neuroscience, 12, 293.</span></li>
</ol>
<span style="background-color: white;">x</span><br />
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<span style="background-color: white; color: black;">In the Netherlands, the psychosomatic physical therapist goes one step further from the osteopath according to his professional competence profile (2009). They see themselves as an instrument in the client’s treatment process. The therapeutic relationship refers to the dialogically embodied contact between client and therapist. This vision requires continuous reflection during the entire treatment process, both on one’s own actions (self-reflection) and on the client’s reaction. Feeling (intuition and experience), empathy and sympathy are required elements in the attitude of the psychosomatic physical therapist (NFP 2009).</span></div>
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<span style="background-color: white; color: black;">The psychosomatic physical therapist examines for red, blue, black and yellow flags, identifies implicit problems and assesses whether the client can actively participate in the process.</span></div>
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<span style="background-color: white; color: black;">This flag system has been postulated by Kendall (1997), among others. The system is a means to map the psychosocial landscape of the patient.</span></div>
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<em><span style="background-color: white; color: black;">References:</span></em></div>
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Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0tag:blogger.com,1999:blog-2550525085215204666.post-48673953678188262402018-06-13T06:56:00.001-07:002018-06-13T06:57:30.181-07:00Osteopathy in the Cranial Field: does it work?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span class="s1"><b>Osteopathy in the Cranial Field: does it work?</b></span></div>
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<span class="s1"><b></b></span><br /></div>
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<span class="s1"><b>Osteopathy in the Cranial Field (OCF) is a standard component of the toolbox of the osteopath. At the same time it is also the most controversial. More and more reviews appear that are questioning the evidence of OCF.</b></span></div>
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<span class="s1">By Sander Kales, D.O.-MRO, M.Sc.</span></div>
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<span class="s1">Published in De Osteopaat Magazine | May 2017 | Vol.18 | Nr.1</span></div>
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<span class="s1">Various disciplines are currently involved in the cranial domain: there are about 175 registered mandibular physiotherapists, 150 Craniosacral therapists and 30 Craniofacial physiotherapists in the Netherlands. At the same time, there are increasing doubts about the effectiveness of the treatment of the cranium. What has been researched so far?</span></div>
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<span class="s1">Most general reviews of cranium treatment conclude that there is little to no evidence for diagnostic reliability and effectiveness (Green, Hartman, Jakel, May, Rogers and Guillaud).</span></div>
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<span class="s1">More specific studies have also been carried out. We explain the most important studies for each explanatory model from the ECOP model. We use the Moran method (2005) which classifies the literature on cranial tests and treatment methods in:</span></div>
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<span class="s1">1) Reliability and validity of the tests of dysfunctions according to the models used in osteopathy in the Cranial Field (OCF).</span></div>
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<span class="s1">2) Evidence that dysfunctions in the OCF can be linked to poor health outcomes.</span></div>
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<span class="s1">3) Evidence of the effectiveness of OCF in changing health outcomes.</span></div>
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<span class="s1">We focus on reliability (1) and effectiveness (3).</span></div>
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<span class="s1"><b>Models</b></span></div>
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<span class="s1"><b>1. Biomechanical model</b></span></div>
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<span class="s1">The earlier models about OCF from Sutherland (1984) and Magoun (1966) are mechanical models in which the brain fluid is driven by moving skull bones. However, influencing the mobility of skull bones is nonsense, according to Hartman (2002), Greenman (1970) and other authors. Cranial surgeons consider this theory as quackery.</span></div>
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<span class="s1">Jayaprakasha (2013) concluded after studying hundreds of skulls that the suture patterns remain plastic until they reach a higher age. Fixation of the sutures, according to Steinmetz (2012) and Gabutti (2014), is due to the myofascial system. Kuchera (2009) indicates that myofascial somatic dysfunction is important in diagnosing the skull.</span></div>
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<span class="s1">In addition to local and regional there is a mechanical global picture: this can be seen in posturology and how "strain patterns" (Zink, 1979) have manifested themselves throughout the body. Kroman (2009), an anthropologists, studied skulls and bones and concluded that there is a clear correlation between cranial dysfunctions and dysfunctions in the rest of the skeleton. This indicates a fascial relationship between the body and the skull.</span></div>
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<span class="s1"><b>Reliability of testing</b></span></div>
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<span class="s1">A study by Greenman (1970) shows that palpation of the 3D structure is significantly similar to the X-ray images of the skull. Halma (2008) indicates that the intra-rater reliability is significant when determining strain patterns.</span></div>
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<span class="s1">This cephalometry can be further refined by means of software and may serve as a measuring instrument for young children, in which it appears that the skull is still malleable (Jayaprakasha 2013, Philippi, 2006).</span></div>
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<span class="s1"></span><br /></div>
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<span class="s1"><b>Effectiveness of the treatment</b></span></div>
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<span class="s1">Lalouze Pol (2009), Lessard (2011), Cazala (2012) and Philippi (2006) have done studies where they mechanically treated the skull post-natally. This treatment to prevent preventive orthodontics is an important indication area for cranial osteopathy in young children and appears to be significantly effective. In contrast, Downey (2004) did not see any effect of a "Frontal Lift" on the sutures in rabbits.<span class="Apple-converted-space"> </span></span></div>
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<span class="s1"><b>2. The circulatory model</b></span></div>
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<span class="s1">The first models in the OCF based on circulation are from Sutherland, Magoun and Upledger (pressurestat model). In short, they state that the rhythms originate from liquid movements of the liquor. Chu (1998) shows that the pulsations in the liquor are a compilation of the different fluid rhythms. Fergusons (2003) hypothesis is that there are many different rhythms (arterial, venous, lymphatic respiration and liquor). This explains why the inter-assessors reliability would be low, as was found by Norton (1996) and Hartman (2002). Moskalenko (2003) indicated that arterial pulsation is the most prevalent. Furthermore, in his measurements he has seen a rhythm that is separate from the aforementioned rhythms: the intracranial fluctuations of 5-15 cpm. These are a composite of all rhythms. Gard (2009) based his model of cranial rhythms mainly on venous parameters. Gehlen (2017) shows that the collapse of the V. Jugularis has an influence on the liquor circulation by changing posture. De Bakker (2006) states in his review that this system should be viewed from arteries, veins and certainly also the lymphatic system that influence the circulation of liquor. The recent discovery of the Glymphatic system confirms this.</span></div>
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<span class="s1"></span><br /></div>
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<span class="s1"><b>Reliability of the tests</b></span></div>
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<span class="s1">Hartman (2002), Norton (1996), Wirth-Patullo (1994) and Sommerfeld (2004) looked at the intra-rater's reliability of the feeling of the rhythm, and found that this reliability is too low. The pulsations that osteopaths feel on the skull are a compilation of different rhythms. Sergueef (2011) has examined the reliability of CRI / PAM. She does, however, conclude a greater reliability (see also page XXX). Hiort provides an overview of the measuring methods that have been used and concludes that there is little evidence for measuring rhythms. Nelson (2006) states that the rhythm is less important, the position of the bones and the power of the pulsations are important.</span></div>
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<span class="s1"></span><br /></div>
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<span class="s1"><b>Effectiveness of the treatment</b></span></div>
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<span class="s1">Even if the osteopath manages to objectify this rhythm, whether it is rhythm or strength (Mokhov 2016), it is still questionable whether it has been found that the cranial treatment significantly improved the rhythms compared to a placebo.</span></div>
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<span class="s1">There is still insufficient evidence that the systemic approach to circulation leads to better results compared to isolated treatment of the skull. Richter-Schulz (2010) is therefore of the opinion that the CRI or Primary Respiratory Mechanism (PAM) should be released as a diagnostic tool and that especially the sutures should be tested.</span></div>
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<span class="s1"><b>3. Biochemical model</b></span></div>
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<span class="s1">The "Gut Brain axis" is seen as increasingly important. Studying the influence of the microbiome on pathologies such as Alzheimer's is increasing. There is still no evidence for influencing biochemistry. In short, here is no model about the influence of the abdomen on the cranium, no correlations between abdominal symptomatology/ dysfunctions and cranial dysfunctions, and no effect studies that show that a treatment of the abdomen changes the parameters of the cranium.</span></div>
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<span class="s1"><b>4. Neurological model</b></span></div>
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<span class="s1">The tissue pressure model of Norton is based on the assumption that the nerve tissue is the motor for the rhythms. Brain tissue provides a pressure and also a rhythm via intracellular fluid. Moskalenko (2013) mentioned the function of the glial cells as a possible explanation for this, as also shown in the Glymphatic system. Richtsmeier (2013) has shown that it is the brain development that determines the shape of the skull.</span></div>
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<span class="s1"></span><br /></div>
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<span class="s1"><b>Reliability of testing</b></span></div>
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<span class="s1">There are no tests for brain and brain nerve functions in osteopathy, but there are neurological function tests. These have been validated.</span></div>
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<span class="s1"><b>Effectiveness of the treatment</b></span></div>
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<span class="s1">Especially the CV4 technique has, according to some studies, influence on the functioning of the autonomic nervous system (Buschatzky 2014), (Collard 2009), (Cutler 2005), (Grill 2006). In contrast, Milnes (2007) and Cardoso (2015) found no significant effect of the CV4. The methodology and the results must be further examined in order to arrive at a conclusion.</span></div>
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<span class="s1">Duncan (2008) and Raith (2016) examined the influence of cranial treatment on motor functioning. Duncan found an effect, Raith did not. Mataran (2011) showed that sleep and tension in fibromyalgia patients changed after cranial treatments. Sandhouse found an improvement in vision after a viscerocranium treatment.</span></div>
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<span class="s1"><b>5. Biopsychosocial model</b></span></div>
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<span class="s1">In the model "the synchronization hypothesis" of McPartland it is indicated that there is a harmonization of electrical and electromagnetic rhythms between osteopath and patient. This has recently been confirmed by Liu (2017) and Stevens (2010). A biophysical exchange takes place, but the information that is exchanged can not be interpreted. Hendryx (2014) states that a bio-energetic model must be added to the ECOP model. The biopsychosocial translates into bioelectromagnetics in the natural sciences, because thinking is seen as an electromagnetic phenomenon of the brain. Stone, Fulford (1997) and Hendrikx (2017) developed models of the bioelectromagnetic field in osteopathy.</span></div>
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<span class="s1"></span><br /></div>
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<span class="s1"><b>Reliability of testing</b></span></div>
<div class="p1">
<span class="s1">Testing the bioelectromagnetic field has not yet been investigated in osteopathy. A start has been made with the bio photon emission of the body (van Wijk, 2016). In his new book, Van Wijk will summarize the therapeutic influence (in mid-2018). So there is no question of dysfunctions and a correlation of this with symptomatology.</span></div>
<div class="p3">
<span class="s1"></span><br /></div>
<div class="p1">
<span class="s1"><b>B. Subjectivity</b></span></div>
<div class="p1">
<span class="s1">Thinking and conducting conversations, which falls within the biopsychosocial model, takes place in the subjective domain. We leave the objectifiable. The osteopath is informed and must objectify the subjective experience of the patient. What do I experience with this patient, and is this true or is this a transfer?</span></div>
<div class="p1">
<span class="s1">When the domain of the psycho-emotional is viewed, it is striking that the boundaries of the domain are determined by psychopathology. It is debatable whether osteopaths know enough of psychopathology to be able to determine whether this is a spontaneously occurring emotional release, as Upledger (2002) states with his Somato-Emotional Release techniques, or a generalized anxiety disorder as a result of, for example, sexual abuse. The osteopath may play an important role here, but must then be trained in psychology and psychopathology to recognize issues such as transference counter-transference, attachment styles and DSM 5 axis 3 problems.</span></div>
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<span class="s1"></span><br /></div>
<div class="p1">
<span class="s1"><b>Discussion</b></span></div>
<div class="p1">
<span class="s1">Cranial osteopathy is a combination of techniques. The models which have the possibility of looking at effectiveness and reliability, seem to lie mainly in the circulatory, neurological and bioelectromagnetic domain. Osteopathic clinical reasoning offers osteopaths the possibility to distinguish themselves. Looking locally, regionally and globally from the different models, using a terminology that is universal and not just for osteopaths, can give us a permanent place in the landscape of health care for the cranium.</span></div>
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<span class="s1"></span><br /></div>
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<span class="s1">For references and recommendations see also www.swoo.nl.</span></div>
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<div class="p5">
<span class="s1"><b>References<span class="Apple-converted-space"> </span></b></span></div>
<ol class="ol1">
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<li class="li5"><span class="s1">Grill, ‘Comparison between CV4 and EV4 via Biofeedback-measurement (master thesis), Wiener Schule für Osteopathie, 2007.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Guillaud, A. et al., ‘Reliability of diagnosis and clinical efficacy of cranial osteopathy: a systematic review’ in: Fleckenstein, J., ed., PloS One, 2016, 11(12), pp. e0167823-21.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Halma, Kelly D., et al., ‘Intraobserver reliability of cranial strain patterns as evaluated by osteopathic physicians: a pilot study’ in: The Journal of the American Osteopathic Association, (2008), 108.9, 493-502.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Hartman, S.E. & Norton, J.M., ‘Interexaminer reliability and cranial osteopathy’ in: Scientific Review of Alternative Medicine, 2002.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Hiort, The Rate of the Cranial Rhythm, 2013, http://craniofascial.com/post-number-1.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Hendryx, J.T., ‘The bioenergetic model in osteopathic diagnosis and treatment: an FAAO thesis’ in: The American Academy of Osteopathy Journal, maart 2014, vol. 24, no. 1, part. files. <a href="http://academyofosteopathy.org/"><span class="s2">academyofosteopathy.org</span></a>.</span></li>
<li class="li5"><span class="s1"> Jäkel, A., & Hauenschild, von P., ‘Therapeutic effects of cranial osteopathic manipulative medicine: a systematic review’ in: The Journal of the American Osteopathic Association, 2011, 111(12), pp. 685-693.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Jayaprakash, P.T. & Srinivasan, G.J., ‘Skull sutures: changing morphology during preadolescent growth and its implications in forensic identification’ in: Forensic Science International, 2013, 229(1-3), pp.166.e1-166.e13.3.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Kroman, A.M., Thompson G.A., ‘Cranial suture closure as a reflection of somatic dysfunction: lessons from osteopathic medicine applied to physical anthropology’ in: Proceedings from the American Academy of Forensic Science, Denver, 2009, pages 326-327.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Kuchera, ‘Perspectives: an overview of support for osteopathy in the cranial field’ in: The American Academy of Osteopathy Journal, 1999.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Lalauze-Pol, R. et al., ‘L'analyse de la base du crâne dans les premières années de vie, une approche complémentaire du diagnostic et du traitement des classes II et III’ in : Actualites Odonto-Stomatologiques, 2009, (246), pp. 179-189.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Lessard, S., Gagnon, I. & Trottier, N., ‘Exploring the impact of osteopathic treatment on cranial asymmetries associated with nonsynostotic plagiocephaly in infants’ in: Complementary Therapies in Clinical Practice, 2011, 17(4), pp. 193-198.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Liu, Y. et al., ‘Measuring speaker–listener neural coupling with functional near infrared spectroscopy’ in: Scientific Reports, 2017, pp. 1-13.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Magoun H.I., Osteopathy in the Cranial Field, 2e. Kirksville, MO, Journal Publishing Company, 1966.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Matarán-Peñarrocha, G.A. et al., ‘Influence of craniosacral therapy on anxiety, depression and auality of life in patients with fibromyalgia’ in: Evidence-Based Complementary and Alternative Medicine, 2011, (808), pp. 1-9.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Milnes, K. & Moran, R.W., ‘Physiological effects of a CV4 cranial osteopathic technique on autonomic nervous system function: a preliminary investigation’ in: International Journal of Osteopathic Medicine, 2007, 10(1), pp. 8-17.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Mokhov, Congres MUPS NVO, 2016. Moran, R., ‘Intraexaminer and interexaminer reliability for palpation of the cranial rhythmic impulse at the head and sacrum.’ in: Journal of Manipulative and Physiological Therapeutics, 2001, 24(3), pp. 183-190.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Moskalenko, Y., Frymann, V. & Kravchenko, T., ‘Physiological background of the cranial rhythmic impulse and the primary respiratory mechanism’ in: The American Academy of Osteopathy Journal, 2003.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Nelson, K.E., Sergueef, N., Glonek, T., ‘The effect of an alternative medical procedure upon low-frequency oscillations in cutaneous blood flow velocity’ in: Journal of Manipulative and Physiological Therapeutics, 2006, 29(8): 626-636</span></li>
<li class="li5"><span class="s1">Norton, J.M., ‘A challenge to the concept of craniosacralinteraction’ in: The American Academy of Osteopathy Journal, 1996, 6(4):15-<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Philippi, H. et al., ‘Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trial’ in: Developmental Medicine & Child Neurology, 2006, 48(1), pp. 5-9, discussion 4.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Raith, W. et al., ‘General movements in preterm infants undergoing craniosacral therapy: a randomised controlled pilot-trial’, in: BMC Complementary and Alternative Medicine, 2016, 16(1), p. 1.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Richter-Schulz, Inter-Intrareliabilitätsstudie zum Test cranialer Strukturen im Konzept der 'Mechanischen Vernetzung‘ (Lien Mechanik Osteopathy-LMO), (master thesis), Wiener Schule für Osteopathie, 2010.<span class="Apple-converted-space"> </span></span></li>
<li class="li5"><span class="s1">Richtsmeier, J.T. & Flaherty, K., ‘Hand in glove: brain and skull in development and dysmorphogenesis’ in: Acta Neuropathologica, 2013, 125(4), pp. 469-489.<span class="Apple-converted-space"> </span></span></li>
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</ol>
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Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com1tag:blogger.com,1999:blog-2550525085215204666.post-2026159511448207002016-12-02T21:55:00.003-08:002016-12-02T21:59:36.940-08:00<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-kerning: none;"><b>Wat kan de osteopaat doen bij whiplash</b></span></div>
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<span style="font-kerning: none;">Het onderstaande verhaal is illustrerend voor patiënten met whiplashklachten. Het is tot stand gekomen dankzij </span>vijfentwintig jaar praktijkervaring met mensen met whiplash, maar ook door de persoonlijke ervaring van de auteur.[/]<br />
<span style="font-kerning: none;">De osteopaat ziet veel mensen met een whiplash. Een vijfde van de mensen in de osteopathiepraktijk heeft nekklachten, waarvan weer een vijfde whiplashklachten. Grofweg gezegd heeft 2,5 procent van de patiënten in de osteopathiepraktijk wel eens een whiplash meegemaakt. Whiplash is een beeld dat ons dwingt om functionele onbegrepen klachten te onderzoeken en samen te werken met de verschillende disciplines die op de deelgebieden actief zijn. Dit is nog steeds een uitdaging binnen het huidige gezondheidsstelsel.’</span></div>
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<span style="font-kerning: none;"><b>Een voorbeeld</b></span></div>
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<span style="font-kerning: none;">Stel u bent voor de tweede keer in vijf jaar van achteren aangereden. De eerste paar weken bent u nog druk bezig met de afhandeling van de schade, plus dat u op uw werk net in een project zit dat veel van uw tijd in beslag neemt. De eerste weken na het ongeval merkt u wel dat uw nek stijf is en dat uw concentratie minder is. Af en toe bent u licht in het hoofd. Na vier weken besluit u toch eens bij de huisarts langs te gaan. De concentratievermindering, duizeligheid en nekpijn blijven aanwezig, maar u merkt ook dat u lichter slaapt, vaker vermoeid bent, uw kaken gespannen zijn en u gevoeliger bent voor geluid. </span></div>
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<span style="font-kerning: none;"><b>Het medisch circuit in</b></span></div>
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<span style="font-kerning: none;">De huisarts constateert een Whiplash Associated Disorder (WAD) type 2 (nekklachten en andere klachten van het houdings- en bewegingsapparaat) en stuurt u door naar de fysiotherapeut. De fysiotherapeut is een specialist op het gebied van spieren en hij constateert dat uw nek- en kaakspieren gespannen zijn. Er wordt gemasseerd en u krijgt oefeningen mee om uw nekspieren op te rekken. Toch blijven de duizeligheid, de concentratieproblemen, het lichte slapen, de pijn, de vermoeidheid, de gespannen kaak en de gevoeligheid voor geluid aanwezig. </span></div>
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<span style="font-kerning: none;">De fysiotherapeut stuurt u door naar een collega die manueel therapeut is: een specialist op het gebied van gewrichten. De manueel therapeut constateert dat uw bovenste nekwervels en kaak vast zitten en dat uw borstwervelkolom gespannen is. De behandeling wordt ingezet. Inmiddels bent u vijf maanden verder, de bewegelijkheid van de nek en kaak zijn toegenomen, maar de verminderde concentratie, de vermoeidheid, de duizeligheid, de pijn en de gevoeligheid voor geluid blijven. </span></div>
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<span style="font-kerning: none;">Inmiddels is het op uw werk duidelijk geworden dat u niet meer goed functioneert en men heeft u aangeraden zich ziek te melden. Volgens de bedrijfsarts is whiplash psychosomatisch en hij stuurt u door naar een psycholoog. De procedure met de afhandeling van de schade blijft ook maar voortslepen. Op het schoolplein ontmoet u een ouder die u adviseert om eens bij de osteopaat langs te gaan. </span></div>
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<span style="font-kerning: none;"><b>Naar de osteopaat</b></span></div>
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<span style="font-kerning: none;">De osteopaat is een specialist op het gebied van functionele onbegrepen klachten van het bewegingsapparaat, de bloedvaten, de stofjes in uw lijf en uw zenuwen. Hij kijkt waar u staat op de schaal van ziekte (0) naar gezondheid (10), waarbij eerst uitgesloten wordt dat er niet een duidelijke ziekte c.q. beschadiging aanwezig is. Indien u niet in dit domein valt (0-3) zit u in het domein van de functionele klachten (4-7). Er zijn dus klachten, maar er is geen duidelijk aanwijsbare anatomische oorzaak. Hier was u zelf ook al achter gekomen.</span></div>
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<span style="font-kerning: none;">Verder kijkt de osteopaat naar de verbanden tussen de verschillende systemen en niet lineair of reductionistisch (bijvoorbeeld. is het de zenuw > neuroloog, is het de nek > orthopeed, et cetera).</span></div>
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<span style="font-kerning: none;"><b>Het eerste consult - klachtenanalyse</b></span></div>
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<span style="font-kerning: none;">Hij onderzoekt u en constateert het volgende: Bij de eerste aanrijding is er al een overprikkeling van uw pijnsysteem (nociceptie) opgetreden. Verder is toen al een verminderde functie van uw oogmotoriek begonnen aangezien u toen al behoefte had aan een bril, maar deze was steeds net niet goed genoeg. Ook had de tandarts toen al geconstateerd dat u toch wel vaak lag te klemmen ’s nachts. De ogen en de kaak worden bezenuwd door hersenzenuwen vanuit de hersenstam, en de osteopaat concludeert dat deze al de afgelopen jaren meer geprikkeld was aangezien u toen ook al fysiotherapie gehad had.</span></div>
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<span style="font-kerning: none;">Door de huidige aanrijding is het pijnsysteem verder overprikkeld geraakt en er is sprake van allodunia: normale niet pijnlijke prikkels leiden nu tot pijn. (Kasch, 2016)</span></div>
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<span style="font-kerning: none;">Een mogelijke oorzaak van uw duizeligheid kan te vinden zijn in een verstoring van de beweeglijkheid van de bovenste nekwervels, prikkeling van de banden van uw nek door de klap of zelfs verstoring van de werking van uw oogspieren. Deze zaken kunnen ook de oorzaak zijn van de regelmatig vastzittende nek.</span></div>
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<span style="font-kerning: none;">Onderzoeken van Curatolo (2011), Jun Li (2014), Oostendorp (1999, 2013), Yacovino, (2013), Sterling (2006) en Nacci (2011) hebben aangetoond dat achtereenvolgens een verstoring van de mobiliteit in de bovenste nekregio door prikkeling van de synoviale gewrichten, irritatie van de ligamentuur en verstoring van de intrinsieke oogmusculatuur oorzaken kunnen zijn van aanhoudende duizeligheid bij postwhiplashklachten.</span></div>
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<span style="font-kerning: none;">De osteopaat constateert ook dat uw pupilreflex veranderd is (flutteren: afwisselend openen en dicht gaan als reactie op een lichtprikkel), dit is een overstimulatie van perifere sympathische neuronen. Blijkbaar heeft de pijnprikkel geleid tot een overstimulatie van een zenuwknoop in uw nek (het ganglion cervicale superior) waar het schakelcentrum is voor bijvoorbeeld de doorbloeding naar uw hoofd en de pupilreflex. Naast deze overprikkeling hoog in de nek constateert hij ook dat uw hartritmevariabiliteit veranderd is naar een meer ‘opgejaagd’ beeld (Passatore, 2006, Brugnoni, 2014, Edwards, 2015). Ook uw tongmotoriek is veranderd, en u had al bemerkt dat af en toe een grote hap doorslikken niet altijd even makkelijk ging (Bordoni, 2015).</span></div>
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<span style="font-kerning: none;">Op basis van deze bevindingen constateert de osteopaat dat er sprake is van een centrale sensitizatie, dat wil zeggen er is een overprikkeling van het pijnsysteem die geleid heeft tot een uitbreiding van de klachten naar het zogenaamde onwillekeurige zenuwstelsel (Winkelstein, 2011).</span></div>
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<span style="font-kerning: none;">Naast de overprikkeling van het zenuwstelsel is er door de lokale ‘ontstekingsverschijnselen’ van het gewricht en de zenuwen (Curatolo, 2011, Kasch, 2016) een belasting op het Neuro Endocrino Immunologische (NEI) systeem. Dit resulteert in verandering van de cortisol, een hormoon dat wordt afgescheiden in de bijnierschors, en dat ook van invloed is op vermoeidheid en slapen (Gaab, 2005).</span></div>
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<span style="font-kerning: none;">De osteopaat legt uit dat het zenuwstelsel na twee posttraumatische nek-ongevallen in vijf jaar overprikkeld is, en dat de prikkel zich ‘gegeneraliseerd’ heeft. Dit is een belangrijk punt bij whiplash; de overgang van acuut naar chronisch. Bij deze overgang wordt in het dagelijks functioneren steeds duidelijker dat u niet meer op 100 procent zit. Dit gegeven breidt zich als een inktvlek uit, u begint te twijfelen of u wel het juiste werk heeft, vrienden merken dat u toch wat vaker afbelt en afwezig bent, kortom: uw psychosociale functioneren lijdt inmiddels ook. Daarnaast levert het onbegrip en de slepende juridische kwestie geen positieve bijdrage.</span></div>
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<span style="font-kerning: none;">Na het eerste consult waarin de osteopaat dit alles heeft uitgelegd, gaat u beduusd naar huis. U probeert te bevatten wat hij u zojuist verteld heeft, maar het duizelt u. Toch heeft u tegelijkertijd het gevoel dat er iemand is die naar u in totaliteit kijkt, de tijd neemt en bovenal al die ‘vage’ klachten verklaren kan. Maar wat belangrijker is: wat kan hij er aan doen? Bij het volgende consult besluit u dit aan de orde te brengen.</span></div>
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<span style="font-kerning: none;"><b>Aanpak van de osteopaat</b></span></div>
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<span style="font-kerning: none;">Duidelijk is dat het zenuwstelsel rust moet krijgen. Dit varieert van leren te ontspannen (bijvoorbeeld met behulp van mindfullness), herkenning van belasting-belastbaarheid en de aanpassing van uw leven daaraan, tot aan concentratieoefeningen. Hier is een multidisciplinaire aanpak van belang.</span></div>
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<span style="font-kerning: none;">Ook moet voor de algehele tonus (sympaticotonus) van de bloedvaten een goed trainingsprogramma opgesteld worden. Tevens zal de osteopaat het autonoom zenuwstelsel trachten te reguleren.</span></div>
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<span style="font-kerning: none;">Er moet gekeken worden naar uw NEI-systeem, en waar mogelijk ondersteund door een goed voedingsadvies (lage suikerinname).</span></div>
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<span style="font-kerning: none;">Een functioneel optometrisch onderzoek is nodig om uw oogfunctie te beoordelen en hier mogelijk een brilcorrectie voor te doen. Allereerst doet de osteopaat dit onderzoek naast een schedel en hersenzenuw onderzoek en zal daar waar verlies aan mobiliteit is het gaan behandelen.. </span></div>
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<span style="font-kerning: none;">U zal door moeten gaan met de oefeningen voor de bewegelijkheid van de nek (alhoewel de stijve nek dus mogelijk een gevolg is van andere oorzaken, een somato-somatische reflex, Janig 2011). De oefeningen zullen het effect van de mobilisatie die de osteopaat uitvoert moeten ondersteunen.</span></div>
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<span style="font-kerning: none;"><b>Effecten</b></span></div>
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<span style="font-kerning: none;">Allemaal mooi en wel, maar wat doet nu precies die osteopathische behandeling? Een Cochrane review laat zien dat er geen eenduidigheid is of een actieve dan wel passieve behandeling beter zou zijn. Er zijn enkele studies naar osteopathie gedaan (Fryer, 2005, Schwerla, 2013, Bordoni, 2014? Giu, 2010, Sun Genese, 2013) waarin er een indicatie is dat osteopathie effect heeft. De vraag is natuurlijk: welk deel van de osteopathische behandeling is dan effectvol? </span></div>
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<span style="font-kerning: none;">De geïndividualiseerde behandeling, waarbij aandacht is voor het gehele lichaam (ook het bekken, onderrug, borstwervelkolom en het bindweefsel rondom de organen) heeft een effect, maar dit dient verder onderzocht te worden.</span></div>
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<span style="font-kerning: none;"><b>De conclusie</b></span></div>
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<span style="font-kerning: none;">Uw klacht is na twee jaar duidelijk minder, u heeft uw werk weer hervat, alleen wanneer u te veel van uzelf vraagt, komen de concentratieproblemen, de pijn, de duizeligheid en de vermoeidheid nog licht terug. Restklachten zijn er doorgaans nog, echter de mate van belemmering in het dagelijks leven kan wel degelijk beinvloedt worden door osteopathie.</span></div>
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<span style="font-kerning: none;">Referenties:</span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>1.<span class="Apple-tab-span" style="white-space: pre;"> </span>Bordoni, 2016, </span><span style="font-kerning: none;">the tongue after whiplash: case report and osteopathic treatment, International Medical Case Reports Journal 2016:9 179–182 </span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>2.<span class="Apple-tab-span" style="white-space: pre;"> </span>Boniver, 2014, Whiplash associated autonomic effects, Chapter 11, </span><span style="font-kerning: none;">D.C. Alpini et al. (eds.), <i>Whiplash Injuries</i>, 281 DOI 10.1007/978-88-470-5486-8_27 </span></div>
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<span style="font-kerning: none;"><span class="Apple-tab-span" style="white-space: pre;"> </span>3.<span class="Apple-tab-span" style="white-space: pre;"> </span>M. Curatolo, 2011, The role of tissue damage in whiplash associated disorders: Discussion paper 1, Spine (Phila Pa 1976). 2011 December 1; 36(25 Suppl): S309–S315 </span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>4.<span class="Apple-tab-span" style="white-space: pre;"> </span>I.J. Edwards et al., 2015, </span><span style="font-kerning: none;">Neck muscle afferents influence oromotor and cardiorespiratory brainstem neural circuits, Brain Struct Funct (2015) 220:1421–1436 </span></div>
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<span style="font-kerning: none;"><span class="Apple-tab-span" style="white-space: pre;"> </span>5.<span class="Apple-tab-span" style="white-space: pre;"> </span>G. Fryer, 2005, Research report: The effect of osteopathic treatment on people with chronic and sub-chronic neck pain: A pilot study, International Journal of Osteopathic Medicine (2005) 41-48</span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>6.<span class="Apple-tab-span" style="white-space: pre;"> </span></span><span style="font-kerning: none;">J. Gaab, 2005, Reduced reactivity and enhanced negative feedback sensitivity of the hypothalamus–pituitary–adrenal axis in chronic whiplash associated disorder</span><span style="font-kerning: none; vertical-align: 18.0px;">, </span><span style="font-kerning: none;">Pain 119 (2005) 219–224 </span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>7.<span class="Apple-tab-span" style="white-space: pre;"> </span>Giu, 2010, </span><span style="font-kerning: none;">Rehabilitation and Osteopathic Manipulative Medicine for a Patient With Dysphagia Secondary to a Hyoid Somatic Dysfunction: A Case Report.</span></div>
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<span style="font-kerning: none;"><span class="Apple-tab-span" style="white-space: pre;"> </span>8.<span class="Apple-tab-span" style="white-space: pre;"> </span>Janig, 2011, Functions of the autonomic nervous system, Chapter 2, The science and clinical application of manual therapy, Churchill Livingstone</span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>9.<span class="Apple-tab-span" style="white-space: pre;"> </span></span><span style="font-kerning: none;">Jun Li , et al., 2014, Sympathetic nerve innervation in cervical posterior longitudinal ligament as a potential causative factor in cervical spondylosis with sympathetic symptoms and preliminary evidence, Medical Hypotheses 82 (2014) 631–635</span></div>
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<span style="font-kerning: none;"><span class="Apple-tab-span" style="white-space: pre;"> </span>10.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kasch, 2016, Whiplash injury; perspectives on the development of chronic pain, IASP press, Philadelphia, pg.242</span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>11.<span class="Apple-tab-span" style="white-space: pre;"> </span>Nacci, 2011, </span><span style="font-kerning: none;">Vestibular and stabilometric findings in whiplash injury and minor head trauma, Acta Otorhinolaryngol Ital 2011;31:378-389 </span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>12.<span class="Apple-tab-span" style="white-space: pre;"> </span>Oostendorp, 1999, </span><span style="font-kerning: none;">Dizziness Following Whiplash Injury: A Neuro-Otological Study in Manual Therapy Practice and Therapeutic Implication, The Journal of Manual & Manipulative Therapy Vol. 7 No. 3 (1999), 123 - 130 </span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>13.<span class="Apple-tab-span" style="white-space: pre;"> </span>Passatore, 2006, </span><span style="font-kerning: none;">Influence of sympathetic nervous system on sensorimotor function: whiplash associated disorders (WAD) as a model, Eur J Appl Physiol (2006) 98:423–449 </span></div>
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<span style="font-kerning: none;"><span class="Apple-tab-span" style="white-space: pre;"> </span>14.<span class="Apple-tab-span" style="white-space: pre;"> </span>F. Schwerla, 2013, Osteopathic Treatment of Patients with Long-Term Sequelae of Whiplash Injury: Effect on Neck Pain Disability and Quality of Life, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 0, Number 0, 2013, pp. 1–7</span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>15.<span class="Apple-tab-span" style="white-space: pre;"> </span></span><span style="font-kerning: none;">Michele Sterling , 2006, The relationship between sensory and sympathetic nervous system changes and posttraumatic stress reaction following whiplash injury—a prospective study, Journal of Psychosomatic Research 60, p.387–393</span></div>
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<span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(25, 25, 25); color: #191919;"><span class="Apple-tab-span" style="white-space: pre;"> </span>16.<span class="Apple-tab-span" style="white-space: pre;"> </span></span><span style="font-kerning: none;">J. Sun Genese, 2013, Osteopathic Manipulative Treatment for Facial Numbness and Pain After Whiplash Injury, The Journal of the American Osteopathic Association July 2013 | Vol 113 | No. 7 </span></div>
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<span style="font-kerning: none;"><span class="Apple-tab-span" style="white-space: pre;"> </span>17.<span class="Apple-tab-span" style="white-space: pre;"> </span>Verhagen AP et al., Cochrane review: Conservative treatments for whiplash, <i>Cochrane Database of Systematic Reviews </i>2007, Issue 2</span></div>
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<span style="font-kerning: none;"><span class="Apple-tab-span" style="white-space: pre;"> </span>18.<span class="Apple-tab-span" style="white-space: pre;"> </span>B.A. Winkelstein, 2011, How can animal models inform on the transition to chronic symptoms in whiplash?, Spine (Phila Pa 1976). 2011 December 1; 36(25 Suppl): S218–S225 </span></div>
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<span style="font-kerning: none;"><span class="Apple-tab-span" style="white-space: pre;"> </span></span><span style="-webkit-font-kerning: none; -webkit-text-stroke-color: rgb(0, 0, 0); color: black;">19.<span class="Apple-tab-span" style="white-space: pre;"> </span></span><span style="font-kerning: none;">Yacovino, 2013, Cervicogenic-Related Dizziness and Vertigo, Seminars in Neurology, Vol. 33, No. 3</span></div>
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Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com1tag:blogger.com,1999:blog-2550525085215204666.post-76988414842148373502015-01-18T00:07:00.004-08:002015-01-18T00:07:48.526-08:00<div dir="ltr" style="text-align: left;" trbidi="on">
<h2 style="text-align: left;">
<b>Osteopathy: empathize with the essence of man.</b></h2>
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Definition Osteopathy.<br />
According to the founder, AT Still, the definition of osteopathy is that Osteo means bone and Pathos stands for illness or suffering in general (1874). He is quoted: "The merging of these two concepts is inspired by the Indians who merged two tribal names". Later new interpretations were added. Osteo is bone and in the 19th century this was seen as the essence of man because it was the only thing that was left of him. Pathos is empathy (see empathy). Merged this means "empathising with the essence of man" (McKone, 2001).<br />
According to the professional competency profile (BCS-1) in the Netherlands osteopathic manual medicine is an examination and treatment.<br />
Osteopathy is a philosophy, a science and an art.<br />
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The <b>osteopathic philosophy</b> is about<br />
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A. Health and illness<br />
B. Process<br />
C. Three general principles<br />
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A. Illness and health are two aspects of development. The death of brain cells is required for the growth. The loss of memory is needed to get new impressions. Also, for the immune system disease is a conditioning for a better immune system. When the path of disease to health (or vice versa) is put on a scale of 0 (ill) to 10 (healthy), then regular medicine is engaged in the domain of disease (0-3), in the domain functional subclinical symptoms (4-7) osteopathy is engaged and things like yoga, Pilates, fitness in the spa are on the wellness end of the scale (8-10).<br />
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B. Process<br />
In recognizing symptoms, functional symptoms and disease it is about placing the processes and patterns in time. Health care providers are accustomed to looking for the symptoms (what do I have) and causality (how I got it) of a patient. Causality is the way the brains organize experiences. Causality cannot be seen, it comes from the subjective experience (Fenomenon) and not from the world (noumenon). Therefore, the effect cannot be distinguished from the source, because it comprises both. For osteopathic clinical reasoning this means that the genesis of the neck problems in its totality is important, not the neck problem 'in itself' and not 'the cause'. In the identification of disease and dysfunction the osteopathic clinical reasoning is important. This reasoning is based on the general principles.<br />
The recognition of the originality of the patient (why do I have this now), depends on the patient history and knowledge of physical, psychological and emotional development. The world of matter (eg. A fist) thus conceals the whole (the hand) and the process (the fisting of the hand). If we apply this reasoning to recognize symptoms and disease, this allows the processes, patterns and thus to understand the information that is stored in the symptom.<br />
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<b>Osteopathy as a science.</b><br />
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In today's academic world, the latest development is that Evidence Based Medicine (EBM) moves in the direction of Outcome-Based Medicine (CBM). Osteopathy takes causes into consideration, making use of these two approaches. Fundamental research is used for hypothesis formation and experimental studies to evaluate the final result. INSERM has published a paper in 2012 in which the current experimental studies summarized in Osteopathy and geëvaluereerd (Falissard 2012).<br />
The physical aspect of osteopathy is based on medicine and is approached in a scientific manner. Aspects of human functioning such as cytology (1), histology (1) anatomy (1), physiology (2 and 3) fluid dynamics (2), endocrinology (3), immunology (3), biophysics (3), neurology (4 ), and psychology (5) are the foundation on which osteopathic thinking is based. However, this will be considered from an osteopathic or health perspective, and not from an allopathic or illness perspective. A systems model is a mental image of a disease or functional complaint. A model can be tested, in contrast to a paradigm (faith structure).<br />
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In regular care, there is a progressive differentiation: cardiology, internal medicine, endocrinology, etc. Developmental Systems Theory (DST) not only provides the before mentioned "Model thinking", but also the connection between the different models, where the psycho neuro-immunology is an example of (Oyama, 2001). This connection between the different models is comparable with the general principle: the body is a unit. Therefore DST is important in osteopathic thinking.<br />
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According to the Dutch Association of General Practitioners (NVH) 40% visited their GP with somatic insufficiently explained physical complaints (SOLK). Because of the three general principles and the Ecop model osteopathy is suitable for assessing functional complaints. She works in this domain and thus osteopathy is a part of functional medicine.<br />
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The Osteopath goes beyond the complaint and the elimination of symptom:<br />
- He identifies disease and assesses the primary disease.<br />
- He identifies the functional "sub clinical" complaints, called dysfunction, and places them in time.<br />
- He uses evidence-based guidelines and basic research in treating the dysfunction.<br />
- He analyzes the factors affecting the life of the patient's disease so that health can be improved, and the body can heal itself.<br />
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Osteopathic authors base their treatment hypotheses on fundamental research and not yet on experimental studies, when they describe empirical techniques in the current osteopathic literature (Georges Finet 2013) (Barral).<br />
If basic research changes the hypothesis that the treatment strategy is based on changes, while the effectiveness has not been studied.<br />
An example of this is the fundamental investigation into the "glymphatic system" (Iliff, Wang et al, 2012). Because the researchers had used a smaller marker than the dye that was used in previous studies, they found that the drainage of CSF is also via the para vascular place in the parenchyma. This shows that the earlier hypothesis in osteopathy of liquor drainage, only via the arachnoid villi and the venous system is incorrect.<br />
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Based on this knowledge, the hypothesis about drainage in the Cranio Sacral system must be re-evaluated. Instead of focusing on the statements of the assumptions (which, incidentally, much more leads to be like sync dog rosen that are long mobile connections between dura and musculature at the height of the occiput) there should be focused on the effectiveness of the techniques.<br />
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Classically the treatment techniques were divided into parietal, visceral and cranio-sacral techniques. This subdivision is by region. The structures that are treated, however, can be summarized in the above five models. As an example the biomechanical model through the fascia, both parietal, visceral as cranial be treated. Neurogenic, autonomic nervous system may also apply to all three. However, the symptomatic approach is still the language of patients and physicians. They want to know if we can help with a specific complaint / symptom.<br />
For example, osteopathy can help with my digestive problem ??<br />
The functional complaints top 10, according to the directive SOLK (NVH): generic low<br />
back pain, neck pain, sleep problems, fatigue, upset stomach, irritable bowel syndrome, headaches, dizziness, anxiety and restlessness. These are the complaints that are within the osteopathic domain.<br />
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conclusion:<br />
Studies have been done, not all of them methodologically sound, but it's a start. The last 10-15 years, more and more studies done in Osteopathy. There is also an increase of Osteopathic doing masters and even PhD. There are several research centers in the world (CORE, NCOR, etc.). In the Netherlands there's Foundation Research in Osteopathy (swoo.nl) which is working on more support from the profession.<br />
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<b>Osteopathy as an art.</b><br />
The osteopathic contact can be divided into the exteroceptive contact between the patient and the osteopath and interoceptive contact the osteopath has with himself.<br />
The qualities that we can palpate exteroceptief:<br />
1. Mechanical (motility)<br />
2. Rhythm and Heat (circulation)<br />
3. Vitality (innervation and metabolic)<br />
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During the exteroceptive contact, an exchange takes place through various phenomena. Brainwaves (Stevens 2010) and heart rhythms (McCraty 1996) have been proven to synchronize during the contact. Besides these physical qualities that are palpated, there is also the "mental" aspect during palpation of the other. In osteopathy the body is seen as an expression of the subconscious.<br />
The person is the context in which the "spirit" finds its expression. So the body which is palpated has a 'mental-spiritual' side. The philosopher Whitehead said: "There are no two substances body-mind, but experience has two aspects: physically and mentally."<br />
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Whith interoceptive contact the inner world of the osteopath plays a role. Michael Shea emphasizes the development of an inner "resting" state during treatment (Shea, 2008). It should be considered that through supervision / peer review and biofeedback it is made clear what this "rest" state is and than what the content of the interoception is. Therefore an open balanced attitude is a prerequisite for observing the impression that the patient has on the osteopath, so it can be properly interpreted.<br />
Subjectivity further calls for a development of one's own observations, so that a reproducible reference system can be developed. Nothing is greater than self-knowledge. This permits the osteopath to maintain distance and proximity and to let go of judgmental thoughts so openness arises for what is there. Therefore, the patient-osteopathy relationship is a collaboration system that promotes the health of the patient. Things like intuition and palpation are examined in relation to the inner world of the osteopath (McNeill, 2013).<br />
The sense of touch is developed by the feedback obtained. Is it really the intestine or ligament that is felt? The feedback in the past was obtained by X-ray or ultrasound. For "hand-workers" the anatomy, histology, physiology and psychology of the nervous system act as a navigation system during palpation.<br />
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It can be concluded that during the osteopathic contact more will be observed than just the mechanical, physical, but that these things should be distinguished in the phenomenological experience of the osteopath and the existential á priori aspect of perception. Both must be reproducible and verifiable. Therefore, the name Osteopathy can be questioned, which literally means disease of the bone. The name empathize with the essence of the human being from the functional medicine would be more appropriate.<br />
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the Future<br />
Problems for osteopathy are the recognition of the profession, which should be by the BIG register. To join this, first one needs to develop a NVAO accredited full-time training. Furthermore, the experimental research will also be extended.<br />
Furthermore, anyone can learn the techniques ("skills") and do "osteo therapy", such as craniosacral therapists, visceral techniques by manual therapists, etc. However, the clinical reasoning and competencies are more complicated and require more study so that the osteopathic medicine, and most importantly the clinical reasoning must be based on adequate knowledge of anatomy, physiology, histology and cytology.<br />
Future directions for osteopathy are increasing the basic medical knowledge. Than the clinical reasoning should take place from an osteopathic conceptual framework, ie how health is defined and what are functional problems (tired, stiff, pain, etc.)? Additionally an osteopath as first-line worker must master sufficient knowledge of the pathology to distinguish the red and yellow, the green flags.<br />
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In Summary:<br />
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The osteopathic philosophy has phenomenological, empirical and process aspects. There are three principles of osteopathy: unity, process of structure and function and self-healing / health.<br />
The science of osteopathy is still in its infancy. Clinical reasoning is based on the statement of five models: biomechanical, circulation / respiration, metabolic, neurological and biopsychosocial.<br />
The art of osteopathy lies in a refinement of feeling, extero- as well intero-ceptief.<br />
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<b>References</b><br />
<br />
Bove, G. M. and S. L. Chapelle (2012). "Visceral mobilization can lyse and preventDefault peritoneal adhesions in a rat model." J Bodyw Mov Ther 16 (1): 76-82.<br />
C Hayden, M. B. (2006 May). A preliminary assessment of the impact of cranial osteopathy for the releif or infantile colic. Complement ther clin pract. Gloucestershire, Churchdown Osteopaths. 12: 251-257.<br />
Chapelle, S. L. and G. M. Bove (2013). "Visceral Massage Reduces postoperative ileus in a rat model." Journal of Bodywork and Movement Therapies 17 (1): 83-88.<br />
Degenhardt, BF, NA Darmani, JC Johnson, LC Towns, DCJ Rhodes, C. Trinh, B. and V. DiMarzo McClanahan (2007). "Role of Osteopathic Manipulative Treatment in Altering Pain Biomarkers: A Pilot Study." JAOA: Journal of the American Osteopathic Association, 107 (9): 387-400.<br />
DR Noll, J. J., RW Baer, EJ Snider (2009). "The immediate effect of individual manipulation techniques on pulmonary function Measures in persons with chronic obstructive pulmonary disease." Osteopath med prim care 8: 9.<br />
Thin, PLS v., E.Dobbelaere, P. Gillies, F. Inghelbrecht, P. v. Eeghem L. Steyaert, E. and Y. Danse Rosseel (May 2007). Influence of a mobilization of the mesentery on the hepatic portal flow, geobjecteerd by echo-Doppler. The osteopath: 22-29.<br />
Falissard, C. B. B. (2012). "Evaluation de l'efficacité de la pratique de l'ostéopathie."<br />
Franke, H. and K. Hoesele (2013). "Osteopathic manipulative treatment (OMT) for lower urinary tract symptoms (LUTS) in women." Journal of Bodywork and Movement Therapies 17 (1): 11-18.<br />
Georges Finet, C. W. (2013). "Viszerale Osteopathy."<br />
Hedley, G. (2010). "Notes on visceral adhesions axis fascial pathology." J Bodyw Mov Ther 14 (3): 255-261.<br />
Herlin, C., Largey, A., deMatteï, C., DAURES, JP, Bigorre, M., & Captier, G. (2011). Modeling of the human fetal skull base growth: Interest in new Volumetrics morphometric tools. Early Human Development, 87 (4), 239-245.<br />
Hodge, LM, HH King, AG Williams, SJ Reder, T. Belavadi, JW Simecka, ST Stoll and HF Downey (2007). "Abdominal lymphatic pump Treatment Increases leukocyte count and thoracic duct lymph in flux." Lymphatic Research and Biology 5 (2): 127-134.<br />
HWC Hundscheid MP, LGJB English, RJLF Loffeld (2007). "Treatment of irritable bowel syndrome with osteopathy: results of a randomized controlled pilot study." Journal of gastroenterology and hepatology 22: 1394-1398.<br />
Iliff, JJ, M. Wang, Y. Liao, BA Plogg, W. Peng, GA Gundersen, H. Benveniste, GE Vates, R. Deane, SA Goldman, EA Nagelhus and M. Nedergaard (2012). "A para vascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes,-including amyloid beta." Sci Transl Med 4 (147): 147ra111.<br />
McCraty, 1996, The Electricity of Touch: Detection and measurement of cardiac energy exchange between people.<br />
McFarlane, 2006 IJOM, Patient perception or intention practitioner in osteopathy in the cranial field - A preliminary investigation.<br />
McKone, W. Osteopathic Medicine, philosophy, principles and practice, 2001, Wiley-Blackwell, UK<br />
McNeill, 2013 JBMT, Accessing intuition in Massage and Bodywork Therapies using mindfulness, knowledge, empathy and flow<br />
McSweeney, TP, OP Thomson and R. Johnston (2012). "The immediate effects or sigmoid colon manipulation on pressure pain thresholds in the lumbar spine." J Bodyw Mov Ther 16 (4): 416-423.<br />
Merdy, O. (2011). "Electrophysiological investigations or an Osteopathic Technique on the ANS: a RCT."<br />
Milnes, K. and R. Moran (2007). "Physiological effects of a CV4 cranial osteopathic technique on autonomic nervous system function: A preliminary investigation." International Journal of Osteopathic Medicine 10 (1): 8-17.<br />
Moskalenko YE, Kravchenko TI. Wave phenomena in movements or intracranial liquid media and the primary respiratory mechanism. Amer Acad Osteopath J. 2004; 14: 29 -40<br />
Aim Meier, Joan T. Hand in glove: brain and skull in development and dysmorphogenesis, Acta Neuropathologica, April 2013, Volume 125, Issue 4, pp 469-489<br />
Shea, Michael J, 2008, Interpersonal nervous system.<br />
Stevens, 2010, PNAS, speaker-listener neural coupling undergraduate groin successful communication<br />
Tozzi, P., D. and C. Vitturini Bongiorno (2012). "Low back pain and kidney mobility: local osteopathic fascial manipulation decreases pain perception and Improves renal mobility." J Bodyw Mov Ther 16 (3): 381-391.</div>
Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com4tag:blogger.com,1999:blog-2550525085215204666.post-1700088963761205302013-08-16T00:08:00.002-07:002013-08-16T00:08:20.750-07:00<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="letter-spacing: 0.0px;"><b>On the possibility to identify the importance of HRV studies in analysis of our mental entities.</b></span></div>
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<span style="letter-spacing: 0.0px;">by Sander Kales, D.O.</span></div>
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<span style="letter-spacing: 0.0px;">Abstract</span></div>
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<span style="letter-spacing: 0.0px;">Introduction</span></div>
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<span style="letter-spacing: 0.0px;">When Descartes started his writing’s on the division of mind and matter, he could not have foreseen the length to which this was taken. Not only in medicine is there a division between the mind (psychology) and matter (biology). Also in our everyday lives we make this division. We live in our world of thoughts, or are confronted with the sensations of our body. Our understanding of our mental lives has led us to think that it is our brain that generates emotions and feelings. 2014 will be the year of the brain in Europe so neurologists and neuropsychologists are more and more on the forefront of medical development and we will start forgetting what our bodies are for.</span></div>
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<span style="letter-spacing: 0.0px;">On the other hand, the latest research on heart rhythms, have shown that it is our physiology which leads to emotions, which leads to feelings, which leads to thinking. Our mental activity is founded upon our physiology. In the works of McCraty this has been demonstrated (McCraty 2006, McCraty, Atkinson et al. 2006). The activity of our heart influences directly the state of our brain. Thus the seperation between our mind and our body becomes blurred. We cannot seperate mind and matter anymore.</span></div>
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<span style="letter-spacing: 0.0px;">In this article, the current assumption that it is our mental activity, that influences our Heart Rate Variability will be renounced. But taking this even further, the generation of the heart rate variability is based on the information from our body. This is what is expressed in the variability. Current methods of studying HRV, such as the Fast Fourier Transform (FFT) which is a linear method will not be sufficient to explain this connection between our bodily functions, such as the state of functioning of our kidneys, and the HRV. New methods, like the Conte Ziblut Federici (CZF) method (Conte, Federici et al. 2009), which is based on non-linear methodology, are able to show this connection.</span></div>
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<span style="letter-spacing: 0.0px;">Emotions, Feelings and Physiology.</span></div>
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<span style="letter-spacing: 0.0px;">We are all familiar with the term: ”it has a visceral feel to it” . In our language we our confronted with this connection between our physiology and our emotions: “it makes me sick to my stomach”, “I have butterflies in my belly”, etc. There is a distinction between emotions (or E</span><span style="font-size: 10px; letter-spacing: 0px;">nergy in</span><span style="letter-spacing: 0.0px;"> motion) and feelings, the former being the sensation of our physiology, and the latter is more the association of brain patterns to the bodily patterns (Lane 2008). We describe this bodily sensation and associate all kinds of mental phenomena to it. So our thoughts arise from within us and are based on our bodies patterns.</span></div>
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<span style="letter-spacing: 0.0px;">The mind-Body connection.</span></div>
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<span style="letter-spacing: 0.0px;">McCraty has demonstrated that a change in HRV corresponds with different emotional states. He differentiated the four basic modes: Mental Focus, Psychophysiological Incoherence, Relaxation and Psychophysiological Coherence. Besides these four modes, which he has shown to be basic axis on which we can draw our emotional functioning, there are two more modes: Positive Hyperstate or Emotional Quiescence and Negative Hyperstate of Negative Emotional State (McCraty, Atkinson et al. 2006).</span></div>
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<span style="letter-spacing: 0.0px;">The differentiation of these emotions into for instance acceptance, grief, etc. goes beyond the possibilities of his type of research. This could be because he uses a FFT, linear method, with which he cannot describe the subtleties of the HRV. It is like transforming a piece of Mozart into basic chords. This is an oversimplification of what Mozart’s music is like, and in that sense what our heart functioning is like. Nonlinear methods are better able to grasp this kind of “music”.</span></div>
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<span style="letter-spacing: 0.0px;">Heart beats</span></div>
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<span style="letter-spacing: 0.0px;">The classical notion is that the heart is a pump. Chitty has demonstrated that the heart is more an integrator of several types of information: haemodynamics, hormonal, electromagnetically, electrically, etc (Chitty 2010). Every heart beat is a taking up of information and changing the parameters slightly. With each ejection phase the direction of the vortex is slightly changed so that blood receives information and through this new vortex, will arrive at the place it needs to be (for instance the kidney’s). In embryonic development of the heart wall, it is demonstrated that the vortices form the trabeculae.</span></div>
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<span style="letter-spacing: 0.0px;">Goncharenko went even further (Goncharenko 2003). In studies of thrombi in baboons, he demonstrated that the thrombus originating from a particular part of the wall of the heart, will always end up in a certain place (for instance the left iliac artery). He studied this in a lot of baboons and was able to come up with a somatotopy of the body on the walls of the heart.</span></div>
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<span style="letter-spacing: 0.0px;">Interesting in this study is that a small change of the contractility of a particular part of the heart wall will result in a change in the electrical conductivity of that part. This will result in a different contraction, and thus a different distance to the R top on the ECG. Thus the HRV will come into place.</span></div>
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<span style="letter-spacing: 0.0px;">So now we can deduce that this change in contraction as a result(!) of different information from a peripheral organ (for instance the kidney) will result in differences in R-R intervals and also account for the dynamics of the HRV.</span></div>
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<span style="letter-spacing: 0.0px;">Measurement of HRV</span></div>
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<span style="letter-spacing: 0.0px;">The classical method of measuring the HRV is through first measuring the distance between the R-R intervals. This interval is than put in a Tachograph, where you can see the fluctuations of the intervals between the heart beats, also called: a time analysis. This is a linear method of measuring. Conte et al. have shown that already here we can apply the principles of Quantum Mechanics and measure not just the change between subsequent beats but also the change between the first and the second, between the first and the third, etc. This will result in a non-linear analysis and give more results (Giuliani, Giudice et al. 1996, Conte, Federici et al. 2009).</span></div>
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<span style="letter-spacing: 0.0px;">The next step in the data processing is taking the frequencies that compile to make up the fluctuations of the tachogram and transforming them into a Power Density Spectrum. When you look at the fluctuations of the HRV you can imagine that it is a combination of all sorts of frequencies, ranging from </span><span style="color: #ff4013; letter-spacing: 0.0px;">.04 Hz to .9 Hz.</span><span style="letter-spacing: 0.0px;"> The number of times a certain frequency is there, it will be added up and put into a PSD. This transformation is done on the basis of a frequency analysis: a Fast Fourier Transformation (FFT). Again here a linear method is used, because of the standard frequencies. It is like taking the accords of a Mozart piece and concluding that, that is the music piece, instead of noting that one “off” note that makes the piece dynamic, and not just a static rhythm. This last can be done through the CZF method.</span></div>
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<span style="letter-spacing: 0.0px;">After the PDS is made, several major frequency bands are distinguished, of which the Very Low Frequency (VLF), the Low Frequency (LF) and the High Frequency (HF) are the major ones. These frequency bands have been associated with the functioning of the Sympathetic Nervous System (SNS): VLF, the Baroreceptor system: LF and the Para Sympathetic Nervous System (PSNS): HF. McCraty has based his emotional grid on the functioning of these nervous systems.</span></div>
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<span style="letter-spacing: 0.0px;">Because of the possibilities of the CZF measuring method, more information is taken from the HRV. This information can than be investigated to see if it correlates with for instance a kidney, spleen, liver, etc. disfunction. We can start to investigate if the stimulation of one organ function will result in a change in HRV. This can only be done through the CZF method, and not the traditional FFT.</span></div>
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<span style="letter-spacing: 0.0px;">Conclusion</span></div>
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<span style="letter-spacing: 0.0px;">It has been demonstrated that our HRV is comprised of several factors originating in the body. This information is than the foundation for the development of “emotions” which will later on be transformed into feelings and thinking. Thus an anxious person, with a certain cortisol expression from his kidney glands, will have a certain HRV, as can be measured through the CZF method. This will result in the feeling of being “anxious”. We can even question where the memory of a previous episode of anxiousness is stored; is it in the brian, or in a certain pattern of the kidney glands. This non-locality of information is what Conte has investigated with the quantum foundations of our thinking. Thus it would be interesting to redo the experiments of McCraty with the CZF method and than elaborate on them to see if specific emotions show specific frequencies on the PSD. </span></div>
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<span style="letter-spacing: 0.0px;"><b>Bibliografie</b></span></div>
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<span style="letter-spacing: 0.0px;">Chitty, J. (2010). "The Heart is not a Pump." from www.energyschool.com.</span></div>
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<span style="letter-spacing: 0.0px;">Conte, E., A. Federici and J. P. Zbilut (2009). "A new method based on fractal variance function for analysis and quantification of sympathetic and vagal activity in variability of R–R time series in ECG signals." </span><span style="letter-spacing: 0.0px; text-decoration: underline;">Chaos, Solitons & Fractals</span><span style="letter-spacing: 0.0px;"> <b>41</b>(3): 1416-1426.</span></div>
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<span style="letter-spacing: 0.0px;">Giuliani, A., P. L. Giudice, A. M. Maneini, G. Quatrini, L. Pacifici, J. Charles L. Webber, M. Zak and J. P. Zbilut (1996). "A Markovian formalization of heart rate dynamics evinces a quantum-like hypothesis." </span><span style="letter-spacing: 0.0px; text-decoration: underline;">Biological Cybernetics</span><span style="letter-spacing: 0.0px;"> <b>74</b>: 7.</span></div>
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<span style="letter-spacing: 0.0px;">Goncharenko, A. I. (2003). "Conjugated heart ties." </span><span style="letter-spacing: 0.0px; text-decoration: underline;">'Delphis' Journal</span><span style="letter-spacing: 0.0px;"> <b>3</b>: 6.</span></div>
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<span style="letter-spacing: 0.0px;">Lane, R. D. (2008). "Neural Substrates of Implicit and Explicit Emotional Processes: A Unifying Framework for Psychosomatic Medicine." </span><span style="letter-spacing: 0.0px; text-decoration: underline;">Psychosomatic Medicine</span><span style="letter-spacing: 0.0px;"> <b>70</b>(2): 214-231.</span></div>
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<span style="letter-spacing: 0.0px;">McCraty, R. (2006). "Coherent Heart deel 1."</span></div>
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<span style="letter-spacing: 0.0px;">McCraty, R., M. Atkinson, D. Tomasino and R. T. Bradley (2006). The Coherent Heart (part 2). California, USA, HeartMath Research Centre, Institute of HeartMath<b>: </b>37.</span></div>
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<span style="letter-spacing: 0.0px;">McCraty, R., M. Atkinson, D. Tomasino and R. T. Bradley (2006). The Coherent Heart: Heart-brain interactions, psychophysiological coherence, and the emergency of the system-wide order (part 1). California, USA, HeartMath Research Centre, Institute of HeartMath<b>: </b>29.</span></div>
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Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com1tag:blogger.com,1999:blog-2550525085215204666.post-40467177312898755292012-08-09T13:19:00.001-07:002012-08-09T13:19:46.946-07:00Neuropsychological Foundations of Conscious Experience by Jason Brown, A Review by Sander Kales, D.O.<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-size: x-small;"><span style="letter-spacing: 0px;">The sequence in this review is the same as the Microgenetic and Morphodynamic process described by Brown and his own Ontogenesis. It will start with the philosophy because it will give us a general starting point. From there we start in the physical Outside world with Pathology, and the brain processes, both in functioning and in growth, while Brown’s work has been as a neurologist with patients who have brain damage. Working with patients always requires a psychological insight, so this is our next phase in discussing this book while it corresponds with the world Inside.</span><span style="letter-spacing: 0px;"> </span><span style="letter-spacing: 0px;">This review will end with a view on time, so more on a Quantum level.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">The brilliance of Brown for me lay in the bringing together of the Outside World (Neurology: processes in the brains and growth of the Brain) and the Inside World (Psychology). Brown is a great analyst, also concerning his own experiences, as in dreams. The bringing together shows up in that he realized that the processes that can be seen in Morphogenesis, or on a cellular (Body) level, also can be seen on a psychological, or Mind level. So we start off with his Philosophical views, or to state in his terms: “The Whole”.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">As William James states: “<i>Philosophy is more a matter of passionate vision than logic, the logic coming afterwards to justify the vision” </i>the same goes for his development of Microgenesis Theory. </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">An important insight of Brown, he describes as follows: “<i>The shift from process to substance theory was one from continuities, transitions and internal relations to logical solids, discrete brain areas or components. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;"><i>For substance theory, being is the source of becoming. For process theory becoming is the source of being. For microgenesis and process theory, the mental evolves with the physical by an expansion of proto-psychic features”. </i>In other words, how do things or thoughts come about and not what are they.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">So in this book, the focus is continually on process/ development/ growth, and not on, can we pinpoint this function to this structure: “<i>The whole is not constructed from the parts but is antecedent to them”. </i>Now we will see where the development of this theory started.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Brown describes a couple of cases in this book. For the reader this gives a daily reality to the theory. That is the reason to start from here, and we can see that the diagnostic skills of Brown are to be reckoned with. “<i>A patient of mine with a retrograde amnesia did not recall being in an accident in which his fiancé was killed, nor did he show an affective reaction when he was repeatedly told what happened. As recall improved, he developed nightmares for some days prior to the return of sufficient recall to ask what occurred in the accident, at which point, when told, he was overcome with grief. The nightmares, however, were not directly about the accident; they reflected the anxiety that forecasted the recall. The symptom is not a bizarre occurrence unrelated to the normal, but reveals preliminary or “pre-processing” phases in the elaboration of normal function”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">So early on Brown realised that he should look at the process of conscious experience and not on the fragments or presentations. “<i>In this respect the symptoms of brain pathology are fragments of unconscious phases that are usually inaccessible to waking cognition. One of Freud’s more important insights was the recognition that psycho-pathological symptoms are not additions but uncoverings”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">He than sets about to look at the brain processes that take place, from a Process Theory viewpoint. “<i>The activation of neurons by external stimuli does not mean neurons are responsible for the perception of those stimuli. Levitan (2006) gives the example of regions in left hemisphere shown to be active in the perception of musical structure that are also active in the perception of sign language”. </i>He than states that it is not just at the neurons but also in the localisation in left and right hemispheres and Antero Posterior within a hemisphere. </span></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">“Some writers have looked at the shift from the simultaneity of spatial cognition to the successivity of the temporal in speech or action. This has also been framed in terms of a shift from the (spatial) right to the (temporal) left hemisphere (e.g. Teuber, 1958) or from posterior to anterior brain processes in language”.</span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Also on the brain stem level he sees a phylontogenetic development, where a tremor is basic and voluntary movements develop on top of it. “<i>A simpler observation is that a voluntary movement such as lifting the finger develops at the cyclical peaks of normal resting “tremor”. This indicates that unconscious rhythms or oscillators underlie voluntary action, as in the respiratory timing that frames an utterance”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">So we see here that Brown focuses on process rather than on functions:</span></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">“Most imaging studies localize functions rather than display mental or neural process. This is no doubt true for most, if not all, studies that purport to map brain areas to cognitive function. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;"><i>A single process is iterated at multiple phases rather than multiple processes acting at different loci”.</i> Here we see a clear break with current popular research where fMRI studies appear daily stating that fear is amygdala, decisions are Pre Frontal Cortex, etc.</span></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">A brain state is that configuration of neuronal activity generating a mental state. A mental state is a virtual duration that corresponds with an epoch of brain activity. Identification of the mental state with the brain state does not apply just to its vegetative core but to every phase in transition. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">So we see a shift from Brain State towards Mental State.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Interesting here is that Phylontogenetic older information comes from organs and Autonomic Nervous System (Vegetative system) <i>“The transition from limbic to neocortical formation is the forward direction of microgenesis”</i>. This information arrives at the brain. Then it continues towards Limbic System and ends at the Cortex, traversing the same path as the Phylontogeny.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Corner (1) also describes the phylontogenetic development of sleep. The REM is the basic activity level of nerves, which develop every moment. On top you have successive states (Sleep stages 1-4 through Dreams to a Waking state).</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">From this view we can understand his remark: <i>“The preponderant opinion is that the precursors of consciousness do not extend “all the way down” but that consciousness arises at some level of neuronal complexity”. </i>So at some point in this traversing the Phylontogeny consciousness arises.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Let us have a closer look at this Phylontogenetic development. It was a realisation from Brown that brain mental processes show the same pattern as Morphogenetic development. This viewpoint that Phylontogeny takes place on different levels and not, like Darwin stated, on the level of the human being, is supported by several authors: Kupiec (2), Corner (1). But also in the analysis of the development of cities, sand dunes, etc. <i>“Microgenesis exhibits and extends to cognition the pattern of growth in morphogenesis”.</i> </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Brown sees this pattern also on the smallest level: the cell: “<i>Mitosis is the model of individuation as complexity grows from within. Some have argued that the tension between the active and the passive in cognition traces back to the biology of approach and avoidance in unicellular organisms (Schneirla, 1965), which evolves to grasping and withdrawal, extro- and introversion, and even aggressive and dependent personality types”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">What does this Morphogenetic process entail? It is a balance between live and death: Growth and Apoptosis. Also on a genetic level this takes place (Kupiec(2)). Again we see the underlying process. “<i>In a mature cognition, the endogenous constraints of the just-prior act are comparable to genetic influences on growth, while the exogenous constraints of the external world (sense-data) are comparable to the effects of the micro-environment on gene expression. Polygenes and timing mechanisms limit the degrees of freedom in the growth process, increasing the likelihood of a given outcome”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">The development can be seen as the growth of the tree, where in the trunk you see all the growth circles. One is on top of the other. <i>“The similarity of the process of growth to that of cognition becomes clear when we consider morphogenesis not as an open end linear succession but as a recurrent pattern, in which new form is laid down over antecedent structure. This shift in perspective helps us to see how the same process that is responsible for the growth of the brain continues as the process that is responsible for behaviour”.</i> </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Interesting is that a Process Theory like Microgenesis Theory introduces time as a new component, from 3D towards 4D (Heterochrony is the rate or timing of this process). </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">As Beloussov (3) describes: “<i>to understand a landscape we must not just understand the structures that are there, but also its history in order to analyse it”</i>. So Brown states: “<i>Behaviour is four-dimensional morphology or structure over time. Memory is the obvious link from structure to function. Early in development, the persistence (recurrence) of brain structure is a kind of organic or “physical” memory. The “permanence” of a learned or remembered item is the structural aspect of thought”.</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">In Morphogenesis it is not just time that is important, but also the axles. Grid patterns are laid down first, before further development. This can be compared to the development of roads before a city develops. <i>“The development that goes from archaic to recent in evolutionary structure corresponds with the transition from axial to distal innervation, from bodily space to the external world, from symmetry to asymmetry, from low frequency kinetic rhythms that mediate inter alia walking and respiration, to higher frequency oscillators or harmonics that mediate selective kinetic patterns such as those involved in prosody or asymmetric limb movement”.</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Asymmetry is a new field of study, which Quantum Physicists started and which now comes to the Biological Sciences. More and more literature appears on Left Right asymmetry in the body.<i>“The dissolution of the self and the inter-penetration with the other accompany a retreat from asymmetric and deliberate limb movements to automatic and symmetrical axial motility. Focal voluntary actions are replaced by rhythmic impulses”.</i> The body strives for symmetry while it is not symmetrical. A symmetrical face is seen as more beautiful.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Fractal development, like the Mandelbroth set, is well known in the Biological science. Brown: <i>“Growth does not lay down a fixed anatomy, but rather morphology is the behaviour of a developing brain. Microgenesis entails a single fractal-like process. The remedy is a concept of brain and psyche in terms of fields or fractals instead of cities and highways”.</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">There are two morphogenetic processes which shape growth:</span></span></div>
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<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">neoteny lay down “force lines” that become the process of cognition. It is a selective retardation or prolongation of a juvenile stage that can be a springboard of evolutionary growth.</span></span></li>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">As we have seen that Brown’s development as a Neurologist was getting to know first the structures in order to analyse the development. This same approach he took to analysing Psychology (Psychoanalysis) and also his own dreams. So here we see an analysis of the inside world. His personal experience with dreams is also a factor in the development of Microgenesis Theory.</span></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">I awoke and could only remember the first two lines of what seemed to be a wonderful poem. The lines were: </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">Pay not a fare to the rhyme or the meter. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">However brief, this was not at all a poem I could have written awake. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">The interpretation of the dream tells us more about the dreamer than the content that is interpreted. We study the reality given in mind, not a reality mind can perfectly measure.</span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">The difference between Brown and colleague’s is that he approached it from a Process and Morphogenetic point of view. <i>“Consciousness is always preceded by, and enfolds, an unconscious transition, so that an attenuated mental state could exist without realizing consciousness. For most psychologists it is the other way around, i.e. experience first passes through consciousness in order to be revived in the unconscious”. </i>Let us look more closely at this Inside World:</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Here he comes up with a good example: <i>“Consider brain and perception like a celluloid film and moving picture. The celluloid is felt to be more real than the movie because it does not represent something other than what it is, whereas events in the film have no actual correlates. We might think a documentary is more real than an ordinary film, but we are still looking at images, not “real” objects. Since all films (and objects) are images, it is not the imaginary or perceptual quality that counts for the unreality. There is a presumption that some mental objects – ideas more than dreams, words more than ideas, objects more than words – are more real than others. Independent of whether or not the self is illusory. We refer to the mental objects as a footprint. We are in error, we should say, it has the shape of a footprint”.</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">“To exist and to be real are different states of affairs. When psychic experience does not conform to the physical world, survival is in danger”. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">In this dialogue between Inside and Outside world, Brown states that a Self develops: <i>“The sense of causal power in the infant who reaches for a rubber ball is perhaps no more than the behaviour of a cat that reaches for a rolling ball of wool. Further individuation of self and object leads to greater autonomy and a feeling of a self opposed to inner and outer contents.”</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">When we look at the psychological “development” that Brown mentions, there are of course different points of view. As Brown describes a development from Core to Outside world, and states that it is unidirectional, Indian Philosophy (i.e. Swami Rama(4)) describes a movement where it is a circle coming back: from core to consciousness and back to the core. Through Self-Reflection, dream analysis we get to know our Core. In India the path also entails that one can stay in this state, and not in an outside state/ phase.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">So to follow this path back inwards we start with perception, through consciousness, Ego, Dream state towards Self and finally Non Self. Again this is another point of view than Brown while he states that the movement is unidirectional (from Core towards Consciousness) and ends in the Non-Self (Outside World). </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">So the dream state, like in Psychoanalysis is a chance to see the unconscious processes. It is a natural state. But:<i>“A delusion is intermediate between the pathological symptom with its delimited interpretation and the dream as a natural phenomenon relating to one’s life. The thin line that separates the passive intention of dream from the active volition of agency is a point in the passage of internal to external mind”. </i>This means that it is the shaping of the outside world that determines if we experience a dream state or a delusion. In the dream there is no outside perception and we experience the dream in an awake state. In a delusion there is outside perception but we experience it in a dream state.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Brown continues: <i>“Given the relation between inner speech, hallucination and perception, the relative depth of realization in perception and action, or the dominant segment of the actualization, determines whether a verbal image is apprehended as voluntary, passive (hallucination), or mind-independent (perception)”.</i> </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">The next stage which we encounter on our path inside, is the ego.</span></span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b><span style="font-size: x-small;">Ego: I and me</span></b></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">“The distinction is embodied in the unconscious and timeless self of the “me”, and the conditional or temporal self of the “I”, one constant and authentic, another transient and adaptive. In the child the “me” precedes the ‘I’. The agent – the “I“ – is inferred from the activity of thinking. The state is not divisible into a self, an object and a direction. Without the object, there is no self. The “I” is always “I am (think, want, etc.)”. The ‘’I’’ does not exist without a verb or relation.” </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Here it is a matter of how we define the “I” and the “me”. Like the Ipad, or Iphone, one can also take the I as the Core and the “me” as the outward development. Interesting here is that in the Indian tradition of Vedanta the whole meditation is on “Who am I” (Nisargadata Maharash(5)). Also Eckhart Tolle (6) describes, while in deep depression, the realisation that I want to kill myself, made him realise the “I” is different from the “myself”. Is it Ego and Self? Again there are many viewpoints possible on this.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Fact remains that more and more research shows that most of our behaviour is an Inside Out development. Core drives and experiences determine our perception. For instance, when holding a heavy object we experience a conversation as heavier, than when holding a light object. </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">So: <i>“A person can either mistakenly believe his act is intentional, or unknowingly act intentionally”.</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Next phase on our way to the Core is the Self:</span></span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b><span style="font-size: x-small;">The Self</span></b></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">“The relation of the self to inner objects is introspection or reflection. The relation of the self to outer objects is exteroception or perception. In perceiving an object, the self, indeed the entire perception, is generated with the object”. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Again we encounter here the matter of defining Self. <i>“There are two categories of the self, a deep core or unconscious self aligned with values, implicit beliefs and character, and a liminal, conscious or empirical self that adapts to momentary needs and future expectations.</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">Core self and its drive-representations, which are then derived to an empirical self and its conceptual feelings, then to images, and to objects and external space”. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Also there is the fact of Inner Speech<i>. “In passing to a perceptual development, inner speech dissociates from the self of agency, and actualizes in voices distinct from the patient”. </i></span></span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b><span style="font-size: x-small;">Psychology: Drives</span></b></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">When we go deeper down into ourselves we arrive at, what Brown calls the Core Self. This is where the basic drives are. In the work of Stephen Porges (7) we come across the same Phylontogeny, but then for the Autonomic Nervous System. We start with Visceral sensations, which correspond with the Enteric Nervous System (Reptilian, Freeze), than up through the Sympathetic Nervous System (Mammalian, Fight/ Flight) up to the Parasympathetic Nervous System (Communication). Here we see again a “rising up” of information from deeper levels towards the surface. Again from a Process Theory point of view, the same Phylontogeny. This information reaches the Brain Stem, where for Brown his Microgenesis starts. So we could assume that it is the interoceptive experience from the body, and its memories, where the Core feelings arrive from. </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Brown<i>:” The initial phases of the mental state arise out of an instinctual core – the inherited repertoire of drive categories - then pass through a phase of affective and experiential memories that shape conceptual feeling in the direction of perception. Instead of perception laying down memory, memory lays down perception. The transition from self to world is from contents that are memory-like to those that are perception-like, from the personal past to the impersonal present. A memory is an incomplete perception, and a perception is a memory specified to an object”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Also: “<i>We come to understand that feeling is not applied to objects but develops into them. Generally Feeling is more intense at early phases of drive and desire, less so at distal ones of object and word-production. Moreover, feeling is felt as a pressure behind or directed to the object, not in it”.</i></span></span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b><span style="font-size: x-small;">Psychology: Non-Self</span></b></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">At the point where we go even further down into our Mind, we come to a point where Indian Philosophy places the Non-Self. Brown names the Non-Self the experience outside oneself <i>“The end-point of the outward-going development is non-self (other, object)”.</i> When we get to this core, according to Indian Philosophy, this is where our convictions, and even deeper our universal feeling of connectedness, bliss, the feeling of divinity is located. Brown states<i>:”This is where Conviction (non-self) replaces the need for choice and decision. It is closer to drive, desire and the core self, often bound up with the self-concept. The continuance of the core due to the overlap of initial phases explains the “persistence”, i.e. recurrence, of implicit beliefs and values, or character, while the rapid vanishing at the perceptual surface “clears the slate” for the next perception”.</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">The Trilogy that is common in Osteopathic Philosophy is that of Body – Mind – Spirit. So Spirit is the deepest level in ourselves, according to Indian and Osteopathic Philosophy. Brown: <i>“Soul and other forms of spirit are not of mind or matter. They inhabit a nether world between the cognitive and the physical. The common belief in spirits indicates that it is not necessary to have a body (or any substrate) to infer a mind”.</i> </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">But we can see that there is not much difference in Brown’s point of view and these philosophies. <i>“To be selfless is not to be without a self, but to revive the other in the self before it individuates. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">When such relatedness occurs with full absorption and abolition of self and a disappearance of the self, is a kind of death from which a return to life and consciousness is possible. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">To be worthy is to be selfless. Self-denial is a mode of active passivity that is the primary condition of submission. In Buddhism, as in most religions, self-denial is central. It is the timelessness of the category that inspires the belief that individuals persist after death as souls, or as ideas in god’s mind”. </span></i></span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b><span style="font-size: x-small;">Quantum Physics</span></b></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">When we arrive at this core level within ourselves, the question arises if this is also on a deeper physical level. Fantappie (8)states that if we go beyond 200 Angstrom, we arrive at the Quantum level in ourselves. At this level Newtonian laws do not apply and Quantum Laws come into play. Also at this level Time is not the lineair unidirectional movement we are so familiar with.</span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Brown<i>:“In organic systems the becoming of the organism is unidirectional. In basic or elementary physical entities the becoming may be reversible or isotropic. The becoming or directionality of the mental state is fundamental to its existence, its being”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Also on Quantum Physics and Time: <i>“In my view, subjective time is neither particle, nor wave but in some sense both; wave-like in an actualization over the temporal extensibility of elementary physical entities or brain states, and particle-like in the modularity of the state once it actualizes”.</i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Time plays an important role in Microgenesis Theory, and Brown, like Bergson, studies Time from a phenomenological viewpoint. First of all there is the important fact that a becoming of consciousness takes place at a fast rate, so that we experience everything as a continuum. Brown uses the following example: <i>“In a movie continuity requires a frequency of around 40 milliseconds per frame, which is close to the estimated duration of a mental state, thus the rate postulated for the replacement. This rate is likely governed by a pacemaker and is relatively constant. Think of the mental state as having a duration of about 50 to 100 milliseconds. The present does not have a fixed duration. James wrote of fuzzy boundaries. In meditation, the present may expand in states of confusion, it may contract”.</i> </span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Pacemakers have been identified in the brain, both in Brain Stem and in Hypothalamus, comparable to the AV and SA knot in the heart. It could be hypothesized that this pacemaker generates an electrical signal that travels through the body and returns to the Brain stem where the becoming of consciousness further advances. We have to keep in mind that information is not just transferred through electrical signals, bit also through electromagnetic fields, light, sound, etc. A new mental state thus comes about every 40-100 milliseconds.</span></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">“The acceleration and deceleration of events in pathological cases, as in the speed of a film projector, might reflect the frequency of replacement. Subjective time does not exist until the process is completed. The existence of a thing depends on the duration over which it actualizes. A tree that exists for a millisecond is not perceived at all. Sustained recurrence creates objects, novelty in the recurrence creates events. All objects are events in which change (recurrence) is more or less imperceptible”. </span></i></span></div>
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<span style="letter-spacing: 0.0px;"><i><span style="font-size: x-small;">“The future is not what the present moves into, it is another present that the past deposits”.</span></i></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Also the origin of Time comes from symmetry. Feynman (9) also elaborates on symmetry being the origin and dissymmetry the end point. <i>“If the Inception of the mental is simultaneous, and temporal order occurs at the conscious endpoint, simultaneity and seriality refer to earlier and later in a single epoch. Less coherent music, the less a sequence can be anticipated, the less revival is facilitated”.</i></span></span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b><span style="font-size: x-small;">Teleo Dynamics</span></b></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Terence Deacon (10) describes three levels, starting with Physics to Morphodynamics and ending with Teleodynamics. This means that there is a direction giver. It is hypothesized by several authors (Lazlo(11), Haisch(12), Sheldrake(13), Fantappie(8)) that on a Quantum level time is reversible and thus can inform the past. Brown states: <i>“In a process approach, objects are states of flux that only appear to be solids</i>. <i>The flux is not random or chaotic but has a direction. In the mind, possibility is the ground of freedom and fact is</i> <i>the final stage of belief. In mind, the progression is from potential to actual, in the world, from cause to effect. A transition from the voluntary to the involuntary in the passage outward to objects”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">To conclude: <i>“That a model of the real should grow out of fantasy, that objects are recognized before they are consciously perceived, that the world is an extension of the mind, that succession in time is generated out of simultaneity”. </i></span></span></div>
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<span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">In this book we see that Brown has done an excellent job on bringing the Outside World and the Inside World together. The dichotomy of Descartes is slowly fading away, and we are becoming more and more a unity, and can experience ourselves as a whole. Also the difference between our perception of the other and ourselves can significantly change. In this sense we can see the world more and more as ourselves.</span></span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b><span style="font-size: x-small;">References</span></b></span></div>
<ol>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Michael Corner, Sleep Evolution, 2011, </span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Jean Jacques Kupiec, The origin of Individuals, World Scientific, New Jersey, 2009</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Lev Beloussov, The dynamic architecture of a developing organism, Kluwer, Dordrecht, 1998</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Swami Rama, Science of breath, Himalayan Institute, Pennsylvania, 1979</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Nisargadata Maharesh, Who am I, The Acorn Press, 1973</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Eckhart Tolle, De nieuwe aarde, Ankh Hermes, 2005</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Stephen Porges, The Polyvagal perspective, Biological Psychology, 2006 </span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Ulisse Di Corpo, Syntropy (Luigi Fantappie), 1996</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Lawrence Krauss, Quantum man, Richard Feynmann’s life in science, Kindle, 2011</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Terence Deacon, The Remergence of Emergence, Chapter 9,</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Ervin Lazlo, Science and the akashic field, Inner Traditions, Vermont, 2004</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Bernard Haisch, The God Theory, Weiser Books, San Fransisco, 2006</span></span></li>
<li style="font-family: Cambria; margin: 0px;"><span style="letter-spacing: 0.0px;"><span style="font-size: x-small;">Rupert Sheldrake, The presence of the past, Park Street Press, Vermont, 1988</span></span></li>
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</ol>
</div>Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com1tag:blogger.com,1999:blog-2550525085215204666.post-75850619565236362882012-08-09T13:13:00.000-07:002012-08-09T13:13:14.121-07:002004 Thesis Osteopathy Vagus<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Abstract</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">The question of this experiment is whether a Cranial Base Release has any influence on</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">distress, heart frequency or bloodpressure. Therefore my base Hypothesis is that a Cranial</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Base Release has no influence on the heart frequency, the bloodpressure or the amount of</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">distress that a person perceives. My end hypothesis is that the Cranial Base Release has an</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">influence on the heart frequency, the bloodpressure and amount of distress that a person</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">perceives.</span></div>
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In chapter 1. I will start by explaining what stress is and the effect it has on the body. In stress</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">there is a change in homeostasis. The system which controls the homeostasis is the</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Autonomic Nervous System. I will then explain how the autonomic nervous system is built</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">up. Finally it will become clear that the relationship between distress and the OAA is through</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">the Vagus nerve. I will clarify the structure of the N.Vagus and its functions. This will be build</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">up from its origin in the brainstem through to the neck, thorax and abdomen. The tonus of the</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">vagus is a tool which is used to describe the amount of stress somebody is under, I will</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">describe why a checklist and blood pressure monitor have been used to measure the amount</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">of distress/ the vagus tonus.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><br />
In chapter 2 the technique which was used will be explained and why this technique is used</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">on the OAA complex to influence the amount of distress.Furthermore the explanation of the</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">methodology which is used: 40 people were divided into two groups through both there</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">dysfunction and their distress score. The group with the distress score higher than 10 and the</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">neck dysfunctions were put in the experimental group. The people with a distress score lower</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">than 10 and no neck dysfunctions were put in the control group. Both groups were during the</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">first treatment given the opportunity to climatize and after 5 minutes on the treating table their</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">blood pressure and heart frequency were measured. After that they were treated during 15</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">minutes with a Cranial Base Release Technique. After this treatment their blood pressure and</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">heart frecquency were again measured.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">The second treatment was after 2 weeks and followed the same procedure except that people</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">filled in their form after the treatment instead of before as in the first treatment.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><br />
Chapter 3 will be a overview of the data and the statistical procedure that was used to evaluate</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">the experiment.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">In chapter 4 it will become clear that there is an significant effect on the amount of distress</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">that a person perceives, through the treatment of the OAA complex after 2 weeks. There is no</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">significant effect on the blood pressure or the heart frequency.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><br />
My conclusion is that during the treatment there is a lowering in heart frequency, and this</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">indicates that there is a lowering of the vagal tone. But this effect is lost after the treatment.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Therefore this technique is good to get a patient in a lower orthosympatic tone, so that other</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">techniques might attain more effect. On the long term there is an effect on the distress through</span><br />
<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">this technique.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Download here</span></div>
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<br /></div>Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com1tag:blogger.com,1999:blog-2550525085215204666.post-68529787366845352462012-08-09T12:00:00.001-07:002012-08-09T12:00:37.294-07:00Sensomotor development, the first six years.<br />1. Growth Movements precedes Motor Development. <br /> <br />There are two new important insights in Sensomotor development. <br /><br />The first is that development also has an Outside In direction and not just Inside-Out i.e. from Central Nervous System (CNS) towards the outside world. For us Osteopaths this implies that the Foetal surroundings are very important for later development. So for the pregnant mom, her well being, motor and sensory behaviour is of the utmost importance for the development of the child. <br />Within Morphodynamics the principles of Neoteny and Parcellation sculpt the development of tissue. These principles also govern the Sensor motor development: the environment sculpts the patterns, first of growth and later of movement. <br /><br />The second insight is when development is always in relation to its environment, the timing of development in relation to its surroundings is important. This is why motor development coincides with hormonal development or sensory development, but also with the development of other organs. So the timeline of development of the sensory motor system but also of its surroundings is important. Here lies for us Osteopaths a new line of research. Van den Heede has already pointed out the importance of the timeline in development between Liver - Heart - Brain.<br /><br />1.a. Growth and parcellation.<br />To understand the first insight on Outside In development, we have to begin with how do motor patterns develop. It is now possible to prove that all patterns of behaviour have embryonic developmental processes as their precursors. What we call instincts are the direct consequences of prenatal developmental events, which are really the prenatal performances of the embryo (Blechschmidt). This growth movement is the intrinsic force of life (see 1). <br />On the other hand we have the parcellating effect of the environment, In this case the Uterus and the Mother (see 2).<br /><br />1.a.1. Growth as an intrinsic force and precursor to motor behaviour.<br /><br />In fetal development, the cephalocaudal growth pattern determines the overall proportions of the head, torso, and limbs, while the limbs’ internal proportions are characterized primarily by the opposite, distoproximal pattern. Thus we see that two opposing growth tendencies are active in the developing human body. Growth ceases earlier in the legs than in the arms and later still in the torso, as many researchers confirm. (Verhulst)<br />This cephalocaudal growth can also be seen in the development of the Reflexes.<br /><br />1.a.2. Embryonic growth directions.<br />Embryonic tissue development follows the information transmitted by the oscillation (Korpiun):<br />The first phase of an inward, centripetal motion, or inward oscillation, occurs when egg and sperm cells come together in the first week of the ovum’s development. The ovum does not grow in size as a morula and blastocyst, instead dividing itself inward in a downswing phase. <br />The first phase of an outward, centrifugal motion, or outward oscillation, occurs during implantation into the uterine wall and formation of the embryonic disk’s trilaminar form, with the ectoderm, mesoderm, and endoderm; this is an upswing phase. <br />The second phase of an inward, centripetal motion, or inward oscillation, occurs at the beginning of the third week. This is the phase in which the heart and the head find their place through inward curling, The lower end folds inward to form the umbilical cord, a downswing phase. <br />The second phase of an outward motion begins centrifugally in the seventh week, with the body moving from the embryonic phase to the fetal period. The extremities begin to sprout from the body, and all main organs of the body are present in the embryo. This continues in gradual motions until birth, an upswing phase. This process is the reversal of process 1 and concludes development from conception to entry into the physical world on earth. <br /><br />Besides the Outward and Inward directions of growth, there is also a left right development (as well as front to back).<br /><br />Also what appears to be a symmetrical growth of the cerebral hemispheres is really an oscillating process between the right and left sides of the head. This alternating and reciprocal growth process ushers in the subsequent reciprocal transmission of nerve impulses from one hemisphere to the other.<br />As an example, we recall the analysis of the child’s suckling reflex let us remind ourselves that if the lips of the young embryo had never rolled in as part of an early growth movement, then the newborn child would never be able to suckle instinctively. <br />Indeed, preceding growth movements are found for all so-called instinctive reflexes. (Blechschmidt)<br /><br />1.b. Evironmental factors in Motor development.<br />The most important elements of the intrauterine environment consist of the wall of the uterus, the extra-embryonic membranes (amnion and chorion) that envelop the fetus, and amniotic fluid. The myometrium of the uterus is composed of smooth muscle that provides an elastic restraint around the fetus that can suppress some aspects of motor activity while facilitating other forms of coordinated movement.<br />The environment contributes to the regulation of behavior in two principal ways: <br />it is a source of sensory stimuli, some of which can elicit specific behavioral responses<br />it provides a physical context in which behavior occurs."<br />The view emerging from this and related studies of other patterns of fetal behavior is that organized patterns of behavior are assembled from simple precursors, and that the rules governing this assembly may be quite different than the basic developmental processes that give rise to the elements themselves." (Smotherman, 1996)<br /><br />Concluding (Verhulst):<br />The growth of the body is an extremely complicated phenomenon: <br />The growth patterns of different parts of the body are interdependent. <br />External circumstances play a role; human beings, for instance, grow faster in summer than in winter. Widen our view to not just the motor behaviour of the foetus/ child, but also what does the environment (mother, etc.) do at different points in time.<br /><br />Next we will look at the development of movement patterns that follow the growth movements.<br /><br /><br />2. General movements, the interlude between growth movements and reflexes.<br /><br />Prechtl, 1982<br />(1) Just discernible movements <br />Startle <br />General movements <br />This category is applicable if the whole body is moved but no distinctive patterning or sequencing of the body parts can be recognized. When they first appear at 8 and 9 weeks, they are slow and of limited amplitude. At 10-12 weeks general movements become forceful. Movements of the limbs, trunk and head are rapid but smooth in appearance. The movements are of large amplitude and therefore frequently cause a shift in fetal position during this age period. After 12 weeks general movements become more variable in speed and amplitude. They may last from about 1 to 4 min hut wax and wane during this period. However variable these movements are, they are always graceful in character. <br /><br />After the General Movements, the next steps are more isolated movements of different body parts, which also take place in a Cephalocaudal direction.<br /><br />(4) Hiccup <br />(5) Breathing <br />(6/7) Isolated arm or leg movement <br />(8) Isolated retroflexion of the head <br />(9) Isolated rotation of the head <br />(10) Isolated anteflexion of the head <br />(11) Jaw movements <br />(12) Sucking and swallowing <br />(13) Hand-face-contact <br />(14) Stretch <br />(15) Yawn <br />(16) Rotation of the fetus <br /><br />Fetal motility in its various components develops early a temporal patterning. The distribution and duration of general movements, for example, changes with age. At 8 weeks, these movements are scattered irregularly over the record, whereas they occur grouped in bursts of several minutes during the following weeks. The occurrence of such bursts becomes obscured after 14 weeks and is replaced by much longer epochs of fluctuating activity. <br />After Growth and later General movements come the reflexes which develop from Intruterine, towards Primitive than Transitional and concluding with Postural reflexes.<br /><br />3. Reflex development<br /><br />3.a. Davies.<br />Inhibition of over activity is one of the most important functions of the Central Nervous System. Therefore there are a large number of inhibiting tracts in comparison to excitating, both in Brain Stem and Spinal Cord. <br />The ability to selectively activate normal musculature is a function of motor control on a cortical level, on instigation of proprioceptieve feedback. <br />Children are born with a great deal of anarchy and overactivity in their motor control. As they get older, this disappears. <br />Reflex patterns are the foundation of movement. By repeating these reflex patterns during childhood, the child learns how to move. Movement only becomes purposeful when the child is able to excite the right movement patterns and at the same time the unwanted components in these reflex patterns are being inhibited. <br />At birth the body is unhibitaly controled by the lower centra of the CNS, which mostly generate unvoluntary reflex movements and postures. <br /><br />3.b. Feldenkrais <br />The unconditioned reflexes are innate and characteristic of a whole class of animals; they are transmitted by heredity and are independent of the experience of the individual animal. The conditioned reflexes are not inherited and depend on the surrounding conditions of each individual. The unborn unconditioned reflex does not require the presence of the cortex. It is present in the decerebrated animal.<br /><br />We see, therefore, that a sensory experience of teleceptor origin is, in fact, always a sensory-motor-vegetative disturbance. The righting function is purely reflective. Thus, in the higher animals there is a voluntary element involved in attitude and posture. The higher corticaI centres have overriding control over other centres. Sherrington has pointed out the importance of the fact that most of the righting functions are located in the brain stem, and are therefore outside voluntary control. The optic righting reflexes in the higher animals give the animal greater freedom in movement, corresponding to the greater variety of activity. With the optical centres taking over, the cortex is given control over the lower centres, and the reference posture encountered before becomes less definite.<br /><br />Reflex development is a Phylontogenetic process in which reflexes are build on each other, starting with brain stem and developing towards cerebellum. If one reflex remains strong, the foundation is laid for weaker development of consequent reflexes. (Goddard Blythe)<br /><br />4. The timeline of development<br />Growth in humans occurs chiefly during the first three seven-year periods of life (Verhulst): <br />The first seven-year period is characterized by rapid growth of the nervous system. Around age seven, the nervous system is 90 percent complete, and the brain (according to some scientists) has already achieved its final size<br />The second seven-year period is characterized by the greatest development of the lymphatic system. Its organs achieve extraordinary size around age ten, when they are much larger than they are in adults.<br />The third seven-year period is characterized by the explosive development of the reproductive organs. It remains a mystery why the growth of the larynx also accelerates during puberty, especially in boys, whose vocal cords can double in length within a year, causing their voices to “break.” The growth of the bridge of the nose is also pronounced during this period. <br /><br />4.1. Development of the senses as pre condition for motor development<br /><br />Before motor development, the senses have to develop first. When our eyes develop, the ability to grasp can develop, the same goes for hearing and turning of the head towards the sound, etc. <br /><br />4.2. The timing of development as it coincides with organ and senses development<br /><br />Mr. Gautier was an endocrinologist who had a slow Thyroid and a slow motor development. He was always convinced that these two were related. He spent his professional life trying to prove the relationship between the two and founded the system Equillos.<br />He shows that each developmental stage is preceded by a hormonal change.<br /><br />5. Conclusion.<br /> The implications for us Osteopaths is to better understand developmental problems. To not just look at the development of the nervous system as a separate system, but to see it in the context of intra-uterine life and developmental milestones in other organ systems. In this way the treatment strategy will also be different because it will include the assessment and treatment of other systems.<br /><br />References:<br /><br />van den Heede P., The Brain, 2009, course given at Panta Rhei, Zeeland NL<br /><br />Blechschmidt E., The Ontogenetic basis of Human anatomy, 2004, North Atlantic Books, Berkely, California<br /><br />Verhulst J., Developmental Dynamics, 2003, Adonis Science Books, Ghent, NY<br /><br />Korpiun O., Cranio Sacral SELF waves. 2011, North Atlantic Books, Berkely, California<br /><br />Smotherman W., The development of behaviour before birth, Developmental Psychology, 1996, Vol 32, No 3, 425-434<br /><br />Prechtl H, The emergence of fetal behaviour, Early Human Development 7, 1982, 301-322 <br /><br />Davies P., Hemiplegie, 1989, Bohn Scheltema Holkema, Antwerpen <br /><br />Feldenkrais M., Body and Mature Behaviour, 1949, Frog Books, Berkely, California USA<br /><br />Goddard-Blythe S., What babies and children really need, 2008, Hawthorne press, Gloucestershire UK<br /><br />Gautier J., www.endocrino-psychologie.org<br /><br /><br />Sander Kales, D.O.<br /><p class='blogpress_location'>Location:<a href='http://maps.google.com/maps?q=Amsterdam&z=10'>Amsterdam</a></p>Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0tag:blogger.com,1999:blog-2550525085215204666.post-9811643706148952662012-08-09T11:34:00.001-07:002012-08-09T11:39:18.441-07:00OSD Kongres The Brain 17-11-12The current situation in Osteopathic Medicine is that we study and treat tissue which we can touch and see (3D). The Cellular level, Electro Magnetic Fields (EMF), Electrical Fields and Time (4D) are not a part of Osteopathic Medicine.<br />In our daily work the client comes to us with a problem of his body and he/ she also brings his psyche with him. We are trained to diagnose the structural and functional problems of the body. The psychological side we tend to see as not our terrain. Following Damasio’s work we see that the emotional side of the psyche originates from the body. So to follow Still’s first principle: the bodily human is a functional unity, we have to aim to unite the emotional and psychological issues, with the body and to see its origin in the body. This is were the Electro Magnetic Fields come into play. These fields are an important way in which the body transfers its information to the brain for further processing.<br /><br />The second principle of Osteopathic Medicine, as stated by A.T.Still, is Structure and Function are reciprocally influential. Sutherland and Still also stated that Function precedes Structure. Through the structure we can come to understand the function. Our palpation is the starting point. Function is Fluid movements, Elecricity, Electromagnetic Fields, etc. To learn these Functions we need to speak the languages of Physics, Biophysics, Quantum Mechanics, Biochemistry, etc. General Medicine has developed into a molecular science, while Osteopathic Medicine is still a science about the tissues. When we expand our knowledge to the domain of the molecules and cells, our palpation will become more refined and our diagnostics will improve. <br />We are used to looking for the Symptomatology (What do I have) and Causality (How did I get it) of a client. Our recognition of the Originality of the client (Why do I have this), depends on this knowledge about the function of cells, fields and time. This can be compared to the First principle of Still: the bodily human is a dynamical functional unity of body (symptom), mind (cause) and spirit (origin). <br /><br />How do we approach this principle in 2012?? We can analyse this on different levels of physics: Tissue (Body), Electricity (Mind) and EMF, Light(Spirit). In Eastern Medicine the physical, emotional, mental and spiritual body are well known. Still spoke about Osteopathic Medicine as being about anatomy, anatomy, anatomy and physiology, physiology and physiology. This can be expanded towards the anatomy and physiology of the electrical, electromagnetic and light “bodies” or fields. When we apply this “field theory” to Osteopathic Medicine, this means that our examination and observations change. <br />When we incorporate the aspect of Time (the 4th dimension) in our diagnostics, through studying Morphodynamics and Embryology, we get an idea of the function and the underlying principles of life and health. By studying these domains, we can see the consistency in the change, we can derive the function out of the structure. In this way the Phylontogeny of the ANS, Sleep or Consciousness helps us understand the underlying principles of Life so we can get to the third principle of Still: “find the Health”. Is the self-healing principle on a informational/ epigenetic/ light level??<br /><br />Now that we have a four dimensional picture on different planes of what we have under our hands we come to the next level:<br />What is Consciousness, Being Aware, Mindfull?? This is important in our work as Therapists. Also from Quantum Mechanics comes the “observer principle”. What we palpate and the Mental Images that come to us, are influenced by our own back ground: “Know thyself, before judging another”!! Is the origin of this sensation mine or the other?? This “Mindsight” process takes us into the depths of ourselves and the others. We have to live Osteopathy. It is not a 9 to 5 job, but a way of seeing the world around us and ourselves.<br /><br />Sander Kales, D.O.<br /><br /><p class='blogpress_location'>Location:<a href='http://maps.google.com/maps?q=Hamburg,%20Deutschland&z=10'>Hamburg, Deutschland</a></p>Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0tag:blogger.com,1999:blog-2550525085215204666.post-6043139349220700952012-08-09T11:31:00.001-07:002012-08-09T11:41:13.829-07:00OSD Kongres The Brain 16-11-12Osteopathic Medicine, the brain and consciousness<br /><br />In our daily work the client comes to us with a problem of his body and he/ she also brings his psyche with him. We are trained to diagnose the structural and functional problems of the body. The psychological side we tend to see as not our terrain. The current situation in Osteopathic Medicine is that we study and treat tissue which we can touch and see (3D). The Cellular level, Electro Magnetic Fields (EMF), Electrical Fields and Time (4D) are not a part of Osteopathic Medicine. If we want to treat the brain, we need to include these phenomena.<br /><br />When we follow Still’s first principle: the bodily human is a functional unity, we have to aim to unite the emotional and psychological issues, with the body and to see its origin in the body. This is were the Electro Magnetic Fields come into play. These fields are an important way in which the body transfers its information to the brain for further processing.<br />Following Damasio’s and Brown’s work we see that the emotional side of the psyche, the proto-self originates from the body. The impulses from the viscera of our organs are transmitted towards the brainstem. The haemodynamics, aerodynamics and electrical/ electromagnetic dynamics are means to transmit information from the body towards the brainstem. From here the information is transmitted towards Limbic system en later the cortex. In the cortex the information is translated into images. This way the body is incorperated into the brain. Our subconscious is 90 % of the information we have, this resides mostly in the body. We are only conscious of a small part of the information that come to us. Our conscious processes a small amount of bits of info, while our subconscious processes millions of bits. According to Brown this microgenetic movement takes places every 20 msec. Also this movement recapitulates the Phylontogeny.<br /><br />Now that we have a four dimensional picture on different planes of what we have under our hands we come to the next level:<br />What is Consciousness, Being Aware, Mindfull?? This is important in our work as Therapists. <br />Also from Quantum Mechanics comes the “observer principle”. What we palpate and the Mental Images that come to us, are influenced by our own back ground: “Know thyself, before judging another”!! Is the origin of this sensation mine or the other?? This “Mindsight” process takes us into the depths of ourselves and the others. <br /><br />This makes it possible to follow Anthony Chilla’s motto: Once the hands are on the body, the body is in command. We need to trust our subconscious, our hands and the mental images that come to us.<br />We have to live Osteopathy. It is not a 9 to 5 job, but a way of seeing the world around us and ourselves.<br /><br />Sander Kales, D.O.<br /><br /><p class='blogpress_location'>Location:<a href='http://maps.google.com/maps?q=Hamburg,%20Deutschland&z=10'>Hamburg, Deutschland</a></p>Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0tag:blogger.com,1999:blog-2550525085215204666.post-81733110953463030682012-08-08T05:49:00.001-07:002012-08-08T05:58:51.033-07:00PsychoneurobiologyCurrently in Medicine there is still a distinction between Body and Mind. In Osteopathic Medicine it was always the intention to unite the two. In order to do this Osteopatic Physicians have to study Psychology, Neurology and Physiology to see what the connections and correlations are between our palpation, the brainwaves, neurotransmittor excretions and mental patterns. Here we can bring Osteopathic Medicine into the realms of Behavioral Medicine.<br />To be continued<br />Sander Kales, D.O.<br /><p class='blogpress_location'>Location:<a href='http://maps.google.com/maps?q=Chemin%20du%20Puits%20d'Eima,Saint-C%C3%A9zaire-sur-Siagne,Frankrijk%4043.659498%2C6.789018&z=10'>Chemin du Puits d'Eima,Saint-Cézaire-sur-Siagne,Frankrijk</a><br /><br />Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0tag:blogger.com,1999:blog-2550525085215204666.post-68768172434620025742011-10-12T02:56:00.000-07:002011-10-12T06:32:39.497-07:00Lecture series From Embryo to ConsciousnessHere are the lectures that I am presenting in 2011 and 2012<br />
<br />
Osteopathy: The road from Embryo to Consciousness.<br />
<br />
The next subjects will be presented:<br />
1. Growth: Morphodynamic principles<br />
2. Rhythms: Asymmetry, Hemodynamics<br />
3. Nurturing: Entoderm, ENS, phylontogenesis of intestinal flora, <br />
entodermal spleen development, lymphatics system , vitamines, entodermal hormones<br />
4. Heart: Mesoderm, SNS, Hartontwikkeling, Bloeddruk, mesodermale hormonen.<br />
5. Hoofd: Ectoderm: PNS, Tinitus, neurotransmitters,<br />
6. Slapen: Electrische ontwikkeling neuronaal netwerk. Relatie buik/ hersenen<br />
7. Bewustzijn: op electrisch niveau<br />
8. Bewustzijn op Quantum niveau.<br />
<br />
Lezing 1: 29 juni 2011<br />
Lezing 2: 14 september 2011<br />
Lezing 3: 16 november 2011<br />
Lezing 4: 18 januari 2012<br />
Lezing 5: 14 maart 2012<br />
Lezing 6: 9 mei 2012<br />
Lezing 7: 27 juni 2012<br />
Lezing 8: Nog nader te bepalen<br />
<br />
Daarnaast geef ik nog de volgende lezingen:<br />
<br />
Healing Tao School: 30 november 2011 Onderwerp Hormonen<br />
Inl. P.v.d. Heede,: 1-4 juni 2012 Onderwerp Brain Morphodynamics 1<br />
Inl. P.v.d. Heede,: 27-30 sept. 2012 Onderwerp Brain Morphodynamics 2Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0tag:blogger.com,1999:blog-2550525085215204666.post-73434577539967220232011-01-13T05:41:00.000-08:002011-01-13T05:41:07.563-08:00Guiseppe Vitiello<link href="file://localhost/Users/sanderhiljekales/Library/Caches/TemporaryItems/msoclip/0clip_filelist.xml" rel="File-List"></link> <link href="file://localhost/Users/sanderhiljekales/Library/Caches/TemporaryItems/msoclip/0clip_themedata.xml" rel="themeData"></link> <style>
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<div class="MsoNormal"><b>My body doubled </b></div><div class="MsoNormal"><br />
</div><div class="MsoNormal">Vitiello states that memory capacity is a result of the possible different ground states in the vacuum. Each ground state is a memory. So he shifts the storage of memory from the electromagnetic level to the quantum level.</div><div class="MsoNormal"><i> </i></div><div class="MsoNormal">The memory recording he describes as follows: both the brain and the quantum level (which are the same, but on different levels) are in a ground state. Than a symmetry breaking occurs and energy dissipates (you see a cat running). The dissipation changes the ground state and is recorded in the vacuum. There are a lot of different ground states possible: hence the memory capacity is huge. </div><div class="MsoNormal"><br />
</div><div class="MsoNormal">Recollection of the memory than occurs through bringing the brain in the same state as it was in when the memory was recorded. This makes it possible to read that specific ground state and recollect the memory.</div><div class="MsoNormal"><br />
</div><div class="MsoNormal">So the second thing Vitiello does is not limiting memory to brain tissue. This coincides with Body Medicine where you know that touching an area can trigger a recollection of events (which where recorded in the vacuum!!!) And the body states makes it possible to read the vacuum.</div><div class="MsoNormal"><br />
</div><div class="MsoNormal">From My Double Unveiled:</div><div class="MsoNormal"><i> </i><i><span style="font-family: Cambria; font-size: 12pt;">Now we see how the dissipative quantum dynamics leads to a dynamic organization of the memories in space (i.e. in their domain of localization) and in </span></i> </div><br />
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</style> <i>time (i.e. in their persistence or life-time).</i><br />
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<o:p></o:p> Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0tag:blogger.com,1999:blog-2550525085215204666.post-24634168037290261292011-01-11T04:24:00.000-08:002011-01-11T04:24:47.720-08:00Alan WallaceLast week I watched a TV documentary about Allan Wallace:<br />
<span style="color: #1f497d; font-size: 11pt;"> </span><span><span style="color: #444444; font-size: 11.5pt;"><a href="http://player.omroep.nl/?aflID=11919960" rel="nofollow" target="_blank" title="http://player.omroep.nl/?aflID=11919960"><span style="border: 1pt none windowtext; color: #2d0af7; padding: 0cm; text-decoration: none;">http://player.omroep.nl/?<wbr></wbr>aflID=11919960</span></a></span></span><br />
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<span><span style="color: #444444; font-size: 11.5pt;"><span style="border: 1pt none windowtext; color: #2d0af7; padding: 0cm; text-decoration: none;">What interested me here is that the stream of consciousness that can be experienced through practice of Samadhi, is comparable to a Quantum Level. </span></span></span><br />
<span><span style="color: #444444; font-size: 11.5pt;"><span style="border: 1pt none windowtext; color: #2d0af7; padding: 0cm; text-decoration: none;">But there is something beyond the Quantum Level which is the state of Bliss which can constantly be experienced. </span></span></span>Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0tag:blogger.com,1999:blog-2550525085215204666.post-20172845730503251502010-12-18T09:08:00.000-08:002010-12-18T09:08:08.994-08:00Today, december 18th started with my personal Blog. I will post my vision on being human from the perspective of an Osteopath.Sander Kaleshttp://www.blogger.com/profile/10466001897125945932noreply@blogger.com0