Systemic reflections regarding the current developments in the Osteopathic Spirit

Ricerca e scienza

di Maximilien Girardin

Biological systems are in essence self-organizing at all level-layers of complexity and dimensions (molecules, cells, tissues, functional systems, organs, organisms, societies or ecosystems)1 2 3 4 5, and all share complex adaptive behavior.

This self-organization is in essence based upon a thermo-dynamic tension field that generates when there is a polarity in the environment, like a system.6

The tension field self-organized between a polarity (that Nature attempts to erase) and the thermodynamic tendency to self-maintain, is so specific too all complex systems.

Each system or entity will react in a manner to reduce its contained energy level, while every system also will try maintaining itself in the environment. This entropic phenomenon is at hand at every measurably dimension, from atomic to galaxy level and is called ‘stickyness’.7

Self-organizing systems appear so perfectly adapted to their environment because they are the ‘form’s’ expression of an ongoing process in the tension field between self-maintenance and erasure, or their dynamics tend exactly towards the edge of chaos.8 9 (See figure edge of chaos)10

The fluctuating flow and eruptions of disruptive stimuli from the environment, make that the complex adaptive system is relentlessly internally reorganizing and shifting its agent’s positions too maintain its form in an apparent balance on the edge of chaos.

The persistently changing environment as such is the ‘aimless random actor’ that disrupts the system’s balance, the system absorbs, and reacts by means of metabolization11, internal reorganization, replication and or differentiation, whatever level of reaction necessary too maintain or adapt its form; in other words: the form is not a fixed system but a mind-boggling constantly shifting adapting process in space-time. ( What Walter McKone describes as process of becoming or there are no things just processes)

Our human senses are not perfectly adapted to notice that process at work, in longer timeframes or in extreme shifts we do notice them, but the process itself is mostly hidden to our senses.

Knowledge integration and awareness
of this process can make it more accessible or noticeable in a shorter timeframe sometimes practically in real time. But this demands understanding and awareness of the professional; one can usually merely recognize what one knows.

Natural selection, as an ongoing process, selects the most adapted forms to the actual environment, and the diversity of forms increases the resilience of the whole ‘forms genus’. 12

These natural laws apply to all complex adaptive systems like a profession, a professional organization or even larger complex adaptive systems like a state, the global economy or financial markets.

These complex adaptive systems are at risk of failing and eventually will be erased if they are steered unnaturally by a multitude of directional or management top down interventions instead the diversity of natural reactions to cope with the stimuli from the environment. Top down management plans to transcend, control or disregard this ongoing natural process.

In doing so it steps outside reality and acts in a virtual reality of its own construction. Why?

Scientists, technocrats and managers, are in the absolute “impossibility” to know, understand or evaluate fully all the parameters and interactions between environment and system; in addition the same applies with the complexity of the ongoing processes within the complex adaptive system itself. In other words they cope with virtual models, taking them for established reality.

Ergo: even when the top down management decisions and interventions are done with the ‘best’ available information, and with the ‘best’ of intentions, they will always be flanked by unintended consequences.

This law of “unintended consequences” was first described by the moral- philosopher Adam Smith, the ‘discoverer’ of free trade principle and theoretical founder of capitalism, as the ‘invisible hand of the market’.13

But what is meant by the ‘invisible hand of the market’ or the ‘law of unintended consequences’?

Interventions of people – especially top down such as by managers or governments- on meta-complex adaptive systems always have unintended or unanticipated consequences.

Austrian school economists, social scientists, ecologists and in general ‘complexity scientists’ pay attention to its powers, because the effects can be devastating as well for the system as for the whole environment.

Politicians and popular opinion, even in mainstream academia and science, have largely ignored it, and still do.

Although there are enough examples that have shown that working along with the ongoing complex and dynamic process of Nature can greatly improve the management decisions, when these include awareness of the complexity, hierarchy and holistic view of system and environment. 14 15 16 17

We experience nearly daily perfect examples of this “ignoring the law of unintended consequences”, through financial debacles, political crises or ecologic catastrophes.

These unintended consequences could be avoided or considerably less devastating, if managers, governments and scientists could have a more contextual approach.

Meaning hereby an approach with respect for the complexity and hierarchies’ present due to the ongoing dynamic process, more holistically observation, with less tunnel vision and the awareness that there are always blind spots whoever the observer is.18

Through contextual approach one can increase the resilience or as Nassim Nicholas Taleb calls it “the robustness” of the system for unthinkable ‘Black Swan’ events.19

The devastating consequences of these ‘well meant, top down interventions’ are legion20, but their common denominator is: commonly the ultimate effect is usually exactly opposite of what the intervention was designed for.

A closer contextual look into the osteopathic profession reveals some similar ongoing effects. The main goal set from top down in practically all countries, is well restricted quality control, firmly embedded political, economical and social status of the osteopathic profession. (Reducing the biodiversity of the osteopathic genus and trying to approach it to the ideal of monoculture = robustness or resilience suffering greatly from this)

Noticeable affects for the osteopathic profession:

           – An impoverishment in the schooling and postgraduate courses on the levels of professional philosophy, history and worst of all: anatomy, while their apparent unimportance for the technical quality-control of the profession, as such opposite to the essence of the osteopathic philosophy and schooling idea of its founder. 21 22

           – An impoverishment in the schooling and postgraduate courses on the levels of auto criticism and awareness, while their apparent unimportance for the technical quality-control of the profession, as such opposite to the essence of the osteopathic philosophy and schooling idea of its founder. 23

           – An impoverishment in the schooling and postgraduate courses on the level of fundamental nature laws, principles and their mechanisms, while their apparent unimportance for the technical quality-control of the profession, as such opposite to the essence of the osteopathic philosophy and schooling idea of its founder. 24 25

           – An increase in purely technical courses, tending to reduce the holistic or contextual view to a recipe test-correct technicalization , as such opposite to the essence of the osteopathic philosophy and schooling idea of its founder.26 27

           – An increasing medicalization and pure symptom thinking in the schooling and postgraduate courses as such opposite to the essence of the osteopathic philosophy and schooling idea of its founder. 28 

The current developments result in an impoverishment of the culture and memetics of the profession, growing a loss of identity and specific essence of osteopathy.

The fact that these postgraduate courses are mandatory in countless professional associations affects in time many professionals and as such will make them stray from the original form and biodiversity of osteopathy. (philosophy-concept-science)

Osteopathy is a philosophy (Core) based upon observation of nature and its principles, from these observations and reasoning came forth a concept (knowledge and principles possible to express and teach but with a high biodiversity due to genus microevolution effect), this developed into a science (derivate knowledge) and finally out of these: concept and science developed the practice, and techniques (tools at the service of the Core). (Osteopathy’s evolutionary sequence or hierarchy and chronology.

The biggest potency of this natural algorithm is that it induces microevolution = high robustness or resilience and permits macroevolution. 

The core, fundament or essence of our profession: the philosophy is progressively reduced, distorted and even negated, accentuating within the osteopathic profession the last derivate: the technique. 

Another effect or unintended consequence of the top down intervention is showing: the systematic alienation from its evolutionary sequence is increasing the speed of the rupture within the osteopathic profession. (Macroevolution leading to a new genus, therefore don’t call it osteopathy anymore)

The author observes a further polarization within the profession. A splintering in thought and being of the osteopaths who converge towards academia ‘the reductionists’ and the esoteric tending “vitalists”; as we named them in the article “l’ostéopathie Di- Stillée”.29  This splintering creates the professional association’s unsteadiness, searching for balance in a compromised position in this tension field. Alike most meta-complex adaptive systems managed by humans, in misbalance, it reacts with top down interventions, loaded with even more unintended consequences.

This author believes that if this polarization enlarges, speeded up by top down interventions and unintended consequences, our profession will splinter up to a breaking point. This phenomenon is not new; it is accompanying the profession practically since it has increased its numbers and resulting complexity…30

A.T. Still, Philosophy of Osteopathy, 1899: “To find health should be the object of the doctor. Anyone can find disease.” and “It is my object in this work to teach principles as I understand them, and not rules.”

From this John Martin Littlejohn made the following in his 1908 publication “the principle of Osteopathy”:

J.M. Littlejohn: “Osteopathy represents a principle, not a set of principles…” and “the underlying principle, as applied to osteopathy, is expressed in the word ‘ADJUSTMENT’” what brings us a lot closer to the “find the lesion” and technique strategy that has become current schooling practice…

The final stimulus or death blow for the phase conversion is added shortly afterwards by his student Edythe F. Ashmore, D.O. in her book Osteopathic Mechanics, 1915: ““The central thought of the science of osteopathy is the Lesion, which has been defined as any structural perversion which produces or maintains functional disturbance.”

In less than 16 years, with presumably the best of intentions (making osteopathy better known and more graspable), a well meant top down intervention (publishing a comprehensive osteopathic practice book) the effect is that the profession’s philosophy is turned by 180°.

A set of principles, with health and harmony of Form as goal in 1899 gets turned into one principle: the lesion and her adjustment, talking about devolution!

The author observes continuity in this paradigm shift: a rigidification or crystallization towards monoculture, yet without natural selection or critical feedback control.

Is there a solution?

In our opinion there isfollowing nature’s laws of evolution and complexity.

Each complex adaptive system can only thrive well and pass natural selection’s test by respecting its own evolutionary origins or basic algorithms, allowing microevolution and high robustness because of the diversity.31

The osteopathic profession as a system is the result of its interacting agents, being the osteopaths; as these are themselves complex adaptive systems (C.A.S.), the profession will behave as a meta-complex adaptive system and is as such submitted to the rules of the game as is any C.A.S. in our Universe.

What is the profession’s evolutionary origin or basic algorithms?

           ♦ Nature

           ♦ Observation

           ♦ Philosophy (these first three translated as Osteopathic philosophy 
and fundamental natural science the mechanisms.)

           ♦ Concept

           ♦ Science (these translated as science in relation to Form ‘structure & 

           ♦ Practice application of all the precedents resulting in techniques 

The author is a prudent optimist, whose motto is ‘prepare for the worst and hope for the best’, but he worries that alike the economy we are in the middle of a “crack-up-boom”32 . And as history repetitively demonstrated, this usually precedes a total collapse of the system involved.

The polarization as well as increase in complexity and top down rigidification of the profession amplifies the criticality (vulnerability) of the system. 

“Expansion means complexity and complexity decay.”33 That’s a Nature’s law!

Maybe we are indeed doomed to repeat history, because the current system does not succeed to learn the rules of Nature’s game, or has forgotten its own profession’s dearest lessons.


Max Girardin D.O., Evost Fellow 2012-03-31

Bibliography, Footnotes and Quotes:

1 Francis Heylighen “Complexiteit en evolutie” pdf cursus nota’s 2003-2004, centrum Leo Apostel, Vrije Universiteit Brussel.

2 Jürgen Jost “External and internal complexity of complex adaptive systems” December16, 2003, Max Planck Institute for Mathematics in the Science, Leipzig Germany.

3 Francis Heylighen “the science of self-organization and adaptivity” Center “Leo Apostel”, Free University Brussels, Belgium May 1999

4 Eiraku M, Takata N, et Ali “Selforganizing optic-cup morphogenesis in three-dimensional culture” Nature, 2011 April 7, 472 (7341): 51-6

5 Simon A. Levin “Ecosystems and the Biosphere as Complex Adaptive Systems” Princeton University, Ecosystems, 1998, 1:431-436

6 What in Still’s words could be summarized as: “Nature tends too ‘no pattern’, harmony, or perfection.”

7 A.T. STill, « The philosophy and Mechanical principles of Osteopathy” Hudson-Kimberly Pub. Kansas City, Missouri, copyrighted 1892, Published 1902 pp 232 All the processes of earth-life must be in perpetual motion to be kept in a healthy condition; otherwise the world would wither and die…pp229 We are only complete when normal in all parts, a true compass points to the normal only.pp215-216 …as an explorer who has use for the most exacting and most thorough study of the true physiological perfection…pp 213 …a subject of thought, we must confine them to her form, and that form in its most perfect condition. pp 250 Harmony only dwells where obstructions do not exist.

8 . P. Crutchfield and K. Young, “Computation at the Onset of Chaos”, in Entropy, Complexity, and the Physics of Information, W. Zurek, editor, SFI Studies in the Sciences of Complexity, VIII, Addison-Wesley, Reading, Massachusetts (1990) pp. 223–269.

9 Stuart A. Kauffman “The Origins of Order: Self-Organization and Selection in Evolution”

ISBN13: 9780195079517 ISBN10: 0195079515 Paperback, 734 pages Apr 1993


11 Metabolization and internal reorganisation usually affect the environment in its thermodynamic process, which in turn will provoke stimuli for all the systems in that environment. A never-ending story or we could even state that the only permanence is the impermanence.

12 Selective pressure is the stress from the environment on each system at all level-layers of complexity. Meanwhile natural selection erases the not actually adapted systems. This should be understood not as frozen picture but as an ongoing dynamic process.

13 Adam Smith “An inquiry into the Nature and Causes of the Wealth of Nations” London 1776

14 Semler Ricardo “Maverick!: Too big for our own good” , Arrow, London [1993], 1994

15 S.Hughes, “Antelope activate the acacia’s alarm system” New Scientist September 1990

16 M.E. Fowler, “Plant poisoning in free-living wild animals: a review”, Journal of Wildlife Diseases, 19 (1), 1983 pp. 34-43

17 Savory, Allan; Jody Butterfield, “Holistic Management: A New Framework for Decision Making” (2nd ed. ed.). (1998-12-01) [1988]. Washington, D.C.: Island Press

18 Boszormenyi-Nagy I.: Grondbeginselen van de contextuele benadering, De Toorts, 2000.

19 Nassim Nicholas Taleb “The Black Swan: The Impact of the Highly Improbable” Allen Lane pub., London 2007

20 In finance, economy, social and ecologic functioning for instance.

21 A.T. Still « Philosophy of osteopathy » 1899 Kirksville Missouri, preface pp 1 “Osteopathy is only in its infancy, it is a great unknown sea just discovered, and as yet we are only acquainted with its shore tide”. pp16 …the necessary studies… that you begin with anatomy, and you end with anatomy...pp28 To find health should be the object of the doctor. Anyone can find disease. pp21 …if order and health are universally one in union, then the doctor cannot usefully physiologically or philosophically be guided by any scale of reason otherwise. 

22 A.T. Still “Osteopathy, Research and Practice” 1910 Kirksville Missouri, Introduction pp2 …it is my hope and wish that every osteopath will go on and on in search for scientific facts as they relate to the human mechanism and health, and to an ever-extended unfolding of Nature’s truths and laws. 

23 A.T. Still « Philosophy of osteopathy » 1899 Kirksville Missouri, preface pp1 When I saw others who had not more than skimmed the surface of the science (osteopathy), taking up the pen to write books on osteopathy…found they were drinking from the fountains of old school drugs, dragging back the science to the very systems from which I divorced myself so many years ago, and realized that hungry students were ready to swallow such mental poison… 

24 A.T. Still « Philosophy of osteopathy » 1899 Kirksville Missouri, preface pp2 It is my object in this work to teach principles …and not rules. pp1 Henceforth I will follow the dictates of nature in all I say or write. pp15 …was hung for murder, not through design, but through traditional ignorance of the power of nature to cure both old and young…pp 27 Thus to obtain good results, we must blend ourselves with, and travel in harmony with nature’s truths.

25 A.T. Still “Osteopathy, Research and Practice” 1910 Kirksville Missouri, Introduction pp2 …it is my hope and wish that every osteopath will go on and on in search for scientific facts as they relate to the human mechanism and health, and to an ever-extended unfolding of Nature’s truths and laws.

26 A.T. Still « Philosophy of osteopathy » 1899 Kirksville Missouri, preface pp2 It is my object in this work to teach principles as I understand them and not rules. I do not instruct the student to punch or pull a certain bone, nerve or muscle …. 

27 A.T. Still “Osteopathy, Research and Practice” 1910, Kirksville Missouri preface pp2, Osteopathy is based on the perfection of Nature’s work. Man cannot add anything to this perfect work nor improve the functioning of the normal body. Disease is an effect only….pp1 I was many years philosophizing, comparing and noticing results which followed taking off strains and pressures. Harold Goodman in the new Foreword, edition 1992: And what is most unusal is that Dr. Still, who was famous for not teaching specific treatments at his school. 

28 A.T. Still « Philosophy of osteopathy » 1899 Kirksville Missouri, pp12 …no book written by medical writers can be of much use to us, and it would be very foolish to look to them for advice and instruction on a science they know nothing of.

29, available in English on request

30 Philip W. Anderson “More and different: Notes from a Thoughtful Curmudgeon” Imperial College Press 1971 UK

31 A fish may want to walk on earth and enjoy the sunshine, in disrespect with its own evolutionary origins or basic algorithms. Natural selection will make it take the test, and it will fail.


33 C. Northcote Parkinson (English writer 1909 – 1993)

34 Edmund Burke (British Statesman and philosopher 1729 – 1779)