Risch Andreas.pdf - Osteopathic Research

for osteopaths to integrate subjective sensory experience (e.g. with the hands) into
osteopathic professionalism (e.g. in interdisciplinary communication) and to resolve
the dilemma of finding the right distance (e.g. to subjective perception), without losing
association or wholeness (e.g. with the osteopathic therapeutic process) and on the
other hand to follow principles and guidelines (e.g. evidence based criteria), without
losing flexibility and the readiness for change (e.g. individual adaption).
Riemann is explaining his model with the metaphor of the earth turning around the
sun as the concept of “association” or social integration and the earth turning around
itself as the concept of “dissociation” or the process of individualization. In addition he
compares the centripedal force or gravity as the concept of “duration” or „holding on“
and the centrifugal force as the concept of “change” or „letting go“. For him these are
the main forces – generating basic forms of “angst” as he calls it - which govern our
existence and guide us between these antinomies. According to Riemann the health
of a person depends on the right balance between these dimensions (Riemann,
1989).
In this metaphor analysis emphasis on bio-mechanical or technical aspects of
osteopathy was less dominant (10%, “STC”) as most education and training
programs would suggest. A preference of metaphors of PROCESS, PATTERN, and
REGULATION” over “FUNCTION and MECHANISM” in the technological category
leads to the conclusion that with increasing professional experience the structural
bio-mechanical and technical model become less prevalent in the concepts of expert
osteopaths. This needs to be further investigated in future studies.
The top category of „rules and regulation“ (12%, HEALTH AS ALLOWANCE,
ACCEPTANCE, TOLERANCE, CONDITIONS) for social/psychological/ethical
understanding of health related to osteopathy is pointing to a „normative“ handling of
these aspects modified by a variety of other categories. This field seemed to be very
important to all interviewed osteopaths explicitly requesting more attention to it in the
education and training programs to gain a better understanding of these aspects.