Zen awareness in the teaching of palpation: An osteopathic perspective

Abstract

Summary Teaching and learning manual diagnosis and treatment create a mutual challenge to both the student and master in communicating. The perception of, and action based on, the information gained by palpation is pre-verbal. However, communication between patient and practitioner, as well as charting and billing, require the translation of this information into a recordable form by the use of cognitive constructs—ideas, words, treatment models and illustrative analogies. These intellectual tools sometime assist but sometime mislead the treating person and patient when the distinction is lost between the original experience and the interpretation. For convenience the constructs evolve into rules which then create expectations that become barriers to the appreciation of the experience of touch and the real state of tissue. In teaching and practice, with few exceptions, the conceptual models are stressed with limited recognition of variation in perception or the actualities of the perceptual process itself. Another challenge is the expression in several practice traditions, including osteopathy, of the integration within the person (patient as well as practitioner) of body, mind and spirit. However, practical application beyond a compartmentalized complementary approach remains a challenge. And although many people recognize the importance of an intention to do well, implementation strategies for working efficaciously with intentionality, or in the realm of mind, appear barely credible or even esoteric. Teaching is often cumbersome. For this author the challenges presented in the more difficult aspects of manual practice mirror the challenges in the Zen Buddhist tradition in teaching the way to enlightened living and practice. But in this centuries-old tradition there are solutions that we may borrow to meet the challenges cited above. Besides promoting serene mental focus, Zen is the foundation of many martial arts including Samurai swordsmanship. In these disciplines mind, heart and hands work together in practical and critical ways. Teaching in this context involves student meeting master and beginning a journey to overcome the barrier between conceptual and tactical analysis on the one hand and the deeper reality which can enhance effectiveness in practice. This article introduces to osteopathy, and manual practice generally, some of these terms and tactics from Zen, hoping to develop an appreciation of the common challenges of perception, action, and communication in both disciplines. In this context, the role of practitioner's awareness is discussed as a means of directing action. Illustrations of attempts to reconcile biomechanics and mental focus in past and current osteopathic literature are cited to help define the problem. It is suggested that a better recognition of the problem of joining perception, intention and action may lead to a change in teaching strategies within the western manual healing arts to better integrate the work of our hands, hearts and minds.