“Like Job, we must learn to take our flesh in our own teeth, put our lives in our own hands, and actively participate with the subtle and awesome forces which weave the web of our existence.” (Juhan, 1998, p. 19)
Brian Broom points to the importance of the way we construct reality in relation to clinical observation (Broom, 2002). The prevailing Western model of illness and disease (the biomedical model) can only present part of the picture. This model is derived from the classic Newtonian-Cartesian worldview in which the world (including the body) is divided into separate, mechanistic parts. More recently, the importance of psychological influences on the body, the biopsychosocial model (Engels, 1977; Brown, 2000; Borrell-Carrio, Suchman & Epstein, 2004 ) has gained wide popularity. But the underlying assumption is still that mind and body are separate and the connection between the two is mediated by the nervous, immune and endocrine systems, which allows no room for the complex interplay of meaning and its role in disease.
According to Wilber even the so-called ‘new’ sciences (such as quantum physics, systems and complexity theory) which view the world as an indivisible play of inter-relationships are “monological” (Wilber, 1998). That is, they reduce ways of knowing the world to the empirical and physically observable. Other ways of knowing such as the subjective and contemplative are ignored or invalidated. Juhan believes that this has not only affected our world-view, but how we see “ourselves, our development, our structures, our functions, our minds.” He goes on to ask “Might not a refinement of our sensibilities concerning our own bodies offer fresh insights to an inadequate world view, just as surely as adherence to that world view leads us to make mischief with our bodies?” (Juhan, 1998, p. 11).
Broom works with the meaning of illness through somatic metaphor, and posits that a unitary model helps us to understand this. He says “I am not saying that the model I elaborate is the model of disease, superceding all others. I do say that it accounts for somatic metaphors and that through this accounting we are led to radical new understandings of disease, the simultaneity of mind and body, and the nature of reality” (Broom, 2002, p. 18).
In a unitary approach “the person is seen as a unitary whole without seeing any aspect as primary or secondary” (Broom, 1997, p. 24). The underlying unifying principle is the “I am”. Broom says “My use of the “I am” language dignifies subjectivity and physicality without subordinating either. It allows matter and subjectivity to co-exist as dimensions of the same unitary dynamic reality. It emphasizes an underlying deep unity to “being” and insists that there is a level of description of our personal reality that is not to be compartmentalized” (Broom, 2002, p. 24).
Many complementary and alternative medicine (CAM) practitioners claim to be ‘holistic’, also addressing aspects of the whole person in their approach. In practice though, a so-called ‘holistic’ approach can be just as materialistic and reductionist as a biomedical model, because the ‘whole’ is seen as a collection of discrete ‘parts’ rather than as an integrated whole. This may be in part a response to the perceived ‘validity’ of the prevailing medical paradigm, as CAM struggles to situate itself as a valid ‘alternative’ or ‘complement’ to medical health care, and in part a result of unexamined theoretical underpinnings.
Whether we consider medical or complementary approaches to illness, the underlying philosophy is still often a linear and dualistic approach, where the mental or physical or psychological or spiritual are seen as separate ‘parts’ and are prioritised in the search for ‘diagnosis’ and ‘treatment’.
I will now analyse the modality I am most familiar with (Holistic Pulsing) in relation to unitary models of illness and disease.
Holistic Pulsing (HP) was developed in New Zealand by the Israeli naturopath and osteopath Tovi Browning in the 1980s. It comes out of a long tradition of Reichian – style body-work (Reich, 1942) where the release of hidden emotion stored in the body is seen as an integral aspect of healing. Holistic Pulsing also includes aspects of bioenergetics (Lowen, 1976), Alexander Technique (Brown, 1992), Feldenkrais (Feldenkrais, 1970), Trager Psychophysical Integration (Juhan, 1984) and Gestalt therapy.
The physical technique of Holistic Pulsing involves the practitioner applying rhythmic rocking, stretching and opening movements to the clothed client usually lying on a massage table. The practitioner and client ideally enter into a two-way relationship where the client is encouraged to connect deeply with his or her whole being through self-awareness and self-acceptance, and to develop his or her own interpretation, meaning and choices about his or her well-being.
Because Holistic Pulsing involves touch, stretching and movement, it is often seen as a ‘bodywork’ discipline, and is generally taught alongside physical therapies such as massage. This ignores the fact that HP addresses many aspects of the person. It asks how the person is in relation to themselves as a whole, using the ‘window’ of body awareness as a tool for accessing this awareness. In this it shares some similarities with Hakomi Body-Focussed Psychotherapy (Kurtz, 1990), although the latter has placed itself firmly in the psychotherapeutic camp.
Placing HP alongside physical therapies is an uncomfortable ‘fit’ as the expectations of client and student alike are of a remedial body therapy which will ‘fix’ their conditions. This is far from the intention of HP. Similarly placing HP in the psychotherapeutic camp is uncomfortable, because HP involves physical touch and movement as well as dialogue.
At present, HP sits in the ‘body-mind’ camp, but terminology such as ‘body-mind’ and ‘bodywork’ are problematic, as they reveal
inherently dualistic and mechanistic thinking. Does body-mind mean they are separate, discrete realities with one influencing the other?
Does bodywork involve ‘working on’ the body in the same way I would ‘work on’ my car? I prefer Deane Juhan’s description of bodywork: “Touching hands are not like pharmaceuticals or scalpels. They are like flashlights in a darkened room.” (Juhan, 1998, p. xxix)
Tovi Browning talks about the deep split which still exists in society between our physical, emotional and spiritual realities. She developed Holistic Pulsing because she “ craved for an approach that would touch and heed us at all the different levels of our being” (Browning, 2004, p. 34). However, as we shall see, Browning’s underlying hypothesis still has elements of a dualistic, rather than a unitary approach.
“As far as we can discern, the sole purpose of existence is to kindle a light in the darkness of being”
– Carl Jung (source unknown)
According to Browning, “The body occupies an all-too-rare place of honour in HP” (Browning, 2004, p. 57). She goes on to explain the primacy of the body because it “is the centre of our experience on this earth” (p. 57). Other theorists expand on this in the notion of the ‘subject body’ (see Todes, 2001).
Browning (2004) believes that, unlike our minds, which are experts at manipulation, the body does not lie, but is a source of inner truth, often alerting us to our human condition through pain, tension and disease, before we are fully conscious of what is going on. Thus the body is privileged above other aspects as the first port of call, so to speak.
According to Browning, becoming conscious involves a process of noticing the ‘blockages’ or areas of constriction, stiffness, or immobility in our bodies through our response to the rocking movement. Any trauma has the potential to create a blockage, which has both a physiological effect, and a mental or emotional one “as the blockages rigidify and constrict our muscles, organs and cells, so too our feelings and thoughts become affected” (Browning, 2004, p. 39). Browning goes on to say that “it is only a matter of time before our blockages inevitably lead to any number of problems, illnesses, pain and disease” (Browning, 2004, p. 41). Blockages can lead us to dissociate from parts of our bodies. “It is like amputating this part of our self from our consciousness, and starving it of sufficient oxygen, lymph and blood supply, not to mention love.” (Browning, 2004, p. 45).
Although clearly making a connection between mind and body Browning explains the process of disease in terms of cause and effect between the two as if they are separate entities. First comes trauma then blockage, then disease. When we become conscious and can process the psychological ‘cause’, the physiological ‘effect’ will disappear. This may be an example of circular causality (Borrell-Carrio et al., 2004). Elsewhere, she states that “In the inter-connected relationship of body and mind, each one continuously affects and reflects the other”, suggesting a more unitary approach (Browning, 2004, p. 320).
According to Browning, the gentle rocking and stretching movement of HP brings the awareness of blockages to the surface, and begins to ‘melt’ the constrictions, freeing up the body. “The relief may present itself in many ways – physically, emotionally, mentally, etc.” (Browning, 2004, p. 48). Furthermore, “as blockages shift and clear, the little ‘stories’ neatly packed away with them surface” (Browning, 2004, p. 49). Browning outlines many clinical examples where physical constriction and dissociation have resolved through awareness of the blockage and the expression of the story and the emotions surrounding it. This suggests that subjective experience and physical manifestation are connected.
Browning points to the possible symbolic nature of disease, for example, “What do hands stiff with arthritis say?” (Browning, 2004, p. 324). However, she then goes on to outline a correlation between the physical parts of the body and psychological characteristics, beliefs and ‘life-issues’. This approach has been explored by many others (see, for example, Dychwald, 1977; Hay, 1987) but it can lead to an unnecessarily deterministic and simplistic interpretation, leaving little room for the person’s own unique use of metaphor in the meaning of illness (Broom, 2006).
According to Browning, awareness (by which she means consciousness) is a key to resolving health issues. Awareness is enhanced by the rocking movement and by connecting with breath and sound. Inner (subjective) awareness is often all that is needed to effect change in a person’s health and wellbeing. “By making the unconscious conscious, we regain our choice and power” (Browning, 2004, p. 149). By becoming aware of the parts or aspects of ourselves that we have suppressed, forgotten, denied or projected outwards, we become whole, rather than fragmented beings, regaining our power in the process. Or as Abram says “As we reacquaint ourselves with our breathing bodies, then the perceived world itself begins to shift and transform.” (Abram, 1997).
Sometimes insight is gained by allowing a symptom to ‘talk’, as “Persistent symptoms often have a locked-in message to convey” (Browning, 2004, p. 313). This ‘disease as communication’ view raises many questions (for example, is the communication personal or interpersonal?) but is predicated on the view of the person as a unitary ‘whole’ (Broom, 2006).
Browning asks “When anatomists look at the body, why is its living story ignored?”. She continues “our body also shows where we have come from, what journey we have made, the challenges we have coped with, the battles we won or lost, the experiences we have encountered, and the conclusions and statements we manifest.” (Browning, 2004, p. 320). This is very akin to the idea of Lebenswelt or life-world described by the phenomenologist Husserl. The life-world is the ‘real’ lived-in world with its rich tapestry of subjective and intersubjective experience and meaning (Abram , 1997; Broom , 2006).
Browning believes that the separation of body and mind has come about because the body is tangible, whereas “emotions, thought, belief, and spirit” are not. She says “when you recognize that the body is the precise physical manifestation of the invisible substance within, you will be able to communicate with it, to read and understand your own, and other people’s fascinating bodyminds” (Browning, 2004, p. 323).
Dualistic thinking leads to many ‘splits’ as Browning calls them. As well as between different parts of the body and aspects of the self, there are splits for example between humans and nature, matter and spirit, inner and outer experience, being and doing, and practitioner and client. If the body is a machine to be fixed then the practitioner sees themselves as ‘doing something to’ the client rather than ‘being with’ them. There is an assumption that the practitioner is the fixer, and the client is the one to be fixed, an inherently unequal relationship which puts the power in the hands of the practitioner.
Browning emphasises the two-way relationship between the ‘pulsee’ and ‘pulser’ where both enter simultaneously into a healing ‘loop’. Here she is pointing to the importance of the intersubjective nature of the client/practitioner relationship and its role in healing. If we take the view of Bohm and others that reality is a dynamic process of patterns and connectedness, then separating ‘client’ and ‘practitioner’ is arbitrary and ignores what may be going on in the whole universe in which they are enfolded (Talbot, 1991).
A mechanistic model also focuses on what is ‘wrong’ and attends to pathology rather than wellness or preventative medicine, and pain rather than pleasure. In HP, the practitioner and client work with pleasure and wellbeing to bring a more holistic approach to healthcare. Clients come not just because they are ill, but because they are actively engaged in maintaining their own wellbeing. As Leder says, “If the objectifying model tends to emphasize an interventionist approach at the point of illness (i.e., fixing the machine), the paradigm of lived embodiment helps to focus attention on the healthy body and personal participation in prevention and treatment.” (Leder, 1984).
“Here in this body are the sacred rivers. Here are the sun and moon as well as all the pilgrimage places… I have not encountered another temple as blissful as my own body” Sahara (source unknown)
Philosophers like Merleau-Ponty explore the idea of the ‘lived body’ as our ‘being-in-the world’ and propose that we are subject and object at the same time: I both ‘have’ a body and I ‘am’ a body (Broom, 2006; Leder, 1984). Merleau-Ponty expands on this, saying “our sentient bodies are entirely continuous with the vast body of the land” (Merleau-Ponty, 1968, as cited by Abram, 1997, chapter, 2). We live in a participatory universe of sentient awareness, where everything is connected and nothing exists in isolation. Browning sees no division between nature and humans, she says “Like our body, the planet is the physical manifestation of our world. Microcosm and macrocosm, body and planet are synonymous” (Browning, 2004, p. 85).
Browning goes on to say that by healing our internal world we heal the external world: “When we reclaim all of ourselves and become whole, we heal not only us but the world! It is as though we take those separated particles that have been projected and enacted out in the world, back home into ourselves” (Browning, 2004, p. 104). Those ‘separated particles’ are a result of our own subjective-objective split, rather than any objective reality (Heron, 1992).
Browning talks about a Holistic Pulsing session being a ‘micro-life’ because, she says, “how you pulse is how you live” (Browning, 2004, p. 311). Not only does a session illuminate our whole life, but we can also use it as a ‘living laboratory’ to test out new ways of being. Quantum physics is insightful in this regard, for not only does “every cell in our body enfold(s) the entire cosmos” (Talbot, 1991, p. 50) but time and space are illusory in a holographic universe. Thus how we are in one dimension (for example an HP session) is representative of how we are in another, and making changes in one will change the other whether they are past, present, or future.
“Your theory is crazy, but it’s not crazy enough to be true” Niels Bohr (source unknown)
Broomfield critiques the reductionism of a ‘Western’ world-view and argues for the reclaiming of other ways of knowing. He says that allopathic medicine’s “concentration on the etiology of disease and the pathology of the body provides only fragmentary answers to how we stay healthy … understanding in this area may come from “the pattern which connects body with mind and spirit, mind and spirit with culture, individual with community, humans with nature” (Broomfield, 1997, p. 140). How would our relationship with disease and illness be if we viewed them from the perspective of a complex interplay between the mental, physical, spiritual and family aspects, as in Mason Durie’s (1994) whare tapawha model?
Browning critiques the biomedical world-view while unconsciously falling back into it with her interpretation of the connection between the physical and psychosocial. She reaches towards a unitary model, occasionally succeeding by focussing on the person’s life-story as manifested in the body, the subjective partnership between practitioner and client and the connection between people and the planet. She clearly subscribes to the notion of “embodiment” (Broom, 2006) but in her emphasis on the body as the portal into awareness (including that of spirit) she is in danger of physical reductionism.
Where Browning does offer something different from the prevailing view is in the relationship between practitioner and client. Advocating a two-way process between two people engaged in a healing relationship opens up all kinds of possibilities not available in a fragmented approach. As Dossey says “When our focus is toward a principle of relatedness and oneness, and away from fragmentation and isolation, health ensues” (Dossey, 1982, p. 112).
The Newtonian-Cartesian world-view is so pervasive that even in a natural therapies college where students are attracted by a more ‘holistic’ approach, I have a constant challenge to encourage students to expand their understanding of healthcare. Their questions and technique show how firmly they are embedded in the view that the role of healing is to diagnose, to ‘do something to’ the client, and to ‘fix’ their ‘problem’. They are surprised and sometimes wary of the degree to which a more holistic approach requires them to be self-aware, to enter into their own healing journey for themselves and to let go of their ‘objective’ and ‘separated’ notions of the world.
In the development of CAM courses, teachers are exhorted to bring their content in line with ‘scientific’ approaches by being evidence-based and research-oriented. There is nothing wrong with this approach per se, as Juhan says: “Objectively verifiable, measurable observations are certainly the cornerstone of the physical sciences. They are serious inquiry’s protection against fantasies, projections, prejudices, and chicanery” (Juhan, 1998, p. xxvii). However, other ways of knowing need to be seen as equally valid if CAM is not to fall into the same trap as conventional medicine and the unitary perspective that CAM can offer is not to be lost or devalued.
With clients it is a gradual process of education and experience. With some, our journey with Holistic Pulsing is an opening into a very different world. We move in a participatory universe; I am both the listener and the listened to, the toucher and the touched, the mover and the moved, the changer and the changed. This is not an experience of merging, rather one of expanding into a space of open inquiry. I am constantly engaged with my own self-awareness at the same time as engaging theirs. I have to stay alert to the many possibilities for projecting my own desires, needs, thoughts and interpretations on to him or her, at the same time noticing the intuitive impulses and insights which arise out of the attunement between us. I journey into the ‘micro-life’ of the client at the same time as keeping a ‘meta-view’ of the landscape. We dance an edge of sometimes leading sometimes following, gradually opening to a level of mutual presence where a deeper ‘field of knowing’ can emerge, where transformation can gently spread its wings.
Holistic Pulsing certainly has the potential to express a unitary model of healthcare and address the person as a whole being. Whether that happens in practice or not depends on the practitioners’ world-view.
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