By Cheryl Hawk, DC, PhD, CHES

Professor and Director of Clinical Research at Logan College of Chiropractic

Objectives: To discuss concepts of postmodernism with respect to the opposing worldviews of vitalism and mechanism, and to present an argument for a viable role for vitalism in chiropractic philosophy and research.

Discussion: Vitalism is only problematic if we begin with the assumption that a mechanist worldview or paradigm is the correct way to explain the world. In postmodern thought, a multiplicity of worldviews may coexist. One view is no more valid or correct than another and these divergent views are judged best by their utility under various circumstances. Exploring clinical practices and methodologies, such as whole systems research, arising from a vitalistic perspective could lead to innovations in both patient care and research, if pursued with flexible non-dogmatic thinking.

Conclusion: Vitalism, approached in a responsible and intelligent manner, may afford the chiropractic profession opportunities to further improve patient care and make contributions to new knowledge.

INTRODUCTION

The 2003, the World Federation of Chiropractic conference convened a panel to address this question: “Is vitalism a strong foundation or quicksand for the chiropractic profession?” As one of the panelists, in order to address what I believed this question was really asking, it was necessary to first deconstruct the question, that is, to examine its underlying assumption. [1]

This underlying assumption is that a mechanist worldview or paradigm is the correct way to explain the world. Based on this assumption, anything that does not fit this worldview would be a potential threat to our profession’s credibility and, therefore, must be modified to fit this view or jettisoned. Vitalism, which entails a different way of perceiving the world, poses such a threat.

This assumption must be examined rather than simply accepted. Only then will it be possible to make a conscious choice of which worldview we want to function within and then thoughtfully and responsibly adhere to the principles of that worldview.

DISCUSSION

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By Daniel Redwood, DC

For at least as long as any living doctor of chiropractic can remember, our profession has engaged in ongoing and sometimes heated debate about the proper role of its practitioners. Should our primary or sole focus be the spine? The nervous system? Vertebral subluxation? Back and neck pain? Should we be musculoskeletal pain specialists? Complementary care generalists? Primary care physicians?

Two new papers, one by Donald Murphy and colleagues in Chiropractic and Manual Therapies [1] and the other by Jan Hartvigsen and colleagues in British Medical Journal, [2] simultaneously point in the same direction—toward the role of primary spine care practitioner. The lead authors of both articles are chiropractors, Murphy from the United States and Hartvigsen from Denmark. Neither proposes the primary spine care practitioner role as the only option for DCs; both make a persuasive case that developing this role on a much more widespread basis will significantly enhance the effectiveness of the health care system’s neuromusculoskeletal (NMS) care delivery. In the process, they demonstrate why many practitioners may find work as a primary spine care practitioner attractive. To the extent that deeper integration of chiropractic is one of the profession’s primary goals, this may be one of the best vehicles for its achievement. At the very least, it’s a possibility worthy of serious examination.

By William Morgan, DC

The term “group think” was coined by the psychologist Irving Janis in his 1972 work, Victims of Group think: A Psychological Study of Foreign- Policy Decisions and Fiascoes. Group think describes what happens when individual thought cedes to the will of group consciousness. This may sound like a cross between an Orwellian novel and a bad zombie movie, but its prevalence in the world is common, and the dangers of group think are all too real, especially when it comes to decision-making in health care. Group think suppresses dissenting views and can lead to an over simplified view of problems and solutions.

Symptoms of Groupthink

Dr. Janis presented eight symptoms of group think:

• Group attitude of invulnerability. The group feels that it is “bulletproof,” so it takes unnecessary risks and is overly confident.
• Group rationalism—discrediting evidence that is contrary to the group beliefs.
• Group peer pressure inhibits the will to dissent. Members of the group are browbeaten into conformity of thought.
• Group belief of moral superiority.
• Stereotyping of outsiders in negative terms—such as “Oh, he is just a dumb straight.” Or, “Those medi-practors are so insecure in their ability to adjust.”

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John W. Reggars

Suite1/593 Whitehorse Road, Mitcham, Victoria, Australia 3132. School of Chiropractic and Sports Science, Faculty of Health Sciences, Murdoch University. Murdoch, Western Australia, 6150 reggars@chirofirst.com.au

Background   Chiropractic in Australia has seen many changes over the past 30 years. Some of these changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes or lack of changes, have hindered the growth, public utilisation and professional standing of chiropractic in Australia. This article explores what influences have impacted on the credibility, advancement and public utilisation of chiropractic in Australia.

Discussion   The 1970′s and 1980′s saw a dramatic change within the chiropractic profession in Australia. With the advent of government regulation, came government funded teaching institutions, quality research and increased public acceptance and utilisation of chiropractic services. However, since that time the profession appears to have taken a backward step, which in the author’s opinion, is directly linked to a shift by sections of the profession to the fundamentalist approach to chiropractic and the vertebral subluxation complex. The abandonment, by some groups, of a scientific and evidenced based approach to practice for one founded on ideological dogma is beginning to take its toll.

Summary   The future of chiropractic in Australia is at a crossroads. For the profession to move forward it must base its future on science and not ideological dogma. The push by some for it to become a unique and all encompassing alternative system of healthcare is both misguided and irrational.

The FULL TEXT Article:

This paper is the author’s perception of the many changes which have impacted, both positively and negatively, on chiropractic and the chiropractic profession over the past 30 years. Some of those changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes, or lack of changes, have adversely affected the profession’s growth, credibility and the public utilisation of chiropractic services in Australia. It would you also appear, that the crossroads confronting the profession in Australia are not unique, as there are many parallels with what has occurred or is occurring internationally.

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Thanks to Moyra Gorski, R.N., B.S.N. for sharing this with us all

skeptic, who had heard of the Buddha’s propensity to always return good for evil, and love those who would abuse him, did not believe this could be possible, so he set out to find, and then test the Buddha.

Finding him, he began hurling insults and spewing criticism at the master. When the accuser finally stopped, he was perplexed and asked the Buddha how he could sit so serenely amidst such abuse, and continue to offer peace and love in the face of such invectives being thrown his way. The Buddha answered his question with a question of his own:

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Through the 1970s and 1980s, those of us seeking to advance alternatives to conventional medicine that would be far less reliant on drugs and surgery, far more friendly to hands-on forms of healing and the use of natural substances, and cognizant that illness and pain usually have more than one cause and potential cure, identified ourselves as proponents of holism, holistic health care or holistic medicine. The words were chosen to convey the importance of seeing ourselves and our patients as whole persons—body, mind and spirit.

But phrases fall out of fashion. By the early 1990s, holistic had become alternative, then complementary and alternative (CAM), and finally (for now) integrative. We all understand that the map is not the territory, but changes in language signal changes in outlook and emphasis. Subtly and gradually, we have lost something in the process. When we raise the banner of holism, we assert the value of a whole systems paradigm. Endorsing alternative, complementary, or integrative medicine lacks this engaged focus on principles and thus affirms far less.

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