The healthcare you provide reflecs your philosophy of how healthcare is delivered. 

By Tedd Koren, DC

What would you say if someone told you that there are only two chiropractic techniques? It might surprise you, as by most estimates there are nearly 100.

In fact, there certainly are many named techniques or methods of locating and correcting subluxations. But if you consider the philosophy behind the techniques, you will discover that they all fall into one of two general categories: Techniques are either vitalistic or mechanistic in approach.

This division is not unique to chiropractic; nearly every healing art is based on mechanism or vitalism.

Theories in transition

For more than 2,500 years, vitalism (empiricism) and mechanism (rationalism) have been battling for the world’s healthcare hearts, minds, and wallets. At various times in history, one or the other has been the dominant paradigm and presently there appears to be a transition from mechanism to vitalism.¹

Whether you are conscious of it or not, every healthcare system and every chiropractic technique is based on vitalist or mechanist philosophical principles. That’s because philosophy guides therapeutics.

Vitalist assumptions

Vitalists, as a general rule, tend to hold the following views:

• The body is intelligent, responding with a purpose to environmental stress using symptoms to maintain and regain homeostasis. Symptoms are seen as intelligent responses to stress and are not to be suppressed or eliminated.
• Living bodies are highly complex with billions of interconnected and rearranging parts in constant flux that maintain (and regain) homeostasis. Because of this constant flux, a complete understanding of what is happening in a patient at any moment in time is by definition impossible.
• The whole is greater than the sum of its parts, expressing qualities the parts cannot. Therefore, studying the parts gives incomplete information about the whole.
• Being greater than the sum of its parts, the whole cannot be reduced to or fully understood by physics, mathematics, mechanics, chemistry, or other analytical disciplines.
• The only way to understand the living organism is to observe how it reacts in sickness and health. Vitalists learn from the whole unique, complex, idiosyncratic patient before them.

For these reasons, vitalistic care tends to be personalized to the unique needs of the individual.

The mechanistic perspective

Mechanists view the body as a machine that is largely passive in its responses to environmental pressures. They tend to see the body in the following ways:

• Symptoms are undesirable signs of breakdown that need to be removed or eliminated.
• Like any machine, the whole is equal to the sum of the parts. By under- standing the parts, by dissecting and using the disciplines of mathematics, chemistry, mechanics, and physics, the whole can be known.
• Like any machine, the body’s parts break down, but they can often be replaced or manipulated without regard to the whole.
• Mechanists develop theories about the body and apply them to all bodies and all people, largely ignoring individual idiosyncrasies.

Different routes, different theories

Mechanist techniques and healthcare systems are invented (intellectually deduced), while vitalist techniques and healthcare systems are discovered (usually by accident). Mechanist techniques are based on educated intelligence, while vitalist techniques are based on innate intelligence.

Medical examples

Coronary artery bypass surgery (CABS) is a mechanistic procedure based on the assumption that blocked coronary arteries can be replaced much as a plumber replaces a clogged pipe. CABS has been linked to brain damage and has not been proven to decrease overall deaths.

Chelation therapy, a vitalistic technique, is used to cure heavy-metal poisoning but was accidentally found to also reverse coronary artery disease by removing plaque from arteries. It has been successful in hundreds of thousands of cases.

Chiropractic examples

Mechanist chiropractic techniques begin with an intellectual conception of what and where the subluxation is and how it should be corrected. These approaches determine in advance what the body needs.

For example: Techniques based on theoretical or mathematical assumptions of where “ideal” spinal curves or segments are supposed to be, based on X-ray or palpation analysis, are mechanistic. Techniques that assume that all locked spinal areas need release (such as diversified and “flying seven”) are mechanistic.

Vitalistic chiropractic techniques do not rely on intellectual concepts to determine

what a subluxation is and what its mechanisms are. A subluxation, to vitalists, is a metaphor for interference in life expression. The vitalist does not know exactly what a subluxation is or what care is needed in advance; the care is a posteriori — after the fact.

Vitalists rely on the body’s reactions to locate and correct subluxations and interference.

Vitalistic chiropractic technique practitioners do not know in advance what the body wants or needs. By testing or “asking” the body, they determine what procedures to use.

Vitalistic practitioners tailor care to the unique needs of the patient.

“Asking” the body

Binary biofeedback is simultaneously the most advanced and the most ancient method of care. Various professions “ask” the body about problems in different ways.

For example: Homeopathy uses “proving” — a response based on the symptoms the patient exhibits. Craniosacral therapy employs the “still point” to ask the body. Applied kinesiology employs the muscle reflex. Biofeedback methods include the short leg reflex, the occipital drop, and skin resistance, among others.

Through the use of biofeedback, the practitioner learns from the body what needs correction or adjustment, in what order, and if the correction was accomplished. Vitalistic techniques are thus highly individualized.

The challenge of vitalism

Vitalistic techniques are ideally an open system that may take you anywhere: from the spine to the cranium, from structure to emotions, from dehydration to dental issues, and other areas of interference. You must be open to exploring, and you are only limited by the questions you ask, based on your knowledge and awareness.

For example: A doctor who does not know the various brain structures will not know how to investigate them, and a doctor unschooled in Chinese medicine will not be able to locate meridian imbalances.

It is not easy to be open to “wherever the body takes you.” Intellectual mechanisms are useful to help organize your thoughts and they offer you a framework in which to work. But they also risk limiting you to prevailing dogmas. Just as DD and BJ Palmer strove to break out of the dogmas of their age, you need to be open to exploration as well.

The challenge of mechanism

Mechanistic techniques are based on the intellect (hence they are rational), and as a result the mechanistic practitioner risks developing a rigid perspective. This can lead to a narrow-minded, intellectual defensiveness unable to acknowledge the failures and limitations of the system being used. At worst, the practitioner may ignore the patient in favor of systems and mechanisms, as expressed in the saying, “the operation was a success but the patient died.”

Educated vs. innate

Mechanistic techniques are based in “educated intelligence,” whereas vitalistic techniques rely on “innate intelligence.”

Chiropractic philosophy is, in this light, vitalistic by nature; it was accidentally discovered by DD Palmer. Therefore, it can be said that purely intellectual, mechanistic techniques are not congruent with chiropractic.

With vitalistic techniques, you can ask the body where its interference or subluxations are located, and what approaches are best suited for correcting them.

Zen balance

In the ancient symbol of yin and yang, life is depicted as a balance of opposites, of heaven and earth, female and male, hot and cold, emotion and intellect, etc. In the symbol there is always some yang in the depths of yin, and yin in the depths of yang.

In the same way, all vitalist techniques include some degree of rationalism (intellectual analysis), and all rationalist techniques include some degree of vitalism (feedback from the body). Mechanists rely mostly on their intellect to approach an understanding of the body, while vitalists rely mostly on innate wisdom to guide them in their practice.

Finally, it is worth asking which approach works better. Care that is more tailored to the individual needs of the patient has historically had better results with minimal adverse reactions. The more vitalistic a healthcare system or technique is, the better the outcomes.

Tedd Koren, DC, is the developer of Koren Specific Technique, one of the fastest growing vitalistic techniques in the profession. For more information, visit korenspecifictechnique.com. He also writes patient education materials. Learn more at korenpublications.com. He can be reached at tkoren1@aol.com.

Reference

¹Coulter H. (1994) Divided Legacy: A History of the Schism in Medical Thought; Vol IV, Twentieth-Century Medicine, The Bacteriological Era. Berkeley, Calif: North Atlantic Books.