The cornerstones of osteopathic treatment lie in osteopathic principles, especially in the idea of a self-regulating, dynamic unity of body, mind and spirit, structure-function interaction and person-context interaction.
There is an urgent need for a solid conceptual framework for osteopathic treatment. There is a need to create a more coherent interprofessional framework that emphasizes the special focus of osteopathic intervention in health care. For example, in the Liem, Lunghi (2021) hypothesis paper and in Liem (2006 and 2017), every complaint and somatic dysfunction is viewed from at least 4 perspectives and can be attributed to at least 4 essential aspects, all of which in turn evolve dynamically and holarchically.
Flexibility increase in adaptation as well as increasing competence in co-creation of external events can both, represent goals of osteopathic action.
These four perspectives are:
– objective aspects such as tissue dynamics, behavior, blood count, etc.
– subjective aspects of experience in the patient, such as belief patterns, cognitions, feelings, arousal patterns and body sensations,
– intersubjective aspects, such as culture, socialization, family, friends
– biosocial contexts such as income, occupational status, housing conditions, health care system, political conditions.
In the consideration of these perspectives in osteopathic treatment, can be seen as improving the individual mind-body function of the patient, in relation to his environment, with the aim of promoting the proactivity of the patient. Increasing flexibility on the part of the patient in adapting to external circumstances and contexts, as well as increasing competence in co-creating external events and contexts, are both goals of osteopathic action.
In the absence of a scientific paradigm, there is a danger of basing treatment on the values or dogmas of the individual osteopath – any practitioner would arbitrarily reinforce the „biological,“ „psychological,“ „social,“ or „spiritual“ aspect without adequate justification. Practitioners should avoid unnecessary boundaries such as body-mind duality. Personality development-and associated health aspects-are an ongoing epigenetic process.
Patient-centered communication, active learning approaches, shared decision making, and self-management coaching can all be integrated into a conceptual system of osteopathic care, while still keeping the traditional models connected through a metatheoretical framework (Liem, Lunghi 2021).
The 4 aspects are described as inseparable dimensions or perspectives of „being-in-the-world“-four irreducible epistemological perspectives or dimensions of reality that occur simultaneously. Illness, malaise, and disease states are reflected in all 4 aspects.
Any limitation to one or absolutization of one perspective may reduce the healing potential in the patient, as possible essential aspects in the complaint behavior or healing process are not taken into account.
For example, tissue-relational, biological, cognitive, emotional, psychosocial, and spiritual responsiveness of a person to the challenges of the person-context environment, among others, are evaluated and treated osteopathically accordingly.
This includes, for example, the perceptual-cognitive-symbolic as well as the direct-intuitive-non-local approach in osteopathy.