Systems thinking in osteopathy

An animal’s body functions as a complex interconnected system, and this complexity becomes especially evident when areas of dysfunction and imbalance disrupt harmony and equilibrium. For many osteopaths, this is observed when they first encounter the animal, and what follows is a thorough investigation process ahead of determining an appropriate course of action. As osteopaths, we acknowledge the animal is a unified biological and ecological whole and recognise the interplay and interconnectedness within the intricate system of the body, its environment, and its social context. The dynamic nature of the body and the fact that the animal plays an active role in its own healing can lead to assessment and treatment journeys that can be anything but linear.

Linear systems, like a domino chain, follow a predictable cause-and-effect path, where cause A directly leads to effect B. However, complex systems (like the body) are dynamic and interconnected. While cause-and-effect relationshipsexist, a single action can trigger multiple cascading effects, which may occur simultaneously. Causes can become effects; effects can become causes; and causal chains of multiple causes can exist. Additionally, many biological processes operate in feedback loops, where the effects of a process ‘feedback’ influence the original cause, creating a cycle of self-reinforcement. For example, metabolic syndrome exemplifies this complexity, where conditions like increased weight, high blood sugar, and high blood pressure contribute to and worsen each other and can aggravate additional conditions. Chronic inflammation can damage tissues, leading to the release of chemicals that further exacerbate the inflammation. Chronic pain might lead to reduced physical activity, which, in turn, worsens the pain.

Dynamic adaptive systems do not always have the same reaction to the same input – it depends on the system’s current state – and because the state itself is dynamic, the reaction is also dynamic. As each patient is unique, the exact “cause” of an issue for one animal might produce different “effects” in another based on factors like their genetics, breed predispositions, medical history, chronic conditions, nutrition, age, stressors, discipline or exercise demands, current routine, interaction and social relationships, environment, and overall health status.

Another element the osteopath considers is that effects don’t always happen instantaneously. There can be a time delay between the cause and the observable effect, depending on the nature of the cause and the system involved. Understanding centrality is also crucial. This concept acknowledges that the biological, psychological, interpersonal, and environmental influences (individual, microsystem, mesosystem, exosystem, and macrosystem) on an animal’s health vary over time and in their degree of influence. The more central an influence is at a given moment, the greater its impact on the animal’s health.

One of the many strengths of the osteopathic approach is that it embraces systems thinking in assessment and treatment. It moves beyond linear thinking to consider the broader ‘whole’ and assesses and analyses the causative factors – not just the symptoms. Symptoms, while valuable, are just one piece of the puzzle noted in the case history and incorporated into the osteopathic sieve process. Like the tip of an iceberg, symptoms often reveal just a glimpse of the underlying issue. Just as understanding the submerged mass is crucial for comprehending the iceberg, exploring the causative factors behind symptoms unveils the complex web of interconnected factors and intricate patterns of causality. This deeper understanding empowers an animal osteopathic practitioner to address the root causes – integrating local and global perspectives in a patient-centred approach – while simultaneously considering the whole.

Treatment then addresses the animal patient in a way that brings mobility, motility, balance, correlation, homeostatic stabilisation, coherence, resilience, and vitality (at a pace in which the animal can assimilate the treatment and integrate the changes into their innate healing processes).

That’s not to say that the linear aspect is entirely discounted – instead, it has limitations. In the process of assessing and treating, we remain aware of a linear perspective. Still, we know the importance of being holistic to understand the complete picture of the animal’s health. This holistic approach creates ripple effects throughout the interconnected system, much like the butterfly effect. By understanding the intricate web of linkages and connections, osteopaths gain a deeper understanding of that individual animal enabling them to choose interventions that resonate and support the entire system’s optimal functioning.