Welcome to my blog

Hello. I am iciclehunter and this is my diary. My job title is "osteopath", and my work is hunting for clues, detective work, problem-solving. These things involve reason and science, but are not limited by them. They also involve the eye of experience, and "hunches". Thus, some would regard my activities as those of a quack, a title I assume here with irony. I am writing this blog because I like writing. I am quite opinionated, and perhaps I suffer from a repressed need for expression. I have no particular prior "agenda"; if I have any bees in my bonnet, no doubt they will make themselves apparent by their buzzing. All names and identifying details of any people featuring in these anecdotes have been changed. Thank you for reading.

Wednesday, 20 June 2018

Lyme disease update - 2 years on

I have written a series of posts about my personal experience of having Lyme disease. You can find them here (latest first, earliest last). I thought I would file an update, two years and and two months after the first onset of my symptoms. I have been substantially well for over a year now. My last serious attack of Lyme symptoms was in February/March of 2017, when my doctor - an internal medicine specialist - refused to prescribe me any more antibiotics, offering me medication for neuropathic pain instead, which I rejected. Instead, I went on the Internet and purchased a month's supply of doxyxycline. All my symptoms subsided and that was the last time I have needed to resort to this. Now my symptoms - intensely unpleasant "needle-stabbing" sensations, pins-and-needles, brachial neuralgia (nerve pain in the arm), other strange sensory symptoms, global fatigue, insomnia, bouts of rage, even right ear deafness for a while - have all but disappeared, except for occasional mild episodes of pins and needles with a few mild stabs, and bouts of mild tiredness, all of which are entirely manageable. In fact, these symptoms are so trivial compared with what went before, that I don't really think about them at all. Everybody is different, but for what it is worth, I'd just like to set down what I did, what I didn't do, and what I think about it, in case it could help anybody else.

What I did:

  1. I read up on tick-bourne diseases. Stephen Buhner's Healing Lyme, while dense, is the most complete and informative book I know.
  2. Antibiotics (mostly doxycycline) 4 courses of from 2 to 5 weeks. Each further course after the first started when symptoms resumed and stopped when they had substantially disappeared. On reflection, I think this is a good ploy. The danger with long courses of antibiotics is, of course, resistance. And with each extra week the kill rate (percentage of live spirochaetes present to be killed) will decrease i.e. there are diminishing returns. So instead, it may be good to hit them on the head when they come out of the woodwork and stop when symptoms are substantially reduced, over several cycles. I figured by that means I would avoid giving the spirochaetes time to multiply very much each time they came out of dormancy, avoid antibiotic resistance, and maintain a high kill rate. That is my idea and my experience, not the absolute truth.
  3. I followed Stephen Buhner's core protocol, including Gou-Teng for neuroborreliosis. I did this only for about a month, during my last (self-prescribed) course of antibiotics.
  4. For several months throughout, I took 3 raw cloves of garlic and 3 drops of essential oil of thyme (this on a teaspoon of sugar or mixed in juice), 3 times a day. I would not generally recommend that people take thyme oil internally because it is rather harsh on the gut. I took it after weighing up the potential benefits and risks, and because I have a robust gut. An unexpected added benefit of this regime was the expulsion of two tapeworms. Again, I intensified this regime when symptoms recurred, and eased off (though not stopping completely) when they subsided. 
  5. I slept and rested a lot. I told myself not to over-exert myself, although sometimes I did anyway. Otherwise I got on with my life.
  6. I learned to deal with the brief attacks of excruciating pain, using meditation and breathing practices.
  7. I kept very aware that one cannot blame every bad thing in life on one's special disease. It is possible to allow that not all of one's symptoms are not due to Lyme or tick-borne infections at all. The presence of Borrelia may be a causal factor for any given symptom in large, moderate, or small part, or even not at all.
  8. I quickly learned not to trust the doctors. They know so little about it (and what little they do know is really hardly worth knowing), and they have neither the time nor the inclination to find out. Also, they are hamstrung by institutional pressure to adhere to blind guidelines and mindless protocols.
  9. I kept in mind that good all round health is the best defence against any special disease. That, in my view, does not mean seeking out all the burgeoning varieties of magical trickery on the market offering to "diagnose and correct your energy imbalances", or such like. It means attending to basic human needs, and eliminating any impediments to self-healing.
  10. I tried to take my experiences as lessons.

What I didn't do:

  1. I didn't identify with my disease. So I didn't begin to call myself a "Lymey".
  2. I didn't fall for all the legions of alternative practitioners or devices offering miraculous solutions to any medical mystery. 90% of it, in my opinion, is hogwash. I have lived and worked in the world of complementary medicine for 25 years, and my considered view from this experience, is that the majority of its practitioners, while happy to (mis)use sciency language, are quite unprofessional, and really do not know as much as they think they do, or would have you believe. 
  3. I didn't obsess about every little detail of my body and mind. As remarked above, I just tried to attend to the basic necessities of a healthy organism.

I know I have been lucky. I have a generally robust constitution, and tend to get over things fairly rapidly. This may have caused me to be a bit blasé about tick bites, irrationally believing I was invulnerable to most kinds of bugs. Borrelia taught me otherwise. That is a lesson in life. At times my symptoms were pretty difficult to bear. I can completely understand why people worse off than I ever was will try anything. I consider myself fortunate that I didn't have to, because I didn't reach that stage of desperation. I am not crying victory. I think it likely that I will have further attacks if I for any reason my immune system becomes compromised again, for example by stress, physical exhaustion, or over-indulgence. I do question that Borrelia was the "cause" of my symptoms in an absolute sense. They may well have been triggered by that tick bite in Malaysia in early 2016. But I had been bitten in Europe on numerous occasions over the years without becoming symptomatic... until two years ago. I have an idea that Borrelia must be pretty prevalent in the "normal", assymptomatic population, and that sometimes, in some of us, because of other factors, "disease" becomes apparent. The whole experience, actually, has made me question what constitutes "disease".

And for now, as Forrest Gump said, that's all I've got to say about that.

Friday, 18 May 2018

Quantum mechanics and quack bollocks for dummies

When I asked my father, a retired research physicist, to explain quantum mechanics to me, he laughed. "Only a few people in the world understand quantum mechanics", he said, "and I'm not one of them". Then I saw something written about one of those few people in the world who are supposed to understand quantum mechanics, who had said that nobody really understands it.

So, what is quantum mechanics? I am certainly not one of the few people in the world who understand it, but I think I can identify a few of its basic constructs and notions. Here we go. Are you sitting tight?

1. The laws of physics conventionally applied to things easily observable in the world as most people know it, are not applicable to things that are very very very small... that is, smaller than an atom.
2. On that very very very small scale, there are such weird things that do such weird things that at times it is difficult to talk about them.
3. These things were conventionally called particles, but we now know that they only look like particles because we were looking at them with instruments that look for particles, and in that world you see what you look for.
4. If you look for those things with instruments that look for waves, you see waves. The waves of "one" of those entities are not in one place but in many places at the same time.
5. Thus if you look for the "particle" you may see it in different places at the same time.
6. To an extent if and where you see the particle depends on probability. That is, it can occur anywhere at any given moment (even in more than one place at once) but with different probabilities. I am not sure about this point - perhaps someone can correct me.
7. If any two of these entities encounter each other once, they will always have influence over each other. That is, the behaviour of one of the pair will depend on the behaviour of the other, and vice versa.

A lot of modern technology has derived from these principles, even though nobody fully understands them... technology such as lasers, magnetic resonance scans, chips in computers and smartphones, GPS.

In the realm of biology, some scientists believe the only explanation for certain phenomena is a quantum explanation... how the eyes of migratory birds can see the earth's magnetic field with their eyes, how cellular respiration (the process of energy production within the cell) and photosynthesis (the way plants derive energy from sunlight) can be so efficient. Photosynthesis, for example, is nearly 100% efficient, meaning almost no energy is lost during the process.

Cellular respiration and photosynthesis are processes involving extremely complex series of reactions, in which millions of different paths could potentially be taken, only one of which would lead to such a high energy yield. Yet it works every time. The only explanations are (a) all paths are taken simultaneously by the same particle (or wave), or (b) the particle (wave) "knows" which path to take because it is influenced by the "experience" of other particles (waves). This, I should add, is only theory as we speak.

This is where I would like to say something about Quack Bollocks. My shackles rise when I hear my fellow quacks attempting to justify their particular therapeutic efforts on the basis of quantum theory. "Quantum" and "quanta" are the current sexy words to use to give any old nonsense you like an "amazing", cutting edge, sciency, medicine-of-the-future, dazzlingly wonderful veneer.

In the time when my particular discipline (osteopathy) grew up, there were different words and concepts, like "magnetism" and, to be honest, also conventional mechanics. That was the age of the industrial revolution and people were fascinated by machines. Among these people was one Dr. Andrew Still, who figured that the human body could be considered, from one important point of view, just like a machine. From this idea he developed his system of therapeutics based on the mechanical manipulation of the body, with a view to curing all ills by this method.

Today there are few osteopaths who still believe that mechanics is the be-all-and-end-all of therapeutics. We have been through different phases when different sciences have caught people's imaginations and dominated our explanations and justifications, from anatomy and mechanics through physiology and chemistry, to ecology (the pathogen/terrain debate), to systems theory and cybernetics to quantum mechanics. The point is, we attempt to explain things most readily from the point of view of the latest fashionable theoretical construct.

However, it is a veneer. It glosses the bare reality that the speaker often has no idea how (or even if) their particular method has any real effect. I am a fairly conventional, mechanically inclined and psychologically literate osteopath. I am confident that the methods I use work consistently if I select my patients carefully, and I have my theories as to why they work, but I would not justify them on the basis of quantum mechanics. That is not because quantum mechanics is not there. If it is involved in biological processes it most certainly is. It is because (a bit like that other mantra favoured by alternative types: "Everything is energy"... Uhm, yes... so???) it is an explanation that is at the same time so vague and all-encompassing that effectively it means everything and nothing at the same time. How very quantum!

Thursday, 3 May 2018

Not a bone out of place

Sometimes a patient comes to me with the self-made diagnosis of "a bone out of place", and the implied requirement that I "put it back in" or "correct its position".

But the idea of a "bone out of place" as a common cause of pain in the back or neck should be consigned to history. It was certainly current among the bone-setters of the 19th century, and even the early osteopaths. However, more enlightened osteopathic thought quickly replaced it with more realistic and sophisticated models. And in the light of all we now know about the way the spine works and behaves, the notion of a bone "out of place" is simply untenable. And yet some osteopaths and chiropractors still peddle this explanation of pain to their patients.

The idea a "bone out of place" as a common cause of pain is simplistic to the point of being wrong. Why? Here are a few reasons:

1) Osteopaths do recognise abnormal states of the spine, in the absence of any disease, which may be localised (e.g. affecting the immediate area around one vertebra) or more extensive. We call them "dysfunctions". The word "dysfunction" means "not working properly". One of the functions of spine is to allow movement in certain ways and to certain degrees. If it is not doing this normally, it is dysfunctional.

Dysfunction is recognised by various signs perceptible to the osteopath. Some of these are: physical tension or other abnormalities in the texture of the tissues (e.g. muscle tissue), asymmetrical orientation (e.g. of a vertebra), restriction (of spinal movement), tenderness to palpation. Sometimes one finds that a specific vertebra seems to be oriented differently from the others, judging from the asymmetrical positions of its bony prominences. However, it gives the wrong idea entirely to say that it is "out of place".

Firstly, the bony prominences of the spine are often naturally asymmetrical. Secondly, even if a whole vertebra is oriented differently from its neighbours, we can still not normally say it is "out of place". "Out of place" means dislocated: a gross displacement with serious tissue injury. Let us take the example of a door which should at this time be shut. Imagine it sticks in its frame so that it cannot be completely closed. It is not off its hinges, it is just stuck in an inappropriate situation at an inappropriate time.

The same with the dysfunctional vertebra. Imagine you bend down and twist slightly to pick up an object from the floor. When you straighten up, you feel pain in your low back which wasn't there before. It is quite likely that for some reason a vertebra has not been able fully to regain the erect position appropriate to your erect posture. It is not "out of place", but it is "stuck".

2) Let us go further. This abnormally behaving part which we have called a "dysfunction" (not a bone out of place!) does not exist in isolation. In anything longer than the short term (a few days at most) it can only be maintained by virtue of its wider relations. The natural tendency of a healthy body is towards the normal. Why then is a dysfunction maintained? Because the wider context (the body) is accommodating it. The problem is not in the individual dysfunction, but the wider dysfunctional pattern involving the whole body. These things are maintained by a complex network of relationships within the body, involving not only the musculoskeletal system, but also the whole network of fascia in the body, as well as the various body systems, especially circulatory, nervous, hormonal, immune. It also involves the mind, with our thoughts, beliefs and emotions. And outside of the organism the relations extend to our physical and social environments.

Trying to "adjust" one part of this system in isolation is hopeless, and if done forcefully, it is asking for trouble. Imagine a twisted piece of string. If you keep it taut and keep twisting, at a certain point it will it will double on itself and a kink will form. Try to straighten the kink and another one will appear elsewhere. This is a good analogy for the behaviour of a single dysfunctional part within a complex whole. (While I am tempted to claim this analogy as my own original, I have to say my thanks go to Kuno Van Der Post for providing it).

3) If I examined ten healthy and symptomless people, I would find a whole array of spinal dysfunctions in all of them. What does this tell us? Firstly, it tells us that at any time all of us have spines which, if examined in minute detail, are not functioning in perfect coordination and harmony. Secondly, it tells us that in many people, most of the time, this situation is well tolerated. I have a cardinal rule: "If it ain't broke, don't fix it". Spines are extremely complex, intelligent, biological machines. There are normally ample tolerance limits for less than 100% efficient function. In fact I would say that less than 100% efficient function is the normal condition. I am not more intelligent in the ways of your spine than your spine itself. A significant problem will manifest itself pain, discomfort or other symptoms. Unless these are beginning to appear, or unless there are potentially damaging abnormalities which a negligible-risk intervention could address, hands off!

4) Even if you are suffering pain or discomfort, it is illuminating to realise that a symptom (e.g. pain) has no single cause. It follows that there is no single remedy. I believe that spinal dysfunction can most helpfully be regarded with reference to the "stress" model. "Stress", in popular parlance, has come to mean "feeling under pressure", but in physiology "stress" refers to any demands which threaten to overwhelm the resources of the organism. These can be mechanical (e.g. daily work at a poorly set up work station), physical (e.g. radiation), biological (e.g. a virus), chemical (e.g. drinking water with high levels of heavy metals), or psychological (e.g. conflict in the workplace). The model I work with postulates that when the sum total of demands on the organism exceeds a certain individual threshold, the organism gets sick. Reducing the physical stress on the organism by improving the body's mechanical efficiency is one way (and only one way) in which osteopathy helps.

Conclusion: It is not about "correcting" the position of bones!

Monday, 30 April 2018

The holistic mindset

Want to know the significance of the elephant? Read to the end!

It is a frequent occurrence that a patient comes to me and, after the preliminaries, on asked the reason for the consultation (or even before), the first response is to get out x-ray or scan results or to give me their medical diagnosis. There is initial incomprehension when I say, "For the moment let's leave aside your diagnosis, tell me instead what it is I can help you with?" My assumption is that if a patient has come to me as an osteopath, it is because he or she is looking for an alternative, not more of the same i.e. the same system of diagnostic pigeon-holing and magic bullets which has failed them so far. Therefore, to start by recounting to me as a holistic practitioner what the medical diagnosis is, rather than what your suffering is and the reason for your seeking help in the first place, seems to me paradoxical.

The bare fact is that there are fundamental differences between the holistic mindset and the conventional medical mindset. I would even go so far as to say they are often incompatible. Here is a brief synopsis of the reasons why:

The medical mindset believes all people are the same: exactly the same in fact as that hypothetical average person that drug trials say might get better 80% of the time on those pink pills. It assumes this person to be an assembly of parts which have little to do with each other: so you go to the gastroenterologist for your gut and the dermatologist for your skin, the proctologist for your arse and the orthopod for your elbow. Medicine is fixated on what it calls "disease". It believes all diseases are different and is happiest if they can all be well-separated in little boxes with neat labels. Diseases are caused by distinct, preferably single, well-defined aggressions on the organism and their symptoms are bad, they must be fought and suppressed. It believes there are specific treatments for each symptom or disease. It only really believes in and knows drugs and surgery. Medicine, however, so often concentrates on what is unchangeable. That being so, its only options are to compensate by diverting the physiology, or to suppress symptoms. Medicine asks, "What is the name of this disease?" "What drug can be used to compensate for it or suppress its symptoms?"

In contrast, holistic disciplines such as naturopathy and osteopathy propose that people are all different, they cannot be treated the same way even if they have been ascribed the same "disease label". It assumes people to be whole, intricately sophisticated systems, in which any significant stimulus has potential effects in every cell in the body. We believe all ill-health to have fundamental commonalities: it is a response, or a lack of response, to external or internal conditions. That is why it is possible to observe predictable progressions through a lifetime, of states of ill-health conventionally considered as quite separate diseases. It is multifactorial: single causes are largely a myth. Symptoms are most usually not bad, they are evidence of positive, necessary, physiological reactions of the body. They should generally be supported, not suppressed, and their reason for existing should be obviated or resolved. We do not involve ourselves in specific treatments for specific diseases, because the concept of specific diseases is not a feature the holistic mindset. The holistic mindset believes in individualised treatment indicated by characteristics specific to the person, as determined by a functional assessment. It concentrates on what is changeable, and attempts to effect positive change. It asks, "Why did this person fall from health?" "What can be done to return them to normal function?"

Unfortunately a whole lifetime of cultural "education" has militated against a holistic understanding of health and disease in the western world. We have been conditioned to believe that "diseases" are discrete, objective, malign entities with single, discrete, objective, malign causes, which have to be "combated" with chemical drugs or cut out with knives. Holism says there is another viewpoint. This alternative mindset is not considered to be irrefutable "truth", nor is it an unbending dogma. It is however, a preferential stance, which we believe to be more rational, and generally to provide better answers.

So what is the significance of the elephant? This is from an old Eastern tale. A group of blind beggars came across an elephant. One said to the others, “Behold this strange tree trunk” (he was feeling a leg). Another replied, “What are you talking about, you dunderhead? This is a great wall” (he was pushing against the elephant’s side). “You two are completely insane”, said another, “It is a kind of whip we have before us” (he had felt the swish of the tail). “Beware!” said a fourth, “I fear this is a great lance (he had hold of a tusk). The fifth cried, “Run, run for your lives! It is a mighty snake” (the elephant was feeling him with its trunk). They all ran away in different directions, none understanding anything much about what had happened.

That is the aproach of modern medicine.

Tuesday, 10 October 2017

Acupuncture: A Stress-Based Model

My second book, "Acupuncture: A Stress-Based Model" is out now in paperback and Kindle editions.

This is what it is about...

My belief is that acupuncture practice is overburdened by superfluous and questionable traditional theory. My book offers a simpler but, I believe, equally effective model for the practice of acupuncture. It bases this model on the concept of stress, rather than traditional theories such as qi and the five elements. I propose a method of treatment which does not rely on traditional maps of meridians or the traditionally described functions of discrete acupuncture points.

Legend has it that acupuncture was conceived as a treatment when physicians observed soldiers cured of various prior complaints after receiving arrow wounds in battle. I can relate to this. I often pick up scratches and gashes on my regular walks in the forest. I am of the opinion that these small wounds are health-giving, keeping the immune system primed and the stress response balanced. From simple observations such as this, at first applied in very simple ways, a method of treatment was developed, codified and progressively elaborated over many centuries into the complex system it is today. I happen to think that system is over-complex, heavily laden as it is with superfluous theory. I have always believed in keeping things simple, essential, and avoiding the temptation to micro-manage in the false belief that in complexity we are afforded more control. In fact, the contrary is true.

Mine is not a conventional acupuncture text. There are so many of those. Nor is it a manual of technique. It is a book of ideas and approach. I am aware that, as the ideas discussed are unorthodox, this book may provoke scorn and irritation, even to the point of spittle-flying rage, in some traditionalists. I hope though that others will at least do it the justice of some reflection.

My book is really two books in one. (You get your money's worth.) One is about the acupuncture treatment of stress and all stress-related illness. The other is about the acupuncture treatment of anything, using a stress-based model. I am interested in stress, and while I could have separated these two concepts into two separate books, the ideas behind them grew together in an organic way and are intimately intertwined, so, loathe to separate them, I have kept them together in print.

I studied Traditional Chinese Acupuncture in Italy under Dr. Ulderico Lanza, one of the first physicians to practise Chinese medicine in that country. I qualified in 1990 and was then mentored by my father-in-law, a highly experienced acupuncturist of some repute, who had taught himself acupuncture (shock horror!) as a young man, but had then learned considerably more from the Korean doctors with whom he worked in South America.

Acupuncture is not an exact science. Each practitioner's own intellect and experience inform his or her modus operandi, to a far greater extent than is supposed to happen in our modern, so-called Evidence Based Medicine. I am told that in rural China, each local acupuncturist has his own method, often passed down in the family over generations. For example, my father-in-law told me that on a trip to Hong Kong he learned, at a price in US dollars, the secret of success of a locally renowned Chinese acupuncturist. It was this: he only ever punctured the Ting points(1), and sometimes he punctured all of them. My father-in-law did not adopt this method: he developed his own, which was in continual evolution (but in which some things never changed), an evolution based on the outcome of constant trial and error and his own idiosyncratic style of inventiveness. Whether this kind of progress in medicine (trialling one's ideas on one's patients) is ethical or not, I shall leave for others more righteous than I to argue about.

I wrote this book because, in over twenty-three years of acupuncture practice, I have slowly but surely come to the conclusion that a lot of traditional theory is an unnecessary distraction from the therapeutic art and act. At best the mystique which surrounds it and its apparent technical complexity act as an elaborate piece of theatre (placebo!) for the patient. The codified traditional acupuncture most widely taught today evolved from a mixture of observation, trial and error, philosophy, reasoning, folklore, magic and tradition lasting many centuries. As such, it is unrealistic, in my view, to swallow it whole and uncritically.

Furthermore, I have not been able to ignore the fact that, since times of yore, particularly in the East, there has been an esoteric convention in the teaching of any art: conceptual edifices were constructed in order not to facilitate the student's early access to the most essential knowledge, but indeed to prepare the student in other ways by hampering it. The reason for this was ostensibly so that the novice would not gain too much technical knowledge before acquiring the wisdom to use it properly. Surely only a cynic (or a realist!) might suggest that it could also serve as an effective smokescreen to protect the master's status (only a true master could possibly understand such complexity), influence and income stream.

The former of these two reasons should not apply here. Anyone intending to apply any of the ideas presented in this book should already have professional-level knowledge of anatomy, physiology and pathology, patient care and management. They should also possess a knowledge of the general and locally specific risks of inserting acupuncture needles, and the necessary precautions attendant on this. Moreover, even though this simplified version acupuncture will be immediately effective, it will still take years to master.

With these considerations and my own clinical observations in mind, I have whittled down the theory underlying my practice of acupuncture to the minimum I have found necessary for effective practice. Let me begin here to set out my store. The principle messages in this book are:
  • A good part of traditional theory, models and method is unnecessary embellishment, from the point of view of therapeutic effectiveness.
  • The most important acupuncture effect is general rather than specific. Point specificity has been enormously exaggerated. All acupuncture affects overarching systemic control systems more than system-specific functions.
  • Many of the effects of acupuncture can be seen in terms of stress responses, in the widest sense.
What do I think acupuncture actually does? Simply stated, acupuncture captures the healing attention. A little more precisely stated, it engages the central nervous system in the production of a coordinated physiological response, which mobilises and directs resources in an effort to normalise physiological functions. To attempt to be more exact about it than this, one runs the risk of superfluous theorising(2) or dogmatising.

I have not discarded all that is traditional, and for that I might draw just as fervent criticism from sceptics amongst readers as from traditionalist acupuncturists. But I am above all pragmatic. If I have experienced the truth of things, I do not let any perceived lack of scientific plausibility stand against them. This applies particularly to diagnosis, including, to my own long-term wonder and intrigue, traditional pulse diagnosis. Traditional Chinese diagnosis is observational, and I have found the observed associations described by traditional texts to be insightful and rather accurate.

I do not attempt to cover all bases, simply to describe a method of practice which is simple and, in my experience, effective. I claim no absolute superiority for the effectiveness of this method, only that it satisfies my felt need to achieve the most benefit with the smallest degree of complexity. (A somewhat Zen idea, don't you think?) I feel this sincere search has been empowering to my practice because it has imbued the therapeutic act with added intent and potency.

(1) Points situated, for the most part, at the ends of the fingers and toes.
(2) Numquam ponenda est pluralitas sine necessitate ("Plurality must never be posited without necessity"): William of Ockham (c. 1287-1347) in Quaestiones et decisiones in quattuor libros Sententiarum Petri Lombardi (Sentences of Peter Lombard). Otherwise stated as: "Don't needlessly multiply hypotheses". Ockham's Razor (or Occam's) is a heuristic that holds that among hypotheses, the best are those that rely on the fewest unverified assumptions, that is, the simplest.

Copyright © Robert Hale 2017. No part of the above may be reproduced in any form without my explicit consent. All rights reserved.

My book may be purchased in the United States from Amazon at the link given below, or from other Amazon marketplaces by changing the .com part of the link to .ca,, .fr, .de, or whatever is appropriate.

Tuesday, 5 September 2017

They don't know what to do because they went to the wrong school

A lady came to see me with pain affecting her upper back and both arms. Her doctor sent her for 20 sessions of physio. No change. 20 sessions???!!! I have never needed to give anybody anywhere near 20 treatments in one course. Ever. Her doctor sent her for scans of her neck and shoulders. He looked at the scan of her spine in her neck (multiple degenerative discopathy, osteophytosis, intraspongious oedema) and said it was bad, but he couldn't offer her any kind of help. Take this medicine (anti-inflammatories) and live with it, he said.

The trouble (one trouble) with conventional medicine is that it equates what it sees in laboratory tests or images from xrays and scans with the patient's problem. It knows it cannot change much of what it finds, and so it offers no hope. It is hopeless and depressing for both patient and doctor alike. Those doctors went to the wrong school*. This patient's problem is not a scan result, her problem is that she is in pain, which is not only unpleasant in itself, but limits her life in ways that are important to her. That is her problem, not what her scan looks like!

Therapists who went to better schools than those doctors also know they cannot change much of what is on the scan, but they do not equate it with the patient's problem, they see it as it should be seen: as one factor which may influence her problem. And they can see other factors, too, which influence it, and which they can change or help to change, so they can offer some realistic hope of improvement in the patient's health and quality of life.

And they call us quacks.

* This may be an apocryphal story but it was told to me that in 2007 when the late, great osteopath John Wernham was taken to hospital at the age of 99 (and still practising shortly beforehand!), he told the doctors there before he died, "You don't know what to do, do you? You went to the wrong school!"

Thursday, 29 June 2017

Scary monsters from another world

Two people, maybe my parents, are having a discussion, or perhaps an argument, and I am butting in, being a little antagonistic, although it is not really my business. Suddenly I feel a malign presence. It holds me from behind and sticks fingers between my ribs. It is not exactly painful but it is unbearable, and I struggle to escape, but cannot. Then I am awake and realise I am yelling loudly. My heart is beating fast.

It's funny, you don't realise while you are still dreaming that you are so afraid, or that you are screaming. It is felt more like an instinctive, visceral, animal fear: an impellent urge to get away. The malign presence had been invisible, but I was left with an associated image in my mind of a black triangular shape with rounded corners, a bit like a bicycle saddle with the thinner corner downwards, or strangely, like the camera carrier I had been considering buying on Amazon. I was left also with another impression: that I had imprudently created a disturbance, unwittingly drawing the attention of the monster.

The dream world is different - it deals in symbols and associations which, while often appearing to be gibberish if remembered when awake, have meaning and coherence in the dream. Is dream life any less real than wakeful life? I think the term "real" loses all meaning in this comparison. It is a different world with different rules, different organisation, different terms of reference. But also, of course, it depends on your criteria for reality.

Take my scary monster. Was it real? It was not concrete, but it had meaning. Does it exist now? Well, time does not work the same way in that world, so the question is meaningless and unanswerable. Could it be verified by another person? No, objectivity is not a feature of that world. Did that dream monster have awareness? Maybe, of a kind, in that it is bound up with my own awareness. I do not know if it had an independent awareness of its own. Did it act upon me? Most surely. Could it have harmed me? Potentially, yes. Remember my heart was beating fast. In a susceptible person that could provoke a heart attack. One could literally die of fright. There is also some research suggesting nightmares are detrimental to our waking psychological state and influence our mood and social interactions.

There is a universe in which we live in our wakeful moments, in which many things (but not all) may be verified by common consent. We see a tree, a car, a dog, a mountain, and all of us would recognise these as such, because we have been trained to do so. Then each of us has a universe within, largely inaccessible to other people, but which is just as vast as the universe without. In that universe, what you recognise as a tree, a car, a dog, a mountain, are not those things as you understand them in your everyday life, they are representations of other things. You may say that the "universe within" is just a part of our internal machinery. But how confidently can you state that you as an aware being are a separate and independent entity from the rest of the universe "out there"? Another point of view is that you as a person are in fact all that you see around you, as well as everything that goes on within you. You exist at the borderland.

Consider this proposition. We exist at a sort of semi-permeable barrier between the consensual universe of everyday life, and a whole different kind of universe on the other side. Both of them are part of us, and we are part of both of them. When we are awake our senses and our minds are tuned to the universe without, which keeps from our awareness most of what is within. When we sleep, we may travel the universe within. However, without the visual reference to things we know that are taken from our wakeful awareness (a tree, a car, a dog, a mountain, a bicycle saddle, a camera carrier, etc.) all we could perceive there would be chaos. So we do make that reference. In that world, whether we can see them or not, there exist forces that we might call monstrous and others that we might call benevolent, although those words perhaps personalise them too much.

In the final analysis, whether you consider its elements to be "real" or not, that other world of dream is just as important to you as the one you are dealing in right now.