To me, this differentiation is key. Admittedly, to be an heir in having is a source of material wealth. However, this wealth is limited. To be an heir in being is a source of infinite wealth: “If you and I both have an object and we exchange these objects, then you and I will still each have one object. But, if you and I both have an idea and we exchange these ideas, then each of us will have two ideas.”(Chinese Proverb found in Favre, 1994, 271 - English translation).

As far as having is concerned, Still left us very little. He constantly evokes the state of mind in which an osteopath must observe and must work. Yet he provides almost no technique. This seems to have been deliberate on his part: “I want to make it plain that there are many ways of adjusting bones. And when one operator does not use the same method as another, it does not show criminal ignorance on the part of either, but simply the getting of results in a different manner. [...] Every operator should use his own judgment and choose his own method of adjusting all bones of the body. It is not a matter of imitation and doing just as some successful operator does, but the bringing of the bone from the abnormal to the normal.” (Still, 1910, 23).

However, Still was very pronounced where being was concerned, and he developed the philosophical and spiritual aspects of the osteopathic approach to some depth. It is on this level that I feel heir to Still. I feel connected to the same stream: the source of being, of consciousness.


In the fourth edition of the Belgian journal entitled "Thinking", Jacques Andréva Duval speaks a little about Rollin Becker and his experience working with him. He shares a few quotes, including this one: “All cells have two things in common: 1/ a philosophy, 2/ a purpose. By virtue of their philosophy, cells are universal: they obey identical laws. By virtue of their purpose, they simply perform a specific action (liver cells, cells of the nervous system, etc.). And as osteopaths, we accept their specific action, but work with their universality.” (Duval, 1998, 5 - English Translation).

Cellular Philosophy

Could cells have a philosophy? If so, what might it be? And what model might we imagine to represent it? Amongst the different possible ways of defining “philosophy”, the following might be useful: “Conception of something based upon a set of principles; these principles .” (Larousse Dictionary - English translation). “General conception, more or less organized vision of the world and of life’s challenges” (Grand Robert - English translation). However, when applied to the cellular dimension, these definitions are particularly diminished. What fundamental principles and major motivations drive the cell? For me, it boiled down to living or surviving, as the simplest, most evident expression of perpetuating existence. And, almost inevitably, this led to the concept of being, which has been challenging the human intellect for a very long time, and which I have focused upon in order to devise a workable model. It is this model that I wish to present here.

Cellular Consciousness

The concept of being probably takes us back to the ladder of causality’s highest rung. But what does being mean? The dictionary has many things to say, but nothing relating to the essence, the mechanism, the act of being. Being, existing, is the effect of a decision: I am. I am defines a central, fulcrum me, in relation to an environment that I consider external and different to me, and that I define or consider as not-me.

In order to be, one must become separate, one must go through a process of individuation. There is differentiation. The above echoes the following definition given by Spencer, who was a great inspiration to Still: “Schelling said that Life is the tendency to individuation. This formula, until studied, conveys little meaning. But we need only consider it as illustrated by the facts of development, or by the contrast between lower and higher forms of life, to recognize its significance; especially in respect of comprehensiveness.” (Spencer, 1866, 1898, V.1, 79). As soon as a living system exists, as an individual entity, it knows that it exists independently from its environment, and its environment knows of its existence. There is a consciousness. The word consciousness borrows from two Latin roots: co from cum “with”, which suggests association (as in coexistence, cognisance, etc.) and scire “to know”.

To be conscious and conscious of one’s consciousness…

We have trouble fathoming cellular consciousness because we associate the concept of consciousness with our ability to watch ourselves be. We confuse being conscious with being conscious of our consciousness. And this confused concept of consciousness is an abstraction that we unconsciously project into our observation of life. As so-called inferior species are not (ostensibly…) equipped with the same capacity for abstraction as us, we deduce that they are not conscious. When in reality, they just do not have the same consciousness as us. The confusion lies in the degree of abstraction.

To be conscious is to exist, quite simply. Or in other words, to exist is to be conscious. The two are indissociable. And to live, is to experience being or consciousness. Therefore, one can say that all living beings, from the most simple to the most complex, are conscious. Furthermore, all living beings will do everything they can to preserve their consciousness, that is to say their state of being or existence. It is in this behavior that mechanisms as complex as immunity and homeostasis find their origin.

Self-consciousness appears to have grown as organisms have evolved: “In the beginning, the ‘perception of self’ is imprecise. It then unfolds with greater and greater precision, presumably as a result of behaviors stemming from the instinct to survive. However, it is very difficult to say much more. We probably do not even have the words. (Reeves, 1986, 186 - English translation).

To be conscious of our consciousness would appear to be our prerogative, as Homo sapiens, radically differentiating us from so-called inferior living systems. Indeed, the very fact that it is possible to be conscious of our consciousness suggests the existence of an I that is distinct from the organism’s I, and that controls it - just like drivers control theis cars, or coachmen controlled their horses, a metaphor often used in Hindu philosophy.

A Being is Immobility (Stillness)

To be, is to be fulcrum, to create a universe in which I is in the centre, immobile, the fulcrum of a periphery in motion. Of course, this immobility is relative. I am only immobile in the universe of which I am the center. Like Russian dolls, there is an infinity of beings. Each being is the immobile center of its own universe, which itself is part of other universes. Therefore, all beings are mobile with respect to the immobile Is at the center of these larger universes, etc. As immobility is a fulcrum’s essential nature, all fulcra are relatively immobile. The only absolutely immobile fulcrum is the Creator of the entire universe, the Fulcrum of fulcra.

Furthermore, to be is to create pairs, the first of which is me/not-me. Therefore, all creations are relative, and exist only in relation to their opposite. In each pair, opposites exist through to their relationship to each other, and are constantly seeking reciprocal equilibrium. The creation of the logical pair me/not-me leads to the creation of other associated logical pairs: center/periphery, immobility/movement, cause/effect, expansion/retraction, etc.

From Immobility to Movement

To be, is to declare oneself different or separate, i.e. to go through a process of individuation. But how does an entity know that this is so, that is to say that it continues to be? Or, in other words, how does an entity experience the state of being? Such knowledge requires the existence of a system that enables the difference between me and not-me to be established, to be preserved, to be felt continuously. The membrane gives the cell a material barrier. However, although this barrier does indeed separate (consciousness once more…) an interior space from an exterior space, and provide individual cells with a physical boundary, it does not enable the cell to experience itself, to feel that it exists. In effect, the membrane provides the structure of existence, but not yet the function.

The actual sensation of existence is born from an exchange with the external environment. Indeed, the me/not-me duality creates an influx/efflux duality. As the efflux cannot be infinite, it must at some point reverse, giving rise to the influx which then seeks to balance the difference in potential between me and the external environment. However, when the returning influx is about to balance out this difference in potential, the need to exist or to feel existence recreates the efflux towards the external environment. This is how the alternation between efflux and influx, is born, in an attempt to reach an impossible balance.

Richard Moss expresses the same phenomenon differently: “In fact, it is impossible to become conscious of something without, at first, being separate from it. Think for a moment of the wind. If you are moving at the speed of the wind you cannot feel it. To become conscious of the wind you must resist it, push against it. This is what the ego is: the “I” that pushes against the All. It is a closing down of unobstructed intimacy with Existence, so that, paradoxically, we can begin to become conscious of Existence. Ego is born out of contrast; it requires being separate; it requires interaction. It gives birth to self-will and the first discernment: yes or no. And, it can be threatened.” (Moss, 1995, 17). Thus, there dwells in living systems an eternal duality between melting into and resisting, between going towards and folding back.

Expansion - rétraction

This exchange enables the cell to feel itself as existing, as an individual entity… Change is necessary in order for sensation to exist. It matters little whether this change occurs towards the outside or towards the inside, as long as change occurs. The alternation between efflux and influx is what gives rise or creates the exchange. This is how the living system can know that it exists, while still conserving its energy to some degree. Consciousness is preserved through this alternation: “Consciousness and breathing intermingle: they are one.” (De Smedt, 2001, 10 - English translation). As do all alternating phenomena, the exchange tends towards self-regulation and a the expression of a steady rhythm.

The exchange also generates a cycle of alternating expansion/retraction within the cell. Therefore, the cell behaves like a converter: converting exchange or communication into movement. And, this is how movement emerges from immobility.

In the words of one of Sutherland’s close students, Thomas F. Schooley: “If all matter is in motion and if all motion is fluctuant in its primary phase, and fluctuation being composed of two cycles, one expansile and one contractile, then fluctuation must be rhythmical. If one phase is affected by the other, then there must be an interchange of an energy factor between the two phases for fluctuation. If fluctuation occurs in all matter there must be a central point from which it originates, and this point therefore has no motion and may be called a Fulcrum. Also there must be a fulcrum for each atom, each molecule and each mass of matter.” (Schooley, 1951, 72-73 and Magoun, 1951, 72).


To say the body is an organized system is a truism. It is this very observation that led Still to perceive the body as created by a Great Architect: “At every stroke of the Master Architect of the universe, you will see the proof of intelligence, and His work is absolute” (Still, 1897, 282). However, what interests us here is not the creator, but how the system is organized, as organization appears to be fundamental to evolution.

Structure and Function

It is generally accepted that all specific tissues and organs are fashioned in response to the imperatives encountered by living systems as they evolve and complexify, and that this process is driven by living organisms’ fundamental survival instinct - or pulsion of survival. With each increase in complexity, new challenges emerged, requiring urgent and effective solutions. It is also probable that, at each stage, many solutions were tested before the right solution emerged and prevailed. However, at the same time, each solution that was found at a given stage in evolution went on to generate more complex problems needing to be resolved through the creation of further specializations, etc. This is how, in response to the requirement for specific functions, differentiated structures were created. We could say the very same thing backwards: differentiated structures were created for the purpose of fulfilling specific functions. This reversible formulation shows us that structure and function are a pair, the front and flip side of a single coin. Indeed, in living systems, structure and function cannot be understood or defined separately.

Structure governs function

This brings irresistibly to mind the famous words attributed to Still: “Structure governs function”. This laconic phrase is quite an accurate synthesis of one of osteopathy’s fundamental concepts: the relationship between structure and function. However, it is not formulated in this manner in any of Still’s writing… What is more, when stated this way, the concept is ambiguous, in particular as a result of the interpretation of the word govern, whose meaning has, over time, been considerably altered. This ambiguity had led many osteopaths to pay more attention to structure than necessary. According to the Larousse Dictionary, to govern is to direct with the help of a rudder. However, a rudder’s function is to orient in a specific direction, not to push. In other words, the force, the driving power comes from the motor, a distinct system which is independent from the rudder.

In living systems, structure orients the life force. The power itself comes from life. Therefore, it is life that we must understand. For the purposes of our model, structure and function are defined as follows:

Structure: in the living world, structure is a material organization whose purpose is to orient the non-specific life force towards specific, manifest functions, in order to satisfy the organism’s specific survival needs.

Function: is non-specific life force made specific through being channeled and oriented by a given structure, in order to resolve any problems compromising the organism’s survival.

A System of Organized Consciousnesses

We have imagined the cell as consciousness contained within a membrane and centered around a fulcrum. The body too can be imagined as an arrangement of self-contained spaces, centered around multiple fulcra. An organized system of consciousnesses or a system of organized consciousnesses… In time, the juxtaposition of these contained systems or spaces produces volumes, and therefore shape and form, the whole continuously expanding and retracting. This pulsation is a perceptible manifestation of life - the breath of life - referred to as the tissular rhythmic impulse.

Thus, the body can be perceived as a rhythmic (expansion/retraction) pulsatile fluid entity, organized by a fibrous partitioning system (membranes, fascias), and mechanically centered around Sutherland’s fulcrum.

From this perspective, the first structure to actuate organization is the dura mater. Indeed, the multidirectional expansion/retraction tissular motion is transformed by the dura mater’s tautness, generating points of restricted motion and areas of unrestricted motion and freedom. It is, in effect, the dura mater which governs the system, which organizes its mechanics. The dura enables the emergence of differentiated patterns of motion in the cranio-sacro-vertebral system. These differentiated patterns of motion have been recognised since Sutherland’s time as motions of flexion/extension of the unpaired, midline structures and external/internal rotation of the paired and peripheral structures.

We also know that during the system’s phase of expansion, the external flexion/rotation of the structures situated along the cranio-sacro-vertebral axis causes a settling of all peripheral tissues directly attached to the base of the skull or the pelvis, while the ensuing ascent is generated during the phase of retraction which causes the internal extension/rotation. However, all peripheral tissue, osseous tissue included, is alive and therefore animated by its own rhythmic pulsation, or motility. Tissues manifest their motility individually within the movement of the whole, something that has been clearly demonstrated by Barral and Mercier in their visceral approach. Depending upon the attention and intention that guides our perception, we will feel one or other of these movements, which co-exist, as has been explained above. Osteopaths are now familiar with these different movements, and have attempted to codify them. Here, we will consider these movements to be integrated within broader movements, as relative expressions of more absolute phenomena relating to the process and manifestation of life itself.

Expansion-retraction: Physiology

Curiously, there is no need to dwell upon these movements too much: when they are perceived to be normal and harmonious, this indicates that life is able to manifest ease fully. In this case, the living system needs no help from us. What we will dwell upon, however, is non-movement. Indeed, non-movement is a sign that life is struggling to manifest. Non-movement creates distortions in the intimate mechanics, or primary micro-mechanics, of the body as a whole, thereby causing distortions in the body system’s secondary macro-mechanics. This point of view is very much in alignment with how Still viewed small packages: “My aim is to carefully explore all, and never leave until I find the cause and use that Nature’s hand has placed in its workings, never overlooking small packages, as they often contain precious gems.” (Still, 1902, 162).

So, basically, we might think of the body as a jellyfish. This image may not seem very appealing at first, because of what we associate with jellyfish. Yet, to me, jellyfish are a beautiful image of the motion of fluids within fluid. The simple separation of internal and external fluids bestows identity and mechanical organization to the system, while its deepest - fluid - nature remains intact.

Of course, it is through our palpation of this system that the fluidity of the structures may be accessed. And, in relation to human organisms, it is wiser to speak of plasticity rather than fluidity, since the physicality of certain human structures, bone in particular, brings them closer to the physical universe.


In order to preserve an awareness of its own existence, a living organism must exchange with its environment. Therefore, it is logical to consider living organisms as relational systems by nature, constantly faced with the dilemma of exchanging with the external environment (maintaining the sensation of existence) and preserving their identity (maintaining separation). This duality makes living organisms vulnerable, and leads to specific behavioral responses. Therefore, what is important is how the body system reacts to the difficulties that it encounters in its life relationships “[The body] is in constant interchange with its external environment physically, mentally, and emotionally. This external environment extends from the person’s immediate surroundings to the farthest reaches of the universe. Why, then, separate them, the internal and external environments? Instead of the terminology, man and his environment, these can be jointed in one term—biosphere.” (Wales ed., 1990, 204).

The tissular approach assumes that prior even to the physiological function that it must fulfill, the primary concern of any living system is to perpetuate its existence. In other words, to survive. Only once the tissular structure’s survival is ensured, are its attributed function(s) then secondarily and automatically fulfilled. This point of view is in alignment with Becker and his universality/specificity dichotomy.

Withdrawing into Isolation

Given, then, that survival is its primary preoccupation, how does a living system behave when it feels threatened? Is not the most logical solution to attempt to isolate itself, to decrease its exchange with an environment now considered hostile, i.e. to individuate even further? Reducing membrane permeability is an excellent way to withdraw into isolation. And how is this achieved, if not by tightening, by increasing the membrane’s tautness? And doesn’t this mean withholding energy?

Therefore, it is possible to predict the behavior of a living system when it is confronted with an identified threat in its environment. It individuates. So that now, we are no longer only interested in the agent of aggression, but in the aggressed entity’s behavior in the face of aggression. And here, relativity reigns. In every situation, we must evaluate both the objective factors (energetic and otherwise) and the subjective factors (acceptance or refusal) which modify the relationship, thereby generating - or not - resistance or refusal to communicate, and as a result energy retention.


This realization led me to the concept of retention, which involves an unconscious, yet proactive, response on the part of a living system in which energy is retained in an attempt to isolate itself from impending danger. It is quite possible that the isolation response (retreat, resistance, refusal) emerged along with living systems themselves, and is therefore integrated into the very mechanism of living systems, whose first responses in the face of adversity are to retreat, resist and refuse, with all the secondary effects that this entails: “The big difficulty in matter is that the material consciousness, that is to say, the mind in matter, was formed under the pressure of difficulties — difficulties, obstacles, suffering, struggle. It was, so to speak, “worked out” by those things, and that gave it an imprint almost of pessimism and defeatism, which is certainly the greatest obstacle. [...] This is the great, the immense foundation of Life. Life is built upon this: upon this NO. A no that takes a thousand forms, a million forms, a million small diseases and weaknesses, all resulting in a thirst for the ultimate no: death” (Satprem, 1977, 64.710 - and partial English translation of original French quote). What a strange paradox: that the survival response should lead to death, for lack of consciousness!

From the Simple to the Complex

This model of behavior can be applied both to simple systems and to complex systems, which on a macroscopic scale reproduce the behaviors of the microscopic systems that compose them. In our own lives, we reproduce this type of behavior each time we are confronted with situations we consider aggressive or dangerous: “Clinical experience has shown that, ironically, it is often our very attempts to solve the problem that, in fact, maintain it. The attempted solutions become the true problem.” (Watzlawick, 1993, 86). Here, Watzlawick is referring to the solutions that living systems will use systematically - over and over again, and without adapting them to changes in context - if at a given moment in their lives, these solutions worked. This behavior can be suspended only if there is a consciousness of its inappropriateness. However, the level of abstraction required to permit such a realization appears inaccessible to a living cell. For such a realization, a living cell needs an external bearing point, or fulcrum. It is this support that a tissular practitioner can provide.

Yet, this mechanism - so fundamental to life and to the survival of living systems - has probably had powerful impact on evolution. Indeed, all energy retention and densification is ultimately organized and integrated, modifying the structure of living organisms, and enabling them to evolve, and therefore survive.

Mechanics of Consciousness

William Garner Sutherland’s primary respiratory mechanism in effect describes a modality or mechanism of consciousness: it is consciousness that produces the living cell’s alternating expansion/retraction, the primary movement manifested by life in all living systems. Just like its constitutive cells, the body may be represented as a rhythmic pulsatile fluid assemblage. A fluid assemblage which is structured by a fibrous partitioning system (membranes, fascias), and whose movement is orchestrated by the dura mater, and mechanically centered around Sutherland’s fulcrum.

Subtle body mechanics are then the manifestation of the living system’s consciousness. And therefore a distortion in consciousness in one area of tissue modifies its inherent mechanics, thereby altering the entire system’s mechanics, just as in the jellyfish metaphor given above.

This is why I no longer see the organism as a ‘mechanical system which also happens to be a living system’, but as a ‘living system which also happens to be a mechanical system’. Which is why I am more interested in life and in relationship than in mechanics. Rather than tending to nuts and bolts, we are tending to consciousness…

The Impacts of Retention

Blocked or withheld energy increase density, tension and inertia. The increase in density makes tissue structure less able to conduct energy. As a result, tissue becomes vulnerable to the flow of energy moving through it, and resists communication: the survival instinct is generating a new pattern of behavior built upon resistance and refusal. Resistance, refusal, becomes an operational strategy for survival. And, this strategy is systematically implemented as a first response each time any anomaly or danger is detected in the living system's environment. The impacts of retention include:

– Reduced consciousness (as a result of reduced exchange).
– Increased vulnerability.
– Densification, inertia, retraction (as a result of energy retention).
– Mechanical impacts. 

Creation of a non-physiological fulcrum, which alters the entire system’s mechanics.
Attraction of connected tissue.
Progressive rigidification of the body system, aging.


From the perspective of consciousness, there are two worlds: the inner and outer world. We might also call these ‘inner and outer space’, or ‘inner and outer universes’, where inner and outer are the two opposite poles of a pair that coordinates space. As far as consciousness is concerned, inner space is single-pointed. This single point being the center in which I resides.Outer space is infinite in nature and represents all that is not-I.

Information and Movement

Our model has postulated that, in order to preserve the consciousness of its existence, I must establish and maintain an exchange with its inner world (I) and its outer world (not-I), expressed in the form of influx and efflux. This exchange occurs in the form of energy, which may be defined as information in movement” (Brinette, 1992, 23 - English translation). This definition is used by bio-energetic practitioners, and I find it particularly relevant. Indeed, it encompasses the two facets - the subjective and the objective - of an identical concept. This definition helped me to see that when energy is retained, information is also retained, and to understand certain phenomena that occur when areas of retention are liberated, such as, for example, (biological or psychological) emotional discharge. Brinette describes information as a concept in motion”(Brinette, 1992, 23 - English translation). Information is not material in nature, information is meaning, significance.

The word Concept is borrowed from the Latin conceptus, past participle of the verb concipere, ‘to conceive, to contain fully’. “Intellectual representation of an objected envisioned by the mind” (Larousse Dictionnary). “General and abstract mental representation of an object. Idea (gereral), notion, representation; conception, conceptualisation: abstraction, generalisation. Concepts are not affiliated to language.” (Grand Robert). It is vital that we understand this last point: a concept is a representation of something, and this representation has no affiliation with the language used to express the concept. Such logic is useful when we communicate with living systems, which, in truth, are responding to concepts (information), not to language. We may also describe a concept as the representation that remains after an experience.

The word information also has Latin roots, borrowing from informatio “formation”, “shape”, “idea”, “conception”. The Larousse Dictionary gives the following definition: “A segment of knowledge likely to be encoded for preservation, processing or communication”, which is very close to the notion of concept. To inform is defined as “to share information” (also Larousse Dictionnary),“To give structure, form, significance to something” (Encyclopædia Universalis).

Inner Space, an Information Repository

Throughout evolution, by amalgamating matter to create life, and increasing its complexity as an organism, single-pointed consciousness became volume. Consciousness equipped itself with material boundaries, the first of which was the cell membrane. Thus, all individuated systems within the body possess an inside and an outside, separated by a membrane. The body also has an inside and an outside, separated by the skin.

The tissular model postulates that all the information concerning a living system exists in its inner space or world. In order to help this system of consciousnesses, we must access this body of information, find the specific information that holds the key to the system’s distress, and then work with this information in order to liberate what must and can be liberated.

Types of Information Retained

When in response to a perceived threat to its survival, a living system resists or refuses to communicate, the situation it finds itself in contains information. And, this information may be more or less complex, more or less fecund, depending upon the exact situation. When it resists or refuses to communicate, a living system withholds energy, and therefore information, which is related to the event that triggered the refusal. Therefore, an area of retention may contain a number of different types of information, determined by the energy flows implicated in its creation. Types of information include:

Decision, deliberation, refusal. The prerequisite to any living entity’s existence is the decision to exist (an I am, as it were). We attribute to tissues the same concept of consciousness as we attribute to ourselves. It is therefore difficult for us to imagine what decision or deliberation might look like at the tissular level. It is actually much simpler than that. Tissular consciousness is elementary, almost exclusively based upon I/not-I, in other words, upon quasi-binary thought. At this level of consciousness, the nature of the response to quasi-binary thought is just as elementary and boils down to yes or no. When tissues refuse to communicate, the decision is therefore no. Perhaps doesn’t really come into play…

Non-communication is a direct result of refusal. Non-communication reduces the refusing area’s consciousness of its own existence, as this area differentiates itself from the organism to which it belongs. As a result, the organism loses consciousness of the area’s existence. The area in retention more or less disappears from the organism’s pattern of consciousness, and proportionally from its control. Which is why patients do not know where their areas of retention are, and are only aware of the resulting discomfort.

Movement may be another aspect of the information retained in an area of retention, especially if the incident which generated the refusal contained significant kinetic energy. In such cases, liberation will occur mainly in and through movement. This type of liberation is quite characteristic of whiplash.

Pain is often an aspect of the information retained in tissue. Indeed, it is pain that most probably generated the resistance and refusal in the first place. Patients often verbalize a form of pain when retention is liberated. This pain is other than the inflammatory pain which immediately manifests when a body area is contacted or mobilized. It appears progressively during this process, and though it may sometimes be intense, it is almost never intolerable. Patients often speak of a soothing pain, because this pain accompanies a process of liberation.

Emotion too

Emotion is often present as informative content within areas of retention. We have all experienced the emotional liberation that can occur when tissue releases.

Chemical residues and toxins often stagnate within areas of retention. These chemical residues and toxins were either present at the time the retention occurred, or build up as a result of the stagnation itself, caused by the refusal to communicate. When an area of retention is liberated, these residues and toxins may be released into circulation and need to be eliminated by the body. This is one explanation for phenomena such as fatigue and diffuse pain, which manifest upon liberation of a retention, or in the following hours and days.

Space-time orientation is another piece of information that is recorded within tissular retention. This stands to reason, as any situation that generates retention occurred at a precise moment in an individual’s life, in which their body was inhabiting and orienting to space in a particular way. When a liberation process occurs, one often feels the patient’s tissues move into the position they were in at the time of the trauma that caused the retention.

In addition, energy retention is a response to actual aggression. When energy retention persists, though the actual aggression is over, a system will remain frozen in a bygone present, a past present. As a result, it will experience the present with obsolete parameters, and be unable to adapt to life in the present. The body is unable to be entirely present and unable to function correctly. It is loaded with areas of retention, each carrying different moments of the past over into the present. “Any event, mental, emotional, physical that distorts, empedes or interrupts the free inherent rhythms of life is a link forged in the chain that binds a man to his past.” (Frymann 1998, 253-254).

This understanding of retention phenomena and retained information irresistibly evokes the concept of memory. To retain energy is to retain information. Halted energy becomes a form of potential energy. This potential energy holds within it information that is frozen in the retention. And, this frozen information disrupts the system’s life processes and prevents it from living in the present.The more unconscious this process of memorization is, the greater the disruption it causes. Such disruption is not spontaneously accessible to the individual’s consciousness, and, unbeknownst to the individual, governs a fragment of their tissular system’s life process. Our liberation techniques are therefore very beneficial for the organism. “Patients and their problems do not retrace steps to return to health: Health is NOW.” (Brooks ed, 1997, 247).


The physician is an involuntary primary respiratory mechanism within a living voluntary body physiology. His patient is endowed with the same qualities, an involuntary primary respiratory mechanism within a living voluntary body physiology” (Brooks ed., 1997, 138 What defines the practitioner is that the practitioner adopts the role of fulcrum and uses the fundamental tools of consciousness, while following a modus operandi.

Les outils du praticien

The most essential tool is consciousness, i.e. communication. To be effective, communication must be grounded in reciprocally acknowledged reality. Bodily reality has two dimensions:

– The material dimension, related to the body’s physical reality. We call this dimension of reality objective reality;
– The immaterial dimension, related to the consciousness of the body. We call this dimension of reality subjective reality.

Communication with the living body system seeks to connect with it in both these dimensions of reality, using the (previously defined) parameters of communication:

– The subjective parameters of presence, attention and intention, related to being;
– The objective parameters of density, tension and velocity, related to matter. When practitioners attune to the density of their patients’ tissues, they are able to perceive plasticity.

Palpation: Perceiving Plasticity

If we accept that absolutely all living systems are animated by alternating movements of expansion and retraction, we come to understand the body system as plastic. We then understand Sutherland when he says: “Osseous tissue is also fluid.” (Wales ed, 1990, 127).

Yet, our first experience of osseous structure (bone) is not its plasticity. Our first misunderstanding - or more accurately misperception - of body structure begins when we are very young, most often in the classroom. The bone specimens that we discover at school have been reduced to their mineral, dry, brittle, hard qualities. Our first representation of osseous structure is built upon this initial experience. And, being our first experience, it implicitly prevails until a different experience compels us into re-evaluating it. Thus, the concept of structure conjures up something material, fixed, rigid, non-living.

Rigid and Supple

This misperception is reinforced because, in normal states of consciousness, bone does indeed seem rigid to us. Is bone not our framework? How then could it be anything but rigid? In our ordinary state of consciousness, we do not discern this rigidity as relative. However, in reality, living bone is both rigid and supple. It is rigid thanks to its mineral constituents. And, it is supple, thanks to its organic constituents. To express the concept of plasticity, Sutherland uses the metaphor of the oak tree: “Even the trunk of the mighty oak possesses flexibility to a certain degree until it becomes a sapless log. The tall Norway pine flexes and sways to the wind. A dead Norway pine of the same diameter and height standing nearby is as rigid and inflexible as a telephone pole. (Strand-Sutherland et Wales eds, 1998, 87). Yet, though Sutherland speaks of his perception of plasticity, he says nothing of his state of consciousness when perceiving in this way, and describes no modus operandi for reaching such a state. Might it be possible that he in fact did not realize that such perception required a change in consciousness? That he simply perceived things this way, without realizing that his perception was different to that of his contemporaries? Could this explain the many misunderstandings that have arisen since?

We perceive the body system’s rigidity when we draw upon our mineral consciousness. However, it is possible to perceive the body system’s suppleness when we draw upon our organic (living) consciousness. When we modify our state of consciousness (in particular through working on presence) and tune into the objective parameters (density) of osseous structure, we may begin to perceive osseous structure as plastic and therefore transform our representation, our conception. It would seem that experience alone has the power to modify, to re-actualize an implicit representation or model. The concept of fluidity or plasticity is logical when we see the cell as a locus of communication.

Modus-Operandi pdf_button

The detailed explanation of the treatment modus operandi is too long to go into in this conference. I will, therefore, simply outline the main phases of the process.

Establishing communication within the system: The information that is disrupting the system resides within the system. Therefore, it is within the system that we must seek it in order to liberate what must be liberated. However, the entire body system must first be brought into a state of communication great enough for it to surrender the information. This first phase is the most important and longest phase of treatment. It draws upon general osteopathic approach techniques, in particular compression of the occiput.

Seeking, finding and liberating areas of retention: This becomes possible once communication has been established within the system. The mechanical approach is used first: a retention disrupts the mechanics of a plastic and pulsating system much like an insect caught in a spider’s web disturbs the harmony of the web.

Restoring harmony in the system: Since an area of retention disrupts the entire body system, its liberation, though salutary for the organism’s life force, will trigger a change that the system may find challenging to manage. The practitioner’s first duty is to help the patient’s body system regain balance, in particular by helping them recenter themselves about their primary mechanical axis (the dura mater) and their physiological fulcrum, Sutherland’s fulcrum.

In Conclusion

In this brief presentation, I have attempted to present the foundations of the tissular approach as succinctly as possible. This is not simply an understanding of osteopathy, it is an understanding of life. This approach underlies everything I do as a practitioner and as a man. It gives me coherence. My understanding emerged gradually, along with the realization that in osteopathic treatment, the practitioner’s relationship with his/her patient cannot be that of an external, neutral facilitator. As Becker says, the therapeutic relationship engages two beings in their voluntary and involuntary mechanisms. Two beings impacting each other and responding to each other. It has become clear to me that the limitations of osteopathy are in essence those of the osteopath, which implies that in order to help patients more effectively, osteopaths must first help themselves and follow a path of personal development. Seen in this light, I see osteopathy as a pioneering approach in the implementation of a new therapeutic paradigm.

Translation: Naomi Walker


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