Learning about the philosophy of chiropractic is both important in a historical context, but also beneficial as we move forward as a profession. Chiropractic has diverse philosophies, each one understood and applied differently based on how they are interpreted. Studying these philosophies, both old and new, assist future chiropractors in discovering their personal beliefs, ideologies, and what they wish to take away from the profession and share with the public. As stated by Haldeman, this diversity of thought in the health field presents chiropractic with an opportunity to “obtain its own cultural authority” by continuing to explore its ideologies (1). The philosophy of the science of chiropractic has had multiple paradigms, originating with the earlier vitalistic concepts and later branching out to the concept of materialism (1). Vitalism essentially looks at the big picture; taking a holistic approach to the way the body can self heal. It is a proactive and preventative concept that argues there is an internal force or energy source that fuels living organisms (1). Conversely, there is the materialism perspective, which takes a more reductionist approach to chiropractic (and medicine), and states that only matter exists (1).
We can compare these different philosophies to the medical models addressed in Engel’s report on the challenge of biomedicine. The discussion states there is a medical crisis that stems from the lack of understanding of the relationship between physical health and its effects on the psychosocial self, and vice versa (2). When critically studied, it is evident that the biomedical model overlooks the dimensions of illness that relate to the social and psychological aspects of the patient (2). It focuses solely on illness at the level of molecular biology, separating body and the mind (2). Here, the reductionism of disease can be considered materialistic, accounting only for matter and not the internal processes felt by the patient. Of greater importance today, the biopsychosocial model considers the behaviours, and social aspect of the patient, encompassing the ideals of how people perceive and interpret pain (2). Yet again, this can be compared to the philosophy of vitalism, as it approaches health care holistically, focusing on the patient’s illness as a complex entity. Perhaps not obvious at first, the ideas of vitalism and materialism can help understand what defines an appropriate approach to health care, and I believe they are both still integral components to the philosophy of the science of chiropractic.
My philosophy of the science of chiropractic is based upon many aspects of my life and personal experiences. It is very much a combination of the theories discussed above, as well as some components of my cultural background. I believe chiropractic should holistically focus on the individual, respecting that every case is unique in the way the pain or dysfunction is interpreted and experienced. The biopsychosocial model described above proves to be a solid framework from which one can critically gather information, investigate and problem solve based on evidence, yet it still allows room for the vitalistic elements human behaviour manifests. To be able to successfully treat the human body, we must be able to understand all its components; emotional, spiritual, physical and mental. Like in Native American teachings, these four components each have their own aspects, and to attain a certain level of health, balance among these must be achieved. Once again, vitalism and materialism are common themes, and we must respect that when the body is subjected to mechanical stress or illness it is capable of self-healing, and we should not impede this amazing function, but rather assist the body’s natural capabilities.
1. Wiese G, Callender A. History of spinal manipulation. In: Haldeman S, editor. Principles and practice of chiropractic. 3rd ed. New York: McGraw-Hill, Medical; 2005.
2. Engel G. The need for a new medical model: a challenge for biomedicine. Science. 1977:196(4286): 129-136.