Chiropractic Honesty

I was recently made aware of a blog post written by Stephen Perle,[1] a well-known voice in the chiropractic profession and a professor at a chiropractic college. Interestingly, the subtitle of Perle’s blog is, “A forum for intellectual honesty.” In my view, intellectual honesty requires that we include as many perspectives as possible, not only one, because it is bound to be limited, narrow in focus, and prone to errors.

It is obvious that Dr. Perle thinks his approach is historically accurate. Unfortunately, such assumptions are at the core of chiropractic’s internal conflicts. When we don’t consider our own perspectives and how they shade our point of view, we are prone to think that we must be correct. Add to that a hand full of references that come from the same perspective and a self-perpetuating false authority gets established. In my first blog post I compared this to the telephone game.[2]

More than anything, I seek to build bridges in the chiropractic profession. Doing so makes it vitally important to point out faulty arguments and bad scholarship so that we may all move forward together. There is hardly anything more important in a profession than good scientific research, accurate historical accounting, and solid philosophical reasoning. When these three methodological approaches are utilized from the widest possible perspectives, we are likely to find large areas of agreement.

Since the post in question was written in 2009, I would have ignored it at this point if not for the fact that it was recently sent to all of the members of a state association. And, it does represent some of the most basic mistakes being made in historical interpretations of the philosophy of chiropractic, so here we go…

Perle begins the article by pointing out the important research of the late Joe Keating. One of Keating’s main contributions to the history and philosophy of chiropractic was establishing how D.D. Palmer’s ideas evolved during his final decade of life.[3]

Palmer’s use of the term vertebral subluxation was only written down after the 1907 Morikubo trial, and after it was widely used in Smith, Langworthy, and Paxson’s textbook.[4]  There is no written evidence of Palmer’s use of the term subluxation before. The term is generally attributed to Langworthy and made important to the profession based on the Morikubo case.

So, I don’t really take issue with the fact, that Perle would equate all of D.D.’s previous theories with his final theory. That is common pluralistic thinking in academia. But to suggest that D.D.’s final writings on chiropractic DID NOT set the tone for decades of the profession’s core focus on vertebral subluxation is bizarre.

In fact, Perle goes so far as to suggest that embracing the vertebral subluxation as chiropractic’s core identity is an “attempt to revise the history of chiropractic.” Does this seem Orwellian to you? Just look at the facts.

The vertebral subluxation as a clinical entity is considered by several researchers and scholars in the profession as its reason for being.[5-7] Furthermore, our understanding of the biological mechanisms of vertebral subluxation is constantly evolving, and not rooted in one model.

Historically, it wasn’t just B.J. Palmer and his school that took up the mantle of vertebral subluxation although the Palmer School certainly carried the torch. Many schools and associations have focused on vertebral subluxation going all the way back to the earliest days. Even the leaders of National College of Chiropractic embraced the scientific research of vertebral subluxation since its earliest days; Howard incorporated it into his encyclopedic system, Forster wrote about it extensively, and Janse developed his own theories about vertebral subluxation.[8-12] Not to mention the fact that vertebral subluxation terminology is codified in state law, federal law, Medicare, as well as chiropractic’s main trade organizations. And, 88% of chiropractors want to retain the term.[13]

I will be the first to agree that the traditional use of the term was embedded in other philosophical concepts that made it difficult to consider it solely in terms of objective physiology, but that is another discussion.

The historical and scientific veracity of vertebral subluxation is hardly the main issue at hand. The issue is really philosophical honesty while understanding the importance of perspectives. I will discuss this issue based on three other historical inaccuracies and omissions from the Perle blog post. All three can be viewed in terms of the philosophical perspectives that the Palmer’s attempted to imbue into the profession and a lack of understanding of the role perspectives play in human thinking.

The next problem comes from Perle’s referencing of Gaucher-Peslherbe’s research.[14, 15] He points out the important fact that D.D. Palmer was indeed better read in anatomy, physiology, and surgery than most medical doctors of his day (Perle doesn’t go that far, but Gaucher-Peslherbe does). Perle then uses this fact along with D.D.’s revisions of his ideas to suggest that chiropractors today should be able to rethink chiropractic.

If that were it, I would say, sure whatever, that seems to be what has been happening anyway if you read the literature on vertebral subluxation research, and keep up with technique development in the profession. The problem is that Perle completely omits Gaucher’s main conclusions about D.D. Palmer’s theories and the important role they played in the history of physiology.

Gaucher-Peslherbe was a medical historian who completed his Ph.D. at Ecole des Hautes Etudes en Sciences Sociales (French for School for Advanced Studies in the Social Sciences). His dissertation was published by National (at the urging of Louis Sportelli) as a book entitled, Chiropractic: Early Concepts in Their Historical Settings. D.D. Palmer’s theories are explored in the context of a history of such theories in the medical literature. Gaucher concluded that Palmer was way ahead of his time and contributed to the physiological literature in a significant way. Gaucher Peslherbe writes,

“D.D. Palmer was undoubtedly a visionary…It was because of this vision that he was able to formulate a scientific definition of the concept of subluxation that was in many ways far superior to anything that medicine and chiropractic were able to produce subsequently.” [15](p.166)

He even went so far as to compare Palmer’s wider philosophical approach in terms of subluxation and “what causes disharmony in man,” to philosophers from the last century such as Bergson, Freud, Merleau Ponty, and Heidegger.

A few other glaring mistakes in the Perle “history” should be pointed out:

Perle offers up a picture of the Rehabilitation Laboratory that was part of the B.J. Palmer Research Clinic in the 1940s. Perle points out that B.J. Palmer’s signature (what we might call a logo today) was on the rugs, thus Perle writes, “What this shows is that even BJ Palmer wasn’t so pure and straight as he “mixed” using rehab.” The logic itself is appalling but to so misrepresent B.J. Palmer’s approach and philosophy is a mistake. Perhaps the mistake is because the Lab was called Rehabilitation Lab? I’m not sure but it certainly shows a lack of knowledge.*

The intent of the Rehab Lab was congruent with Palmer’s Innate philosophy. The premise of the lab was  that the internal self-organizing functions of the organism should be allowed to assimilate the energetic changes set in motion by the adjustment through self-guided movements. Thus the whole concept of rehabilitation was turned on its head. I would add, this was because it originated from a perspective that focused on the inherent autopoietic aspects of the organism. It was an inside-out approach to assist the organism to more fully integrate and express the innate intelligence.

The photo itself is from a magazine from 1945 about the Palmer research clinic. In the magazine it clearly states, “At no time, in no way, do we use any therapeutic apparatus on any case.” The Rehab Lab was really for research purposes and also for a place for patients to “digest” the energy now freely moving to paralyzed parts after the adjustment. Patients were not directed to use the equipment and there were no electrical devices besides a riding horse, “which was seldom used.”

Yet another mistake in the blog post is the erroneous claim that the term “innate intelligence” was coined in the book Modernized Chiropractic and used by Palmer after the Morikubo case like subluxation. Not true. Palmer’s first documented use of Innate comes from an article in 1906.[16, 17] In addition, Modernized Chiropractic does not even mention Innate Intelligence!

Finally, Perle refers to the philosophy of chiropractic as a pseudo-religion. I have dealt with this elsewhere and this blog post is way too long.[18]**

As I see it, the core issue (besides mistakes) is a misunderstanding of the role of perspectives in chiropractic. This is a common problem in chiropractic and in most professions.

As adults develop, the research shows that they can increase in the complexity of their thinking and be able to take on more and more perspectives. The level of thinking that most adults are assured to reach is the objective, rational, third-person point of view. Research shows, somewhere around 40% of our culture are at this level.[19, 20] It used to be thought that this was the height of human development, the rational scientific thinker. This is the person who can comfortably deal in 3rd person perspectives. That is, he or she can take the role of another and even view themselves as an “it” or an “object.” Children have not developed this ability yet, and teens are new to this perspective.

Here is the problem, not only may people develop to even more complex ways of viewing the world, such as 4th person perspectives, 5th person perspectives, etc…, but those of us who spend our days relying on 3rd person perspectives might miss that! We don’t even know those other perspectives exist. And, we may generally confuse all other perspectives as less objective than ours, because anything that is not 3rd person perspective tends to look the same to us; probably 2nd person, or at least dogmatic or fundamentalist.

This becomes a real problem in a profession like chiropractic because evidence shows that D.D. Palmer was one of the first post-conventional thinkers of our era and may have attempted to establish the first 4th person perspectival profession.[21] And get this, his son may have even developed to 5th person perspectives or higher in his later years.[22]

Let’s just all take a step back and acknowledge that we might not have the entire truth even though it sure feels like we do. In fact, we might each have partial truths that could in some way blend together and make for a much stronger profession.

Instead of dismissing “everyone” you disagree with as dogmatists, which has become a very tired and philosophically shallow approach in the profession,[23, 24] let’s see if we can determine what else might be going on that other scientific researchers, perhaps in the social sciences, might shed light upon that we are just missing. Honesty comes from facing things you did not even know were there and accepting them.

References

1. Perle, S. 2009. Foundation for Anachronistic Chiropractic Pseudo-Religion, in Perles of Wisdom: A forum for intellectual honesty.

2. Senzon, S. 2012. Chiropractic games & distortions of truth, in Chiropraction.

3. Keating, J. 1992. The evolution of Palmer’s metaphors and hypotheses. Philosophical Constructs for the Chiropractic Profession, 2(1): p. 9-19.

4. Smith, Oakley G., Solon. M. Langworthy, and Minora C. Paxson. 1906. Modernized chiropractic. Cedar Rapids, Iowa: S.M. Langworthy.

5. Haavik-Taylor, H., K. Holt, and B. Murphy. 2010. Exploring the Neuromodulatory effects of vertebral subluxation. Chiropr J Aust. 40: p. 37-44.

6. Gatterman, M. 2005. Foundations of Chiropractic Subluxation: 2nd Ed. St. Louis: Mosby. [Description @ googlebooks]

7. Boone, W. and G. Dobson. 1997. A proposed vertebral subluxation model reflecting traditional concepts and recent advances in health and science: Part I. 1(1).

8. Beideman, R. 1996. The role of the encyclopedic Howard System in the professionalization of Chiropractic National College, 1906-1981. Chiropr Hist. 16(2): p. 29-41.

9. Phillips, R. 2006. Joseph Janse: The apostle of chiropractic education. Los Angeles: R. Phillips.

10. Janse, J. 1975. History of the development of chiropractic concepts: Chiropractic terminology, in The research status of spinal manipulative therapy: A workshop held at the National Institutes of Health, February 2-4, 1975. M. Goldstein, Editor. U.S. Department of Health, Education, and Welfare: Bethesda. p. 25-42.

11. Forster, A. The White Mark: An editorial history of chiropractic. 1921. Chicago: National Publishing Association.

12. Forster, A. 1923. Principles and practice of chiropractic. Chicago: The National Publishing Association.

13. McDonald, W., K. Durkin, and M. Pfefer, How chiropractors think and practice: The survey of North American Chiropractors. Seminars in Integrative Medicine, 2004. 2(3): p. 92-98. [ABSTRACT]

14. Gaucher-Peslherbe, P., G. Wiese, and J. Donahue. 1995. Daniel David Palmer’s Medical Library: The Founder was “Into the Literature.”. Chiropr Hist. 15(2): p. 63-69.

15. Gaucher, P. 1993. Chiropractic: Early concepts in their historical setting. Chicago: National College of Chiropractic.

16. Zarbuck, M. 1988. Innate Intelligence (Part 1). Illinois Prairie State Chiropractors Association Journal of Chiropractic, 1987. 8(4): p. 12-13.

17. Zarbuck, M. 1988. Innate Intelligence (Part 2). Illinois Prairie State Chiropractors Association Journal of Chiropractic, 1988. 9(1): p. 11,16.

18. Senzon, S. 2011. Constructing a philosophy of chiropractic: When worldviews evolve and Premodern roots. J Chiropr Humanit, 18(1);10-23.

19. Cook-Greuter S. 2007. Ego development: Nine levels of increasing embrace. Wayland, MA: Cook-Greuter & Associates.

20. Kegan, R. and L. Lahey, The immunity to change: How to overcome it and unlock the potential in yourself and your organization2009, Cambridge (MA): Harvard University Press. [Preview @ Google Books]

21.  Senzon, S., Constructing a philosophy of chiropractic: When worldviews evolve and postmodern core. J Chiropr Humanit, 18(1);39-63.

22. Senzon, S., B.J. Palmer: An integral biography. Journal of Integral Theory and Practice, 2010. 5(3): p. 118-136.

23. Keating, J., et al. 2005. Subluxation: dogma or science. Chiropractic & Osteopathy, 13(17).

24. Simpson, J. 2011. The five eras of chiropractic & the future of chiropractic as seen through the eyes of a participant observer. Chiropractic & Manual Therapies. 20(1).

*Please click here to explore photos and quotes about the BJPCC Rehabilitation Lab.

**These themes are explored in greater detail in my online courses.

 

 

4 thoughts on “Chiropractic Honesty

  1. Very well written, Dr. Senzon. Working with Dr. Keating for as long as I have, I, too, disagree with what Dr. Perle mentioned about DD’s evolving theories. Those evolved over the entire time from 1895 until his death, not just the last decade of life. It is true that DD did not come up with the phrase vertebral subluxation, Solon Langworthy did, with his compatriots, Oakley Smith and Minora Paxson. As far as the development of the many techniques in our profession, each can point to one of DD’s theories as the philosophical basis of why it focuses on what it does. It was not in Modernized Chiropractic where the term innate intelligience came from, as you rightly stated. With the combined work of Keating, yourself and the rest of us in the field of Chiropractic History, conclusions made by one of us will undoubtedly be reviewed by the rest of us. Chiropractic Philosophy is not a pseudo religion, it helps to explain WHY we do what we do. We do not worship it. Again, your reply was well written and researched.

  2. Great post Dr. Senzon. It seems the harder our profession tries to come together the harder some camps try to prove why there perspective is correct. I to think it is time for some honesty in these discussions.

  3. Thanks for this thoughtful post, great Monday-morning reading.
    The problems in thinking are more serious than the problems in perspective. Many people don’t want to see or consider the other perspective[s] because they know cognitive dissonance waits around the corner. This is evident in today’s national politics where “being right” and defending personal/party dogma is more important than being accurate, cooperative, or solution-oriented.
    There seems to be a growing trend of taking pride in being dumb these days. You only stand a chance of developing 3rd, 4th, 5th person perspective if you are open and willing to do so. As I see it, many on the medipractor end aren’t willing to do this… and I’m sure they’d say the same about me (us).
    Thanks again, keep up the good work.