Osteopathy is a holistic medicine. When a patient enters the clinic, most of the time their physical problem is clear. However, to be able to treat patients properly a deeper understanding of the person, beyond their physical domain, is required. Therefore, all domains of an individual must be taken into consideration during evaluation of the patient. These can be divided into Physical, Cognitive, Affective, Spiritual and Social.

According to Ritzer (“Sociology” 1979), sociology is “The study of individuals in a social setting that includes groups, organisations, cultures and societies.” Socialisation can be divided into primary socialisation and secondary socialisation. Primary socialisation occurs during infancy, and secondary socialisation is the process when the individual starts school where influences from other sources such as school friends start to shape the child’s view of the world. This process continues throughout life and it strongly influences that person’s view or the world. The control these processes have on health and health beliefs should not be underestimated by osteopaths, or by any health care professional for that matter.

For example, why are there some patients who do not do the exercises advised by the osteopath? The patient may have fixed attitudes as to what treatment is about, i.e. they feel that by only going to the osteopath they will get better, and no effort is needed on their own part. Their lifestyle may be such that they simply do not have the time to fit in exercises or to look after themselves. Some people have had a bad experience of exercising as children, during secondary socialisation, which is affecting them now. The osteopath needs to understand the patient’s health beliefs to get a better idea of where that person is coming from.

The shaping of social life by human action is known as agency. A person seeks help when they can no longer act in ways that are significant to them. The experience of illness makes the individual reflect on their body because their agency is affected. This will be discussed further when looking at the phenomenological view of the body.
Sociology of the body investigates the effects of social influence on the human body.

At one end of the spectrum is the social constructionist view in which the body is constructed by social pressures. Today’s society is very fast moving and employees are often complaining about how stressful their lives are. In their advertisements, tobacco companies portray smoking to make the smoker more calm and successful. Despite the label on the advertisements warning of the health risks associated with smoking, many people take up smoking. A few reasons for why people smoke are peer pressure, image/lifestyle, media pressure, social class, childhood environment and/or work environment. This shows very well how health beliefs and social behaviour are related.

At the other end of the spectrum, there is the naturalistic view. Here the body is seen as a biological object to which sociology has no effect. People with this view see disease as a physical breakdown and the diseased parts need repairing.

There is a third type of view, which combines the extremes of both the social constructionist view and the naturalistic view. It includes the relationship between the individual and society, so people create their own experiences when they act in society. This is known as the phenomenological view.

So what about the osteopath’s view? To completely understand the patient and give the best possible treatment, the osteopath must stay completely neutral. The osteopath must put themselves into the patient’s shoes to get to the root of the disease, and therefore successfully assess and treat them. As mentioned before, every individual is unique and therefore each treatment must be uniquely tailored to that individual. People’s behaviour has a meaning, and the osteopath has to get into the mind of the individual to understand that.

Socialisation institutes the way people react to health and illness. A truly holistic diagnosis of a patient needs to take into account the social determinants of their health. Studying sociology gives osteopaths the tools to help take a step back from their own lives and socialisation so the patient can be understood better.

REFERENCES

• Kate Nash. Sociology and the Holistic Evaluation of the Patient. Conceptual Basis of Osteopathy Learning Resource Package.
• Anthony Giddens, (1997) Sociology, Third Edition, Polity Press, UK
• Nettleton, (1995) The Sociology of Health and Illness, Polity Press, UK

Posted by Mr. Trishul Vadi (Principal Osteopath in West Wickham, Beckenham, Bromley & South East London) on Tuesday, September 21st, 2010