“So many therapists are striking at the pattern of disease, instead of supporting the pattern of health. One of the things that you as Rolfers must always emphasize is that you are not practitioners curing disease; you are practitioners invoking health. Invocation is possible by an understanding of what the pattern is, the structural pattern of health. As you bring a person’s structure to conform to that pattern of health, you achieve health. You invoke health.” — Ida Rolf (Note 1)
“The century just passed may well be examined by future historians as a period during which humans explored their world with a tool, or if you will, a microscope, of specialisation: as a period when people thought that by increasing the detail known about the enveloping universe, they could have their world under control. The fallacy of this now increasingly apparent.” — Ida Rolf, writing in 1962 (Note 2)
The word holism is often used vaguely to mean something like “alternative” or “new-agey”, something to do with philosophy or food or perhaps health. The purpose of this article is to explore the meaning of holism in the field of health and to examine where Rolfing structural integration fits as a therapy within the holism-reductionist spectrum.
The term “holism” has its roots in the Greek word “holos,” meaning “whole” or “complete.” Coined by the South African statesman, soldier, and philosopher Jan Christiaan Smuts in the early 20th century, holism emerged as a concept that aimed to transcend reductionism, a method that breaks down complex systems into simpler components. Smuts introduced holism in his 1926 book, Holism and Evolution, where he argued that wholes have properties that are greater than the sum of their parts. This concept can be applied to various fields, including ecology and environmental science, education, sociology, anthropology, business management, philosophy, architecture and health. The opposite of holism is reductionism, where parts are considered in isolation.
In the field of philosophy reductionism is equivalent to analytical philosophy, where the emphasis is on logical propositions and subjects and objects are treated as independent. Holism is equivalent to phenomenology or existentialism, where subject and object are considered to be interconnected, embedded in a context and where the meaning of objects is shaped by the subject’s consciousness.
Holism and reductionism offer contrasting lenses through which to understand health.
Hippocratic Holism
Although the term holism was coined by Smuts in 1926, the holistic view was exemplified by the “Father of Medicine”, Hippocrates, who lived during the Classical period (circa 460–370 BCE) and is credited with revolutionizing the practice of medicine.
Hippocrates saw balance as a precondition for health and his understanding of balance was deeply rooted in the ancient Greek concept of eucasia, meaning “good blend”, which referred to a state of equilibrium or harmony within the body. Hippocrates’ teachings emphasized the importance of balance in various aspects of life, including bodily fluids, diet, environmental factors and lifestyle. It also focused on understanding the patient’s unique constitution and recognised the need for personalized treatment based on the restoration of humoural balance (referring to the four bodily fluids called humours: blood, phlegm, black bile, and yellow bile).
This approach laid the foundation for a more holistic understanding of health, considering factors beyond mere symptoms and addressing the underlying causes of imbalance. Hippocrates believed in the body’s natural ability to restore balance and health through the vis medicatrix naturae, the healing power of nature. The physician’s role was to restore order where disorder existed, to give the right conditions and support so that the body can initiate its own healing processes.
Cartesian Reductionism
René Descartes (1596-1650), a French philosopher, mathematician, and scientist, made significant contributions to reductionism through his dualistic philosophy and mechanistic view of the body. Descartes is often associated with mind-body dualism, which differentiates the mind and body as distinct substances: res cogitans and res extensa accordingly. He asserted that the mind and body were distinct entities with unique characteristics. This separation of mental and physical phenomena in his metaphysical dualism, also known as Cartesian dualism, provided the foundation for a reductionist methodology.
Descartes’ view of the human body as a complex soft machine governed by mechanical principles contributed to a reductionist understanding of the body’s operations, a mechanistic notion later taken up by Newtonian physics. His metaphysical dualism, sometimes referred to as the Cartesian split because the mind and body were considered to be separate, was a departure from the more holistic view of the human espoused by Hippocrates which was still prevalent in Descartes’ time.
Cartesian dualism had a profound influence on Western philosophy and contributed to the historical separation of mental and physical health in medical practice. Descartes’ Discourse on the Method, published in 1637, is considered a foundational text that significantly influenced the development of the scientific method and the transition from medieval Scholasticism, which blended reason and religious principles in understanding and treating illnesses, to the scientific revolution of the 17th century. His ideas laid the groundwork for the empirical and analytical methods that became fundamental to the scientific revolution and the subsequent development of modern science. He advocated for a systematic and deductive approach to scientific inquiry, emphasizing the use of mathematics as a foundation for understanding the natural world.
Allopathic medicine focuses on the physical aspects of health and illness, and places a strong emphasis on physical interventions, such as surgeries, pharmaceuticals, and other medical procedures. This aligns with the Cartesian view that the body operates as a mechanistic system, subject to physical laws.
Specialisation is prominent in modern medicine where medical disciplines focus on specific organs or systems, leading to a compartmentalized approach that treats the body as a collection of isolated parts. Modern healthcare systems, including insurance structures, may reinforce the separation of mental and physical health because of the existence of different reimbursement structures and systems for mental health services compared to general (physical) healthcare.
Holism and Reductionism: Pros and Cons
While holism embraces the complexity and interconnectedness of human well-being, reductionism seeks to dissect and analyze specific components. It is important to note that while holism and reductionism are often presented as opposing approaches, they are not necessarily mutually exclusive, and there are practitioners of each approach that respect the values of both. Holism and reductionism have their strengths and weaknesses, as outlined below, and optimal treatment should embrace the benefits of both approaches.
Benefits and Criticisms of Holism
There are several key benefits of holism. Its comprehensive perspective considers the patient as a whole, acknowledging the interconnectedness of physical, mental, and social aspects and thereby addressing various factors influencing health. Another name for this holistic approach is the psychobiosocial model of health championed by Gabor Maté, Bessel van der Kolk, Jeff Rediger et al.
Holism commonly emphasizes patient-centered care, giving priority to patient values, preferences and individual experiences. Importance is placed on tackling the root causes of disease and encouraging clients to adopt preventative measures and lifestyle changes to improve overall well-being. Interdisciplinary collaboration between healthcare practitioners is encouraged in order to develop a comprehensive understanding of patient needs. In holistic treatment there is often more time available for the treatment, which gives more opportunity for the advantages that can accrue from an ongoing therapeutic relationship.
Critics argue that holism can be vague and lack precision in defining specific treatment protocols and claim that insufficient attention is given to specialized medical care. Holistic approaches often require more time and resources than traditional medical interventions, which can be problematic in a healthcare system with time constraints and resource limitations. The holistic approach may sometimes be criticized for a lack of standardized interventions and holistic practices are sometimes labelled as pseudoscientific because of a perceived paucity of empirical evidence.
Benefits and Criticisms of Reductionism
“The problem with classical disembodied scientific realism is that it takes two intertwined and inseparable dimensions of all experience – the awareness of the experiencing organism and the stable entities and structures it encounters – and erects them as separate and distinct entities called subjects and objects.” — George Lakoff, (Note 3)
Reductionist approaches often align with the scientific method, promoting rigorous experimentation and empirical validation and contributing to the development of evidence-based medicine.
With its focus on breaking down complex biological phenomena into simpler, more manageable components, reductionism has contributed to numerous advancements in biomedical research and technology.
Reductionist approaches have contributed significantly to an understanding of the immune system at the molecular and cellular levels, which has led to the development of vaccines, immunotherapies, and treatments for autoimmune diseases as well as a profound understanding of the genetic and, more recently, epigenetic basis of various diseases. Other key advances attributable to reductionism include biomedical imaging techniques, stem cell research and precision oncology.
Despite the obvious benefits of reductionism there are also downsides to its emphasis on reducing complex phenomena to simpler, mechanistic explanations. It has been criticized for not adequately accounting for the intricate interconnections between mental and physical health and for not fully capturing the complexity of biological processes and interactions.
If we only consider systems by viewing their individual parts we miss the significance of interrelationship between the parts and may also overlook the emergent properties of a system or disregard the synergistic effects of multiple components working together. For example in pharmacology understanding the effects of a drug on individual receptors may not fully capture how the drug interacts with the entire biological system.
Prioritization of physiological or mechanical explanations may downplay the significant influence that various psychosocial factors, such as stress, social support, and cultural context can have on health. Understanding health requires consideration of the dynamic interactions between various physiological systems, rather than isolating individual components. Chronic health conditions often involve a complex interplay of biological, psychological, and social factors and reductionism may fall short in providing comprehensive explanations and interventions for chronic pain and disease.
Rolfing and Holism
A “whole man” can evolve only when his nervous system is supported internally by his myofascial web and externally by his gravitational field.” — Ida Rolf (Note 4)
The basic concept of holism is the idea of viewing a system as a whole and recognising the interconnectedness of its parts. Rolfing can be said to be a holistic therapy in two senses.
First, Rolfing views the human physical body as an interconnected whole embedded within an environment, with an emphasis on the importance of creating balance and harmony to evoke health.
“Persistent contracture of very powerful tissue compresses the underlying joint. In so doing, it imbalances other muscular structures whose integrity depends on precise balance in related joints. Such compression can enter awareness as pain or discomfort. The only permanent remedy is to balance the joint; frequently this requires balancing the entire body, for these various fascial links can elicit compensatory strain over wide areas.” — Ida Rolf (Note 5)
“In order to make a significant difference to that chronic lesion, the person’s whole system has to be taught a new, more balanced organization.” — Ida Rolf (Note 6)
The Rolfing Series is designed to manipulate the whole body in a sequence of sessions, each session building on those that come before. Instead of being treated in isolation, individual parts are considered within the context of the whole body interconnected throughout the myofascial web mediated by the nervous system. The myofascial system is a tensegrity structure that distributes strain throughout the body. In Rolfing pain or imbalance in any local area is therefore addressed by treating not only the particular part where the pain experienced is but also the strain network within which the part resides.
As an example let us imagine a client with back pain. The pain in the back may have been triggered by a recent event, but the vulnerability of the back could be have been influenced by something in the past. The body can hold compensating imbalances for many years after an injury. The client badly sprained his right ankle playing soccer fifteen years ago. The pain caused him to limp for three weeks and limited the movement in his right ankle.
Even after the ankle injury healed, he retained the habit of putting more weight on his left leg. Over time this contributed to the hamstrings of his left leg becoming permanently tense, and his pelvis to be asymmetrically rotated. Because of the left hamstring tension the sacro-tuberous ligament restricted movement in the left side of his sacrum. The twisted pelvis in turn made it more likely for his back to become locked into a sidebend and rotation, which made his back more vulnerable to injury – a kind of ticking time bomb in the myofascial system.
The solution to this strain pattern distributed throughout the body is not just to manipulate the back. In order to get a long-term resolution to the back pain the Rolfing practitioner needs to prepare the client’s feet to be able to distribute the body’s weight evenly.
The excess tension in the left hamstrings must be addressed and functional aspects of walking improved to reduce asymmetry from side to side. And of course the myofascia of the back where the client feels the pain must be skilfully treated, even though with this body-wide approach it sometimes happens that pain resolves even before the injury is directly manipulated. Because of this thorough approach the chances of the pain recurring in future are reduced.
In addition to getting the individual parts of the body to be more congruent with each other, the goal of Rolfing, originating with Ida Rolf, is to bring the human body and its energy field into better alignment within the greater energy field of gravity. The key is relationship, between the parts and each other, between the parts and the whole, and ultimately between the whole body and the gravitational field:
“A Rolfer’s only secure ground in a body is to establish balanced relationship. That is your secure ground, and it is not possible to convert it into something that is solid like a wall.” — Ida Rolf (Note 7)
“Rolfers make a life study of relating bodies and their fields to the earth and its gravity field, and we so organize the body that the gravity field can reinforce the body’s energy field. This is our primary concept.” — Ida Rolf (Note 8)
“… well-being does not merely manifest the physiological competence of individual parts but rather indicates relationship among parts and, more important, between the person and the earth’s energy field… Reciprocal relations of head and pelvis determine how the individual as a whole fits into the gravity field.” — Ida Rolf (Note 9)
The second sense in which Rolfing is holistic is in its acknowledgement of the human being as having four planes of being which interconnect and affect each other: physical, mental, emotional and spiritual. Ida Rolf’s conviction was that the physical plane is primary, that often what we believe to be psychological or emotional problems have their roots in the human form because of disorder in the human structure. In Rolf’s words:
“… a man’s emotional state may be seen as the projection of his structural imbalances.” — Ida Rolf (Note 10)
The good news is that Rolfing is an effective way to address imbalances in the body and integrate the body to a higher level of order. As the client starts to feel the physical benefit of the Rolfing treatment in terms of pain reduction, ease of movement and an enhanced feeling of connection to the ground and space around them, they sometimes feel more resilient and find that they deal better with stressful situations.
For all its good points, the reductionist approach to health has significant negative points. A doctor client of mine explained how he had entered medicine full of good intentions to help people. He recounted how he had a social gathering with his fellow doctor friends soon after they had all started practicing as GPs. He told me that they were all frustrated with the system which only allowed them seven minutes of time with each patient. They all felt that because of these time constraints they could not really help people and make a difference.
Doctor Rangan Chatterjee’s podcast Feel Better Live More, which explores holistic treatments and ideas, was borne out of his own frustration to be able to help people within the medical system. Gabor Maté is a physician who has written extensively about addiction and trauma. Maté, like Chatterjee, discovered that he was able to help his patients more effectively when he managed to find time to talk to them and find out about their lifestyle, to listen to them and to give space for compassion. For Maté disease is a complex phenomenon that demands to be considered in context:
“Disease is an outcome of generations of suffering, of social conditions, of cultural conditioning, of childhood trauma, of physiology bearing the brunt of people’s stresses and emotional histories, all interacting with the physical and psychological environment.” (Note 11)
If we acknowledge that the human body has a powerful inherent ability to heal, what are the implications of administering pharmaceutical drugs to treat the symptoms of disease? There is nothing wrong per se with administering medication to alleviate immediate suffering. But if we do not go deeper than symptoms to get to the root cause of disease, then this can lead to drug dependency. In my travels I have witnessed people having a basket full of different pills for daily consumption. No one appears to be seriously advising them about how lifestyle choices such as diet, exercise or alcohol moderation can impact health.
If drugs are administered so freely in order to chemically treat symptoms without trying to tackle the root cause of the disease, the problem is not only dependency, but personal disempowerment.
In the words of Jeff Rediger:
“Doctors are taught to ignore the story, the personal life of the person, in order to penetrate through to the underlying signs and symptoms of disease that are present in those with that particular illness. We have been limited by a focus on pathology, on what is missing or diseased, instead of seeing and galvanizing all that is right, special, and great within each individual human life—within your life. As a result, we routinely commit deadly errors even as we seek to heal. We treat the disease instead of the person, missing the larger story of the patient’s life, which is rife with clues and revelations about how best to guide them toward health. We focus on symptoms instead of root causes, prescribing medications that often simply mask the symptoms instead of attempting the longer, harder work of building immunity and vitality.” (Note 12)
As Rolfing practitioners we have the gift of time. The ability to talk and listen to our clients is a key strength of Rolfing as a holistic therapy. The Rolfing Series takes place over ten or eleven sessions occurring once or twice a week. This enables a therapeutic relationship to develop based on trust and safety, which in itself can be deeply empowering for the client. It is this treatment of the whole person in Rolfing, within a healthy therapeutic relationship, which has the potential to catalyse inner reserves of self healing within the Rolfing client.
In his book Cured, Rediger recounts many scientifically evidenced instances of people who spontaneously recover after being given a terminal diagnosis such as end-stage systemic lupus or glioblastoma multiforme, the most aggressive form of brain cancer. Rediger attempts to identify the common factor in these cases of spontaneous remission.
Eventually he comes to realise that the key element in these remarkable changes from disease to health is not diet, exercise, sleep, yoga or stress management, although these played their part — “… the biggest and most crucial change was to their very identities.” (Note 13)
Rediger describes how each of the people who experience spontaneous remissions undergoes a figure-ground reversal in the way they view themselves, a “process of self-discovery, or self-reassessment.” One person, Claire, talks about “getting right with myself”, another Dr. Kaine said that she had to “surrender to a new way of seeing and experiencing myself.” (Note 14)
So how is this relevant to Rolfing? Let me be clear. I am not suggesting that Rolfing can cure people who have been diagnosed with terminal disease. But if it is true that a change in one’s identity can be a key factor in profound health improvements, then Rolfing has something to offer here.
People who receive Rolfing can start to identify more with their body because of the rich sensory information that Rolfing provides to their nervous system. This can cause people to snap out of habitual patterns of sensation and movement to discover new and interesting options. It is as if the body somehow wakes up and the person becomes motivated to be more responsible for their physical well being.
Indeed this happened to me in my first Rolfing Series in 1994. Until that point I had identified primarily with my mind and ignored, even neglected my body. The Rolfing changed this profoundly and permanently. My mind no longer felt separate from my body and instead a bodymind emerged. It was a figure ground reversal in the way I viewed myself, a kind of surrendering to a new way of being.
In modern society I believe many people are like I was. Perhaps thanks to Descartes, the body in modern society has become a soft machine in the way we experience ourselves, a mere vehicle to contain our precious minds. The real gift of Rolfing is to wake us up to our bodily being so that we can become whole again.
Endnotes
1. Ida Rolf. (1990). Rolfing and Physical Reality. Rochester, VT. Healing Arts Press, p. 202.
2. Ida Rolf. (1962). Rolfing Structural Integration. Gravity: An Unexplored Factor in a more Human Use of Human Beings. Boulder, CO. The Rolf Institute, p. 1.
3. George Lakoff, Mark Johnson, Philosophy in the Flesh: The Embodied Mind and its Challenge to Western Thought (University of Michigan, 1999), Goodreads, https://www.goodreads.com/work/quotes/1686657-philosophy-in-the-flesh-the-embodied-mind-and-its-challenge-to-western (accessed February, 19, 2024).
4. Ida Rolf. (1989). Rolfing. Reestablishing the Natural Alignment and Structural Integration of the Human Body for Vitality and Well-Being. Rochester, VT. Healing Arts Press, p. 202.
5. Ibid., p. 69.
6. Rolf, Rolfing and Physical Reality, p. 171.
7. Ibid., p. 111.
8. Ibid., p. 86.
9. Rolf, Rolfing Structural Integration, 249.
10. Ibid., p. 17.
11. Gabor Maté, The Myth of Normal. London. Vermilion, 2022. Kindle edition, chap. 5, loc. 15%.
12. Dr. Jeff Rediger. (2020). Cured. Dublin. Random House. p. 9.
13. Ibid., p. 257.
14. Ibid., p. 257.