Scoliosis
“I wanted only to live in accord with the promptings which came
from my true self. Why was that so very difficult?”
~ Hermann Hesse
Background
Scoliosis is defined as an abnormal side-to-side curvature and rotation of the spine. Idiopathic scoliosis is of unknown origin, and accounts for 80-90% of all cases. Adolescent idiopathic scoliosis is the most common type, and is usually diagnosed during puberty. Scoliosis affects 2-3 percent of the population, or an estimated six to ten million people in the United States. Scoliosis can develop in infancy, early childhood, or adulthood, however, the primary age of onset for scoliosis is 10-15 years old, occurring equally among both genders. Females are eight times more likely than males to progress to a curve magnitude that requires treatment.
The three treatments commonly recommended by medical professionals are: observation, bracing, and surgery. The Cobb angle is a measure of the side-to-side curvature of the spine in degrees, and the severity usually helps doctors decide what treatment to recommend. A curve of 10-15 degrees or less usually results in nothing being done, except for regular checkups until pubertal maturation and growth are complete. At 20-40 degrees, orthopedists will often suggest a back brace. A Cobb angle of 40-50 degrees or more may mean that surgery is recommended. Surgery usually includes fusion of spine with different metal constructions.
Every year in the United States scoliosis patients make more than 600,000 visits to private physician offices, an estimated 30,000 people are fitted with a brace, and 38,000 undergo spinal fusion surgery.
Scoliosis may significantly impact one’s general health and quality of life, often with significant emotional and societal consequences. Reduced participation in social life and interpersonal relationships, physical pain, reduced mobility, poor self-image, depression, and other emotional problems have all been reported. Unwanted physical and psychological side-effects of surgery or brace treatment are also commonly reported.
What is noteworthy about the conventional approach to scoliosis is that, in keeping with the standard western medical model, it is entirely focused on treating symptoms at the physical level. Treatments consist of straightening the spine by force with surgery, or, again using force, preventing the spine from curving further with bracing. Why would the spine curve in the first place? No one knows, but most research into this question again focuses solely on the physical body: abnormal bone growth rates, asymmetrical muscular tension, genetic factors, melatonin levels, and on and on. What if we looked deeper into this phenomenon, not limiting ourselves to the body only, but including the entire person - body, soul, and spirit?
Scoliosis is defined as an abnormal side-to-side curvature and rotation of the spine. Idiopathic scoliosis is of unknown origin, and accounts for 80-90% of all cases. Adolescent idiopathic scoliosis is the most common type, and is usually diagnosed during puberty. Scoliosis affects 2-3 percent of the population, or an estimated six to ten million people in the United States. Scoliosis can develop in infancy, early childhood, or adulthood, however, the primary age of onset for scoliosis is 10-15 years old, occurring equally among both genders. Females are eight times more likely than males to progress to a curve magnitude that requires treatment.
The three treatments commonly recommended by medical professionals are: observation, bracing, and surgery. The Cobb angle is a measure of the side-to-side curvature of the spine in degrees, and the severity usually helps doctors decide what treatment to recommend. A curve of 10-15 degrees or less usually results in nothing being done, except for regular checkups until pubertal maturation and growth are complete. At 20-40 degrees, orthopedists will often suggest a back brace. A Cobb angle of 40-50 degrees or more may mean that surgery is recommended. Surgery usually includes fusion of spine with different metal constructions.
Every year in the United States scoliosis patients make more than 600,000 visits to private physician offices, an estimated 30,000 people are fitted with a brace, and 38,000 undergo spinal fusion surgery.
Scoliosis may significantly impact one’s general health and quality of life, often with significant emotional and societal consequences. Reduced participation in social life and interpersonal relationships, physical pain, reduced mobility, poor self-image, depression, and other emotional problems have all been reported. Unwanted physical and psychological side-effects of surgery or brace treatment are also commonly reported.
What is noteworthy about the conventional approach to scoliosis is that, in keeping with the standard western medical model, it is entirely focused on treating symptoms at the physical level. Treatments consist of straightening the spine by force with surgery, or, again using force, preventing the spine from curving further with bracing. Why would the spine curve in the first place? No one knows, but most research into this question again focuses solely on the physical body: abnormal bone growth rates, asymmetrical muscular tension, genetic factors, melatonin levels, and on and on. What if we looked deeper into this phenomenon, not limiting ourselves to the body only, but including the entire person - body, soul, and spirit?
"Adolescents sense a secret, unique greatness in themselves that seeks expression.
They gesture towards the heart when trying to express any of this,
a significant clue to the whole affair.”
~ Joseph Chilton Pearce, noted child psychologist
A New Model of Illness
Form and content - it is through form that content expresses itself, just as letters and words on a page (form) represent an idea or concept (content). In this way, everything visible, everything concrete and physical, is purely an expression of an idea which is invisible to the senses.
The quality of a painting does not reside in the quality of the canvas or paints; the material components of the painting are merely vehicles of an idea which is the artist’s vision. The function of the canvas and paints is to make it possible for the otherwise invisible to become visible, and so they are physical expressions of a meta-physical (beyond physical) content.
This is also true of the human body, and the consciousness or Spirit that animates us. The content of the invisible Spirit (the artist’s vision) descends to the level of form and is manifested in the body (canvas and paint), and thereby made visible.
Consciousness is to the body as a radio signal is to a receiver; the receiver faithfully displays whatever signal is sent to it from the radio transmitter. And so it is that the body is the representational and visible aspect of our consciousness. If a person’s consciousness falls into imbalance, the fact eventually becomes visible in the form of bodily symptoms. This explains why illness will never be defeated by mankind - it is our nature to become ill. When we cure one disease, another springs up to take its place. One disease or symptom is as good as another. As long as we continue to fall out of balance in our consciousness, we will experience physical symptoms and illness.
Before a problem shows up in the body as a symptom, it makes its presence known in the psyche as a theme, principle, idea, fantasy, or impulse. If we are able to be open and receptive to these unconscious impulses, our way of life becomes creative and lively. If this particular idea or impulse is not welcome or safe to express in the person’s specific environment, with all its expectations and rules of conduct, it will likely be consciously or unconsciously suppressed in order to gain approval and avoid conflict. The idea or impulse is rejected within, and becomes part of our shadow, all in the worthy name of survival.
This would be well and good, except the denied impulse doesn’t just go away. This well-meaning attempt to make ourselves unreceptive to our psychological side leads directly to it condensing into the body and showing up as an unpleasant physical symptom, where it can’t be so easily ignored. The invisible becomes visible, and we are forced to pay attention to it and live it out. The body always keeps us honest.
When physical symptoms appear, rather than addressing the disturbance solely at the level of the physical body, one could work backwards from the physical symptom to the level of consciousness - our psychology - and look there for what is amiss. Invariably, one will find some aspect of the rejected idea or impulse (the shadow) that requires attention. Perhaps it is a creative impulse not allowed expression, or an unpleasant feeling or belief that has not been acknowledged or felt. Something unresolved or unfulfilled, something not as yet lived out, or a seemingly impossible dilemma. It could be anything.
Sometimes, managing physical symptoms at the level of the body is necessary and helpful. Ideally however, it will be seen as an adjunct to the deeper work of delving into the person’s inner world and discovering what is amiss there. When the inner conflict is resolved at the level of consciousness, when the invisible (content) has been fully cared for and addressed, then the unpleasant physical symptom (form) is made unnecessary and can safely fade away. This is a holistic view of health and illness, one that encompasses the entire person and not just the body.
Form and content - it is through form that content expresses itself, just as letters and words on a page (form) represent an idea or concept (content). In this way, everything visible, everything concrete and physical, is purely an expression of an idea which is invisible to the senses.
The quality of a painting does not reside in the quality of the canvas or paints; the material components of the painting are merely vehicles of an idea which is the artist’s vision. The function of the canvas and paints is to make it possible for the otherwise invisible to become visible, and so they are physical expressions of a meta-physical (beyond physical) content.
This is also true of the human body, and the consciousness or Spirit that animates us. The content of the invisible Spirit (the artist’s vision) descends to the level of form and is manifested in the body (canvas and paint), and thereby made visible.
Consciousness is to the body as a radio signal is to a receiver; the receiver faithfully displays whatever signal is sent to it from the radio transmitter. And so it is that the body is the representational and visible aspect of our consciousness. If a person’s consciousness falls into imbalance, the fact eventually becomes visible in the form of bodily symptoms. This explains why illness will never be defeated by mankind - it is our nature to become ill. When we cure one disease, another springs up to take its place. One disease or symptom is as good as another. As long as we continue to fall out of balance in our consciousness, we will experience physical symptoms and illness.
Before a problem shows up in the body as a symptom, it makes its presence known in the psyche as a theme, principle, idea, fantasy, or impulse. If we are able to be open and receptive to these unconscious impulses, our way of life becomes creative and lively. If this particular idea or impulse is not welcome or safe to express in the person’s specific environment, with all its expectations and rules of conduct, it will likely be consciously or unconsciously suppressed in order to gain approval and avoid conflict. The idea or impulse is rejected within, and becomes part of our shadow, all in the worthy name of survival.
This would be well and good, except the denied impulse doesn’t just go away. This well-meaning attempt to make ourselves unreceptive to our psychological side leads directly to it condensing into the body and showing up as an unpleasant physical symptom, where it can’t be so easily ignored. The invisible becomes visible, and we are forced to pay attention to it and live it out. The body always keeps us honest.
When physical symptoms appear, rather than addressing the disturbance solely at the level of the physical body, one could work backwards from the physical symptom to the level of consciousness - our psychology - and look there for what is amiss. Invariably, one will find some aspect of the rejected idea or impulse (the shadow) that requires attention. Perhaps it is a creative impulse not allowed expression, or an unpleasant feeling or belief that has not been acknowledged or felt. Something unresolved or unfulfilled, something not as yet lived out, or a seemingly impossible dilemma. It could be anything.
Sometimes, managing physical symptoms at the level of the body is necessary and helpful. Ideally however, it will be seen as an adjunct to the deeper work of delving into the person’s inner world and discovering what is amiss there. When the inner conflict is resolved at the level of consciousness, when the invisible (content) has been fully cared for and addressed, then the unpleasant physical symptom (form) is made unnecessary and can safely fade away. This is a holistic view of health and illness, one that encompasses the entire person and not just the body.
“Tension is who you think you should be. Relaxation is who you are.”
~ Chinese Proverb
Scoliosis Research
The vast majority of research that has been performed in the field of scoliosis has concerned itself with the efficacy of treatment methods, the effectiveness of certain procedures and treatments in reducing or preventing spinal curves, treatment side-effects, genetic factors, etc. This research is limited to the physical body only.
Some research has been performed related to psychological factors. The majority of this research, however, has dealt with the psychological impacts of having scoliosis, as well as impacts of scoliosis treatments such as bracing and surgery. Most research has neglected the role of psychological factors as relevant in the development of scoliosis. There are several studies, however, that are interesting in this regard:
A 2010 study demonstrated the absence of psychopathological traits in non-treated adolescent girls, but a high level of self-criticism was ascertained as compared to controls.
A 1974 study found a difference in psychosocial adjustment in women with scoliosis. Superficially, the subjects seemed well adapted, but from further analysis, they presented hyper-sensitivity and insecurity.
A 1998 Italian study discovered a discrepancy between a conscious body image and a deeper aspect of feelings of inferiority and insecurity among study participants with scoliosis.
A 2014 study found that 98% of participants with scoliosis had a low expression of aggressiveness, indicating unexpressed or inhibited anger.
A 2012 Polish study found a much greater intensity of internal anger versus external anger in teenagers prior to treatment for scoliosis. The authors concluded that the patients suppressed their anger, and were afraid to express negative feelings in order not to face disapproval and rejection by their families or peers.
According to a 2001 study, only 5% of those with scoliosis declared that they had opportunities to discuss their feelings with health professionals, while 90% of them declared that they wanted to have more opportunities to do this.
The theme that seems to run through these studies is: What you see is not what you get. People with scoliosis often seem on the outside to be well-adjusted and doing fine, but inside harbor unresolved and unattended feelings of hyper-sensitivity, insecurity, inferiority, self-criticism, and anger. The invisible inside and the visible outside don’t match.
It is also interesting to note that according to one study at least, the majority of health professionals involved in a typical scoliosis case apparently do not consider the feelings of the patient to be relevant to treatment outcome.
The vast majority of research that has been performed in the field of scoliosis has concerned itself with the efficacy of treatment methods, the effectiveness of certain procedures and treatments in reducing or preventing spinal curves, treatment side-effects, genetic factors, etc. This research is limited to the physical body only.
Some research has been performed related to psychological factors. The majority of this research, however, has dealt with the psychological impacts of having scoliosis, as well as impacts of scoliosis treatments such as bracing and surgery. Most research has neglected the role of psychological factors as relevant in the development of scoliosis. There are several studies, however, that are interesting in this regard:
A 2010 study demonstrated the absence of psychopathological traits in non-treated adolescent girls, but a high level of self-criticism was ascertained as compared to controls.
A 1974 study found a difference in psychosocial adjustment in women with scoliosis. Superficially, the subjects seemed well adapted, but from further analysis, they presented hyper-sensitivity and insecurity.
A 1998 Italian study discovered a discrepancy between a conscious body image and a deeper aspect of feelings of inferiority and insecurity among study participants with scoliosis.
A 2014 study found that 98% of participants with scoliosis had a low expression of aggressiveness, indicating unexpressed or inhibited anger.
A 2012 Polish study found a much greater intensity of internal anger versus external anger in teenagers prior to treatment for scoliosis. The authors concluded that the patients suppressed their anger, and were afraid to express negative feelings in order not to face disapproval and rejection by their families or peers.
According to a 2001 study, only 5% of those with scoliosis declared that they had opportunities to discuss their feelings with health professionals, while 90% of them declared that they wanted to have more opportunities to do this.
The theme that seems to run through these studies is: What you see is not what you get. People with scoliosis often seem on the outside to be well-adjusted and doing fine, but inside harbor unresolved and unattended feelings of hyper-sensitivity, insecurity, inferiority, self-criticism, and anger. The invisible inside and the visible outside don’t match.
It is also interesting to note that according to one study at least, the majority of health professionals involved in a typical scoliosis case apparently do not consider the feelings of the patient to be relevant to treatment outcome.
"The body is the shore on the ocean of being."
~ Sufi (anonymous)
Specific Approach For Scoliosis
Regarding the holistic treatment of scoliosis patients, it needs to be said that every person is unique. The inner themes, issues and conflicts that may be contributing to the aberrant spinal curves are unique to that person; there is no one-size-fits-all approach. That said, we can make some generalizations. People with scoliosis, as with many other diseases, tend to struggle with the theme of authenticity. There is a shadow, a secret truth deep within them that is not being lived out in some way. The outside appearance indicates one thing, and the inner truth, something else. This incongruence creates tension; they are being pulled in two (or more) directions at once. Their heart, their inherent nature, simply wants what it wants, loves what it loves. Meanwhile, the survival-oriented protector parts choose a visible way of being in the world, a mask or persona, that favors outside approval and acceptance over the heart.
Young people specifically are faced with the dilemma of serving two masters. Their heart, their genius, their destiny draws them inexorably in one direction, but they must also manage relations with their parents, siblings, friends, and others by being who they need to be in order to gain approval and secure their place in the family. Security concerns almost always win out over matters of the heart. And after all, children and adolescents know in their bones that they need their parents for their survival, so the choice becomes clear. The same is also true later in life. We still find ourselves in the situation where we need to be one thing to survive, while suppressing who we really are. The pattern lives on.
Through inquiry, the invisible becomes visible, the unconscious becomes conscious, and a new balance can be achieved. One that honors the heart, honors one’s destiny. When this happens the conflict resolves, the impulses are satisfied, the anger and resentment relaxes, and the tension can safely melt away. The incongruence fades in favor of an authentic life, a heartfelt life, a life lived in congruence with the deepest longings of the heart.
Scoliosis, like most symptoms, can best be worked with at the level of consciousness, where it originated. When the issue is resolved at the level of consciousness, the visible symptom at the level of the body (the spinal curves) can safely release.
If you or someone you care about has scoliosis, I would enjoy hearing from you. I work one-on-one with clients in my office in the Montrose district of central Houston. I am a state certified psychotherapist (Licensed Professional Counselor), and also have 18 years experience as a Rolfer and bodyworker, specializing in chronic pain issues including many scoliosis clients. My results from working with people through bodywork modalities has been positive, but somewhat limited. People got better, with less pain and more mobility, but the curves remained much the same.
My psychotherapeutic approach to scoliosis is more recent, but early results look extremely promising. This approach is completely safe, non-invasive, and without any harmful side-effects. It is applicable during the early stages of progression, as well as for more pronounced cases, older clients, and even post-surgical cases. The effectiveness of this approach depends on several factors, not the least of which is the willingness of the client (and possibly their family) to look honestly at themselves, and speak for what is happening inside. Scoliosis, as with other diseases and symptoms, is capable of moving us towards wholeness, towards becoming the person we were meant to be.
Regarding the holistic treatment of scoliosis patients, it needs to be said that every person is unique. The inner themes, issues and conflicts that may be contributing to the aberrant spinal curves are unique to that person; there is no one-size-fits-all approach. That said, we can make some generalizations. People with scoliosis, as with many other diseases, tend to struggle with the theme of authenticity. There is a shadow, a secret truth deep within them that is not being lived out in some way. The outside appearance indicates one thing, and the inner truth, something else. This incongruence creates tension; they are being pulled in two (or more) directions at once. Their heart, their inherent nature, simply wants what it wants, loves what it loves. Meanwhile, the survival-oriented protector parts choose a visible way of being in the world, a mask or persona, that favors outside approval and acceptance over the heart.
Young people specifically are faced with the dilemma of serving two masters. Their heart, their genius, their destiny draws them inexorably in one direction, but they must also manage relations with their parents, siblings, friends, and others by being who they need to be in order to gain approval and secure their place in the family. Security concerns almost always win out over matters of the heart. And after all, children and adolescents know in their bones that they need their parents for their survival, so the choice becomes clear. The same is also true later in life. We still find ourselves in the situation where we need to be one thing to survive, while suppressing who we really are. The pattern lives on.
Through inquiry, the invisible becomes visible, the unconscious becomes conscious, and a new balance can be achieved. One that honors the heart, honors one’s destiny. When this happens the conflict resolves, the impulses are satisfied, the anger and resentment relaxes, and the tension can safely melt away. The incongruence fades in favor of an authentic life, a heartfelt life, a life lived in congruence with the deepest longings of the heart.
Scoliosis, like most symptoms, can best be worked with at the level of consciousness, where it originated. When the issue is resolved at the level of consciousness, the visible symptom at the level of the body (the spinal curves) can safely release.
If you or someone you care about has scoliosis, I would enjoy hearing from you. I work one-on-one with clients in my office in the Montrose district of central Houston. I am a state certified psychotherapist (Licensed Professional Counselor), and also have 18 years experience as a Rolfer and bodyworker, specializing in chronic pain issues including many scoliosis clients. My results from working with people through bodywork modalities has been positive, but somewhat limited. People got better, with less pain and more mobility, but the curves remained much the same.
My psychotherapeutic approach to scoliosis is more recent, but early results look extremely promising. This approach is completely safe, non-invasive, and without any harmful side-effects. It is applicable during the early stages of progression, as well as for more pronounced cases, older clients, and even post-surgical cases. The effectiveness of this approach depends on several factors, not the least of which is the willingness of the client (and possibly their family) to look honestly at themselves, and speak for what is happening inside. Scoliosis, as with other diseases and symptoms, is capable of moving us towards wholeness, towards becoming the person we were meant to be.