Making sense of cranial osteopathy: An interpretative phenomenological analysis

Abstract

Objective

This study arose from a praxial problem: how best to communicate with patients about the mechanism of cranial osteopathy. The research question was rooted in the phenomenological concept of ‘sense-making’, and was expressed as: ‘What sense do osteopaths and their patients make of the phenomenon of cranial osteopathy?’

Method

Interpretative Phenomenological Analysis (IPA) was used to explore the ‘lived experience’ and embedded sense-making of pairs of osteopaths and patients. Four Fellows of the Sutherland Cranial College of Osteopathy (SCCO) participated, as did one patient of each. The osteopath participants were experienced practitioners, and the patient participants had had positive experiences of cranial osteopathy. The participants were interviewed about their experience of the phenomenon of cranial osteopathy. The semi-structured interviews were audio-recorded, transcribed, and analysed. The analysis was audited alongside the use of a reflexive diary and an account of the theoretical ‘fore-structure’ of the principal investigator, in order to monitor influences on their hermeneutic analysis of the data.

Results

The IPA revealed that both patients and practitioners establish epistemological grounds for their sense-making about their embodied experience of cranial osteopathy (Theme 1: Making sense of sense-making), that they use embodied metaphor and linguistic meta-metaphor to understand their lived experience of cranial osteopathy (Theme 2: Metaphors for mechanisms), and that the mechanism of cranial osteopathy is considered by both patients and practitioners to arise in part from the therapeutic relationship (Theme 3: The meaningful osteopathic relationship).

Conclusions

The main outcome of the study is a hermeneutic model of cranial osteopathy, which posits that the shared, embodied therapeutic relationship facilitates a collaborative rapport which enables the osteopath and the patient to come to an understanding of the source of the patient's malady, and that this understanding is the causal context for the patient's lived experience of better health.