It should come as no surprise to any doctor in active practice that regularly seen patients often are plagued by what might be described as subclinical antalgic postures that seem to reflect periods of inner stress and tension.
Over time, these become easily recognizable as precursors to acute episodes of subluxation activity that often lead to, or result from, somatic anxieties and their self-perpetuating psychosomatic events. These repetitive and unconscious activities of mind and body often conflict with Palmer's metaphysical innate and Freud's metapsychological ego through an energy postulate that might well be thought of as the postural unconscious.
We begin our discussion with the definition of the postural unconscious as an energetic neurostructural activity based on an innate predisposition of selected somatic structures. These structures are able to assume very predictable postural patterns of internalized contracture in response to the level of ego-threatening, free-floating emotional stress within the patient. When this emotional stress reaches a level of heightened proportions that can no longer be psychically tolerated, it spills over into the physical side in the form of myofascial contractions that are repetitive and largely unchanged over the years. They eventually become tied to the formulation of chronic somatic anxieties, both real and imagined.1
This is a postural patterning; a learned behavior upon which the organism has become dependent at times when the need for discharging stress is required by an overwhelmed psyche unable to cope. This release of excess tension throughout the nervous system and into its surrounding infrastructure sets the stage for the resorption of this energy into selected postures. The resulting structural pattern these postures assume is predictable and accurate each and every time.2 This process is a manner of energetic communication from the unconscious innate to the conscious ego that demonstrates a threshold of activity at the boundary between mind and body that regulates emotional discharge. In such a scenario, what cannot or should not be verbally expressed is suppressed. What cannot be acted upon is displayed through expressions of postural dyskinesias and subluxations.
These are learned behaviors whereby the organism retreats from unpleasant situations through a long-axis contraction that draws it back from the negative stimulus, avoiding conflict and turning rage inward upon the self. These "expressive postures" are modeled after what often are called state-dependent frames of mind. These are mindsets that often occur unconsciously when repressed emotions rise dangerously close to the level of preconscious activity; so close that an abrupt means of escape from cognition is necessary and expedited through chronic or latent vertebral subluxation sites. This energy will then disseminate through postural adaptations or expressions that relieve localized physical energetic distress, as well as provide a timely avoidance for the pain and anxiety of an uncensored self-awareness.
In recognizing this activity of the postural unconscious and the expressive postures it faithfully exhibits, the DC eventually might attempt to lower subtle unconscious psychosomatic resistance by releasing any neurostructural inhibitions. These inhibitions take the form of subluxations that interfere with communication pathways between the mind and body, leading to new, but incorrect, neuro-learnings.
Further, one might look to the postural unconscious as the beginning of a psychical subluxation whereby unconscious reflexes within the patient might provoke a particular myofascial pattern to appear. Over time, this will direct stress, fatigue and anxiety toward a specific spinal area, creating a loss of neuromuscular tone and a chronic subluxation. This will appear to be physical in nature, but may indeed be emotional, resulting from a cyclical neuronal loop that is self-perpetuating thanks to an excess quantity of dispersible nervous system energy specific to the subluxation site.3
This might explain the repetitive visits by patients during times of difficulty such as death, divorce and career distress. Patients usually do not equate the chronic nature of their unconscious subluxation patterns to everyday events, as they rarely connect their chiropractic care with any simultaneous life crisis.
If the energetic charge or investment in the anxiety is strong enough to overcome internal or innate resistances, a somatic display of postural contracture will occur. When this takes place, associated groups of myofascial tissue will engage in a patterned response to the active, but variable, internalized stresses that will create a remarkable geographic spasm at the body's surface that is not only specific to its area, but also specific to its particular source of anxiety.
So, in our examination of the patterned subluxation response, we might want to look at factors associated with the postural unconscious that might repress conscious awareness. This often takes place in the case of the occasional, uncommitted patient who will only appear for care after weeks or months of physical or mental pain. These patients tend to exhibit emotional distress throughout their myoskeletal frame. When their infrastructure is sufficiently insulted, toxic myospasms occur and structural distortions follow in the form of long-term, unrelenting subluxation syndromes that often mystify the patient.
Such patients strongly deny any emotional conflict in relation to the myofascial postural duress they are experiencing. However, these same patients often state they had a sense or feeling they "knew" this would happen, as it usually did when stressful situations arose. This reflects what could be called an episodic somatic anxiety - a reaction that seems far removed from an event, but in reality is simply at its end stage.
The doctor must make the patient consciously aware of the fact that the problem of postural distress is an unconscious reaction to an unknown stress.4 Also, as this problem is not yet understood by the patient, they must work with the doctor in recognizing the recurrent nature and timing of the subluxation and its effects. This work should continue until the repressed energies associated with the resistance are recognized and depleted by gradual reductions of symptomatic and nonsymptomatic subluxation sites, improving psychosomatic energy redistribution.
This is an energetic balance between what the mind produces and what the body can use in allowing for homeostatic equilibrium. This is a vital point, as there is no naturally occurring window for the escape of any excess mental energy. Such energy, if potent enough, might result in the aberrancy of neurotic thoughts and subluxation postures. In seeing this situation for what it is, the DC must work to understand the systematized pattern of events that often brings the unconscious to this point in time. Any chiropractic care at this stage is focused upon the postural stress of the subluxation and the mind/body's reactive distress as seen in its anxious and repetitive neurotic behaviors.
If, as we may suspect, the patient has some inkling as to the sequence and consequence of these events, we must still attempt to educate their consciousness to accept the fact that latent unconscious fears and anxieties eventually may find their way to the fragile threshold of tolerance that separates anxiety-based repressed memories and traumas from the more acceptable "reframed recollections" of a neutral nature. Memories and traumas that do eventually reframe themselves into less threatening mental images often seem to disappear into unconscious oblivion, no longer factors in discordant energy distribution.
Anxiety factors that do not disappear then fuel hyperexcitable mental impulses through myofascial spasms and subluxations that offer an active and convenient kinetic vehicle for the displacement of ego-threatening thoughts into somatic discomforts. This often is seen in "angry" or "sick" postures that reveal an active internal conflict that has turned to the somatic side.5 The idea that spasm and subluxation play an active role in the reduction of both internal and external threats to the psyche is a paradox of sorts, as the variable environment in which the central nervous system seeks to cope and survive often finds itself as the reluctant foundation for such neurotic behaviors.
The fact that subluxation activity either is the cause or the result of such psychosomatic events is relative only to the resolution of the unconscious posture within which the subluxation is found. The subluxation might be secondary to an ego event the mind/body is prone to repeat when the same set of circumstances is encountered by the patient. If, on the other hand, the subluxation is first upon the scene and is given the ultimate ingredient of time (which all chronic disorders rely upon), then stress, tension and fatigue will only weaken an already suspect structure. The linkage of physical distress and emotional overload and eventual energetic hyper- or hypo-levels of neurospinal function might indeed foster an unconscious association with long-term physical pain and its mental flip side, chronic anxiety.
If both Palmer6 and Freud7 were correct - that the nervous system is a closed and circuitous route from mind to body with only homeostasis in mind - then we also can assume the active neurosis and the physical subluxation might go hand in hand relative to health and well-being on an energetic level. The new and novel idea Palmer and Freud shared - that energy, by itself, could influence thought and matter - was finally coming into focus.
Palmer and Freud shared a mirror image of 19th-century mind/body vitalistic philosophy, as well as a neuro-energetic understanding of physical and mental health that such vitalistic principles promoted. They had developed therapeutic systems that worked to naturally release the tension of excess energy in both mind and body by allowing for the specific reduction of the vertebral subluxation physically, and hysterical neurosis conversationally.
However, posture and the way in which it expresses itself during times of pain and anxiety is the key to understanding the unconscious activities within the various ego states and the innate defensive initiatives that protective mechanisms assert during these times. The analysis and recognition of latent patient postures and their relationship to ongoing chronic or subclinical structural events offer the doctor a chance to disperse both emotional and structural energies before they can manifest themselves in what might become a full-blown traditional diagnostic syndrome of pain and disability.
The simple idea that the common, everyday stresses of life and living could manifest themselves as both physical and mental symptoms is by no means a new thought.8 It could be argued that the combination of a mind/body approach in analyzing and assessing what we might again call expressive postures might be of value to doctors interested in changes in the patient's postural appearance. This also includes the moods and attitudes that accompany such postures, as well as the degree to which they change over time.
Most expressive postures are likely to be present only during acute and difficult sets of adjustment sessions. With this in mind, the doctor might attempt to deconstruct presenting postures by comparing them to those from prior visits, before the patient began to exhibit the present postural distress. It also could follow that adjustive reductions of expressive postures, built around specific subluxation sites and accompanying specific states of mind, may help diminish mind/body pain and anxiety while encouraging a new and gradual psychosomatic withdrawal from chronic, everyday bouts of ego-based defensive myofascial contractures.
So, just as the ongoing reinforcement of pain and anxiety results in the accumulation of structural distress and distortion, the measured relief of those same symptoms lowers or lessens the stimulatory energies present within the common pathways at the onset of the next episode, allowing for a gradual release of old neuronal learning in favor of new learning. This will raise the threshold for future ego defenses and subluxation postures.
If subluxation and anxiety are defensive reactions or stressful adaptations to energetic mind/body imbalances, must they be immediately corrected, or are they a process that must be gradually reduced allowing for new neuro-learnings to take place over time while physical myofascial tone resets and mental energies seek rest?
In most cases, such subluxations are reduced by repetitive adjustments that promote a set of gradual new neuro-learnings. It is therefore important that patients return for their care corrections immediately after the acute episode is resolved, if not only to reinforce the reduction of subluxation residuals, but also to clear out anxious associations with the body part that exhibited the postural expression of pain and distress, especially as it relates to the organism's external environments and internal biopsychosocial pressures.9
The adjustment seeks to restore and/or equalize the neural pathways of posture and homeostasis. But the adjustment also must act on a psychosomatic level, beyond the simple concept of mind and body, to relieve and provide a new and conscious appreciation of a reduction in anxiety levels. Corrective care, with postural indicators as its guidelines, will be associated with fewer episodes of chronic pain and anxiety, even after the acute subluxation is resolved, and conscious pain and stress are reduced to tolerable levels.
The issue of neural energy and the need for adaptive postures to disseminate the overabundance of unconscious stress and anxiety is a product of repetitive attempts mentally and physically to keep equilibrium within the organism.10 The very slim possibility that patients who fall victim to postural manifestations of unconscious conflicts could successfully fend off energy-releasing conversion activities is not likely and would, in the end, show both patient and doctor the power of the unconscious. However, with the help of adjustive care, the cyclical circuit that allows for the uninhibited maintenance of the aberrant neuronal loop can be disoriented and very likely deconstructed to a point at which its threshold is too low to fire on a continuous basis.
The pains of the physical and the anxiety of the mental are energetic in nature, so much so that neither can be separated from the other, except for the presenting complaint and the order in which the patient has come to expect relief. However, the mere presence of pain brings an associated anxiety which cannot be quantified by simply asking the patient if they feel better. Patients often are poor information sources. So we look again to the postural unconscious for help.
If we were to return to the philosophy of Palmer11 and Stephenson12 and entertain the safety-pin cycle concept of neural travel, we see a simple but effective way to value the care for the reduction of excess mental energies the mind produces if its avenue of transmission is "dammed back" over time. If we were to look again at the Freud/Reich theories and postulations that the ego is first and foremost a bodily ego, we might see a surprisingly definitive psychosomatic connection to the neurotic events that contribute to the development of a subluxation in an area of the spine predisposed to a hysterical conversion in patients where past trauma or injury are common factors.
If this is the case, then a true separation between mind and body is not only illogical but wholly indefinable as well. Note also that Freud saw neurotic intensifiers such as past trauma as byproducts of the nervous system being "dammed up" (in contrast to Palmer's "dammed back" concept) without any alternative release except through a simple form of somatization,13 as chosen by the unconscious for its particular relevance to its anxiety and energetic pathways. This would be defined as the vertebral subluxation in chiropractic.
This concept of "damming up or back," could be likened to a hybrid concept termed a subluxation neurosis, whereby patients with repetitive subclinical postures of vague pains are noted, charted and followed closely during specific rounds of adjustive care. Though such adjustive care is sometimes discouraged as psychosomatic in nature, it could fill the vast middle ground of an intangible symptomatic picture that imaging and examination cannot diagnose and multidisciplinary care can not adequately resolve. The fact that both mind and body are able to produce and reduce these chronic symptomatic factors through their own innate or unconscious mechanisms shows that energy-driven systems are indeed worthy of still more research and even more clinical respect.
- Freud SS. The Ego and the Id. Freud,The Standard Edition, 1923;19.
- Reich W. Character Analysis, 3rd ed. New York: Farrar, Straus and Giroux, 1945.
- Homewood AE. The Neurodynamics of the Vertebral Subluxation. Chiropractic Publishers: Toronto, 1981.
- Lowen A. Depression and the Body. Penguin Press: New York, 1972.
- Fenichell O. The Psychoanalytic Theory of Neurosis. W.W. Norton: New York, 1995.
- Palmer BJ. The Subluxation Specific, The Adjustment Specific. Palmer School of Chiropractic Press, 1934;34.
- Breuer J, Freud S. Studies in Hysteria. Freud, The Standard Edition, 1895;2.
- Lowen A. The Betrayal of the Body. MacMillan Company: New York, 1967.
- Shafer RC. Basic Principles in Chiropractic Neuroscience. ACA Press: Arlington, VA, 1990.
- Freud S. A Fragment of an Analysis of a Case of Hysteria. Freud, The Standard Edition, 1905;7.
- Palmer BJ. Palmer's Law of Life. Palmer School of Chiropractic Press, 1958;36.
- Stephenson RW. Chiropractic Text Book. Palmer School of Chiropractic Press, 1927:14.
- Freud S. The Interpretation of Dreams. Freud, The Standard Edition, 1900;4,5.
Dr. Mark S. Chiacchi graduated from Palmer College of Chiropractic and practiced in Massachusetts for 30 years. Direct questions and comments regarding this article to