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About SAT and Fields and Levels Courses

SAT - Specific Adjusting Technique

The concept of Specific Adjusting Technique (SAT) started as an accident of fate. The story goes that one day back in the 1950’s Parnall Bradbury (osteopath) found himself to be the only practitioner on duty during a flu epidemic. The clinic was for people of limited means and despite the epidemic, there were still almost forty patients to be seen. There was only time to find a key lesion and make a single adjustment on each patient, but the clinical results were astounding especially in those patients who had been adjusted in the atypical areas of the spine (the upper cervical spine and the pelvis). 

SAT as a model of minimal treatment had been born. This method of adjusting one segment at a time effectively gives the body back to itself with very little interference from the practitioner and so is true to Andrew Taylor Still’s (founding father of osteopathy) fundamental precept of ‘find it, fix it, leave it alone’

Bradbury later developed the concept of ‘positional lesions’ which are traumatically induced mobility restrictions affecting primarily the atypical areas of the spine, which require precise adjustment which reverses the force vectors holding the lesion. Through his attention to details and precision, Bradbury observed remarkable changes in the body mechanics of his patients and in the resolution of their pain patterns when treating in this manner. He also went on to publish a paper which describes how specific adjustment of the upper cervical spine coincides with a clear rise in blood sugar and adrenaline levels which may contribute to its profound healing effect. 

The SAT concept is a major influence in treatment philosophy in osteopathy. This philosophy was in turn developed and the knowledge and skill expanded by Tom Dummer into the late 1980’s. 

Tom was both an eminent and influential osteopath who developed SAT from its infancy in the days of Bradbury. He was the principal of the European School of Osteopathy (ESO). 

Specific Adjusting Technique (written by Gez Lamb)

Specific Adjustment Technique started in the 1950’s by Parnall Bradbury and was developed by Tom Dummer into a sublime mixture of structural and functional technique. It relies on the ability to diagnose and adjust the segment of the spine that holds the key to the resolution of the spinal pattern.  Then by a short series of treatments, adjusting only one segment per treatment, the mechanics of the spine (and therefore the balance of the whole body) is brought into functional harmony.

The performance of the technique requires a blend of art and science in order to appeal to the inherent intelligence in the body to bring forward the ideal response to each treatment. What is held in the mind of the osteopath at the moment of the mobilisation is as important as the act of mobilising. The response is not merely mechanical but digs deep into the history of the somatic dysfunction and clears the emotions as much as the physical restrictions.

Traumatically induced ‘lesions’ are effectively neutralised, especially those in the upper neck and the pelvic basin. The concept of ‘floating-field’ adjustment is the only way to effectively resolve such lesions and the technique is Tom Dummer’s gift to the osteopathic profession.

It has been found by practitioners of this art that the body’s response to specific adjustment of the right segment, at the right time, and in the right manner, produces deeply satisfying results for both patient and practitioner. The results are lasting and beneficial on all levels of function and allows the natural healing mechanisms to find optimum expression.

Tom Dummer (written by Cliff Conway)

Tom Dummer was born on October 23rd 1915.  After a busy life as an osteopath he died on May 17th 1998; a great and sad loss for myself and the profession. 

I met Tom when I was a student at the European School of Osteopathy (ESO), of which he was a co-founder.  Tom was still teaching at the age of 80 then, albeit only occasionally; passing on his innate knowledge in his ‘master classes’. I was very privileged to be able to call Tom a friend.  He took me under his wing during the second year of the four year course, and gave me much advice and tuition.  He is still my spiritual guide in my work to this day. Many people have noticed and commented on his photograph in my treatment room.

His first contact with osteopathy was in 1942 when his hands were diagnosed with rheumatism, which was interfering with his playing piano.  He spent many years working as a jazz musician. His condition improved after receiving osteopathy treatment from an American-trained osteopath and naturopath named Harry Clements. This started him on the herbal medicine pathway in his twenties.

He would study while playing piano in a night club by propping his books up on the piano. Some years later he became further interested in osteopathy after visiting an osteopath for a back problem, which set him on a path to a completely new career.

In his lifetime, he wrote a number of books. He wrote one comparing osteopathy, chiropractic, and naturopathy.  He wrote another comparing Tibetan medicine and osteopathy after his experience of meeting and treating the Dalai Lama some years earlier, which led to his interest in Buddhism.

His book on Tibetan Buddhism describes the basic principles as well as some of the pitfalls on the Dharma road to enlightenment. This book was a collection of his notes from Tibetan Buddhist lectures and teachings accumulated over his life. It is a well known book for people studying in the field.

His book on Specific Adjusting Technique is both his and the professions definitive guide in understanding and applying the philosophy of the technique, which underpins the model for all that practice the art.

Osteopathy (and SAT) according to Tom Dummer

Osteopathy is more than the fixing of back problems in a musculoskeletal way. It has a wide scope as described in more of his books - his two volumes  ‘A Textbook of Osteopathy’. 

Tom stated that osteopathy stood in the middle of views held by allopathic medicine and naturopathic medicine, but that it had its own philosophy. It is global in its approach to patients and is based on a sound osteopathic assessment and evaluation of the patient as a whole. All osteopathic work should follow the principles and philosophies laid down by A.T. Still and while variations on treatment styles may occur and evolve, these precepts are not negotiable for change. 

There were four phases in the evolution of osteopathy, according to Tom Dummer. Structural, functional, then cranial with the fourth phase being a holistic return to the source approach to osteopathy, as advocated by A.T. Still. This is described as the osteopathic middle way, encompassing all technique approaches in a minimalist way.

During the evolution of this phase, Parnell-Bradbury, Tom’s friend and a chiropractor, was rediscovering a minimal approach to treatment by specific structural adjustment. This was the forerunner of Tom Dummer’s Specific Adjusting Technique (SAT) which he was developing at the ESO. 

SAT utilises the previous knowledge of various stages of osteopathy to develop a technique that was based in a mechanical but applied in a functional/cranial way. SAT is, in the words of Tom Dummer, a “clinical practice which offers a light, almost ‘feather touch,’ painless and distinctly non-traumatic treatment”.

He felt that in this way osteopathy had turned full circle and returned to the original principles of A.T. Still. Tom Dummer stated that the principles of osteopathy are: the artery is primary (circulation of all body fluids), structure governs function, and the body as a functional unit that can auto-regulate. This relates to the interfacing of the inner and outer forms of the body and it is because of the interrelation between the structure (outer), and the function (inner), that osteopathy works. Put another way, the outer form is under voluntary control while the inner forms are more subjective and subject to involuntary systems of response.

The classic structural-mechanical approach works primarily with the outer form while the more functional approaches, including cranial, bioenergetics and fluidic, work more directly on the inner form. In a holistic way, the inner form approach works with the voluntary (mechanical) system as well. A.T. Still’s original principles worked on both levels of form, this was therefore the 'return to source' embracing all modalities of treatment. 

As in all opposites in life there is a tendency to find a centre and move around that centre.

Tom Dummer stated that A.T. Still presented the human body in three aspects: Mind, Function, and Structure. Still saw the body as a complex system of “connected oneness” that worked under the three concepts of mechanistic, vitalistic, and spiritual This is presented in modern literature as mechanical or structural, physiological or functional, and spiritual. Still’s work then translates as Matter, Motion, and Mind: Matter being the physical portion of the body; Motion being the action of the combined spirit and mind (as in brain); and Mind being the spirit or soul. These are represented in modern literature as Body, Body-Mind, and Spirit.

Tom Dummer wrote a book on SAT, describing how this technique approach combines with Body-Mind-Spirit in Matter, Movement and Mind to define how these are used in treatment and how SAT is the choice of treatment for Mind at the unconscious level.  

Tom used this framework for spinal lesion patterns and saw these three components as Structure, Function, and Mind. This is a complete view of his philosophy as it incorporates elements of body types and Tibetan medicine, as well as Buddhist terms of the elements ie osteopathy as the perfect complement to Tibetan medicine.

SAT has been taught at Post Graduate level by Gez Lamb for more than 20 years across the globe. Tom helped and encouraged Gez who was a great friend to Tom. 

Since 2018 in collaboration with Cliff Conway, Gez is now teaching both SAT and ‘Fields and Levels’ courses in the Lake District.

For the uninitiated, SAT should be viewed independently perhaps from a 'students' perspective. 

Tom encouraged everyone to "be a student every working day of your life". Always reflect on what you learn. Understand how you can use the knowledge gained. In this sense knowledge is always expansive, individual and creative.

SAT not only became Tom’s preferred model of treatment - it was his belief system encompassing his whole life - in the sense of Mind and how bioenergetics have an infinite and universal connexion.  His legacy to the osteopathic profession.

SAT for Tom was the ultimate example of the body’s willingness and ability to change; both with and within all living things; and perhaps, it could be stated, sometimes ‘beyond the horizons of our comprehension, knowledge and understanding’.

Fields and Levels

‘Perception and Knowledge’ 

An Exploration of Tissue ‘Fields and Levels’ of Function By Gez Lamb 

Tissue Fields 

The concept that every tissue-type of the body creates a field of action, has fascinated me for many years. I cannot remember whether I heard of it somewhere or dreamed it or it just came to me but once the idea had formed it would not let me go. I then had to find a way of palpating each field and even more challengingly to find ways to teach it to undergraduate students. 

In essence each tissue field has a distinctive ‘feel’ to it and this quality is a product of the form of the tissue and the manner of its function. So, for example, fascia may be palpated for the distinctive quality of its fibre make-up, its essential structure, or it may be palpated for its function in the sense of its contractile quality and its inherent motility. We could say that both structure and function are equally palpable. 

The tissues of the body may be perceived as a continuum of relative density with bone being the most dense to fluid being the least dense and as one traverses from denser to next less dense, it becomes clear that one is in the space in which the tissue exists and functions. The very distinction between one tissue and the next gives evidence of the existence of its ‘field’ of action. It is as if the tissues belong to a club or organisation and every member of the club knows itself to be in the club. So every bone of the body knows itself to belong to the bony club, and every fascia knows it belongs to the fascial club, and so on. 

There are other fields of action that are not tissue specific but they are equally important as a manifestation of united function within a field of action. Examples of these would be the visceral system, the nervous systems (psns, ans, cns), the vascular system and so on. Even the manifestation of the primary respiratory mechanism could be viewed as a field of action. 

From a therapeutic point of view I have found that an acknowledgement of where the body is most focussed, which tissue field it is most expressing through or engaged in, at the outset of the treatment, is essential for the success of the treatment. It is a starting point that enables the practitioner to let the body know that he or she knows just where the patient is in relationship to their body, and that this evidence of knowingness is paramount in the formation of the treatment relationship and the consequent therapeutic response from the body. I have long been convinced that relationship is as important as technique in the healing outcome. 

Once established in the field of action most favoured by the body at the start of a treatment it is then a matter of method to treat within the presenting field, or to move between fields as the body requires, in order to achieve a therapeutic resolution. 

There is a supreme intelligence within the body but there are limitations due to the reflex nature of the body whereby it can be ‘stuck’ in a loop and needs an external ‘fulcrum’ (in the form of the practitioner’s hands) to be enabled to move out of the loop towards its optimum function. Once the starting point has been acknowledged and engaged then the supreme intelligence guides the treatment and it behoves the practitioner to honour and follow the changes until resolution has been achieved. Toward this end the practitioner’s awareness of the fields acts as a witness so that the body knows that the practitioner knows, and that the practitioner’s knowing facilitates the treatment and enables choices to be made to encourage field change where needed. 

Levels of Function 

Allied to, but distinct from the tissue fields, is the palpable presence of levels of function within the body. These levels may be conceived of as levels within the primary respiratory mechanism (prm) or within the central nervous system (cns) or just within the body as a whole, but however one conceptualises these levels they are clearly present and highly effective when used as a therapeutic tool. 

The sense of level is most readily palpated with the practitioner’s hands placed under the patient’s body. The hands are placed where the system is most readily available for change and in many cases requires a strongly present hand under the sacrum with the second hand placed where the potency for change is most evident. The practitioner then assesses the level that is most evident and facilitates a fulcrum by which the inner intelligence may reorganise. 

The levels are evidenced by how they feel and may be described as expanding and deepening as one moves from the most superficial to the sense of the deepest one may go. At first the sense of depth was all I had to go on until one day it became apparent that each level in fact is an expression of one of the five elements. So that the progression is from earth through fire, water, air and space (ether). It is hardly surprising that the elements exist in the body, as they do in nature, but what is more sublime is that they are present in their subtle form rather than their literal elemental form. Thus what is being experienced is more akin to the earthiness of earth and the fieriness of fire and the fluidity of water and the airiness of air and the spaciousness of space. In fact these qualities are very present in the language when we speak of the qualities a person possesses such as describing someone as being fiery or airy or indeed wet. If indeed we are sensitive to these qualities in another person’s make-up, then how much more should we be capable of palpating these qualities in the functioning of the body? 

Furthermore, these levels and the respective ‘elemental’ quality that each expresses, relate to the functioning not only of the body physical and physiological but to the functioning of the personality as evidenced through emotions, intuition and insight. We could say that the musculo-skeletal system functions in the earth quality, the nervous system in fire, the emotions in fluid, the intuition in air, and insight in space. Each quality functions because the subtle element exists and provides the medium in which the function is made possible and is sustained. It gives a whole new insight into the saying that someone is in their element when they are most enjoying themselves. How much better would our lives function if we were true to our natures and functioned in our predominant element and had that element present and organised within the reflexes of our body. 

These levels give us as osteopaths an opportunity to understand what is manifesting in the patient’s body as a reflection of their adaptation to life and the means to provide a way of bringing the body into balance to help the person’s inner life to also balance. As in the treatment of tissue fields, it is more the fact that the body knows that it is known that facilitates the change, but without the practitioner’s witness the body is less able to adapt to the presence of the practitioner’s hands. 

Once a level is acknowledged, then the process of change can begin and the supreme inner intelligence once more conducts the treatment with the practitioner’s willing cooperation. 

Gez Lamb 

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