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Chiropractic Journal of Australia : CJA December 2012
Chiropractic Journal of Australia Volume 42 Number 4 December 2012 141 The association between language and knowledge is well established.1 Alfred Korzybski discussed the signifcance of a concept called 'time binding' where language is used as a ‘tool’ to refect knowledge that is built up over time leading to the development of an epistemology.2 The language we use to describe chiropractic tells of ideas and beliefs which in differing ways and, perhaps unknowingly to us, mislead and channel us into 'arguments' resulting in false conclusions and conficts. An appreciation of the role of our ‘chiropractic’ language comes from my unique position of being on three organisations within the chiropractic profession. Having experience as a regulator, practitioner and academic, the author fnds that three different languages are being utilised interchangeably which may lead to confusion and false perceptions by outside stakeholders such as government bodies, scientists, skeptics. When someone from the general public, scientifc or political communities is asked about chiropractic, it is not surprising to hear differing and generalised assumptions. The Skeptic Organisation and the 'Friends of Science' (FOS) are highly active in Australia. On two occasions, as head of a chiropractic program, the University Executive has asked me to change the name of the discipline or the word 'Chiropractic' to 'manual' or 'physical' therapies. The word 'chiropractic' is seen as synonymous with non-evidence based practice.3 For example, the use of the word subluxation has a more political and clinical meaning than a scientifc meaning. The Skeptics and FOS perceive the word subluxation as 'dogma', or a word that is intended to be self-evident as opposed to a word that is embedded in evolving scientifc principles. Perceptions from consumers, political groups, academics, rightly or wrongly drive the chiropractic profession. The question is: How can we change this 'non-evidence based perception’ of the chiropractic profession to better refect the practice of our teachings? Changing the perception of a profession would require a number of strategies. One of those strategies should include paying special attention to the language used when ‘defning’ chiropractic especially scientifc and political groups. The purpose is to address wrong opinions, misperceptions and assumptions made about chiropractic that are not refective of an evidenced informed discipline based on critical thought and enquiry. Language skills bind our learning from one time to the next and this 'time binding' is what sets humans apart. Thus, the language we use, in particular the structure of this language, should refect the structure of our evolving, evidence-based principles and this should be taught early in a chiropractor's professional career as a student at University level. Additionally, attention should be given to who is going to read the 'message' and the context of our words to do 'battle' for us. It is noteworthy that the word 'chiropractic' does not necessarily give validity to the construct of chiropractic. The double edged sword of chiropractic, in this context, outlines the benefts of chiropractic to our clients, who accept what we say without question. And on the other side, a static model may be perceived by the general public and members of the chiropractic profession, where historical concepts are embedded within the unchanging defnition of chiropractic. These historical concepts of the profession are used when defning the profession or stating what it ‘is’. When we look at the profession the way it was, how it is today and to what it should become -- how has it evolved? Professions, such as medicine, start with a high philosophical base, explaining what is observed. Over time, this is replaced with knowledge. Has the medical profession's knowledge and language progressed over the years? Should chiropractors utilise static or historical model when in fact the profession is evolving!!! When historical concepts are used in the scientifc arena, chiropractic is perceived as static and incongruent with evidence based enquiry. How chiropractic is marketed to clients, scientists and politicians may differ from how we teach it to our students. When marketing to the general public, scientists and politicians, chiropractors and chiropractic educators should use a language that denotes the evolutionary character of our beliefs refecting our evidence informed practices. A more pragmatic approach is required to communicate the benefts of chiropractic care. When addressing the identity of Chiropractic and what it 'Is' the profession and it's teachings should not use verbal constructs, defnitions, conventional formulae as its interface if we wish to generate a 'meaning' or reaction synonymous with chiropractic being a dynamic, evidence informed discipline. A language is required that revolves around 'how', emphasising what we do rather than what it 'is'. Those who identify chiropractic with what it 'is' may be reluctant because they fear the research might undermine their premise. Hence evidence based principles may not be embraced and communicated in such a way that suggests an evolving profession. In other words, chiropractors who are reluctant to think of subluxation as a 'hypothesis' demonstrate a limited understanding of the signifcance of our epistemology. The profession ends up defending a defnition rather than highlighting our investigative skills and knowledgeable practices. One question that comes to mind is: What changes should we make to our language so that we relate better to our health delivery colleagues? How do we use a language to explain the profession so as to achieve the desired reaction in policy makers and collaborators? If we apply critical thought to our philosophical and scientifc understanding of what we do, then our language should refect this premise. Commentary: The Double Edged Sword of Chiropractic Semantics
CJA September 2012
CJA March 2013