Bowen Therapy: A Review of the Profession

Bowen Therapy: A review of the profession  – as published in the Journal of the Australian Traditional Medcine Society in December, 2012    (JATMS – Volume 18, Number 4)   

This article is printed with permission: Pennington, K. Bowen therapy.

Journal of the Australian Traditional-Medicine Society. 2012;
18(4):217-220.

Katrina Pennington BAppSc(Occupational Therapy) MAppSc(Acupuncture)

Kate works part time in private practice, using acupuncture and Bowen Therapy in Warrnambool, Australia.  She also devotes time to research and development.

ABSTRACT- This article reviews the current profession of Bowen Therapy.  It considers the history of the Bowen technique and the forces which have influenced its development to date.  The article outlines some of the issues relevant to the Bowen Therapy profession as a whole. It also considers whether there is a philosophical basis underlying the technique and whether holistic patient assessment processes are relevant to the profession.  Future directions and challenges are outlined.

DEFINITION

Bowen Technique is any therapeutic approach to body work which is based upon the clinical work of Mr Thomas Ambrose Bowen.  It describes an increasing number of approaches, each based on the conclusions and interpretations of particular individuals who observed Bowen (or subsequent therapists who had some form of Bowen training).  Characteristically, Bowen Technique involves unique rolling movements over soft tissue, performed at precise locations on the body.  It is said to be effective in bringing relief to musculo-skeletal problems, such as sore backs[1], necks and limbs.[2]  It has also said to be effective in treating internal problems such as hay fever[3], stress[4] and migraines.[5]

INTRODUCTION

October, 28, 2012, marked the thirtieth anniversary of the passing of Thomas Ambrose Bowen.  He is said to be the founder of the ‘Bowen Technique’, a popular soft tissue therapy which is known worldwide.[6]  This significant anniversary provides an opportune time for the profession to reflect on its past and make a plan for the future.

At the time of his death, there was no ‘Bowen Technique’; Bowen himself was an unrecognised manual therapist working in his own clinic, using a unique treatment method.  The term ‘Bowen Technique’ was not coined until several years after his passing.

Bowen Technique has been delivered to us by a handful of therapists, each of whom developed a personalized interpretation of the methods they saw Bowen apply while observing him in his clinic.  It seems that one of these interpretations alone has so far defined the public’s understanding of Bowen’s approach to bodywork.

PREVALENCE

Bowen Technique is now practised in thirty countries and taught in more than twenty.[7]  There is a comprehensive network of training facilities and self-accredited teachers and schools, and at least one government recognised school in Australia.[8]  Although known primarily as Bowen Technique, there is a myriad other names by which variations of the technique are known.  Some of these are Bowen Therapy,  Fascial Therapy, Smart Bowen, Fascial Kinetics, Neuro-structural Integration (NST), Fascial Bowen,  Bowenwork and probably other names as well.  In 2009 there were over 26,000 practitioners worldwide.[9]  The technique’s popularity is probably due to the fact it is fairly simple to learn, easy to apply and is frequently effective as therapy.

HISTORICAL ASPECTS

Bowen left no formal training notes about the type of therapy he practised.  To understand and define it, we must rely on accounts of the people who claim to have watched him work.  It is widely acknowledged that at least six men claim to have done so over the twenty-three years he was in practice (1959-1982).  Interestingly, each of the men who observed him developed a different interpretation of his work; perhaps due to differing educational backgrounds, differing time periods of observation or other unknown factors.  One of these men, Oswald Rentsch, has taught his interpretation widely, whilst others have taught only a handful of practitioners.  The result is that a Bowen industry has emerged but most practitioners have had access to only one of the interpretations of Bowen’s work.

Rentsch observed Tom Bowen at work in the mid-seventies.  He was also responsible for taking Bowen Technique to the world at large.[10]  Since 1984 he has taught trainees to apply a systematized ‘recipe’ version of ‘Bowen Technique’.  The Bowen industry at large has adopted Rentsch’s interpretation; however, other interpretations of Bowen’s work have not been widely available.   To date, most of the published authors and treating practitioners of Bowen Technique are using Rentsch’s approach.  On Rentsch’s early teaching notes that were distributed in 1987, the words ‘Bowen Technique – an interpretation by Oswald Rentsch’,[11] were printed on each page.  Over time these printed words have disappeared and current teaching manuals use the phrase ‘The Original Bowen Technique’.[12] Both phrases acknowledge the existence of other interpretations of Bowen Technique.

At least two of the six men who observed Bowen do not use this recipe style approach.  They use a style of Bowen Technique in which treatment is applied based on a holistic assessment of the client, and is targeted to specific dysfunction, in accordance with individual presentation.  In addition to making a holistic assessment, they apply the Technique in a holistic manner, involving a recognition of interrelationships existing within the body.  They also use reassessment techniques to measure the effectiveness of their treatments as they apply them.

Questions are now being posed regarding the basic assumptions of those teaching the popular recipe style of the technique.  Romney Smeeton, a chiropractor, and one of Bowen’s observers in the seventies and early eighties, writes

‘I should state I am at odds with much of the current teachings of Bowen’s work, primarily because they lack a system of individual assessment and are nearly all based on a systematized use of standardised recipes and this was not Bowen’s approach’.7

Kevin Ryan, an osteopath, and another of Bowen’s observers, told the BTFA (Bowen Therapists Federation of Australia) conference in 1998 that

‘Tom Bowen never did a move unless he had an expectation of what effect it would produce.’

Interestingly, according to the transcript of proceedings on the Committee of Inquiry into Osteopathy, Chiropractic and Naturopathy, in 1973, Tom Bowen said, ‘I average 65 patients per day’.[13]  This allowed him around five or six minutes for the treatment of each patient.  The recipe style of treatment widely taught today cannot be applied in this time frame.  It is clear that Bowen did not routinely apply a recipe approach.

PROFESSIONAL ISSUES

The Australian Traditional Medicine Society has recognised Bowen Therapy as a legitimate modality of practice for its members, since Dec 2011.[14]  Over the last two decades, a number of Bowen Technique Associations have formed which have different Regulations and Codes of Ethics and serve their members in various ways, such as through government advocacy and policy formulation.  Health fund rebates are now provided in Australia for treatments offered by members of recognised Bowen Therapy Associations.  It would seem that the Bowen Technique has matured and grown up! But has it?

1.       Lack of Underlying Philosophy:

In regard to various interpretations of the recipe version of Bowen Technique, there seems to be a lack of basic theory and philosophy which many would consider vital to any profession. The majority of those who based their professional approach on Bowen’s work claim he utilised a holistic approach, not a symptomatic one.

Competence in any profession depends upon an understanding of the theory that underlies it.[15]  For most health professions, underlying philosophy and principles guide clinical practice, yet this does not appear to be the case with regard to the practice of Bowen Technique.  Perhaps this lack of theory and philosophy, however, is only a problem if we wish to perceive Bowen Technique as a holistic therapy in its own right, rather than a set of symptomatic treatments. If the profession is to progress, it needs to clarify its principles and theories in order to guide its development.

2.       Lack of  Holistic Assessment:

Many Bowen Therapists can and do perform assessments of isolated muscle groups or individual joints, like a physiotherapist or a myotherapist.  These assessments are helpful in providing a baseline level of function from which to measure progress, but they do not embrace holistic principles, or encourage therapists to view the body as an interrelated whole.    A holistic assessment is one that assesses the body for areas of dysfunction from a systemic viewpoint.  The few Bowen Therapists who do use such an approach claim it enables the Bowen treatment to be targeted and goal-directed.7

First principles are the fundamental assumptions on which a particular theory or procedure is thought to be based.  Adopting and applying such principles may help the profession to clarify the goal of the Bowen Therapist.  The profession could consider the following questions: Is Bowen Technique a holistic therapy in its own right, or is a symptomatic treatment, or is it both, depending on how it is used? Would embracing a holistic model of patient assessment assist in obtaining better clinical outcomes?

3.       Disintegration:

The growth of the profession over the last thirty years has been characterised by individual motivation, where portions of the technique have been sectioned off, patented and sold to the public under differing names.  This fragmentation has hindered the ability of the profession to develop further because each splinter group attempts to create a different ‘identity’ for the technique.

DISCUSSION

1.       Does an appropriate philosophical framework already exist?

The profession may have already been exposed to a philosophy and basic principles. These principles to date have not been taught extensively as part of the Bowen Technique education and this may be to the detriment of the development of the profession.  Embracing them will also help establish the philosophical background and cement the foundation of the treatment technique as a whole.  Guiding principles may also help the therapist when treatment is not progressing as expected.

These principles are not new; they are borrowed from the osteopathic profession.  Bowen described himself as an osteopath, and sought recognition for the work he did from the Osteopathic Board at the time.[16]  The underlying principles of osteopathy are

1. The human body functions as an integrated, interrelated whole unit
2. Structure and function share a reciprocal relationship
3. There exists in the human body an innate capacity for self regulation and healing
4. Therapeutic intervention is based upon an understanding of these three points[17]

It is clear that Bowen embraced these principles.

2.       Are holistic assessment techniques relevant?

In the world of remedial bodywork, regardless of modality, most therapeutic interventions are applied in response to patient assessment.  Across all professions, assessment forms an invaluable tool to guide treatment selection and application.  Most assessment techniques are generic; they are relevant to all corrective therapy because they provide important information about the patient’s condition, as well as the response to treatment.  Up to now, most Bowen therapist have applied a standardised therapy to every patient, independent of holistic assessment, largely due to a lack of education in this area.   Most recently however, the profession of Bowen Therapy is being challenged to address the inherent lack of holistic patient assessment.  If the Bowen Technique is a holistic therapy should it not embrace holistic assessment methods?

3.       Disintegration

The disintegration to so many variations of Bowen Therapy has resulted in the technique itself being hard to define.  The profession itself lacks direction since it cannot agree amongst the differing parties on basic elements about, for example whether to ‘keep it pure’ or to progress and develop with research.

IMPLICATIONS

By utilising the recipe approach to treatment, some Bowen Technique practitioners may be ignoring the very principles upon which the technique is founded.  Applying the recipe style of treatment is a symptomatic approach: no holistic assessment is required and the therapist administers the same treatment to each case, regardless of the presenting problem.  At least two people who observed Bowen at work dispute this approach.  In their interpretation of his work they make a holistic assessment first, then, on the basis of their findings, they administer an appropriate Bowen treatment.

FUTURE DIRECTIONS

This article has outlined some professional issues and problems for the profession to consider.  Is it time to formally adopt a philosophy and embrace a set of guiding principles?  Is it time for the profession of Bowen Therapy to adopt holistic assessment techniques?  Is it time for the different Bowen therapy groups to come together and work for the benefit of the profession as a whole.  Would these changes ultimately help each practitioner achieve better clinical outcomes?

It is clear the Bowen Technique is a treatment technique that is here to stay.  Classical astrologers refer to the ‘Return of Saturn’ when the planet Saturn has made one orbit around the earth and returns to the position it was in when that person or idea was born.  It is the instigator of change and a crossroad period when life altering decisions are made. With the first Saturn return, a person leaves youth behind and enters adulthood.  It takes about twenty nine and a half years to occur.[18]

As we approach the thirtieth anniversary of Bowen’s passing, is it time these issues were addressed?

References