Conference Agenda

This paper proposes a psychobiosocial framework that integrates osteopathy and massage therapy with dialogical self‑therapy to address physical injuries and illnesses as expressions of embodied story, moral injury, and relational trauma. Drawing on dialogical self theory, we reconceptualise pain and bodily symptoms as “I‑positions” that speak from within a multi‑voiced self, including positions such as “I‑as‑injured,” “I‑as‑carer,” and “I‑as‑betrayed by the system.” Osteopathic and massage practices are used not only to restore biomechanical function, but also to invite patients into a co‑created narrative in which sensations, tensions, and postures become portals for conversation and witnessing. Through guided externalisation, the practitioner and patient together name and dialogue with these embodied positions, honouring them as valid responses to injury, overuse, structural violence, and moral constraint rather than as purely mechanical faults. Building on work in narrative and Indigenous‑informed medicine, we emphasise story as ceremony, touch as relational communication, and the clinical encounter as a small community in which new meanings of suffering can emerge. Moral injury in healthcare and labour settings is framed as a human response to systemic wrongs that becomes “stuck” in the body, shaping pain, fatigue, and autonomic dysregulation. By dialoguing directly with bodily I‑positions that carry guilt, shame, anger, and thwarted care, the team supports patients and practitioners in relocating responsibility, reclaiming agency, and reauthoring their participation in families, workplaces, and communities. Clinical vignettes (from musculoskeletal injury, chronic pain, and post‑COVID moral injury among health workers) illustrate how coordinated sessions of manual therapy and dialogical self‑therapy can reduce pain, increase flexibility in self‑positioning, and deepen spiritual and communal connection. We argue that such integrative practice aligns with Indigenous and relational worldviews, challenges narrowly biomedical reductionism, and offers a hopeful pathway toward mutually healing relationships between bodies, stories, and systems.