earlier he noticed the beveled sutures of a disarticulated
skull and realized the cranium must be built for motion. Now
he had another inspiration that would once again alter the
shape of Western manual therapy
"He had his hands on a patient and spaced out just enough to
get out of the way," says Michael Shea, PhD, author of
Biodynamic Craniosacral Therapy.
"Suddenly he observed a force in the body that was making
corrections without his having to add any force to the
system. He began writing about the need to have reverence in
our hands for this self-correcting power."
That reverence for the power of the human body lies at the
heart of each model of CranioSacral Therapy (CST). Yet each
one has its own personality. Here for the first time, three
CST instructors discuss their shared history, what unites
them, what distinguishes them, and what the future holds.
The Membrane Model: Upledger CST
There's one fact all three instructors agree on: The man
responsible for delivering CranioSacral Therapy into the
hands of manual therapists is John E. Upledger, DO. "He had
the courage to take what, until 1985, had been called
cranial osteopathy and encourage people who weren't
osteopaths to study it," says Hugh Milne, DO, author of
The Heart of Listening: A Visionary Approach to Craniosacral
journey began with his own "Aha" moment in 1971, when he was
assisting in a neurosurgery, explains Don Ash, PT, author of
Handbook. "They were opening up the patient's
spine to remove a piece of calcified plaque from the dural
tube." Upledger's job was to hold the dura still, but he
couldn't stop it from pulsing in and out of the incision
site, and no one in the surgical suite understood what was
Intrigued, Upledger set out to resolve the mystery. His path
led him to Sutherland's theories and he went on to become a
skilled cranial osteopath. Then in 1975 he received a
research grant from Michigan State University that would
mark another turning point in the evolution of cranial work.
"He gathered 22 scientists and researchers who were charged
with proving or disproving Sutherland's theories," Ash says.
"They came up with compelling studies demonstrating that
cranial sutures aren't fused as everyone had believed.
Finally, they had scientific evidence supporting
Sutherland's theories on cranial motion."
Upledger also studied the effects of CST on autistic
children. "When he liberated their cranial sutures using
gentle techniques focused on the craniosacral system
membranes, their behavior improved," Ash says. "They became
more social, more engaged in the world." Upledger noticed
some kids had emotional outbursts in session and became more
interactive and responsive afterwards, leading him to expand
his CST model to encompass SomatoEmotional Release.
"John was so inspired, he wanted to gather up all the
cranial osteopaths he could find, put them on a bus and
travel to different schools to work with these kids," Ash
says. As the story goes, he could only find three cranial
osteopaths, and none of them wanted to get on a bus. That
motivated Upledger to dedicate his life to teaching CST to
as many people as possible.
"Upledger said CranioSacral Therapy belonged to the world,
and it's not the exclusive domain of any medical specialty.
He began teaching osteopathic students, PTs, OTs, MTs,
teachers, nurses, parents of special-needs kids, anyone with
knowledge of basic anatomy, good intention and a gentle
The Core Intention: Blend and Trust
Healers on Healing,
Benjamin Shield, PhD, dedicated the book to "Dr. John
Upledger, who taught me that the shortest distance between
two points is an intention." That focus on the intention of
touch is another trait at the heart of each body of
CranioSacral Therapy. The core intention of Upledger CST is
to blend and trust, Ash says. "We use all our senses to feel
the innate movement of the central nervous system. We blend
and listen as the cranial rhythm guides us to tissue
restrictions. Then by way of gentle techniques and good
intention, we invite the body to change."
"Andrew Still, the father of osteopathy, said anyone can
find disease, but how do we find health?" said Ash. "We
can't cure anything with CST. We simply facilitate the
patient's self-healing. It's virtually risk-free. In 25
years, I've never seen an adverse reaction."
A Modality by Any Other Name
As Upledger refined his body of work, other osteopaths and
manual therapists were evolving Sutherland's insights to
create their own models of CST. Yet Ash believes what
distinguishes them comes down to semantics. "We all agree
there's a rhythmic movement of the central nervous system
and healing potential of the cerebrospinal fluid. We agree
with the osteopathic principles that the body is an
interrelated unit, function follows structure, and the body
has all the pharmacopeia it needs to heal itself. Allopathic
interventions may be helpful at times, but the body has
self-healing capability. And we all agree with using as
little manual force as possible."
Finally, Ash says they all appreciate the potency of
cerebrospinal fluid and recognize that it has consciousness,
"although I'm grateful that Biodynamic and Visionary expand
on this. I think there's a lot to be learned about the
nature of fluid in the system."
The Fluid Model: Biodynamic CST
When Michael Shea heard the words "cranial work" as a
massage student in 1976, a light bulb went off in his head.
"I had to learn it, so I rushed to every course I could
find. But it was all underground, taught only by osteopaths
in weekend workshops." One of those osteopaths was John
Shea went on to teach at The Rolf Institute, but by 1981 he
felt burned out using so much pressure every day. "Craniosacral
has such a light touch. I knew it would save my neck, my
spine, my joints, my whole body. So I threw myself at it
again." Five years later, Upledger invited Shea to become
one of his first CST instructors. He accepted the invitation
and taught for about a year before opening his own school so
he could also teach Myofascial Release.
Along the way Shea heard about James Jealous, DO, who had
continued developing Sutherland's cranial osteopathy along
the lines of the Biodynamic approach. "I wanted to find out
if Biodynamic was the next evolution of cranial work," Shea
says. "Jim gave me a year-long series of phone interviews
and it quickly became clear that this was a different
orientation to cranial work. It came from Sutherland so it
was part of the cranial lineage, but it came from what he'd
been developing before he died when he had the inspiration
that the body has self-healing power associated with a tempo
much slower than the cranial rhythm."
The Biodynamic model is based on synchronizing yourself with
that slow body tempo, called the "long tide," rather than
faster rhythms like the cranial rhythm, Shea says. "There
was something Sutherland noticed about this deeper tempo
that's systemic and three-dimensional. It has a potency to
changes in the body, and it has its own ability to direct
the therapeutic process. I tell my students, 'Most of us
learned to work on 8 percent of the human body. But because
Biodynamic work extends to all the fluid sub-compartments as
one entity called the 'fluid body,' we get to work on 92
percent of the human body.'"
The Biodynamic Dance
The central focus of a Biodynamic session is self-awareness.
Shea says, "When you're learning, you've got to spend 80
percent of a session tracking your own three-dimensional
wholeness. Then you bring that attunement to your client.
Later it becomes more like 50/50, but first you learn to get
grounded and embodied so you can trust your own sensory
process, because when you're with a client you read them
with your whole body."
It's a practitioner-patient dance, he says. "We can't keep
our attention on a client for 45 minutes. It'll send the
autonomic nervous system off the charts. So we learn to
dance in cycles of slow attunement. The practitioner brings
his attention to the client, then back to his own body to
monitor himself. Then he may move his attention out the
window to look at a cloud, then back to the client again.
Ultimately, the practitioner is looking for whether the
client's fluid body can breathe as a three-dimensional whole
with the long tide. This rhythmic cycle rebuilds the nervous
A Distinction of Timing
After Sutherland developed the cranial concept, Shea says
several decades were spent refining the mechanical model.
"But after a while, working on the parts wasn't enough.
Osteopaths noticed that the parts had a relationship to the
whole systemic physiology of the body. That's when the
functional model began. Now the spirit of Biodynamic work,
which starts with the whole and moves toward the parts, is
becoming embodied in the different models."
According to Shea, Upledger CST is a highly effective
functional model. "It's got wholeness in terms of its focus
on neurophysiology and fascia." And Visionary brings a
spiritual dynamic and a welcome emphasis on the heart. "The
main difference is that Biodynamic focuses on the long tide
as a perceptual process in a two-person biology between the
therapist and client. Then we wait for the stillness. In
stillness is the renewal."
The Mystical Model: Visionary CST
The Visionary branch of CST goes back to 1899 when
Sutherland was studying under Andrew Still, says Hugh Milne,
DO. "In Contributions of Thought, Sutherland said, 'You
might say Dr. Still was like an X-ray. He could look right
through you and see things without putting his hands upon
the body. Time and again, Still walks in the door, points to
the model and says, 'Look, that's what's wrong.' He didn't
touch the model, but he could see it.'"
"I began having similar experiences at osteopathic school,"
Milne explains. "A patient would walk in and I instantly
knew what was wrong with him. Frankly, I doubted my sanity."
His quest to understand led him to India where he lived in
an ashram and worked at a multidisciplinary clinic. He was
finally free to practice osteopathy any way he wanted. "I
learned Shiatsu and deepened my meditation practice," Milne
says. "All that evolved into Visionary Craniosacral work."
Angeles Arrien, a shaman and teacher, said a visionary can
perceive four things at once - the physiological parts, the
physiological whole, the client's spiritual journey and his
own process -- and treat all four equally. "That's one of
the foundations of the four-fold understanding of Visionary
Craniosacral," Milne says. "But the genius of the work is
simply the magic of what happens between two people."
Milne has a special appreciation for CST as a spiritual
practice. "The honoring of stillness is a spiritual practice
to me, so meditation is my preparation for Visionary work.
Rumi said, 'There is a way between speech and presence where
information flows. In disciplined silence, it opens. In
wandering talk, it closes.' When I get silent, the channel
opens. On a good day I'm picking up information with my
inner ear. I'm sensing the client's soul journey with my own
heart and soul. And I'm doing my best through tactile and
verbal means to help my client regain their inner path."
Visionary work also encompasses tools of classic shamanism,
such as soul-retrieval, ritual, and the healing power of
nature. Ultimately, the intention is simply to set someone
right. "The ancient salutation on arriving at the shaman's
doorstep is, 'I come to you in order to see,'" Milne says.
"That is, I'm having a difficult time. I'm sick. I've lost
my bearing and can't manage on my own. The intention is to
set this person right, to bring them back to their true
self. With Visionary work, I see a radiant human being
standing in his own power and beauty, in touch with his
gifts, his genius. The practitioner's job is to help someone
be in their radiance, not simply let go of a symptom. We
help create an open heart, a clear head and a free body."
The Modality That Shouldn't Be Named
"I have great respect for other styles of cranial work,"
Milne says. "Upledger seems to follow Sutherland's classic
teaching. Biodynamic has evolved Sutherland's work in the
realm he was most fascinated with the last few years of his
life, the wisdom in fluids. It also honors stillness and the
Taoist understanding that what needs to happen will happen
if we create an open, non-directive field. When given an
open space, the human body and the soul's wisdom will rise
to the highest good for body and soul."
Visionary comes in with a focus on the human being as a soul
on a journey. But in the end, Milne says, distinctions don't
matter. "The client is oriented to a therapist, not a
therapy. I once had a dream that Sutherland walked into my
room, looked at me kindly and said, "You shouldn't try to
name it. None of the names are right." I woke with a start.
Was it a visitation? A fantasy? I don't know, but the words
ring true. Whether it's Upledger or Biodynamic or Visionary,
you shouldn't try to name it. None of the names are right."
From Inspiration to Evolution
Today, all three bodies of CranioSacral Therapy inspired by
Sutherland continue to evolve. "When I began teaching in
1984, I thought this was a fad," Milne says. "Instead it's
grown every year. Ida Rolf once told her students, 'If any
one of you is only practicing what I've taught you five
years from now, I will have failed as a teacher.' That's a
good teacher. Every practitioner needs to find and follow
their own genius."
Spelling alternates between "CranioSacral" and "Craniosacral"
based on each instructor's preference.
* * * Top of
* * *
Clear Your Head
with a Subtle Touch
Sezelle Gereau-Haddon, M.D., Otolaryngologist
Instead of surgery or drugs to treat chronic sinusitis, TMJ,
or ringing in the ears, Dr. Gereau-Haddon recommends a
painless, tiny adjustments of the bones of the skull and
spinal cord via craniosacral therapy... Her patients show
improvement and, in some cases undergo full remission of
symptoms. Its thought to work by taking pressure off
the auditory nerves in the lining of the brain, which helps
the cerebral-spinal fluid flow more freely.
* * * Top of Page
* * *
"Alleviating Ear Infections Through
Written and Illustrated by Tad Wanveer,
Craniosacral therapy can help children overcome ear
infections by improving Eustachian tube (ET) shape. As ET
shape improves, substances can then flow through the tube
more easily. Blockage or congestion of the ET is a frequent
cause of ear infections because harmful material can collect
inside the middle ear...
Ear infections can cause pain as well as compromise a
child’s ability to hear, speak, move, read and pay
attention. Craniosacral therapy is a gentle method of
freeing a child’s ET of obstruction or congestion, which can
promote drainage of substances out of the middle ear and
relieve excessive pressure from inside the middle ear. As
this happens, an ear infection can resolve more easily and
the middle ear can work normally, thus leading to
improvements in hearing and other problems caused by ear
* * * Top of Page
* * *
Bodyworkers Can Influence the Cranial
Integrative Health Care Studies, August 18,
by Nicole Cutler, L.Ac.
Known as the cranial keystone, the
sphenoid bone is one of the more
mysterious parts of our anatomy.
Connected with many common problems, a
restricted sphenoid can be freed by
Located in the very center of the skull, the
sphenoid bone is in a unique and
influential position. While many
allopathic physicians address a large
span of health complaints associated
with a restricted sphenoid, working
directly with this bone is far from
simple. However, learning how to
effectively administer cranial-sacral
therapy affords health practitioners
this seemingly challenging feat. Since
its assimilation into complementary
medicine in the 1930s, bodyworkers
trained in cranial-sacral therapy have
been able to create many healing
opportunities by gently manipulating
this cranial bone.
Named for its wedge-like butterfly
shape, the sphenoid is a prominent,
irregularly shaped bone at the base of
the skull. Because it is in contact with
all of the other cranial bones, the
sphenoid is often referred to as the
"keystone" of the cranial floor.
has a number of features and
projections, requiring a student to
study it from various perspectives to
fully appreciate its form. This single
bone runs through the mid-sagittal plane
and helps connect the cranial skeleton
to the facial skeleton. The sphenoid
articulates posteriorly with the
occipital bone, laterally with the
temporal and parietal bones, and
anteriorly with the frontal and ethmoid
bones. It consists of a hollow body,
which contains the sphenoidal sinus, and
three pairs of projections:
1. The more
superior lesser wings
2. The intermediate greater wings
3. The most inferior projecting
surface of the great wings forms most of
the posterior walls of the orbital
cavities. The optic foramina, located in
the bases of the small wings, provide
for the passage of the optic nerves from
the eyes to the base of the brain. The
superior surface of the body of the
sphenoid contains a deep depression
housing the pituitary gland, called the
sella turcica, or Turk's saddle. In
addition, the plentitude of surfaces and
articulations of the sphenoid harbor the
ophthalmic artery into the orbital
· The third, fourth, fifth and sixth
cranial nerves from the brain into the
· The maxillary division of the fifth
· The mandibular division of the fifth
· The middle meningeal blood vessels
a bony septum projecting downward into
the nasal cavity, the sphenoid bone also
contains two sinuses, which lie side by
side. The most common way for allopathic
medical practitioners to access the
sphenoid bone is through the nasal
Cranial-sacral therapy was first
developed by William Sutherland, DO in
1892. Dr. Sutherland realized the
cranial bones allow for small amounts of
movement driven by the flow of
cerebrospinal fluid (CSF). Identified as
a wave-like motion, the cranial-sacral
rhythm carries CSF up and down the spine
and around the brain. Despite it being
tethered in many different planes, the
non-stationary sphenoid bone plays an
active role in the circulation of CSF.
Within the brain, the cranial pumping
mechanism known to circulate the CSF
occurs where the sphenoid bone
articulates with the basilar portion of
the occiput bone.
breath we take, the nasal conchae fill
up with air, which applies pressure on
the anterior portion of the sphenoid
bone and the sphenoidal sinus where it
contacts the basilar portion of the
occiput bone. This pressure causes the
spheno-basilar junction to move slightly
posterior and inferior. On expiration,
the spheno-basilar articulation relaxes
as the pressure created by the inhaled
air is exhaled. This release of pressure
causes the spheno-basilar junction to
move slightly anterior and superior.
These movements of the spheno-basilar
junction are believed to drive the
cranial-sacral rhythm. This rhythm pumps
CSF down through the spinal canal on its
journey around the spine, sacrum and
back up to the cranium.
The movement between the sphenoid and
the occiput has long been considered a
primary focus in cranial therapeutics.
In the osteopathic model developed by
Dr. Sutherland and later presented in
books by Magoun and Upledger, the
following movements occur between the
sphenoid and occiput near or at the
· Torsion (Right and Left)
· Side-Bending (Right and Left)
· Vertical Strain
· Lateral Strain
· Sphenobasilar Compression
Problems Associated With the Sphenoid
Medical professionals often perceive the
keystone of the cranial floor as
off-balance or restricted in its
movement. When the structure deep inside
the skull is not moving freely, there
can be many repercussions. As a direct
or indirect result of hindered CSF flow,
an inhibited sphenoid bone can cause
many conditions. Below are 18 ailments
often associated with a restricted
4. Bell's Palsy
5. Trigeminal Neuralgia
7. Ear Infections
9. Dental or TMJ Problems
14. Eye Problems, Including Visual
16. Tinnitus and Middle Ear Problems
17. Headaches or Migraines
18. Hormone Imbalances
Bodyworkers Can Readjust the Sphenoid
While specially trained physicians aim
to reset an unbalanced sphenoid bone by
inserting specialized instruments up
both nasal cavities, these techniques
are beyond a bodyworker's scope of
practice. Luckily, cranial-sacral
therapy accomplishes this same task
through a non-invasive, extremely gentle
trained in cranial-sacral therapy can
free the sphenoid from any restrictions,
by applying point and direction specific
pressure on the cranium. Equivalent to
the weight of a nickel, this pressure is
barely perceptible to the recipient of
articulates with all of the other
cranial bones and its movement is
responsible for circulating the CSF, the
sphenoid bone is one of the primary foci
of cranial-sacral adjustments.
Understanding the complex, 3-dimensional
anatomy of this bone can help
bodyworkers practicing cranial-sacral
therapy better visualize their work.
Through their influence over this
cranial keystone, bodyworkers who
include this method are in the best
position to help clients recover from a
long list of undesirable ailments.
* * * Top of Page
* * *
Abnormal brain shape may be
a factor in autism spectrum
disorder (ASD). Structure
and function are
inseparable; alterations in
one, to some degree, will
modify the other.
CranioSacral Therapy can
help optimize brain
structure, which often
The irregularly shaped brain
areas associated with ASD
The amygdala regulates
emotions and aggression. The
hippocampus is involved in
learning and memory. The
corpus callosum is the main
pathway for brain
cerebellum is linked to
movement control as well as
Dysfunction of these
structures may explain some
of the atypical behavior
seen in ASD.
A primary focus of
CranioSacral Therapy is
helping the body decrease
structural stress so the
body can improve function,
which has been shown to help
those with ASD improve
communication with others,
enhance interaction with
their surroundings, and
promote a feeling of inner
* * * Top of Page
* * *
The Diseases Associated with
Massage Today March 2012
Vol. 12 Number 3
Michael Morgan, LMT, CST-D,
witnessed the harsh effects
of Alzheimer's firsthand ...
According to Michael, his
determination to help that
growing population spawned a
12-week pilot research study
called "Craniosacral Still
Point Technique: Exploring
Its Effects in Individuals
with Dementia. "*
through the program, about
two-thirds of the patients
Michael said. "They
became more interactive,
more cognizant, and their
verbal and social behavior
improved. We had one
100-year-old woman begin
speaking in complete
sentences and feeding
...Michael is well
acquainted with the benefits
of strengthening the flow of
cerebrospinal fluid to help
"Cerebrospinal fluid can
help wash away toxins that
may have crossed the
blood-brain barrier and
accumulated in the brain."
As people age, their natural
production of cerebrospinal
fluid decreases, Michael
explains. "the body can go
from producing as much as
800 milliliters a day down
to 400 milliliters a day."
The still-point study goes
on to state that
in individuals with senile
dementia can be as low as
200 milliliters a day.
So it makes sense that a
hands-on therapy known for
increasing the flow of
cerebrospinal fluid would
have a beneficial effect on
According to the research
study, the most challenging
aspect of caring for
dementia patients is their
general state of agitation,
because they don't remember
that their caregivers are
trying to help. At the
end of the study, the staff
reported that six of nine
participants were more
cooperative during their
daily caregiving activities.
* "Craniosacral Still
Point Technique: Exploring
Its Effects in Individuals
with Dementia" by Linda A.
Gerdner, PhD, RN; Laura K.
Hart, PhD, RN; M. Bridget
Journal of Gerontological
Nursing, March 2008, Vol.
* * * Top of Page
* * *
by Flo Barber-Hancock, Ph.D., L.M.T.
A variety of cranial and craniosacral techniques are taught by many organizations and individual instructors, and the use of these therapies has become increasingly popular. Because many massage clients have heard or read something about cranial techniques, they are often receptive to experiencing this modality.
More importantly, cranial therapy can offer benefits above and beyond other massage techniques, enhance the effectiveness of other modalities and sometimes contribute to longer-lasting therapeutic outcomes. An added plus is performing this technique is less physically stressful for the therapist than many other hands-on techniques.
A benefit of all types of cranial therapy is the deeper relaxation that can occur when the craniosacral system is balanced. Whether a massage client is seeking primarily pain relief, improved muscle and joint function, or relaxation, enhancing systemic and muscular relaxation is always a plus.
* * * Top of Page
* * *
by Carol McLellan, C.M.T., CST-D
Craniosacral therapy, a light-touch bodywork technique practiced by many massage therapists, has been found in new research to provide "significant reduction in pain" in fibromyalgia patients.
The randomized, controlled trial investigated the effects of craniosacral therapy on pain and heart-rate variability in fibromyalgia patients, according to a report published on www.pubmed.gov. It was conducted by researchers from the Department of Nursing and Physical Therapy at the University of Almería in Spain.
"Fibromyalgia is a prevalent musculoskeletal disorder associated with widespread mechanical tenderness, fatigue,non-refreshing sleep, depressed mood and pervasive dysfunction of the autonomic nervous system: tachycardia, postural intolerance, Raynaud's phenomenon and diarrhea," the researchers noted. Ninety-two patients with fibromyalgia were randomly assigned to an intervention group or placebo group, according to the report. Patients received treatments for 20 weeks. The intervention group underwent a craniosacral therapy protocol and the placebo group received sham treatment with disconnected magnetotherapy equipment.
• After 20 weeks of treatment, the intervention group showed significant reduction in pain at 13 of the 18 tender points;
• At two months and also at one year post-therapy, the intervention group still showed significant differences in pain reduction versus baseline in several tender points. "Craniosacral therapy improved medium-term pain symptoms in patients with fibromyalgia," the researchers concluded.
Results of the study are running in the Aug. 11, 2011 issue of Clinical Rehabilitation.