by Michael Kern
Different conversations can be used to treat different parts of the primary respiratory mechanism. Two principal methods are employed—one is traditionally called an indirect approach and the other a direct approach. The difference between these two approaches is in the intention of motion that is suggested into the tissues or fluids. Nevertheless, both can be used to facilitate states of balance. We will now explore these basic approaches and some of their variations.
Indirect approaches
With an indirect approach of treatment, tissues and fluids are followed into their direction of preference. This is the pathway along which a tissue such as bone most easily expresses its primary respiration despite the presence of inertia. In effect, this is in the direction of the strain pattern. It is also often the path of least resistance. For example, if a bone is stuck in exhalation/internal rotation, it is followed there (see Figure 7.2).
Figure 7.2: Indirect approach (illustration credit 7.2)
Dr. Upledger describes this as an unlatching principle. It is like trying to open a tight door latch by first following the closure.38 Another way to picture an indirect approach is to imagine a kite that has been caught in the branches of a tree. If you try to free the kite by pulling its string, you may entangle it even more in the branches. However, if you let off the slack by loosening the string the wind may then blow it out of the tree. This rationale of treatment can help reduce resistances held in the body, creating an opportunity to free the suspended forces trapped within an inertial fulcrum.
When tissues and fluids are followed into their direction of preference, the pattern that they are holding is essentially being reflected back. In this way, the practitioner acts as a kind of reflective mirror for the patient and his or her potential for change.39 This is an important therapeutic principle because much of the time we walk around unaware of our inertial patterns. It is often only when a pattern is reflected back that it is recognized and can become clarified. Franklyn Sills explains, “In this reflection, something can be rediscovered that was forgotten, something can be reclaimed that was seemingly lost.”40 This process is like shining a light on the pattern, helping to bring it back into focus with the intrinsic biodynamic forces of the body.
There is always a natural boundary for how far a strain pattern can move. This is the point at which no more motion is possible without any force being added. It is marked by a subtle resistance to any further motion. If following a strain pattern, the practitioner always needs to recognize this boundary and take care not to press against it. However, at the level of the cranial rhythmic impulse it is at or near this boundary that a point of balanced tension can often be found. This is the point at which the practitioner may introduce subtle suggestions into the tissues for them to settle into their neutral.
In biodynamic craniosacral approaches it only becomes necessary to follow the intrinsic motions within tissues, fluids and potencies as they naturally seek a state of balance. Therefore, when in relationship to the mid-tide, the practitioner simply needs to follow whatever motions are present and not necessarily approach any boundary to this motion. In other words, one can just keep following the intrinsic tendency towards ease within the system until there is so much ease, there is only settling and stillness as a state of balance is reached. However, subtle conversations and (i.e., suggestions) of settling offered through the practitioner’s hands are sometimes useful to support this process.
Direct approaches
In this approach, states of balance can be sought by encouraging tissues and fluids to move directly out of their inertial pattern. Direct approaches help remind the body of its lost options of movement. If tissues are stuck in one direction, motion can be invited in the opposite direction (see Figure 7.3). This can help counter any distortion and create space for the disengagement of an inertial pattern. For example, if a bone is stuck in exhalation/internal rotation, a suggestion of inhalation/external rotation is offered. Suggestions of traction and decompression invited into compressed tissues are also types of a direct approach.
Figure 7.3: Direct approach (illustration credit 7.3)
When given the space, the self-corrective forces of the body have an opportunity to come back into play.41 This is another important rationale of treatment. The common saying, “time is a great healer” reflects this idea. In essence, time is equivalent to space. This understanding is well known in Ayurvedic medicine. Also, according to the teachings of the Medicine Buddha in an ancient Buddhist text, space is the most important and ultimate healing principle. This is because spaciousness is a fundamental quality of our natural state.42 Therefore creating space enables us to contact the source of our healing potential.
As tissues are gently facilitated to move out of their inertial pattern, their natural boundary of motion is always respected. When working with the cranial rhythmic impulse, it is at a point near this boundary that a settling and stillness can be invited by the practitioner’s hands to access a point of balanced tension, providing an opening through which the pattern can resolve. A student remarked that this was, “like having my forehead flossed.”
Again, when in relationship with the deeper organizing forces of the mid-tide it is sufficient to just subtly invite some space and disengagement without having to go all the way to the boundary of motion. A state of balance can be accessed by the practitioner simply holding this intention in his hands, providing a deep opportunity for re-organization. One patient exclaimed, “It feels like yoga from the inside!”43
Figure 7.4: Hand contacts for working with the frontal bone (illustration credit 7.4)
Intraosseous skills
Particular kinds of strain patterns may be retained within bony tissue, especially if a bone receives a trauma before it has fully ossified (see Chapter 10, “A baby’s skull”). This type of pattern is called an intraosseous distortion. As a result, the bone’s motility, or inner breathing, is affected.
Only direct approaches of treatment are used when working with intraosseous distortions. This is because these kinds of trauma patterns usually stem from an early age, before bones have fused and before any sutures have formed between them. Consequently, any boundaries to the practitioner’s suggestion of motion are often unclear due to a lack of resistance which the sutures would normally provide. As a result, there is a tendency for there to be no clear physiological boundary if an intraosseous pattern is followed into its direction of preference such as with an indirect approach. The patient can then just be taken further into the trauma pattern, rather than helped out of it. Furthermore, especially in adults, the forces that maintain intraosseous distortions are often deeply entrenched, and so may require the facilitation of some space and disengagement.44
Taking gravity off
Another common therapeutic approach is for the practitioner to lift and support a part of the body being treated to help remove the effects of gravity. This is a particular type of indirect approach often used when working with the more freely movable regions of the body. For example, a limb can be supported by the practitioner while tuning in to its pattern of primary respiration. When the influence of gravity is removed, any strain patterns that tissues and fluids are holding may become more easily clarified. Any inherent motion is then followed until a state of balance is accessed. The body as a whole can also be supported like this, although it usually requires the help of more than one practitioner to take the patient’s weight.
Viola Frymann compares this principle to unravelling knots in a telephone wire, “While the receiver remains on the instrument the distortion cannot change. An effort to pull it straight by direct action will be utterly useless … The very simple measure, however, of taking the receiver off the instrument and permitting it to hang … will enable the normalizing forces within to unwind that cord.”45
The motions that ensue when gravity is taken off may be dictated by the particular tension patterns that the body is holding. Therefore, during this process, tissues and fluids are essential
ly given an opportunity to express their pattern of trauma. The body will often move towards the position that it was in at the time of receiving the trauma. It is often when in this position that a point of balanced tension or state of balance may be found. For example, a patient who had slipped on ice and broken his arm recreated this position while we followed the resultant pattern into its direction of preference. It was only when his arm was in a twisted position, as it had been at the time he fell, that the inertial forces at the site of injury started to become mobilized. A re-organization then took place, relieving months of stiffness and pain.
Unwinding
This practice was given the name unwinding by Dr. Viola Frymann.46 Some craniosacral practitioners use it as a cardinal approach of treatment. Many people feel drawn to unwinding processes with the intention of reliving trauma patterns and completing any unfinished business. When trauma patterns are followed, old memories and emotions associated with the experience held in the tissues often come to the surface. This frequently leads to cathartic responses as the patient attempts to discharge the trauma.
However, as a note of caution, when tissue patterns go into an unwinding process it doesn’t necessarily mean that there is any resolution at their organizing fulcrum. As noted, the resolution of the forces held at a fulcrum provides the key to healing—and this experience essentially happens in stillness. Without a change occurring at the fulcrum, nothing significant has actually happened to change the pattern. This is like moving the furniture around in a room but still being stuck in the same living space. Furthermore, the re-experiencing of a trauma pattern may be too much for someone whose available healing resources are low. Therefore, the outcome may be retraumatization rather than benefit. We will look more at some of the ramifications of this approach in Chapter 9.
Light contact
The amount of pressure applied by the practitioner’s hands is minimal. Tissues, fluids and potencies can be invited, reminded or facilitated into finding a state of balance in a spirit of inquiry, rather than with any coercion. Nothing is ever forced in craniosacral work. Dr. Magoun confirms the need for subtlety and sensitivity, “To employ other than skillful and delicate sense perception is to lose the shades of physiological reaction so necessary for success.”47 He further describes,
One is reminded of the old fable of the North Wind and the Sun attempting to remove the man’s overcoat. The blustering gale only made him wrap it more tightly about his body but the gentle warmth of the sun soon effected the desired result.48
Imagine that you are standing on a tow path, trying to pull a barge through a canal lock with a rope. If you apply a strong and sudden force on the rope, the barge will probably hardly move at all. It is more likely that the rope will either break, or you will rebound from the resistance provided by the barge and end up in the canal yourself! However, if you just lean forwards while holding the rope, this gentle and steady pressure will enable the barge to move slowly ahead. In treatment, a gentle and steady intention sustained over a long time is more effective than using a strong force over a short time. This is because less force recruits much less resistance from the patient’s body.49 As one observer commented, “It takes a lot of energy to make a transistor or vacuum tube work, but it takes only a minute amount of energy to direct that work.”50
Although the vast majority of craniosacral treatment is carried out with an extremely light touch, on occasions stronger contacts may be appropriate. These occasions can include when resuscitating a patient, or working with the impact of physical trauma in the body.51 A patient suffering from physical trauma may sometimes require a firmer contact to meet the strong forces locked in the body. However, the practitioner still does not apply any added force into the body, but only matches the forces already there. In this way, treatment is responsive rather than dictatorial.
Domino effect
In the biological sciences it has been proposed that all organisms live on an edge of chaos and are therefore not very stable in their function. According to Chaos Theory it is thought, for example, that under certain conditions a butterfly flapping its wings on one side of the world can cause changes in the weather in the other. It seems that, “living systems are nonlinear: in other words a small change in input to a living system can result in a large change in outcome.”52 This has become known as the butterfly effect in Chaos Theory. In craniosacral work, a gentle invitation or support in the right place and at the right time can trigger such a domino effect. This may activate the self-corrective forces throughout the primary respiratory system and create changes affecting the whole person.
FLUID SKILLS
As human engineers, as physicians, we are dealing with the most powerful force within the human body when we learn to use the tidal movements of body physiology, tidal movements designed by the Master Mechanic.53
DR. ROLLIN BECKER
Relating to the body’s fluid systems can be a primary focus of treatment, helping to facilitate changes at an essential level of function. According to Dr. Sutherland, the longitudinal fluctuation of cerebrospinal fluid (C.S.F.) is the fundamental principle in the craniosacral concept.54 C.S.F. is like the rechargeable battery fluid of the body, carrying the potency of the Breath of Life throughout our physiology. Dr. Sutherland referred to this potency as an invisible element carried in the fluid.55 Wherever C.S.F. goes, so potency also goes, just as energy in the form of heat is carried around in a central heating system.
While the role of cerebrospinal fluid is central to the distribution of potency in the body, other fluids such as blood, lymph and interstitial fluid also share this important function. If all the fluid systems are unimpeded in their motion, the ordering principle of the Breath of Life can manifest without obstruction.
Fluid and potency are fundamental intrinsic resources in our physiology, which can be employed for encouraging health. They bring increased order and vitality wherever they go. The potency carried in the fluids can be relied upon to provide maximum benefit to areas of disorder. Therefore, by simply facilitating the expression of fluid and potency, inertial patterns can be resolved and the original matrix of health restored—obviating the need for more invasive forms of treatment. There are two common approaches to working with fluids and potency:
Working with lateral fluctuations of fluid;
Encouraging a V-spread.
Working with lateral fluctuations
When the longitudinal fluctuation of fluid encounters the resistance provided by an inertial fulcrum, various eccentric patterns of fluid motion may be produced. These eddies, currents and side-to-side motions are referred to as “lateral fluctuations” (see Chapter 6). Wherever there are lateral fluctuations, the presence of an inertial fulcrum is indicated.
As potency is carried in the fluids, the practitioner’s encouragement of these lateral fluctuations towards the site of an inertial fulcrum can bring vital resources to the area. This increases the amount of biodynamic potency available to resolve inertial forces.
Lateral fluctuations can be encouraged by the hands, as if gently pushing a child on a swing, at the start of each pendulate phase of its motion. If an inertial fulcrum is located between the practitioner’s hands, the fluid will rebound against this resistance. However, as the potency carried in the fluid starts to have an effect on the fulcrum, its gradual and progressive dissolution may be palpated with each new lateral fluctuation. This can be of tremendous support in the treatment of an inertial pattern.
Encouraging a V-spread
This approach is used to work with inertial forces held in joints or sutures. It applies two principles of treatment simultaneously—encouraging the movement of potency and fluid towards a site of inertia while facilitating a disengagement of bones that have become compressed.
The practitioner encourages potency towards the joint being treated by giving the fluid in the area a subtle nudge towards the inertial fulcrum. This invitation is introduced by one hand placed at a point on the opposite surface
of the body. Encouraging fluid and potency towards an immobile joint is like applying some deep penetrating lubricating oil.56 One patient described how he experienced the sensation of this “like warm water bringing relief” into his painful arthritic knee. The practitioner also makes a V-shape with two fingers of the other hand. This V is placed on either side of the immobile joint being treated (see Figure 7.5). While fluid and potency are invited towards the joint, the practitioner facilitates its disengagement by suggesting a widening of the V-shape in his fingers with the intention of accessing a state of balance.
Figure 7.5: V-spread process for the squamosal suture (between temporal and parietal bone) (illustration credit 7.5)
STILLPOINTS
At the still point of the turning world. Neither flesh nor fleshless;
Neither from nor towards; at the still point, there the dance is,
But neither arrest nor movement. And do not call it fixity,
Where past and future are gathered. Neither movement from nor towards,
Neither ascent nor decline. Except for the point, the still point,
There would be no dance, and there is only the dance.57
T.S. ELIOT
A stillpoint is a period of deep physiological rest for both body and mind, during which there is a temporary cessation of the cranial rhythmic impulse (C.R.I.) and sometimes the mid-tide. In a stillpoint, rhythmic motion quiets down and settles into stillness throughout the whole system. This differs from the stillness found at the point of balanced tension or state of balance, where an equilibrium is found around a particular inertial fulcrum but the expression of systemic rhythmic motion may still be present. In a stillpoint, as rhythmic motion settles, the inhalation and exhalation of all fluids and tissues come to a place of rest. This kind of systemic stillness may last from just a few seconds to several minutes.