craniosacral therapy


To complement “The Chronically Depleted Client: Touch for Systems Under Stress,” by Eric Moya, C.S.T.-D., in the December 2015 issue of MASSAGE Magazine. Summary: A gentle modality, craniosacral therapy relies heavily on the practitioner’s mindset, which must be focused, still, and open to the needs the client’s body is communicating.

Many massage therapists may have some familiarity with the discipline of craniosacral therapy, and may have had some rudimentary exposure to the technique during massage school training.

This work has its roots in cranial osteopathy, which was introduced by William Garner Sutherland, D.O. (1873–1954), more than a century ago. Sutherland noticed that the cranial sutures of the temporal bones of the skull were “beveled, like the gills of a fish,” in order to allow for expanding and contracting movements with the parietal bones. (An anecdote about this moment of discovery is detailed in Hugh Milne’s book, The Heart of Listening: A Visionary Approach to Craniosacral Work, Volume 1.)

Sutherland’s conversations about his observations with Andrew Still, M.D., D.O. (1828–1917), his mentor and founder of the first U.S. school of osteopathy, began the evolution of the modality we now call craniosacral therapy.


Designed to Breathe

The cranial system is a semi-closed, hydraulic system comprising the spine, skull and its sutures, diaphragms, fascia and cerebrospinal fluid, which flows through the spinal cord and then exits the foramina of the vertebrae and into the interstitial fluid.

Both Sutherland and Still believed the cranial system was designed to breathe. Sutherland called this breath-like movement the primary respiratory mechanism. The idea that the bones of the skull could move at all ran contrary to contemporary anatomical belief, as it still does today to some scientists and medical practitioners.

A deeply spiritual man, Sutherland later described the origin of the respiration-resembling wave inherent in the cranial system as the “breath of life,” echoing Genesis 2:7 in the Bible. This acknowledgement of the primary respiratory mechanism as a vital force became a fundamental aspect of osteopathic philosophy.


Approaches to Craniosacral Therapy

Three approaches to craniosacral therapy have evolved since Sutherland began his work with the cranial system: the mechanical, functional and biodynamic models. The title of each approach refers to the level of intervention required from the practitioner.

Sutherland’s own technique development moved him from the intervention of the mechanical model to the softer, listening approach of the biodynamic model. My own studies also began 21 years ago in the mechanical model with Upledger Institute International; I have since moved to the biodynamic approach.

Whichever philosophical approach is employed, physically craniosacral therapy involves palpating various parts of the body to target areas that restrict cerebrospinal fluid, then employing gentle, light strokes to help release those restrictions and restore balance and flow to the system. The technique is used preventively to help boost resistance to disease, and has shown effectiveness in addressing conditions such as chronic fatigue, scoliosis, stress, temporomandibular joint disorder, post-traumatic stress disorder, fibromyalgia and migraines, among others, according to the Upledger Institute’s website.

One study, “Craniosacral Therapy for the Treatment of Chronic Neck Pain: A Randomized Sham-controlled Trial,” published in the Clinical Journal of Pain in September, indicated that craniosacral therapy is effective for managing pain; improving functional disability, body awareness and quality of life; and lessening anxiety, depression, stress perception, among other results.

Another study, “Heart rate variability and the influence of craniosacral therapy on autonomous nervous system regulation in persons with subjective discomforts: a pilot study,” published in the Journal of Integrative Medicine in 2012, examined the effect of craniosacral therapy on subjects with imbalanced autonomic nervous system activity. The investigators concluded, “Craniosacral treatment had a favourable effect on autonomic nervous activity … but further research will be needed to distinguish specific effects of craniosacral therapy technique from less specific therapist-client interaction effects.”


Your Mindset Matters

The most important tool for therapists practicing cranial work is the cultivation of our state of mind, or what we call the practice of holding stillness. It is a reflective practice by nature. In cranial work we are asked to change our focus to an internal place of quiet, so that the person’s system we are holding feels safe and willing to reveal its story, or history, held within the fluid of the body.

I was taught, in the context of the biodynamic approach, that we project and hold three distinct fields and follow three tides, and experience combinations of both. One of those combinations will be the most conducive to the therapeutic process—it is an intention which allows us to be in deeper relationship with the membranes and connective tissues of our clients.

Our breath is the bridge to this place of healing power. Naturally, everyone’s mind wanders; however, the more powerfully we can control our thoughts, the more profoundly we can be involved in the therapeutic process with our clients.


Achieve Stillness

As a trained craniosacral therapist, you will inhale, then slowly exhale, visualizing the field you are holding while your hands hold and listen to the cranial tide. You may need to use various hand positions to interpret what intervention you should deploy. Eventually, if you are practicing patience and have let go of the need to know anything, the system you are palpating will often communicate its needs.

By coming into contact and awareness in a reflective manner, therapists may create a homeostatic response within clients’ nervous systems.

As an instructor in this technique, I have found my students’ journeys a delight to watch unfold, as their practice deepens with time and their ability to help their clients with a number of challenges unfolds naturally through the quieting of the mind coupled with the practice of technique.


Change Your Life

The beauty of the biodynamic approach is the transformation to the practitioner that may transpire over time, because of the repeated practice of achieving stillness. It is the practice of becoming a witnessing presence—which is life-changing. We create and sharpen great listening skills, which often enhances our daily life interactions with others.

Watching our thoughts, using our breath to still our mind, and allowing deep connection between practitioner and client can transform who we are as humans. These tools can be employed in our garden of consciousness, which we are given a lifetime to cultivate.


About the Author

Judah Lyons is owner of the Lyons Institute, a National Certification Board for Therapeutic Massage & Bodywork-approved continuing education provider. He is a graduate of the Rolf Institute® of Structural Integration in Boulder, Colorado, and the Karuna Institute in Devon, England. He is also certified by Bowen Training Australia and the Hilton Johnson HealthCoachTraining program.