Understanding Craniosacral Work

(c) Anne Hoff, 2008

Here's a relatively simple explanation of craniosacral work to help you decide if this
type of bodywork is right for you. Learn the basic issues of hte craniosacral system,
the history of the work, and how to find a practitioner.

Who Is Craniosacral Work For?

Do you suffer from headaches, TMJ pain, or a stiff neck? Do you have unresolved
issues from a whiplash injury (recent or years ago)? Are you stressed out and find it
hard to sleep well? Read on! This article will explain craniosacral work, a gentle
bodywork modality that could bring you significant relief.

What’s In a Name?
The word “craniosacral” comes from the top and bottom ends of the craniosacral
system. The top end is the cranium (skull) and the bottom end is the sacrum, the
triangular-shaped bone at the base of the spine. The cranium itself is made up of
twenty-one bones (excluding the tiny bones of the inner ear); some of these are
paired bones – meaning there is one on each side of the head – and some are single
bones that reside on the midline. The sacrum leads into the coccyx (tailbone), and is
wedged between other pelvic bones, which craniosacral work can also address. In
fact, a craniosacral approach can be applied to any area of the body.

Equally important to the craniosacral system are membranes and fluid. The
membrane layer of the craniosacral system includes the periosteum that “shrink-
wraps” all these bones, the falx and tentorium that help house and support the brain,
and the dural tube – which is like a stocking around the spinal cord anchored at the
top and bottom ends of the bony system. The fluid layer is the cerebrospinal fluid,
which bathes the brain and spinal cord and also acts as a shock absorber.

The History of Craniosacral Work

Craniosacral work as a form of bodywork came out of cranial osteopathy, which was
developed by William G. Sutherland, D.O. in the early part of the 20th century and
draws on the work of osteopathy’s founder, A.T. Still M.D. As an osteopathic student
Sutherland had an epiphany of realization about the cranial bones: they are able to
move minute amounts. In other words, the adult head is not a solid block of bone,
but rather a complex system of relationships between bones that all move in relation
to the flow of cerebrospinal fluid.

Sutherland’s work stayed in the osteopathic field for the most part until the 1980s.
Eventually some osteopaths began to teach manual therapists outside the
osteopathic world, and variations on cranial osteopathy are now taught to
chiropractors and bodyworkers. Cranial osteopathy still exists, but there are not
many osteopaths who specialize in manual medicine these days.

Problems of the Craniosacral System

Common problems of the craniosacral system include – among many others -
headaches, sacroiliac joint pain, temporomandibular joint (TMJ) pain and
dysfunction, ringing in the ears, teeth grinding, whiplash, and the inability to deeply
relax/sleep. What causes these problems?

The cranial bones are meant to move in precise and balanced ways, but they are
part of a delicate balance that can be disrupted. Many problems stem back to
physical impacts – falls, whiplash injuries, blows to the head, birth trauma – that
leave paired bones out of balance or a feeling of one part of the cranium being
“jammed up.” You can also have issues in the craniosacral system as a result of
scoliosis, poor posture, extended dental work (orthodontics, or uncomfortable jaw
positions during dental procedures), high stress levels, and trauma.

The various cranial nerves (affecting the facial muscles, vision, hearing, etc., as well
as digestion and relaxation vs. fight/flight) in many cases pass through small holes in
the cranial bones, or between cranial bones. So an imbalanced cranial system can
put pressure on these nerves, just as nerves exiting the spinal cord can be impinged
as they exit the spine. The nerves can also be flared up from unresolved trauma or
chronic stress where the body remains in a fight/flight mode of sympathetic nervous
system activation, unable to drop into the parasympathetic system that brings
relaxation and deactivation.

Craniosacral Touch
Craniosacral work tends to be gentle. This is because the cranial system is easily
impacted – think of a sea anemone that retracts as soon as it is touched, or touch-
sensitive plants that close their fronds when you touch them. The body’s intelligence
understands the delicacy of the head and nervous system and prefers an approach
that lets it take the lead. For this reason, many techniques used in craniosacral work
are what we call “indirect” technique. Direct technique (e.g., most massage, most
chiropractic) says “I’m going to make this muscle longer” or “I’m going to put this
bone where it should be.” Direct technique can be very effective, but it is often
rejected by the craniosacral system as interference. In contrast, indirect technique is
like asking the body “Shall we dance? You show me where you are troubled and I’ll
support you in change, you show me where you are healthy and I’ll support health.”

One of the results is that the body will accept this touch and allow the nervous
system to deeply re-regulate. Have you ever had a massage but not felt relaxed
afterwards? Some people’s nervous systems are so charged that standard forms of
therapeutic touch – such as massage or chiropractic – are seen as more stressful
input into an already overloaded system. Because craniosacral touch asks the body
to lead, it is not perceived as unwanted stimulus, so tension in the nervous system
can begin to discharge. You could say that craniosacral work is like an induced
meditation. As the practitioner becomes aware of the craniosacral rhythm – one of
the deepest and slowest rhythms in the body, more primary than the heartbeat and
breath – there is an entrainment effect whereby the client also drops into this deep
layer and profound relaxation occurs.

Craniosacral work obviously requires a particular type of quiet space and light touch.
While it is touch, it is listening touch: the practitioner’s hands have to “listen” to the
body – I think of them as little satellite dishes, receiving signals – and not override
its subtle expressions. To learn to be effective with craniosacral work, a practitioner
has to learn to quiet down internally, to sense subtly, and to be aware of how his or
her “energy” meets the client’s “energy.” When I taught indirect work at a massage
school, I would tell my students that to “listen” well you have to be patient and allow
yourself to be aware of minute, almost imperceptible changes – the pace and level of
drama can be like watching snow melt, but it is fascinating when you are in touch
with its rhythms.

What is the practitioner “listening” for with his or her hands? We are listening for the
very deep and slow movement of the cerebrospinal fluid, which has a rhythmic flow
through the craniosacral system. Like any fluid movement – a stream, a river – it
can have a healthy flow or areas of eddying or stagnancy. We are also listening for
the positioning and movement of the cranial bones, whether they can express their
normal movement or have areas that feel jammed in a strain pattern. And then we
are also listening for “still points” where motion stops and the system resets in a
profound and nourishing stillness, and for releases where patterns are freed from the
inside out and motion and potency return.

Finding a Craniosacral Practitioner

There is no one school or certification program for craniosacral work. As mentioned
above, this work came out of the field of osteopathy, so for medical-level care you
can see if there is a cranial osteopath practicing the traditional work in your area.
You will also find bodyworkers (e.g., massage therapists, Rolfers™, Hellerworkers),
acupuncturists, naturopaths, and chiropractors who have studied craniosacral
therapy, some a little and some a lot. Ask practitioners about their training, and
choose someone who has done many classes and made this one of his/her primary
modalities.

About the Author

Anne Hoff began studying craniosacral therapy in 1994 and has studied both
biomechanical and biodynamic approaches. She is a Certified Advanced Rolfer™ with
a bodywork practice in craniosacral therapy, Rolfing® Structural Integration, and
visceral work in Seattle, Washington.

Further Reading
 
Milne, Hugh, The Heart of Listening: A Visionary Approach to Craniosacral Work. 
Berkeley, CA: North Atlantic Books, 1995. 
 
Sills, Franklyn, Craniosacral Biodynamics. Berkeley, CA: North Atlantic Books, 2004. 
 
Upledger, John, Craniosacral Therapy. Seattle, WA: Eastland Press, 1983.