Cranial Sacral Therapy- The visit

My appointment finally comes around.   The office is located on a trendy street in North Asheville not far from the Grove Park Inn, a famous resort.  The massage therapist’s office is in an older single story cottage.  I am met at the door by the therapist, a middle aged woman with a warm smile.  After exchanging pleasantries, she escorts me into the outer vestibule.  Here, I take a seat and fill out the requisite forms - who am I, what is my profession, next of kin, how did I hear of them, and what am I here for today.  Throughout my exploration of alternative medicine, I often waffle on how to answer this second question - what is my profession?  I don’t like to lie, but I also don’t want to be too truthful.  Perhaps if they know I am a medical doctor, they treat me differently and cheat me out of some of the alternative experience.  I signify that I am a “writer” hoping this will not lead to a host of difficult questions:  “what have you authored?”  “Have I read any of your works?”  Fortunately, when reading the form, she says “a writer, hmm . . . you must be hunched over a computer quite a lot,” to which I say, “yes.”  And then, she moves on to other things.  My alias is not blown.  I tell her about my headaches and back pain, and she smiles and tells me that CST should be just the thing to help me feel better.

Next, the therapist leads me into an octagonal room with a massage table in the center.  It smells of incense (the calling card of alternative practitioners).  The room has carpeted floors and dark wood walls.  There is a lava lamp - yes, they still do exist - sitting on a side table.  There is a framed illustration of a man and a woman with their muscles and skeleton exposed.  Also included on the diagram are labeled acupoints and lines of meridian - another commonality that spans several alternative disciplines including massage, crystal therapy, and acupuncture.   Soothing music plays in the background; it sounds like a didgeridoo from Australia.  I succumb to the moment.  Let the healing begin.

I remain fully dressed and lie face up on the massage table.  The therapist’s hands meticulously feel along my scalp, apparently palpating the suture lines between my cranial bones.  I wonder if she can feel subtle movements of my cranial bones or perhaps even deeper movements in my brain.  She then places her hands at the base of my skull in the back of my neck where I imagine she is feeling for cerebrospinal fluid (CSF) pulsations.  She jams her thumbs into this area at the base of my skull while encouraging me to relax my head back.  It is not the most relaxing position, but I try to channel my inner Buddha.  After a few minutes, she moves to the foot of the table and pulls gently on my feet and applies pressure with her hands over my knees, thighs, pelvis, chest, and shoulders.  She then returns to the base of my skull for a while.  During the course of the visit, she spends time pressing gently along my skull, ears and face.  Fortunately, she does not enter my nose - I have had enough of the inner nose manipulation by my Rolfer.  Periodically, she reassesses the rhythm of my CSF by probing the base of my skull.  I close my eyes throughout most of the session.  The combination of her warm hands on my scalp, the background music, and the dim light put me in a near comatose state.  It would be even better if she were massaging my scalp, but just having someone manipulate and probe your scalp is pretty soothing in its own right.  I lose track of time. I am surprised when she turns up the light and announces that the session is complete.  Where did the hour go?  I tell her how relaxing the session was, and that I normally have a hard time letting go – in line with my Type A personality.  My admission of being Type A surprises her, probably because I am wearing my most hippie appearing clothes, I am unshaven, and I claim to be an author.  She comments that when she first was feeling my CSF pulsations, they were very frenetic and irregular, but now at the end of the session, they are nice and rhythmic.

Next Post: Do my rhythmic CSF pulsations translate into results?

Craniosacral Therapy- Molding the Mind

           It was my wife’s reaction to reading about craniosacral therapy in Andrew Weil’s book that spurred me to begin my exploration of alternative medicine.  Beth had read to me the account of a craniosacral practitioner feeling the movement of the skull bones to diagnoses and treat problems. I was in disbelief, “the movements of the skull bones?!”   Beth on the other hand thought the explanation was reasonable.  Despite my skepticism, who was I to contradict the author’s testimony.  Even though I was a physician I had never tried craniosacral therapy myself, nor did I have any proof that it didn’t work.  It just sounded kooky.  This led me to thinking about alternative medicine as a whole.  My western training told me it was all kooky, but I realized my opinion was based on biases formed in my training in traditional western medicine.  Rather than disparage alternative medicine while being uninformed I was going give it a try and develop my own educated opinion.  So it here I am five years into my alternative education and finally I will be giving craniosacral therapy a try.  I am certainly much more open minded, but I still have a hard time imaging my free floating skull bones.

I had assumed finding a craniosacral therapist would be difficult, but once again Asheville’s deep well of alternative medicine practitioners comes through.  In fact, the craniosacral therapy business appears to be booming- I have multiple options to choose from.   Craniosacral therapy is performed by massage therapists, practitioners of holistic healing, chiropractors, and others; although the massage therapists seem to be the most numerous.  I choose a husband –wife combination who are both licensed massage therapists.  In addition to craniosacral therapy they offer reflexology and more traditional forms of massage.  The craniosacral system is defined as consisting of the protective membranes surrounding the brain, the lining of the cranium, and the covering of the spinal column and the cerebrospinal fluid which ebbs and flows at a rate of 8-12 seconds per cycle. It represents the body’s hydraulic system as well as supporting the entire nervous system. Events ranging from a traumatic birth to other physical and emotional traumas occurring later in life can upset these rhythms.  

Craniosacral therapy follows a gentle, light-pressure protocol, to enhance the body’s natural ability to heal, improve brain and spinal cord function, and restore immune system response.  According to the website some of the maladies which craniosacral therapy claims to heal are: migraine headaches, TMJ (Temporomandibular Joint pain), chronic neck and shoulder pain, fibromyalgia, emotional difficulties, learning disabilities, and joint and muscle pain.  This seems perfect for me; despite my recent rolfing experience I still have lower back pain, and I am prone to frequent headaches. 

My alternative medicine bible reiterates the claimed benefits of craniosacral therapy touted by the website.  In fact, it expands the range of problems that can be addressed to include respiratory conditions, digestive disorders, and even Downs syndrome.  A cranial therapist is trained to feel the motion of the craniosacral system and locate critical points of restriction which can then be manipulated to re-establish a normal rhythm.  There are three primary approaches to CST: the sutural approach, the meningeal approach, and the reflex approach.  The pioneers of craniosacral therapy were Dr. William Sutherland in the early 20^th century and later Dr. John Upledger in the 1970’s, both osteopathic physicians.  Sutherland popularized the sutural approach in which he manipulated the sutures (where the cranial bones meet) to increase the mobility of the cranial bones. An interesting description, but one of which I am instantly skeptical. I was taught early in my medical training to palpate the cranium of infants for their fontanelles or “soft spots” during the first year of life as a possible indication of their volume status (level of hydration).  There are two main soft spots, one at the front of the skull and one near the back.  When an infant is dehydrate or sick the fontanelles may be sunken in.  These spots represent the areas where the cranial sutures have yet to fuse.  Early on the cranial bones remain unfused to allow the brain room to grow.  By 12-18 months of age the cranial bones have fused- the lines of fusion are suture lines.  Once the cranial bones have fused I would doubt much movement could be appreciated.  When I remember back to my first year of medical school and dissecting a cadaver I remember palpating these very same suture lines and the appearance of the skull as a single fused structure.    Dr. Upledger built upon Sutherland’s approach and pioneered   the meningeal approach was which he claimed was very successful for treating chronic, severe headaches.  His approach, which happens to be the approach followed by the massage therapist I will be seeing, works on releasing the restrictions of the cranial tissues and underlying membranes while monitoring the rhythmic movement of the craniosacral system via changes in cerebrospinal fluid pressure. He reported an 85% success rate in curing headaches.  My headaches are feeling better already.  I book a visit for the following week.

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