The BCSTrayal: Pernicious pseudoscience permeates, pacifying pious practitioners un-productively
https://www.painscience.com/articles/craniosacral-therapy.php
https://sciencebasedmedicine.org/alas-poor-craniosacral/ In trying to find the silver lining of Biodynamic Craniosacral Therapy, we must ask several questions: What is *actually* happening when we touch people in this way? What is the maximum benefit we can offer within the structure of this practice? Here is what I've come up with:
1) Co-regulation. A lot of people are all tied up and frozen and stiff and frankly do not get neutral safe touch in their lives. They may have trouble relaxing around other people due to lack of subjective feeling of safety or mal-adaptive thought-patterns. Or perhaps they just never learned how to be in healthy relationship (healthy attachment). The #1 most common effect people have is relaxation. It also functions like a structured meditation. Therefore at least theoretically it will contribute to the established evidence of the benefits of meditation. The practitioner helps to train the clients awareness to their internal state. There is something very physical and real about countering shyness in this way. The client has an experience, in a professional setting, that is different from anything they have had in their life. This allows them to add to a new catalogue of experiences that reinforce to themselves “I can do this. I can be a different way”. The next time they head into a social experience they have this strong memory impression of when they were able to remain relaxed and feel safe in the arms of another person. There is a physical memory they can tap into.
2) Education. Personally in my practice I also try to squeeze in as much psycho/somato education as I can. When people understand theoretically how force should be distributed in their body, it allows them to physically organize around that. That includes teaching anatomy in an experiential way, teaching behavioral principles esp around habits (I reference the work of Judson Brewer & Charles duhigg). I also give them a run down of bio-mechanics including the significance of type 1 & 2 muscle fibers, and the basics of how the musculoskeletal system can become unbalanced due to lifestyle factors, etc, and conceptually what is involved in successful rehabilitation. I usually refer them out to local PT who teaches a twice-weekly affordable “core for life” functional rehabilitative fitness class that personally has been a great boon to me in my own recovery and integration.
3) Identifying clear goals (coaching). I usually talk with my clients in order to get them to be explicit in their intentions. What are the maladies, what results do they want to see? By having them define their goalposts clearly, it is a cognitive tool and a barometer that can help them clarify their own thoughts and give them more agency in resolving their particular distress. Once we define their goals and identify obstacles, I apply all of my fairly broad knowledge to give them the best tools possible to point them in the direction they want to go. I have no fantasies that I have the correct, higher knowledge. In fact, my primary orientation is to identifying the limits of my knowledge and scope of practice.
4) Novel sensory input & mindfulness. I kind of got at this in 1&2, but it’s separate from both of them. When I put my hand on someone’s sacrum, I am helping them create a neural connection with a primary organizing structure in their body. Likewise, when I hold two opposite areas on the body (l & r, top & bottom) it is creating a connection in the brain to help the sensory-motor area integrate/“re-calibrate”, by giving intentional feedback. There is a palpable “energetic” feel that a client may have on the table during a respiratory diaphragm “sandwich” hold. In this hold you have one hand at the posterior diaphragm attachment at the last rib, and the other on the anterior attachment at the sternum. By manually "outlining" the diaphragm in this way, it potentially allows the brain to reorient to it. Isolating it in a specific way that helps reduce co-contraction that may be restricting the completion of a full breath. Likewise with the pelvic floor, and the continuity up through the head. Full, complete, unrestricted breathing is a huge boon to health, and circulates many things including CSF, lymph, muscles, the venous system, etc. It oxygenates the brain and calms the nervous system. It is also a complex process with many working parts that could become inhibited and lead to subjectively unresolvable restriction that has a cascade of downstream effects. It requires strong vagal tone, and is inhibited by inefficient body habits/co-contractile muscles.
So through skillfully applied contacts, the practitioner can help the client relearn their internal body map, via attunement of interoception. This can also allow them to hone proprioceptive awareness as they move through space. This is most effective and highly recommended when combined with a targeted, intelligent movement practice. Experiencing this work has made me a better musician, and better at everything that involves my body in space.
5) Pattern disruption/placebo/"cultural exception". I am in the USA, and while I have experience with other cultures I recognize that I operate in a particular cultural context with particular set of challenges. Similar to the office of a psychotherapist, the professional setting allows me and the space I create to be a “cultural exception”. My culture produces a particular common set of behaviors:
- Narrow range of lifestyle movements. American, society, is, really, truly, madly, deeply, an, orthodic, society. This does not mean orthodics are always bad, but like any tool we must thoroughly assess their need, and the specificities of their design in any given situation. "First, do no harm" - hippocrates.
- Lack, of touch, lack of community/isolation
Thank you for coming to my ted talk
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