Positive Health Online

The Upledger organisation in the US claim to have trained over 25,000 cranial therapists in the past 10 years[1] – and although the largest they are by no means the only training programme in this rapidly growing discipline. Observation of advertisements in professional journals and popular health magazines gives further indication as to the explosion of interest in this therapeutic approach.

The roots of cranial manipulation lie in osteopathic medicine, based on the work in the early part of the century by William Garner Sutherland.

While cranial osteopathy remains the bedrock of cranial manipulation, this originally 'orthopaedic' model has been overtaken (not completely but to a large extent) by far less easily described models which include 'energy' and 'fluid' interpretations as to what is actually happening when the essentially very gentle methods are applied in treatment.

A distinction needs to be made between cranial treatment of infants and adults since the pliability, and indeed soft plasticity, of the infant skull lends itself to direct moulding techniques, which are of little use in the more solidly developed adult skull. It is when treating adults that theory and dogma abound, with very little solid evidence to support what is claimed, apart from recent research which shows that a minute degree of movement occurs in the sutures of the adult skull, when healthy.

The motion potential of the parietal suture is seen to involve about 250 microns (around 100th of an inch).[2] This suggests that pliability is present to allow accommodation of changes in internal fluid pressures as well as to absorb the shock of blows to the head and the enormous stresses imposed by powerful muscles which attach to the skull, such as upper trapezius and sternocleidomastoid.[3]

Internally the skull is lined by the meninges which folds back on itself to become the space in which much venous drainage occurs. The skull lining continues via the foramen magnum, becoming the lining of the spinal cord, the dura, with a filament attaching this to the coccyx (hence 'craniosacral' therapy). The skull's fascia also includes departmental divisions, the reciprocal tension membranes (falx cerebri and tentorium cerebelli) and it is the influences of these investing soft tissues which many believe are the means whereby gentle cranial manipulation can have bodywide influences. Or rather it is those who hold to the importance of mechanical influences that believe this. Others have a far more subtle view of what may be happening. For example the concept of health enhancing influences taking place by means of a process called entrainment, is gathering momentum.

McPartland and Mein[4] state, "Entrainment is the integration or harmonisation of oscillators." They have equated the way in which a union of different rhythms and pulsations pool to form the palpated cranial rhythmic impulse with a process observed in physics and in nature in which patterns or cycles tend to harmonise over time.

In physics they point to the example of pendulum clocks, in the same place, with the same length pendulum, starting to swing in synchrony with each other, a phenomenon described some 350 years ago by the developer of the pendulum clock, Christiaan Huygens.[5]

Examples are given of something similar occurring in our bodies, such as the behaviour of the cells in the pancreas which produce insulin, or the rhythmicity of cardiac pacemaker cells[6] One organism, or function, or cell, or dominant activity begins to 'pull' or 'drag' others towards its mode of behaviour as the various disparate pulsating or moving patterns begin to harmonise. This may be what happens as the hundreds, of oscillating impulses and signals, emanating from the human body integrate and blend to form a personal, individual, probably variable, harmonic end-point, representing the individual's current health status.

It is possible to make sense of the interaction of patient and practitioner in both the assessment and the therapy stages of cranial (and many other) treatment settings (Reiki, Therapeutic Touch for example) using further implications of entrainment, as suggested by McPartland and Main.

They explain that Huygens not only observed that pendulums eventually swung synchronously ('frequency selective entrainment'), but that he also noted that there was a tendency for the heaviest pendulum to determine the frequency of the others ('frequency-pulling entrainment'). Even if it was unable to fully influence the other pendulums the heaviest one would partially modify the others towards its own behaviour pattern.

If a healthy, well balanced, practitioner/therapist, in a state which is calm, centred and focused (a series of conditions which implies a good degree of sympathetic/parasympathetic balance) applies cranial (or other) treatment with a therapeutic intent, this can be seen to be analogous to the 'heavy pendulum', and to offer the possibility of the establishment of a 'resonant bond', of an interaction which can influence, 'pull' or 'drag' the patient's dysfunctional state towards a more balanced and healthy state. Unfortunately this remains a theory as does much of the belief system underpinning all schools of cranial therapy.

If cranial therapy is to break through into mainstream settings, and be understandable and acceptable to the medical mind critical evaluation is called for of the many theories which try to explain its clinical success.

Hopefully a forum which can critically examine the issues will emerge when a Master's level module is developed in a British university in the near future.

References

1. Upledger J Response to Craniosacral iaterogenesis Journal of Bodywork and Movement Therapies Vol.1 Number 1 October 1996 pp6-8
2. Lewandoski M Drasby E et al Kinematic system demonstrates cranial bone movement about the cranial sutures JAOA 96(9) September 1996 p551 PO1
3. Chaitow L Cranial Manipulation Theory & Practice Churchill Livingstone Edinburgh 1999
4. McPartland J. & Mein E. Entrainment and the cranial rhythmic impulse Alternative Therapies in Health and Medicine July 1996
5. Strogatz S, Stewart I. Coupled oscillators and biological synchronisation. Scientific American 269(12): 102-109. 1993
6. Llinas R. Is dyslexia a dyschronia? Annals of N.Y. Academy of Sciences 682: 48-56. 1993