Craniosacral Therapists Discuss: Prescriptive v. Emergent Medicine
I participated in a recent discussion in a group for Biodynamic Craniosacral Therapists. I couldn't help but jump in, its one of my favorite topics of Craniosacral Therapy. (The photo above is an old one: from my Craniosacral Training in 2011. It was the closest of my collection to illustrate a group of my colleagues consulting.)
I love posts like this, it points to an under-recognmized spectrum of therapeutic approaches: the evidence-based, and that which the practice of Craniosacral Therapy teaches, which is to be led by the emergent indicators and fluctuations of the Craniosacral System, the circulating and undulating body wisdom.
Here is the initial conversation starter, led by an Osteopath who recently learned Biodynamic Craniosacral Therapy:
"I studied biodynamics for the past little while, and really enjoy the space it creates both in myself and the people who enjoy this type of work during the sessions! Recently I started working in a clinic. I know I do good work and help the folks in need. As much as I enjoy it, I feel there is little space in that environment for CSBD [Craniosacral Biodynamics - one of three branches of contemporary Craniosacral Therapy], as the clinic is mostly oriented towards the ‘scientific’ approach. Even when I begin a session listening to the tide, and receive valuable Information about their bodies, I quickly feel pressured to use manual techniques. Does anyone relate to this? What worked for you?"
Mine and several other therapists contributions to this discussion are copied below.
My response, January 6, 2021:
"I can relate to this, trained firstly as a treatment massage therapist, trained to provide outcomes along evidence based pathways. The impulse to fix may always be there. Teachers like Ursula Popp, my Craniosacral teacher, her voice will always be in my head when this comes up. The most powerful thing we can do is listen she said. It was hard to hear but more and more its where I feel the deepest most profound work is done. She said this after teaching us advanced techniques that I was eager to master. But to refrain from copiously administering techniques in favor of trusting the wisdom coming from the person's own body wisdom, this is a way of being and providing that can be nourished by practice, trust, patience, and your clients' appreciation - it is what nothing else offers - trusting them, the wisdom that is already responding perfectly to the demands on it, trusting what is, and that trust is plenty for the body wisdom to utilize and integrate into its own inherent potential for integration into the deepest of resources, the breath of life, the long tide. That, Ursula said, is the basis of health, not what we "do to".
I also remind clients that whereas other work is prescriptive, like we need sometimes, CST is emergent: alignment with the forces of health already present and already at work in balance and healing and integration. The two work together I believe, very well! I think its helpful to know when we're doing one or the other or where on the spectrum our work is at. Sometimes I'm called to do some tissue work, so I go to that level and as soon as I feel done, I come back to listening as the ground of all work.
And then there's Franklin Sills. I went to a website that described a conference of CST/BCT and there was a video with a talk given by him, Michael Kern and another. I got my notes ready to hear about rarely taught advanced techniques, thinking I'd hear some secret technique that would be magic for my clients. This is what he said. The most important thing to do is to not know. I laughed outloud in astonishment and also relief. This is what Ursula taught. The body wisdom in another is beyond ancient aeons old. The frontal cortex through which I can attempt to compute such a complex system is only 25 years old (frontal cortex development age being around 25 years of age), and I only have a decade under my belt as a full time Craniosacral therapist. With all honesty, how would I possibly know what is needed? I can only approach another's body wisdom with total humility and therefore listening, following, and administering techniques only when especially called. It has taken me time to distinguish all this and I still have so much to learn."
"As a former director of rehab services in a hospital and practicing CSTALLIANCE therapist for 35 years I can offer you hope Tzach that you can be a bridge to offer your clinic osteopathic community the natural science that supports the biodynamics of the CS mechanism. Cranial and dural tube anatomy can explain the rhythms (tides), the polyvagal theory and the autonomic nervous system can give fabulous justification to the somato-emotional processes of the Inner Wisdom of the body. Have tea with your colleagues Tzach, then offer them a short session and talk them through what they will feel. Your have a great opportunity . I thank you in advance for your efforts. Good luck."
"I work in both fields and find I can move through a continuum of space and fluid to myofascial and boney articulation. Listening to where I am guided. The key to this for me, is in clear consent with my clients and meeting them where they are at."
"I studied visceral manipulation before I did bcst and tbh I've found that usually something similar to the adjustment I may have tried to foster with VM happens anyway and oftentimes more over time, if I work biodynamically and really take the time to set up the receptive holding field. Clients are often more surprised that they feel more shift/sensation/release particularly when they don't think that I'm necessarily doing much. I think it helps them to realize that the health and healing potential comes from within /the field and the holding context. Now when someone comes in wanting specific results or they won't come back, you have those skills in your back pocket to do everything you can to potentially accelerate the process. The irony is that this often gets in the way, in the long run, to a more grounded, holistic process where the client is participating more, through greater receptivity, in their health and well-being."
"For me its mostly the matter of what happens to a patient, what disfunction is there. Some things do need manual and mechamical ostropathy. But one can always integrate at the end with biodynamic method, but again, if needed. The patient is usually showing the level of work needed."
The discussion leader responded: "Very true [A.K.], the field will show how to work during the session. I'm fortunate enough to have studied several modalities as available resources. it is like having more vocabulary or several languages through which the tide can ask to be expressed. Amen to that!"
Thanks for your interest. I'd love to hear your thoughts.
Goodness and Happiness surround you, Broehe