Horizontal Fascia – Rings of Layers of Tension, Shock, Unexpressed emotions and Trauma. Releasing through Craniosacral Therapy
All structures in the body are connected with each other through our fascia (connective tissue), either vertically or horizontally. Fascia covers our bones, organs, blood and lymph vessels and muscles, like an interactive spider web. Diaphragms are horizontal fascial layers, acting like an armour of muscles, tissue’s and tendons in key area's where different important anatomical structures and openings go through and with psycho emotional implications.
Diaphragms can mirror and interplay the state of each other in the tension of the fascia, which has an effect on the chemical, physiological, energetic, communication and exchange processes that take place in the fascia and can have deep effects when we work with diaphragms and adjust something (Summer & Haines - Cranial Intelligence).
The pelvic diaphragm is an area where people can store a lot of tension and deep patterns of life experiences, being a sensitive and personal area. There may have been traumatic experiences, abuse, inappropriate touch, looks, words, surgery or childbirth complications. Often tension related to fight and flight lies here and the emotions of fear, anxiety, protection, terror or panic. As craniosacral therapist we listen for the quality, symmetry and motion of the various parts in this area. We can feel for tightness, tension, restriction, rotations, pulls and twists, or lack of movement of the fascia, pelvic bones and joints. We can feel frozen states, we can feel if a charge is being held here, through the coccygeal ganglion of the sympathetic nervous system, working with any underlying tension patterns or emotions. As the parasympathetic nervous system (rest and digest relaxation state) emerges from our Sacrum (S2,3,4) through the sacral nerves, suppling the lower large intestines, reproduction organs and elimination, it is a great hold to bring calm, balance and homeostasis to the organs, tissues and muscles in this area enhancing their function and the parasympathetic nervous system overall.
The breathing diaphragm is seen as the most important horizontal tissue layer in the body. This diaphragm is intimately linked to our ability to breathe deeply and to breathe functionally. Breath work has taken the world by storm in the last few years and it is easy to see why. Highly recommend! The breathing diaphragm is a super powerful place in function, size and location. When there is a restriction in this area, it will have a knock-on effect to the rest of the body and breathing affects how we use this diaphragm. The breathing diaphragm plays a role in most health conditions from anxiety to insomnia to digestive disorders, to high blood pressure and pain.
The anatomical solar plexus is an essential part of our sympathetic nervous system, playing an important role in the functioning of our stomach, kidneys, liver and adrenal glands, as it prepares the body to respond to stress by making changes in its physiology and oa produce a fight or flight response.
Restrictions here can be of a physical nature, leading to a reduction in its ability to move well, affecting the exchange of air and therefore cell metabolism but also movement of abdominal venous blood, liver function, digestive processes and movement of the spinal column. (Cranial Intelligence 2010, G. Summer and S.Haines).
Restrictions can be of a psycho-emotional element. Stress and trauma can be held in the diaphragm affecting the breathing mechanism. The volume of our breath, impacts our ability to feel emotionally. There is a huge interplay between our emotions, our nervous system and our breath. When emotions are involved our breathing changes, we all have experienced shallow rapid breaths or holding our breath when stressed, in fear or in shock. Unexpressed feelings can lead to restricted breathing, in order to not feel the pain. As the saying goes: When we stop breathing, we stop feeling and a lot of people restrict their breathing as a result. On an emotional level, stuck or unexpressed emotions, like grief, mourning, longing, fear, rage, anger affects the volume of the breath and our capacity to breathe deeply, as it affects our ability to flex the rib cage and expand the lungs. When this area can move freely and the lungs can expand freely and fully, it increases oxygen levels in the body, it activates the internal organs in the abdomen, enhances digestion, lung and heart movement, it increases energy levels and overall well-being. The lungs need to be able to expand not only up and out but also horizontally.
As craniosacral therapist we listen for the quality, symmetry and motion of the various parts in this area. We can feel for tightness and tension in the diaphragm and sympathetic hyper arousal in the solar plexus. We can assess the motility of the liver and the humming and the buzz of the adrenals. So many people breathe incorrectly, affecting their nervous system and the nerve output of the organs lying here. When breathing is shallow, compartmentalised, or restricted on one side, we try and address that and I personally incorporate functional breathing exercises. It is a great hold to bring calm, balance and homeostasis to the sympathetic outflow of nerves in the thoracic region bringing releases, softening and reorganisation of the organs and nervous system.
It is an area where the oesophagus, trachea, jugular vein and the almighty vagus nerve enters as it leaves the base of the skull and enters into the upper thorax, as well as an outlet for the carotid arteries and sympathetic nerve supply exiting from the thorax and passing up into the head (Attlee, Cranio-sacral Integration). Nothing is in isolation and this area has an intricate relationship with the jaw, the cranial base, the spine and the upper chest.
The thoracic inlet is an emotional and stress centre where we can get cut of, tense and process our emotional responses. Deep emotional factors can come into play like hurt, fear, rage, anger, resentment, love, hate and in particular our ability and permission to authentically express ourselves through our voice. Maybe we were cut off when we grew up, maybe we were not allowed to express our emotions, maybe we never spoke up, always meeting someone else’s needs. All the intensity and charge of our swallowed words, anger and unspoken emotions can lie here.
Chronic stress, tension and trauma can lead to disturbances like: chronic sore throats, tension in vocal cords, voice changes, neck tension, structural imbalance between head and chest, jaw problems, shoulder problems, heart palpitations, asthma and anxiety. As craniosacral therapists we listen for all the things described in above diaphragms, in addition here to allowing for the emotional expression, softening the whole area, open up the voice, the throat, the vagus nerve providing a deep sense of relaxation, releasing deep chronic fascial restrictions.
The Sub Occipital Region – Foramen Magnum - Cranial base
Clinical implications can lead to oa. headaches, jaw problems, teeth grinding, vertigo, ear problems, eye problems, vascular and neurological problems like trigeminal neuralgia and migraines. This area is super rich in significant structures passing through from the brain to the body and the body to the brain: arteries, cranial nerves related to upper shoulder muscles and neck muscles, the vagus nerve, regulating our parasympathetic relaxation – rest and digest state and organs and the superior cervical sympathetic ganglia. Here we release the sub occipital area, through compression, decompression and fascial release. This area is a great portal into the PNS and can have a profound influence on many structures inclusive of the heart, lungs and digestion system.
The Tentorium Cerebelli
The Tentorium is a fascial layer inside the head, attaching several cranium bones together and is a space where the brainstem lies (our survival brain, always on the lookout for danger, to keep us safe). As therapists, we can feel for tissue vibrations, pulsations, swirls twists or pulls in the tissues, in the attached cranial bones and address clinical implications like concussion, whiplash, sinus problems, migraines but also agitation, anxiety or emotional turmoil on a central nervous system level. Chronic fear, stress or trauma will affect the tentorium cerebelli, creating headaches, tightness in the head and occipital lobe, tension around the ear (can play a part in tinnitus) and is affected in fight and flight activation.
Putting it all together
The physical body holds all our tension, imprints and stories. When we hold tension, we contract our muscles and our fascia. This is a biological protective response. It is a way of bracing ourselves against feelings, emotions, tension and stress. But what may have been adaptive appropriate responses at some point can become maladaptive when chronic. The protective response will start to impact our well-being, and can lead to muscle spasm, decreased motility, postural misalignment, lock and store any trauma in the body and the body will have a hard time coming back into balance, into homeostasis.
Diaphragms form an important part in any craniosacral evaluation and treatment, as we evaluate the whole system and it being a portal into the deep fascial layers. The whole body is connected from top till toe in fascia, every pattern or symptom, can get reflected to other structures through the fascia. We do not only treat local, where symptoms may be present, as it may not reflect the pattern that is being carried through the body. For instance, if you have an injury in your foot, the pattern can be reflected through the whole system to the knees, pelvis and perhaps even upward.
We treat the psycho-emotional elements that play a role, as the body holds and maintains our stories and imprints. In craniosacral we release fascial tension and as physical structures and tissue releases, often emotional blockages are cleared simultaneously. Tension and stress lodges deeply and you have to go deeply to heal and release it, melting and releasing frozen or overwhelmed parts. Tissue Release can happen on several levels. As a client you may feel: Pulsations, heat release, stream of current or electricity going through, unwinding, digestive rumbling, a twitch, a tremor or having tears without exactly knowing why.
We have to go past the rational analytical thinking mind, past the protective muscular layers and enter deeply into the fascial layers, often with the lightest touch as Fascia is rich with proprioceptors. Releasing, stress, trauma, physical implications of tissue tension and emotional blockages, layer by layer, can have profound effects on your health and wellbeing.
Physical symptoms can often be the result of mental or emotional distress, due to suppressed or unexpressed emotions like anger, fear, quilt, shame, loyalty, grief, unworthiness, anxiety and any beliefs that we may hold about ourselves, that attribute to our emotions.
This is known as somatisation, where the body somatises the emotional component of what has been going on for them. One of the strengths of Craniosacral therapy (CST) is releasing these trapped emotions through biodynamic emotional trauma release or also known as somatoemotional release. Here we allow any emotions to be expressed, to be felt, and complemented through verbal dialoguing, movement or sound (expressing the voice) as a natural way to release any stored life events, experiences and trauma’s from the bodily tissues. This is often experienced as liberating, freeing, deeply insightful and life changing.
CST addresses any kind of standalone acute physical symptoms and also addresses any physical symptoms that may have an emotional root at the core of their condition. Almost everything that we experience in life enters into our body through our connective tissue (fascia): physical stress, emotional stress or any force coming into the body will cause our tissue to react and contract. For instance, when we have an accident or a fall, not only the physical impact of that force but also the emotional effect like anger, pain, anxiety or fright, can enter into our tissue’s, depending on the strength of the impact and our capacity to deal with it at the time. Fascia is capable of retaining the memory of an injury or trauma, known as tissue memory. For example, if we see a cyclist coming towards us at full speed and we cannot jump back in time, then not only the physical force released by the collision of our body against the cyclist but also the emotional power of fear or anger will enter into our fascia. If this remains unresolved, it can be walled off and stored within the body, causing pain. Also, of equal importance, if we endured a physical impact during a particular emotional or anxious time in our life, that impact may be aggravated by the emotional tension that we already carried within us at the time. This can particularly be valid for people that seem to be slow in recovery, do not properly heal or experience a change in emotional behaviour on top of their pain. Often the reason this happens is due to the unresolved emotional tension and emotional charge, that they are still (subconsciously) carrying in their body.
CST also addresses any kind of mental or emotional condition that has a traumatic or emotional root at the core of the condition. When we experience an adverse life experience or trauma (and most of us, do), the body has the capability to repress it from our consciousness and into our body. This often happens as a protective survival mechanism, as perhaps it was too painful or we did not have the resources or capacity to really understand what was going on and act accordingly. An intelligent innate response from the body, as a defence mechanism, is to shut it down and hid it away in the body. We can often remain driven by these emotional patterns and beliefs patterns, without being fully aware of it (see addiction blog).
We can also hide things in our body and out of our conscious awareness, when we don’t want feel or deal with our emotions. CST has been at the root of healing many of my own physical and emotional conditions. One emergency operation left me leaving the intensive care unit minus one organ. I healed the scar tissue with CST but also the pain and the underlying emotion of anger. I was unaware I held that anger and that it was the anger that caused the pain to continue. When that anger boiled to the surface during a session, my therapist gently asked – what lies underneath that anger? My subconscious mind blurred: “the knife of the surgeon without my consent”. And just like that, it disappeared.
Weird? No not at all! I experience it all the time with my clients. Some clients are well versed in mind-body therapies and happily go down the road of inquisitive dialoguing during the treatment, be it for physical pain or emotional pain. Some clients purely come for physical pain and are often surprised when a memory or an emotion comes up, seemingly out of nowhere, that has been lying beneath the surface and out of their awareness for years, but often with great significance and in relation to their condition.
A client came to see me for headaches. During intake she expressed that she had been the victim of a sexual assault. She had been in talk therapy for a while, had made good progress and heard that Craniosacral could assist with her headaches and also release residual emotional elements of her trauma.
In Cranio we really learn to listen to the body through our hands, through the rich proprioceptors in our fingers. We can feel where the body is struggling or where it may be frozen, restricted, out of balance, in a holding pattern or open and flowing. As I was assessing her body through manual palpation, her tissues guided me to her liver and I rested my hands on her liver. I could feel the heat in her liver and the internal motility being out of sync and I sensed a lot of stored emotions. I stayed there, until I felt that the client had gone into parasympathetic nervous system safe mode. When I felt the tissues open, release and the clients craniosacral system ready, I gently asked: what is your liver holding? And before I could take another breath, she said: “anger, so much anger – he was my friend, I thought he would look after me, he was the one person I trusted”. As the anger and the heat was released from her liver, the liver wobbled and came back into unrestrictive functioning, as her tears simultaneously flowed. A perfect combination where she answered both verbally and somatically through her body.
For some people this may be enough for one session, ensuring it is rounded and complete for that session. Little by little and bit by bit-which is known as titration in somatic work. With other people we may be able to take it bit further, this is always assessed in the moment and how the body and the craniosacral system responds. If for instance a client has gone back into sympathetic stress response, into arousal or overwhelm, we would not go any further or even discuss the trauma but purely stay with bringing the client back into a grounded and well-resourced state.
In this particular case the client was grounded, resourced and established in talk therapy. As I further assessed and followed the new movement generated by her body, my hands palpated her sphenoid bone and found their way in particular to her frontal bone and eye sockets. I could feel tissue oscillations, twists and side bends going on beneath my hands. I had no idea what was about to unfold but when I gently asked about the sensations around her eyes and eye sockets, she delved into a deeper understanding that during the assault she had been very drunk, practically in a comatose state and had been unable to keep her eyes open. This made sense as through palpations her tissues had led me to her liver and eyes as the source of her headaches. I dived into some further dialoguing with her to ensure she was not triggered back into the event and in a subsequent session, she was able to express, to safely feel and to release the trapped emotions. She returned fully and completely to life as she had known it, headache free.
Putting it all together
As craniosacral therapists, we often experience that physical and emotional releases take place simultaneously, as the physical body and emotional body are inextricably linked. Emotions can lie at the core of any pain. Our memory may have been suppressed, our mind may have forgotten, but the body remembers. Keeping memories, experiences and emotions beneath the surface comes at a cost, often through pain, anger, unhappiness, restlessness, addiction, anxiety or irritability. It also takes a lot of energy to keep things repressed and frozen. CST is an excellent therapy to release suppressed emotions and tensions that have resulted from physical or emotional trauma, through physical touch, verbal dialoguing and emotional release. Fascia carries our emotional tension with a certain charge in our body, once these supressed emotions are allowed to come up and released, symptoms can be dealt with and resolve.
As one of my client’s wrote in her testimonial on expressing trauma through the body: “I was suffering from involuntary muscle movements & cognitive short circuiting. My doctor found nothing wrong with me; sadly, not all health professionals are trauma informed. Craniosacral has been invaluable; treatments are non-invasive yet powerful. My mind, body and life are back on track now, I am forever grateful. And there is absolutely no need to feel self-conscious about your symptoms, I think she has seen it all”.
The first part described how trauma and our biological stress responses are implicated in all addictions and the benefit of CST. In this second part we will look at the addicts brain and the relevance and importance of working with the brain in CST, as it is rewarding, life changing and totally underestimated in the inclusion of any kind of holistic treatment, be it for trauma, addiction, chronic pain, insomnia or concussion. There are so many bones, cranial nerves, glands, membranes, sutures and cranial foramina - openings that allow passage of cranial nerves, tissues and blood vessels to go through - to work with, with far reaching implications, when there is any kind of dysfunction in the cranium. It is important that all structures in the cranium are functioning properly, in order to maintain optimal function and general health. In my clinics I see clients with all kinds of addiction: from alcohol, work, drugs, shopping, gambling, sex, opioids, behavioural to food addiction, sometimes all combined in one, well almost.
All addictions use the same brain systems and chemicals, creating an altered physiological state, to escape emotional and mental pain, anger, anxiety, deep-seated fear, feeling powerless, less than, loneliness and disconnection. Addiction engages the brains reward (endorphins) system, the reinforcement-motivation (dopamine) system and the brains executive functions, where impulse control and self-regulation lies.
The three dominant brain systems involved in addiction are:
1. The Endorphins (Opioid) System - Attachment-reward system
Endorphins are our natural opiates and feel-good chemicals, produced inside the brains pituitary gland. They are our natural pain reliever for stress and discomfort and play a key role in how we react to both physical and emotional pain, as they calm the nervous system, slow down muscle contraction in the gut and diminishes saliva secretion in the mouth. Endorphins are released during rewarding activities like eating, exercise, work or sex. Endorphins are responsible for the pleasure-reward seeking behaviours that stimulates the addiction, as our brain rewards us when we engage in something that brings us pleasure, reduces pain, triggers the chemistry of love and connection and results in a feeling of general wellbeing.
Endorphins also play a critical role in the emotional bonding between parent and infant and forms the basis of our attachment system. Attachment is the biological impetus for physical and emotional closeness with firstly our parents and later on with other people. When we grow up in a functional household, receive attentive care, nurturing and loving responses, our brain gets flooded with endorphins. Young children who did not receive nurturing love and attentive presence to boost their internal chemical happy hormones are often also not able to self-regulate as well and rely on external dopamine hits. Secure attachment may be difficult when you have been hurt in your primary relationship. You may long to connect and to belong but any form of closeness or intimacy may pose too much of a threat to the nervous system and brain. They will try to escape their distress and are at greater risk for seeking chemical or behavioural satisfaction from external sources in life, as our early attachment style drives a lot of our behaviour and impulse control. Overall, the less effective our own internal chemical happiness is, the more driven we are to seek joy or relief through addictions or other compulsions that are perceived as rewarding and boosts our endorphins levels to receive that hit.
2.The dopamine apparatus - Incentive – motivation system
The brains incentive-motivation system controls our motivation and pleasure by releasing dopamine when we initiate in pleasure seeking and life-sustaining activities like eating, sex, forming new partnerships, exploring and engaging in new activities. Incentive feelings like desire, wanting and craving are all central to increasing dopamine levels and key to the reinforcing patters of addictions. As dopamine levels are increased, it will motivate us to do it again as it makes us feel more energised, inspired, focussed and happier. Addiction elevates dopamine in the reward circuit. Speed, nicotine, caffeine, meth, cocaine, porn, eating all tap directly into this system by flooding the reward circuit with dopamine. When we have learned for instance, that eating a chocolate bar or candy makes us feel good and is pleasurable - the likelihood of doing it again is greater,especially when we lack other self-regulation practices. Dopamine release is triggered in a brain center called the nucleus accumbens, located on the underside of the front brain, and plays a major component in the incentive circuit. graphic Sarah Huges - thesagon.online
Food, sex, novelty seeking behaviour, intense exercise all trigger dopamine release in the NA. Research shows that the existence of relatively few developed or damaged dopamine receptors may be one of the biological bases of addictive behaviours, as we are driven to make up for any loss of dopamine activity. Consistent dopamine releases causes our brain to create new neural pathways leading to desensitisation. The nucleus accumbens also acts as a liaison with the limbic system, which is also known as the emotional brain.
The limbic system consist oa of the Hippocampus (memory conversion) and Amygdala (emotion). The limbic system interprets thoughts, feelings and processes our emotions like love, joy, pleasure, pain, anger and fear. It determines whether we go towards something or away, it makes it possible to feel love, compassion and to have healthy social interactions. When properly developed our emotional brain is a reliable guide to life. When impaired or confused - it can trouble us and addictions is one of its main dysfunctions.
3. The Self-regulation circuits
The prefrontal cortex (PFC) sits in the front of our front brain, acting like the CEO with highly specialised functions like complex planning, problem solving, decision making, impulse control, rational judgement, balancing short-term vs long term consequences and inhibiting harmful impulses.
Gabor Maté describes in his excellent book – In the Realm of Hungry Ghosts - studies that link addiction to a specific centre of the prefrontal cortex – the orbitofrontal cortex (OFC). The OFC has an abundant supply of opioid and dopamine receptors and is responsible for inhibiting inappropriate action and helping to postpone reward seeking behaviour, both not functioning well in addicts.
Of interest and linking why it is so important to work with trauma and the brain, is that neurological traces of early formative events are embedded in the OFC. The emotional traces of psychological and physical trauma/abandonment are encoded in nerve patterns in the OFC, including experiences you cannot consciously recall (implicit memories). The brain structures to conscious recall develop during the first years of life but aspects of the implicit memory system which stores emotional memories are present at birth, priming the OFC unconsciously, as it interprets stimulus through the lens of its experiences.
Maté further describes how through its connections with the limbic system, the OFC serves as its mission control room for our emotional lives. The OFC receives input from all our sensory area’s - vision, touch, taste, smell and sound and regulates how we process our emotions and how we react to them, based on past and present experiences. The OFC decides the emotional value of a stimuli and its personal meaning, our likes, dislikes, preference or aversion and decides in a micro second, what we focus on. The Prefrontal cortex is often impaired as a result of life experiences, leading to poor impulse control when it is highly activated during cravings disrupting self-regulation circuits.
CST and the Brain
In CST we feel, listen and work with all the structures in and around the brain – below the main ones implicated in addiction:
Pituitary gland (the master gland –producing endorphins) is located inside the sella turcica of the sphenoid bone. In CST we assess for any cranial base dysfunctions – between the occipital bone and sphenoid bone. There can be torsion, side-bending or lateral strains imposed upon this area with clinical significance. It is important that the sphenoid bone is able to move optimally, with no lesions within the cranium in order to maintain its subtle movement to optimise the release of hormones.
All the above described brain structures are rich and important sources for CST, as the brain can start to initiate its own healing process by creating change in thought processes, wiring, emotions and behaviour. CST is no quick fix and attending other recovery programs is vital too. The pain that runs far back, runs deep. It takes time, dedication, recognition, effort and a real desire in wanting to change. One day at a time.
Part 3 – The Addicts physiology and bodily symptoms
Headaches and Migraines can be seen as part of the same family and tend to fall on a continuum — where you can occasionally experience mild headaches or on the total other side of the spectrum experience severe migraines.
What exactly is a headache?
A headache is a pain sensation that can appear anywhere in the head. The pain or pressure is usually on the temples, around the forehead, the side or back of the head and/or neck. The intensity can vary from very light to very strong and a headache can last from a few hours to days. The pain is often described as dull and on both sides of the head. Headaches often come on more slowly and gradual and can increase in their intensity. Headaches often occur with muscle aches and pains from the shoulders up, to the back of the head.
The 2 most common primary headaches are:
Headaches can be triggered by factors like: stress, teeth grinding, TMJ problems, lack of fluids, fatigue, certain foods, alcohol and drugs, low blood sugar, eyestrain, bright lights, heat and poor posture. Most headaches are tension headaches and can be a result of muscle tension in the neck and head area. This can lead to a contraction of blood vessels and nerves surrounding your skull – in particular Cranial Nerve 11 – the Accessory Nerve (see blog- Cranial Nerves) which innervates the trapezius shoulder muscle and sternocleidomastoid (SCM) (ie movement of the head and neck muscles). If this nerve is not functioning properly than the Traps and SCM are not properly innervated and will lack a proper tonus, causing headaches and stiff necks.
What exactly is a Migraine?
Migraines are more a disease of the nervous system and cause neurological symptoms. Migraines are can lie on a spectrum ranging from mild to severe to debilitating. Migraines are often on one side of the head, throbbing or pounding pain. Migraines are often accompanied by a variety of other symptoms caused by autonomic dysfunction like eg: nausea, blurred vision, aura, sensitivity to noise or light, increased thirst, irritability, difficulty concentrating and digestive problems. A migraine can last from minutes, to hours to days and often ranges from moderate to severe throbbing pain. Migraines tend to occur on one side of the head, symptoms are more severe, with sharp or throbbing pain. Migraines can last from hours to 4 days.
Headaches and migraines are mostly treated with over the counter and prescription medicine like painkillers, beta-blockers, anti-inflammatory drugs or prescription medicine to stimulate serotonin, with the aim to reduce inflammation and constricted blood vessels.
Does Craniosacral therapy help with headaches and migraines? Yes. Don’t take it just from me – as an ex-headache/migraine suffer – but there are multiple anecdotal and scientific studies to prove so as well. (attach BMC Complimentary study).
Craniosacral therapy can have great effect in particular when the migraines and headaches are caused by tension, neck and shoulder problems, jaw problems, sutural immobility in the cranial bones and/or a distressed and overwhelmed nervous system. My own personal headaches and migraines came from a strong tension pattern and after a whiplash accident – full blow migraines for months – where – as best as I can describe it - all the Christmas lights in my head were on full blast and flared up, along the nerve pathways in my head.
CST can address all above factors as well as any dysfunctions in the autonomic nervous system, neuro-musculoskeletal level and psycho-emotional level which can all be factors contributing to cause of migraines and headaches. It is however not a quick fix especially if it has been a long-standing pattern and will need a succession of treatments to go through all the layers and adjustments.
Our Autonomic Nervous System (ANS), is the conductor of the inner orchestra in our body, responsible for the control of our bodily functions not consciously directed, such as breathing, the heartbeat, blood pressure, sweating and digestive processes. The ANS is always humming at a certain beat and how well it operates, determines our physical, mental and emotional health.
In previous blogs I have written about the ANS. Our ANS was previously seen as having only 2 main divisions: the Sympathetic Nervous System (SNS), fight or flight and the Parasympathetic Nervous System (PNS), relax and digest. Stephen Porges, Polyvagal Theory describes a new model of our nervous system. Porges describes how we respond to threats in 3 different biologically pre-programmed hierarchical ways. In this new model the PNS is divided into 2 branches, each with their own unique pathways and neural influences. Here, the PNS is divided into the Ventral Vagus Nerve (VNN) branch (also known as our Social Engagement System) and the Dorsal Vagus Nerve branch (DVN) which is characterised by immobilisation, freeze, shut down and withdrawal. This new model has great implications for the advancement of our health and well-being both practically and in therapy as each of these states, comes with their own set of physiological and emotional states, well-being and behaviours. (blog: Depression, Anxiety and Vagus Nerve). In this blog we will delve into the VVN, our Social Engagement System, the implications on our health and well-being and how craniosacral therapy can successfully help.
The Social Engagement System.
The Ventral Vagus Nerve (VVN) is associated with increases in health and emotional wellbeing as it generates positive states of relaxation and social engagement. Our Social Engagement system is functioning optimally when we feel safe and connected to the world and other people. Throughout the day we constantly receive cues and triggers through our senses and fascia, which acts like a 2nd nervous system. We have an external environment -the outside world but we also have an internal environment-the physiology of our body, like diving into a deep sea, so much is happening underneath the surface, wave after wave. Our subconscious internal filtering system will immediately evaluate whether we are safe or need to take action. This happens without us even being aware of it or having to think about it. When we feel safe, we can relax, expand, go forward and step out into the world. When there is stress or a perceived threat in our minds, we rely on our social engagement system to establish a sense of safety and connection. This can be achieved through a conversation, a call for help, making eye contact, or hearing a calming voice. This will send signals down to our heart and lungs, slowing down our heart rate and deepening our breathing. It very much functions as a foot brake - a Vagal Brake - and has a calming and soothing effect on our nervous system.
Picture the opposite: For example, a person says something to you that causes you to feel upset. What happens? We tend to change our facial expression signalling our upset, the tone of our voice changes often to an angrier, louder or higher pitch, we seek validation, we pick up the phone and talk to someone. If the social engagement system fails to resolve the stress and it remains active in our body, then we will automatically resort to the older biological response, one step down the ladder into fight/flight, with the Sympathetic Nervous system kicking in.
What are the areas innervated by the VVN?
The VVN innervates the areas above the diaphragm: face, throat, voice box, larynx, middle ear, heart, lungs and serves the social engagement system. This system is regulated by 5 cranial nerves and when these nerves function well, we can enjoy optimal physical and emotional health including great friendship, support, bonding and loving relationships. When we are socially engaged, we can be creative, positive, productive and happy. Socially engaged means we are free from threats, danger, unnecessary worries and in good physical health. The Social Engagement System guides us in orientation, communication and facial expression and comprises the following cranial nerves, which all originate in the brainstem.
Behaviours we display when Socially Engaged:
When our ANS is in a state of stress or shutdown we often have problems with our physical health, emotional states and relationships. Therefore, it makes total sense to have an optimal working nervous system and Craniosacral Therapy is one of the best modalities to address the nervous system. Craniosacral therapy assists our clients to shift into their social nervous system, inhibiting the SNS, improving vagal tone, addressing the cranial nerves and has a great and positive effect on regulating the entire nervous system.
Clients typically report a significant reduction or disappearance of their physical symptoms but also an increased sense of happiness, connection, oneness and openness with the world and feeling safe. This is because clients have come out of Fight or Flight and gone into Ventral Vagus Healing, which is connected to increases in health and emotional well-being.
Here, the goal of Craniosacral treatments is:
On the flip side what I have also experienced is that clients who are in excessive overwhelm or in a depressed, dissociated dorsal vagus state, may experience a sudden increase in anxiety or sleepless nights. This causes them to question if they are on the right track and why this would happen. One thing to consider is that it can actually be a good sign as it means the body is coming out of shut down Dorsal State, up the hierarchical ladder and is shifting into Fight and Flight, Sympathetic State, which may mean perhaps a temporarily increase in anxiousness or other aroused states. Here as Biodynamic Craniosacral Therapists we can assist them in finding a sense a safety through resourcing, grounding, embodiment, breathing, so they can start feeling safe and shift into their social engagement system. In biodynamic craniosacral therapy we can also guide clients through their internal emotions and enhancing their capacity for self-regulation, which is important to maintain a good nervous system.
Polyvagal Wrap up
The application of the polyvagal theory in craniosacral therapy makes total sense for physical symptoms and particularly for Trauma, Depression, Anxiety, Chronic and Complex Pain and illnesses. In past blogs I have written about my own personal trauma and the extensive Dr’s rounds which brought no luck in addressing or alleviating any of my symptoms, as the primary innate biological forces that controlled my symptoms seemed to be overlooked, disregarded and not addressed. I was at the bottom of the hierarchical ladder and totally not socially engaged. For months I was in shut down, collapse, disassociation and hibernation, with little recollection. I was in Dorsal Vagus State and off-line. As for Ventral State and the associated nerves: I could not bear any bright lights or flashes and my ears were high pitched ringing. To my embarrassment as I could not hide it, my voice had gone up a few notches higher, due to my high level of anxiety. As the physical part (but emotional part also played a role as brain stem implicated) of the trauma was to my neck and head, my SCM and Trigeminus were in hyper tonus and over firing on a neural level in my face.
I did heal my myriad of symptoms not by chemical pills for every symptom I had but by addressing the ANS: the Dorsal State, the Sympathetic Chain and finally coming back into Ventral Vagus through weekly & to start, twice-weekly Craniosacral Therapy sessions, which I combined with Homeopathy & Naturopathy. I did not get fixed, I did not get cured but I healed, from the inside, out.
It took time and dedication–it is not a magic bullet – addressing physical symptoms, pain, the nervous system, uncoupling and processing strong emotions takes time but when you overcome your own health problems by the innate power of the body to heal, which we all have, the gratitude is infinite and it is a gift you want to keep on giving.
Psychiatrist Dr. Bessel van der Kolk – explains the polyvagal theory and the use of oa yoga, meditation and Craniosacral therapy so well in his brilliant book: The Body keeps the Score. “The polyvagal helps us understand and explain why seemingly unconventional techniques work so well. It activates the social engagement system, calming the physical tension in the body. It helps people shift out of their fight/flight states, reorganising their perception of danger. If mind/brain/body is the royal road to emotion regulation this demands a radical shift in our therapeutic assumptions" and “Touch, is the most elementary tool we have to calm down. You can’t fully recover if you don’t feel safe in your skin. Therefore, I encourage all my patients to engage in some sort of body work like Craniosacral Therapy”.
The title almost sounds like the start of a joke, right? Four people enter a pub – depression, anxiety, the Vagus nerve and craniosacral therapy. During my Craniosacral education we studied the Vagus Nerve, learning the theory and practicing the different vagal tones by doing hands on work, feeling for the dorsal and ventral branch of the Vagus Nerve. At the time for me, the theory was mostly words on paper about Stephen Porges Polyvagal theory. This is not a light subject matter to begin with and as my course and study materials were conducted in German (not my first language)...…well let’s just say Stephen Porges “Die Polyvagal theorie: die phylogenetische entwicklung des Nervensystems” got filed away in the “one day – too hard” basket of my brain.
Many years later and firmly established in my own clinic, that one day came, when a Psychiatrist started to refer some of his clients with various diagnoses like: Insomnia, Anxiety, Depression and Fibromyalgia to me. This psychiatrist advocates non-medicinal treatment in finding alternative ways to help his clients through TMS, neurofeedback and stimulating the Vagus Nerve, in my case, through Craniosacral Therapy. As I treated his clients, I started to notice various similarities. All had an under-activated dorsal branch of the Vagus nerve, a compression at the Cranial base and different parts of the brains that would be overactive, i.e. over fire on a neural level. I knew I had to revisit Stephen Porges Polyvagal theory and as it turned out, it also confirmed a piece in my own personal journey.
The Vagus Nerve and the differences between the functions of the ventral and dorsal branch of the Vagus Nerve have great implications in the healing of our physical, mental and emotional health. In this blog I will mainly focus on the Dorsal Vagal Nerve, as a chronic activation of dorsal vagus circuit is accompanied by depressive feelings as in loss of interest in activities and surroundings, digestive problems, reduced energy, not being active, sad and/or being anxious. Working with the Dorsal Vagus Nerve through CST, has a great potential for treating people with Depression, Anxiety and Insomnia.
In previous blogs I have written about the Autonomic Nervous System (ANS) and its 2 key branches the Parasympathetic nervous system (PNS - rest and digest) and Sympathetic nervous system (SNS - fight and flight). They should ideally go up and down during the day in a balanced rhythmic way. The Vagus Nerve is part of our PNS and is one of the 12 Cranial Nerves (Cranial Nerve X) that regulates most of our bodily functions for our health, relaxation and emotional well-being (75%), i.e. stabilising our heart rate, breathing & digestion.
The Vagus is the largest ANS nerve, starting in the brainstem at the base of the skull and going through the neck into the chest and abdomen regulating many of our organs, from the heart, to the lungs, to the gut. In below picture you can see its pathway into our organs, where the fibers of the Vagus Nerve act as a surveillance team of our internal organs sending the information up to our brainstem for processing and actioning.
New Model - Polyvagal
Polyvagal as a relative new model (1994) states we have the SNS – fight and flight but that the relax and digest Vagus Nerve has 2 branches (in the classic ANS model the assumption is one vagus nerve). Polyvagal states that there are 2 separate distinct vagal nerves that originate in 2 different locations and have 2 different neural pathways. They are:
Ventral Vagus Nerve
When there is a threat or stress in our environment, we rely on our VVN to establish a sense of safety and connection, this can be through conversation, a call for help, making eye contact, a calming voice etc. This will send signals down to our heart and lungs, slowing down our heart rate and deepening our breathing. It is also referred to as the Social Nervous System and in essence functions as brake – Vagal Brake – having a calming and soothing effect on our nervous system. If the social nervous system fails to resolve the stress and it remains active in our body, then we will automatically resort to the older biological response of fight/flight.
Dorsal Vagus Nerve
When the fight/flight mode fails to resolve the stressor, we then subsequently resort to our oldest biological primitive ultimate emergency response through the Dorsal Vagus Nerve. A sudden extreme surge in dorsal vagal activity can for instance happen when we are faced with great danger. It is a defensive strategy that helps us cope in a traumatic event, or with prolonged extreme stress or danger, real or imagined and can bring our body in a state of “immobilisation with fear”. Much like a cockroach playing dead when he knows his time is up and senses a human being with a spray in their hand (Very much a Sydney thing:).
“A chronic activation of dorsal vagus circuit and its physiology is characterised by depressive feelings. For example, loss of interest in activities that were once pleasurable, loss of appetite, overeating, digestive problems, reduced energy, sad, anxious, problems remembering, making decision and also fibromyalgia. Diagnosis of depression are usually accompanied by a state of activation of the dorsal branch of the Vagus nerve. If the transition into a dorsal state has involved a sudden surge in dorsal branch activation, via a shock, a shutdown results. In a dangerous situation, it is a natural reaction to dissociate from one’s own body from the here and now, and to shut down physically, emotionally and mentally”. (Stephan Rosenberg, 2017).
It is exactly in these words that I found the missing piece of my own personal puzzle. In a previous blog I have written about my own physical and emotional trauma. I was certainly displaying symptoms of depression after the trauma and had many other symptoms including insomnia, anxiety and digestive problems. I was given the label of Depression and heaps of chemical pills. I felt I was not depressed in the classic sense of Serotonin deficiency and I did not want a different pill for every one of my symptoms. I intuitively knew but did not have the knowledge at the time that my answers did not lie in the medical chemical world. It seemed like a valued but incomplete model, as the primary innate biological forces that controlled all of my symptoms seemed to be overlooked, disregarded and not worked with. I now understand that there was a huge activation of my Dorsal Vagus Nerve – partly due to the physical violent head trauma and partly due to the shock and trauma that accompanied it and therefore pills and classic talk therapy did not work for me, as it did not address nor rebalance my Vagus Nerve, its pathway into my organs and digestive system or my Trauma.
Symptoms of Dorsal Vagal State – Shock/ shutdown
The body is truly amazing and in my humble opinion quite undervalued in the western medical conditioned ‘machine-like’ approach. We don’t always have to take out parts, replace parts or fill it up with chemicals to suppress symptoms. We can work with the body, feel the body, regulate the body, regulate the nervous system, reset its physiology, get nerves to fire under their threshold in many ways, and here through the Vagus Nerve. I witness this every day in my practice and am always humbled by the body’s innate power, it’s infinite wisdom and the body's capacity to heal. The below symptoms are designed to keep the basic functions going as it can override less important functions in the body, in times of stress or emergency. The problem lies, when we stay in that very state that was initially only designed to save us and when chronic, will turn against us.
Physical and emotional symptoms of Dorsal Vagal activation:
Craniosacral Treatment for Chronic Dorsal Vagal Activation
The basic goal of CST treatment is to lift the client from a chronic Dorsal Vagal state into activation of Ventral Vagus Nerve. During a CST treatment and with our subtle movements and it’s subtle as we listen, feel, touch and work with the most delicate structures of the body, we aim to:
1. Balance the Ventral and Dorsal Branches of the Vagus Nerve. This can be done
by mobilising the cranial bones to reduce any pressure on the cranial nerves as
they come through various openings into the skull and/or bringing both
branches back into balance.
2. Restoring, calming and strengthening the Nervous System, resetting its
physiology so it can start to self-regulate.
3. Bringing the nerves back under their firing threshold
4. Releasing any compression/jamming at the base of the Skull to increase blood
flow and oxygen back into our brain.
5. Letting the body come back into balance so that any symptoms of depressive
behaviour and shutdown can be reversed, regulating breathing & digestion.
6. Maximise the movement of CSF (clear liquid that circulates around our brain
and spinal cord and carries a lot of nutrients and carries away waste product)
so metabolic waste products can be better eliminated and tissues nourished.
7. Freeing the connective tissues and its structures in the skull (Dural membranes)
and around the cervical neck vertebrae’s.
The positive effects of craniosacral therapy are cumulative. Over time our ANS becomes more resilient each time we can restore a state of our social nervous system following activation of the dorsal vagus branch. The long-term goal is to encourage the ANS to return naturally, on its own from a state of dorsal stress to a state of social engagement, were we feel physically and emotionally safe. Healing the Nervous system does take time, but with time and for me personally with skilled hands-on craniosacral work for all my physical and emotional symptoms, I was able to shift back into the Ventral Vagal state, into a state of social engagement - my Social Nervous System where I was able to reconnect, relax and feel immense joy and happiness again.
As Stephen Rosenberg writes in his book – Accessing the Healing Power of the Vagus Nerve: “prior to Polyvagal, depression and depressive behaviours issues lacked a physiological model in terms of the nervous system. Perhaps why it is difficult to find effective treatments for conditions like depression. With Stephen Porges Polyvagal theory we have a clear focus on relationships of the ANS, the emotions and the behaviours”.
The Vagus Nerve is responsible for our health and essentially controls our entire rest and digest and all the associated organs. So, depression, anxiety, the Vagus nerve and insomnia walk into a bar, ordering craniosacral. All having a healthy drink together around a communal table, working together in harmony, in a balanced rhythmic way, with no side effects or hangover. What are you ordering?
My next blog will focus on the VVN – Social Nervous System and the implications for our physical, mental and emotional health through Craniosacral Therapy.
When Trauma strikes. Addressing physiological and biological nervous system responses in the healing of trauma through Craniosacral Therapy
Trauma is often only understood as a psychological reaction that we need to deal with, in the mind. Trauma is also very much a physiological reaction that keeps circulating in the body long after the trauma, as our reactions and responses to trauma and stress are primarily bodily ones. During a traumatic or threatening situation we tend to go into a highly charged fight/flight or freeze response. This undischarged residual energy can remain in our body for many years as an incomplete physiological response, manifesting itself as physical symptoms like sleep disturbances, anxiety, hyper vigilance, tinnitus, digestive problems, jaw problems, back problems, migraines, depression, inflammation and act as a host to all sorts of other chronic pain and illnesses. The key to resolving and healing Trauma lies in our physiology, in our bodily responses that needs to be resolved and discharged. (M. Kern, Wisdom in the body, 2005). Our physiology is regulated by our nervous system. Our nervous system sends messages to our body and has a major role to play in creating and maintaining our symptoms. No other modality addresses the nervous system like Craniosacral Therapy (CST). CST lowers the sympathetic nervous system responsible for our fight/fight and enhances our parasympathetic nervous system responsible for our freeze response but also for our relaxation response. CST allows the body to come back into it's physiological balance, so the body can release any underlying stress, tension and emotional patterns that lie deeply stored within the body. This is critical and of paramount importance in overcoming not only any kind of trauma but also for chronic pain and complex illnesses, as I witness in my clinics on a daily basis.
CST addresses a wide variety of symptoms and conditions from physical pains, structural misalignments, muscular tensions to emotional blockages. During my training, trauma and stress release was definitely my favourite subject: working with the nervous system survival responses and the residual effects of trauma lodged in the body.………. Ironically, never in a million years did I think trauma would strike me. I came to experience what I had learned during my education when a good few years ago, my world became a very dark and lonely place as I suffered a severe physical & emotional trauma. As a result, I experienced a multitude of physical symptoms: non-stop raging headaches, migraines, tinnitus, neck pain, poor blood circulation, anxiety, nerve tingling and extreme sensitivity to sounds and light, to name a few. For months, I was unable to sleep or eat. The rug had literally been pulled out from underneath me, I was lost.
So my Dr's, specialists and hospital rounds began, from A to Z from the GP to the Neurologist to the Psychiatrist, each with their own well-intended prescription pads: pain killers, beta blockers, digestive relief, anti-anxiety, anti-depressants, muscle relaxants, laxatives, anti-inflammatory, stomach acid reduction pills, sleeping tablets, valium and narcotics in all sorts from tramadol to oxycodone to oxycontin. I ended up being the Pharmacy.
I wanted to clear my anxious state, calm my nervous system, improve my sleeping but most of all find relief for all my physical symptoms by resolving them at root cause. I did not want a pill for every ill as I personally could not see, how that would resolve anything at root cause or bring any long-term solution, as the primary innate biological forces that controlled my symptoms seemed to be overlooked, disregarded and not addressed. Thank goodness I knew Cranio and turned to my colleague: a highly skilled buddy and certified Cranio angel extraordinaire.
During our first few cranial sessions, we focused on my mental and emotional body, getting me back into my body, becoming less disassociated, as my body was a terrifying place to be in. In fact, for the first 2 sessions I was not able to get on the table, touch was just too overwhelming. My nervous system was in an state of hyper sympathetic arousal and my bodily systems so overwhelmed. My therapist focused on calming my nervous system, allowing me to become less anxious, less hyper-vigilant and releasing the undischarged residual energy in a very safe and contained way. We focused on my disturbed vagus nerve. My therapist could only move as fast as my body felt safe to let go, peeling away the layers whilst she facilitated an incredible safe space and presence for me to do so. In further sessions, we were able to deal with my physical body and its pain. I became aware of how much tension I had really been holding, purely as a survival mechanism, as my therapist was unwinding the tissues, layer by layer, releasing restrictions and pain. In one session I could feel this immense anger bubbling up, because of what had happened. I had no idea that this anger but also intense sadness had been living so deeply buried inside of me. I had suppressed my emotions in order to cope, a common theme amongst trauma victims but also for many people in day to day life. I have lived through what I had learned in my education and I have an even deeper respect of how the body deals and expresses itself through any kind of life event or circumstance, big or small. I did clear all my physical and mental symptoms by addressing my nervous system that was in overwhelm and hyper alert. Frequent Craniosacral sessions also addressed the physiology and the fascia in my physical body and CST addressed my emotional body by releasing all these emotions that I had stored. CST truely acknowledges the whole person and works with the interconnected physical, mental, emotional and soul body, creating change on every level.
Thank goodness I found my way back to my happy, bubbly, pain-free, belly laughing self with even a greater passion, empathy and understanding for my work and for all my clients. In my own practice I see people with all kinds of symptoms: acute, one-off or with more chronic and long-standing problems. For these clients their history often reveals that there has been a long road of other seemingly unrelated problems, inflammations, anxiety, autoimmune conditions or neurological problems. By the time these clients come and see me, they have taken various roads to try and resolve their symptoms. They have had things cut out, removed, fused, worked on but are still in pain and often on long-term medication as a way to manage their symptoms. The source of their symptoms however is often traceable to a form of trauma in their past that is still being carried in the present through unconscious emotions, the biology of stress and/or cut of body responses. Trauma wants to be addressed, medication will only suppress it for a limited time and new symptoms will eventually pop up. The nervous system wants to be addressed and it will use symptoms, behaviour or certain patterns like addiction to get our attention to heal the root cause.
Trauma can be a one-off significant event but trauma can also be experienced in a more slow, cumulative kind of way through childhood adversity like an abusive parent/sibling, an emotionally cold, alcoholic, absent or mentally unwell parent. It can be experienced through work, accidents, illness or toxic relationships. Most of my clients are aware that there is some level off trauma on an intellectual level but are unaware of the imprints the trauma has left in their body, mind and soul on a more primal level. Their experiences have created physiological effects in their body, left imprints, continuing to behave and react as if the experience is still happening and therefore can be triggered by seemingly unrelated new experiences.
Renowned Boston based Dutch Psychiatrist and my favorite author on the subject matter Bessel van der Kolk states: ”the most essential aspect of healing is learning to fully inhabit our inner sense of self in all its dimensions– not only emotionally and psychological but bodily as well, as they are inseparable from one another”. “Some of the best therapy is largely non-verbal”. “I always recommend incorporating a bottom up approach like Yoga and Mindfulness and I always refer people to Craniosacral work”.
My pharmacy shop? I tried, but the pills were not for me and caused many side effects, although they most certainly can have a place and give initial support, just like a good psychologist. Some of my clients see a psychologist at the same time, which works really well and complementary together. I was fortunate that I had already discovered Cranio as a holistic mind-body approach and knew from experience that there are other fabulous complementary medicines. So I chose natural medicine, homeopathy and naturopathy as my multi-disciplinary approach. In the end I decided to let my own internal pharmacy go to work and found relief and validation in a quote from Hippocrates, the founder of Medicine: “Natural forces within us are the true healers of disease”
Healing from the inside out, bringing the physiology back into it's natural balance, and allowing the natural forces within us to come into play and self-correct is the strongest and longest lasting healing there ever could be.
“Nobody realises that some people expend tremendous energy merely
to be normal". Albert Camus
Chronic Fatigue Syndrome (CFS) is a complex condition with a vast range of symptoms involving the immune, endocrine, gastro-intestinal system and brain. The root cause of CFS often includes several factors simultaneously like:
CFS is marked by a multitude of physical symptoms. For example: Muscular pain, jaw and throat pain, extreme fatigue and exhaustion, restless sleep, headaches, insomnia, depression, poor bowel movement, sensory hypersensitivity, intolerance to exercise, emotionally helpless and feeling wired yet tired at the same time. Currently there is no known medial cure for CFS, however sufferers can find great relief in complementaries therapies.
Craniosacral is a great complementary therapy for CFS, as it brings the body into a healing state and out of its CFS characteristic dominant state of sympathetic overdrive. Getting the body out of overreactive responses will allow the body to self-correct, find homeostasis and to reset its physiology so it can regulate and perform the correct immunological and neurological functions.
On Vimeo there is a great video by 2 Doctors called: "Chronic Fatigue - cutting through the B.S". Dr Martin Rutherford does an excellent job describing what happens in the body when the fight-flight response in the brain is stuck in the ON position in relation to CFS. "The stress signalling patterns in the brain changes your neurochemistry and disrupts your physiology". He also explains that "if you don't address this sympathetic dominance first, other treatments will fail because this hole needs to be plugged first". "This is a key procedure that produces successful results". And this is exactly what Craniosacral Therapy does, it plugs that hole so to speak.
Craniosacral therapy is one of the best, if not The best therapy to get people out of chronic fight or flight sympathetic dominance, changing the brain's stress signalling patterns, and therefore it's neurochemistry, "plugging that hole" and as a domino effect, changing one's physiological state. Here is how I address CFS in my six step approach:
1. Working with the physiological state of a person.
During a typical day human beings swing back and forth in their nervous system from activated “sympathetic” mode to the recovery “parasympathetic mode”. The physiological state of someone with chronic fatigue is very different than a non-chronic fatigue person. A chronic fatigue body lives in a physiologically stressed and emergency mode ALL the time. One way to look at this is that relatively healthy people start their day with a full fuel tank that has been replenished during the night and starts to run low as the day progresses. CFS sufferers start their day on a virtually empty tank, where they need to keep their foot down on the accelerator, burning fuel and living off the fumes left in the tank. Sufferers are not able to fill up their tank, as they have to expend many extra critical physical resources and energy on a day-to-day basis just to be, that their body is just not able to go back and access the critical “rest and digest” healing recovery state. In essence a CFS person is not able to regulate their output and as the body gets pushed, it has to use more and more activated sympathetic nervous system energy from the reserve tank, whilst in the meantime, the dashboard starts flashing and beeping with warning signs. Rest, unfortunately is not refreshing as the body remains in survival mode, which leaves sufferers tired but wired.
Cranio is a great therapy for switching the body out of emergency mode and into a healing state so it can click into that recovery mode. Here the body can start to self-correct and self-regulate in order to perform the correct immunological and neurological functions, changing the physiological state.
2. Cranio works directly with the nervous system as a way to improve health
Chronic Fatigue people are often operating from a subtle perception of threat in their environment. This can happen subconsciously as it may be linked to something in the past for example, not feeling safe, feeling rejected or abandoned, in other words when one of our three primal survival needs were not met on a consistent basis. You may not even be fully conscious of this but your brain and body are. We essentially live with a 200 million year old part in our brain – called our reptilian brain - which is not there to make us happy but to protect us and to make us safe at all cost. This part of the brain reacts in a nano-second through our senses and has put itself into action long before it reaches our consciousness. Settling the nervous system is a top priority for Chronic Fatigue people as the body’s response to stress underlies many of the symptoms. Cranio works with the nervous system stress and survival responses to these stressors, reducing adrenaline and normalising cortisol output, allowing for the body to come out of overactivation and back into balance.
3. Working with Brain Plasticity to improve health
Chronic Fatigue people are often primed to be more sensitive to stress and sensory triggers. Cranio aims to alter the neural pathways that contribute to this sensitivity through hands on treatment and also by incorporating body awareness exercises so sufferers can track body sensations more effectively, recognise triggers more easily and change the input. I personally also incorporate neuro-associative exercises and emotionally focused techniques to let go of any old patterns and to activate new neural pathways. Healing old patterns and creating new and more effective patterns form an integral part of my treatment plan.
It is very important for CFS to go at their own pace, not to trigger any flare-ups or setbacks. Craniosacral therapy is by nature client led. We go as fast as the slowest part is able to let go in an effective and gentle manner. With the client we look at resourcing and creating more effective coping strategies. Pacing will allow a client to know when to rest and when to build up strength and activity as chronic fatigue people have a natural tendency to push beyond their energy levels.
5. Craniosacral works with Trauma Imprints in the body
For many Chronic Fatigue people a traumatic incident triggered the onset of the disease causing shock in the body. Trauma can cause an overwhelming expenditure of energy in a person’s body. When this is ongoing and the nervous system recognises that the amount of energy/hyperarousal is too high, it has one last card to play and that is to apply a very powerful brake, which leads to parasympathetic shock and immobility. CF people are living on an empty fuel tank with one foot down on the accelerator causing hyperarousal, whilst simultaneously the other foot is down on the brake causing an overwhelming helplessness. Cranio works with trauma and in particular with the effects and survival patterns that are left and imprinted in the body. The important part is and this is what Cranio does so well as a body therapy: the nervous system will only recognise that danger has passed when the mobilised energy has been discharged on a bodily level. You can talk all you want but you if don't discharge that high primal energy on a bodily level it will keep on circulating in your body.
6. Craniosacral addresses Physical pain
CFS people often have various aches, pain and inflammation in their body. Back pain, shoulder, arms, face, jaw and headaches are all part of the syndrome. Cranio address this through soft tissue release and unwinding techniques, improving the physical and physiological state of the body’s internal environment and reducing pain. Cranio allows for the body to switch out of the fight or flight/freeze response and to move into the rest and repair mode. This breaks the circuitry of exaggerated nerve signaling and allows the immune and nervous system to reset itself so it can start working in an improved and enhanced capacity. Cranio deals with the root causes, not just the symptoms, leading to improved health and wellness.
Wait - Whaaa? You wanna do what to my Cranial Nerves?
To alleviate headaches, sore neck and shoulders, eye pain, ear problems, sinus problems, dizziness, tinnitus, TMJ, Vertigo, anxiety, neuralgia, sleeping problems, nausea, depression, balance problems and so much more.
Cranial Nerves – what do they do?
We would not be able to smell, see, taste or be upright without our Cranial Nerves. The most famous Cranial Nerve Nr. 10 – The Vagus Nerve keeps our heart, lungs and digestion system functioning properly. Yet Cranial Nerves and the dysfunctions that they can cause - get very little attention and perhaps understanding in treatments of common or persistent health issues and problems. The table below lists our cranial nerves, their function and some examples of common dysfunctions they can cause in everyday ailments. Worth a check if you are suffering from any of those conditions, like TMJ, Tinnitus, Digestive Problems, Anxiety or Neck Problems and Shoulder problems.
Cranial Nerves – Function and symptoms
We have 12 Cranial Nerves and they primarily serve the head and neck structures, with the exception of the Vagus Nerve, that extends all the way down to our intestines. They form a key part of our nervous system. The cranial nerves give us our special senses of smelling, seeing, hearing, balance and taste. They allow for facial expression, move our eyes, and turning our head. Cranial Nerves go through small openings (foramina) in the cranium to head and neck structures. The Vagus Nerve, which is for 75% responsible for our relaxation rest and digest state– goes all the way down the throat to the heart, lungs, stomach and intestines. Ten of the 12 cranial nerves originate in the brainstem – our reptilian brain in charge of our fight and flight stress responses. What are the changes these Cranial Nerves are going to react one way or another, when the body is on a constant high alert or in a state of emotional or physical stress, leading to sympathetic overstimulation? Pretty high. “Cranial nerves control the secretion of enzymes and acids in the mouth and stomach, the production of bile in the liver, storage of bile in the gall bladder and production and storage of digestive enzymes in the pancreas. Additional functioning of individual cranial nerves: They regulate kidneys, bladder, heart, breathing and reproduction” (Stanley Rosenberg: Accessing the healing power of the Vagus Nerve). You can start to see how important cranial nerves and their proper functioning to our well-being are.
How does Craniosacral Therapy work with these Cranial Nerves and Symptoms?
Cranial nerves can be affected by a multitude of causes. It can be affected by head injuries, inflammation, muscular pulls in the neck and sub-occipital area, teeth grinding, birth trauma, bony or membranous restrictions, tension and stress. Cranial nerves pass through many bony structures and various foramina (little openings in the skull where nerves, arteries and veins go through) in and between the bones of the skull. The cranial nerves can be impacted by restrictions between the cranial bones and foramina’s, leading to a decreased mobility of the bones and/or compression of these openings. One important foramina is the Juglar Foramina between the occiput and temporal bones as many important structure pass through here. Bones like for instance the temporal bones can be in flexion, torsion or side bending due to muscular pulls or restrictions. In CST, we work v gently with the bones in the skull, assessing the movement or lack of movement of the cranial bones, we work with the fascia (membranes), facilitating releases and tracing the nerve pathway. Craniosacral therapy works on many levels to improve overall functioning of the cranial nerves:
· Releasing tension in the membranes (connective tissues);
· Releasing restrictions between the individual cranial bones, removing
impingement of nerves;
· Increasing blood supply to the brain stem;
· Improving the flow of the CSF;
· Lowering stress responses and improving functioning of the nervous system;
· Releasing tension in muscular system – fascial unwinding;
· Improving the function of the cranialsacral system – the spinal cord; the brain
We do not massage nerves or apply deep pressure as it would not be very beneficial. It is no magic bullet, it can take time particularly if problems have been long-standing and are deeply ingrained but then again with acute vagal nerve disturbance or vertigo, 1 or 2 sessions can already produce amazing results. We use a very delicate, experienced and well-trained touch. People often totally zoom out when we work on the head and cranial nerves and will often say: “not too sure what she did - she was just holding my head, I think I feel asleep, but my pain is a lot better or I can move my neck or my jaw feels better, my tinnitus is lower or I am not dizzy anymore and I feel a whole heap lighter”. We are not just holding your head, we are tracing the pathway of the nerve, releasing tissue or bony constrictions, improving blood flood and CSF flow. We listen, touch and work with the bones, the muscles and the nerves with dedicated and precise touch. This allows the nerves to start to fire under their firing range, switch off and coming back into a place of balance: homeostasis. The gentle craniosacral touch really belies it power.
Conditions I treat in my clinic with Cranial Nerves
Personally, I love working with the Cranial Nerves and Cranial Bones. I find it extremely helpful for many conditions. In my clinic I work a lot but not exclusively with:
TMJ-The Trigeminal nerve is associated with receiving sensations from the face and teeth. The motor branch supplies the muscles of mastication (chewing) and can be implicated in teeth grinding but also in sinusitis and migraines. It is also important to work with the Trigeminal Ganglion where all nerves come together, cross over, relay information and go on their individual journey. Further information please see my blog on TMJ.
Tinnitus – tinnitus is a multi-variable condition that can include neck problems, jaw problems, nerve compression, bony restrictions or impingements, membranous restrictions, loud noise exposure, stress and unprocessed emotional issues. People with tinnitus often complain of hyperacusis (hypersensitivity to noise) and/ or a sense of fullness in the ear. This can be because of involuntary contraction of the tensor tympani muscle within the ear that is innervated by the Mandibular division of the Trigeminal nerve to reduce auditory output. (Thomas Attlee, Face to face with the face). The muscle contracts under tension and with loud noise is meant to dampen its vibration. One of the most common variable with Tinnitus clients is high levels of tension and stress (sometimes below their level of awareness) and can lead to involuntary contraction of muscles and nerves. Constant high Sympathetic nervous system activation due to stress, pressure, tension and inner turmoil can cause the tissue and nerves to become hyper sensitive and hyper reactive. (Please see my Tinnitus blog). The Vestibulo-cochlear nerve enables us to hear and receive sensations of hearing and balance and can be involved in Tinnitus when there is a disturbance in the cochlear division. Working with the Trigeminal nerve, the muscles, the bones and the delicate structures in and around the ears is very beneficial for Tinnitus.
Vertigo, Meniere’s disease, dizziness–The Vestibulo-division of nerve VIII is responsible for our balance. Disturbance to the vestibular division can lead to vertigo and/or Meniere’s disease. Here it is important to release restrictions and tension at the cranial base and sub-occipital area and working with the structures and nerves around the inner ear and neck. Instant improvement can often be experienced here after Craniosacral work.
Stress, sleeping problems. anxiety, depression, digestive problems, autism, chronic Fatigue, fibromylgia, inflammation - Vagus Nerve.
Vagus Nerve disturbance can be responsible for a multitude of health issues from inflammation to anxiety to digestive issues. The Vagus Nerve is one of the most important nerves in the body and plays a major role in regulating many aspects of our physiology. The Vagus Nerve travels all the way down from the brainstem, through the neck, where it is involved in speech and swallowing, the lungs where it is involved in respiratory function, the heart where it is involved with cardiac function, the abdomen and into the intestines, where it is involved with digestion. For instance with IBS and Crohn disease clients working with the vagus nerve is important. The Vagus nerve also plays a big role in psycho-emotional states (please see my 2 previous blogs on Vagus). All neurological activity increases by a nervous system that is in constant overdrive, stress and in sympathetic overstimulation. The Vagus is for 75% responsible for our rest and digest Parasympathetic nervous system. One nerve with so much power. You cannot go passed a balanced vagal tone for true optimal health and well-being and trauma recovery. You cannot go past reducing stress and sympathetic overstimulation by bringing the nervous system back into balance for good physiological functioning and optimal health. You have got to plug this hole first particularly in complex and chronic illness and trauma otherwise nothing else will stick.
Neck and upper shoulders problems
CN XI – the Accessory nerve innervates the trapezius and sternocleidomastoid muscles. These muscles allow us to move and turn our head. The accessory nerve is often implicated in chronic tight neck and shoulders and in Torticollis, where the neck muscles contract and causing the head to twist to one side or when there is a problem with cervical rotation and shrugging of the upper trapezius muscles. Here we release the tension and restrictions in the neck and sub-occipital area through fascial unwinding and sub-occipital release.
Swallowing, speech or tongue problems
Adults with swallowing problems or babies with sucking problems or with tongue tie, CN XII – the hypoglossal nerve can be involved as this nerve moves the tongue and is also involved in swallowing and speaking. This nerve can be distorted when there is an imbalance or compression. Here it is important to work with the Occipital bone at the base of our head and some muscles and tissues of the throat like the suprahyoid muscles.
Polyvagal Model for Health and Well-Being
There are 5 Cranial Nerves that are necessary for social engagement in the leading Polyvagal Social Engagement and Communication Model. In previous blogs I have written about Polyvagal and how they relate to different states of our Nervous System: Engaged, Fight or Flight or Frozen. The 5 Cranial Nerves that support Social Engagement and our Well-being are: 5,7,9,10 and 11. Please see my previous blogs.
You wanna do what to what to my cranial nerves? Yes please, balance them out !
The purpose of all my blogs is: would my mother understand it. I purposely don’t overcomplicate. For in-depth information including CN 0, sensory or motor components and polyvagal: I highly recommend below books.
CST is a manual therapy, which delivers some excellent result for brain injuries like concussion. During my Craniosacral years, I have treated various clients with concussion. As I am writing this blog it dawns on me, that most of my concussion clients here in Sydney are mainly people from overseas and familiar with CST. Why is that? In Australia, although growing, CST is unfortunately still only on the radar of a handful of doctors and specialists. That is a shortcoming as CST has strong evidence that for many musculoskeletal, neurological, trauma and stress related issues and concussion, it delivers real value and in my humble opinion is imperative for anybody involved in contact sport.
Concussion & Post-concussion Syndrome
Our brain is made of soft tissue, looking very much like a gelatine pudding, floating in a cushion of cerebrospinal fluid, enclosed in the protective shell of the skull, the (neuro) cranium.
Concussion is often caused by a hit or blow to the head, face or neck, where the force has caused the brain to move inside the head, bouncing and colliding into the walls of skull. This collision will send shock waves through the brain and can damage and tear the axons of neurons (nerve cells) which conduct electrical impulses to transmit information to different neurons, muscles and glands and can innervate multiple parts of the brain. This collision can lead to bruising, injury to the nerves and blood vessel damage.
The force does not have to be hard. It can also happen with a smaller force. The essential part is that the brain has moved, striking the skull and/or twisting upon itself. It can happen through a sporting injury, like boxing or rugby for example, but also through hitting your head on a wall or floor. In one case, my client hit his head on a surfboard.
Post-concussion Syndrome occurs when there have been unremitting blows to the head, layer upon layer and unresolved chronic continuation of symptoms, usually seen in professional athletes. The movie ‘Concussion’ with Will Smith depicts this syndrome really well. One poignant scene in the movie is where he holds a glass bottle with a brain looking substance surrounded by fluid and shakes it, explaining: “The human brain sits in a fluid and is disconnected from the skull with no safety belts and when a person receives unremitting blows to the head, the brain chokes from the inside out, leading to a cascading series of neurological events”. "This can not be picked up from a CT-scan". This is known as CTE - Chronic Traumatic Encephalopathy. CTE can only be diagnosed via autopsy. Australian Researchers have recently uncovered the first evidence of Australian Rugby league players with a degenerative brain condition, commonly found in retired American NFL athletes. (ww.smh.com.au/sport/nrl/rugby-league-rocked-by-first-proof-of-former-players-with-cte).
The brain houses our central nervous system and is pivotal to our everyday lives for all our functions. The effect of concussion can have physical effects but can also have a deep lasting effect on the nervous system. Concussion can cause cognitive, physical (neurological) and emotional symptoms and last for days, weeks or much longer, depending on the severity of the impact, how many other layered injuries there may have been and the resiliency, resourcefulness and fitness of the body at the time of impact.
First and foremost, the brain needs to rest and this means restricting any activities that requires the brain’s excessive activity in order to recover: reducing time spent on phone’s, video games, TV, socialising and any form of physical activity. The brain needs oxygen and fluids to circulate so it can heal. It needs assistance on a neurological level and it needs a dispersion of the tension and this is where Craniosacral Therapy comes in so effectively.
How does CST help as a manual therapy for Concussion?
CST helps in a variety of ways including:
I personally work with images and what I feel and see underneath my hands as I am visually and kinaesthetically orientated. The bones of the cranium, the membranes around the brain and the cerebrospinal fluid move very finely in a certain rhythm, comparable to the ebb and flow in the ocean. Working and living around the foreshores of our beautiful Sydney Harbour, the water reminds me of the fluid in the brain, the rocks in the ocean as the bones in our skull and the seaweed as the tissues always beautifully dancing in a rhythmic way along the shores. I examine, feel and work with these subtle motions in the skull and in the body, picking up any disturbances or restrictions that impacts the body like e.g. abnormal membranous tension or suture immobility in the bones and work with the body to resolve these.
Research & Anecdotal Evidence.
Former US NFL Star Ricky Williams, benefited so much from Craniosacral Therapy, that he not only studied CST but also competed on the US version of Celebrity Apprentice in 2016, in order to raise money and awareness for Upledgers Institute Craniosacral Concussion & Brain injury treatment and research programs. There is a great mini pilot on You tube – the Ricky Williams Pilot study that hosts various long-term NFL Football players and here you can see, hear and witness how they benefited from a week long intensive CST: “Tinnitus was gone, foot placement, knees and hips much better, felt like a different body”. My favourite quote of a player: “with the cranio work each body parts were introduced to one and other, my brain met my heart, my heart met my body and they got along”. Cranio’s subtle touch definitely belies it power.
The research program at Upledger’s Concussion & Brain injuries program showed that outcomes were measured before and after treatment and 3 months post treatment. These outcomes showed statistically significant improvement in lessening the intensity of the pain, better range of movement and improvement of cognition, memory and sleep.
https://www.momsteam.com/health-safety/craniosacral-therapy-may-help-lesson-symptoms-post-concussion-syndrome is a brilliant article of a mother who describes how CST helped her daughter in her Concussion recovery.
My own practice - Anecdotal
One day I noticed that there had been many clicks from Denmark’s Google Search engine to my website. This made sense when a guy by the name of Mads rang me – a young backpacker from Denmark who suffered from concussion after he forcefully hit his head at Bondi Beach, whilst surfing. He had been to the Dr, had his tests done but was not getting any better. He had to get better as he had English exams looming. Not sure what to do, he finally rang his worried mother back in Denmark. She knew just the therapy that could help and her Google searches lead Mads to me. I did Cranial work on him but also limited his screen time to limit the impact on his eyes and neural connections back to the brain.
Mads was so thankful that he ended up leaving me a great Google Review:
“I had a concussion which left me unable to look at a computer screen without feeling discomfort, as well as a constant headache for several weeks. After two sessions with Dorine, the headache is gone, and I am now able to continue my study and look at a screen again. I will highly recommend her therapy to anyone suffering a concussion”.
Steve, an English working Holiday Visa lad who on a night out, not entirely sober, had fallen down a few flights of stairs. He suffered from blurred vision, headaches and dizziness. He had been to see a specialist, was taking some medication but was still having issues and not fully fit. When he rang his worried mum back in the UK, she knew just the therapy that could help her son and her Google Searches from across the world lead Steve to me. When Steve came for his fourth visit, I asked how his symptoms were going and he told me: “ohhh (those......as if they had never happened), they are all gone”. I jokingly asked why he showed up for his appointment and he answered “oh I want to continue as I love the cranio treatments so much”.
And there are many other examples where clients did not necessarily have a concussion but displayed symptoms like brain fog, not being able to focus or concentrate, cognitive problems, neurological complaints or low-level anxiety as the tension went unresolved and consequently lead to compressions, restrictions and impingement of bones, tissues and nerves. Here the incoming force or energy that entered the body may not have necessarily rattled the brain but these tensional forces were absorbed by the bones or tissues through the cranium and transmitted through fascial lines or bones, causing a bone to become compressed and/or cause excessive tension in the intracranial membranal system. The force put into our head or body can compress bones or misalign them. The cranial bones can get stuck or jammed causing complications like headaches, vertigo or emotional and cognitive problems. These symptoms can be caused by cranial nerve dysfunction, which will be the topic of my next blog.
So here is to anybody suffering from a head injury, concussion and/or any kind of head, neck, jaw problems for that matter whom display these kinds of symptoms and hopefully will find their way to Craniosacral Therapy somewhere in the world, rather sooner than later. As one Football player said in the Upledger Research program: “Craniosacral was a revelation-what a gift”.
As your brain would say – I lobe it.
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The base of all my blogs is: ‘would my mother understand it’? – I purposely leave out jargon (meninges etc) and aim to simplify as best as I can. My aim is not to confuse with All there is to know and keep it relevant to the topic. Great detailed information and recommended reading for people who like to know more: