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:
TMJ stands for the temporomandibular joint, which connects the lower jaw (mandible) to the temporal bones of the skull.
The TM joint is one of the most used joints in the body, as we use it at least 2000 times a day when we speak, chew, swallow, yawn, kiss or snore and it has a biting power of 70 kg. A variety of cranial nerves synchronises all of the above activities and it is because of its physiology that this complex structure acts differently than other joints in the body. The TM joint and the powerful muscles attached to it are directly linked to the central nervous system and the whole craniosacral system.
For a long time TMJ was considered to be a dental problem but it is now widely regarded as a multifactorial condition. Wearing a splint can provide relief for TMJ symptoms like headaches and protect the teeth but it does not address any underlying causes. In addressing TMJ issues, clenching, grinding, whiplash, slips and falls, braces, stress, trauma, emotional factors, structural imbalances and integration of all structures – upper jaw, lower jaw, surrounding muscles, temporal bones and cranium needs to be taken into account, including whole body strains.
A few specialists have now upgraded the name from TMJ to the Cranio Mandibular joint and some are working with cranially trained osteopaths and craniosacral therapist to achieve whole body integration. (Dr. Wojciech Tarnowski).
TMJ Syndrome or TMJD - Temporomandibular joint Disorder – can range from mildly annoying to a highly debilitating condition which can manifest itself not only in the classic symptoms of jaw and facial pain, but also in:
TMJ dysfunction can be caused by a derangement of the actual disk or arthritis but what is often not addressed effectively, is that many persistent issues and jaw problems arise as a result of stress, manifesting for example as teeth grinding, muscle spasm or as a variety of other forms of TMJ Syndrome. TMJ syndrome is usually a symptom not a cause. 90% of cases are not primary temporomandibular joint disturbances ((Upledger, 1987, Beyond the Dura). They are usually a result of craniosacral system dysfunction: temporal bone, hard palate, intra-oral imbalances, fascial restrictions and/or due to stress factors like poor posture or emotional tension.
How Does Craniosacral Treat TMJ?
Cranio addresses the whole person not just a body part, i.e. Cranio looks at the interconnected of the systems in the body. The TMJ’s have many interrelationships with the whole body, so treating TMJ issues may involve work on other parts of the body as well. Practically this means that Cranio releases and integrates all surrounding structures: upper and lower jaw, the jaw (masseter) muscle, temporal bones, upper cervical (neck) vertebrae and the whole cranium. Cranio looks at postural imbalances like hip problems or forward head posture but also addresses craniosacral imbalances in other areas that may have ricochet up to the TMJ’s. Stress and emotional states do play a big role in TMJ issues and here Cranio addresses the emotional states first as it causes a deregulation in the nervous system and no amount of mechanical treatment will otherwise completely resolve the problem.
Five easy things you can do at home to start alleviating TMJ issues:
Depending on the cause of your TMJ disorder, different self-care strategies work really well.
Some random facts that might just make you win that Trivia Quiz one day:
Because of the jaw’s unique physiology, it’s important to treat the root cause of your pain as soon as possible. As a practitioner, what I love about treating TMJ patients is that clients respond really well. Some find immediate relief if acute and some find gradual overall relief if more chronic, with regular and consistent treatment. “Craniosacral Therapy has the potential for being the most effective holistic therapy of all for TMJ by restoring homeostasis”. (Dr. Wojciech Tarnowski - Dentist).
Here are some comments clients have texted me after their appointment.
“Thank you Dorine. Amelia felt amazingly relaxed and released after last session”. (Amelia - 9 years old)
“Today was amazing, thank you so much. I can almost get two knuckles in! Feeling very positive about this and looking fwd to seeing our progress. Thanks again”. (DM)
“Thank you very much for yesterday. I am feeling a lot better today! My muscles in my jaw/cheeks are a lot more relaxed, my neck feels less tense and I have had minimal headaches today”. (JF)
Thomas Attalee D.O., R.C.S.T (2016)– Face to face with the face
Dr Upledger, J. (1987) – Beyond the Dura
Dr. Wojciech Tarnowski – The biomechanics of Dentistry – Fulcrum – issue 65 - 2015
In order to heal your chronic conditions, you have to heal the overstimulation of
your survival stress responses in your central nervous system.
There are always the latest medical buzz words floating around and the “I have received this bombshell diagnosis” statements. Lately in my clinic I have been seeing an influx of people diagnosed with mast cell activation syndrome (MCAS), an under-active vagus nerve or functional neurological disorder (FND). When they ask me do you have experience with these syndromes or disorders, can you help me? Well the answer to be honest can range from yes, yes, and no never heard off but yes. You see, the diagnosis is not really the point, great starting point but we have to get beyond the diagnosis in order to heal chronic conditions. The point is what caused your nervous system, immune or hormonal system to (over) react that has caused this overstimulation of stress responses in your body? My answer to that question: Chronic conditions are triggered and held in place by an overstimulation of the stress responses in the nervous system and a hyper sensitive and hyper reactive brain and here is the bombshell – this can lie below the level of your conscious awareness.
So yes, we may have symptoms like chronic aching bodies, painful muscles, over-acidic bodies, sleeping problems, high blood pressure, neurological problems, light/noise/food sensitivities, tinnitus, asthma, addiction, auto-immune system disorder, anxiety, depression, neurological disorders and digestive problems but it is our nervous system and our brain that regulates our physiological changes and symptoms. This seems to be overlooked in the medical health model. It is the central nervous system that runs our internal show, sending messages from the body to the brain in a bi-directional communication loop and driving most of our symptoms on a physical, mental and emotional level.
Let’s have a closer look in detail.
The number one priority our body has is our survival and secondly procreation in order to keep the species going. Neuroception means our autonomic nervous system is always scanning our external and internal environment for cue’s of safety or danger, be if physical, mental or emotional, in the drive to survive and the longing to connect. Neuroception operates below our subconscious mind, meaning it lies outside the realm of our awareness as it accesses information without involving the thinking parts of the brain. When cues are picked up as threats, a cascade of cleverly orchestrated physiological wired-in stress and survival responses occur in the body. Some stress responses we may become aware of in the form of physical symptoms, others we don’t become aware of as they remain below our level of awareness, until overload hits and the body crashes. Neuroception answers to the question: Am I safe or in danger right now?
Interoception means the ability to perceive sensations of the internal state of the body. Interoception helps the brain to identify how you feel both physically and emotionally, as it collects all the feelings from inside the body and uses this information to respond accordingly, this is important for self-regulation. For instance, are you hungry, is your heart beating fast, are you are hot or cold or thirsty, do you need to use the bathroom, are you in pain or are you angry? Some people do not have a clear recognition of their bodily signals or how or what they are feeling. Their interoceptive awareness – the ability to identify, understand, and respond appropriately to their internal signals is off balance and they may not be able to realise that they are anxious or angry as they don’t recognise that their muscles are tense, their breathing is shallow or that their heart is racing. Interoception answers to the question: How am I feeling?
Through neuroception, the brain receives signals up the chain of commands, that there is a threat. This threat can be real or just perceived as real, it can come from people, family members, work stress, pressure, overwhelm, overload, anxiety or from emotional concepts like loneliness, boredom and abandonment, as those concepts can also threaten our existence, our survival and our social connections. The brain thinks: what do I need to do to survive and responds by triggering a targeted set of defensive mechanisms in our nervous system, hormonal system or immune system to counter attack the perceived threat and ensuring our survival. The brain answers to the question: What do I need to do to survive?
In past blogs I have written about our nervous system and its 2 branches – the sympathetic (fight and flight) and the parasympathetic (rest and digest) branch. (blog) When we are in a state of stress our sympathetic branch is activated, we are in fight/flight and respond to danger. We are ready for action, wired, fearful, and we have a hard time to relax, as if we are waiting for something to happen and on alert. This can lead to an over triggering of stress response leading to an over triggering of stress hormones like cortisol and adrenaline and/or an over triggering of the immune response.
On a physiological level it leads to oa:
Putting it all together
Our symptoms are deeply shaped and influenced by our brain and nervous system, due to acute stress, long term toxic stress or (childhood) trauma. Survival stress is held in our central nervous system, in our physiology, in our tissues and our cells as our reactions to physical, mental or emotional stress are primarily bodily ones and lie as the root cause behind chronic conditions. When the brain learns to be in long term survival mode, it will be operating on a hyper vigilant and hyper reactive level. An over reactive brain is more primed to be on the lookout for danger and in a state of hypervigilance for any physical, mental or emotional stress and the brain eventually gets stuck in that hyper mode.
People can have faulty neuroception, where they are no longer able to read the cues adequately in their environment and are unaware of their external and internal triggers leading to things like anxiety or depression. We often see this in trauma as trauma reshapes body and brain, as the brain and nervous system keeps triggering, even when threats are not present.
People can have a compromised functioning interoception, where there is a disconnect between the body’s signals and the brain’s processing of those signals. Here people are unable to read their own internal cues adequately of how their body is feeling or what their body needs ie not drinking when thirsty or sleeping when tired or relaxing when wired. This can underlie anxiety, depression, panic attacks, addictions, post-traumatic stress disorder, obsessive compulsive disorder and attention deficit hyperactivity disorder (ADHD).
Feedback loop is on stuck and in a maladaptive vicious cycle
When an over triggering of responses continues, the nervous system and the brain gets stuck and wired to be in the on-mode and things become more chronic.
This maladaptive vicious cycle, where the body is caught in a loop and cannot reset or switch off properly, feeds the chronic conditions. The body has upgraded itself in this new stuck position and it may even start to feel normal and part of the fabric of who we are and perhaps despite many medical interventions, we are just not able to overcome our symptoms or regulate our physiological processes.
Enter: Craniosacral Therapy
Craniosacral therapy (CST)
Craniosacral Therapy is a powerful physical therapy to reset your central nervous system. To work with chronic conditions, you have to work with the brain and the nervous system on a physical, mental and emotional level, as well as enhancing your neuroception and interoception. This therapy packs a punch and its subtle touch belies its power.
Five core reasons why Craniosacral therapy needs to be included in the treatment
of chronic conditions – chronic pain, trauma, addiction,
complex illness and diseases.
CST is proven to:
Trauma - The Four core reasons why Craniosacral therapy, as a body-based therapy needs to be included in the treatment of trauma
In order to heal your trauma and emotions you have to process it through the body – what is missing in the current cognitive talk therapy model.
A couple of times in my career, I have been vetoed by psychologists and psychiatrists, who advised their clients to work exclusively with them as they process their events, trauma and experiences, on a cognitive level and/or medicate them – dampening their disturbed physiology. Whilst I never met or spoke with their respective therapists and they possibly may not know what craniosacral therapy is, I respect their professional advice and view their advice as a gift. A gift that it is my responsibility to contribute to the education of Craniosacral Therapy for all trauma suffers – developmental, chronic toxic stress, shock trauma - and the medical world. I would like to encourage an open ongoing dialogue in how we can mutually support a Trauma client and the complementary domino effects craniosacral therapy has to talk therapy and vice versa, in a holistic and integrative healing model. I have benefited from talk therapy myself but when it comes to trauma it needs a broader approach. The current model emphasises so much on cognitive functioning without the integration with our bodily experiences. Trauma impacts the body so strongly and the body has often not metabolised its responses, and it can get stuck, repeating the same patterns over and over again. It is through pioneers like Stephen Porges and his Polyvagal theory, Bessel van der Kolk – in the bestselling book the body keeps the score – where he recommends craniosacral therapy, and many other trauma informed practitioners, including my own craniosacral teacher, that hopefully one day the global medical world will play full catch up. Healing trauma and regulating the nervous system by including the body through: Craniosacral therapy – Yes. Trauma Yoga, Breathe work – Yes. Art/Music/ Dance Therapy – Yes. Mindfulness & Meditation – Yes, yes and well of course, yes.
The body remembers what your mind forgets. (Martha Manning)
Why body-based therapies need to be included – The 4 core reasons:
I thank the psychologists who send their clients to me. The woman with severe pelvic pain due to sexual abuse, who was able to unfreeze and come into the healthy healing response, the woman with chronic pain, a history of trauma and many operations and prescription medications who was able to process and integrate her trauma and come off her opioid addiction and the boy with high anxiety and digestive issues: working with his digestive system on a physical level, down regulating his nervous system out of the anxious state on a physiological level, regulating his emotions that kept his system stuck in a negative feedback loop whilst his psychologist provided coping mechanisms, emotional support, identified triggers and put protective and safety measures in place.
The one common denominator that I hear time and time again from all my (trauma) clients is – “I thought I had processed my experiences and memory but it is not until I engaged with my body through craniosacral therapy that I realise that is not the case”. Through Craniosacral therapy, firstly clients regulate their fight and flight nervous system, so important to address anxiety and hyper aroused brains, secondly in the right environment - clients literally come out of their biological freeze response (imperative to heal) as they process their experience and emotions on a bodily level – they often feel so cold after the treatment, bone cold and thirdly in a very safe and contained way - memories or insights may come up that they were not aware of, as we tap into the subconscious mind, bypassing the logical thinking mind. Cranio is not a one-off miracle session, it is very much therapy.
Craniosacral therapy is absolutely gaining in anecdotal evidence on an ever-increasing scale, being written about in trauma, psychology and healing literature and also gaining in scientific evidence with more advanced measurement techniques made available. I would love to be wired up or for my clients to be wired up and measure their brains, track their nervous system, their heart rate variability, their muscle tone, tissues, their nerves, cortisol and adrenaline levels before and after a Craniosacral session.
This week I treated a man with a severe flare up of his colitis. The client is very body aware, has a great sense of interoception and is working with a trauma therapist on his developmental trauma. The client was able to feel every change that happened in his body whilst I was working on him – he could feel the facilitated nerve in his digestive system switch off, he could feel his diaphragm open, his muscles coming out of hyper tonus, his nervous system go into total healthy parasympathetic state, lowering the inflammation response, his brainwaves enter subconscious mode and as icing on the cake, he was able to make some important and crucial realisation why his colitis had flared up. We were so attuned. After 3 treatments and with his own ongoing work, his colitis was back in remission. We joked at the end of our session, that I wished I had a camera on my fingertips that could go through the skin of his body and project what I feel, “see” and how the body responds to the craniosacral touch. We imagined those images projected onto the wall of a classroom or trauma conference, as Craniosacral is not necessarily a spectator sport as little seems to happen on the outside but yet So much is happening on the inside, on a brain, body and nervous system level.
Open to anyone who would like to fund me and these scientific measurements in the advancement of craniosacral therapy, trauma and nervous system work.
Below some heart felt Google reviews from my Trauma clients: Enough said.
Processing 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.
Thankfully Dorine not only has a deep understanding of processing trauma through the body derived from her training; she also has an unconditional acceptance and care derived from her experience. This enabled me to feel safe & comfortable, even when I was highly agitated before I walked in the door. I am not usually one to post reviews. I write this for those going through a similar experience to let them know, “you have come to the right place”. Dorine’s help has been invaluable; her treatments are non-invasive yet powerful. And there is absolutely no need to feel self-conscious about your symptoms, I think she has seen it all.
My mind, body and life are back on track now, I am forever grateful.
I came to see Dorine at the recommendation of my Integrative GP and I'm SO glad my GP told me about her.... I had been struggling with chronic fatigue and was having a lot of difficulty in getting my nervous system to calm down.. My experiences with Dorine have been game changing for my emotional, physical and mental health. With her grounding and nurturing support I was able to FINALLY process and move through traumatic experiences that I had blocked and stored in my body- that talk therapy just couldn't quite help me with to the same degree...Dorine has a way of making you feel so safe and so seen so you can really let go and let out what you have been storing in for years...sometimes decades. Whilst you can move through big stuff, you dont leave the session feeling worse (as you sometimes you do with certain therapies) I always find I feel 100 times better and far calmer...like I can breathe more deeply. More GP's should be recommending this kind of treatment for people with trauma and who have nervous systems that need support in learning to feel safe.
Tinnitus is an internal noise or a hyperactivity in the central auditory system normally experienced as a ringing noise in the ears, coming from within the person. In some cases it is temporary and goes away over time. Unfortunately for others the ringing noise can be constant and impact their daily life. Tinnitus can be experienced in one or both ears. It can make different sounds and can vary in intensity. Tinnitus can be brought on by many different causes including dental trauma, loud music, TMJ (jaw problems), a physical trauma, long-term work stress, trauma or anxiety. Tinnitus is much more widespread than generally known with around 25% of Americans and around 20% of Australians suffering from it.
Tinnitus is considered a neurological/audiological condition but has eluded medical treatment and scientific understanding so far. Initially, sufferers consult an Ear Nose and Throat (ENT) specialist, audiologist and/or a neurologist. In the majority of cases (around 80%) no known cause is found. If nothing specific is found, then sometimes medication is prescribed like Valium or Amitriptyline but thankfully more and more mindfulness meditation. Sufferers are often told by their doctors that not much can be done, to shift their focus, unscramble the picture and mask the sound. At best the brain will adapt and learn to live with it.
However if we view Tinnitus as not just being about a "hearing/ear" problem but a nervous system problem with a whole body reaction, we might be a step closer in bringing relief to Tinnitus sufferers. I believe there is a largely untapped potential in understanding the variables, common threads and biological nervous system responses in Tinnitus sufferers and approaching it in a new light. This calls for a treatment model that not only incorporates the physical body and the Craniosacral system of the physical body but also the mental and emotional body and this is exactly the strength of Craniosacral Therapy.
Craniosacral Therapy views Tinnitus oa as a signal where the adrenal flight and fight response seems to be manifested through the auditory system as noise in the ears, leaving a certain hyper vigilance, which keeps the brain active. This leaves your system so sensitive that you actually hear your own internal noises like ie: nerve impulses, structural movement and/or fluid movement, as well as the external noises. In my personal Craniosacral practice, Tinnitus clients, describe their ringing as: cicadas, kettle boiling, a high pitched dog whistle, the pinging of a microwave, humming of a fridge or as a high frequency. Often, but not always clients symptoms appeared in or around a major event in their life, or related to an echo of past difficult experiences. In these circumstances I usually find, that whatever the trigger was for the tinnitus to occur, it usually is the last overwhelm of previous layering challenges to the clients long suffering system, that breaks the "donkeys" back, like in the kids game Buckaroo. The last suitcase may have triggered Buckaroo's back to buckle but many other suitcases were loaded on top first.
Tinnitus is about our nervous system and brain as our brain continually scans our inner and outer world for threats. When any threats are detected the stress response automatically fires up. As you go through life the brain acquires expectations based on your experience and in particular negative one’s. When situations occur that are even remotely similar, the brain automatically applies its expectations to them, if it expects pain or loss or even just the treat of these, it pulses fear signals, creating hyper vigilance, keeping the brain active (Buddha's Brain-2009). Most of the time these seems to happen subconsciously as people are not aware of how their bodies respond in their day to day life, to stress or threats and how this can manifest as ringing in the brain.
A new scientific study at the University of Illinois (July 2017) seems to validate this. Using MRI, this new study found that tinnitus is in the hearer's brain. They found that chronic tinnitus is associated with changes in certain networks in the brain. A tinnitus patients brain seems to be not truly at rest even when they are resting, as the brain stays more alert. This could also explain why sufferers also feel tired more often.
I personally view Tinnitus more as a Syndrome than a condition as the whole central nervous system is on high alert and tinnitus is just one of the many side effects of this whole body reaction with everybody's Tinnitus being different. Some clients may have a slight hearing loss but not all clients with hearing loss have tinnitus, some clients have neck and shoulder problems and then again some have TMJ issues and/or temporal bone(s)/muscular dysfunction but the common denominator seems to be (unconscious) anxious and/or unprocessed stressful times and patterns lodged in the body. Some people may be aware off of this, some totally unaware but in all cases it has not been dealt with on a bodily level. I find looking at our evolutionary biological stress pathways and the structures involved around Tinnitus very insightful. Let me break it down: (Please view My blogs on our biological Stress Pathways, TMJ and our 3 Brains for more in-depth background information).
The strength of Craniosacral Therapy is that it addresses all of the above: working structurally around the auditory tube structures i.e. temporal bones, cranial nerves, intra-oral work, TMJ - jaw, neck & shoulders, releasing any tissue and bone restrictions, resting the brain & the meninges (brain tissue). Craniosacral is known to resettle the Nervous System, so stored tensions can be released, decreasing “the fight and flight” hyper vigilant sympathetic nervous system and increase the "rest and digest" parasympathetic system, lowering the tone of the Vagus Cranial Nerve. Craniosacral therapy sees symptoms as a signal of the body and unpacking any issues and unconscious thought processes that may have contributed to the onset off their Tinnitus can be very helpful, Having more awareness means you can make a choice. The body tends to hold tension and emotional conflict deep inside until it feels safe and is ready to process it.
UK based Julian Cowan Hill is an ex-Tinnitus sufferer. He found his cure in Craniosacral Therapy and has since become a CS practitioner himself. He has written a book about Tinnitus “From tyrant to friend" which I recommend. It is a handy practical little book, packed with information and a Wellbeing Matrix with levels and exercises to go through. He also has You Tube videos that people find helpful. Simon Baker (an ex DJ with hearing damage) is also an ex Tinnitus sufferer and has also become a CST practitioner himself and is a Professional Tinnitus advisor with the British Tinnitus Association. A link to one of his articles: https://djmag.com/content/hearing-damage-djs-guide-preventing-tinnitus
Tinnitus treatments are about regular treatments rather than a one quick fix. It is a gradual process, as it is about regulating and rewiring the nervous system and brain, learning to switch off the whole central nervous system. Grooves and patterns are often hardwired and they take time to change and integrate, to build a new road. My advice would be that if you do suffer from Tinnitus, try Cranio earlier at the onset of your symptoms. Cranio is one of the best therapies around for settling the nervous system, treating TMJ, resting the brain and cranial nerves and clearing any unprocessed shock, becoming less hyperactive and if applicable uncovering any unconscious emotional conflict. My clients that develop the best results are the ones that don't expect to be just fixed but are prepared to put in the work as well by adopting a multi-disciplinary approach and new life style regimen through diet, meditation, exercise and unpacking any issues. For some clients, the ringing in the ear becomes less intrusive and they don’t focus on it anymore, some clients find the noise has backed off and even forget about it and some clients make a full recovery. As Julian Cowan Hill says: "The state of your nervous system is very changeable and reversible, as the nervous system is a fluid, constantly altering state of balance, when the right conditions come along, it changes". He should know, he cured his.
Keep up to date with news, research and my upcoming book with oa Tinnitus case studies.