Bodymind
and Soul II:
Craniosacral Therapy and Myofascial Release
Reprinted from Massage Therapy Journal.
Spring 1991. All rights reserved.
Presented by: The Upledger Institute
Perhaps some of the difficulties in writing about the relationship between
the body and the mind come from the languages we use to describe them. Currently,
those languages seem to describe not only two different aspects of a person,
but two different realms. The mind contains thoughts, fantasies, dreams-invisible
ephemeral things beyond sight and touch. No one knows what constitutes the
mind. On the other hand, everyone knows what constitutes the body; gross
physical anatomy has an unshakable place in the material world.
When Freud used the language of forces to describe the behavior of the instincts,
he described mental activities with language which belonged to the physical
realm. This very interesting project emerged from his perception of mental
activities. Feelings, thoughts, and desires behaved as if they had the quality
of forces. That is, they exerted pressure on the person experiencing them
to fulfill them or express them. When this did not happen, they did not
simply go away. It took an equal effort to push them away from consciousness
and the pushing away (in some cases called repression) did not vaporize
them but changed them by changing their quality (love to hate), object (father
to uncle) and aim (desire for recognition to desire harm).
Mental force, or instinct, is "the psychical representative of an endosomatic,
continuously flowing source of stimulation: (SE:7,p. 168). As such it is
continuous. Therefore, so is the force needed for repressing it, that is
for "turning [it] away, and keeping it at a distance, from consciousness."
(SE 14, p. 147).
Freud's theory of repression is a good example of his use of physical language
to describe psychodynamics. It describes from the perspective of force how
someone handles emotional trauma. Emotional trauma involves desires, feelings,
and motives perceived as forces. Imagine a child who is continuously humiliated
and rejected. She has primary instinctual desires: the desires for love
and the capacity for aggression. These provide a constant impulse, like
stones continuously dropped into a pond. When she is not loved, is rejected,
is humiliated, all those experiences result in other feelings which are
painful, which thwart expression and satisfaction of her primary desires,
and which themselves become motives acting like forces, contributing to
the movements of her mind. As a psychological and neurological structure,
she now has to handle many, many desires and feelings. She also has to handle
the fear of the pain these feelings bring and the fear she is beginning
to feel as part of simply being herself-that is a creature whose needs bring
her pain and displease her parents.
And so it grows from there. Later in his writings, Freud emphasized the
interplay of forces in this conflict from the ideational perspective. Painful
and conflicted feelings, desires which put one's life in danger-these resulted
in strong motives (also forces) to alter them or even to push them from
consciousness completely. The mind as a structure could not appropriate
them. But his theory originated from a construct which linked the mind to
the nervous system. It was the child's nervous system (like a network of
conducting wires) which could not carry the excitation produced by this
overload of conflicted, unexpressed stimuli. The bUpledgerlding excitation was
experienced as discomfort and then anxiety. When the nervous system could
no longer tolerate this overexcited state, an innate mechanism tending toward
homeostasis did something to get rid of it and that something Freud came
to call repression. This tendency away from excitement became the basis
of the death instinct: the life instinct moves us toward greater aliveness
and activity, the death instinct, away from it.
Of course, when a cluster of forces is repressed, it doesn't go away. If
it is so painful that it cannot be appropriated at all, it becomes a neurosis,
a cluster of disordered motives held in check in a separate part of someone's
personality. That person must then compensate for the excision from his
larger personality of the instinctual components which could have deepened
and enriched his life, had they developed differently; compensate for the
depletion in his vitality from exerting constant psychic pressure to keep
this cluster repressed; and create his life to minimize the chances that
what is repressed will be stimulated, thus deepening anew the cycle of anxiety.
The highly defended (against repressed desires) personality is a rigid,
inflexible one with a limited range of adaptation.
From the perspective of structure and force, we have in Freud's work a physical
language transposed into a mental key, the idea of the person as a continuous
producer of stimuli which are then described with the language of mental
forces and which behave in ways similar to physical force.
Freud's language described the behavior of forces that were mental, neurobiological
and physical all at once. His discussions of them emphasized their mental
aspects. Thus the language of instincts became a language of metaphor-an
"as if" language which discussed mental dynamics "as if"
these were physical forces. In fact no one knows what mental forces are
and logically, within the current categories of English semantics, there
are no such thing. Anything mental is completely inaccessible, except by
indirect observation and complicated interpretation. Wilhelm Reich and the
bioenergeticists collapsed Freud's language in the direction of the physical;
but their project fared no better linguistically and, if anything, seems
to lose the complexity and richness of the Freudian synthesis. I am left
to wonder if perhaps the problems of the Freudian language lie not in Freud's
insights nor his project but with the limits of a language which separates
qualitatively as well as spatially the mental from the physical realm.
This split is tied to language which confines the physical to gross physical
anatomy-to "things". What if the physical were perceived as patterns
of body rhythms or aspects of interactions between physiological systems?
This could open up new ways of looking at not only how the body works but
what the body is. Body rhythms are accessible forces. Imagine finding in
a person a body rhythm such that, when one modulated it, she had emotional
experiences with clear-cut mental content; touching the rhythm would be
like touching her mind. Not touching the body, mind you, touching the rhythm-that
aspect of systemic interactions which is motion.
This is not to say that craniosacral therapy and myofascial release work
offer the "answer" to Freud. It is to say that for at least one
hundred years there has been an ongoing project in the humanities and the
sciences of looking for a language with which to describe the body in a
way that does justice to the mind. The work of John Upledger and John Barnes
contributes to that project in such extraordinary and radical ways that
by the twenty-first century, these two men could well change the way in
which we see ourselves. The Freudian questions (relationship of mind to
body and of meaning to force, how personality forms, what it means to understand
man as a biological organism with a great capacity for abstraction) are
present in their clinical work. In the writings which emerge from that work.
Barnes and especially Upledger are using a language which bears many similarities
to much of Freud's.
These similarities are interesting and need to be explored without preliminary
closure so that they can lead us to new motifs, approaches, and ways to
understand the self. The craniosacral and myofascial systems interact directly
or indirectly with almost every other physiological system. Because we can
learn to monitor them, they could give us access to aspects of other systems
and to aspects of the relationships between them.
There is an interesting parallel between Freud's language of repression
and aspects of the language of craniosacral therapy, as John Upledger develops
it, especially in his idea of an energy cyst. The craniosacral system sends
cerebrospinal fluid through the brain and spinal cord. The rhythm of excretion
and reabsorption creates a force, which is subtle but can be palpated in
the entire body. Many factors affect the rate, regularity and evenness of
rhythm: trauma certainly changes it and in areas where the system is exceedingly
restricted through trauma it can barely be felt. On the other hand, in areas
out of control of the CNS, it becomes exceedingly rapid. Learning to palpate
the rhythm (that is, to touch the force) takes skills best learned in classes;
learning to diagnose with it requires additional reading and there is none
better than Upledger's books (and articles).
The craniosacral system is a complex system, the anatomical parts of which
are the cerebrospinal fluid and all structures related to the production,
resorption and containment of it; the meningeal membranes and the bones
to which they attach; and the connective tissue structures which are intimately
related to the meningeal membranes (Upledger; 1983, p. 5-6). It is also
an open system, and this makes it even more complex. It is an open system
for physiological, structural and functional reasons. First, the fluid seeps
out of the craniosacral system into the surrounding cells and enters the
lymph and blood.
Second, when the cranial bones and meanings are out of alignment or have
restrictions, the functioning of the cranial nerves which run through them
and even of the brain is impaired; thus, many systems and organs can be
indirectly affected. Third, muscle tension and fascial restructions around
the head, neck, spine, and sacrum can affect the functioning of the cerebrospinal
pump.
The craniosacral rhythm has three phases: flexion, extension, and the "stillpoint"
in between. The purpose of craniosacral therapy is to bring the system into
optimal functioning by modulating the rhythm. This includes skeletal manipulation
and soft tissue work to free the spine and sacrum of adhesions and the subtle
manipulation of cranial bones as well as work on the meninges and other
soft tissue structures of the head, face, and neck.
Though William Sutherland was the first person to write about craniosacral
work, John Upledger is the current genius in the field. He has used it with
a variety of physical injuries and phantom pains, in TMJ work and with autistic
children. He is interested in quantifying the subtle forces he has felt
and has been wrestling restlessly with that for years. He has measured the
electric potential in the therapists' hands, tried to correlate craniosacral
diagnoses with meridian diagnoses and Chinese pules, worked with bioelectrics
and biomechanics to try to understand, explain, and describe why clinical
work which seems to rely on "directing energy" and on using imagery
works. Upledger has exceedingly subtle skills of palpation and experiences
a body as if it were moving water: a "mass" of pulsations and
rhythms. He can feel pulsation "arching" from an injured area
in a wave pattern which interferes with the wave pattern emanating from
the surrounding healthy flesh. He can align the skeleton to accord with
energy vectors-subtle lines of force which seem to run through our bones.
And, like John Barnes, he can feel the way tissue wants to move in order
to permit the release of force which is distorting healthy patterns.
In describing what he feels when he touches a human body, Upledger describes
the body as a structure which produces its own rhythm and which also handles
forces originating in the external world. If internal and external forces
are not expressed and dispersed because, for example, traumatic injury gives
the body too much force to handle, or the emotional dimensions of injury
change the way the force is handled, that force gets "stuck" in
tissue, changing its "arching" pattern. It gets walled off, in
an area of disability, or stiffness, or entropy, and the body has to function
around it. Upledger calls this an energy cyst. An energy cyst has a parallel
structure and similar aetiology and function to an area of repression.
Upledger can "unwind" an energy cyst. By a combination of soft
tissue work and bringing an area to stillpoint, he and Barnes have learned
that, in stillpoint (often combined with re-entering the position in which
trauma originally occurred) the body begins to move automatically, "unwinding"
itself in a pattern of movement which permits the excess energy to be expressed.
In stillpoint, people have intense experiences of emotional recall, often
injury related; indeed, they experience a variety of altered states, many
of which are not fantasy, and many of which are related to emotional traumas
which affect body areas in which the craniosacral rhythm is not optimal.
So, if stillpoint is combined with unwinding a myofascial release, often
a person relives an old injury; as he heals physically, he re-experiences
the original event; the entire thing comes back.
This is not physical work which acts as a mental stimulus. This is work
with an aspect or relationship of the body in which the mental and physical
are linked.
Upledger does not only have unusually fine skills of palpation. He has a
very technically well-educated mind, he thinks like a research scientist
(which he is) and he has what can only, well, be described as a lot of guts.
I am giving a very introductory summary of his work. His books are very
technical, highly anatomical and well worth reading. Craniosacral Therapy
is an introduction to the body from a craniosacral perspective. It covers
technical descriptions of the rhythm, techniques for palpation and modification,
evaluation and treatment of diseases and dysfunctions, and most interesting,
anatomical function from a craniosacral perspective. Cranial Theory II:
Beyond the Dura continues this, concentrating on detailed descriptions of
the cranial nerves and the systems they affect, the head and neck, and TMJ
work. It is very refreshing to read highly technical anatomy from a new
perspective. There is no way to do fine Craniosacral work without grounding
it in this kind of medical information. Combined with technical, anatomical
detail is the fascinating narrative of his clinical experience and the history
of how he thinks and what he has tried to measure. SomatoEmotional Release
and Beyond includes detailed descriptions of the theory of energy, cysts,
vertical axis alignment and more mouth, face and throat work. This work
is very important because it affects the spine, the brain, and because cranial
nerves run through this area.
Like Freud and Upledger, John Barnes has drawn from his clinical experiences
a new view of man. Fascia is "a tough connective tissue that spreads
throughout the body in a three-dimensional web from head to foot functionally
without interruption." (Barnes: 1990, p.3) Fascia man is Barnes' term
to describe the person from the perspective of what we know about this tissue,
with the implication that it is important to learn a lot more about it.
This perspective shifts to fascia from skeleton the primary mechanisms which
handle forces and create balance and support and shifts the focus of treatment
of physical injury from localized treatment to working with broader patterns
of physical compensation. Here, too, it appears that when force which can
not be expressed or dispersed or assimilated enters the body (such as the
force of an emotional or physical injury or one which is both, like a terrifying
beating or a car accident), a "pattern" of force is retained in
the fascia. As this unwound-as the fascia is stretched and the body enabled
to go through movements which release this force-the person often relives
aspects of the trauma.
This behavior of fascia links it both to the concept of mind and to the
language of force. John Barnes is looking in many places to understand how
this works. He has no answers. He has a rich, intuitive, insightful, mind
in the first stages of building a theory. He writes about state-dependent
memory (in which physical position might be an element); the role of emotions
in how memories are processed, stored, and recalled; and the relationship
of molecular biology to electric impulses in the nervous system and the
system with which it interacts.
Myofascial Release: The Search for Excellence is aptly named. Though it
includes a wealth of theory and speculation about myofascial work, its largest
section is devoted to technique. Barnes begins with the lower extremities
and moves to the lumbar pelvic area, thoracic area, upper extremities, cervical
area and cranium. There is TMJ work and pediatric work as well. He continuously
distingUpledgershes between soft tissue mobilization (which can be painful) and
myofascial release.
The work is beautifully presented. The techniques are very, very clear,
but so is the approach, which is one of depth and flexibility. Barnes calls
his work three-dimensional, meaning that every person has different patterns
of fascial movement and restriction and one must work with what one finds.
Therefore, techniques cannot be copied; they must be appropriated. Thus,
even as the "emotional" dimension of fascial pulls one to a realm
from which the languages of mind and body emerge, so that very descriptions
of the release techniques draw one beyond them to their conceptual ground
in order to be grasped. The book captures and communicates this palpable
elusiveness through the use of symbolic form. It is a blue and white binder.
Techniques are illustrated with delicately drawn and shaded black and white
sketches of men and women, sketches which capture the curve and feeling
of living bodies and the expressiveness and love of the therapist's hands.
In the layout, space is balanced with the spaces which separated them in
classical architecture. This gives the reader the feeling of stability and
lightness. The typefaces chosen add to this. Articles illustrated with photographs
are also well laid out. Thus, the aesthetic experience of working with Barnes'
book begins to create a mode of consciousness congruent with doing myofascial
work.
It is clear when reading the work of Barnes, Upledger and Freud that one
is reading the work of men whose projects reshape human lives, because they
change our view of ourselves, introduce new categories, and broaden our
view of what is possible. The great Freudian questions are questions about
the essence of human nature: What is the mystery called the person? What
are pleasure and pain, body and mind? What is passion and how is it shaped?
To answer those, one must with courage, intelligence and integrity stand
face to face with the unknown and then seek to describe it. Upledger and
Barnes regularly do so and from this have written clinical and scientific
books of the highest quality, but also books, which meet the basic criteria
for philosophical speculation. It has been almost one hundred years since
someone has had the kind of clinical experience, which led toward a new
language and a new view of man. Barnes' and Upledger's languages are not
the final ones, but they are a beginning; developed and brought into dialogue
with psychoanalysis and neurobiology, they will make a significant contribution
to the self-image and perhaps the ethics of the twenty-first century. These
four books, of the greatest clinical, intellectual and humanistic value,
are the most recent work of men whose minds might change the world.
REFERENCES
Craniosacral Therapy, by John E. Upledger and Jon D. Vredevoogd. Eastland
Press, Seattle. ã 1983. 367 pages. Diagrams, Photographs, Appendices,
References and Index, hardcover
Craniosacral Therapy II: Beyond the Dura, by John E. Upledger. Eastland
Press, Seattle.ã 1987, 259 pages, Diagrams, Glossary, References,
Index, hardcover.
SomatoEmotional Release and Beyond, By John E. Upledger. Upledger Institute
, Palm Beach Gardens, FL ã 1990, 266 pages, Diagrams, Appendices,
Index, hardcover.
Myofascial Release: The Search for Excellence: A Comprehensive Evaluatory
and Treatment Approach, by John Barnes. Myofascial Release Centers, Paoli,
PA ã 1990. 254 pages, Diagrams, References and index, spiral
binder.
LINKS
The Upledger Institute http://www.upledger.com offering courses for therapists
International Alliance of Healthcare Educators http://www.iahe.com
International Association of Healthcare Practitioners http://www.iahp.com