January  18 – 2007

Questions and comments for this issue:

+ Talking during treatment.
+ How the face reflects the cranial rhythm.
+ Why is the ventricular system so important?

Hello,

Let me just put my Hula Hoop down for a second
so I can talk to you.  You don’t Hula?
Why, it’s the latest re-fad.  You know, a fad
that makes a comeback.

In America, “hip hooping” classes, videos and
Hoopster clothing lines are springing up across
the country. Beyonce and Charlize Theron are huge
fans.  They are always pestering me to join them
at hip hooping class.

I can see I’m wasting my time talking to you
about this.  You just want to hear about cranio.

Fair enough, let’s get on with the mailbag.

***QUESTION***

Dear John,

Thank you for your newsletters they are wonderful.

Here is my question.
I would like to get some of my patients more
involved in their process when we are working
together but I don’t want to do a full somato-
emotional release type thing with them.
Do you have any suggestions for an intermediary
type approach I could do?

Thanks again.
PR.
California.

MY COMMENTS:

Okey dokey.  Here’s something you can do.

Once the person is on the table and you are
settling in and chit chatting and generally
entraining with them.

No, not entertaining them, I said ENTRAINING
with them. Now take that clown suit off and lets
get back to the session.

Tell the person that you are going to do
something a bit different this week.  Keep your
tone light.

Take up a contact that allows you a good sense
of the whole cranio sacral system.  Ask the person
to close their eyes and begin to see themselves
shrinking on the inside until they are small
enough to walk around, inside the structures of
their body.

Whenever you are talking with a patient choose
your words carefully.  I used the word ‘see’ on
purpose.   ‘I want you to see yourself shrinking
on the inside until you are small enough to be
able to walk around inside the structure of your
body.’

Don’t say visualise or imagine as I have found
these words can short circuit the process before
it even gets started.

Why?

Well, because some people are convinced they
have no imagination and others have tried
visualisation before and are, ‘just no good at
it.’

Start off with a relatively restriction free
area.  Ask the person to describe what it looks
like.  Get them to describe the area in as much
detail as possible.  Encourage them to tell you
what they see, even though they may be inhibited
by their lack of anatomical knowledge.

They can shrink themselves to whatever size
they need to be to pass between structures or see
something in detail.  Ask them if everything looks
okay in the area.  If it is, move on to another
area, one where you sense a restriction, though
you don’t need to tell them you think it is
restricted.

If they tell you that everything is NOT okay in
an area, ask them to describe what it is that
looks unnatural.  Encourage them to be as specific
as possible.  You may need to move your hands
closer to the area they are describing.

Ask them what needs to happen for the area to
return to a more natural state.

Wait for their answer.

If they are having difficulty seeing a way to
correct the situation you can suggest solutions to
them using the symbols they have communicated to
you. Make full use of their size in the area.

They can climb in between bones and push them
apart.  They can pull and push things with their
hands in very specific ways. You can suggest
little tools that may help them, but avoid
frightening tools like hammers and saws etc.

You can suggest light beam machines to warm
cold areas.  Ice guns for cold.  Muscle oil
aerosol cans for tight or stiff muscles and so on.

All the time you will be monitoring and
following the changes they are making on the
inside with your hands.

This is generally an enjoyable technique for
you and the person.  It seldom has a huge
emotional aspect and is particularly good with
patients who are very out of touch with their
feelings.

Most people don’t find it threatening and are
amused by what they find in their bodies. They can
be surprised at the clarity of the images they
see. This is because the following of your hands
enables the person to see more clearly the
restriction in their bodies.

This technique is a very useful way to involve
the person and use their attention as an extension
of yours, to check things out and correct them
from the inside.

As you get more experience with it you will get
a sense of who this technique is appropriate for.
It is a good introduction for other forms of
therapeutic conversation which you may intend to
use in future treatment sessions with the person.

***QUESTION***

Dear John,
I am currently studying the face and the way it
moves with the cranial rhythm.  Frankly I find it
confusing and hard to remember.

I’m hopping you have some little analogy or trick
for making it a bit clearer.

Yours Sincerely.

KS.
Canada.

MY COMMENTS:

Before I get into the face I need to quickly
run through flexion and extension in the cranium.

Think of the cranium as a balloon.

During extension the balloon narrows and
elongates and during flexion it expands and
becomes squat.  Long and thin in extension, short
and squat in flexion.

To understand the way the face moves with the
cranial rhythm, take the balloon and add a small
box.  Attach it to the balloon roughly where the
face hangs off the cranium.

Now, lets look at how the box moves with the
balloon.

In extension the balloon will become long and
thin.  The box will arc inferiorly and narrow as
the whole balloon elongates

During flexion the balloon will become short
and squat.  The box will arc superiorly and
broaden as the balloon shortens and broadens.

So what does this feel like in practice?

Sit at the head of the person.  With their
permission, place your hands on their face, thumbs
on their forehead and fingers on their mandible.

During flexion you will feel your thumbs and
fingers move closer together while in extension
they will move further apart.

Once you get this overall movement you can work
out the specifics of each bone relatively easily.

Here are some other things to consider.  The
mandible and the frontal bone moving towards each
other in flexion could put stress on the bones of
the face but this compressive movement is
naturally absorbed by the orbits.

This makes the orbits particularly vulnerable
to any restriction patterns present in the face or
cranium, especially the posterior aspect of the
orbit.

Certain bones of the face are designed to
reduce the amplitude of the movement of some of
the larger bones they articulate with. These bones
are the palatines, the zygomae, the vomer and the
ethmoid.

You can think of them like ‘washers’ between
two larger bones.  William Sutherland called these
bones the ‘speed reducers’ but they do not
actually reduce the frequency of the rhythm, they
reduce the amount of movement or amplitude.  So a
40 micron movement of the frontal can be reduced
to a 10 micron movement in the Zygomae. [Remember
a sheet of writing paper is 100 microns thick.]

***QUESTION***

Hi John,
I am being repeatedly told that the ventricles are
very important but I am not sure why.  I have
asked this question of my tutors repeatedly but
never got a satisfactory answer.

I would be grateful to hear your explanation.
Thanking you in anticipation.
PB
South Africa

MY COMMENTS:

It may be easier for you to think of the whole
system in terms of plumbing, which it is in a way.
It’s a very important and significant plumbing
system.

The ventricular system, is a collection of
cavities and canals deep within the brain and
spinal cord. It consists of 4 ventricles connected
by various channels.  It always looks to me like a
model of a space ship.  Think Star Trek.

The four ventricles are made up of the 2
lateral Ventricles located within the two cerebral
hemispheres, each of which connect via an inter-
ventricular foramen to the 3rd ventricle which is
located between the two thalami of the brain.

The 3rd ventricle connects inferiorly through
the cerebral aqueduct (or aqueduct of Sylvius as
you will see it in some books) to the 4th
ventricle which is located between the cerebellum,
posteriorly and the pons and medulla, anteriorly.

The 4th ventricle continues inferiorly as the
central canal passing down the centre of the
spinal cord.

The whole ventricular System is filled with
Cerebrospinal Fluid.

So that’s the plumbing.  Now let’s look at
inlet and outlet valves.

The INLET valves are located in the roof of
each of the four ventricles and are called Choroid
Plexi.  These are filter like structures through
which cerebrospinal fluid is formed as a filtrate
from arterial blood.  Arterial blood enters the
choroid plexi from the cerebral arteries; then
blood cells, proteins and other large particles
are filtered out.  The pure colourless fluid that
filters through this choroid plexi into the
ventricular system is cerebrospinal fluid.

I will get to the outlet valves in a minute.
First I want to focus on something that is very
easy to get confused about.
We know that the membrane system contains
cerebrospinal fluid, right?

Just nod.

And now we have a good idea of how
cerebrospinal fluid enters the ventricular system.
And we also know the ventricular system is
contained within the membrane system.  The thing
is the ventricular system is, for the most part,
closed.
So how does cerebrospinal fluid get out of the
ventricular system into the membrane system?

Very good question.  It all happens in the 4th
ventricle.  In the posterior and lateral walls of
the 4th ventricle there are three foramina,  – the
foramen of Magendie which is in the middle
posteriorly and the 2 foramina of Luschka,
bilaterally.

It is through these 3 foramina that
cerebrospinal fluid passes out into the sub-
arachnoid space where it circulates around the
brain and spinal Cord.

Now back to the OUTLET valves.
Cerebrospinal fluid is eventually returned to
the blood via the Arachnoid Villi which protrude
from the sub-arachnoid space through to the
superior sagittal sinus of the Brain.  It re-joins
the venous blood which then drains from the venous
sinuses via the internal jugular Vein to be
returned to the heart.

So that’s the plumbing, the general flow and
the inlet and outlet valves.   The significance is
that this system is in continuous use which means
it has to be in working order all the time.  If
any one of the valves or canals of foramina are
not working properly the effects are serious.

Just think of the person having a spinal tap.
Only a tiny amount of cerebrospinal fluid is
removed yet the person will have to lie horizontal
for 24 hours to avoid severe headaches.

Also if there is a problem in this system it’s
not like you can just shut it down while repairs
are made.

So that’s it for this issue.

Cheerio for now.

Till the next time.

Your Mate,

John D.

+ How does opposed motion relate to flexion/extension? – October 05

Hey JD,
Enjoying your Q and A’s.
Here’s my Q.
How does opposed motion relate to
flexion/extension?

Thanks
B.F. London.

>>>MY COMMENTS:

Glad you’re enjoying the NL, B.F.
I’m guessing you do a lot of text messaging on
your ph.
Here’s my C’s.

When you first learned cranio sacral, you were
probably told how the cranio sacral system moves
in flexion and extension.   ‘In flexion, the
parietals flex and extend around a medial axis
running along the sagittal suture.’ and so on . .

That’s called the similar motion model.  The
main characteristic of which is that everything
moves symmetrically around the midline of the
body.

What you will have found in practice is that
some people just don’t flex and extend in
symmetrical way.

The fact is that no person fits into the
theoretical models of flexion and extension all
the time.  Some never.  No person’s head moves in
the same way from one day to the next.

It is important to learn flexion and extension
in the beginning so that you can refine your
palpatory skills to really be able to perceive
flexion and extension in all its nuances.

With the opposite motion model flexion and
extension are felt asymmetrically.  When one
parietal is moving into flexion the other one will
be going into extension.  This creates an
asymmetrical peddling motion within the whole
cranium.

The frontal bone will move anterior and
inferior on one side (flexion) while the other
side moves superior and posterior (extension).

The squamous portion of the occiput will flare
and move inferior and slightly posterior as it
tucks under (flexion) on one side while the other
side is narrowing and moving superiorly
(extension).

The sphenoid torsions around its body.  One
greater wing will nose dive  (flexion) while the
other side will be arching superiorly.

It’s probably easier to get a mental visual of
it all if you think of the membranous balloon
lining the cranium, filling on one side while it
empties on the other.  This will help you make
sense of what the bones are doing.

Trying to figure out every bone movement in the
opposed motion model will do your head in.

Not recommended.

Get the idea of the way the membranes move and
the bones will follow.

You’ve probably felt this motion already and
may have put it down to your inability to feel
flexion extension correctly.

Well you were right, there is a motion like
that and it’s called opposed motion.

Some days our system will move in similar
motion flexion and extension and on other days it
will have this opposed motion feeling.

Hope that was of H.

+ What I feel with my hands, am I making it up? – September 05

Mr Dalton.
I feel I am at a crossroads in my craniosacral
training. I have been studying CST for six months.

I have listened carefully to my trainers.
I have read books on CST. I understand the fluid
mechanics of what is happening, in theory.

When I tune into the system I begin to feel things.

Then I begin to wonder am I feeling the rhythm
because I expect to feel it. I wonder if I am
not imagining the whole thing. What I feel with
my hands is so tenuous that I could very well
be making it up.

My trainers say that the feeling will become
clearer with time and practice.

It has been six months now. While I can feel more
than I could at the beginning it is nowhere
as clear as I expected.

I understand that with your experience and in
your position you have a strong vested interest
in ‘believing’ in what you do.

I would appreciate it if you could answer me as
honestly as possible.

Do we make it up?

Regards.

M.S.

Somerset.

>>>MY COMMENTS

Let me tell you right now, it’s not going
to get any easier.. . .

What you are looking for is a kind of certainty.

Where you put your hands on someone’s body and
it lights up like a Christmas tree and you can
see EVERYTHING, every restriction pattern,
every cause.

And the road to health for that person looking
like a well lit highway.

And all this without that awful squirmy feeling
like you are groping around in the dark not really
sure of anything.

I feel for you, but it’s never going to
happen. There is something about this work that
always keeps you at the limit of yourself.

I’ll explain.

When you started to learn six months ago and you
heard about flexion and extension, it probably
all made sense.

Then you put your hands on someone and you tried
to feel it and all you could feel was NOTHING!

And it felt awful.

You trusted your trainers and you persevered.

As time passed you learned new things like feeling
lesion patterns in the sphenoid or some such
and when you tried to feel them, all you could
feel was NOTHING!

And it felt awful.

You looked forward to the day when you wouldn’t
feel that awful feeling.

You didn’t notice two important things.

1) Your palpatory skill was improving and
changing. You were actually feeling more. When
you were struggling to feel whether the sphenoid
had a flexion or extension lesion, you failed to
notice that you were feeling flexion and extension
with relative ease.

2) The awful feeling wasn’t changing. It was the
same awful feeling six month ago that you are
feeling now.

As good as your palpatory skills get,
as good as your diagnostic skills get,
as good as you perceptive skills get,
you will still have that voice in the back of
your head wondering, ‘Am I making this up?’

Outstanding cranio sacral therapists haven’t
eradicated uncertainty, they have mastered it.

It’s not like you get it sorted and never have
to deal with it again. It’s something that goes
on every time you treat someone. It’s one of the
most difficult aspects of cranio sacral work.

I know all this because I went/go through it myself
and I have seen ALL the people I have trained go
through it in one way or another.

Here’s what I suggest: put the question on hold for
another six months. Make a deal with yourself that
for the next six months you are not going to ask
yourself that question. For the next six months
you are just going to take it that what you are
feeling is true. It’s not forever, its just for six
months.

I’m not talking about kidding yourself.
You need to understand what you are trying to do.
You haven’t been conditioned to think in the way
that you’re trying to think when you do cranial work.

Your neuronal pathways are formed in a different way.

Continually asking yourself if you are making it
up won’t allow new neuronal pathways to form.

We are not MRI machines. This is science, but not as we
know it, Jim.

Asking if we are making it up is a question from
another approach.

Because we are not machines we have the capacity
to go far beyond our own expectations and pull miracles
out of the bag. It also means we have the capacity to
have an off day and get it wrong.

To answer your very specific question.

Do we make it up?

Sometimes.

Mostly in the beginning of training.

With experience, 1-2 years minimum, you can begin to
discern when you are making it up? You can spot it
and in time it too becomes another thing to note,
along with the multitude of other things you are
registering as you work.

‘The rhythm is changing, I wonder what that means?

The patient is feeling sadness, I wonder what that
means? Now they are angry, I wonder what that means?
I just made that bit up, I wonder what that means?
Now they are about to release this bit, I wonder what
that means? The sadness is still there. .’ and so on.

Have a good look at what I’ve written. Talk it out with
people who know you and care about you. Cranio sacral
therapy may not be the thing for you. It doesn’t suit
everyone. There are lots of modalities that offer
much more of the certainty you are looking for.

Having said that, I encourage you to persevere.
The rewards far outweigh the difficulties.

And the weird thing is as you become familiar with
and master uncertainty, it permeates your whole life
and it becomes more . . well . . fluid.