Cranio Sacral Therapy - Student and Therapist Newsletter Archive

Hi John,
Just been checking out your website. I am a RCST having trained with Paul Vick. I live in Perth WA. I have had a practise for 3 years now.
I was interested in
1. The information that people would give to you, to make you decide that you wouldn't be able to help them with cst - this has always been a tricky one for me?

2. You talk about clients coming to see you for so many weeks- how often would someone see you in that period? weekly, fortnightly ?

3. I was also wondering if it would be possible to get my details added to your website ?
Thanks for the time you took in reading this
Regards
S.M.
Perth
Australia.

>>>MY COMMENTS:

1. Who I would, or wouldn't, treat?
As a general rule - If someone thought I could help them and wanted to have treatment with me, I would see them.
Having said that, I would explain to them how much I thought they were asking of their body.
So if someone was blind from birth and wanted to see again, well that obviously is a big ask.

I have found that if someone is in the middle of fighting off an infection it is better to wait until they have recovered so they can have more resources to deal with the underlying cause of their illness.

Yes, Cranio sacral is good for breaking fevers and helping to get over infections generally, what I am talking about are the more virulent infections like meningitis.

There is also the logistics of treating someone in the middle of an infection which would depend on whether you do house calls or not.

I have found certain kinds of nerve damage unresponsive to treatment. For example damage to the auditory nerve itself or a 20year old spinal
cord break.

I have found genetic conditions don't respond very well either.

2. How often do I see people?
I find seeing people weekly works best. I would only see them more often if their system was very stuck in a pattern and they had a very short relief from their symptoms after treatment, like a couple of hours but this, more intensive treatment, would only last for a couple of weeks at most.

3. How do you get listed on my site?
It couldn't be simpler. I send you an email. You fill in the blanks and send it back to me.

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***QUESTION***

Hi John,
I am contemplating setting up in a natural therapies clinic. I'm just wondering if you have any thoughts on the subject.
Thanks for the fab newsletters.
B.N.
Melbourne.

>>>MY COMMENTS:

A clinic can enhance your credibility, likewise it can also detract from it if it's the wrong type.

The first thing to look at is the type clinic you are going into. Look at what the overall tone of the place is and how you perceive the clinic when you first walk in.

Is it in alignment with the way you want people to perceive you?

If you want to be perceived in a very professional way and you go into a very New Age, spiritual type of clinic you're going to be at odds with the other therapists in the clinic a lot of the time because you'll be trying to portray a different image.

You obviously have to look at the room size.
Be careful not to compromise on the room size.
You'll need enough space to work comfortably with the persons arms/legs fully extended on either side. You'll also need an area in your room for taking and updating case histories.

Remember you may also have parents in the room with you while you treat their children, they will need to sit somewhere. It's helpful to have enough floor area to accommodate children.

I've always found the more space the better.
If you're working in a small room the releases people have are more intense and dramatic because the energy released bounces off the walls. I have found I get more tired more quickly working in small rooms.

Look at the reception area, the waiting room, is it big enough?
Is it comfortable?
Does it convey the sort of things that you want to your people?
Does the Clinic have a receptionist? Having a receptionist can be a plus, but it will usually increase the cost of your room.

Is there an area that you can use as a post treatment lounge? A post treatment lounge is a place where you can accommodate the people that you treat for the 30 minutes after the treatment in which you may advise them not to drive. If the clinic you're looking at doesn't have a space available for a post treatment lounge then is the clinic itself located near to a coffee shop or similar place? You can then make an arrangement
for your people to go there for a cup of tea or coffee.

When you begin to work in a clinic it is easy to assume that the clinic is going to get you people to treat. Generally it doesn't work like that. You must view your practice as your practice. If people come as a result of the clinic, great, but consider that as an added bonus. Don't rely in any way on the clinic to get you people.

It is easy, as a member of a clinic to get pulled into group advertising. Be cautious about getting involved in group advertising, it can cost a lot of money and it rarely produces any results apart from promoting the clinic's name in general. It won't promote your business in particular and has very little chance of generating a word of mouth referral.

Do not dismiss everything out of hand, look at what the clinic is proposing. If they're doing something like a mail out, look at the mail out and see if it's a mail out you want to be involved in? Don't do any thing that doesn't represent the work you do in the way it deserves to be perceived.

Establish it from the beginning that you are always asked whether you get involved in something or not. It's important to not get locked into any advertising on a long term basis. Having a sign on the clinic will reinforce your permanency to people and introduce the general public to the term "Cranio Sacral Therapy".

The financial management of a clinic is important too. Who is operating the clinic? Do the operators also own the clinic? What experience do they have in business? Most natural therapy clinics will have a premises lease of some sort. When you consider going into a clinic it may be worth looking at the remaining term on the lease. If you're coming in at the end of a 5 year lease does it look as though they will be renewing it or will the clinic be moving in 12 months time?

If you're trying to establish a long term practice staying in the same place will be important to you. Clinics that are new or that have recently undergone a change of ownership are particularly vulnerable. Most small business's fail in the first 3 years, and they are generally difficult years with all those involved on a steep learning curve with a fair amount of tension, highs and lows and long hours.

Consider the people involved and if you and your practice are up to sharing this situation for a while. New projects can ride on a wave of new energy that is satisfying to be around, you need to discern whether those behind it will take it all in their stride of if you will be drawn into making their dream come true rather than building your practice.

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***QUESTION***
Dear John,
Do you penalise patients if they are late or miss appointments and if so in what way?
My other therapist colleges are encouraging me to but I'm not sure.
Would love to hear your take.
Thanks for the newsletters. They are great.
P.B.
Dublin.

>>>MY COMMENTS:

As I see it lateness and missing appointments go in the same box as not having the right money, showing up a day or hour early, looking for discounts, telephoning at inappropriate times, having very smelly feet, complaining about not getting better when they in fact are, bringing you small gifts, being anxious, laughing/crying for no apparent reason, having fluctuations in temperature, having issues with the opposite sex, shallow breathing, pain anywhere in their body, nausea etc.

That box is labelled 'Symptoms' with a sub- heading of, 'This person's story - treat contents with diligence, integrity and respect.' We are in the business of helping the person understand and so bring into harmony their symptoms. Penalising them is only going to serve to further entrench their symptoms.

That's lovely John, but it doesn't sound too good for business.

If you take the view that all behaviours are part of the person's story then you can include and deal with them in treatment. Sometimes that means talking about it, other times it means having the pleasure of watching the behaviours melt away as the treatment program continues.

I've done both lots of times. The conversations can be difficult for both of you but are worth it.

Lastly, it's helpful to keep in mind how scary it can be for some people to come for treatment. It is usually the fear that causes the person to act out their sabotaging strategies that can cause a less perceptive therapist to fall for the traps.

***QUESTION***

Dear J,
Very practical question. I have had a couple of patients look put out by the fact that I don’t take credit cards. I have looked into it a little, but the cost seems prohibitive to me.
I was surprised. So many people have credit card facilities.
Do you? What do you think about it?
Mandy,
Perth.

>>>MY COMMENTS:

No you’ve got it right Mandy, providing credit card facilities is expensive. No, I don’t have them. For the following reasons.

You have to get a separate telephone line for the electronic credit card machine and then you pay for a phone call every time you swipe the patient’s credit card.

On top of that, the volume you put through the credit card machine will determine the percentage the credit card company will take out of each sale.

For example large supermarket chains are at around 1% where as folk like you and I are usually on 5%. That means if you charge $100 you only get $95, minus the phone cost, the set up costs and the annual fees. The credit card companies insist that you don’t pass any on these extra fees onto the customer. So it’s not like you can charge $110 if the person pays with credit card.

You can avoid the phone cost if you opt not to have the phone connected machine and go for the old paper and swipe machine. The disadvantage with the ‘chonk, chonk,’ machine as one bank official gleefully described it, is there can be up to a 3 week delay between the time you swipe their card and the money showing up in your account.

Here’s another thing, while it’s very important to listen to what your patients say, ultimately you have to go with your own feeling about how things are. Over the years I have had patients complain about, pretty much every aspect of my practice, from the colour of the walls, to the temperature in the room, to the type of lighting, to the magazines in my waiting room.

Some of the ‘suggestions’ I have taken on board, others I haven’t. Credit card facilities were a suggestion I looked into but decided against. I usually tell new patients in advance that I don’t have credit card or Eftpos facilities. I accept cash, cheques or they can transfer the money to my account over the internet, which is my favourite.

And finally, I don’t agree with credit cards because they promote irresponsibility. They operate a subtle double standard where they offer
you rewards if you pay your bill on time and are disciplined with your credit card. Yet they make 35% of their income from late fees. That’s 35% of billions of dollars. They actively promote the ‘buy now, pay later’, mentality, then take the moral and financial high ground when us humans get into trouble.

The whole thing goes against what we are in the business of doing, which is helping people to become more responsible.

December 05
This used to happen to me a lot at the sort of functions we all attend at this time of year. The get-together, the dinner party, the bar-be-que, the partner’s office party.

I’d meet new people, we’d get chatting and the conversation would inevitably swing around to occupations. When it was my turn I’d stumble through my latest explanation of CST and leave everyone suitably confused.

Just when I’d think I was off the hook and the conversation was going to move on, that person would pipe up.

You know that person, the one who’s in every fifth or sixth group of new people you meet. The one who feels obliged to ask the questions they think other people are to stupid to think of, let alone ask. The one who takes every opportunity to flex their intellectual muscles at anyone within earshot.
They’re not really interested!
They’ve no intention of coming to see you!
They’ve no intention of telling anyone else about what you do!

They’d preface their question by doing something with their head, either a conceited wiggle or a questioning head tilt. I don’t know why they all do thus but they do.

‘So, does the person coming for treatment have to believe in what you do?’

They’d follow this with more head stuff, usually the slow knowing head nod.

I’d trot out my standard answer. ‘No the person doesn’t have to believe in it, at all. It helps but it’s not required.’ I liked to deliver this answer almost like a challenge. I could never match the head wiggling/nodding/tilting thing though.

This question used to annoy me, oh you noticed, and I would get a bit defensive, oh you noticed that too.

In hindsight I understand why I ended up with so many difficult patients back then, what with the challenge and all.

Fast forward to a couple of years ago.

Stay with me here.

I’m talking with one of the therapists I’ve trained. They’re telling me about a prospective patient.

‘This person asked me if I can help them with their chronic fatigue.’

‘Good.’ They don’t look like it’s good. ‘No?’

‘No.’

‘What’s the problem?’

‘Well I’ve never treated someone with chronic fatigue before.’

‘So?’

‘So they want to know if I can help them, they say they’re a bit sceptical and they want me to reassure them and . . well . . I don’t know.’

‘Don’t worry about it. I’ve treated loads of people for chronic fatigue. You’ll be fine.’

‘It’s not me I’m worried about, it’s them. It’s alright for you, I’m sure you’d get results, I just don’t know if I can.’

‘Oh I see.’

I pondered momentarily and then I had a sort of epiphany. All the years of answering the, ‘Does the patient have to believe?’ question coalesced into a profound insight.

‘Believe, they may not, believe YOU must.’

‘Pardon?’

‘I said it’s more important that you believe you can help them than if they believe you can.’

They looked at me dumbstruck as the import of what I had just said sunk in.

‘Did you just put on a Yoda voice?’

‘No, I just had something in my throat.’

‘You don’t get out much do you?’

‘Look it doesn’t matter how I said it. It’s what I said that counts. If you don’t believe they can get better with you then they won’t.’

‘That’s what I was afraid of.’

‘Look salesmen have known about his stuff for years.’

‘Do they use the Yoda voice too?’

‘I’m talking about dominant realities here.’

‘Dominant realities?’

‘Yeah, it’s a well known fact among salesmen and psychologists that if you get a group of people together, whomever believes in their reality the most will dominate the others.’

‘Whomever?’

‘That’s how sales are made. The salesman believes his vacuum cleaner is a fantastic product and these people’s lives will be vastly improved if they buy it. He believes it so strongly that the people start to believe it too and buy the vacuum cleaner.’

‘Oh I see, you’re talking about kidding yourself. If I kid myself into thinking that I can help this person I stand a much better chance of kidding them.‘

‘No, I’m not saying you kid yourself. I’m saying you need to believe it.’

‘If you tell me to, ‘Feel the force.’ I’m leaving.’

‘Actually, I don’t really think of it as believing, I just sort of expect it. When someone comes to see me I just expect that they will get better. I’m not kidding myself, I just think, "They’ve got a body. They’re breathing. Their body is designed to fix itself. All I have to do is feel what it's trying to do and then help it where it's getting stuck. There’s no good reason why they shouldn’t get better."’

‘Fine, but how do I believe, if I don’t really believe?’

‘Good question. What you need to do is, you need to let the spirit of Elvis enter you heart. . . . no come back . . I’m kidding . . Look, I hear what you’re saying. . ‘

‘Really?’

‘See, it’s easy for me.’

‘Well finally you admit it.’

‘No, that’s not what I mean. I have lots of frames of reference for people getting better. That’s one of the benefits of experience. All those frames of reference support my expectation that the person will get better.
You, on the other hand don’t have enough frames of reference yet. Which leaves you with just one thing determining the outcome.’

‘What’s that?’

‘The way you think about it.’

‘The way I think about it.’

‘The way you think about it.’

‘Stop saying that and tell me what you mean.’

‘You don’t KNOW what the result is going to be when you treat this person. It’s in the future. The only thing you can do with the future is think about it, which leaves you two options. You can think the person is NOT going to get better or you can think they ARE going to get
better.’

‘and that’s going to make a difference?’

‘Yes and no.’

‘Always the yes and no answers with you.’

‘What would you say if I told you that we are making up our reality as we go and the main thing that influences it is the way we think. Things are the way they are because we expect them to be that way.’

‘I’d say you’d lost the plot and were a couple of steps away from the funny farm.’

‘In that case I won’t tell you that and by the way calling a psychiatric institution the funny farm is not very politically correct, you know.. ‘

‘Me not politically correct? You’re one of the least politically correct people I know. You take pleasure in being politically incorrect. I’ve seen you at parties, remember?’

‘Fair point. Look, what have you got to loose by being open to the possibility that the person is going to get better?’

‘I’ve just never been into that whole positive thinking thing.’

‘It’s not really positive thinking, it’s more like . . selfish thinking. You’re thinking about the future in the way you’d like it to be.’

‘Does it really make a difference?’

‘It makes a huge difference if you do it in the right way.’

‘Which is?’

‘The first thing to do is get a very clear picture of the future you want. In your case it would be you supporting this person to move through chronic fatigue successfully. The clearer the image the better. As you think about this outcome you’ll notice you get an uncomfortable feeling in your gut. That uncomfortable feeling is what has kept your current expectations in place.’

I could see I was making progress.

‘You’ve lost me.’

‘Okay, ever thought about winning the lottery?’

‘No . . Yes.’

‘Okay, did you think about all the things you could do with the money?’

‘Yes.’

‘That’s usually where most people stop. A sort of fantasy, up there with being able to fly or having X-ray vision. If they thought they were REALLY going to win the lottery it would be disturbing for them in ways that they never suspected.
It would literally rock their world.
The statistics on lottery winners show that a high percentage of them end up back where they were financially within a couple of years of winning. Which I see as a desperate struggle to get back to their old version of reality as fast as possible.’

‘So it’s more than just positive thinking?’

‘If all we had to do was think positively, we’d have things appearing in our lives all over the place at a ferocious rate. It would be like living in a nightmare where everything you thought about would appear in front of you as soon as you thought about it. Things you wanted and things you didn’t want but couldn’t stop thinking about.’

‘. . . or the one where you go to a party and everyone keeps running away from you screaming and then you catch your reflection in the mirror and you’ve got the head of a shark. . ‘

‘Focus.’

‘Right.’

‘There are reason’s why we expect things to be the way they are. With the lottery winner they could have a deep belief that money is bad and if they have lots of it, they’ll be bad too. Without them knowing about that belief they will try and find unconscious ways to get rid of the prize
money as fast as possible.’

‘So that’s what you meant about struggling to get back to their old version of reality as fast as possible.’

‘Precisely.’

We were making great progress.

‘Yeah well that’s the thing about unconscious stuff, it’s unconscious. How do you know about stuff . . you don’t know about, huh?’

Okay, we were making progress.

‘It’s true, you will do your head in thinking about it like that. There IS a way of starting to become aware of it though. It begins with getting a clear picture of what you want and then asking yourself how you would feel about it if it REALLY happened.
If you can get into how you would feel in that situation and as you’re doing that you also scan your body, you will find it will be making you
disturbed somewhere.
When you look into that disturbance you will get more of an idea of what has been stopping you having the result you want.’

‘How so?’

‘Like the lottery winner believing that money was bad. As soon as they had lots of money that belief was challenged. The money made them very uncomfortable.
If, prior to winning, they had got a clear picture of how their lives would be with the extra money and how they would feel in that life, they would have discovered that it made them uncomfortable.
If they had looked into what that uncomfortable feeling was about they would have discovered the belief about money being bad. They could then have started to work through the belief and when they finally did win, it would have made the process of coming into money much more enjoyable.’

‘So you reckon I have some unconscious belief about treating this person with the chronic fatigue?’

‘I dunno. I think you’ll find out if you get clear about the outcome you want and then listen carefully to how it makes you feel.’

‘Okay I’ll give it a try.’

‘Try you must not, do you must.’

‘Cute.’

Having this chat made me verbalise what had been brewing in me for a couple of years. The question of whether the patient believes in what we are doing is secondary to what we, as therapists, believe is possible.

If there is a difference between the results we would like to be getting and the results we are getting then the onus is on us to sift through ourselves and discover why we are getting the results we are.

It reminds me of a cartoon I saw recently. Santa Claus is lying on the psychoanalyst’s couch looking perturbed. The analyst is saying to him. ‘It doesn’t matter what other people think – the important thing is that you believe in yourself.’

***QUESTION***

Hi John,
Wonder what you have to say about something that always leaves me wondering what the best advice is. When a patient is having a treatment from a doctor and they want to tell the doctor they are also having craniosacral therapy, I never know what to tell them.

It never seems to go well either way. Do you have a little trick to get around this one? A pithy phrase perhaps?
Keep up the great work.
Nora P
Somerset.

>>>MY COMMENTS:

Too much of a good thing can be wonderful.
That's a pithy quote from Mae West.

Doesn't help with your question but I like it.

Write your own newsletter then!

Sorry Nora. No simple answer to this one. It's one of those depending things. It depends on the patient. It depends on what's wrong with them. It depends on the Doctor.

As a very general rule of thumb, if telling the Doctor is going to make it harder for the patient, I will discourage it.

By harder, I mean the Doctor will feel threatened by the patient seeking outside assistance and get defensive and then try and regain control by scaring the patient with veiled and often outright, threats of withdrawing support.

Not helpful and way too medieval.
Sure, there is a time for education and debate about the philosophical merits of our different approaches.

Right in the middle of patient's health situation is not the time. Too much pressure all around.

I have found that what works with tissues, works for me in life.

No, not the, 'Sniff sniff, can you pass me another please. . .' kind of tissues. The other kind.

When encountering resistance I hold. I don't push. I wait for the easing. I try and follow each minute advance in the direction of harmony with diligence. I know the system wants to return to equilibrium. I follow through.

It is an approach that is applicable to almost everything in life, including Doctors.

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***QUESTION***
Hi John,
I'm seriously enjoying the newsletters and the wickedness.

I have a prospective client with severe epilepsy - Grand Mal Seizures. He's had it since his mid teens and he is now in his 50-60s. Epilepsy runs in the family, but he has also suffered several incidents of trauma to the head, so

I don't know if he has inherited the epilepsy or if it has been caused by trauma, or a combination. And possibly there are lots of other restrictions making the epilepsy worse.

I haven't treated anyone for epilepsy before. Is it advisable to treat them. I might be able to do so much for him, but since I don't know anything about what might happen seizure-wise if I do treat him, I'm a bit scared he might have a huge seizure and die.

What is your experience or what do you know of treating epilepsy with CranioSacral?
What could be expected in terms of getting better or getting worse?
I don't want to take him on until I know what the risks are.

Lastly I would like to ask your advise on the frequency of treatments. I know you treat once a week for as long as it takes. In my training in Sweden the norm was once a week for the first couple of times and then every 3 weeks, to allow the continuing process in the "system" after a session.

I have gravitated to treating every two weeks in the last year or so, as I find every 3 weeks too seldom. Can you give me any rational explanation as to why every week would be better than every 2 or every 3 weeks?

Thanks for any advise you can give.
Eva (Eva-Lena) Kuhl Bornefelt
Central Coast
New South Wales

>>>MY COMMENTS:

You need to see people every week, Eva, because if you don't they'll start wearing their underwear on the OUTSIDE and BLAME YOU!!!!

No hang on, that's the irrational answer.

During treatment, restriction patterns in the patient's system begin to release and in a way their body returns to its pre-traumatised state. With the people who come to see us, the restriction patterns are usually ingrained in their system. If the patterns weren't ingrained then the people wouldn't need to see us, would they.

You could think of what happens during treatment as their system 'remembering' and so dropping the 'habit' of being restricted. But habits being habitual and all, in the week following treatment their body will start to go back into the habit of restriction.

2 steps forward, 1 step back, kind of thing. I have found that if I leave it for longer than a week, particularly at the beginning of a treatment program, then the habitual patterns of restriction will come back significantly.

2 steps forward, 1.8 steps back, kind of thing. So at longer than weekly intervals the whole thing is less efficient and just takes longer and costs the person more in the long run.

Towards the end of a treatment program I will go to 2 weekly intervals, at least once. Meaning if the person has a good, symptom free 2 weeks then we are often finished.

Now your epilepsy question.
I have found that the dynamic of epilepsy has two components, one is structural and the other is energetic. The structural component is usually a restriction that is impinging on some part of the brain frequently around the frontal bone.

So a thorough check of all the obvious places in that area is a good place to start. Coronal suture, both pterions, falx cerebri as it meets the frontal bone and then on down to the crista gali and how the ethmoid is sitting generally.

I generally find that if there is a sutural compression it is usually caused by a restriction in the underlying membranes. So check the falx and the membrane lining the frontal and parietal bones.

I have also found it useful to check the central sulcus. Sometimes there can be restrictions there that, once released, alleviate the epileptic symptoms. Check that the frontal and parietal lobes are separated.

The energetic component of epilepsy is like a build up of, what feels like static electricity, in the head that releases itself in the form of a
fit, seizure or convulsion. Which is kind of what happens on a physiological level when all the neurons in the brain fire at the same time during a seizure.

While we're on the subject of fits and seizures, I'll quickly run through the different types.

Tonic/clonic or Grand Mal seizure:
This is the classic epileptic fit. The person becomes totally unconscious with their body spasming or jerking (called the clonic phase). Grand Mals are potentially dangerous for the person because of the risk of them swallowing their tongue during a convulsion. This won't happen if they are put in the recovery position. With grand mals the person generally will experience warning signs that they are about to have a seizure.

Absence or petit mal seizures:
This is where the person looses concentration or focus momentarily. They appear blank, staring off into space, sort of 'vague-ing out'. Petit mals are subtle, only last a few second and so are easily missed.

Myoclonic seizures
These are abrupt jerking movements of one or more limbs. They usually happen in the morning, not long after waking. Patients have described
them to me as feeling like shivers that travel up their spine.

Eva, you sound a little concerned about whether your prospective patient will have a seizure on the table. If you are going to treat someone with epilepsy you need to accept the fact that this may happen.

Witnessing epileptic seizures can be disturbing if you're not familiar with them. The person with epilepsy is familiar and so will their partner or family. So have someone come with them and be in the room. Having someone present who IS familiar with the process will make it easier for you.

The length of time required for treatment depends on the source of the epilepsy. If it's stemming from birth or an accident it generally won't take too long to see results. If it is caused by the after effects of meningitis it can take longer because you are working with scar tissue which you are encouraging to heal in a new way.

Standard medical practice with epilepsy is to try and manage it with various drugs. When you palpate a body with these types of drugs, it will often feel like you are trying to palpate through a layer of cotton wool. This makes it hard to feel what is going on in the first place and then whether your treatment is having any real effect.

In the course of the treatment program you will reach a point where the insulating effect of the drugs is making it hard to know how much more work you need to do. It's a bit like an iceberg with nine tenths of it covered by water. You need to drain off the water a bit to see what else there is to do.

BUT, you need to be careful how you handle this. Discourage the patient from doing any kind of self medicating. Strongly encourage them to go and see the prescribing doctor and ask them to reduce the medication. That way the Doctor is included in the process.

The Doctor will often say there is no need, particularly in light of the fact that the person has gone from having 1 grand mal a day, to 1 a week. The drugs are obviously working. If the patient perseveres, most doctors will relent particularly if the patient says they would prefer not to be on a drug for the rest of their lives. Doctors being very aware of the side effects of drugs and all.

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***QUESTION***

Dear John,
I am enjoying your profoundly irreverent letters very much. I think you are a naughty man.
I have a patient for lower back pain. She also has many emotional conflicts and issues within her. She shows no interest in addressing these issues. The opposite in fact.
Here is my question.
Is it possible to invoke someone to address their issues if they don't want to?
Kind regards.
N. V.
Singapore.
P.S. Be nice.

>>>MY COMMENTS:

Cute . .
When someone first comes to me for treatment, after the initial, 'Hello', and 'Take a seat.' etc. The first question I ask is,
'What can I do for you?'
and then I shut up,
and wait.
Whatever their answer is, is what they are asking me to help them with.

'No kidding Sherlock.'

That may sound obvious but it's surprising how many therapists don't get it. From the sounds of it, you might be one of them.
Whatever they answer to question, 'What can I do for you?'
'I want to sleep better.'
'I want the headaches to stop.'
'I want to stop attracting the wrong man/woman.'
'I want to stop feeling so anxious.'
'I want to get rid of my fibromyalgia'

It goes to form what I think of as a contract between us. It forms the boundaries within which I work and a declaration on their part of what they want assistance with.

Let's say someone asks me to help them with a very physical problem and while treating them, I palpate lots of emotional disharmonies. If the emotional disharmonies are NOT causing the particular physical symptoms I have been asked to help with, then it would be very bad juju for me to try and start working on the emotional issues.

First and foremost it's disrespectful.
It's like passing someone on the street who is struggling to carry a new TV into their house. They ask me to help them carry the TV into the house with them. I do this but once inside the house I get a dose of 'Queer eye for the straight guy,' and take it upon myself to redecorate the hall, stairs and landing because, 'Let's face it, this person has shocking taste!'

Secondly, it's more efficient to stick to the contract because it can always be renegotiated in the future.

Here's a question. How come you are able to palpate the emotional issues in the first place?

Oh, okay I'll answer it. You can only ever see what you are shown.

If you stay within the bounds of the contract, it leaves space for the person to say to you down the track, 'I think I would like you to help me deal with my emotional issues.'

It may sound unlikely but it happens. It's another form of trusting that the person will allow you deeper when they feel safe. You're job is not to invoke them to address their issues but to provide the safest space you can, allowing them to feel empowered enough to address their issues, if and when they are ready to.

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***QUESTION***
Hello John,
I am treating a 3 year old boy - Toby, for behavioural problems. He is responding well. I see noticeable changes in him and I can feel him releasing energy cysts in each treatment.

The problem is his mother says he has not changed at all. She just won't admit he has made any progress.
I am starting to think that she has something wrong with her. I Think SHE needs treatment.
I don't think Toby is going to advance until she sheds some of her baggage.

Is that right or am I just making excuses for my own inadequacies?

Any thoughts would be helpful.

Kind regards.
P.M. Perth.

>>>MY COMMENTS:

I have found that if parents are reluctant to notice changes in their child it's because they are afraid of getting their hopes up.
They want their child to improve so much that they don't trust themselves anymore. They are afraid they are making it up and only seeing what they want to see.

USE A PATIENT DIARY
To help parents focus on what IS changing, I use a patient diary. Which, by the way, works just as well on adult patients who have difficulty recognising their improvements.

Here's how it works. At the first session you get the parents to list the child's symptoms and get them to give each symptom a rating between 0 and 10. 0 is perfect and 10 is the worst it's ever been.

Then ask the parents to record a new figure for each symptom at the end of each day. When they come back the following week they will have a record of the child's symptoms and how they changed for that week.

That helps to keep them focused on what is changing rather than on what is not changing.

CULTIVAE AND ENVIRONMENT OF CHANGE
With children who have been labelled 'difficult', a lot of your work is in helping the parents to see that the child is now in a position where they can CHANGE.

You need to help the parents and the child understand that the child's symptoms are caused by physical restrictions. For example a bone in the
child's head is compressing on their brain and that when it has released, there is a good chance that they may not have the symptoms anymore.

You've got to convey to the parents and the family that they need to drop old ways of relating to the child.

'Oh Toby doesn't like to eat with the rest of the family. That sets him RIGHT OFF. It's just the way he is.'

All those kind of opinions will need to be re-evaluated. You need to get the family as a collaborator in the treatment.

KEEP OFF TARGET.
It's also is important to point out to parents that the initial improvements in the child's condition may not be in the areas that they expect them to be.

I explain it to them in terms of a target. The bulls eye is the main symptom the parents want to change.

For example, when a child comes for treatment for Autism and are displaying classic Autistic tendencies, like unemotional, obsessive behaviour, it's really important to point out to the parents that the first indication of change may not be that the child will suddenly throw their arms around their parents.

More likely it will come in a peripheral way. The child may start singing or start building things or take an interest in something that isn't inanimate, like a pet.

INFORMING THE PARENTS
It also goes a long way towards greasing the wheels of change if you explain the process of cranio sacral therapy to parents as much as you
can.

Get across to them the length of time cranio sacral therapy takes to have effect. Sometimes with children, you can treat them two or even three times before the parents will start to notice an effect.

That may not seem like a long time on paper but it is two or three weeks that they have got to keep coming back for treatment, in the face of no apparent improvements.

Get the family involved at the beginning of the treatment program. Then if there is no apparent improvement for the first couple of weeks they will be more inclined to persevere.

Seem like a lot of work?

The difference between a child and an adult coming for treatment is an adult comes of their own accord and they have control over whether they come back or not.

With a child, the parents have that control and if the parents get the feeling that the treatment is not really helping they won't come back.

Having said all that. The ideal is treating the whole family. This is particularly so with learning difficulties or behavioural disorders.

As a child begins to change it will help the process enormously if everybody in the family can be NEW about that and allow them to change. A lot of families won't be new and they will still relate to the child as they where in the past.

In a way they will keep the child stuck in the pattern long after the cause of the pattern is gone.

For example, if a child is having big tantrums as a result of a compressed parietal and you help the parietal to release. The cause of the tantrums will be gone. But the child may still have tantrums because that's what is expected of them. There is a space within the family that expects them to have tantrums.

Treating the whole family helps create a shared state of change in the family dynamic and in that is a window of opportunity for the changes that you have helped to facilitate in the child to become permanent

If you are not treating the whole family you will be treating the child in isolation. The other members of the family may not want things to change. Particularly older brothers and sisters.

If you can't treat the whole family you will be indirectly treating the family through the child. And that ain't easy. It's like trying to wallpaper the house through the letter box.

Don't be afraid to ask Toby's mother to come for treatment. Chose your moment well. Put it tactfully. Avoid implying that she is holding Toby's progress up.

She may really want to come for treatment but doesn't know how to make it happen.

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***QUESTION***

Dear John,
I have been practicing for two years and am enjoying the work immensely. By an large my practice is going well.
Every now and then a particular kind of patient will come back for their second visit and accuse me of doing something to them.
Sometimes it is subtle, sometimes not so subtle.
They will say things like, 'My neck was fine before I came to see you for back pain. Now it is really painful.'
I find it very hard to know what to say to them.
Any suggestions would be greatly appreciated.
NC
Eire(Ireland) but you knew that anyway.

>>>MY COMMENTS:

Yeah, I may live in Oz but I still know where Ireland is.

Your question highlights one of the most difficult aspects of natural medicine. That people have been conditioned to be irresponsible about their health. 'Fix me Doc.'

When someone asks you, 'What have you done to me?' they are relating to you like a doctor. I don't know whether you have thought about this or not but, like it or not, you are a pioneer. You are at the cutting edge of a fringe. So one of your tasks must be education.

If you are able to tell you are dealing with 'that kind of patient', then you would be wise to take some pre-emptive measures to avoid them asking you the question in ADVANCE.
The best way to solve a problem being to never have it in the first place. Don't know where I heard that but I love using it. When you identify the person as being heavily attached to the 'fix me' conditioning, at the first session, you need to start explaining to them right away how it all works. Focusing particularly on how you are supporting their body to fix itself.

That you are not trying to direct how that process will go, because you know from experience that peoples bodies know best how to fix themselves. How sometimes things can get worse before they get better.
Help them to discover how remarkable their body is.

Worst comes to worst and they come back the following week and ask you what you did to them? You can reframe it for them by reminding them what you actually did. You laid you hands gently on different parts of their body for varying amounts of time.

You didn't click them or manipulate them or adjust them. In light of all that isn't it an indication of how powerful this way of working is, that it can reach such depths in the persons body with such a light touch. And how their body can respond in such powerful ways to this kind of support.

Lastly, if you are getting that kind of feedback a lot, you might need to look at yourself. Your intention may be too strong. You may be trying too hard. You may be too attached to what you think is the right outcome.
Generally speaking any repeating pattern in your Patient's is worth looking at in this way.
'Is this me?'
'Is this my issues/patterns playing out?'

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***COMMENT FROM MIJ FERRETT***
Hi John,

I love your answers and have enjoyed reading them and, for the most part, agree with them. There is one minor point though ... when you say 'Lastly, if you are getting that kind of feedback ['My neck was fine before I came to see you for back pain. Now it is really painful.'] a lot, you might need to look at yourself. Your intention may be too strong. You may be trying too hard. You may be too attached to what you think is the right outcome.'

I think what you said is relevant and true but there is more to say. If you get this kind of comment often then it is almost certain that there is something that needs looking at but whether or not you get this kind of feedback it is inevitable that from time to time all of us will get drawn into being over-focused and doing too much and that as a result we will tend to initiate some kind of protective reaction from the client in response to our inappropriate interaction.

There is a natural tendency for therapists to deny this so the process of denial needs attention paying to it as well. In situations like this it's useful to spend a little time reflecting on what has happened and notice any pull towards being defensive. One of the most beneficial ways of progressing therapeutically with someone is admitting when we make a mistake and apologising for it.

Interestingly this principle has paid dividends in, of all places, american hospitals*. Any authentic acknowledgement and apology will tend to help the therapeutic relationship.

Of course there is the classic healing crisis response as well and the classic response of the client not taking responsibility for their own process but that this can be used as a cover up for therapeutic error.

More power to your keyboard.
Mij

*Due to the litigious nature of the culture and the large sums of money awarded by damages suits many hospitals and doctors have tended to cover up and deny mistakes. However a pilot scheme in Lexington VA Kentucky introduced after some multimillion dollar
lawsuits, encourages doctors to acknowledge their mistakes and apologise for them. When patients have doctors apologise to them and offer fair compensation feelings are much improved and court awards are much lower; there has also been a reduction in unjustified malpractice suits. Subsequently many other US hospitals have introduced the policy with similar results and medical students are now being encouraged by Harvard Medical School to do the same when qualified.

>>>MY COMMENTS:

I agree with everything up to the part about apologising to the patient when we make a mistake.
For some reason this set my alarm bells off.

'Apologise to a patient? Really?'

It troubled me.

I wrestled with it.

I pondered, even.

And then it hit me . . . a few times.
Not all apologies are therapeutically beneficial for both parties.
When I get on an aeroplane I'm not really thinking about the pilot. I'm thinking of where I want to go.
My destination.

If I did think about the pilot I would have to acknowledge that he will probably make AT LEAST one mistake on the flight. I know it but I don't really want to think about it.

If we are flying along at 60,000 feet and the plane lurches suddenly but then rights itself, I want to think that we probably hit an unexpected pocket of turbulence. The 'fasten you seatbelts' sign didn't come on so everything is probably ok.

The last thing I want to hear is the pilot coming over the intercom saying, 'Hi Everyone, this is the captain speaking. Look, the head cabin attendant Nancy, was just giving me my dinner and when I reached for the tray I accidentally hit the throttle with my knee. That's why the plane lurched a minute ago. So I just wanted to let you know and I wanted to
apologise to you all.'

The captain would probably turn off the intercom, look at his co-pilot and say, 'Man, that felt good. Therapeutic almost.'

Back in my seat, I would probably have a glazed sort of look in my eye. My knuckles would definitely be whiter and while rationally I might appreciate the pilot's honesty, most of me would be wanting to get off at the next stop. Which stop? Who cares?

JUST GET ME OFF THIS PLANE!!!

I would still want to reach my destination, just not with that pilot. He is probably perfectly competent to get me there but he just made the process of getting there too scary for me.

Also . .

The sort of 'mistakes' we make are a lot more complicated and difficult to explain than Doctor's mistakes.

'I'm sorry I left my wristwatch inside you, when I sewed you up Mr Smith.' would be understand by most patients. They wouldn't be too pleased about it, maybe they wouldn't sue the doctor for so much but they would understand the error.

Whereas if we say something like. . .'I'm sorry you had that reaction last week. It was my fault because I wanted you to get better too much.'
Most patients could understandably reply, 'That's what I'm paying you for. You're supposed to want me to get better, ya big freak!'

Equally . .

There is the possibility that we could end up apologising for responses that are not actually mistakes but are part of the therapeutic process.

Saying. . 'I want to apologise for your neck hurting this week. It was because my intention was too much last week.' Is apologising for what is actually part of the process of finding the best level to work at for that person's system. There is no way of knowing it in advance. You can only find the right level to work at by going as lightly as possible, while remaining physically in the room, the first time you treat the person and then going deeper with each subsequent treatment.

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***QUESTION***

Ok Maestro. Read your blurb on your website.
You don't seem like your standard "Be still and know that I KNOW,' sort of cranio person. Is there a factory somewhere I don't know about that churns these folk out?
Anyways, I've got a question for ye.
I've been seeing people for 4 years now, using a combination of acupuncture and cranio.
As time goes on I'm seeing the cause of many physical problems are emotional.
They tell you their life stories when they come in and you can see how they keep repeating the same self destructive patterns over and OVER again!
You point it out to them and they just keep doing it?
What gives?
Why don't they get it?
Believe me I've tried everything!
So let's hear your answer on that one Kemosabe.
K. Orlando. Fl.

>>>MY COMMENTS:

Why DON'T people get it?
Is it because they are dumb?
Well let's explore that. If the reason people don't get stuff is because they are dumb then that would include you and me.

Wouldn't it?

Or do you think we are special?

That you and I get stuff quicker than other people?
Maybe it is just you and the rest of us are dumb?
Okay, so maybe there is something else going on.
It's called subjectivity.

Let me explain.
   This situation happens to about once every couple of weeks in clinic. I will be talking with a patient about their condition. I will be in the middle of saying something that I hadn't verbalised before and what I am saying is COOL!
   Part of me will be listening and thinking 'This is really good, profound, insightful stuff I'm saying.'
   Within a few minutes the patient will be looking at me in an awed sort of way. I can see them rummaging around internally for the makings of
a nice pedestal to put me on. That's when my ALARM BELLS GO OFF.
   For me and for them.

While I acknowledge that every now and again I do say something original, I know it's not good for me to get too self admiring about it.
   I also, know that the patient is about to dis-empower themselves if I don't do something fast.
   At this stage they will usually be in the middle of telling me how they feel like a failure. The inference being that there are people in the world who are normal, they are in the majority and the patient is an anomaly.
   I stop them and explain the objective/subjective dynamic.
I make a point of explaining that I can have insight about their lives because I AM NOT IN THEIR BODY. I'M NOT LIVING IN THEIR LIFE.

I further the point by telling them that if we swapped seats and I started telling them about my life, they could have some very useful insights about my life. Particularly the things I am not seeing.

Bottom line Tonto, is you have been sitting in the therapist's chair too long. You have forgotten what it is like to be a patient. You have started to believe your own press and feel like you should be up there on that pedestal your patients have been eager to put you on.

WARNING! WARNING! YOU ARE IN DANGER OF FALLING INTO THE THERAPIST TRAP.

I know because I fell in it a few times myself in different ways. It is one of those things you need to be very proactive in not allowing to happen. You have to nip it in the bud with yourself first and then with your patients.
   No pedestal building allowed.
    No special powers implied.
     No act together imagined.

So be of good cheer, K of Orlando, it's not hopeless but you will need to do something NOW. I suggest going to a therapist, a cranio sacral
therapist even. Put yourself in the other chair for a bit.
   Take a class. Learn something new.
Do whatever you can to break up the cocoon of smug superiority you have woven around yourself.
   Try and stand beside the patient as you look at their problem, rather on opposite sides of it.
   Be with them, two people doing the best they can, sometimes with ignorance and fear sometimes with grace and beauty.

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