When Trauma strikes. Addressing physiological and biological nervous system responses in the healing of trauma through Craniosacral Therapy
Trauma is often only understood as a psychological reaction that we need to deal with in the mind. Trauma is also very much a physiological reaction that circulates in the body long after the event, as our reactions and responses to trauma are primarily bodily ones. During a traumatic or threatening situation we tend to go into a highly charged freeze or fight/flight response. This undischarged residual energy can, unconscious to us, remain in our body for many years as an incomplete physiological response manifesting itself as physical symptoms like e.g.: sleep disturbances, anxiety, hyper vigilance, irritability, tinnitus, digestive problems, jaw problems, back problems, migraines, depression, inflammation and be a host to all sorts of various complex pains and chronic illnesses like fibromyalgia and chronic fatigue. The key to resolving and healing Trauma lies in our physiology, in our bodily responses that needs to be resolved and discharged. (M. Kern, Wisdom in the body, 2005). Our physiology is regulated by our nervous system. Our nervous system sends messages to our body and has a big role to play in creating and maintaining our symptoms. No other modality addresses the Nervous system like Craniosacral Therapy as it lowers the sympathetic nervous system responsible for our fight/fight and enhances our parasympathetic nervous system responsible for our freeze response but also for our relaxation response. Craniosacral therapy allows the body to come back into a physiological balance, so the body can release any underlying stress, tension and emotional patterns that lie deeply stored within the body. This is so critical and of paramount importance in overcoming not only any kind of trauma but also for chronic pain and complex and chronic illness, as I witness in my clinics on a daily basis.
Craniosacral addresses a wide variety of symptoms and conditions from physical pains, structural misalignments, muscular tensions to emotional blockages. During my training, trauma and stress release was definitely my favourite subject: working with the nervous system survival responses and the residual effects of trauma lodged in the body.………. ironically, never in a million years did I think trauma would strike me. I came to experience what I had learned during my education when a good few years ago, my world became a very dark and lonely place as I suffered a severe physical & emotional trauma. As a result, I experienced a multitude of physical symptoms: non-stop raging headaches, migraines, tinnitus, neck pain, poor blood circulation, anxiety, nerve tingling and extreme sensitivity to light, to name a few. For months, I was unable to sleep or eat, the world was a scary place. The rug had been pulled out from underneath me, I was lost.
So my Dr's, specialists and hospital rounds began, from A to Z from the GP to the Neurologist to the Psychiatrist, each with their own well-intended prescription pads: pain killers beta blockers, digestive relief, anti-anxiety, anti-depressants, muscle relaxants, laxatives, anti-inflammatory, stomach acid reduction pills, sleeping tablets, valium and narcotics in all sorts of varieties form tramadol to oxycodone to oxycontin. I ended up being the Pharmacy.
I wanted to clear my anxious state, calm my nervous system, improve my sleeping but most of all find relief for all my physical symptom by resolving them at root cause. I did not want a pill for every ill as I personally could not see, how that would resolve anything at root cause or bring any long-term solution, as the primary innate biological forces that controlled my symptoms seemed to be overlooked, disregarded and not addressed in this medical model. Thank goodness I knew Cranio and turned to my Swiss colleague: a highly skilled buddy and certified Cranio angel extraordinaire.
During my first few cranial sessions we focused on my mental and emotional body by getting me back into my body, becoming less disassociated, as my body was a terrifying place to be in after the trauma. In fact, for the first 2 sessions I was not able to get on the table as touch was just too overwhelming. As my nervous system was in overstimulated state of constant sympathetic stimulation and my bodily systems so overwhelmed, my therapist focused on calming my nervous system allowing me to become less anxious, less hyper-vigilant and releasing the undischarged residual energy in a very safe and contained way. We focused on my disturbed vagus nerve by activating the ventral vagus response. My therapist could only move as fast as my body felt safe to let go, peeling away the layers whilst she facilitated an incredible safe space and presence for me to do so. In further sessions, we were able to deal with my physical body and its pain. I became aware of how much tension I had really been holding, as my therapist was unwinding the tissues, layer by layer and releasing all my restrictions and pain. In one session I could feel this immense anger bubbling up, because of what had happened. I had no idea that this anger but also intense sadness had been living so deep inside of me. I had suppressed my emotions in order to cope, a common theme amongst trauma victims but also for many people in day to day life. I have lived through what I had learned in my education and I have an even deeper respect of how the body deals and expresses itself through any kind of life event or circumstance, big or small. I cleared all my physical and mental symptoms by addressing my nervous system that was so out of whack and so overwhelmed. Frequent Craniosacral sessions also addressed my physiology and my fascia (connective tissue) in my physical body and Craniosacral therapy addressed my emotional body by releasing all these emotions that I had stored through safe and natural releases. Craniosacral therapy truely acknowledges the whole person and works with the interconnected physical, mental and emotional body.
Thank goodness I found my way back to my happy, bubbly, pain-free, belly laughing self with even a greater passion, empathy and understanding for my work and for all my clients. In my own practice I see people with all kinds of symptoms: acute, one-off or with more chronic and long-standing problems. For these clients their history often reveals that there has been a long road of other seemingly unrelated problems, inflammations, anxiety, autoimmune conditions or neurological problems. By the time these clients come and see me, they have taken various roads to try and resolve their symptoms. They have had things cut out, removed, fused, worked on but are still in pain and often on long-term medication as a symptom management. The source of their symptoms however is often traceable to a form of trauma in their past that is still being carried in the present through unconscious emotions, the biology of stress and/or cut of body responses.
Trauma can be a one-off significant event but trauma can also be experienced in a more slow, cumulative kind of way through childhood adversity like an abusive parent/sibling, an emotionally cold, alcoholic, absent or mentally unwell parent. It can be experienced through work, accidents, illness or toxic relationships. Most of my clients are aware that there is some level off trauma on an intellectual level but are unaware of the imprints the trauma has left in their body, mind and soul on a more primal level. Their experiences have created physiological effects in their body and left marks, continuing to behave and react as if the experience is still happening and therefore can be triggered by seemingly unrelated new experiences.
Renowned Boston based Dutch Psychiatrist and my favorite author on the subject matter Bessel van der Kolk states: ”the most essential aspect of healing is learning to fully inhabit our inner sense of self in all its dimensions– not only emotionally and psychological but bodily as well, as they are inseparable from one another”. “Some of the best therapy is largely non-verbal”. “I always recommend incorporating a bottom up approach like Yoga and Mindfulness and I always refer people to Craniosacral work”.
My pharmacy shop? I tried, but the pills were not for me and caused many side effects, although they most certainly can have a place and give initial support, just like a good psychologist. Some of my clients see a psychologist at the same time, which works really well and complementary together. I was fortunate that I had already discovered Cranio as a holistic mind-body approach and knew from experience that there are other fabulous complementary medicines. So I chose natural medicine, homeopathy and naturopathy as my multi-disciplinary approach. In the end I decided to let my own internal pharmacy go to work and found relief and validation in a quote from Hippocrates, the founder of Medicine: “Natural forces within us are the true healers of disease”
Healing from the inside out, bringing the physiology back into balance, into homeostasis, allowing the natural forces within us to come into play and to self-correct is the strongest and longest lasting healing there ever could be.
Kern, M. (2005) Wisdom in the body.
Van der Kolk, B. (2017) How Trauma lodges itself in the body (online) available from http://www.onbeing.org
With immense gratitude and love that no words could every describe my Craniosacral Therapist: Monica Bovy - www.cranio-sante.ch
Wait - Whaaa? You wanna do what to my Cranial Nerves?
To alleviate headaches, sore neck and shoulders, eye pain, ear problems, sinus problems, dizziness, tinnitus, TMJ, Vertigo, anxiety, neuralgia, sleeping problems, nausea, depression, balance problems and so much more.
Cranial Nerves – what do they do?
We would not be able to smell, see, taste or be upright without our Cranial Nerves. The most famous Cranial Nerve Nr. 10 – The Vagus Nerve keeps our heart, lungs and digestion system functioning properly. Yet Cranial Nerves and the dysfunctions that they can cause - get very little attention and perhaps understanding in treatments of common or persistent health issues and problems. The table below lists our cranial nerves, their function and some examples of common dysfunctions they can cause in everyday ailments. Worth a check if you are suffering from any of those conditions, like TMJ, Tinnitus, Digestive Problems, Anxiety or Neck Problems and Shoulder problems.
Cranial Nerves –Function and symptoms
We have 12 Cranial Nerves and they primarily serve the head and neck structures, with the exception of the Vagus Nerve, that extends all the way down to our intestines. They form a key part of our nervous system. The cranial nerves give us our special senses of smelling, seeing, hearing, balance and taste. They allow for facial expression, move our eyes, and turning our head. Cranial Nerves go through small openings (foramina) in the cranium to head and neck structures. The Vagus Nerve, which is for 75% responsible for our relaxation rest and digest state– goes all the way down the throat to the heart, lungs, stomach and intestines. Ten of the 12 cranial nerves originate in the brainstem – our reptilian brain in charge of our fight and flight stress responses. What are the changes these Cranial Nerves are going to react one way or another, when the body is on a constant high alert or in a state of emotional or physical stress, leading to sympathetic overstimulation? Pretty high. “Cranial nerves control the secretion of enzymes and acids in the mouth and stomach, the production of bile in the liver, storage of bile in the gall bladder and production and storage of digestive enzymes in the pancreas. Additional functioning of individual cranial nerves: They regulate kidneys, bladder, heart, breathing and reproduction” (Stanley Rosenberg: Accessing the healing power of the Vagus Nerve). You can start to see how important cranial nerves and their proper functioning to our well-being are.
How does Craniosacral Therapy work with these Cranial Nerves and Symptoms?
Cranial nerves can be affected by a multitude of causes. It can be affected by head injuries, inflammation, muscular pulls in the neck and sub-occipital area, teeth grinding, birth trauma, bony or membranous restrictions, tension and stress. Cranial nerves pass through many bony structures and various foramina (little openings in the skull where nerves, arteries and veins go through) in and between the bones of the skull. The cranial nerves can be impacted by restrictions between the cranial bones and foramina’s, leading to a decreased mobility of the bones and/or compression of these openings. One important foramina is the Juglar Foramina between the occiput and temporal bones as many important structure pass through here. Bones like for instance the temporal bones can be in flexion, torsion or side bending due to muscular pulls or restrictions. In CST, we work v gently with the bones in the skull, assessing the movement or lack of movement of the cranial bones, we work with the fascia (membranes), facilitating releases and tracing the nerve pathway. Craniosacral therapy works on many levels to improve overall functioning of the cranial nerves:
· Releasing tension in the membranes (connective tissues);
· Releasing restrictions between the individual cranial bones, removing
impingement of nerves;
· Increasing blood supply to the brain stem;
· Improving the flow of the CSF;
· Lowering stress responses and improving functioning of the nervous system;
· Releasing tension in muscular system – fascial unwinding;
· Improving the function of the cranialsacral system – the spinal cord; the brain
We do not massage nerves or apply deep pressure as it would not be very beneficial. It is no magic bullet, it can take time particularly if problems have been long-standing and are deeply ingrained but then again with acute vagal nerve disturbance or vertigo, 1 or 2 sessions can already produce amazing results. We use a very delicate, experienced and well-trained touch. People often totally zoom out when we work on the head and cranial nerves and will often say: “not too sure what she did - she was just holding my head, I think I feel asleep, but my pain is a lot better or I can move my neck or my jaw feels better, my tinnitus is lower or I am not dizzy anymore and I feel a whole heap lighter”. We are not just holding your head, we are tracing the pathway of the nerve, releasing tissue or bony constrictions, improving blood flood and CSF flow. We listen, touch and work with the bones, the muscles and the nerves with dedicated and precise touch. This allows the nerves to start to fire under their firing range, switch off and coming back into a place of balance: homeostasis. The gentle craniosacral touch really belies it power.
Conditions I treat in my clinic with Cranial Nerves
Personally, I love working with the Cranial Nerves and Cranial Bones. I find it extremely helpful for many conditions. In my clinic I work a lot but not exclusively with:
TMJ-The Trigeminal nerve is associated with receiving sensations from the face and teeth. The motor branch supplies the muscles of mastication (chewing) and can be implicated in teeth grinding but also in sinusitis and migraines. It is also important to work with the Trigeminal Ganglion where all nerves come together, cross over, relay information and go on their individual journey. Further information please see my blog on TMJ.
Tinnitus – tinnitus is a multi-variable condition that can include neck problems, jaw problems, nerve compression, bony restrictions or impingements, membranous restrictions, loud noise exposure, stress and unprocessed emotional issues. People with tinnitus often complain of hyperacusis (hypersensitivity to noise) and/ or a sense of fullness in the ear. This can be because of involuntary contraction of the tensor tympani muscle within the ear that is innervated by the Mandibular division of the Trigeminal nerve to reduce auditory output. (Thomas Attlee, Face to face with the face). The muscle contracts under tension and with loud noise is meant to dampen its vibration. One of the most common variable with Tinnitus clients is high levels of tension and stress (sometimes below their level of awareness) and can lead to involuntary contraction of muscles and nerves. Constant high Sympathetic nervous system activation due to stress, pressure, tension and inner turmoil can cause the tissue and nerves to become hyper sensitive and hyper reactive. (Please see my Tinnitus blog). The Vestibulo-cochlear nerve enables us to hear and receive sensations of hearing and balance and can be involved in Tinnitus when there is a disturbance in the cochlear division. Working with the Trigeminal nerve, the muscles, the bones and the delicate structures in and around the ears is very beneficial for Tinnitus.
Vertigo, Meniere’s disease, dizziness–The Vestibulo-division of nerve VIII is responsible for our balance. Disturbance to the vestibular division can lead to vertigo and/or Meniere’s disease. Here it is important to release restrictions and tension at the cranial base and sub-occipital area and working with the structures and nerves around the inner ear and neck. Instant improvement can often be experienced here after Craniosacral work.
Stress, sleeping problems. anxiety, depression, digestive problems, autism, chronic Fatigue, fibromylgia, inflammation - Vagus Nerve.
Vagus Nerve disturbance can be responsible for a multitude of health issues from inflammation to anxiety to digestive issues. The Vagus Nerve is one of the most important nerves in the body and plays a major role in regulating many aspects of our physiology. The Vagus Nerve travels all the way down from the brainstem, through the neck, where it is involved in speech and swallowing, the lungs where it is involved in respiratory function, the heart where it is involved with cardiac function, the abdomen and into the intestines, where it is involved with digestion. For instance with IBS and Crohn disease clients working with the vagus nerve is important. The Vagus nerve also plays a big role in psycho-emotional states (please see my 2 previous blogs on Vagus). All neurological activity increases by a nervous system that is in constant overdrive, stress and in sympathetic overstimulation. The Vagus is for 75% responsible for our rest and digest Parasympathetic nervous system. One nerve with so much power. You cannot go passed a balanced vagal tone for true optimal health and well-being and trauma recovery. You cannot go past reducing stress and sympathetic overstimulation by bringing the nervous system back into balance for good physiological functioning and optimal health. You have got to plug this hole first particularly in complex and chronic illness and trauma otherwise nothing else will stick.
Neck and upper shoulders problems
CN XI – the Accessory nerve innervates the trapezius and sternocleidomastoid muscles. These muscles allow us to move and turn our head. The accessory nerve is often implicated in chronic tight neck and shoulders and in Torticollis, where the neck muscles contract and causing the head to twist to one side or when there is a problem with cervical rotation and shrugging of the upper trapezius muscles. Here we release the tension and restrictions in the neck and sub-occipital area through fascial unwinding and sub-occipital release.
Swallowing, speech or tongue problems
Adults with swallowing problems or babies with sucking problems or with tongue tie, CN XII – the hypoglossal nerve can be involved as this nerve moves the tongue and is also involved in swallowing and speaking. This nerve can be distorted when there is an imbalance or compression. Here it is important to work with the Occipital bone at the base of our head and some muscles and tissues of the throat like the suprahyoid muscles.
Polyvagal Model for Health and Well-Being
There are 5 Cranial Nerves that are necessary for social engagement in the leading Polyvagal Social Engagement and Communication Model. In previous blogs I have written about Polyvagal and how they relate to different states of our Nervous System: Engaged, Fight or Flight or Frozen. The 5 Cranial Nerves that support Social Engagement and our Well-being are: 5,7,9,10 and 11. Please see my previous blogs.
You wanna do what to what to my cranial nerves? Yes please, balance them out !
The purpose of all my blogs is: would my mother understand it. I purposely don’t overcomplicate or name all there is to know about everything. For in-depth information including CN 0, sensory or motor components and polyvagal: I highly recommend below books.
CST is a great worldwide applied manual therapy which delivers some excellent result for brain injuries like concussion. During my Craniosacral years, I have treated various clients with concussion. As I am writing this blog it dawns on me, that most of my concussion clients here in Sydney are mainly people from overseas and familiar with CST. Why is that? In Australia, although growing, CST is unfortunately still only on the radar of a handful of doctors and specialists. That is a shortcoming as CST has strong evidence that for many musculoskeletal, neurological, trauma and stress related issues and concussion, it delivers real value and in my humble opinion is imperative for anybody involved in contact sport.
Concussion & Post-concussion Syndrome
Our brain is made of soft tissue, looking very much like a gelatine pudding, floating in a cushion of cerebrospinal fluid, enclosed in the protective shell of the skull, the (neuro) cranium.
Concussion is often caused by a hit or blow to the head, face or neck, where the force has caused the brain to move inside the head, bouncing and colliding into the walls of skull. This collision will send shock waves through the brain and can damage and tear the axons of neurons (nerve cells) which conduct electrical impulses to transmit information to different neurons, muscles and glands and can innervate multiple parts of the brain. This collision can lead to bruising, injury to the nerves and blood vessel damage.
The force does not have to be hard. It can also happen with a smaller force. The essential part is that the brain has moved, striking the skull and/or twisting upon itself. It can happen through a sporting injury, like boxing or rugby for example, but also through hitting your head on a wall or floor. In one case, my client hit his head on a surfboard.
Post-concussion Syndrome occurs when there have been unremitting blows to the head, layer upon layer and unresolved chronic continuation of symptoms, usually seen in professional athletes. The movie ‘Concussion’ with Will Smith depicts this syndrome really well. One poignant scene in the movie is where he holds a glass bottle with a brain looking substance surrounded by fluid and shakes it, explaining: “The human brain sits in a fluid and is disconnected from the skull with no safety belts and when a person receives unremitting blows to the head, the brain chokes from the inside out, leading to a cascading series of neurological events”. "This can not be picked up from a CT-scan". This is known as CTE - Chronic Traumatic Encephalopathy. CTE can only be diagnosed via autopsy. Australian Researchers have recently uncovered the first evidence of Australian Rugby league players with a degenerative brain condition, commonly found in retired American NFL athletes. (ww.smh.com.au/sport/nrl/rugby-league-rocked-by-first-proof-of-former-players-with-cte).
The brain houses our central nervous system and is pivotal to our everyday lives for all our functions. The effect of concussion can have physical effects but can also have a deep lasting effect on the nervous system. Concussion can cause cognitive, physical (neurological) and emotional symptoms and last for days, weeks or much longer, depending on the severity of the impact, how many other layered injuries there may have been and the resiliency, resourcefulness and fitness of the body at the time of impact.
First and foremost, the brain needs to rest and this means restricting any activities that requires the brain’s excessive activity in order to recover: reducing time spent on phone’s, video games, TV, socialising and any form of physical activity. The brain needs oxygen and fluids to circulate so it can heal. It needs assistance on a neurological level and it needs a dispersion of the tension and this is where Craniosacral Therapy comes in so effectively.
How does CST help as a manual therapy for Concussion?
CST helps in a variety of ways including:
I personally work with images and what I feel and see underneath my hands as I am visually and kinaesthetically orientated. The bones of the cranium, the membranes around the brain and the cerebrospinal fluid move very finely in a certain rhythm, comparable to the ebb and flow in the ocean. Working and living around the foreshores of our beautiful Sydney Harbour, the water reminds me of the fluid in the brain, the rocks in the ocean as the bones in our skull and the seaweed as the tissues always beautifully dancing in a rhythmic way along the shores. I examine, feel and work with these subtle motions in the skull and in the body, picking up any disturbances or restrictions that impacts the body like e.g. abnormal membranous tension or suture immobility in the bones and work with the body to resolve these.
Research & Anecdotal Evidence.
Former US NFL Star Ricky Williams, benefited so much from Craniosacral Therapy, that he not only studied CST but also competed on the US version of Celebrity Apprentice in 2016, in order to raise money and awareness for Upledgers Institute Craniosacral Concussion & Brain injury treatment and research programs. There is a great mini pilot on You tube – the Ricky Williams Pilot study that hosts various long-term NFL Football players and here you can see, hear and witness how they benefited from a week long intensive CST: “Tinnitus was gone, foot placement, knees and hips much better, felt like a different body”. My favourite quote of a player: “with the cranio work each body parts were introduced to one and other, my brain met my heart, my heart met my body and they got along”. Cranio’s subtle touch definitely belies it power.
The research program at Upledger’s Concussion & Brain injuries program showed that outcomes were measured before and after treatment and 3 months post treatment. These outcomes showed statistically significant improvement in lessening the intensity of the pain, better range of movement and improvement of cognition, memory and sleep.
https://www.momsteam.com/health-safety/craniosacral-therapy-may-help-lesson-symptoms-post-concussion-syndrome is a brilliant article of a mother who describes how CST helped her daughter in her Concussion recovery.
My own practice - Anecdotal
One day I noticed that there had been many clicks from Denmark’s Google Search engine to my website. This made sense when a guy by the name of Mads rang me – a young backpacker from Denmark who suffered from concussion after he forcefully hit his head at Bondi Beach, whilst surfing. He had been to the Dr, had his tests done but was not getting any better. He had to get better as he had English exams looming. Not sure what to do, he finally rang his worried mother back in Denmark. She knew just the therapy that could help and her Google searches lead Mads to me. I did Cranial work on him but also limited his screen time to limit the impact on his eyes and neural connections back to the brain.
Mads was so thankful that he ended up leaving me a great Google Review:
“I had a concussion which left me unable to look at a computer screen without feeling discomfort, as well as a constant headache for several weeks. After two sessions with Dorine, the headache is gone, and I am now able to continue my study and look at a screen again. I will highly recommend her therapy to anyone suffering a concussion”.
Steve, an English working Holiday Visa lad who on a night out, not entirely sober, had fallen down a few flights of stairs. He suffered from blurred vision, headaches and dizziness. He had been to see a specialist, was taking some medication but was still having issues and not fully fit. When he rang his worried mum back in the UK, she knew just the therapy that could help her son and her Google Searches from across the world lead Steve to me. When Steve came for his fourth visit, I asked how his symptoms were going and he told me: “ohhh (those......as if they had never happened), they are all gone”. I jokingly asked why he showed up for his appointment and he answered “oh I want to continue as I love the cranio treatments so much”.
And there are many other examples where clients did not necessarily have a concussion but displayed symptoms like brain fog, not being able to focus or concentrate, cognitive problems, neurological complaints or low-level anxiety as the tension went unresolved and consequently lead to compressions, restrictions and impingement of bones, tissues and nerves. Here the incoming force or energy that entered the body may not have necessarily rattled the brain but these tensional forces were absorbed by the bones or tissues through the cranium and transmitted through fascial lines or bones, causing a bone to become compressed and/or cause excessive tension in the intracranial membranal system. The force put into our head or body can compress bones or misalign them. The cranial bones can get stuck or jammed causing complications like headaches, vertigo or emotional and cognitive problems. These symptoms can be caused by cranial nerve dysfunction, which will be the topic of my next blog.
So here is to anybody suffering from a head injury, concussion and/or any kind of head, neck, jaw problems for that matter whom display these kinds of symptoms and hopefully will find their way to Craniosacral Therapy somewhere in the world, rather sooner than later. As one Football player said in the Upledger Research program: “Craniosacral was a revelation-what a gift”.
As your brain would say – I lobe it.
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The base of all my blogs is: ‘would my mother understand it’? – I purposely leave out jargon (meninges etc) and aim to simplify as best as I can. My aim is not to confuse with All there is to know and keep it relevant to the topic. Great detailed information and recommended reading for people who like to know more:
Our Autonomic Nervous System (ANS), is the conductor of the inner orchestra in our body, responsible for the control of our bodily functions not consciously directed, such as breathing, the heartbeat, blood pressure, sweating and digestive processes. The ANS is always humming at a certain beat and how well it operates, determines our physical, mental and emotional health.
In previous blogs I have written about the ANS. Our ANS was previously seen as having only 2 main divisions: the Sympathetic Nervous System (SNS), fight or flight and the Parasympathetic Nervous System (PNS), relax and digest. Stephen Porges, Polyvagal Theory describes a new model of our nervous system. He describes how we respond to threats in 3 different biologically pre-programmed hierarchical ways. In this new model the PNS is divided into 2 branches, each with their own unique pathways and neural influences. Here, the PNS is divided into the Ventral Vagus Nerve (VNN) branch (also known as our Social Engagement System) and the Dorsal Vagus Nerve branch (DVN) which is characterised by immobilisation, freeze, shut down and withdrawal. This new model has great implications for the advancement of our health and well-being both practically and in therapy as each of these states, comes with their own set of physiological and emotional states, well-being and behaviours. (see also previous blog: Depression, Anxiety and Vagus Nerve).
In this blog we will delve into the VVN, our Social Engagement System, the implications on our health and well-being and how craniosacral therapy can successfully help.
The Social Engagement System.
The Ventral Vagus Nerve (VVN) is associated with increases in health and emotional wellbeing as it generates positive states of relaxation and social engagement. Our Social Engagement system is functioning optimally when we feel safe and connected to the world and other people. Throughout the day we constantly receive cues and triggers through our senses and fascia, which acts like a 2nd nervous system. We have an external environment -the outside world but we also have an internal environment-the physiology of our body, like diving into a deep sea, so much is happening underneath the surface, wave after wave. Our subconscious internal filtering system will immediately evaluate whether we are safe or need to take action. This happens without us even being aware of it or having to think about it. When we feel safe, we can relax, expand, go forward and step out into the world. When there is stress or a perceived threat in our minds, we rely on our social engagement system to establish a sense of safety and connection. This can be achieved through a conversation, a call for help, making eye contact, or hearing a calming voice. This will send signals down to our heart and lungs, slowing down our heart rate and deepening our breathing. It very much functions as a foot brake - a Vagal Brake - and has a calming and soothing effect on our nervous system.
Picture the opposite: For example, a person says something to you that causes you to feel upset. What happens? We tend to change our facial expression signalling our upset, the tone of our voice changes often to an angrier, louder or higher pitch, we seek validation, we pick up the phone and talk to someone. If the social engagement system fails to resolve the stress and it remains active in our body, then we will automatically resort to the older biological response, one step down the ladder into fight/flight, with the Sympathetic Nervous system kicking in.
What are the areas innervated by the VVN?
The VVN innervates the areas above the diaphragm: face, throat, voice box, larynx, middle ear, heart, lungs and serves the social engagement system. This system is regulated by 5 cranial nerves and when these nerves function well, we can enjoy optimal physical and emotional health including great friendship, support, bonding and loving relationships. When we are socially engaged, we can be creative, positive, productive and happy. Socially engaged means we are free from threats, danger, unnecessary worries and in good physical health. The Social Engagement System guides us in orientation, communication and facial expression and comprises the following cranial nerves, which all originate in the brainstem.
Behaviours we display when Socially Engaged:
When our ANS is in a state of stress or shutdown we often have problems with our physical health, emotional states and relationships. Therefore, it makes total sense to have an optimal working nervous system and Craniosacral Therapy is one of the best modalities to address the nervous system. Craniosacral therapy assists our clients to shift into their social nervous system, inhibiting the SNS, improving vagal tone, addressing the cranial nerves and has a great and positive effect on regulating the entire nervous system.
Clients typically report a significant reduction or disappearance of their physical symptoms but also an increased sense of happiness, connection, oneness and openness with the world and feeling safe. This is because clients have come out of Fight or Flight and gone into Ventral Vagus Healing, which is connected to increases in health and emotional well-being.
Here, the goal of Craniosacral treatments is:
On the flip side what I have also experienced is that clients who are in excessive overwhelm or in a depressed, dissociated dorsal vagus state, may experience a sudden increase in anxiety or sleepless nights. This causes them to question if they are on the right track and why this would happen. One thing to consider is that it can actually be a good sign as it means the body is coming out of shut down Dorsal State, up the hierarchical ladder and is shifting into Fight and Flight, Sympathetic State, which may mean perhaps a temporarily increase in anxiousness or other aroused states. Here as Biodynamic Craniosacral Therapists we can assist them in finding a sense a safety through resourcing, grounding, embodiment, breathing, so they can start feeling safe and shift into their social engagement system. In biodynamic craniosacral therapy we can also guide clients through their internal emotions and enhancing their capacity for self-regulation, which is important to maintain a good nervous system.
Polyvagal Wrap up
The application of the polyvagal theory in craniosacral therapy makes total sense for physical symptoms and particularly for Trauma, Depression, Anxiety, Chronic and Complex Pain and illnesses. In past blogs I have written about my own personal trauma and the extensive Dr’s rounds which brought no luck in addressing or alleviating my symptoms, as the primary innate biological forces that controlled my symptoms seemed to be overlooked, disregarded and not addressed. I was at the bottom of the hierarchical ladder and totally not socially engaged. For months I was in shut down, collapse, disassociation and hibernation, with little recollection. I was in Dorsal Vagus State and off-line. As for Ventral State and the associated nerves: I could not bear any bright lights or flashes and my ears were high pitched ringing. To my embarrassment as I could not hide it, my voice had gone up a few notches higher due to my anxiety. As the physical part (but emotional part also played a role as brain stem implicated) of the trauma was to my neck and head, my SCM and Trigeminus were in hyper tonus and over firing on a neural level in my face.
I did heal my myriad of symptoms not by chemical pills for every symptom I had but by addressing the ANS: the Dorsal State, the Sympathetic Chain and finally coming back into Ventral Vagus through weekly & to start, twice-weekly Craniosacral Therapy sessions, which I combined with Homeopathy & Naturopathy. I did not get fixed, I did not get cured but I healed, from the inside, out.
It took time and dedication–it is not a magic bullet – addressing physical symptoms, pain, the nervous system, uncoupling and processing strong emotions takes time but when you overcome your own health problems by the innate power of the body to heal, which we all have, the gratitude is infinite and it is a gift you want to keep on giving.
Psychiatrist Dr. Bessel van der Kolk – explains the polyvagal theory and the use of oa yoga, meditation and Craniosacral therapy so well in his brilliant book: The Body keeps the Score. “The polyvagal helps us understand and explain why seemingly unconventional techniques work so well. It activates the social engagement system, calming the physical tension in the body. It helps people shift out of their fight/flight states, reorganising their perception of danger. If mind/brain/body is the royal road to emotion regulation this demands a radical shift in our therapeutic assumptions" and “Touch, is the most elementary tool we have to calm down. You can’t fully recover if you don’t feel safe in your skin. Therefore, I encourage all my patients to engage in some sort of body work like Craniosacral Therapy”.
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The base of all my blogs is: ‘would my mother understand it’? – I purposely leave out jargon and aim to simplify as best as I can. My aim is not to confuse with All there is to know about anatomy (eg enteric nervous system) and keep it relevant to the topic. Great detailed information and recommended reading for people who like to know more:
The title almost sounds like the start of a joke, right? Four people enter a pub – depression, anxiety, the Vagus nerve and craniosacral therapy. During my Craniosacral education we studied the Vagus Nerve, learning the theory and practicing the different vagal tones by doing hands on work, feeling for the dorsal and ventral branch of the Vagus Nerve. At the time for me, the theory was mostly words on paper about Stephen Porges Polyvagal theory. This is not a light subject matter to begin with and as my course and study materials were conducted in German (not my first language)...…well let’s just say Stephen Porges “Die Polyvagal theorie: die phylogenetische entwicklung des Nervensystems” got filed away in the “one day – too hard” basket of my brain.
Many years later and firmly established in my own clinic, that one day came, when a Psychiatrist started to refer some of his clients with various diagnoses like: Insomnia, Anxiety, Depression and Fibromyalgia to me. This psychiatrist advocates non-medicinal treatment in finding alternative ways to help his clients through TMS, neurofeedback and stimulating the Vagus Nerve, in my case, through Craniosacral Therapy. As I treated his clients, I started to notice various similarities. All had an under-activated dorsal branch of the Vagus nerve, a compression at the Cranial base and different parts of the brains that would be overactive, i.e. over fire on a neural level. I knew I had to revisit Stephen Porges Polyvagal theory and as it turned out, it also confirmed a piece in my own personal journey.
The Vagus Nerve and the differences between the functions of the ventral and dorsal branch of the Vagus Nerve have great implications in the healing of our physical, mental and emotional health. In this blog I will mainly focus on the Dorsal Vagal Nerve, as a chronic activation of dorsal vagus circuit is accompanied by depressive feelings as in loss of interest in activities and surroundings, digestive problems, reduced energy, not being active, sad and/or being anxious. Working with the Dorsal Vagus Nerve through CST, has a great potential for treating people with Depression, Anxiety and Insomnia.
In previous blogs I have written about the Autonomic Nervous System (ANS) and its 2 key branches the Parasympathetic nervous system (PNS - rest and digest) and Sympathetic nervous system (SNS - fight and flight). They should ideally go up and down during the day in a balanced rhythmic way. The Vagus Nerve is part of our PNS and is one of the 12 Cranial Nerves (Cranial Nerve X) that regulates most of our bodily functions for our health, relaxation and emotional well-being (75%), i.e. stabilising our heart rate, breathing & digestion.
The Vagus is the largest ANS nerve, starting in the brainstem at the base of the skull and going through the neck into the chest and abdomen regulating many of our organs, from the heart, to the lungs, to the gut. In below picture you can see its pathway into our organs, where the fibers of the Vagus Nerve act as a surveillance team of our internal organs sending the information up to our brainstem for processing and actioning.
New Model - Polyvagal
Polyvagal as a relative new model (1994) states we have the SNS – fight and flight but that the relax and digest Vagus Nerve has 2 branches (in the classic ANS model the assumption is one vagus nerve). Polyvagal states that there are 2 separate distinct vagal nerves that originate in 2 different locations and have 2 different neural pathways. They are:
Ventral Vagus Nerve
When there is a threat or stress in our environment, we rely on our VVN to establish a sense of safety and connection, this can be through conversation, a call for help, making eye contact, a calming voice etc. This will send signals down to our heart and lungs, slowing down our heart rate and deepening our breathing. It is also referred to as the Social Nervous System and in essence functions as brake – Vagal Brake – having a calming and soothing effect on our nervous system. If the social nervous system fails to resolve the stress and it remains active in our body, then we will automatically resort to the older biological response of fight/flight.
Dorsal Vagus Nerve
When the fight/flight mode fails to resolve the stressor, we then subsequently resort to our oldest biological primitive ultimate emergency response through the Dorsal Vagus Nerve. A sudden extreme surge in dorsal vagal activity can for instance happen when we are faced with great danger. It is a defensive strategy that helps us cope in a traumatic event, or with prolonged extreme stress or danger, real or imagined and can bring our body in a state of “immobilisation with fear”. Much like a cockroach playing dead when he knows his time is up and senses a human being with a spray in their hand (Very much a Sydney thing:).
“A chronic activation of dorsal vagus circuit and its physiology is characterised by depressive feelings. For example, loss of interest in activities that were once pleasurable, loss of appetite, overeating, digestive problems, reduced energy, sad, anxious, problems remembering, making decision and also fibromyalgia. Diagnosis of depression are usually accompanied by a state of activation of the dorsal branch of the Vagus nerve. If the transition into a dorsal state has involved a sudden surge in dorsal branch activation, via a shock, a shutdown results. In a dangerous situation, it is a natural reaction to dissociate from one’s own body from the here and now, and to shut down physically, emotionally and mentally”. (Stephan Rosenberg, 2017).
It is exactly in these words that I found the missing piece of my own personal puzzle. In a previous blog I have written about my own physical and emotional trauma. I was certainly displaying symptoms of depression after the trauma and had many other symptoms including insomnia, anxiety and digestive problems. I was given the label of Depression and heaps of chemical pills. I felt I was not depressed in the classic sense of Serotonin deficiency and I did not want a different pill for every one of my symptoms. I intuitively knew but did not have the knowledge at the time that my answers did not lie in the medical chemical world. It seemed like a valued but incomplete model, as the primary innate biological forces that controlled all of my symptoms seemed to be overlooked, disregarded and not worked with. I now understand that there was a huge activation of my Dorsal Vagus Nerve – partly due to the physical violent head trauma and partly due to the shock and trauma that accompanied it and therefore pills and classic talk therapy did not work for me, as it did not address nor rebalance my Vagus Nerve, its pathway into my organs and digestive system or my Trauma.
Symptoms of Dorsal Vagal State – Shock/ shutdown
The body is truly amazing and in my humble opinion quite undervalued in the western medical conditioned ‘machine-like’ approach. We don’t always have to take out parts, replace parts or fill it up with chemicals to suppress symptoms. We can work with the body, feel the body, regulate the body, regulate the nervous system, reset its physiology, get nerves to fire under their threshold in many ways, and here through the Vagus Nerve. I witness this every day in my practice and am always humbled by the body’s innate power, it’s infinite wisdom and the body's capacity to heal. The below symptoms are designed to keep the basic functions going as it can override less important functions in the body, in times of stress or emergency. The problem lies, when we stay in that very state that was initially only designed to save us and when chronic, will turn against us.
Physical and emotional symptoms of Dorsal Vagal activation:
Craniosacral Treatment for Chronic Dorsal Vagal Activation
The basic goal of CST treatment is to lift the client from a chronic Dorsal Vagal state into activation of Ventral Vagus Nerve. During a CST treatment and with our subtle movements and it’s subtle as we listen, feel, touch and work with the most delicate structures of the body, we aim to:
The positive effects of craniosacral therapy are cumulative. Over time our ANS becomes more resilient each time we can restore a state of our social nervous system following activation of the dorsal vagus branch. The long-term goal is to encourage the ANS to return naturally, on its own from a state of dorsal stress to a state of social engagement, were we feel physically and emotionally safe. Healing the Nervous system does take time, but with time and for me personally with skilled hands-on craniosacral work for all my physical and emotional symptoms, I was able to shift back into the Ventral Vagal state, into a state of social engagement - my Social Nervous System where I was able to reconnect, relax and feel immense joy and happiness again.
As Stephen Rosenberg writes in his book – Accessing the Healing Power of the Vagus Nerve: “prior to Polyvagal, depression and depressive behaviours issues lacked a physiological model in terms of the nervous system. Perhaps why it is difficult to find effective treatments for conditions like depression. With Stephen Porges Polyvagal theory we have a clear focus on relationships of the ANS, the emotions and the behaviours”.
The Vagus Nerve is responsible for our health and essentially controls our entire rest and digest and all the associated organs. So, depression, anxiety, the Vagus nerve and insomnia walk into a bar, ordering craniosacral. All having a healthy drink together around a communal table, working together in harmony, in a balanced rhythmic way, with no side effects or hangover. What are you ordering?
My next blog will focus on the VVN – Social Nervous System and the implications for our physical, mental and emotional health through Craniosacral Therapy.
Would you like to connect with me? Please feel free to email me at email@example.com and/or like my Facebook Page: The Sydney Craniosacral Therapy Centre
The base of all my blogs is: ‘would my mother understand it’? – I purposely leave out jargon and aim to simplify as best as I can. My aim is not to confuse with All there is to know about anatomy like the enteric nervous system. Great detailed information and recommended reading for people who like to know more:
Tinnitus is an internal noise or a hyperactivity in the central auditory system normally experienced as a ringing noise in the ears, coming from within the person. In some cases it is temporary and goes away over time. Unfortunately for others the ringing noise can be constant and impact their daily life. Tinnitus can be experienced in one or both ears. It can make different sounds and can vary in intensity. Tinnitus can be brought on by many different causes including dental trauma, loud music, TMJ (jaw problems), a physical trauma, long-term work stress, trauma or anxiety. Tinnitus is much more widespread than generally known with around 25% of Americans and around 20% of Australians suffering from it.
Tinnitus is considered a neurological/audiological condition but has eluded medical treatment and scientific understanding so far. Initially, sufferers consult an Ear Nose and Throat (ENT) specialist, audiologist and/or a neurologist. In the majority of cases (around 80%) no known cause is found. If nothing specific is found, then sometimes medication is prescribed like Valium or Amitriptyline but thankfully more and more mindfulness meditation. Sufferers are often told by their doctors that not much can be done, to shift their focus, unscramble the picture and mask the sound. At best the brain will adapt and learn to live with it.
However if we view Tinnitus as not just being about a "hearing/ear" problem but a nervous system problem with a whole body reaction, we might be a step closer in bringing relief to Tinnitus sufferers. I believe there is a largely untapped potential in understanding the variables, common threads and biological nervous system responses in Tinnitus sufferers and approaching it in a new light. This calls for a treatment model that not only incorporates the physical body and the Craniosacral system of the physical body but also the mental and emotional body and this is exactly the strength of Craniosacral Therapy.
Craniosacral Therapy views Tinnitus oa as a signal where the adrenal flight and fight response seems to be manifested through the auditory system as noise in the ears, leaving a certain hyper vigilance, which keeps the brain active. This leaves your system so sensitive that you actually hear your own internal noises like ie: nerve impulses, structural movement and/or fluid movement, as well as the external noises. In my personal Craniosacral practice, Tinnitus clients, describe their ringing as: cicadas, kettle boiling, a high pitched dog whistle, the pinging of a microwave, humming of a fridge or as a high frequency. Often, but not always clients symptoms appeared in or around a major event in their life, or related to an echo of past difficult experiences. In these circumstances I usually find, that whatever the trigger was for the tinnitus to occur, it usually is the last overwhelm of previous layering challenges to the clients long suffering system, that breaks the "donkeys" back, like in the kids game Buckaroo. The last suitcase may have triggered Buckaroo's back to buckle but many other suitcases were loaded on top first.
Tinnitus is about our nervous system and brain as our brain continually scans our inner and outer world for threats. When any threats are detected the stress response automatically fires up. As you go through life the brain acquires expectations based on your experience and in particular negative one’s. When situations occur that are even remotely similar, the brain automatically applies its expectations to them, if it expects pain or loss or even just the treat of these, it pulses fear signals, creating hyper vigilance, keeping the brain active (Buddha's Brain-2009). Most of the time these seems to happen subconsciously as people are not aware of how their bodies respond in their day to day life, to stress or threats and how this can manifest as ringing in the brain.
A new scientific study at the University of Illinois (July 2017) seems to validate this. Using MRI, this new study found that tinnitus is in the hearer's brain. They found that chronic tinnitus is associated with changes in certain networks in the brain. A tinnitus patients brain seems to be not truly at rest even when they are resting, as the brain stays more alert. This could also explain why sufferers also feel tired more often.
I personally view Tinnitus more as a Syndrome than a condition as the whole central nervous system is on high alert and tinnitus is just one of the many side effects of this whole body reaction with everybody's Tinnitus being different. Some clients may have a slight hearing loss but not all clients with hearing loss have tinnitus, some clients have neck and shoulder problems and then again some have TMJ issues and/or temporal bone(s)/muscular dysfunction but the common denominator seems to be (unconscious) anxious and/or unprocessed stressful times and patterns lodged in the body. Some people may be aware off of this, some totally unaware but in all cases it has not been dealt with on a bodily level. I find looking at our evolutionary biological stress pathways and the structures involved around Tinnitus very insightful. Let me break it down: (Please view My blogs on our biological Stress Pathways, TMJ and our 3 Brains for more in-depth background information).
The strength of Craniosacral Therapy is that it addresses all of the above: working structurally around the auditory tube structures i.e. temporal bones, cranial nerves, intra-oral work, TMJ - jaw, neck & shoulders, releasing any tissue and bone restrictions, resting the brain & the meninges (brain tissue). Craniosacral is known to resettle the Nervous System, so stored tensions can be released, decreasing “the fight and flight” hyper vigilant sympathetic nervous system and increase the "rest and digest" parasympathetic system, lowering the tone of the Vagus Cranial Nerve. Craniosacral therapy sees symptoms as a signal of the body and unpacking any issues and unconscious thought processes that may have contributed to the onset off their Tinnitus can be very helpful, Having more awareness means you can make a choice. The body tends to hold tension and emotional conflict deep inside until it feels safe and is ready to process it.
UK based Julian Cowan Hill is an ex-Tinnitus sufferer. He found his cure in Craniosacral Therapy and has since become a CS practitioner himself. He has written a book about Tinnitus “From tyrant to friend" which I recommend. It is a handy practical little book, packed with information and a Wellbeing Matrix with levels and exercises to go through. He also has You Tube videos that people find helpful. Simon Baker (an ex DJ with hearing damage) is also an ex Tinnitus sufferer and has also become a CST practitioner himself and is a Professional Tinnitus advisor with the British Tinnitus Association. A link to one of his articles: https://djmag.com/content/hearing-damage-djs-guide-preventing-tinnitus
Tinnitus treatments are about regular treatments rather than a one quick fix. It is a gradual process, as it is about regulating and rewiring the nervous system and brain, learning to switch off the whole central nervous system. Grooves and patterns are often hardwired and they take time to change and integrate, to build a new road. My advice would be that if you do suffer from Tinnitus, try Cranio earlier at the onset of your symptoms. Cranio is one of the best therapies around for settling the nervous system, treating TMJ, resting the brain and cranial nerves and clearing any unprocessed shock, becoming less hyperactive and if applicable uncovering any unconscious emotional conflict. My clients that develop the best results are the ones that don't expect to be just fixed but are prepared to put in the work as well by adopting a multi-disciplinary approach and new life style regimen through diet, meditation, exercise and unpacking any issues. For some clients, the ringing in the ear becomes less intrusive and they don’t focus on it anymore, some clients find the noise has backed off and even forget about it and some clients make a full recovery. As Julian Cowan Hill says: "The state of your nervous system is very changeable and reversible, as the nervous system is a fluid, constantly altering state of balance, when the right conditions come along, it changes". He should know, he cured his.
Keep up to date with news, research and my upcoming book with oa Tinnitus case studies.
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Whiplash is often referred to as a pure soft tissue (ligaments and muscles) injury in the neck. It is caused by a sudden very strong bending and/or hyperextension of the head, causing a painful cervical spine, tension in the neck and shoulders and can also impact the ligaments of the joints in the jaw. In a worst-case scenario, there can also be damage to the intervertebral discs and/or compression of cervical nerve roots.
Whiplash is most often caused by a car accident but also can happen through a sporting accident, like boxing, karate, diving and rugby or as a result of a physical trauma. In all cases, the head is violently thrown forward, backward or sideways in two different directions. Pain could be immediate but pain can also happen after a delay of several hours or even days.
The diagnosis of Whiplash varies from person to person. Whiplash sufferers often have numerous complaints and can have long periods of pain that may not seem in proportion to the sustained physical injury. It may also not heal in the standard 6-8 weeks that is usually given for soft tissue injuries. However, if we look at the components of whiplash and not only view it as a soft tissue injury, it makes perfect sense why this can be the case. This calls for a treatment model that not only incorporates the soft tissue of the physical body but also the craniosacral system of the physical body plus the mental and emotional body and this is exactly the strength of Craniosacral Therapy.
Let me break it down:
Whiplash not only comprises soft tissue injuries that result in headaches, neck pain and stiffness but the lack of control of the head with all the sensory organs and messages to the brain during the impact can also generate neurological complaints that can range from dizziness or vertigo, ringing in the ears, blurred vision, balance difficulties to concentration and memory problems. It can even trigger emotional symptoms like depression, irritability or anxiety as the shock to the nervous system can linger for months. A disturbance in the entire craniosacral system is often possible due to increased tension of the dura matter (the outermost toughest membrane/fascia which envelopes the brain and spinal cord). Disturbances in the Central Nervous System (CNS) – brain and spinal cord – can relay many different symptoms like a chain reaction that cannot be explained by soft tissue injury alone. Pains that occur can also be of a psychosomatic nature and can fluctuate and worsen with life and emotional stress. The force of the injury can also cause minor traumatic brain injury with post-concussion syndrome, which leads to cognitive symptoms as well as balance and often visual complaints.
Victims of major accidents and/or trauma that result in whiplash may also experience disassociation or freezing at the time of the incident. This is used as an intelligent defensive self-protective mechanism where the sensory and motor overload in the body and the brain was too great to handle all at once. If these physiological states do not come to a natural end with a successful resolution or discharge, it can lead to PTSD or PTSI where the unconscious survival brain – the brain stem – see my blog our 3 brains – may be tricked into thinking that the threat is still present with all its physiological consequences and storage of the autonomic motor and sensory experiences.
My own Whiplash was caused by a direct physical Trauma where my head was forcibly thrown sideways at a high and quick speed. I experienced all of above symptoms, from the physical to the neurological to the anxiety and the dissociation with a time delay from the original incident. Initially I was put in a neck brace, had all the medical tests but my symptoms did not heal nor could be explained or addressed in the current model alone. When the Neurologist suggested Occipital Nerve block injections, I thought: "hmm let's not".
Whiplash is not always straight forward and the road to recovery can be slow and unpredictable, with periods of worsening, particularly if there is Trauma involved. This is because (traumatic) memories can be stored in our body and these memories are linked to the arousal circuitry within the amygdala (Limbic System -pls see my blog on the brain). Any head movement can perpetuate symptoms that is similar to the trauma. I found this out the hard way when on my road to recovery I sledged hard and fast down a long snowy Mountain with the usual bumps only to find that all my symptoms had worsened the next day. Not only did those movements perpetuate my symptoms but my sacrum had transmitted the forces up to my neck and head that was only just recovering. I continued addressing my physical, mental and traumatic part with CST and eventually saw all my complaints completely disappear.
The reason why CST works well for Whiplash is because it has a great effect on the autonomics and linked spinal cord segments. After a whiplash the sutures between bones can be compressed, which creates restrictions that impede the motion of the cerebrospinal fluid (CSF). CST will free these cranial immobility’s and enhance fluid exchange throughout the body and brain. CST also addresses myofascial pain and any emotional effects that may serve as contributing factors to chronic neck pain or shoulder pain and CST has a great ability to reduce stress and anxiety.
CST provides a holistic approach, bringing together all elements, reducing physical discomfort as well as emotional shock and trauma, as it truly integrates Mind, Body and Spirit.
In my own practice I treated a 56 years old lady who had a Quad bike accident and was diagnosed with whiplash. She also suffered from inexplicably fatigue. She has been referred by her doctor for a course of 9 sessions of CST (NB: this was overseas where Craniosacral Therapy is very much part of the medical model). Case history revealed she had another Whiplash injury 4 years ago due to another accident. First examination reveals a weakening in the cranial system rhythm around neck and shoulder area and an increased tension in the whole craniosacral system and attached fascia. Particularly her right shoulder and neck area reveal inertial patterns with big swirling movements around the place of impact where the incoming force of the collision is retained. In the first few sessions the focus is on bringing the central nervous system to rest, working on the general tension around the craniosacral system and the hyper tonus around the cranial base in particular, so fascia can gently unwind, trapped nerves freed and the self-healing capacity of the body stimulated. The client experienced a sharp increase in pain during the session that immediately disappeared when the session was finished. This increase in pain seemed to be related to the old whiplash injury she had sustained and was re-triggered by the new impact. As her system is clearing up the old and new debris she feels very tired, experiences intermittent pain and not capable of doing much but just relaxing. When the immediate fragility of her system has disappeared and she is starting to experience improvement of her symptoms, the focus of the later part of the sessions are more on myofascial release particularly in the muscles of the neck region and the trapezius muscle in the right shoulder.
During one of our sessions the clients literally experiences a structural and emotional release at the same time by sensing and hearing a “plop” inside her body – she can’t really describe it but says “it just felt like something disappeared from my neck, like taking the plug out of the bath”. When she gets off the table she feels no pain, no restrictions in head and neck movements and says she actually feels radiant and full of energy. When she comes back for the last couple of prescribed sessions, she indicates she is actually already better but would like to finish her prescribed treatments as she has seen improvements in many “unrelated” areas as well like her digestion, sleep patterns and overall mood.
This case study and many more conditions and case studies will be more detailed in my upcoming book: Integrative Healing through Craniosacral Therapy.
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Myofascial Release - SchleuderTrauma - Roland Kastner at Future Health Cranial Institute Zurich Switzerland
What is TMJ?
TMJ stands for the temporomandibular joint, which connects the lower jaw (mandible) to the temporal bones of the skull.
The TM joint is one of the most used joints in the body, we use it at least 2000 times a day when we speak, chew, swallow, yawn, kiss or snore and it has a biting power of 70 kg. A variety of cranial nerves synchronise all of the above activities and it is because of its physiology that this complex structure acts differently than other joints in the body. The TM joint and the powerful muscles attached to it are directly linked to the central nervous system and the whole craniosacral system.
For a long time TMJ was considered to be a dental problem but it is now widely regarded as a multifactorial condition. Wearing a splint can provide relief for TMJ symptoms like headaches and protect the teeth but it does not address any underlying causes. In addressing TMJ issues, clenching, grinding, whiplash, slips and falls, braces, stress, trauma, emotional factors, structural imbalances and integration of all structures – upper jaw, lower jaw, surrounding muscles, temporal bones and cranium needs to be taken into account, including whole body strains.
A few specialists have now upgraded the name from TMJ to the Cranio Mandibular joint and some are working with cranially trained osteopaths and craniosacral therapist to achieve whole body integration. (Dr. Wojciech Tarnowski).
TMJ Syndrome or TMJD - Temporomandibular joint Disorder – can range from mildly annoying to a highly debilitating condition which can manifest itself not only in the classic symptoms of jaw and facial pain, but also in:
TMJ dysfunction can be caused by a derangement of the actual disk or arthritis but what is often not addressed effectively, is that many persistent issues and jaw problems arise as a result of stress, manifesting for example as teeth grinding, muscle spasm or as a variety of other forms of TMJ Syndrome. TMJ syndrome is usually a symptom not a cause. 90% of cases are not primary temporomandibular joint disturbances ((Upledger, 1987, Beyond the Dura). They are usually a result of craniosacral system dysfunction: temporal bone, hard palate, intra-oral imbalances, fascial restrictions and/or due to stress factors like poor posture or emotional tension.
How Does Cranio Treat TMJ?
Cranio addresses the whole person not just a body part, i.e. Cranio looks at the interconnected of the systems in the body. The TMJ’s have many interrelationships with the whole body, so treating TMJ issues may involve work on other parts of the body as well. Practically this means that Cranio releases and integrates all surrounding structures: upper and lower jaw, the jaw (masseter) muscle, temporal bones, upper cervical (neck) vertebrae and the whole cranium. Cranio looks at postural imbalances like hip problems or forward head posture but also addresses craniosacral imbalances in other areas that may have ricochet up to the TMJ’s. Stress and emotional states do play a big role in TMJ issues and here Cranio addresses the emotional states first as it causes a deregulation in the nervous system and no amount of mechanical treatment will otherwise completely resolve the problem.
Four easy things you can do at home to start alleviating TMJ issues:
Depending on the cause of your TMJ disorder, different self-care strategies work really well.
Some random facts that might just make you win that Trivia Quiz one day:
Because of the jaw’s unique physiology, it’s important to treat the root cause of your pain as soon as possible. As a practitioner what I love about treating TMJ patients is that clients respond really well. Some find immediate relief if acute and some find gradual overall relief if more chronic with regular and consistent treatment. “Craniosacral Therapy has the potential for being the most effective holistic therapy of all for TMJ by restoring homeostasis”. (Dr. Wojciech Tarnowski - Dentist).
Here are some comments clients have texted me after their appointment.
“Thank you Dorine. Amelia felt amazingly relaxed and released after last session”. (Amelia - 9 years old)
“Today was amazing, thank you so much. I can almost get two knuckles in! Feeling very positive about this and looking fwd to seeing our progress. Thanks again”. (DM)
“Thank you very much for yesterday. I am feeling a lot better today! My muscles in my jaw/cheeks are a lot more relaxed, my neck feels less tense and I have had minimal headaches today”. (JF)
Thomas Attalee D.O., R.C.S.T (2016)– Face to face with the face
Dr Upledger, J. (1987) – Beyond the Dura
Dr. Wojciech Tarnowski – The biomechanics of Dentistry – Fulcrum – issue 65 - 2015
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Life Lesson number 9: have a Craniosacral treatment.
A translated extract from an article featured in a prominent Dutch newspaper with Hollands leading neurologist.
Lesson 1: You can’t keep burying your emotions
“I was working as an intern in a hospital when I noticed that for months I had become angrier, more anxious and depressed. I had actually deeply buried those emotions since the death of my father when I was 12. It had become my survival strategy but now the panic, sadness and anger kept resurfacing. My rock bottom came when I recognized the face of my father in one of my Senior Doctors, I wanted to kiss him. I was so happy to see him. At that moment I realised that I could not continue anymore”.
Lesson 2: When a child loses a parent, it determines the rest of your life.
“The death of my father shattered the unity in our household. Everything collapsed. The only way I could deal with this immense sadness was by studying. Knowledge became my safety net. I had wanted to become a Vet but just before the death of my father he had said – “would it not be great if you become a neurologist as well". Had life been different I may have taken a different road but in his absence, I fulfilled his last wish”.
Lesson 3: Remember your dreams
At 15, my mother wanted to send me to a psychiatrist, presumably because she saw how I struggled with my feelings and emotions. I did not want to go, I was FINE. Finally at the age of 28, I did go into therapy, twice a week for 4 years. My psychiatrist made me relive the trauma of my father’s death, she taught me how to cry, she taught me how to laugh and – very importantly – she taught me to remember my dreams. Dreams are the window into your subconscious and they help you to recognise and name your emotions so you can get to know yourself a bit better.
Lesson 4: Mind and body are one
Bizarrely and ironically, half the countries population does some form of Mindfulness. Yet at the same time most people do not want to deal with the fact that physical symptoms have a mental and emotional component. Many patients and Doctors still think that chronic pain or for example fatigue is a just mechanical problem. To me, this is really a redundant approach. We are not just our body or just our mind: it is One. It is my mission as a Doctor to make this clear, in particular to people that have complaints that don’t fit into our current medical way of thinking. Their symptoms are real but they are just misunderstood. I see how unhappy they are, whilst their body could be working fine. These cases fascinate me as a Doctor, as they are unsolved puzzles and I won’t rest until somebody is satisfied.
Lesson 5: A misunderstood symptom is also a real symptom
Just because you can’t find a plausible cause for a symptom doesn’t make the complaint less real. With 20% of new patients a GP will not find a clear cause for a physical complaint. The majority recovers within a couple of week by themselves. But with some patients, even after extensive medical tests, research and treatment, the problems keep persisting. In the medical field this is known as “Idiopathic Somatic Complaints”.
Like for instance a 55 year old smoking working women – recently divorced and has been suffering for a few months from fatigue and headaches. One day she wakes up and finds that she can’t lift her right arm at all. Doctors can’t find a medical reason. You don’t have to be an Einstein to understand that her personal situation probably plays an important role. However that does not make the complaint less real. She really can no longer lift her arm. The connection between body and mind allows to your experience your symptom. Sometimes there is a medical reason and sometimes there is not. Many people find that hard to accept. Only when you approach body, mind, emotions and individual life circumstances as One, then you can really do something about unexplained medical symptoms.
Lesson 6: Name and claim happiness, before its too late
I had been having headaches for 6 months and I noticed that I started to talk more nasally. If a patient had come to me with those complaints, I would have sent him or her straight for an MRI, but I ignored it. I knew like no one else how awful the outcome could be and buried my head in the sand. When I finally did have it checked out I was diagnosed with cancer, a tumor above the hard palate in my mouth. I was 39 with a wife and young children. The tears kept coming. I did not work for a year and the treatment did leave me with quite a few residual effects and symptoms. I did not become a different person but it taught me how important it is to treasure the happy times and moments.
Lesson 7: Go under Hypnoses
Once a week a hypnotherapist comes to the hospital for our patients who have medically unexplained physical symptoms. Around 500.000 Dutch people suffer from irritable bowel syndrome: tummy aches, bloated, constipated or diarrhea without a clear medical cause. The brain and intestines are in constant communication with one another, without you being aware of it. One can’t instantly regulate the inner works of the intestines, nor the heart or blood pressure for that matter but under hypnoses you can. Whilst you are completely relaxed, imagine your tummy is soft and healthy. You can positively influence the intestines this way. I am convinced that many people with medically unexplained symptoms but also with understood symptoms could benefit from it immensely.
Lesson 8: Exercise!
There is nothing better for body and mind than to exercise. If I don’t exercise every day I get aches and pain, I don’t sleep as well and become grumpy. So I cycle to work every day and on my days off I run. Top athletes know, like no other people, how mind and body are one.
Online:https://www.trouw.nl/samenleving/de-levenslessen-van-neuroloog-emile-keuter-een-onbegrepen-klacht-is-ook-echt - 11 June 2017
Chronic Fatigue – You can’t sleep your way out of it
“Nobody realises that some people expend tremendous energy merely to be normal".
Chronic Fatigue Syndrome (CFS) is a complex condition with a vast range of symptoms involving the immune, endocrine, gastro-intestinal system and brain. The root cause of CFS often includes several factors simultaneously like:
CFS is marked by a multitude of physical symptoms. For example: Muscular pain, jaw and throat pain, extreme fatigue and exhaustion, restless sleep, headaches, insomnia, depression, poor bowel movement, sensory hypersensitivity, intolerance to exercise, emotionally helpless and feeling wired yet tired at the same time. Currently there is no known medial cure for CFS, however sufferers can find great relief in complementaries therapies.
Craniosacral is a great complementary therapy for CFS, as it brings the body into a healing state and out of its CFS characteristic dominant state of sympathetic overdrive. Getting the body out of overreactive responses will allow the body to self-correct, find homeostasis and to reset its physiology so it can regulate and perform the correct immunological and neurological functions.
On Vimeo there is a great video by 2 Doctors called: "Chronic Fatigue - cutting through the B.S". Dr Martin Rutherford does an excellent job describing what happens in the body when the fight-flight response in the brain is stuck in the ON position in relation to CFS. "The stress signalling patterns in the brain changes your neurochemistry and disrupts your physiology". He also explains that "if you don't address this sympathetic dominance first, other treatments will fail because this hole needs to be plugged first". "This is a key procedure that produces successful results". And this is exactly what Craniosacral Therapy does, it plugs that hole so to speak.
Craniosacral therapy is one of the best, if not The best therapy to get people out of chronic fight or flight sympathetic dominance, changing the brain's stress signalling patterns, and therefore it's neurochemistry, "plugging that hole" and as a domino effect, changing one's physiological state. Here is how I address CFS in my six step approach:
1. Working with the physiological state of a person.
During a typical day human beings swing back and forth in their nervous system from activated “sympathetic” mode to the recovery “parasympathetic mode”. The physiological state of someone with chronic fatigue is very different than a non-chronic fatigue person. A chronic fatigue body lives in a physiologically stressed and emergency mode ALL the time. One way to look at this is that relatively healthy people start their day with a full fuel tank that has been replenished during the night and starts to run low as the day progresses. CFS sufferers start their day on a virtually empty tank, where they need to keep their foot down on the accelerator, burning fuel and living off the fumes left in the tank. Sufferers are not able to fill up their tank, as they have to expend many extra critical physical resources and energy on a day-to-day basis just to be, that their body is just not able to go back and access the critical “rest and digest” healing recovery state. In essence a CFS person is not able to regulate their output and as the body gets pushed, it has to use more and more activated sympathetic nervous system energy from the reserve tank, whilst in the meantime, the dashboard starts flashing and beeping with warning signs. Rest, unfortunately is not refreshing as the body remains in survival mode, which leaves sufferers tired but wired.
Cranio is a great therapy for switching the body out of emergency mode and into a healing state so it can click into that recovery mode. Here the body can start to self-correct and self-regulate in order to perform the correct immunological and neurological functions, changing the physiological state.
2. Cranio works directly with the nervous system as a way to improve health
Chronic Fatigue people are often operating from a subtle perception of threat in their environment. This can happen subconsciously as it may be linked to something in the past for example, not feeling safe, feeling rejected or abandoned, in other words when one of our three primal survival needs were not met on a consistent basis. You may not even be fully conscious of this but your brain and body are. We essentially live with a 200 million year old part in our brain – called our reptilian brain - which is not there to make us happy but to protect us and to make us safe at all cost. This part of the brain reacts in a nano-second through our senses and has put itself into action long before it reaches our consciousness. Settling the nervous system is a top priority for Chronic Fatigue people as the body’s response to stress underlies many of the symptoms. Cranio works with the nervous system stress and survival responses to these stressors, reducing adrenaline and normalising cortisol output, allowing for the body to come out of overactivation and back into balance.
3. Working with Brain Plasticity to improve health
Chronic Fatigue people are often primed to be more sensitive to stress and sensory triggers. Cranio aims to alter the neural pathways that contribute to this sensitivity through hands on treatment and also by incorporating body awareness exercises so sufferers can track body sensations more effectively, recognise triggers more easily and change the input. I personally also incorporate neuro-associative exercises and emotionally focused techniques to let go of any old patterns and to activate new neural pathways. Healing old patterns and creating new and more effective patterns form an integral part of my treatment plan.
It is very important for CFS to go at their own pace, not to trigger any flare-ups or setbacks. Craniosacral therapy is by nature client led. We go as fast as the slowest part is able to let go in an effective and gentle manner. With the client we look at resourcing and creating more effective coping strategies. Pacing will allow a client to know when to rest and when to build up strength and activity as chronic fatigue people have a natural tendency to push beyond their energy levels.
5. Cranio works with Trauma
For many Chronic Fatigue people a traumatic incident triggered the onset of the disease causing shock in the body. Trauma can cause an overwhelming expenditure of energy in a person’s body. When this is ongoing and the nervous system recognises that the amount of energy/hyperarousal is too high, it has one last card to play and that is to apply a very powerful brake, which leads to parasympathetic shock and immobility. CF people are living on an empty fuel tank with one foot down on the accelerator causing hyperarousal, whilst simultaneously the other foot is down on the brake causing an overwhelming helplessness. Cranio works with trauma and in particular with the effects and survival patterns that are left and imprinted in the body. The important part is and this is what Cranio does so well as a body therapy: the nervous system will only recognise that danger has passed when the mobilised energy has been discharged on a bodily level. You can talk all you want but you if don't discharge that high primal energy on a bodily level it will keep on circulating in your body.
6. Cranio works with Physical pain
CFS people often have various aches, pain and inflammation in their body. Back pain, shoulder, arms, face, jaw and headaches are all part of the syndrome. Cranio address this through soft tissue release and unwinding techniques, improving the physical and physiological state of the body’s internal environment and reducing pain. Cranio allows for the body to switch out of the fight or flight/freeze response and to move into the rest and repair mode. This breaks the circuitry of exaggerated nerve signaling and allows the immune and nervous system to reset itself so it can start working in an improved and enhanced capacity. Cranio deals with the root causes, not just the symptoms, leading to improved health and wellness.
Factsheet online http://sacfs.asn.au/about/general_info/fact_sheet.htm
Virtual Medical Centre https://www.myvmc.com/diseases/chronic-fatigue-syndrome
https://vimeo.com/227497273 - Chronic Fatigue - cutting through the B.S on Vimeo - Dr Martin Rutherford
Waking the tiger - Peter A. Levine (1997)
Kientalerhof (Switzerland): International School of Biodynamic Craniosacral Therapy. Class Notes (2010). Teacher: Friedrich Wolf