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The Addicts Brain

1/9/2021

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​​The first part described how trauma and our biological stress responses are implicated in all addictions and the benefit of CST. In this second part we will look at the addicts brain and the relevance and importance of working with the brain in CST.  All addictions use the same brain systems and chemicals, creating an altered physiological state, to escape emotional and mental pain, anger, anxiety, deep-seated fear, feeling powerless, less than, loneliness and disconnection. Addiction engages the brains reward (endorphins) system, the reinforcement-motivation (dopamine) system and the brains executive functions, where impulse control and self-regulation lies.
The three dominant brain systems involved in addiction are:
  1. The Endorphins (Opioid) system - Attachment-reward system
  2. The Dopamine system - Incentive-motivation system
  3. Prefrontal cortex - Self-regulation

1.  The Endorphins (Opioid) System - Attachment-reward system
Endorphins are our feel-good chemicals and naturally produced in the brains pituitary gland. Endorphins are the body’s natural pain reliever for stress and discomfort and play a key role in our reactions to both physical and emotional pain. Endorphins act like a pain killer, calms the nervous system, slows down muscle contraction in the gut and diminishes secretion in the mouth (hence the dry mouth when we take opioid painkillers). Endorphins are also released during rewarding activities like eating, exercise or sex. Endorphins are responsible for the pleasure-reward seeking behaviours that stimulates the addiction, as our brain rewards us when we engage in something that brings us pleasure, reduces pain, triggers the chemistry of love and connection and results in a feeling of general wellbeing. Endorphins are called the natural opiates of the body and work similarly as opioid drugs. Opioids like morphine, including codeine or heroine relieves pain and can produce a feeling of euphoria, as it alters your consciousness. 
Endorphins also play a critical role in the emotional bonding between parent and infant, important for our survival and forms the basis of our attachment system. Attachment is the biological impetus for physical and emotional closeness with firstly our parents and later on with other people. When we grow up in a functional household, receive attentive care, nurturing and loving responses, our brain gets flooded with endorphins. Young children who did not receive nurturing love and attentive presence to boost their internal chemical happy hormones are often also not able to self-regulate as well and rely on external dopamine hits. Secure attachment may also be difficult for people who have been hurt in their primary relationship. They may long to connect and to belong but any form of closeness or intimacy may pose too much of a threat to their nervous system and brain. They will try to escape their distress and are at greater risk for seeking chemical or behavioural satisfaction from external sources in life, as our early attachment style drives a lot of our behaviour and impulse control. Overall,
 the less effective our own internal chemical happiness is, the more driven we are to seek joy or relief through addictions or other compulsions that are perceived as rewarding and boosts our endorphins levels to receive that hit.
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           2.The dopamine apparatus - Incentive – motivation system
The brains incentive-motivation system controls our motivation and pleasure by releasing dopamine when we initiate in pleasure seeking and life-sustaining activities like eating, sex, forming new partnerships, exploring and engaging in new activities. Incentive feelings like desire, wanting and craving are all central to increasing dopamine levels and key to the reinforcing patters of addictions. As dopamine levels are increased, it will motivate us to do it again as it makes us feel more energised, inspired, focussed and happier. Addiction elevates dopamine in the reward circuit. Speed, nicotine, caffeine, meth, cocaine, porn, eating all tap directly into this system by flooding the reward circuit with dopamine. When we have learned for instance, that eating a chocolate bar or candy makes us feel good and is pleasurable - the likelihood of doing it again is greater,especially when we lack other self-regulation practices. Dopamine release is triggered in a brain center called the nucleus accumbens, located on the underside of the front brain, and plays a major component in the incentive circuit. graphic Sarah Huges - thesagon.online
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Food, sex, novelty seeking behaviour, intense exercise all trigger dopamine release in the NA. Research shows that the existence of relatively few developed or damaged dopamine receptors may be one of the biological bases of addictive behaviours, as we are driven to make up for any loss of dopamine activity. Consistent dopamine releases causes our brain to create new neural pathways leading to desensitisation. The nucleus accumbens also acts as a liaison with the limbic system, which is also known as the emotional brain.  
​The limbic system consist oa of the Hippocampus (memory conversion) and Amygdala (emotion). The limbic system interprets thoughts, feelings and processes our emotions like love, joy, pleasure, pain, anger and fear. It determines whether we go towards something or away, it  makes it possible to feel love, compassion and to have healthy social interactions. When properly developed our emotional brain is a reliable guide to life. When impaired or confused -  it can trouble us and addictions is one of its main dysfunctions.

                                                 3. The Self-regulation circuits 
The prefrontal cortex (PFC) sits in the front of our front brain, acting like the CEO with highly specialised functions like complex planning, problem solving, decision making, impulse control, rational judgement, balancing short-term vs long term consequences and inhibiting harmful impulses.
Gabor
Maté describes in his excellent book – In the Realm of Hungry Ghosts - studies that link addiction to a specific centre of the prefrontal cortex – the orbitofrontal cortex (OFC). The OFC has an abundant supply of opioid and dopamine receptors and is responsible for inhibiting inappropriate action and helping to postpone reward seeking behaviour, both not functioning well in addicts.
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Of interest and linking why it is so important to work with trauma and the brain, is that neurological traces of early formative events are embedded in the OFC. The emotional traces of psychological and physical trauma/abandonment are encoded in nerve patterns in the OFC, including experiences you cannot consciously recall (implicit memories). The brain structures to conscious recall develop during the first years of life but aspects of the implicit memory system which stores emotional memories are present at birth, priming the OFC  unconsciously, as it interprets stimulus through the lens of its experiences. 
Maté further describes how through its connections with the limbic system, the OFC serves as its mission control room for our emotional lives. The OFC receives input from all our sensory area’s - vision, touch, taste, smell and sound and regulates how we process our emotions and how we react to them, based on past and present experiences. The OFC decides the emotional value of a stimuli and its personal meaning, our likes, dislikes, preference or aversion and decides in a micro second, what we focus on. The Prefrontal cortex is often impaired as a result of life experiences, leading to poor impulse control when it is highly activated during cravings disrupting self-regulation circuits.
 
CST and the Brain
Working with the brain, is rewarding, life changing and totally underestimated in the inclusion of any kind of holistic treatment, be it for trauma, addiction, chronic pain, insomnia or concussion. There are so many bones, cranial nerves, membranes, sutures and cranial foramina - openings that allow passage of cranial nerves, tissues and blood vessels to go through - to work with, with far reaching implications, when there is any kind of dysfunction in the cranium. It is important that all structures in the cranium are functioning properly, in order to maintain optimal function and general health. In CST we feel, listen and work with all the structures in and around the brain – below the main ones implicated in addiction:
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Pituitary gland (the master gland –producing endorphins) is located inside the sella turcica of the sphenoid bone. In CST we assess for any cranial base dysfunctions – between the occipital bone and sphenoid bone. There can be torsion, side-bending or lateral strains imposed upon this area with clinical significance. It is important that the sphenoid bone is able to move optimally, with no lesions within the cranium in order to maintain its subtle movement to optimise the release of hormones. 

  • The Prefrontal cortex -  In CST we work with the prefrontal cortex and with the orbitofrontal cortex within– found near the eye socket/orbit – where important nerve systems are implicated in addiction. This involves working with the frontal bone, the intracranial membrane system, the sphenoid bone and surrounding areas. Intraoral mouth work-working with the hard palate of the mouth is also an important part of CST as it connects with the sphenoid bone and many important nerve structures leading into the eye socket. 
  • Limbic System – working with the limbic system is a key component of CST. Calming the amygdala – the smoke alarm of the brain and the limbic system overall, may discharge traumatic emotional effects in a safe and contained way as it releases any stored emotional energies.
  • Regulating and slowing down brain waves that contribute to anxiety, restlessness and creating new neural pathways – rewiring the old brain and making the unconscious, conscious. Life experiences around unconscious conditioning and patterns may begin to become more conscious and the potential for insight and clarity can come to the surface, as clients make deep realisations about their past life experiences and current situation. Often in Trauma and Addiction our implicit memories, lie below conscious levels and when we work with the brain, the craniosacral system and the entire body, they have a chance to come up to the surface and be released. People often experience a level of calm, insights, stillness and peace that they have not experienced in years.
 
All the above described brain structures are rich and important sources for CST, as the brain can start to initiate its own healing process by creating change in thought processes, wiring, emotions and behaviour. CST is no quick fix and attending other recovery programs is vital too. It takes time, dedication, recognition, effort and a real desire in wanting to change. One day at a time.

 
Part 3 – The Addicts physiology and bodily symptoms
References
  • Class notes – Craniosacral Therapy Education – Switzerland – Kiental – Teacher: Friedrich Wolf
  • Mate, Gabor – In the realm of the Hungry Ghosts - close encounters with addiction - 2008 (Highly recommend).
  • The Guardian (online) – how dealing with past trauma may be key to breaking addiction – November 2018
  • Johann Hari – You tube – Everything you know about addiction is wrong
  • Thesagon.online
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Addiction –Effects of Early trauma, Disorganised Attachment and the stress response

8/26/2020

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Addiction – the longing to Connect and to Belong 
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All addiction is unresolved past Trauma
Early Trauma, Disorganised Attachment and the Stress Response
In my clinics I see clients with all kinds of addictions: from alcohol, drugs, sex, gambling, work, shopping, opioids, behavioural, exercise to food, sometimes all combined in one.  Their first port of call is usually for physical pain, as the tip of the iceberg. Once they commence on the Craniosacral Therapy path, they realise that Craniosacral therapy (CST) not only assists with their pains but also with their unregulated nervous system, their physiological stress states and their anxious brainwaves, as they fire in unregulated hyper vigilant and dopamine seeking waves. All those variables often led them to their addiction in the first place, as a means to try and seek a solution for their internal turmoil and emotional stress states. The roots of any addiction go back to childhood experiences, childhood trauma, disorganised attachment and misattunement (physical and emotional needs not been met), as it forms the foundation of our physiology, mental, emotional health and behavioural patterns. These roots often lie deeply and subconsciously in the body but have formed hard-wired grooves and behavioural patterns in the brain and nervous system. 

Trauma in addiction
Current research is showing that childhood trauma and disorganised attachment are a major underlying source of addictive behaviour. The early years of our lives are the most critical development period for the architecture of our physical, mental and emotional well-being. Here, our brain grows at a rapid rate, firing and wiring, laying the foundation of our neural pathways. We also entirely dependent on the relationship with our caregivers. As we have no ability to regulate our own stress or uncomfortable feelings, we depend on healthy, nurturing attachment styles and emotionally responsive caregivers in the development of: a healthy stress response, emotional maturity, how we receive and are able to give love and how we obtain a healthy sense of belonging, connection and self-worth. We need all those ingredients so our nervous system can self-regulate, self soothe, our physiology can remain in balance and most importantly, we feel intrinsically safe inside. 

Addiction is often complex and multivariable. There may have been a history of mental health issues or addiction within the family. Usually the trauma is not caused by one major event but by an accumulation of hurtful events and painful experiences: a cold, harsh, punishing and critical parent, never been made to feel good enough, an emotionally absent or co-dependent parent, bullying amongst siblings, abandonment, unhealthy patterns of physical or emotional abuse between parents (punishment) and then seeing the parents all loved up again (reward), not having been kept safe by other parent from the abuse or not having been able to save the other parent from the abuse. This often all marinated in a deep sense of having felt powerless, shame and unworthiness.

Addiction is an attempt to solve the problem of what is so out of control inside them. It is an attempt to escape the distress, the high inner physiological arousal, overwhelm, thoughts and emotions. It is as an attempt to cope with the trauma by self-medicating, smoothening the nervous system, numbing the emotional pain as the body is not able to do this through self-regulation. It fills false wants:  altering consciousness, filling an inner emptiness and feeling some form of power, control and validation. But of course this is always short-lived and fuels the desire for more false wants above real needs, as the internal state stays unregulated and the search for a solution outside of oneself, continues.

The Stress Response
From an early age, the nervous system is driven into a freeze, fight or flight survival strategy and the imprints of trauma start layering here. When a natural discharge of the intense survival energy of freeze, fight/flight  was not able to come to its complete natural cycle, it will leave the body highly charged. The imprint of the trauma and/or accumulated life experiences stay very much alive in our system, even if we are not aware of it. It is much like a brewing tropical storm - eye of the hurricane - in the background. The internal intense energy and power is still there, as the pressure has not been released. As the nervous system stays stuck on the higher wired side, emotional imprints are stored in the body and behavioural patterns start to emerge. 

Secondly, when as a child something threatens our capacity to feel safe, to function and to develop a healthy sense of being, the body can repress and shut down conscious awareness of overwhelming painful emotions. The body is very clever as it stores these memories below our level of awareness and hides it in the body. This will not only ensure our survival but also our capacity to endure the trauma or ongoing painful experiences. Although stored below our level of awareness, the body still unconsciously experiences it as a sense of danger and this will continuously reactivate the nervous system and the bodily systems remain on high alert. This internal state starts to feel normal and addicts often have no idea how stressed, tense or chaotic their lives really are, as they have normalised it. 

When unprocessed trauma, core attachment wounds and emotional layers, remain stuck in the nervous system, trauma reenactment is a common theme. Through a nervous system survival strategy called: disassociation - they often act their trauma out, as that is their way of remembering by repeating the old wounds. Children from controlling or (emotionally) abusive homes finding themselves married to a controlling, domineering spouse, having a bullying boss or tyrant neighbour. The sex-worker, promiscuous person with a history of sexual abuse. Whatever it is, they often find themselves in situations and relationships that replicates the original trauma/childhood experience sometimes subtlety, sometimes disguised and sometimes overtly. Other stress responses are: hyper-vigilance, hyper aroused, firing on all cylinders, mood swings, sleeping problems, sugar cravings, attracted to danger, the dark side, living on the edge, panic attacks, isolation, avoidance or emotionally numb, often coupled with guilt, remorse, anger and depressive/low moods. 

Addicts starts to rely on the dopamine and serotonin hit as a means to regulate, numb and sooth their inner turmoil so they don’t have to feel the real mental, psychological and emotional pain and in effect, create a split-off persona.
 

How it relates to CST
Addiction is often about past experiences that are still being carried in the present through the biology of stress and cut of body responses. Until you break that pattern, heal the trauma and the core attachment wound – the destructive cycle will continue. CST deals with the primary innate biological forces of trauma, working through the different levels of the nervous system, the emotional brain, allowing for psychological changes to occur, rewiring of fight and flight brain (limbic) patterning and allowing for any physical and emotional releases.
 
My addict clients tell me that in talk therapy they skirt around subjects, cover things up or fluff a few lies, fiercely protecting the persona they have created and believed themselves to be. The beauty of a body-based therapy like CST is that in treatments, the body can’t hide and the body can’t lie. Talk therapy alone is inadequate for Trauma treatment as trauma is stored in one part of the brain (limbic), while talking, listening and understanding accesses a different part of the brain (neocortex). CST allows for the 2 brains to start talking to one and other and by doing so: making the unconscious, conscious.

Addiction fills a need - a need to belong, a need to connect. The closest I ever felt to a deep connection, belonging, oneness, stillness and shredding the emotional and mental layers of my (childhood) experiences was in deeply held CST sessions. In hindsight it was the (re)birth of me. You have to be really complete in your wounding before you can come from a healed place.

 

CST Treatments in working with Trauma and Stress responses in Addiction lead to:​
  • Regulation of the Autonomic Nervous system coming out of freeze (disassociation)/fight and flight response - completing the survival response
  • Regulation of the Central Nervous System – brain.
  • Regulation of physiology, mental and emotional states.
  • Allowing for deep emotional releases stored in the body.
  • Coming into a healing state where self-regulation can start to happen.
  • Lowered stress response – lowered physiological arousal and nerve interference- Deep relaxation.
  • Feeling safe on a bodily and visceral level
  • Psycho-emotional changes.
  • Improvement of body-mind awareness.
  • Working one layer at a time allowing any shock to discharge from the body, bring back all the lost and denied parts of oneself - working with the emotional brain and connecting it to the thinking brain.
  • In order to treat the physical, mental or emotional pain, you will need to treat the Trauma
  • Releasing on a subconscious level, bringing disowned parts into consciousness 
 Part 2. The Addicts Brain – role of CST
Part 3. The Addicts Physiology and bodily symptoms – CST wrap up​
References
  • Craniosacral Therapy â€“ Switzerland – Kiental – Teacher: Friedrich Wolf
  • Mate, Gabor – In the realm of the Hungry Ghosts - close encounters with addiction - 2008 (Highly recommend).
  • Trauma, Attachment and Neurosciene - Workshop Bessel van der Kolk - Sydney February 2020
  • The Guardian (online) – how dealing with past trauma may be key to breaking addiction – November 2018
  • Johann Hari – You tube – Everything you know about addiction is wrong
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Pain in the Head! Causes, symptoms and more

8/11/2020

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​Headaches and Migraines
Headaches and Migraines tend to fall on a continuum — where you can occasionally experience mild headaches or on the total other side of the scale, experience severe migraines, often.
What exactly is a headache?
A headache is a pain sensation anywhere in the head. The pain or pressure is often described as dull and can sit around the temples, forehead, side or back of the head. The intensity can vary from light to very strong and can last from a few hours to days. Headaches often come on more gradual and increase in their intensity. Headaches often occur with muscle aches and pains from the shoulders up to the back of the head.
The 2 most common primary headaches are:
  • Tension headaches. Often described as a feeling of having a tight band or helmet around the head. The pain is dull, on both sides or around the head and can range from light to moderate
  • Cluster headaches. Often located in spot and/or around one eye. The pain is described as sharp or burning.
 
Causes Headaches
Headaches can be triggered by factors like: stress, teeth grinding, TMJ problems, lack of fluids, fatigue, certain foods, alcohol, drugs, low blood sugar, eyestrain, bright lights (Smart Phones), heat and poor posture. Most headaches are tension headaches as a result of muscle tension in the neck and head area. This can lead to a contraction of blood vessels and nerves surrounding your skull – in particular Cranial Nerve 11 – the Accessory Nerve (blog-CranialNerves) which innervates the trapezius shoulder muscle and sternocleidomastoid (SCM) (responsible for movement of the head and neck muscles). If this nerve is not functioning properly than the Traps and SCM are not properly innervated and will lack a proper tonus, causing headaches and stiff necks.
 
What exactly is a Migraine?
Migraines are a disease of the nervous system, causing neurological symptoms. Migraines can lie on a spectrum ranging from mild to severe to debilitating. Migraines are often on one side of the head, throbbing, pounding or sharp pain and symptoms are often more severe. Migraines are often accompanied by a variety of other symptoms caused by autonomic dysfunction like eg: nausea, blurred vision, aura, sensitivity to noise or light, increased thirst, irritability, difficulty concentrating and digestive problems.
A migraine can last from minutes to hours to days and often ranges from moderate to severe throbbing pain.
 
Causes Migraines
  • Vasodilation of the cranial blood vessels – the blood vessels inside the head change and go into expansion.
  • Nervous system dysfunction – migraines can be an issue of sensory processing. When we are (highly) stressed or overly anxious, the nervous system becomes more sensitive and will respond to small or normal stimulation with an exaggerated response. Our sensory information goes haywire, alert and all off a sudden, smells, light, sounds and touch can stimulate migraines (also headaches) as all senses are filtering the information as if they are under threat, like a smoke detector has gone off but there are no real flames 
  • Inflammation that affects blood vessels and blood flow into the brain
  • Dysfunction of Cranial Nerve XI – the accessory nerve – (see above)
  • Electrical signals from a nerve cell in the brain are passed on through neurotransmitters, which act like chemical messengers.  Changes in nerve signals and neurotransmitter levels (low serotonin) can cause pain.
  • Changes in Cranial Nerve 5 - the trigeminal nerve â€“ connected to the reticular activating system (RAS) in brainstem causing fight or flight.
  • Hormonal changes (Estrogen)
  • Dysfunction in the brain due to injury or illness (concussion, Whiplash, Tumour). Brain stem injury– nuclei (cluster of neurons) that receives pain signals and sends out nerve signals to the meninges (connective tissue around the brain) which causes the release of inflammatory substances.
  • Genetics
  • Braces, dental work – tmj and jaw problems also for headaches
 
Treatments
Headaches and migraines are mostly treated with over the counter and prescription medicine like painkillers, beta-blockers, anti-inflammatory drugs or prescription medicine to stimulate serotonin, with the aim to reduce inflammation and constricted blood vessels.
 
Craniosacral Therapy
Does Craniosacral therapy help with headaches and migraines? Yes. Don’t take it just from me – as an ex-headache/migraine suffer – but there are multiple anecdotal and  and scientific studies to prove so as well. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2442042
Craniosacral therapy can have great effects for migraines and headaches that are caused by tension, neck and shoulder problems, jaw problems, sutural immobility in the cranial bones, brainstem injury, trigeminal nerve, nervous system dysfunction. My own personal headaches and migraines came from a strong tension pattern and after a whiplash accident – full blown migraines for months – where – as best as I can describe it - all the Christmas lights in my head were on full blast and flared up, along the nerve pathways in my head. I addressed it with CST and homeopathy (amazing) as nothing else worked.
CST can also address any dysfunctions in the autonomic nervous system, neuro-musculoskeletal level and psycho-emotional level, all of which can be contributing factors to the cause of migraines and headaches. It is however not a quick fix especially if it has been a long-standing pattern and will need a succession of treatments to go through all the layers and adjustments. For such a gentle therapy it does pack a potent punch - CST addresses:

  • Vertebrae’s issues in the Neck (C1/C2/C3) – issues here can attribute to headaches/migraines,dizziness, pain in the eyes. 
  • Structural cranium misalignments like a temporal bone dysfunction or a sphenoid bone dysfunction which can lead to tmj/mandibular dysfunction, neck pain and headaches.
  • Brain injuries - concussion, brainstem - limbic system
  • Any issues intra-orally (mouth work) if migraines and headaches are eg due to oa trigeminal nerve dysfunction, sensory processing issues, teeth clenching or knocks on the head. Working oa with the bones and nerves on the roof of the mouth, the jaw or individual teeth.
  • Teeth grinding. Often a major factor in headaches and implicates the TMJ, the cranial bones, the masseter muscle and the temporalis muscle to name a few, all things addressed in CST.
  • Braces can cause headaches – when they are on or when they come off – as they have held in a tight position for a long time – working on teeth and gums is an excellent craniosacral way to relieve headaches and migraines.
  • the orbit of the eye is often implicated in migraines and headaches and craniosacral therapists can relieve any pressure or compression around this area working with the nerves and cranial bones, in and outside the mouth.
  • helps to reduce pressure surrounding the head by working with any cranial base dysfunction  (ie cranial nerve XI – asseccory nerve).
  • addresses high stress levels and sensory processing issues– calms the nervous system by lower any sympathetic over-arousal. Migraines are often accompanied by autonomic dysfunction like irritability, fatigue – Craniosacral therapy regulates the nervous system as it works with Vagus Nerve - Cranial Nerve X. This nerve regulates our parasympathetic – relaxation rest and digest - nervous system for 75%.
  • Bringing the body back into homeostatic balance​
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Craniosacral Therapy is your healing nervous system Medicine.                            Is the world in a Stress state or in a Healing state?

3/31/2020

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At the moment the world seems to be in a state of dysregulation. If we look at everything that might have been wrong in our (western) modern world: overconsumption, pollution, fast paced stressful lives that we call life, not enough quality time for family, closed hearts, loss of the art of true communication and connection, comes to mind. The COVID-19 virus seems to have wiped this all out. Blowing out all the candles on the global birthday cake, with one big puff. Bringing everything and everybody to a big grinding halt. Game over. Reset. 
 
In Craniosacral therapy we work a lot with trauma, the nervous system and in particular with dysregulated nervous systems and sympathetic overdrive.  Is the Earth in a deep state of Trauma, desperate to find a solution? Is the Earth crying out, beneath all its turmoil? Has the world been in a Sympathetic Nervous System (SNS) overdrive for too long, pumping out the stress hormones of adrenaline and the cortisol? Has the Earth been put into this state to heal? We have had natural disasters and viruses before: floods, pollution, Sars, Ebola, Mexican Flu, bush fires, climate change etc. The world was shocked, pledged change and help but ultimately, we all carried on. Could the world no longer maintain the organised chaos and went into shutdown?
 
The devastation of losing loved ones and the financial consequences will be gigantic, unprecedented and unfolding every day and with far reaching consequences on our mental, physical and emotional health. It is undoubtedly a very triggering time for many and in particular for those with underlying trauma and mental health problems. Their systems are already more primed to be on the lookout for danger and in a state of hyper-vigilance, stretching it even further. More than ever we can see, witness and experience that our mind and our emotions affect our overall health. In order words, what happens in our nervous system, directly impacts the health in our body and the body’s ability to heal.
 
It is very important for us, as human beings to be and to remain in a Healing state. This perhaps easy defined difference between being in a stress state or being in a healing state, is actually crucial to our health and well-being.
 
When we are in a state of stress our SNS is activated, we are in fight/flight and respond to real or perceived danger. These are the people fighting in the supermarkets aisles and hoarding toilet paper. Many history and psychology books will no doubt be written about these interesting phenomena. For now, we must remain on the side where we will share our last toilet roll with others and help and support people in deep need. In Australia alone in the last couple of days there has been a 35% increase in phone calls to life-line organisations like Beyond blue.

When we are in
Stress fight or flight state, we are ready for action, waiting for something to happen, on alert, fearful, pumped up, looking for danger and we have a hard time to relax. We have overactive minds, looking for things to numb ourselves with, alcohol, food, cigarettes, drugs, medication, we have trouble sleeping as our body releases adrenaline and cortisol, pain and aches increase, we can feel depleted, tired, on edge and tempers flare. Survival stress is often invisible but it shows up in the overall health of body. 

Our symptoms are deeply shaped and influenced by our thoughts, our emotions, stuck patterns and the health of our nervous systems. What it means in a snapshot on a Physiological level if we are in a Fight, Flight or ultimately a Freeze state:
  • Anxiety, overwhelm, panic attacks
  • Sleeping problems
  • Muscular tension, increased muscular aches and pain, jaw problems, chronic pain
  • Narrowing of blood vessels
  • Quick and rapid breathing
  • Increased neurological sensitivities - noise, light, sounds, nerves
  • Decreased digestive function of food– IBS, bowel problems and absorption
  • High blood pressure, faster heart rate, cardiovascular problems
  • Decreased brain function, brain fog, living in our survival brain stem – difficulty focussing, processing and absorbing information
  • Weakening of immune system – increase of colds and flu, slower wound healing, harder time to fight bacteria, infections, viruses and maladaptive cells.
  • Build up off over-acidity and inflammation in the body
  • The body goes into survival mode as a coping system and shuts down, slowing down of metabolism and depression.
 
When our nervous system is in a
Healing state, we are calm and relaxed, our body feels calm and relaxed. We have a sense of peace, flow and calmness. We feel like socialising and connecting. We are calm and joyful. (please see previous blog on polyvagal). We are able to:
  • Relax and digest
  • Maintain Cell repair and regeneration
  • Relax our muscles – ease and flow in the body
  • Breathing slow and deep diaphragm
  • Sleep well
  • Increase digestion–increase of intestinal motility and secretion of digestive juices
  • Store energy to meet the demands of the day.
  • Have an enhanced immune response

So yes, we may have symptoms like painful joints and muscles, inflammation, sleeping problems, high blood pressure, neurological problems, light/noise/food sensitivities, tinnitus, asthma, addictions, compromised immune system, anxiety, depression or a poorly functioning digestive system but IT IS OUR NERVOUS SYSTEM THAT REGULATES OUR PHYSIOLOGICAL CHANGES AND OUR SYMPTOMS. (I can not stress (no pun intended:) this often enough or bold enough). This seems to be overlooked in the medical western health model. It is the nervous system that runs our internal show, sending messages to our body and driving most of our symptoms on a physical, mental and emotional level. It is crucial to work with your natural biological stress responses and to work on a nervous system level. And no, taking valium ain't going to do it. At it's best it is a (temporary) band-aid as your symptoms (your natural life force) will be unnaturally squashed & controlled, only to resurface or worsen, leading you to think you need more or can't do without, keeping you from that Healing state.

Whatever your symptoms are, if the body is not in a Healing state, healing is not the priority in your body. The main thing that stops us from healing, is our system being in a state of stress.The focus of your system will be on maintaining the stress state, keeping you busy and on alert and potentially impeding the effectiveness of sought remedies, chemical pills and interventions. Breaking the cycle is crucial.
 
Shifting people from a stress state into a healing state, has a big impact on our overall health: decreasing pain, better brain health, enhancing immune system, better functioning digestive system. This can not only be done cognitively and with your mind alone. If it is only done with the mind it stays in your mind, you have most likely not solved it on a bodily and deep physiological level and you have not embedded it in your nervous system. `Stress and trauma is very much a physiological reaction that circulates in your body, often long after any event has passed. Trauma and survival stress is held in our nervous system, in our physiology, in our tissues and our cells as our reactions and responses to trauma and stress are primarily bodily ones.
 

For our bodies to heal, we have to be in a healing state. Craniosacral Therapy is one the best modalities to reset your nervous system and is a potent medicine for your nervous system. CST allows your body to come out of the fight, flight or freeze response and allows your body to come into a healing state. CST works with:
  •  the biological stress responses of the body
  •  the physiology of the body
  •  the natural rhythms in your body

CST is proven to:
  • Decrease any sympathetic nervous system arousal, down regulating any activation and  coming out of the stress state.
  • Decrease highly activated beta brain waves.
  • Decrease, remove and heal any hard-wired stress grooves out of the nervous system.
  • Increase healthy parasympathetic nervous system, bringing the body and the nervous system back into homeostasis and into a healing state.
  • Increased awareness of your body, your thoughts, releasing stuck patterns, emotional layering and incorporating any overwhelmed and dissociated parts.
 
Collectively, we have moved to virtual connections. My Craniosacral clinics are officially closed until the world is back on its axis and we have flattened the curve. We have to make sure we also flatten our own fear and anxiety curve.

I cannot wait for the day to re-open my clinics and hug every person coming through the door. We cannot live without touch or connection. We are hard wired for touch and connection. As the saying goes: It is the first language we speak and the last language and one our nervous system so desperately needs.
 
Take good care of yourselves and of your loved ones. Stay safe.
​Dorine 


PS I could not say it any better than this. "Before you Catch the Virus -Watch this"
https://www.youtube.com/watch?v=LBi85WjeDyg
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When Trauma strikes. Addressing physiological and biological nervous system responses in the healing of trauma through Craniosacral Therapy

9/14/2019

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Trauma is often only understood as a psychological reaction that we need to deal with in the mind. Trauma is also very much a physiological reaction that keeps circulating in the body long after the 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 charge fight/flight or freeze response. This undischarged residual energy can, remain in our body for many years as an incomplete physiological response manifesting itself as physical symptoms like e.g.: sleep disturbances, anxiety, hyper vigilance, tinnitus, digestive problems, jaw problems, back problems, migraines, depression, inflammation and be a host to all sorts of other chronic pain and illnesses. The key to resolving and healing Trauma lies in our physiology, in our bodily responses that needs to be resolved and discharged. (M. Kern, Wisdom in the body, 2005). Our physiology is regulated by our nervous system. Our nervous system sends messages to our body and has a big role to play in creating and maintaining our symptoms. No other modality addresses the nervous system like Craniosacral Therapy (CST). CST lowers the sympathetic nervous system responsible for our fight/fight and enhances our parasympathetic nervous system responsible for our freeze response but also for our relaxation response. CST allows the body to come back into 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 illnesses, as I witness in my clinics on a daily basis.

CST addresses a wide variety of symptoms and conditions from physical pains, structural misalignments, muscular tensions to emotional blockages. During my training, trauma and stress release was definitely my favourite subject: working with the nervous system survival responses and the residual effects of trauma lodged in the body.………. Ironically, never in a million years did I think trauma would strike me. I came to experience what I had learned during my education when a good few years ago, my world became a very dark and lonely place as I suffered a severe physical & emotional trauma. As a result, I experienced a multitude of physical symptoms: non-stop raging headaches, migraines, tinnitus, neck pain, poor blood circulation, anxiety, nerve tingling and extreme sensitivity to sounds and light, to name a few. For months, I was unable to sleep or eat. The rug had 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 from tramadol to oxycodone to oxycontin. I ended up being the Pharmacy.
 
I wanted to clear my anxious state, calm my nervous system, improve my sleeping but most of all find relief for all my physical symptoms by resolving them at root cause. I did not want a pill for every ill as I personally could not see, how that would resolve anything at root cause or bring any long-term solution, as the primary innate biological forces that controlled my symptoms seemed to be overlooked, disregarded and not addressed. Thank goodness I knew Cranio and turned to my colleague: a highly skilled buddy and certified Cranio angel extraordinaire.

During my first few cranial sessions we focused on my mental and emotional body, getting me back into my body, becoming less disassociated, as my body was a terrifying place to be in. In fact, for the first 2 sessions I was not able to get on the table, touch was just too overwhelming. My nervous system was in an state of constant sympathetic arousal and my bodily systems so overwhelmed. My therapist focused on calming my nervous system, allowing me to become less anxious, less hyper-vigilant and releasing the undischarged residual energy in a very safe and contained way. We focused on my disturbed vagus nerve. My therapist could only move as fast as my body felt safe to let go, peeling away the layers whilst she facilitated an incredible safe space and presence for me to do so. In further sessions, we were able to deal with my physical body and its pain. I became aware of how much tension I had really been holding, as my therapist was unwinding the tissues, layer by layer and releasing restrictions and pain. In one session I could feel this immense anger bubbling up, because of what had happened. I had no idea that this anger but also intense sadness had been living so 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 did clear all my physical and mental symptoms by addressing my nervous system that was so out of whack and overwhelmed. Frequent Craniosacral sessions also addressed my physiology and my fascia in my physical body and CST addressed my emotional body by releasing all these emotions that I had stored. CST truely acknowledges the whole person and works with the interconnected physical, mental, emotional and soul body, creating change on every level.
 
Thank goodness I found my way back to my happy, bubbly, pain-free, belly laughing self with even a greater passion, empathy and understanding for my work and for all my clients. In my own practice I see people with all kinds of symptoms: acute, one-off or with more chronic and long-standing problems. For these clients their history often reveals that there has been a long road of other seemingly unrelated problems, inflammations, anxiety, autoimmune conditions or neurological problems. By the time these clients come and see me, they have taken various roads to try and resolve their symptoms. They have had things cut out, removed, fused, worked on but are still in pain and often on long-term medication as a 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 wants to be addressed, medication will only suppress it for a limited time and new symptoms will eventually pop up. The nervous system wants to be addressed and it will use symptoms, behaviour or certain patterns like addiction to get our attention to heal the root cause.
 
Trauma can be a one-off significant event but trauma can also be experienced in a more slow, cumulative kind of way through childhood adversity like an abusive parent/sibling, an emotionally cold, alcoholic, absent or mentally unwell parent. It can be experienced through work, accidents, illness or toxic relationships. Most of my clients are aware that there is some level off trauma on an intellectual level but are unaware of the imprints the trauma has left in their body, mind and soul on a more primal level. Their experiences have created physiological effects in their body, left 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 it's natural balance, and allowing the natural forces within us to come into play and self-correct is the strongest and longest lasting healing there ever could be.
 

References:
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, no words could ever describe Biodynamic Craniosacral Therapist:  Monica Bovy - www.cranio-sante.ch

​
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Cranial Nerves for Vertigo, Sinusitis, Neck & Shoulder pain, TMJ, Anxiety and PolyVagal

5/31/2019

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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.
Cranial Nerve
Function
Symptoms
Bones&
​Muscles affecting the nerve
Special Feature
I Olfactory 
Nose
Smell
Reduced smelling
Sphenoid,
Frontal & Ethmoid bones
Direct pathway into the forebrain. Smells elicit a strong emotional reaction as a primitive and instinctual reflex
II Optic -Eyes
Vision
Blurred, foggy or double `vision
Eye strain
Headaches
Sphenoid Bone
Rectus muscles of the eyes
Originates in Forebrain
III Oculomotor
Eyes
Looking
Double Vision, lazy eye or difficulty with depth perception Reactivity to light Sinus problems Headaches
Sphenoid &
Temporal Bones
Rectus muscles of the eye
Part of the Parasympathetic Nervous System -rest and digest
IV Trochlear
Eyes
Looking
Difficulty looking outwards and downwards
Depth perception
Double vision/Lazy eye
Headaches
Sphenoid &
Temporal bones
Rectus muscles of the eye    
-
​V- Trigeminal
Face– 3 Divisions:
Ophthalmic
Maxillary
Mandibular


​​Chewing & Swallowing
TMJ dysfunction Jaw problems
Opening and closing jaw
Sensory changes in face and teeth
Tinnitus
Trigeminal Neuralgia
Headaches
Migraines
Sinusitis

Sphenoid, Temporal
Maxilla (lower jaw)
Bones


Polyvagal – Social Engagement
&
Responsible for Tensor Tympani – eardrum muscle can be involved in Tinnitus/Hyperacusi
s

VI - ​Abducens
Eyes
Looking
Depth perception
Lazy eye
Headaches
Sphenoid Bone
Rectus Muscles of the eye
-
VII - Facial
Chewing
Movement of muscles of the face – tensing and relaxing
Changes in fascial muscle  – Bells Palsy
Mouth asymetry
Changes in nasal secretions and tear formation
Hyperacusis - Tinnitus
Temporal Bone
Polyvagal – Social Engagement.
Responsible for Stapedius muscle – protecting inner ear from high noise levels 
Part of the Parasympathetic Nervous System -rest and digest

VIII Vestibulocochlear -
Ears
Hearing: translates sound waves into nerve impulses & Equilibrium
Problems with hearing, Hearing sensitivity, Tinnitus,
Problems with balance,
Dizziness
Temporal Bone
Cochlear part responsible for hearing
Vestibulo part for balance

IX-Glosso-
Pharyngeal-
Tongue
Swallowing
Changes in Blood pressure and breathing
Difficulty swallowing
Saliva problems
Gag reflex
Changes to taste sensation


Temporal & Occipital bones
Sub-occipital muscles


Assists in regulating Blood pressure
 

 
Part of the Parasympathetic Nervous System -rest and digest


X-Vagus Nerve 
Throat
Lungs, Heart
Abdomen organs: pancreas/liver
Kidneys
Intestines


Innervates Throat. esophagus, regulates heart and lungs, abdominal organs and small and ascending and transverse part of the large intestines.

Responsible for many symptoms like:
Heart rate or blood pressure problems
Swallowing problems
Throat problems
Nausea
Throwing up
Anxiety
Depression


Temporal & Occipital Bones
Suboccipital Muscles
Thoracic inlet
Respiratory Diaphragm

75% responsible for our Parasympathetic, rest and digest nervous system and Homeostasis
 
Poly Vagal Model: Two branches:
Ventral Vagus Branch (Social Engagement)
Dorsal Vagus Branch (withdrawal/shutdown)


XI - Accessory -
Neck and Upper Shoulder
Innervates the Trapezius and Sterno
Cleidomastoid
Muscles – allows you to turn your head and neck
Tension in SCM and Trapezius muscles – Neck and Shoulders
Temporal & Occipital Bones
Suboccipital muscles
Lateral rectus muscle

SCM and Trapezius muscles can pull shoulder and spine out of alignment.
XII - Hypoglossal -
Tongue​
Moves the tongue
Problems with speech or swallowing and sticking tongue out
Occipital bone &
Sub-occipital muscles
-
 ​
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
      and nerves.

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 !

References :
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.
  • Class Notes Biodynamic Craniosacral Therapy & Class notes Cranial Anatomy– Kientalerhof Switzerland 2011. As always, I deeply acknowledge my brilliant teacher Friedrich Wolf who provided an outstanding craniosacral education and not only included oa the Sutherland model, the Polyvagal model, Birth Trauma and Franklyn Sills, Michael Kern, Michael Shea & Hugh Milne teachings but also many of his own teachings and deep life lessons. 
  • Face to Face with the Face by Thomas Attalee (2016)– a brilliant recommendable handbook for students and practitioners.
  • Accessing the Healing power of the Vagus Nerve – Stanley Rosenberg (2017)
  • Online: www.antranik.org/cranial nerves
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Brain Trauma - Concussion

1/18/2019

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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.
 
Picture

 Image:Levent Efe
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
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). 

Symptoms
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.
Physical Symptoms
Mental/Emotional Symptoms
Cognitive Symptoms
Headaches
Pressure in the head
Disorientation
Difficulty concentrating
Dizziness, balance problems, lack of coordination, nausea, vomiting 
Irritability
Feeling dazed, Memory problems or memory loss, Confusion
Double or blurry vision
Excessive worrying
Numbness
Sleepiness Excessive Fatigue
Nervousness
Foggy

Ringing in the ears, Tinnitus, Tingling
Agitated, Anger
Difficulty paying attention
Feeling dazed, Memory Loss, Confusion 
Mood changes& Mood swings – feeling down or hopeless
Excessive use of medicine or numbing agents
Sensitivity to noise and light
Anxiety
Depression 

-
Treatment
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: 
  • CST releases any external forces that may affected the cranial bones and/or been absorbed by the attached intracranial membrane system (the connective tissue inside our head), restoring motion to the bones and motility to the intracranial membranes. CST works on the cerebrospinal fluid and the autonomic nervous system.
  • CST can decrease the pain signals and tension in the body and brain, allowing the whole system to relax, bringing the nervous system back into balance, breaking the pattern of excessive nerve firing, muscle tension, anxiety and sleeping problems.
  • CST increases circulation to the brain, restoring the oxygen and fluid flow to the brain, allowing any lesions in the brain to heal.
  • CST can loosen abnormal tension within the skull and body by releasing connective tissue restrictions, adhesions, compromised motion and any compensatory patterns in the skull or whole body.
  • CST recognises the body’s ability to heal itself, as CST practitioners we set up the right environment to facilitate that process, giving the body a chance to move into a homeostatic state.
  • In CST we can feel the presence of electrical vibration present in tissues and release the shock, the trauma that is being held in the tissues.
 
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”.
or
As your brain would say – I lobe it. 


References:
Like us on Facebook: The Sydney Craniosacral Centre
_______
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:
  • https://qbi.uq.edu.au/concussion/what-is-concussion
  • Ricky Williams Pilot Study – You tube - https://www.youtube.com/watch?v=N05_BZAdZnk
  • www. Massage mag.com – Craniosacral therapies-concussion
  • https://www.momsteam.com/health-safety/craniosacral-therapy-may-help-lesson-symptoms-post-concussion-syndrome
  • https://www.massagemag.com/craniosacral-therapys-concussions-and-cte-88271/
Great article
  • http://www.upledger.org/docs/CranioSacral-Therapy-and-Concussion-Mariann-Sisco-for-FSMTA-Dec-2014.pdf
 
 

 
 




 

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Ventral Vagus Healing & Craniosacral Therapy

11/8/2018

9 Comments

 
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).
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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.
​
  • Cranial Nerve 5 – Trigeminal Nerve: face and jaw chewing muscles.
  • Cranial Nerve 7 – Facial Nerve: controls hearing, middle ear and all facial muscles for communicative facial expressions and mimic. Neural regulation for the middle ear muscles.
  • Cranial Nerve 9 – Glossopharyngeal Nerve: Tongue, Throat, Swallowing. Responsible for sounds produced by the Voice box, vocal tone and creating sounds.
  • Cranial Nerve 10 -  Ventral Vagus Nerve branch– innervates small muscles in the throat, saliva.
  • Cranial Nerve 11 – Accessory Nerve: Innervates the Trapezius and Sternocleidomastoid (SCM) muscles in the neck for head and neck movement, orientation and being able to turn you head.
 
Behaviours we display when Socially Engaged:
  • We feel safe
  • We are connected to ourselves and to others,
  • We can be intimate
  • We reach out to connect with other people, we are able to bond
  • We are calm, breathe easily and we can think clearly
  • Muscles are relaxed
  • We feel playful, we dance, sing and belly laugh
  • We feel love and are able to truly love
  • We can truly relax and relax into connection with others
  • One with the world – feeling the world is open and full of opportunities
Symptoms we can have when not socially engaged:
  • We feel anxious or are not able to relax around ourselves and others,
  • We feel shut down or depressed.
  • We are overwhelmed.
  • We feel anger, disgust, shame.
  • We compulsively have to Do things – as Eckhart Tolle describes so beautifully we are human doings rather than human beings.
  • We are wired.
  • We are loners – don’t really engage and hide from the world.
  • I ............... What do you do? Please fill in your own unique thing you do when you are not socially engaged.
 
Craniosacral Therapy
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:
  • to bring clients out of a state of stress, shutdown or withdrawal and up to the level of social engagement. To bring the body back into a safe state -  you can only use your social nervous system when you feel safe. Many people think they may feel safe in their body and in relation to the world. However, we all know people that can only hold 2-minute fleeting conversations, they can’t sit still for too long, they always have to be doing something for example, cleaning the kitchen or having excessive gym workouts to distract them from their discomfort. This is because they live in a perpetual fight and flight mode and are channelling their fight and flight anxiety into these activities. To sit down and do “nothing” or to be truly intimate would be too daunting.
  • to address the cranial nerves associated with the Social Engagement System.
  • to achieve optimal physical and psychological health so the body can start to self-regulate and bring positive changes to the ANS. We need to have a self-regulating ANS to maintain good health. With my clients I focus on resourcing, guided meditations and/or breathing exercises so they can become more flexible in their coping styles.
  • to achieve a state of social engagement and well-being.
  • to create an environment of safety. As biodynamic craniosacral therapist we ensure the tone of our voice is calm, soft facial expressions, creating a safe space. Clients often describe me as gentle, soft and calming but I can assure you there is Cold Chisel loving Jimmy Barnes rock chick underneath, in ventral vagus state of course:)

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”.

Like on Facebook: The Sydney Craniosacral 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 (eg enteric nervous system) and keep it relevant to the topic. Great detailed information and recommended reading for people who like to know more:
References:
  • Porges, S. (2001) The Polyvagal Theory: phylogenetic substrates of a social nervous system, Elsevier Psychophysiology 2001
  • Polyvagal Class notes 2011 - my brilliant teacher Friedrich Wolf: International School of Biodynamic Craniosacral Therapy, Kiental, Switzerland​
  • Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. 
  • Rosenberg, S (2017) – Accessing the healing power of the Vagus Nerve​
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Depression, Anxiety, the Vagus Nerve and Craniosacral Therapy

7/20/2018

12 Comments

 
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. 
Picture
Vagus Nerve
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.

Picture
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:
  • The Ventral Vagus Nerve (VVN) that is associated with increases in health and emotional wellbeing as it generates positive states of relaxation and social engagement, also known as the Social Nervous System. The VVN innervates the areas above the diaphragm: heart, lungs, throat, voice box, larynx, middle ear, face.
  • The Dorsal Vagus Nerve (DVN) which can have huge consequences on our mental and physical health as it generates slowdown, shutdown and depressive behaviour. The Dorsal Vagus Nerve influences the organs below the diaphragm, stomach, kidneys and intestines.

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:
  • Depression: feeling helpless, numb and hopeless. We may have difficulty in organising our thoughts and remembering. We tend to be inward focused, losing touch with ourselves and our surroundings, unresponsive.
  • Hands and feet are cold and clammy as blood and oxygen that are usually in our arms and legs for fight and flight, are being directed to our chest and abdomen to keep basic functioning going.
  • Muscles and tissues lose their normal tone. Blood pressure does not have to pump as hard to push blood through and can lead to low pressure which can cause dizziness & light headedness.
  • Various symptoms of ANS deregulation – heart rate slows down, breathing becomes shallow, feeling that we can’t breathe, lower blood pressure, gut stops working or totally empties, sweating, nausea.
  • Pain can often move around to different parts in our body, sometimes we don’t even register pain as awareness is shut down.
 
Craniosacral Treatment for Chronic Dorsal Vagal Activation
The basic goal of CST treatment is to lift the client from a chronic Dorsal Vagal state into activation of Ventral Vagus Nerve. During a CST treatment and with our subtle movements and it’s subtle as we listen, feel, touch and work with the most delicate structures of the body, we aim to:
  1. Balance the Ventral and Dorsal Branches of the Vagus Nerve. This can be done by mobilising the cranial bones to reduce any pressure on the cranial nerves as they come through various openings into the skull and/or bringing both branches back into balance.
  2. Restoring, calming and strengthening the Nervous System, resetting its physiology so it can start to self-regulate.
  3. Bringing the nerves back under their firing threshold
  4. Releasing any compression/jamming at the base of the Skull to increase blood flow and oxygen back into our brain.
  5. Letting the body come back into balance so that any symptoms of depressive behaviour and shutdown can be reversed, regulating breathing & digestion.
  6. Maximise the movement of CSF (clear liquid that circulates around our brain and spinal cord and carries a lot of nutrients and carries away waste product) – so metabolic waste products can be better eliminated and tissues nourished.
  7. Freeing the connective tissues and its structures in the skull (Dural membranes) and around the cervical neck vertebrae’s.
 
Conclusion
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?
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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 dorinesiccama@yahoo.com and/or like my Facebook Page: The Sydney Craniosacral Therapy Centre
 
References:
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:
  • Porges, S. (2001) The Polyvagal Theory: phylogenetic substrates of a social nervous system, Elsevier Psychophysiology 2001
  • The Bulletproof Executive (2013) – Transcript of Stephen Porges: The Polyvagal Theory & The Vagal Nerve
  • Rosenberg, S (2017) – Accessing the healing power of the Vagus Nerve
  • Polyvagal Class notes 2011 - my brilliant teacher Friedrich Wolf: International School of Biodynamic Craniosacral Therapy, Kiental, Switzerland
 


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Tinnitus Syndrome- A New Treatment Model - The brain is not at rest (updated&Revised)

7/1/2018

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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). 
  • Our auditory pathways are hard wired to the limbic system which is where the emotional centre in your brain lies and in particular to the Amygdala - which is the brain's alarm system and storehouse of emotion-linked memory. The hearing apparatus of the inner ear and autonomic nervous system provide sensory input to the Amygdala, every time a real or perceived threat presents itself to us, making us hyper vigilant. Ears play a big role in our biological stress response, making our sensory perceptions more acute so we can pick up any danger in the fight and flight, hyper vigilant arousal. If it stays too switched on, you may start to hear your own internal noises, the noises of your nervous system. 
  • The auditory vestibular nerve, known as the eighth cranial nerve, transmits sound and equilibrium through the hair cells of the inner ear to the brain. It originates in our brainstem - which is where our fight and flight lies. The nerve exits the inner skull via the internal acoustic meatus in the temporal bone.
  • People with Tinnitus often have very tight neck and shoulders. We use all of our sense organs in our head, as a basic universal motor pattern, for gathering information as we scan our environment for input. The muscles of the head and neck are intimately involved in this sensory information and brace themselves in response to any real or perceived threat and/or fight/flight survival in a muscular holding pattern and can lead to persistent Myofascial pain. 
  • The two large muscles in the neck and shoulders that contribute to Neck and Shoulder pain, are the Sternocleidomastoid (SCM) and Trapezius also known as the emotional muscle. These two muscles allow us to look up, down, sideways and turn our head. Survival depends on being able to turn the head effortlessly and these muscles are mainly responsible for it. Both muscles are innervated by Cranial Nerve XI - This spinal accessory nerve, emerges from the brainstem, where our fight and flight lies. (All other 650 + muscles in our body are innervated by the spinal nerves) and a dysfunction here can lead to sore neck and shoulder muscles.
  • People with Tinnitus also often have TMJ problems. Can TMJ be a structural cause of Tinnitus? I think it is part of the overall syndrome and is a contributing factor. Jaw clenching is a primitive reflex based on instinctual survival patterns and also a muscular bracing pattern linked to arousal. Common problems of Cranial Nerve Dysfunction are tightly clenched teeth and grinding. TMJ problems are a well-known symptom of stress  We mainly clench at night, a time where we process our experiences of the day. 
  • Some Tinnitus people have none of the above symptoms or very mildly but have conflicting inner thought processes and negative stuck thought processes acting as a pressure cooker but mainly lying below conscious awareness that causes them unduly stress, anxiety and/or inverted anger: "You cant let go of what you don't know and don't acknowledge. 
  • Some people may develop Tinnitus after a one-off trauma like a physical trauma to the head or body. I have had a client with Tinnitus after a one coward punch to the head where the temporal bones were clearly implicated but also the central nervous system, or a client whom after an operation, where many things went wrong and the body went in shutdown during the operation, woke up with Tinnitus. Again here it is dealing with the trauma, fight and flight lodged in the body as it is about resting the brain tissues and working with cranial bones and muscular restrictions.

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.
 
References: 
  • Tinnitus: From Tyrant to friend - how to let go of the ringing in your ears - Julian Cowan Hill - 2010. I want to thank Julian for being a pioneer in bringing relieve and hope to Tinnitus sufferers and being an inspiration to the Craniosacral Community and beyond.
  • Tinnitus: Ringing in the Brain | Josef Rauschecker | TEDx (online - youtube)
  • Living with Tinnitus - sbs life - online www.sbs.com.au -  the sound that comes from nowhere.
  • www.Neurosciencenews.com/tinnitus-attention-7378 (online) University of Illinois - "ringing in ears keeps brain more at attention and less at rest".
  • Buddha’s brain: the practical neuroscience of happiness, love and wisdom. Hanson, Rick 2009.

Keep up to date with news, research and my upcoming book with oa Tinnitus case studies.

F
acebook page: The Sydney Craniosacral Therapy Centre or follow me on Instagram: craniosacralsydney.
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    Dorine Siccama

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