Craniosacral touch and the perception of inherent health

Craniosacral touch and the perception of inherent health

Craniosacral Touch and the Perception of Inherent Health

Be still, and know that I am God (Psalms 46:10)


According to Ron Kurtz, the founder of The Hakomi Method of body-centred psychotherapy:

‘In a study of master therapists, like Milton Erickson, Virginia Satir and others, it turned out that they held certain assumptions in common. The most surprising, to me, of these was the assumption that there is no real problem. The client may feel there is a problem, but the master therapist “knows” there isn’t.’[i]

The implication of this statement encapsulates for me the essence of craniosacral work. Craniosacral therapy and osteopathy from which it derives are based on the belief that the human body is an intelligent and self-regulating system, at the heart of which lies health – an inherent health that is never lost.

We could tell our patients this but it would have as much effect as a psychotherapist telling a client there is no problem. The important aspect of Kurtz’s statement is not that the master therapist believes that there is no real problem but that s/he ‘knows’ it.

In craniosacral work the same is true. The craniosacral therapist does not simply believe that there is an inherent health at the heart of the patient’s system but knows it through direct and repeated experience.

We could argue forever as to whether or not inherent health exists but the curious fact is that when I sense it in my patients they sense it too. When they relax into its stillness with me an often quite extraordinary process of healing unfolds.


In 1988 an osteopathic adjustment of my left sacroiliac joint left me house bound and in intense pain for several months. My visiting Doctor couldn’t help me; his painkillers made me wheeze. My physiotherapist neighbour couldn’t help me; her methods were just too painful for me to bear. When I was able to walk rather than crawl I had X-rays taken but they revealed nothing of significance.

A year later and still in pain I overcame my fear of osteopathy and submitted myself to the hands of a highly recommended practitioner. The first session was reassuringly relaxing with nothing of the high velocity thrusts I had come to associate with the work. During the second session something miraculous happened.

I was sitting on the table while the osteopath gently held her hands around the back of my neck. Suddenly I entered a dream state and felt the inside of my spine relax throughout its length. In that moment I had a flash of memory of a forgotten accident in which I landed with great force on my right buttock. That accident no doubt caused the conditions that my first osteopath sought to relieve with his adjustment. In that moment of recall my pain completely disappeared.

More remarkable than that sudden healing was the extraordinarily peaceful atmosphere that permeated the osteopath’s room. We were both moved close to tears.

Years later as a masseur I experienced similar moments while working with patients. These moments seemed to arise spontaneously and always included a sense that the atmosphere in and beyond the room had changed, as if permeated by a quality that can only be described as love or compassion. These moments always brought with them a profound and rapid process of healing in the patient.

It was the wish to understand experiences like these that led me to study craniosacral therapy. In 1995 I had the good fortune to train with Franklyn Sills. The course drew largely on the work of William Garner Sutherland, the originator of osteopathy in the cranial field and John Upledger who originally coined the term craniosacral therapy to describe his approach to cranial work.

The great benefit of training with Franklyn Sills was that he didn’t simply demonstrate techniques but entered into a real session. It soon became clear that there was another level of work going on – one that wasn’t being talked about and had little to do with the actual techniques of craniosacral therapy. It was that level that interested me because that was what drew me to the work in the first place.

The Development of Craniosacral Work

Since 1995 much has changed in the world of craniosacral therapy. If we turn briefly to the life journey of its founder, William Garner Sutherland, we will see that since its conception that has always been the nature of the work.

In 1899 as a student of osteopathy Sutherland was struck by the thought that the cranial bones did not fuse, as was generally believed, but remained forever mobile at the sutures. From then until the late 1920’s he developed this idea and experimented with the application of osteopathic technique to the cranial bones.

In the early 1930’s Sutherland turned his attention from the cranial bones to the dural membranes within. He perceived a continuity of the membranes from where within the skull they contain and support the brain, down to the sacrum as the dural sheath surrounding and protecting the spinal cord. He described this membrane envelope as ‘tadpole like’ and named it the Core Link. His work deepened to include the resolution of tensions organised by this membrane system.

In the late 1930’s Sutherland’s attention was drawn to the cerebrospinal fluid (CSF) within the Core Link and to the palpable fluctuation of that fluid. From here he developed his theory of the primary respiratory mechanism (PRM). This theory was based on five palpable phenomena, which he collectively called the cranial rhythmic impulse (CRI). These five phenomena are:

  • the inherent motility of the brain and the spinal cord;
  • the inherent fluctuation of cerebrospinal fluid;
  • the inherent motility of the intracranial and intraspinal membranes;
  • the mobility of the cranial bones at their sutural articulations;
  • the involuntary mobility of the sacrum between the ilia of the pelvis.

They are said to occur with a rate of between six and twelve[ii] (or 8-14[iii]) cycles per minute. The theory of CRI became and remains the foundation of osteopathy in the cranial field. Various theories have been advanced over the years to explain its cause.

Sutherland originally thought that rhythmic contractions and dilations of the ventricles within the brain caused a wave of movement through the cerebrospinal fluid. However in 1943 he described the ‘Breath of Life’, sensing it as an external force generating the movements of CRI within the body. Sutherland’s choice of term was no accident. As a Christian it was natural for him to acknowledge God’s presence as the creative force of nature.

In the last years of his life Sutherland abandoned his classical osteopathic techniques altogether and started to work directly with the healing power of the Breath of Life expressed as an ordering force, known as ‘potency’, throughout the fluids of the body. Thus was born Sutherland’s appreciation of the body as a self-correcting system.[iv]

After his death in 1957, Sutherland’s students Rollin Becker and Robert Fulford continued to develop this approach to osteopathy. James Jealous, another osteopath, augmented the work with Eric Blechschmidt’s theories of embryological development.

Blechschmidt suggested that an external force creates the spatial orientation within which the fluids of the embryo organise. This generates an ordering matrix that governs the further development of the embryo. For Jealous and his colleagues this external force is that same Breath of Life to which Sutherland referred.[v]

Jealous borrowed from Blechschmidt the term ‘Biodynamic’ and called his particular approach to osteopathy the Biodynamic Model of Osteopathy in the Cranial Field (BOCF)[vi]. In this approach it is believed that the ordering matrix generated by the Breath of Life remains forever present, manifesting as inherent health at the core of the human system.

As well as generating the rhythmic movements of CRI the Breath of Life is also said to unfold at slower rhythms. Unlike the variable rhythm of the CRI these slower rhythms are stable. They are not palpated but sensed.

One of these is known as the Tide or the Long Tide. Sills refers to it as ‘an expression of the intention of the Breath of Life to create a human being’ and goes on to say that it is perceived as ‘a direct organising intention within and around the patient’.[vii]

Another is referred to by osteopaths as CPM[viii] and by Sills as the mid-tide. Sills says that when the practitioner perceives the mid-tide within the patient ‘potency, fluids and tissues can be clearly perceived to be a unity, or a unit of function.’[ix]

Perception as a Therapeutic Skill

Since 1983 when John Upledger published his book ‘Craniosacral Therapy’ and established the work as a discrete therapeutic modality distinct from the osteopathic world from which it emerged there has been an ongoing debate as to what exactly craniosacral therapy is and just who is fit to practice it.

From the perspective of the osteopathic community, training for the work should be at the level of that undertaken by an osteopath – that is to say the same level of training in anatomy, physiology, pathology and differential diagnosis as that expected of a Medical Doctor.

If the practitioner’s intention is to test for and correct dysfunction in the various aspects of the Primary Respiratory Mechanism I would wholeheartedly agree with this position. There is abundant need for this kind of highly specialised diagnostic and therapeutic work and it should remain firmly within the hands of osteopaths and others with an equivalent level of knowledge.

There is however a whole other level to the work, a level that I touched on accidentally in my work as a masseur and that I sensed was taking place when I sat in class as Franklyn Sills demonstrated his work. This is the level of working directly with the intelligence and inherent health expressed through the fluids of the body. This is the level that I believe should be shared with all therapists regardless of their approach.

As we can see from the brief history of the development of cranial work by Sutherland it is actually multi-layered: encompassing the bones, the membranes, the fluids and the mystery of expression of the Breath of Life.

Sutherland’s personal journey of discovery and its continuation in the hands of all practitioners who undertake the work is, perhaps, not so much to do with the acquisition and application of theory and techniques as the development of the perceptual and relationship skills of the practitioner.

Jealous says: ‘Osteopathy has shamefully hidden its Greatest Mystery and resources. I believe that to acknowledge a higher wisdom at work and to sense rather than palpate is at the Soul of Osteopathy.’[x]

There are two important aspects to this statement. One concerns the perceptual skills of the practitioner. The other refers to knowing that at the heart of the human system there is inherent health.

Of the first Jealous said that he ‘discovered that his therapeutic results improved in proportion to the extent to which he could free himself from conscious rationalization.’[xi]

This idea is not unique to craniosacral therapy. Freud, in 1912, referred to the state of consciousness required of the psychoanalyst when he talked of ‘evenly poised attention’. This is described as:

‘as complete a suspension as possible of everything which usually focuses the attention: personal inclinations, prejudices, and theoretical assumptions however well grounded they might be.’[xii]

Theodor Reik, a student of Freud called it ‘listening with the third ear’.[xiii]

Fritz Smith, the creator of ‘Zero Balancing’ refers to a ‘witness state of observation’ in which the practitioner is ‘uncritical, non-judgemental, expectation-free and uninvolved with an active thought process.’[xiv]

Dr Milton Trager who founded the Trager Approach to bodywork referred to this state as ‘Hook-Up’ and insisted that the practitioner must work on developing this state of consciousness in order to stimulate it in someone else.[xv]

In craniosacral work it is referred to as the ‘neutral’. This is a state of stillness and openness; of reception rather than transmission; of listening rather than doing.

The second aspect of Jealous’ statement is perhaps what makes craniosacral work unique as a body therapy. This aspect is the acknowledgement of the inherent health of the patient and the practitioner’s intention to work with it.

The neutral of craniosacral work is not simply a passive and receptive state but involves an alive and active intention to perceive the intelligence and health at the core of the patient’s system. Curiously, this does not involve a focussing of attention but a widening of the therapist’s perceptual field so as to relate to the whole of the patient and the surrounding environment.

With practice we may experience what Sills refers to as the holistic shift.[xvi] Suddenly the sense of relating to the intelligence organising our patient’s body becomes a reality and not just an idea. We may sense an extraordinary stillness as a presence in the room. We may even sense that the stillness extends beyond the room as if the whole world outside has engaged with the process. 

When we experience the holistic shift we know that our patient has entered a neutral state too. Jealous says of this:

‘With enhanced perceptual skills, the practitioner eventually perceives a sense of Neutral, which is experienced as a homogenization of tissue, fluid, and potency – the Fluid Body, where nothing under the fingertips can be discerned as a separate entity… The Neutral cannot be conceptualised; it can only be experienced. It is here that “holism” becomes more than a philosophical concept, it can be appreciated as an actual sensory perception.’[xvii]

As we settle into the neutral with our patient we see them change. They slip into a deep relaxation. We see their eyes slowly rolling from side to side under the lids. We feel their breathing settle into a relaxed and natural rhythm. As our observation becomes ever more subtle and receptive we might notice colour changes in their skin. We may see the lines of their face soften and the shape of their body change, as the muscles quite literally become more fluid. We may catch ripples of movement through their muscles, perhaps spontaneous twitches and adjustments.

Sometimes we feel their relaxation deepen still further. Our patient’s eyes settle and sink into their sockets. We hear the beginnings of a snore developing in their throat. We sense a potential in the air like that just before it snows or storms. With experience we come to know that these signs herald profound shifts within our patient. Often we will observe broad movements throughout their entire fluid body. We come to know that in those brief moments the patient often revisits and resolves highly traumatic past events.

Over time as we question our patients we realise that there are many common qualities to this state. Although the patient feels very relaxed they rarely experience themselves as asleep. Instead they have a sense of great awareness and peace.

Many patients describe images of the past arising and passing like dreams. Many describe inner sensations such heat or cold or fluid passing through their bodies. Many describe an awareness of inner light and colour.

Time and again I have watched in awe as the patient’s body resolves an injury or adjusts a postural imbalance. Time and again I have heard patients describe the experience as religious. Time and again I have worked with patients undergoing treatment for cancer or even in the terminal stages of a disease who come out of a session with a deep sense of peace and well being.

Therapy As Enquiry

‘Life is not a riddle to be solved but a mystery to be lived.’

Paul Koralek

Despite many years working with craniosacral therapy it continues to enthral and surprise me. I constantly question what it is that I do and what it is that is happening as I work. My practice is a work in progress as is my description of the work.

I can rationalise the concept of the neutral as can any therapist working with an awareness of the therapeutic relationship. I have always believed that in any therapeutic relationship the patient is more aware than the therapist, simply because they have more at stake.

In psychoanalysis it was long ago suggested that beneath the ordinary aspect of the relationship lies a direct communication between the unconscious of the patient and the unconscious of the therapist.[xviii] In body therapy this unconscious dialogue may be even clearer, freed as it is from the fog of words and conducted as it is through the body, our primary means of communication before words.

When I bring my hands in relationship to my patient I have no doubt that they are reading my intentions and assessing whether or not I am fit to share their story. If my intention is to apply my techniques my patient will do his or her best to humour me.

If my intention is to relate to my patient at the level of their inherent health and intelligence an altogether different process takes place. Now my techniques are subtle invitations to talk. When the patient’s body accepts to tell its story all I need do is keep quiet, listen and follow the story as it unfolds.

Although I use the term ‘craniosacral’ to describe my work I wonder if the master therapists to whom Ron Kurtz referred had not themselves intuited the same truth. To them, at the core of the patient there is no real problem. To me at the core of the patient there is inherent health.


Clarification of Terms


According to the website of the General Osteopathic Council of the UK Osteopathy is a way of detecting and treating damaged parts of the body such as muscles, ligaments, nerves and joints. When the body is balanced and efficient, just like a well tuned engine, it will function with the minimum of wear and tear, leaving more energy for living[xix].

Osteopathy in the Cranial Field – also called Cranial Osteopathy.

Cranial Osteopathy is a refined and subtle type of osteopathic treatment that uses very gentle manipulative pressure to encourage the release of stresses throughout the body, including the head[xx].

Biodynamic Osteopathy in the Cranial Field (BOCF)

The approach to Osteopathy taught by James Jealous’. Jealous ‘characterized traditional osteopathy as a science based on anatomy, whereas BOCF is a science based on embryology’.[xxi]

Craniosacral Therapy

The term used by John Upledger to describe the work that he teaches outside the osteopathic community.

Craniosacral Biodynamics

Franklyn Sills approach to craniosacral therapy. This draws on the work of William Garner Sutherland, Randolph Stone, Rollin Becker and James Jealous.



[i] Kurtz R. Body Centered Psychotherapy. LifeRhythm. Mendocino. 1990. p10.

[ii] McPartland JM & Skinner E. The Biodynamic Model of Osteopathy in the Cranial Field. EXPLORE 2005; 1 (1) 24.

[iii] Sills F. Craniosacral Biodynamics Vol 1. North Atlantic Books. Berkely. 2001. p38.

[iv] McPartland JM & Skinner E. The Biodynamic Model of Osteopathy in the Cranial Field. EXPLORE 2005; 1 (1) 24.

[v] IBID. 27.

[vi] IBID. 21.

[vii] Sills F. Craniosacral Biodynamics Vol 1. North Atlantic Books. Berkely. 2001. p418.

[viii] McPartland JM & Skinner E. The Biodynamic Model of Osteopathy in the Cranial Field. EXPLORE 2005; 1 (1) 24.

[ix] Sills F. Craniosacral Biodynamics Vol 1. North Atlantic Books. Berkely. 2001. p38.

[x] From James Jealous’ website.

[xi] McPartland JM & Skinner E. The Biodynamic Model of Osteopathy in the Cranial Field. EXPLORE 2005; 1 (1) 27.

[xii] Laplanche J & Pontalis JB. The Language of Psychoanalysis. Karnac Books. London. 1988. p43.

[xiii] IBID. p44.

[xiv] Smith FF. Inner Bridges. Humanics New Age, Atlanta. 1998. p110.

[xv] Juhan D. Job’s Body. Station Hill Press. New York. 2003. p377.

[xvi] Sills F. Craniosacral Biodynamics Vol 2. North Atlantic Books. Berkely. 2004. p5.

[xvii] McPartland JM & Skinner E. The Biodynamic Model of Osteopathy in the Cranial Field. EXPLORE 2005; 1 (1) 26.

[xviii] Laplanche J & Pontalis JB. The Language of Psychoanalysis. Karnac Books. London. 1988. p93.

[xix] From the website of the General Osteopathic Council in the UK.

[xx] From the website of the Sutherland Cranial College.

[xxi] McPartland JM & Skinner E. The Biodynamic Model of Osteopathy in the Cranial Field. EXPLORE 2005; 1 (1) 27.

Author: Howard Evans
Copyright © 2023 Howard Evans. All rights reserved

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