Demystifying CranioSacral Therapy
Making a case for a nontraditional therapy in mainstream OT practice

By Mandy Lubas, OTR/L, RYT
Originally published on ADVANCE Magazine on March 19, 2014

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As a holistic occupational therapist I am noticing a sparked interest in other OTs who would like to incorporate manual therapy into their treatment sessions, and many OTs already doing this. Craniosacral therapy (CST) is a light-touch manual therapy that OTs can easily bring into their treatment sessions anytime and anywhere. I’ve had the pleasure of educating OTs by putting Craniosacral therapy into action in front of their own eyes. They were amazed at the positive feedback given by the clients that I treat.

By educating and inspiring OTs to learn CST techniques or to become certified we are giving our clients the gift of “human touch” to gently facilitate the free flow and ease of movement of all the body’s fluids, membranes, muscles, and fascia. Occupational therapists are tuned-in practitioners and through CST training we are able to perceive more deeply what our own bodies and our clients are telling us. By studying CST with qualified teachers, a therapist will receive their own healing by experiencing this modality first hand. That way we will become a better resource or conduit to free others from suffering with tension, stress, or dysfunction in all its manifestations. Craniosacral therapy is a tool using your own two hands.

History of Craniosacral Therapy

Craniosacral therapeutics was originated by Harold MaGoun based on work by E. Swedenborg, A.T. Still and William G. Sutherland. Dr. John Upledger named his form of CST “CranioSacral Therapy.” The craniosacral rhythm was identified in 1719 by Emmanuel Swedenborg, a physician and scientist who claimed there were pulsatile movements of the waters of the brain that communicated with the other parts of the body.

Later the term Craniosacral therapy was created, and originates from the workings of Andrew Still (1828-1917), William Sutherland, DO, (1873-1954) and Dr. John Upledger (1932-2013). Along this lineage, Franklyn Sills, biodynamic craniosacral therapist, and Hugh Milne, a visionary craniosacral therapist, were vital branches to this continuum. Sutherland had a passion for working with the cranial system.

Sutherland believed that the cranial bones moved in relation to each other throughout life rather than hardening in childhood. How did he discover this? By palpating. These rhythms can be palpated on different parts of the body. By palpating craniosacral movement, Sutherland discovered the movement to be regular and rhythmical. Upledger later refined Sutherland’s original concepts and created the term Cranisosacral therapy. Upledger further added theories and research about the origin of the cranial rhythmic impulse as well as producing extensive training programs for practitioners all over the world.

What Does Craniosacral Therapy Involve?

Craniosacral Therapy is a form of body work that’s gentle, non-invasive, and hands-on. It is designed to assess and monitor the cranial sacral rhythm to encourage the body to heal itself. Light touch of approximately 5 grams of pressure (the weight of a dime) is placed on a client’s, body allowing the practitioner to listen to the body in its most natural state.

“The Craniosacral System is a physiological structure that extends from the cranium through a system of membranes through the spine to the sacrum,” according to Jodi Carlson. This system involves the assessment of the anatomy of the body vertically and horizontally, involving the bones of the skull and face, the spine, and the sacrum. It also entails the dural tube that surrounds these structures and the cerebrospinal spinal fluid that fills the dural tube.

This amazing system includes the workings of a fluid exchange system between the arterial blood flow to the head and the draining of the fluid back into the venous return flow. These are the workings of the cerebral spinal fluid (CSF) and the rhythms or wave can be used therapeutically to help heal, prevent illness, and promote wellness.

Sutherland described a pulling force while palpating the tissues under the skin. This force is felt more readily at the cranium or sacrum at a rate of 6-12 cycles per minute. This is the cerebrospinal spinal fluid talking. “Be Still and Know, I am” are the words expressed by Sutherland to describe the feelings of the therapeutic force, otherwise known as the Breath of Life.

Don Ash, PT, who is my Craniosacral therapy teacher, speaks about rhythms in the body. Everyone has several kinds of rhythms in their body. There is the cardiac rhythm, the respiratory rhythms of breathing, and underneath that is the Craniosacral rhythm (CSR). This rhythm has “Intelligence.” It is the tide that is making the corrections. Structure follows function!

Craniosacral Therapy (CST) Benefits

As a result of Craniosacral therapy being a holistic modality, a client is able to connect to his or her underlying health, which I equate with the term “life force.” Craniosacral therapy will benefit a client’s general health, function, and sense of well-being for healthy change for all ages.

Normal function of the body is dependent on normal functioning of the craniosacral system. Therapy reduces accumulated physiological stress for the body to function optimally. When a client taps into their own stillness, the relaxation response is created, allowing for miraculous things to happen to their body and mind. Conditions that benefit from CST are headaches (specifically migraines), back and neck pain, TMJ, chronic fatigue, fibromyalgia, motor coordination, eye problems, autism, Erb’s Palsy, chronic pain syndrome, traumatic brain injury, learning disabilities, stress, anxiety, post-traumatic stress, orthopedic issues, scoliosis, and tinnitus (ringing in ears).

Craniosacral therapy can help bring wholeness, greater ability to deal with life’s obstacles or journeys, contentment, life transformations, joy, and connectedness to others. CST can be helpful with the above, but we say CST does not “cure,” but rather encourages the body to heal itself.

CST in OT Scope of Practice

Craniosacral therapy can be utilized on many levels and for many purposes in several occupational therapy settings. My own journey has manifested into being the facilitator for others to heal. I have used CST in an outpatient clinic setting, a school with children who have autism, home settings, and yoga studios.

As occupational therapists, we are able to provide manual therapy to our clients because we have a license to touch. This has allowed me to think “outside of the box” and use CST techniques before, during, and after therapeutic activities and exercises. My most memorable experience was treating a 7-year-old boy who had poor body mechanics when sleeping. He would hyperextend his neck while lying on his back while in deep sleep. This posturing impacted his daily life as a student and when playing on the playground with his peers. While in school he had difficulty attending because his neck was always hurting him. At recess he became uncoordinated and presented with lordosis, impacting gross motor play.

During two Craniosacral Therapy sessions it was evident that his sacrum had decreased joint mobility, causing his cervical spine to hyperextend. After applying manual therapy to his cranium and decompressing his sacrum (L5-S1), his sacrum experienced freedom and motion. This client was also referred to an osteopath with whom I have consulted on a regular basis to share findings in order to provide the best manual techniques to improve the quality of care for this child.

My adult population has received Craniosacral therapy to reduce chronic pain from fibromyalgia and neck-related injuries. CST services were also rendered for clients with gastrointestinal issues. I worked with a woman in her seventies with a diagnosis of interstitial cystitis inflammation of the bladder wall, diabetes, and cancer of the intestinal walls. She acquired cysts that affected the nerve endings of her intestinal wall, impacting bowel management (i.e. a nice ADL term for constipation).

After two mini-Craniosacral sessions along with nutritional changes and lifestyle modifications using yoga and Ayurveda, she was able to have a full bowel movement without the use of 4-6 miralax pills a day. Her quality of life improved as she was less irritable throughout the day as a result of improving her bowel management.

The workings of Craniosacral Therapy in a school setting are quite interesting and unique. I am a consultant for a private school called Nashoba Learning Group in Bedford, MA. This is a beautiful school that services children with autism.

I work with the most loving teachers and professionals who have allowed me to share this work with them by receiving their own mini-sessions and observing their students’ sessions with me. I use a “still point,” which refers to a stopping of the craniosacral rhythm. By touching the student’s head in a gentle manner and using specific techniques they become perfectly still. I’ve worked with this technique as little as two minutes, up to eight minutes. As a result it was noted by teachers that the students are able to participate in their school programs with less anxiety and outbursts.

Lastly, I want to share my passion of using Craniosacral therapy in the yoga classes I teach, particularly in a restorative class. The students receive about three Craniosacral therapy techniques (rock and glide, vault holds, and still points at the feet and head) to tap into the parasympathetic nervous system deeper while in relaxing yoga poses. Students report that they feel lighter, that weight has been lifted off of their shoulders, a profound sense of stillness, and that they experience sensations in their body that make them feel more connected to themselves.

Anyone, anywhere, at any time can receive Cranisacral therapy. Stillness lies within the body and cannot be discovered in the external world.

Who can Become Certified in Craniosacral Therapy

Those who can become certified in Craniosacral Therapy are health care practitioners such as occupational therapists, physical therapists, massage therapists, nurses, physicians, and dentists who are licensed to touch the body as a way of adding this skill to their existing practice. There are a few trainings for certifications in CST. My training with Don Ash, PT, CST-D at Craniosacral Therapy Alliance in Rochester, NH, has been a “wow” training experience for me. The small class size, hands-on experience, Don’s knowledge and passion, the education, philosophy, and research discussed has surpassed my expectation, making me thirsty for more. As a student I was able to immediately take the work learned right into my scope of practice and utilize all the techniques. Don is always available via e-mail, a phone call, or a refresher course to answer any questions or to deepen skills already learned.

A Personal Journey

Healing comes from the body’s true knowing. I make this statement because “true knowing” to me is when I am fully able to trust my own body to heal itself. By receiving Craniosacral therapy my body was supported by the most gentle hands and presence, allowing my body to “let go” and unwind the tension that was built up. My autonomic nervous system became flexible and adaptable in order to handle life’s triumphs and disappointments. I then quickly learned that by softening from the inside out, our bodies are wired to heal regardless of our “inner stories” of trauma on all levels — mind, body, and soul. Whatever we tell the mind to do, the body will do! We can heal at the cellular level because the body is our best friend.

I love this Buddhist proverb, “When the student is ready, the teacher will appear!” The workings of the universe unfold in miraculous ways. I fully understand the reasoning for experiencing all the bumps in the road growing up. It has prepared me to fully embrace the experiences that have been presented to me on a spiritual journey involving holistic therapies, especially Craniosacral therapy.

I have been receiving Craniosacral Therapy treatments on and off since 2008 to heal wounds that almost every single human being encounters at some point. Everybody is different in how their body reacts to specific situations; as a result, Cranisacral work is experienced differently by each person.

For me, I wanted to peel away the traumatic memories that were lodged into my blueprint from familial trauma and societal conditioning. Each treatment session that I had received allowed the layers to become thinner and thinner. This has allowed me to reach a level of deeper clarity in order to discern my way through life confidentially.

I want to acknowledge three Craniosacral therapists who have taken me to a deeper level of knowing, allowing me to trust what has been unfolding before my eyes: Mimi Nelson Oliver, RCST, at B’Yado Healthenergy; Johanna Hattendorf, LMT, at The Spiral Path; and Don Ash, PT, CST-D at Craniosacral Therapy Alliance. Their true devotion, compassion, love, and level of professionalism have set me free on many levels. I will continue to receive Craniosacral therapy from these individuals and will further my studies with Don at CST Alliance and my mentorship with Johanna. I thank you from the bottom of my heart!



1. Lessons from the Sessions
Don Ash, PT, CST-D
2. Your Inner Physician and You
John E. Upledger, D.O., O.M.M

Research Articles

Volume 17, Number 1, 2011, pp. 13-17
Mary Ann Liebert, Inc.
DOI: 10.1089/acm.2009.0644
2. Multipractitioner Upledger CranioSacral Therapy:
Descriptive Outcome Study 2007-2008
Rachel E. Harrison, MBChB, MRCGP, MFHom, CST,1 and John S. Page, CST-D, MCSS2
3. Jäkel, Anne A systematic review to evaluate the clinical benefits of craniosacral therapy. Complementary therapies in medicine. (12/2012) , 20 (6), p. 456 – 465


Certification Programs

The Craniosacral Therapy Alliance (CSTAlliance) is a continuing education provider with the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) #451232-10 and awards CEUs for all CSTAlliance Curriculum classes

Mandy Lubas is a licensed and registered holistic occupational therapist who works with the pediatric, adult, and older adult populations. She is a registered yoga teacher and Ayurveda Wellness Counselor and is working toward her certification in Craniosacral Therapy. She can be reached at [email protected]

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