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Hey folks!  I've spent all week trying to remember what I was supposed to ask you about and I finally did!  One day ahead of my client being here...I'm hoping you have time to help!  One of my clients just found out that she has a hiatal hernia and she's hoping I can help her with it.  I'm planning to do a CranioSacral Therapy Respiratory Diaphragm release; do any of you have any suggestions for how to help with a hiatal hernia?

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I don't see how CST can help with that.  A hiatal hernia is a pocket that food and acid can collect in, and worse, it can strangle blood supply to the stomach.  It is deep within the body, and CST purports to affect the flow of craniosacral fluid only-- or maybe they're now claiming it can also affect things like blood flow through the organs? 

I'm not sure who taught you about CST; they apparently had a negative attitude about it or were unknowledgeable.  CST is about a whole-body approach; yes it affects the flow of CSF but it also (at least the Upledger form of CST) is focused on releasing fascial restrictions in the body.  This includes restrictions at each of the major transverse fascial structures including the respiratory diaphragm.   The reason I would use it here is because it's a very gentle approach that allows the body to unwind itself and would offer the respiratory diaphragm the ability to find its own way to a correction. 

Therese, sorry if I offended --am about to offend you.  CST seems to have evolved from its original Sutherland design, which was strictly influencing the flow of cranio-sacral fluid through the brain stem and spinal cord, a concept which I could buy into.  But, honestly, my opinion of the claims made by Upledger is not high.  Having said that, admittedly I have never had the opportunity to have a CST treatment.  Again, my apologies if I offend you.  I value our friendship.

http://www.quackwatch.com/01QuackeryRelatedTopics/cranial.html

an excerpt:

"Some of Upledger's beliefs are among the strangest I have ever encountered. Chapter 2 of his book, CranoSacral Therapy: Touchstone of Natural Healing, describes how he discovered and communicates with what he calls the patient's "Inner Physician":

By connecting deeply with a patient while doing CranioSacral Therapy, it was possible in most cases to solicit contact with the patient's Inner Physician. It also became clear that the Inner Physician could take any for m the patient could imagine —an image, a voice or a feeling. Usually once the image of the Inner Physician appeared, it was ready to dialog with me and answer questions about the underlying causes of the patient's health problems and what can be done to resolve them. It also became clear that when the conversation with the Inner Physician was authentic, the craniosacral system went into a holding pattern [7].

The chapter goes on to describe Upledger's care of a four-month-old French baby who was "as floppy as a rag doll." Although the baby had never been exposed to English, Upledger decided to see whether the baby's "Inner Physician" would communicate with him via the craniosacral system:

I requested aloud in English that the craniosacral rhythm stop if the answer to a question was "yes" and not stop if the answer was "no." The rhythm stopped for about ten seconds. I took this as an indication that I was being understood. I then asked if it was possible during this session for the rhythm to stop only in response to my question and not for other reasons, such as body position, etc., The rhythm stopped again. I was feeling more confident. I proceeded [7].

Using "yes-no answers," Upledger says, he pinpointed the problem as "a toxin that was inhaled by the mother . . . over a period of about two-and-a-half hours while cleaning the grease off an antique automobile engine" during the fourth month of pregnancy. After "asking many particulars" about what he should do, Upledger was told to "pump the parietal bones that form a large part of the roof of the skull, and to pass a lot of my energy through the brain from the back of the skull to the front." As he did this, Upledger frequently checked with the baby's "Inner Physician." After about an hour, Upledger says, the baby began to move normally [7].

Two Deaths Reported

Relying on CST instead of effective treatment can be dangerous. Moreover, its practice indicates poor judgement that may harm patients in other ways. At least two deaths associated with craniosacral therapy have been reported."

HI Gary,  I get a little defensive sometimes; I've dedicated a LOT of time and energy to learning CST!  I've never heard anything but rumors about the deaths related to CST; all I can say is that there is bad application of good techniques in every field.  OK, I went to the link and read the summaries of the deaths.  Those had nothing to do with CST and everything to do with stupidity on the part of the "therapist".

I've used the "yes, no" system with clients and animals; it's a way of being understood at a pre-verbal level.  I've also had some detailed conversations with clients' bodies and been given clear instructions about how to proceed.  It all happens at an intuitive level.  I'm no where near as good as John Upledger; he had a unique combination of an extremely high intellect and a wide-open intuition.  The work he did with people was spectacular, and he had a very strong desire to facilitate the healing process.

CST practitioners in the Upledger program are taught to be gentle, careful and to put their egos aside in order to treat clients.  It's always supposed to be about the highest and best good of the client, never about the agenda of the therapist.  I don't know about other systems.

The idea that the skull bones fuse after adolescence is perpetuated only in England and the US that I know of; this idea is beginning to shift finally.  Movement of the skull bones was scientifically measured by Upledger.

I think that people have a tendency to attack that which they don't understand; look at all the religious violence out there!

If one of their instructors came here, and gave demo class first, I would attend, and if I could afford the CEU class at the time, would perhaps sign up.  It just seems to me that the way it's being taught today, it is closer to Barnes' version of MFR "unwindings"  than to what my textbooks say CST once was.  

Admittedly, I don't know diddly about it now.

I'm not stalking this thread! :)  I just have a client in a few minutes so I thought I'd check.

The story I heard (and you know how stories can be!) is that Barnes and Upledger were once good friends and worked together.  Something happened and they wouldn't talk to each other.  I don't have any verification of this, but it does explain why some of their work is so very closely related.  The names are different but effectively they are very similar, in my experience.

It definitely is different than CST used to be.  It used to involve a lot more force; Uplegder insisted that low forces over longer time was the way to go.

I don't exclusively use CST in my practice but it has produced some amazing results for me and my clients.  So have MFR, LDT and massage; I find that a balanced approach works really well - I do what I need to, when I need to.

Hello Therese,

I just found this thread and I have exactly the same question: "I'm planning to do a CranioSacral Therapy Respiratory Diaphragm release; do any of you have any suggestions for how to help with a hiatal hernia?" I was wondering you ended up trying with your client with Hiatal Hernia.

By the way, I liked your responses to the thread.

Thanks in advance for sharing any knowledge gained from your experience working with this condition.

A haiatal hernia is where the stomach pushes up through the small opening in the diaphram. The stomach is normally below the diaphram. I dont see how CranioSacral Therapy can help that? But I can't see how it would make things worse either. I do know that often times internal organ stress shows up on the back at the spinal segments that inervate the organ or organs of distress. The diaphram would be T8ish and the stomach would be T6ish. If there is tenderness in those areas, down grading that tendernes would perhaps bring symptomatic relief. Also visceral stress often shows up as tender areas on the abdominal area. Same thing. Down grade the tendernes and you would give symtomatic relief. Those tender areas agrivate the visceral stress. The Stomach meridian, Spleen meridian, Kidney meridian, and the Bladder meridian all run through those areas. Perhaps massaging the major points on those meridians would help? At any rate , the worst thing that can happen( unless you are brutal), is nothing.

Gordon, CST can potentially help because a respiratory diaphragm release (there are actually 5 diaphragm releases done - pelvic, respiratory, thoracic, hyoid and occiput/C1) can encourage the tissue to release in such a way that the stomach could reposition itself.  Notice all the words I'm using - the therapist doesn't dictate what the outcome is (if he/she is a good therapist).  The hands are placed on the client's body in specific places to be able to take the stress patterns out of the tissues; pressure is applied one gram at a time until tissue engagement begins.  At that point, the tissue is allowed to release in whatever way it needs to.

KRMG - Thanks for your comments!  I honestly don't remember what happened with that client.  It's been a long time ago now!  I do remember my husband (who has a small hiatal hernia) suggesting "don't mess with it".  My suggestion is to tune into the tissues and ask what would be most beneficial.  The wisdom of the body will always let us know!  It keeps us from getting our egos/agendas in the way too.  Which CST classes have you had?  I want to gear my answers in the best way for you.  If you haven't yet gone beyond CST 1, I will expand my above answer to give you more help in how to do the dialoging with the tissues.  If you have, I don't want to seem pedantic.

Thanks Gordon and Therese,

Therese, of course you're right about tuning into the body and I was expecting that to appear in your answer ;)  I was just curious because as I said I had exactly the same question and the same inclination to "open the gates".  I've only done CST levels I & II and would definitely love to "dialogue" more with the tissues.  I'm still a new practitioner, so all in due time :)

I love having a few tools to use in cases like this.  After an overall assessment, I used CST, massage as well as Jin Shin Jyutsu, all which appeared to be helpful. This, after the client's initial perception upon leaving the session.  The pulses indicated the diaphragm and heart energies needed support.  I did JSJ flows for the diaphragm, and stomach and sent her home with self help for the spleen.  So, Gordon some of the organs you mentioned called out for attention and all will benefit from the treatment :)

Thank you both again.  Great to have a forum like this to share and ask questions especially since I'm a new practitioner and I'm one of very few foreigners doing this type of work in Hanoi.

KRMG - it takes a long time (at least it has for me!  I've been doing this for 6 years now and still learning every day!!) to develop really strong CST and dialoging skills.  I just got back 2 days ago from being a TA for a CST 2 class; it was wonderful!  The instructor was very encouraging of the students dialoging with the tissues and the clients' (and their own) inner wisdoms.  There are a couple of ways you can do that.  One is to tune into the CranioSacral Rhythm (CSR) and ask it to show you "yes".  Then ask yes/no questions and have the CSR give you the answer.  I encouraged the students to ask things like "is this where I'm supposed to be?".  Several of them wondered if they should work "here" or "there"; I always had them ask the client's body.  It takes self doubt out of it, and as one student pointed out, it also takes the practitioner's ego out of it.

Another way you can do it is to get really grounded and then blend/meld with the tissues (don't think of it as blending with the client - that's a whole Pandora's box of issues!).  Ask questions and listen for the answers.  You might get an image, a picture of where your hands should go, words that you hear...the info comes through in many different ways.  No hard and fast rules on this!

I've never heard of JSJ!  It sounds great!

I hope that helped!  

Therese, my opinion of CST was formulated after many visits to Upledger's website.  CST today is not the CST taught by its inventor Sullivan.  Upledger derived his whole body approach from his former close friend John Barnes' MFR.  I've researched CST and can find not one convincing explanation of a mechanism for craniosacral fluid to flow throughout the body.  I fail t understand how a CST practitioner can manipulate skull bones with the lightest of touch while people die every day due to this very same craniosacral fluid building up within its sheath surrounding the brain-- if extreme brain-killing fluid pressure within the skull cannot force the bones to separate even a silly millimeter, then, Therese, I just cannot accept that light finger pressure can manipulate the bones. 

The skull of an infant is pliable, will expand prodigiously, but the fluid pressure caused by hydrocephalus will still inhibit the baby's brain growth, leading to retardation and a lifetime of disabilities.  They now have a treatment for that...they install a tube that drains the fluid either into his stomach or in severe cases into a bag strapped to his waist.  Why don't they instead treat the infant with CST...move all that fluid from its skull with CST gentle touch?

I know that expressing my negative opinion of your favorite modality may affect our friendship.  I hope you don't take it personally.  I respect you as a therapist and as a person.  Likewise, my dissing TT and by inference other energy modalities will create enemies.  But, frankly, I think Upledger's teachings are simply ludicrous. 

How does the tissue answer your questions? How does that work exactly?-- A discernible CSF pulse that only those specially trained can feel?  Sorta like a Therapeutic Touch practitioner zoning in on the flow of chi via his hovering hands? Or like a Sioux medicine man feeling evil spirits  in the smoke of his magical herbs? 

Oh, I don't doubt that you feel "it".   Anyone who holds their hands perfectly still, either above the body or on the tissue, will eventually feel a throbbing, a warmth, a "something".  Some have labeled it Universal Chi.  CST faithful refer to it as Craniosacral fluid pulse.  When I feel it, I believe it to be the pulse within my own own capillaries.  As for it providing you a negative or a positive answer, there's a logical explanation for that.  Our pulse, our muscles, our sweat glands, even our fascia reacts to our emotions; lie detectors rely on these physical reactions.  There's a who category of forensics specialists who are said to be "human lie detectors" who can discern wee nervous tics of liars.  I understand that a CST practitioner isn't seeking a criminal's lie-- but he/she is seeking answers to questions.  Because the therapist is operating on heightened emotions during the session, he can subtly influence his own perceptions of what he "feels"-- indeed, as the suspect's belief in a lie detector machine's infallibility subtly influences how he reacts physically, the CST practitioner's expectations will subtly guide what he "feels". 

Therese, can I with zero training in CST lay my hand, with your guidance, on the very same spot that has just given you a "yes" or a "no", feel that CSF pulse?  Contrast that with how easily anyone -- even the untrained teenage boy who lives next door-- can be taught to locate a trigger point-- as you palpate for tenderness, when you poke a trigger point, the body on your table will react, there is no mistaking the body's reaction to pain.  And when that "knot" (it isn't really a knot) begins to release, the client can feel it occur, and usually so can you.  No guesswork, no relying on a sensation that only a thoroughly indoctrinated CST practioner can feel.

When you get the opportunity, you really should fly to Anchorage for a session with Gordon.  Trigger point therapy skillfully given really has a magical effect on the client.  But unlike CST, it ain't magic; it relies solely on a physical reaction to a physical dysfunction, and the result is instantaneous.

JSJ = Jin Shin Jyutsu.


Therese Schwartz said:

I'm not sure who taught you about CST; they apparently had a negative attitude about it or were unknowledgeable.  CST is about a whole-body approach; yes it affects the flow of CSF but it also (at least the Upledger form of CST) is focused on releasing fascial restrictions in the body.  This includes restrictions at each of the major transverse fascial structures including the respiratory diaphragm.   The reason I would use it here is because it's a very gentle approach that allows the body to unwind itself and would offer the respiratory diaphragm the ability to find its own way to a correction. 

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