Craniosacral Therapy & Clinical Massage

Recovery from Stress & Pain in Brighton & Hove, Lewes and Haywards Heath, call Steve on 07731 549836


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Craniosacral Therapy and Recovery from Anaesthetic

As a Craniosacral Therapist, I regularly meet clients preparing and recovering from surgery in my private practice and in a hospital in Brighton where I work alongside medically trained colleagues specialising in respite and medical convalescence. I find that the effects of general anaesthetic appear to linger in some people beyond the normal recovery period, sometimes for days or weeks after the surgery and possibly longer. While most people recover well, some experience a range of sensations that can feel disorienting and distressing if left unresolved. I’d like to highlight some of the common experiences I’ve encountered and describe how I support clients through their recovery process.

What happens under general anaesthetic?

General anaesthesia is a whole person experience, affecting body, brain and mind. The variety of medications used ensure the following responses:

  • Analgesia — loss of response to pain and sensation
  • Amnesia — loss of memory
  • Immobility — loss of motor reflexes and control of reflexes of the autonomic nervous system
  • Unconsciousness
  • Relaxation of skeletal muscles

The skill of Anaesthetists and the drugs used continue to be refined and this progress means that people are treated more and more safely and effectively. Hopefully, most people will recover from anaesthetic with no problems although as with all medication, some will respond differently to the combination of drugs used. In these instances, I often hear the following experiences:

  • “I feel like I’m floating and my feet aren’t touching the ground”
  • “There’s a delay from when I decide to do something to when my body actually moves”
  • “A part/side of my body feels like it’s not really there”
  • “I want to burst into tears or shout at someone and I have no idea why?”
  • “I feel like I’m in a dream, everything’s a bit hazy”
  • “I feel as if I’m about to fall over or bump into something”
  • “I have an underlying sense of panic and I don’t know why”

Even when the surgery is deemed successful, the body, brain and mind can appear to respond “as if” still anaesthetised even though the anaesthetic chemicals have been metabolised, perhaps in a non-conscious attempt to maintain a sense of safety. This is fine in the short-term but problematic if it becomes a habitual way of being. These residual effects have the potential to impair the clarity and nuance of movement, body sensation, spacial awareness and emotions.

Emotional Responses

As emotions are experienced in the body, anaesthetic often stimulates an emotional response in addition to the changes in perception and sensation. Along with the physical implications of surgery, “not feeling the body” can distort the sense of self and bring up feelings of fear, sadness and anger. The intense immobilisation and disorientation of anaesthesia, coupled with the loss of control to the surgical team can lead to a sense of vulnerability, agitation and helplessness. This can happen even when the client ‘rationally’ understands that the surgeon is highly skilled and empathic and the operation was successful. The emotional response of the patient needs to be acknowledged and respected whatever the response, and reintegrating a sense of the body is an essential part of this process.

Reintegrating Sensation and Movement with Craniosacral Therapy

In Craniosacral sessions I use touch and simple conversation with the client about their body awareness to support feelings of safety and relaxation. This helps the client to feel their way back into their body in present time so that their physiology no longer responds “as if” still anaesthetised. Returning to sensation too quickly can in itself feel overwhelming after being in such a deeply immobilised state which is one of the reasons why the gentle pace of Craniosacral Therapy is so effective. The numbing effect of anaesthetic means that clients often comment how they weren’t aware that they “couldn’t feel their legs or their connection with the ground” until they have been held in this way.

Sometimes clients feel clumsy, uncoordinated and slow after anaesthetic, their limbs can feel like they aren’t quite connected to the body. Mis-timing small movements can go with the sense of “the body not really being there” or sometimes that the whole body feels like “a ghost” or “a hologram“. While gross movements usually return quickly,   subtle movement is sometimes slower to return so I often help clients to engage with simple, gentle physical movement to help ‘light up’ parts of the body that feel disconnected.

An enormous amount of energy is used to immobilise a whole living system, the surplus of this energy needs to be discharged while coming out of this state and mammals naturally do this through movement. Human physiology is similar to other mammals in this respect yet many of the medications used in human anaesthesia are designed to stop post-operative shivering. Shivering, twitching or trembling sometimes happen in a craniosacral session and I reassure and support clients to do this safely.

Feeling Grounded, Vital and Full

The disorientation caused by anaesthetic can be subtle, distressing and confusing and this is why I think it is so important for people to be supported through the process so that they can reestablish their sense of body, space and self.  Craniosacral Therapy helps the haze of anaesthesia to clear and is followed by a more grounded, fuller sense of the body and a clearer mind.

NB – The medical priority

Maintaining communication with the primary care services available (eg Doctor or Surgical Consultant) is obviously the priority for the client to ensure safety from a medical perspective and there are many vital ways that rehabilitation is supported in this way. The support I offer to clients is ‘complementary tonotinstead of‘ medical care. Anyone who has had surgery or anaesthetic needs to speak with their primary care contact in the first instance and particularly if they have any concerns about their health.


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Movement Multivitamin

Much of my clinical work as a Craniosacral Therapist involves supporting clients to develop their skill in feeling safe, centred and grounded in their body. When this felt-sense of the body really starts lighting up, clients often find that their physical movement in day-to-day life improves and they have more energy and motivation to get moving by starting new exercise or movement practices or rekindling former passions like sport, dance or yoga. Movement feeds our ability to feel our bodies with huge physical and psychological benefits. With this in mind and as part of my own self care, I decided to do the 28 day Movement Multivitamin course with GMB, here’s a summary of my experiences.

GMB and the MMV Course

I became interested in GMB’s approach having tried out a few of their tutorials on youtube with gymnastics style training for non-gymnasts and found immediate benefit from them. The emphasis on skill rather than quantity was a big motivator for me and much more enjoyable than training for ‘how far’, ‘how fast’ and ‘how heavy, how many times’ etc.

The MMV course is 28 days long, split into four weeks, each week has a theme and each day has its own movement. Every morning, I received an email prompt to login to the site for the day’s video tutorial (usually 5-7 mins long) containing instructions and demonstrations of the day’s movement with progressions from a super-simple version, right through to more advanced skills. Each week started with an intro video preparing the week’s theme and ended with a summary, review and feedback session to integrate the movements from each day.

For 28 days I had different rolling, cartwheeling, crawling, squatting and jumping movements to learn and play with, some of which were familiar, some were new, some I had not done since childhood and some I have NEVER been able to do. Whatever my previous experience of the movement, I gained something from each one. Whether 2, 15 or 30 minutes, the idea was to dedicate time each day to doing the day’s movement. This kept things fresh while practicing and also created excitement for the next day, “I wonder where we go from here?“.

What I liked and learned from the GMB MMV

I had fun! This was more of an open-ended exploration of movement than a race to cross the finish line. The emphasis was explicitly on exploring, playing and having fun with movement. The explanations were simple and clear with excellent demonstrations, supported by a lighthearted presentation style which I found really helpful in letting go of my desire to “get it right” or becoming wrapped up in whether or not I was able to do the advanced version of the movement. Point being, there was something to enjoy every step of the way, at every progression, everyday so long as I paid attention to being present with the movement. A playful mind leads to playful movement.

Movements were not named, beyond Week 1 Day 2 etc, which made a surprising difference to how I approached each day. Although I knew Week 1 Day 5 as a forward roll, there was something really helpful in NOT calling it “a forward roll”. There were some movements where seeing the name would bring up preconceptions about whether it was possible or how to do it, “a cartwheel?! I CAN’T do a cartwheel!” or “crow pose?! I find balances REALLY difficult!”, or “a forward roll?! piece of cake, I’ll skip straight to the advanced progression!”. Not naming the movements helped me approach them with a more open (beginner’s) mind, removing a load of pressure and fear, giving more space to feel my way into exploring the movement. There was no way of knowing which movements were coming up later in the course meaning that I had to focus on the current day, a great tool in staying present!

Community. Knowing that other people from a wide range of body types and abilities are trying the movements and having fun at every stage is really inspiring. There are also comments from the site coaches and members are encouraged to post videos of themselves for more in-depth feedback. I found motivation from watching the progress of the other members doing the early progressions as much as the more advanced ones. This peer support also helped on days when I created excuses to skip the day’s movement, things like “my room is too small” and then seeing how others had moved their sofas or found more space elsewhere!

Simple instruction. Less was definitely more when it came to the descriptions and demonstrations of the movements. Having less talk about the absolute specifics of how to perform a movement reduced the lead towards doing the movement ‘perfectly‘ which can take away from feeling the experience of learning the skill and demotivate (“only THE BEST will do, so why bother trying?“). The simple language used gave me more space to explore and work through the movements at my own pace, I  noticed my body responding differently with this mindset.

Progression. The structure of the course meant that foundations were laid from week to week, setting up new skills for the latter stages. Each day also had a thorough range of progressions, meaning that even on a day where I was not YET able to do the more advanced version, I had a solid foundational move to start practicing and so still had a sense of progress. Even the advanced moves were described as being just one of the possible ways of doing this movement and others will appear if you play around enough. With a new movement every day, I found I made exponential progress over the 28 days as I was picking up and at least attempting more complex moves with a greater sense of openness, confidence and enthusiasm than at the start of the course. In other words, my brain and body were getting better at learning new skills and responding accordingly.

My biggest take home from the course is the importance to just move, EVERY DAY. Being mindful and having fun with movement made the experience much more rewarding and enjoyable, meaning that I was more motivated to keep practicing and playing. A few weeks have passed since finishing the course and I’m still playing around with most of the moves, making good progress and having a great time crawling, rolling and bouncing around my living room floor and as a result, I feel I’m moving better in all other areas of my life.


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Personality of an Optimist

Dr Michael Mosley‘s list of excellent BBC Horizon documentaries, including ‘The Truth about Food‘ and ‘The Truth about Exercise‘, now includes ‘The Truth about Personality‘ another really accessible programme. Filled with great information and insight, the content is understandable for non-scientists. Dr Mosley integrates different scientific perspectives from a range of international experts while relating the findings to his own life.

Over the course of the programme, optimistic and pessimistic tendencies are explored in terms of the impact of stress on the brain, how our unconscious mind gives attention to ‘positive’ and ‘negative’ cues from our environment, and the effect this has on how we relate to other people. Through a range of psychological tests and some honest self-reflection, Dr Mosley explores the balance between optimism and pessimism and what this means for humans progressing through life. Are we stuck at one end of the spectrum based on our genes, our childhood and our experiences, or is there potential for change, and how can we help ourselves to change?

In the first experiment, Prof Elaine Fox from Essex University used an EEG to scan Dr Mosley’s brain activity while testing his reaction time in response to a series of facial images, flashed just long enough to enter his subconscious with a mixture of happy/relaxed or unhappy/stressed faces. His responses showed that his subconscious was faster at taking in the unhappy/stressed faces than the happy/relaxed ones and his brain activity concentrated on the areas activated in stressful situations. In other words, subconsciously, his brain found it easier to take a ‘negative’ stimulus than a ‘positive’ stimulus.

To see if this could change, Dr Mosley had to watch a series of images daily for the next two months, picking out the happy/relaxed faces. The process is called ‘Cognitive Bias Modification‘ (CBM), consciously training the brain to pick out the ‘positive’ rather than the ‘negative’. Dr Mosley trained his brain for  eight weeks with CBM before repeating the tests, the results of which would be considered alongside the other exercise he practiced, being Mindfulness Meditation. After an introductory session with meditation teacher Andy Puddicombe, Dr Mosley meditated daily for ten minutes over the eight weeks before being retested by Prof Fox. In this time, his tendency had rebalanced meaning that his subconscious now picked out the ‘positive’ stimulus faster than the negative and his brain activity changed from showing signs of stress to relaxation while performing the task. Over an eight week period, there were measurable changes to  his brain activity and in addition to his general sense of wellbeing, his insomnia had improved significantly having lived with the condition for over 20 years.

In my craniosacral practice I use a combination of Somatic Mindfulness (ie offering attention to the sense of body through touch) and what might be called ‘Somatic Bias Modification‘. I help people to find safe and relaxing ways of paying attention to feelings in the body, even in times of stress and discomfort so that the brain can change to have more of a tendency towards health and comfort.

There is some evidence that optimism and pessimism have a genetic component, certain genes are expressed and passed between generations depending on parental influence. Dr Mosley however, talked about the emerging field of epigenetics and how genes can be altered by changes to behaviour and environmental factors. In the programme, studies involving rats showed that genes associated with stress are more active and present in rats that had less nurturing contact as babies. There are comparable findings for humans, with touch being an important marker for a positive outlook. Thankfully, what the studies also show is that these genetic predispositions to pessimism can change across generations when conditions and behaviours are changed, for example in ways similar to the exercises learned by Dr Mosley.

Prof Roz Picard from MIT conducted (pun intended) another experiment on Dr Mosley using sensors to detect the nerve conductivity in his skin to measure his emotional state (driven by the autonomic nervous system). According to Prof Picard, “your body tells you there’s a change in your state long before your mind recognises there’s a change“. Becoming more familiar with how our bodies feel, for example through the work I do with touch, people can learn to sense and understand the messages the body sends the brain in response to stress and emotions, with more awareness there is more choice.

Dr Mosley finishes the documentary on an optimistic note, “life events can have deep, long lasting and measurable effects on our brains but our personalities are far more malleable than many of us think“. If you have a tendency towards feeling ‘stuck’ and thinking of yourself as ‘a pessimist’, it’s worth remembering that with practice and support, you can change…


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Juggling with Rhythm and Motion

Michael Moschen‘s TED.com video (at end of this post) on juggling with ‘Rhythm and Motion‘ is just AMAZING! Rhythm and Motion are core themes in Craniosacral Therapy. Having just returned from assisting on a CST practitioner training, I really appreciated his comments about learning a new skill and seeing how gentle he was with himself when he dropped a ball, even as a master juggler. In this way, Michael is a great example of skill and patience in learning, especially relevant for the early stages of a learning journey.

Gravity

“A lot of people think juggling is a process of defying gravity, well I think it is a process of joining with forces, so what I like to do is to join with the space, juggling with gravity” CST practitioners work with the underlying natural forces in the body, often perceived as relationships to the ground and to space. For example, how weight is distributed and how the tensile structure of the body is held in space. Working ‘with’ the natural forces strengthens the body’s health and vitality.

Perception

“When you learn juggling, you’re learning to feel with your eyes and see with your hands.  If you spend enough time doing something, time slows down, your skill increases and your perceptions change” CST supports the integration of the senses, shifting perception from fragmentation to wholeness by becoming familiar with the nuances and subtleties of feelings and sensations. With practice, time slows down and these subtleties become more pronounced, improving awareness and the sense of vitality.

Stillness

“Balance, a constant movement to find an approach to stillness. Try to approach stillness with different parts of your body, to try to have a conversation with it. It’s dependent of rhythm and balance. As your skill increases you learn to find those tinier spaces and tinier movements” CST is a wonderful way to develop a relationship to stillness and is a key part of the approach. Feeling and appreciating the aliveness and vitality of moving into stillness has a profound effect on the body and mind.

Shapes

“I like learning about the beauty of the shapes and the stories in the shapes, as well as the fact that they are what protected the contents” Appreciating the beauty of the subtle shapes and gestures the body makes, is an important part of integrating our life story. The body can be shaped by experience so exploring the shapes and movements with safety helps acknowledge “the fact that the shapes are what protected our contents”.

The movie is 37 minutes long, if you just want to see some amazing juggling, I’d recommend my favourite part at 19:30 minutes, WOW!


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The Social Nervous System

Feeling more connected in the body is at the core of Craniosacral Therapy. When we feel safe with the connections in our body, we feel safer with other people and can have more choice in our relationships. Prof Stephen Porges has described  how the human nervous system has evolved to respond to stress with his ‘Polyvagal Theory & the Social Nervous System‘ model. This understanding of how the nervous system helps to regulate and support social interactions, emotions and sensations underpins much of my clinical work, below is a summary of the main points.

In Polyvagal Theory, Porges discusses some of the evolutionary differences between humans and other animals in adapting to our environment and coping with stressful and threatening situations. For humans, he suggests there is a three-tier hierarchy of responses to stress, I’d like to focus on the first response, Communication or the Social Nervous System:

Porges’ three-tier hierarchy of responses to stress

  1. Communication – using negotiation, social skills, vocalisation, listening and facial expression to resolve the stressful situation through social engagement and relationships (Social Nervous System)
  2. Mobilisation – fight/flight, energy is mobilised to defend or escape from the threat physically (Sympathetic Nervous System)
  3. Immobilisation – freeze response, body systems (digestion, respiration, movement) slow or shut down ie ‘playing dead’ (Parasympathetic Nervous System)

Mammals (especially humans) have developed the ability to use their social networks and skills to find safety from threats in their environment. In humans, this has deepened further with the complex social structures and behaviours that we use to ‘be’ safe and in a more nuanced way, to ‘feel’ safe. In an ideal situation, mammals will use communication and their social group in response to stress or threat, however, if this strategy is unsuccessful mobilisation or resources by fight or flight becomes the ‘next best’ option. If this response is overwhelmed (eg fighting becomes ineffective and/or there is no escape route)  the mammal will immobilise until the threat is gone (as in the freeze response video below). Non-social animals like fish and repitles only have mobilisation and immobilisation responses.

In his model of  the Social Nervous System, Porges describes the neurological features of humans that allow us to respond through social engagement. He highlights the relationships between the Cranial Nerves (CN) of the Autonomic Nervous System (ANS), and includes the CNs in the neck, the throat, the face and the middle ear.

How does the Social Nervous System enable us  to respond to stress?

ANS – (CN X vagus nerve) heart and breathing rates are slowed down while we assess if a situation is threatening. If there is no threat, both rates return to ‘normal’. If there is a threat, the heart and breathing rates are fine-tuned to enable a social  response (see throat, face, ears section), as we need different ways of breathing for speaking than for running, fighting or playing dead. To enable a more flexible response to stress, humans have an extra cluster of nerve tissue in the brain stem where the sensory nerves from the heart feedback to, called the nucleus ambiguus, unlike non-social animals like fish and reptiles who only have the dorsal motor nucleus.

Neck – (CN XI accessory nerve) the trapezius and sternomastoid muscles are activated, enabling us to turn our heads to orient towards a potential threat and also to members of our group to engage socially (see below).

Throat, Face & Ears – (CN V trigeminal, VII facial & IX glossopharyngeal nerves) In the throat, swallowing and vocal prosody are adjusted so that we can give a specific vocal response to stress, eg a rousing scream or a soothing whisper. Muscles of the face and jaw help with the articulation and pronunciation of words as well as facial expression, the movement of the muscles around the eyes are particularly important in social engagement and communication. One of the most interesting connections that Porges has made is the passage of the facial nerve through the muscles of the middle ear which enable us to attune to sounds so that we can distinguish the human voice from background noise. Facial expression is hard-wired into the recognition of the human voice.

The Social Nervous System helps us to appreciate the heart, digestive organs, face, voice and ears as a unified system which can be affected by a vast array of factors including stress, shock & trauma, ear issues, surgery, digestive issues, dental work and developmental conditions. Mobilisation and immobilisation are vital responses for survival and are to be appreciated. Social engagement enables us to move beyond survival to being able to thrive in our lives and relationships. As a Craniosacral Practitioner, the Social Nervous System helps me understand the importance of feeling safe and finding support in human connection and social engagement. I’m privileged to see the sense of health and wellbeing growing in my clients when stimulating these amazing neurological mechanisms through touch and communication in our sessions. As this happens, there is a greater capacity and flexibility to move between all three responses.


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Increasing capacity for aliveness

I’ve just come back from a fascinating, challenging and inspiring workshop with Dr Larry Heller about “Healing Early and Complex Trauma“. In this context ‘early’ trauma is concerned with how relationships in the first months and years of life affect our strategies and capacity for coping with stress and forming relationships later in life. The workshop focussed on integrating ‘top-down’ (ie psychotherapeutic models of cognition) and ‘bottom-up’ (body oriented, felt-sense response) approaches in the healing of early trauma through nervous system regulation.

As a craniosacral practitioner, working with the felt sense of the body and learning to negotiate the fluctuations of feelings and sensations linked with our emotions is an integral part of my work. Learning how our physiology responds to these experiences was therefore deeply enriching on a personal and professional level.

Much of the practice over the three days was about connecting to our inner resources to cultivate feelings of being present and grounded. A key theme from the workshop in working with trauma in this way was the importance of  ‘supporting an increasing capacity for aliveness‘, as Larry says,

Our greatest desire is to feel alive. Meaninglessness, depression, and many other symptoms are reflections of our disconnection from our core vitality. When we feel alive, we feel connected, and when we feel connected, we feel alive. Aliveness is not primarily a mental state though it brings mental clarity, nor is it only pleasure. It is a state of energetic flow and coherency in all systems of the body, brain and mind.

In Craniosacral Therapy, we work to increase the sense of vitality by bringing awareness and connection to the underlying mechanisms of health in the body. Contacting our inner resources by becoming more present and grounded creates the energy and awareness needed to process the impact of earlier relationships so that we can respond to stress in healthier ways. When we have a healthier connection to ourselves we can have healthier connections with other people.