Tag: Migraine

August 2 -2008

Questions and comments for this issue:

+ Report on feasibility study on the effectiveness of cranio sacral therapy on migraine.
+ Open letter from Cranio Suisse®, the Swiss cranio sacral association.
+ Comment from Al Pelowski in response to Joyaa Antares and maxillae.
+ Comment from Cathryn Nitschke in Australia about her Osteopathy training and how it compares to cranio.
+ Question about therapist burnout.
+ Question about talking about emotional issues.

Hello,

Well it’s a positively groaning newsletter this
Time it is so full.  Lots happening in the world
of cranio sacral with a report on migraine and an
interesting initiative from the Swiss cranio
sacral association but more on that later.

I have spent quite a bit of time reworking the
training part of the Open Source Cranio website,
making it a better learning tool.  I have begun to
add my training notes and to lay out a learning
schedule.

One of the new features is a search function
which should make it easier to search the site for
specific topics.

Another new function is the comments feature.
This allows you to leave comments directly on the
site, under specific articles.  You have to click
the comments tab.  So you can comment on the
article and letters in this newsletter directly on
the site if you want.
I encourage you to leave comments or send me an
email letting me know what you think.  The more
feedback I get the better I can make it.

I also encourage you to send me articles that
you think might help someone in a developing
country who is using the material to begin their
cranio sacral learning and I will post them.

I have fixed the problem with the newsletter
subscription block so if you tried to resubscribe
before and it didn’t work it’s working now.

Speaking of learning let me direct you to a
website I came across and intend to use a lot in
teaching.  It is called the Visible body and is an
online 3D anatomy viewer.  You can view the demo
for it here.
http://www.open-source-cranio.com/sacral-training/3d-anatomy/
If you like the look of it you need to go to
their site and register and then you can use the
models yourself.  If you’re a Mac user forget PC
only.  Discrimination rears its ugly head again,
sigh, pout.

Rightio, let’s get on with the mailbag.

***REPORT***

Below is an extract from a press release I
received about a proposed test for the
effectiveness of cranio sacral therapy on
migraine.  They propose to use low-strength static
magnets as the control group.

Double blind studies are not my field of
expertise and is it just me or what, but I think
people would know the difference between a
therapist and a magnet.

Ah well, they’re trying.

————————————————–
Craniosacral therapy for migraine: protocol
development for an exploratory controlled clinical
trial.

Migraine affects approximately 20% of the
population.  Conventional care for migraine is
suboptimal; overuse of medications for the
treatment of episodic migraines is a risk factor
for developing chronic daily headache.

The study of non-pharmaceutical approaches for
prevention of migraine headaches is therefore
warranted. Craniosacral therapy (CST) is a popular
non-pharmacological approach to the treatment or
prevention of migraine headaches for which there
is limited evidence of safety and efficacy.

In this paper, we describe an ongoing feasibility
study to assess the safety and efficacy of CST in
the treatment of migraine, using a rigorous and
innovative randomized controlled study design
involving low-strength static magnets (LSSM) as an
attention control intervention.

Methods: The trial is designed to test the
hypothesis that, compared to those receiving usual
care plus a treatment with low-strength static
magnets (attention-control complementary therapy),
subjects receiving usual medical care plus CST
will demonstrate significant improvement in:
quality-of-life as measured by the Headache Impact
Test (HIT-6); reduced frequency of migraine; and a
perception of clinical benefit. Criteria for
inclusion are either gender, age >11, English or
Spanish speaking, meeting the International
Classification of Headache Disorders (ICHD)
criteria for migraine with or without aura, a
headache frequency of 5 to 15 per month over at
least two years.

After an 8 week baseline phase, eligible subjects
are randomized to either CST or an attention
control intervention, low strength static magnets
(LSSM). To evaluate possible therapist bias,
videotaped encounters are analyzed to assess for
any systematic group differences in interactions
with subjects.

Results: 169 individuals have been screened for
eligibility of which 109 were eligible for the
study. Five did not qualify during the baseline
phase because of inadequate headache frequency.

Nineteen have withdrawn from the study after
giving consent.

Conclusion: This report endorses the feasibility
of undertaking a rigorous randomized clinical
trial of CST for migraine using a standardized CST
protocol and an innovative control protocol
developed for the study.

Subjects are able and willing to complete detailed
headache diaries during an 8-week baseline period,
with few dropouts during the study period,
indicating the acceptability of both
interventions.

Author: John D Mann, Keturah R Faurot, Laurel
Wilkinson, Peter Curtis, Remy R Coeytaux,
Chirayath Suchindran and Susan A Gaylord

Credits/Source: BMC Complementary and Alternative
Medicine 2008, 8:28

Published on: 2008-06-10

You can read the full report here.
http://www.biomedcentral.com/1472-6882/8/28

***OPEN LETTER FROM CRANIO SUISSE®.***

I was forwarded this open letter from Cranio
Suisse® who have launched an initiative to
encourage communication between different schools
and therapists which, as you know, I am all for.

Their website is not in English so that limits
the initiative immediately but other than that I
think it’s great.

If you want to read their site in English you
can run it through Google translate.
http://translate.google.com

You need to scroll to the bottom of the page and
enter their web address.
http://www.craniosuisse.ch/

————————————————

*International Networking for the Advancement of
Craniosacral Therapy*

Dear collegues,

All the schools and therapists for Craniosacral
Therapy in Switzerland have organized themselves
in a new association – Cranio Suisse®. We are now
number two among the associations for
complementary therapies. The goal of this
organization is to bring together all the
different approaches of Craniosacral Therapy
within Switzerland and to guarantee a good quality
of schools and therapists. Cranio Suisse® is the
official representative of Craniosacral Therapy
towards governmental institutions and health
insurance companies. In short, Cranio Suisse® is
supporting and promoting Craniosacral Therapy
within in the Swiss Health System.

Furthermore the association acts as connecting
link between patients and therapists. You will
find more details under http://www.craniosuisse.ch/

This year Cranio Suisse® established a new *study
group for international contacts and research*. My
task within this group is to establish contacts
with associations/schools all over the world, thus
building the basis for an efficient networking
beneficial to all of us.

I should therefore be very grateful if you could
let me know whether you are interested in such an
exchange of thoughts and knowledge.

We would suggest the following procedure:

*Step 1*: We put together a list of all
associations/schools interested in putting up a
Craniosacral “Knowledge Network”.

*Step 2*: Evaluation of the importance and
positioning of Craniosacral Therapy within the
health system of each country (questionnaire). The
final goal will be to exchange research reports
and study designs or even realize common research
projects to get more and broader evidence based
facts about Craniosacral Therapy.

Are you interested in such a project and if yes,
do you agree with the proposed procedure or do you
have different suggestions?

We are convinced that an exchange of knowledge
like this would create positive synergies for all
of us, whether it be with regard to the handling
of public health aspects for complementary
therapies in general or strengthening the position
of Craniosacral Therapy specifically.

We are looking forward to your feedback. If you
feel that there is some other institution, school
or person who could be interested in the above
project, please let us know.

Thank you for giving our ideas a friendly,
constructive thought.

With best regards

Barbara Liniger

praxis@barbaraliniger.ch

Member of the study group for international
contacts and research of Cranio Suisse®

http://www.craniosuisse.ch/

PS: Between July 8 and August 24 I will not be
able to answer any emails. I will get back to you
in September as soon as possible. Thank you.

Contactaddress:

Barbara Liniger

Praxis für klassische Homöopathie und
craniosacrale Osteopathie

Alpenstrasse 14
6300 Zug

Tel 041 720 03 20

praxis@barbaraliniger.ch
www.barbaraliniger.ch

Barbara Liniger

Praxis für klassische Homöopathie und
craniosacrale Osteopathie

Alpenstrasse 14
6300 Zug

***COMMENT FROM AL PELOWSKI IN RESPONSE TO JOYAA ANTARES AND MAXILLAE***

Joyaa query, comments:

Maxillary hypoplasia, where the maxillae have not
grown properly, as distinguished from impaction,
is a feature of some craniosynostotic syndromes.

We see quite a few babies with that here in
Africa.  I had a query on that yesterday in fact.

In these cases you find hydrocephalus, premature
closure and ridging of the sutures, bulging vault
bones, protruding fontanels, webbing between
fingers and toes, and distorted distal phalanges,
all in varying degrees.  The maxillae can be
unable to hold in the eyes.

I had one case a few years ago where I had to push
an eyeball back in..!  Most of these kids end up
with craniofacial surgery and shunts.  Some of
them can respond to cranio!  But by no means all.
Many die young gagging with oropharynx
restrictions.

As to possible causes and complications I could
speculate at length, but it wouldn’t amount to
much (estrogenic pollution, dioxins, severe
malnourishment in mother during 1st trimester,
etc..).

I would be interested if any of your readers have
come across this and worked with it.
Al in Joburg

***COMMENT FROM CATHRYN IN AUSTRALIA***

Dear John
Thanks for the link. I have just had a quick wizz
through the site and I think what you are doing is
brilliant, worthy and highly commendable. Good on
you.

I first met you maybe around 2002 or 3 when you
were still in Brisbane. I did one of your
introductory CST courses and really enjoyed it. I
believe that the school wound down shortly
thereafter (my memory is not the greatest so
perhaps this is not quite the case). Anyway, I was
keen to look more deeply into CST which led me to
doing Patricia Farnsworth myofascial release/cst
course and then Roger Gilchrist came to Australia
for 4 years to teach biodynamic CST.

I have also studied with Mike Boxhall in England,
who I think is wonderful and have made contact
with Charles Ridley whose writings really inspire
me. Since then I enrolled in osteopathy at RMIT in
Melbourne, thinking this would take me more deeply
into the world of CST. I have just finished my
first semester there and it has been somewhat of a
let down. I really hear you when you talk about
problems with CST training or training of any
hands on healing modality. I find that the push
towards health degrees and measurable outcomes is
taking away from the power of the apprenticeship,
“hands on” model and I lament this.

I had studied at university before, but this was
in the arts faculty in the early 90’s.  The
science faculty as I find it in the late noughties
is a very different world. The lecturers are
generally not very competent or inspiring teachers
and they seem to find students a nuisance rather
than an opportunity. One of them told me I was
only allowed to ask one question per semester and
seeing as I had already used up my quota in the
first week, that was it.

I thought he was joking, but he wasn’t! This was
disappointing because he is a very knowledgeable
anatomist and I wanted to pick his brains, but
obviously this is not meant to be. Some of the
osteo lecturers find my questions challenging and
potentially threatening, especially the ones
firmly entrenched in the biomechanical model.

On the first day of practical osteo classes, we
practiced range of motion on the lower lumbars.
The technique left me with an instant sore back
and I had to self-treat with cranio work for the
next two days to relieve it! I thought, do I
really want to learn and be subjected to this? I
enjoy the philosophy and principles of osteopathy,
however, the prac classes seem pretty basic and
archaic compared to CST. I feel like it is a
backwards step for me. However, I have enjoyed
delving more deeply into the anatomy and
physiology, so my intention is to continue with
the medical sciences part of the course and drop
the osteopathic parts. Did you know that
osteopathy in the cranial field is only briefly
touched upon in 5th year?  All the rest of the
time is spent on HVLA, MET, counterstrain,
myofascial release, etc.

Many of my CST colleagues lament that they never
studied osteopathy and they seem to hold it up as
the holy grail of osteopathy.  This is not my
experience I can now say and I am glad that I
checked it out. I noticed that osteopaths in
Australia all have a pretty similar and extensive
training but in my experience there are some
pretty ordinary osteos around.

I am obviously not a fan of the “rub and crack”
school. And I have found a few gems whom I highly
admire and have as mentors. So this makes me
ponder what makes the difference b/w the
practitioners I adore versus the ones whose
treatments either leave me feeling worse or at
best, like I didn’t even have a treatment. I put
this down to the more subtle realms that CST takes
the time to unpack and explore. Consciousness,
presence, empathy, openness, etc. Such vital
qualities in a health practitioner of any
persuasion in my opinion.

So really what I want to say to you is good on
you. I admire the time and energy you put into
your newsletter and website to expose more people
to CST and encourage a discussion around all
things CST. I think this is vital work to bring
together a sense of community and to share ideas.

I notice the osteos have a very close knit
community and I think there is strength in that. I
love the opportunity to exchange ideas,
information, experiences with other health
practitioners with a biodynamic bent (gentle and
holistic). Also, I think that osteopathy is held
up as something quite exclusive and prestigious in
comparison to CST. They go to great lengths to
align themselves as primary practitioners with a
solid medical training. It seems that in turn, the
medical world rejects them and they are not really
embraced by the ‘natural therapies’ brigade
either. They are positioned in a potential no-
man’s land or on the flip side a potential
powerful middle way.

My greatest wish is to study this ‘stuff’ with a
mentor, one on one. I think anyone can teach
themselves certain things like anatomy and
physiology out of a book, but the influence of
someone who has walked the path before is
invaluable to point out some of the pitfalls, the
shortcuts and which bits of the scenery are worth
lingering on.

I have a chiropractic friend who I have great
discussions with, and he maintains that he could
teach me the ‘guts’ of the chiro 5 year training
in an afternoon and I believe him. This work isn’t
hard, as such, but the universities certainly turn
it into a cerebrally challenging exercise filling
the students heads with reams of facts at the
expense of understanding.

A phrase that speaks so much to me is “lose the
techniques” as I heard from Gangaji. After all the
study, to let it all go, and see what arises, to
follow the heart and the gut and the fingers and
the senses and feelings and to give the mind a
rest.  This is what I love and see as the power of
biodynamic CST.

So in conclusion, I think any monkey can be taught
the techniques, the vital part is how they are put
together in the final package, the quality of the
touch and the presence and care of the
practitioner.

I wish you all the best with this project.
kind regards

Cathryn Nitschke
somewhere between Brisbane, Melbourne and
Adelaide.

MY COMMENTS:

Thank you for all your kind words Cathryn.
What a great letter.  I cannot agree with you more
about the mentors, they are vital.

I think I was lucky because that whole,
‘osteopaths are a more exalted form of cranio
sacral therapist’ thing was nipped in the bud for
me early in my training.

Liz Kalinowska (http://www.craniosacralstudies.co.uk/about/frames.html)
was one of my tutors.  She told me that she
had become an osteopath first because she thought
it would prepare her to become a cranio sacral
therapist.  She spent 7 years becoming an
osteopath.  She told me she felt she had wasted
her time.  If anything she had to unlearn some of
what she was taught.

I have found over the years that it is very
hard to resist the temptation to ‘pop’ something
back into place if you know how.  I am lucky
because I never learned how to do any thrusting or
strong techniques so I don’t know how to ‘pop’
things back into place.   I am forced to sit and
wait and that is one of the reasons why I, and the
people I have trained, get such great results.

***QUESTION***

Hi John

Thank you for the very valuable information shared
by you and other CS therapists.  I’ve been a
little out of circuit lately – life’s little
challenges – so even though you may have not had a
response from me, I’m still keen to remain
connected.

My preference would be more frequent shorter news
rather than the other.
Kindly advise what the donations will be used for.

Any suggestions for therapist burn out? A long
awaited holiday is needed, I know ,and am busy
working toward one.  My forearms are taking strain
and was told that Kinesiology NOT treatment can
help.  I’m pretty good at caring for myself but
what with juggling teaching yoga, CST, VM and my
latest baby, doing readings it has all suddenly
caught up with me.  I keep the yoga, therapy and
readings for separate days giving me enough time
to replenish.  Please throw some light (energy) on
this subject.

Kindly yours

Peni in Cape Town

MY COMMENTS:

Hello Peni,
There are lots of different energetic
considerations when considering burnout but the
one that stands out to me, from what you have
written, is that you are doing A LOT!

It may be nothing to do with any of the
therapies that you are doing individually.  It may
be that you are doing so many plus your new baby.
I’m getting tired just thinking about it.

It sounds like you know what I am going to say
next but I’ll say anyway.  It’s important to find
a way, that works for you, of removing any
residual energy after you treat someone.

For some people this means a full shower for
others it is simply letting water run over their
hands.

Avoid seeing too many people in a week.  I have
found that somewhere between 12 and 18 adults is
about as much as most people can treat with cranio
sacral therapy without burning out very quickly.

Even if you find a way of removing excess
energy after each person and you don’t see too
many people you will still need to take a break
every 3 months for at least 7 days.

On top of all that you need to take a long
break, around 6 months, every 10 years.

It took me 12 years to figure that one out.

What will the donations be used for?

Well mainly to keep me in cigars and wine, oh
yes and also to help me run open source cranio.
It takes a lot of time and I do have to pay for
things like web hosting etc.  I also plan to put
teaching videos on the site and these all cost
money to make.

Primarily the ‘donate’ button is an opportunity
for people to give back.  This is good for me, not
just because of the cigars and wine, but also
because it’s important to be able to receive, me
included.  I have found that if you can’t receive
comfortably then you can’t really give.

***QUESTION***

Dear John,
Thank you for your wonderful newsletters they are
so helpful.  I find your wellness detective agency
idea novel and very useful.

I have a particular patient with chronic fatigue
and Fibromyalgia for 6 years.  She is in a lot of
pain.  The cranio sacral treatment itself is going
reasonably well but I feel she has emotional
issues that make her condition worse.

I have broached exploring the emotional causes of
her condition with her but she becomes very
defensive and then frustrated and then despairing.

Do you have any suggestions on how to approach
these issues with her.

Thanks again.

PM
Perth.

MY COMMENTS:

The secret weapon of cranio sacral therapy is
silence.

Personally, I can talk a lot about the other
stuff.  Why the person might be sick and so on.
I can talk about that stuff so much I wrote a book
about it for crying out loud.

But for some people talking can only make
things worse.  They will usually have been sick
for some time, like your patient, and will usually
have seen quite a few other therapists.  They will
have a number of theories crashing around in their
heads as to why they are ill.  Ironically each new
‘helpful’ perspective you might offer can push
them deeper into confusion rather than helping to
clarify.

That’s when silence really works. Just let them
get on the table and begin your work.  You can
chat with them but don’t initiate it or keep it
going.  Eventually silence descends and in that
silence and the depths of your work, changes will
percolate to the surface from the depths of them.

Over time deep changes will occur and no one
will talk about it.  Sometimes if you are lucky
they will tell you an insight they may have had
and when they do it will usually have a deep ring
of truth to it.

So that’s it for this issue.

Cheerio for now.

Your Mate,

John D.