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Craniofascial Therapy Essay - The Still Point
INTRODUCTION "During the still period, which may last anywhere from a few seconds to several minutes, all parts of the body become quiescent, and then a profound relaxation occurs." (Manheim p17) As still point (SP) induction is a physiologically-based method, certain technical details are necessarily involved in any discussion of its effectiveness. It is not assumed that the reader is familiar with this approach, so while these details will be described briefly where appropriate, a textbook should be consulted for more specific information. Before proceeding to a description of the still point phenomenon, it is necessary to take a step back and place this concept in context. A still point is a variable period of time when the usual pulsations of the Cranial Rhythmic Impulse cease temporarily. Therefore to understand a still point one must understand the CRI. WHAT IS THE CRANIAL RHYTHMIC IMPULSE (CRI)? The P.R.M. is a term that Sutherland used to describe five inter-related physiological factors. These are: the fluctuation of the cerebrospinal fluid, the function of the 'reciprocal tension membrane' inside the head, the inherent motility of the brain and spinal cord, the articular mobility of the cranial bones and finally the involuntary mobility of the sacrum between the ilia (hip bones). This model was proposed by Sutherland in 1939 and is the orthodox cranial osteopathic theory. Since the 1970's this model has been challenged on several fronts but remains the dominant explanation for the slow bi-phasic pulsatile movement phenomenon of the CRI. The CRI is under-researched and is largely unknown outside of osteopathic and related body-oriented therapies such as massage. The answer to the question posed above may eventually prove to be far more involved and comprehensive than is generally recognised, even by therapists currently working in this field. EVIDENCE OF THE STILL POINT PHENOMENA PALPATION INDUCTION The process of palpation induction begins when the therapist, having followed contraction to its limit, resists the body's movements during the following phase of expansion. By progressively following and taking up slack during successive contractions, while resisting during expansion, the CRI is 'cornered' to a degree that the pulsatile movements begin to falter. This typically takes 5 to 20 cycles. "The still point has been induced by the therapist's resistance to the physiological motion at the subject's feet. It is usually heralded by gross irregularities of the craniosacral motion which become manifest throughout the whole system. The craniosacral system may shudder, pulsate or wobble. As the therapist persists in resisting the return to the neutral position of the physiological motion at the feet, the craniosacral system's activity will ultimately shut down". (Upledger and Vredevoogd p40-1) During the still point period the therapist maintains the palpatory contact applied immediately before the S.P. but does nothing else, as there is no motion to resist. The resumption of the CRI is initially felt in the therapist's hands as a weak stirring of motion that typically takes three or four cycles to regain full momentum. A beneficial change in the symmetry, quality, amplitude and rate of the CRI is usually noted. Depending on the degree of improvement and other client responses noted during the induction process, the therapist may decide to either induce another S.P. or gently disengage from palpatory contact. "With practice you will know the moment to release - when the 'still-point' has been reached, all pulsation ceases and the area appears to settle. This might be heralded by the patient's body language (a sudden visible relaxation) as an obvious relief from undue pressure, whereupon the patient sighs, twitches pleasurably or simply relaxes deeply”. (McCatty p158) As the procedure used for S.P. induction is subtle, the therapist needs to prepare by becoming physically comfortable and 'centering'. In this sense the still point induction procedure is relaxing and meditative for the therapist. The witnessing by the therapist of any behavioural or energetic changes (in the subject coincident with the still point) in a non-attached manner is somewhat like the observation of ones thoughts during meditation. The example given above of still point induction at the feet can be replicated at many body locations. "We frequently induced stillpoints at the knees, the shoulders, the feet or the arms." (Upledger p5) POSITIONAL INDUCTION TRIGGERED INDUCTION SELF-INDUCTION OF STILL POINTS HOW DOES A STILL POINT WORK? This method is called CV4 (compression of ventricle four) and is the sole induction method employed by many cranial therapists. Also known as bulb compression, this is "a technic (sic) to lessen the capacity of the fourth ventricle ...Because the tentorium cerebelli is attached to the internal surface of the occipital squama, it is drawn more closely to the cerebellum, whose hemispheres are thereby brought down over the roof of the fourth ventricle, while the middle cerebellar peduncles are pulled up to elevate the floor, thus augmenting the squeeze both ways." (Magoun p336) As invasive procedures necessarily alter the functional integrity of the system, it remains a challenge to modern science to verify or modify this hypothesis that has not been substantiated by experimental or diagnostic imaging methods. Although profound changes to the client’s sense of wellbeing and physiology can undoubtedly occur with still point induction, the 'CV4 explanation' is routinely accepted as fact when little evidence actually exists to support it. This author has noted the proximity of the hypothalamus anterior to the fourth ventricle and has wondered what effect the anteriorly directed force of the CV4 technique would have on that structure. Minute pressures on the hypothalamus itself (during surgery) have been observed to produce certain characteristic responses. The functions ascribed to the hypothalamus bear some similarity to the described effects of still points. It is worth noting that still points induced with a palpation contact elsewhere than from the occiput appear to be equally effective as those achieved using the CV4 method. The explanation given by Magoun, involving a squeeze on the fourth ventricle by the tentorium, would appear to be irrelevant to a non-CV4 induced S.P. When the total functioning of the P.R.M. is inhibited
by the therapeutic resistance of S.P. induction by the therapist,
the normal kinetic effects of the CRI on the walls of the ventricles
are altered. As these walls themselves form part of many mid-brain
structures and cranial nerve nuclei, it is plausible to assume
that a change in the tension of these structures may produce functional
changes in brain physiology. Additionally, the eight circumventricular
organs (CVO's), being the pineal gland, the subfornical
organ, the subcommissural organ, the area postrema, the intermediate
and neural lobes of the pituitary gland, the median eminence and
lastly the organum vasculosum of the lamina terminalis situated
around the walls of the third ventricle (the fourth ventricle
in the case of the area postrema) have a possible role in homeostatic
regulation achieved through S.P.'s. It is known that the third ventricle is penetrated bilaterally by the thalamus in approximately 70% of individuals. This interthalamic adhesion (also known as the massa intermedia) forms a continuous bridge of neural tissue across both sides of the third ventricle. This author presumes that the existence of an interthalamic adhesion would alter the flexibility of the third ventricle, as the interthalamic adhesion would be less pliant than than the open fluid-filled space present in 30% of human brains. What exact effect this anatomical variation has on the CRI and still point induction for those individuals possessing an interthalamic adhesion is currently unresearched and uncertain. Although a well-defined explanation of how still points work and achieve the clinical effects observed is currently lacking, most authors on this subject agree that S.P.'s appear to reset body homeostatic baselines. UNPREDICTABILITY I NDICATIONS, CONTRAINDICATIONS AND EFFECTS OF STILL
POINTS A comparison with sleep states offers intriguing possibilities, but as the frequency and nature of S.P.'s during sleep is currently completely unknown, this research avenue must await the development of a simple objective monitoring device. Other indications for the use of SP's include: lymphatic stasis and oedema, fever (from acute systemic infections), hypertonic connective tissue, degenerative arthritic conditions, the regulation of labour (uterine inertia), cerebral and pulmonary congestion and chronic pain syndromes. Also see the comments above in relation to the hypothalamus and the circumventricular organs. PSYCHOLOGICAL ISSUES Just as with other relaxation methods, a great variety of individual responses to a given stimulus are possible with S.P. induction. Still point induction has historically had a clinical context and it is physiologic responses, such as perspiration, breathing pattern changes and involuntary movements that have predominantly been noted. Although this author believes that S.P. induction is more physiologically-based than psychologically-based, and that therefore the subject's co-operation is less important, there are nonetheless certain psychological influences at work, both conscious and unconscious. The individual's touch history is relevant. This is rarely fully conscious, or fully disclosed to the therapist in early treatment sessions. As some people do not tolerate gentle palpation, this should be borne in mind and respected, particularly when the reasons are obscure. Memories of prior situations, involving voice, physical positioning, images and so on may be unknowingly (sometimes to both therapist and subject) re-created during sessions. Prior abuse or trauma may thus be uncovered by the crossing of normal interpersonal boundaries that therapy involves. Other variables in the relationship between therapist and subject, such as gender, age and physical size may be relevant in this regard. Behavioural responses vary widely, from minimal to wildly cathartic to gently euphoric. In a sense, S.P.'s affect energetic and unconscious issues in a direct manner, bypassing consciousness to some degree. In this regard the therapist should pay close attention to subsequent integration of the still point experience by the subject. "The awareness, relaxation and sense of well-being that result from this therapy go very deep. The recipient feels the duality of body/mind starting to dissolve, feels more deeply connected to meditativeness. Because of its subtle nature, depth and attention to small details, a cranio-sacral session nurtures both the client and the practitioner. Both discover a new awe for the mysteries of life energy." (Osho Training in Cranio-Sacral Balancing Touching the Inner Core of the Body/Mind Anonymous (1) p88) CONCLUSION S.P. induction is very time efficient in comparison to other relaxation methods. Five minutes is often sufficient to bring about a significant and lasting change to tension levels. The information available on the still point phenomenon is mainly anecdotal as no detailed study has been conducted to date. It should be remembered that S.P. induction is usually used in combination with other clinical methods in a treatment session, rather than as the sole technique. A still point is a distinct experience that, like most tactile phenomena, is poorly described by language. The effectiveness of still point induction is difficult to assess and as many variables are involved with no recognised 'yardstick' for comparison purposes, this therapeutic option must remain a matter of preference and individual judgement at this stage. There is a wide range of subject's responses and
attitudes. One individual, having experienced a profound integrative
still point, may value the technique highly, while another, having
not responded at all, may rate it poorly. It may be that it is
the sum of the subject's expectation, susceptibility and response
effect that best describes the BIBLIOGRAPHY Anonymous (1) Osho Multiversity Rebel Koln 1990 Malcolm Hiort November 1997 (revised October 2001) |
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