Circle No. 65: "Re-Inventing CST for These Times"

Craniosacral Virus Care: First, what it is NOT! To be sure this is not the abandonment of the complete CST session. This is a temporary adjustment to be able to safely offer adjunctive care in the face of a contagious illness and a moment in time when the world is rocked by stress, fear, loss, death and uncertainty.

Historically, this is a most unusual and important moment for all of us. At no other time in my memory has there been such an existential threat to our just trying to live our lives. Fear, stress, anxiety, loss and depression are exclusive to no one and everyone is subjected to negative effects. Sometimes these issues lead to overwhelm and an emotional and spiritual uncertainty affecting the body physically, emotionally and spiritually. We are dealing with a serious contagious disease, a broken economy and at the same time raging anger in gun violence, police brutality, social unrest, equal rights issues, racism and unbelievable political failure and distrust. The uncertainty and constant emotional stress and tension can lead to a sympathetic autonomic nervous system state of fight, flight and freeze. I remind my patients it is authentic to have fears, doubts, concerns, stressors and anxiety about the future now. It is particularly normal for emotions to have an impact on the physical body. We need to hold loving kindness space to help folks know this is a normal reaction to abnormal times and can be mitigated by compassionate touch, self awareness and witnessed self-expression and mitigated by  their own self-help strategies.

Being a witness to people who have suffered injury or loss as they describe how badly the virus has affected their lives and made them feel is very therapeutic to help them express those feelings and begin to start healing. In our craniosacral world the offering of stillpoints gently promotes that self-expression, the change of physiologic tone, and the release of emotional holdings.

"Any CST therapist/student willing to let time be their ally, who can induce a stillpoint while evaluating CS rhythm, and be still and know when rhythm returns -- can go forward and evaluate the subtle movement of CSF, fascia and lymph indicating where to go forward with a modified CST Virus Care session." -- Don Ash

Some clinical session considerations: On your table you may be asked to hold space for some to express their feelings fears and questions about these issues. Our role, I believe, is to be an exquisitely present listener. Please rest in the fact you do not have to cure, heal or solve the immediate problems presented by the virus to the person on the table. You cannot save, protect, feed, shelter or employ them. You do not need a lot of dialogue. Your role, I believe, is to hold space for the person on the table to express how they are feeling. This comes from the physical release of tensions (heat, pulsing, softening, breath change) and the quiet expression of emotions (gentle tears, verbal expressions of feelings, fears and the like). Great healing comes when the person on the table is confident that someone has heard how badly they have suffered and all that they have been through. Being listened to is therapeutic. This chance to express themselves has a way to discharge negative effects of those experiences.

Our teaching constantly suggests that points of stillness in the craniosacral mechanism activates the body’s self-healing effects like softening of tone, increased circulation of CSF and lymph, breath change, emotional expression, decreasing pain, increasing range of motion and better sense of self-esteem and well being. And importantly, there is often a sense of recognition we are not in control of our world, only our response and reaction to it.

A focused way of changing a CST session to efficiently deal with identifying the primary restrictions in the CS mechanism can be done essentially from the ankles. This is a way of gathering information from the most socially distant locations on the body. This is a focused Craniosacral Virus Care change in our listening. We then can invite change from the key system locations, thoracic inlet, sacrum and the vault as needed.

On the table we can create a space for constructive self-regulation and healing by focusing on the three stage settling in process we teach in all our structural classes. (See Diagram "3 Stage Settling In")

1. From the heels we listen to the craniosacral rhythm, initiate a stillpoint and observe the body’s reaction. Arcing and feeling drawn to an area of the body can also be identified. It is a sacred moment for the patient to express what is happening inside. Asking the patient what they are feeling brings focus for them as well. The manual motion observation is medial and lateral.

2. The second stage is to gently, very slowly draw longitudinally from the heels visualizing the lengthening of the connective tissue, fascial planes or the lack thereof. Sometimes as you feel one leg gradually lengthen and the other not, if you allow time to be your ally, 30-60 seconds or more, you may witness the other shorter leg begin to relax, lengthen and equalize. If not further treatment may be indicated.

3. Finally, with hands grasping gently around the lower half of the calves, the manual influence is superior, gently and gradually compressing the superficial lymphatics. We ask the patient what they feel anywhere on the body while we are gently holding the system. When we release our hands, there may be an appreciated gentle surge in fluid flow to the amazement of the patient. They also may report a body change that can focus our treatment to another area. The body self-regulates to our gentle influence to the place most reactive to our gentle influence.

A revised CST session could include listening from the lower legs, stillpoints as indicated and reassessment. Treatment could then go further with lymphatic opening at the thoracic inlet position (see Diagram “Enhanced Thoracic Inlet Opening”). For those without lymphatic experience, simple gentle skin stretch four directional open hand movements can start at the inferior sternum, then right upper chest, hyoid downward and then left upper chest. Simply repeat these directional gentle stretches, beginning at the inferior sternum, three times. A sense  of filling, increased swallowing and increased warmth in the center chest and borborygmus from the abdomen are common sensations. This is lymphatic movement and basic clinical lymphatic approach that can also be given as a self-help home program. Thoracic inlet and vault techniques from OCB and the vault holds including sphenoid can be applied. This precludes some diaphragms, specific cranial bone or mouth techniques unless indicated by the body responses dictate and at the discretion of the therapist and patient. Facemasks — as well as shields — can and should be used together by the therapist when warranted with close fascial proximity like most mouth work.

Treatment emphasis is on stress reduction, fascial release, somato-emotional processing as initiated by the self-regulation process of the patient. Independent self-help programs are a big part of our CST Virus Care and will be discussed in another essay.

Stay strong, stay smart, stay kind and let us move CST forward in these times.

Don Ash