Comparison with Craniosacral, Biodynamic, SOT

Posted 10/26/13 by Malcolm Hiort and filed under:

The human body is naturally interconnected and therefore benefits from a whole body approach if therapy is needed. Many cranial problems have their cause lower down the body via postural compensation patterns of restriction. The reverse, where cranial problems cause body symptoms does occur, but is much rarer.

Many therapists using craniosacral techniques touch the client using only head and sacrum techniques, with no other body locations included in their repertoire. An even greater number touch the head only, despite the name Craniosacral Therapy implying otherwise.


Similarities between CFT and other Cranial therapies

A focus on the head unites these various cranial therapy approaches:

Craniosacral Therapy (CST)
Cranial Osteopathy/Osteopathy in the Cranial Field (OCF)
Biodynamic Craniosacral Therapy (BSCT)
Sacro-Occipital Technique (SOT)
Endo-nasal balloon therapy (NCR)
Cranial Rebalancing and several other versions of cranial therapy

as conventional physical therapy, remedial massage and bodywork methods do not view the cranium as a structural unit composed of slightly mobile pieces, the cranial bones, with connective tissue in the sutures between each cranial bone. The fascia inside the head is also important to therapy, as the tough dural membrane lines the cranial vault and forms the meninges, which Sutherland viewed as a ‘Reciprocal Tension Membrane’.


All cranial approaches use very light forces and pressures compared to most manual therapies. Cranial practitioners such as Chiropractors, Osteopaths and Physiotherapists undertake many years of full time training before further cranial therapy education. Many versions of cranial with varying pedigrees are now in the marketplace. A similarity is that no matter the training or orientation of cranial therapists, they face similar issues in dealing with unique client circumstances in the clinic.



The ‘What do I do now?’ treatment dilemma is solved through tactile ‘listening’ and interpretation. The body will tell you much information if you ask the right tactile questions and ‘listen’ through your hands.
This interactive dialogue is physical and appears to be very subtle until familiarity is gained. With practice it is immediate, accessible and provides extra therapeutic levels for use with more client types.

In relation to therapist intention and biodynamic craniosacral, see Intention in Craniosacral Therapy

Emphasis is given to understanding fascia, the cranial rhythm, de-mystifying anatomy and physiology, and the utilisation of existing skills. Release of mobility restrictions, treatment principles and practitioner poise are all given prominence.


CFT has no overt emotional therapy aspect such as Somatoemotional Release.
Light touch is more likely to evoke ’emotional’ responses such as tears and catharsis or autonomic responses such as twitches more frequently than heavier touch in a therapeutic setting.

While catharsis should be expected occasionally, consider that manual therapists are not qualified and experienced psychologists or professional counsellors. Despite good intentions, dabbling in this area may do more harm than good. Not recognising signs or containing catharsis are possible examples of this.
Therapists should know their treatment boundaries, be empathetic and wise, develop a referral network and use it where appropriate.


Using the Cranial Rhythm:
This remarkable, under-recognised phenomenon is present throughout life, moving all body tissues rhythmically, but is difficult to learn to palpate reliably. It can take a long time for the therapist to gain confidence using this rhythm as both an assessment and a treatment tool. Using the cranial rhythm in practice is like the therapist passing through a ‘sensitivity gate’.

If the therapist is sensitive enough to palpate the cranial rhythm, it means that they are sensitive enough to feel and react to other subtle movements, tension patterns and the unwinding of fascia. The rhythm is not used in practice at all by many cranial therapists. Approaches such as Biodynamic Craniosacral actively avoid it and discourage intentional intervention.

The cranial rhythm need not always be used in CFT, it is an optional level for the therapist to choose. Traction or pressure with any technique, without an awareness of the rhythm, provides the therapist with useful feedback to interpret. It is like asking the body a series of physical assessment questions, to localise restrictions and the patterns of these restrictions. Employing the cranial rhythm to enhance release techniques is like an analogy of switching a television from a black-and-white in mono to colour with surround sound.

The rate of the CRI has been researched with authors reporting wildly varying results between 3.7 and 14 cycles per minute. The speed of the rhythm should be a basic point of commonality between all cranial therapists. Most craniosacral therapists are taught a rate of 6 to 12 cyles per minute when learning to palpate the CRI. The Australian Craniofascial Therapy School teaches a slower rate of around 4.5 cpm, and promotes the relevance of ongoing research.