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The History and Development of Craniosacral Work by Michael Kern D.O., B.C.S.T., A.B.D., N.D.

Worms will not eat living wood where the vital sap is flowing; rust will not hinder the opening of a gate when the hinges are used each day. Movement gives health and life. Stagnation brings disease and death. Proverb in traditional Chinese medicine


My belief is in the blood and flesh as being wiser than the intellect. The body-unconscious is where life bubbles up in us. It is how we know that we are alive, alive to the depths of our souls and in touch somewhere with the vivid reaches of the cosmos. D. H. Lawrence

Around the start of the twentieth century a final-year student of osteopathy named William Garner Sutherland was examining a set of disarticulated human skull bones in his college laboratory. As with other students of his time, Sutherland had been taught that adult cranial bones do not move because their sutures (joints) become fused. However, he realised that he was holding in his hands adult bones that had become easily separated from each other.

Like the gills of a fish

While examining some of the bevel-shaped sutures of the cranium, in particular those at the temporal and parietal bones, Sutherland had an insight that changed the course of his life. He described how a surprising thought struck him like a blinding flash of light.1 He hit upon the idea that the sutures of the bones he was holding were like the gills of a fish and designed for some kind of respiratory motion. He didn’t understand where this thought came from, nor its true significance, but it echoed through his mind.2

William Sutherland set out to prove to himself that, as he had been taught, adult cranial bones do not move. As a true experimental scientist, he reasoned that if cranial bones did move and that if this movement could be prevented, it should be possible to experience the effect. So he designed a kind of helmet made of linen bandages and leather straps that could be tightened in various positions, thus preventing any potential cranial motion from occurring.

Cranial Movement

Experimenting on his own head, he tightened the straps, first in one direction and then in another. Within a short period of time he started to experience headaches and digestive upsets. This response was not what he was expecting, so he decided to continue his research to find out more. Some of his experiments with the helmet led to severe symptoms of cranial tightness, headaches, sickness and disorientation. Of particular interest was that when the helmet straps were tightened in certain other positions, it produced a sense of great relief and an improvement in cranial circulation.3

After many months of pulling and restricting his cranial bones in different positions with these varying results, Dr. Sutherland eventually stopped this research, having convinced himself that adult cranial bones do, in fact, move. Furthermore, the surprising responses that he felt in his own body had shown him that cranial movement must have some important physiological function. Sutherland spent the remaining fifty years of his life exploring the significance of this motion.

Historical Acceptance

Although most Western countries did not recognise cranial motion, this possibility was not new to other cultures. There are various Asian systems of medicine such as acupuncture and Ayurveda that have long appreciated the subtle movements which occur throughout the body caused by the flow of vital force or life-energy. This has also been traditionally taught in Russian physiology. Interestingly, anatomists in Italy in the early 1900s were also teaching that adult cranial sutures do not fully fuse, but continue to permit small degrees of motion throughout life.4

Cranial manipulation has been practiced in India for centuries, and was also developed by the ancient Egyptians and members of the Paracus culture in Peru (2000 B.C. to 200 A.D.).5 Furthermore, in the eighteenth century, the philosopher and scientist Emmanuel Swedenborg described a rhythmic motion of the brain, stating that it moves with regular cycles of expansion and contraction.6

Tissue Breathing

From an early stage of his investigations, Dr. Sutherland understood that he was exploring an involuntary system of subtle “breathing” in tissues, important for the maintenance of health. At a fundamental level, it is this property to express motion that distinguishes living tissues from those that are dead. Dr. Sutherland perceived that all cells of the body need to express a rhythmic “breath” in order for them to function to their optimal ability. Much of his research was carried out by combining a profound knowledge of anatomy along with finely-tuned tactile and perceptual senses. He started to realise that these subtle respiratory movements can be palpated by sensitive hands, and also discovered that this motion provided a wealth of clinical information.

An Interdependent System

Dr. Sutherland recognised that the motion of cranial bones is connected to other tissues with which they are closely associated. The membrane system, which is continuous with cranial bones along their inner surfaces, is an integral part of this phenomenon. Significantly, Dr. Sutherland also found that the central nervous system, and the cerebrospinal fluid that bathes it, have a rhythmic motion. The sacrum, through its dural membrane connections to the cranium, also forms part of this interconnected system. Thus, there is an vital infrastructure of fluids and tissues at the core of the body (consisting of the above five elements) that expresses an interdependent subtle rhythmic motion.

As Dr. Sutherland dug deeper into the origins of these rhythms, he realised that there are no external muscular agencies that could be responsible. He concluded that this motion is produced by the body’s inherent life-force, which he referred to as the Breath of Life – taking this name from the Book of Genesis in the Bible.7


Think of yourself as an electric battery. Electricity seems to have the power to explode or distribute oxygen, from which we receive the vitalizing benefits. When it plays freely all through your system, you feel well. Shut it off in one place and congestion results.8 Dr. A. T. Still

The inherent life-force of the body, the Breath of Life, was seen by Dr. Sutherland to be the animator or spark behind the involuntary rhythms he discovered.9 Alluding to the source of this phenomenon, other practitioners have referred to it as the soul’s breath in the body. The Breath of Life is considered to carry a subtle yet powerful potency or force that generates subtle rhythms as it becomes expressed in the body.10 Dr. Sutherland realised the significant role played by cerebrospinal fluid in expressing and distributing the potency of the Breath of Life. As potency is taken up by the cerebrospinal fluid, it produces a tide-like motion that is described as its longitudinal fluctuation. This motion has great importance in carrying the Breath of Life throughout the body and it is a key marker of health; as long as it is expressed, health can follow.

Expressions of Health

Dr. Sutherland believed that the potency of the Breath of Life carries a basic Intelligence (which he spelled with a capital “I”), and he realised that this intrinsic force could be effectively employed by the practitioner for promoting health.11 An essential blueprint for health is carried in this potency, which acts as a basic and powerful ordering principle at a cellular level. This integrates the physiological functioning of all the body systems. A similar concept is found in many traditional systems of medicine, where the main focus for healing is also placed on encouraging a balanced distribution of the body’s vital forces.12

The presence of full and balanced rhythms produced by the Breath of Life signifies a healthy system. As long as these rhythms are expressed naturally, the body’s essential ordering principle is harmoniously distributed. Therefore, these rhythmic motions are primarily an expression of health. Their existence ensures the distribution of the ordering principle of the Breath of Life, and their restriction or fragmentation can have far-reaching consequences.

This now brings us to two basic tenets of Craniosacral work:

  1. Life expresses itself as motion.
  2. There is a clear relationship between motion and health.

Dr. Harold Magoun D.O., a student and colleague of Dr. Sutherland, described the intelligent action of the Breath of Life in the following way:

All life is manifested in energy or motion. Without motion, in some degree, there can only be death. Furthermore, motion is essential to function. But that motion must be intelligent and purposeful for the living organism to successfully compete with its environment. Hence that motion must be guided and directed by a Supreme Being. There must be a channelling of the Universal Intelligence down to the individual cell or organism. Otherwise all would be chaos. What is the Supreme Intelligence? How does the channelling take place? No one knows for sure. The fact remains that the existence of such is a positive and irrefutable fact which is emphasised by the world’s greatest scientists.13

Primary Respiratory Motion

Dr. Sutherland named the interdependent system of tissues and fluids at the core of the body the craniosacral mechanism or primary respiratory mechanism. As the subtle rhythmic motion of these tissues is not under voluntary muscular control, they are also sometimes referred to as the involuntary mechanism (or I.V.M.). Sutherland used the term “primary” because this motion underlies all others. It is the manifestation of the life-stream itself, and each cell in the body expresses primary respiration throughout its life.

Significantly, many different symptoms and pathologies that involve both body and mind can be traced back to disturbances of primary respiration.

There are, of course, other vital rhythms in the body such as the heartbeat and lung breathing. Although necessary for the maintenance of life, these are considered secondary motions because they are not the root cause of the body’s expression of life. Without the Breath of Life these other rhythms could not be present. Lung respiration – the breath of air – is therefore sometimes referred to as secondary respiration.14

This fact was proved to Dr. Sutherland early in his development of this work. During the days of alcohol prohibition in the United States during the 1920s, he was staying at a cottage on the shores of Lake Erie. One day he heard a commotion outside. A drowning man who had been drinking too much illegal liquor was being dragged out from the water. By the time Dr. Sutherland reached the shore, the man was lying on the ground. His normal life signs – lung function and cardiovascular pulse – had ceased, and all attempts to resuscitate him had failed.

With some quick thinking, Dr. Sutherland held the sides of the man’s head and encouraged a rocking motion of his temporal bones, in an attempt to stimulate primary respiratory motion.15 This worked and within a few seconds the man’s breathing and heartbeat started again, he regained consciousness and made a full recovery. This experience helped to affirm to Dr. Sutherland the tremendous power of working directly with the Breath of Life.

Sustained by the Breath of Life

The importance of an underlying vital force for the maintenance of health has been demonstrated by many reliable accounts of seemingly magical feats performed by advanced yogis. Some of these feats include being buried alive for up to seven days with no access to air, water, food or light. Amazingly, it seems that these yogis are able to sustain their bodies by going deep into meditation and being conscious of the fact that their lung breathing is not the main thing keeping them alive. It seems they are able to suspend many of the secondary physiological functions of the body, but still preserve the primary expression of the Breath of Life. Their survival depends on their ability to stay in relationship with this fundamental, life-giving principle.

The expression of the Breath of Life at a cellular level is a fundamental pre-requisite for good health. If the rhythmic expressions of the Breath of Life become congested or restricted, then the body’s basic ordering principle is impeded and health is compromised. The main intention of Craniosacral work is to encourage these rhythmic expressions of health. This is done by gently facilitating a restoration of primary respiration in places where inertia has developed.


Nature heals, the doctor nurses. Paracelsus

Dr. Sutherland developed various therapeutic approaches to harness the intrinsic power of the Breath of Life and help resolve any restrictions to the expressions of primary respiration. He began to teach this work to other osteopaths in the 1930s and continued to do so tirelessly until his death in 1954. Because it challenged some of the closely held beliefs among practitioners of the time, his work was at first largely rejected by the mainstream osteopathic profession. However, his clinical results in a wide range of cases were impressive, and he began to attract a small band of colleagues who wished to study with him.

In the 1940s the first osteopathic school in the United States started a post-graduate course called “Osteopathy in the Cranial Field” under the tutelage of Dr. Sutherland. Soon after, others followed. This new branch of practice became known as Cranial Osteopathy. As the reputation of Cranial Osteopathy began to spread, Sutherland trained more teachers to meet the demand. The most notable of these early teachers were Drs. Viola Frymann, Edna Lay, Howard Lippincott, Anne Wales, Chester Handy and Rollin Becker.

However, even today many osteopathic colleges do not teach this work in their basic courses, and so it is often studied as an option at post-graduate level. Consequently, many practicing osteopaths do not use this approach. Nevertheless, in the last few years, post-graduate training courses for practicing osteopaths have become widely available.

Dr. John Upledger

In the mid-1970s Dr. John Upledger was the first practitioner to teach some of these therapeutic skills to people who were not osteopathically trained. Dr. Upledger had become drawn to this work after an incident that occurred while he was assisting during a spinal surgical operation. He was asked to hold aside a part of the dural membrane system that enfolds the spine while the surgeon attempted to remove a calcium growth. To his embarrassment, Upledger was unable to keep a firm hold on the membrane, as it kept rhythmically moving under his fingers.16

Dr. Upledger took a post-graduate course in Cranial Osteopathy and then set out on his own path of research. Over the following years, he developed some very accessible treatment protocols, practical perspectives about the impact of trauma on the primary respiratory mechanism and a combined mind-body approach for working with traumatic experience called somato-emotional release. Furthermore, he has done a great deal to popularise Craniosacral work around the world.

When Dr. Upledger began to teach non-osteopaths, he encountered great opposition from many in the profession who believed that the foundation of a full osteopathic training is necessary to practice the Craniosacral approach. Many osteopaths are still of this opinion, and it continues to be a cause of debate. However, in the last forty years Craniosacral work has become a profession in its own right outside of the exclusive domain of osteopathic practice, providing an integrated and valuable approach to healthcare that is used around the world. Nevertheless, one thing is for sure, a good foundation in anatomy, physiology and diagnosis is necessary in order to apply Craniosacral work with safety and competency. It also takes time and proper training to develop the necessary skills. It is an unfortunate fact that in recent years many people have set up in practice with only minimal training.

Cranial Osteopathy and Craniosacral Therapy

As mentioned earlier, Dr. Sutherland used the phrase “craniosacral” to describe the anatomical and physiological system at the core of the body, but it was osteopath Dr. H.V. Hoover who was the first to use the term “Craniosacral Therapy” in an article published in the Yearbook of Academy of Applied Osteopathy in 1950. Dr. Upledger then used this term when he started to teach to a wider group of students outside of the osteopathic profession. Dr. Upledger wanted to differentiate the therapeutic approaches he had developed and the title “Cranial Osteopath” could not be used by those practitioners who were not osteopathically trained.

One question I’m frequently asked is, “What’s the difference between Cranial Osteopathy and Craniosacral Therapy?” Although Dr. Upledger states that these two modalities are different,17 the differences are not always so obvious. They have both emerged from the same roots and have much common ground, yet different branches have developed. A variety of therapeutic skills are now commonly used by both osteopaths and nonosteopathic practitioners of this work, so neither Cranial Osteopathy nor Craniosacral Therapy can be accurately defined by just one approach. However, in practice, Craniosacral Therapists often work more directly with the emotional and psychological aspects of disease through the interconnections of body and mind.

Biodynamics and Biomechanics

In the branch of practice known as Biodynamic Craniosacral Therapy (BCST) there is an emphasis on working with the underlying forces that govern how we function. The focus of a biodynamic approach is to cooperatively and respectfully employ these forces for both diagnosis and treatment. This has practical ramifications for the way in which diagnosis and treatment are carried out.

Biodynamic Craniosacral Therapy practitioners work with less directive and less invasive treatment skills that are oriented to the slower rhythms of primary respiration and also to the stillness that can be experienced at the deepest levels of our being. Furthermore, BCST practitioners are trained to recognise how unresolved trauma becomes stored in the body and to apply skills that can safely and effectively resolve and dissipate this trauma. As a core principle, practitioners learn to listen and respond to the treatment priorities led by the client’s own natural tendencies and capacities to find health. Treatment can then be applied with appropriateness, effectiveness and safety according to individual needs.

Other forms of Craniosacral Therapy may focus more on the results or effects of these organising forces (i.e., the manifestation of tissue tensions in the body) rather than directly relating to the underlying forces themselves. This approach is sometimes referred to as “Biomechanic Craniosacral Therapy”, and it relies on the application of relatively active and directive techniques of treatment. Also, the tendency in a biomechanic approach is to work with the faster and relatively superficial rhythms that get expressed within the body. We could say that biomechanic treatment works more from the outside-in, whereas biodynamic treatment works more from the inside-out.

Craniosacral Biodynamics

In a biodynamic perspective, the healthy functioning of the body is determined by the ability of the potency of the Breath of Life to play freely throughout the body; an understanding that has a direct connection to the pioneering insights of Dr. Sutherland.18 It is interesting to note that during the latter years of his life, Dr. Sutherland increasingly focused his attention on directly synchronising with the potency of the Breath of Life which can be used as a therapeutic medium.19 He saw that if the expression of this vital force can be supported, then health is effectively restored. Dr. Rollin Becker, Dr. James Jealous and Franklyn Sills have each added valuable insights into the operation of these natural laws that govern our health.


Another feature of a biodynamic approach involves the study of embryology. Embryology is not just something that happened at the start of our lives; it continues throughout our lifespan. We are constantly being created! This is how and where a great source of health and healing can be found, as the body is in a constant state of creation, maintenance and repair.20 Consequently, even so-called “incurable” diseases can sometimes be healed, if the conditions that allow this can be established. It is considered that these processes are primarily guided by the same forces that created us in the first place. In other words, the highly organised forces that created us during our embryological development continue to maintain and heal us throughout our lives. According to pioneering embryologist Dr. Erich Blechschmidt the process of early cellular differentiation and organisation occurs in response to an ordering force that operates through the fluids of the body, a conclusion that corresponds to Dr. Sutherland’s insight about the role that fluid plays in carrying the intrinsic ordering principle of the Breath of Life.

Furthermore, the patterns of motion that occur during our embryological development correspond to the subtle motions that become generated in the body throughout life in response to the rhythms of primary respiration. Therefore, a study of the movements that occur during our embryological development can provide great insight into how the body is organised, maintained and healed. If we can support the expression of these natural motions, we may tap into to the original and generative forces of creation and so access an immense – perhaps even unlimited – potential for healing.

Biodynamics in the modern world

In recent years there has been a surge of interest in Biodynamic Craniosacral Therapy. Trainings have been set up in many countries and practitioners are increasingly in demand; not because of some public relations exercise but because of the experiences that clients and practitioners are having at a grass roots level. Many international practitioner associations have also been established to support and maintain professional standards of practice. Furthermore, research projects are currently being set up that may enable this practice to gain greater recognition and acceptance, and so provide a resource for more and more people. In this way, BCST can take it’s place in the medical systems of the future, which with all the great advances must also sooner or later become more aligned to natural laws and holistic principles.


  1. Dr. H. Magoun D.O., Osteopathy in the Cranial Field (3rd ed. Sutherland Cranial Teaching Foundation, 1976): xi
  2. Dr. W. G. Sutherland D.O., Teachings in the Science of Osteopathy (Rudra Press, 1991): 4
  3. Dr. W. G. Sutherland D.O., Contributions of Thought (Sutherland Cranial Teaching Foundation, 1967): 49
  4. Professor Guiseppe Sperino, Anatomia Umana, vol. 1: 203
  5. Hugh Milne, Heart of Listening (North Atlantic Books, 1995): 54
  6. Emmanuel Swedenborg, The Cerebrum and Its Parts (The Brain Considered Anatomically, Physiologically and Philosophically, vol. 1; Swedenborg Scientific Association, 1938): 209
  7. Sutherland, Contributions: 102-3
  8. Dr. A. T. Still, Autobiography of A. T. Still (A. T. Still; reprinted by American Academy of Osteopathy, 1981): 235
  9. Sutherland, Contributions: 102
  10. Sutherland, Science of Osteopathy: 14
  11. Sutherland, Contributions: 142
  12. N.B. This concept is found in traditional Chinese, Ayurvedic and Tibetan systems of healing and also referred to by Hippocrates as “the healing power of nature.”
  13. Dr. Harold Magoun D.O., Osteopathy in the Cranial Field (1st ed. Sutherland Cranial Teaching Foundation, 1951): 15
  14. Sutherland, Contributions: 97
  15. Ibid, 138-39
  16. Dr. John Upledger D.O., Your Inner Physician and You (North Atlantic Books, 1991):15
  17. Dr. John Upledger D.O., “Differences Separate CranioSacral Therapy from Cranial Osteopathy,” Massage and Bodywork (Autumn 1995)
  18. Sutherland, Science of Osteopathy: 14
  19. Sutherland, Contributions: 143
  20. Dr. James Jealous, “Healing and the Natural World”, interview by Bonnie Horrigan Alternative Therapies, January 1997. Vol. 3, No. 1

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Warm Wishes
Michael Kern