Going with the Flow, CranioSacral Therapy for Kids!

Note: This is a republishing of a post that first appeared in 2017. After receiving a few emails with questions about CranioSacral therapy, we decided to re-post this interview. CranioSacral Therapy is a very gentle modality of bodywork and is very child compatible. One ETM reader, after coming across the first publishing of this post, brought her toddler to receive CranioSacral Therapy. While receiving the bodywork, the toddler’s eyes started rolling back and forth which perturbed the mother. The therapist assured her that it was a just an involuntary reflex. I asked CranioSacral practitioner, Debbie Sera, who I had interviewed a few years ago, about this involuntary eye movement witnessed by this particular mom. She echoed the sentiments of the toddler’s therapist, and added that if the child is really relaxed, the child can fall into a “waking sleep” state where their eyes can go into the REM patterns. It is actually a good sign that the therapist has hit a particularly good place for the child to release any tensions stuck in the body. Though the REM patterns can look a little strange, it is quite normal. Small twitches are also normal and healthy reactions. Seizures and anything more dramatic than a gentle twitch is NOT normal and the practitioner should recognize this as such.

I was first introduced to CranioSacral Therapy through a chiropractor who I saw regularly for neck problems that stemmed from an old whiplash injury. During one session, after adjusting my neck, my chiropractor asked me whether she could do a little CranioSacral Therapy work on my neck to help relax the tissues and recalibrate the area post-chiropractic adjustment. Minutes later I felt like I had melted into a puddle– I was practically asleep on her table.

A few years later, after my daughter was born, I was struggling with caring for the highly sensitive little nap-dodger. I was exhausted and desperate to get her to sleep more than 20 minutes at a time. In a rare moment of lucidity, I decided to try having my chiropractor perform some CranioSacral Therapy on my daughter to see if it could “take the edge off” her enough to help her find her sleep! What did we have to lose, certainly not more sleep?! I quickly made an appointment on behalf of my daughter before my moment of thought clarity disappeared and brought her in to get the the CST* work.

My daughter happily went through her session and seemed to enjoy it. After the session, she took an epic nap and that evening, she fell asleep early and slept through the night for 12 hours straight! I was sold on CranioSacral Therapy. From then on, I took her regularly to get CranioSacral work.

So, what is CranioSacral Therapy, apart from being some sleep-inducing voodoo that magically transformed my child from a short napper to a “good” sleeper?

     “CranioSacral Therapy (CST) is a gentle, hands-on approach that releases tensions deep in the body to relieve pain and dysfunction and improve whole-body health and performance. It was pioneered and developed by Osteopathic Physician John E. Upledger after years of clinical testing and research at Michigan State University where he served as professor of biomechanics.
     The central nervous system is heavily influenced by the craniosacral system which is made of the membranes and fluid that surround, protect and nourish the brain and spinal cord. A CST practitioner is looking for areas of the body that feel protected/ defensive.”(Upledger Institute)
By using an extremely light touch, a CST practitioner looks to release that tension in order to get the fluids surrounding the brain and spine flowing freely again without restriction. This, in theory, soothes the nervous system and promotes and general sense of ease in the body.

Since moving to the bay area, I found a new practitioner to perform CST on my family. Debbie Sera is a CranioSacral Therapy practitioner that works in the Bay Area in CA and in Bend, OR and she is AWESOME! ETM caught up with her at her home in Bend to ask her questions about her work with CST in pediatric cases.

CranioSacral Therapy is gentle

A: I know that CST is beneficial for everyone, but what makes it so beneficial as a modality for children?

D: Well, what makes it so perfect for children is that it is super,super, super gentle.

Children are just so much more open to work with. They don’t have years of belief systems built up in them yet. They are unguarded. Their bodies are just so open to healing and wanting to correct themselves. Unlike adults, there is no protective mode that their bodies go into when we (CST practitioners) start working on an area of the body that is possibly uncomfortable, emotionally or physically. Adults bodies will almost put a wall up when there has been a trauma, while children don’t usually do that. CranioSacral work just naturally fits with children’s ability to be guided into undoing tensions that have built up in their bodies.

These tensions are caused by lots of different things. Sometimes it is a fall on the playground, other times it is stress at school or at home…with children, there is a large emotional component that shows up during a CST session. The emotional competent gets stored in the tissue (organ and muscle). Through the light touch used in CST, the children are prompted to release and express what was being held in their bodies.

For example, children that have sensory problems or whatever their challenges may be, have difficulty in recognizing and expressing their feelings, especially in moments that are intense or troubling to them. If they feel frustrated or they get upset, or someone hurts their feelings,  they don’t have the capacity to express it clearly. So, these unexpressed feelings get stored in the body as points of tension.

CST looks to release these areas of stored tension and restore balance to the body. As a CST practitioner, I look for areas of the body that feel protective or defensive. Those areas feel like the natural movement of the tissue is restricted in some way.

For instance, I work regularly with a teenage boy, he started seeing me when he was 9 and now he is 14. A few weeks ago I was working on his chest, and I asked him, “So, what is being held in here?” and he started to tell me about several situations at school that he had not been able to tell to his mother. I had been able to put him at ease enough so that he could verbalize what had been tamped down frustration. As he was talking, I started feeling movement around the areas of tightness in his chest, and more and more stories about his school difficulties came out!

Once he was able to verbally express what was going on, his body relaxed more and moved into a pattern of ease.

A: You talk a lot about an area that we, the general public don’t think a lot about when it comes to traumas that affects our bodies. You have mentioned to me before, during sessions with my daughter, that you can recognize signs of a trauma that might have happened during birth. You spoke to me about how the birthing process can set up protective patterns in the body that can later lead to imbalances. Is this more common for children to exhibit these “patterns” and what exactly do you mean when you say that your recognize these “patterns” or commonalities in certain session with children. Do you see that “pattern” only in the pediatric patients you work with or does it occur in adults that you treat as well?

D: As far as seeing patterns that I recognize as birth trauma, it is more common for me to see that in my pediatric patients because that memory is relatively new. When I work with adults, birth trauma patterns rarely come up, it does come up once in a while, but it is really rare.

Babies seem to know which ways to move to help release where they might have been stuck

A: But how do you recognize, in children, the pattern of a traumatic birth?

D: Usually the children that come in that have had a difficult birth have some sort of problem like difficulty with nursing, or the baby is spitting up excessively, or they are exhibiting colicky behavior.

When I work with the little ones, they are so tiny, so precious and so open, all I have to do is put one hand behind their little head and one hand holding their sacrum and I hold them in a supported traction for their whole spinal column. Then they start to move their hips around and squirm. It’s amazing, they know what they need to do to correct their restrictions in their own tissues. When they squirm, I can feel the tissues pulling in certain ways and I can feel where the restrictions are, but unlike in an older child, I don’t need to prompt their bodies to let go of the held area. The babies seem to know which ways to move to help release where they might have been stuck.

I see this frequently in babies born from a Cesarian birth. They never get the natural compressions that happen in the birth canal which seems to help the baby’s spine align itself properly. So, many times they will come in with problems I had listed off earlier, colicky behaviorvior and the like, and I just hold their spines and these babies start to twist and turn and mimic body positions that would have happened naturally had they been born through the birth canal. It is beautiful to witness.

Usually, I’ll have the mother nearby to help hold the squirming, shifting baby as it eventually transfers fully into her arms. I have older kids that mimic that same fetal position and twist and turn while I work on them, so its not just the newborns! This pattern of curling into a fetal position and twisting and turning on the table, even dangling their heads off the table and corkscrewing their bodies to the floor or (preferably) into their parents arms– this is what I mean by the birthing “pattern.” It is almost like the children are choosing to create a “do-over” of their journey through the birth canal in order to un-do the area of tension that was being held.

This movement pattern may present itself repeatedly over the course of several CST sessions. When the pattern stops, then that part of the body’s healing has been completed.

The body has an unbelievable way of knowing what it needs.

With my own daughter, I witnessed this same pattern happen, though at the time I did not yet recognize it to be the “birth” pattern. My daughter is now 23, so she must have been 4 at the time. She was such a sensitive child from the get go, really sensitive to sounds.

I was taking the CST courses to deepen and broaden my skill set as a massage therapist. During my CST coursework and practicum, I could see how this type of work could benefit my daughter with all of her sensitivities.

As her mom I knew that it would not be easy or appropriate for me to work on her directly. So I took her to a fellow CST practitioner for a session and see what would happen.

It was an intense session. All of the work was predominantly done around her head and a little on her spine. When the session started, I was chatting with the therapist as she worked on my daughter. My daughter, at 4 years old, said, “Don’t talk, Mommy, don’t talk.” I said, “Ok,” and I kept quiet. I sat in the corner and let the therapist continue to work on her.

She was curling herself up into fetal position and twisting and turning. I could see that pattern that I would witness over and over again when working on children; the pattern that I call “the birth pattern,” but at that point in time, I did not recognize it because I had not been practicing CST for very long.

When the session was done and my daughter and I were back in the car, she was totally spaced out and silent.  I asked, “How are you doing? Are you ok?” She replied,”Do you really do that as your job?” I said, “Yes.” Then she said, “That is so weird, you and Judy (the therapist that had worked on her) are so weird,” which prompted me to ask, “Why? What did you feel in there?”

She paused for a moment. And then she started to recount what seemed to me a first person POV of her entire birth process. She told me when she had gotten on the table and closed her eyes and she felt the therapists hands move to her head, she was transported by her thoughts to a dark comfortable place and she felt happy that she was there. Then as the work on her head continued, she said that she felt an intense pressure on her head and that it really hurt the top of her head. Now, keep in mind that CST uses an extremely light touch, so this intense pressure was coming from a pain memory and not coming directly from the therapist working on her. She said she was screaming, “Stop it, stop it!” but it the pain would not stop and she felt like nobody was listening to her or could hear her screaming. Then she said she felt her head being yanked on really hard and everything got really bright and cold, but the pain stopped. Then she said she felt herself being placed on my chest and everything was ok.

Well, I was completely shocked to hear her say all of this. All I could think of was her positions and gestures on the table during the session. When she was born, the doctors had used a suction to help pull her out of the birth canal. I had never shared the story of her birth with her, I mean, she was 4 at the time of her first CST experience.

I started to cry when I heard her describe what she had felt while the therapist was working on her, because CST is really really gentle. The touch is so light. But what it had accessed was something so big and scary, as far as my daughter’s emotions, that it had brought to light her first trauma, which was the trauma of being suctioned out when she was born. And it brought to light that intense pain memory.

She seemed to remember every detail of pain when she was suctioned out, and how she felt helpless because no one could understand her distress and hear that she wanted them to stop. She still, to this day, gets very upset when she feels that people aren’t listening to her. If I interrupt her when we are talking, she gets very very upset with me and I have to back off.

So that is my own personal story of witnessing CST at work and how children remember these emotions and feeling states and how CST can help them process what they went through.

The body has an unbelievable way of knowing what it needs

A: I realize that sessions are organized around the individual, but what do you normally recommend as far as frequency of treatment when kids start having CST sessions with you?

D: Usually for the newborns, I recommend doing three or four sessions once a week, in succession. When they are that little, they adapt, adjust and heal so quickly. Like I said earlier, they are so open in their little bodies, they may not need much more work than that to help release the tensions that are being held.

When I am starting to see an older child, it depends upon the parents and their schedules. Many of the kids that come in to see me go to many other therapies in addition to coming in to see me. The parents of ADHD kids, Autistic kids, kids with anxiety issues usually have a pretty loaded schedule with occupational therapy, physical therapy, social skill groups, etc. So, I know it is not convenient for them to come in daily for one week, for example.

It is good, when a child first comes to see me, to come in once a week or once every other week, just to get a pattern set up where the child knows what a session with me is like. After the first once of working on a child once a week, then we can stretch it out. But really, it is up to the family, their schedule, and what benefits or positive changes they are seeing in the child after the session they had with me. Once our relationship has been established with my patients, then coming in once a month is just fine, for tune-ups– so to speak.

A: And what changes do parents usually see?

D: Well, of course, it depends upon the child, but usually within 48 hours of the session with me, there will be a easing of the more negative behaviors. For example, if a child has come in because of ADHD behaviors, then the parents may see the child sleep better, especially the day the work was done on the child. The child will be less anxious, more relaxed, more easy going and adaptable. Sometimes bossy behavior will turn into more of a patient leadership type of behavior. That type of thing.

CST helps these kids move through their difficulties with greater ease

A: I had a practical question about working on toddlers or the Pre-K set. When you are working on a baby, they are not mobile, so you can work on their whole spine in one go because they are so little and, beyond squirming, can’t really move. Older kids will just lay still because they know what is expected of them. But toddlers just don’t stop exploring. How do you work on the toddlers?

D: I let them move! If they want to walk around and explore, I put my hands on them and walk around with them. We just walk around my massage table together. We will be walking around and then something will shift in them, like their bodies will release some tension they were holding, and they just stop in their tracks. They will turn and they will look at me. And I usually say, “So what was that?!” and they will stand there and look at me for a good 30 seconds, and then they continue on their way, running around the table. But they know when something shifts. And after a few of these body tension shifts, they start feeling more spacey and relaxed and they will get on the massage table and lay there for me to continue the work. If they don’t, I’ll have the parents play with them while I continue to work, or I ask for parents to bring in books for them to look at together while I work on them. Whatever works for the child and the parents.

I remember one little boy who was a patient of mine, he was a preemie when he was born. He started coming to see me as a baby. Later, he had some health complications and they had to put a tracheal tube into his throat which caused some scarring and trauma, obviously, which in turn caused other issues.

When he’d come to see me as a toddler, he’d bring his little toy trucks and he’d line them up on my table and walk around my massage table with them. I’d follow him around, I’d have one of my hands on his chest and one of my hands on his back, and we’d walk around my table together. Once in a while he’d take his hand and remove my hand from his chest. I think my hand on his chest was triggering the memory of the tracheal tube. I could feel the tightness in the area of his trachea, and he just didn’t want me to go there. So, I’d back off and take my hand off of his chest, and I’d work the tension point from his back, and when he felt triggered again by the manipulation of this point of body tension, he’d move my hand from his back. So we had this little dance going on between us, back and forth, working this spot from the frontal and dorsal sides of his body. I never forced the point, I’d make a little game of it. If he was laying on the table, I’d take one of his trucks and lay it on his chest and do the work using the toy!

With these little ones, you have to get creative. I mean you just can’t expect them to be still, especially the ones with challenges. Its just not going to happen.

A: Too true! As a last thought, how do you see CST dovetailing with other therapies or with helping newborns ease the transition from being in utero to being in the outer world? For example, do you see it fit in with chiropractic work, physical therapy, occupational therapy, etc?

D: It could fit it beautifully, but currently isn’t viewed as fitting in with other therapies. This is largely because people aren’t aware or educated about it as a complimentary therapy. If you talk to a pediatrician, that doctor has most likely NOT had any exposure or training around CranioSacral Therapy. When you try to explain it to them, they are hesitant to give their approval of the therapy because they aren’t familiar with it and don’t want to risk getting sued. Most insurance companies don’t cover massage, which is the category CST falls into, so the doctors additionally don’t want to recommend a therapy that is going to bring their patients out-of-pocket costs.

In regards to kids with developmental challenges that are already going to see an Occupational Therapist; they are more likely to have CST recommended to them as a complimentary therapy because most OT’s** have heard of CST and have had their clients try it out. Those clients have usually given them positive feedback and practitioner recommendations. The OTs have seen the benefits of including CST as a complimentary therapy to theirs. But it is still rare to have an OT trained in CST. Finding that OT who also had CST training would be like hitting the jackpot!

A: Yes! So many parents of kids with challenges end up taking their kids from one therapy to the next every week because nothing is centralized under one roof. It would be so much easier if there were more offices that offered many different types of therapies in one health center, one that combined allopathic practitioners, massage therapists, Physical Therapists, Occupational Therapists, and Naturopathic Practitioners. There are a few centers for Integrative Health, one that I know of is through UCSF Benioff Center in San Francisco. But these types of centers for Integrative Health are few and far between.

D: Yeah, I really feel for the parents of these kids that have difficulties. I don’t know how they do it. Every day after school, there is some appointment for something.

I wish healthcare could be organized in a way that would make these alternative modalities more readily available to them and make the access easier. There should be a center that houses it all. There should be a center that has an OT, a PT***, a Speech Therapist, a person who specializes in sensory integration, etc. and that these professionals would work as a team for each patient. It just makes sense and it would be such a tremendous benefit to the kids. I hope at some point in the near future someone takes the initiative to open up a center like this. It is so, so needed.

A: That would be awesome. Here’s to hoping! Thank you for your time. I really appreciate it.

*CST: CranioSacral Therapy as developed by John Upledger.

** OT: Occupational Therapist, someone who helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes.”[2]

***PT: Physical Therapist, highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility.


Debbie Sera is a licensed Massage Therapist, who specializes in CranioSacral Therapy and Reiki. She feels her purpose is to help make a positive difference in others lives, helping them to connect with their authentic selves. She lives and practices CranioSacral Therapy in Bend, OR.

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