Cranio-sacral Therapy and the Alexander Technique

by Jane Turney

Cranio-sacral therapy is becoming increasingly recognised as one of the most powerful natural therapies, penetrating deep into the central nervous system, releasing long-standing patterns of tension and trauma. Underlying the profound and very gentle nature of its work, is a therapeutic and philosophical approach that in many ways complements the Alexander Technique. Both are concerned with undoing habitual patterns in the body caused by accumulated tension, and restoring the natural alignment of the body; both work on the whole person rather than the symptoms, seeking a higher level of psycho-physical integration; both are concerned with the concept of “non-doing”; both require sensitive listening skills and for the teacher/therapist to be fully present to the patterns held in the pupil’s/patient’s body for any change to occur.

But it is perhaps the differences in approach between the two that potentially make them a powerful combination with which to address problems of incorrect use and habitual tension. The fact that cranio-sacral therapy is a treatment and the Alexander Technique a psycho-physical reeducation or learning process, is an important difference in this respect. They offer two different “means whereby” to the same ends. Underlying restrictions in the body can be done particularly effectively treated through cranio-sacral therapy, which releases tension, adhesions and blockages on many levels - bony, membranous, fluid, tissue and energetic, whether arising from before, during or after birth, whether of visceral, neurological, physiological or psychological origin.

For example, one of the techniques employed in cranio-sacral therapy, “fascial unwinding” (used to release physical and emotional trauma and tension bound up within the fascia), should, if carried through to completion, bring about the complete release of any fascial restriction. But many problems, from back pain and neck pain to visual disturbances and visceral disorders, can arise through persistently holding the body in inappropriate or tense positions. Where such postural or occupational patterns are deeply ingrained, habitual patterns of behaviour mean that patients may reintroduce tensions as soon as they have been released - obviously this is where the Alexander Technique comes in.

But on the other hand, Alexander technique on its own (without fascial unwinding) may not always be enough to change these patterns. Thomas Attlee, principal of the College of Cranio-Sacral Therapy in north London, says: “I have seen many Alexander pupils (and teachers) who have applied the Alexander technique for years in an unsuccessful attempt to counteract or undo chronic physical restrictions in their bodies, only to discover that these chronic tensions and restrictions can be released very rapidly through fascial unwinding, thus enabling them to apply their Alexander technique far more effectively and successfully. Teachers of the Alexander technique with their sensitivity and awareness of the body usually take to fascial unwinding readily and find that it enhances their work with their pupils considerably.

Another important difference between the Alexander technique and cranio-sacral therapy is that while Alexander students work mainly with the conscious mind, thinking in activity, in cranio-sacral therapy the treatment operates mainly on trauma and tension locked below conscious awareness. It could be said that Alexander Technique works from the conscious and reaches the unconscious and cranio-sacral therapy works from the unconscious and reaches the conscious. Like the Alexander technique cranial work is such a gentle process it can get underneath the body’s protective “habit patterns”, held in place to prevent overwhelming pain or trauma rising to the surface. Its subtle approach, contacting unconsciously held material can therefore deepen or accelerate one’s Alexander work.

Thomas recalls working with one such typical case, where an original trauma was so deeply overlaid by tension, that it was only through the gentle technique of fascial unwinding that release was brought about comparativelyquickly:

“One carpenter whom I treated came to me with extreme tension and restricted mobility in his shoulder and upper back, to the extent that it was impairing his ability to work. He was in his mid-forties and the condition had been there for many years and was solidly established, with many layers of deeply ingrained fascial restriction to unravel.

“After a few treatments we reached a point where, following a substantial release, the patient experienced a vivid memory of his time as an apprentice carpenter in his teens (almost 30 years previously) when he had been forced to work through agonising pain in order to keep up with his workmates and keep his job.

“Ever since that time he had suppressed the pain and injury of the incident into his body tissues and kept it under the surface with layer upon layer of protective tension, gradually building up a huge bulk of muscular tension to prevent the pain from rising to the surface. Only through the delicate and sensitive process of fascial unwinding was it possible to peel off these layers and unravel the many twists and tensions ingrained into the body by subsequent years of carpentry and so reach back to that initial incident.

“He, of course, had been totally unaware of the cause of his condition and had completely forgotten about his apprenticeship days until the release occurred and was very surprised to experience that sudden and unexpected memory. His condition improved rapidly after the original injury had been contacted and released.”

What exactly is cranio-sacral therapy and how does fascial unwinding work? At core cranio-sacral therapy carries a revolutionary premise - that underlying the cardiovascular and respiratory systems is an even more fundamental life giving system in the body, that of the cranio-sacral system. This consists of the bones of cranium and sacrum, the membranes surrounding the brain and central nervous system, the fascia which radiate out from these membranes to all parts of the body, and the cerebro-spinal fluid. All structures within the cranio-sacral system express a rhythmic, symmetrical motion (a sort of internal breathing system), expanding and contracting at around four to 14 cycles per minute. The system is believed to convey a biodynamic “potency” or vital force (known as the “Breath of Life”) which arises initially in the cerebro-spinal fluid and is then distributed throughout the entire body via the fascial network.

The Breath of Life functions as a dynamic, intelligent ordering principle, coordinating all tissue and cellular function and integrating all bodily systems. It is present from the moment of conception, guiding the development of the embryo up until death, and even in the most resistant of pathologies will still be present. The aim of the cranio-sacral therapist is to reestablish the relationship between damaged, dysfunctional or diseased tissues and cells and the potency of the Breath of Life. So the practitioner is essentially looking to enhance the life force in the body.

This is performed by gently palpating the bones of the cranium and sacrum and other parts of the body as appropriate, to identify the strength - or weakness - of cranio-sacral motion in different structures. The practitioner also looks for resistances and blockages in bones, membranes, tissues and fluids of the body which may also be affecting energy flow and physiological function. The goal of the therapist is to facilitate the body’s own potential for release, clearing and balance and just the act of being present to the energy flow and resistances and using the gentlest contact as a counterpoint to these, is very often enough to stimulate release on one or many levels, be it physical, emotional or energetic.

What hampers the cranial rhythm, and thus the distribution of the Breath of Life, is the accumulated stresses, strains and knocks we encounter every day - both physical and psychological - which, according to cranio-sacral thinking become locked in the fascia. This explains why it can be so difficult to change habits in our body, since, despite our best intentions, the traumatic memory or tension will be imprinted and safely “sealed off” in the fascia, out of our conscious awareness.

Fascial unwinding is one technique which addresses this. It can probably only be appreciated through the experience of being treated. It involves firstly identifying the source of the fascial restriction by gently resting the hands on various parts of the body (the listening posts) and identifying subtle pulls and tensions in the fascia. The therapist gains an impression of lines of force all drawing towards a specific focal point (the source of the restriction) just as iron filings are drawn towards a magnet.

Treatment then involves placing both hands on the appropriate body part and following the tissue demands, very subtly twisting, turning and pulling wherever they wish to go, until a point of resistance is encountered, where the original traumatisation is located. This point, known as a still point is where the crucial moment of fascial release occurs. By gently staying with this resistance, it will eventually dissolve and the tissues will settle down to a more balanced and freely mobile state, no longer pulled out of alignment by the former tensions and pulls.

Fascial unwinding can be carried out on any part of the body, on an arm, on a leg, on the abdomen or on the trunk, on a sprained ankle, a tense pericardium, a frozen shoulder, a twisted knee, an old operation scar, a spastic colon, an inflamed pleura etc. In cases of multiple traumatisation through car accidents, skiing accidents, or where generalised emotional tension is being held in the body, whole body unwinding may take place.

Fascial restrictions can develop as a result of prolonged strains and tensions, poor posture, perhaps due to occupational demands, such as typing or machine operating, playing musical instruments, causing RSI, writer's cramp, musician's cramp, tennis elbow and similar restrictions.

Refia Sacks, an Alexander teacher and cranio-sacral therapist who studied at CCST, finds that cranio-sacral therapy has given her a different set of tools with which to tackle certain problems. She cites one case history:

“I had a woman who had come to me for a lot of Alexander lessons in the past. Her Alexander was going reasonably well. However, after several years gap, she came to see me again with a severe frozen shoulder. At this time, It seemed appropriate to do cranio-sacral therapy because she was so much in pain and was so fragile that I could hardly move or touch her. The work had to be very subtle indeed and the most gentle unwinding was most appropriate. As the shoulder got better, we returned to doing Alexander Technique.”

Sometimes Cranio-Sacral Therapy can go deeper more quickly than the Alexander Technique. This may or may not be appropriate. Although it is not always the case, usually the most obvious habit patterns are shed first - the most outer and more recent - then slowly the deeper patterns are reached. CST can go in quite quickly because one is working very directly with sharp focus on underlying patterns in the body. This is particularly so with the “stillpoint” technique which is a very direct route into very deep levels whilst still being exceptionally gentle and non-intefering.

As cranio-sacral therapy is a treatment which works with diverse conditions including migraine, meningitis, digestive disorders, joint problems, birth trauma and ME, it places greater emphasis on physiological diagnosis than in the Alexander Technique, and Refia finds it has added detailed knowledge to her understanding of the body and its psycho-physical unity.


Jane Turney is the Publicity Officer for the College of Cranio-Sacral Therapy in London, England.

For more information about the Alexander Technique:

The Complete Guide to the Alexander Technique