The Breath of Life

A Craniosacral Primer

By Aureal Williams

Craniosacral touch is a light contact modality that invites the body to self-correct through skilled touch, conscious presence, deep stillness, and a working knowledge of anatomy, physiology, and embryological development. This modality is known by a variety of names, such as craniosacral therapy, Visionary Craniosacral Work, biodynamic craniosacral therapy, craniosacral biodynamics, and dynamic stillness. The spectrum of approaches to craniosacral touch extends from direct manipulation, as in inducing a stillpoint, to a non-action presence that holds neutral. Whatever the name or the approach, the client, practitioner, and the field around them seems to sink into deep stillness where the body can self-correct. A universal client experience of craniosacral touch seems to be one of renewal, well-being, and deep contentment.

 While there are various approaches, the core root is deep and singular. We find these roots in the works of Andrew Taylor Still and his most famous student, William Sutherland, doctor of osteopathy (DO). In 1892, Still established the first school of osteopathy and following that development, Sutherland created cranial osteopathy. Doctors of osteopathy practice cranial osteopathy, and massage therapists and other bodyworkers train and practice in the various programs of craniosacral touch.  If you are interested in exploring craniosacral touch as a modality for your practice, the following primer offers a summary of leaders in this field and the training programs they offer.

The Biodynamic Craniosacral Therapy Association of North America

Based on the work of Franklyn Sills and his Karuna Institute, located in Devon, England, biodynamic craniosacral therapy works to help resolve the trapped forces that underlie and govern patterns of disease and fragmentation in both body and mind.

Peggy Risch, a registered practitioner of this approach, is also a teaching assistant with the Biodynamic Craniosacral Therapy Association of North America (BCTA/NA) training programs. She says toward the later years of Sutherland’s life,  he recognized that there was an Intelligence, an Innate Wisdom in the body that was expressed through what he called the Breath of Life, or the body’s life force. The Breath of Life manifests itself through palpable rhythms, like the craniosacral rhythmic pulse.

Risch says biodynamic craniosacral therapy looks for the downregulation in the nervous system when these deeper tides become dominant, hold potency, and allow the client’s Innate Intelligence to self-regulate. “The human system will tend to want to go to a level of higher order,” she says. “The biodynamic craniosacral therapy work is an acknowledgement of the Breath of Life and its manifestations within the human system. It is the recognition that health is never lost and the intention is to reestablish this relationship between the cells and the tissues with the Breath of Life, and that this is possible even in the most acute processes or pathologies.”

Training through the BCTA/NA involves a 700-hour certification course spread over 10 segments. Completion of the course spans a minimum of two years to a maximum of three years.  In addition to course training, each student gives 150 one-hour practice sessions, receives 10 sessions, and completes 150 hours of independent home study.  An exam and a class project complete the requirements, allowing one to apply for certification as a registered craniosacral therapist. 

Breath of Life Cranial Touch

Charles Ridley, founder of dynamic stillness, says in his school of thought, the practitioner does not treat. Instead, the practitioner senses and cooperates with the movement of health as it is directed by the client’s primary respiration. One of Charles Ridley’s valued contributions to the craniosacral and biodynamic community is a clear delineation of three distinct approaches to the work: biomechanical, functional, and biodynamic. In his book, Stillness: Biodynamic Cranial Practice and the Evolution of Consciousness, Ridley presents each cranial enfoldment, or tide, as a level of human consciousness, as accessed by resting in heart perception.

Ridley’s biodynamic approach represents a total non-doing. He believes the Breath of Life is in charge and intention and regard for function get in the way. Sensing the relationship between body and the Breath of Life requires deepening one’s heart perception to the psychic level of consciousness (fluid tide), where the self knows itself as one with nature. Deepening further, one evolves with the unfolding of the Breath of Life into subtle consciousness. Direct contact with cosmic breathing, of long tide, is sensed as a 50-second excursion one way out to infinity and a 50-second cosmic infusion back to the body. Finally, one touches dynamic stillness, that point of intersection where the invisible meets the manifest world. “Causal consciousness is where utter relaxation of ego begins and awareness can realize itself as non-dual—both a separate individual and one with the whole simultaneously,” Ridley says.

Sutherland, Ridley shares, evolved all three approaches. “He didn’t finish [the process], yet he did teach that in the science of osteopathy you no longer have to motion test; you wait for tide to show up. You follow the unerring guidance of the tide and wait.” After Sutherland, Ridley credits the work of Rollin Becker, DO, and James Jealous, DO, for delineating the harmonics of the longer tides and furthering along the biodynamic evolution.

Ridley’s training program involves a bridging class of four days and a yearlong mentorship that meets four times a year. Student access to Ridley is available to refine skills, as needed. Upon completion of the mentor course, one can become a certified practitioner of this work.

Michael Shea Teaching

“What interests me most is that embryology is the new anatomy in biodynamic craniosacral therapy,” says Michael Shea, PhD, of the Shea Educational Group. “The word biodynamic comes from the study of human embryology. It refers to the slow movements in the fluids of the embryo and adult that maintain and repair the body.”

Shea’s work is based on Sutherland’s last teaching, where a practitioner senses and synchronizes her attention with the slow embryonic rhythms within the client. This process involves sustained skin contact (SSC) because the practitioner frequently has her hands in one location for 10–15 minutes. Shea says that “SSC actually goes into the attention centers of the brain and can heal disorganized patterns from infancy and childhood.”

For SSC to have a lasting effect, the therapist has to self-regulate her own emotions and autonomic nervous system. Utilizing his focus on pre- and perinatal psychology,  Shea’s training teaches practitioners how to do this with slowness and stillness. “I call it therapist-centered therapy because the infant research shows that positive resonance between the child and caregiver builds inner regulation,” he says. “It is the same when treating a client, according to researchers. Positive resonance does most of the work.

“I have stated in my book, Biodynamic Craniosacral Therapy, Vol. I, the evolution of the work is about healing the heart by establishing a heart-to-heart circulation between a client and therapist,” Shea says. “The focus in the cranial world has been the brain and I feel it has to be deeper down and into the middle of the heart. This is what the embryo has taught me—the brain is subservient to the heart throughout life.”

Prospective students with no craniosacral experience can pursue Shea’s introductory courses and foundation certification training of 700 hours to become a biodynamic craniosacral therapist (BCST). His trainings are approved by the International Affiliation of Biodynamic Trainings. Those with experience can pursue a bridging program for BCST or training to become an advanced biodynamic practitioner.

Primary Respiration

The foundation of the work taught by James Jealous, DO, is set upon “the therapeutic powers of the dynamic stillness, the Breath of Life, the tidal potency, fluids, and other natural laws at work supporting and generating life.” According to his website, Jealous says, “It’s not about bones, or levers, or palpation. It is not about balanced membranous or ligamentous articular tension; these approaches are a different composite. It is about the Tide at work as the primary source of diagnosis and treatment with no application of force to osteopathic lesions or psycho-emotional systems.”

Primary Respiration is the focus for Jealous as a therapeutic tool, and he calls it “uniquely complete in its wholeness.” Even with his deep roots in the field, Jealous says osteopathy has “shamefully hidden its great mystery and resources.” On his website, he says, “I believe that to acknowledge a higher wisdom at work and to sense rather than palpate is at the soul of osteopathy.” With his BioBasics course and his postgraduate offerings in pediatrics, Jealous continues to bring great depth to the field.

The Upledger Institute

One of the most recognized training programs of craniosacral therapy is The Upledger Institute. Roy Desjarlais, LMT, CST-D, vice president of clinical services for The Upledger Institute says that the training is based on three principles defined by Andrew Taylor Still: the body is a unit; structure and function are interrelated; and the body is self-correcting. “Our curriculum is steeped in research and comes from an osteopath [John Upledger, DO, OMM] who has dedicated the majority of his career to a single-minded focus of looking at how we can engage the body with natural, self-corrective mechanisms.”

The work, Desjarlais adds, “is very gentle in nature. It tends to be indirect.” Yet, Desjarlais says, “What I like about our way of teaching and working is that we have a choice based on the signals that we get from the body … There might be times when the body wants to recreate a little bit of pressure in order to engage the tissue memory more fully so it can release and get to the depth of tissue we are dealing with. That is not dictated by the therapist; that happens naturally from the patient/client and then we follow.”

Desjarlais says that The Upledger Institute trainings incorporate a holistic view, encompassing work with tissue, energy, emotion, and belief systems. “Ultimately, we are trying to help people become empowered in their own health, to be able to become tuned into their bodies in a way that they can live a much less dependent life on medicines.”

There are two levels of certification training at Upledger. The first is a technical certification that includes anatomical techniques from the 10 Step Protocol, hard palate work, advanced dural tube and spinal cord evaluation, and release techniques. The diplomate level of certification occurs after technical certification and includes somatoemotional release techniques, dialoguing techniques within the scope of practice, and training on the energetic system, including arching phenomena that Desjarlais describes as “active lesion patterns.”

Craniosacral Work

The genesis of Hugh Milne’s, DO, Visionary Craniosacral (VCSW) program dates to 1967 when, as an osteopathic student, he had experiences of inner-eye perception. “What most touched me as I read Sutherland’s work was when he wrote of his own teacher, Andrew Taylor Still: ‘He could look right through you and see things, and tell you things, without even putting a hand upon the body. I have seen him do that! Time and time again.’”

Milne says those words spoke to him. “It touched me because things like that had happened to me, and it took me years to find teachers to help me understand it. I think that this aspect of the work can and must be taught. Of course, we must also understand the Breath of Life, the biodynamics of craniosacral work, the anatomy, develop skill in sensitive touch, become more present, and work on interpersonal skills.”

On perception and touch, Milne says, “The harnessing of perception is part of the reason that craniosacral work exists and is in demand. Human beings want and need to be seen and touched at their deepest levels. When you can see where they need to be touched, it helps your touch be effective. Such visionary touch can be transformative.

“The visionary approach does its best to honor what [Carl] Jung called dreambody, what Carlos Castaneda called the Nagual: the complete human being. When we can be open and vulnerable in a session, we allow energy to come into the room.”

VCSW certification involves seven core classes requiring a minimum of two years and allowing flexible scheduling and completion time to support the student’s personal process. Requirements include review classes, 140 client sessions, student exchanges, and receiving professional sessions. There are also three postgraduate classes. Auxiliary classes include VCSW anatomy and Beyond the Stillpoint with Giorgia Milne, an embryology class based on Erich Blechschmidt’s work with Konrad J. Obermeier, and two pediatric craniosacral classes and two visceral manipulation classes with Benjamin Shield, PhD.

Pediatric Craniosacral

As a result of worldwide acceptance of biodynamic, craniosacral, and visionary work for adults, and the growing rates of autism, sensory processing disorders and learning disabilities, and youth violence, massage therapists and bodyworkers look to pediatric craniosacral therapy for effective help for these stressing issues. Shea addresses pediatric biodynamic craniosacral therapy, and the following two programs also offer trainings in pediatric craniosacral therapy.

The Upledger Institute

Rebecca Flowers, OTR, CSP, CST-D, is the ombudsman for the pediatric curriculum at The Upledger Institute. In this capacity, she develops the pediatrics curriculum and supervises the institute’s pediatric instructors around the world. Her background is in occupational therapy and sensory integration. “Craniosacral therapy has the ability to facilitate the body self-correcting in that the system is able to come back into more balance and the central nervous system (CNS) is able to function in a more efficient and effective way, so that when you apply other therapies like physical therapy, occupational therapy, speech therapy, sensory integrating therapy, aquatic therapy, you actually see great gains and you see them occurring more quickly, because you have just facilitated correction of the foundational pieces of the CNS,” Flowers says.

“We recognize that we need to meet the child where he is and not expect him to do what we want and meet us where we are. We recognize that the work of the child is play and we allow her to move in and out of positions as she needs to, recognizing that the behaviors that we see from her tell us a great deal, even if they are nonverbal.”

Pediatric health conditions that can benefit from craniosacral therapy for pediatrics (CSP) include sensory processing disorders like autism, learning disabilities, visual deficits or visual motor incoordination and dyspraxia, brain damage disorders like cerebral palsy or genetic disorders, traumas including posttraumatic stress disorder, and reaction attachment disorder with children who are adopted. Treating seizure disorder is The Upledger Institute’s next focus of pediatric research, based on the positive effects of CSP treatments for this condition to date. 

The path to training with The Upledger Institute for CSP is to complete the core curriculum, Cranial Levels I and II, and somatoemotional release. Once the basic CSP class is taken, the student may take Clinical Applications for Pediatrics, a class of four students working in The Upledger Institute clinic with Flowers. Here, students receive direct hands-on feedback and coaching as they develop their skills. There is also an advanced Clinical Applications for Pediatrics and Flowers is currently working on a certification track for The Upledger Institute’s CSP training.

Visionary Craniosacral Work

Benjamin Shield, PhD, teaches the pediatric craniosacral classes for the Visionary Craniosacral Work of the Milne Institute. “The nature of the course,” Shield says, “is to bring the practice of craniosacral therapy and manual therapy into the hands of practitioners who want to work with infants and children. The principle of the work is to honor the consciousness of the infant. The courses that I teach involve infant-centered therapy and they incorporate a caring, common sense approach utilizing craniosacral therapy, manual therapy, prenatal and perinatal psychology, and principles of infant development.”

One component of Shield’s pediatric craniosacral class includes information on the polyvagal theory of Stephen Porges, PhD. In addition to the sympathetic and parasympathetic branches of the autonomic nervous system, Porges’s research posits a third part: the social nervous system. Polyvagal theory relates to five of the 12 cranial nerves involved with newborn acclimation. Specifically, these nerves relate to sucking, crying, hearing, facial expression, and head turning to orient to surroundings. Shield teaches that upregulating one of these cranial nerves upregulates them all, allowing for optimal functioning of the nervous system, beyond stuck points of fight-or-flight sympathetic response or parasympathetic freeze and withdrawal response. Another component of Shield’s classes includes learning how to establish safety, trust, and possibility of choice for the pediatric client, even a newborn, to help resolve experiences of physical or emotional birth trauma. In addition, the classes include information on the birth and development process, newborn and child cranial anatomy, craniosacral evaluation of newborns, and maternal care. Broad spectrums of pediatric health conditions, in relation to the applications of craniosacral therapy, are taught in the classes. This program includes two, four-day classes. The first class covers pediatric craniosacral work for infants and babies, newborn to 2 years. The second class addresses craniosacral treatment for children age 2 to 14 years. There is a master class for pediatrics in the works, where students will have the opportunity to work directly with pediatric clients under the teaching and supervision of. Shield.

Big Mind

There are many lines of thought in the world of craniosacral touch. Milne offers this anecdote to give perspective: “I was teaching in Hamburg, Germany, and I was exhausted from the jet lag and the traveling. A question came from a student: how did the biodynamic, Upledger, and visionary approaches differ? It is hard to avoid personal bias, that my approach is the best. I answered the question as openly as I could, but I knew I hadn’t found ‘big mind’ and felt dissatisfied.

“I hand the class over to Giorgia, and go to have a nap. A dream comes. I am in a big room, and Sutherland walks in. He is dapper, bright, and grandfatherly. He looks at me and says, ‘You shouldn’t try to name it. None of the names are right.’

 “I wake up from the dream feeling as if he poked me in my hara, like a Zen master. I felt corrected in the ‘big mind’ way. I think that is the best that can be said about all the schools. This is something, the perception of where to touch, then the laying on of hands, that has existed since prehistory: ‘You shouldn’t try to name it. None of the names are right.’”

 Aureal Williams, BSN, RN, LMT, is a public speaker, writer, and craniosacral bodyworker specializing in craniosacral work for prenatal and postpartum women, newborns, infants, and toddlers. In addition to individual sessions in Cincinnati, Ohio, Williams offers experiential classes for schools, parenting groups, corporations, and nonprofit organizations. She is certified in Visionary Craniosacral Work and an advocate of all types of craniosacral touch. To learn more about Williams’ work and to contact her, visit