SKEPTICAL EYE: Gentle manipulation of the skull is nothing more than just that, argues Paul O'Donoghue
An increasingly common form of alternative therapy that is often particularly recommended for babies is craniosacral therapy (CST). It is claimed that CST is a "gentle but profound form of treatment that works at the deepest level of the human system".
CST's basic assumption is that the body possesses a craniosacral system, consisting of the central nervous system, cerebrospinal fluid (surrounding the brain and spinal column and filling the ventricles within the brain), the skull bones and the vertebrae at the base of the spine (sacrum).
It is further assumed that the integrity of this system must be maintained in order that optimal health can be achieved.
CST practitioners also claim that there exists a pulse within the craniosacral system that can be detected through the scalp and sacral area and that fluctuations in the rhythm of the pulse can give useful diagnostic information. It is claimed that when the rhythm becomes restricted or blocked, discomfort and eventually disease processes set in.
They assert that by gently manipulating the skull and sacrum they can influence the rhythm of the craniosacral system and can release blocks, thereby influencing the body's general health and the course of a variety of conditions.
CST therapists claim, therefore, that they can unlock blockages and treat a great variety of conditions by what is essentially the laying on of hands.
Mainstream anatomy indicates that the bones of the skull are generally fused by late adolescence. Furthermore, the manipulations of the CST practitioners are so gentle, (described by some as no greater than the weight of a small coin), they would cause little or no movement in these structures even if such movement were possible.
Day-to-day activities, such as nodding yes or no, or jogging must surely cause much more generalised and vigorous movements in the cerebrospinal system and with no apparent ill-effects.
CST was first described by William Garner Sutherland in the 1930s. Sutherland was an osteopath who believed that the craniosacral system contained the primary life force and had an enormous influence on general health and wellbeing.
Although CST has evolved into a practice that is now independent of osteopathy and is promoted by a wide range of individuals with various kinds and durations of training, the idea that there is an esoteric vital force is still widely accepted among modern practitioners.
Unfortunately, many mainstream practitioners, including physiotherapists, doctors and nurses have become involved in the promotion or practice of CST and lend an air of kudos and respectability to what is essentially another pseudo science.
The claim that a pulse can be reliably detected by CST practitioners by gently palpating the skull and sacrum (area at base of spine) has been tested and results were negative. It has also been found that when compared under experimental conditions different therapists do not agree on the rate of the craniosacral pulse.
With regard to treatment, it is claimed that CST is especially effective in treating colic, ear infections, weakened immunity, disturbed sleep, irritability, restlessness, sucking and feeding problems.
Perhaps more worryingly, it is further claimed that other conditions that respond well to CST include asthma, autism, behavioural and emotional problems, cerebral palsy, dyslexia, epilepsy, hyperactivity, squints and visual disturbances.
There is not a shred of objective evidence to support any of the claims made above. As is common in the world of alternative medicine we are offered only the testimonials of practitioners and users of the system to convince us of its efficacy. In general, it is wise to avoid therapies and therapists where claims are made to diagnose or treat a wide and disparate range of conditions.
A major problem from my perspective is that parents of young children are very vulnerable and will try anything that they believe will do good for their child.
That vulnerability is significantly increased in cases where children suffer from conditions such as cerebral palsy, autism, epilepsy and so on.
Claims that CST can positively influence these and other serious conditions are unfounded and consequently, exploitative, even if the latter result is unintended.
CST practitioners recommend not only that babies with difficulties be treated by them, but that all babies should receive a craniosacral check-up soon after birth, just to make sure there are no residual problems that might compromise future healthy growth.
There is nothing in my reading of CST theory and practice to suggest that they can assess anything of the kind. This is the role of specialised medical and paramedical professionals.
CST is also offered to older children and adults. In these cases it is proffered to treat stress, post-operative and dental trauma and post-accident difficulties among other problems. It is also offered to pregnant women where it is said to reduce morning sickness, improve hormonal balance and enhance energy levels.
It is also claimed that treatment has a direct effect on the foetus as any restrictions or imbalances in the uterine environment are eased.
Once more there is not a scintilla of objective evidence for these claims. Why are people taken in by such alternative therapies when there is no objective support for them and many reasons to reject them?
Why do mainstream professionals become directly or indirectly involved in these hugely questionable areas? These are questions I am often asked and I will address them in the next column.
Paul O'Donoghue is a clinical psychologist and founder member of The Irish Skeptics Society.