CONTEMPORARY CRANIAL ORGANIZATIONS

Osteopathic Cranial Organizations

By the time of his death in 1954, Sutherland's cranial concepts were firmly established. Today, the Sutherland Cranial Teaching Foundation (formed in 1953 to carry on Sutherland's work and to maintain the ‘purity of the concept') and The Cranial Academy are the major organizations teaching osteopathic cranial courses in the United States. Other cranial training programs are available through osteopathic colleges and are open to allopathic and osteopathic physicians, dentists and physical therapists. However, chiropractors and other health care professionals are excluded from these osteopathic-sponsored programs.

In addition to the two cranial organizations mentioned above, there are currently four other large organizations - and a number of smaller ones - teaching workshops based on Sutherland's cranial concepts, but not necessarily using his techniques.

The largest of these, the Upledger Institute, was founded by John Upledger, an osteopath who became aware of dural membrane movement (Sutherland's ‘Primary Respiratory Mechanism') while assisting in surgery in 1971. Upledger (1983, pp. 2-3) describes this as his first awareness of the PRM. (Sutherland had described the PRM in 1939; see also Magoun, Sr., 1966). Upledger later attended a Cranial Academy seminar, and studied cranial with Herbert Miller, D.O. Although he appears to apply many of Sutherland's cranial concepts, he has made his own modifications to both concepts and techniques. In 1983 he co-authored the book Craniosacral Therapy (Upledger & Vredevoogd, 1983) which made cranial techniques much more widely available. The Upledger Institute's cranial workshops are open to all health care professionals and to lay people, and are presented in many countries. This organization advocates a very light force of 5 grams (the weight of a sheet of computer copy paper).

Chiropractic Cranial Organizations

The other three large organizations are chiropractic. All conduct workshops internationally and have strong certification programs.

The first is Sacro Occipital Resource Society International (SORSI). This organization was established in 1957 to promote the work of Major Bertrand De Jarnette, D.O., D.C., the founder of Sacro Occipital Technique (SOT). De Jarnette studied with Sutherland and accepted his cranial concepts, but approached diagnosis and treatment from a different perspective. His extensive research on the relationships between the occiput and the sacrum dates back to the 30's, and he began a cranial teaching program in 1968. SORSI cranial workshops are open only to physicians.

Sacro Occipital Technique Organization (SOTO-USA) is a newer organization, founded in 1999. It also promotes the concepts and treatment protocols of De Jarnette. SOTO-USA is very active in the presentation of cranial workshops. This organization stresses research and strives to upgrade the quality of education available to SOT practitioners. However, both organizations share many of the same presenters and instructors.

The International College of Applied Kinesiology (ICAK) is the other large chiropractic organization teaching cranial techniques. It was formed to contribute to and expand on the research of George Goodheart, D.C. Acknowledging the cranial concepts of Sutherland and the craniosacral mechanism, Goodheart uses the techniques of Applied Kinesiology (which he developed) in the diagnosis and treatment of cranial dysfunctions, but confines AK cranial techniques to cranial bone and sutural releases. Sphenobasilar synchondrosis (SBS) patterns are not directly addressed. Like SORSI and SOTO-USA, both Dr. Goodheart and the ICAK have worldwide followings, and their workshops are also open only to physicians.

Eclectic Cranial Organizations

Numerous professional schools and smaller organizations provide cranial workshops for healthcare practitioners; they are found throughout the United States and in a number of other countries. Many present international workshops and some have certification programs. Almost all teach cranial concepts and treatment procedures based on their perception of Sutherland's cranial concepts. Although some of the instructors are osteopaths, many are healthcare professionals from other disciplines who have studied osteopathic concepts and procedures.

Hancock CranioSomatic Institute - G. Dallas Hancock, Ph.D.(c)., D.C., L.M.T. and Flo Barber, Ph.D.(c), L.M.T.

Dr. Dallas Hancock has combined osteopathic cranial techniques, SOT, and Applied Kinesiology in his clinical practice since his graduation from Los Angeles Chiropractic College in 1976. His cranial background includes training from Drs. Stober (Endonasal cranial), De Jarnette (S.O.T.), Goodheart (International College of Applied Kinesiology), Upledger (craniosacral), and Gehin, in addition to extensive studies of Dr. Sutherland's work (Magoun and numerous other sources).

His diversified studies and unique background have allowed him to develop important new diagnostic and treatment procedures in cranial therapy. He founded the National Institute of Craniosacral Studies (NICS) in 1988 to teach the new cranial techniques he had developed. That organization has since been replaced by the Hancock CranioSomatic Institute, which he formed with his wife, Flo Barber. The numerous techniques developed by Dr. Hancock focus on releasing Primary cranial restrictions to restore normal neuromusculoskeletal function. His therapy is highly structural in its intent, procedures and outcomes, and relates specific cranial functions / dysfunctions to somatic functions / dysfunctions. Dr. Hancock has been presenting lectures and workshops in alternative therapies since 1974 and has maintained his holistic clinical practice in Tampa, Florida since 1976.

HISTORY OF CRANIAL THERAPY

The evolution of cranial manipulative techniques into a therapeutic modality as we know them, may have originated in the United States during the early twentieth century. Ligeros, a Greek medical doctor, used the museums and libraries of Europe in the 1930's to do research for his book, How Ancient Healing Governs Modern Therapeutics (Ligeros, 1937). Authors Cottam and Smith (1981), note that although Ligeros researched back to 1250 BC, he found no examples of cranial manipulation in the ancient world of Europe. In fact, he found no prior examples of cranial manipulation with the exception of “a form of cranial manipulation used as ‘a sort of secret healing' by the Bedouins of the Greek tribes”.

An Emerging Modality

The first use of cranial manipulation as a therapeutic modality, according to Cottam and Smith (1981), was by Willard Carver, D.C., who reportedly used a technique on the head in 1906 for treating hydrocephalus. Cottam and Smith stated that Carver (1909), in his book Chiropractic Analysis, made two statements that seemed to refer to cranial manipulation for the treatment of hydrocephalus and ‘Brain Fever'. However, he did not describe the technique in writing.

During the teens and early twenties the discovery and use of cranial manipulative techniques was limited to a few isolated osteopaths and chiropractors using a variety of procedures, such as pressure, vibration, and manual thrusting. Many osteopaths and chiropractors shared knowledge in those early days, leaving the origin of different techniques open to debate. However, records are available to show that two doctors - first Nephi Cottam, D.C. and later William Sutherland, D.O. - emerged as the principal developers of cranial techniques (Cottam and Smith (1981). Both men developed comprehensive systems of cranial techniques, but systems with notably different characteristics. Cottam's very direct osseous manipulation of cranial bones became associated with the chiropractic profession. Sutherland's approach, which conceptually and functionally involves the primary respiratory mechanism (now known as the craniosacral mechanism), became associated with the osteopathic profession.

Nephi Cottam, D.C.

In the mid-twenties, Dr. Nephi Cottam discovered the power and effectiveness of cranial manipulation when he performed a cephalad lift on the cranial vault of a seated patient. This procedure provided immediate relief to the woman, who had been hysterically running around screaming, pulling her hair, tearing her clothes, and destroying furnishings for three days (Calvin Cottam, 1990). Eight days later he performed a similar procedure on a young woman who had not been able to sleep for three months without opiates. She had lost her eyesight and hearing and was near death. After Cottam performed a cranial release the patient lapsed into normal sleep and soon recovered (Cottam did not elaborate on how long ‘soon' was). These successes impressed Cottam enough that he began to research cranial manipulative techniques on his patients and later to teach his techniques to others.

Cottam's techniques were spread across the United States and Canada, and into Europe, by visiting doctors who had witnessed his demonstrations. In 1929 George A. Cole, D.C., began teaching Cottam's cranial adjusting techniques throughout the United States. Cottam named his techniques ‘Craniopathy' in 1932. Four years later he moved to Los Angeles. There, in 1936, he published The Story of Craniopathy and founded the Cottam School of Craniopathy. The cranial teachings of Cottam (and his two sons) profoundly influenced the chiropractic profession. Many of the legendary chiropractic practitioners were associated with cranial manipulative techniques (which could explain how they achieved the results for which they are remembered!).

William Garner Sutherland, D.O.

Dr. Sutherland's developmental contributions to cranial technique were not inspired by chance spectacular results; his cranial research was the result of what he later described as a ‘guiding thought' which occurred to him in 1899 as he stood before an osteopathic school display case viewing a disarticulated skull. The bones had been positioned in their normal anatomical relationships, but were slightly separated to allow observation of the individual bones. Dr. Sutherland later wrote, “…my attention was called to the beveled articular surfaces of the sphenoid bone. Suddenly there came a thought - I call it a guiding thought - ‘beveled, like the gills of a fish, indicating articular mobility for a respiratory mechanism.' '' (A. S. Sutherland, 1962, p. 12). The thought that cranial bones had articular motion nagged him until the mid-1920's, at which time he resolved to settle the issue once and for all. This turned into a long and complex task.

Sutherland spent years methodically studying the anatomical and physiological characteristics of the cranial bones. By experimenting on himself, and later applying his findings to the treatment of others, he proved not only that the cranial bones were capable of articular mobility, but that they were in both constant motion and acting under the control of a guiding reciprocal tension membrane. The osteopathic profession was slow to accept Sutherland's cranial concepts. A. S. Sutherland (1962, p. 64) describes the professional response to his first introduction of his work at a convention in 1929 as ‘no response' and ‘a dud.' His presentation at a 1932 American Osteopathic Association (AOA) convention was attended by only seven people. His articles, which appeared in two professional periodicals, The Northwest Bulletin and The Osteopathic Profession between 1931 and 1939, generated scant interest.

Sutherland's contribution to the cranial field was an elaborate unified system, the ‘Primary Respiratory Mechanism', which he described in his book, The Cranial Bowl, published in 1939. The book sold poorly, and an invitation to discuss The Cranial Bowl at an osteopathic convention in 1940 was even canceled due to the protests of doctors who were opposed to the inclusion of cranial in their conference (A.S. Sutherland, 1962, pp. 72-73).

The turning point for Sutherland's work came in 1942 when he was invited to present his cranial concept to a group of six outstanding osteopathic physicians immediately prior to the annual AOA convention in Chicago. Kimberly (1987) describes how their enthusiasm for this ‘new concept' stimulated professional interest and a demand for cranial courses. Between 1943 and 1950 a number of writings by Sutherland and his close associates - including Howard and Rebecca Lippincott, D.O., Beryl Arbuckle, D.O., and Paul Kimberly, D.O. - added to the cranial literature. In 1951, Osteopathy in the Cranial Field was published. Edited by Harold I. Magoun, Sr., D.O. from a compilation by the Osteopathic Cranial Association, it rapidly became the ‘bible' of cranial studies. Two subsequent editions have been published (Magoun, 1966, 1976), and it remains in print and in regular use. Within the osteopathic profession it is still considered the standard text on osteopathic cranial concepts and techniques.

BIBLIOGRAPHY

Cottam, C. (1990). Cranial and Facial Adjusting: Sources, References, Index (Vol. 2). Los Angeles, CA: Caraco.

Cottam, C., & Smith, E. (1981). Roots of Cranial Manipulation. Chiropractic History, 1(1), 31-34.

Cottam, N. (1963). The Story of Craniopathy. Los Angeles: Author.

De Jarnette, M. B. (1979). Cranial Technique 1979 - 1980. Nebraska City, NE: Author.

Kimberly, P. (1987). History of Cranial Osteopathy. In E. W. Retzlaff & F. L. J. Mitchell (Eds.), The Cranium and Its Sutures (pp. 59 - 67). New York: Springer-Verlag.

Ligeros, K. A. (1937). How Ancient Healing Governs Modern Therapeutics. New York: G. P. Putnam's Sons.

Magoun, H. I., Sr. (1966). Osteopathy in the Cranial Field (1st ed.). Kirksville, MO: Journal Printing Company.

Magoun, H. I., Sr. (Ed.). (1976). Osteopathy in the Cranial Field (3rd ed.). Kirksville, MO: Journal Printing Company.

Sutherland, A. S. (1962). With Thinking Fingers. Kansas City, MO: Cranial Academy.

Sutherland, W. G. (1939). The Cranial Bowl. Mankato, MN: Author.

Upledger, J. E., Vredevoogd, J. D. (1983). Craniosacral Therapy. Seattle, WA: Eastland Press.

Walther, D. S. (1983). Applied Kinesiology, Volume II. Pueblo, CO: Systems DC.

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