| Craniosacral Therapy - Babies and Children |
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Along with
these consequences of prenatal trauma and shock such as maternal cigarette
and alcohol use, thoughts of abortion, adoption and others, there is
yet another hurdle to cross. We must be born nine-months after being
conceived. Here in the West the "medicalization" of the birth
process, while saving many lives also leaves scars on the mind and body
of the infant and future adult. Emerson (1999) reports that 95% of western
births involve shock and trauma to the infant. This number in itself
is shocking. This chapter is not about the right or the wrong of western
birth practices; it is about the use of craniosacral therapy when encountering
birth dynamics, whether in an adult or in an infant, from the point
of view of pre and perinatal psychology. How does the craniosacral therapist
meet the shock and trauma in an infant or the infant in the adult and
hold it in a way that allows resolution to occur? I have encountered
numerous protocols for treating infants and children using craniosacral
therapy. My experience spans over the last twenty years with a particular
focus on infants and children with brain damage and/or developmental
delays. The protocols I've learned in the past while valuable for some
children were non-the-less formalistic and biomechanical in nature,
which frequently disempowers the child. A different set of skills needs
to be learned and incorporated into the treatment of newborns and who
experience shock and trauma inutero and during birth. Part one of these
chapters on pediatric craniosacral therapy discusses how to make well-bounded
contact with an infant (or the infant in the adult). The principle is
to honor the consciousness of the infant and therefore pediatric craniosacral
therapy is infant centered therapy. To begin
with the therapist must understand that the newborn is undifferentiated
from the mother. The infant is actively involved in a process called
self-attachment and bonding. This process is the foundation of love.
It includes somatic and neurological development as well as the integration
of emotions which is the primary neurological job in the first two years
of life. The mother and father are part of the metabolic field of the
child. The infant in turn must take care of the parents in order to
insure its own safety and protection. This principle of growth is a
very strong force in the infant: to take care of the mother or primary
caregiver. I have often seen an infant try to stroke or cuddle their
mother in a nurturing way when they sense that she is under stress.
Likewise the parents must protect and resource the infant as much as
possible through nurturing physical touch, eye gazing (which develops
the right hemisphere on the brain), verbal mirroring and a host of non-verbal
contact skills. These behaviors or instincts support the healthy development
of the baby in this critical time of its new life. Therefore the first
role of the therapist is to evaluate shock and trauma in the whole family
system as well as the self-attachment and bonding sequence. The mother
is the primary resource and she must be supported in a treatment session
as much as the infant. Are they bonding via breast feeding, etc.? Where
is the stress in their relationship? Resourcing
the infant through eye contact is crucial. If the infant and mother
are not able to make deep eye contact with each other, it may be an
indicator of shock. The mother and the infant metabolize each others
feeling states through non-verbal contact such as eye gazing, skin to
skin contact, respiratory and cardiovascular entrainment (Schore 1996).
The infant helps to absorb and process the mother's emotional states
as much as the mother absorbs and processes the infants through her
own mind and body. They are metabolically linked together, each one
helping the other by a similar means. Likewise, the therapist enters
the metabolic field and begins to exchange with or holds the difficult
places in the infant-mother relationship. In part four of this series
on Pediatric Craniosacral Therapy, I will go into some detail on this
process of co-metabolism. The therapist
must find out the story of the birth but without the infant present.
Otherwise it can be retraumatizing to the infant. Remember, infants
hear and understand everything but in their own way. Infants experience
and process the world with their whole body. We construct a body image
as the world communicates to us through our skin to our internal soft
tissue and fluid systems, the home of our inner world of knowing who
we are. Our body is our original ego in the first six years of life.
The limbic system, especially the amygdala, which is the prime significator
of emotions, is quite active in babies and directly connected to the
right hemisphere, the emotional cortex. The first few sessions of craniosacral
therapy with an infant involve a process of discovery and observation
of these deep physical and emotional interactions. The therapist must
learn how to support both the mother and her child, especially allowing
the infant to be in ready physical contact with her. Thus the early
sessions of craniosacral therapy are more observational and contained.
The therapist watches how the story of this birth is being played out
between mother and child and senses slowly into the field of love and
bonding being created moment by moment. I really enjoy being in the
presence of the mother-infant bond. It is so incredibly warm and tender. The infant
needs to be fully informed of the purpose of his or her visit with the
therapist. The craniosacral therapist must speak in the first person
to the infant. "Do you know what I do?" The therapist explains
to the infant what they do and who they are. Infants are quite capable
of responding to this information except with certain kinds of shock.
They often shake their head knowingly from side to side to indicate
"no". So the therapist carefully observes the infant for their
communication style. Infants will use their whole body to speak in response
to a question or comment. They will also verbally talk to the therapist.
The conversation skills are emotionally based and developed in the body
ego i.e. skin, muscles, vocal tones, micro movements, macro movements,
etc. It may take a session or two for the therapist to intuit the infants
unique style of communication. It is equally important to state questions
and comments to the infant simply in a way that only require yes and
no answers. The infant just went through a very intense experience and
wants to tell the story. Someone needs to listen and the infant needs
to know it's being heard for healing to occur. As the therapist
discusses his or her intentions with the infant they begin to pay close
attention to the infants physical movement patterns. The goal of tracking
these movements is to see where the infant's personal space extends
via the amount of extension the infant is capable of making with their
arms. Spastic, jerky and uncoordinated movements are often signs of
shock. When the therapist has a clear picture of the physical space
the infant inhabits then contact is negotiated at that point in space.
The therapist asks for permission to touch the infant. Often an infant
will say no at first with a definitive movement of their head, their
body or a vocalization. Follow the infants lead and talk to them a little
more about why touch is important. Here is a key: Its important for
the therapist to give up any intention of being clinical with their
hands in the early sessions of craniosacral therapy. The actual intention
is to establish safety and trust with the infant so that the physical
contact is contained in loving kindness rather than the lifting of a
frontal bone, etc. Structural work comes later; evaluation of shock,
trauma and the bonding sequence is first. The therapy is playful rather
than clinical. Shock babies
will often become distressed quite suddenly during play or contact with
the therapist. If this activation occurs spontaneously the therapist
acknowledges that to the infant, "Yes that is a very difficult
place and you have every right to be upset". Everyone's feelings
must be acknowledged in some way for deep healing to take place. This
is especially true of the infants feelings and emotions. If the infant
has an anger response then its important to acknowledge him or her by
saying, "I see you're angry" or "I see you're happy",
etc. The therapist must accurately reflect the feeling states that are
evoked in the infant during the treatment. The shock that results from
medical interventions during the birth process not only must be acknowledged
but also requires an apology. As a therapist I often find myself saying
to an infant "I'm sorry that happened to you when you were born".
Many medical interventions are necessary and many are completely unnecessary.
Regardless, they frequently shock and traumatize the infant necessitating
an apology. This is true even if a therapist encounters someone's birth
issues when they are an adult. The client, the infant must hear an apology
to heal that wound. The infant experiences a deep sense of emotional
betrayal as result of the shock and trauma from birth interventions.
The message they get at birth is "You do not get to do it your
way, you are forced to do it my way". At some point in the first
or second session when working with an infant and when I know they are
available for the listening, I'll offer them an apology. I will also
let the infant know that everyone was worried about them when they were
born and felt they had to do what they did to save their life. The two most
fundamental things that infants need in their primary respiratory system
are space and choices. Birth dynamics involve compression and very few
choices especially if there is a cascade of medical interventions. One
intervention frequently leads to another. Therefore the therapist who
eventually establishes well-negotiated contact with the infant makes
these two offerings of space and choices to the infantís primary
respiratory system. These offerings comprise the first clinical protocol
when treating infants. Once the preliminary evaluation as I've just
talked about is thoroughly negotiated, then the therapist can make these
telepathic suggestions to the infant. The therapist is attempting to
contain the physiological and psychological aspects of the infant's
shock and trauma. The therapist holds the shock and trauma silently
as an inner witness. Certain elements of the birth can be referred to
while the therapist is working with the infant but without being too
literal or descriptive. When the therapist senses part of the trauma
schema in the infant's craniosacral system he or she might say "Oh,
that was a lot for you" rather then saying "Oh, those forceps
were big and nasty". The difficult parts of the birth story are
held by the therapist within their heart, who then retells the story
wordlessly while in the presence of the infant. In this way the shock
and trauma of the birth events are acknowledged and held in a silent
container. This communication is received and integrated by the infants
fluid system. The therapist suggests space 'Would you like some space
here?" Then the therapist suggests choices to the infant "Would
you like to do something different here?" All together, the above suggestions usually involve the first several sessions in which a craniosacral therapist sees an infant. Typically I am with an infant no more that 20 or 30 minutes. If the time goes beyond that it must be carefully negotiated especially for infants with shock and trauma. In part two I will continue to discuss the next themes for a therapist to explore with an infant in craniosacral therapy, which are the four stages of birth, conjunct sites and conjunct pathways. In part three I will continue to discuss the biodynamics of the ignition process in the fluid system of the infant during birth and evaluating specific biomechanical parts of the whole body and craniosacral system. Finally in part four I will discuss emotional development in infants. I am most grateful for my mentors, Ray Castellino and Franklyn Sills, for showing me a common sense approach to treating infants. REFERENCES:
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