It should be noted that practitioners of many health care disciplines often learn some massage therapy techniques during the course of their training without necessarily having any of the following credentials. Thus they may practice massage therapy (and facilitate insurance coverage) under another kind of license or credential such as nursing, chiropractic, or the like.

The AMTA has recently begun to discourage practitioners from using initials after their names, feeling this may be confusing to the public because there is no standardization and such initials tend to mimic academic degrees. Instead the AMTA encourages practitioners to spell out what their credential is. In some states the use of initials is controlled (such as licensed massage therapist, L.M.T.), but in many states it is meaningless.

The most common titles for massage therapists are as follows:

Nationally Certified in Therapeutic Massage and Bodywork. This title designates the person has completed the requirements for and passed the National Certification Board for Therapeutic Massage and Bodywork (N.C.B.T.M.B.). This is the leading national certification exam.

Massage Practitioner (M.P.). This title is often used by practitioners whose training is less extensive than that required for certification by schools or by the AMTA as a massage therapist.

Certified Massage Therapist (C.M.T.). This is a voluntary, professional, non-governmental certification from organizations that can attest to the therapist’s competency. This is granted by many massage therapy schools, which may or may not meet AMTA standards for training. Thus the quality of this credential depends on the quality of the certifier and its standards. (For example, even a person who has only taken an eight-hour course can claim to be certified.)

Registered Massage Therapist (R.M.T.). This is a form of voluntary licensing for the use of a specific professional title. Rarely used in the United States, some Canadian provinces use this to designate government licensing. At one time it also designated a special credential for members of the AMTA who had advanced training in therapeutic massage and passed a special exam, but this usage has been discontinued.

Licensed Massage Therapist (L.M.T.). This refers to occupational licensing by a state or local government. Nineteen states have licensing laws requiring massage therapists to meet minimum standards of training. The basic requirement is usually five hundred hours of classroom training with instructors present, followed by a written and practical exam. The following states have licensing laws: Arkansas, Connecticut, Delaware, Florida, Hawaii, Iowa, Louisiana, Maine, Nebraska, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oregon, Rhode Island, Tennessee, Texas, Utah, and Washington, D.C.

In states that do not require licensing, a good credential to seek is graduation from an AMTA-accredited program that meets the five hundred-hour standard. There are many schools of massage therapy and bodywork that require fewer hours of training (often one hundred to two hundred hours), so the extent of training is an important question in choosing a practitioner.

The American Massage Therapy Association is the predominant organization for massage therapists with over eighteen thousand members, representing all fifty states, D.C., the Virgin Islands, and several foreign countries. Membership is a good indication of professional preparation. It requires one of the following:

1. Graduation from a training program approved by the Commission on Massage Training Accreditation/Approval. This is an accreditation agency commissioned by the AMTA. This assures the practitioner has completed a program of a minimum of six months duration with five hundred in-class hours of training. There are currently fifty-eight massage therapy schools accredited by COMTAA. Subjects include anatomy and physiology, massage techniques, and practical training.

2. Holding a state license that meets AMTA certification standards.

3. Passing an AMTA membership entrance examination.

4. Passing the National Certification Examination for Therapeutic Massage and Bodywork. Six states have adopted this exam, developed by the AMTA, as their licensing exam. It is anticipated that eventually all the states that license massage will adopt this exam and the number of such states is expected to increase.

In early 1994 this exam was accredited by the National Commission for Certifying Agencies, a major independent agency that evaluates professional certification programs according to stringent standards.

Membership in the AMTA also requires six hours of continuing education every two years.

The AMTA publishes a membership registry for use by its members and provides referrals to local practitioners. Address: 820 Davis St., Suite 100, Evanston, IL 60201-4444, phone (708) 864-0123.

Other Forms of Bodywork or Energy Work


Finding a competent practitioner of the other forms of bodywork or energy work is essentially a matter of asking whether they are certified by the particular professional association for the method being used. Some practitioners integrate multiple methods, but if they are not certified in any one, their preparation is dubious. It is best to work with someone who has completed training and thereby has achieved a standard of expertise in at least one method.

Following are the professional associations for the most common forms of bodywork and energy work.

Rolf Institute of Structural Integration. The training is typically twelve months long for basic certification. A Certified Advanced Rolfer is one who has practiced at least five years and has taken an additional six weeks training. A list of certified practitioners is available. Address: 205 Canyon Blvd., Boulder, CO 80302, phone (800) 530-8875.

Hellerwork, Inc. Training is a 1,250-hour program leading to certification as a Hellerwork practitioner. Trainings are offered internationally. Address: 406 Berry St., Mt. Shasta, CA 96067, phone (800) 392-3900 or (916) 926-2500.

Rosen Method Professional Association. Certification training is two years plus an eighteen-month internship. Certified practitioners must also hold a state-approved massage certificate. A directory of practitioners is available from the association. Address: 2550 Shattuck Ave., Box 49, Berkeley, CA 94704, phone (510) 644-4166.

The Trager Institute. Training for Trager practitioners takes a minimum of 269 hours usually over at least six months. A list of certified practitioners is available. Address: 33 Millwood St., Mill Valley, CA 94941, phone (415) 388-2688, FAX (415) 388-2710.

The Feldenkrais Guild. Only people trained by Moshe Feldenkrais or graduates of guild accredited training programs are eligible to be members of the guild. Practitioner members are qualified teachers of Awareness Through Movement and Functional Integration. Associate members are qualified teachers of Awareness Through Movement. The professional training program spans 160 days over three and a half years. The guild publishes a directory of certified practitioners. Address: 3611 SW Hood Avenue Suite 100, Portland, OR 97201, phone (800) 775-2118 or (503) 221-6612, FAX (503) 221-6616.

North American Society of Teachers of the Alexander Technique (NASTAT) formed in 1987 to educate the public about the Alexander Technique, to establish and maintain standards for certification of teachers and teacher training courses in the United States, and to ensure that the educational principles of the Alexander Technique are upheld. It publishes a directory of certified teachers. Training to become a teacher takes three years (sixteen hundred hours). Address: P.O. Box 112484, Tacoma, WA 98411-2484, phone (800) 473-0620 or (206) 627-3766.

Nurse Healers Professional Associates, Inc., provides information about Therapeutic Touch and training for health care providers. The length of trainings varies and there is no formal certification. Address: P.O. Box 444, Allison Park, PA 15101, phone (412) 355-8476.

Jin Shin Jyutsu, Inc., is an organization for practitioners who have completed a five-day training course in this method. Practitioners are encouraged to repeat the basic training several times, but there is no formal certification. There is also an advanced course. Address: 8719 E. San Alberta, Scottsdale, AZ 85258, phone (602) 998-9331.

Jin Shin Do® Foundation for Bodymind Acupressure^tm; is a network of authorized teachers and registered practitioners who have received standardized training in this approach. Registered practitioners have 250 hours of training plus practical experience. A directory of registered practitioners and authorized teachers is available from the foundation. Address: 366 California Ave., Suite 16, Palo Alto, CA 94306, or P.O. Box 1097, Felton, CA 95018, or call J.S.D.F. in Palo Alto, CA at (415) 328-1811.

American Oriental Bodywork Therapy Association (AOBTA) is an educational and certifying organization for practitioners of a variety of forms of oriental bodywork. Associate members have at least 150 hours of training with a certified instructor and a hundred hours of practice. Certified practitioners have completed five hundred hours of such training and passed a certification exam. AOBTA has about eight hundred members and publishes a membership directory. Address: 6801 Jericho Turnpike, Syosset, NY 11791, phone (516) 364-5533.

Associated Bodywork and Massage Professionals (ABMP) provides professional support and legislative advocacy for massage therapists and bodyworkers. Membership is of two levels: practitioner level requires a hundred hours of training. Professional level requires five hundred hours or state licenser or registration. ABMP also publishes Massage and Bodywork Quarterly. Address: 28677 Buffalo Park Rd., Evergreen CO 80439, phone (303) 674-8478.

The Upledger Institute, Inc., is an educational and clinical resource and training center for manipulative therapies such as CranioSacral Therapy, visceral manipulation, and other holistically oriented approaches used by bodyworkers. Founded by John Upledger, D.O., it conducts training nationally and internationally. It also produces several instructional publications and a directory of alumni of its trainings. Address: 11211 Prosperity Farms Rd., Palm Beach Gardens, FL 33410, phone (800) 233-5880.

American Academy of Reflexology conducts training in ear, hand, and foot reflexology and can provide referrals to certified practitioners. Address: 606 E. Magnolia Blvd., Suite B. Burbank, CA 91501, phone (818) 841-7741.

International Institute of Reflexology conducts two-day trainings nationally and internationally and a certification exam in the Ingham Method of reflexology. They also can provide referrals to trained practitioners. Address: 5650 First Avenue North, P.O. Box 12642, St. Petersburg, FL 33733, phone (813) 343-4811.

Zero Balancing Association offers training in this method, a fifty-hour basic course, and an eighteen-month certification program. Address: P.O. Box 1727, Capitola, CA 95010, phone (408) 476-0665.

Nothing in this book should be considered as medical advice for dealing with a given problem. You should consult your health care professional for individual guidance with specific medical problems.

For this chapter, the sections on varieties and techniques are combined. As stated earlier, there are over eighty different types of massage therapy and bodywork. Many are variations on each other, often developed by a practitioner who is trained in one particular approach and then goes on to develop his or her own variety, with its own new “brand name.”

Most varieties can be broken down into the following five broad categories:

Traditional European Massage

Contemporary Western Massage

Structural/Functional/Movement Integration

Oriental Methods

Energetic Methods (Non-oriental)

The majority of activity in this field is oriented toward the traditional European and contemporary Western forms of massage simply because there are such large numbers of practitioners of these methods.

Traditional European Massage

Traditional European massage includes methods based on conventional Western concepts of anatomy and physiology and soft tissue manipulation. There are five basic kinds of soft tissue manipulation techniques: effleurage (long flowing or gliding strokes, usually toward the heart, tracing the outer contours of the body), petrissage (strokes that lift, roll, or knead the tissue), friction (circular strokes), vibration, and tapotement (percussion or tapping).

Traditional European massage was brought to the United States by two doctors from New York who were brothers— Charles and George Taylor—who studied in Sweden and introduced Americans to Swedish techniques in the 1850s. After the Civil War, the first Swedish clinics opened in Boston and Washington, the latter frequented by U. S. Grant.

Swedish Massage. Swedish massage is by far the most predominant example of traditional European massage and it is the most commonly used method in the United States. It was developed by Per Henrik Ling in Sweden in the 1830s and uses a system of long gliding strokes, kneading, and friction techniques on the more superficial layers of muscles. It usually goes in the direction of blood flow toward the heart because there is an emphasis on stimulating the circulation of the blood through the soft tissues of the body. Swedish can be a relatively vigorous form of massage, sometimes with a great deal of joint movement included.

Oil is usually used, which facilitates the stroking and kneading of the body, thereby stimulating metabolism and circulation. Its active and passive movements of the joints promote general relaxation, improve circulation and range of motion, and relieve muscle tension. Swedish massage is often given as a complete, full body technique, though sometimes only a part of the body is worked on.

Contemporary Western Massage


This includes methods based primarily on modern Western concepts of human function, anatomy, and physiology, using a wide variety of manipulative techniques. These may include broad applications for personal growth, emotional release, and balance of mind-body-spirit in addition to traditional applications. These approaches go beyond the original framework or intention of Swedish massage. They include Esalen or Swedish/Esalen, neuromuscular massage, deep tissue massage, sports massage, and manual lymph drainage. Most of these are American techniques developed from the late 1960s onward, though the latter was developed in the 1920s.

Esalen and Swedish/Esalen. Esalen massage is a modern variation that was developed at the famous growth center, Esalen Institute in Big Sur, California. Its focus is not so much on relieving muscle tension or increasing circulation as it is on creating deeper states of relaxation, beneficial states of consciousness, and general well-being. Whereas Swedish is more brisk and focuses on the body, Esalen is more slow, rhythmic, and hypnotic and focuses on the mind/body as a whole.

Esalen massage is not widely taught as a pure form. Rather, a marriage of sorts has been formed by the integration of Swedish and Esalen as a way of incorporating the strengths of each. Many massage therapists describe their method as Swedish/Esalen, and this hybrid is commonly taught in massage schools.

Neuromuscular Massage. This is a form of deep massage that applies concentrated finger pressure specifically to individual muscles. This is a very detailed approach, used to increase blood flow and to release trigger points, intense knots of muscle tension that refer pain to other parts of the body (they become trigger points when they seem to trigger a pain pattern). This form of massage helps to break the cycle of spasm and pain and is often used in pain control. Trigger point massage and myotherapy are varieties of neuromuscular massage.

Deep Tissue Massage. This approach is used to release chronic patterns of muscular tension using slow strokes, direct pressure, or friction. Often the movements are directed across the grain of the muscles (cross-fiber) using the fingers, thumbs, or elbows. This is applied with greater pressure and at deeper layers of the muscle than Swedish massage and that is why it is called deep tissue.

It is also more specific. For example, in the case of someone with a sore shoulder, the practitioner may focus on the trapezius and the rhomboid underneath, trying to work in all the layers of muscle that might be involved. Deep tissue massage lends itself to being more focused on a problem area.

Sports Massage. This uses techniques similar to Swedish and deep tissue but more specifically adapted to deal with the needs of athletes and the effects of athletic performance on the body. Sports massage is used before or after events, as part of an athlete’s training regimen, and to promote healing from injuries.

As Elliot Greene explains, the problem with severe spasm is that it cuts off its own circulation and becomes a self-reinforcing syndrome. This is another case of opening up the flow of blood and lymph through the area, releasing adhesions, and using deep transverse friction to encourage the unhealed part of the muscle to heal.

Manual Lymph Drainage Massage. This approach improves the flow of lymph rhythmic strokes. It is used primarily in conditions characterized by poor lymph flow, such as edema.

Structural / Functional / Movement Integration


These approaches organize and integrate the body in relationship to gravity through manipulating the soft tissues, and/or through correcting inappropriate patterns of movement. These are methods that bring about more balanced use of the body and nervous system, creating greater integration and more ease of movement.

This category of approaches is interesting in that some do not even involve the practitioner touching the client. There is no clear line of demarcation between where the bodywork therapies end and the movement therapies begin. Furthermore, many practitioners use multiple techniques that integrate massage, deeper tissue work, and movement all in the same session with a client.

These approaches work on the body structure and how it moves. The most common approaches include Rolfing, Hellerwork, the Rosen Method, the Trager approach, the Feldenkrais Method, the Alexander Technique, and Ortho-Bionomy.

Rolfing. Rolfing is the most established method in this category. There are over eight hundred Rolfers practicing in twenty-seven countries, with about seven hundred in the United States.

Rolfing is a trademarked approach within the generic field of structural integration. It was developed by Ida Rolf, Ph.D., a biophysicist who earned her doctorate in the 1920s. She began doing her form of bodywork in the 1940s and 50s. Her clientele included Georgia O’Keeffe and Buckminster Fuller and she worked with other pioneers in the bodywork field. In the 1960s she began teaching at Esalen Institute. She formed the Rolf Institute of Structural Integration in Boulder, Colorado, in 1972.

Rolfing involves a form of deep tissue work for reordering the body so as to bring its major segments—head, shoulder, thorax, pelvis, and legs—into a finer vertical alignment. The technique loosens or releases adhesions in the fascia, the flexible tissue that envelops our muscles and muscle groups. The fascia is supposed to move easily and allow easy articulation or movement of muscles or muscle groups past each other. However, trauma such as injury or chronic stress can cause stuck points or adhesions, in which the fascia is in a sense frozen, not allowing full freedom of movement.

The Rolfer works to restore this freedom of movement, resulting in a more balanced, vertical alignment of the body and often a lengthening or expansion of the body’s trunk. Rolfing usually takes place over a series of ten organized sessions dealing with different areas of the body.

Hellerwork. This approach was founded by Joseph Heller in 1979. A former Rolfer, Heller developed a method that, along with structural reintegration, incorporates a movement reeducation process with exercises that teach stress-free methods for performing everyday movements such as standing, walking, bending, sitting, and reaching. (Since he left the Rolf Institute, Rolfing has also incorporated movement in its work.) Heller’s approach often includes video feedback to show clients how they move.

Hellerwork takes place in a series of eleven sessions. Each session includes about an hour of bodywork and a half hour of movement education. There are over 160 certified Hellerwork practitioners in twenty-three states and seven foreign countries.

Rosen Method. Marion Rosen began her career in the 1930s and is still actively teaching her technique today. She founded her training program in 1972. The Rosen Method sees the body’s tensions as indications of unexpressed feelings or other repressed or suppressed aspects of the self. The result of such holding patterns, which may be very subtle, can be lifelong patterns of tension or organic malfunction.

The Rosen Method uses gentle, nonintrusive touch and verbal exchange between practitioner and client to help draw the client’s attention to areas of holding. This serves to help the client become fully aware of how the patterns of tension are associated with emotional or unconscious material. This awareness itself is the key that allows the tension or holding patterns to be released. Often the tightness softens and the area that was being held begins to move easily with the breath.

In the words of Marion Rosen, “This work is about transformation, from the person we think we are to the person we really are.”

Trager. The Trager approach is a system of movement reeducation or psychophysical integration developed by Milton Trager, M.D. It uses gentle, noninvasive movements to help release deep-seated physical and mental patterns and in turn allow deeper relaxation, increased physical mobility, and better mental clarity.

A session is one to one and a half hours. The practitioner moves the client’s trunk and limbs in a gentle, rhythmic way so that the person experiences new sensations of freedom of movement. The practitioner’s concern is fostering a sense of freedom and lightness.

After the hands-on portion of the session, the client is given instruction in the use of Mentastics, a system of movement sequences developed by Trager for the purpose of re-creating and enhancing the sense of lightness and ease of movement initiated on the table. The benefits of the Trager approach are cumulative, though there is no set series of sessions.

Feldenkrais Method. This approach was developed by Moshe Feldenkrais, a Russian-born Israeli educator. It uses physical movement to focus learning on the juncture of thought and action. It is known for its ability to improve posture and flexibility and alleviate muscular tension and pain.

It works with the nervous system’s capacity for change and learning new patterns for moving, feeling, and thinking. The method involves two applications: Awareness Through Movement (ATM) and Functional Integration (FI). ATM consists of verbally directed, pleasurable, and effortless exercise lessons involving highly sophisticated movement sequences. FI is a one-on-one process that involves the use of specific skilled touch and passive movement. It is known for its ability to address serious muscular and neurological problems and improve human functioning.

The Alexander Technique. This is an approach to psychophysical reeducation. It was developed by the Australian actor F. M. Alexander and works with unconscious patterns of thinking and the resultant movements or postures that become set in the musculature. Such patterns can be made conscious so the student can then become aware of how he/she moves and can make the choice to change patterns, allowing more balance, grace, and ease of movement, thereby reducing and eliminating chronic tension or distortion in the musculoskeletal system. The relationships among the head, neck, and back are of particular importance.

The Alexander Technique is taught in private half-hour to hour lessons. The teacher works with the student to observe and change mind/body habits that interfere with optimal functioning. The teacher uses both verbal and hands-on guidance to help the student experience new ways of moving and embodying him- or herself. It is not a fixed series of treatments or exercises, but often a series of several lessons is recommended. Training to become a teacher takes three years (sixteen hundred hours).

Ortho-Bionomy. Ortho-Bionomy was developed in the 1970s by the bodyworker Arthur Lincoln Pauls. This approach uses gentle, relaxing movements and postures to help the body release tensions and muscular holding patterns. No force or pressure from the practitioner is used. Its goal is a restoration of structural alignment and balance.

Oriental Methods


Oriental methods are based on the principles of Chinese medicine and the flow of energy or chi through the meridians. The geography of the acupuncture meridians is relied upon to determine points of applying the techniques and the ultimate goal is restoration of harmony or balance in the flow of chi. These forms may also be used in concert with herbs and acupuncture.

Pressure is applied by finger or thumb tips to predetermined points rather than by the sweeping broad strokes of Western style massage. Strong pressure or very light pressure may be applied. There are over a dozen varieties of oriental massage and bodywork therapy, but the most common forms in this country are acupressure, shiatsu, Jin Shin Jyutsu, and Jin Shin Do® Bodymind Acupressure^tm.

Acupressure and Shiatsu. These are similar varieties of finger pressure massage. They are both based on applying pressure to a pattern of specific points that correspond with the acupuncture points. Pressure is applied with the thumb, finger, and palm rather than needles.

The goal is the efficient and balanced flow of chi through the meridians. It is believed that where there is tension being held in the musculature, the flow of chi is impaired through those areas, which can lead to chronic problems not only in the musculature but in the associated organs. Stretching and movement are also sometimes used.

Acupressure is the more generic term used for this approach and shiatsu is the Japanese version.

Jin Shin Jyutsu. This approach comes from an ancient Japanese healing tradition that uses touch to restore the internal flow of energy through the body by releasing energetic blockages. A session lasts about an hour and the client is fully clothed, lying on a table. The practitioner uses pulse diagnosis to identify energy blocks and then gently holds or touches a specific combination of two of twenty-six acupuncture points to allow release of the blockage.

As it is practiced in the United States the holding uses less pressure than other forms of acupressure or shiatsu and there is no application of massage-like movements to specific points. Rather the touch is very light and works to balance the flow of energy.

Jin Shin Do® Bodymind Acupressure^tm;. This approach was developed by California psychotherapist lone Marsaa Teeguarden. It applies stronger acupressure on the points and for a longer period of time than does Jin Shin Jyutsu. It focuses on the deep release of armoring (muscular tension of physical or emotional origins) through gentle yet deep finger pressure.

Jin Shin Do© incorporates Taoist breathing techniques, oriental acupuncture theory, Japanese finger pressure technique (sometimes holding points for as much as one to three minutes), and Reichian segmental theory (an understanding of how tensions in different parts of the body affect each other as well as particular feelings or emotions).

Energetic Methods (Non-oriental)


In a sense, all the oriental methods described above are also energetic methods in that they are working with energy according to principles of Chinese medicine and view the human being as an energy system. However, there are other energetic methods that are not based on Chinese principles. The most prominent of these are Therapeutic Touch, polarity therapy, and Reiki.

Therapeutic Touch. This method is unique in that it was born and reached its maturation within the context of conventional Western medicine. It was developed in the 1970s by Dolores Krieger, Ph.D., R.N., a professor at New York University, and Dora Kunz, a natural healer. It is a contemporary interpretation of several ancient healing traditions.

It is based on the principle that the human energy field extends beyond the skin and the practitioner can use the hands as sensors to locate problems in it that correspond with problems in the physical body. Disease is seen as a condition of energy imbalance or blocked energy flow. Assessment is done by passing the hands over the body from head to toe at about two to four inches above the surface.

The practitioner then serves as a conduit for universal energy, consciously and actively transferring energy into the recipient. The hands are used to direct and focus the energy, sometimes in rhythmical, sweeping motions. The method is initially taught “off body,” meaning the practitioner’s hands do not touch the physical body, though later with experience some physical touch may take place.

Since it is not necessary to touch the physical body (what is being touched is the energy field or energy body), this method can be applied in situations where the patient may not be able to tolerate contact (e.g., in postsurgical patients or burn victims). Sessions last up to thirty minutes and can be done sitting or lying down fully clothed.

Therapeutic Touch is currently taught in over eighty universities and thirty countries and is practiced by twenty to thirty thousand health care professionals in the United States and around the world.

Polarity Therapy. This is a form of energy work that was developed by Randolph Stone, a chiropractor, osteopath, and naturopath in the mid-1920s. The practitioner uses subtle touch or holding on specific points to harmonize the flow of energy through the body and also to enhance the body’s structural balance.

It is based on the principle that every cell has both negative and positive poles and the body is gently manipulated to enhance the energy flow. Emotional tension or physical pain are released as the flow of energy becomes more properly balanced. Polarity therapy is often given in a series of four sessions and may be accompanied by guidelines for diet and exercise.

As Elliot Greene states, “It is very common that someone will come in for one reason, and then they will discover another whole dimension to the problem or to themselves that they want to explore.”

Reiki. This is the Japanese word for “universal life force energy.” It is an ancient approach in which the practitioner is a kind of healer in the sense that he or she serves as a conduit for healing energy coming from the universe.

The Reiki energy enters the practitioner through the top of the head and exits through the hands, being directed into the body or energy field of the recipient. Reiki is another very subtle form of healing and may be done through clothing and without any physical contact between practitioner and client.

While all the above energetic methods appear to operate on different principles than most other varieties of massage therapy and bodywork, they nonetheless have an important and growing role.

Other Approaches


Integrative Methods. There are other approaches and combinations of approaches that do not fit neatly into any of the above categories. Many massage therapists and bodyworkers use combinations of approaches that could be called integrative massage or integrative bodywork.

CranioSacral Therapy^tm. This approach was named in 1977 by John Upledger, D.O., and Ernest Retzlaff, Ph.D., to distinguish it from Sutherland’s cranial osteopathy. According to Upledger, “CranioSacral Therapy is not osteopathy. Sutherland’s approach was bone-oriented and you make bony corrections. This is soft tissue-oriented, fluid-oriented, membrane-oriented, and energy-oriented. It’s much more subtle than any other kind of cranial work I know of.”³

Palpation (touch by the practitioner) is used both to observe and treat dysfunctions in the craniosacral system, which includes the head, spinal column, and sacrum in one continuous membranous sheath. This system has its own pulse for circulating the cerebrospinal fluid (six to twelve cycles per minute) and the practitioner can feel the rate, amplitude, symmetry, and quality of the rhythm—somewhat analogous to pulse diagnosis in Ayurveda and Chinese medicine. Corrective pressure of only about five grams (the weight of a nickel) is applied to various areas to promote the re-establishment of a normal, symmetrical pattern of pulsation throughout the system. This in turn allows more efficient functioning of the entire nervous system throughout the body.

Upledger reports success in treating chronic pain, chronic brain dysfunctions when there is no structural problem involved, endogenous depression, migraines, learning disabilities, dyslexia, hyperkinesis, spasticity in cerebral palsy, strabismus (cross-eyes), Ménière’s disease (vertigo), and many other conditions.

Reflexology. This approach involves the manual stimulation of reflex points on the ears, hands, and feet. Similar methods resembling shiatsu and acupressure have also been practiced in China for thousands of years. Thumb pressure is applied to specific points that correspond somatotopically to specific areas or organs of the body.

Reflexology was introduced to this country by William Fitzgerald, who termed it “zone therapy,” in the early 1900s. One of the contemporary explanations for how it works is that compression by specific touch techniques affects a system of points and areas that are thought to “reflex” through neurological pathways to distant parts of the body. The pressure on these reflex points (also called “cuteneo-organ reflex points”) is used to relieve stress and tension, to improve blood supply, to promote the unblocking of nerve impulses, and to help restore homeostasis or balance in the body.

Zero Balancing. This is a painless, hands-on method of aligning body energy with body structure. It is done through clothes and involves the practitioner in using gentle pressure at key areas of the skeleton in order to balance the energy body with the structural body.

The theory holds that each of us has an unseen energy body that exists like a glove surrounding the physical body. When injury or trauma occurs, healing of these two bodies does not necessarily occur simultaneously. “Balancing” refers to balancing the relationship between energy and structure. Zero Balancing seeks to bridge the gap between those methods that work with structure and those working with energy.

Nothing in this book should be considered as medical advice for dealing with a given problem. You should consult your health care professional for individual guidance with specific medical problems.