Can craniosacral therapy cause harm?

A client asked me: can craniosacral therapy cause harm? My answer is Yes. It absolutely can, and I have seen many examples. Some influential voices in this field will say it’s not possible, not in the hands of a trained professional. I have heard this said, and I disagree.
First, a note on where I’m speaking from, since it shapes how I see this.

My starting position

I don’t identify primarily as a craniosacral therapist. It’s one of my trainings, in two different schools. My work and interests are more broadly concerned with embodiment than with any particular therapy method. I have studied other subjects that influence my work with people, and no doubt I will continue to do so. Primary among them are meditative practices and Soulmaking Dharma (as taught by Catherine McGee) which influence how I see everything in my life and the world.

I am interested in our relationship with the body, with this body ensouled, and I work with people who want a better relationship with their embodied experience. I realise that people like familiar labels, but a label only tells you the basics. A craniosacral therapist uses certain kinds of touch and attention to support health, and within that broad stroke practitioners work in very different, sometimes contradictory, ways.

A question of harm

Where I stand gives me a particular perspective from which to view the culture within craniosacral and similar healing spaces. My notes here would equally apply to any space that is designed for improving health, on any level. 

Of course, the hope and intention in any healing space is that it will be beneficial. That we will find something supportive, perhaps discover something new, develop a better relationship with ourselves, or find some relief from what has been troubling us. Much of the time, this is what happens.

I believe my work can support others. I have accessed many kinds of support that have been good for me. But I don’t think we need to pretend that difficulties never arise in order to value the work or recognise its potential.

Anything that can do good can do harm. Anything that has power to have any effect, can potentially have an effect that is harmful. To say otherwise is a delusion, in my view.

Even experiences as elevated as spiritual love can cause harm, when people don’t know how to handle that kind of energy or perhaps when coupled with other kinds of dynamics. Humans of any sort can cause harm, whether they mean to or not. Health practitioners, no matter how well-trained and how high up in the hierarchy of their profession, are still capable of harming. 

What kind of harm?

As part of our healing process we sometimes need to feel and release what has been difficult for us, within manageable limits. To grieve perhaps, or feel pain from old injuries. It lasts for a while and then changes, we feel supported and accompanied in this process. A while ago I received acupuncture treatment and bawled my eyes out for a day, feeling tender and a bit scared. In the next days my mood was better than ever. The doctor said: You released stress. That made sense.

This is not the kind of unpleasant experience I refer to as harm. I am speaking of experiences that are too much, too fast, too alone, or for too long. Those that leave us rattled and unstable, hurt and maybe even ill, for significant periods. There are many examples of this I can think of, from my own life, accounts from clients, friends, colleagues. Within craniosacral work itself, I have known people to be pushed too far into difficult material from their past without adequate resources or support, and left overwhelmed. I have known practitioners to tell clients what happened to them in the past, instead of asking, which is really unhelpful. I have also seen extreme physical responses to treatment that the practitioner didn’t know how to manage (of course, these need to be checked medically).

I have undoubtedly made mistakes in my own work too. I cannot assume that the absence of a complaint means everything has landed well. I hope I remain open to hearing about my actions that have felt unhelpful, and to learning from them.

Practitioners need to be able to question their own interpretations of what is happening. What we understand as a healing response or a positive change may not be the whole story. We need to remain curious about what the person is actually experiencing, rather than assuming we know what is happening for them.

Acknowledging the effects

Does this mean we should not be using craniosacral or other healing systems? Of course not. The fact that something can potentially cause harm means only that we must do everything possible to reduce and repair this. The first step in that is to admit when things have gone wrong and seek to understand and mend, with humility and mutual respect. 

When after a service someone feels worse, that is not necessarily because the practitioner is unskilled or careless (although that can also be the case). It may be that they don’t have the particular capacity or attunement needed for this person. Perhaps something from the person’s past or healing process has been activated, but the relationship or available resources aren’t sufficient for them at the time. Or perhaps something else is needed. Whatever the reason for the experience, the practitioner still has responsibility for managing the situation. Many times it is possible to learn from these experiences and adjust, develop insight, use other skills, balance power dynamics or boundaries, and come to a good, supportive relationship.

This is how a healthy system works: it learns, it changes, it seeks to be beneficial for everyone involved. 

Sometimes these experiences can also mean that the particular space is not a good fit; the training, the model, the style, or the personality, is not a match. The best thing then is to acknowledge this difference and move on. Not everyone can help everyone. Practitioners do real service when they communicate who they can and can’t help.

It is also definitely possible that trained professionals in positions of power cause direct harm through their unethical behaviour. I’m sure we can all think of examples of this.

Rupture & repair

We find in our many relationships, casual, intimate or professional, that mistakes are sometimes made, feelings hurt. Such relationships when repaired – actually repaired – can become some of our strongest bonds. To repair means to take accountability, acknowledge any harm done, apologise, make amends, and change behaviour. The opposite would be claiming that no harm was caused, ignoring, denying or minimising any problems.

An example, with one of my mentors: he did something, an error, that left me feeling disappointed and sad. Fortunately I was able to tell him how I felt. He was genuinely contrite, we repaired together, looked together at how I felt, worked together to make amends. I trusted him through this, more than before. Nothing like that happened again with him.

I can think of various examples like this from my life, friendships repaired and stronger than ever, and also the opposite – some situations are just not tenable. You may recognise these from your own life:

Did a relationship or other situation rupture, and once repaired become stronger than ever? Or did the rupture show you that there were significant rifts that cannot be mended? 

Reclaiming power

Repair is not always possible. Sometimes a person or system has caused harm but doesn’t have the capacity to understand or acknowledge it, they may do nothing helpful about it. The harm is still theirs to answer for, but waiting for them to act can keep us stuck. Reclaiming power means turning toward what is within our own capacity, and what is good for us.

I once felt very angry about support I accessed, it left me ill and vulnerable for a long period after. The anger made sense, but in a moment of insight I realised it was keeping me stuck, because without realising it I was waiting for them to do something about the situation. Recovering my power meant feeling my grief at what happened and turning it into action: getting help elsewhere, using my experience creatively, and understanding my needs better.

Giving & taking feedback

Ideally we would feel able to acknowledge both when things go wrong and when they go well. This means as a service user we feel able to tell the provider how we feel, and the provider will listen, validate, seek to understand, learn, apologise if needed, or acknowledge mismatch. This communication would happen both during and after our time together. We would feel safe to ask them to stop, slow down, disagree, say if something isn’t helpful, and also say what feels helpful. In the safest relationships this happens naturally.

It’s quite hard actually to take critical feedback; we like praise and we don’t like criticism. Or we do lip service: we say we are open to feedback, but when it comes we do nothing about it. We get defensive, use our power to hide, or diminish the other, or play other games.

Giving feedback is also a skill. We may say nothing, or lash out in blame, or offer platitudes. Can we share: this is how it was for me, this is the impact of our time together. Not blame or praise, just being able to share honestly how it was and listen for the response. It requires us to actually notice how we feel and think, how we are affected, and be generous enough to share that. It also requires the other to be available to listen.

Making complaints

If you feel you have been harmed by a professional you went to for help with your health and wellbeing, you could let them know what has happened, if that feels safe. In a supportive situation they will take you seriously, they will listen and make amends. This would be ideal. A genuine apology, appropriate follow-up or referral to someone else could go a long way towards repairing trust. You might also both agree on a mismatch and simply move on.

If you feel you have not been heard, understood or supported, you could get support elsewhere, talk it through with someone else you trust. Even these kinds of difficult experiences can teach us something about who we trust in the future or how we take care of ourselves. You could also make a formal complaint, the procedure for this will vary based on which, if any, professional body your practitioner is registered with. In some cases of gross harm this may be essential, to protect yourself and others, only you can decide whether this step feels worthwhile to you.

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If anyone ever tells you that this or that method or person – or anything really – can’t possibly cause harm, I do hope you will sprinkle some doubt on that claim. I hope that instead you will find places and people where mistakes are acknowledged, openly discussed, learnt from, worked through and repaired. Meaningful feedback, given and received, is an important way we learn and grow.