Overview of childhood sexual abuse and the impact it has on adult survivors.

The impact of being sexually abused as a child

Both women and men may experience a wide array of symptoms that may be associated with a history of childhood sexual abuse. Frequently, the underlying cause of these symptoms is not recognized by the physician and, in many cases, by the patient.

For some survivors of childhood sexual abuse (CSA), there is a minimal compromise to their adult functioning. Others will have a myriad of psychological, physical, and behavioral symptoms as a result of their abuse.

Adult CSA survivors have a disproportionately high use of health care services, more severe symptoms with more complex patterns of presentation, and often somatic symptoms (somatic symptoms represent psychological distress that manifests itself as bodily ailments) that do not respond to routine treatment. These issues can create frustration for women and men and treatment challenges for their physicians.

Definitions of childhood sexual abuse

Childhood sexual abuse can be defined as any exposure to sexual acts imposed on children who inherently lack the emotional, maturational, and cognitive development to understand or to consent to such acts. These acts do not always involve sexual intercourse or physical force; rather, they involve manipulation and trickery. Authority and power enable the perpetrator to coerce the child into compliance. Characteristics and motivations of perpetrators of childhood sexual abuse vary: some may act out sexually to exert dominance over another individual; others may initiate the abuse for their own sexual gratification.

Although specific legal definitions may vary among states, there is widespread agreement that abusive sexual contact can include breast and genital fondling, oral and anal sex, and vaginal intercourse. Definitions have been expanded to include noncontact events such as coercion to watch sexual acts or posing in child pornography.

Prevalence of childhood sexual abuse

The prevalence of childhood sexual abuse in the United States is unknown. Because of the shame and stigma associated with abuse, many victims never disclose such experiences. Incest was once thought to be so rare that its occurrence was inconsequential. However, in the past 25 years, there has been increased recognition that incest and other forms of childhood sexual abuse occur with alarming frequency. Researchers have found that victims come from all cultural, racial, and economic groups.

Current estimates of incest and other childhood sexual abuse range from 12% to 40% depending on settings and population. Most studies have found that among women, approximately 20% - or 1 in 5 - have experienced childhood sexual abuse. Consistent with this range, studies have revealed that:

• Among girls who had sex before they were 13 years old, 22% reported that first sex was nonvoluntary.
• Twelve percent of girls in grades 9 through 12 reported they had been sexually abused; 7% of girls in grades 5 through 8 also reported sexual abuse. Of all the girls who experienced sexual abuse, 65% reported the abuse occurred more than once, 57% reported the abuser was a family member, and 53% reported the abuse occurred at home.
• Approximately 40% of the women surveyed in a primary care setting had experienced some form of childhood sexual contact; of those, 1 in 6 had been raped as a child.
• A national telephone survey on violence against women conducted by the National Institute of Justice and the Centers for Disease Control and Prevention found that 18% of 8,000 women surveyed had experienced a completed or attempted rape at some time in their lives. Of this number, 22% were younger than 12 years and 32% were between 12 and 17 years old when they were first raped.

Sources:

• Administration for Children and Families
• National Clearinghouse on Child Abuse and Neglect Information
• National Institutes of Health National Library of Medicine
• U.S. Department of Health and Human Services, National Center on Child Abuse and Neglect

next: Myths Surrounding Domestic Violence
~ all abuse library articles

Self-Therapy For People Who ENJOY Learning About Themselves

ABOUT THIS SERIES OF ARTICLES

This is the first of a series of articles on the general topic of childhood sexual abuse.

Our focus will be on adults who were sexually abused as children and who did not receive adequate parental or professional care afterwards.

This first article aims only to introduce the topic through some general statements. If you have a personal or professional need to learn more you will definitely want to read later articles.

AN APOLOGY TO MALE SURVIVORS

I will be using female pronouns throughout this series. I will, however, make my statements and examples generic enough that you can easily understand what I am saying by simply changing pronouns.

WHAT IS SEXUAL ABUSE?

Sexual abuse is "unwanted sexual contact."

The age of the person involved must be taken into account when we define the word "unwanted."

For children, all sexual contact except "exploration among equals" is unwanted and abusive.

(Even inappropriate "leering" by an adult - without touch - is sexually abusive to the child.)

THE CHILDHOOD EXPERIENCE

A child who has to deal with sex is overwhelmed by it. Children do not have the bodies or the minds to cope with intense sexual energy.

Making a child deal with sex is like demanding that they "learn calculus or die!"

Since handling it is simply impossible for them, they often just "wait to die."

ABOUT "SPLITTING"

The feeling of being overwhelmed as a child usually leads to "splitting." It's as if the child breaks into two pieces mentally.

Half of them has one "life" and the other half has another "life." What they are robbed of is a whole life.

THE TWO MOST COMMON "SPLITS" OF CHILDHOOD

The "Day Child" / "Night Child" Split: This child either knows what happens during the day
or what happens at night, but NEVER BOTH.

The safer day disappears when the sun goes down; the terrifying night finally disappears when the alarm clock goes off.

The "Mind / Body" Split: This child either knows what she thinks or what she feels, but never both.

She usually focuses on what she thinks because her feelings are just too strong for a child to handle.

Each time the feelings break through she feels abused all over again - just by the intensity of the accumulated and unexpressed terror, anger, and sadness.

THE ADULT EXPERIENCE

If the childhood abuse was overwhelming and the child had to "split" to survive, the only way the adult will ever know about her childhood abuse is through flashbacks.

What is a flashback?: A flashback is a momentary, split-second recollection of the abuse.

Sometimes this split second awareness is visual: SEEING something mentally that seems like a dream but feels SO real.

At other times it is auditory: HEARING something that was originally heard during the abuse.

Often it is kinesthetic: FEELING something that was originally felt during the abuse.

A flashback is "triggered" by ordinary events in adult life. The most common trigger comes when an adult is having sex and her partner moves in a way which reminds her of the abuser's movements.

But these triggers are very unique to each person, and they can be either one-of-a-kind events (like a scene from a movie) or very frequent occurrences (like walking past a certain kind of tree).

"Triggers" cannot be avoided. They are too commonplace. We can ignore the SIGNIFICANCE of the trigger for a while (by saying they "mean nothing"), but they will continue to haunt us until we face the memories that prompted them.

The terrorized child will not be ignored for long. Once she notices she has grown into a powerful enough person to begin to protect herself, that little girl will keep telling the grownup over and over about her memories - until she finally gets the safety and protection she has needed for so long!

THERAPY FOR SEXUAL ABUSE

There are many more people who need good therapists to help them overcome the ravages of childhood abuse than there are therapists capable of providing the service.

In these articles, I hope to give you at least some of the tools you will need to deal with sexual abuse while our society and mental health professionals try to catch up.

If you know you were sexually abused, GET PROFESSIONAL HELP!

On something this complicated, there is only so much you can even hope to do on your own.

Even when you are receiving excellent help from a therapist, there will be a lot for you to do on your own.

Enjoy Your Changes!

Everything here is designed to help you do just that!

next: Shame: What You Can Do About It

Self-Therapy For People Who ENJOY Learning About Themselves

This quiz is based on ideas emphasized in other topics. Some questions are harder than they appear at first glance. Sometimes more than one answer is technically correct, but one answer is always best. The best answers are listed at the bottom.

Click on the topic the question came from to learn about why I chose the answers I did.

CHOOSE THE *BEST* ANSWER

From Guidelines For Emotional Health

1) To be emotionally healthy, the first thing to check is:

A) Your emotions.
B) Your body.
C) Your relationships.

2) Feelings are:

A) Biologically programmed.
B) Messages from your body about how your life is going.
C) Messages from your body about what you want and need.

3) Take Care Of Yourself At The First Small Sign of:

A) A problem.
B) A sad or angry or scared feeling.
C) Discomfort.
D) Conflict of any kind.

4) During our awake hours we should spend most of our time on:

A) Work
B) Play.
C) Rest.
D) Equal time on each.

5-9) Match the five natural feelings (top) with the key words about the causes for the feelings (bottom):

5) Sadness
6) Anger
7) Joy
8) Scare
9) Excitement

A) Block.
B) Existence.
C) On Our Way.
D) Got It.
E) Loss

From Who's Healthy?

10) The best measure of our emotional health is:

A) How we handle daily life.
B) A diagnosis by a therapist.
C) Successful relationships.

11) An emotionally healthy person is Spontaneous, Intimate, and:

A) Successful. B) Happy. C) Competent. D) Aware.

From Growing Up

12) A person who has grown up emotionally has a family which consists of:

A) Parents and siblings, selected relatives, spouse and children (if any).
B) The relatives they choose to deal with.
C) People they choose from among everyone they know.
D) Everyone who treats them well.

From Self-Love

13) You can tell if you are self-loving if you look in a mirror and:

A) Know you would like this person.
B) Like how you look.
C) Feel warmth for this person.
D) Don't feel any guilt or shame or anger.

From About Change

14) We can change our values, our thinking, and our feelings in therapy. Which one changes most quickly in therapy?

A) Feelings. B) Thinking. C) Values.

15) Which one takes the longest to change in therapy?

A) Feelings. B) Thinking. C) Values.

From Life Scripts

16) Once someone's subconscious script becomes known to them, a therapist might help them to "shuffle." In this context, "shuffling" means:

A) Doing the same things as always but in a different order.
B) Replacing unhealthy actions by experimenting with healthier actions.
C) Re-deciding about each major element in the script.

From Motivation

17) We get our energy from:

A) Self-Love. (Feeling good about ourselves.)
B) Eating, sleeping, etc. (Taking care of our bodies well enough.)
C) Enjoying ourselves. (Being treated well by others and by ourselves.)
D) Being successful. (Achieving appropriate goals.)

18) When someone has plenty of energy but they think they are "lazy" or "unmotivated" this shows:

A) They don't know what their real motivations are.
B) They are stalling as a way of frustrating someone who made them angry.
C) They are working too hard to please someone instead of pleasing themselves first.
D) They aren't really lazy, they were just taught to believe that are.

THE ANSWERS

EVALUATING YOUR ANSWERS

To learn why each answer is correct, read the topic.

Notice if any question or answer (correct or incorrect) shows you something good about how your life is going! Be proud of it!

Notice if any question or answer (correct or incorrect) gives you an idea about how you can improve your life! Be proud you leaned this today!

Enjoy Your Changes!

Everything here is designed to help you do just that!

next: Self Help Quiz #2

Chapter 60 of the book Self-Help Stuff That Works

by Adam Khan:

ENERGY IS A BEAUTIFUL THING. A person with a lot of energy can accomplish twice what someone without much energy can and have more fun doing it. You get more life with more energy. And here's a way to crank up your engine: Act more energetic. That sounds like shallow, positive-thinking hype, but it's actually based on solid evidence: It works.

When you act more energetic, it stimulates your body. Lying down is relaxing. Moving around is more stimulating. Moving around quickly is even more stimulating. It gets the heart pumping. It puts the mind in gear.

Our biology has evolved to fit a different kind of world than the one in which we now find ourselves. There were plenty of times in our prehistory when food was scarce. People who wantonly used up energy would be the first to die, leaving no offspring. The bodies following the prime directive conserve energy passed their genes to us.

But times have changed. It's no longer difficult to find food. If anything, food is difficult to avoid. Calories are everywhere, hugely and abundantly available. As a matter of fact, now a major concern for people in America is being overweight. Times have changed dramatically. There's no longer any need to conserve energy, but your genes don't know it. They've still got their orders, like a soldier in a jungle who was never told the war is over.

You can be more energetic, but you'll have to override your feelings. And you can do this. You'll have to essentially ignore the natural laziness we all share.

The way to override your body's prime directive is to act energetic whether you feel like it or not.

The truth is, you are energetic when you act that way, regardless of how you feel. Listen to what I'm saying here. You want to be more energetic? By simply acting more energetic, you immediately become more energetic in reality, in the same way that when you act ethical, you are ethical, regardless of whether or not you were tempted to do the wrong thing.

You can become more energetic in ten seconds. Simply start acting more energetic.

You don't have to feel energetic to be energetic. A nice bonus, however, is that often when you act energetic, it will rev you up and make you feel energetic too.

Experiments show that when people walk quickly, it speeds up their metabolism, making them feel more energetic, and this energetic feeling lasts for several hours after the activity. Acting energetic physically changes your body into a more energetic body.

So don't wait until you feel energetic before you act. Act first. The feelings will follow.

Act more energetic.

Would you like to feel more enthusiastic about your work? One way is to act enthusiastic. But there is another, more fundamental principle that can make your work a flow experience more often:
Zoning Out

One of the things that can make us feel tired or listless is small feelings of defeat we get when things don't go the way we expect or when we experience setbacks. Learn how to prevent many of those feelings of defeat:
Optimism

next: Burn Your Own BTUs

"Your belief system is the foundation from which all your thoughts, feelings and actions stem."

Now that you've identified who you want to be, and what you want to do and have, let's look at the obstacles you perceive to be in your way of accomplishing those things. I'm here to tell you, although it may appear as if the roadblocks are real, tangible things (time, availability, money, ability, etc), most of the problem is an issue of perception and belief. Nine times out of ten, it has to do with fear. Where there's fear, there's stagnation. Somehow when you transform your beliefs, what was once an obstacle, becomes doable. New beliefs can allow you to see your way around or through the obstacle.

Beliefs

Beliefs are any ideas you think are true about yourself, others, and life. Many of the beliefs you hold today, are the result of a) what your parents/guardians believed, b) what your friends believed and/or c) what you've been told is true by a perceived authority.

Unfortunately, some of those beliefs are not helping you in your life. What if you looked at yourself as the accumulation of all the beliefs you've been exposed to and took on as our own. And what if you made a vow to rebuild yourself with new more useful beliefs? What belief system would you build?

Would it be one that supported your desires and wants? One that gave you the greatest freedom? Encouraged happiness? Some beliefs are counter-productive to what you say you want. Wouldn't it be nice to identify those beliefs? Examine them for validity? There are so many self-defeating beliefs but here are just a few I've identified in myself and others. Do you believe any of the following?

Self Defeating Beliefs

• I don't have time to do what I want.
• I can't change. This is just the way I am.
• I'd be selfish if I focused on my desires.
• I have to be realistic. People who are optimistic aren't realistic.
• I have to have [love, sex, new car, money, etc] to be happy.
• No pain, no gain.
• You have to do some things in this life you don't want to do.
• You can't have your cake and eat it too.
• If my happiness was a priority, I'd be inconsiderate of others.
• It's a dog-eat-dog world out there.

Changing Your Beliefs

So far this site has mainly engaged you at the reading level. Changing the beliefs that are causing you pain is where the rubber really hits the road. If you are serious about wanting to turn your life around, you're going to have to go beyond simply reading. You will not experience any lasting change reading about ideas. Oh, I'm all for ideas. I love to read too. But real change doesn't happen until it's personal.

I don't know if you're like me, but I have read a lot of books, attended a lot of programs, listened to umpteen tapes and talked about personal growth an awful lot. But none of this really made any huge difference in how I felt, what I did, or helped me get what I wanted, at least in the long term.

"If you see a difference between where you are and where you want to be - consciously change - your thoughts, words, and actions to match your grandest vision.

This might require tremendous mental and physical effort. It will entail constant, moment-to-moment monitoring of your every thought, word, and deed. It will involve continued choice-making - consciously. This whole process is a massive move to consciousness. What you will find out if you undertake this challenge is that you've spent half your life unconscious. That is to say, unaware on a conscious level of what you are choosing in the way of thoughts, words, and deeds until you experience the aftermath of them. Then, when you experience these results, you deny that your thoughts, words, and deeds had anything to do with them."

- excerpt from "Conversations with God"

I'm telling you this because I've been where you are. If you're reading this, you're searching for answers. I didn't experience any concrete changes in my life until I was exposed to the Option Method. Although the Option Method has been compared to many different types of psychotherapies, it is radically different than anything I've ever experienced.

It's the only process I've found that not only helped me changed my mind, but where you could visibly see the differences in my life. And isn't that what we all want? I mean it's nice to feel inspired and get high off a new realization, but what I really wanted was to feel better about myself and life on a more consistent basis. I wanted to be able to pursue my desires without all the fears (and they were numerous.) I wanted to make more permanent changes where I didn't keep falling back into old habits that weren't working. The Option Method did all that for me.

The Option Method

The Option Method is a series of carefully designed questions, that when asked, help you identify, and change (if you wish) those beliefs that are causing your pain, fear, anxiety, anger, depression, etc.

Although the process was designed as a Self-Help tool, it's my personal opinion that you can't really reap the full benefits of a dialogue by yourself until you've had a few dialogues with an Option Method Practitioner. When I first did the process on my own, I kept getting stuck. After I had had four or five dialogues with a Practitioner I was much better able to do the dialogues by myself.

It certainly doesn't hurt to read about the Option Method, but you won't experience the changes I talked about until you actually have an Option Method dialogue on your own. I make no money if you schedule a dialogue with a Practitioner, but I will have the satisfaction of knowing I helped you. Below are links that will help you learn more about the method. The links will open a separate browser window so you'll easily be able to return to this site.

Learn More About the Questions
The Attitude Behind the Questions
List of Available Option Method Practitioners
The History Behind the Method
Articles About the Method

next: How Creation Works

One day I was feeling particularly miserable and guilty about not working hard enough. I was so sick of feeling guilty I just wanted the feeling to go away.

It was in the summer of 1996 that I decided to put guilt to the test. I wanted to completely understand guilt. Why I felt it, why these feelings were encouraged by others, and what effect it was having on my life.

I do some of my best thinking when surrounded by nature so I put on my sneakers and went for a long walk. A 5 mile walk to be specific. I decided the best way to look at my guilt was to examine specific incidences where I felt guilty. As I made the turn down the street onto the gravel path, I went back to my earliest memory of guilt.

I chuckled as I remembered an early memory. I had gone outside in my bunny slippers when my mother had told me specifically not to. I remembered feeling "What kind of person was I to disobey? There must be something wrong with me. I must be a bad person." I didn't know it at the time, but I thought if I could feel bad enough, maybe it would make me act "right."

In college, I had an 8am Art History class across campus. I wasn't a morning person, the classes were in a dark room, and didn't feel like walking that far. After a month or so into the semester I started missing some classes. I felt guilty every time. I thought about how I was wasting my parent's money, how I was not disciplined enough, how if I was a "good" student, I would MAKE myself go. Consequently, I felt bad every time I skipped Art History.

So I thought of those experiences and every specific example I could remember from age seven on. The examples were numerous. After each example, I asked the following questions.

1) Why did I feel guilty in that situation?
2) What did I hope to accomplish by feeling guilty?
and
3) Did feeling guilty help me accomplish what I wanted?

As I went down the list, the answers surprised me. The reason I felt guilt in ALL the situations could be narrowed down into three categories.

1. To get myself to behave differently
2. I thought that's what I good people were suppose to feel
3. To show others that I was a caring person.

The most popular reason was to try and get myself to do something I thought I "should" be doing, or stop myself from doing something I didn't think I "should" be doing.. Now here's the clincher.

Did Guilt Change Me?

The answer was a resounding, NO. In all the cases I could remember, guilt hadn't motivated me to ever make any lasting changes in how I thought or behaved. In some cases I had changed in the short-term, but in all the examples I could think of, I inevitably went back to the behavior I was trying to stop. This made me ask, then why use guilt if it doesn't work? The only times I stopped behaviors was when I simply didn't want to do them anymore or changed my thoughts/beliefs about the situation..

Did I Have To Feel Guilt?

Was there some requirement that necessitated me feeling guilty? I couldn't think of one valid reason to feel guilt if it didn't work! If it wasn't functioning as a tool for change, then why use it? Why feel miserable if it serves no purpose?

Did Guilt Show My Caring To Others?

Unfortunately, sometimes yes. We belong to a culture that believes guilty feelings are a sign of a caring and thoughtful person. But most of the time it was difficult knowing what others were thinking. Most times they could care less what I was feeling. The ones who wanted to try and manipulate me to do what they wanted, liked the fact that I felt guilt. The ones who loved me, and wanted me to be happy tried to reassure me that there was no reason to feel bad. I decided I didn't want to spend time with people that supported me feeling guilty.

Take Your Own Walk

Don't trust my answers for your life. Take your own walk and examine your experiences. Put your guilt through the wringer. See what answers you find using the same questions I did. Look at the long-term results. The answers you reveal will have a profound effect on how you view guilt. And I suspect, like me, you'll discover just how useless the emotion of guilt really is.

next: Interview On Acceptance

Introduction

• Still My Mind Homepage
• About Me
• Adrian Newington Books

Getting Off the Roller Coaster

• Getting Off the Roller Coaster Table of Contents
• Book and Music
• Introduction to Getting off The Roller Coaster
• The Struggle of the Ego
• The Concept of "The Now"
• Understanding and Working Through Fears
• The Mirror Action of Life
• Conditioned Emotions and Choosing.
• Cultivating a New Discipline.
• A Good Way to Love.
• Affirming Your Right to Love
• The Gratitude Principle.
• Co-Creating With God.
• The Peaceful Balance.
• Appendix I
• Appendix II
• Bibliography
• To My Readers

I Am the Heart

• Introduction
• I Am the Heart The Book Part 1
• Part 2
• Part 3
• Part 4
• Part 5

Catch an Autumn Leaf

• Catch an Autumn Leaf - A Short Story

Personal Growth

• Still My Mind Personal Growth

The Nature of the Mind

Prosperity

Faith and Inner Struggle

Meditation: Seeking the Spiritual Connection

Defining the Sense of Self

The Concept of The NOW: Understanding the Power of the "Present"

Meditation Course for "I Am the Heart"

Right Understanding

• I Am the Heart Meditation Course
• I Am the Heart Download
• Still My Mind.com Short Discourse series.

Music

• Music Homepage
• Lyrics Table of Contents

back to: Still My Mind Homepage

Craniosacral therapy is an alternative treatment for depression, ADHD, autism, Alzheimer's and other psychological disorders. But does craniosacral therapy really work?

Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.

• Background
• Theory
• Evidence
• Unproven Uses
• Potential Dangers
• Summary
• Resources

Background

In the early 1900s, the osteopathic doctor William Sutherand developed a theory that the relationships and motions of the bones of the skull (cranium), of the fluid that flows through the brain and spinal column (cerebrospinal fluid), of the membranes around the brain and spinal cord (meninges), and of the bones of the lower back (sacrum) lie at the core of the body's functioning and vital energy. A series of techniques grew out of these concepts, which were further developed in the 1970s by John Upledger, also an osteopathic doctor. Dr. Upledger coined the term craniosacral therapy, which refers to a form of therapeutic manipulation that is oriented to tissue, fluid, membranes and energy.

Theory

Craniosacral therapy practitioners touch areas of the patient lightly to sense the cranial rhythm impulse of the cerebrospinal fluid (CSF), said to be similar to feeling the pulse of blood vessels. Practitioners then use subtle manipulations over the skull and other areas with the aim of restoring balance by removing restrictions to CSF movement, a process that is proposed to help the body heal itself and improve a wide range of conditions. Treatment sessions usually last between 30 and 60 minutes.

There are numerous anecdotes about treatment benefits, although effectiveness and safety have not been thoroughly studied scientifically. Craniosacral therapy may be practiced by osteopathic doctors, chiropractors, naturopathic doctors or massage therapists. This technique is sometimes referred to as cranio-occipital technique or cranial osteopathy (when practiced by osteopathic doctors), although it is controversial whether there are subtle differences between these approaches.

Evidence

Scientists have studied craniosacral therapy for the following health problems:

Effects on heart and breathing rates
Early evidence shows that craniosacral therapy does not appear to have an effect on heart or breathing rates. More information is needed before a conclusion can be drawn.

Pregnancy (labor and delivery)
Preliminary research shows that there is no added benefit for using craniosacral therapy during labor and delivery. Check with a qualified obstetrician before using craniosacral therapy.

Unproven Uses

Craniosacral therapy has been suggested for many uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using craniosacral therapy for any use.

Potential Dangers

The safety of craniosacral therapy has not been thoroughly studied scientifically. Although the movements of this technique are usually gentle, there may be a small risk of stroke, nervous system damage, bleeding in the head, intracranial aneurysm or increased pressure in the brain. The following people should approach craniosacral therapy with caution: those with recent head trauma or skull fracture, those with diseases that affect the brain or spinal cord, those with conditions in which a change in pressure in the brain would be dangerous, and those with disorders of blood clotting. In theory, craniosacral therapy may make some existing symptoms worse. Adverse results have been reported in patients with traumatic brain syndrome.

There are anecdotal reports of diarrhea, headache and increased anger after treatment. It has been proposed that craniosacral therapy may enhance the effects of drugs used for diabetes, epilepsy or psychiatric disorders, although this has not been tested in scientific studies. Craniosacral therapy should not be relied on as the sole treatment (instead of more proven approaches) for potentially severe conditions, and it should not delay consultation with an appropriate health care provider about a symptom or condition.

Summary

Craniosacral therapy has been suggested for many conditions. There are numerous anecdotes about successful treatment with craniosacral therapy, although effectiveness and safety have not been thoroughly tested scientifically. Speak with your health care provider if you are considering treatment with craniosacral therapy.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

back to: Alternative Medicine Home ~ Alternative Medicine Treatments

Resources

1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Craniosacral Therapy

Natural Standard reviewed more than 30 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

1. Blood SD. The craniosacral mechanism and the temporomandibular joint. J Am Osteopath Assoc 1986;86(8):512-519.
2. Ehrett SL. Craniosacral therapy and myofascial release in entry-level physical therapy curricula. Phys Ther 1988;Apr, 68(4):534-540.
3. Elsdale B. Craniosacral therapy. Nurs Times 1996;Jul 10-16, 92(28):173.
4. Geldschlager S. [Osteopathic versus orthopedic treatments for chronic epicondylopathia humeri radialis: a randomized controlled trial. Forsch Komplementarmed Klass Naturheilkd 2004;11(2):93-97.
5. Gillespie BR. Dental considerations of the craniosacral mechanism. Cranio 1985; Sep-Dec, 3(4):380-384.
6. Green C, Martin CW, Bassett K, et al. A systematic review of craniosacral therapy: biological plausibility, assessment reliability and clinical effectiveness. Complement Ther Med 1999;7(4):201-207.

1. Greenman PE, McPartland JM. Cranial findings and iatrogenesis from craniosacral manipulation in patients with traumatic brain syndrome. J Am Osteopath Assoc 1995;95(3):182-188.
2. Hanten WP, Dawson DD, Iwata M, et al. Craniosacral rhythm: reliability and relationships with cardiac and respiratory rates. J Orthop Sports Phys Ther 1998;Mar, 27(3):213-218.
3. Hartman SE, Norton JM. Craniosacral therapy is not medicine. Phys Ther 2002;Nov, 82(11):1146-1147.
4. Hehir B. Head cases: an examination of craniosacral therapy. Midwives (Lond) 2003;Jan, 6(1):38-40.
5. Heinrich S. The role of physical therapy in craniofacial pain disorders: an adjunct to dental pain management. Cranio 1991;Jan, 9(1):71-75.
6. Kostopoulos DC, Keramidas G. Changes in elongation of falx cerebri during craniosacral therapy techniques applied on the skull of an embalmed cadaver. Cranio 1992;Jan, 10(1):9-12.
7. Maher CG. Effective physical treatment for chronic low back pain. Orthop Clin North Am 2004;35(1):57-64.
8. McPartland JM, Mein EA. Entrainment and the cranial rhythmic impulse. Altern Ther Health Med 1997;Jan, 3(1):40-45.
9. Moran RW, Gibbons P. Intraexaminer and interexaminer reliability for palpation of the cranial rhythmic impulse at the head and sacrum. J Manipulative Physiol Ther 2001;Mar-Apr, 24(3):183-190.
10. Phillips CJ, Meyer JJ. Chiropractic care, including craniosacral therapy, during pregnancy: a static-group comparison of obstetric interventions during labor and delivery. J Manipulative Physiol Ther 1995;Oct, 18(8):525-529.
11. Quaid A. Craniosacral controversy. Phys Ther 1995;Mar, 75(3):240. Comment in: Phys Ther 1994;Oct, 74(10):908-916. Discussion, 917-920.
12. Rogers JS, Witt PL, Gross MT, et al. Simultaneous palpation of the craniosacral rate at the head and feet: intrarater and interrater reliability and rate comparisons. Phys Ther 1998;Nov, 78(11):1175-1185.
13. Rogers JS, Witt PL. The controversy of cranial bone motion. J Orthop Sports Phys Ther 1997;Aug, 26(2):95-103.
14. Sucher BM, Heath DM. Thoracic outlet syndrome: a myofascial variant. Part 3: Structural and postural considerations. J Am Osteopath Assoc 1993;Mar, 93(3):334, 340-345. Erratum in: J Am Osteopath Assoc 1993;Jun, 93(6):649.
15. Upledger JE. Craniosacral therapy. Phys Ther 1995;Apr, 75(4):328-330. Comment in: Phys Ther 1994;Oct, 74(10):908-916. Discussion, 917-920.
16. Weiner LB, Grant LA, Grant AH. Monitoring ocular changes that may accompany use of dental appliances and/or osteopathic craniosacral manipulations in the treatment of TMJ and related problems. Cranio 1987;Jul, 5(3):278-285.
17. Wirth-Pattullo V, Hayes KW. Interrater reliability of craniosacral rate measurements and their relationship with subjects' and examiners' heart and respiratory rate measurements. Phys Ther 1994;Oct, 74(10):908-916. Discussion, 917-920. Comment in: Phys Ther 1995;Apr, 75(4):328-330. Phys Ther 1995;Mar, 75(3):240.

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Colonic irrigation, colonic hydrotherapy may be helpful for some medical conditions, but for treatment of addiction, chronic fatigue syndrome and insomnia, there's little proof it's effective.

Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.

• Background
• Theory
• Evidence
• Unproven Uses
• Potential Dangers
• Summary
• Resources

Background

Colonic irrigation, also called colonic hydrotherapy, is a variant of enema treatment, which involves flushing the bowel with water in different quantities, temperatures and pressures. Through a tube inserted via the rectum, water may be introduced alone or with added enzymes, coffee, probiotics or herbs. Treatment sessions usually last about one hour. During a "high colonic," water goes in through one tube in the colon and is removed along with debris through another tube called an obturator.

Colonic irrigation may have been used as early as ancient times in Egypt, China, India and Greece. This practice gained some popularity in 19th century European spas, and it has been used in modern times for general well being and a variety of other conditions.

Theory

Colonic irrigation is proposed to improve mental outlook, modulate the immune system and eliminate toxic substances. Some practitioners suggest that intestinal flora (bacteria that normally live in the intestine) or waste products can affect the entire body's immune system and may therefore be involved with diseases outside of the gastrointestinal tract. It is proposed but unproven that washing away these flora or waste products may have beneficial effects.

There are numerous anecdotes about the benefits of colonic irrigation, although there is limited published scientific research in this area.

Evidence

Scientists have studied colonic irrigation for the following health problems:

Fecal (stool) incontinence
There is early research regarding the use of regular irrigation of the lower part of the colon in people with fecal incontinence. Further study is necessary to determine if benefits are likely to occur in most patients.

Ostomy care
Special types of colonic irrigation may be used in patients with ostomies (surgically created connections between the intestine and the side of the body). This area has been studied scientifically, and use of colonic irrigation in this setting should be conducted only under the strict supervision of a qualified ostomy health care provider.

Colonic spasm (during colonoscopy)
Evidence from some studies has shown that irrigation with warm water during colonoscopy may help reduce the incidence of colonic spasm. Further research is needed.

Surgical uses
Surgeons or other health care practitioners may use colon irrigation before or during some bowel surgeries (for example, colon cancer resection) for purposes such as cleansing or toward improved healing.

Unproven Uses

Colonic irrigation has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using colonic irrigation for any use.

Potential Dangers

Colonic irrigation can potentially cause severe adverse effects and must be carefully administered. People receiving frequent treatments may absorb too much water, leading to electrolyte imbalances in the blood, nausea, vomiting, heart failure, fluid in the lungs, abnormal heart rhythms or coma. Infections have been reported, possibly because of contaminated equipment or as a result of clearing out normal colon bacteria. There is a risk of bowel perforation (breakage of the bowel wall), which is a severe complication. Deaths have been reported.

Colonic irrigation should not be used in people with diverticulitis, ulcerative colitis, Crohn's disease, severe or internal hemorrhoids or tumors in the rectum or colon. It also should not be used soon after bowel surgery (unless directed by your health care provider). Regular treatments should be avoided by people with heart disease or kidney disease (renal insufficiency). Be sure that the equipment used is sterile and that the practitioner is experienced. Colonic irrigation should not be used as the sole treatment (instead of more proven therapies) for severe conditions, and it should not delay consultation with a qualified health care provider for a potentially severe symptom or illness.

Summary

Colonic irrigation has been recommended for many conditions. There are numerous anecdotes about successful treatment with colonic irrigation, although effectiveness and safety have not been thoroughly studied scientifically. Because of the potential risks involved, colonic irrigation may not be safe for many individuals.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

Resources

1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Colonic Irrigation

Natural Standard reviewed more than 40 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

1. Anon. Amebiasis associated with colonic irrigation: Colorado. MMWR Morb Mortal Wkly Rep 1981;30(9):101-102.
2. Briel JW, Schouten WR, Vlot EA, et al. Clinical value of colonic irrigation in patients with continence disturbances. Dis Colon Rectum 1997;40(7):802-805.
3. Chen WS, Lin JK. A potential alternative treatment of uncomplicated painful diverticular disease by trans-colonoscopic irrigation technique: a preliminary report. J Chin Med Assoc 2003;May, 66(5):282-287.
4. Church JM. Warm water irrigation for dealing with spasm during colonoscopy: simple, inexpensive, and effective. Gastrointest Endosc 2002;Nov, 56(5):672-674.
5. Ernst E. Colonic irrigation and the theory of autointoxication: a triumph of ignorance over science. J Clin Gastroenterol 1997;24(4):196-198.
6. Istre GR, Kreiss K, Hopkins RS, et al. An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic. N Engl J Med 1982;307(6):339-342.
7. Lim JF, Tang CL, Seow-Choen F, et al. Prospective, randomized trial comparing intraoperative colonic irrigation with manual decompression only for obstructed left-sided colorectal cancer. Dis Colon Rectum 2005;48(2):205-209.
8. Sisco V, Brennan PC, Kuehner CC. Potential impact of colonic irrigation on the indigenous intestinal microflora. J Manipulative Physiol Ther 1988;11(1):10-16.
9. van der Berg MM, Geerdes BP, Heij HA, et al. Defecation disorders in children: treatment with colonic irrigation through an appendicostomy. Ned Tijdschr Geneeskd 2005;149(8):418-422.

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• Watch the video on Narcissists and Midlife Crisis

Question:

Are narcissists likely to go through a midlife crisis and, if so, to what extent will such a crisis ameliorate or exacerbate their condition?

Answer:

The sometimes severe crises experienced by persons of both sexes in middle age (a.k.a. the "midlife crisis" or the "change of life") is a much discussed though little understood phenomenon. It is not even certain that the beast exists.

Women go through menopause between the ages of 42-55 (the average age of onset in the USA is 51.3). The amount of the hormone oestrogen in their bodies decreases sharply, important parts of the reproductive system shrink and menstruation ceases. Many women suffer from "hot flashes" and a thinning and fracturing of the bones (osteoporosis).

The "male menopause" is a more contentious issue. Men do experience a gradual decline in testosterone levels but nothing as sharp as the woman's deterioration of her oestrogen supply. No link has been found between these physiological and hormonal developments and the mythical "midlife crisis".

This fabled turning point has to do with the gap between earlier plans, dreams and aspirations and one's drab and hopeless reality. Come middle age, men are supposed to be less satisfied with life, career, or spouse. People get more disappointed and disillusioned with age. They understand that they are not likely to have a second chance, that they largely missed the train, that their dreams will remain just that. They have nothing to look forward to. They feel spent, bored, fatigued and trapped.

Some adults embark on a transition. They define new goals, look for new partners, form new families, engage in new hobbies, change vocation and avocation alike, or relocate. They regenerate and reinvent themselves and the structures of their lives. Others just grow bitter. Unable to face the shambles, they resort to alcoholism, workaholism, emotional absence, abandonment, escapism, degeneration, or a sedentary lifestyle.

Another pillar of discontent is the predictability of adult life. Following a brief flurry, in early adulthood, of excitement and vigour, of dreams and hopes, fantasies and aspirations, we succumb to and sink into the mire of mediocrity. The mundane engulfs us and digests us. Routines consume our energy and leave us dilapidated and empty. We know with dull certainty what awaits us and this ubiquitous rut is maddening

Paradoxically, the narcissist is best equipped to successfully tackle these problems. The narcissist suffers from mental progeria. Subject to childhood abuse, he ages prematurely and finds himself in a time warp, constantly in the throes of a midlife crisis.

The narcissist keeps dreaming, hoping, planning, conspiring, scheming and fighting all his life. As far as he is concerned, reality, with its sobering feedback, does not exist. He occupies a world of his own where hope springs eternal. It is a universe of recurrent serendipity, inevitable fortuity, auspiciousness, lucky chances and coincidences, no downs and uplifting ups. It is an unpredictable, titillating, and exciting world. The narcissist may feel bored for long stretches of time but only because he can't wait for the ultimate thrill.

The narcissist experiences a constant midlife crisis. His reality is always way short of his dreams and aspirations. He suffers a constant Grandiosity Gap - the same Gap that plagues the healthy midlife adult. But the narcissist has one advantage: he is used to being disappointed and disillusioned. He inflicts setbacks and defeats upon himself by devaluing persons and situations that he had previously idealised.

narcissist regularly employs a host of mechanisms to cope with this simmering, festering incessant "crisis". Cognitive dissonance, over- and de- valuation cycles, abrupt mood swings, changes in behaviour patterns, goals, companions, mates, jobs and locations are the narcissist's daily bread and escapist weapons.

Whereas the healthy and mature adult confronts the abyss between his image of himself and his real self, his dreams and his achievements, his fantasyland and his reality only late in life - the narcissist does so constantly and from an early age.

The healthy and mature adult recoils from the predictability of his routine and is abhorred by it. The narcissist's life is not predictable or routine in any sense of the word.

The mature 40+ years old adult tries to remedy the structural and emotional deficits of his existence either by a renewed commitment to it or by a cataclysmic break with it. The narcissist so regularly and habitually does both that these decisions are rendered flitting and insignificant

The narcissist's personality is rigid but his life is changeable and tumultuous, his typical day riddled with surprises and unpredictable, his grandiose fantasies so far removed from his reality that even his disillusionment and disappointments are fantastic and, thus, easily overcome.

Soon enough, the narcissist is engaged in a new project, as exciting, as grandiose and as impossible as the ones before. The gap between his confabulations and the truth is so yawning that he chooses to ignore his reality. He recruits people around him to affirm this choice and to confirm to him that reality is illusory and that his fantasyland is real.

Such pretensions are counterproductive and self-defeating, but they also serve as perfect defences. The narcissist does not go through a midlife crisis because he is forever the child, forever dreaming and fantasising, forever enamoured with himself and with the narrative that is his life

next:    Reconditioning the Narcissist