In her Tory leadership pitch Andrea Leadsom ‘ended up talking about how important it was to massage the prefrontal cortex of a baby’s brain’, according to an MP who was there.
What? Massage of the prefrontal cortex? Is that perhaps a new health technology that we have not yet heard about? Probably not. Readers below suggest Leadsom has been misquoted. That might be so. If quoted accurately, though, she was most likely referring to an alternative type of treatment called ‘cranial osteopathy’ or ‘craniosacral therapy’ (CST).
CST was invented about half a century ago by an osteopath. He made several assumptions, one more implausible than the next:
• that the spinal fluid is pulsating
• that the cranial bones are sufficiently movable to enable a therapist to feel this pulse
• that it is possible to influence this process with gentle manual manipulations
• that illness is caused by abnormalities in these pulsations
• and that CST would restore health in sick individuals by normalising them.
The CST-practitioner thus uses his or her own hands to evaluate the craniosacral system, feeling various locations of the body to test for the ease of motion and rhythm of the fluid pulsing around the brain and spinal cord. Soft-touch techniques are then used to release any perceived restrictions.
This probably sounds rather vague and nebulous, and we might well ask, how does CST really work? Let’s ask a practitioner of CST who surely must know best:
When a self-development issue is linked to the illness, it is enough for that issue to be acknowledged by the client (without any further discussion unless the client desires it) for the body to release the memory of that issue — sensed by the therapist as tightness, tension, inertia within the body’s systems — so that the healing can proceed.
Several treatment sessions may still be needed, especially if the condition is a long-lasting one. Our bodies’ self-healing mechanisms rely on a combination of the various fluid systems of the body (blood and lymph flow and the fluid nature of the cells making up all the organs and systems within our bodies) and the body’s energy fields. Our hearts generate their own electrical signal independently of the control of our brains. Such signals travel around the body through the blood and other fluid systems. Blood is an excellent conductor of electricity and, when electricity flows through a conductor, magnetic fields are created. It is with these fields that the craniosacral therapist works.
These same fields store the memory of the events of our life – rather like the hard disk on a computer – but these memories can only be accessed when the underlying body intelligence ‘decides’ it is needed as part of the healing process. There is absolutely no danger, therefore, of more being revealed than is strictly necessary to encourage the client back on to their self-development route and to enable healing to take place.
To many desperate parents of ill children — CST is mostly advocated for children — this sort of lingo might sound impressive; to anyone understanding a bit of physiology or anatomy, it is likely to look like pure quackery. CST has therefore been considered by most independent experts to be way out on the lunatic fringe of alternative medicine.
But criticism or ridicule do not stop proponents from making impressive therapeutic claims for CST. It would be quite difficult, I think, to find a condition that some CST practitioner does not claim to cure or alleviate. One UK organisation boldly states that any symptom a patient may present with will improve in the hands of one of their members; in the eyes of its proponents, CST clearly is a veritable panacea.
And let’s be fair, the fact that CST is implausible does not necessarily mean that it is not effective. The theory might be barmy, yet the treatment might still work. Let’s keep an open mind. What we need is evidence from clinical trials.
When I recently evaluated the findings from all randomised clinical trials of CST, I was pleasantly surprised to find that as many as six such studies had been published. The conditions treated in the trials ranged from cerebral palsy, migraine, fibromyalgia to infant colic. Unfortunately, the quality of the studies was, with the exception of one trial, deplorably poor. All the badly flawed studies reported positive results. The only rigorous trial was the one with children suffering from cerebral palsy — and in this particular study the findings were squarely negative. The conclusion of my review was therefore blunt: ‘The notion that CST is associated with more than non-specific effects is not based on evidence from rigorous randomised clinical trials.’ This is polite, scientific speak for saying that CST is bogus.
Some might argue that no harm can be done using CST; on the contrary, the gentle touch might even calm over-excited children and CST could thus be a helpful relaxation technique. In a way, such arguments make sense. Should we then care that it has no specific therapeutic effects?
Few people would argue against the potential benefits of gentle touch or other non-specific effects. But we should realise that, for achieving them, we do not need CST or any other placebo treatment. An effective therapy that is given with compassion and empathy will have a similar effect; and crucially, in addition, it will also generate the specific therapeutic effects that the patient needs.
Whenever CST or other bogus treatments (that is, therapies whose claims are either disproven or not supported by sound evidence) are used, it hinders patients’ access to effective treatments. This is not in the patients’ best interest and can, in extreme cases, have serious consequences.
Whenever CTS or other bogus treatments are endorsed by politicians — and, for some mysterious reason, lots of them engage in this sort of activity — we ought to wonder about their competence and ability to think critically. A lack of these qualities is certainly not in the best interests of the country.
Edzard Ernst, emeritus professor at the University of Exeter, is the author of A Scientist in Wonderland and the awardee of the John Maddox Prize 2015 for standing up for science. He blogs at edzardernst.com.