The Evolution to Modern Biodynamic Craniosacral Therapy (BCST)


The roots of Biodynamic Craniosacral Therapy’s arise from Osteopathic Medicine, developed by Dr. Andrew Taylor Still (1828-1917) in the late 1800s, which itself has its roots intertwined with traditional Shawnee Indian bodywork. (Read Our Origin Story here)

William Garner Sutherland and many others contributed to the evolution of BCST as it is practiced today.

William Garner Sutherland

The discoveries of osteopath William Garner Sutherland (1873-1954) pioneered the evolution of modern craniosacral work. As a senior at the American School of Osteopathy in 1899, he became fascinated with the bones of the cranium. Though he had been taught that these bones fuse in adulthood, their structure seemed to imply that they were designed for movement. Sutherland’s discoveries resulted in the creation of the field of Cranial Osteopathy.

While looking at a disarticulated skull in a case at the school, his attention was drawn to the temporal bone. The thought struck him that it was “beveled like the gills of a fish for primary respiration.” Thus began Sutherland’s life long journey of investigating whether the living skull expresses motion and whether this motion is physiologically important.

Being an osteopath, Sutherland began to describe the subtle inherent motions and pulsations that he felt in a biomechanical language. He used motion testing to explore patterns and created various techniques to release what was experienced as resistance in the cranial structures.

In 1945, however, he had an extraordinary experience that transformed his understanding of his approach to healing work and the language he used. He was called to the bed of a dying patient who was in great pain. As Sutherland held the man’s system, a depth of stillness arose as the man peacefully passed from this life.  Sutherland had a direct experience of what he came to call the “Breath of Life”.

Sutherland’s language and work now shifted from a largely biomechanical orientation to one that focused on primary respiration as a holistic and unified experience. He moved beyond biomechanical language, the use of motion testing and the application of techniques to an approach where no force from outside is used.

The unerring potency (life force) from within is trusted to initiate and carry out healing processes. What needs to happen cannot ultimately be learned through analysis or motion testing. Instead, it is a factor of what Sutherland called the “Intelligence” of the system and the intentions of the Breath of Life. At its depths, this way of working brings one in relationship with the mystery of life itself.

The term Craniosacral” (as in craniosacral mechanism”) was first used by Sutherlands colleague Harold Magoun, DO, (1951) to describe the presence of synchronized, coordinated movement in the head, spine and pelvis.

John Upledger

Many practitioners have carried on the work of Sutherland within the field of osteopathic practice. Outside of the osteopathic community, Dr. John Upledger began to teach something he called CranioSacral Therapy in the 1970’s. Dr. Upledger brought this work out in a particular form and framework. His endeavors have been paramount in the creation of a defined craniosacral profession and practice outside of the osteopathic framework. His work is taught all over the world by the Upledger Institute.

Franklyn Sills

In 1975-1979 Franklyn Sills, with a group of other enthusiastic students, studied the Polarity Therapy work of Dr. Randolph Stone, DO. Sills was fascinated by what Stone called primary energy and the neuter essence. He discovered that Sutherland was a major influence on Stone in this venue. A connection with Polarity Therapy is still a strong current in the Biodynamic Craniosacral community.

In 1982, Sills moved to England and co-created the Karuna Institute in Devon. During this time, he undertook an osteopathic training and underwent an apprenticeship in a busy London practice. One of the osteopaths in the practice was a cranial practitioner and greatly influenced Sills’ work. Sills was encouraged to enter a receptive state, to orient to what was called the tidal potency and the fluid tide, and wait for the potency of the Breath of Life to manifest its healing intentions.

In 1986, Claire Dolby, DO, encouraged Sills to begin teaching a form of cranial work outside of the osteopathic profession. He had already developed a two-year training program based on the work of Randolph Stone, DO. The first cranial training developed by Sills was taught at the Karuna Institute in 1986, assisted by Claire. It was a mixed biomechanical and biodynamic program where people learned biomechanical language and technique and were then encouraged to deepen into the more formative forces of primary respiration.

It soon became clear that this mixed approach did not serve the teaching staff’s intention to orient students to the deeper organizing forces in the human system. At a group meeting of tutors at Karuna in 1992, everyone present agreed that they wanted to begin to teach what they were actually practiced.

The hallmark of a biodynamic craniosacral approach is a direct orientation to the universal and conditional forces of life. In this approach, the practitioner:

  1. Settles into a still and receptive state of being
  2. Clearly negotiates a relationship with the client and their system
  3. Orients to the presence of primary respiration
  4. Waits for a shift within the client’s system to this formative ordering force
  5. Creates a container within which decisions are made by the Breath of life and the primary respiration it generates.

Over a period of years, it is the practitioner’s task to deepen perceptual clarity, grow in relational skills, and increase appreciation of the presence of both primary respiration and the conditional forces and patterns held within the system.

In 1992, Sills and the Karuna team were a lone voice in the craniosacral community orienting to a less biomechanical approach. It took a good ten years of development before a fully biodynamic training approach was grounded at Karuna which came to be called Craniosacral Biodynamics.

Sills also introduced the work of Sutherland and Sutherland protegee, Rollin Becker, DO, to the wider craniosacral community, and helped people orient to what Becker called the inherent treatment plan. Sills’ use of the term “biodynamics” was derived from Dr. Becker’s use of the term “biodynamic potency,” which denoted the ordering forces present within the human system.

Sills and colleagues in the biodynamic craniosacral community developed perceptual exercises and contemplative practices that help attune students and practitioners to primary respiration and the different levels of mid-tide, Long Tide and Dynamic Stillness. They helped practitioners learn how to generate a negotiated and holistic relationship to clients and their healing process.

Sills included the dynamics of how the practitioner and client come into relationship and the healing of personal and interpersonal wounding, as a primary focus in training and session work. Sills also developed terms like the negotiated relational field, the holistic shift and the mid-tide to help clarify some of the perceptual territories that emerge in session work. Over this period of time, Sills and his colleagues taught trainings in Switzerland, USA, Spain, Australia and Germany and the biodynamic approach to craniosacral therapy has now spread around the world.

In an interview  published by Kate White in 2011, Sills provides more detail about his approach to BCST, and the skills required of a practitioner.  Read the full interview.

Formation of the Biodynamic Craniosacral Therapy Association of North America

In the United States, graduates of Sills’ first US training began teaching in 1995. The American teachers built their own trainings as Sills continued to come and teach in the US.

The number of students graduated grew and eventually the need for continued support for graduates became apparent. The Biodynamic Craniosacral Therapy Association of North America (BCTA/NA) was formed in 1998 to meet that need.

Today, BCTA/NA has nearly 600 members, including more than 40 teacher members who are approved to offer Biodynamic Craniosacral Therapy (BCST) Foundation trainings leading to certification as a Registered Craniosacral Therapist (RCST®).

BCST work continues to spread around the world and is a vital and growing field of practice.


 Read our Origin Story