Craniosacral Therapy 10 step technique

The 10 step protocol was taught by Dr. John Upledger at the very first basic seminar CST1. It is taught to this day, and serves as the foundation of Upledger Craniosacral Therapy, CST. The purpose of giving a template / guideline of the steps and sequence is to provide a methodological approach that targets many of the higher powered areas of the body. That which stimultes and facilitates change in the physical body. It gets the human mechanism moving, reigniting, rejuvenating. Applying Craniosacral Therapy (CST) to the patient’s body to achieve its intended result.

As the Craniosacral Therapy practitioner gains experience, awareness and knowledge, almost always there is a deviation from the original technique approach of the ten step protocol. It is a body map that helps the practitioner provide CST in a predetermined fine-tuned manner while enhancing their hands-on skill set.  The more ten step protocols are done by the practitioner, the more experience is gained with every patient. It is a an effective method of facilitating the body to start achieving physiological and physical positive change.

Advanced Craniosacral Therapy

As more advanced CST training is partaken by the practitioner, and the more experience is gained from simpler cases, the therapist gains knowledge, and deviation from the 10-step protocol becomes imminent. Simply put, a practitioner’s more advanced skill-set, through practice, allows for the option of a more focused / intended session, incorporating multiple modalities and techniques. giving ability to the practitioner to deviate as he/she deems appropriate during the session to more advanced CST techniques, away from the ten step.

Dr. Kaminsky

Dr. Kaminsky uses CST and has taken many seminars up to Advanced Level. He also implements Pranic Healing and Vibrational / Sound Healing techniques.

Basic vs Focused Care

CST is gentle therapy. It is a light touch technique illuminating from the practitioner’s hands on to the body, resulting in a therapeutic response in the patient.

The therapeutic response in a patient is called by many names: release, energetic breakthrough, therapeutic pulse, healing response, letting-go, energy release, tissue softening, somato emotional release, closure, symptom relief, etc.

Both basic care and focused care in the office setting can be provided. Based on the practitioner’s experience, skill set and delivery of care.

Most importantly the delivery of care to a patient must be accompanied by love, gratitude and the patient’s best interest in mind.

10 Step Protocol

  1. till Point
  2. Diaphragm Releases
    – Pelvic
    – Respiratory
    – Thoracic Inlet
    – Hyoid
    – Occipital Cranial Base
  3. Frontal Lift
  4. Parietal Lift (two parts)
  5. Sphenobasilar Compression-Decompression
  6. Temporal Techniques
    – Temporal Wobble
    – Finger with Ear
  7. Temporal Decompression
  8. TMJ Compression and Decompression
  9. Dural Tube Evaluation
  10. Still Point (CV-4)

Many of the points of contact, hands-on craniosacral therapy correlates to the major chakras of the Energetic Human Anatomy. Dr. Kaminsky incorporates Pranic Healing into his sessions for maximum response of the body.

Still Point Induction

One important aspect of the 10 step protocol is the Still Point, first recorded electronically by Dr. Upledger’s assistant Dr. Zvi Karni. As the still point is induced, the patient will experience positive physiological changes. During the still point everything relaxes. Pain diminishes, somatic (muscular) dysfunction may spontaneously correct, occasionally with a noticeable “pop.” Breathing becomes very relaxed. Any muscle tensions seem to melt away.

The still point may last a few seconds to a few minutes. When it is over, the craniosacral system will resume its motion, usually with a better symmetry and a larger amplitude.

A still point is an intended temporary suspension and recalibration of the craniosacral rhythmic flow, a pause in the mechanism.

After the practitioner has induced your still point, upon the restart, you should notice changes in the quality and range of motion at the arms, feet, head and other parts of the body being worked on. If the excursions into internal and external rotations are now restored to equality, and left-right symmetry of motion is improved, nothing further is required. If in the practitioner’s judgment the motion is not satisfactory, a repeat in the still point procedure with another turn may be repeated. Each repetition of facilitating a still point, will bring the abnormality (symptoms and lack of range of motion) closer to the norm and benefit the patient.

Not more than ten still point repetitions during the same treatment session is required. There are no side-effects, other than extreme relaxation and sleepiness, which will occur. However, the still point is contraindicated in cases of intracranial hemorrhage and cranial aneurysm, where changes in intracranial fluid pressure might prove detrimental to the patient.

For the practitioner of craniosacral therapy, the technique described for induction of a still point using the patient’s head or feet can be applied anywhere on the body with an intended effect. It is a question of determining the direction of greatest ease and range of physiological craniosacral motion. The practitioner follows this motion to its physiological end point, and resists its return. After the still point is induced, and then restarted an improved craniosacral system activity is resumed, the therapist monitors and evaluates the new physiological motion patterns.

The still point is most often induced from the head and secondarily from the sacrum. Techniques applied to these anatomical parts are usually somewhat more rapidly effective than when applied to other parts of the body. The goal is simply to improve the activity of the craniosacral system.


The still point achieved by application of the technique to the subject’s occiput is traditionally called a “CV-4” technique. CV-4 means compression of the 4th ventricle in the head. Dr. Sutherland, the originator of this technique (Sutherland 1939), believed that he was compressing the 4th ventricle of the brain and thus affecting all of the vital nerve centers located in and about the walls of this ventricle.

The occipital squama provides an accommodation to changing intracranial fluid pressures. The CV-4 technique significantly reduces the ability of these squama to accommodate. The intracranial hydraulic fluid pressure is therefore increased and redirected along all other available pathways when the motion of occipital squama is extrinsically restricted. Thus, the CV-4 technique promotes fluid movement and hence, activation of dormant fluid pathways leading into the body.. The enhancement of fluid movement is always beneficial except in cases of abnormal intracranial pressure, aneurysm or hemorrhage.

The CV-4 technique positively affects diaphragm activity and autonomic control of respiration, and seems to relax the sympathetic nervous system tone to a significant degree. Autonomic functional improvement is always expected as a result of still point induction.

Clinically, this technique is beneficial in cases where a lymphatic pump technique is indicated (Magoun 1978). It can significantly lower fever by as much as 4 degrees Fahrenheit in 30-60 minutes. It relaxes all connective tissues of the body and therefore benefits acute and chronic musculoskeletal spasm, tightness and strain. It is effective in degenerative arthritic processes, in both cerebral and pulmonary congestion, in regulating labor and as a means of reducing dependent edema. As well as significantly reduce pain.

The CV-4 technique is, quite simply, an excellent “shotgun” technique for a multitude of problems as it enhances tissue and fluid movement and restores flexibility of the autonomic response.


To facilitate the still point, your therapist will cup your head with his hands and lightly hold them there. Feeling for the movement of the head. As the patient’s occiput narrows in the extension phase of the craniosacral system cycle, this movement is followed by the thenar eminences of the therapist’s hands. As the subject’s occiput attempts to widen during the flexion phase of the cranial cycle, the practitioner’s hands become immobile resisting this widening phase of the mechanism. As extension phase narrowing of the subject’s occiput recurs, the practitioner will follow the narrowing of the subject’s occiput. Then the occipital broadening of the flexion phase of craniosacral system motion is again resisted. This procedure is repeated until the cranial rhythm becomes reduced then ultimately stops, temporarily but completely.

When this stop occurs in the cranial Rhythm, the still point has been induced. The still point will continue for a variable number of seconds or minutes. The patient’s respiration will change, and light perspiration will often appear on the forehead. A noticeable relaxation of the body will occur.

Within a few minutes, you will notice that the patient’s occiput once again attempts to broaden into the flexion phase of the craniosacral system’s rhythmic cycle. When you feel a concerted strong motion bilaterally we follow this broadening and evaluate for amplitude and symmetry of craniosacral motion.


When inducing a still point through the sacrum, the therapist’s hand is applied to the sacrum. Follow the sacral motion into either the flexion or extension face, whichever seems to present the greater excursion. The therapist will resist the attempt by the patient’s sacrum to return to neutral through several cycles until the inherent motion of the craniosacral system ceases. The still point has been induced

Several factors might be considered in selecting where on a patient’s body the still point should be induced. Selection may be based upon convenience when, e.g., the therapist is already holding the sacrum or the feet and does not wish to disturb the patient’s body by changing position. It may also be based upon a desire to monitor the effect of the induced still point upon a given body part. Manual contact with painful body parts is unnecessary since, with practice, still points may be induced almost anywhere on the patient’s body, thereby affecting the pain symptoms at a different area of the body. The motion may be palpated in a restricted body region when the therapist desires to evaluate the effect of a still point upon the restriction in that area. The most convenient method of monitoring this effect is to have your hands upon the area in question during the procedure.

The induction of a still point from the body extremities when, e.g., one is attempting to evaluate and treat an uncooperative child, is an excellent means of obtaining cooperation. The still point experience is a pleasant one for the patient. The child soon learns to associate your touch with the pleasant experience of the still point. Cooperation ensues from this association and the stage is set for a mutually beneficial therapeutic process. It is beneficial to the therapist, both in terms of satisfaction and therapeutic value to the patient. Once cooperation and Trust has been achieved, more specific and efficacious treatment can be used with the 10 Step Protocol.

The Still Point is an excellent way to conclude the 10 step protocol. Many patients fall asleep, allow their nervous systems to integrate, process and as a result are better physically, mentally and emotionally after the session.

Each craniosacral therapy session builds upon the previous session and ultimately healing and health is achieved.

Dr. Kaminsky is a licensed Chiropractor and advanced Craniosacral Therapy practitioner.

About Dr. Kaminsky & Craniosacral Therapy

Having a Chiropractic background since the year 2000, Dr. Kaminsky offers many methods of treatment with an emphasis on Craniosacral Therapy in NYC.

Craniosacral Therapy (CST) is a method focusing on the link between the cranium (head) and sacrum (the second to last bone at the base of your spine), scientifically proven to work in unison to pump fluid throughout the body, an unknown disruption of which can cause many health issues.  The craniosacral mechanism pumps vital fluid called cerebro-spinal fluid (CSF) through the body and in a sense energetically lubricates the joints, tissues, organs; basically all cells of the body. It is the driving force of all your body’s systems of function; including maintaining the tone of your muscles.

The Central Nervous System (brain and spinal cord) are surrounded with CSF generating energetic rhythmic impulses of fluid delicately pumping throughout your body’s parts “breathing” the movement of life. This measurable rhythm of moving fluid, like the heart rhythm, pulse rhythm, breathing rhythm is the foundational “blueprint” and primary principle of our real-time state of our health. 

Compromises of our rhythmic movements of fluid flow correlates to the impulse restrictions in the system which the body is unable to overcome or self-correct. This is the reason why we have “dis-ease”, symptoms, conditions, basically all ailments.  This is where the skill of an experienced craniosacral therapist becomes valuable.  By placing his or her hands on your body the practitioner can feel, detect, evaluate, and facilitate correction of these restrictive arrhythmic impulses.

The craniosacral therapist helps your rhythm restore and renew in compromised areas allowing for healing to take place of sensory, motor, musculoskeletal, neurological disorders, symptoms, conditions and pain.  To learn more, visit the other pages on this website. Call to schedule your healing treatment with Dr. Kaminsky.