Ask the Expert: Patricia Rogers of Body to Brain

We’ll feature an expert in the mental health and substance use disorder field to answer questions

Q: How can body awareness impact recovery?

Many approaches to addiction recovery incorporate a variety of practices that improve body awareness, including yoga, meditation, mindfulness-based interventions and CranioSacral therapy. These practices foster awareness of inner bodily sensations, which may help to regulate the nervous system and improve substance use disorder treatment outcomes1. Body awareness practices have been shown to decrease stress and reduce substance cravings2.

Substance Use Disorder (SUD) is driven by disruption of the reward circuit in the brain, which regulates our experience of pleasure and governs the behaviors we repeat in order to feel pleasure. For example, a healthy reward circuit helps us to choose delicious foods in order to get the nutrition we need. SUD is characterized by dysregulation of these neural processes. Evidence now suggests that body awareness impacts these mechanisms3, preventing relapse.

Q: What is CranioSacral therapy?

CranioSacral therapy (CST) is a noninvasive, light touch therapy that supports relaxation of the nervous system and promotes the body’s natural healing mechanisms. This gentle hands-on treatment tones the nervous system for enhanced rest and digest functions and allows for release of strain patterns and restrictions within the tissues of the body.

SomatoEmotional Release (SER) is a natural extension of CST. As the body relaxes during CST, sometimes emotions percolate to the surface. SER techniques, practiced by more advanced practitioners, may be used to bring awareness of emotional issues to the forefront. Imagery is used to help make sense of emotions and their sources, so that they may be resolved. Increased awareness and release of underlying emotions allows for deeper level physical healing within the body’s tissues.

Developed by Dr. John Upledger, CST draws on his background in cranial osteopathy, his surgical experience and his research in biomechanics at Michigan State University from 1978-1983. Over 125,000 practitioners have trained in CST through the Upledger Institute in 110 countries worldwide.

CST treats a person as a whole. It can be used to address a wide range of physical and emotional issues for people of all ages, from Attention Deficit Hyperactive Disorder (ADHD) to chronic fatigue, anxiety, cerebral palsy, concussion, orthopedic injury, depression, and especially trauma.

Q: How does CranioSacral therapy address trauma?

Traumatic stress disrupts nervous system regulation, creating heightened alertness and can develop into post-traumatic stress disorder (PTSD). Additionally, traumatic events and their associated emotions can be stored within the tissues of the body, called somatic memories. Upledger and many Upledger trained practitioners have utilized CST as a hands-on treatment of trauma in the body4,5,6. CST facilitates relaxation of the nervous system. It promotes tone of the ventral vagal part of the nervous system, which calms breathing and heartrate. It also provides an opportunity, only when the client feels safe and ready, to integrate and release destructive emotions associated with traumatic events, facilitating deeper levels of healing of the tissues of the body. This body-based, noninvasive approach to trauma treatment taps into the body’s wisdom and is guided by the body’s innate knowledge of what is needed for healing. CST treatment supports feelings of safety and empowerment to the trauma survivor.

Q: How did you get involved in treating SUD?

My home state of West Virginia has been particularly riddled by the opioid crisis. I jumped at the opportunity to get involved when I was invited to participate in a State Opioid Response grant, which provides a variety of integrative therapies to participants of an outpatient program for opioid recovery in my community. The program provides participants Medically Assisted Treatment (MAT) under a physician’s care in addition to CranioSacral therapy, massage, acupuncture, physical therapy, yoga and nutritional support.

Q: Can you explain more about how CST works?

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The application of gentle, light pressure supports the nervous system to relax. Responding to this light touch held over a period of time, tissues soften and lengthen, allowing scar tissue to release its restrictions and making sustainable changes in the shape of the body’s fascial network. This light therapeutic touch connects with structures layer by layer, as the therapist’s awareness is drawn from one layer to the next, allowing for treatment of structures deep within the system.

Though structures can be treated throughout the body from head to toe, special focus is given to the CranioSacral system, which includes the brain and spinal cord and the connective tissues surrounding them. Restrictions are released in these areas in order to optimize central nervous system function. Additional techniques are used to enhance the flow of cerebrospinal fluid, which bathes and cleanses the brain and spinal cord.

The deeply relaxed and safe space created by CST may naturally allow for somatic memories to arise in the form of mental images or emotions. Experienced therapists may employ therapeutic imagery and dialogue techniques to make sense of the images and release destructive emotions associated with somatic memories. This process of SomatoEmotional release in turn leads to a deeper capacity of the body’s tissues to heal.

Q: What are you finding in CranioSacral treatment of people in opioid recovery?

Every CranioSacral session is highly individualized. There’s no knowing, from one session to the next, what may be presented for treatment. And the program is still young with room to learn and grow. But what I’m observing so far provides great hope. Here are special considerations I’ve come to look for, as opportunities arise:

  • For a person in opioid recovery, it may be overly challenging to receive touch from a therapist at first. Before a session, I find that video chat with the client helps set expectations, providing extra opportunities to ask questions and express concerns. If during the session the client struggles with feeling unsafe, hands-off techniques may be used, as necessary, to return the client to feelings of safety in the present moment.
  • I also find it valuable to talk about the physical experience of feeling emotions, which may be particularly uncomfortable for some people with SUD. Conversation beforehand may help the client tolerate this experience if it arises. Continued treatment may help the client become comfortable experiencing a range and depth of emotions, leading to increased emotional maturity.
  • Trauma is a common factor leading to SUD7. Some people with history of trauma may have clear memory of traumatic events from their past. Others may have repression of traumatic memories, which is a valuable defense mechanism that aids in survival but may lead to disruptions in day-to-day memory recall and intrusive flashbacks. Treatment of SUD must be approached with the awareness that a history of trauma may impact the therapeutic process. This makes fostering feelings of safety of utmost importance. Supporting relaxation by promoting vagal tone is central to all CST treatments, but is particularly integral to trauma treatment. The branch of the nervous system that innervates the gut, called the enteric nervous system, may also be impacted in people with a traumatic past, and CST treatment may focus on these structures as part of the healing process8.
  • As mentioned above, dysfunction of the reward circuit of the brain drives SUD. Prolonged opioid abuse can actually rewire the reward circuit as well. So, I keep in mind to check in with these structures and treat them whenever the opportunity arises. This can be particularly critical for those who also have eating disorders.
  • Many people in opioid recovery had an underlying pain pattern before their addiction to opioids began. CranioSacral therapy can be used to treat the site of injury or pain, for example knee or back pain. In addition, chronic pain may result in hyperactive areas of the brain involved in the processing of pain, called the pain matrix. For people in recovery, I keep the structures of the pain matrix of the brain on my radar for CranioSacral treatment.
  • With or without a history of PTSD, the lifestyle of people before and during active addiction is often high stress. Many people in recovery have stress related illnesses. Depending on a recovery patient’s background and medical history, CST may address various systems of the body, for instance, the urinary, lymphatic or immune systems.
  • Thus far I’ve talked about CST in terms of the body and mind, but when I say it treats the person as a whole, that may include the spirit as well. Spiritual connection is central to recovery for many people with SUD. For clients in recovery, their CranioSacral treatment may incorporate step work from their 12-step program, or spiritual growth work in whatever way benefits them. Some of the most impactful sessions I’ve facilitated involved therapeutic imagery and dialogue with incorporation of the spiritual aspect of the self. My role is to support whatever belief system the client brings with them to the treatment, checking my own beliefs at the door.
SEE ALSO  Substance Use Disorder and Trauma

Q: What should I look for in a CranioSacral therapist to support my recovery?

You may search for a therapist9 in your area, trained thru the Upledger Institute. This listing shows which courses each therapist has taken. It also shows whether a therapist is Techniques and Diplomate Certified through the Institute. When you reach out to a CranioSacral therapist, arguably the most important criterion is how safe you feel interacting with the prospective therapist. It may be valuable to ask if they are comfortable and experienced treating trauma. Also consider that your CranioSacral therapist should approach your treatment without agenda, allowing your healing process to be guided by you and your body’s innate wisdom. (S)he should be willing to work alongside whatever support system and other medical and mental health care you find beneficial. When you find the right fit, a qualified CranioSacral therapist will help you feel safe and supported to work through your therapeutic process at a pace that’s just right for you.


  1. Interoceptive Awareness is Important for Relapse Prevention: Perceptions of Women who Received Mindful Body Awareness in Substance Use Disorder Treatment
  2. Mindfulness treatment for substance misuse: A systematic review and meta-analysis
  3. Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications
  4. pdf
  5. pdf
  6. Upledger CranioSacral Immersion Report for Dr. John E. Upledger
  7. Prevalence of trauma, PTSD and psychotic symptomatology in relation to suicidality and quality of life in substance users
  8. It’s All in Your Gut
  9. Find a Therapist

Patricia Rogers, CST-D, Diplomate CranioSacral Therapist & Owner,  Body to Brain Therapy, has an advanced CranioSacral practice in Charleston, West Virginia. She is a teaching assistant, advanced preceptor and primary therapist at Intensive Therapy Programs thru the Upledger Institute as well as Integrative Intentions. She treats people of all ages with all types of conditions, including participants of an opioid recovery program.

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Last Updated on January 12, 2021

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