Jules Rampal – Osteopath in Saigon, Vietnam

Chapter 15 – The difference between osteopathy and craniosacral therapy – Part 2

Here we go, time to make some friends again.
Previously on Jules Rampal’s blog, we talked about Still’s work to build the foundations that could allow us to understand a bit better how different osteopathy is from craniosacral therapy.

And I kind of mentioned how Sutherland’s work is not osteopathy anymore.

Before I go any further, I would like to remind you of a few things, and even add a few more items to the list. My current understanding of Still’s work is very simple. Very simple if you can just stick to the facts for once, and not try to read between the lines like Sutherland invited you to do. Also, I write this text between two patients: I am not angry, I am late 😉

Still, again

Still is bringing back something through his philosophy. He is including the body as the very first object. But wait. Not the body of the patient. Our body as the very first object we encounter. Read that again.

In a world where manual therapy tries to be patient-centered, Still is telling you that your whole world is osteopath-centered and that you can’t bypass that. He is telling us that everywhere, and the craziest part is that I don’t even think he is aware of what he is doing, just how we are not aware of what we are doing.

He is telling us to start with what is here. And if you are honest and don’t think based on what you were told by culture and society, the first thing that is here isn’t the patient, it’s you. And you can’t just spend your life pretending that you are not part of what’s felt. I mean you can, but we are trying to offer an alternative.

Careful here. I am not telling you to dive inside to feel. We leave that to the miserable entrepreneurs we can find online who pretend they can become more productive by doing mindfulness. We leave that to the osteopaths who don’t read my blog (boooooo). No outside/inside. That’s the whole point. If you start with the idea you need to feel what is inside you, it’s game over before you even start the game. No outside/inside. You perceive the entire universe but you just take one step back and feel with your body, through your body. You don’t feel your body, you feel the entire universe, the bottomless starry sky WITH your body, as a whole. That’s not the full topic of this article, but I hope that those who read my words understand I am taking them there…by telling them to stop going anywhere.

Another thing that Still is doing is to tell us that health is the result of a perfectly adjusted machine. Pay attention to that. He doesn’t tell us to work with health. He tells us that health, just like sickness, is an effect. Health is the end product of a perfectly adjusted machine, while sickness is the result of a poorly adjusted machine. Bring the parts from normal to abnormal, and you’ll obtain health. Find it fix it and leave it alone.

As a result, all of his techniques are developed with the idea in mind to adjust things. Again. No technique to restore the mobility of a joint, no technique that requires you to ground yourself. A lever and a fulcrum, to adjust the parts so health can be restored. The techniques are so simple even people who were working with him couldn’t understand how he could get results. No complex hand positions, no trying to pump the CSF, nothing like that. They just couldn’t see what he was seeing.

AND NO AXIS. Gosh. He would never tell anybody that this joint moves in a specific direction. And he would never treat according to that idea! This is reductionism!

So I will close this chapter about Still because I want you to understand that osteopathy is very specific. It’s not classic manual therapy because it is not based on the same philosophy. It’s not a bridge between the inside and the outside. There’s no separation to start with, hence no bridge is needed.

And now ladies and gentlemen, Sutherland

If you have been serious about reading Still and reading Sutherland, I don’t even understand how you cannot see what I am talking about. I sincerely don’t see how osteopaths don’t see it. But who actually reads Still?

Nowadays, everybody wants to go beyond osteopathy. They think more techniques, more EBP, and more tools, will allow them to evolve osteopathy. But osteopathy is not something you achieve and then move on. It’s like meditation. It’s something you practice. There’s no beyond.

Before I go further, let me remind you something important. I love craniosacral therapy. I will talk about it later because for me it’s a form of art that has to be performed just because it is beautiful. And there’s a form of healing in beauty. Probably the deepest form of healing.

So, William Garner Sutherland. I think Sutherland didn’t have the same philosophy as Still. He wasn’t wired as Still was, just like how we are not wired the way Still was. Think about it. Sutherland describes the mobility of the cranial bones with axes. So what does it mean?

First of all, Sutherland moves from the lesion to the lack of mobility of the bones. This means that we are not looking for the same thing anymore. And this mobility is reductionist. Flexion, extension, internal rotation, external rotation, etc. This is not the same thing at all. What about tides? They are just the same thing (if you consider them as happening inside the patient’s body). The cranial impulse? oh please no. If at this point you cannot see that cranial impulse and tides are the product of a very very very cartesian mind, then I don’t know what to do. That’s where you see that he went further and further away FROM osteopathy.

The more Sutherland develops his concept, the more he wants us to work with the forces within the patient instead of applying a force from the outside. First of all this is all about an inside and an outside again. But also, where is the find it, fix it, leave it alone? This leads inevitably to working with health as something always available, instead of working with the machine and obtaining health as a result. Don’t tell me the idea is similar. It changes everything in the way the practitioner acts, behaves, etc.


I hope you can understand what I am trying to point out. Sutherland missed the point. He founded an amazing therapy though. But if I were telling you I play the piano with a guitar, you would probably tell me that I am very good at playing the guitar but that it looks like I can’t even tell what a piano is, so I should probably not call myself a piano player.

And that’s my point exactly. Osteopaths are amazing at practicing a reductionist manual therapy. But they still don’t understand what osteopathy is. Because it is not a manual therapy that just moves parts or a manual therapy that uses tides. And it is certainly not a mix of both, as an ultimate attempt to build a bridge between two worlds that never were separated in the first place.


Link to part 1







6 responses to “Chapter 15 – The difference between osteopathy and craniosacral therapy – Part 2”

  1. […] The difference between osteopathy and craniosacral therapy – Part 2Jules Rampal […]

  2. Bradley avatar

    I’m enjoying your work and fundamentally agree with your ideas. I’m a teacher and find it hard to communicate these ideas to students. Would you be able to comment on how to get these ideas across?

    1. Jules avatar

      Thanks for your comment Bradley. I am not a teacher myself, but I believe it’s a tricky topic.
      First of all, I believe that no matter what we do, it requires a huge implication of the student. After all, Still talks only about that and his books are free. So anybody can decide to study it. So the only thing I can think about is to talk about it. Again, and again ang again. Talk about what Still was doing, about what other scientists do etc.
      Now, this being said, I also think we could get more practical. When it comes to plants, there are places where people work first hands with plants in order to experience what Goethe talks about. And I think we could organise training doing the same with anatomy and practice.
      I also like to talk about my own experience because it is an ongoing one and I can really see how I went from randomly experiencing people’s pain to becoming more and more aware of “what’s happening” by actually feeling it. Like how a rib is felt out of place, but not under my fingers. I really have the feeling that the form of meditation I teach helps people to experience things first hands.

      So yeah, a bit of talking, a lot of practicing. I think that if a teacher’s used to it enough, they can even tell when a practitioner falls back into a reductionist practice. At least, based on the feedbacks I get from when I work with osteopaths, it is totally doable 😉

      When I get people to work with me, I basically start with a “meditation” and then practice right away. No talking. Talking comes later 😉

  3. Philippe De Coster avatar

    Hi Jules,
    Thank you for your Blog.
    I also love cranio, but all those axes and movements didn’t make any sense for me. I never felt what teachers said I should feel. Thank you for sharing.

    1. Jules avatar

      Hi Philippe, thanks for your comment 🙂 It never made sense to me either, and I found a way to work without all that following becker’s work (and later biodynamic). If you switch the tide from something happening in the patient to something happening in/to the practitioner’s mind/consciousness, it can become an interesting material I believe.
      BUT, and I am still in the process of understanding that further, in my opinion it is NOT osteopathy. I remember telling a friend of mine a few years ago that Sutherland was going in one direction whereas Still…wasn’t moving. This feeling you can actually get it from reading all of the early Journal of osteopathy. You can feel that Still is spot on, and others, even the closest ones, are slightly drifting away. Slightly but already.
      I shared a few of those texts in my MIND list (Check in the menu of this website). Also, you might like to read Barret Dorko’s texts about ideomotor movements. It is known that we might end up to feel what we think. But Dorko doesn’t stop there and wonders how we could use that to help people.

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