Inside-Out Paradigm^©
Healing From the Core
Dale G. Alexander Ph.D. L.M.T.

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From ancient times we have been endeavoring to language the essential elements of how the body & psyche dance together in the healing process. Inherent in my life purpose is the desire to contribute to this momentum and to ideas that illuminate the many dimensions of healing.

Sometimes ideas aggregate into simple paradigms that have been obvious yet, not spoken clearly. With this spirit, you are invited to consider a new paradigm that reflect core elements of my learnings from the past 23 years.

Conceive of working with the body from the "inside-out".

Imagine a quality of touch that accesses the body's core and assists the discharge of its tensions more effectively.

Consider an approach which can assist unraveling the body's sophisticated capacity for distributing strain thus, bringing to the surface physiological problems which have been degrading your clients' quality of life for years.

Appreciate your sense of satisfaction when clients, whom you have sensed needed additional medical intervention, actually receive this care. And, the increased sense of confidence in your competence when clients make steady progress in their healing from chronic problems.

The short form of this paradigm goes as follows:
a. Tensions of stress affect the visceral organs first, gathering momentum & intensity to a point where these tensions overflow into the body's intrinsic musculature,
b. Once these tissues have exhausted their capacity to distribute the strain, the normal motions of the axial & appendicular joints become affected.
c. Any dysfunction of motion within any joint complex triggers neurological reflex arcs requiring that the extrinsic musculature contract in order to protect the joints from further displacement.
d. This pattern of discharge sets the stage for physiological & biomechanical deterioration that follows a progression of: adaptation, compensation/substitution, injury/illness and finally degeneration/disease.

When a client comes to your office with an acute or chronic muscle spasm or any other problem without a recent injury or illness, this described sequence has pre-dated its occurrence. When our attention is focused principally on the extrinsic musculature we are only working with the tip of the iceberg.

Some is better than none, yet we can do better. All touch techniques do assist the body to "feel" itself thus, enhancing the feedback loops which stimulate the body's self-corrective capacities. However, I propose, that the models that govern most technique application are incomplete.

The premise of this new paradigm that advocates working from the "inside-out" postulates that "healing from the core" involves enhancing the suspension & function of the visceral organs. Their improved efficiency represents the "tipping point" in building momentum toward healing. For, without the appropriate absorption of nutrients & oxygen and the timely elimination of wastes, one cannot, but lose ground, in the face of traumatic incidents, immunological challenges, or the grinding effects of daily stresses.

Let's begin at the beginning. The visceral organs are central to our ability to thrive as infants. They are composed of smooth muscle. Smooth muscle is the first kid on the neocortical block as the job of a baby is to ingest, digest, & excrete in the phenomenal growth spurt of infancy. The functioning of visceral organs is key to an infant's capacity to survive.

Infants have no psychological sense of separation between self & other. They are physically dependent & vulnerable yet, they experience everything around them as an extention of themselves.

Consider how an infant reacts to family tension and conflict. It becomes upset, it's body contracts and writhes, the baby cries & screams. See deeper, what is happening within the visceral tissues? They are contracting. These smooth muscles are the ones that are initiating the movements that we may observe.

This does not suggest that the baby's extrinsic musculature has no tone or function rather that the visceral smooth muscle is predominant. In my opinion, this is what has been overlooked in our focus on the musculoskeletal system, on structural models that view the human body from the outside-in rather than from the "inside-out".

Contracture of the visceral smooth muscle predisposes the eventual capacity for gross motor movement(1). It is a simple idea with many implications related to human development.

We are all clear in our understanding that from the mouth to the anus the human body is just one long tube. However, less understood is that the muscular tube we swallow with, the esophagus, is fascially suspended from the spheno-basilar junction of the cranium. This junction is directly behind your eyes. Consider that tensions anywhere in the gut tube may eventually be expressed by the eosphagus pulling the head down upon the neck. Obviously, this can affect the craniosacral system's capacity & efficiency in circulating cerebrospinal fluid throughout the central nervous system(2).

Less appreciated too, is the anatomical fact that the esophagus is cradled behind the heart in front of the spine. When the esophagus shortens its resting length in response to highly emotional stresses or in response to whiplash-like biomechanical insults the resulting contracture can only serve to require more effort from the heart.

In my clinical experience, the most important intrinsic muscles include the esophagus, the diaphragm, & the iliopsoas. This triad represents the soft tissue linking pins from the lower extremities through the trunk to the cranium.

Consider how tensions overflowing from the viscera into these intrinsic muscles may exert more and more pull on the axial skeleton, activating and/or perpetuating the influence of the righting reflexes set in motion from traumatic incidents thus, winding the spring even more tightly. This entire process is accretive and insidiously subtle for many.

The body endeavors to physiologically allocate its resources and to distribute the biomechanical strains until the "tipping point" of negative momentum is reached and an episode of dysfunction/pain, injury or, illness occurs which allows the body to re-set the resting length of these core muscles.

Dr. Barral D.O., the developer of the Visceral Manipulation approach, often refered to the diaphragm & iliopsoas as the body's "garbage muscles"(3). It took a few years of study with him before I finally recognized what he really was articulating. In sum, that the body builds charge in the form of tension which eventually must be discharged. This notion was compellingly helpful to understand how & why the body will use musculoskeletal episodes of pain & dysfunction to discharge the accretion of tension.

What is offered in this paradigm is simply that there seems to be a logical order to this discharge process. One that offers each of us as massage therapists greater clarity of intention to our quality of touch. With your next client, allow your hands to relate to the basic physiological processes of their body. Seek to enhance their central circulation. Where do you sense the kink in the hose? Work from the "inside-out".

The ongoing key question for us to consider is, how does one activate the homeostatic capacities inherent in the human body? The simple answer is to enhance the circulation of bodily fluids in all of its forms; from how it is pumped, the resistance to its flow through the various planes of tissues, how it is filtered, to how it is re-constituted and/or excreted. The name of the healing game in the body turns around the central theme of "who gets the blood".

This article will serve as an introduction with others to follow.
In conclusion, I would like to acknowledge some of my most important teachers; Lansing Barrett Gresham, Dr. John Upledger D.O., Dr. Jean-Pierre Barral D.O., Dr. Richard MacDonald D.O., Frank Lowen L.M.T., Bill Williams Ph.D., Ellen Gregory Ph.D. & Jon Zahourek.

This article is intended to delineate this new paradigm in a way that you may make useful shifts in your clinical work with clients today. And, to incite your curiosity to seek further training in whatever healing art that your heart & spirit are drawn toward.

This article was 1st published in Massage Today, Parts 1 & 2 in the Sept. & Oct. 2004 issues, Vol. 04, Issue 09 and Vol. 04, Issue 10.

REFERENCES:

1. The Body's Map of Consciousness©, Lansing Barrett Gresham & Julie J. Nichols Ph.D., 2002.

2. CranioSacral Therapy, John Upledger D.O. & J. Vredevoogd, Eastland, 1983

3. Visceral Manipulation I & II and, Trauma, Jean-Pierre Barral D.O., Eastland Press, 1988.

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