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Visceral Manipulation 

We often forget about our inner world.

The parts of us most involved in our lives often receive the least attention. How often do you consider the healthy movement of your spleen, kidneys, or intestines? Our internal organ structures make up who we are in a very real way, as the assimilation of food, water, sunlight, and their restructuring occurs because of our organs.
 

Chinese Medicine makes up a major part of how I perceive people's states of health. Within Chinese Medicine, the internal organs, or Zang Fu, play an essential and broad role in the capacities of the body. The physiological roles of the organs, known by the Chinese in their modern specific anatomical positions, are much more extensive than just their apparent local function. The nuances and details of these broader roles must be detailed in further writings; however, when I stumbled across the Barral Institute and Visceral Manipulation, I was immediately intrigued because of the ideas already ingrained in me by my study of Chinese Medicine. 

 

Visceral Manipulation broadly refers to any manual technique that specifically targets the viscera of the connective tissue directly associated with it. The style I am practicing is taught by the Barral Institute, which is dedicated to spreading the practice of Jean-Pierre Barral, a French Osteopath. A few characteristics differentiate Visceral Manipulation from other modalities that target the abdomen. First, it requires anatomical precision, as a detailed knowledge of the viscera and their interconnections is a requirement for practicing this art. Second, to utilize this knowledge, an intentional style of palpation is used to actively listen to the client’s body. This blends the tactile ability to physically feel the organs with the intentional effort to allow the hand to be drawn to areas of tension within the body. This allows the practitioner to perceive precisely where a restriction exists in the visceral system.

Jean-Pierre began his career as a physiotherapist. Working directly on the organs had not occurred to him until a patient returned telling him about how a folk healer cured his back pain by pressing into his stomach. Barral’s earlier treatment had been ineffective for this person. Since facilitating meaningful changes for the patient is the most important part of therapeutic work, Barral began exploring how pressing on the organs could relieve suffering. He worked with different physicians in hospitals in France using modern imaging and radiological equipment as well as extensive fresh cadaver dissections to study the effect of the manipulations on the organs.

The Barral Institute is an education company that teaches Barral’s approach to manual therapy. The Visceral Manipulation program represents a core aspect of the teachings. With a very French flavor, Jean-Pierre Barral offers an analogy by comparing the skills of the wine taster and the manual therapist:

"No one argues with the wine tester who, by using his palate, can tell us the characteristics of a wine - its region, its vineyard or even its vintage. The education of touch can go at least as far."

 

The organs need to easily move in relation to one another. One famous Chinese saying is translated as ““If there is free flow, there is no pain; if there is pain, there is lack of free flow.” This idea certainly permeates the understanding behind Visceral Manipulation. Our organs comprise the core of our body. At first it may sound odd to say that a restriction in the ability of the liver to move can manifest in shoulder or neck pain, but after studying the anatomy and seeing how the lines of connective tissue are stressed, this connection appears as more reasonable.

Digestive peristalsis and breathing, as well as general body movements, require significant movement within our internal environment. A structure called the peritoneum is a connective tissue membrane that envelopes many of the abdominal organs. It secretes serous fluid which allows for the slide and glide between the organs. It hardens into denser “ligaments” providing structure for blood vessels, nerves, and lymph to flow, as well as structural support. The peritoneum plays a major role in the concepts of Visceral Manipulation, as it can easily adhere to itself. Infections, surgeries, diet, and emotional trauma can all lead to the failure of serous fluid to effectively lubricate the peritoneum.

 

What to Expect from a Treatment

A treatment with Visceral Manipulation differs from a traditional massage. Visceral Manipulation does not incorporate the various kinds of rhythmic strokes of massage. We spend more time doing assessment through touch in order to determine which structures to treat.

Its “manipulations” involve the practitioner's hands making as direct contact as possible with the determined structure and mobilizing it in three dimensions. I put “manipulations” in quotation marks because the word is often associated with chiropractic or other high velocity joint mobilizations. Visceral Manipulation, in contrast, utilizes small and precise movements.

 

Maintaining softness in the hands is pivotal, and the stimulation to the target structure is quite subtle. This stimulation serves to help “wake up” the organ and have it move in its three dimensional environment. The therapist can feel planes of motion where the organ struggles to move and facilitate release in those directions. Different positions such as lying down, sitting up, or lying on your side may be utilized based on the location and qualities of the perceived restriction. The process is subtle, yet still mechanical. Discomfort at some moments is likely, but pain should not occur. 

 

How Many Treatments are Necessary?  

People often feel a difference immediately after the first treatment, but this is not always the case. Discomfort and other temporary symptoms as the client's body integrates are also possible. If positive change is not perceived by the client after around three sessions, then either I am not effectively treating the structures which need attention, or this type of work is not what the client needs. I suggest spacing out the treatments over at least three weeks, as the body needs time to fully adjust.