Here are links to make it easier to find all the articles in the Brain Gut Connection Series (based on interviews with Elinor Silverstein)
Brain Gut Connection Part 6 – coming soon
The Brain Gut Connection Series – Links to Part 1 – 5
Monthly Archives: October 2012
Brain Gut Connection Part 5
This is Part 5 of the Brain Gut Connection series. It is my understanding of the impact of nutrition and genetics in children with special needs as explained to me in conversation with Elinor Silverstein.
In previous articles Elinor has detailed how important nutrition and properly functioning metabolism are to everyone’s health. She has discussed how the gut and the liver work and how dysfunction can impact the brain, CNS, muscle tissues, and other systems of the body due to inflammatory response, inability to eliminate toxins, and/or inability to deliver nutrients to the cells themselves.
Good nutrition and metabolism are important to any growing child, but children with special needs are more at risk for the issues Elinor has discussed to cascade into severe limitations. Many doctors and medical professionals are making information available about the impacts of nutrition on children with Autism Spectrum Disorder and similar conditions. What is less known is the impact on of deficiencies and toxicity for children with Cerebral Palsy, torsion dystopia, Torticollis, and other neuromuscular conditions. Knowledge of this relationship between movement disorders and the Enteric Nervous System can change the course of a child’s condition. When the gut calms down and children get the nutrients their bodies need to thrive, improvement is dramatic.
The Viscera
Elinor is a highly skilled Feldenkrais practitioner. She was trained by Moshe Feldenkrais and was mentored by Gaby Yaron and Ruthy Alon. Years ago she asked Gaby for advice about her work, “What else can I do to help?” Gaby responded, “Everything in the body is connected. People will leave your lesson improved and come back next week crooked because you never talked to the organs and connective tissue in the abdomen.” To do this Gaby worked very deep in the viscera, but Elinor found that she could put her hands very lightly on the belly and feel something pulling and moving.
Years later, a well-known physical therapist who Elinor was working with, and is one of the main Upledger teachers, explained to her what she was feeling. While Elinor used Feldenkrais hands and touch, she constantly felt pulls and movement. The PT, showed her the anatomy and physiology of sphincters and connective tissues suspending the organs, and what they were doing while receiving this kind of touch. A light went on and Elinor moved forward with this in her way of working with her clients. Especially, those in dire need. Slowly, but surely, more and more of the people who came to her practice improved quicker than before. She created lessons to teach them what she was doing and how they could use their movement lessons to help their organs function in synchrony with the rest of their body.
Sphincters are the ring muscles that function by closing and opening. The most well known are the gastric-esophageal sphincter where people experience reflux from the stomach to the esophagus, and the anal sphincter that controls the passing of bowel. We have sphincters in many places throughout the body including around the orbit of the eye, between the liver and the bile ducts etc. Sphincters in the body are related to each other in a rhythmic way. Deliberately contracting one sphincter, such as pursing lips, can impact the other ring muscles in the body.
Elinor explained that some of this understanding of the viscera comes from the work of osteopath and physical therapist, Jean-Pierre Barral, the founder of the Barral Institute. Also, Ruthy Alon, a masterful Feldenkrais practitioner and founder of “Bones for Life”, was “huge on the sphincter muscles” explained Elinor. In 1981, Ruthy recommended reading the book “Secret of the Ring Muscles” by Paula Garbourg, which became a major source of information and inspiration for Elinor.
Spasticity and the Gut
Elinor uses her knowledge of visceral and sphincter functioning through the lense of Feldenkrais thinking. She incorporates healing the gut, ensuring that nutrition is being delivered to the cells, eliminating toxic build up, decreasing inflammation, making a healthy and viable connection between the enteric and central nervous systems, and always remembers the millions of years of evolution from which we have come. By using our body in movement we can work with all of these systems as a whole.
We have two nervous systems. The Central and the Enteric Nervous System. The Central Nervous System (CNS) is the brain, the spinal cord, and nerves connecting to the tissues of the body that have to do with physical movement. The Enteric Nervous System (ENS) is embedded in lining of the gastro-intestinal system (gut). It has been called our second brain. It includes everything that involves the organs and the viscera and it can operate separately from the brain and the spinal cord. Working in the mouth is working with the enteric nervous system. What goes on in the mouth with enzymes and acids goes on in the rest of the enteric nervous system.
Each nervous system influences the other. Sitting crooked can affect the gut. Gut issues can affect posture, tonus and the entire CNS. When the ENS starts to spasm it trips off the CNS too. In her work with children with movement disorders Elinor can feel a wave of spasticity originate in the Enteric Nervous System and move its way to the Central Nervous System. The origin of the spasticity can be the ENS.
Elinor says, “When I put my hands on their belly and show the viscera how it can function properly the contractions with the arms stop and torsion and twisting of the head, neck, and spine quiet down without even touching the limbs and skeleton.”
HUGE VITAL INFORMATION!!
Kids with CP almost always have gut issues, says Elinor. She explains, children with hypoxic trauma have experienced oxygen deprivation in both the Central NS and the Enteric NS. Both systems directly communicate with each other. You cannot damage one without damaging the other. The recent concept that we have 2 brains for nervous system control, one in our head and one in our gut, helps us to understand this relationship. The impact of hypoxia to the CNS can appear as damage to parts of the brain that control movement and thinking. The impact from the same hypoxic event can cause damage to the ENS which will appear as dysfunction of the organs and intestinal tract. This is why these children seriously suffer from constipation and other dysfunctions of the gut. A truly fantastic way to take care of the brain is to take care of the gut, states Elinor Silverstein.
In extreme cases Elinor sees the belly in these children become big and bloated, the head and neck arch back, their arms go to the sides, there is excessive sweating, and there can be difficulty breathing. Some part of their nervous system is being triggered because of existing damage in the ENS from the oxygen deprivation. As a seizure can move through the brain in the Central Nervous System, this same kind of chaos can move through the Enteric Nervous System. Stress can trigger it. Hunger can trigger it. Anything that jolts the system can trigger it. Elinor says this can be worked with and these children can be helped. We are teaching them to have tools to self regulate.
In addition to the existing trauma to the ENS that occurred at or near birth, or in utero, there can be all the issues Elinor has discussed in previous articles, such as reduced or non existent vitamin and mineral absorption and wastes being reabsorbed back into the systems and taxing the tissues, the cells of body, and the body’s ability to eliminate waste and toxins.
Elinor Silverstein has shared video of her teachings on Youtube. Below are some examples with a brief description. For more videos go to Elinor’s Youtube Channel and browse for her videos about children with special needs.
Example 1 – Dylan – Cerebral Palsy, Seizures
Dylan would improve and be great for a week and then go backwards. We needed to work with his gut health, said Elinor. He had very strong cerebral palsy, was hospitalized frequently with seizures.. Eventually, if he regressed he could return to balance with a 30 minute lesson. Sadly, Dylan recently passed away very quickly from what might have been a flu virus. Have no doubt he lived a very gracious, happy, and fulfilling life through his young childhood. Here are short video clips filmed with Elinor Silverstein in which she discusses the things that helped him be a vital little guy.
Example 2 – Miles – Very Important talk – Methylation and the Liver’s ability to detoxify
A short video in which Elinor explains methylation of the liver, and what it means, it’s vital importance, and how to check for MTHFR gene variations. It’s a Simple, simple, simple test for the MTHFR gene variation. Elinor explains how methylation relates to the FM and how we might approach it.
Recorded on January 6, 2011 using a Flip Video camera. Video quality is poor, but the content is so valuable Elinor wanted to include it here.
(video coming soon)
Example 3 – Annabelle – Working with metabolic issues 3.1 (part 1 of 3)
If you would like to view a complete lesson with Elinor Silverstein, here is a the first part of a 4 part series of videos showing one lesson with Annabelle. You can hear conversations between myself and the parent exploring the ideas about metabolism and it’s impact on the movement disorder in their child.
Some signs Elinor has mentioned that might indicate your child’s issues with their musculoskeletal system/brain might be connected to their Gut:
- One eye moving differently than another (alternative issue to strabismus) nutritional deficiency
- Teeth not erupting and positioning correctly – nutritional issues
- Eyes showing more white around eyes – strong indication of processing issues
- Breathing pattern seems to be very quick – erratic – possible nerve tone issues
- Scratching, itching, skin problems-nutritional issues, especially fatty acid deficiencies
- Bright pink cheeks, or face suddenly turning red -allergies, possible reaction to food(s),
- Ears flushing – possible nervous system dysfunction
- Baby crying from lying on back in stroller in malls but fine on stomach – processing issues – overwhelmed by stimulation from floursecant lights and passing images
- Babies’ reactions to things nursing moms eat – watch for skin color, eyes, mouth shape, temperament changes
- Spasticity – issues with the nervous system, and/or with B vitamin deficiency
- Torticollis – turning of the head to one side with a twist of the spine – B vitamin deficiencies, especially methylated folate.
- Scoliosis – possible ENS dysfunction
- Seizures – can indicate CNS and/or ENS (gut) issues
- Nutritional deficiencies -Can be seen as cravings, issues with skin, hair, behavior, and/or sleep
- Belly distended – never normal – can be formation of Gas/Wind – swallowed air – reaction to food, sign of inflammation and swelling in the viscera
- Diarrhea – possibilities: pancreatic enzyme issues, gut bacterial flora not normal, sphincter disregulation
- Constipation – possibilities: food sensitivity/allergy, gut flora not normal, issues with mobility and motility of gut intestines and organs, sphincter disregulation
Seeking more information
Here are some of the professionally specialties that help with these areas of health and well being. Interview the professionals to make sure their specialty or they cover these concerns. Bring list of your concerns and your child’s symptoms.
Pediatric Functional Medicine Doctor – Institute for Functional Medicine (IFM)
Naturopath
Homeopath
Pediatric Immunologist
Pediatric Allergist
Metabolic Specialist
Pediatric Nutritionist
Elinor says “An educated parent is a happy parent. An educated, happy parent makes for a happy and healthy child. Now that you have some tools for viewing your child more fully, you can use your eyes and know what you see, and what you can do to work with him/her. This way your child can have a world of possibilities for growth and well-being. And that is a gift.”
Future articles in this series will focus on the Vagal nerve connection between Gut and Brain, nutritional supplement recommendations for healthy guts, and how to get more information through testing.
Variety Creates Learning Opportunities
There are situations when the opportunity to learn and change are enhanced. I knew that my son, Don, was creating this for himself when he chose to try a new piece on his wheelchair for positioning. There is so much different about how he is supported and sitting with this new equipment that his brain needs to re-calibrate how it solves the challenge of being upright in gravity. I wanted to influence that as much as possible by making sure that he has access to all of himself – no stuck patterns or simplifying his skeleton by holding parts immobile – and by making sure that he was creating new relationships between parts of himself that helped him move easily and with balance in gravity.
Many people know that my son has quite severe athetoid type cerebral palsy, also called torsion dystonia. We found out at 15 years old that he also has a milder form of spina bifida affecting one of his lumbar vertebrae. At 29 years old, Don has had years of Feldenkrais and Anat Baniel Method lessons. He has been driving a power wheelchair since he was two years old.
The new equipment is a bar, called a sub-ASIS bar, which replaces the traditional seat belt for holding his hips. When he was younger we declined this option because it just looked uncomfortable and harsh. Don has been asking for his seat belt to be tighter and tighter trying to gain control. His movements and balance have become more and more about trying to find stability by pressing into something or tightening up muscles in a rigid pattern. Recently, Chris Wright-Ott gently suggested this bar again based on her years of experience working at Stanford Childrens’ Rehab and the Bridge School. I respect her opinion so much that I also recommended to Don that he give it a try. Chris says that the goal is to give him an anchor, or point of support. What I see is that it immobilizes his pelvis.
Don’s movement disorder is about not being able to use gravity. He is not efficient with how he pushes against the ground and he looks for stability by tightening muscles to reduce all those moving parts. Learning balance is very difficult when you don’t have a “down” and an “up” and movement options are reduced. Balance is about being able to constantly correct for your head not being vertical. The more moving parts you have to fluidly compensate the smaller the balancing movements can be. (There’s a good reason that we have all those vertebrae in our spine.) Cirque du Solell performers balance with such small movements that your eye can barely see them. They tighten up nothing. 
Remember first learning to ride a bicycle? Yeah – big movements to balance until you relaxed, left your head in the center and used all of the rest of you to make tiny changes to keep your head centered and vertical. Having Don’s type of cerebral palsy is very similar to that first bicycle experience.
Don has gradually worked up to using the bar for most of the day. It has not caused discomfort and now does not keep his attention at all. We started noticing differences in how he used his torso and the uprightness of his head within 1 to 2 weeks. I was excited when he started saying muscles were sore in unusual places. I knew that meant his brain was coming up with new solutions that used his muscles in ways he hadn’t been using them before.
With his pelvis immobile Don has a different foundation for lining up his skeleton. His pelvis is now an anchor. Typically developing infants learn to use themselves this way. As adults we take for granted that we sit on a base. Don has never had this experience before. I wondered what his brain would do with it. How would he stack up his spine, ribcage, shoulders, neck and head? Would he be able to do more balancing and less clenching with this stable base?
We’ve started doing lessons in week three. I have been traveling a lot so it has been awhile since we have done a series of lessons together. Since it has been so long I expected him to have lots of trouble settling down on the table and stopping compulsive muscle contractions. I was pleasantly surprised when half way through the first lesson he took a big breath and just settled down. The next lesson it only took moments. There were major issues, which we’ve worked with in the past, with how he was lining up the vertebrae in his lower back (that vulnerable spina bifida area) and his neck, but they changed so quickly that I was amazed. It feels like Don has the opportunity to create something that was never possible before. Today I took these photos because I was so excited about the learning he is doing.
One of my concerns was that by adding this bar, which is a compensation very much like a brace and is an external substitute for learning, Don would lose ability to sit when not in the wheelchair. Quite the opposite is true as you can see. His whole system is quieter, he is wiser about using gravity, and able to balance with far less effort. He has real confidence about his ability to keep himself safe sitting on my table.
I’ll put a video here showing how Don gets back into his chair after lesson #4 once I figure out how to upload it.
I’m excited about the opportunity that Don has created and really looking forward to exploring where he can go with this. This is not a solution for every person in a wheelchair but you can see that the novelty and variety of trying something new gives an opportunity for new experience and learning.