How I work.
Twenty-three years of practice have taught me one thing more reliably than any technique: the body you are treating knows more than your diagnosis of it. Everything follows from that.
Listening before doing
The first part of every session — sometimes a surprising amount of it — is an attempt to understand what is actually happening, rather than what I expected to find. This begins with conversation: what brings you in, what you have already tried, what you would like to be different in three months. It continues with hands-on assessment, which in practice means following what I find rather than applying a sequence.
This is what Robert Fulford called Eclectic Practice: holding many tools lightly, and using what each particular body and each particular moment requires. Over two decades I have studied structural, cranial, visceral, myofascial, and biodynamic approaches. I do not choose between them according to a protocol. I choose according to what I find.
Bodies exist in gradients
My thesis on complexity in Osteopathy — written in 2003 and still the frame I work within — started from a simple observation: the body does not have discrete states. Tissue is not locked or free. A system is not regulated or dysregulated. Everything exists somewhere in a gradient: a particular quality of tone, restriction, fluidity, or ease.
Perceiving where in that gradient a person is, session by session, is a different skill from applying a technique to a named condition. It means the treatment for two people with the same presenting complaint will often look different. This is not imprecision — it is the work.
What actually happens in a session
Sessions are sixty minutes. Most of that time is hands-on. You will lie on the treatment table, clothed; the work is slow and generally gentle. I will tell you what I am attending to as I go, and I will ask what you notice. Your feedback shapes what I do next.
At the end I will tell you what I found, what I worked with, and what I would expect over the following few days. If the work points somewhere else — toward a different kind of practitioner, or a different approach — I will say so then rather than later.
Trauma-aware in practice
This is a low-stimulation clinic by default: quiet room, warm light, no unexpected sounds, minimal scent. But trauma-aware practice is less about the environment than about how I read the session.
Before and during treatment, I pay attention to nervous system state — whether your system appears regulated and safe, or contracted and defended. Pace, contact quality, when to proceed and when to simply wait: these decisions shift depending on what I am reading. Not all bodywork practitioners work this way. For patients who have found other treatment uncomfortable, overwhelming, or ineffective, it tends to make a significant difference.
For more on how I work with neurodiverse patients and developmental trauma, see the nervous system page.
When I refer
I refer out regularly, and I will tell you early when I think something is outside my scope or would be better addressed by someone else — before you have invested more sessions in something that is not serving you.
I commonly work alongside or refer to: pelvic floor physiotherapists, trauma therapists (when patterns are primarily relational or psychological rather than somatic), GPs when a working diagnosis is needed before treatment makes sense, and specialist physiotherapists for post-surgical or complex orthopaedic presentations.
How often
Most people work through a first course of three to four sessions. The gap after the first session is typically two weeks; subsequent sessions run about three weeks apart, at sixty or forty-five minutes depending on what the work requires. The aim of that arc is specific: clearing what has accumulated, establishing a more stable baseline. Setting foundations.
After that, the choice is theirs. Some return when something new comes up. Others come once or twice a year — often in winter, going towards spring — to work through what the preceding months have held in the body and to settle into what the next season will ask of it. I will not suggest it if I do not think it is warranted for you. But for patients who have found that rhythm useful, it tends to matter more than random as-needed visits.
I will tell you when I think you are done.