The Science of Spinal Health

Origins of CBP®

Part II : By Don Harrison, PhD, DC, MSE

My Discovery of Mirror Image® Adjusting

In November of 1979, Dr. Dan Murphy, who was my roommate in college, and I obtained a loan from Bank of America, with Deanne’s (my late wife) house as collateral. We leased a 2100 square foot suite in Bell Plaza Shopping Center on El Camino Real in Sunnyvale, California. Dr. Murphy and I were practicing Pettibon at the time. We had an examining doctor, Jeff Blanchard, DC, who worked for us until June 1980. While I was just in practice in March 1980, I had a difficult case (I’ll call him John for identification) on Friday afternoon.

I adjusted John with the Pettibon upper cervical instrument per Pettibon’s procedures as a Left Against the Angles configuration on the nasium view. (See Figure 1) The Pettibon procedures (at that time in 1980) required calculating a line of drive with a 5 part formula that included the lower angle (on the nasium AP cervical view) multiplied by his “CLF”. This Pettibon Cervical Leverage Factor was derived from a right triangle with Grostic’s arm length as one side and a one inch height vector as the other side. Arctangent of the ratio yielded a 2.38° angle and Pettibon rounded this off to 2.5. Pettibon had a plastic x-ray tool that was placed over the lateral cervical radiograph. It had CLF = 2.5 for a normal Ruth Jackson’s angle and 5.0 for a military cervical configuration. In typical fashion, Pettibon claimed that he did research with the University of Washington to discover these CLF numbers. A similar procedure for determining a line of drive consists of multiplying 2.38° by the lower angle in Atlas Orthogonal technique (Dr. Roy Sweat).

Figure 1  Pettibon Left Against the Angles Configuration was “adopted” from  Grostics’Against the Kink definition. The left designation comes from the acute upper angle between the atlas plane line and a center skull line.

Figure 2 Pettibon’s Left Against the Angles Set-up

In the Pettibon procedures, the Left Against the Angles configuration was set up as follows: 1) left side of skull superior on head block, 2) head lowered towards floor  (which is actually a lateral head translation) and 3) shoulder rolled to side of the C2 spinous position on the nasium view. (see Figure 2)

After adjusting John’s atlas with the Pettibon cervical instrument, Pettibon’s procedures required that a post nasium be taken to ascertain if improvement was made in the angles constructed (along with a leg check of course!). Dr. Blanchard was taking the x-rays and reported no improvement. The Pettibon procedures then called for increasing the line of drive by adding an additional factor of LAxCLF. After several of these attempts, my line of drive was 105°! I finally realized that “all I had to do was drill down through his parietal bones, brain, and condyles to hit the atlas at this magic line of drive”! Frustrated, I asked this patient (John) to come in the next morning (Saturday) when no other patients would be in the clinic (but he and I) and I would concentrate on getting him corrected. He agreed because he had some severe symptoms and appreciated my extra concern.

On Saturday, after another failed upper cervical adjusting attempt on John, I was taking the post nasium radiograph myself. At that time we were using a positioning chair to help center the patient in the head clamps. As I turned the chair to get John’s head to look forward between the head clamps, I suddenly realized that his right head rotated posture was creating the lower angle on the nasium x-ray. (see Figure 3 below) I stopped right there and asked John to return to the upper cervical instrument for a different set-up. I laid him on his back, turned his head to the left 90° and applied the force perpendicular to the skin over the atlas TP on the opposite side (right), i.e. no line of drive. I asked him to sit up straight and assume a comfortable head position. His head was NOT rotated! I took the post nasium and was satisfied to find near perfect alignment. John’s symptoms started to subside and he went home.

Figure 3 Head axial rotations project an oblique of the cervical lordosis to appear as a lower angle with a Pettibon “uncompensated” CD angle at C5.

As I sat in my office chair that day, I wondered why, in 50 years since Dr. Wernsing first took a nasium, that no other upper cervical chiropractor had noticed that the nasium angles came from different head postures. I began to wonder what nasium configurations might result from head lateral flexions and other combinations of postures.

I decided that on the following Monday, I was going to inspect every patient’s head posture and their nasium x-ray image to see what I could learn. I also decided to reverse whatever posture I observed in the patient’s head and to completely disregard Pettibon’s set-up rules. Within a month, I knew that head lateral flexions projected as “Into the Kinks” on the same side. (Figure 4) I also discovered that combinations of head axial rotation and lateral flexion might cancel (appear aligned on the nasium) or add in severity and appear as huge angles depending upon if these postures were ipsi-lateral or contra-lateral. (Figure 5) I began to realize that most upper cervical techniques had learned with their “cook book rules” to “straighten” the nasium alignment by actually making the patient’s head posture worse, i.e. create double combinations of head posture.

Some head postures were very difficult to reduce due to soft tissue changes. I began to use both hands to stress head lateral flexions and rotations as maximally as I could to achieve normal head posture. While I was seated facing my cervical instrument, I put a mirror above and behind me on the wall so that my patients could see their own postures, as they sat on the cervical instrument bench, before and after I adjusted them. I stopped taking nasiums after every upper cervical adjustment (my patients appreciated less exposure) and waited to take these posts until after 2 months of care. I knew immediately that if their heads appeared more centered, then their necks were better aligned.

Figure 4  Head lateral flexions project as Into the Kinks with a “low plane line”

Figure 5 Combinations of head rotation and lateral flexions can cancel on the nasium if these are contralateral or appear as huge displacements if these are ipsilateral.

I began to realize that I was in a difficult position. I was teaching Pettibon technique at Northern California College of Chiropractic (NCCC became Palmer-West) and teaching his seminars but not practicing his technique! At the end of April 1980, I decided to show Pettibon what I was discovering. At first he tried to tell me that stressing necks like I was doing would inhibit any correction. As I put multiple sets of pre-post on the view box in front of him, he finally admitted that he had never made such complete reductions as he was seeing. He decided that he would let me teach this postural adjusting as an advanced Pettibon seminar in June 1980. However, as the time grew near, he informed me that I could only teach rotating the patient on his/her back or stomach as a “super stress” for his CD angle and that I was not to teach reversing posture. I was very discouraged, but I did as he wished. However, in December 1980, when I split with Pettibon, I began to teach the details of Mirror Image® Postural AdjustingSM as CBP® Technique. There are still some interesting details in 1980 that I would like to share.

In the fall of 1980, there was a NCCC student, now Dr. Harry Wong, who was very interested in what I was doing with posture. He had taken the Pettibon class from me and when he came to observe my clinic he noticed that I was doing something entirely different. I began to teach him what I had discovered so far. He saw me lower the head for lateral translations (I had the regrettable name of head deviation for it at that time). He asked me how those postures appeared on a nasium and I told him that I did not know yet. He suggested that we x-ray some NCCC students and find out. Figure 6 illustrates what we discovered for the nasium image of a right lateral head translation. He arranged to have about 25 students come for 14 nasium x-rays each (3 rotations of different degrees to right, 3 rotations to left, 3 lateral flexions to left, 3 lateral flexions to right, left translation of 1 inch and right translation 1 of inch). Figure 7 illustrates this private study. Later I often wished that I had known something of research design at that time, because I could have published that study.

Figure 6  Lateral Head Translations project as “INTO the KINKS” on Nasium images with a small upper angle (UA), slightly elevated atlas Plane line (APL), and an extra angle at T2 (UTC).

Figure 7 Different x-ray positions of posture and their nasium images.

One of my most fun experiences was at my friend Dr. Dan Murphy’s expense. He taught for Pettibon also. In the beginning, I did not tell anyone except my brother about what I was discovering about postural adjusting. I wanted to wait until I had something coherent to explain in detail and I still had more to learn. However, one Saturday in April 1980, I came into our clinic to do some PI reports and observed Dan and Dave Lungren adjusting Dave’s wife, who had a terrible headache. They had multiple post-nasiums on the view box and were trying to decide what to do next according to the Pettibon rules. I noticed that she had a right head lateral flexion, but her upper angle was abnormally on the left side and that Pettibon would classify this as a left Against the Angles. I told them that what they were doing wouldn’t correct her and that I could. They ignored me and kept trying Pettibon, so I went back to my paper work, but only after replying that when they gave up, I would be around!

About an hour later, they finally asked for help. I laid her down on the opposite side (they were placing her in side posture with left side up according to the Pettibon rules). With her in the right side posture position, I bent her head over the head block as stressful as I could for reversing the right head lateral flexion, and then tapped perpendicular to the skin over the atlas area. Figure 8 illustrates this Mirror Imageä postural set-up.

Figure 8  In 1980, I began to maximally stress lateral flexion postures of the head into the mirror image posture over the head block (the patient was in side-posture on the bench of an upper Cervical instrument).

I asked her to sit up, close her eyes and nod her head twice. She sat with her head vertically centered to her episternal notch and without saying anything I walked off. They couldn’t believe it and took another nasium; she was near zero/zero in displacement from 90 degrees in the Upper, Lower, and CD angles. They demanded to know what I had done and why because it violated all Pettibon rules. I told them that I couldn’t tell them; it was a secret! Finally, I explained what I knew at that time and Dr. Murphy began to use mirror image postural adjusting.

During the early years of developing CBP®, I would talk once per week on the phone with my brother Glenn. He was younger than I was, but he had become a DC one year earlier than I in 1978. After adjusting head to rib cage postures as I explained on the phone to him, he suggested that we reverse the postures of the rib cage as I had done with the postures of the head in the AP view.

Next time, I will explain how my brother, Dr. Glenn Harrison, got me to mirror image these thoracic cage postures in January 1981.