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2014-2015 – Manual Lymph Drainage Therapy – Dr Bruno Chikly, MD, DO, LMT

Lymph Drainage Therapy is an innovative hands-on method of lymphatic drainage developed by Bruno Chikly. It is a gentle technique that works through the body's interstitial & lymphatic system to activate the body's liquid circulation & stimulate the functioning of the immune & parasympathetic nervous systems.

LDT is the first technique that enables practitioners to detect & palpate the specific rhythm, direction, depth, & quality of the lymph flow anywhere in the body. LDT practitioners develop “listening” skills to assess & enhance overall circulation as well as to identify areas of fluid stagnation (lymph, interstitial, synovial fluid, etc) or fibrosis, & determine the best alternate pathways for drainage. Practitioners learn how to “map” the lymphatic pathways with their hands (Manual Lymphatic Mapping) as well as to assess the client before, during, & after the session.

Advanced LDT practitioners develop the skill to perceive & respond to the body's innate ability to heal itself. They learn to reroute lymph following the subtle indications given by the body, thereby enhancing the healing process. This eliminates mental mistakes in assuming we know what the body needs & therefore enforcing pathways that are not optimal. Honoring the intelligence of the body ensures deeper & long-lasting results.

• LDT-1: Lymphatic Pathways: Anatomical Integrity – Anatomy: Superficial lymphatic system of the anterior body. Traditional lymph drainage techniques with an added level of precision. Detect the specific rhythm, direction, depth, & quality of the lymph flow as well as areas of stagnation.

• LDT-2: Pathological Pathways / Manual Lymphatic Mapping – Anatomy: Superficial lymphatic system of the posterior body. Review & hone existing skills learned in LDT-1. Assess & drain the superficial lymph circulation over the entire body as well as the cisterna chyli & the breast tissue. Explore the impact of cancer treatment on the lymphatic system & learn the foundational principles of lymphedema care along with numerous other pathological conditions. Detect restrictions in the fascia & learn to release these restrictions with Lympho-Fascia Release (LFR).

• LDT-3: Deep Pathways: Viscera, Articulations, Organs of the Senses – Continue to build on the knowledge & skills learned in previous classes. Explore deeper lymph pathways & interstitial flow. Learn techniques to address the sense organs, the viscera, and the joints of the body.

• LDTA-1: Lymph, Interstitial Fluid & Blood; Applications to Humans, Animals & Plants – Expand understanding of the blood, lymph, & interstitial fluid, including applications to humans, animals, & plants. Learn mapping of the superficial & deep lymph flow, the layers of fascia, & interstitial fluid. Identify interstitial fluid stagnation & learn techniques to release, with applications for edema, fascia, muscles, skin (i.e. scars & acne), & articulations (joints). Assess & release areas of the central nervous system (including pia & dura maters, ventricles, & spinal canal), blood vessels, ear canal, & more. Learn advanced applications for the viscera (organs). Explore microanatomy / microphysiology & the applications for cells & organelles.

Jean-Pierre Barral, DO, MRO(F), RPT

Jean-Pierre’s methods of manual manipulation are not just another form of manual therapy that we add to our work, but rather it is a style of communicating with the body. “We do these techniques, not to FIX something in the body, but to ‘wake up a little something'” as Jean-Pierre says over & over again.

“What we are wanting to do is give the body a clear message… to be specific in a short time.” He says these things over & over. These are his messages of proprioceptive communication: his unique style & approach to working with patients; to have & hold this deep appreciation of the messages of the body; to hear him say, “Ahh you know, you can fool yourself with your stories; only the tissues know.”

2015-2016 – Visceral Manipulation – Jean-Pierre Barral

Visceral Manipulation studies the models & theories of functional biomechanics as viewed from Barral's innovative approach. It teaches how to assess structural relationships between organs & their fascial or ligamentous attachments to the musculoskeletal system. This method of evaluation & treatment is based on the concept that each of our internal organs rotates on a physiological axis.

The visceral system relies on the interconnected synchronicity between the motions of all the organs & structures of the body. At optimal health, this harmonious relationship remains stable despite the body's endless varieties of motion. But when one organ cannot move in harmony with its viscera due to abnormal tone, adhesions or displacement, it works against the body's other organs & muscular, membranous, fascial & osseous structures. This disharmony creates fixed, abnormal points of tension that the body is forced to move around. That chronic irritation, in turn, paves the way for postural distortion, neuromuscular dysfunction, & disease processes.

• VM-1: Abdomen 1 – Study & assess structural relationships between abdominal viscera & their fascial or ligamentous attachments to the musculoskeletal system. Focus is on the abdominal cavity & includes the organs, their membranes, ligaments, innervation & their spatial functional interrelationships. Introduction to Listening Techniques. Learn to evaluate & treat the organs & their attachments.

• VM-2: Abdomen 2 – Expand on structural & functional anatomy, hand placements & techniques learned in VM-1 to gain a deeper understanding of the abdominal cavity & its relationship to the cranial, thoracic, & pelvic cavities.

• VM-3: The Pelvis – Study & assess the relationship between functional & structural mechanics of the pelvis. Evaluate & treat organ systems of the pelvis & their attachments. Integrate the pelvic organs with the complex ligament system of the body regions, & differentiate between somatic & visceral causes for pelvic & low back problems.

• VM-4: The Thorax – Study & assess the anatomy, biomechanics & function of the thoracic organs & their attachments. Explore the relationship between the hard frame & soft frame with its countless articulations for respiration, circulatory requirements and upper body movement patterns. Evaluate & treat the organs & articulations of the thoracic cavity. Learn how to differentiate between somatic & visceral causes for thoracic & spinal problems.

2021-2022 – Listening Techniques – Jean-Pierre Barral

Listening Techniques are specific & precise palpation tools developed by Jean-Pierre Barral, which enable the practitioner to fine-tune assessment skills. The evaluation phase of a patient’s treatment session is key to long-lasting results. Through precise evaluation techniques, the practitioner is able to determine, and focus on, the primary causes of a patient’s dysfunctional pattern.

The most fundamental, yet most complex, question that a practitioner faces when working with a patient is, “How do I determine what are the reasons for this person’s pain and dysfunction?” Listening Techniques assists the practitioner in answering that question.

The body offers information regarding imbalances & dysfunctions, as well as what treatment approaches are most appropriate for best results. Practitioners learn to interpret the information the body is offering, & through precise evaluation techniques, they are then able to determine & focus on the primary causes of a patient’s dysfunctional pattern.

• LT-1: Listening Techniques 1 – Review listening techniques learned in VM-1 that help guide the practitioner to the appropriate manual manipulation site. Learn to better interpret the information the body is offering regarding imbalances, dysfunctions, involved structures & systems, & appropriate treatments. Enhance specificity when evaluating the body for restrictive patterns which will enable more effective treatment applications.

• LT-2: Listening Techniques 2 – Deepen listening techniques that help guide the practitioner to the proper manipulation site. Expand on skills learned in LT-1. Enhance precision & specificity. Focused listening on the brain, nerves, vascular system & articulations.

2023-2025 – Neural Manipulation – Jean-Pierre Barral & Alain Croibier

A nerve only functions correctly when it is able to move freely within its surrounding structures. This freedom of movement is essential for: nerve conduction, electromagnetic conduction, intraneural blood supply, intraneural nerve supply, local & systemic responsiveness. By understanding the detailed anatomy of the nerves & nervous system, one can clearly see the potential for pathological change when nerves are restricted. Manual therapy, as it applies to the treatment of nerves, follows the standard principles of mobility & function.

Neural Manipulation as developed by Barral & Croibier examines mechanical relationships between the cranium/spine hard frame to the dura & neural elements. It provides assessment & treatment approaches to address restrictions of the dural and neural components not commonly focused on with musculoskeletal symptoms. Neural Manipulation identifies & releases local nerve restrictions while at the same time examines the effect these local fixations have on the rest of the body, & by accessing this relationship, resolves the more comprehensive (global) dysfunctional patterns.

• NM-1: Neuromeningeal Manipulation: An Integrative Approach to Trauma – Explore the biomechanics of trauma, especially whiplash, its effect on the nervous system, & application for treatment. Understand how whiplash creates restriction patterns throughout the whole body, including within the cranium & brain. Learn to evaluate & identify techniques that encompass the whole body. Learn to assess & treat soft-tissue injuries to the cervical region to obtain optimal release. Learn new applications of VM principles & techniques as they can be utilized for patients presenting with whiplash & other conditions involving trauma.

• NM-2: Neural Manipulation: Peripheral Nerve Manipulation: Upper Body – Explore in detail the anatomy & function of the peripheral nerves of the upper body. Discover typical pain patterns that arise from their dysfunction. Learn evaluation methods & treatment techniques to facilitate normal nerve function. Discover various methods for releasing nerve restrictions.

• NM-3: Neural Manipulation: Peripheral Nerve Manipulation: Lower Body – Explore in detail the anatomy & function of the peripheral nerves of the lower body. Discover typical pain patterns that arise from their dysfunction. Learn evaluation methods & treatment techniques to facilitate normal nerve function. Discover various methods for releasing nerve restrictions.

• NM-4: Neural Manipulation: Cranial Nerve Manipulation – Explore in detail the anatomy & function of the brain & cranial nerves. Learn typical pain patterns that arise from their dysfunction. Learn evaluation & treatment techniques to facilitate normal function. Learn differential evaluation skills to determine skull, suture & brain fixation. Explore how compressions of the brain cause dysfunction in the cranial nerves. Discover how intracranial pressure affects the function of the entire body, & learn cranial techniques to restore normal functioning.

2025 – Advanced Visceral Manipulation Courses – Jean-Pierre Barral, D.O.

• VMAT: Advanced Visceral Components of the Neck & Thorax – Build on the knowledge & techniques learned in VM-4: The Thorax. Delve deeper into the anatomy, breathing mechanism, function, & physiology of the organs & structures of the thorax. Learn more specific & precise advanced techniques for the thoracic structures, ligaments, & fascia.

• VM-5: Manual-Thermal Evaluation & Viscero-Emotional Relationships – Body cavities & techniques learned previously are revisited. New evaluative tools for listening to the "messages of the body" are learned with focus on organs & their relationships to the neuro-musculoskeletal structures. Techniques learned are essential to evaluate & treat the whole person.

• Manual Thermal Evaluation: Utilizes sensitivity to temperature changes to identify areas of physical & emotional dysfunction within the body. This very scientific method was developed by Barral, a physicist & engineers, & verified by a special thermal scanner.

• Viscero-Emotional Relationships: Practitioners learn to go deeper into the evaluation of dysfunctions of the body & integration of body/mind in a “tissue listening” way.  We do not guess where emotions are stored; we feel them with our hands. The techniques learned are as specific as those learned in the previous levels of the visceral work. This work is unique with its “nonverbal dialoguing” & mechanical ways of linking body to mind.

• VAP: Visceral Manipulation: Application for Pediatrics – Embryology & developmental landmarks (normal & abnormal) that occur during & after gestation are studied. Understand how early therapy on newborns & infants can possibly reduce the percentage of problems later in life. Treatment ideas for children of all ages, & for those who are tactilely sensitive are explored, as well as special considerations (surgeries, prematurity, neuromotor problems & craniosynostosis). Integrate specific treatment techniques for common visceral restrictions found in children, as well as Barral's approach to cranial techniques. Learn pediatric precautions & contraindications.

Hopefully in Autumn 2025

• Clinical Interventions: Concussion Recovery; Barral Manual Therapy -- Understand the concussion injury from acute to chronic. Explore the mechanism & physiology of a concussion & how it affects the entire body. Understand the importance of the diaphragm for the body-head connection. Explore the basic premise & clinical reasoning for neurological, visceral & fascial manipulation for the concussion patient & learn specific visceral techniques for recovery. Identify how specific manual therapy can enhance our treatment outcomes for concussion injuries & their related symptoms (such as head pain, cervical dysfunction, loss of memory, depression, anxiety, fatigue & sleep disorders). Palpate & identify deeper fascial restrictions within the articular, diaphragmatic, visceral, neural & vascular systems of the body as they relate to clinical tests & treatments; Understand the connections between the organs, emotions, trauma & pain for concussion recovery; learn & understand the connections between sleep, mindfulness & emotions. "If there has been a trauma, there will always be an emotional component that must find a way to release."  Jean Pierre Barra

• Clinical Interventions: Pregnancy, Labor/Delivery & Postpartum Care for Mother & Baby; Barral Manual Therapy -- Learn to identify how specific manual therapy can enhance treatment outcomes for pregnancy, mother & baby. Understand the connections between organs, emotions, trauma, & pain. This class does NOT teach internal work.

HOPEFULLY IN 2026

• NM-5: Neural Manipulation: Central & Peripheral Connections -- Discover the most recent advancements & expand on concepts & applications of NM. Continue to build on the techniques presented & practiced in NM-1 to NM-4. Explore in more detail the anatomy & function of the Brain, Cranial Nerves, and Peripheral Nerves.
  “We can attest to the notion that there are more beautiful subtleties still to discover. In NM-5, we expand on those areas, & elaborate in depth on many parts of the nervous system.” – JPB

• Manual Approach to the Brain (1, 2, 3, 4) – “Approaching the brain manually allows us to perceive its responsiveness & its complexity. We feel it come alive under our hands, sometimes in unpredictable ways. This work offers a new therapeutic approach to working with people with brain problems so we might improve the lives of countless people who seek help.”  – JPB

Jean-Pierre Barral has been interested in the brain for over forty years. After treating many people with head trauma, stroke, brain diseases, & psychomotor disabilities, he has developed original techniques to help these patients. Barral demonstrates how to work simply with what is considered the most complex organ of the human body—the brain.

The objective of this manual approach is to help improve the functioning of the different circuits of the brain by addressing the circulatory, fluidic, meningeal, neural, & electromagnetic systems that are brought into play during daily activities. It is thus possible, by precise manual therapy techniques, to come to the aid of patients who have been afflicted with such ailments as brain damage, trauma or stroke, as well as aiding those with neurodegenerative diseases, depression, as well as those patients with both motor & sensory dysfunctions. 

• Manual Approach to the Brain 1: Two parts – structural & functional approaches --
  The structural approach is aimed at the vascular, nervous, meningeal, ocular, barometric, & cerebrospinal fluid circulation systems.
  The functional approach explores the sense of smell, hearing, sight, language, coordination, proprioception, emotions, etc.

Practitioners learn to view systemic diseases in a new light. This includes discussions about such conditions as Parkinson’s disease, Alzheimer’s disease, & Multiple Sclerosis. Such pathologies & the limitations of manual therapy with regards to helping people with these conditions are discussed, as well as how a manual approach to the brain may transcend these limitations & help alleviate symptoms that people are experiencing due to these diseases.

Barral shares how precise manual therapy may encourage the central nervous system to self-repair and thus may help people with certain conditions. The practitioner will also learn ways to help people who have had a stroke or ictus. Because the brain is inherently plastic, the tools learned enables the practitioner to help restore 'inner bridges' within the brain, which is vital to the life of those facing difficulties. The principle underlying this work is the striking of a balance between the ease of minimum manual effort & the finesse of maximum manual precision.

• Manual Approach to the Brain 2 (MAB2) – builds upon the foundations laid in MAB1, delving deeper into the intricate workings of the brain. It broadens its scope by incorporating additional structures and functions. This comprehensive course encompasses a range of areas, such as the ear, language, pain, emotions, memory, balance, the pituitary and the hypothalamus.

• Manual Approach to the Brain 3 (MAB3) delves deeper into the realm of patient care, specifically focusing on individuals with specific conditions. This advanced material empowers manual therapy practitioners to adopt a fresh perspective when approaching systemic diseases. The course explores a range of conditions, including Parkinson’s disease, Alzheimer’s disease, Tinnitus, and Multiple Sclerosis. Engaging discussions revolve around understanding the intricacies of these pathologies and the limitations of manual therapy in addressing the unique challenges faced by individuals with these conditions. 

• Manual Approach to the Brain 4 (MAB4) delves deeper into the realm of patient care, specifically focusing on individuals with specific conditions. This advanced material empowers manual therapy practitioners to adopt a fresh perspective when approaching systemic diseases. Engaging discussions revolve around understanding the intricacies of pathologies.