Alexander technique

The Alexander Technique teaches the ability to improve physical postural habits, particularly those that have become ingrained and conditioned responses. The technique can improve performance, self observation and impulse control and relieve chronic stiffness, tension and stress.

The technique is named after Frederick Matthias Alexander, who, in the 1890s,^[1] developed its principles as a personal tool to alleviate breathing problems and hoarseness during public speaking. He credited the technique with allowing him to pursue his passion for Shakespearean acting.^{[citation needed]}

History

Alexander was a Shakespearean orator who developed voice loss during his performances. After doctors of the era informed him they could find no physical cause, Alexander reasoned that he was doing something to himself while speaking to cause his problem. His self-observation in multiple mirrors revealed that he was contracting his whole body prior to phonation in preparation for all verbal response. He developed the hypothesis that this habitual pattern of pulling the head backwards and downwards needlessly disrupted the normal working of the total postural, breathing and vocal mechanisms. After experimenting to develop his ability to stop the unnecessary and habitual contracting in his neck, he found that his problem with recurrent voice loss was resolved. While on a recital tour in New Zealand (1895) he began to realise the wider significance of head carriage for overall physical functioning.^{[citation needed]} Further, Alexander observed that many individuals commonly tightened the musculature of the upper torso as he had done, in anticipation of many other activities besides speech.

Alexander believed his work could be applied to improve individual health and well being. He further refined his technique of self-observation and re-training to teach his discoveries to others. He explained his reasoning in four books published in 1918, 1923, 1931 (1932 in the UK) and 1942. He also trained teachers to teach his work from 1930 until his death in 1955. Teacher training was interrupted during World War II between 1941 and 1943, when Alexander accompanied children and teachers of the Little School to Stow, Massachusetts to join his brother. A.R. Alexander also taught his brother's technique, despite being in a wheelchair.

The Technique

The Teaching Process

F.M. Alexander's approach emphasizes the use of freedom to choose beyond conditioning in every action. The technique is applied dynamically to everyday movements, as well as actions selected by students.

Because of a change in balance, actions such as sitting, squatting, lunging or walking are often selected by the teacher. Other actions may be selected by the student, tailored to their interests or work activities such as hobbies, computer use, lifting, driving or performance in acting, sports, speech or music. Alexander teachers often use themselves as examples. They demonstrate, explain, and analyze a student's moment to moment responses as well as using mirrors, video feedback or classmate observations. Guided modeling with light hand contact is the primary tool for detecting and guiding the way past unnecessary effort. Suggestions for improvements are often student-specific.^[2]

Exercise as a teaching tool is deliberately omitted because of a common mistaken assumption there exists a "correct" position. There are only two specific exercises practiced separately; the first is lying semi-supine. Resting in this way uses "mechanical advantage" as a means of releasing cumulative muscular tension. It's also a specific time to practice Alexander's principle of conscious "Directing" without "doing." The second exercise is the "Whispered Ah," which is used to coordinate and free breathing & vocal production.

Freedom, efficiency and patience are the prescribed values. Proscribed are unnecessary effort, self-limiting habits as well as mistaken perceptual assumptions. Students are led to change their largely automatic routines that are interpreted by the teacher to currently or cumulatively be physically limiting, inefficient or not in keeping with anatomical structure. The Alexander teacher provides verbal coaching while monitoring, guiding and preventing unnecessary habits at their source with a specialized hands-on assistance. This specialized hands-on requires Alexander teachers to demonstrate on themselves the improved physical coordination they are communicating to the student.^[3]

Alexander developed his own terminology to talk about his methods, outlined in his four books. These terms were created to describe the sometimes paradoxical experience of learning and substituting new improvements.

Sensory appreciation

F. M. Alexander insisted on the need for strategic reasoning and "Constructive Conscious Control" because kinesthetic sensory awareness is a relative sense, not a truthful indicator of factual bodily relationship in space. The current postural attitude is sensed internally as customarily normal, however inefficient. Alexander's term, "debauched sensory appreciation" describes how the repetition of a circumstance encourages habit design as a person adapts to circumstances or builds skills. Once trained and forgotten, completed habits may be activated without feedback sensations that these habits are in effect, just by thinking about them.^[4] Short-sighted habits that have become harmfully exaggerated over time, such as restricted breathing or other habitually assumed adaptations to past circumstances, will stop after learning to perceive and prevent them.

End-gaining

Another example is the term "end-gaining". This term means to focus on a goal so as to lose sight of the "means-whereby" the goal could be most appropriately achieved. According to Alexander teachers, "end-gaining" increases the likelihood of selecting older or multiple conflicting coping strategies. End-gaining is usually carried out because an imperative priority of impatience or frustration justifies it.

Inhibition

In the Alexander technique lexicon, the principle of "inhibition" is considered by teachers to be the most important to gaining improved "use." F.M. Alexander's selection of this word pre-dates the modern meaning of the word originated by Sigmund Freud. Inhibition describes a moment of conscious awareness of a choice to interrupt, stop or entirely prevent an unnecessary habitual "misuse". As unnecessary habits are prevented or interrupted, a freer capacity and range of motion resumes, experienced by the student as a state of "non-doing" or "allowing."

Primary control

This innate coordination that emerges is also described more specifically as "Primary Control". This is a key head, neck and spinal relationship. The body's responses are determined by the qualities of head and eye movement at the inception of head motion. What expands the qualities of further bodily response is a very subtle nod forward to counteract a common backward startle pattern, coupled with an upward movement of the head away from the body that lengthens the spine. Students gradually learn to include their whole body toward their new means of initiating motion.

Directions

To continue to select and reinforce the often less dominant "good use", it is recommended to repeatedly suggest, by thinking to oneself, a tailored series of "Orders" or "Directions." "Giving Directions" is the term for thinking and projecting an anatomically ideal map of how one's body may be used effortlessly. "Directing" is suggestively thought, rather than willfully accomplished, because the physical responses to "Directing" often occur underneath one's ability to perceive. As freedom of expression or movement is the objective, the most appropriate responses cannot be anticipated, but are observed and chosen in the moment.

Psycho-physical unity

Global concepts such as "Psycho-physical Unity" and "Use" describe how thinking strategies and attention work together during preparation for action. They connote the general sequence of how intention joins together with execution to directly affect the perception of events and the outcome of intended results. ^[5]

Disadvantages

In the United Kingdom, there is some insurance coverage of the costs for Alexander lessons through the Complementary and Alternative Practitioners Directory. Otherwise, individuals must pay for their Alexander Technique education out of pocket. Private lessons usually cost in a similar rate compared to private music lessons, depending on the reputation and available time of the teacher.

Inexpensive classes are rarely available. Workshops do exist, but usually do not last long enough to fulfill educational requirements for most students, who must then attend additional private lessons if they want to gain proficiency. Consumers who have been sold on the benefits of instant results may hesitate giving the required commitment of twenty to forty private lessons. This is the duration most Alexander teachers recommend to gain proficiency.

Lessons may result in changes of height and posture, which call for a new wardrobe or require other costs for new ergonomic adjustments in the daily environment. Practicing the Alexander technique cannot affect skeletal deformities once they occur (such as arthritis, osteoporosis) or halt the progress of other diseases affecting movement ability, (such as Parkinson's, etc.) However, Alexander Technique can augment the ability to cope with these issues, which may be a significant help.

Benefits

The Alexander technique is used in three main ways. Originally, it was used to address the nuisance habits of actors and musicians. As remedial movement education, it teaches freedom of movement, improving specific self-imposed limitations brought about by unconscious postural habits. It offers a means of aware self-observation and holistic impulse control.

The remedial application includes alleviating pain and limitation as a result of poor posture or repetitive physical demands. The Technique improves pain management for chronic disability. It offers rehabilitation following surgery or injury where compensatory habits were designed to avoid former pain that needs to be eliminated after healing for complete recovery. The Alexander technique has been proved to be an effective treatment for chronic or recurrent back pain in a randomized study published by the British Medical Journal Aug. 19, 2008.^[6]

As an example among performance art applications, the work is used and taught by classically trained vocal coaches and musicians. Its advocates claim that it allows for the free alignment of all aspects of the vocal tract by consciously increasing air flow, allowing improved vocal technique and tone. Because the technique has allegedly been used to improve breathing and stamina in general, advocates also claim that athletes, people with asthma, tuberculosis, and panic attacks have also found improvements.

It has also been informally reputed to allow height retention in older adults. Some adults gain height.^{[citation needed]}

Along the application of impulse control, proponents of the technique suggest that it can eliminate stage fright, allow more spontaneity, and to expand skill repertoire. It is suggested that it can be an adjunct to psychotherapy for people with disabilities, Post-traumatic Stress Disorder, panic attacks, stuttering, and chronic pain because using its principles can improve stress management abilities.^[7][8]

Influences of Alexander's work

The English novelist Aldous Huxley was influenced by F. M. Alexander and the technique to the extent he included him as a character in the pacifist theme novel Eyeless in Gaza.^[9]

The American philosopher and educator John Dewey became impressed with the Alexander technique after his headaches, neck pains, blurred vision, and stress symptoms largely improved during the time he used Alexander's advice to change his posture.^[10][11] In 1923, Dewey wrote the introduction to Alexander's Constructive Conscious Control of the Individual.^[12]

Since Alexander's work in the field came at the turn of the century, his ideas influenced many originators in the field of mind-body improvement. Fritz Perls, who originated Gestalt Therapy, credited Alexander as an inspiration for his psychological work.^[13] The Feldenkrais Method and the Mitzvah Technique were both influenced by the Alexander technique, in the form of study previous to the originators founding their own disciplines.

Teaching

The technique is most commonly taught privately in a series of twenty to forty private lessons which may last from thirty minutes to an hour. Its principles have also been adapted to be taught in groups and workshops. This often uses short individual lessons demonstrated in turn which act as examples to the class, along with other group activities about principles. To qualify as a teacher of Alexander Technique, completion is required of at least 1600 hours, spanning at least three years of supervised teacher training. The result must be satisfactory to qualified peers to gain membership in professional societies.^[2]

Scientific evidence

In 2011, a study of postural tone concluded that the Alexander Technique alters the muscular tension along the spine and hips that supports the body against gravity, reducing stiffness in these areas.^[14]

A 2008 randomised controlled trial published in the British Medical Journal found marked improvement in addressing back pain with this technique. Those receiving 24 lessons had 3 days of back pain in a four week period, 18 days less than the control median of 21 days. The cohort receiving 6 lessons had a reduction of ten days in days-of-pain reported. Outcomes were also measured by Roland disability scores, a measure of the number of activities impaired by pain, with a control baseline of 8.1. 24 lessons reduced this by 4.14 points, while six lessons combined with exercise produced a reduction of 2.98.^[6] A subsequent analysis and comparative study of the economic implications concluded that "a series of six lessons in Alexander technique combined with an exercise prescription seems the most effective and cost effective option for the treatment of back pain in primary care."^[15]

In 2004, Maher concluded that "Physical treatments, such as acupuncture, backschool, hydrotherapy, lumbar supports, magnets, TENS, traction, ultrasound, Pilates therapy, Feldenkrais therapy, Alexander technique, and craniosacral therapy are either of unknown value or ineffective and so should not be considered" when treating lower back pain with an evidence-based approach.^[16]

In 2002, Stalibrass et al. published the results of a significant controlled study into the effectiveness of the technique in treating Parkinson's disease. Four different measures were used to assess the change in severity of the disease. By all four measures, Alexander technique was better than no treatment, to a statistically significant degree (both P-values < 0.04). However, when compared to a control group given massage sessions, Alexander technique was only significantly better by two of the measures. The other two measures gave statistically insignificant improvements (P-values of approximately 0.1 and 0.6). This appears to lend some weight to the effectiveness of the technique, but more studies and data are required.^[17]

In 1999, Dennis ran a controlled study of the effect of Alexander technique on the "Functional Reach" (associated with balance) of women older than 65. He observed a significant improvement in performance after 8 sessions, but this improvement was not maintained in a one-month follow-up.^[18] With regard to the claims made for reducing the need for medication in patients with asthma, Dennis concluded that additional "robust, well-designed randomized controlled trials are needed."^[19] (Note that Alexander technique teachers recommend more than three times or more as many lessons than 8 to retain educational benefits.)

In 1973 Nikolaas Tinbergen referenced scientific evaluations of the Alexander technique in his Nobel prize acceptance speech.^[20]

See also

• Feldenkrais Method
• Mitzvah Technique
• Posture release imagery
• Body Mapping
• Semi-supine position
• Somatics
• Squatting position

References

1. ^ Rootberg, Ruth (September 2007). Mandy Rees. ed. "Voice and Gender and other contemporary issues in professional voice and speech training". Voice and Speech Review, Voice and Speech Trainers Association, Inc, Cincinnati, OH 35 (1): 164–170. 
2. ^ ^{a b} Arnold, Joan; Hope Gillerman (1997). "Frequently Asked Questions". American Society for the Alexander Technique. http://www.alexandertech.org/misc/faq.html. Retrieved 2007-05-02. 
3. ^ Improvement in Automatic Postural Coordination Following Alexander Technique Lessons in a Person With Low Back Pain - W Cacciatore et al. 85 (6): 565 - Physical Therapy
4. ^ Body_Learning - An_Introduction to the Alexander Technique, Macmillan, 1996 ISBN_0805042067, quote p. 74, an article in New Scientist by Professor John Basmajian entitled "Conscious Control of Single Nerve Cells"
5. ^ McEvenue, Kelly (2002). The Actor and the Alexander Technique (1st Palgrave Macmillan ed.). New York: Macmillan. pp. 14. ISBN 0312295154. http://books.google.com/books?id=ixvTPRlcSMoC. 
6. ^ ^{a b} Paul Little et al.,Randomized controlled trial of Alexander technique (AT) lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain, British Medical Journal, August 19, 2008.
7. ^ Aronson, AE (1990). Clinical Voice Disorders: An Interdisciplinary Approach,. Thieme Medical Publishers. ISBN 0865773378. 
8. ^ Vigeland, C (December 2000). "The Answer to a Stress Test". Sports Illustrated Golf Plus 35 (1): 57. 
9. ^ Aldous Huxley, Eyeless in Gaza, Harper and Brothers, 1936
10. ^ Ryan, Alan (1997). John Dewey and the high tide of American liberalism. New York: W.W. Norton. pp. 187–188. ISBN 0-393-31550-9. 
11. ^ John Dewey vs. The Alexander Technique
12. ^ F. M. Alexander, Constructive Conscious Control of the Individual, E. P. Dutton & Co., 1923, ISBN 0-913111-11-2
13. ^ http://www3.interscience.wiley.com/journal/112411834/abstract?CRETRY=1&SRETRY=0 A note on the influence of F. M. Alexander on the development of gestalt therapy by Roger Tengwall, School of Social Sciences, University of California, Irvine
14. ^ Cacciatore, T.W.; Gurfinkel, V.S., Horak, F.B., Cordo, P.J., Ames, K.E. (1 February 2011). "Increased dynamic regulation of postural tone through Alexander Technique training". Human Movement Science 30 (1): 74–89. doi:10.1016/j.humov.2010.10.002. 
15. ^ Sandra Hollinghurst et al.,Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain: economic evaluation, British Medical Journal, 11 December 2008.
16. ^ Maher CG (January 2004). "Effective physical treatment for chronic low back pain". Orthop. Clin. North Am. 35 (1): 57–64. doi:10.1016/S0030-5898(03)00088-9. PMID 15062718. 
17. ^ Stallibrass, C; P Sissons, C Chalmers (July 2002). "Randomised Controlled Trial of the Alexander Technique for Idiopathic Parkinson's Disease" (PDF). Clinical Rehabilitation 16 (7): 695–708. doi:10.1191/0269215502cr544oa. PMID 12428818. http://www.londonalexander.co.uk/CR544%5B1%5D.pdf. Retrieved 2007-05-01. 
18. ^ Dennis, RJ (1999). "Functional reach improvement in normal older women after Alexander Technique instruction". Journals of Gerontology Series a : Biological Sciences and Medical Sciences 54 (1): M8–11. doi:10.1093/gerona/54.1.M8. PMID 10026656. http://biomed.gerontologyjournals.org/cgi/content/abstract/54/1/M8. 
19. ^ Dennis, J; Cates, Christopher J; Dennis, Jane A (2000). "Alexander technique for chronic asthma". Cochrane Database of Systematic Reviews (2): CD000995. doi:10.1002/14651858.CD000995. PMID 10796574. http://www.cochrane.org/reviews/en/ab000995.html. 
20. ^ http://nobelprize.org/nobel_prizes/medicine/laureates/1973/tinbergen-lecture.pdf, see p. 123

Further reading

• Alexander, FM Man's Supreme Inheritance, Methuen (London, 1910), revised and enlarged (New York, 1918), later editions 1941, 1946, 1957, Mouritz (UK, 1996), reprinted 2002. ISBN 0-9525574-0-1
• Alexander, FM Constructive Conscious Control of the Individual, Centerline Press (USA,1923), revised 1946, Mouritz (UK, 2004) ISBN 0-9543522-6-2, ISBN 978-9543522-6-4
• Alexander, FM The Use of the Self, E. P. Dutton (New York, 1932), republished by Orion Publishing, 2001, ISBN 0-7528-4391, ISBN 978-0752843919
• Alexander, FM The Universal Constant In Living, Dutton (New York, 1941), Chaterson (London, 1942), later editions 1943, 1946, Centerline Press (USA, 1941, 1986), Mouritz (UK, 2000) ISBN 091311118X, ISBN 978-0913111185, ISBN 0-9525574-4-4
• Brennan, Richard (May 1997). The Alexander Technique Manual. London: Connections UK. ISBN 1-85906-163-x. 
• Jones, Frank Pierce (May 1997). Freedom to Change; The Development and Science of the Alexander Technique. London: Mouritz. ISBN 0-9525574-7-9. 
• Jones, Frank Pierce (1999). ed. Theodore Dimon, Richard Brown. ed. Collected Writings on the Alexander Technique. Massachusetts: Alexander Technique Archives. ISBN ATBOOKS058. 

External links

• Mouritz: F.M. Alexander Bibliography
• The Monkey Squat (Position of Mechanical Advantage)