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Alexander Technique

The Alexander Technique is a discipline with a focus on the self-perception of movement and is aimed at alleviating pain, promoting rehabilitation, improving breathing, and decreasing stage fright, as well as improving other conditions related to previous physical habits.

It is commonly taught by hands-on coaching and by demonstrating to participants of the value of physical poise. What makes it unique is its lack of preset exercises; any movement can be used to demonstrate its principles.

Historically taught in private lessons, its principles have also been adapted to be taught in groups, often using short individual lessons which, in turn, act as examples to the rest of the class.

The technique takes its name from F. Matthias Alexander, who first formulated its principles between 1890 and 1900.

History

Alexander was a Shakespearean orator who developed problems which resulted in losing his voice. After doctors informed him there was no physical cause, he carefully observed himself in multiple mirrors. This revealed that he was needlessly stiffening his whole body in preparation to recite or speak. Further, Alexander observed that many individuals experiencing voice problems tightened the musculature of the upper torso, especially the neck, prior to phonation in anticipation of the act of voicing. He suggested that this pattern rotates the head backwards and downwards in relationship to the spine, disrupting efficient overall body alignment; later termed a "startle pattern." He attempted to change this reaction, using both direct and indirect means. After identifying substitution strategies and improving his ability to choose a new response, he found that the old pattern of voice loss not only ceased, but he continued to improve towards his original intention to become a better orator.

Later, Alexander came to believe that what he termed the empirical scientific method or self-observation and reasoning applied to one's own manner of moving, could be used to ease physical performance in general: sitting, standing, walking, using the hands and speaking. He recorded his methods by developing his "work" (termed Alexander Technique after his death,) so as to make experimentation and training repeatable, and also by recording his experiences in four books. He also trained educators of his Technique mainly while living in London from 1931 until his death in 1955, except for the wartime period between 1941 to 1943 which was spent teaching with his brother Albert Redden Alexander (1874–1947) in Massachusetts, USA.

Technique

Basic premises

The Alexander Technique teacher provides verbal instructions while monitoring and guiding with hands-on assistance in order to help the student to change their previous physical habits. This specialized assistance requires Alexander teachers to demonstrate what they are attempting to communicate to the student. The Alexander Technique is considered to be an educational technique to be practiced by the student on their own, rather than a curative treatment. It is designed to be used while doing any other activity, so there are no prescriptive forms or exercises recommended as a proscriptive separate practice time - with the exception of lying semi-supine as a recommended means of effective rest.

Alexander developed some of his own terminology to talk about his methods. An example is the term of "End-gaining," which means to focus on a goal so as to lose sight of the means by which this goal is achieved. This "end-gaining" is argued to increase the likelihood of selecting older, poor physical habits with the potential for injury. In the Alexander Technique, the term "inhibition" describes a moment of conscious awareness that interrupts a habitual pattern of muscular misuse. "Directing" selects and reinforces the proscribed Head-Neck-Back relationship that emerges when habitual misuse is stopped.

Benefits

A number of self-improvement claims have been made for practicing the Alexander Technique. These include alleviating pain and weakness as a result of poor posture or repetitive demands, improving pain management for chronic disabilities, and “enhanced” rehabilitation following surgery or injury. Further, the Technique has been suggested to improve breathing and stamina for athletes, people with asthma, tuberculosis, and panic attacks. Promoters of the Technique suggest that it can help performers manage stage fright, become more spontaneous, and increase skill repertoire. It is suggested that A.T. can be an adjunct to psychotherapy for people with disabilities, Post-traumatic Stress Disorder, panic attacks, stuttering, and chronic pain because it can improve stress management abilities.

Obviously, practicing Alexander Technique cannot directly affect structural deformities (such as arthritis or other bone problems), or other diseases, (such as Parkinson's, etc.) In these cases, Alexander Technique can only mitigate how the person compensates for these difficulties (which can be significant for them).

Disadvantages

In the United Kingdom, there is some coverage of the costs for Alexander lessons through the Complementary and Alternative Practitioners Directory. Otherwise, individuals must pay for the service out of pocket. Outside of the United Kingdom there is little or no coverage. Classes and workshops are an inexpensive alternative, but consistent availability can be an issue. Those who are used to getting instant results may balk at a commitment of twenty to forty private lessons, which is what most Alexander teachers require. The educational process requires the student to work at a somewhat paradoxical goal that is, at first, based on the teacher's (or classmates') perception of success. The learning process also demands giving up out-dated, but sometimes "favored" ways of thinking and acting. If a student must halt lessons at an awkward stage, this can leave them without substitutions for the bad habits. In rare occasions, undoing old habits may trigger possibly unpleasant "unresolved" emotions that were the basis for the development of the subject's habitual remedies - which may need intervention that the Alexander teacher is not trained to address.

Influences

Gertrude Stein's brother Leo called the Alexander Technique: "the method for keeping your eye on the ball applied to life".

The English novelist Aldous Huxley was strongly influenced by F. M. Alexander and the Technique so much so that he included him as a character in the pacifist theme novel Eyeless in Gaza published in 1936.

The American philosopher and educator John Dewey was very favorably impressed by F. M. Alexander and the Technique. In 1923, Dewey wrote the introduction to Alexander's magnum opus Constructive Conscious Control of the Individual.

The Feldenkrais method and the Mitzvah Technique were also influenced by the Alexander Technique.

Along with the Feldenkrais Method and yoga, the Alexander Technique is one of the three healing arts that help form the foundation of the Nia Technique.

Scientific evidence

A 2008 randomized controlled trial published in the British Medical Journal found marked improvement in addressing back pain with this technique. Exercise and a combination of 6 lessons of AT reduced back pain 72% as much as 24 AT lessons. Those receiving 24 lessons had 18 fewer days of back pain than the control median of 21 days.

Prior to this there was a lack of peer-reviewed studies in scientific journals regarding the effectiveness of the technique. In 1999, Dennis ran a controlled study of the effect of AT on the "Functional Reach" (associated with balance) of women older than 65 and found a significant improvement in performance after 8 sessions but this improvement was not maintained in a one-month follow up. Further, in 2004 Maher concluded that "Physical treatments, such as ... Alexander technique ... are either of unknown value or ineffective and so should not be considered" when treating lower back pain with an evidence-based approach. Finally, 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.

While there is an abundance of anecdote which suggests that AT instruction contributes to improved vocal quality and vocal health (including its apparent success in treating the vocal health issues of its creator, Alexander), only two studies of AT use with voice were found, neither of which were published in peer-reviewed journals. In both, there was an apparent attempt to measure the effects of AT on voice and to analyze some data; however, neither methodology nor statistics were provided to lend scientific credence to the interpreted results (e.g., representative sampling, control groups or blind testing) or acoustic measurements (i.e., microphone type, microphone placement, microphone directionality, recording environment, recording media – all of which could affect the spectral characteristics of the recording). Thus, while both studies may report actual effects, one cannot have confidence that they demonstrate anything more than possibly placebo improvements without the inclusion of carefully designed methodologies, legitimate metrics or statistical analysis. With regard to the claims made for reducing the need for medication in patients with asthma, Dennis concluded that "robust, well-designed randomised controlled trials are needed.