Alexander Technique
The Alexander technique is an alternative medicine and educational discipline focusing on bodily coordination, including psychological principles of awareness. It is applied for purposes of recovering freedom of movement, in the mastery of performing arts, and for general self-improvement affecting poise, impulse control and attention.
The Alexander Technique takes its name from F. Matthias Alexander, who, in the 1890s, developed its principles as a personal tool to alleviate his breathing problems and hoarseness and hence enable him to pursue a career as a Shakespearean actor.
Teachers of the Alexander Technique use demonstration, explanation, and repeated examination of what spontaneously occurs in the student. Light hand contact is also used to detect the student's unnecessary physical and mental stresses. Hands-on suggestions are offered in the context of everyday actions such as sitting, standing, walking, using the hands, and speaking. Assistance with sports, hobbies, or the performing arts may be requested by students as further topics of personal interest.
History of the Alexander Technique
Alexander was a Shakespearean orator who developed problems that resulted in losing his voice. After doctors informed him they could find no physical cause, he carefully observed himself in multiple mirrors. His use of the empirical scientific method of reasoning revealed that he was needlessly stiffening his whole body in preparation to recite or speak. Further, Alexander observed that many individuals experiencing breathing and voice problems commonly tightened the musculature of the upper torso, especially the neck, prior to phonation in anticipation of the act of voicing. He suggested that this habitual pattern of dropping the head backwards and downwards in relationship to the spine, needlessly disrupted efficient overall body alignment. This was later termed the reaction of a "startle pattern." After innovating new substitution strategies that included sharpening his ability to choose that new response, he found that his old pattern of voice loss ceased entirely. His new process also allowed the discovery of additional improvements towards his original intention to become a better orator.
Alexander came to believe that his work could be applied to improve longevity and human evolution in general. He developed the quality of his "work" (termed Alexander Technique after his death) so as to make his process of experimentation and self-training repeatable. He recorded his experiences in four books. He also trained educators of the Alexander Technique while living in London from 1931 until his death in 1955. Teacher training classes were interrupted during the wartime period between 1941 to 1943, which Alexander spent teaching pupils with his brother Albert Redden Alexander (1874–1947) in Massachusetts, USA.
The Technique
Basic premise of the Alexander Technique
The National Institutes of Health (NIH) and National Centre for Complementary and Alternative Medicine (NCCAM) defines the Alexander Technique as an education/guidance practice to "improve posture and movement, and to use muscles efficiently."
The Alexander Technique is considered to be primarily an educational process to be practiced by the student, rather than a curative treatment or therapy. Generally, it does not consist of routine exercises, but is applied in any moment when quality improvements are desired during action. For this reason, F.M. Alexander preferred not to recommend exercises for his students to perform, and most teachers of the Alexander Technique follow this intent. Alexander's approach was to emphasise the use of freedom to choose beyond conditioning in every action.
The exceptions in the Alexander Technique are two prescriptive forms or exercises intended to be done in separate but brief practice times. A procedure recommended to all students is lying semi-supine as a means for effective rest, releasing muscular tension and as an opportunity to use the conscious mental "Directions" Alexander devised. The other procedure is termed a "Whispered Ah," used to subtract unnecessary effort from the use of the voice.
Freedom, efficiency and patience are the prescribed values in the Alexander Technique. Proscribed are unnecessary effort, self-limiting habits as well as mistaken assumptions. Students are led to change their previous habitual and largely automatic routines that are interpreted by the teacher to currently or eventually be physically limiting and structurally inefficient. The teacher of the Alexander Technique provides verbal coaching while monitoring, guiding & preventing unnecessary habits at their source with specialized hands-on assistance to show what is meant. This specialised assistance requires teachers of the Alexander Technique to demonstrate on themselves the improved physical coordination they are communicating to the student.
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 "Creative, Conscious Control" because kinaesthetic sensory awareness is a relative sense, not a truthful indicator of fact. The current postural attitude is sensed internally as a normal state of affairs, 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. Short-sighted habits that have become harmful over time, such as restriction of breathing or other poor postural attitudes that limit freedom of movement & shorten stature, will stop after learning to perceive and prevent them.
"End-Gaining"
Another example in the Alexander Technique is the term "end-gaining", which means to focus on a goal so as to lose sight of the "means-whereby" of how the goal could be more appropriately achieved. According to teachers of the Alexander Technique, "end-gaining" increases the likelihood of selecting older or multiple conflicting coping strategies with the potential for needless cumulative, ongoing self-injury. End-gaining actions are usually carried out because a more imperative priority justifies it, which is usually impatience or frustration.
"Inhibition"
In the Alexander Technique lexicon, the principle of "inhibition" is considered by teachers to be the most prominent. (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."
"Primary Control"
This innate coordination that emerges is also described more specifically as "Primary Control". This is a key head, neck & spinal relationship. The body's responses are determined by the qualities of head & eye movement at the inception of head motion. What expands the qualities of further response is a very subtle nod forward to counteract backward startle pattern, coupled with an upward movement of the head away from the body that lengthens the spine. Students of the Alexander Technique learn to include their whole body toward their intention of purposeful motion.
"Directions"
To continue to select and reinforce the often less dominant "good use," it is recommended in the Alexander Technique to repeatedly suggest, by thinking to oneself, a tailored series of "orders" (also termed Directions.) "Giving Directions" is the term for thinking and projecting an anatomically corrected map of how one's body is designed to be used effortlessly. "Directing" is suggestively thought, rather than wilfully accomplished. This is because when freedom is the objective, the appropriate responses cannot be anticipated but can be 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.
Disadvantages of the Alexander Technique
In the United Kingdom, there is some coverage of the costs for Alexander Technique lessons through the Complementary and Alternative Practitioners Directory. Otherwise, individuals must pay for their Alexander Technique education out of pocket. Those who are used to getting instant results may complain at a commitment of twenty to forty private lessons, which is the duration most Alexander Techique teachers recommend that is required to gain proficiency. Private lessons usually cost in a similar range to private music lessons.
Inexpensive classes are rarely available and though Alexander Technique workshops do exist, they usually do not last long enough to fulfil educational requirements for most students, who must then attend additional private lessons if they want to gain proficiency. Outside of the United Kingdom there is little or no insurance coverage, and the Alexander Technique's effectiveness is also not yet recognised.
Practicing the Alexander Technique cannot directly affect structural deformities once they occur (such as arthritis or other bone problems), or other diseases, (such as Parkinson's, etc.) In these cases, the Alexander Technique can only mitigate how the person copes with these difficulties.
The learning process often demands giving up "favoured" ways of thinking and acting. This challenge can result in unanticipated and illogical defensiveness and apparently wilful resistance. If a student must halt lessons at an awkward stage, this can leave them without practical solutions for the "bad" habits they have just learned to sense.
Benefits of the Alexander Technique
The Alexander Technique is used remedially to regain freedom of movement i.e. it is used to undo the establishment of nuisance habits by performers, and it's used as a self awareness discipline and a self-help tool to change specific habits.
These first application areas include alleviating pain and weakness as a result of poor posture or repetitive physical demands, improving pain management for chronic disabilities, and rehabilitation following surgery or injury where compensatory habits that were designed to avoid former pain need to be revised after healing. The Alexander Technique has been shown to be an effective treatment for chronic or recurrent back pain in a randomised study published Aug. 19, 2008.
As an example among performance art applications, the Alexander Technique is used and taught by classically trained singers and vocal coaches. Advocates of the Alexander Technique claim that it allows for the proper alignment of all aspects of the vocal cords and tract through consciously increased air flow. With this increase of breathing capacity, singers are said to be better able to exercise proper vocal technique and tone. Because the Alexander Technique has allegedly been used to improve breathing and stamina in general, advocates of it claim that athletes, people with asthma, tuberculosis, and panic attacks have also found benefits.
Along the application of self-help, proponents of the Alexander Technique suggest that it can help performers manage stage fright, become more spontaneous, and to increase skill repertoire. It is suggested that the technique 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.
Influences Since Alexander's Work
The English novelist Aldous Huxley was strongly influenced by F. M. Alexander and the Alexander 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 favourably impressed by F. M. Alexander and the Alexander Technique. In 1923, Dewey wrote the introduction to Alexander's magnum opus Constructive Conscious Control of the Individual. 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 the Alexander Technique as an inspiration for his psychological work. 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. The Alexander Technique is one of the three healing arts that formed the foundation of Nia Technique. John Appleton, Alexander Technique teacher, has originated a variation that uses visualisation techniques called Posture release imagery. David Gorman, formerly working as an Alexander Technique teacher trainer, originated a variation called Learning Methods using the systematic exploration of experience to understand the psychological root of problematic habits and change them.
Teaching of the Alexander Technique
Alexander taught his technique to pupils for thirty years before creating a school to train other teachers to pass on his work. Today, the UK Society of Teachers of The Alexander Technique and its worldwide affiliates certify Alexander Technique teachers after successfully completing a three-year, 1600-hour curriculum from teaching lineage traced to Alexander.
The technique is most commonly taught in a series of twenty to forty private lessons that may last from thirty minutes to an hour. Its principles have also been adapted to be taught in groups, often using short individual lessons demonstrated in turn which act as examples to the class.
Scientific evidence on the Alexander Technique
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. 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. (Note that Alexander Technique teachers recommend more than three times or more as many lessons than 8 to retain educational benefits.) Finally, in 2002, Stalibrass et al. published the results of a significant controlled study into the effectiveness of the Alexander 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 Alexander Technique, but more studies and data are required.
While there is an abundance of anecdotes which suggest that Alexander Technique instruction contributes to improved vocal quality and vocal health (including its apparent success in treating the vocal health issues of its creator, F.M. Alexander), only two studies of Alexander Technique use with voice were found, neither of which was published in peer-reviewed journals. In both, there was an apparent attempt to measure the effects of Alexander's work on voice and to analyse 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, (in 1999,) Dennis concluded that additional "robust, well-designed randomised controlled trials are needed."
A 2008 randomised controlled trial published in the British Medical Journal found marked improvement in addressing back pain with the Alexander 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. A subsequent analysis and comparative study of the economic implications concluded that "a series of six lessons in the Alexander Technique combined with an exercise prescription seems the most effective and cost effective option for the treatment of back pain in primary care." Prior to this 2008 study, there was a lack of peer-reviewed studies published in scientific journals. Additional scientific verification would accelerate public knowledge of the effectiveness of this 100-year-old discipline.
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