Alexander Technique

The Alexander Technique, named after its creator Frederick Matthias Alexander, is an educational process that was created to retrain habitual patterns of movement and posture. Alexander believed that poor habits in posture and movement damaged spatial self-awareness as well as health,[1]:221 and that movement efficiency could support overall physical well-being. He saw the technique as a mental training technique as well.

Alexander began developing his technique's principles in the 1890s[2] in an attempt to address his own voice loss during public speaking.[1]:34–35 He credited his method with allowing him to pursue his passion for performing Shakespearean recitations.[3]

Proponents and teachers of the Alexander Technique believe the technique can address a variety of health conditions, but there is a lack of research to support the claims.[4][5] As of 2015 there was evidence suggesting the Alexander Technique may be helpful for long-term back pain, long-term neck pain, and could help people cope with Parkinson's disease.[5] Both the American health insurance company Aetna, and the Australian Department of Health have conducted reviews and concluded that there is insufficient evidence for health claims to warrant insurance coverage.[6][7]

Uses

The Alexander Technique is used and taught by classically trained vocal coaches and musicians in schools and private lessons. Its advocates state that it allows for a balanced use of all aspects of the vocal tract by consciously increasing air-flow, allowing improved vocal skill and tone. The method is said by actors to reduce stage fright and to increase spontaneity.[8]

The Alexander Technique is a frequent component in acting training, because it can assist the actor in being more natural in performance.[9]

According to Alexander Technique instructor Michael J. Gelb, people tend to study the Alexander Technique for reasons of personal development.[10]

Health effects

A review of evidence for Alexander Technique for various health conditions provided by UK NHS Choices last updated in 2018 said that advocates of the technique made claims for it that were not supported by evidence, but that there was evidence suggesting that it might help with:

  • long-term back pain – lessons in the technique may lead to reduced back pain-associated disability and reduce how often you feel pain for up to a year or more
  • long-term neck pain – lessons in the technique may lead to reduced neck pain and associated disability for up to a year or more
  • Parkinson's disease – lessons in the technique may help you carry out everyday tasks more easily and improve how you feel about your condition[5]

NHS Choices also states that "some research has also suggested the Alexander technique may improve general long-term pain, stammering and balance skills in elderly people to help them avoid falls. But the evidence in these areas is limited and more studies are needed. There's currently little evidence to suggest the Alexander technique can help improve other health conditions, including asthma, headaches, osteoarthritis, difficulty sleeping (insomnia) and stress."[5]

A review published in BMC Complementary and Alternative Medicine in 2014 focused on "the evidence for the effectiveness of AT sessions on musicians' performance, anxiety, respiratory function and posture" concluded that: "Evidence from RCTs and CTs suggests that AT sessions may improve performance anxiety in musicians. Effects on music performance, respiratory function and posture yet remain inconclusive."[11]

A review published in the International Journal of Clinical Practice in 2012 found: "Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson’s-associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the elderly, in general chronic pain, posture, respiratory function and stuttering, but there is insufficient evidence to support recommendations in these areas."[12]

A 2012 Cochrane systematic review found that there is no conclusive evidence that the Alexander technique is effective for treating asthma, and randomized clinical trials are needed in order to assess the effectiveness of this type of treatment approach.[13]

A review by Aetna last updated in 2016 stated: "Aetna considers the following alternative medicine interventions experimental and investigational, because there is inadequate evidence in the peer-reviewed published medical literature of their effectiveness." The Alexander technique is included in that list.[14]

A review published in 2015 and conducted for the Australia Department of Health in order to determine what services the Australian government should pay for, reviewed clinical trials published to date and found that: "Overall, the evidence was limited by the small number of participants in the intervention arms, wide confidence intervals or a lack of replication of results." It concluded that: "The Alexander technique may improve short-term pain and disability in people with low back pain, but the longer-term effects remain uncertain. For all other clinical conditions, the effectiveness of Alexander technique was deemed to be uncertain, due to insufficient evidence." It also noted that: "Evidence for the safety of Alexander technique was lacking, with most trials not reporting on this outcome.[4] Subsequently in 2017 the Australian government named the Alexander Technique as a practice that would not qualify for insurance subsidy, saying this step would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence".[15]

Method

The Alexander Technique is most commonly taught privately in a series of 10 to 40 private lessons which may last from 30 minutes to an hour. Students are often performers, such as actors, dancers, musicians, athletes and public speakers, people who work on computers, or those who are in frequent pain for other reasons. Instructors observe their students, then show them how to move with better poise and less strain.[16] Sessions include chair work – often in front of a mirror, during which the instructor and the student will stand, sit and lie down, moving efficiently while maintaining a comfortable relationship between the head, neck and spine, and table work or physical manipulation.[17]

To qualify as a teacher of Alexander Technique, instructors are required to complete 1,600 hours, spanning three years, of supervised teacher training. The result must be satisfactory to qualified peers to gain membership in professional societies.[18][19]

Process

Alexander's approach emphasizes awareness strategies applied to conducting oneself while in action, (which could be now called "mindful" action, though in his four books he did not use that term.)

Actions such as sitting, squatting, lunging or walking are often selected by the teacher. Other actions may be selected by the student that is tailored to their interests or work activities; hobbies, computer use, lifting, driving or artistic performance or practice, sports, speech or horseback riding. 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 modelling with a highly skilled light hand contact is the primary tool for detecting and guiding the student into a more coordinated state in movement and at rest during in-person lessons. Suggestions for improvements are often student-specific, as everyone starts out with slightly different habits.[18]

Exercise as a teaching tool is deliberately omitted because of a common mistaken assumption that there exists a "correct" position. There are only two specific procedures that are practiced by the student; the first is lying semi-supine. Resting in this way uses "mechanical advantage" as a means of redirecting long-term and short-term accumulated muscular tension into a more integrated and balanced state. This position is sometimes referred to as "constructive rest", or "the balanced resting state". 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 co-ordinate freer breathing and vocal production.

Freedom, efficiency and patience are the prescribed values. Proscribed are unnecessary effort, self-limiting habits as well as mistaken perceptual conclusions about the nature of training and experimentation. 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 best "use" of themselves as a whole. The Alexander teacher provides verbal coaching while monitoring, guiding and preventing unnecessary habits at their source with a specialized hands-on assistance.[20]

This specialized hands-on skill also allows Alexander teachers to bring about a balanced working of the student's supportive musculature as it relates to gravity's downward pull from moment to moment. Often, students require a great deal of hands-on work in order to first gain an experience of a fully poised relation to gravity and themselves. The hands-on skill requires Alexander teachers to maintain in themselves from moment-to-moment their own improved psycho-physical co-ordination that the teacher is communicating to the student.[20]

Alexander developed terminology to describe his methods, outlined in his four books that explain the experience of learning and substituting new improvements.

Constructive conscious control
Alexander insisted on the need for strategic reasoning because kinesthetic and proprioceptive sensory awareness are relative senses, not truthful indicators of a person's factual relationships within him/herself or within the environment. A person's habitual neuro-muscular relation to gravity is habitually sensed internally as "normal," despite being inefficient. Alexander's term, "debauched sensory appreciation" describes how the repetition of an action or response encourages the formation of habits as a person adapts to various circumstances or builds skills. Once trained and forgotten, completed habits may be used without feedback sensations that these habits are in effect, (even when only thinking about the situations that elicit them.)[21] Short-sighted habits are capable of becoming harmfully exaggerated over time, such as restricted breathing or other habitually assumed adaptations to past circumstances. Even exaggerated habits 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"[22] the goal could be most appropriately achieved. According to Alexander teachers, "end-gaining" increases the likelihood of automatically selecting older or multiple conflicting coping strategies. End-gaining is usually carried out because an imperative priority of impatience or frustration justifies it. Excessive speed in thinking and acting often facilitates end-gaining. Going slowly is a strategy to undo "end-gaining".
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 predates the meaning of the word originated by Sigmund Freud. Inhibition, or "intentional inhibition". It is the act of refraining from responding in one's habitual manner – in particular, imposed tension in neck muscles (see Primary Control). 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 and a more spontaneous choice of action or behavior can be discovered, which is experienced by the student as a state of "non-doing" or "allowing".
Primary control
How the eyes and head initiate movement governs the training of ourselves in relationship to gravity. Our responses are influenced for good or ill by the qualities of head and eye direction at the inception of any reaction. The qualities and direction of our "primary control" occur in every waking moment in response to the stimulus to "do" – everything. A person can learn to influence their primary control, improving effortlessness. This influence involves the education of a particular quality of head, neck, torso, and limb relationship that works as we move and respond. A student learns to pay attention during action, without imposing expectations.
Directions
To continue to select and reinforce the often less dominant new ways, it is recommended to repeatedly suggest, by thinking to oneself, a particular series of "Orders" or "Directions". "Giving Directions" is the expression used for thinking and projecting the positive aspect of how one's self might be used in the most unified psycho-physical way as conveyed by the teacher's hands during a lesson.

"Directing" serves to counteract the common backward and downward pull and shortening in stature that can be detected at the beginning of every movement – particularly addressing a startle pattern of "fight, flight or freeze". A mere thought, as a projection of intention, shapes preparatory movement below the level of sensing it. Alexander used these words for reshaping these subliminal preparations: "The neck to be free, the head to go forward and up, the back to lengthen and widen". Some teachers have shortened this to a suggestion of, "Freer?" Negative directions (that use Alexander's other preventive principle of "inhibition") have also been found to be effective, because negative directions leave the positive response open-ended. Whichever is used, all "Directing" is suggestively thought, (rather than willfully accomplished.) This is because the neuro-muscular responses to "Directing" often occur underneath one's ability to perceive how they are actually carried out neuro-physiologically and neuro-cognitively. As freedom of expression or movement is the objective, the most appropriate responses cannot be anticipated or expected, only observed and chosen in the moment. Teacher trainees gradually learn to include a constant attending to their lengthening in stature in every movement. It becomes a basis for initiating and continuing every action, every response to stimuli or while remaining constructively at rest.

Psycho-physical unity
Global concepts such as "Psycho-physical Unity" and "Use" describe how thinking strategies and attention work together during preparation for an action or for withholding one. 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.[9]

History

Frederick Matthias Alexander (1869–1955) was a Shakespearean orator from Tasmania, who developed voice loss during his unamplified performances. After doctors found no physical cause, Alexander reasoned that he was inadvertently damaging himself while speaking. He observed himself in multiple mirrors and saw that he was contracting his posture in preparation for any speech. He hypothesized that a habitual conditioned pattern (of pulling his head backwards and downwards) needlessly was disrupting the normal working of his total postural, breathing, and vocal processes.

With experimentation, Alexander developed the ability to stop the unnecessary and habitual contracting in his neck, displacement of his head, and shortening of his stature. As he became practised at speaking without these interferences, he found that his problem with recurrent voice loss was resolved. While on a recital tour in New Zealand (1895), he came to believe in the wider significance of improved carriage for overall physical functioning although evidence from his own publications appears to indicate it happened less systematically and over a long period of time.[1]:36

Influence

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.[23] In 1923, Dewey wrote the introduction to Alexander's Constructive Conscious Control of the Individual.[24]

Aldous Huxley had transformative lessons with Alexander, and continued doing so with other teachers after moving to the US. He rated Alexander's work highly enough to base the character of the doctor who saves the protagonist in Eyeless in Gaza (an experimental form of autobiographical work) on F.M. Alexander, putting many of his phrases into the character's mouth.[25] Huxley's work The Art of Seeing also discusses his views on the technique.

Sir Stafford Cripps, George Bernard Shaw, Henry Irving and other stage grandees, Lord Lytton and other eminent people of the era also wrote positive appreciations of his work after taking lessons with Alexander.

Since Alexander's work in the field came at the start of the 20th 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.[26] The Mitzvah Technique was influenced by the Alexander Technique; as was the Feldenkrais Method – who expanded on the one exercise in Alexander Technique called "The Whispered Ah."

See also

Citations
  1. Bloch, Michael (2004). F.M. : the life of Frederick Matthias Alexander : founder of the Alexander technique. London: Little, Brown. ISBN 978-0-316-86048-2.
  2. Rootberg, Ruth (September 2007). Mandy Rees (ed.). "Voice and Gender and other contemporary issues in professional voice and speech training". Voice and Speech Review. 35 (1): 164–170. doi:10.1080/23268263.2007.10769755. S2CID 144810660.
  3. Harer, John B.; Munden, Sharon (2008). The Alexander Technique Resource Book: A Reference Guide. Scarecrow Press. pp. xii–xiii. ISBN 978-0810863927. Retrieved 3 June 2014.
  4. Baggoley C (2015). "Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance" (PDF). Australian Government – Department of Health. Archived from the original (PDF) on 26 June 2016. Retrieved 12 December 2015. Lay summary – Gavura, S. Australian review finds no benefit to 17 natural therapies. Science-Based Medicine (19 November 2015).
  5. NHS. "Alexander Technique – NHS Choices". www.nhs.uk. Retrieved 17 April 2016.
  6. Baggoley C (2015). "Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance" (PDF). Australian Government – Department of Health. Archived from the original (PDF) on 26 June 2016. Retrieved 12 December 2015. Lay summary – Gavura, S. Australian review finds no benefit to 17 natural therapies. Science-Based Medicine (19 November 2015).
  7. "Complementary and Alternative Medicine – Number 0388". Aetna. Archived from the original on 19 September 2016. Retrieved 19 September 2016.
  8. Aronson, AE (1990). Clinical Voice Disorders: An Interdisciplinary Approach. Thieme Medical Publishers. ISBN 0-86577-337-8.
  9. McEvenue, Kelly (2002). The Actor and the Alexander Technique (1st Palgrave Macmillan ed.). New York: Macmillan. p. 14. ISBN 0-312-29515-4.
  10. Gelb, Michael J. (1995). Body learning : an introduction to the Alexander Technique (2nd Owl Book ed.). New York: Holt. pp. 3–4. ISBN 0805042067.
  11. Klein, SD; Bayard, C; Wolf, U (24 October 2014). "The Alexander Technique and musicians: a systematic review of controlled trials". BMC Complementary and Alternative Medicine. 14: 414. doi:10.1186/1472-6882-14-414. PMC 4287507. PMID 25344325.
  12. J. P. Woodman; N. R. Moore (January 2012). "Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review". International Journal of Clinical Practice. 66 (1): 98–112. doi:10.1111/j.1742-1241.2011.02817.x. PMID 22171910. S2CID 7579458.
  13. Dennis, JA; Cates, CJ (12 September 2012). "Alexander technique for chronic asthma". The Cochrane Database of Systematic Reviews (9): CD000995. doi:10.1002/14651858.CD000995.pub2. PMC 6458000. PMID 22972048.
  14. "Complementary and Alternative Medicine – Number 0388". Aetna. Archived from the original on 19 September 2016. Retrieved 19 September 2016.
  15. Paola S (17 October 2017). "Homeopathy, naturopathy struck off private insurance list". Australian Journal of Pharmacy.
  16. Rodenburg, Kelly McEvenue (2002). "Foreword by Patsy". The actor and the Alexander Technique (1st Palgrave Macmillan ed.). New York: Palgrave, Macmillan. p. 3. ISBN 0312295154.
  17. Jain, Sanjiv; Kristy Janssen; Sharon DeCelle (2004). "Alexander Technique and Feldenkrais method: A critical overview". Physical Medicine and Rehabilitation Clinics of North America. 15 (4): 811–825. CiteSeerX 10.1.1.611.4183. doi:10.1016/j.pmr.2004.04.005. PMID 15458754.
  18. Arnold, Joan; Hope Gillerman (1997). "Frequently Asked Questions". American Society for the Alexander Technique. Retrieved 2 May 2007.
  19. Little, P.; Lewith, G.; Webley, F.; Evans, M.; Beattie, A.; Middleton, K.; Barnett, J.; Ballard, K.; Oxford, F.; Smith, P.; Yardley, L.; Hollinghurst, S.; Sharp, D. (19 August 2008). "Randomised controlled trial of Alexander Technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain". BMJ. 337 (aug19 2): a884. doi:10.1136/bmj.a884. PMC 3272681. PMID 18713809.
  20. Cacciatore, W; et al. (2005). "Improvement in Automatic Postural Coordination Following Alexander Technique Lessons in a Person With Low Back Pain". Physical Therapy. 85 (6): 565–78. doi:10.1093/ptj/85.6.565. PMC 1351283. PMID 15921477. Archived from the original on 29 October 2006. Retrieved 15 July 2008.
  21. 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"
  22. The subject of "Means whereby, rather than the end, to be considered" is discussed many times in Man's Supreme Inheritance, typically Chapter VI, p. 263
  23. 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.
  24. F. M. Alexander, Constructive Conscious Control of the Individual, E. P. Dutton & Co., 1923, ISBN 0-913111-11-2
  25. Aldous Huxley, Eyeless in Gaza, Chatto & Windus, 1936 ISBN 978-0-06172-489-3 F. M. Alexander is named in the last section of Chapter 2. Miller, the character whose description immediately resembles Alexander, appears at the beginning of Chapter 49.
  26. Tengwall, Roger (1996). "A note on the influence of F. M. Alexander on the development of gestalt therapy". Journal of the History of the Behavioral Sciences. Wiley. 17 (1): 126–130. doi:10.1002/1520-6696(198101)17:1<126::AID-JHBS2300170113>3.0.CO;2-X. ISSN 1520-6696. PMID 7007480.

References
  • Alexander, FM Man's Supreme Inheritance, Methuen (London, 1910), revised and enlarged 1918, later editions 1941, 1946, 1957, scholarly edition Mouritz (UK, 1996, reprinted 2002, ISBN 0-9525574-0-1)
  • Alexander, FM Conscious Control , Methuen (London, 1912), revised and incorporated into the 1918 (and later) editions of Man's Supreme Inheritance . Republished by Alexander Technique Centre Ireland (2015).
  • Alexander, FM Constructive Conscious Control of the Individual, E. P. Dutton (USA,1923), Methuen (London, 1924), revised 1946, scholarly edition Mouritz (UK, 2004, ISBN 0-9543522-6-2)
  • Alexander, FM The Use of the Self, E. P. Dutton (New York, 1932), Methuen (London, 1932), republished by Orion Publishing, 2001, ISBN 9780752843919
  • Alexander, FM The Universal Constant in Living, E. P. Dutton (New York, 1941), Chaterson (London, 1942), later editions 1943, 1946, scholarly edition Mouritz (UK, 2000, ISBN 0-9525574-4-4)
  • Alexander, FM Articles and Lectures, Mouritz (UK, 1995 – A posthumous compilation of articles, published letters and lectures – ISBN 978-0952557463)

Further reading
  • Alexander, FM Aphorisms, Mouritz (UK, 2000 – a compilation of teaching aphorisms – ISBN 978-0952557494)
  • 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). Theodore Dimon; Richard Brown (eds.). Collected Writings on the Alexander Technique. Massachusetts: Alexander Technique Archives. ASIN B0006RIXCO.
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