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The Alexander Technique is a technique of body reeducation and coordination, accomplished through physical and psychological principles. The technique focuses on the self-perception of movement and has applications in alleviating back pain, promoting rehabilitation after accidents, improving breathing, playing musical instruments or singing, and other stress-related habits.
The technique takes its name from F. Matthias Alexander, who first formulated its principles between 1890 and 1900. Alexander developed the Technique as a personal tool to alleviate pain and hoarseness that affected his ability to pursue a career as a Shakespearean actor. Alexander taught his technique for 30 years before creating a school to form other teachers of the technique. All current Alexander Technique teachers have participated in the 3-year, 1600-hour training, all with a pedagogical ancestry traced to Alexander himself.
The technique is taught in lessons, through a combination of hands-on coaching and verbal explanation. During lessons, which may last from 30 minutes to an hour, students, guided by the teacher, inhibit habitual reactions and instead find newer and more efficient ways to perform simple tasks, like walking, standing, and sitting.
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.
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.
The Alexander Technique is considered to be an educational technique to be practised by the student on his own, rather than a curative treatment. It is designed to be used while doing any other activity. There are no prescriptive forms or exercises intended to be done in separate practice time - with the exception of lying semi-supine as a recommended means of effective rest.
The advantage of physical freedom and gradual continuing education are the values that are taught. The Alexander Technique teacher provides verbal coaching while monitoring and guiding with hands-on assistance. Students are led to change their previous routines, which may have been perceived as physically limiting and structurally inefficient. This specialized assistance requires Alexander teachers to demonstrate on themselves what they are attempting to communicate to the student.
Alexander developed some of his own terminology to talk about his methods, outlined in his four books. "Sensory debauchery" is about how repetition of circumstance encourages habit design; habits disappear after being successfully trained. Kinesthetic awareness is a relative sense, not an indicator of absolute truth; as such, habits may be performed without conscious awareness of their existence. Another example is the term "End-gaining," which means to focus on a goal so as to lose sight of the means by which the goal is achieved. This "end-gaining" is argued by teachers to increase the likelihood of selecting older or conflicting compensations with the potential for cumulative, ongoing 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. These characteristics are also described in the terms "Psycho-physical Unity" and "Constructive, Conscious Control." McEvenue, Kelly (2002). The Actor and the Alexander Technique, 1st Palgrave Macmillan ed, 14, New York: Macmillan.</ref>
The technique, unlike other methods of physical therapy, is applied to every activity in daily life, and for this reason, Alexander preferred not to give exercises for his students to perform.
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. 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.
Other issues are that 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 demands giving up out-dated, but often "favored" ways of thinking and acting. If a student must halt lessons at an awkward stage, this can leave them without practical substitutions for the bad habits they now sense they are doing; there is no going back once the door to new perceptions is opened. 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).
A number of significant improvement claims have been made for the effectiveness of the Alexander Technique. It is used remedially to regain freedom of movement; 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 compensation habits need to be unlearned. As an example among performance art applications, the Technique is used and taught by classically trained singers and vocal coaches. It allows for the proper alignment of all aspects of the vocal chords and tract through consciously increased air flow. With this increase of air, singers are better able to exercise proper vocal technique and tone. Because the Technique has been used to improve breathing and stamina in general, athletes, people with asthma, tuberculosis, and panic attacks have also found its benefits.
Along the application of self-help, proponents 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 using its principles can improve stress management abilities. The Alexander technique has been shown to be an effective treatment for chronic or recurrent back pain.
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.
A 2008 randomized 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. Hence the paper concluded that 6 lessons combined with exercise would be the most cost effective option for primary care. A subsequent review of the economic implications of the study 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'
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 was 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."
- ↑ Rootberg, Ruth (September 2007). 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: 164–170.
- ↑ Arnold, Joan, Hope Gillerman (1997). Frequently Asked Questions. American Society for the Alexander Technique. URL accessed on 2007-05-02.
- ↑ 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
- ↑ The Definitive Guide to The Alexander Technique provided by STAT - The Society of Teachers of The Alexander Technique
- ↑ Aronson, AE (1990). Clinical Voice Disorders: An Interdisciplinary Approach,.
- ↑ Vigeland, C (December 2000). The Answer to a Stress Test. Sports Illustrated Golf Plus 35: 57.
- ↑ 7.0 7.1 Paul Little et al.,Randomised controlled trial of Alexander technique (AT) lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain,British Medical Journal, August 19, 2008.
- ↑ Michael J. Gelb, Body Learning - An Introduction to the Alexander Technique, p. 2, Macmillan, 1996 ISBN 0805042067
- ↑ Aldous Huxley, Eyeless in Gaza, Harper and Brothers, 1936
- ↑ F. M. Alexander, Constructive Conscious Control of the Individual, E. P. Dutton & Co., 1923, ISBN 0-913111-11-2
- ↑ 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.
- ↑ 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.
- ↑ Maher, CG (January 2004). Effective physical treatment for chronic low back pain. The Orthopedic clinics of North America 35 (1): 57–64. ISSN 0030-5898.
- ↑ Stallibrass, C, P Sissons, C Chalmers (July 2002). Randomized Controlled Trial of the Alexander Technique for Idiopathic Parkinson's Disease. Clinical Rehabilitation 16 (7): 695–708.
- ↑ Jones, FP (1987). Body Awareness in Action: A Study of the Alexander Technique.
- ↑ Harris, C, S Pehrson (1993). Using the Alexander Technique in Voice Therapy. Speech and Language Therapy in Practice 2 (3): 565–78.
- ↑ Dennis, J (2000). Alexander technique for chronic asthma. Cochrane Database of Systematic Reviews (2).
- Alexander, F. Matthias (1932). The Use of Self, 1985 Edition, London: Orion Books Limited.
- Jones, Frank Pierce (May 1997). Freedom to Change; The Development and Science of the Alexander Technique, London: Mouritz.
- Jones, Frank Pierce (1999). ed. Theodore Dimon, Richard Brown Collected Writings on the Alexander Technique, Massachusetts: Alexander Technique Archives.
- Brennan, Richard (May 1997). The Alexander Technique Manual, London: Connections UK.
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