By Frank Wildman, Ph.D.
Many physical therapists are now familiar
with the Feldenkrais® Method. Yet, there remains some uncertainty
about the place of this controversial method in physical therapy due
to a lack of familiarity about what the method involves. What is the
Feldenkrais Method® and what are some of the major differences and
similarities with techniques already familiar to physical therapists?
The Feldenkrais Method® is an approach
to improve peoples' ability to learn and to function through simulating
the exploratory style of learning natural to infants. At its heart is
the overwhelming need for learning in human development and the equally
enormous capacity for learning throughout life. A major concern of the
Feldenkrais Method® is to enable the person to include body parts
never before considered in one's image of movement and to experience
how the whole body cooperates in any motion. In this way, people can
learn new patterns of movement specifically designed to expand body awareness
and to enhance the neuromuscular self-image through more efficient and
The Method accomplishes these goals through
two parallel techniques:
Awareness Through Movement® (ATM)
lessons consist of verbally directed
movement sequences presented primarily to groups. The lessons, which
last up to an hour, are not "exercises" but,
rather, highly structured movement explorations.
Many are based on developmental movements and functional activities
as well as on more abstract explorations of joint, muscle, and postural
relationships. The lessons begin with comfortable, easy movements that
gradually evolve into movements of greater range and complexity. The
inhibition of habitual neuromuscular rigidities and the expansion of
motor options increases sensitivity and reduces muscular stress so
as to improve sensory motor learning and increase efficiency. There
are hundreds of ATM lessons to choose from in the Feldenkrais Method,
from ones simple for the disabled to perform to difficult lessons that
would be reserved for those who already have superior movement abilities.
Functional Integration® (FI)
is an intensive, hands-on technique used for individuals requiring more
specific attention. The practitioner promotes and communicates changes
in a patient/student's body organization, enhancing muscular efficiency,
coordination and ease. This is done by touching or moving the patient/student
in ways that hint at new functional motor patterns.
The patient/student then assembles a more
complete image of movement, mostly at a subcortical level, which can
be translated into new achievements. (The image to which I refer is kinesthetic,
visual and neurophysiological. It is similar to Dr. Karl Pribram's image
Whether the practitioner uses ATM, FI, or
both depends upon the needs and aspirations of the patient/student. In
serious neurological and orthopedic disorders, FI might at first be the
exclusive modality, until the patient/student is better able to direct
his own movement.
The Method is commonly used by people with
all types of clinical disorders, from hemiplegia and cerebral palsy to
acute or chronic back and other pain problems. Interestingly, it is also
used by superior athletes, dancers, and musicians who have recurring
injuries or stress symptoms and by their coaches and physical education
teachers needing more refinements in movement analysis and teaching technique.
Other major areas of application include elderly citizens with motor
limitations, people with breathing disorders, and those suffering from
chronic anxiety and psychosomatic disorders. The method has been dramatically
successful in those shadowy medical areas where both diagnosis and/or
treatment are difficult or where there is little hope for further improvement.
One of the most striking aspects of the Feldenkrais
Method® is that functional limitations are not corrected or treated.
In Functional Integration, for example, the practitioner's touch is instructive,
not corrective. The Method engages the patient/student in a learning
environment custom-made in each treatment/lesson to the unique configuration
of that particular person at that moment. Through kinesthetic rapport,
the practitioner conveys the experience of comfort, pleasure and ease
in movement while the patient/student learns how to reorganize his body,
including his limitations, in new and more effective ways. The patient/student
experiences the practitioner not as someone trying to shape him to a
concept of normalcy, but rather as someone who understands him deeply
and feeds that back to him as useful information. The areas in which
he operates effectively and comfortably then begin to expand into other
functions not previously achievable. Never does the patient experience
himself as a trained animal drilling to become "normal."
A simple example is a woman with difficulties
in the head, neck and shoulder region. Rather than working exclusively
on the problem area as though it were a mechanical entity operating independently
of her whole functioning, a Feldenkrais practitioner would look comprehensively
at how she arranges her body in movement and in rest. She will have a
very specific gait, balance and joint motion in her hips, knees and ankles,
as well as a characteristic distribution of tone in her feet and hip
adductors. She may also have an overactive sympathetic neural charge
that makes it hard for her to relax, normalize her tone or engage in
a learning process. The Feldenkrais® practitioner would tailor a
Functional Integration lesson to help her become aware of how her overall,
fixed patterns of movement are stressing the particular area with which
she is preoccupied. A Functional Integration lesson for this woman would
require a keen analysis of her unique arrangement of self-limiting patterns
of movement. In addition, the practitioner must recognize how she obtains
information about her body and how she organizes this information, so
if a joint is mobilized it is experienced as part of a whole pattern
that changes with the new joint position.
If one has little awareness of the lower back's
relationship to the forward movement of the head upon getting out of
a chair and does not understand how that affects hip and knee extension
at exact moments, a person who suffers damage from any source may find
rising to standing a difficult or impossible feat. Likewise, an athlete
who uses weights and continuous repetition to try jumping higher may
be unaware of similar spatial and temporal relationships and therefore
may never be able to become a superior athlete. People like this usually
blame their difficulty on lack of strength or talent rather than on kinesthetic
misunderstanding and an incomplete body image.
How much of ourselves can we bring to the
image of an action we want to achieve? This is the important question
to ask about anyone's ability to function effectively in the world. The
more limited a person becomes through accident, stress or badly learned,
fixed habits of behavior, the less he can bring to the image of an action.
Each person needs to become aware of exactly what is missing in his or
her internal representation of what is needed to act.
Most people limit their self-image by learning
only what they absolutely need to know about their bodies and in a disorganized
way at that. In addition, the individual must conform to patterns of
action that are socially imposed. These actions are then generalized
to any situation, which does not necessarily serve the person well in
life. One of the major effects of the Feldenkrais Method is enhanced
ability to learn, not just movement skills, but the process of learning
itself. Learning to dissolve rigid, habitual patterns of action and behavior
linked to ordinary motor skills serves the interests of occupational
therapists, educators, and learning theorists working with the mentally
handicapped as well as with superior achievers.
The more we learn to recognize sensations
that correspond to increased ability and comfort, the less we need to
repeat the same movement lessons and the more we can internalize and
recreate those sensations. Once a lesson is clearly represented internally,
then the practitioner and patient/pupil move on to expand other parts
of the self-image.
One of the most exciting things about working
in this way is that one begins truly to work with the whole person. Someone
coming for Functional Integration lessons does not experience him or
herself as a "hemi" or as someone needing his back put in place. Instead,
he begins to understand his own dynamic organization within the context
of the unique learning environment created by the practitioner.
Many occupational and physical therapists
enjoy studying and applying the Method not only because of its effectiveness
but because it allows them open-ended creativity in their work. Many
feel they are able to involve their patients in the excitement of discovering
something entirely new each session rather than re-applying known procedures
with occasional variations.
Another difference between this and other
approaches involves the training of a Feldenkrais® practitioner.
Studying the Method requires considerable self-development and experiential
understanding on the part of the therapist. Achieving kinesthetic rapport
and feeling the complex involvement of another person's system demand
that the therapist's sensory capacities be greatly heightened along with
his ability to integrate and organize his own movements. (Functional
Integration refers to the functioning of two systems as one cybernetic
whole.) Awareness Through Movement retrains the therapist's sensory-motor
system to enable him to use FI as more than a set of clever tools or
techniques. Without this improvement of the therapist's system well beyond
what could have been learned from previous academic or clinical studies,
many of the procedures in FI will not work. They are dependent upon subtle
and discrete changes which many experienced therapists cannot at first
sense and therefore cannot feed back to the patient.
Some therapists have asked for research supporting
the Feldenkrais Method®. Research which supports any effective treatment
modality also supports much of the Feldenkrais Method. However, a technique
that is pushing back the envelope of possibilities cannot be explained
or even described accurately until such time as research catches up with
the clinical experimentation that the Method is currently offering. This
has been true for every method new to the profession. So far, the effectiveness
of the work has greatly surprised many skilled physical therapists, occupational
therapists and physicians, not to mention their patients. By the time
we all think we know why it works, I hope it will have developed into
something better yet.
For those interested in background material,
I would suggest a careful reading of the works of Nobel laureate Dr.
Gerald Edelman, in particular his notions of coordinative structures.
The most useful material lies in the realm of learning theory and cybernetics.
Drs. Humberto Maturana and Francisco Varella's notions of self-organization
and cognition in biological systems is excellent for establishing an
appropriate context for understanding the Feldenkrais Method®. These
ideas allow for a more complete notion of the therapist, the environment,
and the patient's internal character structure as they are involved in
learning and improving function.
Note: Dr. Wildman developed
a Feldenkrais® audio cassette series originally to serve as an introduction
to the method and as an adjunct to clinical application
seminars designed for occupational and physical
therapists. Remastered as CDs, the course is
available through the Feldenkrais Movement Institute
©1988 Dr. Frank Wildman
as published in Physical Therapy Forum
Volume VII, No. 6, February 8, 1988