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Coming Full Circle

by Joy Dirham

I want to talk to you this evening about what I have come to explore in my own "gradual accumulation of the knowledge of the laws of the material world." I will be speaking of problems associated with the central nervous system (brain and spinal cord), and the musculoskeletal system (muscles and bones).

First, I will address some experiences I've had, in the clinic, that transcend purely scientific investigation, and go beyond anything I was taught in school. Second, I will cite some information from others that will substantiate the occurrence of outcomes that transcend the easily explained and their recognition of the importance of these events. Last, I will offer a brief explanation of my understanding of the approach of Moshe Feldenkrais and his philosophic/therapeutic method that offers a plausible theory that sheds light on these transcendent phenomena. Along the way, I hope to allude to the need to reconsider our purely scientific stance, and to come full circle by realizing the importance of the "laying on of hands," both literally and figuratively; which is to say, using actual touch and using emotional touch. I hope to give you questions about your own ability to come full circle, as an individual, through looking back to your earliest development and thinking about what behavioral and physical habits you've formed which may no longer serve you. An increase in personal control can happen when we recognize our past and free ourselves from it--come full circle.

As I stated, the transcendent experiences I've had during my work with people with brain injury and strokes have occurred as a result of looking at a much bigger picture of the patient than I was ever taught to look at in school.

Several important factors can affect the outcome in giving these people an increase in motor control. The ability of the patient to respond cognitively is important, but of greater importance is the ability of the body to experience a feeling of normal movement. This "feeling" of normal movement involves not only the sensory perception of movement, but also the emotional feelings associated with the ease of normal movement.

Normal movement has an inherent lightness, and in the impaired system, when this movement happens, there is a profound emotional response that reverberates throughout the whole organism. In order to impose a feeling of normal movement on a disrupted system, it requires the therapist/teacher to view the entire human organism sitting before her, and to gently guide the distorted body parts into a posture more related to normal body postures. I have learned that the greatest success can happen if this gentle guiding takes into account the patient's psychological need for security--both physical and emotional safety. I am able to establish this bond of trust by touch: in the firmness or lightness of the touch, the speed of the movement, the physical support or lack of support, or sometimes by just placing myself in the position to catch them if they fall. Very little verbal exchange takes place. Furthermore, an awareness of my own muscle tone, as well as my own emotional tone, helps to establish the necessary setting. The act of utilizing the correct components of movement, via positioning the patient properly, which I have been taught, could be elevated to a more dynamic healing event when the whole person was considered, and when the teacher/ therapist brought herself wholly to the task. Occasionally, all of the elements come together, and the patient experiences the look of recognition associated with normal movement. I call this event a "cordial connection" between myself and the patient. It sometimes feels like a holy moment, and we are both blessed. I feel that this must represent a true laying on of hands.

In our search for purely scientific, reproducible proof of how and why something works, we have seen a loss of favor for the simple loving act of laying on of hands. I do not propose to take away anything from all the marvelous discoveries that have been made or the tremendous gains that occur through use of the factual, reproducible, scientific method. I have come to believe, however, that our search for answers will increasingly bring us full circle to the discovery of the potency of the laying on of hands and the intangible, unreproducible results that can occur. And this has to do with the recognition of the whole person, and with an interchange between two persons involved in this creative act of healing.

Oliver Sacks discusses the split between science and life, between the pure facts of science, as in physics, and the variety of phenomena that defy strictly factual explanation. We can physiologically identify specific areas of the brain in which memories and images are held, where sensations and experiences reside. We cannot, however, locate the geographic site of judgment or the home of human dignity; these are transcendent functions of the mind. The focus of science on the physiology of the mind misses the importance of looking at the organism in its entirety--looking at the total being. By focusing on the lesion and treating only this lesion, a failure to see the ramifying effects throughout the whole person is inevitable.

Sacks discusses his book, Awakenings, and cites the divergence in the particular manifestations of catatonia seen in patients with Encephalitis Lethargica Syndrome. Even in a catatonic state, beyond a level of generic similarities, the "sub-types" of the syndrome became as varied as the individuals who possessed them. When the drug L-Dopa was introduced and these patients experienced an awakening, after the initial euphoria, the response to L-Dopa was not necessarily associated with the degree of physiologic damage that had taken place, but appeared to have a great deal to do with the individual patient's state of mind. Sacks describes Rose R., who was nostalgic for those things familiar to her, all of which happened in the 1920's (the awakenings happened in 1969). Rose finally concluded, "I can't bear this present timeall this television, trash, nonsense." Shortly after making this statement, she suddenly ceased to respond to the L-Dopa. More than one story hinges on how other elements in a person's life came to bear on his or her response to L-Dopa. What became obvious, as Sacks relates, was that the L-Dopa was only the beginning, and what was necessary for optimal success with the L-Dopa was for the patient to find a life with purpose and dignity.

A.R. Luria, considered by many to be the father of neuropsychology, felt strongly about the interrelatedness of a patient's biology and biography, a person's electrochemical, cellular processing of information, and the relationship to individual personal experience. An understanding of this concept of how a person grows and becomes emotionally/psychologically, and how that growing and becoming is connected to the physical body, is essential to attaining increasing control.

Spinoza (1632-1677), in Ethics, states: "no one hitherto has gained such an accurate knowledge of the bodily mechanism that he can explain all its functionsThe body can, by the sole laws of nature, do many things which the mind wonders at."

We are now in possession of a vast amount of research related to the physiology of the brain, but still the intangibles of the body's unexplained potential give us reason to wonder.

This laying on of hands, of which I've been speaking, is beginning to gain more and more attention these days in the non-medical community, and the reason is, we are finding that it does work. We also are becoming increasingly aware that traditional American medicine often focuses only on the specific location of bodily insult or focuses too much on the tests, X rays, etc., to the exclusion of viewing the whole person. (One of the greatest gifts you can find is a medical practitioner versed in the scientific knowledge necessary, and who is sensitive to all the "ramifying" effects emotionally.) There are many different theories about and methods of touch therapy, both for dysfunctional systems and for normal central nervous systems. To one degree or another, these theories draw upon the body's hidden potential--the transcendent intangible. All of these methods come under the umbrella title, "body work"; there is Heller work, Traegger method, the Rosen method, Mittendorf breath work, and Feldenkrais method, to name a few.

I am going to discuss with you, this evening, some of the ideas of Moshe Feldenkrais. I want to make clear that I do not think the Feldenkrais method holds all the answers or the only answer. This method of body work has had special significance for me, because it has reconfirmed experiences I have had as a practicing clinician and has made me consistently feel (physically and emotionally) the way I have striven to have my patients feel, but with which I have met inconsistent success.

Dr. Moshe Feldenkrais lived from 1904-1984 and developed this method in the late 1940's. He held Ph.D.'s in mechanical engineering and physics and worked with Fredric Joliot-Curie in nuclear research. He was the first European to earn a black belt in Judo. Synthesizing this background with his deep curiosity about linguistics, biology, perinatal development, and athletics, Feldenkrais taught himself to walk again, without pain, after a crippling knee injury. This personal breakthrough led to Feldenkrais' innovative contribution in showing how the body, through movement, influences the mental process.

I have been exposed to his teachings for the past two years and have just recently begun a four-year certification course to learn this method of movement therapy. I am only a beginning student in this method, so that my ability to express Feldenkrais' work must be weighed in light of my inexperience. It is difficult to easily or briefly explain this work, so please bear with me. When I was first exposed to this work (and my first exposure was as a recipient of the actual touch therapy), what I experienced felt profoundly right to me based on my work in the clinic, when I was the one doing the teaching.

As I lay on the massage table, my body was gently manipulated by my teacher, with no work on my part and no verbal instructions on her part (similar to the nonverbal communication I spoke of earlier). Almost immediately my breathing changed dramatically--fuller, slower, a feeling of the breath moving not only in my lungs, but throughout my whole body. When you hold an infant you can feel the breathing throughout the whole body. This must be normal breathing.

I had a deep sense of being more connected in my body and realized that parts of my body that were previously not touching the table (the small of my back; between my shoulder blades) were now in contact. It was a feeling of being more normally aligned around my skeleton.

What happened after my session, which Feldenkrais teachers call "lessons," was a feeling of lightness, both physically and emotionally, that lasted several days. There was no one thing that I could point to as having changed, since I had no real specific complaint to start with, but I experienced such a generalized feeling of well being, a feeling of being balanced over my feet, of moving from a balanced center--and all without conscious effort on my part.

This coincided with what I had worked years to achieve in my patients with central nervous system dysfunction this laying on of hands that gave me a feeling of "normal" movement, unlike anything I could remember experiencing. It established the same "cordial connection," with me as the recipient, that I had experienced on rare occasions with a patient, but this cordial connection had come about in such an effortless way. Not only was I able to experience this feeling through the laying on of hands of my teacher, but I became aware of exercises that can be done gently and easily by myself, or in groups, that could effect this change.

My understanding of Moshe Feldenkrais' observations has to do with habituation of movement patterns. His work discusses the interrelatedness of movement and behavior, the habituation of movement patterns that are established in childhood that prevent ease of movement, even in a normal central nervous system.

The mature person has the ability to learn newer, more appropriate patterns of movement and behavior, based on becoming aware of habitual patterns. We start, as infants, with free and easy movement; we habituate movements that prevent free, easy movement; we recognize these habitual movement patterns and choose another way, thus freeing ourselves once again. This is the avenue for coming full circle, as an individual, that I promised to challenge you with in my introduction. For example, in our society we are chair sitters, so that when we are seventy years old, our ability to rise from sitting on the floor has usually slowed. In a society of floor sitters, the seventy year old has no such difficulty. We all started as infants with the same flexible skeleton.

Human infants, unlike other animals on the planet, are subjected to a prolonged period of motor development (as compared, say, to a horse that stands up within the first few minutes after birth), and an even longer period of dependence on parents. At birth, we have only primitive reflexes working intact, and we slowly lay down motor patterns that are controlled by the higher cortical centers. As the infant begins to develop a sense of self and sense of world--"myself" versus "other"--movement/action facilitates this emotional/psychological development. Superimposed upon these motor and behavior explorations, because of the total dependence upon the parent, are all the expectations of the parent. To please the parent is necessary for survival. Our experience of movement and, hence, the appropriate behavior for survival, becomes influenced by the society, culture, economics, and education of our parents. Therefore, movement becomes the expression of behavior and behavior is shown through movement, and both of these are the product of our own individual personal experience.

According to Feldenkrais, faulty posture and behavior come about when a normal child is asked to perform a task that is beyond its ability to perform with ease, based on its motor development at that time. People slouch or tense their bodies unnecessarily, not because of a problem with the nervous system, but secondary to attempting to perform tasks that were beyond their means, as children, and they have habituated that effortful performance. The child's dependence is so great and so linked to survival fears that it will perform what is expected, even if it is unable to accomplish the task with ease.

Remembering that muscle control in humans is gained through prolonged training, our actions are more influenced by our experience and environment than those of other animals. This comes back to, and validates the idea of, looking at the entire organism--the whole person. There is also a definite connection, using this line of thinking, between the highly individual nature of each person's personal experience and the highly individual nature of each person's healing and/or response to healing (physical and psychological).

With Feldenkrais' technique, in both the individual lessons, called Functional Integration, and self/group exercises, called Awareness Through Movement, an attempt is made to free the nervous system from its habitual patterns of movement (even in its most subtly restricted patterns) and to re-establish in the body the feeling of light, effortless, normal movement.

In movements we performed for the first time, we experienced the initial effort, and that effort was repeated with each subsequent like movement. In time, the effort becomes so habitual and automatic that there is a complete loss of awareness of the effort involved, as well as of the subsequent restricted movement it causes.

An example would be to turn the head slowly to the right, several times, staying within a comfortable range of motion. While turning the head, become aware the degree of smoothness and ease of movement, and also notice the end point, visually, at the end of motion. Next, repeat the exercise, slowly turning the head to the right again several times, while turning the eyes to the left. Repeat slowly, head right and eyes left, for four to five repetitions. Now, resume turning the head right with eyes following right, and evaluate again the quality of movement and the visual end point of the movement. Are there any changes associated with this break in the habitual pattern of neck movement being influenced by eye movement? Did you notice a slight increase in the range of neck motion; i.e., was the visual end point of the movement slightly beyond what you made note of in the first exercise?

So, what we have talked about here are phenomena that transcend measurable, reproducible, scientific research, because they appear to be--in one way or another--imbued with the individual experiences, both physical and psychological, of the person or persons involved. We have discussed coming full circle in our approach to healing by recognizing, rethinking, the contribution of the laying on of hands despite the intangible, unreproducible results. Further, we have talked about one theory of touch therapy which acknowledges the importance of individual experience in creating behavioral, psychological patterns that influence movement patterns, and vice versa. As we have created these patterns because of survival needs in early childhood development, so we can recognize--rethink--these patterns and recreate ourselves, thus "coming full circle" in our own lives.

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