Sparks is a new hub of ‘sustainability, creativity and education’ which has been set up in the old Marks & Spencer in Broadmead shopping centre, Bristol.

Last Sunday, I had the opportunity to introduce the Alexander Technique to members of the public passing through this space, thanks to the brilliant support of Mila Plants.

The event was a real success. I gave around 10 minutes of free hands-on Alexander Technique work to 16 people of all ages and backgrounds. Some had musculoskeletal issues, and some didn’t, but all of them said it was a positive experience. Many of them looked quite different walking away, even after that short intervention.

From my perspective, it’s really exciting to be able to bring the Alexander Technique to a wider audience. Certain groups have often heard of it (musicians, actors and those with back pain) but many more haven’t.

Most of the people I worked with on Sunday had never come across the Alexander Technique. There’s a lot of work to do to make it better known.

The Alexander Technique is about becoming conscious of our habitual reactions to things, and seeing instead whether we can encourage a set of responses that is kinder to us. You could say that, at any moment in time, we can either orient ourselves towards greater ease or towards greater tension. The choice is ours.

What this means in practice can feel very obvious after a one-to-one session: clients tend to feel taller, lighter, more expansive, more energised, freer emotionally and (quite literally) as if a weight has been taken off their shoulders.

But how to keep it going outside lessons? Keeping it going is, after all, the point of the Alexander Technique: it is a self-management technique, and not a therapy (though undoubtedly a session can feel therapeutic).

Improving our ‘use’ through our environment

Let’s return to some basic Alexandrian Directions designed to encourage (in Alexander’s words) an ‘improved use of ourselves’. These are the kind of Directions which students often encounter in Alexander sessions, and we can employ them any time we wish:

Let the neck be free so that the head can go forward and up so that the back can lengthen and widen, all together, one after the other

Bruce Fertman has written inspiringly on how, with practice, we can associate a long set of directions such as these with a single word such as ‘One’ or even a sound such as ‘Paaaah’ (the Japanese sound for an arrow being released by a bow).

Bruce goes further, though. He suggests that we can also look outside of ourselves and begin to associate objects in our environment with these Directions too. He calls this ‘the Voice of the World’.

The simple example of a red traffic light comes to mind. We can play with its basic meaning so that whenever we’re waiting at a traffic light, we can allow it to signify both stopping in a conventional sense but also a profound psychophysical stop (Alexander’s Inhibition) and a release into expansiveness (Alexander’s Direction).

In summary, then, we can experiment with the following links in a chain:

Choosing external triggers for better ‘use’

The example of a traffic light is a good one. Anyone living in an urban area will probably come across a red traffic light at least a few times a day. The traffic light is not so present to us as to become overwhelming or meaningless, but serves as a useful reminder a few times a day.

Another simple example is the presence of a tree. It is already well established that the sight of anything natural in our environment can improve wellbeing. It doesn’t take much to deepen this relationship a little; we can allow the upward expansiveness of a tree to trigger our own upward expansiveness.

The key is to experiment and be playful.

Three types of triggers

You may decide to begin this exploration by choosing relatively neutral aspects of your daily routine as your triggers. Examples such as waiting for the kettle to boil, brushing your teeth or getting into your car or on your bike spring to mind. Often not much else is going on at these times, and so it might be easier to find a little more headspace for our Alexander Directions.

The next level up might be to choose triggers where we know we are likely to significantly interfere with our ‘use’. One example for many people is driving a car. What if we could associate placing our hands on the steering wheel with our Alexandrian Directions? Another example in my case is going up a flight of stairs. Unless I pause for a fraction of a second and Direct, I know that I am likely to shorten my stature so that going upstairs will be more effortful and feel heavier than it needs to be. However, these days I am able to prevent my habitual reaction to going upstairs on most occasions. The stairs themselves have become the trigger.

The third set of triggers you might experiment with are situations, in particular those which you know from the outset are going to be stressful. A business presentation. Public speaking or performing. A difficult conversation. A claustrophobic journey on a crowded train. The question here becomes: can I get good at associating these situations with looking after myself instead? Both before and during the event? In other words, can I change the meaning of this situation (even slightly) to my benefit? Can this situation be saying something to me which is different to my normal associations?

Conclusion and exercise

You could say, we need stressors in our lives to help us develop the skilful resilience fostered through the Alexandrian principles of Inhibition and Direction. Although not exactly the same, I’m reminded of what the Dalai Lama has said about enemies and how we need them to help us practise patience.

As an exercise, then, write down five external triggers you’d like to experiment with over the coming week. You could start off small and choose five objects such as a traffic light, a kettle or a toothbrush. And then the following week, you might then choose a mixture of relatively neutral (brushing teeth), challenging (going up stairs) and stressful (a business presentation). For example:

1. neutral
2. neutral
3. challenging
4. challenging
5. stressful

It’s of course up to you, but writing down the list and sticking it on the fridge (for example) is going to make the activity much more conscious.

And wait! A colourful list – enhanced perhaps with an Alexander aphorism or two – can become a trigger in itself. How about that!

In the summers of 2018 and 2019 I introduced the Alexander Technique to musicians on the Young Grittleton chamber music course at St Marys School, Calne.

A Testimonial

A brief overview of what I covered in the 2019 workshop is included below. But first, a testimonial from the course organiser:

We were privileged to have Henry visit us at the Young Grittleton Chamber Music Course for a session on the Alexander Technique with the members, aged between 11 and 18 years. The session was hugely beneficial to the young string players who had been working intensely on a wide variety of chamber music in the previous days. There was a calm, meditative mood in the hall during the session and the students came out relaxed and seemed just a little taller for it! It was noticeably impactful in their playing stance during the subsequent rehearsals and is a great tool for them to carry forward. Thank you, Henry!

Fiona Robertson, Young Grittleton course organiser

Workshop content

The workshop focused on the benefits of looking after your whole self in practice and performance. What are some of these benefits?

• pain and injury free playing
• your most comfortable playing
• your full enjoyment
• greater technical accuracy
• less wasted energy
• more efficient practice
• less stress
• less performance anxiety
• ability to carry instruments easily
• deal better with sitting in rehearsals for long periods of time
• improved mental health: better mood, more balanced emotions, more self-confidence etc

But what does it mean to look after our whole selves? We played games to explore a number of principles such as:

• The performance of the parts depends on the health of the whole.
• We need to learn how to allow natural movement, and not interfere with it.
• In its natural state, our muscle system is very springy.
• There are no straight lines in movement.
• Large parts move before small parts to create smooth beginnings and endings.

Finally, with more activities, the three main principles of the Alexander Technique were introduced: Inhibition, Primary Control and Direction.

I’m sometimes asked for advice on beds, mattresses and pillows. My standard reply is that it can be beneficial to practise active rest immediately before sleeping and/ or first thing in the morning. The latter can seem counter-intuitive, but our habits of misuse persist through our sleeping hours, and a conscious unwinding of these patterns immediately before starting our day may be just what we need.

In the past, I have steered clear of recommending what to sleep on. However, the BBC radio series Sliced Bread has recently done some evidence-based work on this. Here are its essential findings:

• according to a 2021 review, ‘a medium-firm mattress offers more advantages to subjects with non-specific low back pain and reduces the risk of developing low back pain’;
• according to a 2015 systematic review: ‘a medium-firm mattress is optimal for promoting sleep comfort, quality and spinal alignment’.

Here’s some additional information from the programme about mattresses and pillows:

• There’s no standard measure for measuring spinal curvature when we sleep, and so there’s no really good standardised measure for measuring the firmness of a mattress. However, recent meta-analyses suggest that a medium-firm mattress is ideal. If the mattress is too firm, it doesn’t let your shoulders and neck sink into it, and if it’s too soft you can get problems with your hips and shoulders because they sink too far in.
• Mattress types can be divided into two: sprung types (open coil, continuous coil and pocket sprung), and non-sprung types (standard foam, memory foam and latex foam). Hybrid mattresses can be the best of both worlds and have come out top in a lot of consumer tests.
• Coil sprung mattresses are less expensive and lighter to move around. However, they wear out more easily, and when you or your partner moves, they are more likely to disturb the other person in the bed. Pocket-sprung mattresses offer independent support: they isolate any movement. The general advice is to go for 1000 springs or more.
• Standard (polyurethane) foam mattresses are the cheapest to manufacture. Memory foam is known as a visco-elastic which reacts slowly to weight and body heat, moulding slowly to the shape of the person lying on it. When the person moves, the mattress very slowly recovers to its original shape. Since the mattress becomes indented with your shape, they are ideal for people who don’t need to move much during the night.
• Sleep position. Studies suggest that people who habitually sleep on their side are better on a foam mattress, whereas those who are heavier or who sleep on their back or front are better on a sprung mattress.
• From a health perspective, you should consider replacing your mattress every seven or eight years.
• Buying an ‘orthopaedic mattress’ is not worth it. The term ‘orthopaedic’ is unrestricted and can be used by manufacturers whether the mattress truly is orthopaedic or not.
• Pillows. A flatter pillow is recommended if you lie on your front, and a larger pillow is recommended if you lie on your back, in order to maintain the arch in the neck. Placing a pillow between the legs takes the weight off the hips to some degree and can be useful for controlling pain.

Among psychologists there is a common distinction between two types of happiness: hedonia and eudaimonia. Roughly speaking, hedonic happiness involves immediate pleasure, enjoyment and satisfaction, along with the absence of pain or distress. On the other hand, eudaimonic happiness involves long-term aspects such as meaning, personal growth, excellence and authenticity.

Both hedonia and eudaimonia can be taken to excess. The former has the potential to turn into addiction and impulsiveness, and the latter can derail into a workaholic lifestyle, overthinking things and losing touch with one’s body, for example.

Most wellbeing researchers agree that a well-rounded and flourishing life requires a combination of hedonia and eudaimonia. There is also a significant overlap between the two types. For example, ‘life satisfaction’ and ‘self-efficacy’ seem to belong to both, and there is disagreement among researchers over how best to categorise all the many concepts related to happiness.

Enter the Alexander Technique

In a chapter entitled ‘Sensory Appreciation in its Relation to Happiness’ FM Alexander, the originator of the Alexander Technique, asserted that:

the lack of real happiness manifested by the majority of adults of today is due to the fact that they are experiencing not an improving, but a continually deteriorating use of their psycho-physical selves.

Alexander (1923/2004) p.191.

This is a bold claim. In this article, I am going to look at recent research on Alexander Technique outcomes and see how it relates to the psychological understanding of happiness. The key resource I am drawing on in the psychological literature is the superb overview of hedonic and eudaimonic well-being concepts by Veronika Huta (Huta, 2015).

The scope of my article is summarized below.

Alexander Technique and Hedonia

Affect

At the centre of hedonia are two types of ‘affect’ (or ’emotions’): positive affect and low negative affect. The Alexander Technique has been shown to have beneficial impacts on both, particularly when it has helped reduce or eliminate pain symptoms. In these cases, the experience of pain or discomfort gives way to feelings of ease and wellbeing. In addition, greater enjoyment of life is reported as individuals feel able to resume activities which they had previously had to avoid (Kinsey et al., 2021).

Regardless of pain symptoms, Alexander Technique has also been associated with positive affect in general (general wellbeing, confidence and enjoyment) and with reductions in negative affect (fear, anxiety, depression, low mood, anger and stress) (ibid.). There are several possible explanations (Cacciatoire et al., 2020). One is so-called ’embodied cognition’ theory where the experience of emotions relies on the interpretation of bodily sensations. Thus, reductions in chronic muscle tension could lead to reduced negative emotions, and other more ‘open’ postural patterns could lead to positive emotions such as being calm, alert or confident.

Based on the above evidence, the Alexander Technique could be viewed as an effective method of emotional self-regulation. This can be defined as the ability to restore or enhance one’s affect, and is arguably a major function of hedonia (Huta & Ryan, 2010).

Sensuality

According to Huta (2015), one of the things that hedonically-oriented people are good at is sensuality. These people are are more in touch with their bodies, they savour the physical senses, and they immerse themselves in physical experiences and activities. Logically speaking, sensuality also goes along with two other hedonic orientations: spontaneity (or living in the here and now) and an appreciation of the ‘concrete’ (or practical) over abstract thinking. In other words, you can only be touch with your senses in the present moment and when you get ‘out of your head’.

A number of studies support the notion that people who practise the Alexander Technique are more in touch with their bodies. In their review article, Kinsey and colleagues (2021) conclude that the Technique leads to the experience of mind-body integration and the development of a more holistic sense of self.

Moreover, there is further evidence that the Alexander Technique has another very specific contribution to make. It has been shown that experts in the Alexander Technique are skilled at dynamically matching gravity and other external forces acting on the body. To consciously use a ‘matching strategy’ for balance and movement (rather than a predictive, preplanned strategy) necessitates allowing a flow of proprioceptive (‘body sense’) information to guide one’s motor system in real time. What is interesting from the point of view of this article is that this skill has a hedonic aspect to it. It is termed affective proprioception (Cole & Montero, 2007) or the ‘pleasure in and of movement’.

There is a contrast to be made here, because to fail to tune in properly to one’s proprioceptive and other senses might arguably be a source of unhappiness and malaise. This was Alexander’s own view, and he linked it to a lowering of the overall standard of functioning:

Unfortunately, we have been taught that all the ordinary, most necessary, and therefore most oft-repeated acts of life should be automatic and unconscious; for this reason they have become indifferent. The psycho-physical condition here indicated is one that induces stagnation in the organism, and, as it is a condition which becomes more and more pronounced with advancing age, we gradually lose the capacity to take conscious interest in and derive pleasure from those normal and useful activities of life in the sphere of doing, hearing, seeing, etc.

Alexander (1923/2004) pp.198-9

Alexander Technique and Eudaimonia

Transcendence

The eudaimonic orientation has been linked to a sense of connection with a greater whole, transcendence and spirituality in general (Huta, 2015).

Although the Alexander Technique is non-religious, transcendent experiences are quite common amongst those who practise it. This is not particularly surprising since the Alexander Technique’s core principle of mind-body unity itself implies transcendence. Research shows that the Technique seems to give people an experience of mind-body integration and help them develop a more holistic sense of self (Kinsey et al., 2021). Expanding outwards, people also report improved relationships with others and a deeper connection to their environment (ibid.) – both of which are related to eudaimonia.

Transcendent Alexander Technique experiences have similarities with aspects of the psychological concept of ‘flow’, which has been categorized as a eudaimonic experience. Flow is described as ‘a harmonious experience where mind and body are working together effortlessly’ and is characterized by (among other things) ‘the merging of action and awareness’ and ‘loss of self-consciousness’ (Jackson & Csikszentmihalyi, 1999).

In short, much has been written on various aspects of the Alexander Technique and spirituality (Fischer, J., n.d.).

Developing skills

In the hedonic view, what matters is subjective feelings – positive feelings in the moment, and frequent positive feelings in the long run. In the eudaimonic view, what matters is the quality of behavior – feelings are seen as markers of a life well lived rather than ends in themselves …

Huta (2015) (italics mine)

Huta’s reference to what matters in the eudaimonic view gets quite close to the focus of the Alexander Technique. This is because, in the broadest sense, the Alexander Technique is the skill of improving our ‘quality of behaviour’ through how we ‘use’ ourselves in all the acts of living.

The satisfaction of developing a skill (or achieving competence or excellence) is a eudaimonic attribute which falls under the broad category of personal growth. This satisfaction would seem to be magnified in an unusual way with the Alexander Technique.

Firstly, the Technique claims to develop the overall general skill of ‘good use’ of our ‘psychophysical selves’. It is difficult to describe the deep sense of satisfaction when the mind and body are working well together, but perhaps the word concinnity comes close. This can be defined as ‘the skilful and harmonious arrangement or fitting together of the different parts of something’ (OED, n.d.).

Secondly, through improving overall coordination of body and mind, the Technique claims to enhance the learning of specific skills, such as sports or music. This is doubly satisfying, a point which FM Alexander made himself:

‘They [children] find a new interest in all activities to which they can apply an improving use of themselves, and their happiness in finding, for instance, that they can improve their games by a conscious general direction of themselves (a very different thing from the usual specific directions they receive in coaching lessons) is a happiness which increases with their psycho-physical improvement.’

Alexander (1923/2004) pp.190-1.

As far as recent research is concerned, there is indeed evidence that the Alexander Technique improves various aspects of movement and balance (Cacciatore et al, 2020). Further, its ‘ripple effect’ on other domains is well documented; for example, Kinsey and colleagues (2021) report that applying the Technique to a variety of situations not covered within lessons was linked to a positive feedback loop which included increased feelings of self-efficacy and self-confidence.

Autonomy

Autonomy is the capacity to make independent, informed decisions. It is a eudaimonic orientation with links to other concepts such as being authentic, integrated, non-conformist or intrinsically motivated (Huta, 2015).

Kinsey and colleagues (2021) theorize that, because the Alexander Technique helps people to recognise unconscious and unhelpful habit patterns, they become aware of more possibilities in responding to situations. They can then get better at making conscious, informed decisions based on wants and needs, rather than reacting habitually.

A sense of control and confidence seems to flow from this process. For example, in one study,

Participants described that, as a result of their Alexander Technique lessons, they had a greater sense of control over their lives and more confidence that they would be able to achieve their goals. This combination of confidence and control allowed them to become aware of a greater number of options in their lives and to consider new options as real possibilities, thereby providing a feeling of freedom and flexibility with life decisions and allowing opportunity to take a course of action that differed from their habitual unwanted patterns of behaviour.

Armitage & Glover (2014) p.7

Bringing it all together

As I hope to have shown, the Alexander Technique helps people to live happier lives. There is evidence that it encourages emotional self-regulation, sensuality, transcendent experiences, skill development and autonomy. The Technique does not connect with every single aspect of hedonia and eudaimonia, but that is not surprising given the breadth of concepts involved.

I want to end by including a personal testimony. It includes a number of the elements of Alexander Technique and happiness that I have explored in this article, and shows what a difference the Technique can make to someone’s lived experience.

The Alexander Technique teaches that there is no separation between our minds and our bodies and that we can learn to release stressful symptoms of tightness and collapse by substituting new ways of thinking and moving. Working with the body via the very simple but incredibly profound methods of the Alexander Technique made me aware for the first time of how I was reacting to life. It gave me a choice. By refusing to tighten my shoulders, for example, I no longer felt so crushed by the world, my breathing was able to flow more easily, therefore my body received more oxygen, my digestion improved, even the waste from individual cells could be transported more efficiently, etc. As a result, I felt better and gradually I no longer felt a victim at the mercy of random black thoughts or moods. As I continued to feel better, so my responses to the world became lighter and less circumscribed and I felt myself to be on a positive feedback loop rather than a negative one.

Hatton, D. (2015)

Bibliography

Alexander, FM (1923/ 2004) Constructive Conscious Control of the Individual. London: Mouritz.

Armitage, J., L. Glover, L. (2014) Situations of wellbeing: psychological experiences of learning the Alexander technique. Alexander Journal, 24, 3-11.

Cacciatore, T., Johnson, P., Cohen, R. (2020) Potential Mechanisms of the Alexander Technique: Toward a Comprehensive Neurophysiological Model. Kinesiology Review 9, 199-213.

Cole, J, Montero, B. (2007) Affective Proprioception. Janus Head 9(2) 299-317.

Fischer, J. (n.d.) Religion, Spirituality. In Mouritz Companion to the Alexander Technique. https://mouritz.org/companion/article/religion-spirituality. Accessed Mar 2023.

Hatton, D. (2015) Where are your emotions? https://daskahatton.co.uk/articles-about-complementary-therapy/2015/03/where-are-your-emotions. Accessed Mar 2023.

Huta, V., & Ryan, R. M. (2010). Pursuing pleasure or virtue: The differential and overlapping well-being benefits of hedonic and eudaimonic motives. Journal of Happiness Studies, 11, 735-762.

Huta, V. (2015). An overview of hedonic and eudaimonic well-being concepts. In L. Reinecke & M. B. Oliver (Eds.), Handbook of media use and well-being. Chapter 2. New York: Routledge.

Jackson, S. & Csikszentmihalyi, M. (1999) Flow in Sports. Champaign, IL: Human Kinetics.

Kinsey, D., Glover, L., Wadephul, F. (2021). How does the Alexander Technique lead to psychological and non-physical outcomes? A realist review. European Journal of Integrative Medicine 46, 101371.

OED (Oxford English Dictionary), Definition: Concinnity. Accessed online Mar 2023.

My teacher trainer and mentor Peter Ribeaux has been teaching the Alexander Technique for around 50 years. Around fifteen years ago he gave a definition of the Alexander Technique which I still return to for its no-nonsense clarity. The definition includes Alexander’s own terminology and so it is only suitable for intermediate students and not beginners.

If, however, you are au fait with the basic Alexander terms, it’s a great definition. It lays out the basic problem we’re all faced with as human beings, and explains Alexander’s solution. It doesn’t go into the specific issues the Alexander Technique addresses, or the Technique’s benefits, but you can read about those on my Alexander Technique science page.

Here’s Peter’s definition:

i) Most of us distort the manner in which we respond to the stimuli which we face in life.  For example, we may pull our heads back and down on our necks in response to the stimulus to speak, etc…..   When repeated sufficiently often these tendencies bring about distortions throughout ourselves, creating wrong habits in the use of ourselves.  What is more, we become unaware of these habits as a result of our unreliable sensory appreciation.  In order to reverse these distortions we must start to:

ii) inhibit our distorted reaction to the stimuli of life, and 

iii) give ourselves orders or directions for an improved use of ourselves and only then, whilst maintaining these, respond to the stimulus in question.

iv) The benefits of such a procedure will be not only an improved manner of responding to the stimulus but also a progressive removal of the overall distortion in the primary control of the use of the self which arises from a history of such individual distorted responses.

Peter Ribeaux, ‘Alexander’s terminological maze’ in Conscious Control, Vol.2 no.1 (2008) 43-53 pp 44-5.

And about those terms: there’s only about half a dozen of them in the Alexander Technique, so you shouldn’t be put off!

In November 2022, I presented a workshop for the sports and music scholars at City of London School for Girls, as part of their Aspiring Performers Wellbeing Programme.

It was a great opportunity to introduce the benefits of the Alexander Technique in a fun and practical way, and I had some fantastic feedback.

Below is a summary of what I offered. It is a very adaptable workshop that can be tailored for any group of young people.

• Warm-up walk: how we think alters how we move and feel. 1) think ‘heavy knees’ 2) think ‘up’. What do you notice in yourself and others?
• Less effort can result in better performance among athletes – a fascinating story from top coach Robert Kriegel.
• Big Idea: Use affects Functioning. Even Bigger Idea: Thinking affects Use affects Functioning.
• Endgaining, or overfocusing on goals instead of staying easy with the process. General examples: Holding your breath at a difficult passage. Tightening your muscles because you’re anxious to get something right. Just wanting to get to the end of your practice. Specific examples: A trumpeter loses height on their outbreath, rather than staying tall. A singer leans forward rather than staying balanced. A cellist tightens up in preparation for a shift. A pianist arches their back and tightens in their hip joints at the piano. Do you recognize yourself in any of these?
• Importance of whole self awareness. Your best coordination comes about when you’re aware of your whole self. Your full potential is released when you’re aware of your whole self. We need to find a way to stop reacting with tension.
• Principle no.1: Inhibition, or stopping. Three Inhibition games: feel the tension then come back to balance and open awareness. 1. threading a needle. 2. looking for lost key 3. cycling through a blizzard.
• The Ready List. 1. Am I breathing? 2 Am I balanced? 3. Can I see the world around me?
• Some Alexander Technique science. See here.
• Principle no.2: Direction. ‘Directing is having the wish, the intention, the aspiration, to be going in those directions that are expansive rather than contractive, but the wish must be expressed through muscular release rather than tension and effort.’ (John Nichols).
• Julia Duschenes’ anchor visualisation.
• An Alexander Technique étude. See here for details.
• Summary, Q&A and further resources.

There’s been a bit of a buzz this week about a new video introduction to the Alexander Technique, and it’s definitely worth the hype. It’s only ten minutes long and worth a watch!:-

In my view, the following is what makes this video so great:

• it shows very clearly from the client’s perspective what it’s like to try out the Alexander Technique for the first time;
• it’s made by endurance athlete and social media influencer Laura Try;
• the instructor is Anthony Kingsley, one of the Technique’s most experienced teachers;
• Laura not only describes her experience first-hand as the lesson progresses, but also gives accurate descriptions of its benefits such as improved movement and posture, reduced tension and pain, and increased energy and performance;
• Laura describes what were for her some unexpected effects of the Technique, for example feeling more present-minded and calmer in both body and mind;
• Laura includes some fantastic ‘before and after’ footage so that the effects of the Technique are clearly visible.

Laura is right when she remarks that the experience ‘was as much a brain exercise as it was a body exercise’. Here’s a quote from the instructor Anthony Kingsley which confirms this important and unusual aspect of the Alexander Technique:

So unlike a massage where you’re very dependent on someone sort of pushing the muscles and releasing little muscle groups, and you go ‘oh that’s nice’, this is a different sort of thing where your nervous system is learning how to self-regulate, how to regulate back to its original design.

Anthony Kingley (at 7:02 in the video)

My colleague, Maaike, has updated her Alexander Technique app with some fantastic new audios. You can try out some of these audios for free via her website here. The four new audios (subscribers only) are described below:

1. ‘Freeing up your shoulders – improve your body schema’
2. ‘Freeing up your arms – improve your body schema’
3. ‘Lunging easily – push, pull & lift’
4. ‘Accents & sforzandos – with ease and expression’

The first two audios work with our body schema, which is our brain’s map of our body parts in space. It is possible to tune up your body schema: a better internal map means that movement becomes more accurate and easeful, and less prone to injury (imagine the strain caused by trying to move from a joint you have inaccurately conceived).

The third audio focuses on the Alexander Technique lunge, a procedure I’ve described in detail here, and the fourth audio is part of Maaike’s helpful series of audios for musicians.

Well done again Maaike for a fantastic app to help students get the most out of their Alexander Technique lessons!

Back pain is the number one cause of disability worldwide and in this blog I want to compare two solutions.

• First, a course of 24 Alexander Technique lessons. A Randomised Control Trial (RCT) published in 2008 showed that back pain sufferers reduced their pain levels from ‘every day’ down to only 3 in 28 days a year later.
• Second, four weeks of Pain Reprocessing Therapy. An RCT published in in 2022 showed that 66% of back pain sufferers were pain-free or nearly pain-free after treatment, with improvements largely the same after a year.

Although both approaches are clearly effective, what is interesting is that they are both unconventional and very different to each other. The Alexander Technique is a mind-body discipline that changes aspects of postural muscle tone. Conversely, Pain Reprocessing Therapy (PRT),

provides patients with a causal model of pain as due to brain processes and not due to bodily injury. Viewing the pain as a brain-generated “false alarm,” PRT emphasizes that the pain is reversible and the body is healthy.

‘Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain’, Supplement 2. doi: 10.1001/jamapsychiatry.2021.2669

One of the reasons that the recent PRT trial had such a high success rate is that it targeted patients who had no clear underlying physical condition which could account for the persistent pain. Indeed, the authors cite evidence that as much as 85% of back pain is this kind of primary or non-specific pain.

PRT has five main steps:

1. education about the brain origins and reversibility of pain;
2 gathering and reinforcing personalized evidence for the brain origins and reversibility of pain;
3. attending to and appraising pain sensations through a lens of safety;
4. addressing other emotional threats;
5. gravitating to positive feelings and sensations.

Ibid.

An introduction to Pain Reprocessing Therapy and some powerful testimony to its effects are included in the recent BBC podcast, ‘Is back pain a transmissible disease?’ – Dan’s story The programme situates PRT within the approach to understanding illness known as the biopsychosocial model. This model suggests that pain is best explained by a combination of biological, psychological and social factors. The show’s presenter Professor Guy Leschziner explains the model as follows:

Just to be clear, the three elements that influence how you experience any illness are biology (what’s happening inside the body, so things like genetics, an infection or the effects of medication), social (what’s going on in your life, relationships or stressful events) and psychology (what’s going on in your mind, how are you feeling emotionally, are you anxious or depressed, are you worried this could be life-threatening).

Professor Guy Leschziner

The biopsychosocial framework is useful for understanding both Pain Reprocessing Therapy and the Alexander Technique, despite the two approaches being so different to each other. The Alexander Technique is an educational method premised on the unity of body and mind (which Alexander calls ‘the self’), and impacts on all aspects of human functioning: mental, emotional, physical and social. Conversely, Pain Reprocessing Therapy is a psychological treatment but which includes a ‘somatic tracking exercise’.

Both the Alexander Technique and the ‘somatic tracking’ component of Pain Reprocessing Therapy have some similarities with mindfulness practices. However, as far as I can see, this is where the similarity between the Alexander Technique and Pain Reprocessing Therapy ends. Indeed, mindfulness is very broadly defined and applied, and does not in my view contribute meaningfully to an understanding of these two unique solutions for back pain.