Category Archives: Feldenkrais Research, theory

2012 Feldenkrais Conference: Embodying Neuroscience



The Feldenkrais Guild of North America has announced its 2012 conference entitled, “Embodying Neuroscience: The Feldenkrais Method® in Human Development, Performance and Health.” They have made a call for proposals, due January 3rd, 2012: Conference Proposal Information.

According to the conference announcement, “The program will demonstrate that when we practice the Feldenkrais Method, we are embodying neuroscience.”

Hmmm.

“Embodying neuroscience” does not sound quite right to me. Neuroscience is a large field encompassing researchers in biology, psychology, genetics, philosophy and other fields. They publish papers, conduct research, come up with theories etc. Do we embody that when we do the work? I did a session from the New York Quest workshop this morning. It felt like I was embodying myself, not neuroscience. But perhaps I am missing something.

The chair of the Guild’s conference committee is Roger Russell, a Feldenkrais “Trainer” who practices in Germany. Roger has been focusing on science (as he understands it) related to the method (as he sees it) for quite a number of years. And though I can admire his tenacity, there is nothing in the conference description that particularly resonates. Yes, Roger Russell likes neuroscience, yes, he thinks it is important…and? I do not see an underlying focus on practitioners, practitioner’s needs and the needs of the public that would make the event a “must see.”

I will look forward to reading workshop and conference descriptions to see how they turn out.

In the meantime, I would like to leave you with a quote from one of the latest editions of my handwritten commonplace book. Perhaps you can see a connection.

The Serenity Prayer For System’s Theorists

“God grant me the serenity to exercise my bounded rationality in the systems that are structured appropriately, the courage to restructure the systems that aren’t and the wisdom to know the difference.” From Thinking in Systems: A Primer (A brilliant book, suitable for beginners. I highly-recommend it.)

Feldenkrais and TMJ: The Mayo Clinic Gets It Wrong.

About 30 minutes ago, I read a statement on the Mayo Clinic website that noted:

“Severe TMJ disorders may need to be treated with dental or surgical interventions.” (From: Mayo Clinic)

That’s a simple statement that few would take issue with. And it seems to meet the unconscious expectations that many of us have, such as “Long term pain in body means surgery may be necessary.” As I have written previously on this blog, there is a great deal of research to suggest that pain symptoms do not always have a structural cause and it has been demonstrated that many people with defined “causes” do not necessarily have pain symptoms (See: Think Your Pain Symptoms Are Caused By a Structural Problem?)

However, the Mayo Clinic’s assertions are somewhat shocking because in the case of TMJ problems, there isn’t any reliable evidence that surgery or dental implants work for TMJ pain. Research organizations such as the NIH have repeatedly stressed that there is little evidence supporting surgery. For example,

“There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Nor are there standards to identify people who would most likely benefit from surgery.” (From: NIH)

If you want more detail, I did a post about TMJ and Dental devices on my blog that promotes my Feldenkrais TMJ program. For those of you who do Feldenkrais-related work or are interested in doing so, using Feldenkrais for TMJ meets all of the suggested requirements put out by the NIH and NIDCR. Namely, that treatments should be

1) Conservative and reversible

2) Customized to a client’s special needs.

And treatments that can cause permanent changes in the bite or jaw should be avoided.

Even more to the point: “Simple self-care practices such as relaxation techniques, stress reduction, and biofeedback are often effective in easing TMJ symptoms.”




Feldenkrais Research Reviewer: But What did you DO?


…and how can it be replicated?

I think it has been about 4 years since I left my PhD studies – without finishing my dissertation. Maybe five. And I’m starting to pull out some of my non-published papers, and reviewer comments, and begin making sense of them and all that time I spent in academia. And of some projects that I would still like to finish up. Doing so, I bumped across an interesting paragraph, that will likely make some sense to those who have conducted or reviewed research. It’s about a manuscript that I submitted for publication:

“The intervention procedure [Feldenkrais] is not clearly characterized. The authors provide an example of treatment activities (p. 9) but also state that the FM involves “flexibility of its methods,” a “large variety of movement sequences,” and a progression of lessons that “is not predetermined.” No further detail is offered regarding exactly what the participants experienced in the treatment sessions. The absence of detail renders the intervention non-replicable.” – Anonymous Manucscript Reviewer.

Ahh replicability! The need to be able to perfectly replicate an experiment and its conditions to test the validity of the experiment’s conclusion. Replicability. If one could replicate a particular Feldenkrais session, it would not be a Feldenkrais session. Trying putting that statement in a research article!

The reviewer is referring to several portions of the manuscript that I submitted over 5 years ago. Namely,

“In order to help individuals their functioning and ability to act, Feldenkrais practitioners use verbal and touch-guided movement sequences. The sequences used are both developmental and functional. As an example, consider the previous example from Teitelbaum et al. (1998) of an autistic infant’s difficulty in rolling onto the stomach. In order to evoke the most efficient pattern of turning and orienting of eyes, head, shoulders, and pelvis, a Feldenkrais practitioner might begin by differentiating and then integrating individual components of the movement. Using touch the practitioner can evoke turning in the head, shoulders, and pelvis so that the components are working smoothly together, “teaching” if you will, a more functional pattern. The basic pattern of turning can then be invoked in a variety of positions – on the side, in sitting, and in standing – so that the individual can learn how to move effort in a variety of configurations and with the least amount of muscular effort.”

As well as, the following “rationale” that I provided:

“A primary reason we have chosen to use the Feldenkrais Method is the flexibility of its methods, an important consideration when dealing with a complex and heterogenous disorder such as autism. There are a large variety of movement sequences that Feldenkrais practitioners use to evoke developmental change. Likewise, the progression of the Feldenkrais lessons is not pre-determined but based on patterns that can be adapted in-the-moment to the responses of the individual participant. If a particular movement or position is not comfortable to the participant, or not developmentally available, another way of evoking the pattern can be found.”

I feel a little odd as I read the rationale, as with the rationale behind much psychological research, and perhaps much research in general it is a lie. Though, I didn’t think so at the time. I certainly did not do a reasoned search for autistic treatment options and then choose the one that had the most flexible methods. Neither did my co-researcher Alan Fogel nor the one who created the study. We were all biased toward’s Moshe Feldenkrais’s ideas from day one. Nearly all researchers have such a bias, though they almost never mention it.

I also remember reading the reviewers comments years ago, and thinking that the non-replicability of the research was what doomed it from being published in that particular journal. But as I read the detailed comments (not published) a few moments ago, I began to think otherwise. The study was flawed in so many ways and the theoretical justification was so outside main stream thinking, that the paper didn’t stand a chance. At least not in the way that I framed it. Consider the following comment:

“This reviewer struggled to understand the conceptual framework for the intervention. I find unconvincing the assertion that “motoric difficulties are universal in autism” (p. 7) ;and the theoretical link between such motoric difficulties and the central social and communication features of autism spectrum disorders seems even more tenuous. The proposed logic chain, (i.e., learning “basic motor skills” leads to increases in “core self awareness” and “a sense of safety and agency” which will then yield “spontaneous exploratory behavior” and “seek[ing] out social contact”) is insufficiently developed and defended in the introduction.”

The fact that a reviewer would doubt the idea that movement problems are universal in autism makes me speechless. Though I can see how scientists not used to considering the body and self-awareness would need much more information and “hand holding” in order to learn some basic ideas about learning, movement and self-awareness.

I’m going to sit with blog post a while and decide whether or not to post more at a later time.

cheers – Ryan

The Satanic Verses of Frank Wildman


Please Note: This blog post is certified safe for both Guild and Non-Guild Members.

I spent a considerable amount of time last month scanning documents and books and such into my computer, getting ready for my cross-border move. In the process, I came across an article that Frank Wildman published in the Physical Therapy Forum called, “Learning – The Missing Link In Physical Therapy: A Radical View of the Feldenkrais Method.” I was told that someone in the field of Physical Therapy, called the article “Satanic.” I find that rather humorous. Here’s a brief sample of the article:

“Today, there are a large variety of techniques available in physical therapy and many diverse schools of thought brought to bear upon the patient population. However, the many theoretical and clinical inconsistencies and occasional discrepancies between techniques point up to a lack of agreement as to what basic principles of human functioning underlie effective treatment. I observe an unfortunate lack of any integrated, comprehensive theory pertaining to the function of the brain and body that could include all modalities of patient care.

Many therapists resolve this dilemma by using an eclectic approach. They might problem solve a particular neurological case by using some NDT here and a little PNF there, depending on the type of condition, or sometimes according to what seems to work best at the moment. This can create problems, since assumptions underlying the operational models of PNF about how the brain actually functions are quite different than the models used for NDT. It is as though there are two different brains with mutually exclusive principles of operation in the same patient’s head.”

And later:

“In order to develop a conceptual framework to integrate the current procedures in Physical Therapy, a model must be developed that would include all aspects of human functioning from motion to emotion. As is the current focus in physics, there is a need to discover a unified “field theory” to encompass all the types of clinical cases that are worked with piecemeal in the hospital and clinic today.

At the heart of this more potent conceptual framework for physical therapy should lie the recognition of not only the enormous capacity for learning that exists in the human being but also the overwhelming need for it.”

Though the article is over 20 years old, it’s still an interesting read. The ideas in the article could be extended to psychology and medicine and a variety of other fields. Hell, you could even take a look around the larger Feldenkrais communities and apply it there as well. I don’t know where Frank stands on the issues now, or even if he considers them at all, but here’s a link to the article if you want to view the pdf: Wildman Learning Feldenkrais. You can also find the full text version on Frank’s website: Radical View of the Feldenkrais Method

Enjoy – Ryan

DISCLAIMER: No actual physical therapists were harmed in the creation of this blog post. Any resemblance to actual theories, living or dead is purely coincidental. Avoid contact with skin. Sanitized for your protection. No anchovies unless otherwise specified.

Science is an essentially anarchic enterprise…

Paul Feyerabend

Paul Feyarabend

[and this] theoretical anarchism is more humanitarian and more likely to encourage progress than its law-and-order alternatives. – Paul Feyarabend, Against Method (Fourth Edition), page 5.


“The idea that science can, and should, be run according to fixed and universal rules, is both unrealistic and pernicious. It is unrealistic, for it takes too simple a view of the talents of man and of the circumstances which encourage, or cause, their development. And it is pernicious, for the attempt to enforce the rules is bound to increase our professional qualifications at the expense of our humanity. In addition, the idea is detrimental to science, for it neglects the complex physical and historical conditions which influence scientific change. It makes our science less adaptable and more dogmatic: every methodological rule is associated with cosmological assumptions, so that using the rule we take it for granted that the assumptions are correct.”
Outlines of an Anarchistic Theory of Knowledge.

Increasing our professional qualifications at the expense of our humanity? Sounds familiar. Guild dues are going up. Renew soon.

Feyarabend is the exception that demonstrates that not all scientists are myopic brain-dead idiots. Just most of them.

Feldenkrais Research

I just received an anonymous email from – I presume – a member of the public, asking me:

Where might one find and review the “30+ outcome studies that have been conducted on The Feldenkrais Method.” cited in your critique of Dr. Gorski?

I no longer have a complete list of Feldenkrais Research, as my initial compilation is at least 3 years out of date: Feldenkrais Research Archive and I don’t currently have the time or desire to keep up to date on the latest research in that area. To be perfectly blunt, I find outcome research boring and relatively unhelpful from both epistemological and philosophical perspectives. Yes, you can reduce your view of a phenomena to that which can be quantified and replicated and yes you can do that over and over again coming up with some type of verbal-semantic roadmap to guide your belief. But have you really learned anything? Has it changed your ability to sense, feel, and act?

On the other hand – I do understand why people want to do it and I applaud their efforts. It’s just not my cup of tea.

If you do want to get a sample of the research go to PubMed and search for the term “Feldenkrais”:

http://www.ncbi.nlm.nih.gov/sites/pubmed

You will find about 40 studies. It’s not all of the studies on the Feldenkrais Method, but it’s a start. Beyond that, I cannot be much help.

Feldenkrais Google Search Trends (Deceiving!)

Feldenkrais Search Trends

I was initially puzzled – and annoyed – at the chart below. It show a 5-year long decline in the number of people searching on Google for the word, "Feldenkrais." Surely that can’t be right???

The Graph is deceiving. What it is actually showing is a change in search habits. People, in general, are doing much more complex searches on Google. Their knowledge of Feldenkrais may actually be increasing and they are doing more knowledgeable and specific searches.

This is the graph for the same period as above. But for the search “Feldenkrais Therapy”

And for “Feldenkrais Exercises”

Feldenkrais Practitioner:

Here’s some other Feldenkrais search terms that are increasing:

 

1.    feldenkrais übungen     +160%
2.    feldenkrais exercises     +110%
3.    feldenkrais therapy     +110%
4.    feldenkrais practitioners +100%
5.    feldenkrais méthode     +90%
6.    feldenkrais paris     +80%
7.    feldenkrais metodo     +70%
8.    methode feldenkrais     +70%
9.    feldenkrais institute     +60%

The biggest trends are likely not showing because the numbers are too small for google to bother tracking. These are the long keyword searches such as the ones below. Below are actual searches that people typed to reach this blog. There are about 500 unique searches that people type every month:

feldenkrais for carpal tunnel and thoracic outlet
feldenkrais lesson for the core
feldenkrais lessons online free
feldenkrais exercises for emotional integration
feldenkrais classes salt lake city
feldenkrais abdominal breathing, posture correction, and nerve glides
copyright feldenkrais free atm nagy
cervical degenerative disc disease feldenkrais
bone mineral content related to bone healing
alexander technique opinions about rolfing
david zemach-bersin training in berkeley bad teacher Ha ha!!
power of feldenkrais on you tube
amherst training videos on youtube    
the work of moshe feldenkrais cd/dvd
the goal of feldenkrais to move in any direction
sample atm mp3 feldenkrais
moshe feldenkrais quote intimacy choice
moshe feldenkrais book self defense moti nativ
more flexible than a child lesson feldenkrais
link between rolf, alexander feldenkrais
judo: the art of defense and attack feldenkrais download

 

The take home message: Don’t be shy about using long sentences and blog post titles (or page titles) when you write about your work. “Feldenkrais for your grandma so she can slap the sh*t out cha mama.” That’s totally fine. You may not get many visitors, but the ones that you do get will be looking for exactly what you are talking about.

By the way: Google searches are getting longer and longer in general: Ryan Nagy: Keyword Searches

Feldenkrais Trainings: How Many Graduates Start a Practice?

Have you ever wondered how many people graduate from Feldenkrais Trainings on a yearly basis? Curious how many of those people actually start practices?

Paul Rubin’s Answer

Last month on the FeldyForum, Feldenkrais Trainer Paul Rubin stated his belief that most people who graduate from a Feldenkrais professional training program end up using the work in some type of professional context such as a Feldenkrais practice, physical therapy practice, dance practice etc.

When someone on the forum asked him where he was getting his data from, Rubin made some vague reference to a straw poll that he had conducted. I am not surprised that a trainer would want to see himself, his trainings, and perhaps the profession at large, as able to successfully launch careers in the Feldenkrais Method. However, I was stunned that Paul would simply put forth his own assertions – with no supporting evidence or data – and expect people to believe what he was saying. Several people, myself included, said as much.

Rather than owning up to the fact that he had no reliable nor meaningful data, Paul began engaging in a whole series of ad hominem attacks, many of which were directed at me. Apparently, the fact that I challenged him to provide some evidence for assertions means that I am frustrated individual, who is preaching gloom and despair – blah blah blah.

I don’t remember exactly what Paul wrote and I have since canceled my membership to the FeldyForum and can’t go back to check. But suffice it to say, that in the absence of having any evidence or reasoned response, Paul Rubin saw fit to attack me personally. In fact, at one point, Rubin refused to even speak to me directly, writing, “someone said…” and wrote that I was “claiming to be an expert.” Point taken. If you disagree with Paul Rubin, you become a nameless, faceless “other.” And being unable to meaningfully criticize my views he attacked my credentials. I am truly sorry that he is in that space. Not only does it serve no purpose for anyone and degrade both him and the method, but it in no way supports his case.

The Research Answer

After a few days, Paul did manage to find a survey done by Rob Black (currently the FGNA President-Elect) in 1997. (PDF Download: Snapshot of Feldenkrais Practice. Rob’s survey was a valiant first attempt, and does provide some very interesting data about the state of the Feldenkrais Method 12 years ago. For example, it has data on practitioners reported income and satisfaction with their work.

However, like most convenience sample studies it has major limitations. For example, it’s not clear that Rob had access to contact information for those who were not in the guild database and may not have been practicing. We don’t know how many attempts were made to contact people, some regions of the country where not represented, and overall, there is no way of saying that the study is representative of the population of Feldenkrais practitioners 12 years ago, let alone today.

Again, it’s great that the attempt was made, and I am sure at some point that FGNA (The Feldenkrais Guild of North Americal) will follow-up up. However, one study does not constitute an answer to the question:

“How many people take Feldenkrais Trainings and actually start practices?”

Who else might have an answer to the question?

The IFF’s Answer

The IFF (International Feldenkrais Federation) has been doing a great deal of work in the area of developing competency profiles and attempting to improve the practice of practitioners. In a 2008 report, they stated:

It’s sobering but true. Only a fraction of Feldenkrais training program graduates are still
practicing members of their guild five years later.

(IFF Competency Profile, p4)

Note: The full IFF competency profile can be downloaded here: www.feldenkrais.com/download/profession/IFFCompetencyProfile.pdf

How they know that “only a fraction” are practicing members of their guild 5 years later, I do not know. Though I would hope that the report, compiled by representatives of Feldenkrais Guilds worldwide, has some factual basis for the assertion. I would certainly give it more credence than Paul Rubin’s dubious assertions.

Personal attacks on my character and intelligence notwithstanding, I cannot find any reliable or meaningful data on the efficacy of Feldenkrais trainings. If anyone can send me information, published or not, please do so, or leave a comment on this post.

Ryan’s Opinion

My personal opinion, (yes, that’s right my opinion) is that many people who take trainings have no intention of becoming practitioners, even if they state that as their goal. Currently, it’s difficult to find intensive experiences of the Feldenkrais Method without going to a training. Many people realize the value of the work and – I think – take trainings because they want a deeper experience of themselves and the method than they can get in a weekly class or weekend workshop. If that is true, it represents a huge opportunity, not just for Feldenkrais trainers, but for practitioners and assistant trainers.

Why?

I’d be willing to bet that those taking a feldenkrais training for largely personal reasons would be willing to spend money for less-expensive, but equally valuable intensive workshops. That is, they might be willing to attend a 1-week, 2-week, or even month-long workshop that would allow them to go deeply into the work without having to pay for the additional costs associated with the certification process (administration costs, staffing costs etc.) In addition to costing less, the workshop could be conducted by any practitioner willing to take the plunge and could serve as a valuable pathway for more people to learn about the work. It might also appeal to a much larger segment of the population.

And one last time – the question of how many people graduate from Feldenkrais trainings and then successfully create practices? I do not know.

And neither does Paul Rubin, nor anyone else in the Feldenkrais community.

Like it or not.

cheers – Ryan

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Think Your Pain Symptoms are Caused by a Structural Problem? Think Again.

Capsule of shoulder-joint (distended). Anterio...
Image via Wikipedia

Have you or a loved one ever been in that uncomfortable position of asking a health provider:

“What is the cause of my back pain?

“…shoulder pain?”

“…neck pain?”

or some other painful condition? And your well-meaning nurse, doctor, or physical therapist was kind enough to do a “diagnosis” with an MRI or X-Ray, solemnly telling you afterward that the cause was:

a torn rotator cuff

degenerative disc disease

disc protrusion

or some other scary and official sounding “cause”? And those explanations sound convincing, do they not? If a person has intense and recurring back pain and someone shows them an x-ray with a “herniated disk” that disk must be the cause, right? After all, SOMETHING must be causing the pain. It is difficult to not associate pain that with some type of structural abnormality…especially when someone who is supposed to be an authority on pain tells you so.

But do structural anomalies cause pain?

Is it true that disk protrusions, torn rotator cuffs, herniated disks and the like actually cause pain? It’s not a trivial question. If a surgeon believes a spinal problem is causing a pain symptom, he or she may want to conduct an expensive and invasive surgery to “fix” the structural “problem.” The “cure” could cost tens of thousands of dollars and require months of recuperation. It might be nice to know if structural abnormalities are a necessary and sufficient cause of pain.

I’m not going to directly answer the question of whether so-called structural problems cause pain symptoms. You will have to be the judge. I will give you some information from several studies that demonstrate how many people with structural issues are, in fact, pain-free. In other words, the research shows that some people have pain “causes” and yet do not report pain symptoms. Let’s begin.

Pain and the Lower (Lumbar) Spine

The first research I will cite was conducted in 1991 and reported in the Journal of Neuroimaging (cited in PubMed). The researchers used magnetic resonance imaging (MRI) to examine the lumbar spine (the lower part of the spine) of 66 asymptomatic people. Asymptomatic means they had no back pain.

Given that they had no back pain, they had structurally perfect lower backs, right?

Not so fast.

Twelve of the people in the study (18%) had either a disc protrusion or a herniated disk of some kind. Twenty-six of the people in the study (39%) had a bulge that could associated with degenerative disc disease. In addition, there were many other structural issues found, including spinal stenosis, and narrowed nerve root canals. The researcher’s conclusion? “Degenerative disc disease is a common finding in asymptomatic [pain-free] adults…”

Pain and the Cervical Spine (Neck Region)

Next up, a more recent study, reported in 2005 in the European Journal of Radiology (PubMed). This study examined the cervical spine of 30 pain-free individuals. The cervical spine is the seven vertabrae at the top of your spine, beginning at the base of the skull and ending near the top of your shoulders. Again, 30 people who have no reports or history of pain near the cervical spine likely have no structural problems in that area, right?

Au contraire.

An astounding 73% of the sample (22 of 30) had a “bulging disk”! Fifty percent of the sample had a “disk protrusion”. The thought occurs to me that if the majority of the sample had a bulging disk perhaps having a bulging disk is normal? In that particular sample it certainly was not out of the ordinary. Let’s do one more.

Shoulder Pain and the Rotator Cuff

This one is from the Annals of The Royal College of Surgeons of England and was published in 2006 (Full-text online: Dead Men, and Radiologists Don’t Lie). This study is a review study, meaning they did a review of many different studies that had already been conducted. They reviewed the prevalence of rotator cuff tears in people who had reported pain and people who had not. Interestingly, they reported on studies of living people as well as cadaver studies of people who had died. In the cadaver studies, on average, people who had pain symptoms in the shoulder area had rotator cuff tears at a rate of 42%. Meaning that only 42% of those who were in pain had a rotator cuff injury. And for those without any pain? About the same: 39% of them had injuries.

The study of living people was a bit different. According the the studies 26% of pain-free people had rotator cuff injuries and 49% of those in pain had injuries. The researchers concluded that “rotator cuff tears demonstrated radiologically during investigation of the shoulder may well not be responsible for the presenting symptoms.” In plain english, rotator cuff injuries might not be the cause of pain symptoms.

You’ve got the take home message by now? According to the research, pain and structural problems are not necessarily related. Be wary when someone tells you that they are, even if they have an X-Ray or MRI scan to “prove” it. Get a second opinion. Look for other factors.

I am not a medical doctor, nor am I giving medical device. I am merely reporting on the literature that has been produced. Do not make any medical decisions based on my opinions.