By Frank Wildman,
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 comfortable movement.
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 of achievement.)
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
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
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 CD series originally
to serve as an introduction to the method and as
an adjunct to clinical application seminars designed
for occupational and physical therapists.
The audio CDs are available in the INTELLIGENT
BODY™ CD set by clicking
© 1988 Dr. Frank
as published in Physical Therapy Forum,
Volume VII, No. 6, February 8, 1988