Last week I blogged about the curriculum I created for young musicians at Trinity Laban conservatoire. This week, I’ve been collating their reflections on their last year’s study of the the Alexander Technique with me.

The young people I work with range from 11 to 19 years old. It’s always fascinating to see these students’ very individual responses to the Technique, and so heartening to see what a difference it has made in their lives.

Below are four of around twenty responses I have had this year, some of which demonstrate a maturity beyond their years.

For me, Alexander Technique is the awareness of our body and our behaviours. It helps us to be aware of the spaces that surround us and the people and events that influence us. It could be defined as the practical study of being, where we reflect on us and come back to ourselves.

Maya (15)

It helps me ground myself and take the necessary time to do things, however minor they are. It brings clarity into my life. It helps me to look after my physical well-being, which feeds into my mental well-being. The thing that most resonated with me was the concept of end-gaining and how to make the most of doing something rather than ‘getting it done’. It also helps me with preventing injury and anxiety. It also helps with preventing unhealthy physical responses to injury, for example dropping something and lurching to pick it up.

Mimi (16)

The idea that there is no right or wrong way to be. We are habitual beings and we can sometimes be cruel to ourselves and expect ourselves to do more than we need; for example, when we practise we decide that we won’t make any mistakes but then when we do we beat ourselves up about it. Alexander technique for me is being kinder to yourself and allowing freedom in your mind and body by creating space. The way we react to different happenings in our lives affects our posture and tension in our muscles. Sometimes the best thing to do when I practise is to just play the whole piece through without reacting to my mistakes. I know I have got into the habit of pulling faces and stopping if I make a mistake but in the long run when I perform this piece I need to just carry on regardless. Alexander Technique has allowed me to learn to just observe my annoyance or anger and accept it and move on. Another BIG part of the technique is pausing, just taking a moment and checking in with yourself and your freedoms. Am I breathing, is my neck free, are my feet spreading? It’s an awareness of your environment and paying attention, living in the now rather than worrying about the past and the future. It’s making life simpler and easier, being kind to yourself. 🙂

Rose (15)

For me the Alexander Technique is a way of me being more in tune with my body which in turn helps my interpretations to breath and sing more; I have felt for a while that there is a disconnect between my imagination and my body when it comes to playing music, almost as if there is a thick mist in between my mind and body which hugely affects the way I sound. This is slowly beginning to improve as I become more aware of my body and surroundings. It also allows me to enjoy playing more too as it is physically more comfortable and helps me to feel more natural and relaxed when thinking about emptiness in my body. I also have found it useful in other aspects of my life; in the past I have had a tendency to hunch over lots and ‘shrink’ in the face of social situations in particular. I still need to work on it but thinking about the head going up and away for example has really helped with my confidence. The idea of ‘end-gaining’ has also proved useful in school when comparing grades etc to my friends or when doing competitive things! I feel AT is definitely helping and I look forward to continuing with it.

Tom (17)

Term is coming to an end soon at Trinity Laban Conservatoire in London where I teach young people the Alexander Technique.

The curriculum I have devised for them is fun, varied, practical and multi-media, using poetry, literature, images and videos (this Charlie Chaplin clip is brilliant, for example). The students come in pairs and they explore so much together in quite a short time, with and without their musical instruments. Below is a flavour from this year’s curriculum; a hint of what we covered in the first ten weeks.

Week 1: Do Pause: you are not a To Do list by Robert Poynton. ‘Between the stimulus and the response there is a space, and in this space lies our power and our freedom.’ Viktor Frankl

Week 2: ‘A Peaceful Body’ by Bruce Fertman. Inspiring art from Finding Quiet Strength on Instagram.

Week 3: The ‘Primary Control’, the relationship between your head, neck and back. James Sholto’s fun explanation.

Week 4: The ‘Primary Control’ again, and some body mapping. Three types of ‘startle pattern’.

Week 5: The Science of Stress. Three ways we can dial down our stress response.

Week 6: Alexander’s 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.

Week 7: ‘Performance of the Parts depends on the Health of the Whole’. For example, ‘I tense up in my back, and my arms and hands don’t move well’, or ‘I get stuck in negative emotions and my practice is unfocused and unproductive’.

Week 8: The Shoulders Week. ‘Shoulderblades are not attached to the ribs, or to the spine, or the skull, or each other! So they can go all over the place!’ (What Every Musician Needs to Know About the Body by Barbara Conable).

Week 9: How you pay attention changes everything. ‘Attention changes what kind of a thing comes into being for us: in that way it changes the world’ (Iain McGilchrist). The Open Focus Life by Les Fehmi and Susan Shor Fehmi.

Week 10: An Alexander Technique summary. Before and After the Alexander Technique. Poetry Time: ‘The Road Not Taken’ by Robert Frost.

This week, The Economist reported on how myopia (short-sightedness) is now ubiquitous in East Asia. For example, one study of male high-school leavers in Seoul found that 97% were short-sighted. For decades, the scientific orthodoxy was that myopia was genetic, but it has become impossible to ignore its sharp increase in countries such as Singapore, China and South Korea as they have industrialized. So what is going on?

Many studies now confirm the link between myopia and young people’s education levels; not only their attainment, but the extent to which they participate in after-school classes and tutorials. The popular belief is that myopia can be caused by too much close-up work, such as reading and writing, and the idea was even espoused 400 years ago by the German astronomer Johnannes Kepler who also wore glasses. It feels intuitively right, and would dovetail nicely with the Alexander Technique principle that how you ‘use’ yourself affects your functioning. Yet the evidence simply isn’t there.

Instead, the scientific picture that is emerging is that myopia in young people is linked to the amount of daylight they are exposed to. Exposure to bright light appears to stimulate the production of dopamine in the retina, and this seems to help regulate the rate at which the eye grows. Too little light, and the eye grows too long to focus properly.

The answer therefore is to allow children more time outdoors, which has all sorts of other benefits. This is incidentally the message promoted by The Economist leader article on the subject.

And as far as the Alexander Technique’s ‘use affects functioning’ argument is concerned, this can I think be usefully extended to one’s environment. Spending quality time outdoors, and particularly in nature, must be considered essential to the healthy use of ‘the Self’.

The Alexander Technique is often known for the way it reduces unnecessary muscular tension, the way it changes postural and movement habits, and how it is an effective solution for back, neck and other musculoskeletal pain.

All of this is true. And yet it is also to miss the point. The essence of the Alexander Technique is something else, as the well-known instructor Anthony Kingsley explained in an interview last year.

I love the clarity of Anthony’s thinking on this topic, and so I’ve transcribed some of what he said below. He describes the Alexander Technique as a technique for preventing the distorting effects of reactions to living. He goes on,

Later on in his life, [Alexander] understood his work as a technique of preventing reaction. He said, ‘You all think my work is about getting in and out of a chair properly … – how to stand properly, how to have a good spine, how to have the shoulders nicely broadening [etc] – [but] it’s nothing of the kind. It’s about receiving a stimulus and learning not to react against the habits of life.’

And I think that’s so exciting! … It doesn’t really matter how you sit and stand: it’s a function of how you cope with everything in living, life’s ups and downs, life’s struggles and hopes and dreams and aspirations, all the things that happen to us in an average life, and all the dramas: how we cope with it, how we manage it. Do we manage it in a way that disturbs and distorts ourselves – Alexander called it the self, the psychophysical self – or do we manage the struggles and the ups and downs and the frustrations and hopes and disappointments and pains and losses – all these things – in a way that isn’t so destructive to the health of the organism, to the health of the mind-body.

And that for me is really exciting, that actually the thing that hurts us isn’t necessarily the event – Alexander was very clear – it’s how we react to the event. Two people can have the same event, or stimulus, and come out totally different. And I think the work – the deep Alexander work – is how to manage some of the things that really are quite big stimuli, the big struggles, in a way that isn’t so harmful, or so disturbing or so toxic for the mind-body, for the psychophysical self.

Thank you, Anthony, for this clarity. There are plenty more of Anthony’s videos online.

Oliver Burkeman, well-known for his critiques of psychology and the self-help industry, published a new book last year entitled Four Thousand Weeks: Time Management for Mortals. Whereas time management techniques tend to present ways of being more efficient, Burkeman steps out of that narrative to an extent, and in a recent discussion suggested instead that you ‘Embrace Your Limits’. In his words,

Much more than saying ‘change your life in these ways’… I’m saying ‘see that this thing about your life is true’ and see that the fact that your time is limited imposes certain truths on your life. … [You] can make an important internal psychological shift [where] you can stop thinking that the path to happiness is to get on top of absolutely everything and to please absolutely everybody, and you can cut yourself some slack for those areas where you end up failing a bit – because you’re always going to end up failing a bit. … This is just baked-in to the situation, and so I think that seeing the truth of it can be a real weight off people’s shoulders.

Oliver Burkeman, ‘Embrace your limits’, https://youtu.be/gW-7CUyCrpQ

This notion strikes me as another antidote to the capitalist drive towards efficiency, perfection and self-betterment, and so resonates with Jenny Odell’s book How to Do Nothing which I reviewed in another post.

I think Burkeman’s words could help broker a lasting peace, if not at least a truce, with the lifelong inevitability – indeed the indestructibility – of the to-do list. I’m experimenting with visualizing the collection of items on this list, no matter what they are, as a single entity, a particular kind of phenomenon which most people are in thrall to. Pausing to objectively take stock of this almost universal stimulus – from afar, as it were – helps me to notice and reflect on my habitual reactions to it. This brings about the possibility of a different kind of response, one which hopefully better reflects my own agency, my integrity and my decision-making.

In short, the never-ending to-do list is yet another test of how to apply the principles of the Alexander Technique to stay sane, healthy and whole. I’m grateful to Oliver Burkeman for this opportunity to rethink it.

We need a change in society where … we’re not surprised when someone wants to talk to us about something other than medicines [for chronic pain]

Dr Benjamin Ellis, leading pain expert

This week, a survey commissioned by the BBC revealed that one in four UK adults are living with chronic pain (chronic pain is defined as pain defined as persistent pain that lasts longer than three months). An accompanying half an hour documentary investigated the real stories behind the survey, and the way chronic pain ‘destroys careers, breaks up relationships, steals independence and denies people the futures they had imagined.’

One of the most striking interviews in the documentary was with Dr Benjamin Ellis who wants to see a move away from medication (particulary opioids) being seen as a long-term solution:

The health system is set up to support the prescribing of medication rather than supporting patients to access other treatments – physical activity, programmes to help people with their mental health, community support, peer support – they’re not so readily available, and even where they are, they’re not well connected with health services.

The Alexander Technique is one of these other interventions. It is effective at reducing chronic musculoskeletal pain, and two major clinical trials into back pain and neck pain have now provided substantial evidence for this. Although it is encouraging that GPs in my local area do sometimes refer patients to me, a lot more needs to be done to get the word out about this unique approach to the management of pain and tension.

A research study published in 2016 provides clear evidence that the Alexander Technique is beneficial for people suffering from knee osteoarthritis. On average, following 20 lessons in the Alexander Technique, participants experienced a significant reduction in knee pain and a significant improvement in functioning. What’s more, these changes were long-lasting, being evident 15 months later.

The study showed the Alexander Technique to be more effective in reducing knee pain than typical exercise-based interventions. So, what might be going on? How did the Alexander Technique achieve its effects?

The most likely answer to this question involves co-contraction, which is the simultaneous activation of muscles on opposite sides of a joint. The researchers in the study provided evidence that the Alexander Technique significantly reduced knee muscle co-contraction: specifically, it reduced the simultaneous activation of medial quadricep and hamstring muscles (vastus medialis and semitendinosus respectively).

As the researchers explain, this is hugely important because there is now a large body of evidence demonstrating that

patients with knee OA [osteoarthritis] exhibit excessive muscular co-contraction … during walking and other functional tasks. This co-contraction increases compressive loads at the knee joint surface, accelerates structural progression of the disease and increases the likelihood that patients will progress to total knee arthroplasty [surgical reconstruction or replacement of a joint]. Elevated loading may also increase the stress on articular structures, such as the joint, bone, synovium/joint capsule and periarticular structures [structures around the joint], resulting in increased pain.

In summary, the study authors suggest that the Alexander Technique, by reducing co-contraction, ‘could reduce the articular loads on the knee joint and this may have a long-term protective effect, reducing the rate of joint destruction’.

Based on a comparison of pain scores, the research paper provides evidence that the Alexander Technique is more effective than traditional approaches in dealing with knee pain, which tend to focus on building muscle strength. In fact, quite remarkably, the Alexander Technique intervention in this study did not result in any increase in muscle strength at all, and yet it led to substantially reduced pain and improved functioning.

This finding confirms the uniqueness of the Alexander Technique: by bringing to light our habits of unnecessary tension we are then able to prevent them, and so improve our overall functioning.

A couple of months ago, New Scientist magazine published a feature which challenged the idea that there is a link between posture and pain. ‘If you worry that slouching is causing you long-term discomfort, think again’, wrote the author. The article examined the large body of research that has failed to find a connection between posture and pain. For instance, a 2021 review by researchers at Monash University concluded that there was no reliable evidence linking specific driving postures with lower back pain.

And yet there is also evidence to the contrary. Another recent review paper found that Forward Head Posture (FHP) is significantly correlated with neck pain in adults and older adults. Age-related hyperkyphosis (as it is also known) is also understood to cause a raft of other adverse effects on health and quality of life, such as impaired breathing and balance, and greater risk of spinal fractures. It is even a predictor of mortality.

Over the years, our bodies mould themselves to the habitual ways we hold them. ‘Bones are getting rebuilt every day, and they get rebuilt in response to the stresses we put on them’, notes Professor Leon Strakerin in the article. And some researchers are worried: ‘We don’t know yet what’s going to happen to these kids who slouch all day long,’ said Wendy Katzman at the University of California, San Francisco.

Postural support is multidimensional

The research referenced in New Scientist focused on the link between pain and postural alignment – in other words, how segments of the body line up with each other. Yet this approach ignores the multidimensional system that underlies our posture. For example, alignment doesn’t capture the overall level of tension a person may be holding, or the particular distribution of muscle tone through the system, or how adaptable that tone is. Our nervous systems have multiple strategies for maintaining posture – for example, with differing levels of activity in surface and deep muscles – and these contrasting strategies do not reveal themselves in a snapshot of postural alignment.

The Alexander Technique and posture

There is good evidence that the Alexander Technique is effective in dealing with chronic back and neck pain, but it influences postural alignment in an indirect fashion. The most recent research into the Alexander Technique suggests that it changes the postural muscle tone in the body, both by making it more adaptable and better distributed. And it is the latter effect of the Alexander Technique – the re-distribution of muscle tone away from surface muscles – that has so far been correlated with a reduction in neck pain.

Concluding remarks

This short blog post is a reminder that both ‘posture’ and ‘pain’ are more complex than most people think: the different processes underlying posture are only just beginning to be explored scientifically, and pain itself is a multidimensional biopsychosocial phenomenon, according to the dominant theory among scientists.

Should we therefore be surprised that the relationship between the two is also complicated?

Last month I had the privilege of introducing the Alexander Technique online to an international group of pianists. They were all training to be Suzuki method piano teachers on the prestigious course run in Cambridge by Jenny Macmillan. Here’s what Jenny had to say about my introduction to the Alexander Technique:

Henry’s presentation was interesting and varied, including Powerpoint slides, short videos and an audio, and involving all participants. He understands his subject well and is able to explain it clearly and succinctly. Afterwards, he was willing to share his materials so participants can benefit further by reviewing his presentation. Henry is easy and pleasant to deal with and prompt to reply to emails. I would highly recommend him to give an Alexander presentation.

Jenny Macmillan, Suzuki Piano Teacher and Trainer, MA BA(Hons) FTCL LRAM DipESA​

Workshop summary

I wanted the workshop to be both intellectually engaging and practical, with plenty of time for questions and feedback. To begin, we took a whistlestop tour of the latest science on the Alexander Technique. What are scientists saying about its benefits and how it achieves its affects? Here’s the summary diagram I shared:

Next, we listened to a ‘lying down audio‘, noticing how it encouraged in ourselves two fundamental principles of the Alexander Technique, termed ‘inhibition’ and ‘direction’.

We then explored the relevance of those principles at the piano by taking part in an Alexander Technique ‘étude’. I have explained the Alexander étude in a previous post, and included instrument-specific guidance there.

Finally, we took a look at shoulder anatomy because tense upper back and shoulders are such a common problem for pianists. To eliminate unnecessary tension in that area, we need to conceive differently of that part of the body and instead encourage space, buoyancy and adaptability for the arms and shoulders. You can try this video I’ve created if you’d like to explore that aspect further, particularly the third section which I term ‘the golden exercise’.

Many thanks to Jenny Macmillan and her Suzuki trainees for this rewarding opportunity, and for the insightful feedback and questions raised during the workshop.

Many people are familiar with William Hurt, the American actor who sadly passed away last month. Not so many people know, however, that Hurt, along with many actors – Dame Judi Dench, Sir Ian McKellen and Alan Rickman to name a few – was a huge fan of the Alexander Technique. Not only that, but in 1998 Hurt featured in a full-length introductory film about it with teacher Jane Kosminsky. An updated version was released in 2007, and you can watch it here.

The video covers some of the basic procedures used in the Alexander Technique – such as chair work, ‘monkey’ and walking – but there is also an unusual ‘self-lesson’ in lying down. I say unusual because when Alexander Technique students are asked to lie down, the request is normally that they do nothing for around 15 minutes. However, Jane Kosminsky’s ‘self-lesson’ includes movement while lying down, and it’s therefore an interesting contrast to standard lying down work (here’s my audio guide for that if you’re interested). Below is the self-lesson section of Jane’s video which lasts about 20 minutes:

Jane wraps up her film by answering some of William Hurt’s questions, one of which is about the kind of commitment the Alexander Technique involves. Jane replies that she doesn’t want to begin to teach a student unless they can commit to ten sessions. I agree, and also ask beginners to commit to a series of lessons. The Alexander approach is something quite different to what most people are familiar with, and it simply takes a while to get your head around.

And as for taking the Alexander Technique further than a series of lessons, Jane explains it beautifully as follows:

Of course when people fall in love with the work, they continue to want to do it because – like anything else that’s of value – the more you use it and the more you stay with it, the more it’s there for you, and the more it unfolds for you. So that I still take lessons, I do exchanges with other teachers: I care to do that because it empowers me as a teacher and it makes me happier. I continue to grow in it, I continue to improve in it, and there’s no point in sharing this work unless you’re continuing to work on yourself. That’s the demand.

Jane Kosminsky on the Alexander Technique.