Feldenkrais Method and Chronic Pain

Deborah Bowes, DPT, GCFT

Everyone, regardless of age or condition, has the ability to learn and improve. The Feldenkrais Method® of Somatic Education is an effective and pleasurable way to discover how to move more easily and with less pain. The method is an educational modality with therapeutic benefits. The Feldenkrais Method has two distinct, but related, learning modes. In both modes, you learn to notice what you are doing, how you are doing it, and develop new ways to move.

In Awareness Through Movement® lessons, the Feldenkrais teacher verbally guides the students in gentle and easy movement sequences. The learning environment created is non-competitive and non-judgmental. Students are instructed to respect their own situations and move only within their personal ranges of ease and comfort. The emphasis is on discovery and exploration, attending to the quality of movement, and observing one's internal process while moving. Awareness Through Movement lessons are generally done in group classes. However students may also work individually with a teacher, or learn from books or audio recordings, which can be used for a home program. Whenever possible, personal instruction from a certified teacher is preferable for people with chronic pain.

The hands-on work, called Functional Integration®, is done in individual sessions or lessons. In Functional Integration, the client lies fully clothed on a padded table in a comfortable position while the teacher uses gentle touch to explore ways that he can move comfortably. Functional Integration lessons are tailored to the individual and will be different each time. People with long-standing pain conditions often experience deep relaxation, improved breathing, and a renewed sense of well being, even after one lesson. The quality of touch in a Feldenkrais Functional Integration lesson reassures the limbic system and can help restore the sympathetic and parasympathetic balance to the nervous system.

The Feldenkrais Methodis a form of movement education, and Feldenkrais teachers are experts in movement learning and analysis.Feldenkrais Teachers are interested in promoting a sense of agency and are agents of change. For people with chronic pain, gaining a sense of control over one's body is essential for learning new movement patterns. There are some basics that each person learns to apply to his or her own situation. Clients learn how to:

• 'listen' to your body so you can better sense the early signs of pain and change how you are moving,
• find and use positions of comfort for rest and tasks,
• use awareness of your breathing to guide your sense of comfort and ease,
• direct attention to how all parts of the body participate in any activity, and
• overcome movement restrictions by increasing skill, not by forcing or pushing.

The coordination and control of movement depends on accurate information from complex feedback loops in the brain and nervous system. This is called proprioception and is sometimes referred to as the kinesthetic sense. We unconsciously rely on proprioception to sense motion and the position of the joints and parts of the body, to balance, and to coordinate all of our movement. The Feldenkrais Method improves proprioception. The exercises and hands-on sessions help you to develop your kinesthetic sense. Your body awareness improves, and you have more options for the way you function.

In his book Awareness Through Movement, to Improve Your Vision, Posture, Imagination and for Personal Awareness, Moshe Feldenkrais writes that we act according to the image we have of our self, or our self-image. For Moshe Feldenkrais the self-image consists of four parts: moving, sensing, feeling, and thinking. Each part is essential, and all four parts work together to make us who we are and influence how we act in our lives. Using this model, consider how the experience of chronic pain affects these aspects of your self-image.

Let's first look at what happens to his moving in relationship with pain. Over time, you may develop restrictions in both the kind of movement and amount of movement you can comfortably do. Your movement repertoire shrinks to a hint of what is possible. Generally with persistent pain, the fundamental movement relationship between the spine, head and pelvis is disrupted. Feldenkais lessons teach how to sense and use this mechanical linkage functionally in day-to-day activities emphasizing qualities of movement, such as ease, comfort and pleasure. Larger movements of the spine, ribcage and limbs are made from many small ones that are then combined together efficiently, with the effort of movement shared throughout the whole body. When you first begin Feldenkrais lessons, the movements that are comfortable for you may be quite small. Gradually, as your awareness increases and the confidence in your body is restored, your range of movement increases. Balance, breathing, and coordination also improve.

If you live with persistent pain, sensing may become focused around the presence or absence of pain. You may lose the nuance and subtlety of other sensations of being alive, especially the pleasant ones. Your proprioception is limited because you're not fully moving all of the joints and muscles in her body. Feldenkrais lessons direct attention to qualities of sensation, such as the sensation of contact, skeletal support, ease of movement, the sense of the physical dimensions of the body, and how body parts move through space. Having more ways to sense your body improves proprioception and, therefore, the way you move.

With chronic pain, your thinking may become repetitive, revolving around issues of pain, suffering, loss, and limitation. Feldenkrais lessons often employ helpful images to organize your movement and teach you how to shift your attention away from habitual thoughts. Some have compared this aspect of Feldenkrais lessons to the letting go of thoughts and shifting of attention found in mindfulness-based meditation.

And, of course, your feelings while in chronic pain often include feelings of isolation, fear, depression, and hopelessness. When one gains a greater awareness and sense of control of your pain and your body, then hope reappears.

Feldenkrais enlarges the self-image by expanding how one moves, senses, feels, and thinks. Many people report improvements in all aspects of their lives.

Finally, pain patterns can be interrupted and changed by using our curiosity. An active mind, open to new ideas and possibilities is curious. For many, chronic pain may dull your curiosity about yourself or the world. Chronic pain is considered a disease of the nervous system. In his book, Elusive Obvious, Moshe Feldenkrais writes that the nervous system engages in multiple activities: it gives us information about the environment; it gives us information about the body; and it has the curiosity to do so. Through the process of directed attention in Feldenkrais lessons your curiosity is stimulated, to discover what you can do now, in the present moment, to change your painful patterns of moving, sensing, thinking, or feeling. As curiosity about your self is fostered, new resources for pain management are uncovered. The functional health of the nervous system is supported.

Ask your self the following questions. 'What do you notice when you have pain? How are you breathing? Where are your eyes looking? What are you doing with your hands and feet?' These questions provoke the brain and nervous system to search for an answer. Often asking questions like these will lead you to make small changes in your posture, in how you are holding your self, in your breathing – this can shift the pain pattern. Small changes can add up, resulting in increased function and lower pain levels.

The Feldenkrais Method is congruent with a biopsychosocial model of medicine. It promotes curiosity and awareness resulting in a more fulfilling life. The lessons learned and the attitudes and values from the Method make a valuable contribution to your self-care and any pain management program.

References

• Butler, David S. and G. Lorimer Moseley (2003). Explain Pain. Adelaide, Australia: Noigroup Publications.
• Feldenkrais Guild of North America, www.feldenkrais.com.
• Moshe Feldenkrais. (1972).  Awareness Through Movement: Easy-to-do Exercises to Improve Vision, Posture, Imagination and for Personal Awareness. San Francisco CA: Harper San Francisco/HarperCollins.
• Moshe Feldenkrais (1981). Elusive Obvious. Cupertino, CA: Meta Publications.

Deborah Bowes, 2008

Click for information on Deborah Bowes' CD program for Easy Movement and Pain Relief.