What does cello intonation have to do with fear of falling??!
FM Alexander recognised during his lifetime that people would likely mistake his work as something purely physical. Any long time reader of my blog knows that this isn’t true! Within the Alexander Technique there is a very strong emphasis on changing one’s thinking in order to improve both mentally and physically. But sometimes the less helpful ideas that form part of the mental matrix with which we interact with the world can be tricky to spot. I’ve been working with some older students recently, and they have highlighted one prevailing mental attitude that really isn’t helping anyone very much: our attitudes towards ageing, and the likelihood of falling as we age.
Fear of falling is something that my older students identify as a very real concern, if not for them personally, for their circle of friends. Having done a bit of research, today I want to use the whole issue of fear of falling as an example of the way a prevailing attitude can change our lifestyle and behaviours for worse or for the better. I’m going to suggest that some of the problems that I see with young musicians (especially strings; especially cellists) actually have a very similar root to fear of falling in the elderly. I also want to show a way that Alexander Technique principles can help if you happen to be stuck in a cycle where fearfulness is limiting your horizons.
Fear of falling as a mental attitude
Having spoken with my students, we’ve identified three areas where we think fear of falling has its root: outdated societal beliefs (in this case about ageing); language use that takes away personal responsibility; and personal decision-making that generates an attitude of mind.
Outdated or mistaken ideas about what is normal:
Our ideas of ageing can be woefully outdated. We consider ourselves on a path to inexorable deterioration after age 40, even though we know that life expectancy is now vastly higher than 30 or 40 years ago. On the one hand we are healthier than ever before, but our beliefs about health expectations haven’t necessarily kept up with the science. As a running enthusiast myself, I know that the races I enter are full of people older than me (and they are frequently far fitter than me, too). In fact, the oldest female to complete the 2019 London Marathon was 84 years old – there’s a video of her that is well worth watching if you want to challenge your perceptions of what older people can achieve.
We say to a toddler that they ‘took a tumble’ – their fall is minor and unimportant. Someone who is adult might say ‘I fell over’ – it’s a sentence in the active voice. They’re taking a measure of responsibility for the event. But for the elderly we typically use the expression ‘you had a fall’ – it’s in the passive voice. It takes away any sense of personal agency or responsibility in the event.
One of my students described how one of his neighbours injured herself by tripping over a hosepipe in her garden. She was furious when friends tried to describe her as ‘having had a fall’. “I fell over!” she exclaimed. My student’s neighbour was not going to allow a change in language use to take away her responsibility for having left a hosepipe in an unfortunate place!
Not only is there no sense of personal agency or responsibility in the sentence when we use the phraseology ‘had a fall’, but the fall becomes a noun – a thing. It has an identity, like a table or a chair. It becomes something that might happen. Falling becomes, in fact, something to fear.
Personal attitude of mind.
And there’s good evidence that attitude of mind has a huge part to play in the likelihood of a bad outcome with falls in the elderly. A study carried out by the University of Sydney demonstrated that, even when people have a relatively high physiological risk of falling, if they perceive their risk of falling to be low they are actually less likely to fall than someone physiologically well who has a fear of falling.
Obviously physiology is hugely important, but we can’t deny that attitude of mind is crucial. If we continue with the example of fear of falling, that fear can lead to:
- gait changes (which actually increase the likelihood of a loss of balance);
- reduction in stride length;
- and giving up activities that are considered risky (and the loss of activity leads to loss of strength, which leads to more balance problems and, you guessed it, a higher chance of falling).
This is why FM Alexander stated that:
When therefore we are seeking to give a patient conscious control, the consideration of mental attitude must precede the performance of the act prescribed. The act performed is of less consequence than the manner of its performance. 
Put very simply, if a person fears falling, they are very likely to change their gait and their stride length to anticipate the fall and hopefully limit the damage when it happens. Sadly, the very act of changing gait is enough to make the fall more likely. (A similar thing happens to people of any age when it snows)
We can make changes to shoes, flooring, and so on. But shouldn’t we also change the mental attitude that anticipates disaster?
Cello intonation as a mental attitude
When I work with strings players, I very often see them using a lot of muscle tension when they are playing, particularly in the left arm and hand. They have a concern about intonation. When I press them about it, I come across certain broadly common beliefs:
- Intonation is really difficult, especially relating to shifts
- If it’s wrong, the audience will hear instantly
- If one note is even slightly out of tune, the whole performance is ruined
- The note (which note? Any note!) is really difficult to get in tune.
- The way to try and control the intonation is to use lots of muscle tension in the left arm, hope, and then if it’s slightly wrong to fix it and pull a face.
Can you see the similarities with the areas that contribute to fear of falling? I hope so!
In both cases the tension and anticipation of a bad outcome contributes to the creation of the outcome. How could we fix this?
Anticipation of fear? Planning for excellence
It’s a truism of the personal development world to say that a person gets the result that they’ve put their mind on. If we anticipate failure, we’re actually in a sense planning that failure, even though we don’t really want it. Not only that, but we then have to put in place ‘disaster recovery’ plans or course corrections to avert danger. So why not use all that thinking where it will make a real difference – before we act?
- For the older person (or anyone on snow), this means making a decision to keep with a normal gait; to make any reasonable physical adjustments (moving the hosepipe); and to plan before each step where and how the next step is going to be.
- For the strings player, this means hearing the next note in their head before they play. Then they can trust in their practice and training, and allow the subordinate controls of the body to make the shift.
In both cases, planning for the desired outcome is the key to success. It won’t work every time (life is sometimes random and odd things occur), but it will increase chances of a positive outcome happening regularly. And there’s the satisfaction of knowing that one is doing something useful and positive, rather than being fearful and reactive. Just that satisfaction has to be worth giving it a try.
I also know that my suggestion sounds very simple and a bit glib. But it isn’t. What I’m talking about here is taking back responsibility, and then applying consistent mental discipline to attain a positive outcome. That’s a core principle of the Alexander Technique, and I firmly believe that it can help in almost any circumstance, if you sincerely give it a go.
 Her name is Eileen Noble. See also https://www.runnersworld.com/uk/news/a27302824/oldest-woman-london-marathon/ Accessed 2 May 2019.
 This website from the NHS has a great example of use of passive voice when describing falls. https://www.nhs.uk/conditions/falls/ ; accessed 1 May 2019.
 https://www.nhs.uk/news/older-people/fear-of-falling-raises-fall-risk/ ; access 1 May 2019. See also http://fallsnetwork.neura.edu.au/wp-content/uploads/2013/11/Delbaere-Wagga-Wagga-2014-2.pdf – A PowerPoint that has some lovely graphics that support the NHS article above. Accessed 1 May 2019.
 Alexander, F.M. Man’s Supreme Inheritance in the complete edition, NY, Irdeat, 1997, p.60; FM’s italics.
Image By Pz – Own workThis W3C-unspecified vector image was created with Inkscape., CC0, https://commons.wikimedia.org/w/index.php?curid=13281261