Fear of falling; cello intonation: Attitude changes create life changes

fear of falling is both a physiological and a psychologic phenomenon.

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Having spoken with my students, we’ve identified three areas where we think fear of falling has its root: outdated societal beliefs (in this case about ageing); language use that takes away personal responsibility; and personal decision-making that generates an attitude of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Outdated or mistaken ideas about what is normal:

Our ideas of ageing can be woefully outdated.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.[1]

Language use:

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.[2] 

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.[3]

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. [4] 

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.

References

[1] Her name is Eileen Noble. See also https://www.runnersworld.com/uk/news/a27302824/oldest-woman-london-marathon/ Accessed 2 May 2019.

[2] 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.

[3] 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.

[4] Alexander, F.M. Man’s Supreme Inheritance in the complete edition, NY, Irdeat, 1997, p.60; FM’s italics.

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Shoulders and breathing: should my shoulders move when I breathe in?

I’ve been working with a fair number of singers of late, and I’ve noticed afresh just how much stress and uncertainty exists around what shoulders should do during breathing. When you breathe in, should they move up, or should they stay still? Of course, it isn’t just singers who worry about their breathing; any musician who plays wind or brass may have similar concerns. I’ve worked with sportspeople who also wonder about the relationship between shoulders and breathing.

An image of the shoulders, as we wonder about the relationship of shoulders and breathing.

I’m going to suggest that we work from the protocol created by FM Alexander in his ‘Evolution of a Technique'[1], and see if we can work out what these structures should do.

Analyse the conditions (of use) present

In this phase we analyse what structures are there, and (if there is a physical student in the room) how the student actually uses them in activity. If you are the student – which, for the purposes of today, you are! – then find a mirror and watch yourself breathe for a couple of moments, and note down what you see.

From my blog a couple of weeks ago we know the basic structures behind the breathing mechanism. We know that the ribs move, including the top couple just under the collarbone. (They are raised during inhalation by the scalene muscles)

We also know that the shoulder girdle structures sit over the top of the ribs. The acromioclavicular (or AC) joint is a fixed number of degrees (around 20) but allows for some play as one moves the whole shoulder girdle.

Reason out a means whereby a more satisfactory use could be brought about.

This is the phase where we reason out a general route towards a better use of ourselves. Let’s have a go at creating a general use of ourselves involving shoulders and breathing.

We know that the ribs move and expand in order to make the pleural cavity larger; we also know that the first two ribs move and raise. We know that the shoulder girdle sits over the ribs. Therefore, it seems logical that the shoulder girdle is also likely to raise during breathing.

But do we actively need to control this? Again, logic would suggest not. As we’ve discussed, there’s not a lot of articulation in the A/C joint, and the first two ribs don’t move a massively long way up. So it seems likely that any movement would be accessory movement – that is, movement that happens to accommodate the body part that is actively moving.

Therefore: we need to pursue a means of breathing that enables the shoulder girdle to passively move.

Project the directions necessary to put the means into effect.

This is where we start creating actual thoughts about what we are going to tell ourselves to initiate movement. Here I want to leave the specifics up to you, but I want you to think about the following ideas:

  • If you include a sentence that involves your shoulders, you will almost certainly activate them BEFORE you turn them off. That’s probably not so helpful! Ironically, possibly the best thing you can do to more effectively handle the relationship between shoulders and breathing is not to think about it actively…
  • You will want to include something to remind yourself that your ribs, chest and back will all experience movement during inhalation and exhalation.
  • You might want to think about what you do with your head and neck as you begin to inhale.

I’m hoping that setting out the question of shoulders and breathing in this way won’t merely give you a simple answer, but also teach something more important. FM Alexander wanted to teach people to think: he wanted us to make our reasoning faculties more alive.[2] If we use the process from his third book, as we have today, we can begin to carry out the kind of thinking that Alexander hoped we would learn to do. And if we do it consistently, maybe our experience both of thinking and of moving will substantially improve.

Let me know how you get on.

[1] Alexander, F.M., The Use of the Self, London, Orion, 1985, p.39.

[2] Alexander, F.M., Man’s Supreme Inheritance, NY, Irdeat, 1997, p.39.

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Whole body vs separate parts : how choosing the right concept changes everything

A cut up apple - whole body or separate parts?

Have your ever seen someone play music, or take part in a sport, and felt as if they were needlessly throwing all of themselves into the activity? Or perhaps you’ve seen (or been) the person who is obsessed with the action of one particular part of the body – possibly because it hurts – to the exclusion of all else. I see both things a lot with the musicians that I work with: the trombone player who uses absolutely every part of her body to move the slide; the pianist who is obsessed with the action of his right thumb.

Both of these characteristics – the ‘kitchen sink’ approach and the ‘laser focus’ on one particular area – stem from correct ideas about the human body, but in both cases they have been taken to unhelpful extremes. So how are we whole, and how are we separate? And how can we change our ideas to think more helpfully about our physical structure?

Body as whole

On the one hand, we are a psycho-physical unity. As FM Alexander said,

it is impossible to separate ‘mental’ and ‘physical’ processes in any form of human activity.[1]

This means that everything is connected – mind and body. And if we decide to change the way we are using one part of our body, because our body is a whole system, everything else must necessarily change around it. This means that taking the body as a whole system is likely to effect better and more effective changes than looking at specifics.

Each request from his teacher to do something, and each injunction not to do something else, means a building-up of a series of specific psycho-physical acts towards the given “end,” namely, learning to write. This means that although the “end” may be gained, the result as a whole will not be as satisfactory as it might be, for nothing will have been done in the way of re-education on a general basis…[2]

Here’s an example of this in practice. A student can come to me with an issue involving arms and hands (when playing a trombone or a saxophone, for example); I work to help them stop muscular tension in their neck and back by perhaps questioning their concept of what they need to do to breathe, or whether they need to use neck muscles to think, and the arm problem vanishes. This is very cool, and looks a little like magic, but is based on the physiologic truth that a change in the musculoskeletal relationships in one part of the body will have ripple effects everywhere else.

Body as separate parts

But things are also separate, and often, like Alexander, I see people who are using themselves in such a way that their whole body is involved in an unhelpful pattern of tension. FM, for example, noticed this in some of his clients who came for help with speech defects:

When he spoke, I also noticed a wrong use of his tongue and lips and certain defects in the use of his head and neck, involving undue depression of the larynx and undue tension of the face and neck muscles. I then pointed out to him that his stutter was not an isolated symptom of wrong use confined to the organs of speech, but that it was associated with other symptoms of wrong use and functioning in other parts of his organism… I went on to explain that … he “stuttered” with many other different parts of his body besides his tongue and lips. [3]

Sometimes I work with musicians who want to use their whole bodies to play their instruments. For example, a trumpet player might use her whole body to raise the instrument up to play, bending backwards with her spine, rather than simply using her arms. If I work with the trumpeter and help her to separate her arms (appendicular structure) from her spine (axial structure) then raising the instrument becomes much easier.

And both things are true. They may look a bit contradictory, but they’re not – they just function on different levels. And we can take advantage of both ideas in order to improve how we’re performing.

Questions to ask yourself.

So if you’re practising, for example, you could ask yourself these questions:

Kitchen sink scenario: Am I using everything to carry out this activity? Could I think a little more about things being separate?

Laser focus scenario: am I thinking of myself too separately, or am I concentrating on separate parts and forgetting the rest of my body?

The extra credit challenge: can I manage to think of things being separate AND hold the idea of being a whole person, all at the same time?

You may find that your ability to play your instrument without crunching into the music stand, or to use a laptop without being sucked into the screen, improves if you play with these ideas. Let me know.

[1] Alexander, F.M., The Use of the Self, London, Orion, 1985, p.21.

[2] Alexander, F.M., Constructive Conscious Control of the Individual, NY, Irdeat, 1997, p.233.

[3] Alexander, The Use of the Self, p.70.

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