A New Approach to Chronic Pain

Bridget Quebodeaux, a GCFP in Los Angeles, shares her experience and insight into chronic pain in this very interesting article. If you suffer from pain, I bet you will find this intriguing:         

Why toaster ovens don't get fibromyalgia...By Bridget Quebodeaux, GCFP

As a Feldenkrais® practitioner, I often work with people who have chronic conditions and unexplained pain. They come from different walks of life. They have different personal histories and life experiences. They have different strengths and weaknesses and different temperaments and moods. They are different. Their pain is different. And yet the first words they speak are often the same: “I’ve tried everything and nothing helps.”

Sometimes it’s as if I’m being offered a fair warning, “Don’t feel badly if what you do doesn’t work. Nothing does.” Other times, I feel as if I’m being dared to make any difference at all. Always present is the hesitant hope that the Feldenkrais Method® will be the something that finally helps.

  



In recent decades, the biopsychosocial model has become the most accepted model for viewing chronic pain. The biopsychosocial approach says chronic pain is just part of the experience of a whole person living in the world. Hurting bodies cannot be understood in parts or in isolation of the thinking, sensing, feeling person walking around in them and the environment in which they live and ache. Personal histories, feeling management strategies, relationships, and beliefs are no less a part of felt pain than an old injury or a job that requires repetitive movement, and getting better is not a linear process of problem identification and symptom removal.

 



Research suggests a multidisciplinary healing strategy. Many people take that to mean they need a physical therapist, psychotherapist, massage therapist, energy healer and breath coach (to name a few). My belief is that less is usually more. Doing more won’t make what you do more helpful. Doing more won’t make it more likely that you will stumble onto the one approach or combination of approaches that “fixes” your problem and ends your pain. Doing more makes you tired and it isn’t necessary.

Doing well is much easier and will yield much better results. I suggest beginning by banishing the hope of being fixed. People can’t be fixed like kitchen appliances and old cars.

It may feel as though all your pain exists in one or more parts of your body and if you could just fix those parts, you’d be flying high. Indeed, if you were a ’69 Mustang or a toaster oven, you could have those parts repaired or replaced and be on your way. Not so with the parts of you that hurt.

I began the last lecture I gave on chronic pain with the following quote from the NOI group, “Discs do not cause pain anymore than genital stimulation causes love. Discs contribute to the pain experience.” If discs in fact merely contribute to the pain experience (as I believe they do) then consider the following:

FEEL MUCH BETTER THIS WINTER!

Hi Everyone!

We seem to feel our aches, pains and physical issues more, when the weather is cold or changeable, so stability and balance are even more important to us when the ground is wet or icy.  Who hasn't taken a tumble from stepping on an unseen slippery place during winter?

To support better balance and to relieve wintery aches and pains, Feldenkrais will help you keep your feet on the ground in comfort and stability.  Dr. Feldenkrais' primary focus was to create lessons that teach to us bring more of ourselves into our conscious brain map, thereby connecting to ourselves more fully.  In this way, your body is more able to call upon its own natural internal intelligence in all the movements you undertake.

This improved connection with your internal body intelligence will have a positive influence on all your activities!

• In yoga classes and fitness training
  
• walking the dog, or going up or down stairs
• skiing and other winter sports
  
• or going out for the mail, getting in or out of your car!

And as your range of movement and stability improve, aches and pains lessen; tension releases, feeling returns and a sense of comfort develops, no matter what your age or condition.

Note that 'no matter what your age and condition' is a key Feldenkrais concept and I will say more about it soon.  The point is, you can optimize how you feel and move, whether you are 20 or 80 yrs old; whether you are a professional athlete or using a walker.  Each of us can find movement that is more comfortable and efficient, when we are are more fully present in our bodies, instead of dissociated from our physical conditions.  This is what Feldenkrais teaches and I invite you to explore for yourself what this can mean for you. 

Classes will be going all winter:
It's a good opportunity to take time for yourself, make feeling better a personal priority.  It can give you more energy and capacity to do the things you love.  Maps and complete schedules are in the left side bar.  Check often for Holiday schedule updates.
Meanwhile, stay warm and feel well!
Best wishes,
Carole

How is Feldenkrais different from other modalities?

The purpose of the material below is to address in a simple way questions people often ask me about the Feldenkrais Method -- it looks at a few basic elements of form, and does not touch on philosophy, function, or the endless list of possible comparatives. The material is a synthesis of existing information and my own thoughts.  I hope the reader will take these brief paragraphs in the spirit in which they are meant.  Thanks! Carole


FUNDAMENTAL FELDENKRAIS® = LEARNING
Awareness Through Movement® and Functional Integration®

The basis of the Feldenkrais Method is about learning in the body and the nervous system — learning that happens profoundly through your own experience, while doing gentle, guided, non-habitual movement sequences. As you direct your attention to sense and feel yourself in movement, your brain understands at a deep level that it is no longer limited by habits. The body and mind learn to release and connect more deeply; new patterns of thinking, feeling and movement emerge that can be used at any age and in every activity.

How Feldenkrais is different than…

· Yoga: The Feldenkrais Method is focused on movement, function and individual, dynamic organization, i.e., each person discovering their own most efficient and comfortable way to accomplish the action required in each moment. Yoga focuses on perfecting specific positions or static poses that everyone seeks to perform or hold in the same, ideal way.

· T’ai Chi: Feldenkrais, though similar to T’ai Chi in focusing on movement with the whole self, builds up incrementally to a refined quality of movement using simple, developmentally oriented steps. Each person performs Feldenkrais movements differently, according to capacity and physical condition; i.e., there is no form. T’ai Chi movements are precise forms that are learned in whole, and are performed in the the same by everyone.

· Pilates: Feldenkrais is similar to Pilates, being concerned with physical coordination and organization; it differs by being oriented toward efficient, easy and reversible movement and not only building strength. Your body is the only equipment you need for Feldenkrais.

How is Feldenkrais different from physical therapy?

The Feldenkrais Method centers on helping students study their existing movement patterns and re-learn the transmission of movement throughout their whole body, while minimizing unnecessary muscular contraction and tension. Examining movement in all parts of the body and its effect on all other parts, supports the development of stable, comfortable and efficient action and movement. Physical therapy targets specific muscles or muscle groups that are isolated from the rest of the body for repair and/or strengthening.

How is Feldenkrais different from chiropractic?

Feldenkrais lessons do not adjust or manipulate bones per se. Instead, lessons present new movement patterns and possibilities to your nervous system that safely help you regulate your own movement choices--both consciously and subconsciously. Chiropractic manipulates bones directly; but because muscles pull bones out of alignment, if new movement patterns aren’t presented, your muscles return to their old patterns, despite numerous skeletal adjustments--and the sequence of events causing misalignment begins anew.

Carole Bucher, BA, GCFP/T
renofeldenkrais.blogspot.com
775-240-7882

What Awareness Means for Musicians (and the rest of us, too...)

Musicians (and others) have long used the Feldenkrais Method® to refine and improve their playing; in effect, tuning themselves, by bringing their bodies and brains into greater harmony. When we use ourselves with more conscious awareness, we cannot fail to improve nearly any undertaking. This is one of the gifts that people often receive as their capacity for self-awareness and sensing develops and accumulates. This capacity becomes apparent in our daily activities and in nearly everything we do, enriching our experience in living.

Our brief journey below into one musician's experience is uplifting and exciting, and most important, his experience can apply to us all. 

I hope you enjoy reading it.  Best wishes, Carole

Freeing Your Body Towards Greater Motion and Emotion
By Patricia Holman, GCFP

A saxophone player once came to me suffering through arm, shoulder and back pain. He was familiar with the Feldenkrais Method because he had taken the group classes, called Awareness Through Movement, during his college music training. His practices were becoming more and more troublesome and he found he needed to inhibit certain movements in order to make it through a performance. Technically, he had mastered his instrument. His level of virtuosity was quite apparent. Yet, he was physically uncomfortable. This same virtuosity, as well as his livelihood, was being threatened by his current condition.
In the beginning of one of our first lessons, I asked him to play a few musical passages that were: a.) easy and comfortable, b.) difficult and required significant effort, and c.) poignant and full of emotion. Observing him play, I noticed a great attention to the music, but considerably less attention to himself. The musical notes were the foreground, and his body a distant background. I noticed there was little acknowledgment of the ground through his feet. His difficulty manifested itself in back and shoulder pain. His eyes were strongly tensed and his head position forward, as if he were trying to reach the musical notes on an imaginary music stand. His habitual tensions were forming the quality of tone, effort and expression in his playing.
When we are unaware of habits such as tensing our shoulders, neck and jaw, or stressing our backs unnecessarily, or are unaware of the support of the ground through our feet, we may develop some kind of difficulty. In the series of lessons we would have together, I was hoping to show him the relationships among these forgotten parts of himself and how this new awareness could change his overall effort and tension. I wanted to help him become more present to the process of music making.
After this initial exercise, I had him lie down on a table, where I began to explore with him the simple act of lifting and lowering his right arm, then his left arm, on the table, resting for several breaths between each series of small lifts. We proceeded to lifting and lowering his right leg, then 

How the Feldenkrais Method works, by Dr. Feldenkrais!

‘Bodily Expressions’ Moshe Feldenkrais D.Sc.

Published posthumously in Somatics, Vol. 6, No. 4, Spring/Summer 1988. (Translated from the French by Thomas Hanna)  http://www.feldworks.com/kbp/entry/9/

Our self-image is a body-image, which not only determines what we think of ourselves but also what we do and how we do it. The behaviour of human beings is firmly based on the self-image they have made for themselves. Accordingly, if one wishes to change one's behaviour, it will be necessary to change this image.

What is a self-image? I would argue that it is a body image; namely, it is the shape and relationship of the bodily parts, which means the spatial and temporal relationships, as well as the kinaesthetic feelings. Included with this are feelings and emotions and one's thoughts. All of these form an integrated whole. How does a self-image come about? Everyone feels that his way of walking, speaking, and behaving is uniquely his own and unchangeable. He totally identifies with this behaviour-as if he were born with it. The way he sees objects in space, the way he tracks movements, the way he inclines his head, and the way he looks at things seem to be innate; and he believes it impossible to change any of these things --other than perhaps their rate of speed or intensity or duration.

Despite this belief, everything central to human behaviour is acquired only by a long period of learning: to walk, to speak, to see a photo or painting in three dimensions -one's very movements, attitude, and language are acquired purely according to the accidental circumstances of one's place of birth and environment. Thus, when we learn to speak a second language, we always speak it with an accent-an earlier learning always stands in the way of a new learning. It is always difficult to sit as the Japanese or Hindus do, because earlier habits stand in the way.

Thus, whatever the accident of one's birth, the difficulty we experience when attempting to change mental or physical habits has little to do with heredity and everything to do with the general problem of changing any habit that has already been acquired. It is obvious that the difficulty is not in the habit per se but with the earlier point in time at which these accidental habits were formed. And so it appears that our self-image is acquired purely by accident.

Hence, the question arises as to whether it might be possible that one can freely choose new habit patterns which are more appropriate and fitting to one's unique person. Understand that what is in question here is not simply the replacement of one mode of acting with another which would be purely a static change. What I am suggesting is a change in our way of acting which aims at a dynamic change in the whole process of one's action.

Before we go any further, it may be worthwhile to engage in a brief experiment that will allow one to feel this possibility rather than merely to understand it.

If you lie down on your stomach and bend the right knee so that the lower leg points up toward the ceiling, you will find that the relation of the foot with respect to the leg is highly variable with different people. Everyone does not hold his foot in the same position. This becomes obvious if we place a book on the sole of the foot: The plane of the book will most

Understanding Feldenkrais - Low tech, high tech self-improvement?

You CAN Take It With You! (FELDENKRAIS)

Thank you to divamover| of Houstonfeldenkrais.com for this insightful, clever and brief description of The Feldenkrais Method.

Image by Companygolflessons via Flickr

I think that FELDENRKAIS is the most low-tech, high tech system for self-improvement out there. Think about it — all you need is a floor to lie upon, or a chair to sit in, and you have a very accurate and personalized  biofeedback “device” that will give you a lot of detailed information about yourself, if you stop and pay attention.
Each lesson is an exploration, or an experiment in movement. The stakes are low — the cost of failure is ZERO — and you’re going so slowly and gently that you won’t risk injury. There are no gadgets, weights, medicine balls, or torture racks — just you and a mat, perhaps a couple of towels. Best of all, the technology is completely portable. Have body and brain, will travel. As my friend and colleague Ayala Teichman says, “You don’t have to go to the gym in order to “do” Feldenkrais. You already have “Feldenkrais” Built within you, in every movement that you make. If you do go to a Feldi Lesson – Take the movements with you to your own life.”
Once a student “gets this” —  how to take the movements into life — there’s no stopping them. Last week at the class at the MD Anderson Integrative Medicine Center, a man shared two really interesting comments with me. Immediately after the lesson (one with tilting crossed legs slowly to the side, noticing details; then slowly tilting arms in the opposite direction) he got up on his feet and then walked around a bit, with a curious smile on his face. “I hope it’s OK,” he grinned, “but during that lesson I kept thinking about how that twist was really going to help my golf swing.” I told him that was indeed OK – and indeed, it was the whole point — to take the movements into your own life, doing whatever it is that you want to do, or must do.
He then shared that he is currently undergoing proton therapy, a very advanced type of radiation treatment, for his cancer — and that he must lie very still within the “tube” during the treatments. “I realized that even when I’m not moving, there’s a lot moving — like my breathing. Maybe I can just THINK about moving while I’m in there — and they’ll never know.” This man got some of his power back that day on the floor, and was looking forward to getting out on the links to try his Feldenkrais-improved swing.

An 8 wk old goat kid joined our Awareness Through Movement class last Thursday at the River School Farm in Reno, near the Patagonia Outlet.  He saw himself in the mirror and not knowing about mirrors, challenged himself to a little head butting.    Exploring change, but a little too effortful for Feldenkrais... Good thing class was almost over!  The River School is a beautiful and  quiet setting for ATM, right on the Truckee River.  Students can enjoy the property before and after class, or join in the communal Thursday dinner following class, but be sure to bring a potluck dish to share.

What part does ATTENTION play in Feldenkrais and Cognition?

Dr. Feldenkrais was the grandfather of neuroplasticity, observing changes in people and their brains several decades before technology existed to verify his hypotheses and anecdotal evidence.  This excerpt from a blog by Gisele at Feldenkrais Manitoba gives us some fascinating insight into how Awareness Through Movement® and Functional Integration® lessons can work to keep us connected and cognizing!  Best wishes! Carole

Check out the following quotes from <”The Brain That Changes Itself: Stories of Personal Triumph From the Frontiers of Brain Science“>by Norman Doidge about discoveries recently made in the neuroscience of learning and his conversations with neuroscientist physician Michael Merzenich:
“The cerebral cortex”, he says of the thin outer layer of the brain, “is actually selectively refining its processing capacities to fit each task at hand.” It doesn’t simply learn; it is always “learning how to learn.” The brain Merzenich describes is not an inanimate vessel that we fill; rather it is more like a living creature with an appetite, one that can grow and change itself with proper nourishment and exercise.”
“Finally, Merzenich discovered that paying close attention is essential to log-term plastic change. In numerous experiments he found that lasting changes occurred only when his monkeys paid close attention. When the animals performed tasks automatically without paying attention, they changed their brain maps, but the changes did not last. We often praise “the ability to multitask.” While you can learn when you divide your attention, divided attention doesn’t lead to aiding change in your brain maps.”
Other discoveries have had to do with the neurotransmitters (chemicals in your brain). When we experience the sense of well-being after doing something satisfying, it is like a reward. Reward in learning is important because it is then that we “secrete such neurotransmitters as dopamine and acetylcholine, which help consolidate the changes in the brain that have just been made. (Dopamine reinforces the reward, and acetylcholine helps the brain “tune in ” and sharpen memories.)”
Another important brain chemical is brain-derived neurotrophic factor, or BDNF. BDNF seems to do many things, and is crucial in infants and youth as it is what makes learning so effortless at these stages of our lives. After these initial critical learning period of youth are over, the only way the areas of the brain that need to be “turned on” to allow enhanced, long lasting learning are activated is only when something important, surprising, or novel occurs, or if we make the effort to pay close attention.
For those of you familiar with Feldenkrais® lessons, you know that very often you are doing things that are very novel to you as adults, and that often, surprising changes happen. And, you are constantly directed in your use of attention.
It may be interesting to know that I’ve heard it said that Moshe Feldenkrais had once made the comment that he could do the same thing with his students teaching them mathematics. That, to me, says much about what the work is and isn’t about.
Here is some more from the book that may inspire you to continue learning in the true sense of the word:
“We have an intense period of learning in childhood, every day is a day of new stuff. And then, in our early employment, we are intensely engaged in learning and acquiring new skills, and abilities. And more and more as we progress in life we are operating as users of mastered skills and abilities.
…We still regard ourselves as active [in mid life], but we have a tendency to deceive ourselves into thinking that we are learning as we were before. We rarely engage in tasks in which we must focus our attention as closely as we did when we were younger…By the time we hit our seventies, we may not have systematically engaged the systems in the brain that regulate plasticity for fifty years…
…To keep the mind alive requires learning something truly new with intense focus. That is what will allow you to both lay down new memories and have a system that can easily access and preserve the older ones.”

Thanks for reading!

Try a MINI Awareness Through Movement Lesson!

First MINI ATM: 

1) In a sitting position with feet flat on the floor, gently and slowly turn your head to the left and then to the right. Notice the place on the wall that is the point you can see with no feeling of strain in the neck. This should not be the maximum that you can turn. A very small turn is okay. Repeat this a few times, each time noticing the point on the wall that is the farthest you can comfortably see.

2) Cradle your head with the palms of your hands, so that the heel of your hands is at your jaw line, and the fingers rest on the sides of your eyes. Your elbows or upper arms are resting on your chest with your forearms together as much as possible.

3) Keeping your elbows glued to your chest, with your hands cradling your head, gently turn to the left side only as far as is comfortable and then back to the center. Then turn to the right side. Repeat this to the left and the right a few times. Notice that your upper body is turning.

4) Slowly drop your hands to your lap again and pause briefly. Then, cupping your head again in the same position as before, look upwards gently and then downwards. Do this a few times and stop.

5) Turn your head to the right and then the left. Do you see a point that was farther than the point you saw when you began?

6) Do this sitting at your computer from time to time – the AWARENESS of what you are doing is most important.

Second MINI ATM:

1) Lie down on the floor with your legs straight. Notice how much space is behind your lower back. If your back hurts, bend your knees. Otherwise keep your legs straight.

2) With your arms at your sides, lift your head for a moment to look at your feet. Notice how high your head lifts easily. The key word is "easily." Don't strain, please! Make a mental note of how high your head went.

3) Please bend your knees and place your feet about hip width apart.

4) Cross your hands over your sternum (breastbone).

5) Gently press down on your sternum. Does it feel springy or immovable? Can you feel movement in your chest as you do this?

6) Gently press down on your sternum several times. Think of your sternum as simultaneously going closer to the floor and closer to your pelvis.

7) Now slowly lift your head as you press down on your sternum with your crossed hands. Does your head lift higher?

8) Slowly lift your head a few times while gently pressing down on your sternum.

From Chriskresge.com

FROM PAIN TO FUNCTION

This interesting article by Feldenkrais practitioner Kathy James gives us insight into how our protective habits may actually interfere with recovery from injury or chronic pain.  Kathy also illustrates how using Feldenkrais gives you new, effective and accessible tools to manage your pain and recovery.  Thanks for reading!  Carole Bucher, BA, GCFT

MOVING OUT OF PAIN  --  THE FELDENKRAIS WAY

We all experience physical aches and pains at some time or another.  Some of these are acute (from an injury or accident), while others may stay with us or develop over time (chronic).

If you’re like many others, you may have had the experience that your physical pain is aggravated by movement—which is accurate:  Our body’s natural response to pain is often to increase muscular tension, restrict movement, and make postural changes to guard or protect the painful area.  But sometimes this natural protective response, while serving an important purpose in the short term, can actually create different, and more complicated, problems over the long term.

It’s worthwhile noting that dealing with chronic pain is usually more challenging than acute problems.  We are now learning that this is because chronic pain follows different pathways in the nervous system than acute pain—which explains why pain medication that alleviates acute pain often doesn’t have the same effect on chronic pain.

Fortunately, there are a variety of alternative approaches to chronic pain that may be effective, and which don’t entail costly drugs or surgery.  As a Feldenkrais teacher, my perspective is generally to start with the basics:  How is a person moving—walking, sitting, standing, and how might their habitual (unconscious) movement patterns be contributing or even causing the pain.

Let’s take Mary as an example… Mary limped into my office complaining about severe pain in her right hip when she walked.  She often woke in the middle of the night with pain, but couldn’t figure out what was causing it.  Although she had broken her ankle (and had surgery for it) three years earlier, that couldn’t be the cause of her hip pain, could it?

I first asked Mary to walk back and forth a few times, so that I could observe how she moved.  I then asked her if she noticed how differently each of her legs swung when she walked, and how she always placed her right foot way off to the side, while the left foot came down right under her hip?   She was surprised to realize that she was doing that, and commented that this was exactly how she had walked when her leg was in a cast after her ankle surgery.

In other words, Mary was walking today, three years later, as if her ankle were still broken and in a cast. Though her ankle injury had long since healed, the habitual way she had compensated for this injury had continued, and was now causing problems with Mary’s hips.  At some point, she might well start feeling pain in her spine, or even neck, if this habitual pattern of movement continued.

The key word in all of this is “habitual.”  Our bodies have tremendous wisdom, and will often (if we listen) inform us how best to respond to life’s immediate challenges.  But sometimes we continue responding the same way long after the immediate challenge is over.  This is clearly what was happening with Mary.

Over the next several sessions, Mary and I worked on helping her to sense and feel her habitual movement patterns more clearly, and to practice new ways of moving that were easier and more comfortable for her.  Just by focusing her attention on what she was doing, Mary started feeling differences almost immediately.  Pretty soon her limp had disappeared and she was walking normally again.  Without all of the added strain of having to walk in such a lopsided way, her hip pain also vanished, letting her sleep through the night comfortably.

Most of us take our movement for granted.  We do what we do, and we do it the same way, every day.   The next few times you stand up from your chair or sofa, pay attention to how you actually do it—how you shift your weight, where you put your feet, how you use your head, what you do with your hands.  You’ll probably notice that you do it the same way every time.  Is this a problem?  Not necessarily, since we all need to be able to do some things without thinking too much about them.  But it may be a problem if you’re caught in a cycle of pain, discomfort or limitation that just doesn’t seem to go away.   In that case, becoming aware of these habits, and learning new ways of moving, with greater balance and ease, may be exactly what your body is asking for.

This entry was posted on Friday, February 5th, 2010 at 2:47 pm and is filed under Managing Pain, The Feldenkrais Method. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site. 
Tagged as: Musculoskeletal Pain, Pain Management, The Feldenkrais Method