From the top

The Alexander Techniue can help nurses to take better care of their bodies and posture.
Caroline Swinburne reports

It is lunchtime on a grey day at Bridgeside Lodge, a large modern nursing home just off City Road in Central London. In a small room overlooking the canal, Alexander Technique practitioner Nick Chapman is talking to a group of nurses about stress management.
"Put your hand up if you have never felt stressed," Mr Chapman says. Predictably, no one raises their hand. We all know what stress is, but definitions are tricky. The Health and Safety Executive defines it as "the adverse reaction people have to excessive pressure or other types of demand placed upon them". But while pressure is part and parcel of all work and helps to keep us motivated, excessive pressure can lead to stress which undermines performance, is costly to employers and can make people ill.

Like the founder of the Alexander Technique, Frederick Matthias Alexander, Mr Chapman originally worked as an actor. He was advised to study the Technique to help his performance, but soon realised that the simple relaxation exercises were having an amazingly beneficial effect on his entire physical and mental wellbeing. In an effort to bring these benefits to a wider audience, Mr Chapman became a full time Alexander Technique practitioner.

Recently he has been working with nurses - a client group he considers ideally suited to the Technique.
"People in nursing tend to have a mentality that means they get on with their work and keep on going regardless of how they feel," he explains. "Nurses are commites to helping everyone else, but they do not help themselves."

Battling on
So far Mr Chapman has worked mainly with staff in private nursing homes. "We are still working on the NHS," he admits. "But I would like to spread the word, to as many nurses as possible, that it is far better to take responsibility for yourself and make sure you stay fit and healthy. Good, healthy, strong nurses do good, healthy, efficient work. This mentality of battling on is not always wise. That way you often end up needing a nurse yourself."
"It is a stressful job," admits Bridgeside Lodge staff nurse Madelaine Ingleton, who spends her days looking after people with conditions ranging from Alzheimer's disease to strokes.

Physical stress
She is often involved in organising patients' daily activities, rehabilitation and generally helping them live thier last days as well and as comfortably as possible.
"It is stressful to see people suffering and it is demanding having to deal with their physical needs," she explains. "You can feel under pressure from the relatives too if they are upset or demanding."
Many nurses also show signs of significant physical stress, such as pain and exhaustion.
"I have noticed that a lot of nurses have a concave posture," says Mr Chapman. "It is common for nurses not to stand up straight. The often tell me that they get back pain, but their instinct is to carry on regardless. They want a quick fix rather than any longer term solution."
"I trained in the days before they taught proper handling techniques," says Mary Howley, who works on Bridgeside Lodge's dementia ward. For more years than she can remember, Ms Howley has suffered lower back pain.
"My problems started long ago, in the days when we used to lift patients from toe bed ourselves, without any mechanical help from hoists."
Even now, the work is often physically demanding. "Some of the residents cannot do much for themselves," explains Ms Ingleton. "It is heavy work - even to adjust the hoist to raise them can be difficult."

The Alexander Technique is designed to tackle the physical and mental aspects of stress in tandem. The theory is that reactions to stress or emotional upset show up in the various postures and attitudes people adopt, and that these postures in turn reinforce how people feel. Only by dealing with the physical and mental components of stress at the same time is it possible to shed light on the less conscious patterns of thought, feeling or posture that interfere with correct functioning.

Mr Chapman usually spends the first half of atwo-hour session on practical work. Each participant in turn is asked to come forward. Using a chair he explains correct sitting posture and then with the nurse in a standing position he explains the location of three weight-bearing points on the foot - behind the big toe, behind the little toe, and the heel.
"If you have had a busy day with a lot of running around, one of the best things you can do is stand still, take a big breath, and find those weight-bearing points," he he advises. Then Mr Chapman demonstrates how to align and lengthen the spine slightly by allowing the weight of the head to lift, and length to come into the neck.

The second half of the workshop involves a "releasing exercise". The window blinds are pulled and each participant is asked to lie on their back, knees bent, with their head resting on a book. For the duration of this exercise, nurses are asked to forget about problems with their patients or arguments with their matron or spouse and instead concentrate only on their breathing.

Mr Chapman helps participants to focus on each body part in turn, beginning with the left foot and ending with the face. The concentrate on achieving complete relaxation and release. Eventually, at the end of the exercise, everyone is asked to slowly and gently move into an upright position. Mr Chapman beleives this should never be rushed. "I do not want to interfere with the improved use of the body that we have been cultivating. The aim," he explains, "is to leave people feeling calm, connected and focused."

"It is very effective," says Ms McIntyre, who has worked alongside Ms Howley on Bridgeside Lodge's dementia ward for the past 12 years. "It was worthwhile. I admit I am surprised - I never thought something like this could be so helpful. I felt completely relaxed and completely focused - all the tension seems to have gone. I haven't felt like this for a long time. I am going to put this into practice because I think it will help a lot."

It's brilliant that we should be encouraged to think of ourselves for a change," agrees Ms Ingleton. "Otherwise you are just giving and giving and getting nothing in return. I think everyone in the health service should have access to training like this."

Summary

The Alexander Technique can help nurses deal with their stressful jobs, as one group recently discovered in a session aimed at their specific needs.

• While work pressure help people maintain motivation, excessive amounts can be stressful and damaging.
• The Alexander Technique involves learning about stress-induced bad habits, such as tightening the neck muscles.
• It also involves mental techniques and discipline.
• Easing the weight-bearing points on the feet can be restorative after a busy day.

Roots of the Technique

The Alexander Technique was developed by Australian actor Frederick Matthias Alexander. Mr Alexander (1869-1955) developed persistent voice problems. He started to wonder if something that he was doing while performing was causing the problems and so spent months in front of an arrangement of mirrors, observing himself at rest, talking and reciting. Mr Alexander soon came to the conclusion that the functioning of the human body is strongly affected by how we coordinate our head, neck and back when we are engaged in any activity. When we interfere with this subtle dynamic balance we can create distortion and strain. This may be experienced as specific symptoms such as backache, stiff neck and shoulders, postural problems, or more generally as feeling "out of touch" with our body.

The Technique Mr Alexander Subsequently developed involves learning about stress-induced bad habits, such as tightening the neck, narrowing the shoulders, or bracing the knees. The practice places much emphasis on correct posture and breathing. It also involves mental techniques such as "inhibition". The means fighting our natural instinct of immediate obedience, and instead learning to stop, pause and think - and possibly even just to say no - when some stess-inducing act is asked of us.

Caroline Swinburne is a freelance journalist

For further information go to www.alexandertechnique.tv