An overview of earlier investigations into the Alexander Technique
The Development of the Alexander Technique and Evidence for its
Effects
First published in British Journal of Therapy and Rehabilitation,
November 1997, Vol 2, No 11, p. 621-626
The Alexander Technique has become increasingly recognised as a
self-help method for various health and performance problems. It
enjoys some scientific support and is widely available on a private
basis. What does it do more precisely and what physiological principles
may underlie it? This article looks briefly at its development and
some of the evidence for its effects.
The Alexander Technique is named after FM Alexander who developed it
in the last two decades of the 19th century (Alexander, 1985; Stevens,
1995a). Alexander was attempting to deal with problems he had with his
voice but found that it could be used to help many other types of
difficulties. The list of conditions for which it is reported to be
useful include stress-related problems such as ulcers and other
digestive disorders, some forms of heart disease and high blood
pressure, asthma and chronic bronchitis, tension-related sexual
disorders, epilepsy and migraine (Barlow, 1973). Barlow found it of
particular use in the rehabilitation phase of many illnesses, and a
range of rheumatic problems from disc lesions, low back pain and
arthritis, to tennis elbow and frozen shoulders have also responded
well. Barlow also reports that the technique has had considerable
success in helping people suffering from anxiety and depression. What
could account for such reported improvements in so many different
conditions? Either some mechanism is activated which has widespread
effects on the body, the reports are a result of some sort of
suggestion like positive thinking, or some as yet undiscovered
mechanism is at work. To evaluate these possibilities, the author will
first look at what Alexander himself reported.
Alexander's experience
1 He was breathing in with an audible gasp;
He found that 1 could be prevented by preventing 2 and 3 but that
these in turn could only be prevented by inhibiting 4 first. He found
also that he needed the objective information from the mirror to
correct his incorrect proprioceptive sensations which he could see
were not giving him accurate information about his body state. By
using this objective information he could then consciously inhibit
the behaviours which were causing his loss of voice.
Thus the Alexander Technique rests on careful observation and the
conscious inhibition of faults discovered by observation with the use
of objective instruments to augment the unaided senses. For these
reasons, it is unlikely that the results reported are due to
suggestion. When Alexander found how to put this method into practice
he found that his voice problems were cured, and that problems with
his health were also helped.
What lessons in the Alexander Technique entail
Most teachers use touch to augment vision and speech for the
assessment and teaching of the fine coordination of posture and
movement. This touch is a gentle sensing and guiding, not a
manipulation or treatment. As the technique is an education and not
a therapy, the thrust is in helping a student to understand and sense
what they are doing and for them to learn what they can do for
themselves to make improvements.
Depending on the type of training teachers have received, they will
use different approaches to assessing a student's problems and the
way in which they propose to treat these difficulties.
What mechanisms may explain the improvements?
One misconception of Magnus' work is the idea that in human adults
such reflexes were pathological. It now appears that this is not so,
unless they are overt, as with stroke patients. Such reflexes,
however, underlie normal postures and movements (for a literature
survey see Stevens, 1995b). From the above it would appear that
Alexander found a method for consciously inhibiting interferences
with normal postural reflexes (when these interferences are not due
to damage to the reflexes themselves). Such interferences can be seen
particularly when people are sitting at unsuitable furniture or in
difficult emotional situations of conflict or failure. In the first
example of ergonomically unsuitable furniture, only part of the
answer seems to lie in better design. Equally important is leaning
to inhibit interferences with the reflex support system. It is well
accepted that the various postural reflexes modify the stretch
reflex and affect the body in general (Roberts, 1978). This provides
an economical explanation for the diversity of results reported.
However, it should be noted that the author is open to other
explanations for the effects of the Alexander Technique.
Let us look more carefully at the claims and tests that have been
made to assess their validity.
Scientific opinion
The number of physicians and surgeons seeing the importance of
Alexander's work reached the point where Bruce and 18 colleagues wrote
to the British Medical Journal urging that his technique be included
in the medical curriculum (Bruce et al, 1937)
Shortly afterwards Alexander worked with the biologist Coghill, who
wrote:
Later Dart, discoverer of Australopithecus africanus, took lessons
and reported (1970):
More recently, Tinbergen (1974) devoted half of his Nobel Prize
acceptance speech to the Alexander Technique. In it he said:
So much for opinions; what published experimental evidence is
available? In this account I will initially describe the literature,
making some critical comments at the end. For a more exhaustive
critical survey see Stevens (1995b).
Dr Wilfred Barlow
Effects on performance
Jones (1972) also showed that not only did the singer and others
listening feel that the voice and breathing were improved, but that
there were measurable changes in the sound indicated by spectral
analysis. More recently Doyle (1984) also observed objective
improvements in violin players after Alexander training.
While considering improvements in performance the following experiences
of two athletes are noteworthy. Paul Collins, Canadian National
Marathon Champion 1949-52 and veterans world record holder in 10
events from 200 kilometers to 6 days (ie the distance run in 6
days) has said:
Howard Payne, Commonwealth record hammer thrower, improved his throw
by 5.64 metres at the age of 37. Commenting on this, which he believed
to be due primarily to taking Alexander lessons, he says:
Breathing
Pain
Professor FP Jones
Straightening up from a slumped sitting position is usually associated
with a sense of effort. When muscle activity is measured there is a
high level of activity in the main neck muscles. However, when the
habitual stiffening is prevented, the movement feels easier and the
neck muscles show less activity. Jones (1965) suggested that this was
due to the facilitation of appropriate head-neck reflexes.
Jones and Gilley (1960) used radiographs to confirm that the Alexander
movements produced an increase in the length of the sternomastoid
muscles, these being key muscles in the control of head position and
movement. Further examination of the radiographs showed that there was
an increase in the height of the cervical discs in Alexander subjects
and that there was also a forward movement of the centre of gravity
of the head.
Jones (1965) also used interrupted light photography to study the
sit-to-stand movement. The photographs show a quicker and more direct
movement following Alexander training.
Some criticisms of these studies
The breathing studies demonstrate significant changes using standard
procedures, in Austin's case with a control group.
The pain study was of course based on subjective reports and could
usefully have been extended to include some objective studies. However,
it was controlled and involved follow-ups.
Jones' work often did not include controls, although it could be
argued that each subject acted as their own control. As the methods
used in the first two studies reported are standard ones and were
carried out by qualified personnel, it is assumed that the measures
are reliable. In the interrupted light study the sampling rate was
low, putting some doubt on the validity of the derived velocity and
acceleration calculations.
To deal with problems such as these, together with others, an
experimental programme of research was undertaken.
The author's experimental programme
1. We began with an examination of the influence of leg position on
the sit-to-stand movement. This enabled criteria for determining the
quality of a movement to be developed, without requiring subjects to
assume unusual positions (Stevens et al, 1989).
2. We then performed an analysis of habitual and guided (using the
Alexander Technique) sit-to-stand movements. Force plate,
electromyographic and displacement data confirmed that guided
movements required less muscle activity and less force to perform the
movement and were also quicker. In addition the centre of balance was
more to the rear; with the subject being taller at the end of the
Alexander movement. A higher sampling rate that that used by Jones
(50 Hz vs 10 Hz) was used to measure displacement data
(Stevens et al, 1989).
3. A comparison of unguided movement patterns in an experienced
practitioner of the Alexander Technique when using the Technique in
the movement or when not was then undertaken. Using the criteria
developed previously the Alexander movements were found to be more
efficient than the non-Alexander movements, using less force and
taking less time. Here we used higher sampling rates of 300 Hz to
allow more reliable calculations of velocity and acceleration. The
study suffers, however, from being restricted to one subject and only
six sets of measurements (Stevens, 1995b).
4. The effect of neck and back splinting on postural stability was
examined in untrained subjects to explore the relative importance of
the neck, back and other postural reflexes. No significant effects
were found (Stevens, 1995b).
5. A comparison of postural stability between subjects who had
undergone Alexander training and those who had not was made. The
Alexander group were no more stable with their eyes open or when their
feet were in the normal position than the non-Alexander group; however,
their sway was up to 26% less when standing with the eyes closed and
the feet together. 15 male and 15 female untrained subjects were
compared with six male Alexander subjects; studies with more subjects
are required (Stevens, 1995b).
6. The influence of Alexander lessons on static posture was studied.
Significant increases in both height and shoulder width were observed
in musicians and office workers following Alexander training. Here 20
subjects were measured using standard anthropometric methods (Stevens,
1995b).
7. An investigation into the effects of the Alexander Technique on
raised blood pressure in professional musicians under the stress of
performance. The Alexander Technique produced similar reductions in
stress-induced raised blood pressure to Beta-blockers but without the
adverse effects on quality or performance associated with the use of
the latter. There has been anecdotal evidence that practising the
Alexander Technique can reduce high blood pressure. In this study of
39 subjects an attempt was made to control for stress-induced effects.
The changes found were small but reached statistical significance
(Nielson, 1994).
Conclusions
References
Austin JH, Ausubel P (1992) Enhanced respiratory muscular function in
normal adults after lessons in proprioceptive education without
exercises. Chest 102: 486-90
Barlow W (1956) Postural deformity. Proc Roy Soc Med 49: 670-4
Barlow W (1973) The Alexander Principle. Gollancz, London
Bruce BP, Caldwell JR, Dick JH et al (1937) Constructive conscious
control (letter). Br Med J 1: 1137
Coghill JE (1941) Appreciation: the educational methods of
FM Alexander. In: Alexander FM, ed. The Universal Constant in Living
(reprinted 1987) Centerline Press, Downey, California: xxi-xxxiii
Dart RA (1970) An Anatomist's Tribute to FM Alexander. Sheildrake
Press, London
Doyle J (1984) The Task of the Violinist: Skill, Stress and the
Alexander Technique. PhD thesis, University of Lancaster, England
Fisher K (1988) Early experiences of a multidisciplinary pain
management programme. Holistic Med 3: 47-56
Jones FP (1965) Method for changing stereotyped response patterns by
the inhibition of certain postural sets. Psychol Rev 72: 196-214
Jones FP (1972) Voice production as a function of head balance in
singers. J Pyschol 82: 209-15
Jones FP, Gilley PFM (1960) Head balance and sitting posture: an
X-ray analysis. J Psychol 49: 289-93
Magnus R (1925) Animal posture. Proc Roy Soc Lond 98B: 339-53
Nielsen M (1994) A study of stress amongst professional musicians.
In: Stevens CH, ed The Alexander Technique: Medical and Physiological
Aspects. Stat Books, London : 8-9
Payne H (1968) How I improved this year. Athletics Weekly Nov 30th
18-20
Roberts TDM (1978) The Neurophysiology of Postural Mechanisms.
Butterworth, London
Robinson L, Garlick D (1985) Comparison of respiratory movements and
frequencies in normal and trained subjects. Proc Aus Physiol Pharm Soc 16: 256
Sherrington CS (1946) The Endeavour of Jean Fernel. Cambridge
University Press, Cambridge
Stevens CH (1987, 1993, 1995a in press) Alexander Technique.
Vermilion, London
Stevens CH (1995b, in press) Towards a Physiology of the Alexander
Technique.
Stat Books, London
Stevens CH, Bojsen-Moller F, Soames RW (1989) Influence of initial
posture on the sit-to-stand movement. Eur J Appl Physiol 58: 687-92
Tinbergen N (1974) Ethology and stress diseases. Science 185: 2027
by Christopher Stevens
FM, as he was called, became an actor but developed voice problems
which forced him to stop performing. Determined to find out what was
the reason for his voice loss, he observed himself in a mirror when
reciting and when talking normally to see if he could observe any
behavioural reasons for his problems. After a long period of
observation he noticed that when he recited:
2 He was adversely affecting the balance of the head on the neck;
3 He was exaggerating the curves of his spine and there was undue
muscle tension throughout the body;
4 This undue muscle tension was particularly noticeable in the legs
and feet.
Problems are usually assessed by observing the student in everyday
situations and helping them to understand and sense what they are
doing to their body which may be a factor in the symptoms they are
suffering. They are then taught how to improve their way of using the
body's support system and applying this to their movements.
By 1894 FM had developed his methods to the point where others asked
him to help them with their problems. His discovery was, as far as we
can tell, entirely empirical: lots of trials and lots of errors led
to it. It was not until the 1920s that knowledge of the various
postural reflexes became widely available because of the work of
Magnus and his collaborators (Magnus, 1925). He showed that posture
is the result of a number of local, segmental and whole body reflexes
whose activities are integrated in the spinal cord, brain stem and
midbrain. Later investigators showed the influences of the cerebellum
and other brain structures, including the cortex.
Sir Charles Sherrington, who had trained Magnus, knew of and supported
Alexander's work. He wrote:
Alexander has done a service to the subject (the physiology of posture
and movement) by insistently treating each act as involving the whole
psychophysical man. To take a step is an affair, not of this or that
limb solely, but of the total neuromuscular activity of the moment,
not least of the head and neck. (Sherrington, 1946)
Mr Alexander's method lays hold of the individual as a whole, as a
self vitalising agent. He reconditions and re-educates the reflex
mechanisms and brings their habits into normal relation with the
function of the organism as a whole. I regard his method as thoroughly
scientific and educationally sound. (Coghill, 1941)
The electronic facilities of electromyography and
electroencephalography have confirmed Mr Alexander's insights and
authenticated the technique he discovered ... of teaching both average
and skilled individuals to become aware of their wrong body use, how
to eliminate handicaps and thus how to achieve better use of themselves
both physically and mentally.
We already notice, with growing amazement, very striking improvements
in such diverse things as high blood pressure, breathing, depth of
sleep, overall cheerfulness and mental alertness, resilience against
outside pressures, and in such a refined skill as playing a musical
instrument.
Barlow (1956) had subjects adopt a standard standing position and
photographed them from the front, side and back. Analysing these
photographs he was able to score their posture by using a grid system.
He compared two groups of individuals before and after receiving
training; one group received Alexander lessons and the other exercises
aimed at improving posture. In the Alexander group there was a
significant reduction in the number of postural faults following the
lessons in both men and women, while in the other group there was no
significant change. The Alexander group were students at the Royal
College of Music. In an attempt to determine whether fit young
individuals have postural problems, Barlow measured 112 female
physical education students who also showed a large number of postural
defects.
Barlow's study with music students suggested a correlation between
objective postural changes and performance. Their teachers reported
the following on the students' progress: all the students improved
physically both in their singing and acting abilities. They were
easier to teach and had become more psychologically balanced. In
addition, the success of the students in an important singing
competition was far greater than could have been expected. In their
opinion the Alexander Technique was the best method they had
experienced of aiding singing performance and should form the basis
of a singer's training.
Through the Alexander Technique I was able to rehabilitate my running
after 25 years of being unable to run through injuries, to the extent
that I was able to set ten world records for veterans in 1982.
(Stevens, 1987)
Balance is a vital aspect of good hammer throwing and getting the
head, neck, spine and pelvis in the correct relationship enables the
balance of the throw to come so much more easily. Once the balance is
settled there is an enormous improvement in turning speed.
(Payne, 1968)
Lung capacity and peak expiratory flow rate shows a significant
improvement after a course of Alexander lessons (Austin and Ausubel,
1992), while breathing is deeper and slower (Robinson and Garlick, 1985).
A study was made of the use of the Alexander Technique in a pain
management clinic (Fisher, 1988). Patients rated it the best of 13
activities used on a course on pain management. Questionnaires
measuring this were administered at the end of the course, 3 months
later and 1 year later.
Jones used a different approach to Barlow, preferring to measure
muscle activity and movement patterns for unguided and guided
movements. Only a few of his studies are considered here.
Barlow's studies can be criticised for the artificial nature of the
test situation but give consistent, if subjective criteria for
assessing static posture.
The Alexander Technique is a well established method for dealing with
an individual's health and performance problems. Its probable
underlying physiology is becoming clearer but more research is needed
in particular, both in the laboratory and in the treatment of clinical
conditions. All the studies listed require confirmation and extending
to look at more specific conditions. This requires greater financial
support than has been forthcoming in the past.
Reprinted by permission of the publisher.
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