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Alexander Technique

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The Alexander Technique, named after its developer Frederick Matthias Alexander (1869–1955), is a type of alternative therapy based on the idea that poor posture gives rise to a range of health problems.[1][2]: 221  The American National Center for Complementary and Integrative Health classifies it as a "psychological and physical" complementary approach to health when used "together with" mainstream methods. When used "in place of" conventional medicine, it's considered "alternative".[3]

Alexander began developing his technique's principles in the 1890s[4] in an attempt to address his own voice loss during public speaking.[2]: 34–35  He credited his method with allowing him to pursue his passion for performing Shakespearean recitations.[5]

Proponents and teachers of the Alexander Technique believe the technique can address a variety of health conditions, but there is a lack of research to support the claims.[6][7] As of 2021, the UK National Health Service and the National Institute for Health and Care Excellence (NICE) cite evidence which suggests that the Alexander Technique may be helpful for long-term back pain and for long-term neck pain, and that it could help people cope with Parkinson's disease.[7][8] Both the American health-insurance company Aetna and the Australian Department of Health have conducted reviews and concluded that there is insufficient evidence for the technique's health claims to warrant insurance coverage.[6][9]

Method

The Alexander Technique is most commonly taught in a series of private lessons which may last from 30 minutes to an hour. The number of lessons varies widely, depending on the student's needs and level of interest. Students are often performers, such as actors, dancers, musicians, athletes and public speakers, people who work on computers, or those who are in frequent pain for other reasons. Instructors observe their students, and provide both verbal and gentle manual guidance to help students learn how to move with better poise and less strain.[10] Sessions include chair work – often in front of a mirror – during which the instructor will guide the student while the student stands, sits and walks, learning to move efficiently while maintaining a comfortable relationship between the head, neck, and spine, and table work or physical manipulation.[11]

In the United Kingdom, there is no regulation for who can offer Alexander Technique services. Professional organisations do exist, however, typically offering 3 year courses to people becoming instructors.[7]

History

The Alexander Technique is based on the personal observations of Frederick Matthias Alexander (1869–1955). Alexander's career as an actor was hampered by recurrent bouts of laryngitis, but he found he could overcome it by focusing on his discomfort and tension, and relaxing. Alexander also thought posture could be improved if one became more conscious of one's own bodily movement.[12]

While on a recital tour in New Zealand (1895), Alexander came to believe in the wider significance of improved carriage for overall physical functioning, although evidence from his own publications appears to indicate it happened less systematically and over a long period of time.[2]: 36 

Alexander did not originally conceive of his technique as therapy, but it has become a form of alternative medicine.[1]

When considering how to classify the Alexander Technique in relation to mainstream medicine, some sources describe it as alternative and/or complementary, depending on whether it is used alone or with mainstream methods. The American National Center for Complementary and Integrative Health classifies it as a "psychological and physical" complementary approach to health when used with mainstream methods. When used "in place of" conventional medicine, it's considered "alternative".[3]

Influence

The American philosopher and educator John Dewey became impressed with the Alexander Technique after his headaches, neck pains, blurred vision, and stress symptoms largely improved during the time he used Alexander's advice to change his posture.[13] In 1923, Dewey wrote the introduction to Alexander's Constructive Conscious Control of the Individual.[14]

Fritz Perls, who originated Gestalt therapy, credited Alexander as an inspiration for his psychological work.[15]

Uses

The Alexander Technique is used as a therapy for stress-related chronic conditions. It does not attempt to cure the underlying cause, but to teach people how to avoid bad habits which might exacerbate their condition.[12]

The Technique is used as an alternative treatment to improve both voice and posture for people in the performing arts. As of 1995 it was on the curriculum of prominent Western performing arts institutions.[16]

According to Alexander Technique instructor Michael J. Gelb, people tend to study the Alexander Technique for reasons of personal development.[17]

Health effects

The UK National Health Service says that advocates of the Alexander Technique made claims for it that were not supported by evidence, but that there was evidence suggesting that it might help with chronic back or neck pain. According to the NHS, Alexander technique may be of benefit for people with Parkinson disease.[7] The National Institute for Health and Care Excellence (NICE) guidelines state that people with Parkinson disease who are experiencing balance or motor function problems should consider the Alexander Technique along with disease-specific physiotherapy.[18]There is limited evidence for chronic pain, stammering, and balance skills in older people. There was no good evidence of benefit for other conditions including asthma, headaches, osteoarthritis, difficulty sleeping, and stress."[7]

A 2012 Cochrane systematic review found that there is no good evidence that the Alexander Technique is effective for treating asthma, and randomized clinical trials are needed in order to assess the effectiveness of this type of treatment approach.[19]

A review published in BMC Complementary and Alternative Medicine in 2014 focused on "the evidence for the effectiveness of AT sessions on musicians' performance, anxiety, respiratory function and posture" concluded that "evidence from RCTs and CTs suggests that AT sessions may improve performance anxiety in musicians. Effects on music performance, respiratory function and posture yet remain inconclusive."[20]

A 2015 review, conducted for the Australian Department of Health in order to determine what services the Australian government should pay for, examined clinical trials published to date and found that "overall, the evidence was limited by the small number of participants in the intervention arms, wide confidence intervals or a lack of replication of results." It concluded that "the Alexander Technique may improve short-term pain and disability in people with low back pain, but the longer-term effects remain uncertain. For all other clinical conditions, the effectiveness of the Alexander Technique was deemed to be uncertain, due to insufficient evidence." It also noted that "evidence for the safety of Alexander Technique was lacking, with most trials not reporting on this outcome."[6] Subsequently in 2017, the Australian government named the Alexander Technique as a practice that would not qualify for insurance subsidy, saying this step would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence".[21]

A review by Aetna last updated in 2021 stated: "Aetna considers the following alternative medicine interventions experimental and investigational because there is inadequate evidence in the peer-reviewed published medical literature of their effectiveness." The Alexander Technique is included in that list.[9]

See also

References

  1. ^ a b Ernst, Edzard (2019). Alternative Medicine – A Critical Assessment of 150 Modalities. Springer. pp. 153–154. doi:10.1007/978-3-030-12601-8. ISBN 978-3-030-12600-1. S2CID 34148480.
  2. ^ a b c Bloch, Michael (2004). F.M.: The Life of Frederick Matthias Alexander: Founder of the Alexander Technique. London: Little, Brown. ISBN 978-0-316-86048-2.
  3. ^ a b "Complementary, Alternative, or Integrative Health: What's In a Name?". NCCIH. 10 March 2023. Retrieved 10 March 2023.
  4. ^ Rootberg, Ruth (September 2007). Mandy Rees (ed.). "Voice and Gender and other contemporary issues in professional voice and speech training". Voice and Speech Review. 35 (1): 164–170. doi:10.1080/23268263.2007.10769755. S2CID 144810660.
  5. ^ Harer, John B.; Munden, Sharon (2008). The Alexander Technique Resource Book: A Reference Guide. Scarecrow Press. pp. xii–xiii. ISBN 978-0810863927. Retrieved 3 June 2014.
  6. ^ a b c Baggoley C (2015). "Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance" (PDF). Australian Government – Department of Health. Archived from the original (PDF) on 26 June 2016. Retrieved 12 December 2015.
  7. ^ a b c d e "Alexander Technique". National Health Service. 6 September 2021. Retrieved 1 December 2021.
  8. ^ "Parkinson's disease in adults". NICE. Retrieved 7 November 2023.
  9. ^ a b "Medical Clinical Policy Bulletin Number 0388: Complementary and Alternative Medicine". Aetna. Retrieved 1 December 2021.
  10. ^ McEvenue, Kelly; Rodenburg, Patsy (2002). The Actor and the Alexander Technique. New York: Palgrave Macmillan. pp. 3–14. ISBN 0-312-29515-4.
  11. ^ Jain, Sanjiv; Kristy Janssen; Sharon DeCelle (2004). "Alexander Technique and Feldenkrais method: A critical overview". Physical Medicine and Rehabilitation Clinics of North America. 15 (4): 811–825. CiteSeerX 10.1.1.611.4183. doi:10.1016/j.pmr.2004.04.005. PMID 15458754.
  12. ^ a b Moroz A, Cohler MH, Schulman RA (2011). "Chapter 21: Body Work and Movement Therapies". In Lennard TA, Walkowski S, Singla AK, Vivian DG (eds.). Pain Procedures in Clinical Practice (3rd ed.). Elsevier. pp. 205–222. doi:10.1016/B978-1-4160-3779-8.10021-1. ISBN 978-1-4160-3779-8. (subscription required)
  13. ^ Ryan, Alan (1997). John Dewey and the high tide of American liberalism. New York: W.W. Norton. pp. 187–188. ISBN 0-393-31550-9.
  14. ^ F. M. Alexander, Constructive Conscious Control of the Individual, E. P. Dutton & Co., 1923, ISBN 0-913111-11-2
  15. ^ Tengwall, Roger (1996). "A note on the influence of F. M. Alexander on the development of gestalt therapy". Journal of the History of the Behavioral Sciences. 17 (1). Wiley: 126–130. doi:10.1002/1520-6696(198101)17:1<126::AID-JHBS2300170113>3.0.CO;2-X. ISSN 1520-6696. PMID 7007480.
  16. ^ D'Antoni ML, Harvey PL, Fried MP (September 1995). "Alternative medicine: does it play a role in the management of voice disorders?". J Voice. 9 (3): 308–11. doi:10.1016/s0892-1997(05)80239-5. PMID 8541975.
  17. ^ Gelb, Michael J. (1995). Body learning: an introduction to the Alexander Technique (2nd Owl Book ed.). New York: Holt. pp. 3–4. ISBN 0805042067.
  18. ^ "Parkinson's disease in adults". NICE. Retrieved 7 November 2023.
  19. ^ Dennis, JA; Cates, CJ (12 September 2012). "Alexander technique for chronic asthma". The Cochrane Database of Systematic Reviews (9): CD000995. doi:10.1002/14651858.CD000995.pub2. PMC 6458000. PMID 22972048.
  20. ^ Klein, SD; Bayard, C; Wolf, U (24 October 2014). "The Alexander Technique and musicians: a systematic review of controlled trials". BMC Complementary and Alternative Medicine. 14: 414. doi:10.1186/1472-6882-14-414. PMC 4287507. PMID 25344325.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  21. ^ Paola S (17 October 2017). "Homeopathy, naturopathy struck off private insurance list". Australian Journal of Pharmacy. Archived from the original on 18 April 2021. Retrieved 11 January 2018.
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