The Elusive Obvious

If you are a practicing therapist wanting to help clients find relief from chronic pain, you may feel much of the same frustration that many experienced therapists I recently interviewed expressed-

- “Patients are often fearful of movement and therefore lack compliance with home programs.” 

- ”The new pain science can be helpful, but also confusing to communicate to the patient without having them feel we are saying it’s all in their head.”

- “With my chronic pain patients, I am using all the tools that I have available to me and yet I feel I am missing something important.”

The key differentiation between the Feldenkrais method and other movement approaches is that it creates customized “learning how to learn” lessons that improve and expand one’s movement repertoire.  Each lesson is individuality tailored to the biomechanical and neurophysiological needs of patients on a case-by-case basis.  As a Feldenkrais practitioner I have never taught the same series of moves and neuromuscular engagements to any two people!

Take for example a 56-year-old client of mine that came to me with ongoing chronic back pain despite having had 2 prior series of physical therapy elsewhere. 

She appeared anxious and all of her movements were slow and cautious. Unquestionably “central sensitization” was a factor. Her central nervous system, the “little woman in the control room”, had made a strong association between movement and pain and had “put on the brakes”. 

After demonstrating her prior home exercise program, she was relieved when I suggested that she discontinue it. The exercises were linear in nature and quite standard, something many physical therapists would be bored to death doing themselves. 

Using a Feldenkrais approach of hands-on Functional Integration and a pelvic clock lesson sitting on a balance disc, she returned one week after her first session with a big smile and reported good progress. She used the balance disc many times daily and expressed feeling more connected to her body in a comfortable, fluid and joyful way. And she recorded finally being able to pick up her granddaughter “with only a minimal feeling of strain.” 

This client was far from out of the woods, but she was learning to identify stressful movement patterns, and have access to Feldenkrais lessons that expanded her movement repertoire and provided her with efficient and comfortable functioning.  Additionally, her nervous system began to trust movement once again because of the gentle, individually structured lessons that tapped into her brain’s curiosity and sense of wonder.

The Feldenkrais method is a whole brain system for whole body learning.  It is powerfully effective because it uses the same individualized process of neuromuscular learning that one would engage in, for example, learning to refine and expand one’s repertoire on the piano. Think of the spine “having 24 piano keys”.  How well do you feel you can guide your patients to learn to differentiate and then integrate “those keys” in all kinds of various combinations?

Over 95% of my chronic pain clientele come to me having had previously unsuccessful physical therapy.   Thus, my commitment to educating the PT world in a method that is extremely well responded to by people with chronic pain.

If you are interested in learning more about how you can have more success treating chronic pain using a Feldenkrais inspired approach, please check out my online course, Movement and Awareness for Healing Chronic Pain.  It starts in just a few weeks on September 23rd!

Warm regards,

Paul

Living An Embodied Life

Working on behalf of others well-being brings joy and purpose to our own lives.  We are built to nurture and connect with one another.

-Daniel Siegel, Author of The Mindful Therapist

The above reminds me of the self determination theory which is based on three motivational factors :

1. Autonomy, 2. Mastery, and 3. Purpose.

 Implicit in the statement about working on behalf of others well-being is that we have the skills, caring, and time to provide the experiences that enrich the lives of our clientele. 

The irony is that healthcare workers, and certainly physical therapists, typically spend less time than they would prefer and what is considered necessary for a truly beneficial interaction to be fulfilled. 

This is contributing to considerable displeasure, disillusionment, and despair within our profession and healthcare in general. I interviewed over 30 practicing physical therapists about their experience working with chronic pain patients. Regardless of being a new grad or having over 40 years experience I heard expressions of frustration with the pressures of rendering services to our patients.

We have had to adapt, and subsequently our joy derived from our work has diminished or is absent.

A physical therapy colleague and wonderful Alexander practitioner put it this way– “When you look in the mirror are you the person you want to be?”

Are you practicing the dream that you had when you applied to physical therapy school, or entered massage training, or completed athletic training?

Let’s go back to the self-determination theory. 

1. Autonomy- the human urge to make decisions for oneself

 It is defacto sabotaged by at least the temporal limitations.

2. Mastery- the urge and need to create new things

It is severely interfered with for both the provider and client when learning requires more time than what is available- Time for in depth focus, reflection, insights, and beneficial action. 

3. Purpose- focusing on the well-being of others

It is bound to suffer as we attempt to find solutions to an apparently untenable situation.

What can be done about this?  Well, as with most challenging situations, the changes need to begin with and within ourselves. 

Maybe you would like to take a look at my proposed actions for a practitioner to feel more present, inwardly connected, and at peace. 

Don’t get me wrong, this is no simple solution- but in a world fraught with stress I invite you to consider it as a beginning guide to the experience of inner calm and overall well-being.

   Peace be with you,

            Paul 

My Journey to Embodiment With Feldenkrais

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Hello. I am Paul McAndrew and have been practicing physical therapy since 1972. In the early 80s my wife Lorraine and I had a very profound and life-changing experience that is still at the core of my work, and why I am starting this blog. 

My wife Lorraine Davis and I participated in a weekend Feldenkrais Awareness Through Movement workshop and after the first lesson (about 10 years into being a physical therapist), I got up off the floor, turned to Lorraine and said “this is what I’ve been looking for.” 

I had been searching outside of myself for the answer to how to become a more effective and connected therapist. I had ingested a great deal of information about the human body, but had learned nothing ‘from the inside out.’ What an enormous missing link!

My experiences as a PT had been challenging and varied, and included being head PT at a major urban hospital, teaching for the Paris Institute, and working at what was then his Atlanta back clinic. But I knew I was missing important pieces of truly learning how I could help people improve their function and the quality of their lives. The Feldenkrais Method gave me a remarkable addition to my training as a therapist, providing me with a greatly enhanced education and mind set for understanding how we move, how we heal, and most significantly, about our capacity to learn, change, and grow throughout our lives.

Presently my wife Lorraine Davis and I are co-directors of the Wellness Station in Durham, North Carolina, where the principles of the Feldenkrais Method are at the heart of all that we do.