Barrett L. Dorko, P.T.
I was bored. I stopped thinking and put my hand on his head, but I wasn t unobservant, although, I actually felt that I fell asleep several times. When the man got up from the table, he said, That s the best lesson I have ever had. That was a major change in my life.
Moshe Feldenkrais quoted in In Touch Newsletter Feldenkrais Guild of North America 2nd Quarter, 2000
I could very often describe the care I provide in precisely the same way I see Moshe Feldenkrais describe his here. I spend long periods quietly seated at the patient s head, my hands gently placed in various ways. I sit and I wait, and changes occur. Feldenkrais had many of his own ideas how this might have helped, but I ve my own.
Touch always produces two effects, mechanical and reflexive. The former is dependent upon the tissue s response to outside force, and there is a linear relationship between that force (with some consideration for its speed) and the amount of alteration it produces. There are many problems with this as a primary modality of care, not the least of which is the specificity with which the force can be applied. Reflexive effect is dependent upon the connections within the nervous system, and it grows in inverse proportion to the stimulus employed. In short, gentle touch is far more likely to produce wide-ranging sensation than heavy pressure. When touch is used on the epithelium, the opening of ion channels in the cellular membrane leads to nervous depolarization and, eventually, activity in the sensorium. The amount of ion exchange produced with the deformation of touch is directly related to the membranous tension of the cell mechanically disturbed. Touching skin that is pulled tautly over a bony prominence (like the cranium, for instance) is more likely to be productive in a reflexive sense. Touching it gently and then varying the pressure of that touch seems a reasonable way to avoid accommodation, and this is the essence of the technique in Simple Contact.
I presume that movement is required in order to reduce the mechanical deformation responsible for pain. This movement may take many forms, but it certainly seems that Feldenkrais himself favored those motions closely associated with our instinctive nature. The intricate precision and emphasis on effortlessness associated with Feldenkrais Awareness Through Movement evokes the qualities of ideomotor activity when it is fully expressed. Thousands of times I ve heard patients describe the sensation of movement though nothing is to be seen on the surface. In my experience, asking the patient what and where they feel this activity occurring enhances the learning that takes place and leads quite naturally toward mild modifications in manual pressure and a larger therapeutic response. My presumption is that a corrective maneuver is simply waiting to emerge and it really only needs some permission and encouragement without coercion to fully express itself. Knowing the materials as we do, it doesn t make sense to try and produce change that requires learning in any way that involves overt or forceful manipulation.
When Feldenkrais says that he fell asleep, I recognized in that description something very important about the nature of my handling: the absence of a willful plan. I simply allow whatever the patient s unconscious desires. I observe, but I don t judge. There is some excellent literature alluding to this attitude and to the efficiency of movement when the ego is transcended.
For example, in Breakfast at the Victory: The Mysticism of Ordinary Experience by James Carse (Harper Collins, 1994), the author writes of the proprietor and sole employee at a busy Manhattan diner, Ernie: It should have been obvious that he was actually preparing and serving food, but it wasn’t. Over the years his actions had been reduced to their minimum. Cutting and buttering a roll was a matter of a few effortless moves. Ernie’s actions having been reduced to their smallest size, we could not see him at the center of this activity for, Tao-like, no one was doing anything, yet nothing remained to be done.
Carse, a college professor, goes on to explain how this kind of effortless doing nothing characterized the best of his teaching when he somehow interrupted the familiar paths of his student’s thinking and provided them an opportunity to find a thoughtful way through new ideas. I honestly believe that a certain kind of handling can make this available to our patients as well, but it must not begin with the therapist’s effort. I tell my students to emulate Ernie buttering a bagel, and sometimes they understand.
Another example. Chuang Tzu’s famous description of cutting up an ox by the cook of an oriental prince is often cited for its insight. It describes profound change occurring while very little force is used. Paraphrased, the cook says, I see nothing with the eye, but rather my whole spirit apprehends. Following its own instinct, the spirit finds the secret opening, the hidden space and I move through like a breeze. I stand still, and let the joy of the work sink in.
I feel that this attitude is the most important aspect of Simple Contact, but it is the hardest to teach initially. That teaching becomes much easier once the characteristics of ideomotor activity, the nature of the cellular mechanics leading to sensation/learning and the possibilities of reflexive effect are made clear. Feldenkrais seems not to have had access to portions of this knowledge, and some of it came about in research following his death.
But we know it now.
For more information about cellular mechanics and sensation see Simple Contact and Distant Change; A Hypothetical Model on my web site <http://barrettdorko.com>
For more on ideomotor movement see Without Volition: The Presence and Purpose of Ideomotor Movement on the same web site.