Improving Human Functioning ~Awareness of Body and Mind Unity with Feldenkrais Method~

What is “functioning” to us? Is it a way to live our life better by moving our body such as playing, walking, cooking or running? Or is it a way to connect with our loved ones or others via talking, laughing, singing or smiling? There is no right or wrong answer to define “functioning” to us because each of us has a different way to live our life better. But when our “functioning” suddenly or gradually became “inefficient” as unnecessary “pain/tension” (e.g., emotionally and/or physically, conflict with others) was developed, how would we want to improve our functioning?

I recently learned the meaning of “human functioning” from one of my patients while I was working at a neurological rehabilitation facility as a Physical Therapist Assistant. This patient was motivated to perform out of bed activity training but she was unable to stand by herself due to chronic “pain.” She required maximum assistance by two people and a Hoyer lift was also used a day before I saw her. Her functional mobility was limited by the “pain” which is produced by muscle spasm development with both active and passive movement of her legs and with light touch even placing/removing a blanket/bed sheet after she got a spinal stenosis surgery few years ago.

When I visited her room, she was very agreeable to a therapy and expressed that her goal for this session was to be able to transfer to a bedside commode. However, as soon as I asked her to move her legs, she started to get muscle spasm. She started to cry and expressed that she was afraid of losing control of her body because nobody knows what is happening to her body.

After I listened intently to her, I changed my plan. I tried to figure out how to invite her to move herself comfortably. As she also mentioned chronic pain in her back, I asked her to sense her airflow first. Interestingly, she had more pain in the body parts (low back and pelvis) where she could not sense the airflow. We both smiled. That was the beginning of both of us connecting with her body through the movement of her breath!

Some people may think releasing the pain may help her body to move comfortably but pain is “self-destructive” so I thought it was more important for her to become “aware” what generates her pain in order to improve her functioning. I just wanted to remove her fear first and create “security” to herself because she was very fearful about her current physical condition. I also wanted to invite her to connect with her body and mind by increasing awareness of herself.

As we both found out together what made sense to us and “moving away from a pain or what we don’t want” is one of Feldenkrais Method concepts, I asked her to turn her head to left, which was the direction of movement away from pain and muscle spasm for her. She was also not sure where the midline was while her entire body was cricked toward right. Her head was gradually positioned toward the midline which she also noticed after few times of turning her head. So I moved onto her trunk which was moving toward her pain in order to prepare her body for bed mobility and functional transfer training.

I first told her that she would need to prepare herself first what I’m going to do with her together as I was planning to align her body to the midline. I also told her the most important thing that I will discontinue to move her body if her body started developing the muscle spasm. She agreed with this plan and started talking to her body and herself what will happen first and then we both moved her trunk/pelvis together. As her body allowed us to do this movement, we did the same thing for her legs and finally we were able to move the entire of her body to the midline without any pain!

The article of “MIND AND BODY” written by Moshe Feldenkrais, Ph. D., a pioneer of Feldenrkrais Method, stated “the healthy mind makes a healthy body.” As I’m Japanese, this statement totally makes sense to me because when we get sick with unknowing causes, we say “Yamai wa ki kara.” an old Japanese saying, meaning illness starts in the mind. In my patient case, by talking to herself, her body and mind started to unite and her voice and facial expression also changed dramatically. She looked happier how she was able to move her body effortlessly.

Before conducting bed mobility training, we saw an interesting phenomenon how her body responded to her mind especially when her mood changed. I found her ankle foot orthosis (AFO) by her bed so I asked her if she would need to wear this since I couldn’t find any Dr’s order for it. She started to talk about a story of AFO and suddenly her mood was changed. She was upset with what happened to her AFO (long story short, she didn’t need to wear it). I thought that I may need to change the topic to calm her down but I let her to continue expressing what she was feeling. As soon as her mood was changed, something happened to her body. Can we guess what happened…? Yes, her body started to develop the muscle spasm again so she discontinued her talk because of discomfort.

I asked her what she experienced from her talk. She began to become “aware” of how her emotional change generated the muscle spasm development. I asked her again how her emotion talked to her brain and how her body responded to it. She nodded and smiled. By organizing herself again and making this process a little step by step, she was finally able to complete bed mobility and transfer training without producing “pain.” After this session, she told me this was first time for her to be able to get out of bed by herself very comfortably.

What did we learn from her story? Do we now believe “healthy mind makes a healthy body?” How did she improve her functioning? The reduction of pain was necessary for her because she was very fearful of losing her functioning while she was living her life with unknown pain for years. Throughout the process, she gradually started to become “aware” of what she was doing through the small movement of her breath and talking to herself. As the result, she began to initiate moving her body efficiently without any effort. Her self-knowledge through awareness of body and mind unity finally invited her to open a door to improve her functioning as a human! I am so fascinated what I have been learning and experiencing with Feldenkrais Method to open the door together with people.

Reference

Feldenkrais M (1980). MIND and BODY. pp.73-80.