Many leveled recovery: just dance
The psychological and emotional aspects of recovery go in tandem with physical recovery. F.M. Alexander proposed and deeply believed that the mental, physical and emotional aspects of the Self are integrated and inseparable. Although some activities may be described as primarily “mental” (problem solving, for example) or “physical” (e.g. athletic pursuits) or “emotional” ( distress, joyous participation), the entire Self is involved in any activity. We don’t as animals know we are feeling an emotion, for instance, unless we have an indicating physical and mental set of cues. All animals have this integrated response; humans have emphasized the mental priority with sad consequences.
Experiencing ongoing physical pain and immobility has myriad psychological consequences. The Self that has been recognizable by daily physical activity is no longer on line. New means of accomplishing simple tasks must be found, and the familiar Self, as cued by previous experience, changes and morphs. The danger of a Self as identified by “disabled” lurks and haunts emotional stability. We can sink into a notion of disability as a constant, or rise to a concept of the whole Self, with choices in response to stimuli, whether internal or external. This is what F.M. Alexander proposed as the next step in human evolution.
My current means of responding to my (temporarily) reduced condition of Self is to, once again, dance! I watch videos of Michael Jackson, who was one of our generation’s greatest movers. The mirror neurons in my wee brain take great delight in viewing his ease and skill in motion. So, I dance in my mind and instruct my whole Self accordingly, despite my less than functional leg. And, I put on music and dance like a crazy person, so my injured leg can learn to respond again. I look pretty silly, but I have fun, feel joy, renew hope and also re-connect neural sequences that have been temporarily lost with 6 months of arduous recovery. My whole Self feels better and more on line.
That’s the spirit! Just dance, despite limitations!
Graduation to further recovery
It has been nearly six months since I fell and fractured my patella. I had no idea when I injured myself of what a long road of recovery would be required, and of how many challenges I would face. Six months of being less than fully mobile is a very long time for anyone, but a dramatically long time for a person (me, for instance) who is typically active in a vigorous, daily fashion. My emotional survival has often come under question, and my physical recovery has been challenging far beyond any expectation.
My surgeon “graduated” me from his care this week. Until our final meeting, he had never seen me move. He had seen me in a wheelchair, on the operating table, and on an examination table. Given his limited observation of me, I dismissed his dire predictions that I would never walk without a limp nor ever run again.
On our last visit, my surgeon (who, by the way, did repair my patella with great skill) asked me to stand and “walk” in a very small space. I literally walked in a very small circle. He pronounced that to be “good”. He did not ask if I can walk down stairs, run, do Gyrotonics, teach a full schedule or ride a horse.
My point is that the surgeon doesn’t see the patient in a full-time function fashion. The full function recovery is up to the patient.
What has worked well, thus far, in my recovery is ignoring dire predictions, diving into as much activity as I can manage, with Alexander principles applied, finding PT’s who think beyond mechanics, and trusting that the resources available from my extensive professional contacts will yield far more than the standard recovery protocol.
Alexander lessons, osteopathic treatments, acupuncture and Gyrotonic exercise, in addition to intelligent Physical Therapy, have assisted me. I have no idea where I am on the spectrum of standard recovery from a patella fracture. I am walking an average of 3 miles every day, teaching a full schedule of Alexander lessons, and vigorously exploring Gyrotonic routines. I cannot yet run, walk down stairs in a normal way, sleep comfortably or claim that I am pain-free. Pain continues in a random and frequent fashion. I still don’t recognize myself in my current level of challenged mobility.
Still, I am recovering, not stuck, and will continue to improve with intelligent PT, Gyrtotonic exercise, acupuncture, osteopathy and, most enduringly, Alexander principles, until I am functional and mobile to the degree that I consider full and acceptable.
I am much better than I have been and hope to be better than I am, with the expert support of all the good people who guide me, and with continuing thoughts of dynamic non-interference, and of up, forward and wide!
Going up more, pulling down less
From an Alexander perspective, we can all go up a little more and pull down a little less. This applies throughout life, and especially for Alexander teachers, who have been applying Alexander principles to activity on a daily basis for many years. The Alexander Technique is not a quick fix. The habits of a lifetime are addressed by continuous attention to overall use of the self, and an intention in response that is elastic and whole-person attentive. More and more layers of potentially pulling down in response to stimuli need to be kindly and gently addressed, so that thinking with the whole self becomes a continuously developing skill.
I can walk with much more ease and speed now, much to my joy. But I must apply the directive of “going up more, pulling down less” to daily mundane activity to continue with recovery. When I find myself limping and lurching, I have to calm and quiet my mind, refuse to pull down in my attention, and decide on the priority of springing up from the ground with my entire neuro-muscular response. This results in a more balanced means of walking, less pain and fear of pain, and a wider attention to the wonderful world that surrounds me. I can enjoy the views and the experience involved in walking without pulling my attention down to my injured knee.
This is not to suggest that I ignore or suppress any discomfort, whether physical or emotional. Instead, I choose to notice my intention and attention, and decide to welcome a freedom of self in whatever condition of self might be current, and to dynamically spring up from the ground with joy and ease.
I saw a hawk today in the city and heard the hawk’s chirps because I had a wider view than possible knee pain. Evidence of embracing a wider view!
More hope, further recovery
This continuing journey of recovery from serious injury has led me into unexpected paths of exploration and connection. Previous to enduring an injury, I had minimal experience with Physical Therapy. Now, I am building a matrix of sources and connections, so that I can have the best possible expert support for my eventual full recovery.
This past week, I was delighted to exchange work with another PT referred to me by my Gyrotonic instructor, Lindsey. Janette Arhndt is a PT with refined skills in Gyrotonic, myofacial release, and lymphatic drainage therapy. Janette kindly came to my office for our work together. I gave Janette her first Alexander lesson, and she gave my injured knee much needed hands on soft tissue work. Her intent was to relieve the inflammation (and the resulting pain and immobility) in my knee, as well as to encourage lymphatic drainage. As an Alexander teacher, I am quite selective about hands on me. Janette’s hands reflected her overall superb use. I experienced an immediate increase in flexion, reduction in discomfort, and a deep sense of well-being.
Janette was very optimistic about my recovery, as she observed my movement with care and attention. Her calm, kind and professional presence, as well as her intelligent recommendations for pursuit of simple recovery approaches, was hugely reassuring.
The day after my delightful exchange of work with Janette, I enjoyed a Gyrotonic session with Lindsey. I was able to happily explore much more vigorous movement, and all without pain or fear of pain. I also walked most of the way from my office to the Gyrotonic studio (about 1 and 1/2 miles), a greater distance than I have walked with any ease since injury!
Our current health care system (please, can we just change it?) outlines a “productivity model” for injury recovery that is deeply end-gaining. PT’s are typically expected to advise specific muscle strengthening exercises (focussing on the part more than the whole) and present a standardized list of exercises for an injury. There is often little time or attention allowed in our current system for the PT to notice how the recovering person is motivated to think or believe about the process of recovery. The weight falls upon the recovering person to find a means of rehabilitation that best suits their hopes and personal goals. Due to my Alexander skills, and connections I have made through my long term interest in intelligent activity, I am blessed to have found PT’s who are compatible in their approaches with Alexander principles, and who support me in my insistent belief that I will recover fully.
New PT approach for recovery
I have never, previous to fracturing my patella in a fall, required the skills of a Physical Therapist, so my expectations were relatively uninformed. After injury, I’ve had two Physical Therapists through my co-operative health group, and they did their expert best for me. Although I have been very appreciative of their work, my pain levels and mobility had not improved significantly from the exercises they had assigned to me. Thus, I took it upon myself to find further, less mechanically oriented PT guidance.
My Gyrotonic instructor, Lindsey, referred me to a PT who is a former dancer and Gyrotonic instructor. Heidi spent a considerable amount of time in listening to how I am now, how I have been since injury, and then observing how I walk. She gave me new ways to think about walking that helped me tremendously. And, happily from an Alexander perspective, the “exercises” she gave me were far less about strengthening specific muscles than concerned with overall awareness of co-ordination. Although she didn’t employ the term “use” in an Alexander fashion, she attended to use and the big picture of personal co-ordination choices.
The result is that my mobility and pain levels have improved. I walked home from work today at my pre-injury speed and ease.
There is more recovery in my future, I hope. I can’t walk down stairs like a normally co-ordinated person, walking downhill is very challenging and often painful, and running, riding a horse, or doing many of the activities I did previously with confidence are currently far beyond my capability. I am grateful to be able to teach well. I have renewed hope that with the skilled guidance of a PT who thinks less mechanically and more widely, combined with Alexander lessons, I will be able, in time, to enjoy all the activities I love, and more, once again.
Renewed Joy in Movement
This past week, I travelled to, and deeply enjoyed, a visit to NYC, a city where I lived for many happy years. One of the myriad reasons that I love NYC is the experience of easy, independent mobility in a pedestrian-friendly city. Previous to my trip, I had some minor trepidation about how my reduced mobility would affect my daily functioning and enjoyment. And, very happily, I can report an experience of joyous ease!
I did have to keep an alert eye for uneven cobblestone streets and slate sidewalk irregularities, but I walked with surprising ease, and even found a “passing gear”. There is a rhythm to NYC, and it is a rhythm that I entered happily. My pace was slower than previously, but I could enter the wave with newly found patience and inner quiet. I couldn’t run for the train or beat the “don’t walk” light. I could allow the wave and rhythm to move around me and find the moment that carried me with the heartbeat of the city. Five months of reduced pace and mobility have indeed changed me. Patience is a new experience for me, especially patience with myself. There is a difference between hurrying and going quickly. And, I don’t have to be the fastest, I just need to move well.
Much of the increased ease that I experienced was due not only to my association of being in NYC with joy in mobility, but also to frequent Alexander lessons, while there, with John Nicholls. I have been teaching the Alexander Technique for 22 years, and studying with John for 19 of those years. His work is nothing short of sublime. He is skilled in restoring an overall elastic response, encouraging respiratory support, and finding a coherent organization of the whole self. I left every lesson with a renewed sense of my entire coordination and support, the ground as support for going up. My knee hurt far less, flexion increased, and mobility improved.
In NY, I was able to climb and descend subway stairs, to walk many blocks in my daily routines, and to wander museums extensively without undue pain or exhaustion. There were some subway stations that I found to be taxing and tiring, so I simply avoided them. I did everything that I wanted to do with surprising ease.
Although I must continue with Physical Therapy to recover full flexion, knee stability and leg strength, the experience of Alexander lessons enhancing my overall use was wonderful. The Alexander Technique never promises to heal or to address a specific part of the body. It is always indirect and involves the entire elastic response of the self. For those recovering from injury, serious or slight, a combination of intelligent PT and Alexander lessons could be key to opening a window to full and lifelong recovery. As the use of the self improves, the conditions which may have caused or increased injury diminish.
I go to NY to observe components of my personal use, growth and change against the background of my familiar and much loved NYC. Ease in movement is an important indication of my overall use of self. Newly found patience indicates some personal growth. My trip demonstrated that I can be happy again, that I can move with more ease, and that there is even more ease in movement to come.
Another expression of gratitude
Many humans and non-humans have provided essential assistance during my recovery journey. As I proceed through this long haul, it is important for me to express deep gratitude to the following kind and/or expert folks:
All of my dedicated students, who have been willing to learn with me in my journey to full recovery; Yoshiro for transformative acupuncture treatment; Maureen for many-leveled osteopathy; Lindsey for being wisely willing to explore recovery with me via Gyrotonic exercise; all the folks at Lighthouse Coffee who daily note and cheer my slow but steady progress; dogs Ella, Ruffles, Georgie and Oliver for their enthusiasm to see me; my nephew Gabe for teaching me to moonwalk; Physical Therapists Heather and Barb for guiding me in necessary daily pursuits toward recovery; my dear and patient friends for being willing to listen to me when I am in much dismay; my sweet and loving parents and siblings who have fed me, transported me, and understood how very hard it is for a Barrett to be less than fully mobile; Carmella, the cat who runs my home life, for insisting on play and affection daily; and Marty, most emphatically, who has lifted my leg, rubbed my back in the wee hours, done all the household chores, endured my outbursts of frustration, and loved me even in my temporarily reduced state. He deserves a medal for endurance with grace!
Also thanks to local birds who brighten my days with song and flight, the lush views of foliage from home and office windows, the summer light and warmth that defeats depression, and the Alexander Technique, without which I may be wallowing and adrift.
My thanks to all!
Longer, larger moments
During the five months since I fractured my patella, there have been many notable steps of recovery. I no longer wear a full-leg splint or brace. A cane is not necessary. I can get into a car without extraordinary acrobatics. Bathing no longer requires assistance. Walking to work and home again (nearly a mile each way) is challenging (especially the downhill portions) but possible. I even sleep comfortably now and again.
During the months long initial stages of recovery, my awareness narrowed to pain management and moment by moment choices in balance. My entire life seemed to become focussed on how best to use myself in basic activity. Despite my intentions to “see the big picture”, pain and/or the possibility of pain dominated every moment.
In the past week, most likely due to my new Physical Therapist, Barb, reducing and refining my daily PT exercises, and thus reducing some measure of knee inflammation, I have experienced long moments, even into chunks of time, when I don’t have to think about every step as I walk. I can enjoy, once again, the flow of thought, and the widening of perception, that occurs when I am moving with ease and rhythm. This is what I have missed so dearly, and I nearly weep with delight at being able to “let the walk do itself” in a dynamic and quiet fashion.
Time shifts and perception changes when pain lessens and joy of movement resumes.
hard lessons
With this slow, tedious and often painful recovery, you’d think I would be learning something important. Given that my preferred way of being is one of ease in vigorous activity, the removal of activity seems like some sort of learning. Mostly, I am learning to deal with deep frustration, dismay, depression and pain.
The Alexander Technique, on many levels, is about choosing a conscious response to stimuli. F.M. Alexander explored a stimulus (speaking) that made him go wrong, and then discovered a means of response that was much more productive and expansive. Rather than attending to the specific of speaking, he attended to the whole co-ordination of himself, including his intention and attention. He decided to not make the outcome (speaking) his priority, and instead to choose an entire co-ordination of self.
Applying this principle to my current situation of severely limited mobility involves complex direction of my entire self. F.M. wanted to speak, but had to relinquish that goal to an overall dynamic non-interference (inhibition). I want to be able to move with the grace, ease and delight that I formerly enjoyed. It is a huge challenge for me to relinquish my goal of full mobility and attend, instead, to how I am directing my entire self.
The temptations of despair and depression are very strong, but these involve collapse through my entire psycho-physical being. Then, once I have collapsed, my knee hurts more keenly, and my entire self diminishes. When I choose instead to widen onto the ground so that I can spring up, my knee hurts less and I have an improved emotional experience. The dismay and despair may continue, but in a less dramatic fashion.
I grapple and fight to relinquish the urgency for ease in movement. And, in moments, after many hard lessons, I go up again.
Even for a moment
I walk to my local coffee shop every morning because they make an excellent Americano, and because the staff and customers there know me well enough to know they don’t know me well enough to offer unsolicited advice or insights about “what I am learning”. Instead, they give me welcome encouragement, applaud mobility progress, and generously allow me my own experience. All in all, a good interaction and a gift, in my estimation.
During my walk today, I experienced about a minute of walking normally, as in without thought to pain, no limp, and nearly my former pace! This came as a joyous surprise. Then, pain renewed its presence, and my limp returned, but the minute of walking without concern gave me huge hope. The increments of recovery add up in moments.
I recall when I was initially taking Alexander lessons 25 years ago a moment of walking on the street in Brooklyn when I realized that I was not narrowing my shoulders in order to move. It was a moment of revelation, and one that inspired trust in the process of the Technique, as well as hope for continuing to improve my use.
My 13 year old nephew, Gabe, showed me how to moonwalk this morning. Although I can’t claim to have mastered this skill, his lesson broke the increments down to doable sequences, and gave me a sense of possibility. For a moment in watching Gabe, all movement became joyously accessible.
Improvement in the overall coordination of the self requires shifts on all levels, especially the aspect of belief. We don’t believe that we can do something in a new way until we have the new experience. Alexander students classically learn a new way of moving in life through the experience of chair work, and begin to see what is necessary, and mostly what is unnecessary, in that ordinary experience. New experience in a mundane activity changes all aspects of possible experience when one learns to actively allow the increments to add up.
In recovery from any major injury, new neural, muscular, emotional connections are made, for good or for ill, through new experience. No one outside yourself can tell you when and how and why fresh understanding arrives. But at last, concept and experience, with good use in mind, can unify, resulting in the joy of surprising ease, even for a moment.