Alexander Technique

Psychology
- Alexander Technique

The Alexander technique, named after its developer Frederick Matthias Alexander (1869–1955), is an alternative therapy based on the concept that poor posture leads to various health issues. 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 conventional medicine.

In the 1890s, Alexander started formulating the principles of his technique to overcome his own voice loss when speaking in public. He attributed his method as the key that enabled him to follow his passion for performing Shakespearean recitations.

Advocates and educators of the Alexander technique assert that it can address various health issues, although supporting research is limited. As of 2021, the UK National Health Service and the National Institute for Health and Care Excellence (NICE) reference evidence suggesting that the Alexander technique may benefit individuals with chronic back and neck pain, as well as assist those managing Parkinson's disease. However, both Aetna, an American health insurance provider, and the Australian Department of Health have reviewed the evidence and determined that it is not sufficient to justify insurance coverage for the technique's health benefits.

Method

The Alexander technique is most commonly taught in a series of private lessons that 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, as well as people who work on computers or those who experience frequent pain for other reasons. Instructors observe their students and provide both verbal and gentle manual guidance to help them learn to move with better poise and less strain. Sessions include chair work – often in front of a mirror – during which the instructor guides the student while the student stands, sits, and walks, learning to move efficiently while maintaining a comfortable relationship between the head, neck, and spine, as well as table work or physical manipulation.

In the United Kingdom, there are no regulations governing who can provide Alexander technique services. However, professional organizations do exist, generally offering three-year training programs for those aspiring to become instructors.

History

The Alexander Technique stems from the insights of Frederick Matthias Alexander (1869–1955). His acting career faced challenges due to frequent laryngitis, yet he discovered that by directing his attention towards his tension and discomfort and learning to relax, he could alleviate the symptoms. Furthermore, Alexander believed that being more aware of one's body movements could enhance posture.

While on a recital tour in New Zealand (1895), Alexander came to believe in the broader significance of improved carriage for overall physical functioning. However, evidence from his own publications suggests that this understanding developed less systematically and over an extended period.

Alexander did not initially conceive of his technique as therapy, but it has become a form of alternative medicine.

In classifying the Alexander technique within the context of mainstream medicine, various sources label it as either alternative or complementary, depending on its use alongside traditional methods. The American National Center for Complementary and Integrative Health categorizes it as a "psychological and physical" complementary health approach when paired with standard practices. Conversely, when utilized "instead of" conventional medicine, it is regarded as "alternative. "

Influence

The American philosopher and educator John Dewey was greatly impressed by the Alexander technique after experiencing significant improvements in his headaches, neck pain, blurred vision, and stress symptoms through the use of Alexander's guidance on posture. In 1923, Dewey contributed the introduction to Alexander's book, Constructive Conscious Control of the Individual.

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

Uses The Alexander technique serves as a therapeutic approach for chronic conditions related to stress. Instead of targeting the root cause, it focuses on educating individuals to prevent habits that could worsen their condition.

The technique serves as an alternative treatment to enhance both voice and posture for individuals in the performing arts. Since 1995, it has been included in the curriculum of prominent Western performing arts institutions.

According to Alexander technique instructor Michael J. Gelb, people tend to study the Alexander technique for reasons of personal development.

Health effects

The UK National Health Service (NHS) states that supporters of the Alexander technique have made claims that lack evidence, but there is some evidence suggesting it may help alleviate chronic back or neck pain. The NHS notes that the Alexander technique could benefit individuals with Parkinson's disease. The National Institute for Health and Care Excellence (NICE) recommends that those with Parkinson's disease facing balance or motor function challenges consider the Alexander technique alongside physiotherapy tailored to the disease. Evidence regarding its efficacy for chronic pain, stammering, and balance skills in older adults is limited. Moreover, there is insufficient evidence to support its effectiveness for other conditions, including asthma, headaches, osteoarthritis, sleep difficulties, and stress.

A systematic review by Cochrane in 2012 determined that there is insufficient evidence to support the effectiveness of the Alexander technique in treating asthma. Randomized clinical trials are necessary to evaluate this treatment method's efficacy.

A 2014 review in BMC Complementary and Alternative Medicine examined "the evidence for the effectiveness of AT sessions on musicians' performance, anxiety, respiratory function and posture." It 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 remain inconclusive."

A review in 2015, commissioned by the Australian Department of Health to assess which services the government should fund, analyzed clinical trials up to that date. It 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." The review 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." Additionally, it pointed out that "evidence for the safety of Alexander Technique was lacking, with most trials not reporting on this outcome." Subsequently, in 2017, the Australian government identified the Alexander technique as a practice ineligible for insurance subsidy, stating this action would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence. "

A 2021 review by Aetna^{[Note 1]} noted: "Aetna considers the following alternative medicine interventions experimental and investigational because there is inadequate evidence in the peer-reviewed medical literature demonstrating their effectiveness." The Alexander technique is part of this group.