Feldenkrais on prescription – mindful movements for pain relief, inner peace and optimism

Julie Wrigley, Practitioner of the Feldenkrais Method

Published in JHH 19.2- Embodiment and bodywork

I am a Feldenkrais practitioner, trained in a movement method that works with the whole of a person – their thoughts, feelings, sensations and their movements.

This method brings to students a growing awareness of their sensory experiences in the moment and leaves them with an increased sense of embodiment and a rebalanced mind/body relationship.

For me, its purpose can also be to:

  • improve our understanding of ourselves
  • increase our sense of agency
  • enhance our health, satisfaction and potential.

The Feldenkrais view of health… and learning

Moshe Feldenkrais, the 20th century founder of the method, was extremely interested in the notion of health. He was a polymath scientist and judo master who initially developed his method to help himself in the face of an inoperable knee injury. He went on to work over many decades with people with neurological, developmental and musculo-skeletal conditions (MSK), in addition to elite musicians, actors, directors and dancers.

His core concept of health was that of resilience: the ability to recover equilibrium after a shock such as an illness, injury or trauma. Health, for him, also included wider social, psychological and emotional elements such as relationship satisfaction and self-actualisation:

‘If a human being needs no medical services for years and has no complaints of pains or aches, is he or she healthy? If, on the other hand, this same person leads a dull, uninteresting life with marital difficulties that end up with suicide – is that a healthy person?’*

and

‘Health is the ability to realise our avowed and unavowed dreams.’

Feldenkrais identified that the means to health was a special type of sensori-motor lifelong learning, begun when we are babies on a mat, waving our arms and legs around and – if we are lucky – continuing to the end of a fulfilling life:

‘Even in our culture a number of us succeed in continuing their health life process to an old age… The outstanding difference between such healthy people and the others is that they have found by intuition, genius, or had the luck to learn from a healthy teacher, that learning is the gift of life. A special kind of learning: that of knowing oneself. They learn to know “how” they are acting and thus are able to do “what” they want – the intense living of their unavowed, and sometimes declared, dreams.’

How Feldenkrais is done – what happens

I am a movement facilitator or guide who works in a class format called Awareness Through Movement (in-person and online) as well as one-to-one.

In class I ask the students to lie down on the floor on a mat. I guide them how to adjust to being on the floor, to choose their position and use cushions or props that may relieve their pain.

Then they close their eyes, listen to my voice and are taken on an inward journey within their own experience. I bookend each lesson with an improvised body scan, inviting students to compare if sensations of themselves have changed along the way.

The main section of each lesson is a cunningly structured sensory-movement adventure, where the destination is not seen as important. At first, I ask the students to try out for themselves a simple move, a few times, slowly, as they feel the effects of that on other parts of their body. For example, if I ask them to bend their legs and lift a foot from the floor, I may ask:

  • what happens to their other foot?
  • do they feel their pelvis roll or is the movement only of the thigh with everything else held still?
  • are some new parts of their back pressing into the ground as the foot lifts each time?
  • is it time now to let your foot and leg rest fully back down on the floor?

In this way they are guided to shift their weight, roll and wriggle, reach, lift, lower, turn and rest themselves.

Throughout 45 minutes simple moves are imperceptibly developed into slightly more complicated patterns. Students discover how to do new things with their limbs, with their whole selves, all while using only the minimum of effort that each action requires. Old habits of bracing, protection and other forms of chronic tension can start to loosen their grip, leaving room for ease, satisfaction and optimism to arrive instead.

The joy of teaching students with challenges

I had started to notice that the students who were most engaged by my classes were often those who were navigating health challenges. Perhaps they were working with persistent pain, fatigue, fibromyalgia, experience of trauma, MSK surgeries or mobility limitations. They also proved to be lively, motivated, open-minded and curious. So I enjoyed teaching them.

Before joining me they may have tried or still be practising yoga, Pilates, meditation or mindfulness; or attended physiotherapy, counselling or osteopathy. They were on a quest to keep active, to re-learn how to move well, to settle their own nervous systems and relieve pain. In short, they wanted to feel more at home in their bodies and minds.

For these students my classes function in a number of ways:

  • as a complement to their other activities and forms of healthcare
  • as a stepping stone back into eventually resuming their original activities
  • or as a substitute and solace if they can no longer manage their other activities.

I love teaching them how to:

  • be more comfortable and take care of themselves in the moment
  • move gently, mindfully and with less pain
  • let go of excess muscular tension and find looser, pleasurable movement as a result
  • learn about themselves from the inside out
  • have a different experience of themselves during class and when they stand up at the end.

One of my great satisfactions is seeing their realisation dawn that they really can do the class, can enjoy it, with no need to worry about perceived deficits related to their illness or failing to match up to the teacher’s expectations.

Applying for funding to work with social prescribing patients

I already knew about social prescribing as a form of community referral that sought to help people address their health and wellbeing needs in a holistic way and to take greater control of their health. I wondered if my classes could be suitable, so emailed (unsuccessfully) and looked out for information locally about how to get involved.

In my area, social prescribing is run by a group of organisations operating under one umbrella made up of the city council, the local GPs and the local council for voluntary services. By chance, in August 2021, I spotted a tweet from them, inviting interest in bidding for funding:

‘We’re encouraging York-based charities, social enterprises, voluntary & community groups to apply to the new cultural and social prescribing grant scheme for grants of up to £5,000.’

The deadline was only a few days away and I was unsure about applying as it seemed I might not be suitable. I am not a charity, as they requested, but a sole trader. After exploring the website and reviewing their aims, I decided to go ahead. The aims I believed I could help to address were:

  • reduce isolation
  • emotional wellbeing
  • healthy lifestyles
  • improve physical health through social initiatives
  • physical activity.

The project guidelines I received included an invitation to ring the co-ordinator before sending in my submission. I highly recommend taking up this opportunity if it is offered. I had not yet had time to formulate my offer and was nervous to speak to them. They put me at my ease, helping me to understand what they were looking for and develop my own thinking to clarify the nitty gritty details of what I would propose. We covered a range of questions:

  • would it be in-person or on Zoom?
  • how would I respond to changing Covid circumstances?
  • would my offer be open to all or more tightly defined?
  • would the sessions be drop-in or structured as a course?
  • would I offer transport to my venue?
  • how would I promote the sessions and invite or recruit people to take part?

I was also given a very useful tip – that I should make sure in my bid to cost sufficiently for all of my admin and preparation time as well as contact hours spent teaching.

Mindful Moves – the project

I developed my project called Mindful Moves as a six-week course for people with movement or mental health difficulties. This was my plan, for which I was lucky enough to receive funding.

The attendees could be:

  • experiencing injury, stiffness or pain – yet looking to regain confidence in moving
  • experiencing stress, anxiety.

I also advised that, as the method would be a new way of thinking to them, coming with an open mind was essential.

The courses would run throughout the six months of the project, with four rounds of six weeks in all. Varied material was planned for each six-week course, with time allowed for settling in at the beginning and care given to the ending phase, including discussions of how or whether the students wished to progress. The sessions were mostly to be spent lying down, with students following my directions for gentle, guided movement explorations. All they would have to do was listen, sense themselves and follow along. Discussions would take place among the group where they could share self-care strategies or reactions to the lesson.

Audio recordings of each lesson would be made available as would a bank of resources that I would build over the period, in response to the interests and questions of students. As it turned out the topics covered included:

  • pain science
  • learning to learn principles
  • balance, falling and vestibular issues
  • comfort
  • flow
  • improvisation and play
  • Zen Buddhism and Daoism
  • stress and the autonomic nervous system
  • neuroplasticity

To accommodate Covid and to allow for people with different capabilities, I offered each course in two modes: in-person in the studio or online.

Students joining in person would have more opportunity to interact socially, including in the on-site café afterwards. They could become familiarised with a gym environment in case this was something they wanted to pursue in future.

Students joining at home for the Zoom sessions could choose to stay in their own safe, comfortable space and have their own props to hand. These sessions were particularly suitable for those who were housebound due to mobility or anxiety issues. Anyone unable to get down easily to the floor could lie on their bed instead.

Receiving referrals

I liaised with the local social prescribers, also known as link workers. They were working within GP practices, at the council for voluntary service and in deprived neighbourhoods as local area co-ordinators. They put me in contact with patients who may be interested in joining me.

I had an intake interview chat with everyone referred to check we were a good fit. I explained the course, found out if they remained interested and heard about their challenges, hesitations and aspirations. I asked some standard baseline questions to give a benchmark by which I could make comparisons at the end of the project. I found out if certain positions or movements were particularly challenging for them so I could be ready with alternatives and modifications.

Mindful Moves students with physical challenges

Students described in their own words a range of physical challenges, often reporting more than one of these simultaneously:

  • experiences – chronic pain, fatigue, limited mobility, use of wheelchair, extensive scar tissue, breathing problems, restricted night and day to a recliner
  • areas affected – neck, back, hip, knee, pelvis, shoulder, discs
  • conditions – arthritis, congenital spinal condition, fibromyalgia, myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), bowel condition, nerve pain syndrome, colitis, neuropathic damage, Meniere’s disease, vestibular migraine, osteoarthritis, reflux
  • past interventions – hip replacements, bone grafts, spinal fusions, knee replacement.

Their most frequently hoped-for physical results were for help with pain, with relaxing, releasing tension and with improving physical confidence.

‘That I might be able to find a way to exercise that doesn’t make my pain any worse.’

and:

‘I hope to work on my physical confidence, because my illness destroyed it completely.’

Mindful Moves students with social, emotional or nervous system challenges

Students also described their experiences of social, emotional or nervous system challenges, which in most cases co-existed alongside physical challenges:

  • experiences – loneliness, no social contact, bereavement, stress, calm then angry, isolated, low mood, family problems
  • conditions – depression, mental health, trauma, anxiety disorder, perimenopause.

Some hoped to leave their house and start socialising again, to have contact with others. Another common preoccupation was the desire for improved ability to relax themselves (mind and body) and feel connected (mind and body). Common aspirations were for ‘peace’ and ‘calmness’, along with self-help strategies for managing their illness.

Giving feedback to the funders

Part of the condition of funding was to produce a summary report including:

  • numbers of people who attended
  • demographic data, if available
  • how outcomes are recorded
  • case studies.

At the end of the course I asked attendees to complete a short follow-up questionnaire about their experiences. This could be completed online (anonymously, if wished) on my website or on a paper copy. Half of the participants did complete the questionnaire.

Physical benefits

Physical benefits reported included increased self-knowledge about what exacerbates pain; having a positive experience of ‘exercise’; feeling a pleasant reduction in muscular tension; and profound relaxation.

‘I learned to stop when it hurts and work around it. Gentleness…release expectations. I learned my right shoulder is probably driving the rest of my back/neck pain.’

‘I feel more comfortable doing exercise without hurting too much.’

‘Nice to have an experience of becoming unknotted, one side at a time.’

‘That was amazing. I was nearly asleep. I feel very relaxed. My whole body relaxed, I felt everything go, felt my head tingle. Felt breathing down to toes and back up… It was amazing. I have never been so relaxed.’

Social, emotional and nervous system benefits

Social, emotional and nervous system benefits reported by students included: being more open to trying new activities; feeling and enjoying how to slow down the mind; using strategies for insomnia, managing difficult emotions and for pain relief; understanding responses to different movements and a sense of safety in the small group.

‘It felt alien to go so slow at first, then I started to find how it made my mind slow down…’

‘My head felt it had just calmed down. I’m normally fretting, going from one thing to the other. It was nice for an hour not to be doing anything. It was a really nice feeling.’

‘The other night I couldn’t get to sleep, had a lot going round in my head. I used the techniques of feeling how my body was touching the bed, some of the things you have said, and it helped, helped calm me down as well… It was useful.’

‘It is something I can use as a distraction… a different way of managing my feelings…’

‘I have learnt how to pause, realise if I am in pain and stop or do something else.’

‘It was very valuable experience for me, so thank you for that… I learned more about my body and reactions to movements. I learnt that even a small movement can make me feel different – it made me more aware.’

‘I really enjoyed the small group. I felt really safe during the classes. The atmosphere was safe and supportive and adjusted to the ability of the participants. You adjusted to my needs and I could do it in seated position.’

What was surprising

Students were asked to compare the course with their expectations or with other classes they had taken. They had been surprised by a new way of thinking, a new way of ‘doing’ mindfulness, an ease in moving to their own satisfaction and gratitude for a caring environment:

‘It is a new angle on thinking about the body.’

‘I have done mindfulness, but I like how you do it… how your body is feeling at the end.’

‘Very good, not what I was expecting at all. I thought it would be more strenuous. I was comparing it to yoga. It’s not like that at all, where it is difficult to get into the right positions…. I found it very relaxing. It has been really good.’

‘Surprising to feel hope and warmth from someone offering to help me…’

‘I didn’t know what to expect but found the sessions very restful and the tutor was obviously concerned for my welfare.’

‘The resources are inspiring and generous. I will keep doing the recordings.’

Next steps for students

As the course was a brief intervention of only six weeks, I included discussions with the groups about their ideal next steps. What might they try? What could they imagine themselves doing now to help foster their wellbeing?

We spoke of activities they used to do or new ones they wanted to try. The students sometimes helped each other by swapping suggestions and information about local classes and volunteering opportunities.

By the end of the six-week course, almost every student had already joined at least one new activity or was enthusiastically making plans for how they would do this. The wide range of choices included physical classes, social events or more Feldenkrais. See Table 1.

An expanded sense of self

More subtle, yet profound, changes were also discernible in the way the students referred to themselves, in their expanded or renewed sense of self. They felt relieved to be seen as a person in a new context, beyond their mental health or physical diagnosis.

‘Nice to be with people not just for mental health.’

‘As someone with limited mobility it is a wonder to feel like I am doing something physical and mindful but within my limits. The emphasis on finding ways to be comfortable is very valuable to my everyday life.’

They felt that long-held and restrictive attitudes of mind were loosening up, in a way that was as surprising as it was enjoyable. And they felt a coming home – to be like themselves once more.

‘I think I’m changing my attitude… it changed my way of thinking.’

‘I feel like myself again.’

* All quotes on Feldenkrais and health from: Moshe Feldenkrais, “On Health” Dromenon, Vol. 2, No. 2, August/September 1979, accessed from https://feldenkrais.com/67862-2/