יום רביעי, 21 בספטמבר 2011

The Alexander technique as a shared language within a family


Yitzhak’s story

Several days before Yom Kippur my cell phone rang.  On the other side of the line I heard the voice of Naomi, Yitzhak’s mother.  After an exchange of greetings she asked that we meet in Jerusalem – she, her husband, me and my wife.  I agreed with pleasure. 
Yitzhak had been drafted into the army and was already finishing up boot camp.  Naomi and Baruch had always had a special manner of thanking me for the work I had done with their son.  They touched my heart and the more the acquaintanceship grew, the more I appreciated them.  This feeling of gratitude and appreciation was mutual.  They had taught me about determination.  They had taught me about that very characteristic which I spoke so often about, even preached about, and which they themselves lived with gentleness and modesty – a characteristic I call the ‘role of parents’ as a condition that enables work with children.  Their trust in the Alexander process, their determination to persist for years, the gratitude which they expressed by small gestures of attention and Naomi’s active participation in Alexander lessons – all these turned Yitzhak's story into a success proving that positive changes in the life of a child are possible. 
We met on Friday.
‘Yitzhak wants to speak with you,’ said Naomi immediately after we sat down.  Baruch dialed Yitzhak’s number on his cell phone.  I spoke with him for several minutes.  He sounded quiet and self-confident, in control of his situation and coping courageously with the difficulties of the army.
I thought about the fact that the story of my work with Yitzhak contained both the central themes that I am trying to describe here in my book and also the principles of Alexander technique according to which I work with children.  Yitzhak’s story contains an aspect of rehabilitation – both physical and emotional – and it contains an educational aspect as I understand the term ‘education.’
It talks about acquiring the tools of consciousness and understanding, about the student’s free decision to use them for his personal good and about a dialogue with the world.  His story contains the active intervention of parents, and it contains great mutual affection between teacher and pupil.
 ‘When did I begin to work with Yitzhak?’ I asked Naomi, as soon as I had ended the phone conversation.  She smiled. ‘Seven years ago.  Don’t you remember?  The school counselor referred us to you.’  I remembered.  It all began with a telephone conversation. Naomi had phoned me and told me about her son, age eleven.
Yitzhak had been born with a club foot.   In the course of several years he had four operations to straighten the foot.  The operations succeeded; the foot straightened almost completely.  The doctors believed that one more operation was needed but Naomi decided to try an alternative treatment.  The difficulty, she emphasized in her phone call, was Yitzhak’s severe limp.  Although the operations had succeeded, Yitzhak’s walking had not improved, his limp was even worse.  We made an appointment.
In my first meeting with Yitzhak, I found him to be friendly and pleasant.  It was easy to make a connection with him, and he enjoyed the attention I gave him.  He limped badly, dragged his feet and rocked from side to side as he walked.  His movements showed lack of coordination and weakness.
As my acquaintance with Yitzhak continued, I discovered that he had learning difficulties:  arithmetic, reading and other subjects. In addition he suffered from attention disorder and was treated with Ritalin.  The school was planning to move him to a special education framework but Naomi opposed this strongly. 
I recommended that Yitzhak receive two lessons a week.  My work plan included strengthening his movement by improving the daily movements (getting up from a chair, sitting, walking) and also blending the Alexander Technique into those studies that were hard for him in school: arithmetic, reading and writing.
 In the first lesson it was already clear to me that Yitzhak not only enjoyed our shared work in the Technique, but he truly understood with a child’s intuition that our work would open to him a way to rehabilitate himself.  He was decisive in his desire to come to our meetings and to cooperate with me.  He was ready to try the new, to study and to develop. 
Positive changes began slowly, subtly, but as a clear and stable process.  His walking rocked less; he nearly stopped dragging his feet; his balance improved and his back straightened.  The school also began to notice that Yitzhak was quieter, more focused, participated in lessons and began advance in his studies.
Yitzhak’s intensive work continued for two years.  Afterwards we continued to meet once a week and later from time to time with lessening frequency.  His limp nearly disappeared; he stopped the Ritalin.
In parallel to Yitzhak’s lessons, his mother received one lesson a week.   She participated fully in the process, interested in the Technique both for her son and herself.  The understanding she acquired created optimal conditions for working with Yitzhak and aided his rehabilitation.  Work in the Alexander Technique creates a subtle awareness of the body and a new language between a man and his body, between a man and himself.  When this language is shared by members of the family, a synergy of strength develops, creating conditions which strengthen the entire family.
It was Friday morning and we were still sitting together.  The conversation was lively; the atmosphere, warm and friendly.  Without it being mentioned, there was a feeling of summarizing, the end of an era.  I understood that my role as care-giver and educator had ended.  I released a deep breath of happiness mixed with a light sadness.  I felt proud, and a little worried, but I was full of confidence that Yitzhak and his family were on the right road.
The idea guiding work with families
In parallel to my individual work with children, I relate to them also as part of a wide circle of family including, most importantly, their parents.  Not only is it the child who is disappointed of himself because he cannot meet the expectations adults have hung on him.  Many parents who speak with me also feel disappointed.  Often they, too, have been hurt; their trust has been hurt, the trust they had in care givers, in the possibilities for their child and in their own ability to help him.
I look at them.  They look at me and at their child. 
What are they thinking about? 
What are they feeling? 
I try to get to know them, to have an impression of them, to feel.  What are they saying?  What does their body language say?
 I say to them in my way:  ‘Observe.  Ask.  Don’t work from blind faith, but don’t refuse without understanding as well.  Take part in the process.  I’m not hiding anything.  I have no tricks, no magic, no professional secrets or short cuts.’
I invite them to join the process of trial and error, repair and renewal, freedom and direction.  I explain my method of work to them and the principles behind my work, and I guide them in that area which Alexander called ‘The use of the child by himself.’  I explain to them the new terms of the Alexander Technique:  direction, primary control, sensory appreciation, giving directions, and such, and I demonstrate on their child and on themselves what I mean by these terms.  In this way I give them my message of shared work and cooperation, cooperation between them and their child, between them and me.
My work offers changes.  It teaches children to do what they want to do in a new way, and later they are asked to live this change also outside the work room.  The children have, of course, personal responsibility for themselves and for the change that comes to them from the work, but at the same time they are a part of a wider system of family and society.  From this comes the great importance I give to the condition that the child’s close environment, and in particular his family, understand the processes that are affecting him, in both theory and practice, and know how to contain these processes so as to support the child.  It is important that the parents, or at least one of them, receive practical lessons in the Technique.  Without their own practical experience it is impossible to truly understand their child’s experience
The basic, immediate and natural wish of every parent is to help their child, especially whenever there is any problem, such as back pains, difficulties in writing or a curved spine.  However, occasionally parents are unaware of the importance of the way in which they help. 
The great contribution that they can make to help their child lies first of all in the work that they do on themselves.  Only when they do this work seriously and honestly have they the possibility of establishing a supporting dialogue between themselves and their child.
Parents have an enormous influence on their child from the day of its birth.  They are the example their child copies, and from them he learns the most basic, primary matters.  Among these basic matters is the way their child uses himself.  For example:  a father’s particular style of walk can be clearly seen in the walk of his son or daughter; a mother’s special tilt of her head can be recognized in her son or daughter.
Sometimes parents forget or they don’t properly appreciate the power of personal example, one of the most significant powers in education.  A father who smokes has vast difficulties persuading his son not to do as father does.  A mother who suffers from lower back pain should not wonder if her daughter develops similar pain.
So, parents are the model to copy and from a very young age children integrate their parents’ habits, for good or for bad.  Therefore, when a parent asks me, ‘What can I do to help my child?’ I suggest that he begin to create consciously a change for the good in his own use of himself.  When the parent improves consciously his use of himself, he changes his unconscious, harmful influence on his child to a conscious, positive and beneficial influence without any direct effort from the child.
Occasionally I run up against parents who believe that if they only sit and observe the lessons without taking lessons themselves, they will understand what I am talking about.  Parents who observe a lesson and have no training themselves will see a child who sits straight and comfortably in a chair and plays.  Usually at the end of the lesson they say to their child: ‘From today, you’ll begin to sit straight, just as Gal showed you.’ for that is what they think they have seen.  Of course, they say this because of their lack of understanding, because of their desire to help, certainly not from any desire to harm, but such words may accomplish exactly the opposite of their desire.  They may create unnecessary tension in their child, who cannot yet control by himself his new use.  They may also create unnecessary tension between the parents and their child, for the child feels that he does not live up to his parents’ expectations.  This tension can arouse the child’s opposition to the Technique and to what is happening in our meetings.
I never ask a child to ‘sit straight’.  A wall or a floor is meant to be straight, but a back has naturally a kind of S shape, and is not meant to be ‘straight’.  A back is meant to be in a constant subtle movement of lengthening and widening.  The child’s upright sitting is the active result of his improving use.  My advice to the parents of a child who studies the Alexander Technique is, first, there is no homework and, second, no need to tell the child, ‘Sit straight’ or to give any other order.  If parents follow this advice, they will save themselves a frustrating struggle.  Helping their child is actually a total impossibility for the child doesn’t yet know how to do what they are telling him to do.
Second, I suggest that they take some Alexander lessons, so that they acquire understanding, both theoretical and practical, of the Technique.  When parents want their child to become stronger, it is better that they first become stronger.  With their own process of inner strengthening, their child will also strengthen.  The parents of a child with difficulties must take an active part in his change, as it is first of all their own inner change.  Through the process of change that they undergo, they will themselves be an active part in the processes their child undergoes; they can become themselves a model and an inspiration for him to copy. 
These words are just as true regarding education and preparation for a healthy and balanced life.  When a parent acquires basic knowledge related to the way he uses himself, he is able to guide and support his child exactly as he teaches him to speak properly or to eat with a knife and fork at the table.

יום שני, 5 בספטמבר 2011

יום שישי, 15 ביולי 2011

Avshalom -teaching the Alexander technique to youth at risk



When Avshalom was seven, his father died of disease.  His mother describes Avshalom as sensitive, easily offended , in need of constant attention, stubborn and very energetic.  From the time he was born she remembers him as mischievous and difficult to control. He was a demanding baby who slept very little.  In her own words  ‘He did everything quickly.  In the sixth month he already wanted out.  His head was down and he moved constantly in my belly.  He was born at the beginning of the ninth month.  He walked early and at ten months was running.  Everything too fast.’  When his father became sick, the difficulties that Avshalom’s active, troublemaking temperament caused became even greater.  His mother found it very difficult to enforce limits and to restrain him.
In kindergarten Avshalom was placed on Ritalin in an effort to calm his stormy temperament.  He suffered from moderate asthma and as a small child walked on his toes because of short tendons.
Avshalom entered the boarding school at age 14.  He was large, awkward and moved heavily.  In his entrance diagnosis he was said to be intelligent but with an extremely low self-image, feeling that he didn't fit in and that he was an object of ridicule to all around him.  This feeling expressed itself in an inability to control his emotions and a hostile and angry attitude towards the environment, creating a tendency to isolation and inauthentic relationships with others as well as weakening his inner ego strength.  His difficulty in coping with the outside world and the pressures of daily life brought him to such a point that he reacted to his environment with threatening aggression. 
These findings indicated that Avshalom was a youth at risk with a potential for behaviors that endangered himself and those around him and that he was in need of intensive attention, of being both embraced and strengthened by the various environments he participated in – his family, the dormitories and the school.
As a result of this diagnosis an art therapist worked with him for two years.  At a certain stage he also required a small dosage of psychiatric medication to calm his reactions.  His outbursts of anger and violence were difficult for the school staff.  The other pupils feared him.  When the art teacher recommended that I be added to his treatment plan it was the last resort before sending him to a psychiatric institution.
I met Avshalom at the beginning of October, 2003.  The official reason he was sent to me was for back pains; he was very bent over and continually more so.  In addition to the back pains, the art therapist thought I might serve as a father figure.
When I first met him, I felt as if I were standing opposite Goliath (The one from the Bible).  Avshalom was a gigantic young man, almost terrifying.  He broadcast aggression towards the word – 'Just try and touch me.'  But along with that, there was a mixture of strength and weakness, anger and willingness, coarseness and delicacy.  It was a mixture of psychological and physical 'materials' that had not yet found the proper balance.
 In our first meetings Avshalom expressed deep feelings of inferiority and accused the boarding school of basic injustice as regards supplying his needs.  He claimed that the environment didn't behave as if it respected him and didn't appreciate his efforts to help, to contribute and to be OK.  The other students continually put him down and he wasn't sure he could control himself and his feelings toward them even to the point that he was afraid of what he might do.
During our meetings he received my complete attention.  I expressed appreciation for his efforts even more than for the results of the efforts.  I related to him with respect and he returned the same to me.  In this way a balance was kept between being directed and being independent and personally responsible.  He received clear messages that I was not giving up on him and most importantly that I was not afraid of him.  I was impressed neither by his strength nor by his 'stories' of not being able to control himself.  I stressed clearly his rational and logical ability, based on his own reasoning, and his personal responsibility for his actions.  These messages were given in words during our conversations together and in experiences during our Alexander work.  The Avshalom revealed during these meetings was a charming fellow, sweet and gentle despite his physical dimensions and his appearance.  In time a relation of trust was built between us which allowed a progress toward change and growth.  
Examples of Alexander technique work with Avshalom
I will present here two examples of Alexander work with Avshalom focusing on their unique influence on him.
Avshalom sits down heavily in his chair.  I ask him to get up.  He gathers up his strength, bends his back forward as he shortens his spine and stands up with an effort that explodes upward.  I ask him to sit down again and he again sits heavily in the chair.  A dialogue begins between us in which I ask and he answers.
‘Come, let's discover how we sit and if it's not possible to improve something.’  Avshalom agrees.  I describe to him the movements he habitually and unconsciously makes and explain the anatomical damage that he can suffer from this.  After he understands, I suggest that there is an alternative way to sit, one that prevents the damage to his health, and ask him if he is willing to try it.  When he agrees I explain the new process.  In order to support him as he tries the new technique, I place my hands gently on his back, give him a direction which lengthens his back and then ask him to stand up.  He immediately tries to stand according to the habitual and trusted process which he knows, with which he feels safe and which he controls.  'Wait a second,' I ask, simultaneously signaling also with my hands.  He stops and I direct his attention to the fact that he has again bent his back. 'Come, let your back lengthen.' I ask and once more signal with my hands the desired direction.  After his back lengthens he rises from the chair more correctly.
This example shows how consciousness of the body is created and how the ability to control external movements results from this consciousness – as in standing and sitting.  It shows further the inner movement, the back lengthening as a background to external movements. In this way a dialogue is created – a dialogue of direction and accompanying the pupil, supporting his change.
The second example is working with Avshalom to organize his body.  I ask Avshalom to lie on his back and to let me organize his body so that there will be more quiet within it.  I begin in the area of the head and slowly pass from one body part to another – shoulders, arms, legs.
I ask Avshalom not to help – I will do all the work.  He is to listen to what happens in his body and to let go of the various tensions that have accumulated there.   In these conditions I enable him to release himself from within, to release the systems of defense/aggression which he has adopted.  In this process he learns to be calm, to relax, to listen to his body and to himself.
The psychological and physical processes (involved in table work) are not passive.  Rather they are a special, subtle variety of activity, which we almost never use in our daily life.  For this work involves an active agreement to allow oneself to be guided.  To a certain degree it can be said that Avshalom is experiencing a process of losing control of his habits but at a deeper level, since he has willingly and consciously agreed to the work, we can say that this is a process of attaining a new control.
When I ask Avshalom to let me do the work, I create a situation in which he is not asked 'to succeed.'  He has, therefore, no fear of 'failing.'  There are no expectations from him and no tasks laid on him.  He can be free to experience himself here and now.  When this process is initiated by an adult and takes place in the adult’s presence, it acquires legitimacy, thereby becoming even more meaningful and substantial.  When such experiences are repeated, they become an active force on the path to change and growth. 

The foundations for change
In one of our first meetings, after the connection between us had already been formed and we had met several times for Alexander work, Avshalom did not arrive for his lesson.  My experience at the youth village had already taught me that even when a pupil enjoyed his lessons this gave no assurance that he would arrive for the next lesson.  The position I had chosen on this matter was not to wait for pupils to arrive and not to confront them with challenges that they could not meet but to go and look for them, to show them that I was interested in meeting them, wanted them to come to lessons and was willing to absorb their opposition, their pulling away and their fear.
I found Avshalom in the school auditorium, sitting in one of the upper rows.  I called him to come.  He refused.  I insisted.  He defied me.  Again I insisted.  'Come and talk.'
   'Don't want to! What are you going to do to me?'
  'I have no intention of doing anything to you.  Come and talk. We arranged a meeting and we have to respect it,' I answered him.
He got up heavily and came down, stumbling on the steps.  He approached me threateningly, waving his arms.  'I don't want to come.  Leave me alone.   Don’t want to!'
'Calm down, Avshalom.  I have no intention of forcing you to do anything.  How about having a cup of coffee and a chat?  We don't have to meet again after today if you don't want to, but, after all, we did make an appointment for today.  What do you think?'
When he saw that I wasn't afraid of him, didn't get excited at his refusal but continued to invite him and that for a cup of coffee, he stopped, calmed down, thought again and answered.  'You know what? – OK.  For a cup of coffee I agree.'
We left the auditorium, walked to my workroom, sat there for half an hour and chatted – mostly about coffee, its smell, its taste, and recommended ways to prepare it.  Avshalom taught me why you can't toast 'To Life' with coffee – the color is wrong – black brings bad luck.
During that chat something was created between us that enabled communication: as I had taught him, this time he also taught me, and I answered to his need.  I truly listened to him.  A certain 'plan of work' with him was created; a chat over a cup of coffee became something significant, a ‘ritual’ after every lesson.  We parted pleasantly with the decision to continue meeting over a cup of coffee and the Alexander Technique.
The idea of coffee appealed to him; it was incredible how the ‘ritual coffee’ created such a special relation between us.  In some way my suggestion touched him far more than just the invitation for coffee and a chat.  Without explaining it or analyzing it to myself I allowed the ritual to remain as long as Avshalom needed it.

On indirect work
For a long period of time I had to go and collect Avshalom from his class for our Alexander meeting.  He always apologized, saying that he had forgotten. Time after time, over and over again I would calm him down and tell him not to worry – if he forgot to come, I would come to collect him.  I understood that my picking him up was a necessary condition to ensure the tie between us.  I had to prove to him time after time after time that I had not forgotten him.  There was no sense in asking from him what he could not do which meant in this case expecting him to come on his own initiative.
The Alexander work began immediately with the beginning of our shared walk from the school to my workroom.  I would give myself directions, slow down my steps a bit and wait to see his reaction.  Avshalom, despite his normal awkwardness and heavy movements, was extremely sensitive to other people.  In response to my actions his steps also slowed down; his voice became lower; he freed his shoulders and actually responded to my directions.  With time this process became quicker and more exact.  He internalized the process of giving inner directions in order to create a change for the better in the way he walked.

Concerning responsibility
One day when I met Avshalom at the school he was disturbed and nervous.  I knew from my talks with his counselors that he was going through a difficult period.  His classmates had chosen him as their victim for teasing.  He suffered both from this and also because when he attacked them in return he was scolded for being aggressive and violent.  On the way to my work room we talked about these difficulties.  I questioned him about every detail – how did a certain fight begin; what happened during the fight; what did he think; what did he feel; how did it all end.  We continued to discuss it as we entered the workroom. 
He sat down heavily on the chair and talked:  ‘When someone touches me on the shoulder, even just a friendly pat, I immediately get angry.  My arm flies out by itself; I can’t control it and I want to tear that person to bits.  I simply have no control over my arms.  I’m afraid of it; I’m so strong I could kill someone.’  I listened with full attention until he finished and then I said:  ‘Let’s make a little experiment – Do you agree?’  He nodded his agreement.  ‘Raise your right arm, please.’  He raised it.  ‘Now lower it.’  He lowered it.  ‘Who raised and lowered your arm?’ I asked. ‘I did ‘he answered and I saw something happen inside him even as he said that word ‘I’. 
 ‘Do you understand that your arm, anyone’s arm, doesn’t move alone, by itself?  We move it.’  My words seemed to sink into him, to create a new consciousness.  I waited a bit and continued, ‘Now, as for the boys who pick on you, who is stronger — you or them?’
‘Me, why I could break them into pieces,’ he told me in a threatening voice.
‘OK, but let’s try to see it a little bit differently.  If they say something to you – try to get you angry and you get angry, then they’ve gotten exactly what they wanted.  Actually, they’re stronger than you are – they control your reactions.’
I saw that he considered my words seriously.
 ‘The next time they annoy you, try not to react, not to be weak and to give them the victory.  Moreover, the person who ‘is paying the price’ is actually you yourself.  So leave it; don’t react.’ 
He smiled.  I saw that the idea pleased him.
 ‘Come, let’s do some Alexander.’ I said and began the lesson.
My words had been a direct touch on the connection between himself and his body.  He understood that his arms could never do what they wanted to do, but what he decided to do with them.  In addition he had been certain that he was much stronger than the other boys but I showed him they were much stronger than he was when they managed to get from him the reaction they wanted.  They controlled his movements and his reactions; therefore, they were much stronger.  And not only that but in the end, he was the one who was blamed for attacking.
All this seemed very logical to Avshalom and he adopted the new attitude completely.  After he left, I spoke with his counselor, told her briefly about our conversation and asked her to react firmly towards any boys who annoyed him, to give them no opening to twist matters in any way that pleased them.  I had no trouble persuading her; she agreed immediately and promised to keep a sharp watch.
I spoke also about the matter to the psychologist, the head of the treatment team.  She found it hard to believe that it had been so simple to explain to Avshalom how to control his reaction.

The physical/emotional process of transformation and growth
Avshalom experienced his body as large, awkward, strong, threatening, foreign and frightening.  He knew neither his body nor himself within it.  He did not experience himself as a part of his body; instead, he felt that he was unable to control it.  Since he did not know his body, he also did not know what to expect from it.
He experienced at a very deep level and with great force a feeling of helplessness and lack of control.  He radiated these feelings to all around him: classmates, the educational staff, the counselors and the caretakers.  Those close to him experienced similar feelings about Avshalom himself:  big, strong, threatening, frightening, uncontrollable.  In this way the reaction of his surroundings strengthened and reinforced the truth of Avshalom’s own inner experience for it served as a guarantee that yes, definitely, what he felt was the truth.
The experience of the Alexander Technique allowed  Avshalom to  feel the existence of his own body, the simple organic feeling of existence without any ‘additions’ of thought or criticism, without negativity, opposition  or emotions such as fear, confusion or rejection.  This new experience, the organic feeling of existence, melts away feelings of separateness and strangeness such as Avshalom experienced in relation to his body and to himself.  In this experience comes the first wordless consciousness that my body belongs to me and I belong to my body.  With this feeling of belonging Avshalom ‘gained’ anew the ownership of his own body.  We are born with this feeling of ownership but Avshalom had lost it somewhere in his past.  Continuing from this primary ownership, Avshalom might now develop a feeling of natural organic responsibility which is not the moral or educational control of ‘You’re OK.’ or ‘You’re not OK.’
Avshalom experienced, ‘I live in my body; my body belongs to me – I own my body and so I can control it.’  From this experience, the feeling of belonging to the life around us takes root and grows.  We feel a belonging to the people around us and with this a feeling of responsibility for life.  Avshalom stopped feeling that he was separated from his environment as if he were a stranger, the odd man out, the one who didn’t belong, was not understood, could not be restrained and controlled.  He learned to be responsible for his actions.  This responsibility begins from small voluntary movements of the body – raising and lowering the arm, turning the head right and left and afterwards, rising from a chair and sitting. In the beginning rising and sitting was for Avshalom a large movement without awareness.  Later it became a controlled conscious movement of rising and sitting down.  He learned to decide to rise, then, to begin to rise, to stop, to be conscious of himself and to judge his position once again; then to correct as needed and to continue according to the mental/ emotional/ physical processes of his renewed decision.  Eventually he learned to experience the possibilities of a new, conscious control even in the space of life outside the workroom. 
Work with Avshalom opened my understanding to the idea that in sensory appreciation we have an additional key, an additional secret through which it is possible to create the very experience of constructive conscious control.  My role as an Alexander teacher and as a caregiver, as I saw it, was first of all, not to be frightened, not to ‘buy’ his story of fear and lack of self-control.  My task was to contain Avshalom’s experience, which was nearly overwhelming him. I had to contain all the complexity of his experience and not to ‘break down’ myself.  I had to create for him a basis of trust and security, to offer him new and practical possibilities to cope with difficult, repetitive conditions.  I had to wake up the processes of change and growth and to accompany these processes across all our time together.  I had also to share my work with the other professional caretakers in the village who were working with Avshalom so as to create a synergy in his treatment because the sum of all the treatments he received was greater than the work of each individual caregiver. 

Summary

In our meeting to summarize the results of our first year together, I asked Avshalom what he was taking with him from the technique.  His answer in his own words was:  ‘I understand that my back also has its own needs.’ 
In these words he made it clear to me that he understood something essential about the Alexander Technique.  In the staff meeting at the end of the year one of his caregivers mentioned that another boy in the group she took care of had attacked Avshalom and Avshalom didn’t do anything.  Avshalom still had confrontations, but his anger appeared far less frequently and he was able to control it. He was no longer defined as ‘aggressive’ and those around him were far less afraid of him.
As for his studies, when I began to work with Avshalom he spent 70% of his time on working with the grounds keeper.  In the Hadassah exams he failed seriously and was kept an extra year in ninth grade.  After learning the Alexander Technique his grades improved and he left to study in a technical school.
At the end of our first year the psychiatrist told me during an evaluation meeting, that he was considering the possibility of stopping Avshalom’s tranquilizing medication.  This was after the dosage had already been reduced to half.  Later on it was decided that Avshalom no longer needed medication.
Avshalom’s change during the two years of our work together was amazing.  He experienced a process of becoming gentle, exposing characteristics up to then kept well hidden by his aggressiveness – delicacy, listening, intelligence, responsibility and caring.  In my judgment it was on one side Avshalom’s openness to accept, and, on the other, his ability to let go and allow his inner self to appear that enabled the expression of these characteristics.  The process was the result of, among other things, his work in the Alexander Technique.

The beginning of a new road
One morning I arrived at the dormitories to take Avshalom with me to visit my home, only a few minutes drive away from the youth village.  I had suggested the visit to him at our last meeting because during our entire conversation he had unexpectedly shown an intense interest in me, asking many questions about me and my family.  He had never before shown any interest in me as a person, being  occupied only with himself, his difficulties and his desires.  I had answered all his questions openly and honestly
When I reached the village it was suspiciously silent.  Usually in these morning hours the kids were on their way to school.  During the last few months Avshalom had begun to meet me on his way to the school.  He would wave hello as if to let me now that he had remembered the meeting and walk to the workroom.  Today I saw him nowhere.
In my mind I began to consider the possibilities for this ‘disappearance.’  Perhaps I had frightened him with my invitation to come and visit?  Perhaps he regretted his boldness and had taken a step backwards?
In the end I met one of the teachers and learned that all the pupils had been gathered to receive instructions concerning the yearly school trip which was to take place the next day.  Although I was not aware of it at that moment, I felt relief.
After the meeting Avshalom came to my workroom.  It was a Monday and he looked a little confused since we usually met on Wednesdays.  On the road to my home he remembered that in the past we had met twice a week, including Mondays. I reminded him that that had been at the beginning of the previous year.
 ‘Wow! That was a while ago!’ he commented.
I nodded.
‘I work much better in your treatments,’ he added.
He completely surprised me with his open and honest relation to the fact that he was being treated as well as with the way he accepted his progress during the treatment.  I nodded my head in agreement and said quietly, ‘Yes, I absolutely agree with you.’  Then I added, ‘Can you explain a little to me of how you see the progress?’ His words came out slowly with a certain confusion, as if he were saying something deep and important but didn’t find the words.  ‘If once my back hurt, now it doesn’t… or my knee…today I know how to let go…I can…’  
‘Would you agree with me that you’ve learned to control your body?’ I asked. 
‘Yes!  Exactly!’  His eyes glowed.  ‘I’ve learned to control my body.’  And he repeated it a second time, as if to give extra validity to the words.
We continued our drive without speaking, watching the beautiful landscape that opened before us.  In this silence various memories rose up in me.  I seemed to see the processes that Avshalom had gone through, the processes in which our connection and the Alexander work had been the central axis.  Two years ago I had met a wild boy, violent, frustrated and bitter, isolated from the other pupils, a boy they and everyone else around him had feared.
I remembered that at the staff meeting the previous week one of the caregivers had related with wonder the story of a boy she was responsible for, a small boy in seventh grade who had attacked Avshalom twice and Avshalom had not even reacted to the challenge.  I remembered that I had seen Avshalom several times in the afternoon sitting at the center with a group of friends, telling jokes and carrying on, looking as if he were one of them, part of the group.  I remembered a conversation with his classroom teacher who told me proudly about Avshalom’s astonishing progress in his studies in comparison to the previous year.  I remembered also a conversation today with Avshalom’s counselor – she had told me that she was afraid that he would not behave properly during the school trip.  We discussed that reason for her worry and I realized that she and Avshalom were having an argument about a certain very small matter.  The matter was explained; the teacher understood what Avshalom needed and it was possible to bridge their differences to the satisfaction of both.  I remembered the new art therapist who had taken the place of the one who had gone abroad.  After she had read the old reports and I talked to her about Avshalom before his change; she reacted with shock: ‘That can’t be true; it can’t be the same boy.  I don’t believe it.  Where is this thing?  Where has he been?’
Not only the Alexander Technique caused these changes in him, the entirety of the interventions by the treatment staff had made possible his transformation.
Yes, Avshalom and I had traveled a long way together and it was still not the end.

יום רביעי, 8 ביוני 2011

טכניקת אלכסנדר כעזר להתמודדות עם עקמת


דרך הישר
שלושה עד ארבעה ילדים מכל מאה סובלים מעקמת, המתבטאת בסטייה של עמוד השדרה ובגב כפוף. למה חשוב לטפל בה כבר מגיל צעיר, איך עוצרים את ההידרדרות ומתי כדאי לשקול ניתוח?

ד"ר דרור עובדיה




גב מוטה מעט, שכמות לא סימטריות וכפלי מותניים לא סימטריים מעידים על תופעה המכונה "עקמת" - סטייה הצידה של עמוד השדרה ביותר מעשר מעלות, המלווה בסיבוביות של החוליות.
בגיל הילדות המחלה היא על־פי רוב א־סימפטומטית, מה שאומר שלילד לא כואב ולא מפריע, והביטוי של התופעה הוא חיצוני בלבד. הבעיה היא שבהעדר טיפול עלולות להתפתח בהמשך בעיות שונות: מהפרעה בתפקוד נשימתי - בגלל עיוות בגודלו של בית החזה והקטנה בנפח שלו - ועד מחלת ריאות רסטרקטיבית הגורמת לירידה בתפקוד הנשימתי. לילד יש אמנם רזרבות נשימתיות גבוהות, אבל בבגרות העודפים האלה אוזלים, ואז צפות בעיות הנשימה.
בעיה נפוצה נוספת הנגרמת בשל העקמת היא כאבי גב קשים, גם עקב שחיקת המפרקים הבין־חולייתיים בעקבות העומסים הלא שווים שלהם, וגם בשל ההיצרות של תעלת השדרה, שבה עובר חוט השדרה. העקמת נחלקת לשלוש קבוצות עיקריות:

עקמת מולדת
עקמת המתפתחת בשלב הראשוני של ההיריון, בשבועות 2 עד 8, ובמהלכה יש היווצרות פגומה של עמוד השדרה מסיבה לא ידועה, ולכן עיוות מולד במבנה של חוליה אחת או כמה חוליות לאורך עמוד השדרה. שכיחותה של העקמת המולדת נדירה יחסית, והיא  מלווה בדרך־כלל במומים מולדים נוספים בלב, בכליות, בחוט שדרה או במערכת השלד. עקמת מהסוג הזה ניתן לזהות בסקירת מערכות במהלך ההיריון. מרבית הילדים הסובלים מעקמת כזאת יזדקקו לטיפול ניתוחי בשלב זה או אחר של חייהם.

עקמת משנית
זוהי עקמת שנגרמת כתוצאת לוואי של מחלות אחרות, בעיקר נוירולוגיות, כמו שיתוק מוחין, ניוון עצב או שריר, או מחלות שקשורות ברקמת החיבור ותסמונות שונות כמו תסמונת דאון.


עקמת אדיופטית
זוהי העקמת השכיחה ביותר ומקורה אינו ידוע. מדובר בעקמת שמופיעה אצל ילד בריא, שאין אצלו פגם מבני בחוליות. במקרה כזה, מסיבות שאינן ברורות, עמוד השדרה צומח בצורה עקומה. הצמיחה העקומה באה לידי ביטוי בשלושה מישורים: המישור הפרונטלי, שמוביל לכך שהגוף מוטה הצידה; המישור הסגיטלי (צדדי), שגורם לכיפוף יתר או יישור יתר של הגב; והמישור האקסיאלי, שבו סיבוביות של החוליה גורמת להופעת גבנונית, בדרך־כלל באזור השכמות.
לא ברור בצורה חד־משמעית מהם הגורמים שיוצרים או מעודדים התפתחות של עקמת אדיופטית. מחקרים עדכניים מצביעים על מספר גורמים שעלולים להשפיע על התפתחות עקמת, בהם גנטיקה, הורמונים (בעיקר אצל בנות), חולשה של מספר שרירים בצד אחד של הגב בהשוואה לצידו השני, וגמישות יתר וירידה בצפיפות העצם כבר בגיל ההתבגרות. עם זאת, עד היום לא ניתן להצביע על גורם אחד כסיבה להיווצרות העקמת. ומכאן מגיע גם שמה - עקמת אדיופטית. כלומר, מסיבה בלתי ידועה.
3%־4% מהאוכלוסייה הכללית סובלים מעקמת אדיופטית, וגם אותה מקובל לחלק לשלוש קבוצות, על־פי הגיל שבו היא מופיעה:
עקמת הינקות: כשהיא מתפתחת בשלב שמהלידה ועד גיל שלוש.
עקמת הילדות: כשהיא מתפתחת בין גיל ארבע לתשע. 4־9 היא עקמת ילדות.
עקמת מתבגרים: כשהיא מתפתחת מגיל עשר ומעלה. זוהי גם העקמת השכיחה מבין השלוש.


מוקדם יותר, מאוזן יותר
הבשורה הטובה היא שרוב העקמות לא יחמירו באופן משמעותי, ולכן הטיפול הראשוני החשוב מתמצה במעקב כדי לוודא שהעקמת אינה מידרדרת. זה חשוב במיוחד כשמדובר בעקמת קטנה.
כשעקמת מידרדרת ומראה סטייה הולכת וגדלה של עמוד השדרה, הטיפול המקובל הוא בחגורת גב קשיחה שהילד לובש על גופו במרבית שעות היממה ומטרתה למנוע את המשך ההידרדרות. יש הממליצים לשלב גם טיפולי פיזיותרפיה ותרגילי התעמלות שונים לשיפור היציבה, אם כי אין הוכחות מדעיות לכך שטיפולים אלה מצליחים לטפל באופן ישיר בעקמת עצמה.
עם זאת, ככל שהעקמת מתחילה בגיל צעיר יותר, היא עלולה להיות קשה יותר ולדרוש בהמשך טיפול אגרסיבי יותר כמו ניתוח. בנוסף, אצל חלק קטן מהילדים חגורת הגב לא מסייעת בעצירת ההידרדרות, וההטיה גדלה לרמה משמעותית של מעל ל-50 מעלות. במקרים אלה אין מנוס אלא לעבור לטיפול ניתוחי שמטרתו לייצב ולתקן את העקמת ככל הניתן, ולהשיג איזון טוב של עמוד השדרה. מחקרים ארוכי טווח שנעשו על בעלי עקמת שנותחו, הראו שבתקופה של עד 20 שנה לאחר הניתוח המנותחים תפקדו היטב, וברמה המאפיינת את שאר האוכלוסייה. המנותחים אף דיווחו על פחות הפרעות בריאותיות ותפקודיות בהשוואה לחולים בדרגות עקמת דומות שלא נותחו.
חשוב לזכור שככל שאיתור העקמת נעשה בשלב מוקדם יותר, סיכויי הצלחה של טיפול שמרני למניעת ההידרדרות - גבוהים יותר.

ד"ר דרור עובדיה הוא אורתופד ילדים ואחראי על הטיפול במחלות עמוד שדרה בילדים בבית חולים דנה, תל־אביב


אל תפנו גב
כך תאתרו עקמת אצל ילדכם

בחנו את גוף הילד כשהוא לבוש בבגדים תחתונים בלבד:
1. האם גובה הכתפיים שווה?
2. האם כפלי המותניים שווים – כלומר אין צד "עמוק יותר" באזור המותן?
3. האם גובה השכמות שווה?
4. בקשו מהילד לעמוד כשגבו מופנה אליכם, ולהתכופף קדימה. במידה שיש לו עקמת - הדבר יבליט את ה"גבנונית" הנוצרת כאשר שני צדי הגב אינם בגובה זהה, בעיקר באזור השכמות (צד אחד גבוה מהשני).



טכניקת אלכסנדר
לאפשר לגב להתארך בדרך הטבעית-גל בן-אור

על־פי טכניקת אלכסנדר אחד  הגורמים הנוספים לעקמת הם הרגלים שגויים ולא מודעים של תנועה, שעם השנים הופכים לקבועים. השיטה גורסת כי שינוי ההרגלים ולימוד עקרונות היסוד שבבסיס התנועה הזורמת והמאוזנת, תוך מודעות להרגלי תנועה־מחשבה לקויים – עשויה למנוע, למתן או להעלים את הכאבים הנגרמים בשל קיומה של העקמת ובמקרים מסוימים אף למנוע את העקמת עצמה.
המפגשים כוללים מידע מעשי ועקרונות שימוש נכונים יותר בגופנו באופן שמאפשר לזהות את ההרגלים המזיקים, וללמוד כיצד ניתן לשנות אותם כדי לשמור על זקיפות הקומה ועל היציבה הטובה. בלימוד טכניקת אלכסנדר חוזרים לתנועה המאוזנת והקלה, לשיווי המשקל התקין, לקואורדינציה המתאימה ולנשימה הרגועה.
טכניקת אלכסנדר נלמדת בשיעור פרטי ובהדרכה אישית. לימוד עקרונות השיטה מתקיים תוך כדי ביצוע התנועות היומיומיות הבסיסיות: קימה וישיבה על כיסא, עמידה, הליכה, התכופפות ושכיבה. הלמידה מתבצעת באמצעות הנחיה מילולית של המורה ובמגע יד עדין ומכוון. התלמיד משתתף פעיל בשיעור ולומד לחזור לתנועה הטבעית והנכונה של גופו.
          
                                                                                                       (פורסם בעיתון קופ"ח לאומית
                                                                                                        לרפואה משולבת)      


יום ראשון, 29 במאי 2011

נועם מתמודד עם הגמגום בעזרת טכניקת אלכסנדר

נועם נולד כילד רגיל, אך בגיל שנתיים וחצי הוא עדיין לא דיבר. הוריו התייעצו עם קלינאית תקשורת שהמליצה על טיפול בדיבור. אמנם לאחר שבועות אחדים אוצר המילים של נועם גדל, אבל התקדמותו הואטה בהדרגה, והוא החל להתקשות בהגיית מילים ואפילו הופיע גמגום. קלינאית התקשורת הציעה להתעלם מהקשיים בתקווה שהם ייעלמו מעצמם.
הכרתי את נועם כשהיה בן 11. הערכתי שכבר בגיל צעיר הוא סבל מקשיים בקואורדינציה ומחולשה פסיכו־פיזית. טיפול בטכניקת אלכסנדר בגיל צעיר היה מלמד אותו להשתמש בעצמו נכון יותר תוך כדי משחק. לימוד ללא מאמץ וללא התמקדות מיותרת בחולשה שלו היה מחזק אותו ומאפשר לו לארגן את עצמו יותר טוב. שינוי פסיכו־פיזי חיובי היה מאפשר לו להמשיך להתפתח באופן נורמלי ללא צורך בהתערבות ספציפית מיוחדת, ואז גם הדיבור היה מתפתח מעצמו. חולשה זו (היפוטוניה) הייתה נעלמת ואיתה הקשיים המוטוריים האחרים, הן של המוטוריקה הגסה והן של העדינה. אולם קלינאית התקשורת ריכזה את המאמץ בטיפול בדיבור שבו בלטה החולשה במיוחד, בלי לספק לנועם כלים מתאימים להתמודדות עם הדרישות החדשות.
היות שנועם הוא ילד שאוהב לעבוד ומשתדל לעשות את שמבקשים ממנו באופן מושלם, הוא התאמץ ככל יכולתו לבצע את הדרישות החדשות. המאמץ אכן הניב פירות, אך בסופו של דבר המחיר היה כבד. המאמץ לדבר כאשר המערכת הפסיכו־פיזית עדיין לא מאורגנת ולא בשלה להתמודד עם פעולה מורכבת ועדינה כמו דיבור יצר לחץ ומתח מיותרים על המערכת באופן כללי ובמיוחד באזור הצוואר. בהמשך התהליך הפריעו הלחץ והמתח המיותרים האלה לניסיונות של נועם לדבר, דבר שבא לידי ביטוי בקשיים בביטוי מילים ובגמגום.
אחרי זמן מה הופיעו אצל נועם תסמינים נוספים הקשורים לאותה חולשה פסיכו־פיזית כללית: קשיים במוטוריקה עדינה וגסה, חולשה בחגורת כתפיים וקשיים אחרים. הוא הופנה לריפוי בעיסוק, לפיזיותרפיה ולטיפול אצל פסיכולוגית והועבר לגן מיוחד.
כל מומחה בתחומו אבחן את הבעיות לפי מיטב הבנתו. לכל אחד מהם יש שיטת טיפול ספציפית לבעיות שבתחום התמחותו ובצידן דרישות נוספות מהילד, אבל איש מהם לא הבחין בחולשה הבסיסית של המערכת הפסיכו־פיזית ובהיעדר הכיוון המרכזי באופן שבו נועם השתמש בעצמו. נועם הלך עם אמו ממומחה למומחה, מאבחון לבדיקה רפואית, לצילום EEG ועוד ועוד. הוא ניסה ככל יכולתו להצליח באבחונים, משתדל ומתאמץ ליישם את הטכניקות המיוחדות שהיו אמורות לטפל בבעיות המיוחדות, אך ככל שהתאמץ יותר כך הוא נכשל יותר, משום שאף מומחה לא ראה שדווקא המאמץ להצליח ולהגיע למטרה שהציבו לפניו הוא המכשלה העיקרית של נועם בדרכו אליה.
נועם איבד בהדרגה את הקשב וניסה להתנתק מההנחיות. החלו להופיע אצלו טיקים בשרירי הפנים וכמובן שהקושי בדיבור והגמגום הלכו והתגברו והפכו למכשול של ממש ביכולת שלו לתקשר עם סביבתו.
כדי לנטרל תופעות לוואי של ההתערבות נתנו לו רטלין, במקביל לעבודתם של המומחים. מה שעצוב בסיפור של נועם הוא שהמטפלים התגאו בהצלחותיהם ובשיפור שהשיגו במצבו, אבל כל אחד המשיך להתמקד רק בתופעות הספציפיות שבתחום טיפולו.
אני מאמין כי בהנחיית הכיוון הנכון ובהתערבות מינימלית, לחיזוק כללי של מנגנון הפיקוד הראשוני, מצבו הכללי של נועם היה משתפר ועימו היו משתפרות גם הבעיות הספציפיות. טיפול כזה היה מחזיר את נועם למסלול הנורמלי והמהנה של לימוד ויצירה שאותו חווים שאר הילדים בגילו.
בתחילת עבודתנו המשותפת נפגשנו במשך שלושה חודשים פעמיים בשבוע, חצי שעה בכל פעם. בשיעורים הראשונים התמקדתי בעיקר בהסרת ההתנגדויות שנועם פיתח כלפי כל ניסיון להתערב בעולמו הפנימי. היה עליי לרכוש את אמונו ולהוכיח לו שאיני מתכוון להכריח אותו לעשות או לא לעשות תרגילים כלשהם ושהוא לא יידרש להצליח במבחנים. הראיתי לו שהקשר בינינו והתהליך שאני מציע לו מבוסס אך ורק על הסכמתו ועל רצונו החופשי לשתף פעולה. עם זאת הבהרתי לו שיש כאן כיוון מובנה של פעולה, גם אם השיטה שונה משיטות אחרות, ושחופש אין משמעותו הפקרות.
לאט לאט החל להתרחש השינוי הצפוי ונועם הסכים להיפתח לחוויה חדשה. עדיין מדובר רק בתחילתו של תהליך ארוך, אך הכיוון היה ברור ואפשר לראות את האור בקצה המנהרה




יום שני, 16 במאי 2011

על חינוך הילד לעבודה מול מחשב בעזרת שיטת אלכסנדר



קדמה טכנולוגית – ישיבה ארוכת שעות מול המחשב
בחברה המודרנית של היום המאופיינת בקדמה טכנולוגית אנו נידונים לישיבה ארוכת שעות על כיסא מול מסך המחשב.מידע רב מועבר באמצעות האינטרנט, והחל מגיל הגן נחשפים הילדים לנפלאותיו של המחשב במשחקים, ומאוחר יותר בבית הספר כאשר על הילד להגיש את שיעוריו שהם מוקלדים על גבי המחשב ומודפסים. בבית הספר התיכון חומר הלימוד מועבר באמצעות האינטרנט, וכל מה שעל התלמיד לעשות הוא להוריד אותו מהאתר המתאים בכל מקצוע ומקצוע.
עד כאן אין שום פסול – המידע נעשה זמין ויש באפשרותנו להשיגו ללא שום מאמץ – הוא מגיע אלינו הביתה, אבל מה עם האופן שבו אנחנו משתמשים בעצמנו בעת הישיבה מול המחשב?

"הנדסת אנוש" של הילד עצמו – שימוש נכון בגוף
חברות רבות משקיעות סכומי כסף גדולים בחשיבה ותכנון בתחום של מה שנקרא - הנדסת אנוש: סוג הכיסא, צורתו, החומרים ממנו עשוי, גובה השולחן וכדומה, אך אין למיטב ידיעתי ולו חברה אחת שחשבה על הנדסת האנוש של הילד עצמו או נכון יותר לומר: לחינוך הילד להשתמש בגופו נכון יותר בזמן שהוא משתמש במחשב.

"כיסא פלאים" לעבודה מול מחשב
ננסה לבחון את השאלה מנקודת מבט מעשית. גם אם ימצא כסא פלאים המסוגל לשאת את גופו של הילד המשתמש במחשב באופן מושלם, וגם אם ניתן היה לייצר כסא פלאים מיוחד כזה לכל ילד וילד בנפרד בהתאם למידותיו האישיות, ושניתן יהיה להחליף כסא זה מידי שנה בשנה בהתאם לקצב גדילתו של הילד צריך יהיה לקחת בחשבון שתי נקודות: האחת – ההשקעה הכלכלית העצומה הנדרשת למחקר, לפיתוח ולייצור של רהיטים דמיוניים אלו, והנקודה השנייה היא נפשו של הילד והשפעתה על מתרחש בתוך גופו.

עבודה מול מחשב – מאמץ נפשי ושכלי בעל השלכות פיזיות
לכולנו ידוע היטב מניסיוננו האישי, שהעבודה על המחשב דורשת מאמץ מהכשרים הנפשיים/אינטלקטואלים שלנו, מאמץ שיש לו השלכות על גופנו אשר עלולות לבוא לידי ביטוי לאורך זמן בכאבי גב תחתון, כאבי גב עליון, כאבי צוואר, כאבי כתפיים, כאבים ודלקות בפרק היד, כאבי עיניים ועוד.

הניסיון "לחנך את הרהיטים" נידון לכישלון
לריהוט חשיבות משנית ביחס לאופן שבו הילד היושב עליו משתמש בעצמו. אין זה הכיסא שזוקף את קומתו של הילד היושב עליו, הילד עצמו אחראי למתרחש בתוכו והוא היחידי שיכול לשמור על אורכו הטבעי של גבו, וכן על המתח הנכון והמדויק של שאר אברי גופו הלוקחים חלק בתהליך הישיבה. 
הניסיון של העוסקים בהנדסת האנוש "לחנך את הרהיטים" נידון לכישלון בהיותו בלתי מעשי מבחינה כלכלית ובלתי שלם היות שאינו לוקח בחשבון את הילד עצמו, אלא מתייחס לגופו בלבד.

יש פתרון – לימוד טכניקת אלכסנדר
אל ייאוש ! יש פתרון שהוא פשוט וניתן ליישום מידי בהשקעה קטנה יחסית. הכוונה היא לחינוך הילד לשימוש נכון יותר בעצמו בזמן שהוא משתמש במחשב. כפי שחקר ומצא כבר לפני למעלה ממאה שנה פ.מ. אלכסנדר, ניתן ללמד ולהקנות לילד את היכולת להשתמש בעצמו ובגופו באופן שיבטיח מניעת אי נוחות והתפתחות הרגלים גופניים מזיקים וכן שמירה על בריאות ואיזון פסיכו-פיזיים אופטימאליים ללא קשר לריהוט שבו הוא משתמש.

שיטה המלמדת את השימוש בעצמנו – תנועה, מחשבה ונפש
טכניקת אלכסנדר מציעה פתרונות ודרכי התמודדות ייחודיים לקשיים אותם מציבה העבודה מול מחשב. אין מדובר בטיפים פשטניים, בטריקים מתוחכמים או בתרגילים שמטרתם טיפול בבעיות לאחר שהן כבר ישנן. שיטת אלכסנדר מתוך הבנה שהילד הוא יצור פסיכו-פיזי מורכב, מלמדת את העובד מול המחשב להשתמש בעצמו, על המכלול התנועתי, המחשבתי והנפשי, באופן כזה שנמנע היווצרותן של הבעיות מלכתחילה.
כאשר הילד משתמש בעצמו באופן המתאים לפעילות שאותה הוא מבקש לבצע נמנעים מתח השרירים והלחצים הנפשיים, השחיקה המתלווה לשעות רבות של עבודה נפסקת והילד שומר על בריאותו לאורך השנים.
בסדרת מפגשים בני כחצי שעה (תלוי בגיל הילדים) ניתן להקנות כמעט לכל ילד את עקרונות השימוש הנכונים בעצמו לפי שיטת אלכסנדר ולהכשירו למעשה לכל חייו להתמודדות שמציבים לו החיים המודרניים וביניהם השימוש במחשב.