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. 


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.