The Alexander Technique is a method aimed at re-educating people to do everyday tasks with less muscular and mental tension. According to the ‘Complete Guide to the Alexander Technique’, this method can help you if:
- You suffer from repetitive strain injury or carpal tunnel syndrome.
- You have a backache or stiff neck and shoulders.
- You become uncomfortable when sitting at your computer for long periods of time.
- You are a singer, musician, actor, dancer or athlete and feel you are not performing at your full potential.
Sounds good!? But which of these claims are actually supported by sound evidence.
Our own systematic review from 2003 of the Alexander Technique (AT) found just 4 clinical studies. Only two of these trials were methodologically sound and clinically relevant. Their results were promising and implied that AT is effective in reducing the disability of patients suffering from Parkinson’s disease and in improving pain behaviour and disability in patients with back pain. A more recent review concluded as follows: Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson’s-associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the elderly, in general chronic pain, posture, respiratory function and stuttering, but there is insufficient evidence to support recommendations in these areas.
This suggests that the ‘Complete Guide’ is based more on wishful thinking than on evidence. But what about the value of AT for performers – after all, it is for this purpose that Alexander developed his method?
A recent systematic review aimed to evaluate the evidence for the effectiveness of AT sessions on musicians’ performance, anxiety, respiratory function and posture. The following electronic databases were searched up to February 2014 for relevant publications: PUBMED, Google Scholar, CINAHL, EMBASE, AMED, PsycINFO and RILM. The search criteria were “Alexander Technique” AND “music*”. References were searched, and experts and societies of AT or musicians’ medicine contacted for further publications.
In total, 237 citations were assessed. 12 studies were included for further analysis, 5 of which were randomised controlled trials (RCTs), 5 controlled but not randomised (CTs), and 2 mixed methods studies. Main outcome measures in RCTs and CTs were music performance, respiratory function, performance anxiety, body use and posture. Music performance was judged by external experts and found to be improved by AT in 1 of 3 RCTs; in 1 RCT comparing neurofeedback (NF) to AT, only NF caused improvements. Respiratory function was investigated in 2 RCTs, but not improved by AT training. Performance anxiety was mostly assessed by questionnaires and decreased by AT in 2 of 2 RCTs and in 2 of 2 CTs.
From this evidence, the authors drew the following conclusion: A variety of outcome measures have been used to investigate the effectiveness of AT sessions in musicians. Evidence from RCTs and CTs suggests that AT sessions may improve performance anxiety in musicians. Effects on music performance, respiratory function and posture yet remain inconclusive. Future trials with well-established study designs are warranted to further and more reliably explore the potential of AT in the interest of musicians.
So, there you are: if you are a performing artist, AT seems to be useful for you. If you have health problems (other than perhaps back pain), I would look elsewhere for help.
What was used as a control, and how were they blinded?
it is not possible to blind in this case, I think.
So, study it then. As an Alexander Technqiue instructor, I found the title of this article to be dismissive. As the parent of a person who is in recovery from substance use disorder, I find the last statement to be alarmingly dismissive. The United States is in the midst of an opioid addiction epidemic, with overdose deaths surpassing car accidents as the leading cause of accidental death. There are over 100 overdose deaths each day, more than half of them due to prescription pain medications. As the addiction crisis has been fueled by a combination of deceptive marketing practices and physician overprescribing, alternatives to opiate pain medication for back pain are urgently needed. Alexander Technique’s efficacy for back pain should be promoted. Yes, this technique ought to be studied for it’s role in injury prevention, rehabilitation, and pain management, and regulation of stress related conditions. In the arena of pain management, quality of life improvements should not be dismissed, as quality of living typically increases among people who practice the technique, and this may allow a person to live with pain rather than mask it with opiates and falling prey to the horror that is opiate dependency.
…and until there is good evidence, I see it as my duty to point this out – regardless of whether you find this dismissive or not.
@Gaynelle – If it’s not blatantly obvious that studying and practicing conscious movement would help with repetitive strain, backache, stiff neck and shoulders, etc…it’s not AT that needs a study. Research should be done on where the hell we left our common sense, so we can retrieve it.
You can promote the AT for an N=1, but often these techniques–when not subjected to proper study–are only just as good as doing nothing at all. Lets not compare to medicine, pain meds, and surgery, which suffer from their own inability to be provided to the correct patient. Your point seems to be that standard of care in some cases is ineffective and sometimes dangerous, you are somewhat correct. But we also should not be wasting peoples time on things that are unproved and a waste of time and resources.
The AT should be a “try it if nothing else is effective” type of treatment until it can be better justified.
As a performing musician and Alexander Technique teacher, I say that this review has been asking the wrong questions. The technique is more subtle than to be subject to this matter-of-fact testing. The results depend 50% on the response of the pupil, as it places that much responsibility on the self. It is an education, so has the potential for better long-term results than any outside intervention but on the other hand will have very little result if the pupil does not apply what he has learnt. So any trial results will have limited meaning in the same way as trying to decide whether a subject taught at school will result in all the pupils becoming experts in that subject.
For performers, the Alexander technique can be directly applied to any performing technique, which in turn should have a knock-on effect for the things that were reviewed. However there will be a range of understanding and application in each person, as well as variations in occupation eg. performers and teachers of music have different types of stress.
It is difficult to get the scientists undertaking these trials and reviews to understand what they are testing before they start. A bit of a chicken and egg syndrome.
I’m also a musician and Alexander Technique teacher, and I say that any claim of health benefits of the technique can be put to the test in randomised controlled trials. Good study design will reduce problems with individual differences in teaching, learning and practicing the technique.
I also say that we should avoid making exaggerated claims. Having said that, I would suggest that proposing the Alexander Technique for being able to reduce stiffness in necks and shoulders is reasonable and not wishful thinking, although if it isn’t yet supported by evidence.
Angela says this on her website (http://www.alexandertechniquesouthlondon.co.uk/)
“On the medical side:
Clinical trial results published in the British Medical Journal on 19 August 2008, show that Alexander Technique lessons provide long-term benefit for chronic back pain sufferers.
“Of all the approaches tested, 24 Alexander Technique lessons proved to be the most beneficial.” (BMJ 2008)
What Angela failed to mentioned (and I hope it wasn’t because of her commercial interest) is this; “Six lessons in the Alexander technique followed by exercise prescription was almost as effective as 24 lessons..
I’m an Alexander Teacher and think this is an excellent summary of what the current research says. It’s a great challenge to us to fund/develop more studies.
This is quack science and journalism at its worst.. Present a façade of credibility with – A photo, list of degrees, and impressive databases (googled).
Then write an article with no scientific method, no rigour of analysis, erroneous conclusions, and obvious bias presented as fact.
If you want a serious review of research then best look elsewhere.
you are correct, of course: this is a blog not a scientific journal. if you want to read one of my > 1 000 articles published in medical journals, you need to look there.
Methinks you have skin in the game and are miffed that your beliefs are being questioned. I could, of course, be totally wrong, but I doubt it. Your beliefs could, of course, be wrong but I doubt you would acknowledge it.
I’m an Alexander Technique teacher and Edzard’s approach is correct. It doesn’t necessarily mean that he is correct in saying that claims about the Technique are wishful thinking – it’s just that a) there are very few convincing studies b) the Technique is an exceptionally difficult thing to build a scientific test for. Also it is debatable as to whether the Technique should be viewed as a therapeutic process or as an educational technique. I tend towards the latter opinion, even though I came to the Technique because I had terrible sacro-iliac pain which I only became free of 10 years after qualifying as a teacher. It took that long for me to discover the movement I had a tendency to make which caused the pain. Most of the evidence we present in the profession is anecdotal – that doesn’t mean that it’s not correct – just not easily testable.
“b) the Technique is an exceptionally difficult thing to build a scientific test for.”
I think the difficulty is due to the multiple claims being made for the Alexander Technique. I see no reason why it would be difficult to subject each of its claims to a test for efficacy.
However, if it claims to be a heterogeneous system that defies scientific understanding and it claims to be more than the sum of its parts then it belongs to the realm of wishful thinking / belief systems — a hallmark of quackery.
The burden of proof is on those making the claim for efficacy. If, as you say, the Alexander Technique is exceptionally difficult to scientifically test then on what do you base your evidence for its efficacy?
@ Jan – Do most of your students come to AT due to a pain issue, or because they are interested in the work? Most of the folks I’ve talked to discovered Alexander Technique to help with a chronic pain issue but end up staying because of the practice itself – but I’d love to hear your perspective as a teacher.
Jan Steele said:
Why do you say that?
Claims of health benefits are not difficult to test. You don’t have to know the working mechanism.
But the working mechanism is pretty obvious. If the Alexander Technique influences health it is because, as we say: use affects functioning. Or as I like to put it: If you stop banging your head against the wall it will probably stop hurting.
(Also Alexander Technique teacher).
Dr Kieran Tobin, M.B, B. Ch, BAO, FRCS(Eng), FRCS(Irl), D.L.O., Senior Surgeon, University College Hospital Galway Ireland. Past President of the Irish Otolaryngological, Head and Neck Society and Past-President of the E.N.T. Section of the Royal Society of Medicine of Ireland is one of many doctors who are of the opinion that the Alexander Technique should be a part of the medical training for doctors. He had first hand experience of the technique. I really don’t think it was wishful thinking that made him say this:
‘Neck problems are virtually an occupational hazard for Ear, Nose and Throat surgeons. I had serious problems during my working years, but hoped for relief on early retirement. This was not the case and limitation of cervical (and thoracic) movement became quite an intrusion on my life. Physiotherapy and medication gave only short-term improvement. On being introduced to the Alexander Technique I was somewhat sceptical that anything was going to work, but can only describe the relief gained, and maintained, as quite incredible. General posture has improved and neck mobility has returned to that last experienced more than twenty years ago. What more could one ask for?’
More comments from the medical profession here: http://www.alexander.ie/quotations.html
More information about research here: http://www.alexander.ie/at_research.html
Richard Brennan said:
Appeal to personal incredulity. Tobin may well be right, but, fortunately, we no longer have to rely on what someone believes is right. Prof Ernst has presented some of the best evidence that has looked at the Alexander Technique and found it wanting. I see you have linked to a page on evidence in your next comment, but a lot of the links are to magazine article, letters, posters, etc. There do seem to be a few links to research papers but they get lost in with the rest. Perhaps you could highlight the papers you think are the most compelling evidence for AT?
you might be interested in the following scientific evidence about Alexander Technique
It seems to me that ´Alexander technique‘ is an example of ´re-branding‘ a field of working knowledge into alternative quasi-quackery with unrealistic ancillary claims. Similar to the re-branding of nutritional science for pretentious make-believe medicine and profit.
You seem to be saying that we Alexander Technique teachers are taking ideas from elsewhere. Could you please specify?
(Ideally I would like you to specify which of the principles of the Alexander Technique this concerns and/or which part of the teaching method).
I just wondered have you had any Alexander Technique lessons? If so what was your experience like?
Why do you ask?
I never answer such questions; I do not see the relevance.
I completely agree that it is not relevant to the issue of scientific evidence-based research whether you have personally experienced a lesson with a qualified teacher. It is more a question of professional interest – whether the interaction was conducted in a professional manner, and whether you thought the teacher made any claims that were farfetched in any way.
If anyone finds information about the Alexander Technique that contains what they consider to be unreasonable claims or ‘wishful thinking’, they will do the Alexander Technique profession a service by informing the teacher in question about their views, and by informing the relevant professional organisation.
Alexander Technique teacher
Dear Dr. Edvard,
Thank you very much for your kind interest in underlining the deep importance to the Alexander Technique profession of the necessity for the pursuit of serious scientific research.
I would like to call your attention to the earliest scientific research done on AT which perhaps may be of interest to you. It was conducted by Frank Pierce Jones at Brown and at Tufts. The archives of his research are held at The Dimon Institute:
“During the beginning of the century, Alexander gained notoriety for his discovery and the support of a number of eminent scientists, educators, and literary figures. But no scientific research was conducted on the subject until 1949, when Frank Pierces Jones, a classics professor at Brown University, embarked on a 26-year scientific investigation into Alexander’s discovery… Employing various experimental methods including multiple-image photography, force platform analysis, and X-ray photography, Jones produced over 40 papers, corresponded with teachers, scientists, and doctors all over the world, and collected a large body of research data. The result was an extensive and fascinating record, substantive and historical, on the Alexander Technique. There is increased and focused efforts being made in the Alexander Technique (and the cognitive science) community to develop, fund and publish more and more scientific research. I am sure there will be a quite different body of evidence within the next five to ten years.”
(from The Dimon Institute website: http://dimoninstitute.org/resources/archive)
Currently there is an increased and focused effort being made in the Alexander Technique (and cognitive science) community to develop, fund and publish more scientific research. I am sure there will be quite a different and intriguing body of evidence in place within the next five to ten years.
However, it is important to remember that we also test and review AT from other research and evaluation methodologies besides medically-based clinical trials, research methods that are appropriate to the field of study and populations to which it is being applied.
For instance, AT interventions improved efficiency, reduced time off from work and increased worker satisfaction on the job at the Victorinox factory in Switzerland:
Research into improving physical and emotional conditions for children in schools is ongoing. The original Little School begun by Irene Tasker and others during FM Alexander’s lifetime and with the support of progressive educator John Dewey, all the way through to the work currently being done with children and schools by Sue Merry and Sue Holladay in the UK, and Gal Ben-Or in Israel, among others. I am beginning a modest project at a local public elementary school here in Asheville NC, as well as at a private middle school in New York city. Certainly these sorts of social science research projects are relevant and important, thought they involve surveys of perceived (subjective) benefits by the participants (teachers and students) immediately following the interventions, and also follow ups with perceptions of long term benefits at periods of time following the interventions.
Similar research needs to be done in the area of AT and “performance anxiety,” not only for performing artists but for athletes, first responders and other “high stress” professionals. Sports psychology has become a recognized part of improved athletic performance, but AT has the greater potential ability to offer reductions in both physical and psychological stress at the same time.
I’m not sure if you had accessed these sites, but there is additional scientific research on AT that can be found at these two links:
Also, for above study an accompanying video of subjects before/after AT training:
The Embodied Mind project in Europe is bringing cognitive scientists, neuroscientists, and robotics researchers as Third Person Experts together with AT teachers as Second Person Experts in designing innovative ways to study subjective First Person Expert experiences of change:
A new site, Alexander Studies Online, has been designed as a depository to collect and disseminate new scientific research and other types of social research on the uses and efficacy of AT. It is an initiative of the Society of Teachers of the Alexander Technique: http://www.alexanderstudies.org
I think AT teachers are all very eager and excited to finally see in the 21st Century such positive potential for accurate clinical scientific research in AT now that there are more and more subtle ways to make evidence-based research in the efficacy of AT training in human functioning.
Looking forward to us all celebrating together these interdisciplinary studies as they develop, and more importantly, celebrating the positive effects they will have for the general public’s well being!
Certified Teacher of the Alexander Technique since 1985
Teaching Member, Alexander Technique International
For low back pain a few people have Alexander Technique lessons while many people take paracetamol. Systematic review and meta-analysis has recently been reported in the BMJ about the ineffectiveness of paracetamol for low back pain. This is surely important and a matter of concern. Why haven’t scientific methods of effectiveness, and updating checks to evaluate effectiveness, been carried out here in pharmacology? Just think of how much placebo doctors have been prescribing and to how many people and for how many years. They’ve been giving people’s bodies the challenge to health of processing all that paracetamol. The British Medical Journal published 31 March 2015 says:-
Paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines.”
What is your point?
“Why haven’t scientific methods of effectiveness, and updating checks to evaluate effectiveness, been carried out here in pharmacology?”
They have and that is why paracetamol is no longer advised for that condition. The same can’t be said for AT.
Jack Stern, Spinal Neurosurgeon
97% of people with back pain could benefit by learning the Alexander Technique – it is only a very small minority of back pain sufferers that require medical intervention such as surgery.
“Jack Stern, Spinal Neurosurgeon
97% of people with back pain could benefit by learning the Alexander Technique – it is only a very small minority of back pain sufferers that require medical intervention such as surgery.”
If Stern treated 100% of patients with low problems and conducted an equivalent to an RCT, there would be merit to your statement. However, that is not the case and your post is little more than an appeal to (shallow) authority.
I Googled Stern and watched a YouTube video of an interview. He lost me when he said many patients get relief from acupuncture. He appears, and they can be deceiving, an unctuous fellow who despatches his wisdom without any evidence or consideration. In Australia, we have an equally unctuous fellow, named Edelsten, who was his near equal before being struck off for his “medical misdemeanours”.
Dr. Stern received his medical degree and Ph.D. degree from the Albert Einstein College of Medicine. He completed his internship in General Surgery at NYU Medical Center and completed his residency in Neurological Surgery at the Neurological Institute of Columbia University, Presbyterian Medical Center. Dr. Stern is board certified by the American Board of Neurological Surgery and an Assistant Professor at New York Medical College, and the Yale University School of Medicine.
Ph.D. Albert Einstein College of Medicine
M.D. Albert Einstein College of Medicine
B.A. Yeshiva University
Postgraduate Training and Fellowships:
Research Fellow, Department of Pathology, Albert Einstein College of Medicine, Bronx, NY
Instructor, Department of Biological Sciences, Marymount College, Tarrytown, NY
Lecturer, Department of Pathology, New York State, College of Optometry, NY
Resident in Neurosurgery, Department of Neurosurgery, New York University School of Medicine, NY
Resident in Neurosurgery, Neurological Institute, Columbia-Presbyterian Medical Center, NY
Clinical Fellow in Neurosurgery, Department of Neurosurgery, Neurological Institute, Columbia-Presbyterian Medical Center, NY
Diplomate, American Board of Neurological Surgery
Awards, Honors & Societies:
U.S.P.H.S., National Institute of Health Fellowships
Tay-Sachs and Allied Disease Foundation Fellowship
Biomedical Research Grant-National Institute of Health
American Association for the Advancement of Science
American Association of Neurological Surgeons
American Medical Association
American Pain Society
Congress of Neurological Surgeons
Eastern Pain Association
International Association for the Study of Pain
New England Neurosurgical Society
New York State Neurosurgical Society
Research Society of Neurological Surgeons
Society for Neuroscience
Stroke Council, American Heart Association
Academic Appointments & Hospital Affiliations:
Assistant Professor of Neurosurgery, New York Medical College, Valhalla, NY
Assistant Clinical Professor of Neurosurgery, Yale University School of Medicine, New Haven, CT
Westchester County Medical Center, Valhalla, NY
White Plains Hospital Medical Center, White Plains, NY
Northern Westchester Hospital, Mt. Kisco, NY
Our Lady of Mercy Hospital, Bronx, NY
Ellenville Hospital, Ellenville, NY
Lenox Hill Hospital, New York, NY
Roosevelt-St. Luke’s Hospital, New York, NY
Lawrence Hospital, Bronxville, NY
Sound Shore Hospital, New Rochelle, NY
Mt. Vernon Hospital, Mt. Vernon, NY
Phelps Memorial Hospital, Center, Sleepy Hollow, NY
St. John’s Riverside Hospital, Yonkers, NY
Stern, Jack: The Induction of Ganglioside Storage in Nervous System Cultures. Laboratory Investigation 26: 509-511, 1972.
Stern, Jack; Novikoff, Alex B.; and Terry, Robert D.: The Induction of Sulfatide, Ganglioside and Cerebroside Storage in Organized Nervous System Culture. IN: Advances in Experimental Medicine and Biology, Vol. 19, Ed: Volk, B.W., and Aronson, S.M., Plenum Press, New York, London, 1972, pp. 651-660.
Bornstein, Murray B.; Pelletier, Georges; and Stern, Jack: A Light and Electron Microscopic Study of Rat Anterior Pituitary in Organotypic Tissue Culture. Brain Research 40: 489-495, 1972.
Pelletier, Georges; Bornstein, Murray B.; Stern, Jack; and Puviani, Romano: Etude Morphoiogique des effets du 3′, 5’Adenoside Monophosphate Cyclique (AMP Cyclique) sur l’Adenohypophyse du Rat Maintenue en Culture de Tissu. Journal de Microscopie 13: 383-390,1972.
Stern, Jack: The Formation of Sulfatide Inclusions in Organized Nerve Tissue Culture. Laboratory Investigation 28: 87-96, 1972.
Stern, Jack; and Bornstein, Murray, B., The Formation of Sulfatide Inclusions in Cultures of Organized Central and Peripheral Nervous System. Journal of Neuropathology and Experimental Neurology, 31: 195, 1972.
Stern, Jack: The Development of Intracellular Inclusions in Cultured Nervous Tissue after the Addition of Different Lipids. Dissertation Abstract Int. 37:2, 1976.
Hochwald, Gerald, M.; Wald, Alvin; Marlin, Arthur E.; Stern Jack; and Malhan, Chaman: Exchange of Sodium between Blood and Cerebrospinal Fluid in Hydrocephalic Cats. Developmental Medicine and Child Neurology: 18: 164, 1976.
Hochwald, Gerald M.; Wald, Alvin; Marlin, Arthur E.; and Stern, Jack: Evidence for the Movement of fluid, Macromolecules and Ions from the Brain Extracellular Space to the Cerebrospinal Fluid. Neurology 27: 386, 1977.
Hochwald, Gerald M.; Wald, Alvin; Marlin, Arthur E.; Stern, Jack; and Malhan, Chaman: Sodium Exchange between Blood, Brain and CSF in Normal and Hydrocephalic Cats. Journal of Neuroscience Research 3:267-273, 1977.
Stern, Jack; Hochwald, Gerald M.; Wald, Alvin; Gandhi, Mysore: Visualization of Brain Interstitial Fluid during Osmotic Disequilibrium. Experimental Eye Research 25: 475-482, 1977.
Stern, Jack; Hochwald, Gerald M.; Wald, Alvin; Gandhi, Mysore: Visualization of Brain Interstitial Fluid Movement during Osmotic Disequilibrium. IN: The Ocular and Cerebrospinal Fluids, Ed: Bito, L.Z.; Davson, H.; and Fenstermacher, J.D.; Academic Press, New York, 1978, PP 474-482.
Stern, Jack; Correll, James W.; Bryan, Nick: Persistent Hypoglossal Artery and Persistent Trigeminal Artery Presenting with Posterior Fossa Transient Ischemic Attacks. Journal of Neurosurgery 49: 614-619, 1978.
Michelsen, W. Jost; Hilal, Sadek K.; Stern, Jack: The Management of Arteriovenous Malformation of the Orbit. IN: Ocular and Adnexal Tumors, Ed: Jakobiec, F., Aesculapius Publishing Company, Birmingham, Alabama, 1978, pp 782-786.
Correll, James W.; and Stern, Jack: Carotid Artery Lesions Causing Vertebral Basilar Insufficiency. Stroke 9: 107, 1978.
Stern, Jack; and Housepian, Edgar M.: Neurofibromatosis and Optic Glioma: Clinical-morphological Correlates. Neurosurgery 3: 228, 1978.
Stern, Jack; DiGiacinto, George; Housepian, Edgar M.: Neurofibromatosis and Optic Glioma; Clinical and Morphological Correlations. Neurosurgery 4: 524-528, 1979.
Stern, Jack; Whelan, Margaret; Brisman, Ronald; Correll, James W.:Management of Extracranial Carotid Stenosis and Intracranial Aneurysms. A Plan for Management. Journal of Neurosurgery 51: 147-15O, 1979.
Correll, James W.; Stern, Jack; Zyroff, Jack; Whelan, Margaret A.: Vertebral Basilar Insufficiency Relieved by Carotid Surgery. IN: Advances in Neurosurgery, Vol. 7, Ed: Marguth, F.; Brock, M.; Kazner, E.; Klinger,M.; Schmiedek, P.; Springer?Verlag, Berlin?Heidelberg, 1979, pp 40-43.
Jakobiec, Frederick A.; Stern, Jack; and Housepian, Edgar M.; Optic Nerve Glioma in Neurofibromatosis. Investigative Ophthalmology and Visual Science 18; 204?205, 1979.
Stern, Jack; Whelan, Margaret A.; and Correll, James W.: Spinal Extradural Meningiomas. Surgical Neurology 14: 155?159, 1980.
Correll, James W.; and Stern, Jack: Neurosurgery. IN: Pediatric Therapy, Ed; Shirkey, H.C., Mosby, St. Louis, MO., 1980, pp 1084?1097.
Stern, Jack; Jakobiec, Frederick A.; Housepian, Edgar M.: The Architecture of Optic Nerve Gliomas with and without Neurofibromatosis. Archives of Ophthalmology, 98: 505?511, 1980.
Whelan, Margaret A.; and Stern, Jack: Intracranial Tubercloma. Radiology 138: 75?81, 1981.
Stern, Jack; Bernstein, Carol A; Whelan, Margaret A.; and Neu, Harold C.: Pausteurella Multocida Subdural Empyema. Journal of Neurosurgery, 54:550?552, 1981.
Whelan, Margaret A.; and Stern, Jack: Sarcoidosis Presenting as a Posterior Fossa Mass. Surgical Neurology 15: 455?457, 1981.
Whelan, Margaret A.; Stern, Jack; and DeNapoli, Robert A.: The Computed Tomographic Spectrum of Intracranial Mycosis: Correlation with Histopathology. Radiology, 141: 703?707, 1981.
King, Lucille W.; Molitch, Mark E.; Gittenger, John W.; Wolpert, Samuel M.; and Stern, Jack: Cavernous Sinus Syndrome Due to Prolactinoma: Resolution with Bromocriptine. Surgical Neurology, 19: 280?284, 1983.
Moorthy, Chitti, R.; Fakhry, Joseph; Shih, Lyn; and Stern, Jack: Feasibility of Ultrasound?Guided Iodine?125 Bratty Therapy for Recurrent Glioblastoma Multiforme. Journal of Endocurie?Hyperthermia Oncology, 2:213,1986.
Trobe, Judy; Haber, Joel; Stern, Jack; The Alexander Technique in the Physical Therapy Management of Low Back Pain. Pain Suppl. 4: 92, 1987.
Stern, Jack: Management of the Near?Drowned Child; Emergency Pediatrics, 2: 3?5, 1989.
Stern, Jack: Neurological Evaluation and Neurological Sequelae of the Spinal Cord Injured Patient. IN: The Spinal Cord Injured Patient. Comprehensive Management, Ed: Lee, B.Y.; Ostrander, L.E.; Cochran, G.V.; Shaw, W.W.; Saunders, Phil. 1991, pp 115-123.
Mills, Catherine M.; Wolpert, Samuel; Herman, Talia; Molitch, Mark; Prager, Robert; Stern, Jack; Fisk, John. High Detail Coronal Computed Tomography in Patients with Suspected Pituitary or Hypothalamic Dysfunction. American Journal of Neurosurgery. February 1992
Lectures & Presentations:
Stern, Jack: A Tissue Culture Model for the Lipid Storage Diseases. Meeting of The National Tay-Sachs and Allied Diseases Association, Philadelphia, April, 1971.
Stern, Jack; and Bornstein, Murray B.: The Formation of Sulphatic Inclusion in Cultures of Organized Central and Peripheral Nervous System. 47th Annual Meeting of the American Association of Neuropathologists, San Juan, Puerto Rico, June, 1971.
Stern, Jack; and Terry, Robert D.: The Induction of Sulphatide and Ganglioside in Organized Nervous System Tissue Culture. IV International Symposium on Sphingolipids, Sphingolipidosis and Allied Disorders, New York, October, 1971.
Stern, Jack: Exchange of Sodium between Blood and Cerebrospinal Fluid in Hydrocephalic Cats. Annual Meeting of the Society for Research in Hydrocephalus and Spina Bifida, Bern, Switzerland, June 1976.
Hochwald, Gerald M.; Wald, Alvin; and Stern, Jack: Evidence for the Movement of Fluid, Macromolecules and Ions from the Brain Extracellular Space to the Cerebrospinal Fluid. 29th Annual Meeting of the American Academy of Neurology, Atlanta, Georgia, April, 1977.
Correll, James, W.; and Stern, Jack: Carotid Artery Lesions Causing Vertebral Basilar Insufficiency, Third Annual Joint Meeting on Stroke and Cerebral Circulation, New Orleans, Louisiana, February, 1978.
Stern, Jack; and Hochwald, Gerald M.: Visualization of Fluid Movement in Brains of Cats with Osmotic Dysequilibria. 21st Annual Meeting of the Research Society of Neurological Surgeons, New York, June 1978.
Stern, Jack; and Housepian, Edgar M.: Neurofibromatosis and Optic Glioma: Clinical-morphological Correlates. 28th Annual Meeting of the Congress of Neurological Surgeons, Washington, D.C., September, 1978.
Correll, James W.; and Stern, Jack: Vertebral-basilar Insufficiency Relieved by Carotid Surgery. Joint Meeting of the American Academy of Neurological Surgery and the Deutsche Gesellschaft fur Heurochirurgie, Munich, Germany, October 1978.
Stern, Jack; Jacobiec, Frederick, A.; and Housepian, Edgar M.: Optic Nerve Glioma in Neurofibromatosis. 11th Annual Meeting of the Neuro Ophthalmology Pathology Symposium, San Francisco, California, February, 1979.
Stern, Jack; Brisman, Ronald; and Correll, James W.: Carotid Stenosis and Co-existing Intracraniai Aneurysm. Fourth Annual Meeting of the American Association of Neurological Surgeons, Los Angeles, California, April, 1979.
Jakobiec, Frederick, A.; Stern, Jack; and Housepian, Edgar M.: Optic Nerve Glioma in Neurofibromatosis. Annual Meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Florida, May 1979.
Correll, James W.; and Stern, Jack: Intracranial Hemorrhage following Carotid Endarterectomy. Annual Meeting of the American Academy of Neurological Surgery, Memphis, Tennessee, November, 1979.
Copeland, Brian; Stern, Jack; Michelson, W. Jost; and Hilal, Sadek: Dural Arteriovenous Malformations. 48th Annual Meeting of the American Association of Neurological Surgeons, New York, April 1980.
Stern, Jack: Carotid Endarterectomy. 48th Annual Meeting of the American Association of Neurological Surgeons, New York, April 1980.
Housepian, Edgar M; Quest, Donald 0.; and Stern, Jack: Differences in Surgical Objectives and Techniques in the Treatment of Optic Nerve Gliomas and Meningiomas. 50th Anniversary Meeting of the American Association of Neurological Surgeons, Boston, Massachusetts, April 1981.
Housepian, Edgar M.; Quest, Donald 0.; and Stern, Jack: Transcranialorbital Surgery for the Optic Nerve Sheath Glioma and Meningioma. Seventh International Congress of Neurological Surgery, Munich, Germany, July, 1981.
Stern, Jack: Managing Neurosurgical Trauma. Grand Rounds. Penobscot Bay Medical Center. Rockland, ME. December 1981
Stern, Jack: Cranial and Spinal Trauma: An Update. Third Annual Meeting of the American College of Emergency Physicians. Waterville, New Hampshire, February 1982.
Stern, Jack: Cerebral Revascularization. Visiting Professor Lectureship. St. Mary’s Hospital, Waterbury, CT. April 1982
Stern, Jack: Emergency Management of Head and Spine Trauma: National Association of Emergency Medical Technicians, Boston, Massachusetts, May, 1982.
Stern, Jack: Management of Pain in Oncology Patients. Medicine Grand Rounds.Tufts University School of Medicine. September 1982
Stern, Jack: Neurosurgical Management of Pain. Grand Rounds. Bon Secours Hospital, Lawrence, MA . September 1982
Stern, Jack: Syndromes of the Cavernous Sinus. Ophthalmology Grand Rounds. New England Medical Center. Boston, MA. December 1982
Stern, Jack: Guest Discussant. Neurology Grand Rounds. Brown University School of Medicine. January 1983
Stern, Jack: The Neurosurgical Management of Benign and Malignant Facial Pain. Grand Rounds. Department of Otolaryngology. New England Medical Center. Boston, MA. May 1983.
Stern, Jack: The Neurosurgical Management of Pain. Rehabilitation Medicine Grand Rounds. Tufts University School of Medicine. July 1983
Stern, Jack: Surgical Intervention in Chronic Pain. Pan Symposium. Montrose, V..A. Montrose, NY. March 1984
Stern, Jack; Kasoff, Samuel: Intraventricular Morphine for Control of Malignant Pain. American Pain Association, Fifth General Meeting, Dallas, Texas, October 1985.
Jabbour, Ihsan; Savno, John; Kasoff, Samuel; and Stern, Jack: Conjunctival Oxygen Tension more Accurate that Cerebral Perfusion Pressure in Monitoring Cerebral Oxygenation; 19th Annual Meeting Association for Academic Surgery, Cincinnati, Ohio, November 1985.
Kasoff, Samuel; Holder, Donovan; Agrawald, Nawakrami; Lansen, Thomas; and Stern, Jack: Aggressive Physiological Monitoring of the Pediatric Patient with Elevated Intracranial Pressure. 14th Annual Meeting of the Section of Pediatric Neurological Surgeons of the American Association of Neurological Surgeons. Houston, Texas, December 1985.
Jabbour, Ihsan; Savino, John; Kasoff, Samuel; and Stem, Jack: Comparison of Conjunctival Oxygen and Cerebral Perfusion Pressure in Monitoring Cerebral Oxygenation. A New Technique: 56th Annual Meeting of the American Association of Neurological Surgeons. Denver, Colorado, April 1986.
Moorthy, Chitti R.; Patel, D.J.; Kasoff, Samuel; and Stern, Jack: Intracranial 1-125 Brachy Therapy with Ultrasound Localization. American Society of Therapeutic Radiologists, Los Angeles, California, November, 1986.
Stern, Jack: What’s New in the Acute Management of Head Trauma; Is Anything New? Symposium on the Comprehensive Management of the Brain Injured Patient. New York Medical College, Valhalla, NY, November 1986
Stern, Jack; Reynolds, David; and Kasoff, Samuel: Influence of ICP Monitoring on Outcome after Near Drowning. 15th Annual Meeting of the Section of Pediatric Neurological Surgeons of the American Association of Neurological Surgeons. Pittsburgh, Pennsylvania, December 1986.
Moorthy, Chitti, R.; Fakhry, Joseph; Shih, Lyn; and Stern, Jack: Feasibility of Ultrasound Guided Iodine – 125 Brachy Therapy for Recurrent Glioblastoma. Ninth Annual Meeting of the American Endocurietherapy Society, San Juan, Puerto Rico, December 1986.
Stern, Jack: Brachytherapy and the Treatment of Malignant Gliomas. Annual Meeting of the New York Neurosurgical Society, New York, March 1987.
Rothman, Stanley J.; Stern, Jack; Tenner, Michael; Leslie, Denise; Kasoff, Samuel: Subclinical Optic Lesions in Childhood Neurofibromatosis. 39th Annual Meeting of the American Academy of Neurology, New York, April 1987.
Stern, Jack: Management of Pain. Grand Rounds. Cornwall Hospital. Cornwall, NY. June 1987
Trobe, Judy; Haber, Joel; Stern, Jack: The Alexander Technique in the Physical Therapy Management of Low Back Pain. Fifth World Congress on Pain, Hamburg, West Germany, August 1987.
Stern, Jack: Symptom Management of the Patient with Cancer. Update Course Director, New York Medical College, Valhalla, NY, September 1987
Stern, Jack: Magnetic Resonance Imaging for the Practicing Physician. A Postgraduate Course. New York Medical College, Valhalla, NY, October 1987
Stern, Jack: Brachytherapy for Malignant Brain Tumors. Columbia University Comprehensive Cancer Center. Neuro-Oncology Workshop, November 13, 1987
Stern, Jack: Contemporary Technical Options: Ultrasound Guided Brain Biopsy. Eleventh Annual Post-Graduate New York Neurosurgery Course, December 1987
Stern, Jack: Surgical Management of Spacticity. Grand Rounds. Burke Rehabilitation Institute, White Plains, NY 1989
Stern, Jack: Surgical Management of Spinal and Cranial Metastasis. Department of Surgery Grand Rounds. Lincoln Hospital. Bronx, NY, December 1991
Danto, Joseph: Rosenthal, Alan; Schneider, Steven; and Stern, Jack: Evoked Potential and EEG Monitoring of Surgery of the Skull Base. Jerusalem Symposium on Surgery of the Skull Base and Adjacent Midline Region, Jerusalem, 1992
Stern, Jack: Diagnosis and Management of Increased Intracranial Pressure. Department of Surgery, Grand Rounds. Lincoln Hospital. Bronx, NY. December 1992
Stern, Jack: Differential Diagnosis of Low Back Pain and Radiculopathy. Annual Meeting of the Hudson Valley Chapter of the NY Physical Therapy Association. White Plains, NY. May 1993
Stern, Jack: Low Back Pain ? Treatment Algorithms. Symposium, Manhattan Center for Pain Management, New York, NY, March 1995
Stern, Jack: Spinal Instrumentation Update. Annual Meeting of the NY State Chiropractic Association. Ellenville, NY. May 1997
Stern, Jack: Alternative and Complimentary Medicine. Manhatanville College Women’s Center. Purchase, NY. March 1997.
Stern, Jack: Alternative and Complimentary Medicine. Westchester County Office For Aging. White Plains, NY. August 1997.
and with all this education, he has not learnt how to spell complementary medicine correctly? [see last two references]
I had to look this little spelling issue [url deleted by admin because of suspected malware] up myself just to make sure 🙂
Like Prof. Ernst, English is not my native language but I did not live in England for decades, like Professor Ernst and most of all I did not, like he did, author and co-author well in excess of a thousand learned articles in English about Complementary[sic] and alternative Medicine. Compliments[sic] are due to the good professor for his mastery of the English language and the nice catch.
I compliment your abstention from hiding behind a pseudonym Mrs. Gross, but compliments are absolutely not forthcoming for your abusive shitload dumps (excuse my lack of verbal restraint) of cut-and-pasted text when simple links to key references or to any of Dr. Sterns many bumptious biographical advertisements would have sufficed. We all know how to follow links and we are generally very competent at finding complementary information on our own, thank you. If you wish to argument your admiration for Dr. Stern or for the merits of your beloved Alexander technique, please consider that you are mostly addressing an educated assembly of well informed medical and health-care enthusiasts in here.
You have brought to mind the delightful Scottish informal word “numpty”.
Guru based medicine is not effective. “Expert” opinion is a low level of evidence.
You cant argue FOR the effectiveness of a technique by arguing AGAINST another. That is an infomercial tactic!
The earlier post (Frank Collins on Tuesday 22 September 2015 at 07:41) comparing Dr. Jack Stern to Dr. Geoffrey Edelsten as “his near equal” seems bizarre:
Dr. Geoffrey Edelsten
(Wikipedia – https://en.wikipedia.org/wiki/Geoffrey_Edelsten)
Geoffrey Walter Edelsten (born 2 May 1943) is an Australian medical entrepreneur who founded Allied Medical Group.
Edelsten was a general practitioner, but was deregistered in New South Wales in 1988 and later in Victoria. In 1990, he was jailed for perverting the course of justice and soliciting Christopher Dale Flannery to assault a former patient.
In the 1980s, Edelsten’s unconventional clinics and lifestyle attracted media attention. He owned mansions, helicopters, and a fleet of Rolls-Royces and Lamborghinis with license plates such as Macho, Spunky and Sexy. His multidisciplinary clinics – the forerunners of modern corporate medical practices – were open 24 hours, and were fitted with chandeliers, grand pianos, and mink-covered examination tables.
In 2005, Edelsten and a business partner founded Allied Medical Group, which by 2010 administered 17 medical centres and employed around 250 general practitioners. Edelsten is not, however, a shareholder or owner of the company.
Following his graduation in 1966, Edelsten practised as a resident medical officer at the Royal Melbourne Hospital before entering general practice. As a general practitioner, he worked in remote rural regions of New South Wales and Queensland, including the towns of Wauchope, Aramac and Walgett, where he bought his first private practice. He obtained a private pilot’s licence in order to provide medical services to remote communities – often at no cost to patients when they could not afford to pay.
In 1969, he and a colleague set up a new medical practice in the Sydney suburb of Coogee. After training an assistant doctor to perform the work in Walgett, Edelsten devoted more time to the Sydney practice, which soon expanded to Liverpool.
In 1971, Edelsten and a colleague, Tom Wenkart, launched Preventicare, a Sydney-based company providing diagnostic tests and computerised history-taking for doctors throughout Australia, using new equipment from the United States which could quickly and cheaply process pathology specimens. Preventicare quickly incurred debts, because some of its operations were economically unsound, and because of the slow payment of patients’ accounts totalling far more than the company’s debts. In July 1971, the Equity Court appointed a provisional liquidator to act as a temporary business manager to put the company’s financial affairs in order. Later that year, the General Manager of Preventicare, Brian Wickens, reported that the organisation was on a sound financial footing. By 1975 – and under the new name of Morlea Pathology Services – it recorded annual profits of $2.5 million to $3 million. Macquarie Professional Services is the successor to Preventicare. During this period, Edelsten and his colleagues established eight practices in the Sydney area, and performed obstetrics at three western Sydney hospitals. After three years in Los Angeles, California, Edelsten returned to Australia in 1978 to resume his general practice, surgical and obstetric commitments.
Following the establishment of Medicare by the Hawke government in February 1984, Edelsten began to run innovative and multi-disciplinary 24-hour medical centres which were the forerunners of modern corporate medical practices. Decorated with chandeliers, white grand pianos and mink-covered examination tables, the clinics attracted considerable media attention. Edelsten’s clinics were the first in Australia to bulk-bill patients to Medicare so that they incurred no direct cost. Within four months of opening, the first clinic was dealing with 2,000 patients every week. Edelsten eventually owned thirteen medical centres, in which approximately 20,000 patients consulted 200 doctors every week.
Edelsten was the first private owner of a major Australian football team – the Sydney Swans Football Club, which he bought in 1985
Also Dr. Edelsten seems to be quite popular in the tabloids in Australia. I couldn’t find anything remotely similar for Dr. Stern:
So, you tell me that two different person are two different person ? Breaking news.
How is copy-pasting CV an argument for AT ? What are you trying to do ?
@ Monika Gross,
I wondered how you would react and I haven’t been disappointed.
AT is not a medical procedure although medical benefits have been observed. In today’s fast paced medical world, At would be out of place. It is better regarded as an exploration of human potential. In what century our we going to find a physician say: “h I have just thing to help you reach your full potential.” AT cannot be reduced to a few platitudes and practice by auto-suggestion. That is wishful thinking and there the author hits the nail on the head. I don’t find either side of the argument off base. Those in the author’s camp are justified as are those in the Alexander camp. Both are talking at cross purposes. The whole question depends on what an individual wants. If they want to change their lifestyle they will find a willing helper in AT, but if they want a quick fix, they should go elsewhere.
As a teacher/practitioner of the Alexander Technique may I refer you to the following RCTs:
1) concerning lower back pain, http://www.bmj.com/content/337/bmj.a884
2) concerning neck pain, http://annals.org/aim/article/2467961/alexander-technique-lessons-acupuncture-sessions-persons-chronic-neck-pain-randomized
They speak for themselves, though only cover a small fraction of the area covered by a training in this work.
Dear Dr. Ed,
I appreciate your attempt to investigate the Alexander technique. After several years of study myself, I must say that it is extraordinarily difficult to describe to someone what we study without them having the experience of a lesson; it’s like trying to talk you through the benefits of listening to a Bach fugue.
Western scientific studies are valuable, but in my experience, some people (like myself) are quick studies of the basics and get tremendous pain relief. Others for one reason or another just don’t want to examine their habits and get absolutely nothing from a lesson. Remember this is not a medical field, but rather a TECHNIQUE.
To further complicate the issue, the quality of the AT teacher very much affects the effectiveness of a lesson. Rather than discouraging people, I invite you to find some teachers for yourself and conduct a proper study on yourself!
PS – I found this article while looking for testimonial reviews of individual teachers. The information out there is spotty at best, but that’s more or less what I expected.
the question is not so much what Alexander teachers do exactly – but whether their techniques are effective. for that you need trials and evidence.
Dear Dr. Edvard,
as others have pointed out, you should try the Technique for yourself in order to know (at least partially) whether is effective or not. That would make you sound more credible.Then you can search of all the trials and evidence you want. Alexander himself has built this Technique from inside out. He tried it on himself and as it worked he tried it on others and also worked. Your skepticism around this technique is, I would suggest, built on ignorance about the Technique itself. Of course you are a scientist and you need to be skeptical. But I would like to point out to you that a handful of scientists before you who had also been skeptical about this technique have had the courage to try it by themselves and, as far as I know, they changed their skepticism for a proactive scientific attitude towards it. Just to name one famous example, perhaps you could benefit from reading 1973 Nobel Prize Nikolaas Tinbergen speech about the Alexander Technique. https://www.youtube.com/watch?v=XXr-9kQZ0ow
[not that it matters]
but you should try to at least get my name right.
Please read my 2005 dissertation, pages 272-273:
“Niko Tinbergen’s 1973 Nobel Prize acceptance speech ‘Ethology and Stress Diseases’ was reported worldwide, including in Tasmania. The speech analysed two topics, autism and the Alexander Technique. Tinbergen opined that Alexander’s story in The Use of the Self demonstrated perceptiveness, intelligence and persistence “shown by a man without medical training;” he concluded Alexander’s story was “one of the true epics of medical research and practice.” Tinbergen, who had had Alexander Technique lessons with Dick and Elizabeth Walker, qualified the Alexander Technique as a breakthrough in medical science and found that “many types of physiotherapy which are now in general use [are] surprisingly crude and restricted in their effect, and sometimes even harmful to the rest of the body.”…Publication of Tinbergen’s speech led to two debates; a medical dispute on autism, another — in two general science journals — on Alexander’s methods. Roger Lewin’s ‘Did Nobelist go too far in advocating Alexander Technique?’ in the 31 October 1974 New Scientist started the debate about Tinbergen and the Alexander technique. A prolonged late-1974, early-1975 New Scientist discussion followed, until finally the New Scientist Editor wrote in the 16 January 1975 issue, “the correspondence is now closed.” Discussion, however, flared up again in the 2 May 1975 Science. In November 1976, Tinbergen gave [Society of Teachers of the Alexander Technique’s] Alexander Memorial Lecture, titled ‘Use and Misuse in Evolutionary Perspective.’ Tinbergen’s biographer Kruuk, in his 2003 Niko’s Nature, states that not long after this occasion Tinbergen’s “interest in Alexander petered out…his brush with it was past.” His 1985 autobiographical sketch Watching and Wondering does not even mention Alexander. Kruuk concluded, “All in all, perhaps the Nobel lecture would be best forgotten.” “
Niko Tinbergen’s work and expertise related to the organization of individual and social behavior patterns in animals.
Say no more!
My only problem with AT, is that it is a common pathway to cults like Gurdjieff
Professor Dr. Rob Oostendorp, founding father of evidence based medical research in The Netherlands, was supervisor of “Frederick Matthias Alexander 1869-1955,” my 2005 dissertation on F. M. Alexander, his work, writings and legacy. I am really, really proud he supervised the dissertation. In Dutch, he was “streng maar rechtvaardig,” meaning firm but fair. Having examined all available research, the dissertation’s conclusion re. Alexander Technique (AT) research was: “In 2003, Ernst and Canter performed computerized literature searches in the Medline, Embase, Amed, CISCOM and Cochrane Library databases in order to identify randomized clinical trials of the Alexander Technique. The search located sixty-eight articles, of which only four fulfilled Ernst and Canter’s inclusion/exclusion criteria. The authors excluded thirty-one articles for not being clinical studies (reviews or commentaries); nineteen articles for not relating to medical problems; seven for being case reports; and another seven for being uncontrolled studies…. A poor bounty, that looks even poorer after taking notice of Ernst and Canter’s discussion of these articles (Staring, 2005, p. 278). My advice for all AT teachers was, “It is now clearly up to the Alexander Technique community to prove, evidence-based, via controlled trials, that the Alexander Technique is not “either of unknown value or ineffective,” and should therefore be considered in medical therapy” (p. 279).
We are now in mid-September 2017. When Ernst says in 2014, “…some evidence and plenty of wishful thinking” then Alexander Technique teachers must not have understood the importance of research between 2005 and 2014, and most probably will not have understood it by now.
Perhaps it is useful to them to read my recent article where I explain one of the causes of their being adverse to research as a legacy of Alexander’s : “F. M. Alexander, the Use of the Self, and a 1932 Book Review + Discussion in the Yorkshire Post: A Failure to Impact Medical Science”.
Staring, J. (2005). Frederick Matthias Alexander 1869-1955: The Origins and History of the Alexander Technique. Nijmegen: Integraal.
Staring, J. (2016). F. M. Alexander, the Use of the Self, and a 1932 Book Review + Discussion in the Yorkshire Post: A Failure to Impact Medical Science. International Journal of Case Studies, 4 (10), pp. 26-43.
@ Dr. Jeroen Staring
Thank you for your responses. We definitely need much more scientific evidence with solid studies to render legitimate what we have experienced to be true in ourselves and our students through the study and practice of the AT (did you guess? I am also “one of those” AT specialists…). I actually trained in the Netherlands and your dissertation was on the bookshelf at my training course. My Dutch wasn’t (and still isn’t good enough) to plunge into your comprehensive dissertation. But some 10 years later, I am increasingly curious and would really like to read it. I am wondering how to get a hold of an English translation (if there is one still in print?). I have the English Summary, but would like to purchase a complete version.
Reading this whole discussion, we AT people take ourselves and our work for granted just because it has helped us so much… and this though benefiting the “insiders” has in fact crippled us towards having an inquisitive and open mind that would lead our community to demand more scientific evidence and research so that we would have more legitimate standing. Clearly, the studies we have done, are too few and far between or not specific enough nor respecting typical scientific criteria. I am aware of all the studies mentioned here. We another Frank Pierce Jones! It is indeed difficult to objectively assess human experience and to determine if the Alexander Technique does indeed significantly affect “the control of human reaction” (FM Alexander). I do believe though if we can be open enough as a professional body to let our technique be evaluated under strict scientific criteria we will gain credibility and move forward. This is a good wake-up call. 😉
I regret the fact that you did not take the copy of my dissertation from your instructor’s bookshelf. You would have noticed then, 10 years ago, that you could read it perfectly. It does not need an English translation since it is in English from beginning to the end, except for a Dutch summary. The English summary you have mentions my e-mail address where you can inquire further.
I welcome your recent interest in scientific research, and would recommend to start your path by studying:
Ernst, E., & Canter, P. H. (2003). The Alexander Technique: A Systematic Review of Controlled Clinical Trials. Forschende Komplementärmedizin und Klassische Naturheilkunde, 10 (6), 325-329.
It should be pointed out that “The Complete Guide to the Alexander Technique”, despite having a very good internet address, a name that makes a bold claim and a great many pages, is actually only the website of one Alexander Technique teacher living in Nebraska, USA. For this reason it is quite inappropriate and even unreasonable to consider this to be representative of the views or claims made by profession as a whole.
That having been said, there is an ever-growing body of evidence to support the claims that you have listed. Your own systematic review conducted in 2003 predates most of the important studies now available on the A.T, especially with regard to back pain, neck pain and Parkinson’s disease. The systematic review of 2014 that you mention and link in your article is only for evidence related to performance in music. A more up to date systematic review (2011) of evidence for the medical benefits of the A.T. can be found at this address: http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2011.02817.x/abstract and this was published before the large RCT of the effectiveness of the AT for people with neck pain was published in 2015 here: http://annals.org/aim/article-abstract/2467961/alexander-technique-lessons-acupuncture-sessions-persons-chronic-neck-pain-randomized
Perhaps now would be a good time to update your article?
With kind regards,
@ Peter Bloch.
I agree. A lot has happened. Thank you for these references.
@ Dr. Edzard: a new article is needed here. There is a new study coming out soon regarding people living with Parkinson’s funded by the National Parkinson’s Foundation.
Dr. Edzard Ernst,
I would be curious to hear directly from you (even if it isn’t relevant here) what your experience of Alexander lessons was like.
Dear Sir. I think you need to go and have some Alexander lessons yourself before just saying that if you have a medical problem, you should seek help elsewhere. The AT does have a scientific basis – the way that we work as a psycho-physical unity. It’s just that a lot of that science hasn’t yet been researched. Those of us whose lives have been saved by the AT (yes, saved), know that science can’t explain everything.
Dr Alison Loram
(ARCM, Dip RCM, BSc (Hons), MSc, PhD, MPAAT)
If it hasn’t been researched, then how is it science?
There is a growing body of research literature on aspects of Alexander technique training. This was a reference list of related research that our nonprofit, The Poise Project, distributed at the recent American Congress for Rehabilitation Medicine in Dallas. We led a course and symposium and shared a few pilot study research posters there. https://tinyurl.com/yadyvjuj
Clearly much more research and expansion on pilot studies is needed as there have only been three RCT published to date. The next five to ten years should see AT-related research literature continuing to be published.
The Poise Project
I am not a scientist nor am I medically qualified, but a lawyer so naturally sceptical.
I do have back and neck problems developed over many years at work, and particularly since using computers became an everyday and indeed all day necessity.
I have had a number of Alexander lessons and found them to be helpful if somewhat mystifying (how do you define Forward and Up for instance) and expensive compared to one off physio or osteopathic sessions.
I am convinced that there is some self evident truth in sayings such as “If you stop the wrong thing, the right thing does itself”. However do you need to spend several hundred pounds in order to put this into practice, and does the effect wear off unless you keep having lessons. No one gave Alexander lessons, and he rapidly built up a well paying clientele among actors. As far as I am concerned the jury is still out, but I remain interested.
Simon, reviewing your comment again, I realise that you made one observation to which I did not respond, that “no one gave Alexander lessons”. Alexander actually studied and consulted extensively with a range of other professionals; doctors, voice coaches, acting teachers, etc, and read widely during his ten years of work to resolve his own problems. He was always adamant (and stated this clearly in one of his books, “The Use of the Self”) that anyone could solve their own problems if they followed the steps that he laid out in the book. However, he warned, to do so they would need firstly to recognise a number of potential pitfalls that made such a journey long and without any guarantee of success. As with many intricate skills, the AT is easier and quicker to learn, and you are vastly more likely to succeed in your efforts, if you consult a skilled teacher.
If you would like a more detailed explanation as to why it is difficult to teach yourself the A.T, I have summarised the main challenges under the heading “Can I learn the AT from a book?” near the bottom of this page: http://peter-bloch.co.uk/frequently-asked-questions
Again, I hope this is helpful.
To answer what I think are your questions here:
1) Most beginners find the principles of the A.T. to be mystifying. Although the concepts (such as what is meant by “forward and up” can readily be explained by a good and/or experienced teacher, it is the practical understanding of these concepts that transforms the quality of movement, and this perforce takes time and experience.
2) The A.T. “directions”, such as “forward and up” are akin to the gestures than follow naturally from ideas. To clarify by analogy, it is rather like learning to smile if you have somehow forgotten how to do so. You might describe it in terms of facial muscles, but in the end it is really best located through a way of thinking that leads naturally to the activation of those muscles – in this case by a happy, or an amusing thought. A.T. lessons are essentially practical guidance towards the ways of thinking about and during movement that re-activates the postural activity naturally exhibited by small children, gifted athletes, etc. Because words are insufficient fully to describe this, the task of an AT teacher is not so much to teach these principles as to guide a student towards an understanding of them.
2) A.T. lessons can seem expensive, in that a reasonably extended course is recommended. However, since most people actually attend physiotherapy or osteopathy several times over the years, and not “one-off”, the total costs are not usually greater.
3) Although there is quite a steep “dose response curve” in some studies (more lessons usually lead to more improvement), nonetheless in the low back pain RCT just 6 lessons reduced days with pain by more than 50% at a one year follow-up. Seems pretty cheap to me!
4) I can state with some good supporting evidence that the effect of AT lessons does not wear off. For example, in the two large randomised controlled trials for back pain and for neck pain, later follow-ups found effects to be undiminished by the passage of time. Even in the (admittedly small and unrandomised) knee osteoarthritis study, a degenerative condition, a 15 month follow-up after the completion of all lessons found absolutely no reduction in the overall 54% reduction in pain and disability found immediately after the course of lessons was completed.
5) Finally, all juries ought always to be out! This is the essence of the scientific method. However, the formal scientific evidence for the usefulness of the AT for addressing problems such as yours in a lasting way is now becoming quite strong.
I hope that this will be helpful to you and that you will continue with your lessons. Since almost nothing is right for everyone (even some of the most effective approaches to human health do not work for all people all of the time), I suggest that you allow yourself also to consider your own experience, the original way of determining the value of something. If, as you say, you have found the lessons that you have had so far helpful, then proof that you seek may be “in the pudding”!
With kind regards,
Teacher of the Alexander Technique