lørdag 17. mars 2018

A dark chapter

This blog post is written mainly for Alexander Technique teachers and is a rewritten and expanded version of Et mørkt kapittel (in Norwegian).

The claims to cure cancer and other potentially life threatening diseases reveals the dark side of the alternative health industry. There seems to be an abundance of implausible methods on offer, and there are many examples of how tragically it may end if necessary conventional medical treatment is abandoned. 

We Alexander Technique teachers prefer saying the technique is not a therapy, but still we do put forwards claims of health benefits. For the most part these claims are quite reasonable, but if we go back in time, we do find claims of cure of serious diseases on behalf of the Alexander Technique, even cancer. 

In the preface to his first book, Man's Supreme Inheritance(1), Frederick Matthias Alexander writes:
In the work which will follow I shall deal with the detailed evidence of the application of my theory to life, of cases and cures, and all the substance of experience. And there are many reasons why I should hesitate no longer in making my preliminary appeal, chief among them being the appalling physical deterioration that can be seen by any intelligent observer who will walk the streets of London or New York, for example, and note the form and aspect of the average individuals who make up the crowd. So much for the surface signs. What inferences can we not draw from the statistics? To take three instances only: What of the disproportionate and undeniable increase in the cases of cancer, appendicitis and insanity? For that increase goes on despite the fact that we have taken the subject seriously to heart. (Alexander 1996, p. xx-xxi) (2) 

Alexander continues by criticising the scientific efforts of finding pathogenic causes for cancer, (the success of the HPV-vaccine proves him wrong), and then offers his own solution: 
Therefore I look to that wonderful instrument, the human body, for the true solution of our difficulty, an instrument so inimitably adaptable, so full of marvellous potentialities of resistance and recuperation, that it is able, when properly used, to overcome all the forces of disease which may be arrayed against it. (ibid, xxii) 

It was Alexander's view that if we use our bodies in the best possible way, any disease could be overcome. He does not say so directly, but in the context, we have to assume this also includes cancer.

In the chapter titled Conscious Control Alexander criticises faith-healing, writing that: ‘Faith-healing is dangerous in its practice and uncertain in its result.’ (ibid, 30). But he is at the same time in accordance with the notion that changing mental habits could have an effect on bodily tissues: 
The ... way in which this act of faith operates is in the breaking down of a whole set of mental habits, and in the substitution for them of a new set. The new habits may or may not be beneficial from the outset apart from the effect produced by the emotional state, which is hardly ever maintained for a long period, but even so the breaking down of the old habits of thought does produce such an effect as will in some cases influence the whole arrangement of the cells forming the tissues, and dissipate a morbid condition such as cancer (ibid). 

Erroneous preconceived ideas 
In the chapter Synopsis of Claim, cancer is again mentioned: 
My next claim is that the limitations and imperfections referred to above, as well as cancer, appendicitis, bronchitis, tuberculosis, etc., are too often permitted to remain uneradicated and frequently undetected, and so to develop in consequence of the failure to recognize that the real cause of the development of such diseases is to be found in the erroneous preconceived ideas of the persons immediately concerned, ideas which affect the organism in the manner described in Part I of this book (ibid p.114). (3)

Serious diseases, like cancer and tuberculosis develops, according to Alexander, because of bad habits of thought, ‘erroneous preconceived ideas’. Mental attitude is a factor in any condition, but believing that getting rid of ‘erroneous preconceived ideas’ would mitigate cancer is dangerously naive.

Alexander continues: 
The only experience which the average man or woman has in the use of the different parts of the human organism is through his or her subconsciousness. The result is a subconscious direction which in the imperfectly co-ordinated person is based on bad experiences and on the erroneous preconceived ideas before mentioned. Small wonder, then, that such direction is faulty and leads to the development of serious defects and imperfections (ibid).

‘Erroneous preconceived ideas’ leads to faulty subconscious direction which in turn leads to ‘serious defects and imperfections’, including, we must assume, cancer and tuberculosis. As we shall see later, this subconscious direction must be replaced by a reasoned conscious direction, a vital element in ‘treatment’.

Treatment by re-education
In the chapter ‘Notes and Instances’ Alexander replies to questions from the readers of the first edition of Man's Supreme Inheritance (4). One of the questions is: ‘How are the principles of Conscious Control to be applied to the cure of specific bad habits, or to the cure of specific diseases?’ (ibid, 176). 

Again, Alexander writes about what he believes causes the problems: 
In the first place, all specific bad habits, such as overindulgence in food, drink, tobacco, etc., evidence a lack of "control" in a certain direction, and the greater number of specific disorders, such as asthma, tuberculosis, cancer, nervous complaints, etc., indicate interference with the normal conditions of the body, lack of control, and imperfect working of the human mechanisms, with displacement of the different parts of that mechanism, loss of vitality and its inevitable concomitant, lower activity of functioning in all the vital organs. When the subject has arrived at this condition, harmful habits become established, and the standard of resistance to disease is seriously lowered’ (ibid, 177). 

According to Alexander, ‘re-education’ (Alexander Technique) was a necessary part of the ‘treatment’: 
To regain normal health and power in such cases, what I have called "reeducation" is absolutely imperative. This treatment begins, in practically all cases, by instructions in the primary factors connected with the eradication of erroneous preconceived ideas connected with bad habits, and the simplest correct mental and physical co-ordination. The displaced parts of the body must be restored to their proper positions by re-education in a correct and controlled use of the muscular mechanisms. In this process the blood is purified, the circulation is gradually improved, and all the injurious accumulations are removed by the internal massage which is part and parcel of the increased vital activity from such re-education (ibid). 

The habits causing the unhealthy condition can only be changed through conscious control: 
Thus the first stage in the eradication of bad habits and disorders is reached when improved conditions of health are established. Nor must it be forgotten that in this process of re-education a great object lesson is given to the controlling mind. In the very breaking up of maleficent co-ordinations or vicious circles which have become established, a new impulse is given to certain intellectual functions which have been thrown out of play. The reflex action which is setting up morbid conditions can only be controlled and altered by a deliberate realization of the guiding process which is to be substituted, and these new impulses to the conscious mind have, analogically, very much the same effect as is produced on the body by the internal massage referred to above. The old accumulations of subconscious thought are dispersed, and room is made for new conceptions and realizations (ibid).

It almost seems as if Alexander believes that the ‘faulty’ subconscious directions in themselves constitutes ‘injurious accumulations’, and that the new conscious direction likewise have healing properties. The idea that diseases are caused by accumulation of toxic substances is an old one, which is still very much alive in the alternative health industry. (5) 

In 1944 the periodical Manpower published an editorial strongly criticising Alexander and his work. The title was Quackery versus Physical Education. Manpower was the periodical of the South African ‘National Advisory Council for Physical Education’, and the article was written by its editor, Dr. Ernst Jokl. (6) 
Alexander, seeing his work threatened, sued for libel. After a lengthy process in the South African judiciary system Alexander won the case and received damages of £1000. In the years after, Alexander Technique teachers have seen this case as proof that Alexander's theories and method were sound and not quackery. They are not entirely correct. (7)

Judge Clayden says in his judgement: 
In the passage at p. 110 [in MSI] the claim is, I consider, made that cancer, appendicitis, bronchitis and tuberculosis can be prevented. 

And further on: 
As far as cancer is concerned he says in MSI, p. 28, that the teaching ‘will in some cases influence the whole arrangement of the cells forming the tissues, and dissipate a morbid condition such as cancer,’ and at p. 173 he speaks of the cause of cancer, among other diseases, and says, ‘To regain normal health and power in such cases, what I have called “re-education” is absolutely imperative’. Both these passages are referred to in the index under ‘cancer’. There can, I think, be no other reading of these passages than that a claim to cure cancer in certain cases is made. 

And referring to the evidence from the Jokl's defence: 
Now, accepting as I do, that Mr Alexander has no cure for cancer, or for appendicitis in the middle stage, yet claims to cure these diseases, it seems to me that much of this evidence is unanswerable in its force. 

In his judgement, Judge Clayden gave a fair description of the Alexander Technique but his conclusion was: 
The conclusion to which I come is that the defendants have shown that Mr Alexander is a quack in the sense that he makes ignorant pretence to medical skill; they have shown that many of the physiological reasons put forward are wrong; they have shown that in its claims to cure the system constitutes dangerous quackery; but in these matters they misrepresented the views of Mr Alexander and in showing how foolish were these views, which he did not put forward, they have in the article called him much more of a quack than they were entitled to do. In addition they have failed in my view to prove that the system cannot bring about the results which it does claim in the improvement of health and the prevention of disease, and again they have made matters worse by overstating the claims made for the system (Alexander vs. Jokl And Others). (8)

Alexander won the case, not because he wasn't a quack, but because he was less of a quack than he was accused of being. 

(1) Man's Supreme Inheritance is actually a collection of texts written over the span of several years. The first part was published as Man's Supreme Inheritance in 1910. In 1911 an Addenda was published. In 1918 the book was re-published and extended to include Conscious Control (1912) and The Theory and Practice of a A New Method of Respiratory Re-education (1907) which constitute the second and third parts of the book respectively. 
(2) It is a well established fact that Alexander made use of a ‘ghost writer’ for his first book, the author J.D. Beresford. The collaboration was terminated early in the process, but it is assumed that parts of the preface here quoted, and the two first chapters are formulated by Beresford. But we still must hold Alexander responsible for the content and its meaning.
It is interesting that the Wikipedia article on Beresford has this comment mentioning several of his novels: ‘He has used his novelist's skill to convince the sensitive reader that the age of miracles is not over, and that, in certain circumstances, the spirit may exercise what seem to us miraculous powers over the substance of the body. This he did in 'The Camberwell Miracle' and 'Peckover'; and in this absorbing novel, he returns to the theme, with the study of a man fitting himself to become a great healer.’ Was Beresford in some way inspired by Alexander? Or did the just happen to share some of the same ideas?
(3) In this quote Alexander mentions tuberculosis. In 1903 Alexander wrote a pamphlet titled The Prevention and Cure of Consumption (Alexander 1995) in which he envisages a role for his technique in the fight against the disease. With today's knowledge this does not seem very realistic. The subject of Alexander and tuberculosis deserves a separate article 
(4) The chapter ‘Notes and instances’ constitutes Addenda to Man's Supreme Inheritance, written 1911. 
(5) We may be amused by Alexander's outdated views on the cause of disease and proposal for treatment, but he was not alone. When Alexander arrived in London in 1904 he brought with him introductory letters to several leading medical men, among them was Dr. Robert Henry Scanes-Spicer. Spicer was a leading throat specialist who had already written about negative effects of mouth breathing. This could be the reason the got on very well from the start. Both Spicer and his family became pupils of Alexander. In 1909 Spicer presented a talk at a meeting of the British Medical Association titled 'Cancers of the Throat'. He says: ‘To my mind cancer is a biological syndrome or symptom complex which may be caused ..., by intrinsically arising mechanical forces, which are excessive in degree when the muscular mechanisms of the body, and especially those of equilibrium and respiration, are chronically used other than to maximum or, at least, very high efficiency. In such cases the increased irritation and undue stimulation of cell growth, the power expended unproductively being transformed into the energy of cell-growth and multiplication. This is the local irritation factor. This alone is not cancer. Now the very same low efficiency use of the muscular mechanisms (especially those of equilibrium and respiration) which have caused local irritation (much power lost and wasted in doing internal work), also result in impaired oxygenation and purification of the blood, defective aspiration and compression of the blood out of the portal area, and a general state of splanchnic stagnation, intestinal texaemia, and non-elaboration of essential internal secretions, alexins, opsonins and ferments. ... When both [factors] are at work each process reacts on and intensifies the other. Each manufactures its own poisons in ever-increasing bulk, and so the biological syndrome advances to the fatal end. Such is the view of the nature and origin of cancer that I have been led to form. I believe this is new.’ (Spicer 1909, p.1151). 
Spicer presented his theory on several occasions, without referring to Alexander who, at least in part and most probably, was the inspiration for his theory. Alexander published articles criticising Spicer and indirectly accused him of plagiarism (Alexander 1995). The story about Alexander and Spicer is an interesting one and possibly the subject of another article. 
(6) Ernst Jokl (1907-1997) was a German born doctor and Director of physical education in South Africa. In 1942 he received a demonstration of the Alexander Technique from one of Alexander's assistants, Irene Tasker, who had moved to South Africa in 1935. But she refused to give him lessons, possibly because she felt he did not have the right frame of mind (Bloch 2004, p. 198). She advised him instead to contact Alexander himself in London, not very realistic during the height of war. Maybe the story had been different if Jokl had had lessons instead on having to rely only on Alexander's books? 
Jokl has a bad reputation in the Alexander Technique world, but he seems to have been a man of both competence and integrity: Dr. Ernst F. Jokl, a Pioneer In Sports Medicine, Dies at 90
 (7) Wilfred Barlow and Frank Pierce Jones in their books More Talk of Alexander and Freedom to Change edits their quotations from the judgement quite heavy-handedly, leaving out anything that could put Alexander or the Alexander Technique in a bad light, in particular the word ‘quackery’. See Barlow (2005, p. 325) and Frank Pierce Jones (1996 p. 92). Barlow in particular does this without revealing that the text has been edited. This is morally questionable. The result is that the fact that the judgement was not entirely in Alexander's favour is unknown to most Alexander Technique teachers
(8) Jokl's article was written in a scornful tone and ends derisively: ‘It seems indeed appropriate that Mr Alexander's concepts, although alleged by its founder to apply to normal human beings, are in reality based upon experimental evidence obtained from decerebrate preparations’. (Decerebrate preparations = vivisection animals who have had parts of the brain removed). But it seems that Alexander won the case mainly because Jokl overstated his claims about the technique. The judgement says: ‘To be effective, the justification must be as broad as the libel. In the present case, defendants had said that there was quackery in the field of physical education, and dishonest quackery in the field of medicine, both in claims to cure and in claims to prevent disease and improve health. They had proved only quackery and dishonest quackery, in the sense that quackery is always dishonest, in the claims to cure. Even in that regard they had made the quackery appear to be worse than it was and they had alleged dishonesty to a greater degree than would be implicit in the quackery itself. The justification was not, in these circumstances, as broad as the libel’ (Alexander versus Jokl and Others).

Alexander. FM. 1995. Articles and Lectures. Mouritz. 
Alexander, FM. 1996 (1918). Man's Supreme Inheritance. Mouritz. 
Barlow, Wilfred (ed.). 2005. More Talk of Alexander. Mouritz (2.ed). 
Bloch, Michael. 2004. F.M. The Life of Frederick Mathias Alexander. Little, Brown. 
Jokl, Ernst. (1944). Quackery versus Physical Education. (Editorial) Manpower (Volkskragte), vol. 2, no. 2, pp. 1-26. 
Jones, Frank P. 1996. Freedom to Change. Mouritz.
Spicer, R. H. 1909. Cancers of the Throat: some remarks on their sites of origin, pathogeny, early diagnosis, and radical cure. British Medical Journal 1909 Oct 16; 2(2546): 1149-1152. 
Supreme Court of South Africa (Witwatersrand Local Division). Frederick Matthias Alexander versus Ernst Jokl, Eustace H. Cluve, Bernard M. Clarke. 19th February, 1948.