I saw Mahmoud for the
first time as his mother wheeled him into the dining room.
The boy had a lovely face whose expression of sad resignation
immediately touched my heart. So did the unexpected sensation
when I took his hand while Adeelah, an attractive young woman
who spoke a few words of English, introduced her son to me.
Mahmoud’s
hand felt like a velvet glove filled with wool. The little
boy was so weak that his hands and feet did not seem really
connected to the rest of his skeleton. I learned that he had
been born with congenital muscular dystrophy (like his two
year older sister) and lacked the strength to sit without support
- let alone move around on his own two legs. I was, however,
in no way prepared for the question: “Do you think my
children will be dead before they are ten?” As Adeelah
anxiously scanned my face for a hopeful sign of disagreement
with the two specialists who had independently made the same
devastating pronouncement, I found little else to reply than: “Doctors
aren’t God and their diagnoses are not always right.”
I was doing something that gives me more awareness and control over my body.
It's something that works with the whole of me and uses the reflexive nature
of my posture. It's re-educational as opposed to therapeutic and gives me an
actual experience of a new way of using myself. It enables me to discover unconscious
patterns of mis-use, and grow beyond them. It enables me to discover new directions
and repertoires of movement. Sounds familiar doesn't it? I'm talking about the
Feldenkrais Method.
In this article, I will write mainly about Mahmoud, using
his amazing transformation as a kind of case-study, since
he was the only child who received a sufficient number of
Functional Integration lessons from me to make a truly spectacular
difference to his life. For how long, is another question, but during his stay
at the Princess Basma Centre the child himself and his mother were as sure about
the improvement as myself. The tangibly ‘objective’ results – some
actually captured in snapshots which may say more than words – were obtained
during a process of cumulative dynamic learning. This happened in the course
of altogether 9 FI sessions, broken up into 2 batches of 4 on consecutive days.
During the week’s break in between, Adeelah, the breadwinner in her family,
returned to work, leaving her two children in her sister’s care as usual.
She told me later that she could not really afford to be absent from her beauty-salon
in Qalqilia, but had decided to come back for an additional week at Amira Basma
because she felt that my approach was just what her son needed.
I was delighted to see them again since both Mahmoud and his
mother responded exceptionally well to the particular application
of the Feldenkrais Method I had come to explore with the children
at Princess Basma in an informal research project. This approach
systematically employs inflated balls in the somatic dialogue
between practitioner and ‘pupil/patient’ during a FI session. Previous
exploration had brought about some excellent results in my Feldenkrais practice
in the UK, especially with children suffering from cerebral palsy. Similarly,
encouraging results were obtained during several years of voluntary work at a
hospital’s Head Injury Neuro-Rehab Unit and a HEADWAY Daycare Centre for
brain-injured and neurologically impaired adults.
Amira Basma’s director Mrs. Betty Majaj had welcomed my proposed contribution,
intended to complement her staff’s range of skills which had been mainly
acquired through studying the Voijta and Bobath Methods. She decided that my
input would be most appropriate in the Occupational Therapy Department and on
my arrival introduced me straightaway to Basma, Head of the Unit, and her team.
Since everybody spoke English, it was relatively easy to explain how I intended
to use the colourful oval and round balls of different sizes which I had brought
with me as a gift. For the next three weeks I was assigned a number of babies,
toddlers, and older children who were expected to benefit - amongst them Mahmoud.
Most of the kids really enjoyed the sometimes peaceful, at
other times more active and exciting ‘whole-body’ games we played, and soon started smiling,
gurgling, giggling, and laughing, while their mothers visibly relaxed and occasionally
even joined in – some more hesitantly at first, others enthusiastically
from the start like Adeelah. Basma was caught up in administrative work connected
with possible financial support from the Jerusalem municipality, but Lucy, her
deputy, and several other therapists discretely kept an eye on what I was doing
and quickly approved of it. My way of working with the children fitted rather
well into the joint approach of the Occupational, Recreational, and Physiotherapy
Units. The common aim is to provide little patients with ways and means to lead
as functionally satisfying lives as their disability permits, while teaching
the mothers how to interact and play with their children so as to stimulate curiosity
and learning capacity and, most importantly, support them in becoming as independent
as possible. Such intentions are new to many of the young women from the ever
more segregated and underprivileged Palestinian territories where adequate medical
and educational facilities are largely lacking. During their ‘learning
holiday’ at the Princess Basma Centre, the young mothers have a chance
to talk about shared experiences, worries, interests, and aspirations, and to
form friendships which may become a lifeline when left to their own devices again
after they have returned home. Daily contact with a number of staff members with
various degrees of disability (teachers, therapists, technicians, and the secretary
Saida who has been living at the centre since a devastating Polio attack in her
early life) also shows the mothers that their children may one day lead an active,
fulfilling life, even if sitting in a wheelchair.
Many of the little patients arrive in, or are introduced
to, a wheelchair, but leave without. Others learn how to
get about on crutches or with a walking-frame for at least
part of the time. Mahmoud was introduced to these aids
step-by-step, but he also found out things for himself
during our purposefully open-ended, largely self-directed
learning sessions. These gave him ample opportunity to
eagerly – and very intelligently – set about
exploring on his own initiative, occasionally trying to
imitate what he had seen others do. The secret of the enormous
progress he made lay undoubtedly in the fabulous working-playing
relationship between the three of us: child, mother, and
myself. From the start Adeelah succeeded in intuitively
doing just the right thing to encourage her son on the
path to greater independence. At the same time she supplied
me with useful additions to the minimal Arab vocabulary
with which I had arrived. For example “Hassan” (horse)
when her son was bouncing happily on an oval EGGball supported
by a small ball strategically placed between his back and
the front of my body (See photos of Adeelah doing the same).
“Idfa!” (push!) became crucial for Mahmoud’s
discovery that his skeleton could serve him well if he
established an appropriate relationship with the floor
and gravitational force. The inflatable learning tools
were invaluable in this process. Mahmoud’s badly
distorted left ankle, which had been surgically reset soon
after birth, initially only correctly transmitted the impact
of a push from foot to lower leg when his sole encountered
the gently yielding surface of an appropriately inflated
ball, but not when it met something hard like the wall,
floor, or even my shoulder. There the foot and lower leg
usually lost alignment. Even a small round ball made all
the difference though. This gentle little learning aid
proved its worth so consistently that Adeelah asked me
for one to take home and also to let her have a page of
sketches as a reminder of at least some of the ways in
which we had been using the small ball during our sessions
(See examples of such sketches from my notebook). Once
Adeelah had caught the spirit of the Method, coming up
with ideas of her own, her son felt encouraged to make
suggestions too. Already in our first session, while lying
on his back, he got his mother to throw a ball so that
he could kick it in the air and try to catch it again with
his hands. Maybe it was Adeelah who prompted him in Arabic
- but to me it looked as if he spontaneously chose to alternate
left and right foot.
During the first FI lesson we also discovered that supporting
the weight of Mahmoud’s torso with a medium sized
EEGball while his knees, elbows, and forearms were in good
contact with the floor was of great assistance in experiencing
the solidity of the skeletal structure. It only took seconds
for the child to begin experimenting with various ways
of propelling himself forward to get hold of a ball his
mother encouraged him to take out of her hand. In subsequent
lessons the little boy spontaneously began transferring
his weight from right to left knee and elbow, rolling gently
from side to side. This was another crucial weight-bearing
experience.
Our second lesson the following day, took place in the
Physiotherapy Unit, where the therapists were curious to
observe what I would do to help Mahmoud sit up properly
after he had asked for another session with me. We negotiated:
a little work – a little play, including his idea
of throwing a ball into the basket net attached to the
wall (See photo). Halfway through the session he pulled
himself up all on his own and started walking sideways
holding on to the physio-stepping equipment. His mother
translated his triumphant declaration “I am free!”.
Mahmoud’s next feat was even more daring. He had
his mum place a ladder against the wall so that he could
climb up to look out of one of the very high windows. I
couldn’t understand where he suddenly got all that
strength and remained very alert lest it might suddenly
evaporate - especially as he insisted on climbing up a
second time, declaring with pride “I am a man making
a wall!” (See photo. Both jubilant statements struck
me as heart-rendingly poignant, considering Palestinians’ increasingly
desperate situation after voting Hamas into power.) During
the concluding much more ‘contemplative’ part
of the lesson, I caught sight of a young mother playing
with a severely handicapped little girl, who subsequently
turned out to be also extraordinarily responsive to playful
and exploratory intervention. Having got hold of the same
combination of balls as I was using at the time, the young
woman was actually trying to imitate my moves and succeeded
in getting her little daughter to smile happily.
Mobilizing pelvis and spine, releasing tension in the hamstrings
so that Mahmoud found it easier to straighten his legs
etc., became the focus during our remaining lessons: three
of them in the wonderful recently renovated hydrotherapy
pool - mainly because Mahmoud and his mother were very
keen on FI in the lovely warm pool. I could hardly believe
how quickly Mahmoud lost all fear of water, which he couldn’t
overcome completely in the somewhat noisy group-hydrotherapy
sessions. With the pool all to himself and a little coaxing
from his mother and myself, he was soon courageously walking
sideways holding on to a rail and finally crossing the
pool without clinging to my hands, ultimately even relinquishing
the ring he had needed for much of the time (Unfortunately
there is no photo of that stage). While I was beginning
to have had enough, Mahmoud wanted to stay in the water: “I
don’t feel tired!” In the last hydrotherapy-FI
he progressed to pushing himself off the side of the pool
with both feet, happily floating backward without the slightest
fear that I might not be there to catch him. In the end
he kept ducking under and jumping up and down, laughing
and splashing me with water exactly like any child without
his condition might have done.
Just before mother and child left the Princess Basma Centre,
I gave Adeelah the session she had requested. She just
wanted to feel the impact of my work with the small overball
so she could continue it on her own with the help of the
sketches I had done for her. While I was looking for ways
of helping Adeelah to let go of severe tension in her spine,
pelvis, neck, and shoulders, I caught sight of her son
amusing himself on his own. At first he explored walking
up and down a wooden flight of steps, confidently holding
onto the hand rails on both sides. A little later he began
pushing himself around the room leaning over a stool on
wheels (See photo) - until he discovered a pair of crutches
in a corner. Although they were too big for him, Mahmoud
immediately began experimenting how to use them – again
with surprising skill and confidence. Delighted but also
very much on the alert, Adeelah and I decided to conclude
our session so as to be able to jump at the first sign
that the little boy might be in danger of falling. I am
glad that I managed to take a photo before that actually
happened.
During the three weeks I spent at Amira Basma I tried
to give two general introductions to the Feldenkrais Method
and my particular approach which I sometimes call “Air
as a Bridge in Communication with the Nervous System. From
this experience I now know that next time (I was urged
by everybody to come again - and for much longer) I will
need to have an interpreter for those who speak only minimal
English and to limit such sessions to a much smaller group
of interested people who have sufficient motivation and
time to be entirely present. Many members of staff asked
for an individual FI in order to have first-hand experience
of the Method. During the almost 30 sessions I managed
to fit in, I encountered a wide spectrum of people ranging
from Mrs Majaj to the jolly cleaning lady with a stiff
neck. Dr. Waddeh Malhees, the medical director, who could
only spare 20 minutes, told me the following morning that
he had slept better than usual and felt fully satisfied
that what he had heard from mothers and staff was not exaggerated.
George, an initially highly sceptical physiotherapist from
the Out-Patient Physiotherapy Unit, who kept quizzing me
about my qualifications and credentials and asked for “reliable” scientific
research involving “experimental and control groups”,
was amazingly quiet after his first FI and immediately
asked for a second opportunity to experience and assess
this novel approach and its “good movements”. What surprised me most was that all the adults I worked
with – however badly affected by invariably stress-related
aches, pains, breathing disorders, insomnia etc – quickly
returned to a more balanced state of inner calm and outer
relaxation - often within 15 minutes. That takes longer
with my (occasionally severely alienated and fragmented)
clients in the UK – despite the fact that they do
not have to undergo daily humiliations and threats at the
hands of soldiers often half their age as experienced by
all the Palestinians like Basma and Dr. Waddeh Malhees
who live in Ramallah and work in Jerusalem. Having found
out for myself what it means to queue at two checkpoints
twice daily (for hours on a bad day), I am deeply impressed
by the inner ‘groundedness’ and outer discipline
and resilience of the wonderful human beings I met at Amira
Basma who feel treated as third-class citizens in what
was once their country and abandoned by the Western world
whose media they see as portraying them all as “terrorists”. |
 |
