Six year old Mahmoud from Qalqilia in the West Bank was one of the first little Palestinians I encountered at The Jerusalem Princess Basma Centre for Disabled Children, an extraordinary medical-educational complex on the Mount of Olives in East Jerusalem where Muslims and Christians work side by side. Since its foundation in 1964 by Princess Basma, sister of the late King Hussein of Jordan, the centre has gradually grown to its present eminence - thanks to a lot of international assistance and many private donations. Today Amira Basma (as it is called by the locals) houses a school with 450 pupils, a speech therapy unit for 70 children, and an Out-Patient Physiotherapy Unit. The In-Patient Unit for disabled children from the West Bank and Gaza is at the heart of the centre. Its dormitories can accommodate 20 boys and girls from birth to age 15 and their mothers. The length of stay varies according to personal circumstances and what the medical staff deem necessary. In the evening, when everybody has left - except for the nurse on duty and the tiny caretaker, a sweet old lady who locks the doors punctually at 10 p.m. - the young women feel even more at home. Most of them remove their head scarfs and just enjoy each others’ company. There is time to gossip, watch TV, and entertain each other with treats and the occasional little party.

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, 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.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.

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 littlegirl, 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”.

“I am free!” Moments of somatic learning and triumph in a small Palestinian’s hard life by Ilana Nevill

		Intelligent body Flexible mind Appropriate action La Ruzole du Haut--09400 Saurat--France

Feldenkraisnow