The hand as the human outer brain

 

The hand as the human outer brain

By Margaret Kaye, October, 2015
originally published in Feldenkrais Australia, Journal of the Australian Feldenkrais Guild, October, 2015

Kant called the hand the human outer brain, and psychologist Revesz thought the hand is frequently more intelligent than the head. Our hands are often the first point of contact with our environments, and movement with our hands a primary way of communicating.

Ashley Montagu
, Touching : The Human Significance of the Skin

Moshe Feldenkrais liked to open a public workshop with a hand Awareness Through Movement® lesson, such as the Bell Hand. My understanding of this lesson is it is based on primal movements of the hand. The folding and unfolding has more significance than the mere capacity of the hand. The sensory cortex of the brain has neurons that identify areas of the body being stimulated from somatic receptors in the skin and proprioceptors in the skeletal muscles. The representation or map of the body is called the homunculus, or ‘little man’. In it, the ‘body within the brain’, the representation of the hands is, as a percentage of the brain, huge. In this way Feldenkrais believed we could access a large part of the brain very quickly.

If I ask you to do nothing but notice your hands, they will feel larger, warmer, more vital. If I ask you to do no movement, but to notice your little finger on your left hand, it will feel something else again. We’ve now engaged a large part of the brain.

Or how about this: interlace your hands together. It’s possibly a familiar feeling. Now notice which thumb is on top. And which little finger is below. Unravel them, and interlace them the other way, so the opposite thumb is on top, and the other little finger. You know they are your hands, but they feel so unusual. It’s as if someone else is holding your hand. But it is yours. I hook cynics in every time with this experience. They’re ready to learn.

My fascination with hands came originally from my own dilemmas. When I began to work as a Feldenkrais practitioner, I was unable to do Functional Integration in many of the ways we were taught. My hands were still painful and hyper sensitive from a condition so severe I was told I could never work again. My repetitive strain injury was lessened, but I still had to find a way. There was no way I could lift limbs and shuffle trunks. I had to learn how to affect people’s sense of self without doing myself harm. I had to work with my hands, and find out how my body could get behind them. That’s always the dance.

So how can we think about the hand?

  • anatomically
  • functionally
  • developmentally
  • posturally ( the kind of grasp for example)
  • symbolically (think of handshakes, and prayer poses)
  • gesture
  • emotionally
  • and in relationship to human thought, growth and creativity

There are so many ways. In this article I explore some of these concepts with case studies.

 


Theo, and his helping hands

In this case study I hope to illustrate how engaging the use of hands in space and in the environment can elicit the freedom of movement and perhaps even voice.

A six year boy I see, ‘Theo’ who has a severe form of cerebral palsy, is kept in a wheelchair for most of his waking time. When I met him he spent most of his time on an iPad with a touch screen on his lap, and was able to swipe with his index finger for screen interactivity. Theo was unable to raise his head, to interact visually with people when they were in his vicinity, and had no verbal skills.

The only vocalization I heard was him crying.

We may be familiar with the movements of the hand, but the link to expression and communication is profound. It is summed up beautifully in the book The Hand by neurologist Frank R. Wilson.

‘Somewhere between 18 months and two years... the eruption of mobility gesture and verbalism(are) an incomparable moment in human cognitive life and in the genesis of human consciousness.’

My priority was to find a way Theo could move from what seemed like permanent flexion and activate his extensors. Then when I came to visit he would lift his head and stare me in the eyes.

Once he was able to raise himself, we could play with the use of the hands. We spent a long time enabling his capacity to grasp objects, cross the midline, and contact between the left and right hand. We did this with Aboriginal clap sticks. We gurgled and laughed together. As we worked he would begin to verbalise, in his own way, his interpretations of his experience. I don’t know if it had anything to do with the rhythm of the sticks, his hands or whether he was going to get there anyway. Whether this was coincidental is not clear to me.

The confluence of gesture and speech is quite specific according to Dr Susan Goldin-Meadow. In her book Hearing Gesture: How our hands help us to thinkiii, she suggests that the movement and gesture of the hands and the rhythmic pattern is a key mechanism that launch the process for human language acquisition. This was certainly my interpretation of Theo’s increased ability to babble with me. His language may not have had specific meaning to me, but it certainly did to him.

The other day when I saw Theo at school his hands were in splints to differentiate the use of the thumb, which is chronically flexed. I removed them and placed him on his belly. He had forgotten how to raise himself and collapsed on the ground. Here's how we got him to do it himself: just by showing him he could weight bear. He was able then to use his hands push down and so to lift his head up high to see the world. If we were to think of an Awareness Through Movement lesson that fit the work we did it may be the Active Dominant Hand, exploring the opening and closing of the hand in various positions. We then put it into practice, in relation to the physical world of the school floor. With Theo those positions were all about engaging with the world. In this context the use of the hands were an essential part of this small boy being able to organize his own weight shift, but more importantly to organize his self-image as an individual with capacity in the world.


Alison and her frozen shoulder

My work with Alison elucidates how the hand can be a conduit to other parts of the body. The freeing of the movement of the hand can enable the rest of the body to be without pain.

Alison is an academic, who sits at the computer a lot, and fits into the main demographic of people who get frozen shoulders: Women over 40.

There’s that beautiful Awareness Through Movement lesson called the Bell Hand, but in a one-on-one session I also make it available as the ‘ball hand’. At the conclusion of a range of movement strategies, the take-home exercise is quietly rolling the hand on a tennis ball, in specific ways We sneak up on the shoulder without directly working on it (at least to start with). It’s fun and not painful. If we work with pain, we’ll be telling the body that it needs to protect itself, and that just means limited action. If we work without pain, we feel free to learn to move differently.

 

 

 

So what did we do to get there? Unlike some other lessons where we focus more on the whole movement patterns of the person, this time we focused on the movement of the hand, and implicitly the arm, and shoulder. Any endeavours, at least in the beginning to work in the symptomatic area, were useless. This is a classic strategy of working distally and integrating to a proximal action in order to influence the self-image.

Within six sessions Alison was able to reach above her head. I must confess some of my colleagues did not believe this could be possible.

Here’s what Moshe Feldenkrais has to say on it:

Functional integration turns to the oldest element of our sensory system – touch, the feelings of pull and pressure; the warmth of the hand, its caressing stroke. The person becomes absorbed in sensing the diminishing muscular tonus, the deepening and the regularity of breathing, abdominal ease, and improved circulation in the expanding skin. The person senses his most primitive, consciously forgotten patterns and recalls the well-being of a growing child.

 Alison’s take home exercise was to quietly roll the ball, enabling pronation, and supination, flexion and extension. Every joint in the hand is woken. And more. Her self is enabled.


The cellist with focal or musician’s dystonia

This case study demonstrates how small integrative actions can the affect the disjuncture between desire and ability.

Emma is a professional cellist who described her fourth finger on her left hand as weak. She had tried various exercises to increase its strength, but it continued to inhibit her playing. I watched her playing and it was clear the finger was dystonic.

Dystonia is an imbalance of muscle firing (too much tone or too little) resulting in stiffening, involuntary movements, and inability to control the movements.Her finger was responding with reduced rapidity and visibly shaking while she tried to reach to press to the string.

Dr. Nancy Byl, PhD, PT, Professor and Chair of the Department of Physical Therapy and Rehabilitation Science at the University of California at San Francisco trained several monkeys to work for their supper by making them do repetitive hand movements. After several months they became increasingly reluctant to use their hands and showed signs of stiffness, clumsiness and pain. She believes that the monkeys lost their ability to identify which finger was which, that their brains were unable to make the distinction or map the fine finger action.

So it was with curiosity that I gave Emma a Functional Integration lesson, while she was sitting, her left hand in my hands. We explored the movement of her hand in various ways, including the detail of finding a way where each fingertip easily came to the thumb. More, it was finding out what action could be elicited through the nervous system to engage different organisation of the tiny joints, tendons, muscles and skin.

 

 

It’s rather like the Awareness Through Movement lesson "Surgeon’s Hands", but in Functional Integration format, and with only the one hand.

Byl subsequently developed the Practical Guidelines for Sensory and Selective Sensory Motor Training which have as the primary goal the restoration of the somatosensory representation of the hand and normal fine motor control.

Three main ways she recommends are:

  1. Identify everything about the surface of the instrument, eyes closed..
  2. reflect back to the time when the hand was working normally
  3. constantly remind [yourself] how easy it was to do the task, how warm the hand felt, how each individual digit felt absolutely controlled...and how coordinated the hand felt.

We did not specifically follow any of the actions suggested in Byl’s guidelines, but I suspect simply sitting in the context of playing the instrument, before and after, fulfilled them.

I’ll let Emma describe the result:

‘Margaret worked with me for only a short time, yet my finger, and my hand in general, feels massively stronger and somehow more whole. The subtlety of (the) work goes far deeper than any other treatment I have had. The difference to my playing is profound. I have more vigour in my hand, all fingers work evenly and, most importantly, I am now able to fully express my musical desires.’


 

Conclusion

I have barely ‘touched’ upon many of the fascinating attributes of our humanness and the meaning and intelligence that our hands contribute to that. Suffice to say that if we do consider the hands to be the outer brain, then this may well indicate that our brains are visible, kinesthetically available and not just an interior concept. The relationship of this to the breadth and development of our self- image, and our capacity to learn is vast.

Just recently a friend of mine had to go to hospital for surgery. She told me while in recovery that while she was drug induced, in pain and in distress, just out of surgery, the nurse sat with her and held her hand. It was an enormous gesture that filled her whole body with warmth and calm and comfort. ‘I’d forgotten the significance of the holding the hand,’ she said.

I’ll hand it over to you for now to explore those ideas more. I invite you to hold someone’s hand and feel what you can do with that.

About Margaret Kaye

Margaret Kaye has run an active Feldenkrais practice in Australia since graduating from the Melbourne training in 1991. She is a Certified Feldenkrais Practitioner, an Assistant Trainer and a Bones for Life teacher.

As well as her own regular classes she also runs classes for an organisation that specialises in providing exercise for older people. She runs corporate programs including the Smart Sitting© program; the Leadership and The Body program and the Running Easy program.

Margaret runs a series of post-graduate Feldenkrais Trainings on the topics of the function of the hand, arms and shoulders, called The Hand, Arms In Acture, and Active Sitting. She recently released recordings Sitting Easy, Sleeping Easy and Running Easy. Margaret also works with performers, such as actors, musicians and athletes.

References

The Human Significance of the Skin Ashley Montagu. 1986

Cortical Homunculus- Click to see wikipedia article  

The Hand Frank R. Wilson. 1998

Hearing Gesture: How our hands help us to think, Dr Susan Goldin-Meadow. 2005

The Elusive Obvious: Moshe Feldenkrais 1981

Dr. Bly's work was noted by Barbara Conable in How To Resolve Dystonias: A Movement Perspective) http://bodymap.org/main/?p=226.

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Study-FM and Parkinson's

The following was from MedScape, May 28, 2015. I will re-edit it to make it more readable to the regular reader. --rob

PALM SPRINGS, California — An exercise program based on the Feldenkrais Method can improve the mood and quality of life among people with Parkinson's disease, a new study shows.

By damaging neurologic functioning, Parkinson's disease often diminishes quality of life and leads to depression.

"The Feldenkrais Method uses easy movement and breath control and flexibility and balance to facilitate more control in the whole body," said first author Lavinia Teixeira-Machado, PT, PhD, from the Education in Health Department, Federal University of Sergipe in Sergipe, Brazil. "I use it in cerebral palsy, autism, and Down syndrome."

"We reduced the isolation," said Dr Teixeira-Machado toldMedscape Medical News. "It's very interesting."

She presented the finding here at the American Pain Society (APS) 34th Annual Scientific Meeting.

Whole-Body Exercise

To see whether the Feldenkrais Method could help with Parkinson's disease, Dr Teixeira-Machado and her colleagues administered the Mini-Mental State Examination (MMSE), the Parkinson's Disease Quality of Life (PDQL) questionnaire, and the Beck Depression Inventory (BDI) to 36 people with Parkinson's.

They excluded four people from further study because of cognitive impairment, cardiopathy, or advanced impairment. Two others declined to participate.

The researchers then randomly assigned 15 of the patients to instruction in exercises based on the Feldenkrais Method. The remaining 15 got educational lectures. Both groups attended 50 one-hour sessions, with two sessions given per week.

The patients had an average age of 61 years, an average weight of 64 kg, an average height of 159 cm, and an average body mass index of 26 kg/m2. These measures did not statistically significantly differ between the two groups.

The groups were also statistically similar at baseline on the Unified Parkinson's Disease Rate Scale Part III (UPDRS III), the MMSE, and the BDI.

After the 50 sessions, the researchers tested the patients once again on the PDQL and the BDI. The group receiving Feldenkrais instruction improved significantly on both quality of life and depression while the control group got slightly worse on both scales.

 

The change in the Feldenkrais group compared with baseline was statistically significant for both PDQL (P = .004) and BDI (P = .0005).

The differences between the Feldenkrais group and the control group were also statistically significant for both PDQL (P = .002) and BDI (P = .05).

"People with Parkinson's have all kinds of trouble with movement, so if we can modify that it would be great," said Kathleen Sulka, PT, PhD, a professor of physical therapy at the University of Iowa in Iowa City.

 

But other exercise programs have also proved beneficial for people with Parkinson's disease, she said, so she would like to see a larger study in which some patients practiced the Feldenkrais Method and others practiced different exercises.

"I see this as a wonderful pilot study," she told Medscape Medical News.

The study was funded by Conselho Nacional de Desenvolvimento Cientifico e Tecnológico. Dr Teixeira-Machado and Dr Sulka have disclosed no relevant financial relationships.

American Pain Society (APS) 34th Annual Scientific Meeting. Presented May 14, 2015.

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Our computer Brain-or is it?

computer brainAbout a year ago,  Gary Marcus wrote an article for the New York Times titled,  Face It, Your Brain Is a Computer. Dr. Marcus is eminently qualified to present this perspective as he is a professor of psychology and neural science at New York University, and the editor of “The Future of the Brain”.

He opens his essay, 

SCIENCE has a poor track record when it comes to comparing our brains to the technology of the day. Descartes thought that the brain was a kind of hydraulic pump, propelling the spirits of the nervous system through the body. Freud compared the brain to a steam engine. The neuroscientist Karl Pribram likened it to a holographic storage device.

Many neuroscientists today would add to this list of failed comparisons the idea that the brain is a computer — just another analogy without a lot of substance. Some of them actively deny that there is much useful in the idea; most simply ignore it.

He argues, "Too many scientists have given up on the computer analogy, and far too little has been offered in its place. In my view, the analogy is due for a rethink."

(click to read his essay)

 

This week we have another essay, this one  by  Dr. Robert Epstein, who attempts to convince us that 

neuron soup?Your brain does not process information, retrieve knowledge or store memories. In short: your brain is not a computer

Robert Epstein is no slouch. He is a senior research psychologist at the American Institute for Behavioral Research and Technology in California. He is the author of 15 books, and the former editor-in-chief of Psychology Today.  You'd think we should listen carefully to him, with these kinds of credentials.(click to read his article) . But read on. We're not in Kansas anymore, Toto.

 

But his article seems to have generated a lot of argument. It's kind of like angry bees.

wigglythingSoon after, Sergio Graziosi had a delightful review of the the flaws, titled, Robert Epstein’s empty essay. (click to read). 

Sergio seems to have a very broad background and seems to be particularly motivated to debunk anti-science or shallow-science articles. He has some very interesting points to counter the arguments of Dr Epstein. To clarify his mood in writing the article he says, 'Sometimes reading a flawed argument triggers my rage, I really do get angry, a phenomenon that invariably surprises and amuses me. What follows is my attempt to use my anger in a constructive way, it may include elements of a jerk reaction*, but I’ll try to keep my emotions in check."

Julie Lee

The next article is by Julie Lee, a PhD student in Neuroscience in UCL. In her blog, titled, "The Not-So-Empty Brain, or Lessons Against Confusing the IP Metaphor. Julie's review is more of an analysis of the faulty logic in Epstein's article. It has some good points, and is worth a read (click to follow).

She summarized her thoughts as: "Epstein’s well-publicised argument is poorly argued as it conflates two orthogonal stances, (1) the information processing metaphor, and (2) the very much non-metaphoric computational theory of mind. Even if these were the same, Epstein frequently contradicts his anti-representational stance with logical inconsistencies. "

 

jeffThe final article gets back to the computer-brain conumdrum, and si titled, "Yes, Your Brain Certainly Is a Computer" Jeffrey Shallit opens his article with a conversation:

- Did you hear the news, Victoria? Over in the States those clever Yanks have invented a flying machine!

- A flying machine! Good heavens! What kind of feathers does it have?

- Feathers? It has no feathers.

- Well, then, it cannot fly. Everyone knows that things that fly have feathers. It is preposterous to claim that something can fly without them.

Shallit pulls no punches. "The most recent foolishness along these lines was penned by psychologist Robert Epstein" and finished with, 'I don't know why people like Epstein feel the need to deny things for which the evidence is so overwhelming. He behaves like a creationist in denying evolution. And like creationists, he apparently has no training in a very relevant field (here, computer science) but still wants to pontificate on it. When intelligent people behave so stupidly, it makes me sad."

In between are some interesting arguments as well as some irrefutable truths. Also particularly interesting is the comments after his article. (click to read more)

Dr.Shallit is a computer scientistnumber theorist, a noted advocate for civil liberties on the Internet, and a noted critic of intelligent design. He is currently a Professor in the School of Computer Science at the University of Waterloo and is a Distinguished Scientist (2008)

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Parkinsons Disease and Feldenkrais

Many people with  Parkinson's Disease are finding that the Feldenkrais Method can be a useful way to find new ways to regain movement.

Ernie Adams wrote, "For a person with Parkinson’s Disease (PD), the natural rhythm and flow of perception, feeling, and movement is disrupted. There is a disconnection between the intention to move and the ability to start or complete an action. Routine automatic behaviors, such as those involved in walking, speaking, breathing, swallowing, and facial expression, become difficult or unavailable." 

He continues, 

Many people with PD are frustrated with the typical generic prescriptions of “exercise therapy’,’ “fall prevention,” or “gait training,” and want to find additional ways to help themselves. There has been an upwelling of political advocacy and fund raising in the last few years to increase research and awareness of PD by nonprofit organizations, such as the Michael J. Fox Foundation. Complementary medicine and mind-body approaches, such as the Feldenkrais Method, are becoming more widely recognized as significantly beneficial to people with both orthopedic and neurological conditions.

The Feldenkrais Method influences brain and behavior through a learning process involving movement exploration, trial and error, and problem solving. With the Feldenkrais Method students develop their ability to attend to internal (proprioceptive ) as well as external and environmental feedback. Children learn to lift their heads, crawl, roll over, sit, stand, walk and talk using this same process. Rather than “correcting” or “showing’’ the student how to do something, the practitioner presents possible choices that may help the client solve the problem for herself or himself. These ‘choices’ are carefully designed movement sequences that can be adapted to the student’s specific needs. The student decides what feels right and what works. It is a self-organizing learning process, rather than a prescription to follow a generic exercise regime. The Feldenkrais Method offers persons with Parkinson’s Disease a way to discover and implement action patterns that can enhance functional ability. It will be different for each student. The goal of the practitioner is to create the optimal conditions for learning. (click to read more)

Parkinson's Recovery - Irene Pasternack

 Irene Pasternack speaking at a Parkinsons Recovery conference

A short (3.5 minute) video version of the presentation can be viewed  -- click the yellow square.

In 2010, Irene Pasternack of Seattle spoke with a radio program on Parkinson's Recovery. In this program  she describes how you can use the Feldenkrais Method to improve your balance, prevent falls, cope with freezing, maintain facial mobility, speech volume and swallowing, and find greater comfort and ease in day-to-day activities.

The show includes a short Feldenkrais lesson to improve posture, comfort and stability in sitting. In addition to making you feel more comfortable, this lesson helps improve the mobility of your neck, head, and eyes, and has a direct impact on your balance in standing. (The broadcast is 89 minutes: click to go to the page and hear the presentation)   

 Matt Zeppelin of Denver has been providing support for persons with Parkinsons for some time, including a 4-hour workshop. On his website he has audio versions of the four lessons in the recent workshop. He writes, "The lessons build on each other thematically, and you may hear me make reference to a prior lesson from time to time, but they are also intended to stand alone." Click to go to his website.

 

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