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An interview with a Paediatric Physiotherapist

As in many similar trainings all over the world, about a quarter of the students at the Professional Feldenkrais Training Programme in Santa Fe, New Mexico were physiotherapists. At the end of the final segment in the four-year training process Connie McGhee, who can look back to twenty years of experience in paediatric physiotherapy, agreed to be interviewed and say a little more about an interesting statement she had made in a conversation: "Bobath is like a swimming pool - Feldenkrais like the ocean."

Connie's love for children had impelled her to begin specialising in that field already as a PT student in the late seventies. After graduating with a Bachelor's degree she worked in schools, rural pre-schools, hospitals and state facilities for the disabled. During that time she realized that "there wasn't enough training in PT School to understand normal and abnormal development, to understand all the strategies to facilitate the developing child, the developing nervous system, help this child through with the best possible outcome."

Four years after starting her professional career she therefore decided to attend an intensive NDT training course. Neural Development Treatment, an "American version of the Bobath Method", provides professionals with in depth understanding of normal and abnormal development due to brain damage or "some kind of insult to the central nervous system." While the theoretical part of the course focused on neuro-anatomy and neuro-physiology, the practical part gave students a chance to experience movement patterns for themselves and facilitate each other. Beside the opportunity to observe instructors demonstrate, students also worked with children under supervision.

"This was really the first time I understood normal movement, how normal movement develops and can be facilitated through weight-shifts and transitional movements...

The emphasis in NDT is on the components of normal movement. Understanding these components, As a therapist I could see if a child did not have spinal extension antigravity in sitting for instance - and then how in the world could we expect the child to stand up and walk? It gave me an understanding of the missing parts, if you will, for the child's movement and of giving the child what he or she wanted. . . to crawl, to walk, or to sit up and play. The children all want that, but they can't figure it out on their own because of the insult they had in their nervous system. So at that point my hands were able to start supporting the child through to where the child was interested in going. And then I could make more realistic expectations for the family, for the child, and for myself for the child. Before that I would look at a child and I would go: 'Oh, I see this is a problem and that is a problem, but I don't really know what to do about it...except I could do bracing or other more traditional things'."

A year after the NDT training Connie and a colleague opened their own private clinic in Albuquerque:

"I realized that with this new understanding I didn't want to sit in meetings any longer; I didn't want to do a bunch of paperwork, and I didn't want to be in hospital situations where doctors only wanted to cut kids up. I realized there was this whole understanding available to allow a child the opportunity to move which would give the kid and the family so much more potential for preventing problems. And even if the child wasn't going to be able to walk, the child could drive a power-chair, the child could use a communication device. The child could have the confidence and interaction in the community he or she was in, whether it be home or pre-school, grade or high school. It didn't matter, but with this kind of approach the child finally had the chance to come to having more ability for interaction and communication."

Connie is now in charge of her own recently opened, successful clinic in Santa Fe, where a staff of eight offer Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy, and Feldenkrais. She stressed that she is committed to see and cooperate with parents as partners:

"Why private practices succeed right here and now is because parents realize their child's potential. They don't know how to help their child necessarily, but they can see that their child is a person who has got so much going on and so much there for them. . .and nobody has been able to tap it in traditional clinical settings. Parents would tell me the story of taking the child to therapy and the child crying the whole time. So why would they want to do that when they can take the child to our clinic and the child would be happy, do as much as it could in communication and movement independently and get so much respect?”

A presence without an agenda

To the question whether parents learned with and from her, Connie replied:

"All parents learn by watching…for the feeding, for changing diapers, whatever the situation...Parents actually take the ideas they see with us and they integrate them into their whole life: the way they speak with their child, the way they carry their child, the expectations they have of their child; they begin to be more allowing, more gentle, more respectful. Not that they weren' t that way before, but you know how parents are disappointed when they don't have a normal kid. . . But they have a beautiful child whatever their child is, and they learn to appreciate their child. and it's a beautiful experience we all get.

Parents can learn very quickly, and parents can teach therapists very quickly because they usually know their kids better and that gives us a chance as a team then. . . . The team concept really started making sense to me. The family, the physical therapist, the occupational therapist, the speech therapist, the doctor, the grandparents, aunts and uncles, babysitter, caregiver, nurse - whoever happens to be there in the child's life - we all share information together and give this child the most for the chance to grow. It's kind of been a trend in paediatric PT since NDT and Bobath became more available to people. And it's not just in the therapy world, it's also in the psychological and developmental world. There is a whole change and expansion in understanding how children function and interact and grow, where they find their stability, security, and attachment. I think that there is a tremendous amount of good information now. There is a man named Stanley Greenspan who's been developing an approach to really be with the child, giving a child the opportunity to know that somebody is there listening. Then they have more and more safety and trust and I think that is the nicest thing I have seen so far in my career. This approach to me is more like Feldenkrais because it involves a presence without an agenda."

Connie first became aware of the Feldenkrais Method when she discovered Moshe Feldenkrais's book ‘Body and Mature Behaviour’ in the University of New Mexico Library in Albuquerque.

"I read a little and thought: 'What the heck is that guy talking about? And then, in 1978, Carl Ginsburg came to PT Club and gave a Functional Integration lesson in front of the group and tried to explain what his idea was, and, of course, it was very foreign to us. We had no idea that connecting one body part to another was meaningful. But I had the feeling that was good stuff because it felt good, that's all I can say. It felt safe and it was very gentle and non-intrusive. There was clearly contact on some level that was meaningful."

Connie began participating in Awareness Through Movement classes in the context of Adult Education. Later she invited a Feldenkrais teacher to give classes and workshops for colleagues and friends at her clinic in Albuquerque.

"I knew there was so much value in it but I still didn't have it cognitively. By then I was reading more of the books, but it didn't help me the way I traditionally think about cognitive understanding - linear this-causes-that thinking. Now that I have been to the Training, I think Moshe's thinking is very linear, but he has a very broad base to draw from and infinite understanding it seems."

When Connie moved to Chicago for eight months she took a week-end course with Larry Goldfarb at the Rehab Institute of Chicago. This was an eye-opener for her: “because Larry tried to explain Feldenkrais in the kind of linear way therapists think - not just to limit the explanation that way but to give us the experience and to give us more broad information to work with. It was a very good combination and then I knew it was the most important thing I would ever meet, and I needed to do it some time. "

Eventually Connie ended up in Santa Fe, New Mexico, and in 1993 received information that a Professional Feldenkrais Training was going to start there the following year - with Carl Ginsburg Ph.D. as Educational Director. "I knew I wanted to do it... and there was in my mind no way I could do it, no way I could afford the tuition." Watching a PT colleague, who had already qualified as a Feldenkrais Practitioner, work very briefly with one of her little patients was a decisive experience: "My little girl did more in five minutes with B's hands with her than I had seen her do in four years! So I just went: Forget it! I have to do this! ...So then I managed... and I have a lot of debt now. But it's all been worth it!"

The most valuable, personal thing I have ever experienced

Asked about the benefit of the four year training process for herself personally, Connie had this to say:

"I have been thinking about this every day since I started the training, and right now it's even bigger. I think that the main value I have from this work is more chance to be with myself, in myself, be myself, however you want to think about it. I feel like I am getting to know myself in a way that I enjoy myself more, enjoy other people more. But you know it's also just to value sensation, not to diminish it. As I grew up - not only as a kid in a family, but also as a person in this culture and a student in PT, and then as a physical therapist - I don't feel we were ever encouraged to appreciate ourselves, our sense of our being, and then to be able to share that with another person to the degree Feldenkrais has allowed me to do. To me that is the most valuable, personal thing I have ever experienced, and will experience for the rest of my life!

In my work with the kids it's the same thing. I can appreciate them, I can appreciate the nuances of how and where - when the child has an intention - they stop themselves and where I can be present to help them be more successful with their intention, to show them in their body where they do not have to hold in a certain way, where they can actually move. It's a tricky thing because with children with muscle tone problems and a long history of moving in a certain way, it's a way of being present with the child and showing them at the same time a movement possibility that is of interest for them. It was always in their intention but not in their ability. They hadn't formulated the steps to reach that..."

Did she find her little patients responded differently compared to when she worked with them from a more traditional PT vantage point?

"It's like a black and white difference. Once I had NDT, I think I moved into the gray area… Some of my therapy friends tell me my handling looks no different from ten years ago, but it feels like an entirely different experience to me. The kids respond more comfortably, more pleasurably than ever...

The reason I came up with the idea that Bobath is like a swimming pool and Feldenkrais like ocean was, 1 think, because when I was lying down on the floor in class going through an Awareness Through Movement lesson and was given the chance - with very little verbal direction or suggestion - to sense myself, then I was able to open my sensing almost to an infinite capacity…not to the point of chaos and too much though, but just to where I am and what I am doing. And that is so much! It's such an infinite amount of information. It didn't just open up my sensation of my muscles and my movement. It opened up my sensation through my vision, through my hearing, through my taste, my smell, and through my touch ... everything.. .also my thoughts. My thoughts were more open and more receptive to myself. "

Also clearer?

"No, at least not in the beginning. I felt like a nut-case because I wasn't familiar with this process, this way of being. "

A sense of - oh, I don't know - a peaceful sense, a sense of allowing

Comparing the Feldenkrais experience with that of NDT, which felt safer because it was more directive, Connie stressed that she considers the Bobath approach a very good beginning for therapists:

"A very good beginning to understand normal movement patterns, and to understand how to facilitate or inhibit a child or a person help them with the tone that kicks in which they don't know how to control, and to help them gain tone or gain feeling where they need it. The teaching is very good, the idea is very good. It's really very similar to Feldenkrais. But what I also found is that I felt lack. I felt lacking in my sensibility for a child, with a child. And I knew - I can't tell you why I felt this - there was more to know.

When I started taking ATM classes in Albuquerque, I felt that difference which I was 1onging for, if you will, because I felt it in myself and then, when I touched a child afterwards, I had more sensitivity… I knew the process that Feldenkrais offered was different from NDT. I wouldn't want not to have my NDT, I want both. One is a very clear understanding from where medicine is right now, and understanding of normal and abnormal development. Feldenkrais gives me the extension of that - to understand myself in movement, experientially, in my own sensing, so that I can give that, share that with another person… We were talking about truth in class recently. There is something about when something is right, real, and you don't really know what all that is, but you know it in your being. I have had more experience of t h a t in my being, and so when I touch another person I am able to have a sense of - oh, I don't know - a peaceful sense, a sense of allowing. The word I think of that feels right for me is allowing: not having the limitations I used to have limit that person, or limit my perception of that person - which maybe limits their perception of themselves and their experiences... I guess Feldenkrais has given me a tremendous amount of patience:"

The shift from the 'security' of habitual limitations in thinking, sensing, feeling, and acting to an initially unfamiliar openness, allowing, and patience happened gradually during four years of training. Now, at the end of that process, Connie could affirm with a big smile that she has finally understood the Feldenkrais process: "For the first time.. so clearly and so peacefully and safely actually, now that I got used to it! It's also so enjoyable! And when I am able to give this to a child or to anyone I touch now... I feel anybody, the whole world, can benefit. When we take away these limits we all let go, because we get safer and safer just being and we get closer to the truth of whatever that contact level is."

This interview with Connie McGhee was conducted in Santa Fe on 26.9.1997 and subsequently transcribed and edited by Feldenkrais Practitioner/Assistant Trainer Ilana Nevill Dip.Ed.