This article was originally published in Positive Health issue 59 – December 2000

How do you know if a treatment is working? Can you tell if you are feeling better or not, better or worse? Although the answer seems obvious (after all, it is your body), relying on how you feel may not be a good indicator of your progress towards health.

First, getting better is not always, at least at the beginning of the treatment or re-education, associated with feeling better. The road to recovery is often paved with discomfort, aches and even pain; it is also a long road. Nature is not a sprinter: it works slowly and cannot wipe out the effects of years of misuse overnight. The longer established the misuse, the more time it will take before you can register an unmistakable sense of well-being. Always beware of the quick-fix, the instantaneous ‘cure’, because even if the cause(s) of the trouble were removed all at once, the body still would have to ‘lick its wounds’ and heal the scars of misuse or injury.

Having said that, if, during your treatment, you don’t feel aches and pain, it does not automatically mean that you are not getting better. It just depends on your condition. One thing is sure though: you should feel different. And even just feeling different can take time.

In some cases, in spite of obvious external signs of changes as, for example, when the physical form has been improved, the corresponding feeling is absent, not registered. The senses are blunt, deadened and need awakening.

This brings us to the second point of our topic. Ill-health, dysfunctioning and disease are always associated with a faulty sensory appreciation, especially when the problem predominantly affects the musculoskeletal system. In these conditions, our kinaesthesia (the sense that enables our brain to be aware of the varied positions and movements of the different parts of the body and its muscles), is like a distorting mirror: it does not present a faithful reflection of reality. In other words, what is correct and right might be felt as wrong and vice versa. Practically speaking, it means that you can have a crooked body and feel perfectly straight. Let your body be more or less straightened by the skilful manipulations of a therapist, and you will feel all crooked. You can imagine, in these conditions, how difficult it is to know if you are getting better or not.

The untrustworthiness and unreliability of human kinaesthesia has led some therapists to decide for their patients how well they are feeling. Some of these therapists seem gifted in mathematics or statistics if one judges by the ease with which they drop figures.

Without any support from specific tests or a rigorous scientific methodology, they are in the habit of telling their patients at the end of a treatment: “Now, you are 70% (or 80, 90…%) better.” Most patients like this kind of talk. They like to be told and to believe how much better they are and are easily impressed by figures, even if these numbers come from nowhere and are totally arbitrary.

Unfortunately, when the treatment is not aimed at the removal of the cause(s), the proudly announced percentage of betterness only serves to delude the patient. The impressionable patient’s brain is left a blank concerning causes but has been under the power of suggestion that all is better.

FM Alexander was the first one to address the problem of unreliable sensory appreciation seriously. In Constructive Conscious Control of the Individual (Gollancz), talking about breathing exercises, he says that: “It may be argued that, as the result of the lessons, the pupil’s chest measurements are increased, that he ‘feels better’, and so on.

We are quite ready to admit that this may be so, but owing to the unreliability of his sensory appreciation, what he feels is as likely as not to be a delusion…It is only a matter of time before the unfortunate pupil will be awakened from his dream by discovering that he has developed certain other serious conditions.”

Another author who has something interesting to say in relation to our topic is Thérèse Bertherat. She is known in Britain for her bestseller The Body has its Reasons. But she wrote other books, all of them about Françoise Mézières’ discoveries. In Courrier du Corps [The Body Mail], her second book, she casts a critical eye over some forms of bodywork. She describes an exercise devised by Moshe Feldenkrais where the pupils are told to lie down on their front and, from this position, to lift and move the head in various directions. She remarks that this exercise can only contract and shorten the back muscles – muscles that are in any case always too short. Yet, after this exercise, Feldenkrais asks his pupils to lie on their back and “…to appreciate how longer, and flatter against the floor are their backs. But it is not, it cannot be, it’s anatomically impossible. It’s the front part of their bodies which may have lengthened, but the pupils, under the effect of suggestion and because they have difficulty in distinguishing between the sensations coming from the front and those coming from the back, are under the illusion that their backs have lengthened.” To be fair, I must say here that Bertherat does not contest the whole of Feldenkrais’ work, and that she finds some of his exercises useful.

Our kinaesthesia is a crucial ‘instrument’ for judging reality since the observer conditions the observation. With a faulty sensory appreciation, kinaesthetic illusions and delusions abound. When both patients/pupils and therapists are deluded, the blind is leading the blind and progress towards health is arrested. Re-education of our faulty sensory appreciation is vital to any health plan in order to cultivate a highly sensitive and intelligent body that can distinguish between ‘right’ and ‘wrong’. The moral of this story is: before feeling better, you have to develop better feelings.