Performing Arts Medicine Therapy

Dear Paul,
It is not at all hard to say how happy and surprised I am by your kind gesture. I appreciate you have found time and found it possible to post the articles. When I wrote to you, I really couldn’t have hoped to receive this kind of a gift. I am inspired by the joy and motivation I see in you towards your profession.
Mr I. U. Professional guitarist.  Zagreb, Croatia.

‘Thank you so much for yet another inspiring session with you. I feel I am really getting to grips with the breathing – I practised it on the journey back and it was the least tiring 3 hours drive I can ever remember!’ H. Dyson. Professional guitarist. UK.

Well-being: The Arts and Health Conference, Royal Society of Medicine in London 2005: ‘The remaining musical contribution came from the engagingly articulate guitarist Paul Anders Søgaard, telling the story of his discovery of the benefits of the Alexander Technique…it remained fascinating to see Søgaard’s detailed demonstration, guitar in hand, of just how the principles affect the minutiae of performing. In the course of his lecture, Søgaard also offered a penetrating insight into the musical performer’s psychological attitude to injury.’  Andrew Green, Classical Music Magazine 5 November 2005.

Performing Arts Medicine Therapy takes its name from two different worlds; Music and Medicine. By combining the knowledge of how the brain and the rest of the body work together with the experience of performing, the therapy is directed towards preventing/rehabilitating physiological, psychological and physical injuries.

Movements are directed and created by thoughts. Our reactions to stimuli are based on how we interpret what we feel, see and hear. We choose what that reaction might be and how it may be executed.

To what degree this will be done with maximum efficiency through minimum effort depends on two aspects; firstly, whether our body is alert and in neutral position and secondly, how great is our ability in using our awareness to choose the right movement at the right time based on the constant flow of information we receive as feedback from our nervous system.

Whether you are an Actor, Office Worker, Performer or Teacher it is a powerful tool to create and control your ‘performance’  by increasing your awareness of the use of the Self as a whole dynamic Person.

The therapy includes:

  • Assessment of the muscolo-skeletal system
  • Re-education of postural awareness including head-neck-back relationship
  • Treatment of upperlimp disorders
  • Work Ergonomics—you and your pc
  • Breathing technique
  • Treatment of performing anxiety
  • Recovering from burnout
  • Stress management techniques
  • The importance of exercise

Read about one guitarist’s road to recovery from Focal Dystona:

Case study A (Actor)

Case study B (Guitarist)

Case study C (Business woman)

Case study A 

David came to see me via his parents who were worried that he would have a relapse back to hospital due to severe depression. Having being admitted to hospital several times and on anti-depressive medication for 2 years, David was on the brink of giving up his acting course. His posture and self confidence were so impaired that he hardly dared to look at me first time we met.

Through the Therapy David not only corrected his posture but also regained his former confidence in himself and the world around him. He rediscovered that he could trust himself and  by giving the right commands to his body, direction of his thoughts, he was able to face the challenges of his course; learning how to deal with stress and fatigue. David came to understand the connections between his thoughts and how he interacted with the world, and the effects the first have on the second.

He learnt how to deal with anxiety towards other people and most importantly towards his own Self; that he was not a loser and that his talent as an actor was intact and ready to be explored. David came to understand that life is not an ego trip, but about sharing his art with other people.

As he approached the exam for his degree David took responsibility for his own life, thoughts, actions and received an Honours Degree for his acting.

The Therapy had come to a successful end and David decided to continue his career as an actor with a new belief in his own abilities to create and control his life.

Case study B (Guitarist)

Peter came to see me  via the ISSTIP Performing Arts Clinic with Focal Dystonia on his right hand ring finger. This means that his finger curled up when he was playing and after the string attack he could not release the finger into neutral position.

At the same time he had a very bad posture. He was leaning over the guitar and holding his head in a fixed position always looking to the left side at the finger board. This meant that there was a constant pull on his neck down towards his chest creating neck and lower back pain. Likewise he felt pain in the left arm/hand when playing.  He also spent many hours a day typing on his computer with a similar bad posture and curled up finger. This misuse of his Self together with the Focal Dystonia had a devastating effect on his playing and general quality of his life. He had stopped playing live, composing and recording CDs.

Firstly I made him aware of what the problem was and what he could do to rehabilitate himself. This included a complete re-education of his sensory awareness. The relationship between the head, neck and the back (know as the Primary Control in the Alexander Technique) had to be re-established, so that he could use the feedback from his body to correct any misuse of the body and avoid causing pain in the upper limbs. As his neck became free, so did the rest of his body and he was able to play with greater freedom and less pain.

The right and left arm/hand were also liberated from any unnecessary  pressure on the guitar due to the fact the Peter now was able to lengthen his spine while playing and maintaining a correct posture without dropping his head, but only his eyes to see the finger board.

To release the ring finger on the right hand I first asked him to let the hand flop on the guitar body relaxing the finger after each string attack as slowly as possible so that he could feel and control every muscle and their movement. As he was resting his little finger on the body of the instrument (as a point of contact) I asked him to release it so that he only used the minimum effort for any activity on the guitar. The stroke was changed and divided into two stages; the attack followed by the release and the use of rest stroke was eliminated to avoid keeping the finger in contraction after the attack.

My special exercises using p,i,m and a in all chromatic scales helped him to divide the work load for the right hand and at the same time improved the co-ordination between the two hands.

After two months he was able to play new and old pieces with complicated arpeggios slowly and to release the finger back to neutral state. He was in control of his posture and was more positive about his career and life in general. As Focal Dystonia can take a long time to recover from further therapy is needed to asses the final result from this treatment, but Peter had made a start and his recovery had begun towards continuing his life in music.

Peter came to see me after a month. Though he is not 100% cured, Peter has made some remarkable progress. He is now able to play complex finger patterns with the right hand with musical expression, use of dynamics and at a greater speed. Peter’s freedom of movement when playing has likewise increased together with greater technical control of the instrument. He is far more positive with regard to the future and he has increased his body awareness in relation to holding and balancing the instrument. Peter has also developed a better control of his breathing while playing.

Case study C (Business woman)

I was contacted by a company to help rehabilitate one of their business clients. Jane had a leading role high up in the hierarchy of a  well known mortgage company in the UK. The job carried a big responsibility and she was expected to perform at her very best all the time. She was just about to decide whether to apply for a new job and felt that she lacked the self confidence and motivation.

We talked about the way she used her Self at work and whether she could use less energy by increasing her body awareness while working under pressure. As she spend a lot of time at her desk in front of her computer and in meetings I suggested that we first worked on the ergonomics when she was working at her desk. She discovered that she was very tense and used far more muscles than needed when typing on her PC and that her body was not well balanced which lead to head, neck and back pain.

We worked on her balancing of the head and neck in relation to the spine and shoulders. I gave her specific exercises that she could use at her desk while working to release tension in the head, neck and the back and suggested that she took time to stand up and take small walks around her office to improve circulation and to avoid sitting in the same position for too long.

For her interview I suggested that she worked on her performance. Firstly we focused on her breathing and how to get it under control so that she could feel calm. Secondly we looked at her overall posture while standing and walking. I asked her to visualise herself walking into the room where her interview would take place being relaxed yet focused. The more she could prepare her performance mentally the more control she would get of herself and the use of her body. This would help her in a situation where she would be under pressure to avoid wasting physical and mental energy. By increasing her mind/body awareness and understanding it as a “whole” and not two different parts of her self she became more confident and motivated to pursue a new challenge.