It's a long way to the top and other lessons in humility...

A conductor is certainly a specialist, but there is a very big difference between being a specialist and being an expert - and I love that difference.  I specialise in teaching people with neuro-motor disorders strategies and skills to enable them to manage their bodies better.  I don't make up these tricks and techniques, they are not my intellectual property - and I see my role, my specialty, as being able to articulate and share these solutions as openly and as freely as possible, and to facilitate the process of sharing and tweaking solutions that have worked for other people with similar challenges.  I have learned some of these tricks from other conductors, but most have been learned by being a partner in a problem solving process with an individual, and more often by letting my clients teach me the tricks they have worked out for themselves.  This means that the expertise and success are not mine; it means that I am teacher-learner combined, it means that I'm always on the lookout for new tricks to add to my repertoire and therefore always open to learning and growing, and it means professional humility is a part of being a conductor and I love that.

Lessons in humility come packaged in many wonderful formats.  Last week BC, a private client decided to stop training with me.  BC is a woman with advanced Parkinson's who started training with me because she was having frequent falls and trouble getting out of bed.  After a few weeks of private in home sessions she had mastered the tricks and techniques we had been working on to the point that she is no longer falling and can now get out of bed unassisted, and she no longer needed me to come to her home and practice with her.  I could choose to dwell on not being needed - but in reality no longer being needed is the best possible outcome and I'm celebrating. Conductive humility means knowing it is not about me - and that it never was - and there is nothing better than being around somebody who learns something and stepping back to let them own it.

Lessons in humility are sometimes delivered by posties on motorbikes. RP is a stroke survivor and a Harley Davidson enthusiast who has set up a rehabilitation space in his garage with parallel bars and steps - a dream workspace for a mobile conductor.  Last week while I was there working with RP, the postie - a big burly guy on a motorcycle - came up the long driveway to deliver the mail.  This week the same postie came up the driveway on his motorcycle. He had no mail to deliver, just wanted to tell RP that a few years ago he had been in a bad motorcycle crash resulting in a brain injury, and despite what everyone told him he was now walking again, and was back on his motorcycle, and that RP shouldn't give hope.  That day, for the first time, RP and I walked all of the way down and all of the way back up his long driveway.  This week RP did it again, twice in one session.  Conductive humility is being able to celebrate that after months of RP and I working towards something together and of me encouraging and teaching RP, what got him over the hump was a burly postie on a motorcycle and his heartfelt act of kindness. 

It's a long way to the top - but he made it!

Is it CE? YOU tell ME!

When people ask me what a conductor is, I usually say something along the lines of "a conductor is an educator and re/habilitation professional that specializes in teaching movement strategies and skills to people with neuro-motor disorders such as cerebral palsy, Parkinson's Disease, stroke, acquired brain injury, MS".  Who am I kidding - I don't usually say that, I always say that.  Sometimes I substitute "disabilities caused by conditions like..." for "neuro-motor disorders such as...", but the limited list of conditions and the automated emphasis on movement strategies and skills is always the same and I no longer really believe that this is what a conductor does.  People rarely ask for more details - let's face it, that's a pretty good small talk conversation killer - and I am left with this empty feeling of a missed opportunity to elevate Conductive Education (CE) by talking about the subtle but essential and  essentially human aspects of what I do beyond teaching movement -- the conductive magic -- and its applications beyond the motor disordered population.

Wait a minute - so am I saying that CE is not about teaching movement to people with motor disorders?  Yes - sort of.  In traditional CE people with motor disorders come to learn to move better and on the surface the obvious skills and strategies being learned are motoric.  And yes, I certainly spend the bulk of my time working through movement and teaching movement strategies and skills, though I do not limit myself to working only with people with motor disorders.

However, teaching movement is only the obvious 'on the surface' part of what CE is, of what I do.  Below the motoric exterior, psycho-social change - conductive magic - is happening, not accidentally, not as a side bonus, but as part of my what I am purposefully trying to do, as part of what conduction is.  The movement and the magic are intricately tangled and inseparable.  It doesn't feel like CE unless that conductive magic is there too - those changes that happen under the surface when somebody starts to have hope, have confidence, to connect, to think differently, to believe in themselves, to problem solve, to be positive, to be willing to try.  Those changes don't always happen, even when somebody successfully achieves a movement related goal.  And -- perhaps more tellingly -- those changes sometimes occur even when somebody does not achieve their movement related goal, and these changes may in fact actually be pre-requisites for that person's success.

When that conductive magic is there, regardless of the person's diagnosis or lack thereof, it feels like 'we are doing CE'.  Let's push the boundaries shall we -- here are some examples.

Of all my clients, LE is the one that I feel most conductive with.  LE is 46, rather autistic and rather prone to anxiety.  His mind imprints memories and experiences differently to how yours or mine does.  This makes it really difficult for him to un-learn or un-associate experiences that leave a mark, particularly negative experiences such as a recent fall on a slippery surface.  He also has vertigo -- so understandably going down escalators is a major trigger for his anxiety, especially considering he is looking down at his feet to avoid tripping or slipping.  LE's carers and family were finding it impossible to take him on recreational outings as the panic attacks (which included screaming, crying, and repetitive self injuring at the top of escalators or on reflective floor surfaces) were becoming unmanageable; LE was becoming more isolated and depressed.  My role is to help him regain confidence walking around the local shopping centre and on the escalators so he can resume going on recreational outings.

Through strategic trial and error LE and I have worked out a system for managing escalators and shiny floors.  We choose a landmark on our approach to the escalator or shiny floor where we begin marching and singing (we started with 1-2 buckle my shoe because it was easy, subconscious, but LE has since informed me that he likes ABBA so we now march to the dolce tones of us singing 'Dancing Queen').  As we get closer (still marching and singing) I remind LE to keep his head up and give him something specific at eye level to look at - he repeats what he is looking at while still marching, looks down briefly to check his feet and looks at that focus point.  The marching never stops, the singing resumes and on we go.  If necessary LE knows to march on the spot for a few steps before stepping onto the escalator but doesn't stop moving or singing when at the top (the singing and the concentration needed to keep marching mean that the anxiety a.k.a 'bad thoughts' can't come into his head -- we literally are stamping and drowning out the anxiety with ABBA).  If LE starts to freak as we approach, with the simple command 'detour' we march away, regain composure and approach again.  If we are successful I am over the top with praise and high fives.  If we are not successful I acknowledge the effort, don't react to the panic attack (this takes an incredible amount of concerted energy on my part) and as soon as possible try again until we have a good one because I don't want to risk him imprinting a negative experience of escalators and panic and me, I want to leave him with a positive experience to imprint.

Everything I say when I'm with LE is purposeful.  I don't know what bit of what I say might imprint in his mind, and he is echolalic (repeats certain things that are said over and over, sometimes with increasing volume) and has certain programmed learned verbal responses making his responses to what he is not repeating relatively predictable.  Which means while we are walking towards the shopping mall and the escalators I have time to get him repeating and affirming what I want him to be thinking.  It goes one of two ways.  I'll say 'LE, you've been doing really well with the escalators', he'll say 'well with the escalators, well with the escalators' (echolalia) or I'll say 'you are getting better and better at the escalators', he'll say 'yes I am' (programmed learned agreeing response).  Imagine the effect of me slipping and saying  'you don't seem scared anymore' and him repeating 'seem scared' or me saying 'no biting and screaming like last time' and him saying 'yes I am'.

LE knows the system we are using -- his memory is very good -- so while we are walking we break down the task ahead and go through the plan step by step.  He knows what's expected of him, what is going to happen, and what the back up plan is.  I ask him to visualize it happening perfectly and smoothly, while we are walking and talking about it, and to try to imagine feeling brave and confident and strong and proud of himself - I don't know whether he understands these 'feelings' but he gives me these words back as part of the dialogue we have when we are talking about the system or visualizing doing it and I ask him he feels.

I know it must sound odd, but it works so well to work conductively with LE - the manifestation of his autism lends itself so perfectly to working through repetitive intention and systematically broken down and practiced complex tasks.  Repetition of key words and phrases and systematisation of everyday tasks are weird for most people new to a CE environment but are perfectly normal to LE -- it's how he does everything.  Because I can manipulate the way he already uses language to affect his thinking, intention, confidence, ability and can use language so obviously to plan and structure his actions he becomes able to do things that seemed impossible to him and to those helping him.  I'm working with what he already could do - repeat things, memorize things, walk rhythmically - and using his autism positively instead of trying to stop him from being autistic.  His mom and carers have reported that he is managing better with them now and that he uses the exact system with whomever he is with, even 'explaining' it to new staff.

Is it CE? You tell me!  I'll give you some more 'unusual examples' of working conductively and of variations on the conductive magic theme in my next posting.  In the mean time you can LOL while you think about LE and I marching our way onto escalators singing....        http://www.youtube.com/watch?v=REElUors1pQ

"Yes, I am a dreamer
For a dreamer is one who can find his way by moonlight
and see dawn before the rest of the world."
-- Oscar Wilde --

Saying goodbye to MrsVB

One of my long standing pet peeves about telling people what I do for a living is the sigh, head shake, and smile that come before the standard stereotypical comment about how "wonderful/patient/special/angelic I must be" to do "such hard work" that "they would never be able to do", but "how rewarding it must be". The comment is always well intentioned, and the moment is never right for a rant and a rave about seeing the person instead of the disability, and my awkward response is almost always something equally standard about being lucky enough to find value in my work or to do work that I love.

I wish that more often there were moments when I could gush exuberantly about the amazing people I work with and amazing little things that these people say and do; to explain that I never have to look far for everyday heroes and inspiration and simple pleasures and joy. I wish that the moment was appropriate to talk about the genuine relationships and friendships that I have developed with participants and clients over years, based on mutual trust and respect, based on shared experiences of battles won and lost and overcome and worked through over hours, weeks, years of working closely together. Shhhhh -- I know -- I'm supposed to be all professional and objective, to keep a professional distance -- don't tell anyone, but I often find myself really caring about, really loving the people that I am lucky enough to work with. In fact, even the ones that drive me bonkers have this amazingly special place in my heart.

One of the big challenges for me personally with the Enable Me project is that the clients are in the program for only 9 weeks -- in other words the relationships have a pre-determined end date. My other clients and participants drift in and out or fade away, and often stay in touch by email or facebook when they aren't actually seeing me, but the Enable Me bunch are literally discharged from the program. We have a running joke at my gym that when a training relationship ends it feels a bit like breaking up -- with the Enable Me project it feels like I'm breaking up with people every few weeks.

Mrs VB is in her mid 80s and for 2 months we worked hard to find ways for her to use exercise to manage her back and sciatic nerve pain while learning strategies to move and function with as little pain or aggravation of pain as possible. It was very hard work for both of us -- learning to manage inoperable and untreatable chronic severe pain can never be anything else. There was tears, exhaustion, frustration -- much more often than moments of joy or relief. While we worked she told me stories of her late husband and of her life, her passions, her hobbies which included volunteering at a museum and genealogy. She lent me her Leonard Cohen box set when she noticed me noticing it.

On the day of her last session (her 'discharge'), Mrs VB invited me to stay for coffee and a chat. Though I didn't really have time, I stayed back, and looked at wedding and antique photos. I stayed because I recognized that the gesture wasn't about saying thank you, but about acknowledging the end of the relationship, and more importantly acknowledging that something 'magic' had happened in the exchange that had meant something to us both, that wasn't tied up in whether or not the goal of pain management had been achieved, but in the gruelling experience of working on it together. I knew that if I didn't stay, I wouldn't have honoured the fact that we hadn't just worked together, but that she had let me in, had exposed so much of her fear and her pain to me. I wasn't done; I really wanted to be able to keep working with her -- I felt that if only I had a bit more time I might be able to find something that worked, or worked a bit better. I left feeling sad about the end of the relationship, and sadder that I had not been able to help her, and that I was leaving her with the same pain that I found her with.

I have just had an email from the case manager saying that in the post intervention interview Mrs VB reported feeling more positive and in control of her life, and that even though the pain was still there she had more things she could do that provided her with some relief, and that trying to remember and do the exercises distracted her from the pain for a few minutes. And she said that she didn't feel as alone in the whole thing, and that she was going out with her daughter and volunteering more often even when she was in a lot of pain, because she knew that having a laugh was better than sitting at home in pain.

And I can't even remember what exercises I left her with. But I can remember the green coffee beans that were too hard for her to grind so we drank instant, the wedding dress that she made herself, the pictures of her grandmother as a baby, and the Leonard Cohen dvds.

"I did my best, it wasn't much
I couldn't feel, so I tried to touch
I've told the truth, I didn't come to fool you
And even though it all went wrong
I'll stand before the Lord of Song
With nothing on my tongue but Hallelujah"
                                         Leonard Cohen

Seeing is believing -- and believing is seeing

We often say seeing is believing -- and this is taken to mean that whatever we it is that we want to believe must first be demonstrated, must be proved, must exist, and must be objectively true.  Skepticism is considered healthy - be critical, suspend judgment, just the facts ma'am.  Our society values evidence over experience and intuition, and faith and hope are considered charlatan.  Conductive Education has been ridiculed and denounced and disregarded -- we haven't figured out how to quantify and clearly articulate what it is that we do; nor have external researchers, and why should they -- it is their job to be critical and objective.   And we, the 'global conductive community' -- for lack of a better way of describing the flotsam of people around the world working in the field of Conductive Education, supporting and fighting for Conductive Education, and benefitting from experiencing Conductive Education -- don't help the situation.  We talk about the intangible and psychosocial defining elements of Conductive Education and then try to find a tangible and objective way to be measured and defined so that we can fit in to wherever it is we are trying to eek out an existence.  Or we quietly do what we do and hope to remain unnoticed and therefore unscrutinized but never actually articulate what it is that we are so passionate about and protective of.

Where am I going with this ranting raving opening to this first blog, you ask?  I don't pretend to have the answers, just my experience, my stories, and my thoughts.  In this blog I plan to write about some of the unmeasurable and intangible conductive magic underlying the practice -- because it is important, because it is what makes us different, and because it is what makes me and many of the others that I have conducted love Conductive Education.  And I will start today with some thoughts inspired by KD about seeing and believing.

KD is an adult with cerebral palsy -- she attended a CE group I ran here in Sydney a few years ago.  She is also an elite boccia player and has represented her state and her country at major competitions.  KD thrived in the Conductive Education environment -- she came into the classroom with a determination of steel and an attitude that roared "I will until".  And she did, regardless of who told her she shouldn't or couldn't.  I'll never forget the relief and joy she expressed when we first met for our initial consultation when she expressed her goals and her dreams and I said let's give it a shot.  She was amazed that I didn't tell her it was impossible, and I continue to be amazed that there are people out there like KD who despite decades of discouragement still have the guts to have goals and dreams, let alone express them.  Over a few years I watched KD go from a few assisted steps with two conductors and a walker, to practicing with a friend outside the classroom, to walking across a beach promenade with her walker, unassisted, as part of a fundraiser that she organized so that she could afford to travel with the boccia squad to compete overseas.

KD contacted me a few months ago asking if we could get started again.  She said that she had had a rough year -- not just any old rough year; frequent and severe seizures, injuries, hospitalizations, life support; we had nearly lost her on more than one occasion.  KD said that as a result she had lost a lot of motor and sensory function affecting her entire life and well-being and, most importantly to KD, her boccia.

When I met with her for consultation, it was clear that she had not exaggerated any of what she had described.  Her struggle and fatigue were apparent, there was less fire in her eyes -- it still flickered, but it was dim.  I imagine a couple of years of illness, loss, grief, fear, worst case scenarios, and being told that she was lucky to be alive but that no recovery of function could reasonably be expected would extinguish most people's fires -- but KD was still fighting, dragging herself up for the next round.  We struggled through a first session -- very basic movements.  It was challenging for both of us -- because the last time we worked together everything was very different.  KD got teary as we tried movements that she hadn't tried since her down turn, and added more things to the mental list she was keeping of what she could no longer do.  I asked about her goals for our sessions she met my eye (which in itself is a big challenge for KD at present) and said, pleadingly but with determination "I don't care what or how much, I just want to get some of it back".  And I saw the fire -- I stopped seeing all of the deterioration and stopped wondering where we would start -- I saw the fire in her eyes, and I heard myself say "you will".  I couldn't see, but I believed.  And because I believed, KD believed -- without question, without proof, without a promise, without seeing, she believed.

We believed in hope, in possibility, in potential.  I believed in KD -- more importantly, she believed in herself.  And because we believed instead of doubted, the next week when we worked together it was totally different.  Same bedroom, same body, same debilitating last few years.  But it was totally different.  Her ability to initiate and control movement was different; her pain free range of motion was different; her ability to stabilize non moving parts of her body was different; I'm talking about significant, noticable differences in her head, trunk, and limbs -- despite a stressful week of seizures so severe she nearly missed her own 40th birthday party.  I knew it, she knew it.  No miraculous recovery, but certainly some conductive magic.

When I commented (excitedly and amazedly) KD smiled and said she had been practicing.  Practicing basic movements physically when she could, in her mind -- visualizing -- when her body was too tired.  Thinking the movement commands to herself or having a friend repeat them out loud to her over the phone.  I lift my arm; I hold my head up; I move my leg.  There was no reason that this could not have been happening previously -- except that despair and frustration and hopelessness probably made trying and practicing seem futile.  A bit of belief -- an attitude adjustment -- refuelled KD's natural determination of steel -- I can; I will.

We talked that day about the verbal intention used in the CE task series -- not in terms of what rhythm was used or in terms of connecting intention and movement through  external and internal commands and involving higher brain functions.  We talked about the affirming power of the statements in positive present tense expressing and painting a picture in her mind of what she wants.  I lift my arm; I hold my head up; I move my leg -- out loud, in her mind, over and over again stating the goal in present tense as if already achieved, speaking what she wants not what she doesn't, replacing conscious and subconscious I can't with I am; I do; I will until.  Creating an image and holding it firmly in her mind's eye -- believing, seeing; seeing, believing.

We say 'listen, say, do' when explaining verbal intention --
Perhaps we really mean 'listen-say/believe/visualize-do'; perhaps the conductive magic is about what happens mentally in those precious seconds before the 'doing' starts.  There is no shortage on literature about the power of positive thinking, goal setting, and affirmation -- perhaps this should be included in our quest to define and make sense of Conductive Education.

"What the mind can conceive and believe, the mind can achieve"
   ---Napoleon Hill