Contents:

• Introduction
• AT Experiences of Inhibition and End-gaining
• The Science of Executive Function
  • Working Memory
  • Cognitive Flexibility
  • Executive Inhibition
  • Connecting Inhibition and End-gaining with the Science of Executive Function
• Experiments on Inhibition and End-gaining
  • Dr. Rajal Cohen: End-gaining and Posture
  • Dr. Ian Loram: Proactive Inhibition of Neck Muscle Activity 
  • Dr. Tim Cacciatore: The Lurch in Sit-to-Stand
• Discussion and Conclusions

pdf version

Introduction

Most Alexander teachers consider the words “inhibition” and “end gaining” vital for describing their work. The concept of a healthy control over reactions lies at the heart of AT practice.  In simple terms, teachers describe letting go of a goal (stop end gaining) so that one can intervene in the activation of unwanted habits (inhibition).

One early account of AT inhibition and end-gaining can be found in F.M. Alexander’s (1869–1955) description of his first investigations into his own psychomotor¹AT teachers typically refer to mind-body experiences with the word “psychophysical,” with “physical” referring to the body. In scientific terminology, the “physical” in psychophysical refers specifically to physical stimuli, not the body (psychophysics, 2019). The word “psychomotor” is clearer when referring specifically to thought-action relationships, though it may not describe all of the phenomena associated with the AT term psychophysical (psychomotor, 2019). habits. In The Use of the Self, Alexander frames his problem as that of ridding himself of habits that were interfering with his voice, which included tightening muscles in his neck (Alexander, 1932)²The Use of the Self gives an account of Alexander’s earliest investigations, but was written after Alexander had already been developing his teaching for more than three decades.  Among the other unwanted habits he describes are lifting the chest and excess leg tension.. He describes how at the moment of speaking his old habits would activate, regardless of how carefully he prepared to speak. His problem is one of “end-gaining” in that he cannot help but focus on the goal of speaking rather than the new patterns he is attempting to activate. According to Alexander, one of his key breakthroughs was to let go of the idea of speaking by considering alternative movements that he might engage in instead of speaking. This allowed him to turn his attention away from the ultimate goal, speaking, so that he could prevent (i.e inhibit) his habits, for example tightening his neck. 

This account can be interpreted in an attractively simple way. By learning to prevent a habitual reaction to a stimulus, in his case the urge to speak, one increases control over one’s habits, allowing one to turn attention away from the end goal and reason through a more appropriate response. This interpretation emphasizes learning to inhibit habitual reactions to stimuli as central to AT pedagogy³This quote from Alexander serves as an example of his emphasis: “You learn, first, to inhibit the habitual reaction to certain classes of stimuli, and second, to direct yourself consciously in such a way as to affect certain muscular pulls, which processes bring about a new reaction to these stimuli. Boiled down, it all comes to inhibiting a particular reaction to a given stimulus” (Mouritz, 1995).. 

This pedagogical focus on inhibition might come as a surprise. To an outsider, AT appears to be about changing habits of posture and muscle tension. So why such an emphasis on a specific cognitive process? Is this process paired with specific bodily processes or does it really stand alone as an AT skill? 

From a scientific perspective, the concept of a cognitive “stop” that interrupts the progress from stimulus to response to allow for alternative reactions is familiar to psychology. Called executive inhibition, it is one of several so-called executive functions that control behaviour. Given this conceptual overlap between executive inhibition (from science) and the descriptions of inhibition above (from AT) it is tempting to assume that executive inhibition and AT inhibition are the same.

Simple as this connection with psychology seems, it is not the whole story about AT inhibition, nor about the science behind it. AT teachers actually refer to a broad range of experiences when describing both inhibition and end-gaining that can be associated with a variety of states and processes in the nervous system. I’ve often been surprised by the degree to which AT teachers include posture and tension in their definitions of inhibition. Alexander himself used the words in diverse circumstances to describe a variety of experiences and observations. Scientists also treat executive inhibition as an evolving topic. The field is very active at the moment, with much debate about how exactly to define and measure executive inhibition in action and how inhibition integrates with other executive functions, such as working memory and task switching. The diversity of both AT and scientific interpretations will be one of the main themes of this essay.

I will first describe how the words inhibition and end-gaining are broadly used by the AT community. Then I will describe how scientists describe executive inhibition and some associated executive functions. Finally I will describe recent scientific experiments that directly address both AT inhibition and end-gaining. This essay is intended to be accessible to both AT practitioners and those outside of the AT world who are interested in these concepts, including scientists, psychologists, and medical practitioners. Where either AT or scientific terminology is used I try to provide clear explanations.

My attempts to describe these concepts will fall short in many ways. The word inhibition in both AT and science are not always precisely defined. In certain cases it is used clearly and specifically, while in other cases it is used more vaguely and broadly. While I aim to clarify definitions I will almost certainly oversimplify and omit elements of the concepts in both fields. With this in mind, I hope the readers from both inside and outside the AT world will find useful information to incorporate into their own thinking and work.

Part 1: AT Experiences of Inhibition and End-gaining

As I’ve written about before (Johnson, 2018), an essential practice in connecting AT with science is to separate observations and experiences from jargon and explanations. In practice, this often means asking AT teachers to deliberately drop assumptions about how AT works⁴One model of AT inhibition that Alexander advocated based on research from that time, proposed the existence of natural reflex patterns waiting to happen when “bad” habits are inhibited. This model originated with the work on reflex posture in animals by the physiologist Rudolf Magnus in the 1920s, which we now know to be out of date (Fischer, 2019). It is now well understood that reflexes, while important in specific circumstances, do not form a foundation for coordination or posture. However ruling out Magnus and postural reflexes does not rule out the idea that dormant innate postural patterns might, to some degree, be activated by AT training. Deep back muscle activation is one hypothetical possibility. These ideas go beyond the extent of this article. and avoid terminology as they describe observed phenomena⁵Roughly speaking this can be considered a phenomenological approach, though we have not yet applied systematic research methods to collecting and analyzing data. I will present the results of this approach here as applied to inhibition and end gaining. 

We’ve solicited descriptions of raw experiences and observations that practitioners associate with the words inhibition and endgaining (Johnson, 2019) (Table 1). These descriptions were collected anonymously from over 50 teachers and trainees who were following our classes, workshops, and webinars. Participants were asked to express themselves in jargon-free terms and put asside own assumptions about what they might think is going on physiologically. Levels of experience ranged from decades of teaching and practice, to those still in training. 

Table 1 contains representative quotes from this process. I’ve also included several references from well-known AT texts by prominent, well-respected teachers, including Alexander himself, for which I’ve included the specific reference. Quotes in the chart that are not referenced were collected anonymously.

Table 1:

Table 1: Descriptions from AT teachers of their experiences of inhibition and endgaining in action. Teachers were asked to avoid jargon and assumptions and instead describe experiences as directly and clearly as possible.

Inhibition Experiences	Endgaining Experiences
I1: What we mean by inhibition is stopping your initial response to the idea of something you want to do, or have to do.	E1: Attention is placed on what your are trying to achieve, rather than on how to achieve it. The focus is the destination and not on the journey.
I2: I use this word to remember myself to stop before doing something without thinking. For example when I walk fast to arrive to a place on time, and I start to feel tense in my neck and legs, I remember then that I can stop doing that.	E2: I would say end-gaining has no need of AT in particular. End-gaining in my understanding is universal. If you are so fixed with your activity and your will to achieve that you lose any contact with yourself.
I3: [inhibition is] the moment of awareness within yourself in which you are so quiet that you can observe everything: how your body is reacting to the outer stimuli or to a mental pattern. Only in this moment you will be able to recognize them, stop them and [choose] something else.	E3: In dentistry end-gaining means twisting and bending the spine to gain access to the mouth. All attention is on the treatment being carried out and the intention is to get the work done in the shortest time. Not end-gaining in this context means the dentist being mindful of oneself, thinking about gaining access to treat the patient in such a way that the correct joints are used for bending and maintaining length and width of the torso, checking in with oneself frequently and directing into length rather than contracting movement muscles unnecessarily. (Ball, 2019)
I4: to stop, to stop automatic reaction, to stop holding, to stop tightening, to allow the weight travel down to the floor… To prevent unnecessary effort. To block the pathway for the habitual reaction. To stop to collect yourself before action.	E4: An individual who end gains may be a student preoccupied with hitting a deadline for a paper. If the thought of hitting the deadline is present, the student’s attention will be split between being expressive and being expedient. This split does not help the student type faster nor does it help create a better thesis statement. From my personal experience, this preoccupation comes with a tightening of muscles and a holding of the breath. During one bout of writer’s block some years ago, I noticed I was tightening my neck. Upon wishing my directions, my physical block in my neck went away and the thoughts began flowing rather instantly.
I5: Tell your pupil to inhibit…but you can’t expect him to before you get him going up because it’s almost impossible for a person to inhibit when he’s pulled down. The more ‘up’ you can give him with your hands, the easier you’ll make it for him to inhibit. (Rengstorff, 2015)	E5: his habit of “end-gaining” causes him to try to “do” the act in the habitual way that feels right (Alexander, 1932, p. 63)
I6: I come now to the point which marks the differentiation of man from the animal world, and which is first clearly evidenced in the use of the reasoning, intellectual powers of inhibition. (Alexander, 1996, p. 22 – originally published in 1910/1918)
I7. The subconscious jerkings and contortions pointed out one by one are patiently inhibited by the pupil, sometimes directly, but more often by the explicit use, under my direction, of guiding orders (Alexander, 1996, p. 143)

These quotes suggest that teachers refer to a broad range of experiences when talking about inhibition and end-gaining. In some, they describe a cognitive “stop.” In others, they describe experiences and skills, from sensing bodily states to maintaining an overall sense of calm and support. We can associate these descriptions with 3 distinct types of phenomena (Nicholls, 2016):

1. a cognitive stopping process
2. a process of sensing or altering patterns of muscle tension or movement
3. persistent states that allow processes 1 or 2 to be performed more easily.

This categorization distinguishes between processes (1+2) and states (3). Processes are short lived, with a beginning and an end. States persist over a longer term, evolving slowly compared to short term processes. This differentiation is essential for connecting AT with science, where the distinction between processes and states is fundamental.

Under category 1, descriptions involve general cognitive processes, and make no specific mention of neuromuscular processes such as shortening or tightening. Teacher I1 describes “stopping your initial response to the idea of something you want to do.” Teacher E1 says “attention is placed on what your are trying to achieve, rather than on how to achieve it.” Teacher E2 is very clear about end-gaining being a general process that “has no need of AT in particular.” Perhaps these respondents had more specific concomitant neuromuscular processes in mind, but they didn’t include them in their descriptions. The quote I6, from F.M. Alexander, while very general in its application, specifically connects inhibition with reasoning and intellect. 

Under category 2, descriptions of inhibition and end-gaining include sensing or altering specific patterns of muscle tension or movement. In some cases, muscle tension serves as a trigger for stopping processes. For example I2 describes “. . . when I walk fast to arrive to a place on time, and I start to feel tense in my neck and legs, I remember then that I can stop doing that . . .” The feeling of tension triggers an inhibitory reaction. Teacher E4 describes “during one bout of writer’s block some years ago, I noticed I was tightening my neck . . .” which triggers an inhibitory response. Others experiences describe specific patterns of movement and tension that are altered for example I2, I8, E3, E4, and E5. Teacher E3 says “In dentistry end-gaining means twisting and bending the spine to gain access to the mouth.” Alexander (E5) describes the “doing” part of an act as that which is caused by end-gaining.

Several descriptions fall under category 3: persistent mind-body states that facilitate control. For example, Carrington claims in I5 that “The more ‘up’ you can give him with your hands, the easier you’ll make it for him to inhibit.” The “up,” which likely refers to a reorganization of postural support, facilitates inhibiting. Teacher I3 describes “the moment of awareness within yourself in which you are so quiet that you can observe everything: how your body is reacting to the outer stimuli or to a mental pattern.” This sounds very much like a mindfulness or meditative state, which has been described in the literature as “nonjudgmental observation of the ongoing stream of internal and external stimuli as they arise” (Baer, 2003). Such a state facilitates the next step of stopping the unwanted patterns and focussing on process rather than ends. 

This categorization is by no means perfect or complete. Some of the descriptions challenge the distinctions made between processes and states, psychological and somatic, and sensing and activating. But this analysis does show that teachers are talking about a broad range of phenomena when describing the relevant AT experiences. It provides a base from which we can begin to describe the relevant science.

We begin our investigation of the relevant science with a description of executive functions in general and executive inhibition specifically. This order of presentation does not mean that executive inhibition is the most important scientific concept for understanding AT inhibition. Think of executive inhibition instead as a base concept for developing a more nuanced and inclusive picture of the relevant science.

Part 2: The Science of Executive Function

Executive function is a fundamental concept in cognitive psychology. To quote a recent review, executive functions

. . . refer to a family of top-down mental processes needed when you have to concentrate and pay attention, when going on automatic or relying on instinct or intuition would be ill-advised, insufficient, or impossible. (Diamond, 2013)

In other words, we use executive functions when we need to consciously⁶Technically being conscious of the process is not an absolute requirement for executive function action. Decision making during states of hypnosis is one example (Dienes, 2007). control our behaviour. With executive functions, psychologists have taken the complex task of explaining behavioural control and broken it down into potentially manageable parts. We will briefly describe the three functions described in the review by Diamond (2013), namely working memory, cognitive flexibility, and inhibitory control. (Other researchers refer to slightly different functional groupings⁷Notably, Diamond groups the category of “selective attention” with inhibition rather than referring to is as a separate function. Other researchers give higher priority to selective attention as an independent executive function.).   

Psychologists have developed a series of simple tests to measure these functions. Some of these tests remind one of the “brain games” that one finds on various websites or apps that are supposed to help you think better. You might find these tests simple compared to the complex daily process of thinking, choosing, and acting. Yet psychologists have successfully correlated these tests with specific subsystems and brain areas, specific deficits in brain functioning, and specific stages of child development (Diamond, 2013). While the validity of the exact definitions of the executive functions continues to be debated (Braem, 2019; Chan, 2008), there is some agreement that high level cognitive processing can indeed be broken down simply and usefully into neurological subsystems working together (Karr, 2018).

This idea of multiple subsystems functioning together is essential for understanding the nervous system in general. We sometimes intuit the nervous system as top down control, our conscious selves in charge telling the system what to do. The reality is much more complicated, with multiple things happening in parallel in the brain and body and processes both supporting and interfering with each other. Executive inhibition, for example, involves at least two signals travelling through the brain at the same time, one pathway stepping in to block another. Research into executive functions attempts to describe the key subsystems of high level cognition, their interactions, and even the specific anatomic activation patterns they form in the brain.

Working Memory

Working memory is the simplest executive function to understand. It is a limited repository of information that you can manipulate in your head while solving a problem or making a choice. The easiest way to understand working memory is with a simple game.

Game 1: 

Part 1: Memorize the following list of animals: horse, mouse, elephant, cat, ant. Close your eyes and repeat the list to yourself. Do that now. Do you have it? Don’t read part 2 until you have the list memorized.  

Part 2: Now close your eyes and repeat the list, but this time arrange the animals from smallest to largest. Don’t peek at part 1 again, and don’t open your eyes until you have got it. Go!

This is working memory. It is your capacity to manipulate numbers, letters, words, concepts, or ideas without losing track of what you’re working on. Interestingly, working memory is more than just a single storage location and relies on more than just visual resources. In fact it has multiple components (including auditory and kinesthetic modules) that dynamically refresh and manipulate information. (D’Esposito 2015). Without working memory, it is impossible to systematically manipulate information, and thinking loses its structure. Working memory deficits have been correlated with everything from difficulties with mathematics (Raghubar, 2010) and reading comprehension (Swanson, 2009) to schizophrenia (Lee, 2005).

Cognitive Flexibility

A second category of executive functions is sometimes called cognitive flexibility or task switching. This is the ability to change your processing strategy in mid task. To do this you need to be able to recognize the strategy you are currently using, compare it to alternatives, and make a choice. It is also referred to as mental set shifting or mental flexibility. It is active in the moment when you decide, “This isn’t working, I’ll try something else.”  

The simplest cognitive flexibility test given to infants is the “A not B” task. An object is hidden under an opaque container like a cup—location A. The infant is shown where it is. This is repeated until the infant can find it unassisted. Then the object is located under a different cup—location B. Up to one year of age, the infant will stick with location A and give up if it is not there. After 1 year, the infant begins to be more flexible in their thinking, and will check out location B as well. Of course for adults, this is trivial, and cognitive flexibility is tested by more sophisticated means.

Game 2: If you want to try a validated cognitive flexibility test for adults, try the Wisconsin card sorting task at this link: https://www.psytoolkit.org/experiment-library/experiment_wcst.html

As you will see, the rules change from time to time as you go through the tasks, so you are constantly asked to rethink your approach. You can sense the internal discussion going on in your brain, letting go of one approach and adopting another, as you navigate changing rules. 

Game 3: Here is a simpler task. This one is used more as a measure of creative thinking in general but likely involves cognitive flexibility in action (Gilhooly 2007). In the next 30 seconds think of as many uses for a pencil as you can. Be creative and even absurd in your attempts and try to create radically different uses. Repeat this game for a table. 

Notice what happens in your brain in game 3. You start thinking about the pencil one obvious way (perhaps writing or poking someone). But then you force your mind to start thinking differently about the pencil. Maybe you focus on another characteristic of the pencil like the fact that it is made of wood, and think of making a little fire. Or maybe you think of attaching something to the pencil to make, for example, a pinwheel. Those moments of approaching the pencil from a new perspective are examples of cognitive flexibility. You think about things one way for a bit, and then shift to a different approach.

Executive Inhibition

Executive inhibition refers to a host of skills involving stopping the processing of one idea or impulse to allow for the processing of another. One classic inhibition test is the Stroop test (Henik, 2018), in which you try, as quickly as you can, to say the color of a word rather than reading the word. 

Game 4:

Try a Stroop test now. Refer to the image below (Fig. 1).

Part 1: Read out loud the 3 rows of black words as fast as you can.

Part 2: Say out loud the name of the color of each of the 3 rows of solid rectangles.

Part 3: Say out loud the name of the colors of the letters in each word, in the bottom 3 rows. Note that the colors are different from what the text actually says. For example, the answer to the first of these is “blue” because the color of the letters is blue even though the word says “red.”

Notice a few things. If you are like most people, part 1 went quicker than part 2. This means our brain converts written words into spoken words faster than we can name colors. Part 3 was the most difficult. During part 3 did you notice a few moments when something in your brain was in a pause mode? One part of your brain was eager to just read the text and say it while part of your brain was saying “wait.” This gave another part of your brain time to process the actual color of the letters and then you said it. All of this took time and extra processing, which is why part 3 takes the longest for most people. 

That “wait” feeling is an experience of executive inhibition in action. Remarkably, a psychologist could roughly predict which parts of your brain would light up during that moment of inhibition (Aron, 2011) (Fig. 2). There are inhibitory subsystems in your brain waiting to step in as processes unfold. You can think of a kind of internal gatekeeper, letting some impulses through and others not. 

Inhibitory control is important for functioning well in the real world. All of us need to make numerous choices that involve weighing possibilities and choosing the less automatic ones in order to navigate work and social situations. In fact, various actions are being rejected throughout the day via inhibition.  When this breaks down, disorders may arise. One extreme disorder associated with a breakdown in executive inhibition is “alien hand syndrome” in which the patient’s hand may spontaneously carry out unwanted activities (Biran 2004). It is no surprise then that healthy adults do just fine on the Stroop test. If there are variations among neurotypical adults, either inherent or achieved through learning, it is not as if any group fails the test completely.

Over the last 15 years or so, psychologists, neuroscientists, and cognitive scientists have begun to use a broader term, “proactive inhibition” (Meyer, 2016). Proactive inhibition refers to activity before a stimulus that either changes the response stopping mechanism or prevents the response from initiating at all. This makes intuitive sense—preparation for a stimulus changes the reaction. By contrast, “reactive inhibition” is the stopping signal that intervenes once a response has already begun. Proactive and reactive inhibition may work together to prevent a response, with proactive inhibition preparing for the stimulus and reactive inhibition intervening, if necessary, once the response is initiated. Something like this may be occuring in the Stroop test that you took above. You proactively prepared by understanding the rules, strategizing their implementation, and tuning reactive mechanisms. You still needed reactive inhibition if the incorrect response, to say the text, is activated.

The existence of an inhibition subsystem raises some interesting questions. If there is a subsystem in charge of “stepping in” to tell another process to “wait,” can that subsystem be stronger in some people than others? Yes. For example, it is known that 3 year olds and 80 year olds have weaker inhibitory control than 30 year olds, statistically speaking. Can some people have inhibition deficits? Yes, inhibitory control is also affected in a wide variety of neurological problems involving self monitoring and control, including substance abuse, ADHD, OCD, schizophrenia, conduct disorder, Tourette syndrome, pathological gambling, Huntington’s disease, and Parkinson’s disease (Meyer 2018). Can you train executive inhibition? Yes, training in mindfulness, yoga, and related disciplines have been shown to yield improvements on various tests of inhibition (Gallant 2016; Gothe, 2013; Bilderbeck, 2013).

Connecting Inhibition and End-gaining with the Science of Executive Function

In our interviews with Alexander Technique teachers, we found that inhibition and end-gaining experiences could be roughly organized in three categories:

1. a cognitive stopping process
2. sensing or altering patterns of muscle tension or movement
3. persistent states that allow processes 1 or 2 to be performed more easily.

In the research literature, all the executive functions are considered essential to effective learning. It is interesting to note that in AT literature there is rhetorical emphasis on inhibition, even though other executive functions must, by definition, be crucial in learning AT. These ideas will be discussed further in the conclusion.

In comparing AT experiences with the literature on executive inhibition, it is clear there is overlap, but it is far from a one to one relationship. Though proactive inhibition is a relatively new concept in cognitive psychology, it seems potentially broad enough for describing many AT inhibition phenomena, especially in category 3. That said, here are limitations with associating AT inhibition directly to the literature on executive inhibition. 

First, AT inhibition often refers to embodied states, whereas executive inhibition doesn’t necessarily depend on muscle tension or support. Some of the experiences described by Alexander teachers cannot be explained based on the current literature on executive function: for example Walter Carrington suggesting that, “The more ‘up’ you can give him with your hands, the easier you’ll make it for him to inhibit.”  An experienced AT teacher once commented to me, “Of course, you can’t inhibit without directing,” where directing refers, roughly speaking, to an intentional focus on posture and muscle tone.⁸Describing the AT practice of directing in detail to an outsider is beyond the scope of this essay.

Second, most adults are pretty good at executive inhibition whether they are AT practitioners or not. By contrast, inhibiting what Alexander technique teachers call “misuse” is extremely difficult, as Alexander found out when he tried to inhibit tensing his neck before speaking. Even when Alexander was quietly working on his own, the neck-tensing habit would return despite his best efforts. AT teachers report that changing habits of misuse requires consistent work over periods of months or even years. Being good at executive inhibition is clearly not sufficient to be good at AT. There must be something about the kinds of patterns we try to inhibit that makes them particularly thorny. Given these facts, the central question about AT inhibition is not “what is executive inhibition?” but rather “why is inhibiting misuse so difficult?”

Finally, the extensive research on executive function cited above does not include studies of the Alexander Technique. While studies have established positive results on inhibitory control with disciplines like mindfulness (Gallant 2016) and yoga (Gothe, 2013; Bilderbeck, 2013), no one to our knowledge has published measurements of direct effects of AT lessons on executive inhibition.    

Luckily we have at least three practicing research scientists who have a strong research interest in the mechanisms of AT as well as rigorous training in AT. Below are three of their experiments that shed light indirectly on the more psychomotor sides of AT inhibition and end-gaining. While the results of all three of these experiments should be considered as preliminary evidence rather than proven fact, these studies considerably deepen our understanding how inhibition and end-gaining relate to embodied phenomena in AT practice.

Part 3: Experiments on Inhibition and End-gaining

Dr. Rajal Cohen: End-gaining and Posture

The first example comes from Rajal Cohen at the University of Idaho. She and her graduate student (Jason Baer) were able to correlate anticipatory postural movements, goal oriented tasks, and psychometric tests of inhibition and mindfulness (Baer, 2019). As a trained and experienced AT teacher, Dr. Cohen designed this experiment, in part, with end-gaining in mind.

Cohen’s team monitored head, neck, and trunk positions in quiet standing with no explicit goal as well as before and during a simple goal-oriented task: walking towards a platform with a tray and setting it down at elbow height. They also made the task more challenging by having subjects also place the tray on a low platform (Fig. 3), or prevent a cylinder from rolling on the tray while walking. Subjects were also separately given several standard inhibition and mindfulness tests such as the Stroop test that you took above. 

Cohen’s group found several things. They discovered a clear anticipatory tendency to pull the head forward towards the task, before walking even starts, for which there is no obvious biomechanical reason. It’s as if people want to move their head toward the goal before they even get started. This effect increased as the challenge of the task increased. Furthermore, the research team found correlations between shortening of the neck during movement preparation and worse performance on general inhibition tests.  Finally, they found correlations between habitual neck alignment and scores on both inhibition and mindfulness tests, with worse scores associated with more forward head posture and a backward tipped head. In short, poor inhibitory control is associated with disruption of the head/neck relationship, in both anticipatory movement and static posture in healthy young adults.

Given the range of measures in this experiment, one doesn’t want to read too much into the results immediately. The correlations, while statistically robust, show that postural measures account for only 15-20 % of the variations in psychometric scores. The experiment is innovative and novel with potential for a whole new direction of groundbreaking research.  

One of Baer & Cohen’s hypotheses is that there is something particularly deep-seated about the tendency to pull one’s head towards a goal. Their paper speculates that this tendency might be an evolutionary remnant from our quadruped ancestors, for whom “leading with the head” to sense food or threats would have been biomechanically perfectly reasonable. Such an explanation, while speculative, would account for the results of other published studies, such as those that find forward head posture in both concentration and stress tasks (Shahidi, 2013). This is a difficult hypothesis to test directly. Future measurements of diverse populations, tasks, and conditions might clarify the phenomena.

Dr. Ian Loram: Proactive Inhibition of Neck Muscle Activity 

Second, let’s look at a study carried out by Ian Loram and his team of researchers at the City University of Manchester (Loram, 2017). Loram had violinists use real time ultrasound images to monitor their neck musculature movement during tasks of varying difficulty on their instrument (Fig. 4). They were instructed to minimize changes in this neck muscle movement as they played and performed the various movements associated with playing. None of the violinists had any AT training, and no instructions were given on what the image meant or how to change this neck activity.

The results show that a) violinists could change neck muscle activity using this setup b) their ability to minimize neck muscle movement led to uninstructed effects through the body, including reduced pressure on the violin chin rest, reduced forward movement of the shoulders, reduced leg muscle activity, and reduced galvanic skin response. Since these changes had no reported adverse effects on the tasks, they were described as reduction in unnecessary activity and effort.  Loram describes this as “proactive selective inhibition,” meaning a) that the violinists could inhibit activity selectively in one part of the body without adversely affecting movement in the rest of the body or diminish performance of the task and b) that this was persistent inhibition rather than a short lived reaction to an immediate stimulus. Loram also points out that despite the inhibition acting selectively in the neck region only, it produces global positive global effects, indirectly inhibiting unnecessary activity throughout the body. 

In the discussion section of his article, Loram attributes the global effects to kinetic chains due to the complex overlapping nature of muscles in the neck and back. In other words, if you ensure that the neck doesn’t activate too much, you automatically minimize activity throughout the body due to mechanical interconnectivity. Loram calls neck muscle activity a “constraint” in a positive sense, guiding the whole system towards more efficient behaviour. 

One interesting aspect of Loram’s experiment is that there was no training of executive inhibition of neck tension. The biofeedback was enough for the violinists to immediately affect the neck muscle activity. This would suggest that information and feedback from the body, in this case, are as or more important than developing generalized inhibitory skills in minimizing neck muscle activity.  

Loram was inspired by the AT when designing the experiment and he and a co-author on the study are both trained AT teachers. Neck tension is considered of primary importance in the study of the Alexander Technique. Loram has explained informally that one intention in the experiment was testing the plausibility of the claims made in AT about the neck (Loram, 2018). However, it is not clear that Loram is directly measuring an AT skill. There is no mention of AT in the article and the subjects did not receive AT training. Furthermore it’s not obvious that the measured reduction in neck activity is the same as what Alexander teachers call “freeing the neck.” Like all good experiments, this raises lots of interesting questions and lots of potential for further research.

Dr. Tim Cacciatore: The Lurch in Sit-to-Stand

The final example is not an inhibition or end-gaining experiment, but it has implications for understanding this topic. Dr. Tim Cacciatore has studied differences between how AT teachers and healthy, untrained subjects execute sit-to-stand. Alexander teachers stand up smoothly, while healthy subjects tend to “lurch” out of the chair—that is accelerate suddenly at “seat off” (Cacciatore, 2011).  In follow up research, Cacciatore had AT teachers and healthy, untrained subjects stand unusually slowly—from sit-to-stand in 8 seconds—making the task more difficult. AT teachers could still perform the task without lurching while healthy adults without AT training couldn’t stop lurching even when they tried their best (Cacciatore, 2014)(Fig 5).  

In AT lessons, this lurch is sometimes held up as an example of a student’s inability to inhibit and “stop end-gaining” as if student just can’t resist trying to attain the goal of standing and therefore thrusts himself forward out of the chair. As such it might be interpreted as a kind of executive function deficit—the student is just bad at inhibiting in the cognitive psychology sense.

Dr. Cacciatore describes the problem differently. His analysis suggests that slow standing exposes a complex interference between the postural system’s stabilization strategy, which stiffens the hip, knee, and ankle joints, and needs of the movement, which requires deep hip flexion and activation of the extensor muscles. According to Cacciatore’s analysis, it is the highly trained postural system of AT teachers that allows them to succeed at the task, not their ability to inhibit, per se. In other words, a student who constantly lurches out of the chair may be missing postural skills rather than the ability to inhibit. Once the student learns these skills, inhibition of the old habit becomes possible. This would explain quotes we’ve discussed above such as, “The more ‘up’ you can give him with your hands, the easier you’ll make it for him to inhibit” (I5 above) and “of course you can’t inhibit without directing,” where the words “up” and “directing” refer to reorganization of postural support.

This model of the postural system functioning in tandem with the planned movement system suggests a particular way to think about inhibition and end-gaining. When faced with a problem such as standing up from the chair with feet far forward, it is more intuitive and simple to try to plan a movement based solution rather than a posture based solution.  Furthermore, unskilled movers may not have the necessary skills to communicate with the postural support system and maintain those messages during movement—what AT teachers might call “maintaining direction in movement.” Given this, they resort to a momentum based solution, a “lurch” to overcome stiffness rather than undoing the stiffening reaction itself. Within this model, end-gaining could be defined as focusing on the movement system rather than the postural system to solve a problem.

Cacciatore’s analysis challenges some assumptions about why students fail at slow sit-to-stand. Are they lurching because they are end-gaining, because they lack the proper stabilization patterns to meet the support needs of the task, or some combination of these factors? This question seems extremely important from a pedagogical perspective.

Discussion and Conclusions

Let’s summarize some key points:

• Learning AT is a high level cognitive-motor process with multiple components. AT involves working with some particularly thorny habits having to do with goal directed behaviour and postural support. Learning to overcome these habits requires a high degree of motivation, sensitivity and understanding of body signals, understanding of the psychomotor nature of goal oriented tasks, practice in communicating with the underlying support systems, and a calm mental focus. 
• Executive inhibition explains certain phenomena associated with AT inhibition. This is clear from quotes such as, “What we mean by inhibition is stopping your initial response to the idea of something you want to do, or have to do.” (I1) But it is only part of the story, especially when referring to states of muscle tension and movement or persistent states of calm.
• Cognitive flexibility, along with inhibition, is also important for AT teachers to consider when thinking about AT learning. For example, the creative shifting of strategies that Alexander used to address his neck tension (Alexander, 1932) is a beautiful example of cognitive flexibility. Cognitive flexibility is also required in AT lessons when confronting and changing misconceptions about postural states, referred to by some teachers as faulty sensory appreciation. In terms of persistent effects due to AT lessons, the philosopher John Dewey is claimed to have “found it much easier, after he had studied the technique, to hold a philosophical position calmly once he had taken it or to change it if new evidence came up warranting a change” (Jones, 1997) an anecdotal example of improved cognitive flexibility through lessons.
• Unlike in science, the intertwining of mental and bodily processes (for example mindfulness, reactivity, muscle tension, and postural states) often plays a central role in AT teachers descriptions of inhibition, which explains in part the importance of this word in AT parlance. It refers to more holistic processes than executive inhibition.
• The ability to inhibit specific patterns of muscle tension, as explored by Loram et al., may lead to cascading effects⁹It also offers an explanation for pedagogical approaches that encourage students to “let the right thing do itself” since whole body effects are not consciously activated, but allowed to activate subconsciously in response to a local constraint.. This might amplify the power of selective inhibition since one can learn to inhibit unnecessary neck activity to reap benefits throughout the body.
• The correlations between posture and inhibition from the work of Baer (2019) suggest that refined proactive inhibition is necessary in preventing maladaptive postural habits. The authors also point to evidence that extreme forward head posture makes reactions happen more quickly (Fugiwara, 2009), suggesting that postural habits might influence inhibitory responses proactively. In other words there is initial scientific evidence that inhibition affects posture and that posture affects inhibition. These connections between postural and cognitive states are not well understood, but are of interest to scientists. They are fundamental to AT.
• There is some evidence that movement and postural control are parallel systems working to provide planning and support respectively. Behavior that looks like failure to inhibit or stop end-gaining may in fact be using movement, such as lurching, to try to solve postural problems, such as stiffening. The student may require a calm state of mind to focus on postural control rather than movement planning. In this case the skill of AT inhibition and not end-gaining may in fact involve learning to work consciously with postural control rather than movement planning.

Proactive inhibition may be a broad enough concept to encompass many of the AT phenomena that we’ve mentioned. Recall that unlike reactive inhibition, which initiates after a stimulus is present, proactive inhibition refers to preparatory processes and states active before the stimulus. Proactive inhibition may either facilitate reactive inhibition or eliminate the need for a reactive process (Gallant 2016). This definition seems to include a wide range of processes and states. Consider for example, the quiet observational state described in I3 “the moment of awareness within yourself in which you are so quiet that you can observe everything: how your body is reacting to the outer stimuli or to a mental pattern. Only in this moment you will be able to recognize them, stop them and [choose] something else.” The practitioner refers to a preparatory state that allows them to observe bodily reactions and thus choose alternatives. Body awareness, as described in I2 “I start to feel tense in my neck and legs, I remember then that I can stop doing that.” and E4 “I noticed I was tightening my neck. Upon wishing my directions, my physical block in my neck went away and the thoughts began flowing rather instantly” provide advanced warning signals that facilitate upcoming reactive inhibitory tasks. Or it might strengthen the availability of alternative reactions that eliminate the unwanted responses altogether. Solving movement problems by tuning the postural system, as described by Cacciatore, might involve inhibiting movement plans using proactive inhibition. At the same time, postural tuning may make available new movement patterns, allowing unwanted movement responses to be dissociated from stimuli before they are activated. The correlations between posture and inhibition from the work of Baer (2019) may suggest that refined proactive inhibition is a necessary skill in preventing maladaptive postural habits. The authors also point to evidence that extreme forward head posture makes reactions happen more quickly (Fugiwara, 2009), which might influence inhibitory responses proactively. All of these examples require diverse psychomotor skills that can’t be pigeonholed into one simple stopping mechanism, but can be categorized generally as proactive means of changing the response.  

Research into defining and categorizing proactive inhibition is still in an explorative phase, meaning lots of potential but lots of unknowns (Meyer, 2016). It is neither as well studied nor as well defined as reactive inhibition. In fact, since proactive inhibition may include both persistent states and short lived processes, it cannot be simply categorized as an executive function. While a broad range of physiological processes might contribute directly to proactive inhibition, it is not clear exactly what these processes these are. Attentional habits, stopping goals, motivation, and bodily states may all affect inhibitory response. This means that improving proactive inhibition involves a diversity of task-specific mechanisms. 

Expanding the dialogue between AT practitioners and scientists on these and other topics might be mutually beneficial. AT teachers can benefit from the wealth of science relevant to their work.  This includes work on proactive inhibition, studies that connect postural states to reactive processes, and studies of the posture and movement systems and how they work together to plan and support goal directed behavior. AT teachers also may benefit from describing experiences and observations objectively to make their work more accessible. Scientists interested in interactions between somatic states and cognitive processes may benefit from looking at AT phenomena and observations. They offer rich examples of how patterns of muscle tension and posture interact with cognitive and behavioral processes. 

What do you think? If you’re an Alexander teacher, do these ideas change the way you might describe inhibition and end-gaining? If you are a scientist or other reader from outside the AT world, does this make you curious about AT phenomena such as relationships between postural tone and reactivity? 

About the Author

Patrick Johnson, PhD., M.NeVLAT/STAT was a full time research physicist for 15 years with over 40 peer-reviewed publications and over 2000 citations to date. He is currently a full time NeVLAT/STAT certified Alexander Technique teacher in Amsterdam where he runs Smartbody Studio with his wife Jelena.

Acknowledgements

Many teachers and scientists over the last two years have contributed their thoughts and insights to this discussion and feedback on early versions of this essay. In particular, I would like to thank Dr. Rajal Cohen for extensive feedback on both editing and content, Andrew McCann for extensive editing of the final version, and Dr. Tim Cacciatore for insights on content. John Nichols provided early insights into categorizing attitudes about inhibition and also gave feedback on a late version of the essay. Jean Fischer also provided useful feedback on a late version.

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