Heart-Mind and Axon: Reflections on MS

In News by Ira Feinstein

by Ingrid Willenz-Isaac

I touch my student’s foot as she is lying on the table, and suddenly her big toe pops up. Momentarily startled, I take my hands away and ask her if it hurts. It doesn’t. I already know that the toe twitching is called the Babinski sign, that it is an indication of demyelination of patches along the length of a person’s nerves, and that it is associated with difficulties in muscle control. What I don’t really know is how it feels to her. Gently, I return to touching her foot and ankle, feeling for where movement is easy, wondering what sensations she is experiencing as I proceed. Some of my touching elicits more toe twitches, puzzlingly not even always in the foot I’m touching. My mind flashes back to the first practicum of my training when a young woman diagnosed with Multiple Sclerosis approached my table. “Don’t get hypnotized by her diagnosis, look at her organization!” was my trainer’s quick advice then. It was sound advice. Still, I wondered then, and wonder now: How much do I need to know about Multiple Sclerosis (MS) in order to be an effective Feldenkrais® practitioner in this situation, and can I learn about MS but stay detached from limiting medical assumptions and expectations? What is a helpful way of thinking?

Buddhists talk about “heart-mind,” which includes aspects of mental activity that are both intellectual and emotive. Focusing on the activity of my heart-mind is as useful to me as learning enough anatomy so I know where to aim when wanting to move ribs or hips. In both cases, I’m after greater clarity, of purpose, and of aim. Engaging heart-mind has been especially helpful to me when working with students who have a diagnosis of Multiple Sclerosis, or with other students whose challenges are less familiar to me than, say, problems with knees, something that’s part of my own history.

Myelin is often described as a protective sheath around nerves. I’ve always pictured it as looking like the colorful plastic covering around electrical wires at the hardware store. We are not born with all our myelin already in place, so the Babinski sign is normal in children until they are about two years old. Like so many other aspects of human maturation, the process of growing a protective covering for the nerves goes on for many years. This means that all of us have had the experience of moving without the full benefit of myelin, an interesting consideration when Feldenkrais practitioners strive to create conditions emulating “how the thing was learned in the first place.” Even in adults, not all axons, or nerve bodies, are myelinated, just the ones where speed is essential in transmitting information. Of course, that includes the neurons used for movement. Although the presence of the Babinski sign is one part of an MS diagnosis, the general movement and balance disturbances that it implies are of greater importance than the sign itself.

Interest in the movement challenges of Multiple Sclerosis motivates me to do a little research, not in order to gain a full and comprehensive understanding of the condition, but enough so I can be a friendly, aware partner in the neural dance that is a Functional Integration® (FI®) lesson. What most draws my attention is research regarding neuroplasticity and MS, the nervous system’s ability to create entire infrastructures of connection “on the fly,” as needed, in response to the changing neural landscape of patients with the disease. This is optimistic territory that I recognize, because this is where the Feldenkrais Method operates.

Looking for Feldenkrais resources to help me think about movement and balance in the context of MS, I turn to an eight-part video series from the Amherst Evening Lessons made available through the International Feldenkrais Federation. It chronicles Moshe Feldenkrais’ work with Ethel, a woman diagnosed with MS 17 years before.  I see Moshe encounter the Babinski sign and watch him masterfully work to bring the involuntary twitching under Ethel’s voluntary control. Then, slowly metamorphosing the movement into something functional for walking, he exclaims: “That’s marvelous! They [big toes of each foot] are equally bent!” Moments later, integrating the movement further, he says, “There! Did you see what you did with your eyes? Do it again… That’s what you did! In other words, you listened to yourself feeling!” It is an electric moment.

I watch, mesmerized, as Moshe uses rollers to both bridge communication between the two sides of Ethel’s body and to help her differentiate between right and left. He works with her in a variety of positions, attending to her ribs, her neck, her lower spine, each time helping local sensations connect with whole-body movements. Everything he does, verbally and nonverbally, seems meant to bring Ethel’s attention to her own learning: “listen to yourself feeling!”

For anyone with chronic illness, and actually for anyone, learning to listen to oneself feeling is crucial. My experience as a Feldenkrais student and teacher, both in Awareness Through Movement® (ATM®) and in FI sessions, is as much about this general attending to subjective experience as it is about the particular “aha” moments that come. When I feel myself getting taller over one leg more than the other, breathing more fully as I adjust my ankle or any of the countless discoveries that are part of filling in my body map, I am gaining, or regaining, a sense of my own interiority. With that comes a greater sense of “being in charge” of myself, not in an inflated way, but in a way that makes me more at home in my own skin. It’s what I wish for my students, too.

One woman coping with MS says, “I don’t want my physicality to be a distraction.”  She is talking about the social aspect of moving differently, how she thinks she is perceived, and that can indeed be a distraction. The statement could apply, as well, to times when there is “static on the line” that interferes with her ability to listen in that internal way. But sometimes when we work together, or days after, she reports pleasant sensations, like a more “feet on the ground” feeling in standing. In those moments and others that she creates through a variety of other movement experiences, her physicality is not a distraction, but a source of confidence and pleasure, a place to see improvement.

Improvement in the context of what is often considered a degenerative process may seem like a tall order, but actually it is common. I started practicing the Feldenkrais Method the year I turned sixty when I myself was already well along into the process of aging, which, octogenarian marathoners notwithstanding, undeniably involves some chronic degeneration. There are changes taking place in me, and keeping pace with them is like one long serenity prayer, “to change the things I can change, to accept the things I cannot change, and the wisdom to know the difference.” When working with my own functioning and that of my students, it seems useful to keep a radically open mind about that first category, the things that can be changed, not so much by insisting that things be different, but by holding possibilities open. Sometimes the wisdom is not so much in knowing the difference between what can and cannot be changed, but rather in sitting as comfortably as possible with the uncertainty. Staying in contact with my sense of vulnerability in facing aging allows me to more fully join my students in the meeting of our two nervous systems.

There is a paradoxical intimacy in accompanying people as they explore their interiority, which is, and is not, something I can share. Paying attention to my own heart-mind, and to my physicality, helps me show up more fully for my students.

(With gratitude to Sheryl Field, GCFP, Director of the Field Center for Children’s Integrated Development, NY, NY.)



Ingrid Willenz-Isaacs, GCFP, lives in Arlington, VA. Her interest in somatic approaches to everyday life began early on when she discovered that sleeping with a  teddy bear was a soothing experience. An avid dancer and spiritual seeker, Ingrid has worked as a counselor in school and community settings. In addition to practicing the Feldenkrais Method, she writes articles about arts, child development, and education for an independent school. You can contact her via email at [email protected]

Please follow, like, and SHARE