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Journal of Creativity in Mental HealthVolume 7, Issue 4, 2012 , pages 375-380 Correcting Poor Posture Without Awareness or WillpowerUri Wernik
AbstractIn this article, a new technique for correcting poor posture is presented. Rather than intentionally increasing awareness or mobilizing willpower to correct posture, this approach offers a game using randomly drawn cards with easy daily assignments. A case using the technique is presented to emphasize the subjective experience of living with poor posture, participating in the game, and the accomplishments gained. This playful way of changing can be used with other bodywork techniques. Some hypotheses are offered to explain the effectiveness of the technique. This technique has no known side effects and warrants further exploration and adaptation to other problems. Keywords: posture, willpower, playfulness, chance, motor behavior, change, creativity, counseling
Charles Darwin (1872/1965) observed that successful individuals tend to display an upright and erect bearing, which communicates pride, the antithesis of humility. Briñol, Petty, and Wagner (2009) demonstrated that sitting up straight not only makes a good impression on others, but also boosts self-confidence and reinforces positive thoughts. Participants told to sit up straight were more likely to believe thoughts they wrote about their qualifications for a job while in that posture. Those who were slumped over their desks were less likely to accept written feelings about their qualifications. In addition to the interpersonal (i.e., body image, pride, confidence) and intrapersonal (i.e., negative impression, diminished attractiveness) implications, poor, slouching posture may lead to health issues. Liebenson (2008)linked poor posture to sedentary lifestyles. Prolonged periods of sitting result in muscle memories, which distort lifting, bending, and turning movements that lead to shoulder, neck, and lower-back disorders (Liebenson, 2008). A European Commission study (2007) revealed that lower-back pain is a major health problem throughout Europe and that 67 million people suffered pain in their lower or upper back, which affects their ability to carry out daily-living activities. In any 1 year, the incidence of back pain is reported to be about 5% of the European population, and the lifetime prevalence has been estimated at 59% to 90% (Veerle, 2000). Correcting or aligning poor posture is an important step in treatment and self-help for musculoskeletal disorders. Treatment is usually offered by physicians, physiotherapists, or practitioners of bodywork techniques. Some commonly known techniques are yoga, tai chi chuan, Ida Rolf's structural integration or “rolfing,” the Alexander technique, Feldenkrais's Method, and Pilates. Different technical devices are advertised as well, such as taping, braces, and corsets. However, the improvements taught in bodywork techniques are time consuming because they require much training and continuous awareness and attention to one's posture (Heller, 2005). Maintaining conscious awareness of activities that are usually performed unconsciously is difficult. As a result, many individuals do not maintain the advances made after training ends. In this article, I describe a new approach to correcting posture, which counselors can apply to other movement problems. It offers another treatment option when other techniques were not successful or clients did not find them appropriate. This approach might be useful in conjunction with other bodywork techniques. Following the description of the technique is a case example using the technique. PROCESSA blank pack of cards with a distinctive design on one side was used for the original intervention. Cards may be purchased in a stationary store or stores catering to teachers. Another option is to create cards with cardboard or with stickers pasted on standard index cards. On the card, write out assignments that the client thinks they can easily complete. In following sessions, add or modify cards to complete a deck of 21 cards (see the Appendix). Instruct the client to shuffle the deck before going to sleep and to randomly pick a card. This card is the client's challenge for the next day. This challenge is a specific situation in which the client will have to watch their posture. For example, if the “driving” card was picked, the client would have to sit straight in the driver's seat with their head touching the headrest. CASE EXAMPLEThe client, a 60-year-old psychologist, believed his poor posture started during adolescence. He speculated that it was the result of moving to a new school, being shy, and being unathletic. The client stated he felt awkward and demoralized. His slouching, perhaps, was an attempt to hide from the scrutiny of others. As he got older, and after many frustrating attempts, he almost gave up on changing his posture. He was worried that his poor posture would be more resistant to change and become fixated permanently. He tried many solutions for the problem, such as intermittent lessons in the Alexander technique, believing it to be effective in correcting back and posture problems. Frederick Matthias Alexander developed the Alexander technique in the 1890s as a way to alleviate his breathing and hoarseness problems (Brennan, 1997). In this method, clients are trained to recognize habitual tensions and relieve them through coordinated breathing, posture, and movement. In another attempt to correct his poor posture, the client saw a physiotherapist and tried doing different back exercises. Most interventions were effective as long as he had sessions once or twice weekly. Usually due to monetary or time considerations, he discontinued the sessions and the achievements disappeared. He would try to remind himself to “walk straight,” “stand straight and tall,” and “sit straight” to no avail. In photographs, he would push his chest forward, only to be unhappy when seeing the artificial posture in the picture. The client concluded that it was impossible to continuously remember and be aware of his posture. This experience is supported by the “willpower depletion” hypothesis (Baumeister, Bratslavsky, Muraven, & Tice, 1998), in which individuals can only use willpower for short spans of time with undemanding tasks, which may leave them with diminished energy for coping. With each attempt, the client learned a new technique. For example, his Alexander technique teacher taught him not to push his chest forward but rather imagine that he is a puppet on a string, standing as if pulled by a string from the top of his head, letting his hands hang. A gym instructor taught him exercises, such as clasping his hands behind his back and raising them or pulling them down. The physiotherapist showed him that his hands were an unequal length. To align them, he had to make sure the fingers of one hand touch the fingers of the other. One day walking around the university campus and seeing his figure reflected in a building's glass, the client realized he was trying to hide his breasts—his feminine part. He took a deep breath, pushing his imaginary breasts forward, and said, “Be proud of your breasts!” With this understanding, he felt the power of insight in action, experiencing how a new and deep understanding translated into behavior. Unfortunately, like all other posture revelations, the effect was short-lived. InterventionThe client was taught that posture problems are common, usually due to a sedentary lifestyle, and that slouching and slumping can turn into unconscious muscle memories (Liebenson, 2008). The client was informed that he would never be requested to walk “straight and tall,” but would be asked to play a game, carrying out daily suggestions that would take very little time and effort to perform. The counselor reviewed informed consent with the client because this method was new and without any known negative side effects. The client was asked to record his impressions while playing the game. He reported he shuffled and selected the card with his wife beside him. She took part in the game and had some good questions: What would he do if the same card comes up again and again? What would he do about cards that never come up? What if he would forget to pick a card in the evening? After a few days of playing, the client reported a realization that a strong effect was taking place. For example, having the “driving” card a day before, he would continue the activity days later. When he chose the “walk on all fours like a dog” card, the client would sniff his surroundings like a dog when walking to his office, and the situation seemed very funny to him. The client reported that he did not forget to pick a card, and he would pick cards in advance when he traveled. The activity seemed like a game, similar to a crossword puzzle . Case ResultsThree months after beginning the game, the client was buying clothes and noticed his reflection in the fitting room mirror. To his surprise, he was standing tall without consciously telling himself to do so. After 6 months, he still picked a card every day but did not always carry out the instructions. Later, he began to only pick a card once a week. Twelve months later, the results continued, and it seemed his body had adopted a new set of instructions. He was sitting and standing straight on many occasions, without having to remind himself. CONCLUSIONAdditional trials of using chance and action approaches to correct posture are needed. Because the cards are designed individually, control design experiments may be difficult to complete. Wernik (2010) offered some accumulative validation, demonstrating successful use of similar techniques to solve habitual problems of overeating, overuse of sexually explicit media, obsessive-compulsive behaviors, smoking, and panic attacks. This approach has no known negative effects. The approach described could be adapted to other problems. Recognizing that it is almost impossible to solve posture problems voluntarily or with the use of willpower, the technique utilizes judo principles of joining and going with clients and not against them. The very process of preparing action cards introduces creativity, collaboration, and playfulness into the helping relationship. APPENDIX
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