Journal of Creativity in Mental Health
Volume 7, Issue 4, 2012 , pages 375-380
Correcting Poor Posture Without Awareness or
In 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.
Darwin (1872/1965) observed that successful individuals tend to
display an upright and erect bearing, which communicates pride, the antithesis
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
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
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
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,
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.
A 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 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
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.
The 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
Three 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.
Additional 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.
Baumeister, R. F.,
Muraven, M. and
Tice, D. M. 1998 . Ego depletion: Is the
active self a limited resource? . Journal of Personality and Social
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Brennan, R. 1997 . The Alexander
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Petty, R. E. and
Wagner, B. 2009 . Body posture effects on
self-evaluation: A self-validation approach . European Journal of Social
Psychology , 39 : 1053 – 1064 .
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Veerle, H. 2000 . Research on
work-related low back disorders , Brussels , Belgium : Institute for
Occupational Safety and Health .
Wernik, U. 2010 . Chance action therapy:
The playful way of changing , New York , NY : Nova Science Publisher .
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