Chapter 5: Diagnosis and Medical Training

1. Why does Alexander receive referrals from doctors as pupils rather than patients?

2. What does Alexander invariably find when examining these pupils?

3. What has he found in all cases where harmful conditions of use and functioning exist?

4. What has his experiences in all these cases brought home to him?

5. What constitutes a predisposing cause of disorder and disease? Why?

6. What must happen for a diagnosis of a case to be complete?

7. How will a doctor’s deductions be limited and why?

8. What is essential to a doctor’s equipment? Why?

9. What must the practitioner who makes diagnoses based on tests take into consideration? How can this assertion be proved?

10. In what way is the doctor even more limited in the area of preventive work than in the area of cure?

11. What does Alexander cite as an example of a diagnosis based upon a recognition of the close relationship between use and functioning?

12. What is always associated with specific wrong symptoms of disease?

13. What happens in Alexander’s experience to specific symptoms when the use and functioning of the organism as a whole are improved?

14. Why does Alexander believe that medical training today does not give the student the knowledge to diagnose what is wrong with the body as a whole?

15. What will happen if specific symptoms are alleviated? Why?

16. How does Alexander disagree with the navigation metaphor used by Dawson?

17. How does Alexander see the role of sensory appreciation in this metaphor?

18. What has not been recognized in medical practice vis-a-vis sensory appreciation?

19. What is the relationship between unsatisfactory use and reaction to stimuli?

20. What explanation does Alexander offer for the conflicting diagnoses of doctors when presented with the same case?

21. What do doctors need to possess for accuracy and efficiency of diagnosis?

22. What do doctors need to attain these qualities?

23. What is the nature of the process whereby pupils learn to acquire a conscious direction of their use?

24. Why should Alexander’s technique be incorporated into medical training?

25. How would doctors’ methods of treating patients change if they had knowledge of and experience in using Alexander’s technique?

26. What 3 examples does Alexander give to illustrate how his methods would work in a medical diagnosis?

27. What answer does Alexander make to the question of whether or not his technique would be applicable in cases of “mental” defects?

28. What makes it clear that Alexander is not concerned with fixed standards of value as to what constitutes right or wrong in any particular case?

29. Is the same true where the use of the self concerned? Why or why not?

30. What do the experiences involved in acquiring a knowledge of the “right” and “natural” use of the self give a person? How is this accomplished?

31. Why will a valid criterion relating to the use of the self be a criterion that is valid in relation to all a person’s activities?

32. What renders people unable to carry out their resolutions and to make certain changes for the better in themselves and in their conduct and attitude towards others?

33. What will happen to a person who wants to make a change but has no other criterion to go by but that of the familiar feeling of their wrong habitual use?

34. What happens in the process of employing Alexander’s technique, and what type of criterion do people develop who follow his process?

35. What is the only way difficulties such as Alexander has described can be overcome?

36. What was the obstacle to Alexander’s employing the new means whereby in reciting?

37. What must all who wish to change something in themselves learn to do?

38. What will their new conscious direction gradually come to be associated with?

39. What may a particular stimulus start up in a person who has an untrustworthy sensory appreciation?

40. Why is merely “trying not to be deceived” futile?

41. What is the danger of continuing to base our efforts to help ourselves or others upon beliefs, judgments and convictions which have their source in sensory experiences?

42. What does the experience of putting into practice the technique for the building up of a conscious direction of their use give to people? Why?

43. What do people find who continue to make the principle underlying Alexander’s procedure their guiding principle in all their activities?

44. What does the foregoing ability mean?

45. What in Alexander’s opinion would be the result if his technique were made the basis for education?

Thought Questions

1. Alexander writes (p. 113) “I have found that in this process of acquiring a conscious direction of use my pupils gradually develop a higher standard of sensory awareness or appreciation of what they are doing in the use of themselves, so that when it comes to carrying out a course of activity they have decided upon, they possess a criterion within themselves which will enable them to judge whether the use they are employing is right or not for the purpose.” Later (p. 115) he writes “…all those who wish to change something in themselves must learn to make it a principle of life to inhibit their immediate reaction to any stimulus to gain a desired end, and, in order to give themselves the opportunity of refusing to fall back upon the familiar sensory experiences of their old habitual use in order to gain it, they must continue this inhibition whilst they employ the new direction of their use. By adhering to this principle they will find that this conscious direction of their use will gradually come to be associated with a sensory criterion upon which they can rely as a more accurate register of impressions.”

Is the “sensory criterion” upon which we can rely in the second quote the same as the “higher standard of sensory awareness or appreciation” in the first quote? What does it mean to “fall back upon the familiar sensory experiences” to gain one’s end? What is it about sensory appreciation that makes it unreliable? Is there a difference between relying on (a now presumably accurate) sensory appreciation to be aware of when we have “gone wrong” in our directing, and relying on it to guide our movements in the first place? How do we use our sensory appreciation when acting habitually? How do we use it when acting non-habitually? Is there a difference between the two uses? Is there a difference between a reliable sensory appreciation and an accurate one? What do we mean when we say our sensory appreciation is reliable? What do we rely on it to do?