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NEUROPHYSIOLOGY OF HANNA SOMATIC EDUCATION By Caroline Wright My intention in writing this paper is to present a clear outline of what Hanna Somatic Education (HSE) is and how it works. Since the methods of HSE are all scientifically based and work directly with the brain and nervous system, I will provide an overview of the structures and functions involved. Created by Thomas Hanna, HSE is the use of sensory-­‐motor learning to reawaken the mind’s control of the neuromuscular system. When contraction patterns become neuromuscularly habituated, they can cause a host of functional issues including chronic pain, stiffness and postural distortion. The word Somatics comes from the Greek word Soma, which means “the living body in its wholeness.” To learn somatically is to have a first-­‐person experience of one’s self and to create changes from the inside out. As HSE practitioners, we teach clients how to improve the functioning of their nervous systems, release contracted muscles, gain conscious control of movement and improve their health. Our knowledge of neurophysiology informs our practice and enhances our ability to facilitate this transformative process. THE NERVOUS SYSTEM The nervous system is a complex network of systems that coordinate our voluntary and involuntary actions, transmitting information throughout the body. It is divided, both structurally and functionally, into the Central Nervous System (CNS) and the Peripheral Nervous System (PNS). The CNS is the core of the human body and consists of the brain and spinal cord. The PNS consists of cranial and spinal nerves that serve as messengers between the CNS and the rest of the body. With the exception of primitive reflexes, our movement patterns are learned. HSE takes full advantage of this fact, recognizing that since we learn our way into dysfunction and pain, education is the way out. HSE utilizes all three functions of the nervous system: sensory, integration, and motor. The brain is the main control center for the body, and is the initiator of voluntary movement. It connects to the spinal cord via the brainstem. Thirty-­‐one pairs of spinal nerves branch out from the right and left of the spinal cord, carrying both sensory and motor information. Through ascending sensory tracts and descending motor tracts, the spinal cord transmits signals between the brain and the rest of the body. The Nervous System has two basic divisions: the Somatic Nervous System, which can be controlled voluntarily, and the Autonomic Nervous System (ANS), which refers to neurons that control our bodily functions that can go on without conscious input. The ANS has two main branches that have largely opposing effects on the body: the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS). The primary function of the SNS is to defend the body against attack. When there is a perceived threat, either internally or externally, it’s nerves help mobilize 2 us for what is commonly referred to as the “fight or flight” response. Typical effects of this include an increase in heart rate, blood pressure and blood sugar, elevated stress hormones and decreased digestive activity. This stress response stimulates the reticular activating system (RAS), which increases mental alertness and contributes to overall muscle tone. Unfortunately, SNS dominance is a very common condition, especially among people who are in chronic pain. The PNS serves to heal and regenerate the body, facilitating a state of “rest and repair.” The PNS activates the digestive system; improves immune function and sleep; and allows detoxification to take place. The PNS helps reduce the activity of the brain and muscles, leading to a calm, relaxed state of readiness. From this place of neutrality, we have the most options, and we are better prepared to perform at our best. The PNS helps tune down the RAS, which contributes to an overall reduction in muscle tension. One of the benefits of HSE is that we help clients move into PNS dominance. THE BRAIN: 3 LEVELS OF MOTOR CONTROL The brain can be divided into three portions. From the bottom up, these are the hindbrain, which includes the cerebellum, pons and medulla; the midbrain, which contains the reticular formation; and the forebrain, which is comprised of the thalamus, hypothalamus, basal ganglia and the cerebral cortex. Voluntary actions follow a command hierarchy from the most conscious level of our brain down to the spinal cord. The association cortex and limbic system influence motivation and work together to produce a motor plan. Once the intention to move has been set, the 3 motor cortex, cerebellum and basal ganglia help select an appropriate motor program. The brainstem and spinal cord carry out the intended action by transmitting the movement information from the brain to the muscles. A motor unit has two components: an alpha motor neuron cell body within the CNS and the contractile muscle fibers it innervates. When more motor units are recruited, the muscle can contract with more force. Gamma motor neurons function in a loop with alpha motor neurons to determine the amount of force needed. Gamma motor neurons innervate muscle spindles: sensory feedback mechanisms that are sensitive to the resting length of the muscle, and the speed at which lengthening occurs. This feedback loop determines the resting level of skeletal muscles and helps us to maintain posture and balance. Golgi tendon organs are located within the tendons and respond to muscle tension. They help us modulate the force needed to initiate and complete movements with smooth transitions while maintaining stability and balance. Throughout the intricate process of motor control there is continuous interaction between the brain, brainstem and spinal cord. Sensory feedback from peripheral receptors is crucial to the success of the intended movement. In short, we sense to move and move to sense. SENSORY MOTOR AMNESIA Thomas Hanna coined the term sensory motor amnesia (SMA) to describe the loss of voluntary control of a muscle. This “forgetting” is actually an adaptive response of the nervous system. The sensory motor system responds to a stimulus 4 and adapts to do its best given the circumstances. This adaptation can become an unconscious pattern, whereby conscious control of the muscles involved has been given over to the brainstem. This means that the muscles are receiving sub-­‐cortical output from the brain, instructing them to contract day in and day out. This chronic contraction deprives the muscles of the blood flow and oxygen they need to function well, leading to a build up of lactic acid and a feeling of weakness. Joint mobility becomes restricted, often resulting in pain and inflammation. Many conditions that are often thought of as structural problems (such as arthritis, sciatica, carpal tunnel, bursitis, and tendonitis) have a functional component: SMA. This functional component can be addressed through HSE. THE REFLEXES Sensory Motor Amnesia takes over our posture and movements in three basic patterns. Thomas Hanna identified them as the Red Light Reflex, Green Light Reflex, and the Trauma Reflex. The Green Light Reflex is a natural action response that activates the extensor muscles. It is first seen in infants as the Landau response, and it is part of our innate desire to stand upright. When it becomes habituated, however, it can cause an exaggerated lumbar curve, heavy heel strike and tight hamstrings. The Red Light Reflex is a protective withdrawal response. Also known as the Startle Reflex, it is associated with fear and apprehension, and causes contraction of the flexor muscles. When it becomes habituated, it can cause the upper body to round forward, slumping the shoulders and compressing the lungs and viscera. The head is no longer optimally supported by the spine, which makes 5 additional muscle contraction necessary to maintain an upright position. It can progressively limit gait, causing the feet to shuffle along the ground. The Trauma Reflex is a response to injury that helps guard against pain, as seen in limping, for example. It can also be an adaptive response to repetitive, asymmetrical tasks such as holding a baby, talking on the phone, or playing a sport that utilizes one side of the body more than the other. Habituation of the Trauma Reflex can cause lateral flexion and rotation of the spine. It may appear as though one leg is longer than the other. The contralateral motion of walking becomes restricted. Thomas Hanna also recognized a fourth postural reflex called the Dark Vise, or Senile Posture, which is a simultaneous activation of the Red Light and Green Light Reflexes as a stop-­‐and-­‐go response. APPLICATION OF HANNA SOMATIC EDUCATION Sensory Motor Amnesia requires sensory motor re-­‐education. We can offer this to groups, leading students through slow, gentle movements. The classes are designed to give students a first-­‐person experience of themselves, enabling them to create changes in their neuromuscular systems from the inside out. One-­‐on-­‐one clinical sessions are the most rapid way for clients to free themselves from SMA. Assessing a client’s posture, gait and overall muscle tone allows us to identify their dominant reflex pattern, the memory of which is stored in the cerebellum. Specialized protocols help us to be precise in addressing the clients’ SMA accordingly. With a gentle, hands-­‐on approach, we work with the client to break the pattern down into slow, simple movements. Once we have re-­‐programmed the 6 components of the pattern to be both functional and conscious, we give the new and improved motor plan back to the cerebellum and brainstem to reinforce muscle memory. By reprogramming the nerve supply to the muscle, voluntary control is restored. THE TECHNIQUES In a typical clinical session of HSE, three primary techniques are utilized: Means Whereby, Kinetic Mirroring, and Pandiculation. Means Whereby, a strategy first employed by F.M. Alexander and Elsa Gindler in the early 1900s, helps clients gain a first-­‐person awareness of the internal process involved with their movements. We slowly move the clients’ extremities within a comfortable range of motion and ask that they inhibit their tendency to either help or hinder the movement. The client has a chance to experience, often for the first time, what it feels like to simply allow a movement to take place without effort. This technique is applied actively as well. We ask a client to pay close attention to the “means whereby” they are performing a movement. Their awareness increases cortical activity and helps improve the functionality of their motor plan. To increase relaxation within the muscles on the spinal cord level, we use Kinetic Mirroring, which originates from the work developed by Moshe Feldenkrais. This technique involves bringing the origin and insertion of a muscle closer together, followed by a slow release out of the position. “If a muscle is stretched, it responds by contracting, and this is known as the stretch or myotatic reflex” (C&N,pg 73). Shortening the muscle, on the other hand, produces an inverse effect. 7 Muscle spindles emit sensory information to the CNS that decrease the firing rate of the motor units. To avoid triggering the stretch reflex, we return the muscle to a lengthened position slowly. Thomas Hanna developed the clinical practice of Pandiculation, a two-­‐part active movement that is neuromuscularly similar to yawning. As our primary technique, it sets HSE apart from other forms of somatic education. The pandicular response is instinctual and functions to refresh cortical awareness of muscle contraction, allowing the muscles to then come to rest. This action is carried out by the corticospinal tract, which is voluntarily controlled by the sensory-­‐motor cortex. It has the ability to synapse on interneurons that can inhibit the firing of the motor units. By minimizing distractions and taking the client out of gravity, we quiet the spinal tracts that are not conducive to our work and enhance the function of the corticospinal tract. Golgi tendon organs, receptors within the tendons, respond to the gentle change in force applied to the muscle by further inhibiting the firing of the motor units. Most vertebrates, human and animal, instinctively pandiculate upon waking. HSE uses hands-­‐on techniques and specific verbal instructions to amplify the benefits of this response. We ask the client to make a voluntary, concentric contraction of the muscle we are working with. This activates the sensory-­‐motor cortex and increases the activity of the Alpha and Gamma motor neurons. Next, we ask the client to make a slow, eccentric contraction, lengthening the muscle. This action causes the alpha and gamma motor neurons to decrease in activity, inhibiting the firing of the motor units. The client is in control of the movement, and part of our role is to provide load or assistance as needed to help the client gain fresh 8 sensation of the movement. After a few repetitions, it is sometimes helpful to follow up with a quick-­‐release and/or a lock-­‐in. A quick-­‐release is a ballistic movement that returns the motor control to the brainstem, especially the cerebellum. A lock-­‐in utilizes reciprocal inhibition. By contracting the opposing muscle group, the target muscle is further inhibited. Our goal as practitioners is to provide our clients with the tools they need to maintain their results on their own. We provide daily maintenance “Cat Stretch” exercises that the client can easily practice at home. We also help the client integrate their neuromuscular changes into functional actions of sitting, standing, and walking. Somatic learning is an ongoing process. CONCLUSION Knowledge of neurophysiology informs the principles by which we practice and helps define our role as educators. We do not treat, or work on, bodies-­‐-­‐we teach, and work with, the whole person. It allows us to explain to clients how SMA is affecting them, and why it is so important for them to practice their HSE exercises slowly and with maximum awareness. Understanding the structures and functions involved with diseases such as Parkinson’s and MS make it possible for us to customize our work to suit the needs of the individual. Sometimes clients are working with a healthcare team, so our knowledge helps us to be clear and concise with explanations and recommendations to other specialists, such as doctors, trainers, and therapists. 9 BIBLIOGRAPHY Brooks, Vernon B. 1986. The Neural Basis of Motor Control. New York: Oxford University Press. Criswell Hanna, Eleanor. 1998. Drafts of HSE Lectures, Wave 4. Crossman, A.R. and Neary, D. 2010. Neuroanatomy An Illustrated Colour Text, Fourth Edition. Churchill Livingstone Elsevier. Hanna, Thomas. 1980. The Body of Life: Creating New Pathways for Sensory Awareness and Fluid Movement. New York: Knopf. Hanna, Thomas. 2004. Somatics: Reawakening the Mind’s Control of Movement, Flexibility and Health. Cambridge: Da Capo Press. Hanna, Thomas. Autumn/Winter 1990. Clinical Somatic Education: A New Discipline in the Field of Health Care. SOMATICS, Magazine-­‐Journal of the Bodily Arts and Sciences. 10