Thursday, 23 April 2009

Conductive Education: it’s magic

Some serious points here

Three weeks ago Susie Mallett (2009a) posted an item on magic and tricks in Conductive Education. This was a characteristically informal and practical piece, touching characteristically upon important themes rarely explicitly expressed in Conductive Education but deserving to be.

At the time I jotted down some immediate things that I was reminded of by this. Unfortunately, however, I had no opportunity or access to check on these over the Easter break. Here now are my immediate random associations. I have no doubt that a more thorough and formal enquiry would find more.

This is enough, though, to suggest that I am not alone in finding the notion of ‘magic’ and of ‘tricks’ acceptable means to raise questions about and around Conductive Education.

András Pető

Here is something written by Péter Popper, one of the then impressionable young people who knew András Pető in the years after the War, interviewed many, many years later.

Today as I look back as an old university professor [of psychology] I’m convinced that Pető was an excellent man, and he was far ahead of the others in limbering up spastic patients. He could achieve a relaxing, a loosening. He really got results with spastic patients, and although I know that this is not a very nice ting to say, his method achieves results because it is done by fanatics, no one else could do it, only fanatics. (Péter Popper, interviewed by Forrai, 1999, p.112).

He added:

I have been to India several times, as well as to Istanbul. Pető’s was a mystical personality, and he never hid that for a second. Some people understood it, and some people considered him a lunatic…. He was a peculiar, unconventional person who lived like a stranger in our midst, and he was led by his destiny. A solitary magus or a monk (ibid., p. 113)

Granted that this is an English translation from the Hungarian, for what it is worth the English word ‘magus’ means an astrologer, sorcerer or magician of ancient times.

‘A special kind of magic’

This was the title of a short research report published more that twenty years ago, at a time that Australia looked to achieving pole position in the early race to get CE established outside Hungary:

David Cooper was a social psychologist and structured his evaluation of a ‘CE camp’ in social-psychological terms.

Methodologically his study laid down a pointer for future evaluations that has not been followed up by a field that has since then largely surrendered its evaluation to methodologies less appropriate to phenomena of the complexity involved in Conductive Education. It is a pity that the camp in question was run according to 'the principles’ rather than by conductors, but no matter: from the viewpoint of exploring relevant evaluation models this was an excellent if unfulfilled beginning.

David Cooper’s title came from something said by one of the parents taking part in this camp, to describe what he had felt there. This is also, incidentally, one of the most affirmative research studies undertaken upon practice dependent upon the ‘principles of Conductive Education’. Had people working in that way been more alert to this, they might have followed it up with enquiry into just what factors might have been in operation here to produce this feeling, with important implications for future service developments of this sort. Unfortunately, the ‘magic’ seems not to have become a subject for further consideration.

As for the wider question of evaluation of outcomes of Conductive Education, researchers might have been more relevantly employed in pursuing questions related to this ‘magic’, rather that by such extraordinarily irrelevant activities as ‘the ten-metre test’!
  • What is it that makes people feel this way?
  • How was it that they felt before, and how was that brought about?
  • What are the possible material components in the ‘conductive’ lives of children and parents children, hope, wellbeing, success etc that are summed up in this word?
  • What is the practical contribution of feeling this way to the rehabilitative/educational process?
  • How far can you get without it?
Perhaps the very word ‘magic’ put people off asking what vital material mechanisms might lie behind it.

Ronni Nanton’s ‘tricks’

Around the same time Ronni Nanton in Birmingham had been investigating the relevance of Conductive Education to people with Parkinson’s disease.

Along the way she hit upon the spontaneous self-help culture largely ignored by the professionals who earned their living from Parkinson’s disease. She focussed upon often self- discovered activities that Pakinsonians used to facilitate movement, referring to them as ‘tips‘ or ‘tricks’:

There has emerged spontaneously amongst patients a folk psychology which offers methods of overcoming this problem [‘freezing’]. This folk psychology comprises a number of ‘tips’. Many of these are widely known amongst sufferers and are accepted as useful ways of getting going. Some involve the sufferers’ own imagination, some verbal instructions by the sufferer or someone else, and some visible objects or sounds...
In professional folklore it is a standing joke that at the call of ‘Fire!’ Parkinsonian patients will be the first out of the hospital. Despite the intriguing nature of this phenomenon it has been the subject of only one systematic account… (Ronni Nanton, in Cottam and Sutton, 1986, p. 188).

These strategies or tips have frequently appeared in books written specifically for and often by sufferers and families, where they are generally referred to as ‘tricks’. I do not know whether now, twenty years or so later, such ‘tricks’ remain underground and ignored. Whatever their status in contemporary professional practice, however, these tricks do hold a most illustrious place in the history of psychology and neuro-rehabilitation:

Starting in 1926 two Russian psychologists, A. R. Luriya and L. S.. Vygotstkii carried out a series of observations and experiments with Parkinsonian patients at the Moscow Institute of Psychology. (ibid., p.189)

Despite the limitations the experiments were important as they demonstrated, like the sufferers’ own tips, the capacity of the intact second-signal system to override or circumvent a lower-order deficit. (ibid., p.193).

Tricks, popular folklore and folk psychology of this kind, whatever term you favour, should in no way be looked down upon or ignored:
  • they may confer real practical help to those in need, and
  • their association with theoretical understandings of rehabilitation, a paradigm leap, leapfrogged a conceptual generation (a generation that unfortunately many people will meet still in their present-day rehabilitation services).

Ronni’s work with the Parkinson’s Disease Society lead over the next few years led to that Society’s close and active invilvement the early establishment of adult conductive rehabilitation in the United Kingdom. As far back as 1984, however, she had already presented a memorandum to Society suggesting a research programme:

  • invoking Luria’s neuropsychology
  • involving the tricks
  • suggesting a preliminary analytic matrix for these tricks on the basis of Luriya's theoretical position, and
  • proposing that they be researched and developed further for their potential benefit to people with Parkinson’s disease.

This was not taken further, though Ronni’s underlying a priori notion still merits serious examination:

It seems to me important that a welfare worker should try to discover the strategies for coping adopted by individuals, in order to avoid casting the sufferer in the role of passive recipient of services. He should rather be recognised as the primary agent in the management of his condition (Nanton, 1984).

Her invocation of Luriya’s work indicates the immense heuristic value of mysterious, magical, psychological tricks, apparent mental sleights of hand, in bringing about practical and theoretical advance, if responded to with appropriate scientific investigation.

The Sorcerer’s apprentice (der Zauberlehrling)

Early in 1987, at the height of the public, professional and political furore over Conductive Education in the United Kingdom I had one of my most vile experiences in Conductive Education, when Mária Hári and I presented to the Second International Congress on Child Health, in Edinburgh. The weather was raw and chill, indoors as well as out, and the reception that we received from the audience was frosty to the point of iciness.

I recall our standing together under bright lights in front of a large, darkened auditorium. The waves of silent, suppressed indignation, hatred even, that greeted what we said were almost palpable. Then the ‘questions’ came, not so much questions as… well, I don’t know the right word: condemnations, dismissals, accusations, curses, often introduced with that most terrible imprecation: 'I... am a Superintendent Physiotherapist…'

I am sure that there were some in that audience who would have gladly watched us burned as heretics or witches. Great fun!

Afterwards we were interviewed together in our hotel, the Caledonian on Prince’s Street (quite the coldest palace that I have ever slept in), by Pat Scowan who was then editing the magazine Health at School, a most competent journalist whose interview was a great salve after what we had just been through. Towards the end she raised the issue that some of our questioners had also expressed, that they had known all about Conductive Education for years, and indeed already did it (and it didn't work!)

Pat Scowen. Is it true, Dr Hári , that that you don’t approve of people doing Conductive Education by half-measures? Some people have tried to set up a modified form in this country.

Andrew Sutton. People have come to Budapest and taken some of the superficialities some of the components, and think they’ve got Conductive Education. But they haven’t - it needs both the philosophy and the huge repertoire of personal skills.

Dr Hári. Do you know Goethe’s poem about the Sorcerer’s Apprentice? He thought he could practice magic when his master was not there, but when he tried it he found it didn’t work properly.

Some years later, in the early-mid nineties (I cannot for the moment find the written report) I was at one of the informal gatherings that Helga Keil engendered, held over the period of a few years in Austria, Germany and Belgium. I did not approve of everything that I heard there but they did serve as a sort of master-class. It is a great shame that this tradition has not been taken up and expanded but I do not suppose that many people could afford this nowadays if it were.

At one of these seminar-style events I had been asked to offer for discussion a taxonomy of Conductive Education in Europe. I had no idea what to say and only as the preceding couple of presenters spoke did I manage to jot down a matrix of sorts, just I time to deliver it when my turn came.

They liked it, especially the final category of all: Mickey Mouse.

I had by then been using this mildly pejorative phrase for a long time, to refer to attempts to establish conductor-free practices under the name of Conductive Education, based upon the ‘principles’. I remember introducing the phrase to Mária Hári sometime in the eighties. She liked it and told me that in Hungarian an equivalent phrase in this sense would be hokusz-pokusz. This European seminar was, however, the first time that I had employed the phrase Mickey Mouse in a formal setting. I believe that it has since gained a certain currency in this sense within Conductive Education (including in the German-speaking lands).

I have a small Mickey Mouse puppet hanging above my desk at NICE. I used to use it as a visual aid in lectures to student conductors. Only a few years ago, though, did the sight of this puppet brought to mind the a coincidental link to what Mária Hári has replied to Pat Scowan in the Caledonian Hotel back in 1987. I am pretty sure that Mária Hári could never have seen Fantasia, so coincidence it remains, but here’s Walt Disney’s take on the Sorcerer’s Apprentice:

http://www.youtube.com/watch?v=LD8HDta7Z_4

* * * * *
Susie Mallett (2009b) has subsequently returned to tricks and magic in a further posting, so I may come back to it too.

References

Cooper, D. (1986) A special kind of magic: changes in family dynamics arising from parent participation in a Conductive Education program. Community Health Studies, vol. 10, no 3, pp.294-306

Forrai, J. (1999) Memoirs of the beginnings of Conductive Education and András Pető, Budapest and Birmingham, Uj Aranhíd and Foundation for Conductive Education

Mallett, S. (2008a) The stroke group - or is it the Magic Circle? Conductor, 3 April
http://konduktorin.blogspot.com/2009/04/stroke-group-or-is-it-magic-circle.html

Mallett, S. (2008b) A conductive of tricks - or taking the mystery out of the magic, Conductor, 19 April
http://konduktorin.blogspot.com/2009/04/conductive-box-of-tricks-or-taking.html

Nanton, V. (1984) Self-help for Parkinson’s disease: ideas for research. Unpublished document

Nanton, V. (1986) Parkinson’s disease, in P. Cottam and A. Sutton (eds.) Conductive Education: a system for overcoming motor disorder, London, Croom Helm, pp.178-205

Scowen, P. (1987) Conductive Education: treating the whole child, not the disability, Health at School, vol. 2, no 8, May, pp. 234-236

2 comments:

  1. I can think of one other piece written by an Australian lady with cerebral palsy entitled My bag of tricks. I did blog this some time ago. Its very frustrating that I am not able now to quickly consult the library catalogue to find other written examples.
    It does raise the question in my mind whether CE is common sense, using ingenuity or magic or whether it has a definite scientific basis? - perhaps both?

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  2. As is often the case, it all depends what you mean by the words that you use!

    You brought up:

    common sense
    ingenuity
    magic
    scientific

    As I wrote towards the end of the above item this is a question to which I intend returning. I think that my intended line offers a possible, concrete answer to the question that you raise.

    ReplyDelete