Transcript: Beverly Atkins on The Back Doctors Podcast

Host: Dr. Michael Johnson Guest: Beverly Atkins, Guild Certified Feldenkrais Practitioner and founder of Pauseture Show: The Back Doctors Podcast (thebackdoctorspodcast.com)

A Back Injury, a 90-Degree Walk, and a Lesson on the Floor

Dr. Michael Johnson: Welcome to this episode of the Back Doctors Podcast. Our guest today is Beverly Atkins. Welcome to the podcast, Beverly.

Beverly Atkins: Thank you for having me, Dr. Johnson.

Dr. Johnson: I'm excited to hear what you have to share with our listeners. Just from reading your bio and the things you're into, I think this is going to be different and exciting for them. But let's start with your personal journey first.

Beverly: Twelve years ago, I was 47 years old and I had debilitating back pain. The only way I could walk was bent at almost a 90-degree angle. A very flexed position was the only way I could find comfort. Being upright just wasn't available to me. I walked around like that for three weeks.

I had a history of back pain going back to high school, which was the first time I saw a chiropractor. But this pain was different from any recurring pain I'd had before. I visited all the practitioners who had helped me in the past, and nothing improved it. As a matter of fact, it felt like it was getting worse.

As fate would have it, at the end of those three weeks I had a planned vacation at a health resort. I had planned to do fitness classes there, but I just could not move. Then I saw one course description that said, "Lie on the floor and make slow, gentle movements to improve your movement and posture." I had had a hunched posture my whole life, so I thought it would be a good idea to give it a try.

I walked into the class at a 90-degree angle, and the instructor told us to lie on the floor, close our eyes, and not be tempted to open them and compare how other people were interpreting the movement cues. That was really frustrating for me, because I had always considered myself a visual learner. I was used to yoga and seeing a demonstration of how to do something, so listening intently was a problem. I was certain I was doing it wrong.

One cue she gave us was, "If you're in pain, do not do anything above your baseline pain. Go less, go slower, go smaller, and look for what feels good for you, even if that means rolling up into a fetal position and just listening and imagining doing the movement." It was very permissive. It wasn't corrective at all. It was about getting curious about my own movement and finding what might feel better for me. I was still certain I was doing it wrong. But 45 minutes later, I stood upright and I had no back pain at all.

Dr. Johnson: Wow.

Beverly: It left me deeply curious. It really felt like magic, like it wasn't possible. It took time, and more conversations, for me to understand what might have happened.

Dr. Johnson: Now you have both me and the listeners hooked. What could you possibly have done in 45 minutes that you couldn't do in those three weeks, when all the practitioners couldn't help you?

Beverly: I will say it was the right lesson at the right place at the right time. I was on vacation, so my day-to-day stress had lifted. And I later learned something about the instructor. But first, just to explain what this is: it was a Feldenkrais Awareness Through Movement lesson.

Dr. Johnson: Say that one more time.

Beverly: Feldenkrais. It rhymes with "nice." Awareness Through Movement.

Dr. Johnson: Okay.

What the Feldenkrais Method Is

Beverly: That's the method I had barely walked into. I ended up becoming a Feldenkrais practitioner, and the instructor of that class turned out to be one of the assistant trainers in my training program. We talked about my experience. She told me that if she sees someone in excruciating pain like I was in, she adapts and intentionally teaches a lesson that will be supportive for that person. She saw me in a flexed position, so she made a game-plan decision to teach a flexion lesson. There are thousands of Feldenkrais Awareness Through Movement lessons.

What she did in that lesson was have me flex more. We were lying on our backs, and she had me lift my arms and legs to bring them closer together. Through the whole class, I repeated different ways of bringing my arms and legs together. She was guiding me to be more flexed.

In this method, it really is about studying movement patterns and supporting the student's pattern, going deeper into the pattern where they're finding comfort, as opposed to being corrective and trying to push them in the other direction. The reason is that the nervous system starts to feel safe, and when the nervous system feels safe, it can start to open up options. It's incredibly surprising: if somebody has a hunched posture, going more into the hunch can actually open up a more upright position.

Dr. Johnson: Yes, a little counterintuitive.

Beverly: It is so counterintuitive to our culture and the corrective approach we've taken. Moshe Feldenkrais was a student of physics. He had a PhD from the Sorbonne in physics, and he was a judo master and a small man in stature. He understood from judo how he could lift somebody twice his size and throw him across the room. He understood physics. He started playing with his own body because of knee pain, to figure out how to move differently. He was ahead of his time with his theories about supporting the nervous system so it can reorganize the musculoskeletal system to move more efficiently.

Dr. Johnson: So how long has this method been around?

Beverly: He was writing books in the 1940s, and he was teaching this method after World War II. He started with hands-on lessons, and so many people were asking for his support that he created large group classes so he could guide people through the movements. The group class is the adaptation of his hands-on work. It's the Awareness Through Movement class I made my way into.

Feldenkrais practitioners are also trained to do hands-on work, which is really the same movements. The benefit of working with a practitioner who moves you is that the practitioner goes much slower and smaller, because most people left to their own devices go too hard and too fast for the nervous system to feel safe. The hands-on lessons are called Functional Integration, and the group lessons are called Awareness Through Movement.

From Facebook to Feldenkrais

Dr. Johnson: I want you to share more about that, but let's go back to your background. What was your career before you started doing this?

Beverly: When I put my back out, I was working in advertising sales at Facebook.

Dr. Johnson: No kidding.

Beverly: The irony is that the culture there was "move fast and break things." I think that stress, plus other things going on in my life at the time, and my longstanding hunched posture, were all contributing factors to my back going out. It was ironic that two years into working at Facebook, I found a method that is really about moving slowly.

I kept doing the recorded lessons when I got home, because I was committed to improving my posture. The more I worked at a computer, the more hunched over I became, and I was frightened I was going to end up with severe kyphosis. I was going in the wrong direction. I did the lessons before work every day, and for the first time in my life I was sleeping better and focusing better. At the time I had a lot of conflict at work, and I was showing up in a more regulated state, so my conflicts improved. Really big changes started to happen, and it felt very mysterious to me.

I didn't understand it. At first I thought, there are a lot of rib-opening lessons, where you gently side-bend and open the ribs, so maybe I'm sleeping better because I'm breathing deeper. I think that was part of it. But a big part was that I had always had a hypervigilant, move-fast, very Type A personality. I never paused, never took a break. These lessons gave me the opportunity, similar to people who find meditation, to find that calm before I went into work. For the first time in my life, I found a more downregulated nervous system.

Dr. Johnson: So now you've made the transition to doing this full-time as a certified practitioner.

Beverly: Yes. The training program to be certified is four years, eight weeks a year, 800 hours total. I was so fascinated by the changes I was having that I looked into signing up. There aren't a lot of programs, unfortunately, and the next one wasn't starting until 2016. I applied, got accepted, and thought, "I'll start the training, and when I run out of vacation days, I'll quit Facebook." This was 100% what I wanted to do.

My original idea was to build a back pain app, because at first I thought it was only about back pain. I've since learned that having a reorganized nervous system and musculoskeletal system benefits so many parts of your life. The app, which we'll talk about, isn't necessarily a back pain app, but I'm learning from testers and subscribers that it is helping back pain.

I ended up completing the four-year training program while working at Facebook, by working remotely and using earned vacation days. I don't even know how it worked out. But when you have a well-regulated nervous system, your company starts to make exceptions for you. Then, right before COVID, I resigned to open a private practice. My mentor said, "Before you build this app, you really need to open a private practice and work with people one-on-one to understand the benefits of the method."

Dr. Johnson: I'm still curious about the method, and now I'm curious about the app as well.

Walking Patterns and Back Pain: Homolateral vs. Contralateral

Beverly: I had a private practice for four years, and for the last few years I overlapped it with building the app. Eventually I closed the practice to stay focused on the app. From a back pain perspective, there were two recurring issues I saw in my private practice, and I want to share one of them quickly, to show how I worked with clients who had back pain.

We're students of watching people's movement patterns. What I often noticed in people with back pain was that they were walking homolaterally. When the right arm goes forward, the right leg goes forward; then the left arm and left leg go forward together. Think of how Frankenstein would walk. I would see this homolateral pattern, and the direction I wanted to work with them on was bringing in contralateral movement, where the right arm comes forward as the left leg comes forward.

If they were comfortable lying on their side, I would have them lie on my table with their top arm and leg resting on really soft, gentle foam rollers. I would find the pattern they liked. With homolateral walkers, the arm and leg would move forward together, then backward together. The hands-on work is about listening with our hands. We're not moving them with our hands; we move with our pelvis. That way it's much lighter. Rather than feeling yanked and pulled, they're gently guided by where my nervous system is going.

I would take them forward and backward, and when they felt safe, I would gently introduce the arm going forward while the leg goes back. The movements are really small, and I'm talking a millimeter. Eventually I might move up to an inch, but we don't really move more than an inch. It starts with a millimeter.

The trick of the method is that this gives a slight spinal rotation. The client is probably thinking about their limbs, and I'm thinking about their limbs, but what's happening as the arm comes forward and the leg goes back is that I'm introducing a contralateral pattern while they're lying down. Then when they get up from the table and walk, they begin to walk with that contralateral pattern. That was incredibly helpful for many forms of back pain I was seeing.

Dr. Johnson: Does it normally take just one session? Will people start moving contralaterally after one session?

Beverly: That's a great question. It depends on the person. If it's a newly acquired movement habit, people will typically feel relief in that one lesson. Even as a new practitioner, I was surprised by how many texts I'd get later in the day that said, "I don't know what you did to me, but this is the most comfortable I have felt in a long time."

Here's the thing, though: the lessons were designed for neuroplasticity, for changing things at the brain level. Moshe Feldenkrais said he wanted flexible brains, not flexible bodies. He was saying this in the '40s and '50s, before neuroplasticity was validated in the '80s or '90s.

Dr. Johnson: Right.

Beverly: He was just ahead of his time. What modern neuroplasticity science tells us is that you cannot erase your old pattern. If someone has a longstanding pattern of walking homolaterally, they may walk contralaterally when they get up from the table, but they will more than likely default back to the homolateral pattern, because that's how the nervous system works. It goes back to its old patterns.

Everybody is different, and with some clients I could do just a few lessons. But typically I would set the expectation of committing to 10 lessons, because it takes repetition. That was also my motivation for creating the app: so people could do the lessons at home. I would give clients recorded lessons that worked on the contralateral pattern lying on their side. It's repetition, with variation in the repetitions, so that the nervous system learns. What we're really doing is creating the conditions for the student's nervous system to learn new options.

When you're not sleeping well, not eating well, or under stress, you'll typically default back to the comfortable pattern you've always known. But with awareness, which is why the lessons are called Awareness Through Movement, you can consciously choose the new pattern, and over time your nervous system can adopt it.

Dr. Johnson: And eventually you have a new default, to a degree.

Beverly: Yes. And age really matters. I worked with a lot of young, very plastic brains, and they adapt and adopt a new pattern much more quickly. That's why my mission with this app is to get younger people improving their movement patterns, so back pain doesn't arrive later in life.

I'll speak to my own experience. I had a very hunched posture, and when I'm busy working at the computer and catch myself, I think, "Oh my God, I'm so hunched." I haven't perfected my posture by any means. Over time I have a more upright posture, but my default mode is going back to that hunched position. Scientifically, you cannot erase that old pattern. It's going to be there.

Who Is This For?

Dr. Johnson: So this method isn't just for back pain. It's for posture, and you said regulating the nervous system. Should everybody do this?

Beverly: I'm biased. The answer would be yes. It's not for everybody, especially people who have a hard time settling in, and that's why I designed Pauseture the way I did. There are more movement-based lessons to bring people into the method, and there are more subtle lessons. I know from my own experience, as an overactive person with no kinesthetic awareness, that it was the bigger, movement-based lessons, as opposed to the really tiny and subtle ones, that attracted me to the method and worked for my nervous system.

To answer your question: my original idea was to build a back pain app, then I opened a private practice and worked with people. Most of my clients had chronic pain, because people don't find the word "Feldenkrais" until they've already tried everything. They're trying to prevent that surgery, or that one last thing. They've already seen everybody. Most of my chronic pain clients came to me after reading Norman Doidge's book The Brain's Way of Healing, which goes into why the Feldenkrais Method is effective from a neuroplastic standpoint and why we're able to change the brain.

With people in pain, I was really nervous about launching an app and saying, "These are the lessons for hip pain. These are the lessons for back pain." I went back to what the method is, which is improving movement patterns by breaking up habitual patterns and introducing new ones. It really is a movement-based app to improve your movement.

When you improve your posture and your movement, modern research supports that you free up mental capacity. If you have poor posture and you're fighting gravity just to walk, you're using up mental bandwidth, and that's preventing you from connecting with others and from thinking clearly. Your whole nervous system is so busy fighting gravity that you don't have the capacity to really connect.

I was an athletic person. I did Ironman Hawaii in 2009. But I was running with my head down. Everything was done with grit, not grace, because I didn't have efficiency. When you move better, it opens up mental clarity and the ability to connect with others better. It can be a big change.

Testers, Nervous System Regulation, and Helena's Story

Beverly: When I launched Pauseture, I never mentioned pain at all. There's a trend now around nervous system regulation, and this is incredibly regulating for the nervous system. We recruited about 300 testers, marketing it purely for nervous system regulation, and had them go through our first 21 lessons. It's a guided 21-lesson intro, with lessons from 5 to 18 minutes. I did not promise or mention pain relief. It was simply, "Come regulate your nervous system and sleep better at night."

Then the emails started coming in about the pain relief people were feeling. I had direct email communication with all of these testers, and a group where they could comment so I could support them.

I want to be mindful of time, so I'll share a recent email from Helena. Helena was about one year postpartum and had had excruciating SI joint and back pain since her pregnancy. In her application for the test program she didn't mention that at all. She mentioned a dysregulated nervous system and not being able to sleep at night. Then she did the 21-lesson series, and she emailed me on day 19 and said, "I want to let you know I repeated day 18. Is that okay?" I said absolutely, do whatever you want.

After day 18, there's an 11-minute lesson called the Pelvic Clock. After that lesson, her SI joint pain went completely away.

Dr. Johnson: Wow.

Beverly: She also said that for the previous three weeks she had been sleeping better than she had in more than ten years, which was before she ever even got pregnant.

I want to preface this by saying it wasn't the 11-minute lesson alone that relieved her pain. It was the turning point, but she had built a consistent practice over 18 days. The Pelvic Clock is probably our most effective lesson, but it's incredibly nuanced, so it's not a good first lesson, which is why I intentionally put it later in the 21-lesson series. We build up to it. On day 16, we do pelvic rocks going up and down, 12 to 6. On day 17, we do pelvic rocks side to side, 3 to 9. Then on day 18, we go all the way around the clock, subtly tilting the pelvis. She was being led up to that lesson for 18 days.

After that lesson she got up and went for a three-hour walk. If she'd been my client, I would have said, "Maybe ease back into your activity." In my private practice, people would feel really good after a lesson and then go do too much.

Dr. Johnson: Yeah.

Beverly: But she said she couldn't believe how well she felt. The next day she repeated the lesson, and that's when she emailed me asking if it was okay to repeat it before moving on. I said absolutely, that's what the app is for: to make it your practice.

That's one of many emails I've gotten from people I recruited for nervous system regulation. I think it mirrors my own experience of the method: not doing the lessons to be achievement-oriented, because then you're back in a fix-it, achievement mentality. Doing the lessons just to be present and curious is when I think they're most effective.

Dr. Johnson: Wow.

How to Try Pauseture

Dr. Johnson: I'm excited to download the app. Can you share with our listeners how they can do that, and your website and contact information?

Beverly: Thank you. The website is pauseture.com, which will take you to the Google Play Store or the Apple App Store, or you can go straight to either app store and download Pauseture. We normally have a seven-day free trial, but for your listeners I created a redemption code in both app stores: BACK30, B-A-C-K-3-0. If they use that code, they get a 30-day free trial. That gives people the opportunity not to rush. I think going through the 21 lessons is incredibly effective, and what we've seen is that people sign up for the seven-day trial and try to do all 21 lessons to maximize it. I'd like your listeners to have 30 days to see if it's supportive of where they are in their healing journey right now.

I did not launch the app until we had 365 lessons in it, and we will continue to grow, because what's important is the novelty of the lessons. You can save the 21 lessons and revisit them, but it's when you do one where you don't know where it's going that you're forced to turn off autopilot and think, "I don't know. I don't understand. I'm really confused."

That's the caveat. We don't have videos in the app. They are audio by design, because neuroplasticity research shows that it's in the confusion and the mistakes that your nervous system learns. If you go in like you're doing yoga or Pilates, trying to be perfect, your nervous system isn't learning; it's mimicking. Being confused and being frustrated is how your nervous system learns.

Dr. Johnson: I'm glad you said that. That makes a lot of sense. For our listeners, we'll put all of your contact information and the BACK30 code in the show notes. And once you've downloaded this and done the 30 days, I want to hear from you, so email me.

Beverly: I love that. We're not a huge company by any means, and I respond to every email. If you email contact@pauseture.com, I read and respond, and I want to be as supportive as possible as we work to improve the app. And I love that you'll have them email you too, because the emails I'm getting are why I'm so excited about bringing this to more people.

Dr. Johnson: That's great. Thank you for sharing all this with our listeners. I certainly appreciate your time on the Back Doctors Podcast.

Beverly: Thank you so much.