lørdag 3. mai 2014

Eyebody part 2

The art of integrating eyes, body and brain – and letting go of glasses forever.

Vision is our dominating sense. Its influence on how we think, act and live should not be underestimated. Peter Grunwald is regarded by many as the leading authority on eyesight and visual functioning in the Alexander Technique community. In the first part of my article I presented the principles underlying Grunwald's Eyebody Method. In this second part I write about the health claims of the Eyebody Method, and about some of the things Grunwald says about the functioning of the eyes.

A cure for all ills

In the Frequently Asked Questions section in his book Eyebody(1) Peter Grunwald writes:
“Does this Method help every condition? Generally speaking, yes. It is possible to change most eye or body problems by gradually working with and coordinating the entire visual system. Specific visual and physical conditions will, over time, improve and begin to function naturally and optimally” (Grunwald 2004, page 123).
Grunwald believes all visual dysfunctions have a common origin: 
“My understanding is that all visual dysfunction arises not in the eyes themselves, but in the brain; specifically in the function of the upper visual cortex. The upper visual cortex guides the whole visual system”(2) (ibid, 37).
If you are near-sighted, this is what Grunwald believes happens inside your head and eyes:
“The upper visual cortex contracts onto the limbic system which then presses against the reptilian brain. As a result of this the auxiliary areas of the eye will tighten, followed by a tightening of the frontal area of the eye. The pressure on the third ventricle causes the pupil, retina and choroids to contract. The panoramic part of the retina receives less light and the panoramic photoreceptors transmit less stimulation to the thalamus. The thalamus then deflates and moves back and down, pulling the optic nerves along with it. This creates an elongated eyeball” (ibid, 61).
In other words – if you are nearsighted you have a deflated thalamus. One can wonder whether a thalamus actually can 'deflate', and if so, how Grunwald is able to know that it is deflated.

Fortunately, he advises medical attention in urgent situations, like in the case of retinal detachment, a condition which can lead to blindness.
“In the case of detached retinas, for example, it is very important to seek medical advice immediately – a laser operation will help the choroid and retina to function together again” (ibid, 60).
But he does not shy away from suggesting that the Eyebody Method can help prevent recurrence:
[...] But then some time after the operation it is important to undo tensions and contractions which have resulted from the operation itself, to undo the tension which caused the retina to detach in the first place, and to re-educate the visual system to prevent recurrence. (3) (ibid)
In the Frequently Asked Questions section Grunwald also writes:
“Will the Method help glaucoma, cataracts or macular degeneration? Yes, in all three conditions the overall activity of the visual brain needs to be increased first through conscious depth perception. Eye improvements will follow”(4) (ibid, 123).
Glaucoma, cataracts and macular degeneration are all serious conditions that are major causes of blindness.

“..., no person shall publish, or cause or permit to be published, any medical advertisement that (a) directly or by implication claims, indicates, or suggests that medicines of the description, or medical devices of the kind, or the method of treatment, advertised will prevent, alleviate, or cure any disease, or prevent, reduce, or terminate any physiological condition specified, or belonging to a class of disease or physiological condition specified, in Part 1 of Schedule 1;”
Schedule 1 is a list of diseases and conditions. Cataracts and glaucoma are on the list.(5)
I don't know if Peter Grunwald is legally bound by this, but I think ethically he should be. (6)

The Medicines Act of 1981 also states that 
“no person shall publish, or cause or permit to be published, any medical advertisement that— [...] directly or by implication claims, indicates, or suggests that a medicine of the description, or a medical device of the kind, or the method of treatment, advertised — (c) (i) is a panacea or infallible;”
Conditions mentioned in Eyebody and upon which the Eyebody Method apparently is supposed to have an effect are: astigmatism, bunions, cataracts, depression, detached retinas, dry eyes, floaters, dyslexia, fear and anxiety, general fatigue and exhaustion, glaucoma, headaches, hearing difficulties, heart problems, high/low arches of the feet, hip joint pain, hypermetropia, immune deficiency or auto-immune disorders, jet lag, light sensitivity, lower back pain, macular degeneration, memory problems, menopause, irregular or painful menstrual cycles or menstrual tension, migraines, myopia, pelvic imbalances, poor blood circulation or feeling of pins and needles, poor night vision, presbyopia, reproductive disorders, scoliosis and spinal dysfunctions, shin disorders, neck and shoulder tension, singing difficulties and speech impairment, squints, throat disorders, tinnitus, varicose veins. (Grunwald 2004. Most are from pages 60-89)

Snake oil, anyone?

Apart from the specific eye conditions, a similar list could have been derived from the writings of F.M. Alexander. We should be careful not to repeat his mistakes.

Even if you hurt your back in an accident, the Eyebody Method is apparently the answer:
“The pain may go away, whether over time or by means of physical intervention, but the contraction, pain or trauma of the lower back can still be found in the visual system, even years later [...]”.
You can try any other modality and maybe feel better:
“If I have sessions of cranial osteopathy, Feldenkrais, Alexander, structural integration, massage, physiotherapy, chiropractic, or other body or mind/body work, my body may feel lighter and I may feel more aware and alive, and pain-free. I might be thinking more clearly, be more coordinated and in better shape.”
But it just doesn't do the trick:
“... this is likely to have only a marginal affect on my visual system as the appropriate relationship of the brain region to the eye area has not been addressed directly.”
Peter Grunwald's Eyebody Method is what you need:
“Only when we bring consciousness into the visual system can these patterns be dissolved from the source” (ibid, 48).
Peter Grunwald is probably an honest person, but he definitely sounds like a quack.


The pseudoscience
Peter Grunwald gives the impression of being someone who knows a lot about eyesight and the brain. Whenever he writes or speaks he produces strings of words from the medical dictionary. A closer look, however, reveals that his understanding has serious shortcomings.

You have already read about the deflated thalamus of the myopic brain. In the corresponding description in his article in the Oxford Congress Papers Grunwald states that: 
“This in turn narrows and shortens (depresses) the thalamus, which literally pulls back and down and pulls the optic nerve downwards with it, shortening the brainstem and spinal cord. This causes the eyeball to over-lengthen and hence allows the light to fall short of the fovea centralis, the area of photoreceptors within the retina needing stimulation for the brain's ability to perceive clarity” (Grunwald 2005, page 158).
It is clear that he believes that there are mechanical changes somehow taking place in the brain. Could it be that he takes the popular idea of neural plasticity a few steps beoynd reason? One could forgive him by thinking it is meant only figuratively, but when he writes that the thalamus “literally pulls back and down” he obviously believes it actually happens.

Peter Grunwald is very fond of fluids. Apparently believing that they are so subtle that they can be influenced by our thoughts:
“There is a hierarchy in our organization: the overall coordination of the brain is at the top and the body is at the bottom. The body is made of dense matter while the brain and visual system is made of delicate tissue [...] The system of organization goes from more subtle to less, [...]” (Grunwald 2004, page 82).
About the vitreous fluid - which he relates to the “reptilian brain and its fight or flight response” (ibid, 84), he writes:
“The vitreous humour plays a major role in the balance of emotions [...] by releasing the vitreous humour, the jelly like fluid within the eyeball, emotions are eased and the lower back and visceral organs will gradually function normally” (ibid, 126).
“Detached retinas [a sight-threathening condition] often seem to happen in conjunction with an emotional stress, like a loved one dying or a sudden relationship break-up. The vitreous humour contracts or shortens very rapidly so the retina is suddenly not supported and pulls away from the choroid” (ibid, 78).
“Allow this vitreous humour fluid to be alive. Notice you can move this fluid by visualizing it” (ibid, 114).
“In some people this fluid can start to solidify and have little ability to move” (ibid, 84).
The vitreous fluid is the gel-like substance that fills most of the eyeball. It is produced by cells which degenerate after birth. It has no blood vessels and changes very little. In older people it can liqueify and increase the risk of retinal detachment. You wouldn't want to move it around even if you could. (7)

One thing is Grunwald's warped concepts of brain physiology. Even more serious, maybe, is his failing understanding of how the eyes function.

In the above quote from the Congress Papers Grunwald says that the changing eye-ball “allows the light to fall short of the fovea centralis”. Strictly speaking this is wrong. The light doesn't stop. It is the clear image that falls short. We understand what he means, but this error may shed some light on other peculiarities. (8)

This is what Grunwald believes about the use of glasses or contact lenses:
“As we have seen, lenses are cut in such a way that light is directed onto the fovea centralis, so that the 5% of the brain within the lower visual cortex receives constant, intensive amounts of stimulus and picks up a clear image” (Grunwald 2004, p. 57).
This is wrong. The clear image comes not from the amount of stimulus received. The amount of stimulus is irrelevant as long as it is not too dark.

Grunwald continues:
“A major side effect is that we are using only 5% of the photoreceptors actively and 95% lie dormant. The rest of the retina is not stimulated. And just as the retina is not being stimulated, so the rest of the visual cortex is not being stimulated or activated. A large portion of our brain is being starved of information and stimulation” (ibid).
He says something similar in the May 2000 issue of Statnews: 
“Prescription lenses focus the light only onto the fovea centralis, where we receive information for clear sight. This way of seeing excludes light from the all-important peripheral vision” (Grunwald 2000, p. 12).
It seems as if Grunwald believes that using prescription glasses or lenses reduces the amount of light hitting outside of the fovea. Glasses may create artificial alterations in the field of vision, requiring adaptation. It is not a perfect solution. But they don't prevent the retina outside of the fovea from being stimulated. And even if there are any impairments to peripheral vision it is unlikely that this means that a large portion of our brain is starved of information. The advantage of being able to see clearly is probably much more important to brain activity. (9)

There seems to be almost no limit to the ills the use of prescription glasses might cause. According to Grunwald they may even make your head shrink slightly:
Wearing glasses or contact lenses can create patterns of thinking and seeing wich may affect the memory and the ability to visualize, while causing an overall subtle contraction of the surrounding bone structures of the skull (Grunwald 2004, p. 57).

About the retina Grunwald says that:
“The retina consists of at least ten layers of photoreceptors called rods and cones” (Grunwald 2004, page 28).
This is incorrect. The retina has multiple layers, but only one layer of photoreceptors.
He presents a simplified description of the retina:
“Cones are found within the fovea centralis and the macula which surrounds it; this area is responsible for detailed vision. The rod photoreceptors are situated in the peripheral area of the retina beyond the edge of the macula, [...]”
What he doesn't tell you is that there are also cone receptors beyond the macula, even though the number of rod receptors dominate.

Grunwald believes you can access the rod receptors at will by using panoramic vision:
“When you think of using your panoramic vision you are accessing, by means of your intention, more of your rod receptors and thereby stimulating different pathways in your brain.” (ibid, 36)
Even if true it wouldn't necessarily help as rod photoreceptor activation depends very much on light conditions.

Grunwald puts much emphasis on the rod photoreceptors, possibly because signals from the area outside of the fovea goes to the area he calls the upper visual cortex where you can find his primary coordinating mechanism. (10) This could also be one of the reasons he recommends using pinhole glasses (11):
“Pinhole glasses have pin-sized holes stamped out in black plastic. The specific size of the holes helps light reach the fovea centralis, where the cone photoreceptors send messages to the lower visual cortex for clear-sightedness. The result is similar to that of wearing normal prescription glasses. As an additional benefit, the blackness of the plastic helps stimulate the 95% of photoreceptors within the peripheral area of the retina (the rods – as in night vision) which send messages to the thalamus and to the upper visual cortex. This means the all-essential panoramic vision is stimulated” (ibid, 110).
The rod photoreceptors are active when there is less light. But covering the eyes with plastic will not give these receptors anything useful to do. One can wonder why he criticises prescription glasses for hampering the peripheral vision when pinhole glasses excludes it almost completely. One can also wonder how someone like Grunwald, who has such a scant understanding of how the eyes function has managed to become the vision-guru of the Alexander Technique world.

[After I published this article Grunwald wrote an article in Statnews January 2015, titled Applying Alexander principles to seeing without glasses. In the article he writes: Glasses for nearsightedness are cut just like a magnifying glass, and once I became aware of how they really affected me I had the image of trying to start a fire in my retina (Grunwald 2015, p. 23).
Glasses for nearsightedness are not cut like a magnifying glass. In myopia, the light is focused in front of the retina. Prescription glasses or lenses are used to disperse the light. It is quite remarkable that Grunwald has promoted seeing without glasses for decades, but doesn't know the basic facts about how glasses work. Maybe even more remarkable is it that he is himself nearsighted. He doesn't even understand the workings of his own glasses. But most remarkable of all is that Alexander Technique teachers still are not able to call his bluff.]

Grunwald ends one of the chapters in Eyebody by telling about two old ladies, aged 81 and 100 respectively, who found that in old age they no longer needed glasses for reading. (Grunwald 2004, 108) Grunwald seems oblivious to the fact that this is not unheard of. Due to the general tendency for presbyopia, someone myopic may with age experience that they no longer need glasses in some situations. Indeed, this may well be something some of his pupils and workshop participants experience when they are able to let go of glasses forever.

Does the Eyebody Method work at all? That is the question I will discuss in the next part of the article. I will also be discussing the wider implications for the Alexander Technique community.


Please feel free to comment below.


Related blogposts
Eyebody part 3

NOTES
1) My main source of information has been the first edition of the book Eyebody from 2004. An updated version was published in 2007 but I have reasons to believe that Grunwald's theories have been extended but not modified.

2) Attributing all illness to a single cause is very often wrong and very often a sign of quackery. Alexander Technique teachers tend to regard misuse as the cause of most problems and we should be very careful not overstating it.

3) Grunwald warns against laser eye surgery: “After these operations the eye remains myopic, that is, elongated towards the back and contracted towards the front. The visual cortex is still contracted, with resulting contraction in the rest of the visual system. All that has happened is that instead of glasses on the outside to compensate for the shape of the eye, the cornea has been permanently altered, thus fixing for life an area that may hinder the movement in the frontal area of the eyes. This frequently leads to presbyopia. The conjunctiva and cornea relate to the neck, throat and shoulder area. Thus a laser eye operation can – long-term – cause physical problems in the torso, neck and head beyond those caused by the dysfunction the surgery was performed to treat. The limbic system and the corpus callosum can be adversly affeted which can create different problems over time” (Grunwald 2004, page 60).
Only operating when necessary is a good principle, and the value of laser eye-surgery can be debated, but here Grunwald is effectively scaring people with nonsense.

4) On the FAQs page on his website he answers the question like this:
“Will the Method help glaucoma, cataracts or macular degeneration?
In all three conditions the overall activity of the visual brain needs to be increased first, then: (a) in case of glaucoma it is necessary to release the shortening in the areas of the front of the eyes (especially the Canal of Schlemm); 
(b) in the case of cataracts, to bring nutrition into the fluid of the lens so that it can decalcify and the capsule of the lens can function optimally;
(c) with macular degeneration, applying the principles helps the retina, the vitreous humor and the choroid behind the retina to function better. Even if you have had an operation to correct one of these conditions, the habits, which set up the problem in the first place, can be modified using the Method.
The core areas of the rest of the body likely to be affected are:
1. Glaucoma: a tightening of the upper chest affecting the lymphatic system and the heart area, also there is an affect on the pelvis/hip area and the femur bone connection.
2. Cataracts: affects the diaphragm and the breathing with very often a marked curvature of the upper back and shoulders.
3. Macular Degeneration: affects are shown in the pelvic area, lower back and visceral organs.”
In Eyebody he also explains how he deals with glaucoma:
“After establishing the primary coordinating mechanism, people with glaucoma need to relate the visual pathway through the limbic system together with the frontal area of the eye, especially the canal of Schlemm, the optic nerves, optic discs, the retinas and the choroids to activate the thalamus” (Grunwald 2004, page 71).
And cataracts: “As with all dysfunctions, establishing the primary coordinating mechanism is the first step to undo the pattern of cataracts. The frontal area of the eyes, the retina and vitreous humour need to be stimulated so that the fluids of the lens can be supported with nutrients to undo the calcification. The reptilian brain and limbic system play a major role in this, together with the efficient functioning of the pineal and pituitary glands. Even if there has been a cataract operation, it is vital for the long-term health and optimal functioning of the eye to establish the primary coordinating mechanism and prevent recurrence” (Grunwald 2004, page 73. For additional imaginative descriptions of visual pathologies, see pages 60-81).

5) Peter Grunwald indicates that his method can help against cataracts and glaucoma several times in the book Eyebody, and in several other connections, for instance: on the front page and FAQ page on his website; in the article 'The Eye-body Reflex Patterns' in Direction Journal vol 2 number 7; in the youtube video Alternatives London presents a workshop in the Eyebody Method (about 1:50); in the interview How the Alexander Technique can help with vision improvement - Part 1 at Robert Rickover's website for podcasts on the AT; and in the description of a continuous learning session titled Vision and the Brain at the 2015 International Congress in Ireland.

6) Medsafe, the New Zealand Medicines and Medical Devices Safety Authority, has a “Guidance for Natural Health Practitioners” with some exemptions from the Medicines Act 1981, but there are still some things Natural Therapists can't do:
“What Natural Therapists can't do: [...]
Advertise methods of treatment to prevent, alleviate or cure the diseases or conditions listed in Part I of the First Schedule to the Medicines Act 1981.” That is: they can't claim to prevent, alleviate or cure cataracts or glaucoma.

7) The vitreous humour has a very high water content but a viscosity up to four times that of water. When the gel liquefies it is the collagen fibers in the gel that begin to lump together.

8) In the second of two interviews with Robert Rickover, Peter Grunwald begins his outlining of the visual system by talking about the speed of light, which may impress the ignorant, but which is quite irrelevant.
http://bodylearning.buzzsprout.com/382/108137-how-the-alexander-technique-can-help-with-vision-improvement-part-2

9) I have not been able to find information about research that could give any indication that the use of lenses or prescription glasses causes reduced activity in the brain.

10) The rod photoreceptors are important because Grunwald claims that: “Using panoramic vision actually stimulates the functions of the thalamus and hypothalamus, essential for the optimal functioning of the entire physical mechanism. If the thalamus and hypothalamus are not being adequately stimulated by panoramic vision, the parasympathetic functions of the body – such as the heartbeat and breathing – will suffer and the body will be adversely affected. This happens when we use focused vision exclusively; we stimulate only the lower visual pathway” (Grunwald 2004, page 36).

11) Peter Grunwald sells his own brand of pinhole-glasses, with “special hole sizes”. In the US it is illegal to claim that pinhole glasses improves eyesight (Wikipedia: Pinhole glasses) and in the UK there have been court cases (The Independent: The Truth about Pinhole Glasses). 
When Grunwald promote his pinhole glasses in this YouTube video (at 3:23), he is at pains at telling you that they are not designed for alleviating particular symptoms. He claims “the brain's optimal focus is being used.” and that the visual system will start to improve. He then goes on to say they are good for “near-sightedness, far sightedness, for people with presbyopia,” and for lower backs. In Eyebody he writes that: “They help in cases of short-sightedness, far-sigthedness, astigmatism, and middle-aged sight.” (Grunwald 2004, page 127) The same claims are repeated on the FAQs page on his website:


Literature and resources
Grunwald, Peter. (1999) The Eye-body Reflex Patterns. Direction Vol.2 No. 7 - Eye See Vision issue. Direction - [Fyncot] (Australia).
Grunwald, Peter. (2000). Eyesight and the Alexander Technique. Statnews Vol. 6( Issue 1), 12-13. STAT.
Grunwald, Peter (2004). Eyebody, The Art of Integrating Eye, Brain and Body – and letting go of glasses forever. Eyebody Press, New Zealand.
Grunwald, Peter. (2005) Integrating Eyes, Brain and Body. In A. Oppenheimer (ed.), The Congress Papers: 7th International Congress of the F.M. Alexander Technique. Stat Books.
Grunwald, Peter. (2015). Applying Alexander Principles to Seeing Without Glasses. Statnews Vol 8 (Issue 8), 23. STAT.
The website for the Eyebody Method: eyebody.com
Video presentation on the youtube channel AlexTechNews: Peter Grunwald on Eyebody 
The New Zealand Medicines Act 1981
New Zealand Medicines and Medical Devices Safety Authority: Guidance for Natural Health Practitioners. 


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