DOCSLIB.ORG

Awareness Through Puppetry

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Awareness Through Puppetry Awareness Through Puppetry: Self-image in Feldenkrais Method and Material Performance by Krystin Elinor Fredricksson Royal Holloway, University of London Thesis submitted for the degree of PhD Department of Drama and Theatre Studies 2017 1 Signed Declaration I, Krystin Elinor Fredricksson, declare that this thesis is entirely my own work. Where I have consulted the work of others, it is always clearly stated. Krystin Elinor Fredricksson 13 December 2017 2 Abstract This thesis investigates somatic movement and puppetry as tandem practices. It draws particularly on the somatic education approach of Moshe Feldenkrais, originator of the Feldenkrais Method (FM) and its two modalities; verbally guided Awareness Through Movement and hands-on Functional Integration lessons. I pinpoint self-image in FM, which relates to a person's kinaesthetic awareness of herself as she acts, as a key concept for theorizing puppetry, reframing it as person-image to avoid some of the theoretical pitfalls of 'self'. I re-examine the idea of body-image in Paul Schilder, Feldenkrais's source, and identify the importance of his work for critical thinking on person- image and performance. Relating person-image to the trainings and writings of Jacques Lecoq, Dennis Silk and Heinrich Von Kleist, I analyse the ways in which it can include objects, puppets and materials and propose a new practice, Awareness Through Puppetry, which goes beyond an application of FM in puppetry training. I apply the fresh understanding of person-image I have developed to specific performances by Pierre Tual, Ilka Schönbein and Xavier Le Roy. Throughout the thesis I refer to Tim Ingold's concept of the 'meshwork', weaving lines in, out and around my practice and thinking, connecting them to critical thinking more broadly in performance studies and beyond. My contributions to knowledge in this thesis are an assessment of Schilder and Feldenkrais's work applied to somatic performance practice in puppetry, which I understand as an approach as much as an outcome, leading to the practice of Awareness Through Puppetry, and a fresh approach to performance analysis through the lens of person-image. I situate the thesis in a 3 broad ecological context where puppetry has a new subversive role as a somatic technology through which it is possible to discover something about what it is to be human and nonhuman, and how these interact. 4 Acknowledgements Writing a PhD is both a lonely and collective act. Here I nod to my support meshwork in the real and virtual worlds. I would like to thank my supervisor, Libby Worth, for her patience with the gestation and birthing of this thesis, for her ability to combine gentleness and toughness, and for her knack of finding the light switch when I was in the dark. I also extend heartfelt thanks to my advisor, Matthew Cohen, for his rigour and his generosity with the depth and breadth of his knowledge. Both have challenged and encouraged me, and Libby particularly has been an invaluable and constant support. Now for the deceased. I thank Moshe Feldenkrais for the inspiration of his life's work and for creating his Awareness Through Movement lessons which have saved me from the physical demands of researching and writing a thesis! (Who knew?!) I am grateful to Myriam Pfeffer for first bringing his work alive for me. I thank Jacques Lecoq for my foundations in theatre, Krikor Belekian for an early inkling of the meshwork, Ken Campbell for shaking things up, Christopher Leith for transforming my approach to puppetry and theatre- making, and my mum and dad, Jean and Karl, for introducing me to theatre, dance, silliness and critical thinking at a young age. I thank all the artists, practitioners and students with whom I have worked, workshopped, communicated or conversed during the thesis and before it, especially Rene Baker, Stephen Mottram, Nicolas Gousseff, Claire Heggen, Jean-Louis Heckel, Pierre Tual, Sylvie Baillon, Iestyn Evans and Bénédicte Holvoote. Claire Vialon deserves a special mention for our discussions, Feldenkrais/puppetry practitioner exchanges, friendship and 5 Parisian hospitality (and looking after a screaming 10 month-old Pansy on a hot day in Paris while I interviewed Claire Heggen!) I thank my collaborators on Cooking Ghosts, a performance made during the PhD: Georgina Roberts, Seiriol Davies, Helen Mugridge, Elena Pena and Dan Copeland. And all those from earlier projects, too numerous to mention. I thank the women improvisers I've played with in Permission Improbable and the support from 'Mothers who Make' for keeping me ticking when I had a young baby/child and an identity crisis as a scholar-artist-mother. Matilda Leyser is central to both projects. Thank you. I thank the AHRC and Royal Holloway for their funding and the Institut de la Marionnette in Charleville-Mézières, France, for two three-week research residencies in their Centre de Documentation, one with a bursary in April 2012, and one without in June 2013. Robert Vesty has been a great friend and source of support; I would like to thank him for reading and discussing the thesis as it evolved on many occasions (and for beds on boats and floors). Lastly, I thank my friends and family for their patience, support and spare rooms/floors to sleep on over the years. Particularly my funny and wild daughter, Pansy Fredricksson, my sisters, Katy and Erica Fredricksson, my local motherhood - Nadia Bailey, Catriona Blackburn, Clare Kemsley and Aurelie Riaud, my far-flung motherhood - Maria Andrews, Valentina Fago, Mariette Arnaud, Louise Hart, Yve Hall and Dot Brady, and Sam Bailey and Steve Baggs. And thanks to Stuart Ocock. 6 Contents Abstract 3 Acknowledgements 5 Contents 7 Chapter 1 Introduction 9 1.1 A chorus of voices 10 1.2 Critical tools: Meshworks 17 1.2.1 Critical tools: 'Umwelt', 'Lebenswelt', 'Innenwelt' 21 1.2.2 Critical tools: ‘actants’ and agency 23 1.3 First approximation: Feldenkrais Method 26 1.4 First approximation: ‘self-image’ 30 1.5 First approximation: ‘puppetry’ and ‘material performance’ 38 1.6 Methodology, structure and case studies 45 Chapter 2 Personal grounding 49 2.1 Why connect Feldenkrais Method and puppetry? An anecdote 49 2.2 Second approximation: Feldenkrais Method 52 2.3 Second approximation: self-image 57 'Thing interlude #1: Teddy' 60 2.4 Second approximation: puppetry and material performance 62 Chapter 3 Schilder's mercurial body-image 71 3.1 Introduction 71 3.2 Movement, action, function: the enmeshed body-image 74 3.3 Schilder and the community of body-images 81 3.4 Schilder on ‘outside space’ 85 3.4.1 Objects and touch 89 3.4.2 Agency 95 3.4.3 Structure 97 3.4.4 Focus 101 3.4.5 Gravity 103 3.4.6 Expanding body-image 106 3.5.1 Body image since Schilder 109 3.5.2 Towards somatic ethics 117 3.5.3 Towards somatic ecology 120 7 Chapter 4 Feldenkrais's self-image: ‘something invisible, visible’ 123 4.1 Introduction 123 4.2 Feldenkrais and self-image 128 4.2.1 'Improvement' 133 4.2.2 Awareness (through movement) 135 4.3 Why change? Is FM a normative practice? 141 4.4 Self-image in ATM 151 4.5 Self-image in FI 158 4.6 Feldenkrais, Nora and puppetry 161 4.7 Playing with self-image: beginnings but no endings 167 Chapter 5 Towards training: Awareness Through Puppetry 171 5.1 Transition from FM to puppetry 171 5.2 Towards 'Awareness Through Puppetry' 175 5.3 Things as guides / miming the world (Jacques Lecoq) 183 5.3.1 Things as guides / monomotivation and intention (Dennis Silk) 187 5.3.2 Things as guides / perfection, awareness, readiness (Kleist) 198 5.4 Skeletons as guides 207 5.5 Meshworks and skill 211 5.5.1 The puppeteer-puppet relationship 215 5.6 Imagining things 217 Provocations for a puppeteer (Awareness Through Puppetry) 222 Chapter 6 Case Studies: Protean person-images in performance 225 6.1 Preamble 225 6.1.1 Theoretical groundwork: a critique of ‘manipulacting’ 225 6.1.2 From Self-Other to dynamic person-image 228 6.2 Pierre Tual and company / Fastoche 231 6.3 Ilka Schönbein / Chair de ma chair 248 6.4 Xavier Le Roy / Self Unfinished 268 Chapter 7 Conclusion 288 'Thing interlude #2: Noodling' 294 Bibliography 298 Workshops and trainings 324 8 Chapter 1 Introduction When I was fifteen, the stillness of my mother in her coffin was shocking. The coldness of her brow that I kissed, like stone. The fixity of death. No longer in time. No future, except that of decay. No self, no person present. Movement is life indeed. The warmth of my soft-breathing child asleep. The delicate movement of her breath that I sense, even in the dark, as I check on her, accompanied by its gentle, intermittent sound. The puppet has multiple possible futures and only a very slow process of decay ahead, generally speaking. It is brought to life, and in a sense it really has a life of its own; it is an extension of the person who gives it movement and breath. It is a way of extending and exploring her self-image. In this thesis I use examples from puppetry and material performance to explore the notion of person-image, a development from Schilder’s ‘body-image’ and Feldenkrais’s ‘self-image’, and its place in a radical performance ecology. * Feldenkrais Method (FM) is a somatic education process that uses the development of situated movement awareness and environmentally anchored movement for neuromuscular retraining. In the method, which is named after its founder, Moshe Feldenkrais (1904-1984), self-image broadly refers to kinaesthetic awareness of oneself in action.
Load more

Recommended publications
  • 2016 Issue 29: Aesthetic Experience
    The Feldenkrais #29 Aesthetic Experience Online Edition 2016 Journal Contents 2 40 81 Response to Somaesthetics Book Review: “Developing a and Beauty: The Brain’s Way Healthy Bias: Richard Shusterman of Healing Four Days with Interviewed by Norman Doidge Sheryl Field” Hermann Klein Matt Zepelin Sheryl L. Field / Martha C. Nowycky 43 88 Voluntary & Book Review: 10 Involuntary Several Short Could Feldenkrais Movements: Sentences Resolve the Somatic Practice About Writing Paradox of in Contemporary by Verlyn My Jewish Self- Art Klinkenborg Image? Helen Miller Adam Cole Ilona Fried 68 92 16 Moments of Developing a A Body to Mind Being: The Healthy Bias: Franz Wurm Feldenkrais Four Days with Introduction by Method in Actor Sheryl Field David Zemach-Bersin Training Seth Dellinger Connie Rotunda 38 104 Developmental 73 Contributor Bios Movement Intimacy: Adopting Observation the Feldenkrais Tiffany Sankary / Method’s Principle of Matty Wilkinson Constraint to Create a New Dance Theatre Work Ingrid Weisfelt #29 Aesthetic Experience The Feldenkrais Journal 1 Letter from the Editor / 2016 Last year I wrote in this space about the distinctive nature of the Journal: a print publication, written just for those fascinated by Feldenkrais, that only comes out once each year. I celebrated with you the wide range of wonderful articles that could be savored at our leisure and the beautiful, tangible magazine we enjoy. And as you are reading this, you may be holding the 2016 edition of the Journal in your hands. Or maybe not. Because for the first time we are publishing the Journal in both print and electronic versions. At www.feldenkrais.com/2016-journal you can see a complete version of the print publication, plus some features that are only online.
    [Show full text]
  • Complementary and Alternative Medicine
    Complementary and Alternative Medicine Policy Number: Original Effective Date: MM.12.013 01/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO 11/17/2017 Section: Miscellaneous Place(s) of Service: Outpatient I. Description Complementary and alternative medicine (CAM), also called non-traditional medicine, is a group of diverse medical and healthcare systems, practices and products that are not typically considered to be a part of traditional Western medicine (i.e., conventional medicine). This policy addresses services performed by CAM providers such as naturopaths, chiropractors and acupuncturists. Complementary medicine generally refers to using a non-traditional approach together with conventional medicine. Alternative medicine refers to using a non-traditional approach in place of conventional medicine. Various CAM assessments and therapies are supported by some degree of scientific evidence and are intended to reduce disease-based symptoms and to improve health outcomes. However, due to a lack of well-designed scientific studies and/or peer reviewed literature many CAM therapies have not been shown to improve health outcomes over conventional therapies. II. Criteria/Guidelines A CAM service or procedure is covered (subject to Limitations and Administrative Guidelines) when all of the following criteria are met: A. It meets the definition of medical necessity as specified in Hawaii Revised Statutes (HRS) Section 432: 1. It is for the purpose of treating a medical condition. 2. It is the most appropriate delivery or level of service, considering potential benefits and harms to the patient; 3. It is known to be effective in improving health outcomes; provided that: a. Effectiveness is determined first by scientific evidence; b.
    [Show full text]
  • A Preliminary Survey of the Practice Patterns of United States Guild Certified Feldenkrais Practitionerscm
    Buchanan BMC Complementary and Alternative Medicine 2010, 10:12 http://www.biomedcentral.com/1472-6882/10/12 RESEARCH ARTICLE Open Access A preliminary survey of the practice patterns of United States Guild Certified Feldenkrais PractitionersCM Patricia A Buchanan Abstract Background: The Feldenkrais Method® of somatic education purports to guide people of varying ages and abilities to improve function. Many people choose this method to aid with recovery from injury, manage chronic conditions, or enhance performance even though limited research supporting its safety and effectiveness exists to guide decisions about use and referral. Very little information about practitioner characteristics and practice patterns is publicly available to assist researchers in the design of appropriate safety and effectiveness studies. The purpose of this study was to obtain an initial overview of the characteristics of United States Guild Certified Feldenkrais PractitionersCM. Methods: Of 1300 certified Feldenkrais® practitioners at the time of the study, there were 1193 practitioners with email accounts who were sent invitations to complete a web-based survey. The survey inquired about practice locations, additional credentials, service patterns and workloads during the previous 3 months. Response rate and descriptive statistics were calculated. Results: The survey had a 32.3% (385/1193) response rate. The top states in which responders practiced were California (n = 92) and New York (n = 44). Most responders did not hold other credentials as traditional health care providers or as complementary and alternative medicine providers. Among those who did, the most common credentials were physical therapist (n = 83) and massage therapist (n = 38). Just over a third of traditional health care providers only provided Feldenkrais lessons, compared to 59.3% of complementary and alternative providers.
    [Show full text]
  • SUGGESTED READINGS Lundberg P: the Book of Shiatsu, New York, NY, 1992, Simon & Schuster
    CHAPTER 16 Massage and Manual Therapies 231.e1 SUGGESTED READINGS Lundberg P: The book of shiatsu, New York, NY, 1992, Simon & Schuster. (photography by F. Dorelli). Brennan BA: Hands of light: A guide to healing through the human MacDonald G: Medicine hands: Massage therapy for people with energy field, New York, NY, 1988, Bantam Books. (illustrated by cancer, ed 2, Forres, 2007, Findhorn Press. J. A. Smith). Myers T: The ‘anatomy trains’, J Bodyw Mov Ther 1(2):91–101, Byers D: Better health with foot reflexology, revised ed, St. Petersburg 1997a. FL, 2001, Ingham Publishing, Inc. Myers T: The ‘anatomy trains’: Part 2, J Bodyw Mov Ther Clum GW Cervical spine adjusting and the vertebral artery. (2006). 1(3):135–145, 1997b. http://www.chirocolleges.org./acccva.html. Myers T: Anatomy trains: Myofascial meridians for manual and Dash VB, Dash B: Massage therapy in Ayurveda, New Delhi, 1992, movement therapists, ed 2, Edinburgh, 2009, Churchill Concept Publishing. Livingstone, Elsevier. Donoyama N, Manakata T, Shibasaki M: Effects of Anma therapy Nissen H: Swedish movement and massage treatment, Philadelphia, (traditional Japanese massage) on body and mind, J Bodyw Mov PA, 1889, FA Davis. Ther 14(1):55–64, 2010. Pritchard SM: Chinese massage manual: The healing art of tui na, Donoyama N, Satoh T, Hamano T: Effects of Anma massage Bulverde, TX, 1999, Omni. therapy (Japanese massage) for gynecological cancer survivors: Rand WL, Martin SA, editors: Reiki: The healing touch, Southfield, Study protocol for a randomized controlled trial, Trials 14:233, MI, 1996, Vision Publications. (illustrated by S. M. Matsko). 2013.
    [Show full text]
  • Applications of Somatic Education Principles to Voice Pedagogy
    Running head: SOMATIC EDUCATION AND VOICE PEDAGOGY APPLICATIONS OF SOMATIC EDUCATION PRINCIPLES TO VOICE PEDAGOGY By ALISON J. MINGLE A dissertation submitted to the Mason Gross School of the Arts Rutgers, the State University of New Jersey In partial fulfillment of the requirements For the degree of Doctor of Musical Arts Graduate Program in Music Written under the direction of Dr. Stephanie Cronenberg And approved by ______________________________ Dr. Stephanie Cronenberg ______________________________ Dr. William Berz ______________________________ Professor Judith Nicosia ______________________________ Dr. Kathy Price New Brunswick, New Jersey May, 2018 SOMATIC EDUCATION AND VOICE PEDAGOGY ABSTRACT OF THE DISSERTATION Applications of Somatic Education Principles to Voice Pedagogy By ALISON J. MINGLE Dissertation Director: Dr. Stephanie Cronenberg Students of voice are trained in complex processes of coordinated movements, many of which occur internally. Somatic education techniques may promote complementary skills, such as the ability to integrate the mind and body, to move with ease and efficiency, and to intervene with awareness and volition against interfering habits. After examining three related approaches to somatic education, a multiple case study was conducted on three professional voice teachers, each of whom is also certified in the somatic education disciplines of the Alexander Technique, the Feldenkrais Method, or Hanna Somatic Education. Each teacher was interviewed three times, and observed teaching four voice lessons. One voice student at each site was interviewed as well. A comparison and analysis of interview and observation data from these contexts may illuminate the ways in which somatic education principles can be applied to the teaching of voice. ii SOMATIC EDUCATION AND VOICE PEDAGOGY For Nana Barbara.
    [Show full text]
  • Complementary and Alternative Therapies Status: Not Funded
    Policy statement: Complementary and Alternative Therapies Status: Not Funded M&SECCGSs do not fund standalone treatments using complementary or alternative therapies. This restriction applies equally to primary and secondary care provision, and GPs must not prescribe such products e.g. homeopathic remedies/supplements/desensitising injections on FP10s. This list is not exhaustive but provides examples. Acupuncture Osteopathy Children with spastic cerebral palsy Paediatric dysfunctional voiding Adults with Lumber or Cervical pain not warranting surgical referral. Adults with large joint pain as part of a care pathway that may lead to joint replacement. Biofeedback, for: Chronic constipation (biofeedback is the primary treatment option for patients with dyssynergic defecation). Irritable bowel syndrome. Levator ani syndrome. Migraine and tension headaches (muscle, thermal or skin biofeedback); Neuromuscular rehabilitation of stroke and traumatic brain injury (TBI) (policy does not cover neuromuscular electrical stimulators). Raynaud's disease. Refractory severe subjective tinnitus – See Tinnitus. Temporomandibular joint (TMJ) syndrome – See TMJ. Urinary incontinence. Electrical stimulation As an adjunct or as an alternative to the use of drugs either in the treatment of acute postoperative pain in the first 30 days after surgery, or for certain types of chronic, intractable pain not adequately responsive to other methods of treatment including, as appropriate, physical therapy and pharmacotherapy. A physician evaluated trial lasting between 1 and 2 months should determine if treatment is to continue. Selected use in palliative care Mistletoe in cervical cancer. Meditation and Tai Chi in selected elderly patients with optimally treated heart failure – evidence of reduction in sympathetic activity (SIGN 95). Hypnotherapy Severe chronic insomnia. IBS. Manipulation and Stretching Selected cases of osteoarthritis of the hip as an adjunct to core treatment.
    [Show full text]
  • The Feldenkrais Method of Somatic Education and Its Two Components, Functional Integration and Awareness Through Movement
    7 The Feldenkrais Method® of Somatic Education Patricia A. Buchanan Des Moines University, USA 1. Introduction The Feldenkrais Method® of somatic education is an integrative approach to learning and improving function among people of varying abilities across the lifespan. With an emphasis on increasing self-awareness through lessons that stimulate sensing, moving, feeling, and thinking, certified practitioners or teachers of the method propose to take advantage of the human capacity to self-organize behavior (Buchanan & Ulrich, 2001; Ginsburg, 2010). People have used the Feldenkrais Method to enhance their function in many aspects of life, including performance at work, in sports, or in the performing arts. However, estimates are that many more have used it to recover from injury, manage pain, reduce stress, or improve other health-related conditions, either as complementary or alternative approaches to traditional Western medicine. Because of this usage, some groups, such as the United States National Institutes of Health’s National Center for Complementary and Alternative Medicine (National Center for Complementary and Alternative Medicine [NCCAM], 2004), view the Feldenkrais Method as a form of complementary and alternative medicine, despite the broader self-identification as a learning method. Method founder Moshe Feldenkrais, DSc, (1904-1984) was cautious about the constraints he perceived would be associated with establishing his method within a medical model and the broadly held allopathic emphasis on disease of his time (Feldenkrais, 2010). Despite medicine’s growing biopsychosocial perspective, identification with it remains controversial today among practitioners. Some recognize the improved access that may be afforded by that association, while others express apprehension, as did Feldenkrais, about the limitations on this learning method that may follow.
    [Show full text]
  • Do You Have Any Experience of the Following Medicines Or Therapies in Managing the Rare Disease?
    SURVEY ON COMPLEMENTARY AND ALTERNATIVE THERAPIES Preliminary results 20 May 2017 Sandra Courbier, Surveys and Social Studies Manager, Rare Barometer Leader Survey methodology Sandra Courbier, EURORDIS 2 Rare Barometer Voices framework 1900 respondents Group of people living with a rare diseases who participate in EURORDIS surveys and studies Rare Barometer Voices members received an invitation to participate in the survey/New participants had to register first (social media, patient organisations, etc.) High level of data protection (data storage in France, de-identified data, approved by French data protection authority) Covers 48 countries Survey translated in 23 languages 3 Movement therapies (yoga, Tai Chi, Qigong, Healing Touch, Pilates, Question Feldenkrais Method etc.) Chiropractic or osteopathic manipulation Aromatherapy or herbal therapies Phage therapy Supplements (vitamins, minerals, probiotics, etc.) Homeopathy Traditional medicines (Chinese, Ayurvedic) Special diets (gluten-free, ketogenic diet, etc.) Physiotherapy and massage Energy therapies (acupuncture, acupressure, Shiatsu, Reiki, magnetic therapies etc.) Relaxation techniques (meditation, guided imagery, sophrology, biofeedback, etc.) Psychological therapies (cognitive behavioural therapy, group therapy, equitherapy etc.) Art therapies Spiritual therapies (spirit release therapies, shamanism, druidism, etc.) Do you have any experience of the following medicines or therapies in managing the rare disease? No, but I am interested in such therapies No,
    [Show full text]
  • THE FELDENKRAIS METHOD in the TREATMENT of CHRONIC PAIN: a STUDY of EFFICACY and COST EFFECTIVENESS American Journal of Pain Management AJPM Vol
    IFF Academy Feldenkrais Research Journal 1 (2004) ® 2004 by the author THE FELDENKRAIS METHOD IN THE TREATMENT OF CHRONIC PAIN: A STUDY OF EFFICACY AND COST EFFECTIVENESS American Journal of Pain Management AJPM Vol. no. 1 January 1999 By David Bearman, MD, and Steven Shafarman Abstract. A preliminary study was undertaken to determine both the efficacy and cost effectiveness of the Feldenkrais Method for treatment of Medicaid recipients with chronic pain at the Santa Barbara Regional Health Authority (SBRHA). SBRHA staff wished to offer treatment for chronic pain patients beyond what is provided for in the Medicaid scope of benefits. Conventional intensive chronic pain treatment programs costs range from $ 7,000 to $ 30,000 and are not covered by regular Medicaid benefits. Patients with chronic headaches and/or musculoskeletal problems were enrolled in the study. Seven patients began the program; all completed it. Patient satisfaction, function and perception of pain were evaluated by using the National Pain Data Bank (NPDB) protocol of the American Academy of Pain Management. Participants reported more mobility and decreased perception of pain, both immediately after the program and in a one-year follow-up questionnaire. Results compared quite favourably with NPDB comparison groups. Cost effectiveness calculations were based on Medicaid costs for one-year periods pre- and post-intervention. Patient costs dropped from an average of $ 141 per month to$82 per month. This represents a 40 % savings. Descriptors. Alternative medicine, chronic pain, complementary medicine, cost effectiveness, Feldenkrais AJPM 1999; 9:22-27. Received: 10-16-98: Accepted: 12-10-98 INTRODUCTION Traditionally, patients with chronic pain have been demanding of their primary care The Santa Barbara Regional Health Authority providers and generally unhappy with their (SBRHA) serves 41,000 Medi-Cal (California health care.
    [Show full text]
  • Complementary and Alternative Medicine
    Complementary and Alternative Medicine Policy Number: Original Effective Date: MM.12.013 01/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO 09/23/2016 Section: Miscellaneous Place(s) of Service: Outpatient I. Description Complementary and alternative medicine (CAM), also called non-traditional medicine, is a group of diverse medical and healthcare systems, practices and products that are not typically considered to be a part of traditional Western medicine (i.e., conventional medicine). This policy addresses services performed by CAM providers such as naturopaths, chiropractors and acupuncturists. Complementary medicine generally refers to using a non-traditional approach together with conventional medicine. Alternative medicine refers to using a non-traditional approach in place of conventional medicine. Various CAM assessments and therapies are supported by some degree of scientific evidence and are intended to reduce disease-based symptoms and to improve health outcomes. However, due to a lack of well-designed scientific studies and/or peer reviewed literature many CAM therapies have not been shown to improve health outcomes over conventional therapies. II. Criteria/Guidelines A CAM service or procedure is covered (subject to Limitations and Administrative Guidelines) when all of the following criteria are met: A. It meets the definition of medical necessity as specified in Hawaii Revised Statutes (HRS) Section 432: 1. It is for the purpose of treating a medical condition. 2. It is the most appropriate delivery or level of service, considering potential benefits and harms to the patient; 3. It is known to be effective in improving health outcomes; provided that: a. Effectiveness is determined first by scientific evidence; b.
    [Show full text]
  • Holistic Modalities
    HOLISTIC MODALITIES Acupressure Based on the same system as acupuncture, but fingers and hands are used, instead of stimulation with needles, to restore the balanced flow of the body’s life energy (qi or chi, pronounced “chee”). This force moves through the body along 12 energy pathways or meridians, which practitioners unblock and strengthen. Common styles of acupressure include Jin Shin, which gently holds at least two points at once for a minute or more, and Shiatsu, which applies firm pressure to each point for three to five seconds. Acupuncture An ancient Chinese technique that stimulates the body’s ability to sustain and balance itself, based on the theory that an electromagnetic life-force (qi or chi, pronounced “chee” is channeled in a continuous flow throughout the body via a network of meridians. Disease is understood as an imbalance in the meridian system. Diagnosis of an imbalance is made by “reading” the pulse, face, tongue and body energy. To correct it, a practitioner inserts acupuncture needles at specific points along the meridians to stimulate or disperse the flow of life-force. Acupuncture principles include the yin and yang polarities and the associations of the five elements of fire, earth, metal, water and wood with bodily organs. Air Purification: The process of reducing contaminants in the air. Alexander Technique A system of reeducating the body and mind to support and facilitate proper posture and ease of movement. Through gentle manual guidance, accompanied by verbal directions, the Alexander teacher coaches the student to become aware of unnecessary tension and to unlearn longstanding patterns of movement.
    [Show full text]
  • Aromatase Inhibitors
    Survivorship Clinic Aromatase Inhibitors What Are Aromatase Inhibitors? Aromatase inhibitors (AIs) are drugs used to treat advanced breast cancer, or to prevent breast cancer from returning after surgery. AIs are used in post-menopausal women who have tumors that express estrogen receptors. How Do Aromatase Inhibitors Work? In pre-menopausal women, the ovaries produce most of a women’s estrogen. Yet, in post-menopausal women, estrogen is synthesized in the peripheral tissues from another hormone called androgen. AIs stop the enzyme aromatase from turning androgen into estrogen, which decreases the amount of estrogen produced in peripheral tissues. AIs do not block estrogen produced by the ovaries. Therefore, AIs are used primarily with post- menopausal women because the ovaries are no longer producing estrogen. Breast tumors can be “estrogen sensitive,” which means estrogen can promote tumor growth. AIs can stop growth of these tumors by decreasing the level of estrogen produced in the body. AIs can only be used with tumors that have estrogen receptors. The Types of Aromatase Inhibitors Currently, there are three AIs used, which include exemestane (Aromasin), letrozole (Femara) and anastrozole (Arimidex). AIs are given to post-menopausal women who have tumors that express estrogen receptors. The U.S. Food and Drug Administration (FDA) approved these drugs to be used in the following ways: Arimidex has been approved for women with early-stage breast cancer following surgery. This is a Type 2 “non-steroidal inhibitors,” which stops the activity of aromatase, but not permanently. Aromasin has been approved for women with early-stage breast cancer who have taken tamoxifen for two to three years.
    [Show full text]