Positive Health Online

Two years ago the Parkinson's Disease Society surveyed its members on their use of complementary therapies and was surprised at the high positive response rate. Of the wide range of approaches tried and experienced as beneficial, most frequently mentioned was Yoga. Conductive Education – often known simply by its initials CE – came a close second.

Yoga is long estab- lished in this country, well regarded and accepted as an effective means towards spiritual and physical well-being. Conductive Education (CE) is a relative newcomer, regarded with askance by many doctors and therapists in the NHS and still very hard to find.

Walking programme. Father and Son leaving together

CE for children and adults with motor disorders offers neither treatment nor cure and, if thought of as therapy, should be considered a psychotherapy. CE is psychological in a social context, a pedagogic (teaching) approach to learning to live with chronic disability.

Motor Disorder is for Life

The conditions known as 'motor disorders', (sometimes 'motor disabilities') have nothing in common at the physical or medical level – except that they all involve some sort of problem of controlling bodily movements as a result of disease or damage to the central nervous system. Each motor disorder has its own characteristics and even a single condition may manifest in a host of ways.

Take Parkinson's disease, for example. Typically, it begins in the later years of life (it is estimated that around one in a hundred people over seventy years of age are affected), though 'young Parkinsonians' may be in their forties, their twenties or, in very rare instances, even younger. It is due to a lack of dopamine in the brain, the cause of which remains unknown. In contemporary Western societies Parkinson's disease is treated by drugs. Occasionally one hears of promising surgical breakthroughs but early high hopes have always been disappointed.

Well known amongst the symptoms of the disease are tremor, 'Parkinsonism', difficulties in initiating and completing movements, effortful and cramped handwriting, and a fixed and expressionless face, the 'Parkinsonian mask'. The condition is progressive, its advance marked by heavier cocktails of drugs which may result in serious side effects, including depression and superfluous movements, bad enough to amount to disabilities in their own right. Many Parkinsonians become sophisticated managers of their own drug regimes, adjusting them to suit what they wish to do next to live their lives.

Compare this with the effects of a stroke. Strokes are also more characteristic of the later years but may too occur at any age, right down to pre-school. In a stroke, brain damage results from haemorrhage of a blood vessel in the brain. Effects may include paralysis down one side of the body, problems of speech and language, and difficulties with short-term memory. These effects are not progressive but there is increased chance of a further stroke in the future. There is no medical treatment.

Most motor disorders are 'late-onsetting', that is they first occur in the adult years by which time, though we of course remain open to learn from new experience, much of our personality has already been formed. We have an incalculable store of knowledge, skills and understandings, our own adult emotions (more or less under our control!), our own hopes, motivations and intentions, our established values, our social skills and relationships. If we experience motor disorder in adult life, however they are manifested, our essential beings, our developed personalities, remain for the large part intact. Initially at least, motor disorder in itself cannot take these things away, though living with its effects may bring experiences from which new psychological attributes are learned.

This notwithstanding, adults finding themselves with a motor disorder can bring to bear psychological attributes formed over a lifetime to learn to compensate for their impairment. When, however, motor disorder is present from birth or very shortly afterwards – such as in the cerebral palsies – effects are more far-reaching, since the development of psychological attributes themselves depend, in part, upon effective, reliable control of movement. Thus emotional bonding with parents may be affected by difficulties in directing the gaze, sensory-motor intelligence by difficulties in grasping and manipulating, the onset of speech by articulation difficulties, etc.

Granting real differences between motor disorders, their origins, manifestations and age of onset, CE considers them all to result in problems of learning and as such, of course, problems for teaching.

Mysterious Origins

CE originated in the work of an Austrian-Hungarian physician, András Petö (1896-1968).

We know surprisingly little of Petö's life. He was born into a Jewish family in the Hungarian town of Szombáthély close to Austria (at the time Austria and Hungary were united under the Habsburgs). He studied medicine in Vienna where he was one of the intense, mystical young men surrounding fellow medical student, Jacob Moreno, who invented Stehgreiftheater (Theatre of Spontaneity), sociodrama and the sociogram. We know nothing else for certain about his student years, except that he received his medical degree at the same time as Willhelm Reich (of subsequent orgone fame). Vienna was exciting and the young Dr Petö stayed there rather than returning home to provincial Hungary, moving from hospital to hospital, perhaps because of his unconventional ideas. He was fascinated with mysticism and Eastern religion, with the Kabbala, meditation, Buddhism and reincarnation, and for a time edited a periodical called Biologische Heilkunst (Biological Healing Art). He worked with people with chronic diseases though not as far as we know with motor disorders.

One horrific movement to emerge from Vienna in those inter-war years was Nazism – and Petö was a Jew. When Nazi Germany incorporated Austria in 1938, Petö left briefly for Paris and then unaccountably moved to Budapest – and vanished. Hungary was already a quasi-Fascist state, with anti-Semitic laws preventing Jews from practising as doctors. We have no firm word of Petö again till the last year of the War when Hungary fell under direct Nazi control and he appears to have been involved with an underground Jewish movement working to save Jewish children.

The Nazis bitterly resisted Soviet liberation and when peace came Budapest, the economy and the civic institutions all lay in ruins. Dr Petö began to practise again, with the few resources available to him, including 'movement therapies' used with chronically sick patients in Austria before the War, his personal philosophy of life and the force of his of own powerful personality.

In these most extenuating circumstances a new method took shape surprisingly quickly. Petö called this 'conductive therapy', to indicate that people may be led ('conducted') to see that they can indeed learn to do things for themselves, despite their conditions. In 1952 the Ministry of Health provided him an institute to continue his work. But although this work, particularly with the paralysed survivors of polio, impressed some medical people, his unorthodox views and difficult personality made him enemies and many regarded him as a charlatan so that in 1962 he and his institute parted company with the Ministry of Health.

For some years Petö had been referring to his method not as therapy but as pedagogy – teaching – and, as 'conductive pedagogy', his institute was absorbed into the Ministry of Education. András Petö died in 1967, since when the institute (which now bears his name), though much larger and better known, has become very much an educational provision.

Conductive Education Today

Do you remember Standing up for Joe, on BBC TV in 1986? It showed a British family at the Petö Institute and led to creation of the Foundation for Conductive Education, a national body to establish CE here. The Foundation's National Institute of Conductive Education (NICE), opened by Princess Diana in 1995, now offers CE from babyhood to old age, across the motor-disorder spectrum, and provides degree-level training for conductors, validated by Wolverhampton University. Already nearly thirty UK establishments employ conductors (so far mainly Hungarians), some of which are coming together in a national network, with NICE taking a lead in modernising CE to meet the values of disabled people and their families in the West and our national, official requirements.

CE is coming in from the cold.

Motor disorders include

• Parkinson's disease
• Strokes
• Multiple sclerosis
• Head injuries
• Dystonia
• Dyspraxia
• Cerebral palsy

Case Study

Jacqui and Louise: Where there's Life there's Hope

Louise is married with two children and cares for her sister Jacqui, aged 36, who lives with them. Jacqui was hit by a car when she was 21 and suffered a head injury, leaving her severely disabled.

Though she received good hospital care at the time, there came a point when it seemed that Jacqui could progress no further. Louise came across Conductive Education in a local paper and decided to bring Jacqui along for sessions in December 1998.

'In just a few months Jacqui has made such fantastic progress it has given me new hope. Conductive Education has brought the old Jacqui back. She's sharper and brighter mentally than she has been since the accident. She believes in herself. The conductors have made her feel good about herself. She doesn't feel a freak or a write-off any more.

'At a recent session Jacqui was learning how to put her make-up on. After not even looking in the mirror for years she's started taking an interest in herself. She feels part of the human race again. To me that is more important than any physical improvements she might have made. It's wonderful to see her like this.

'The conductors have not only helped Jacqui but they've helped me by providing me with tips for working with her at home to ensure she is using her body correctly. And everyone at NICE is so approachable, you can ask them anything. They really care about you. Coming to Nice is the high point of Jacqui's week, she really hates to miss a session. I'm just sad we didn't know about it earlier.'

Case Study

Bethany and Kim: Empowering Mother and Child

Kim and her daughter Bethany who is aged two and has cerebral palsy have been attending the Parent and Child service since December 1998.

'What makes Conductive Education so different is the positive attitude the conductors take towards the child. Children are thought of in terms of their ability, what they can do not what they can't do. Then the conduc- tors say: "Okay, let's see what we can make happen for this child." They don't mollycoddle the children, they push the children but it's a gentle sort of discipline. And it's how I want her to be brought up. I want her to be stretched just like any other child.

'At our weekly sessions I learn how to help Bethany do things for herself. This is hard sometimes because it's often easier and quicker to do it for her. I have learned that I have to, and can, let go if I am going to help Bethany gain her independence.

'One of Bethany's major achievements has been learning to lie on her front and push herself up with her arms. That may sound nothing to most parents but to see the sense of achievement and empowerment on her face is wonderful for us. Simply by learning how to open her hands she has become aware of herself, her body, and can interact with the world around her. In fact she is so much more physically expressive now.

'Without Conductive Education I would not have a daughter who feels confident in herself and has been given the freedom to progress and be treated as any other child. As a mother, I feel empowered because I know that I am providing Bethany with the very best facilities that will develop her fullest potentials.'

Further Reading

Akos Karoly and Akos Magda. Dina: a Mother Practises Conductive Education. Foundation for Conductive Education. Birmingham. 1991.
Brown Melanie and Mikula-Toth Agnes. Adult Conductive Education. Stanley Thornes Medical. Cheltenham. 1997.
Forrai Judit. Memoirs of the Beginnings of Conductive Pedagogy and András Petö. Új Aränyhíd and The Foundation for Conductive Education. Budapest and Birmingham. 1999.

Further Information

To join in with the world-wide conductive movement or to learn more about services at NICE and conductor-training see: www.conductive-education.org.uk or www.wlv.ac.uk/maps/essential/courses/Conductive.education.html
National Institute for Conductive Education, Russell Road, Birmingham, B13 8RD. Phone: 0121 449 1569,
Fax: 0121 449 1611, enquiries@conductive-education.org.uk