Diagnosis in Alexander’s writings refers both to medical diagnosis, and to people’s own diagnosis of their own problems. Alexander also uses it to refer to the assessment of a person’s use and functioning.
F. M. Alexander on diagnosis
In UoS, in the chapter ‘Diagnosis and medical training’, Alexander argues that no diagnosis can be complete without considering the influence of use upon functioning, and that since medical training does not include such considerations, a medical diagnosis alone is incomplete.
He is further of the opinion that there is a connection between disease and wrong functioning, and that wrong functioning is always associated with ‘undesirable use of the mechanisms of the organism as a whole’.
Alexander was a keen observer of people’s use and functioning, and he observed his pupils very carefully, as is revealed in an aside by Alexander in a 1925 lecture:
Consequently, as we must all of us sit down a number of times, it occurred to me long ago that it would be a very good idea if we could apply some technique to the act of standing and sitting during the day. The consequence is that my first attention is given, when the pupil comes into the room, to the different little things he or she happens to be doing, walking and so forth, and then when he comes into my room at first, I ask him to sit down in the chair - and we all do that, it is a matter of etiquette - and when he has sat down in the chair, I have the history of his life’s use of himself. It is all there.
Walter Carrington testifies to this in Explaining the Alexander Technique:
Another important aspect of FM’s character was that he was extremely observant. He was very, very sharp-eyed indeed. From the moment anyone walked into his room or if he encountered them in the waiting room, he’d be watching very closely and noting everything he could.
Sometimes Alexander would share his observations with his pupils, as Sir George Trevelyan reported in first meeting with Alexander in 1928:
He [Alexander] looked at me, felt me with his hands and said, ‘Young man, what have you been doing to yourself?’. He made me make some movements as in fencing (a sport in which I indulged a great deal and with much skill) and to my surprise raised his hands in horror. Then he expounded: I was using myself abominably; I had cultivated unconscious habits which felt quite right but in fact were pulling my poor body out of shape and creating pressures and tensions, pushing organs into the wrong places and so forth. I was stiffening my neck and pulling my head back; I had got my back pulled right in and it had fixed there as if the framework of the lung was battered in. This in itself threw out of gear the great and strong muscle sets in the back; throwing the strain onto the wrong sets, notably those of the neck, which resulted in the head dragging back even more and the wretched vertebrae being ground down one upon the other. He pointed out to me a thing I’d never thought of before. I was doing these things myself.
Dr Wilfred Barlow
Dr Wilfred Barlow was the only teacher who developed the idea of making a formal diagnosis of a pupil’s use. Pupils would undress and stand – in front, side and rear poses – against a grid so that any asymmetries, deviations from the upright, etc., would be easy to identify and record. For his research papers he (or research associates) would take photographs, some of which are reproduced in his books, The Alexander Principle, More Talk of Alexander, and Postural Homeostasis.
Whereas almost all teachers observe their pupil’s use, teachers differ as to the extent they share these observations with their pupils. Because of the medical connotations almost no one would use the word ‘diagnosis’ today for such ‘use assessment’.