Forging Perseverance – Focal Dystonia and Loving Patience

Here is an article I wrote some time ago now – it may resonate with some guitarists who have suffered from a non-painful but debilitating syndrome called “focal dystonia”.

I believe it is of the utmost importance to care for oneself mentally and physically to avoid getting it. Comparing oneself with other players can be extremely harmful to development and can lead to you doing things that you were not made to do!

Learning about Body Mapping from Barbara Conable’s book was particularly helpful as were discussions with Dr.Joaquin Farias and Jerald Harscher.

Around fifteen years ago I had an experience which I now realise has affected many many musicians, not just guitarists. I was pursuing a fairly active career giving concerts and had just recorded three CDs that year. I was in demand as a session musician and had also gone on tour with the group John Williams and Friends and had worked with leading British composers. Everything was going well and I took it all for granted.

Then one morning, after an uncharacteristically flakey concert in Cleveland, I woke up and found that my right hand felt weak and not able to play a simple scale. As the days wore on, I discovered that my right hand was not just weak, it would occasionally rebel and go out of control – the fingers felt like typewriter keys all trying to hit the ribbon at the same time (does anyone remember that?).

Interestingly enough, I did not panic, but assumed this was a temporary, if inconvenient, glitch and that normal service would be resumed as soon as possible. This was an expression of faith in the human body’s ability to heal itself and youthful optimism. After a year of extremely uncomfortable concert giving where I started evolving strategies to make up for readily apparent technical deficiencies (eg using thumb and index because index and middle were no longer behaving), I gave a truly terrible and terrifying concert where I felt I was walking a tightrope with both legs tied together. I knew that I had a problem and no amount of optimism was going to help.

Even then, I shied away from the medical establishment and started asking guitarist friends about their approaches to guitar. This was not a long and dedicated journey as it has been for others. I still felt I still had a lot to offer musically even in the darkest moments when playing guitar felt like I was putting on lead gloves. I felt I could write music, teach and conduct thus making music that way. In the back of my mind I had probably given up and felt bad about it without admitting it to myself. After my final contractual obligations I felt that my concert giving days were over. Practicing had become a chore, as I was actually getting worse when I practised. I just could not analyse what the problem was and came to the conclusion it must be mental.

Throughout this time, I felt it was important to talk about the problem, as someone else must surely have experienced it. What I now know is that many people have experienced this condition but are reluctant to talk in case they they lose a gig, or even a job.

I finally came across an ex-pupil who said that he had similar symptoms and was going to go to California to work with a woman called Nancy Byl (see for a brief discussion of her work) who called the condition focal dystonia and had worked with monkeys and used Braille to help musicians. It seemed to be a condition caused by the overlap or blurring of areas of the brain which normally were separate – specifically the areas for the different fingers seemed to merge under pressure. But what caused the overlap? I continued practising and getting worse and feeling by now as if I had a mental illness which affected the fingers of my right hand! Nostalgia for the days when I used to be able to play would sometimes plunge me into depression when I listened to old recordings of myself.

Yet I still carried on playing, believing that there had to be an answer – I had somehow dug a hole and there must be a way to climb out of it. I realise now that this faith in my ability to heal myself was a lesson in perseverance, not in the gritted teeth sense, but more like casting out a net to see what would float into it. Patience is the mother of perseverance. As someone said “Patience comes to those who wait”!

I also carried on reading and talking, learning that abnormal movement which is practised over and over again can lead to dystonia. In fact this is the flipside of perseverance. Most sufferers tend to be dedicated, ambitious people persevering in their folly. But I had done Tai Chi and Alexander technique and taught others to make graceful movements and beautiful sounds. Why was this happening to me?

I actually improved enough to make another recording, but was also aware enough to play easier repertoire than I had planned. This was a clue – ease was the goal of practice, not continual challenge.

Next I heard about David Leisner, who had suffered from focal dystonia and had (after seeking treatment for many years from others who did not seem to have a clue) cured himself after persevering in analysis of his own movements, much as Alexander had done before formulating his technique. David was kind enough to stay in my house for a week and was a very patient teacher, showing me the use of larger muscles when the smaller ones in the hand seemed to give up. This was something I could work with and I managed to regain some kind of mobility, but I still felt that I had not tackled the fundamental cause. David was a real inspiration, as he had managed to recover the ability to play fluently through sheer willpower and diligent self study.

My real breakthrough came less than a year ago. I noticed at a summer school that a friend of mine had tape around the joints of his middle and ring fingers. When we talked about it he confessed that he had, indeed had focal dystonia, and had been very frightened by the seemingly rapid onset of it. I reflected that for many, this would strike at the core of their reason for existing! My friend had however come across a doctor who specialised in focal dystonia, who had given a workshop and enabled him to play again fluently even if only for just that session. The doctor’s name was Joaquin Farias and he had made my friend aware that he was using movements which he didn’t need to do, but had become habitual, creating tension every time he played. When my friend asked how to stop, the doctor pointed out the movement and said “Just don’t do it!”. Unbelievably, this worked. I thought deeply about this and my friend and I had many discussions. It appeared that I, too, was making one or more unnecessary movements, specifically, moving the ring finger away from the hand every time the middle finger played, rather than moving into the hand together with it. This realisation seemed to recover 50% of my technique and, coupled with learning repertoire very slowly with full awareness of relaxing movements of the right hand, I was able to do my first solo concert after fifteen years. It was a wonderful experience being able to let go rather than feel tension during playing.

In fact, I have since found that “letting go” is the key for me – casting a net rather than gritting teeth. Rather than making rapid movements to play fast, allow the body to be at rest and make everything easy and slow enough to be understood by the rebellious machine that it is. How many times do we say this to students? It is so difficult to see it in ourselves and we can even become resentful if someone points it out!

I am aware of many technical shortcomings and have yet to discover a further elusive unnecessary movement, but friends can help by watching me carefully as I play, as can a video camera on the computer. Again, I find that patience and kindness to one’s own shortcomings are the key to progress. Is this the true meaning of perseverance?

The future seems good – the hand is working organically and at a pace where it feels comfortable – speed is not an issue, as long as I am aware of it. Guitar playing has once again become a lovely, living activity and the enthusiasm of the true amateur has again taken hold of me.

Other Helpful Links
Mark Ashford
London Hand Therapy
The Poised Guitarist

3 thoughts on “Forging Perseverance – Focal Dystonia and Loving Patience

  1. Pingback: Apostolos Paraskevas Recovery from Focal Dystonia | Gerald's Guitar Grab Bag

  2. Hi Gerald, Thank you for sharing your experience about focal dystonia….what a terrible thing to be faced with. So glad you are playing again.
    I wanted to add another possible line of defence/ treatment in assisting muscle function that you and your practitioners may find worth considering – which is trigger point therapy. I am not suggesting this is a treatment for focal dystonia (that is outside my experience), rather that some of what you mentioned in the article rang bells and I wondered if it would be useful maybe as a preventive tool?? Briefly, a trigger point is a small contraction knot in muscle tissue (Travell and Simons) – once there, it keeps the muscle both tight and weak, interfering with normal function and causing numerous problems both local and distal, from pain to reduced function…muscle misfiring, etc. The book i’d recommend for a readable and practical approach to helping the whole body with trigger point massage is by Clair Davies ” The Trigger Point Therapy Workbook”; forearms and small muscles of the hand by musicians are especially prone to formation of trigger points, due to use/ stress/ repetitive use under stress… etc…then there’s our posture and its effect on the neck, shoulders etc and consequent impact on nerve function. It can be possible to release these unyielding areas with specific massage and help restore normal funtion. Of course this is a very body-based approach, but I wondered if it may have a place as a useful tool to add to a wholistic way of dealing with physical difficulties if they arise.

    Also, I think regarding musicians in part as athletes would widen our awareness of what demands we can put on quite small areas of our body, and perhaps lead to new ways of helping, physically, mentally and emotionally?

    Very best of luck with everything


    ps am a member of midland fretted orchestra, pupil of Danielle Saxon Reeves, and keen amateur guitarist

    • Hi Sue
      Thanks for the comment, and the insight.
      I will certainly follow up your lead and see what happens.
      Best wishes Gerald

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