Working at a VA: Andrew Carter brings the Feldenkrais Method® to Veterans
Ira Feinstein: You work at the VA as a Feldenkrais® practitioner. How'd that happen?
Andrew Carter: I was teaching ATM® classes at a local senior center. One of the attendees was a friend of Rochelle Rubin, a nurse practitioner, and coordinator of the Interdisciplinary Pain Rehabilitation Program at the Brooklyn VA. Rubin was looking to add a Feldenkrais practitioner to her team, and her friend recommended me.
IF: Besides the Feldenkrais Method, what other options are available to Veterans at the clinic you work at?
AC: Acupuncture, acupressure, medical hypnosis, and Reiki.
IF: I didn't realize that the VA was open to so many alternative approaches.
AC: Yes, Rubin has put together a really powerful team. Vets have the opportunity to discover what works best for them in terms of non-opioid dependent pain management. I think that the push to give Vets options that don’t involve medication has created an opening for the Feldenkrais Method and other non-allopathic options.
IF: How long was the onboarding process?
AC: There was a year between my initial conversation with Rubin and the application process. Once that started, it took four months for all the paperwork to get sorted out. Typically it’s a faster process, but there was a glitch with my paperwork.
IF: Do you teach classes and give Functional Integration® lessons?
AC: I teach there two days a week. One hour on each of those days is a class and then the other hours are Functional Integration lessons as well as teaching patients body mechanics. So, it's not necessarily that I always have somebody lying on the table for a traditional FI® lesson.
As a Feldenkrais practitioner, I am probably one of a very, very, very small number of people that Vets will have contact within the VA system that will actually have the time to interact with them as people.
IF: Has working with Veterans changed your teaching style?
AC: The Vets I work with are very injured, very traumatized. They don't come in with just some pain in their back or their knee. It’s the knees, and the right ankle and/or the left hip, and the lower back, and the right shoulder, and they have nerve damage and suffer from migraines. So, doing an ATM lesson and just feeling and noticing differences is not helpful for them in and of itself.
Through trial and error, I’ve found that it is critical to engage them intellectually. When I provide concrete information about how the brain functions and how changing it affects the musculoskeletal system which then affects their ability to function and how that then affects wear and tear of joints and soft tissue and bones, my students become more engaged and proactive. For example, I'll explain how the ankle needs to bend if their knee is bending (in a closed chain movement).
It's also changed how I teach my public ATM classes. The extra information helps bridge the gap for students between their experience of change and something concrete. I think this gap is often a problem with people connecting to our work.
IF: What have you had to be aware of when working with Veterans?
AC: Many of the people that I work with, especially the Vietnam Vets, have numerous systems operating poorly. They have digestion issues, diabetes, a messed-up ankle, pain in their back. They take well over five different drugs for depression, pain, sleep. They can’t sleep for more than a couple of hours a night because of the pain. It has been humbling to witness their tenacity to carry on despite the obstacles.
It is wonderful to witness when they experience comfort or less pain. This is most likely to happen before the lesson has even begun, while I’m supporting their bodies when they’re on the table—I use the pads and rollers extensively—and all of a sudden they say, “Oh my God, I don't feel any pain. I could fall asleep like this.” Sometimes that is all I can help somebody with, but I think that is still a huge help because sleep is so vital to healing.
Another issue that is pervasive is MST—military sexual trauma, which is sexual assault, including rape, committed by their colleagues. It happens to both men and women. Whenever I see a new patient, I always check their files beforehand to see if MST is noted. When it is, I’m careful to use less touch. I’m also aware that it is often harder for, not just survivors but even Vets without MST to let go and let you support them while you work.
I’m also lucky to have several large windows in my room, so if someone tells me, they suffer from migraines or headaches I go and turn the overhead lights off. They are incredibly thankful for this.
IF: Would you say that the possibility of someone having a flashback is high?
AC: With the patients that are sent to me, I would say no. But often because they become very relaxed, they fall asleep, and I can’t know what they’re dreaming. There have only been a couple of times that it seemed like somebody experienced a bit of a flashback, or was disturbed by something associated with trauma.
At the end a lesson with one fellow I was working with, I had him sit up and said, “When you're ready to stand up, sense your weight on the floor check how things may be different."
He paused and said, “Would you bring my shoes over to me?” He explained that due to an experience he'd had while deployed, he couldn't stand on floors without wearing shoes.
I couldn’t have prepared myself for that answer.
IF: It seems like the Feldenkrais Method has something unique to offer Veterans. What do you think is unique to your time with them?
AC: As a Feldenkrais practitioner, I am probably one of a very, very, very small number of people that Vets will have contact within the VA system that will actually have the time to interact with them as people. I think that for Vets especially, this can be extremely important because often they have very little structure or support outside of the VA.
IF: What is it like working within the confines of the VA system?
AC: Working for the VA means that I am part of a bureaucracy. There is a lot that I can’t control. I see patients for a predetermined number of sessions, and I don't set that number. Initially, I was allowed to see people eight times, and then it got cut to six. It’s frustrating because for people with severe trauma, how far can we really get in six sessions?
IF: For practitioners who would like to offer the Feldenkrais Method to Veterans, what guidance could you provide for connecting with the VA?
AC: Ideally, they’d find a contact on the inside who knows about the Feldenkrais Method and what it can offer Veterans. If they don’t have a contact, their first step should be to check if their local VA has a chronic pain program. Following that, find out if the VA offers an interdisciplinary pain rehab program. If neither of those is offered, I’d look to the physical medicine and rehabilitation department (PM&R). And obviously, tell them that the Feldenkrais Method is being offered at two of the NYC VA Hospitals!
IF: Andrew, thank you so much for sharing your experience, your advice, and most importantly—for the work you do with Veterans.
AC: Thank you.
Andrew T. Carter is a movement specialist and director/choreographer based in NewYork. He’s been teaching somatic modalities since 1989. He’s a Guild Certified Feldenkrais Teacher® and PMA® Certified Pilates Instructor (Pilates Method Alliance). He spent ten years teaching in a physical therapy clinic that specialized in treating performing artists. As a director/choreographer his work has been seen at theatres and festivals in New York, Toronto, and Baltimore. He's conducted workshops on varying topics in the USA, Canada, Peru, and Paris.