In my previous post, I presented the Alexander Technique as "the art of radical presence", presence to space, support, and oneself. Presence is framed as a powerful and liberating capacity, the ability to meet experience as it is, rather than as we wish it to be.

That idea resonates deeply, but as a teacher who works with people with chronic pain and other symptoms, I've come to realise that this "presence" isn't always straightforward, can be somewhat ideological, and needs to be caveated. In fact, when we're dealing with persistent pain or long-term health conditions, and their various symptoms, the invitation to "simply be present" can be not only unhelpful but actively counterproductive.

Because for many people, presence is not immediately liberating. It can feel threatening. 

Let me be clear, people in chronic pain are understandably desperate to escape their symptoms. After months or years of constant discomfort, distraction becomes a survival mechanism. The television left running, the endless scrolling through social media, the obsessive planning and mental to-do lists, these aren't character flaws or failures of mindfulness. They are intelligent adaptations. They're lifelines. Presence is not neutral when pain and other symptoms are constant. When symptoms are relentless, presence is precisely what you don't want, even if it's what you need.

As pain researchers have found, mindfulness-based strategies can help patients separate the cognitive and emotional experience from the sensory components of pain, but this requires a degree of safety and capacity that many chronic pain sufferers simply don't possess. Asking someone to "be present to their pain" without adequate preparation isn't radical; it's reckless.

So when we ask someone in pain to simply “be present,” we have to be careful. Because without context, what we are really asking is: “Turn fully toward something that overwhelms you.” And that’s not skillful. It’s potentially destabilising.

The Alexander Technique's emphasis on awareness is powerful, but only when applied skillfully. Pain science has evolved from a fairly simple biomedical model to a more wide-reaching bio-psycho-social one, and our teaching has evolved accordingly.  This is why I've come to see that asking a student to be present to their symptoms without context is actively unhelpful. Symptoms without context are overwhelming. They flood the system. They trigger the very tightening, bracing, and reactive patterns the Technique aims to dissolve.

As modern pain science reveals, the Alexander Technique likely reduces pain through multiple mechanisms, including learning, mind-body engagement, normalisation of sensorimotor function, improvement of psychological factors, and self-efficacy. But these mechanisms don't work if the student feels ambushed by their own discomfort.

One of the core insights of the Alexander Technique is that pain is rarely the whole story. Focusing narrowly on the site of pain often increases tension, distorts coordination, and amplifies the very problem we’re trying to solve. This is why the work consistently points us away from symptom-fixation and toward whole-system awareness, how we move, think, breathe and react.

In other words: pain and other symptoms need context.

Without that wider context, “being present to pain” easily becomes being trapped in pain.

A more helpful approach is not to force attention onto the symptom, but to expand the field of awareness around it. The change comes when symptoms become part of a larger picture, when they are contextualised, not eliminated. This is where the Alexander Technique's concept of "inhibition" becomes crucial. F.M. Alexander defined inhibition as thinking "no" to repeating our habits, not suppressing them. For someone with chronic pain, this means not fixating on the discomfort but shifting attention to be more inclusive.

Consider how this works in practice. Rather than saying, "Notice your lower back pain," we might say:  “Can you notice your whole self, the areas that are OK, as well those that aren't?”. We function as a whole, so each part needs the support of every other part (although I'd argue there are no "parts")

And we can further that to: "Notice the space in the room around you and how that provides you with the intention and means to move". 

The pain remains present, we're not denying it, but it's no longer the only thing in the room. It becomes one sensation among many, a smaller part of a bigger picture.

This isn't distraction. It's a deliberate expansion of attention that includes the symptom but is not captured by it. The symptom loses its tyranny when it's placed within a context of support, space, and relationship. The pain is no longer the centre of the experience, it becomes one element within a larger, more dynamic whole.

This aligns directly with the Alexander principle that the body works as an integrated system, not as isolated parts to be fixed. 

When awareness widens, pain often loses its dominance, even if it doesn’t immediately disappear.

But even this contextualised presence requires something from the student: courage. It takes genuine bravery to stop running from pain and to turn toward it, even with support. That courage is built through small, manageable steps, never through heroic displays of endurance.

This is where acceptance and kindness become essential. Acceptance in the Alexander Technique doesn't mean resignation ("I'll always be in pain") but radical approval of what is: "This is what's here right now. I don't have to fix it immediately. I can just... let it be." And kindness, towards oneself, is perhaps the most overlooked element of the work. 

There is a quiet bravery in learning to sit with discomfort, especially when that discomfort has been relentless.

But courage here doesn’t mean pushing through.

It means: 

• allowing yourself to go slowly
• recognising when distraction is needed
• building tolerance gradually 

And perhaps most importantly, it means bringing kindness into the process. Because without kindness, “presence” easily turns into another form of pressure:

• “I should be able to handle this”
• “I’m failing if I can’t stay with it”

That mindset recreates the very tension patterns we’re trying to undo.

Radical presence, in this context, is not about endurance or stoicism.

It is a trained capacity: 

• to include without being overwhelmed
• to notice without tightening
• to stay available without collapsing into reaction 

This is where key Alexander concepts like inhibition come into play, the ability to pause habitual reactions and create space for a different response. But this takes time. You cannot demand neutrality toward pain. You can only develop the conditions in which neutrality becomes possible. 

We must abandon the fantasy of pure presence. No one is purely present to chronic pain, and asking them to be is unkind. Instead, we teach relational presence, presence to support, to space, to the environment, and we allow symptoms to find their place within that larger context.

We also become phenomenologists of distress. We inquire not just about the quality of the pain, but about your relationship to it. Do you brace? Do you hold your breath? Do you mentally flee? These patterns are the actual material of the work. And we normalise the desire to escape, acknowledging the immense challenge of what you're being asked to do.

Finally, we remain humble. The Alexander Technique is not a cure and was never intended to be. We do not fix. We accompany. We create conditions in which symptoms can soften, not because they've been conquered, but because they've been welcomed into a context large enough to hold them. And yes, often the pain goes, but due to a change in the conditions the pain was in, not by directly trying to fix the pain. In the Alexander Technique, we’re not trying to eliminate pain directly. We’re learning how not to organise ourselves around it.

Radical presence, then, is not about direct confrontation with pain. It is about creating a field of awareness - spacious, supported, and kind - in which symptoms can be acknowledged without becoming the entire landscape. It takes courage to sit with symptoms. It takes acceptance to stop fighting them. And it takes kindness to do all of this without shame or judgment.

This is the deeper art of the Alexander Technique: not the elimination of discomfort, but the transformation of our relationship to it. Not presence to pain, but presence with pain, as part of a larger, more generous whole. And that is a presence worth investing in.

From this place, something shifts. The pain is still there. But it is no longer everything.

Presence, when approached with sensitivity, becomes less about confronting symptoms, and more about reclaiming the space in which those symptoms exist.

And in that space, there is often more freedom than we expect.