Humans are extraordinarily adaptable. We can survive in Artic cold and desert heat, we can live on grains or mollusks, we can continue to function with damage to muscles, joints, and ligaments, and we can find ways of successfully moving without optimal use. There are top athletes with very poor posture as there are top musicians who use themselves quite poorly.

Carl Stough was a voice teacher who was able to greatly help patients with emphysema to leave intensive care and to function independently. He did this by teaching them to get the most out of their breathing musculature without actually using that musculature in a natural, efficient way, supported by good posture. Like the hunchback violinist, they learned to make the most of what they had.

As I’ve written, healthy respiration begins with spinal extension, indeed, with extension of the entire trunk, such that, not only is the aponeurosis (central tendon) of the diaphragm drawn up from above on inspiration it is in fact pushed up from below by the action of abdominal muscles pressing the internal organs inward and upward against the diaphragm. In healthy breathing, the descent of the diaphragm is limited as it is lifted from above as well as being maintained from below. Someone suffering from emphysema is likely to be retracted in his neck, so his diaphragm will press down on inhalation, often moving so low that its return may be impeded by the ribs pulled in on inhalation. Straining to exhale, he struggles to free his ribs to allow its return to a higher condition. . Using simple vocalization exercises, Stough worked to train these patients to find more ease in their breathing. Any kind of forcing, fixing, or squeezing has an effect on the sound the voice produces. Working to allow for a better sound helped his students to remove unnecessary effort from their breathing, therefore permitting the diaphragm greater range of movement and allowing for greater respiratory volume, in spite of very poor overall breathing mechanics.

Alexander stated that it is wrong to attempt to consciously control any aspect of respiration – much better to learn to direct the body to lengthen and widen, knowing that reflex breathing will follow this improved posture. Stough, teaching his students to produce better sound allowed for greater movement of the diaphragm and allowed them to exhale more completely. However, allowing length in inhalation, as I learned in my Alexander Technique lessons, would keep the diaphragm up and let it do its work in lifting the ribs and expanding the ribcage much more fully and with greater ease.

A body that shortens to allow the diaphragm to move downwards will not lift the ribs and expand the ribcage on inhalation.:

I took a workshop with Carl in the 1980s and years later, at the suggestion of one of my vocalist students, had lessons with one of his most senior teachers to find out more. I was not able to get much out of them, because I wasn’t moving my diaphragm up and down. But I found the vocal work of some use.

What I remember about Carl was that his use did not seem good when he moved. I never heard him sing, only count on a sustained note. It is certainly interesting to vocalize without starts and stops and allowing the vocal cords to adapt without adding neck and jaw muscle tension. And, while one can more easily hear misuse in the voice than one can see it in movement, with hands-on work one can sense misuse before it is expressed in movement, and one can guide posture in a way that one cannot verbally direct it – it is too late once movement or sound has begun.

When I took a workshop with Carl, I knew little either about the voice or about the Alexander Technique, but his belly softening didn’t fit my sense of active, free posture. Everyone believed in the diaphragm moving up and down – although I’m sure Alexander didn’t – too bad, when he stopped teaching “whole chest breathing”, he didn’t keep some of its notions active in his teaching. With good hands-on work, you can leave out so much possibly useful information and just “do” the work. The action of the vocal cords in creating a tone has to be more important than is completing the exhalation that will actualize that note. That means that sustaining directions for good use has to take precedence over trying to sing well

Note: In natural respiration, the spine extends, lifting the ligaments that maintain the diaphragm so that when it contracts it cannot descend but works with intercostal muscles to lift the ribs and open the thoracic cage. When, for myriad reasons, the spine does not lengthen to draw up the diaphragm and it descends, working against intercostal muscles – the diaphragm moves down and works against muscles lifting the ribs. The patients Stough worked with would get stuck, diaphragm contracted down, and actually pulling the lower ribs inwards. His vocal lessons helped students to release the ribs while freeing the abdominals to push the diaphragm back up. This is where Jessica got the idea that one shortens in inhalation and lengthens in exhalation. Lengthening in exhalation gets the diaphragm back up. But allowing length in inhalation would keep it up and let it do its work with more ease

https://www.alexandertechnique-running.com/breathing-and-the-alexander-technique/