Tuesday, December 6, 2011

Dr. Fabra: "Dystonia is an emotional condition" ...Really???

Check out this video on Dr. Fabra's site. I thought it was interesting because one of the trombone players who have FTSED had his first symptoms a couple years later after a major embouchure change. "If it ain't broke, don't fix it."

I've heard Dr. Fabra state in his videos and online that Hand Dystonia and Embouchure Dystonia is an emotional condition, which I highly disagree with or at least dislike labeling it as such. I disagree it is the source or culprit (of a neurological disorder), nor the pathway to recovery. 

It is a good starting point in recovery, especially for those who have just been hit with dystonia and going through a lot on the inside. Learning how to cope on an emotional level, or learning how to keep a positive mentality/inner strength throughout the process of rehabilitation is important, but it is not the source and cure of musician's dystonia.

To view a similar blog I wrote over....the link can be accessed here: Focal Dystonia is an Emotional Disorder? Since When?

Dr. Fabra states in one of his videos that his own teacher tried to change his embouchure, and not long afterwards he started to have dystonia symptoms, and the same goes for one of the trombonists in the video. There are players that have undergone embouchure changes and resulted in tremors or spasms in the embouchure. My question is so why isn't it a possibility that their symptoms occurred as a result of physical/mechanical change in their playing over time....rather than some deeply rooted emotional trauma?

My point is, no matter what triggered the dystonia symptoms, I believe it takes a lot of embouchure function retraining (or sensory-motor retraining) and inner healing together to make progress due to this setback...but do I believe their dystonia is an emotional disorder? (especially when there are many other cases people ignore, that show other possible triggers)....I do not believe it is valid enough or excusable to label it as an emotional condition.

When I say psychology. I'm referring to "emotional" disorders (acute or chronic) or the emotional realm, and when I say neurological, I mean the brain and sensory. And when I talk about muscle retraining, I am also linking it to cognitive restructuring....the way you perceive rehabilitation...how you approach it (basically setting up your mentality for rehabilitation, as it's much different focus than what you use in performance training).

I'm also not fond of him making it seem like if a musician does not find success when they visit him, it's because they did not understand his approach, or they did not fully embrace it, or "THEY" were too mentally exhausted to invest....why is it "their" fault? He makes it seem like it's the musicians fault that they couldn't embrace the "cure." Why isn't it a possibility that his method doesn't work for some people? or that it isn't the cure-all. One size doesn't fit all.

I may be repeating myself, but the psychology Fabra emphasizes is important for attending to the emotional turmoil you go through...I think that is important for many. But equally important, if not more...and what will carry on after emotional healing....is retraining the muscles and sensory...which all has to do with restructuring your mentality to focus on sensory-motor/embouchure function retraining- the way you think/focus or perceive what you're dealing with....I call it "embouchure awareness" or embouchure tension and body intuition awareness. That's what's given me the most progress on a physical level when facing my embouchure dystonia. Being aware of how my dysfunctional embouchure functions.


  1. Good points. I've wondered similarly after seeing those videos. I would agree that dealing with the emotional upheaval that comes from a sudden breakdown in a musician's abilities to play (and earn a living, in many cases) must be dealt with. However, it seems to me that the psychological issues follow the physical ones, not the other way around.

  2. Thanks David! I'm a huge fan of yours! I had a muscle tear and played on it for too long up against a sharp tooth and it caused peripheral nerve damage, but not deep enough to paralyze my face or anything that bad, but it was still delicate and debilitated my playing to the point of not being able to play.

    When I was injured I wasn't sure what was going on, and at the time I had a lot of pain, but slight dystonia symptoms. It wasn't until after I healed and started to try and play again, that my dystonia symptoms were out of control.

    So even though I strongly believe my dystonia symptoms were triggered by my injury, I know that it isn't always the culprit or main cause of dystonia in other people, so I don't go around telling people they can't have dystonia unless they were absolutely physically injured.

    Even though there isn't one main culprit to blame for triggering dystonia, nor one specific method of recovery, doesn't mean we know nothing about dystonia......we have one thing to rely on, and that is when it does occur, it is neurlogical-based. So that's what I focused my rehabilitation around, and that's what a lot of hand dystonia patients focus their rehabilitation around as well; neuroplasticity.