As Angela arrived in the dance therapy space today she seemed delicate and completely out of touch with her body. When I looked at her, I felt her body tension was painful to witness. We stood opposite each other, there was no eye contact between us at this stage, and Angela was grinding her teeth. Her torso was held and her shoulders felt clenched. I commented on her tension and she nodded, signalling yes.
In the summer 98 issue of animated Laurence Higgens posed the question: Is Dance Therapy? (2) in all overview in which he clearly defined dance movement therapy (dmt) and the basic similarities and differences between dmt and dance in general. Working from this premise, I hope to offer readers an opportunity to understand more about the field by providing an alternative perspective, which gives an insight into the dance therapy process of one client.
In contrast to other areas of dance, an aim of dmt is to focus on the emotional material which emerges within the therapeutic relationship. I was interested in an article in the last edition of animated in which there was a quote by Rosemary Lee, dance artist and researcher. In an interview with Catherine Hale, Rosemary made a comment in relation to a Year of the Artist project she had been working on with primary aged children in Barking and Dagenham, in which traumatic feelings emerged around the project subject of 'home'. Lee commented: 'I felt it was an area I couldn't even touch on. I didn't have the training, language skills, and didn't know how to deal with what it might bring up (3). This insightful comment illustrates how Lee acknowledged the boundaries of her work its this particular situation. She acknowledged that a dance project of this nature was not the context in which to deal with such complex emotional material.
However, dance movement therapy is based upon a fundamental belief that changes in the body effect changes in the psyche and vice versa and this is an important consideration in the work. Mary Whitehouse, a dance movement therapy pioneer from the United States, noted: ' ... our movement is our behaviour; there is direct connection between what we are like and how we move. Distortion, tension and deadness in our movement is distortion, tension and deadness in ourselves.'(4) This statement reflects the interdependence of the process of the body on the psyche and vice versa. The dance movement therapist uses dance and movement as the primary tool for communication, and it is the medium through which the therapeutic relationship develops. It is through the body that the therapist facilitates the conscious and unconscious processes that enable the recognition and expression of feelings and emotions. Dance movement therapy aims to further emotional and physical integration of the individual.
As I intimated earlier this process will be illustrated through the presentation of a case study of individual dance movement therapy with a client. Readers will be taken through the dmt process, from referral to the end of a one-year treatment plan. A pseudonym will be used for reasons of confidentiality. There will also be references to a selection of the client's drawings in order to help illustrate some of the changes that took place within the therapeutic relationship over the year.
Angela
It is useful to stress at this point that one must be careful about interpretation, as it is an extremely subjective area. The comments I am making are thoughts and suggestions about what might be taking place in the therapeutic relationship.
Referral
Angela was a 16-year-old girl who had been diagnosed at an early age as having developmental delay with several autistic characteristics. She was tall, had dark hair, and some verbal capacity. However, her language was limited, with only a small vocabulary. Angela was still at school and there was concern from many of the staff about her behaviour within this environment. She was exhibiting strong feelings of anger and jealousy and she was frequently being aggressive to other pupils in the school. The school thought it could be useful for Angela to receive some individual dance therapy in addition to her normal curriculum in order to try to help her address some of the intense emotional issues that were present.
Assessment
My initial assessment of Angela involved several observations in different contexts followed by a meeting, in which we moved together, talked and drew. From my observations of Angela, in particular the movement observation, I was struck by the overall tension in her body, much of which was being held and stored in the shoulders, face and torso. However, in contrast to her body tension, Angela's body seemed to be naturally quite flexible. This was apparent from her mobile joints and hyper-extended knees.
Angela seemed to move as one part, with little differentiation between upper and lower body. Her chest area was concave and her stance/gait wide. She seemed to have a preference of moving her hands and feet - her extremities. Her pace was slow, appearing tentative. She moved very lightly with little weight being transferred through her body. This gave a sense of her being in a remote inner state. She had a very small and limited personal kinesphere (one's personal space around the body), with awareness of space limited so directly in front, or to the side of her immediate proximity. When she moved, her pathways were either linear or circular, with little other variation, and it was extremely difficult for her to make, or maintain, eye contact.
From this movement assessment, I was able to infer that Angela had a poor sense of self and a poor body image. This was reflected through her lack of overall body awareness, her poor movement repertoire and the diminished use of weight in any of her movements. The lack of awareness of her lower body and the absence of weight in her movements could support the fact that she was not physically or emotionally grounded. This supported my original observation of how bodily tense she was and how this tension was being held and stored in her upper body. Considering this physical state from a more analytical perspective, Angela's body tension of 'holding' herself together physically, could be a learned defence, a way of 'holding' all her painful and difficult feelings and emotions inside. Her body had become armour. 'Physical experiences leave long-term traces upon the way people hold themselves together and move.' (5) Angela's body tension seemed to reflect her psychic state, one of being stuck and not able to express her emotions. Then when she was able to express an emotion it was in an inappropriate way of attacking others, the emotional content came pouring out. This could be seen sometimes in Angela's shadow movements. These are movements that are unconscious and 'leak' out of the body often giving additional information about the internal state of a client. Angela's shadow movements could be seen in her very rapid, short, sharp, quick hand movements. This represented her agitated internal state. Marion North refers to the way in which 'the body speaks clearly and is usually understood and recognised at a non verbal level'. (6)
Angela found it extremely difficult to initiate any movement material of her own, play or take an equal or a leadership role in a relationship.
From the initial assessment of Angela, I set the following aims:
- to develop a sense of safety and trust within the therapeutic relationship;
- to help Angela get in touch with, and express, some of her strong feelings through movement and dance;
- to help Angela understand that dance therapy was a place in which her feelings could be expressed safely, thought about, and made sense of;
- to help reduce the level of tension in her body.
The development of the therapeutic relationship
When Angela and I began working together not only was her musculature frozen she would also struggle with words and ideas of her own, not having the confidence to express herself. Initially she required considerable direction and support from the therapist. There was little eye contact and she found it impossible to be in a spatial relationship in which I as the therapist was opposite to her (see figure I). It is interesting to note that there are no faces in her drawings from this early stage of the therapy relationship. This could be linked to there being little trust at this point. I wondered about the impact of her being seen and witnessed by another. What did faces mean to her? We found a starting place in which we worked side by side and slowly she became responsive to more directed movement ideas and able to copy. At this stage, it was difficult for Angela to move out of her habitual movement patterns. However gradually she grew more relaxed and comfortable in the relationship and we would move together side by side. On a psychic level, it was apparent how difficult this relationship was for Angela as she 'came and went' physically and psychically. Her attention would be with me, and then it would disappear, to return at a later point. I sensed Angela was very out of touch with her body. Her body tension was painful to witness at times. Sometimes she would arrive grinding her teeth, which was yet another example of the acute tension she was carrying and storing in her face and jaw.
Angela's drawings are significant, as I believe they help reflect the development of our relationship in the early stages of the therapy process. They illustrate something about Angela at a body level and how she experienced herself in relation to me. In the second drawing (see figure 2) it is interesting to note how much more developed her drawings of the body are which could suggest how she was becoming more aware of her own body.
Music was a useful tool and prop, which helped Angela unlock and let go a little. She became able to follow movement material I had set more confidently, for longer periods of time such as being able to reach up and let her arms go or to bend her knees and drop her pelvic area in order to touch the floor. This then enabled her to try movements that were outside her own repertoire, and which could help her to access a different physical state in her body. Then she became able to add one or two of her own ideas on to the dance sequence. This directed structure provided Angela with something that was safe and containing in the early part of our relationship. Breathing and sound games also began to help her access her torso area. Swinging actions encouraged her to let go and provided a 'softer' movement experience. This took some time but, as can be seen in figure 3, her drawings of the body continued to develop, appearing quite different to those in figure I. It is also interesting to note how much bigger I as the therapist am in relation to Angela. Drawing for Angela became an integral part of each session and was used as a way of closure or of ending the session. She chose to draw and her drawings were spontaneous, reflecting unconscious processes that could have been triggered from her movement experience. Drawing was a particularly useful medium in conjunction with dance and movement as Angela's language was so limited. It offered me as a therapist an additional tool from which to try to understand, and make sense of, the emotional material emerging.
Angela soon became able to take turns in our dances. This led to our first movement improvisation in which a sense of movement play began to emerge. A wider range of props was introduced and these were useful in aiding Angela to express some of her anger in a safe and controlled way through her body. She would kick a ball very hard and her increased use of weight in her movement was noticeable - something very angry was being kicked out through the ball. Simultaneously, she began to draw faces with teeth, which were prominent, big, and angry looking. (See figure 4)
Gradually Angela's use of single body parts developed into more whole gross body movements. The spatial relationship between us developed as contact and sharing weight began to take place. An example of this was when Angela initiated some supported back work. This highlighted her increased awareness of her middle and torso. In order to help Angela experience stronger and more controlled movement in her body we explored weight and strength through pushing and pulling. As Melville-Thomas states: 'External changes in the body are marked by internal ones which carry emotional and social significance for us.' (7) These physical changes witnessed in Angela could have been outward manifestations of the internal changes which were beginning to take place. Angela was increasingly getting in touch with, and expressing, her feelings of anger and deep sadness. Her sadness was also being illustrated through her drawing in which she was able to 'label' (put words to describing what she had drawn) the tears coming down the paper and falling off the edge. She was clear and confident in her differentiation between the earrings and the tears.
Angela had a history of 'merging' (an early developmental phase) with adults in her life and the merging began to take place in the therapy. This became evident again through her drawings from which it became difficult to identify who was who. (See figure 4.) However, through the dance movement therapy Angela seemed to have found a place in which she was able to express some of her difficult emotions of anger and sadness in a safe, supportive environment. This allowed the feelings to become more conscious through her dance and her drawings. She managed to find words to describe how she felt. The tears could suggest she had been able to get in touch with her sadness through the body work. But this could have been a frightening experience for her as, through this, she also began to get in touch with her feelings of separateness. It could have been this that caused her to merge with another in order to cope with the strong feelings that were arising inside her. However, Angela was beginning to allow herself access to a part of her that had perhaps been unbearable before. Therefore not only was she able to express her feelings, but the was beginning to be able to think about them with the support of myself as therapist.
Therapy can be a long and slow process, sometimes taking years. In this article I have only been able to share a little information, with selected comments on part of the therapy process with one client. It is essential to point out that each client, or group of clients, has its own process, its own journey. Angela's therapy process was hers alone. As can be seen from the case study, the process takes time and there can be difficult moments. But dance movement therapy is fascinating and rewarding work in which the power of movement, and its importance in the well-being of a client, becomes apparent again.
Sara Bannerman-Haig, senior registered dance movement therapist. Email sara_haig@hotmail.com
References
1, 4. Whitehouse, M. Fran Levey
2. Higgens L., Is Dance Therapy? animated, summer, 1998
3. Hale C., Apart from the Road 2, animated, summer, 2001
5. North M., Personality Assessment Through Movement, MacDonald & Evans, 1971
6. Sossin. M., Loman S., Kestenberg J. and Lewis P., The Meaning of Movement, Gordon & Breach, 1999
DMT training
Training to be a dance movement therapist involves a post-graduate course, which takes a minimum of two years part-time. It is demanding and requires considerable commitment. For information concerning courses, which have been recognised as meeting the Association of Dance Movement Therapy (ADMT) UK Criteria for Registration as a Practitioner, see below.
There are three main areas of training:
1. personal development in which you must participate in your own personal therapy for at least the duration of the training course;
2. the academic requirements of a postgraduate course;
3. clinical requirements - clinical placements which will be supervised throughout the training period.
If you are interested in training in the future and would like to begin preparation, it can always be useful to have had some personal therapy prior to the course. It is also helpful to have had a variety of experience with a range of different groups. For example, the elderly, young children, people with disabilities. This work, or indeed voluntary work, could have taken place in the community, in education, in social service provision, or within the health service. This can offer insight and experience with different groups, highlighting some of the needs and issues which can arise in the different contexts. It can also familiarise potential students with some of the management and organisational issues attached to the different services.
Contact ADMT UK on +44 (0)117 953 2055. Email query@dmtuk.demon.co.uk