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Animated Edition - Winter 2013
Communicating through the body using creative movement in health care
Elisabeth Zeindlinger, freelance dancer and project coordinator in Northern Ireland, sets out her manifesto for working in health care settings

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Image: Elisabeth Zeindlinger with Sue Lyttle, Arts Care concert by musician Brendan Popplestone. Photos: Colin Cairns
Elisabeth Zeindlinger with Sue Lyttle, Arts Care concert. Photo: Colin Cairns
The music starts and interweaves with the sound of a specific location, the murmur of the people waiting for treatment, who immediately draw their attention to the tunes. The character of site-specific performances is intangible; it always involves immediate responses to audience and adaptation to space. This makes it a big challenge for performers and has to be understood to recognise the great achievement for a performer with a brain injury, whose space of interaction in everyday life is relatively small and repetitive.

I work as a freelance dancer in Belfast, Northern Ireland, going into very different healthcare settings to dance with patients in rehabilitation, day centres for the elderly or people with disabilities, in mental health, on long stay wards and I perform in waiting areas or wards in hospitals with service users and other dancers. Most of my projects I got through Arts Care (www.artscare.co.uk), which is an organisation that employs artists to work in the field of healthcare. I strongly believe in dance as a tool to unlock channels for self-expression and strengthen self-esteem, therefore in my dance sessions I give guidance for participants to find their own movements, based on structured improvisation and strengthening body awareness as well as connecting with people and the environment through listening and talking with the body.

For me the wish to work in healthcare has to come from the honest and genuine interest to get to know another human being and the complexity of his or her life; to be ready to accept and furthermore respect participants, without judging them is the foundation of going into every session. It cannot come from feeling pity or seeing only negative things that happen in their lives.

The first time I saw a long stay ward I was shocked about the sterility and sadness there and that was the mood I brought with me while working there for the first few weeks, then I decided that this had to change. I wanted to be totally positive for the service users to bring them some happiness from outside. It also turned out that this didn’t really work for me, because I am simply not always happy and so it felt fake. So I thought: “Why should I play a masquerade and present them a ‘perfect me’ without any problems, while they are themselves with all their edges?” That is when I changed my approach into an authentic one that actually gives me the freedom to share when I have a sore head or feel homesick.

My practice is very much influenced by Alito Alessi’s (1) method of DanceAbility, which allows people with different abilities, backgrounds and needs to come together and dance. I am convinced that this way of interacting supports wellbeing in general but can have a special impact on people living in a healthcare environment. These are people who often have lost ownership over their lives; usually somebody else decides when they have to get up, get their food, how they can decorate their ‘room’ or what they are allowed to spend their money on. Their voice does not count anymore; these people live in a parallel world to our society because they had an accident and suffer from a brain injury, are old and have dementia or have a mental health problem and just do not ‘fit’ anywhere.

Erich Fromm, a philosopher, psychotherapist and psychologist wrote in his book, Revolution of Hope, that in the moment we (human beings) are ‘standing still’ we start to die (2). Bringing this statement into the context of health care I see it as a call for more creativity in this environment. To fill it with life and make the people living or spending a lot of time there emotionally and physically feel alive instead of staring at the television or the ceiling for a big part of the day. Staff engagement can also lead to a new way of connecting with patients and understanding them better, and to more satisfaction and fun during their working days.

One of the main outcomes of a creative movement programme is that it activates people; it lifts their mood because they have a holistic experience that involves body, imagination, emotions and they interact with others often with the outcome of a product. Participants are encouraged to create their own dances during a workshop so they get empowered and can be proud of their movements and inventions rather than reproducing the facilitators routines. I am more interested in approaching individuals, looking at the strengths of each person and developing something around that.

Taking this idea from a workshop into a performance situation I still use the same principles, the wellbeing of the service user has to be the main focus; giving them ownership over the creation of a piece will have a totally different impact on them than performing the movement material of the choreographer. Also it is much easier to remember your own movements, which allows you to be more confident on stage.

Another positive way to stand out on stage is by having stage ‘presence’ and I ask myself if you need to understand the concept of it in order to be able to recreate that state off stage? This question arose while working with a group of men with brain injuries. One of them stood out. As soon as he had the feeling of being in a performance situation he seemed to switch into a different state but it didn’t matter if it was a rehearsal or a real showcase. He is so focused and while he is slowly making his way from one side of the room to another trying to keep his balance you are drawn to watch him. I wonder what happens in the brain during those moments.

Coming back from the stage to less abstract ideas about my personal experience, marked by the fact that I am from Austria and my mother tongue is German; sometimes I am asked if I fully understand the people I am working with. There are a few answers to that question. One is that although being quite fluent in English, there are expressions I just don’t know, for example, somebody told me about the children’s game ‘Chinese whispers’. I had to ask what that was, they explained it to me and that did encourage the participants to paraphrase it, which turned it into a learning experience for all of us.

Another answer is that empathy is universal. I have also met people whose language skills were affected by brain damage or a neurological disorder, so in fact you need to find another way to communicate. This can be through touch or just being with that person and trying to dive into his/her world to give them a sense of normality. I recommend the book The Creative Arts in Dementia Care by Jill Hayes. She talks about kinaesthetic empathy, which she describes as accompanying someone, while breathing like he/she does and moving the way they do, in order to see and understand their perception a bit better (3).

What I have noticed works best in all my work situations is being passionate about what I am doing. This passion jumps over and encourages participants to become more engaged. Furthermore I to try to understand their cultural background, especially when it involves a conflict as it does in Northern Ireland.

The significance of being aware of that also depends on the target group; I find it extremely important when dealing with elderly people. Asking about the dance hall times when Protestants and Catholics met and danced together is always a good start to get to know a new group. Usually men and women have positive memories relating to the dances and are willing to share these. I would usually enhance this kind of sharing and connect these memories with movement, which adds a new layer to a well known story. We are creating shared knowledge that gives everybody something to talk and think about later.

A session does not stop when I leave the room; it always leaves an impact, as much on my participants as on me. The honest giving and receiving makes this job so beautiful to me; the experience of being fully in the moment, because all my senses are alert to what is happening around me, enables me to be able to invite people to come on a creative journey with me.

contact zeindlinger_elisa@gmx.at / visit elisabethzeindlinger.jimdo.com

(1) Alessi Alito, Artistic Director, DanceAbility International www.danceability.com
(2) Fromm, Erich: Die Revolution der Hoffnung: fuer eine Humanisierung der Technik. (Uebersetzung Liselotte und Ernst Mickel) Frankfurt/M.; Berlin; Wien: Ullstein, 1981. Page 24
(3) Hayes, Jill; Povey, Sarah: The Creative Arts in Dementia Care. London and Philadelphia: Jessica Kingsley Publishers, 2011. Page 56.

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Animated: Winter 2013