The music is slow, barely audible, a soothing cello wafting across the room from the stereo in the corner. Anya stands between two chairs, her muscles rigid and clearly strained as she attempts to walk from one chair to the other, her therapist standing close by, but not touching her.

Midway, Anya suddenly freezes and her back leg becomes paralyzed. She is unable to move in any direction, and her whole body begins to shake from the strain. The therapist attempts to ground her by reminding Anya that she is in this room, a safe room, and not the traumatic place she is experiencing in her mind. Through this reaffirming tone, the therapist is attempting to teach Anya ways to alleviate the stress of these traumatic episodes.

The therapist moves closer to Anya, coming into her field of vision to establish direct eye contact, and stretches out her hand. Warily, Anya takes the hand and together, they begin to slowly sway, moving gently from side to side in a shared rhythm. Guided by Anya’s subtle movements and the continued eye contact, the therapist “dances” with her until the terrified period subsided, and Anya sits down in the chair to rest.

Looking up at the therapist with tears in her eyes, Anya finally makes the connection that her immobility was caused by some deep-rooted psychological disturbance, rather than her previous self-diagnosis that she was experiencing some rare form of stroke that went undetected, despite the extensive neurological work-up that had been performed on her.

Armed with this simple awareness, Anya is prepared to begin confronting the pain she realizes has been haunting her subconscious mind for a long time.

Different Symptoms, Different Therapy

It is one of the stereotypical aspects of human nature to divide and conquer certain obstacles as they are presented. And to many, the concept of therapy is no different. In the common view, people who have mental disabilities or behavioral problems are sent to a variety of psychologists or behavioral therapists, while people who are in need of bodily rehabilitation, due to injuries or physical disabilities, should be redirected to their type-specific physical therapist.

The logic is so cut and dry that it seems almost preposterous to question, yet, there are a large number of therapy patients whose symptoms would have them tumbling through the gaping holes in this rigid therapeutic divide.

The dance/movement therapist works on the premise that the mind and the body are interrelated, and the disturbances of one can often be seen by the reactions of the other. Not all people who are experiencing mental duress or overcoming a particularly traumatic experience react to it in the same way; many people, unsure of how to deal with the enormity of their feelings or how to express these feelings to others, attempt to repress the entire event.

This type of emotional suppression can sometimes surface later along with a number of different emotional, cognitive, and social problems, ranging from intimacy issues, to physical disability, to a disconnect with their normal activities.

Dance/movement therapists work with individuals of all ages and cultural backgrounds, operating in both group and private sessions, depending on which is better for a patient at a particular stage of therapy. Therapists primarily focus on helping their clients improve their cognitive skills or social abilities by developing effective communication skills and expanding their movement vocabulary, a particular pattern of actions that mirror the client’s own usually-limited range of expressed emotions.

“The language of the body is, in essence, our ‘native language’, since human beings communicate through their bodies long before they learn to talk,” says Susan Kleinman, MA, ADTR, NCC, a dance therapist for residential and outpatient services at the Coconut Creek-based Renfrew Center of Florida. “As we develop, we add words to our communication; however, body language remains our most acute means of recognizing our needs and expressing ourselves.”

Movement is the primary medium that dance/movement therapists use for observation, assessment, research, and therapeutic interaction. Working in settings where the patients are most susceptible to mind-body distortions, dance/movement therapists can be found in psychiatric and rehabilitation facilities, schools, nursing homes, drug treatment centers, counseling centers, crisis centers, and various medical facilities.

A Healthy Image

An eating disorder is just one of several ways in which repressed traumatic experiences can manifest themselves. Eating disorders need to be understood in the context of experienced trauma, with many eating problems beginning as survival strategies rather than vanity or obsession with appearance. Feeling helpless in the face of an inflicted trauma, people look for a part of their lives they can control – food and weight become that “control” for them.

Low self-esteem and constant self-criticism cause these individuals to constantly fear losing control, and even consuming a small amount of food could be considered a loss of control. Studies on women from various social backgrounds, sexual orientation, and ethnic cultures find that eating disorders are a common response to environmental stresses, such as sexual, physical, and emotional abuse.

“I work with girls and women with eating disorders, who also have trauma or abuse issues, or have substance abuse issues,” says Kleinman. “Women with eating disorders tend to avoid connecting in their body and because of this, they often feel numb. Whenever they get feelings that overwhelm them, they turn to their eating disorder in order to cope with those feelings. Instead of expressing a feeling or a problem, a person might hold back or restrict a problem, and that person may then go on to turn it into an eating disorder in which they mix up food and feelings. They then begin to restrict food, which becomes their main calling in life – restricting food – and quickly evolves into anorexia.”

To confront this common theme of disconnect, dance/movement therapists encourage their patients to communicate via postures, gestures, and idiosyncratic movements, with the therapist using their own physical responsiveness to create a therapeutic interaction.

Through these non-verbal sessions, underlying issues, such distorted body image, fear of intimacy, lack of body boundaries, and fear of taking risks, start to become visible in this exchange between patient and therapist.

A Child’s View
   
Dance/movement therapy is also utilized to treat a number of pervasive developmental disorders (PDDs) – characterized by delays in the development of socialization and communication skills – which has the therapist most frequently working with children. The most commonly known developmental disorder is autism, but PDDs also include Rett syndrome, childhood disintegrative disorder, and Asperger syndrome.

While parents may note symptoms of PDD as early as infancy, typically onset is prior to 3 years of age, evident by delays in the child’s ability to adjust to their environment or socialize with others.

Children afflicted with PDD vary widely in abilities, intelligence, and behaviors. While some children do not speak at all, others speak in limited phrases or conversations, and some are noted to have relatively normal language development.

These children are shown to display repetitive play skills and a limited set of social skills, as well as atypical responses to certain sensory information, such as loud noises or different kinds of light. Limited to particular patterns of expression and mechanical socialization, this disorder represents the sort of ‘break’ in the mind-body sensory input that dance/movement therapy can readily assist.

Gayle Gates, MA, ADTR, NCC, LPC, a dance/movement therapist and associate director of dance/movement therapy education at the Hahneman Creative Arts in Therapy program at Drexel University in Philadelphia, has worked extensively with adolescents with developmental disorders. Working exclusively with autistic children at the Philadelphia-based Green Tree School, Gates recommends that therapists pay close attention to a child’s physical posture before beginning therapeutic interaction.

“[Ask yourself], ‘What do I think when I look at this body as a whole? What are the body parts that the child is using?’” says Gates. “Is there a lack of complex gestures? Are there stereotypic and atypical patterns of mobility?”

From her experience, Gates has developed her own dance/movement therapy assessment, which allows therapists to observe and measure the movement data and interaction that patients express in a given environment:

• Limitations interfering with the patient’s adaptation to an environment
• Strengths that patients use to compensate for weaknesses
• Emotional problems, such as depression, anxiety or anger
• Behavioral problems, such as attention span, impulsivity, and low tolerance level
• Body image disturbances involving distortion of self and environment
• Fragmented communication patterns affecting the patient’s ability to interact and socialize

Through dance/movement therapy and the kinesthetic awareness that its therapists employ, patients are given another outlet through which they can express their suppressed emotions. By allowing patients to overcome their emotional hurdles at their own pace, therapists form a tighter bond with their patients – oftentimes this is a necessity when assisting them.

As exploration into the field continues, therapists from other modalities, such as physical and occupational therapy, are becoming steadily aware of the chances for progress available for patients that may have already plateaued in respect to physical rehabilitation.

— Bob Stott is a staff writer for Therapy Times. Questions and
comments can be directed to bstott@therapytimes.com.