Dance movement therapy and depression - blog article by Sarah Boreham DMP
By sarah boreham, Sep 19 2014 08:56PM
It seems congruent to immerse myself in writing this blog today, being world suicide prevention day.
This blog will describe a drop in the ocean of what is a multi-layered experience of depression and touch on dance movement therapy as a useful intervention and source of knowledge.
For me there has always been something about a protest in depression almost as if the body/mind voices a resistance that words can only partially express. It seems to me if you want to make a statement of change refusing to move/feel or think in the required normative way is very effective.
A male with depression choosing to resist the tough guy role; doing distress just as a soldier goes AWOL, choosing to literally move his body out of the traumatic experience of war, a woman may insist with an angry embodied voice that she wants to challenge an accommodating female role prescribed by societal and familial pressures, in the past this woman has been branded a hysteric!
But what does this have to do with mental health, depression and dance movement therapy?
Some historical bones to this story lie in the prevalence of global diagnostic statistics and a movement towards questioning the biomedical/pharmaceutical models as effective in the treatment of depression – 120 million persons globally were diagnosed with depression (WHO 2010). A biopsycho social model is being favoured by mental health practitioners for depression and this is where dance movement therapy really takes centre stage.
Because of dance movement therapy's unique focus on the body/mind, collaboration and integration of the whole person working, it Includes biological, psychological and social experience providing a visceral interface on which to make changes in a person’s understanding and life.
An introduction to benefits of DMT with depression may include helping to:
• Encourage a sense of well-being, self-confidence, energy, emotional balance, relaxation, focus and motivation.
• Improvement may be seen in: relationships, sleep, concentration, enthusiasm, hope, self-awareness/knowledge, positivity, emotional self-regulation, impulse control, physical health and problem solving capacity.
• A decrease in anxiety and distress, self-harm, delusions, destructive behaviours and mood swings.
These benefits as shifts can happen in all creative and therapeutic endeavours; so how does dance movement therapy help specifically with depression?
• To help alleviate anxiety and develop a sense of cohesion, building commitment to the group or relationship, understanding another perspective/position can build empathy through social learning.
• To develop the skills of self-regulation (emotional, psychological, physical and developmental)
• To build a definition of personal boundaries and separation; dance therapists often use the concept of space to explore our developed attitudes towards ourselves and others.
• To identify the Dance Movement Therapy area as a safe place to develop, repair and trust by engaging in the therapeutic process, to reshape/reframe relationships.
• To encourage movement and verbal reflection as a means to self-expression and communication, with the knowledge that the individual is not alone in his/her experiences.
• To identify problems in one’s mode of relating to others; problem spotting and facilitating change, by exploring interpersonal patterns that cause difficulty and identify alternate choices such as metallisation, cognitive and emotional integration.
• To concentrate on the process of ‘the here and now’ or with an insight orientated approach.
• To use nonverbal techniques providing a feedback loop of self reflexivity and increased self awareness
• To find a way of expressing difficult emotions and shift emotional blockages held in the body/mind (Fuchs 2009, Reich 1990).
Finding your creative self through DMT with depression:
Fuchs talks about a divide between the lived/experienced body and the material/subjective body. If we imagine such a divide creatively: We may dance and move in metaphor of a valley in which we can’t connect to the other side, on a felt level this may feel like a detachment or isolation. Imagine taking this into a dance movement therapy space, where you are with the group and then you are placed behind an opaque black veil, in an alcove of the room, you are still able to see and hear your group in the space but your perception and experience will be different, perhaps you will curl up into a ball, or attempt to move out from behind the curtain, maybe you will experience panic and quickened heart rate or breath; feeling disconnected and alone. Your movement may be bound and tight from the tension in your body, you may feel stuck or heavy, you may even feel protected and safe with your separation from the world. A person with depression may feel and think many things and DMT can develop a poignant embodied voice to capture the subjective experience of a person that can’t be articulated by language alone. Dance Movement Therapy can offer an antidote (Harrison 2007, Leventhal 1989) to heal and integrate the somatic, cognitive and feeling aspects of life.
Exploring relationships in depression:
Exploring relationships in depression is a key theme in DMT practice with depression: Firstly the therapeutic relationship that is built, may help to improve trust or reframe developmental patterns embodied and built with early care givers. Daniel Stern (1985) talks on creating subjective experience and cognition in relationship; through affective attunement, mismatching and rhythms. I have found Stern's developmental embodied theory helpful to consider the developmental patterns that emerge in the therapy space. Imagine a client and therapist are moving in the space and a client moves in one direction with a short darting extension of the arms requesting the therapist follow him, but a mismatch in time, and direction occur, which leads to the client feeling angry and frustrated at the mismatching, enabling a cathartic experience for the client to express his emotions in a safe space ; the client chooses and bounces a large exercise ball activating full body weight to produce a satisfying slapping sound on the floor and a released deep breath out follows. This kind of intervention can clear the way for a more attuned experience between therapist and client and I’ve often found this taking the form of rhythmic almost ceremonial tribal dance with our feet beating out on the shared ground, in which we create our shared embodied voice.
Exploring emotions connecting the body mind and spirit/soul through dance movement therapy:
Dance movement therapy can create a space in which a depressed person can build awareness and embodied mindfulness whilst working with energy and breath. Breath as a vehicle of depression through which energy travels between the inner and outer connection of; self to world, cells to environment, vitality to interaction (Hackney 1998, Hartley 1994). It’s as if through the body, a reclamation of power can happen through the flesh and meeting others, as they undergo their own existential journey through life. I’ve come to view this as direct resistance of a disempowered body, perhaps in response to diagnosis in depression.
Imagine a client swearing and producing a defiant stance of not moving or sticking up two fingers to the process, accessing the moving rebel within, defining and differentiating themselves; exploring the archetype of warrior (C J Jung). Whirling fists... stabbing at the air… holding their breath as they roller coaster the moving metaphor of their rage.
A DMT may witness clients becoming stuck/still as if to allow the depressed body to activate an inner witness, unfolding, holding, placing trust enough to shrink into their kinaesthetic cocooned space, allowing a vulnerable body, accessing memories of a walk in the park with ‘mother’ whom never quite provided enough hands of support.
It has been my privilege to co-create with clients in the dance movement therapy room, silent but present tears, not looking away but holding my gaze and remaining ‘here and now’ in the healing experience. This is DMT at its finest; exploring emotions and loss (Allegranti & Wyatt 2014) and stepping into transitional space allows clients to experience the depth of moving through trauma and losses that have shaped the distress in a depressed moving response.
Integration to Closure:
As I sit here reflecting on integration and depression, I flit back to last night’s film “When Nietzsche Wept” based on the book by Irvine Yalom. I recall the dialogues being voiced by 3 significant influences: the neurobiological body of Bauer whom termed the phrase ‘The talking cure’, his protégé Sigmund Freud whom represents the psychological body, labelling the practice of integrating the unconscious and conscious and finally the existential body of Friedrich Nietzsche, whom holds the combination of cognitive, emotional and philosophical weight of the story that he shares so fully and authentically.
As he weeps his words are simple, his body saying it all of despair and distress released with the enormity of a life lived in relationship to another human being. His embodiment literally falls from a tense, bound, heavy structure to an open, soft, engaged and focused man expressing his depression through warm tears of connection.