Dance/Movement Therapy Groups for Clients with Eating Disorders:Jumping the Hurdle of Fearinto Conscious Embodiment Marybeth Weinstock, PhD Marybeth.Weinstock@castlewoodtc.com; 831-718- 9595Monarch Cove Treatment Center for Eating Disorders
WelcomeWhat we’ll be exploring today:-Basic tenets of Dance/Movement Therapy (DMT)and how they apply to Eating Disorders-Focus on clients with severe, chronic diagnoseswho are challenged with grave fears of beingembodied-DMT techniques that have been effective inrecovery process
Definition of Dance/Movement Therapy Dance/Movement Therapy Based on the assumption that the body and mind are interrelated, body movement therapy is defined as the psychotherapeutic use of movement to further the emotional, cognitive, physical, and social integration of the individual. The dance/movement therapist focuses on movement behavior as it emerges in the therapeutic relationship. Expressive, communicative, and adaptive behaviors are all considered for both group and individual treatment. Body movement as the core component of dance simultaneously provides the means of assessment and the mode of intervention for dance/movement therapy. American Dance Therapy Association
DMT Integrating ancient healing practices of movement, meditation, and imagery, it is uniquely suited to take its place as a cost-effective, interpersonal practice in a newly reinvented healthcare system. Dance therapists provide treatment for people with psychological and physical conditions, including anxiety, depression, psychogenic somatic disorders, heart disease, cancer and neurological impairment. Dr. Ilene Serlin, The Corsini Encyclopedia of Psychology
DMT Dance has existed in every human culture and is used in ritual, rites of passage, and as a cathartic healing tool. In early civilizations dancing, religion, music and medicine were linked. Modern D/M therapists use the power of dance and movement to help individuals access their own natural ability to heal and grow. Anne L. Wennerstrand, CSW, DMT Eating Disorder Referral and Information Center With respect to the ancient roots of DMT, these are much older than the roots of the modern medical/psychiatric model and go back to the ancient healing practices in which circles, rhythm, images, and energy were used for group transformation. Dr. Ilene Serlin, The Corsini Encyclopedia of Psychology
Forms of DMT Chace Method, Marion Chace Authentic Movement, Mary Whitehouse Organic Movement, Alma Hawkins Dance as creative transformation, Blanche Evan Adler, Liljan Espenak Source/Core/Creativity, Norma Canner Folk Dance, Elizabeth Polk Mime, Trudi Schoop
Commonalities of Forms of DMT Dance therapists are trained in bodily attunement and attachment theories that can open up powerful preverbal experiences. In their work, they provide a safe space to contain, re-experience, and work through bodily held blocks. They understand that movement is a language, an expression of the self that expresses its coping style, defenses, leadership styles, and capacities for intimacy. Movement is a special way of knowing. Kinaesthetic intelligence is one of the multiple modes of intelligence, a way of knowing in the body, a form of active imagination. Movement embodies the creative process. The act of shaping raw material or emotion into symbols or images is healing, as it helps objectify the emotions, creates distance from them, and unleashes a powerful creative force. Movement is healing and transformative. It can unlock primitive feelings and traumas that are stored in the body, restoring our connection to our bodies and the earth. And, in many cultures, dance takes us to the sacred. Dr. Ilene Serlin, The Corsini Encyclopedia of Psychology
Chace Method Began in St. Elizabeth’s Hospital, 1940’s Basis in dance forms such as modern dance Circle Rhythm and music Mirroring Format of a dance class: warm up development of themes cool down
DMT and assessmentTheir attention is drawn to how they enter the room, where they choose to place themselves in the room, the attitude or posture they assume in stillness, how they breathe, the degree of tension experienced in their bodies, how they move out in space, and how they relate to others nonverbally through movement. Dr. Erma Dosamantes-Alperson, Dance Movement Therapy: An Emerging Profession
Laban and Effort/Shape: A Brief Overview Hungarian architect and dancer Rudolf von Laban created: Movement choirs Labanotation Effort-Shape: method for systematic description of qualitative change in movement in terms of the kinds of exertions and the kinds of body adaptations in spaceCecily Dell, a primer for movement description
DMT and AssessmentPosture and gesture (Schilder)
Philosophy of TreatmentAt Castlewood, we encourage an exploration of the mind/body connection in order to assist those struggling with eating disorders to begin to forge a new relationship with their bodies, one that is compassionate, accepting and kind.
Co-existing conditions Body Dysmorphic Disorder Mood disorders Anxiety disorders, including panic, OCD, and phobias Substance Abuse and Chemical Dependency PTSD / Trauma
Eating Disorders and DMT DMT serves as a powerful medium for people suffering with eating disorders to explore their relationship to their bodies. A characteristic of eating disorders is the tendency to detach from feelings and focus on body distortions, obsessive thoughts, and concrete, black and white thinking. DMT provides a way to safely become more aware of feelings that arise from the body’s sensations, and teaches people with eating disorders how to listen to their body’s needs. This is critical to recovery. People with eating disorders can become socially isolated. The relationship focus of DMT, both in group and individual formats, helps the individual risk connecting to others in supported, honest, and meaningful ways. Discoveries made in DMT-about one’s own mind/body connection and about relating to others-transfer to other relationships and how one moves through life.
Eating Disorders and DMT When everyday movements are transformed into expressive movements, participants become able to release and externalize their feelings. In this creative process it becomes possible to find the metaphoric connections between the expressive movement and the familiar patterns in their lives that may underlie the eating disorder. DMT helps people understand how their feelings are given form through their actions, and empowers them to take risks. Healing cannot fully take place unless they are able to challenge themselves to live in their bodies, a central component of their body image. DMT provides a structure so this can occur. American Dance Therapy Association
Definition of Body ImageA subjective experience of one’s own physical appearance established both by self-observation and by noting reactions of others. Merriam-Webster
DMT and Body Schema Dance is movement, and movement is essentially a process of ongoing change. Moving with one’s whole body, with and against gravity, one learns to both yield and resist, to feel one’s strength and to feel one’s vulnerability, to try on new qualities of action and behavior. This is what it means to be fully human. DMT can improve body image. Paul Schilder, a developmental neuroscientist, once said that dance is a loosening up of the body schema. He was describing how when we dance, the movement activates a dynamic and constant feedback loop back and forth between our brains and our bodies, so that our experience of our felt and living selves is one of change. Sherry Goodill, NEA Blog
Definition of Body Dysmorphic Disorder Body Dysmorphic Disorder (BDD) is defined as a preoccupation with an “imagined” defect in one’s appearance. Alternatively, where there is a slight physical anomaly, then the person’s concern is markedly excessive. The preoccupation is associated with many time consuming rituals such as mirror gazing or constant comparing. BDD patients have a distorted body image, which may be associated with bullying or abuse during childhood or adolescence. Such patients have a poor quality of life, are socially isolated, depressed, and at high risk of committing suicide. The condition is easily trivialised and stigmatized. Dr. David Veale, Postgraduate Medical Journal
DMT and the Treatment of Body Image Problems DMT is effective as a technique to help those with eating and body image problems. One of the most crucial tasks of any therapy is helping an individual put her feelings and experiences into words. When an individual does not allow herself to know or put her feelings into words she must be helped to recognize and name feeling states in order to heal. Research shows that many patients with eating problems struggle with alexithymia, which is defined as difficulty in putting feelings and fantasies into words (Zerbe, 1995). Though eating disorders are incredibly complex, one way to think about the “symptom” of the eating problem is to understand it as an individual’s best attempt to cope in some way with internal or external stress. The eating problem represents the individual’s difficulty in finding other more gratifying ways to address key needs and issues which may or not be within the individual’s awareness…Feeling states manifest in the body and the “site” of the eating disorder is the body itself, making body-based therapies ideal in helping those with eating problems.
DMT in the Treatment of Eating and Body Image ProblemsFor someone with an eating disorder, the bodily-felt sense of self isdistorted, frozen, traumatized, or too filled with shame to be known orseen by another person. One of the ways DMT helps is through thedevelopment of mindfulness of bodily sensations leading to a morerealistic sense of body boundaries. This can lead to greater ability toknow herself and recognize physical cues such as hunger andsatiation. DM therapists help clients to name and modulate strongemotions. By attending to a bodily felt sensation, the individual canstart to notice different intensities of the sensation, and notice whatchanges occur.Anne L. Wennerstrand, CSW, DMT, Eating Disorder Referral and Information Center
DMT in the treatment of Eating and Body Image ProblemsExperiential understanding begets cognitive understanding and connection with feelings can be translated into insightful cognitions. There is always communication present. When therapists can connect with and utilize their own feelings as part of the therapeutic process, they can help their patients decode their own inner experience and transform them into opportunities for growth. Susan Kleinmen, Eating Disorder Hope
Challenges: Just getting them in the room! Body image issues/Body Dysmorphia Feeling disembodied Dissociation/Trauma Social and general anxiety Challenges with sexuality Ambivalence about Recovery Inability/lack of permission to have fun and play Perfectionism Anhedonia Orthorexia/body checking Media bombardment Previous negative treatment experiences Exhaustion/heart issues Medication side effects Malnourishment side effects
Meeting the ChallengesExistential Dialectics meets DMT:Validating existence through mirroring, sharedleadership, circleSynthesis/Antithesis=Thesis via expandedmovement repertoireSalomon Rettig, Existential Dialectics in Therapeutic Groups
Meeting the ChallengesTake them where they’re at!CHOICEMirroringCognition
How??!! Begin with choice, respect the mood Begin with structure that’s safe, quiet, simple Breath Stretching Pass around/leadership Socialization Repetition Rhythm Humor
How??!! Gentle stretching Relaxation Creative Movement DMT Anna Halprin’s Movement Ritual
Goals of DMT Connection to/awareness of the body and its functions. Increased ability to be present with self and others. Increased awareness of safe and healthy expression through the body Increased ability to utilize self soothing and affect regulation skills Increased connection to and acceptance of all parts of self Increased sense of physical and emotional boundaries Awareness and expansion of movement repertoire Experience of fun, play, humor Increased understanding of self through imagery, metaphor, imagination Safe space to express full range of emotions Healing effects of creative art experience
How do we invite the client’s body into thetherapeutic process?Ask regularly about what clients are experiencing in their body during therapy. This integrates the mind and body and dismantles the familiar “talking head” syndrome, in which clients are cognitively and intellectually insightful but disembodied. The eating disorder lives in the body. The only way out is through the body. Deanna James, R-DMT, LPC, Castlewood DMT
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