webinar- dance movement therapy with ed clients

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Dance/Movement Therapy Groups for Clients with Eating Disorders: Jumping the Hurdle of Fear into Conscious Embodiment Marybeth Weinstock, PhD [email protected] ; 831-718-9595 Monarch Cove Treatment Center for Eating Disorders

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Marybeth Weintock, Ph.D discusses dance movement therapy and its application to clients with eating disorder treatment.

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Page 1: Webinar- Dance Movement Therapy with ED Clients

Dance/Movement Therapy Groups for Clients with

Eating Disorders:Jumping the Hurdle of Fear into Conscious

Embodiment

Marybeth Weinstock, [email protected];

831-718-9595Monarch Cove Treatment Center for

Eating DisordersAn affiliate of Castlewood Treatment Center

Page 2: Webinar- Dance Movement Therapy with ED Clients

Welcome

What 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 diagnoses who are challenged with grave fears of being embodied -DMT techniques that have been effective in recovery process

Page 3: Webinar- Dance Movement Therapy with ED Clients

Definition of Dance/Movement Therapy

Dance/Movement TherapyBased 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

Page 4: Webinar- Dance Movement Therapy with ED Clients
Page 5: Webinar- Dance Movement Therapy with ED Clients

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

Page 6: Webinar- Dance Movement Therapy with ED Clients

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

Page 7: Webinar- Dance Movement Therapy with ED Clients
Page 8: Webinar- Dance Movement Therapy with ED Clients

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

Page 9: Webinar- Dance Movement Therapy with ED Clients

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

Page 10: Webinar- Dance Movement Therapy with ED Clients
Page 11: Webinar- Dance Movement Therapy with ED Clients

Chace Method

Began in St. Elizabeth’s Hospital, 1940’sBasis in dance forms such as modern danceCircleRhythm and musicMirroringFormat of a dance class:

warm up

development of themes

cool down

Page 12: Webinar- Dance Movement Therapy with ED Clients
Page 13: Webinar- Dance Movement Therapy with ED Clients

DMT and assessment

Their 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

Page 14: Webinar- Dance Movement Therapy with ED Clients

Laban and Effort/Shape: A Brief Overview

Hungarian architect and dancer Rudolf von Laban created:

Movement choirsLabanotationEffort-Shape: method for systematic description of

qualitative change in movement in terms of the kinds of exertions and the kinds of body adaptations in space

Cecily Dell, a primer for movement description

Page 15: Webinar- Dance Movement Therapy with ED Clients

Effort/Shape

Effort: Flow: free/bound Weight: light/strong Time: sustained/sudden Space: direct/indirect

Shape: Growing/shrinking Vertical: rising/sinking Sagittal: advancing/retreating Horizontal: widening/narrowing

Page 16: Webinar- Dance Movement Therapy with ED Clients

DMT and Assessment

Posture and gesture (Schilder)

Page 17: Webinar- Dance Movement Therapy with ED Clients

Philosophy of Treatment

At 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.

Page 18: Webinar- Dance Movement Therapy with ED Clients

Eating Disorder Diagnoses

Anorexia Nervosa Bulimia Nervosa Eating Disorder NOS Binge Eating Disorder

Page 19: Webinar- Dance Movement Therapy with ED Clients

Co-existing conditions

Body Dysmorphic Disorder Mood disordersAnxiety disorders, including panic, OCD, and phobiasSubstance Abuse and Chemical DependencyPTSD / Trauma

Page 20: Webinar- Dance Movement Therapy with ED Clients

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.

Page 21: Webinar- Dance Movement Therapy with ED Clients

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

Page 22: Webinar- Dance Movement Therapy with ED Clients

Definition of Body Image

A subjective experience of one’s own physical appearance established both by self-observation and by noting reactions of others.

Merriam-Webster

Page 23: Webinar- Dance Movement Therapy with ED Clients

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

Page 24: Webinar- Dance Movement Therapy with ED Clients

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

Page 25: Webinar- Dance Movement Therapy with ED Clients

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.

Page 26: Webinar- Dance Movement Therapy with ED Clients

DMT in the Treatment of Eating and Body Image Problems

For someone with an eating disorder, the bodily-felt sense of self is distorted, frozen, traumatized, or too filled with shame to be known or seen by another person. One of the ways DMT helps is through the development of mindfulness of bodily sensations leading to a more realistic sense of body boundaries. This can lead to greater ability to know herself and recognize physical cues such as hunger and satiation. DM therapists help clients to name and modulate strong emotions. By attending to a bodily felt sensation, the individual can start to notice different intensities of the sensation, and notice what changes occur. Anne L. Wennerstrand, CSW, DMT, Eating Disorder Referral and Information Center

Page 27: Webinar- Dance Movement Therapy with ED Clients

DMT in the treatment of Eating and Body Image Problems

Experiential 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

Page 28: Webinar- Dance Movement Therapy with ED Clients

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

Page 29: Webinar- Dance Movement Therapy with ED Clients

Meeting the Challenges

Existential Dialectics meets DMT:Validating existence through mirroring, shared leadership, circleSynthesis/Antithesis=Thesis via expanded movement repertoire

Salomon Rettig, Existential Dialectics in Therapeutic Groups

Page 30: Webinar- Dance Movement Therapy with ED Clients
Page 31: Webinar- Dance Movement Therapy with ED Clients

Meeting the Challenges

Take them where they’re at!CHOICEMirroringCognition

Page 32: Webinar- Dance Movement Therapy with ED Clients

How??!!

Begin with choice, respect the mood Begin with structure that’s safe, quiet, simple Breath Stretching Pass around/leadership Socialization Repetition Rhythm Humor

Page 33: Webinar- Dance Movement Therapy with ED Clients

How??!!

Gentle stretching Relaxation Creative Movement DMT Anna Halprin’s Movement Ritual

Page 34: Webinar- Dance Movement Therapy with ED Clients

How??!!

Chace structure Check in Warm up Development Cool down Check in

Page 35: Webinar- Dance Movement Therapy with ED Clients

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

Page 36: Webinar- Dance Movement Therapy with ED Clients

How do we invite the client’s body into the therapeutic 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

Page 37: Webinar- Dance Movement Therapy with ED Clients