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How to Build Self-Esteem in Teens & Adults with a History of Abuse
10 CEUs How to Build Self-Esteem in Teens & Adults with a History of Abuse

Section 9 (Web #23)
Dance Therapy for Women Survivors of Child Sexual Abuse - Part I

Question 23 | Answer Booklet | Table of Contents | Self-Esteem CEU Courses
Social Worker CEU, Psychologist CE, Counselor CEU, & MFT CEU

This qualitative, phenomenological study explores the experiences of dance therapy for 5 women who had been sexually abused as children. Using in-depth, largely unstructured interviews, the women reflect on their dance therapy spontaneity Self-Esteem psychology continuing edexperiences and on their perceptions of the role of these experiences in their psychological healing. Analysis of these data revealed 6 common themes related to the women's sense of spontaneity, permission to play, struggle, freedom, intimate connection, and bodily reconnection. The implications of the findings are discussed in terms of the therapeutic nature of dance therapy and how this therapeutic modality facilitates change and healing in clients' lives.

 

Counseling therapy traditionally been have known as “talking cures,” used to relieve the symptoms of emotional distress and the problems in living encountered by clients as they progress through life. Consistent with the mind-body duality that had its origins in the teachings of Aristotle and Plato, whatever the theoretical underpinnings of the various theorists, and irrespective of the psychological or somatic nature of clients' concerns, these talking cures have all had as their goal facilitating changes in clients' thoughts, feelings, behaviors, and perceptions. Noticeably absent in most traditional approaches, however, has been attention to the body—to the embodied aspects of clients' psychosocial experiencing (Simonds, 1994). Even when clients have experienced significant physical trauma, as in the case of physical or sexual abuse or various health crises (e.g., mastectomy, hysterectomy, spinal cord injury, stroke), direct attention is rarely paid to the clients' relationships with and experiences of living in their bodies.

 

Yet, each individual's history is etched in their body and is reflected in their breathing, in the lines on their faces, in their eyes, and in the way they walk in the world (P. L. Bernstein, 1986; Levy, 1988; Siegel, 1995). As Alice Miller (1981/1984) aptly stated in relation to traumatic childhood experiences,

 

The truth about our childhood is stored up in our body, and although we can repress it, we can never alter it. Our intellect can be deceived, our feelings manipulated, our perceptions confused, and our body tricked with medication. But someday the body will present its bill. (p. 316)

 

Vigier (1994) also speaks of the power of the “voice of the body”—a “voice inside the flesh” that is beyond interpretation, “that is simply the body speaking” (p. 236). She underscores the importance of finding ways to give voice to this “place of subtle and silent speech” (p. 236), in particular through dance.

 

In virtually all known cultures, dance has existed as a form of communication, ritual, and celebration (Schmais & White, 1986). However, it was not until the 1930s that dance was formally adapted for therapeutic purposes (Levy, 1988), to provide individuals with mental illness or disabilities with a means of communication. Since then, it has been used in the treatment of anxiety disorders (Leste & Rust, 1990), eating disorders (Wise, 1984), Parkinson's disease (Westbrook & McKibben, 1989), addictions (Murray-Lane, 1995; Rose, 1995), head injuries (Berrol & Katz, 1985), multiple personality disorder (Baum, 1995), abused children (Goodill, 1987), battered women (Chang, 1995), older persons (Sandel & Hollander, 1995), people who are blind (Fried, 1995), people with learning difficulties (MacDonald, 1992), individuals with physical disabilities (Levy, 1988), and survivors of sexual abuse (B. Bernstein, 1995). B. Bernstein uses numerous case examples and anecdotal material to illustrate how dance therapy can be used to work through and resolve various issues that commonly arise in therapeutic work with sexual abuse survivors. These include shame, guilt, dissociation, sexuality, boundaries, intimacy, and personal power.

 

Commonly referred to in the literature as “dance therapy” or “dance-movement therapy” (Payne, 1992), this approach to facilitating therapeutic change uses psychomotor expression as its major mode of intervention. The American Dance Therapy Association defined dance therapy as “the psychotherapeutic use of movement as a process which furthers the emotional, cognitive and physical integration of the individual.” Conducted individually and in groups, dance therapy is aimed broadly at facilitating personal mind, body, and emotional integration; emotional growth (P. L. Bernstein, 1986); and clearer self-definition (Payne, 1992) The movement component of dance therapy can include rhythmic dance, spontaneous and creative movements, thematic movement improvisations, unconscious symbolic body movement, group dance, and range of movement and relaxation exercises (P. L. Bernstein, 1986). It may or may not include music and verbalizations.

 

Theories in psychology that have been most influential in the field of dance therapy include Reichian, psychoanalytic, Gestalt, object relations, humanistic, family systems, and Adlerian. Levy (1988) noted a trend toward increasing theoretical eclecticism and integration in the field of dance therapy. However, there are some key conceptual themes that are common to most dance therapy approaches. Human beings are assumed to have unconscious memories, feelings, and motivations that need to be introduced and integrated into individuals' conscious awareness (P. L. Bernstein, 1986). Furthermore, it is assumed that some unconscious material, especially memories formed during preverbal stages of development and bodily trauma, are stored in the body and are more easily accessed through physical expression (Levy, 1988). Within the holistic conception of the individual conscious intellect, the emotions, the unconscious, and the body are considered interconnected, with the experiencing and processing of physical experiences believed to positively affect emotional and cognitive growth and functioning (P. L. Bernstein, 1986; Espenak, 1981).

 

Despite the growth in this and other nonverbal modes of intervention (Levy, 1995; Simonds, 1994; Zwerling, 1989), dance therapy remains a “diverse, complex, but little-known subject area” (Payne, 1992, p. 1). Therapeutic goals are rarely or poorly defined, and change is often measured based on the dance therapist's intuition and judgment rather than on the client's self-report or on concrete behavioral indices. The theoretical and empirical literature in this area is sparse. The few available efficacy studies involve single cases (Hammond-Meiers, 1992), rely on anecdotal reports of client change and symptom improvement (e.g., Lawlor, 1995; Liebowitz, 1992, Meekums, 1992), or attempt to assess change based on only one dance therapy session (Brooks & Stark, 1989). Descriptive accounts of intervention strategies abound, to the neglect of conceptual discussion and theoretical application (P. L. Bernstein, 1986; Levy, 1995; Musicant, 1994).

 

Overall, the reader is informed about what dance therapy looks like in practice but is left to wonder about how it works and why certain interventions are used in certain circumstances. Little is known about client's subjective experiences of this form of therapy and their perceptions of how dance therapy facilitates client change.

 

We undertook this qualitative study in an attempt to begin to understand how dance therapy effects change in clients' lives. The purpose of this phenomenological exploration was to explore the lived experience and meaning of dance therapy for women who found that this form of therapy contributed to their personal growth and healing. The question that guided this research was, “What is the lived experience and meaning of dance therapy for individuals who found it to be facilitative of their personal growth and healing?”

 

Results

Six themes that were common to the participants emerged from the data analysis. The words of the participants are used in the following descriptions of the themes and subthemes to more accurately capture the essence and meaning of their dance therapy experiences. To enhance reporting, each subtheme is italicized within the thematic descriptions.

 

Theme 1: Reconnection to Their Bodies

All of the women in this study mentioned having felt disconnected to varying degrees from their bodies. Some spoke about a rejecting attitude they had toward their bodies, either because it seemed fragile or because it had attracted a child abuser. As one participant put it, “I thought of my body as this unfortunate accessory … it has just caused me trouble … it always felt like the enemy.”

 

Others talked about a general sense of not having been present in their bodies. One recalled, “I had spent most of my life feeling that my body either walked in front of me or behind me, so that's what I mean by not being in my body.” At the extreme were various descriptions of dissociation, which seemed to be related to experiences of childhood sexual abuse. For example, one participant reflected on her sense of having been a collection of pieces: “I always felt sort of fractured, fragmented, like parts of my body are on different planes and they're not connected to me personally.” Another stated, “because of the nature of the abuse done to me &helip; I was encouraged to dissociate … shut off, literally right down the center of my body, one side or the other.” These women reported having felt sad and angry when they reflected on the personal costs associated with being split off from their bodies and dissociated from their feelings.

 

In fact, having experienced various other forms of more traditional “talk” therapies, these women specifically sought dance therapy as a means to help them reconnect to their bodies. It is not surprising, then, that a sense of bodily reconnection was an extremely prominent theme running through the transcriptions of each of the participants. All of the women talked about how dance therapy involved a process of getting back into their bodies. One woman defined this as “being conscious and at the same time aware of my physical parameters.” The women related stories of becoming aware of their body parts and the thrill of new physical sensations. As one put it, “you get total awareness of your body … it was exciting … even talking about it now I get tingly … it felt like coming alive.” By becoming more connected to their bodies, the women were able to become more “present” in and more comfortable with the range of energetic and emotional sensations in their bodies.

 

In reestablishing a connection with their bodies, the participants reported feeling an increased sense of acceptance and care of their bodies. One woman reported, “I like my body a lot more. I am much more accepting of how I physically look and how I feel physically.” Another woman commented that subsequent to dance therapy, she shifted her attitude regarding self-care and was making healthier food choices and exercising more frequently. Three of the participants talked about how dance therapy provided them with a sense of safety and control, which allowed them to stay present in their bodies during times when painful feelings or sensations related to past bodily trauma resurfaced, rather than distancing or dissociating themselves from their bodies. In this way, these participants believed that dance therapy helped them “reprogram” themselves by learning an alternate response to the resurfacing of painful memories. They talked about how, through dance therapy, they were able to use their bodies to anchor themselves in the safety of the present time and place when faced with, or when processing, distressing psychological material. One woman's story illustrates this process.

 

In the dance therapy room, you can have one new experience where [abuse] doesn't happen … you can force your body past that place where it remembers what happened and have a new memory, of something that's different and positive … now I can say to myself “it just feels like where I was before, but I am not actually there” and then I can snap out of it. I just have to remember to go back to my body and do those things where I can feel present.

 

The participants also talked about their previous tendencies to cope with physical and psychological discomfort by “going into their heads” through intellectualizing, minimizing, and denying. One woman stated that she entered dance therapy “wanting to know what happened to [her] without [her] mind's censor involved.” The participants reported that, unlike traditional talk therapies, dance therapy offered them a way to bypass this defensive reaction to discomfort, because this therapeutic process was rooted in bodily expression. As one participant observed, “I think the moving repeatedly helps you to stay in your body, and not go back into your head.” Another stated, “Dance therapy is good because it doesn't let you analyze yourself to the nth degree and never come up with any answers.”

 

Participants in this study also talked about the experience of getting to know themselves better through dance therapy. They spoke about discovering bodily “truths” that had previously been inaccessible to them. As one woman put it, “I knew somehow my body would tell me the truth … the surprise was how deeply my body felt the things that happened to me … for the first time I understood what body memory means.” Another woman had a similar realization: “Dance therapy was one of the first experiences of discovering how much was stored in my body.… I discovered that there were whole aspects of my body and my experiences that I hadn't gone into … it was a powerful way of getting connected to myself.”

 

The women also reported an increase in their emotional awareness through dance therapy. By becoming more connected to their physical selves, the women felt they were able to detect and identify their deeper feelings more accurately and more easily. They reflected on how working in the medium of movement rather than just words helped to make their emotional worlds more accessible to them. As expressed by one participant, “It's being able to move and show the emotion in some way that helps the words come out.… I don't have to just say how I feel, I can show how I feel.”

 

All of the participants also reflected on how, through their enhanced connection to their bodies, they experienced a sense of wholeness and integration that had been lost to them for many years. Through their experiences of dance therapy, the participants believed they were able to reunite their minds and bodies, to reconnect to split-off parts of the self, and to recover and reclaim their emotional and psychological worlds.

 

Theme 2: Permission to Play

The women in the study had experienced talk-based therapies as sometimes serious and hard work and were surprised that play was encouraged as an integral part of the dance therapy process. One woman found that, contrary to her expectations, she really enjoyed the dance therapy sessions. She remarked, “I thought, aren't we supposed to be crying and upset and angry?” The women described the playful element of this therapy as “delightful” and “exciting.” They experienced it as a means of recapturing a sense of carefree youth that had been lost to them over the years. This aspect was particularly significant for some women who remembered childhood years in which play and fun were lacking or forbidden. Through dance therapy, these women were able to experience, as adults, a sense of the type of playfulness that is characteristic of childhood.

 

The participants noted especially, how the playfulness of dance therapy provided a balance to and a relief from some of the emotionally heavier aspects of therapeutic work. As one participant said, “There was at least one moment every time I went where I just had a good time. And that was a neat thing to learn, that I could do some healing work and it didn't have to be totally serious and really hard all the time.” Indeed, that play and work could coexist and, in fact, that both together could lead to healing and growth was considered a significant new insight by the women in this study.

 

Theme 3: Sense of Spontaneity

Spontaneous movement was mentioned as an important aspect of the dance therapy experience by the women in the study. When they spoke about spontaneous body movement, the participants described movement that was free, self-determined, natural, and uncontrived. They spoke about a progression during their dance therapy experiences toward increased spontaneity in their body movements and toward overcoming the various obstacles they encountered along the way.

 

One obstacle that emerged from the women's stories of their group dance therapy experiences was what one participant referred to as having an “outer focus.” They reflected on how, at times, their concern with “what others might think” about they way they moved led to self-conscious and constrained body movement. One woman explained, “If I'm in the middle of [moving] and someone else is there, I'm so busy gauging what they're feeling about what I'm doing, that I stop being in what I'm doing.” This tendency toward heightened self-consciousness was particularly salient for two of the participants who had had formal ballet training. They reflected on how this painful self-consciousness became an obstacle at times—impairing their ability to honestly express themselves through spontaneous movement.

 

The women in this study described how dance therapy was about challenging themselves to focus less on the evaluation of others and more on expressing themselves authentically. One woman described her therapeutic process in terms of moving her attention away from the “gaze of others” and into her own body. Another participant talked about dance therapy helping her to open the passages to her emotions and to express herself in a more authentic way: “Because of dance therapy … I'm moving naturally as opposed to moving in a controlled way … more from my body as opposed to my head … I think more of me will come out, I'll be freer in how I express how I feel.”

 

The women also talked about how their inclinations toward rigid mental control blocked their connection with their bodies and their authentic emotions. For example, one woman reported that she had never felt safe to move and be present in her body without mental vigilance. While engaged in dance therapy, however, she experienced a dramatic shift: “It suddenly dawned on me that I had actually moved without thinking first! It's in the nature of an epiphany!” She talked about how this experience opened her to a “whole other way of being” one in which she could enjoy being present in her body without expending large quantities of energy on being “in control.”

- Mills, L., & Daniluk, J. (2002). Her body speaks: the experience of dance therapy for women survivors of sexual abuse. Journal of Counseling & Development, 80(1).

 

“Personal Reflection” Journaling Activity #9

The preceding section contained information regarding dance therapy for women survivors of sexual abuse.  Write three case study examples regarding how you might use the content of this section of the Manual in your practice.  Affix extra paper for your Journaling entries to the end of this Manual.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

QUESTION #9

How did The American Dance Therapy Association define dance therapy?

 
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