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Enhancing Your Therapy with Gestalt Approaches
Gestalt Therapy continuing education counselor CEUs

Section 25
Gestalt Techniques in Dance Therapy

CEU Question 25 | CEU Answer Booklet | Table of Contents | Gestalt
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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).

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?"

Participants were required to have been involved in individual or group dance therapy that was facilitated by a certified dance therapist. Individuals were screened through telephone conversations, and the first 6 women who met the inclusion criteria were included in the study. However, when it became apparent during the data collection that 5 of the 6 participants had histories of child sexual abuse, we decided to limit our analysis to the 5 abuse survivors.

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. 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." 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. 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.

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. 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."

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.

Theme 4: Sense of Struggle
All of the women in this study reported that their experience of dance therapy was infused with a sense of struggle. Initially this involved the unfamiliarity of this type of therapy. Many found dance therapy to be new and strange and used words like "challenging," "difficult," and "uncomfortable" to describe their experiences. Some felt inhibited and embarrassed at the idea of dance itself, whereas others felt apprehensive because this approach to therapy was non-traditional and represented uncharted territory. As discussed previously, the women struggled with the discomfort of being seen by others. They felt self-conscious and worried about looking foolish. For some, the experience went beyond embarrassment to a more acute sense of vulnerability and exposure. One woman's metaphor poignantly conveyed this feeling: "Moving is like opening the book … it wasn't just like opening the book, it was like ripping the book open. It was really difficult." Some of the women also reported that they struggled with how to deal with painful memories and feelings that arose during their dance therapy sessions. Many talked about how their bodies contained information about past traumas and about how that powerful and sometimes shameful material surfaced while they were engaged in the therapeutic movements. Anticipating the emergence of new and potentially painful material contributed to the women's sense of apprehension. This was dramatically captured in one woman's metaphor: "Being in my body always feels like walking through a minefield … you know that there's danger out there, you just don't know where … you're waiting for the inevitable." The women also reported their struggle to cope with the fact that particular aspects of the dance therapy process (e.g. music, certain movements, structured activities) could trigger physical and emotional responses associated with past trauma. Certain kinds of music triggered in one woman a deluge of emotion and frightening mental images related to the ritual abuse she had experienced as a child. An exercise that involved holding still reminded another woman of being bound and confined as a small child, and these memories resulted in considerable emotional and physical distress during the session. Although these women struggled to keep from being overwhelmed by body memories and emotional triggers, they were also aware that this material was necessary "grist for the therapy mill," the identification and working through of which was critical to their own growth and healing. As such, these women considered it essential to develop a sense of safety in the group. They reported that the therapist and other group members helped create a safe environment in which they were able to challenge themselves to explore difficult and painful issues.
Despite these struggles, the women said they continued in dance therapy because they saw their hard work actually helping them to grow and heal.

Theme 5: Sense of Intimate Connection
The women in this study reflected on their experience of a unique kind of emotional connection with others while engaging in dance therapy. They remarked on how this intimacy was created without words, simply by moving together and at times, physically connecting with each other. The women talked about how the sense of intimacy they experienced with other participants during dance therapy was uncontrived. It seemed to emerge spontaneously through the wonder of simple gestures, playful moments, and dances that conveyed trust and caring. The women also spoke about factors like music and synchronized movement that contributed to a feeling of unity in the group. The participants believed that this connection and intimacy added greatly to their growth and healing through dance therapy, because they felt supported by others and accepted both physically and emotionally within the group.

The participants in this study remarked that observing another person being vulnerable while dancing was also a meaningful aspect of their dance therapy experience. They called this observation "witnessing" and said it was important for them in several ways. Seeing others taking risks and being vulnerable made them more willing to risk and to open up and share more of themselves and their struggles. The women also felt "honored" to receive the gift of another's dance and said this contributed greatly to their own sense of self-worth. The women also discovered that during group sessions, they gained insights about themselves and were engaged in their own work, even when bearing witness to the struggles of other members or when others were working individually with the therapist. As one participant said, "My experience was that things always came up for me. It never stayed feeling like it was the other person's time; it was always my time as well."

Theme 6: Sense of Freedom
The word freedom appeared repeatedly in all of the women's stories in many different contexts. The participants reflected on how they appreciated the freedom of choice that characterized dance therapy. They talked about having their choice of the activities that were presented and about feeling free to adjust their participation according to their own needs, agendas, and comfort levels. One woman explained, "It was clear to me that I could choose not to do any exercise, which was very important, or I could choose to do it in my own way." For one woman, this freedom of choice and control over the therapeutic process was especially significant and meaningful in light of her past abuse experiences:" For most people that have been sexually abused, that's one thing that was taken away from them, their ability to move, emotionally, physically, mentally, everything. So you've got this freedom that is so important." This woman described the sense of personal freedom as entitlement—reclaiming her right to be in charge of her body and her experience. All of the women told stories of emotional release, which they experienced to some degree in more traditional forms of therapy. What the women believed was unique to dance therapy, however, was the opportunity to discharge some of the physical energy that accompanied these powerful emotions. As one woman put it, "When stuff comes up in dance therapy you've got some way to expend the energy that's involved … to deal with it in terms of your body, and to get the energy out of your body, not just out of your mouth."
- Mills, Letty J.; Daniluk, Judith C.; Her Body Speaks: The Experience of Dance Therapy for Women Survivors of Child Sexual Abuse;  Journal of Counseling & Development, Winter2002, Vol. 80 Issue 1
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #11
The preceding section contained information about Gestalt techniques in dance therapy.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 25
What were six themes regarding dance therapy discussed by sexual abuse survivors? Record the letter of the correct answer the CEU Answer Booklet.

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Table of Contents

The article above contains foundational information. Articles below contain optional updates.
Being in-between: A model of cultural identity negotiation for emerging adult immigrants. - March 15, 2018
This qualitative study explored the cultural identity negotiation of young adult immigrants. Using a grounded theory research design, 10 semistructured interviews were conducted with emerging adult immigrants (EAI), ages 19–27. Results yielded a substantive model of cultural identity negotiation (MCIN) for EAI and posited that One’s Motivation and Sense of Agency to Negotiate Cultural Identity is at the core of how participants navigate their cultural identities. This model included 6 major categories: (a) Family Cultural Rigidity; (b) Connections Specific to Canada; (c) Connection to a Same Cultured Community; (d) Sense of Permanency; (e) Desire to Preserve Culture of Origin; (f) Desire to Fit in to Canadian Culture, as well as 2 overarching factors (Dimension of Time and Dimension of Age), which were found to be influential on participants’ cultural identity negotiation. The model also included the identification of 4 approaches to cultural identity negotiation: (a) Blended; (b) Dual; (c) Disconnected; and (d) Intermediate. The MCIN for EAI is discussed in terms of the current literature on cultural identity formation as well as implications for counseling psychology training and practice. Recommendations for further research are also suggested. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Helping others increases meaningful work: Evidence from three experiments. - May 11, 2017
The aim of the current research was to examine whether manipulating task significance increased the meaningfulness of work among students (Study 1), an online sample of working adults (Study 2), and public university employees (Study 3). In Study 1, students completed a typing task for the benefit of themselves, a charity, or someone they knew would directly benefit from their work. People who worked to benefit someone else, rather than themselves, reported greater task meaningfulness. In Study 2, a representative, online sample of employees reflected on a time when they worked to benefit themselves or someone else at work. Results revealed that people who reflected on working to benefit someone else, rather than themselves, reported greater work meaningfulness. In Study 3, public university employees participated in a community intervention by working as they normally would, finding new ways to help people each day, or finding several new ways to help others on a single day. People who helped others many times in a single day experienced greater gains in work meaningfulness over time. Across 3 experimental studies, we found that people who perceived their work as helping others experienced more meaningfulness in their work. This highlights the potential mechanisms practitioners, employers, and other parties can use to increase the meaningfulness of work, which has implications for workers’ well-being and productivity. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Change in post-traumatic cognitions mediates treatment effects for traumatized youth—A randomized controlled trial. - March 15, 2018
Posttraumatic stress symptoms (PTSS) are associated with serious impairments in psychological, social, and academic functioning in youth. The aim of this study was to investigate whether changes in posttraumatic cognitions mediate treatment effects. Participants were multitraumatized youth (N = 156, mean age = 15.1 years, range = 10–18; 79.5% girls) randomly assigned to receive trauma-focused cognitive–behavioral therapy (TF-CBT) or treatment-as-usual (TAU). Mixed-effects models were applied to investigate the impact of treatment conditions on posttraumatic cognitions. Mediation analyses were applied to examine whether changes in posttraumatic cognitions mediated the relationship between treatment conditions and outcome in posttraumatic stress symptoms, depressive symptoms, and general mental health. Participants receiving TF-CBT reported significantly lower levels of negative posttraumatic cognitions at the end of treatment compared to participants in TAU. Change in posttraumatic cognitions mediated the treatment effect difference found for PTSS. When the overall change in cognition was divided into early and late changes, it was only the late change that significantly mediated the PTSS treatment effect. A mediation effect of posttraumatic cognitions was also found for the treatment effect difference in depressive symptoms and in general mental health symptoms. Traumatized youth report having many negative posttraumatic cognitions and changes in negative cognitions plays a key role for treatment outcome. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Discrimination, work outcomes, and mental health among women of color: The protective role of womanist attitudes. - March 15, 2018
With a sample of employed women of color (N = 276), we tested the associations of sexist and racist discrimination with poor work outcomes (job-related burnout and turnover intentions) and mental health outcomes (i.e., psychological distress). Drawing from the Theory of Work Adjustment, Organizational Support Theory, and scholarship on discrimination, we tested perceived person-organization (P-O) fit, perceived organizational support, and self-esteem as mediators of the associations of workplace discrimination with the outcomes. Based on intersectionality scholarship, womanist attitudes were tested as a moderator. Participants provided cross-sectional data via an online survey. Latent variable structural equation modeling results indicated that a second-order latent workplace discrimination variable yielded better fit to the data than modeling sexist and racist discrimination separately. Workplace discrimination was directly and indirectly (via the mediating role of self-esteem) associated with higher psychological distress. Furthermore, workplace discrimination was indirectly associated with poor work outcomes through the mediating roles of perceived P-O fit, perceived organizational support, and self-esteem. Last, moderation analyses indicated that higher womanist attitudes weakened the direct association of workplace discrimination with psychological distress. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Associations among psychological distress, high-risk activism, and conflict between ethnic-racial and sexual minority identities in lesbian, gay, bisexual racial/ethnic minority adults. - July 06, 2017
In this brief report, we present results from a study exploring the associations of high-risk activism (HRA) orientation in lesbian, gay, and bisexual (LGB) issues; HRA orientation in racial/ethnic issues; conflicts in allegiances (CIA) between one’s ethnic-racial and sexual minority identities; and anxiety among LGB racial/ethnic minority adults. A racially and ethnically diverse sample of 208 LGB racial/ethnic minority adults (age: M = 27.52, SD = 8.76) completed an online survey. Bivariate correlations showed that HRA orientation in LGB and in racial/ethnic issues, as well as CIA, were each positively associated with anxiety. However, regression analyses indicated that CIA moderated the association between anxiety and HRA orientation in LGB issues (but not racial/ethnic minority issues) such that this association was significant and positive at low levels of CIA and nonsignificant at high levels of CIA. These findings can be used to not only inform psychological practice with this population (e.g., by encouraging practitioners to be more attentive to these issues as potential sources of stress), but also more broadly, as knowledge that can inform the burgeoning psychological literature on collective action. We highlight, for example, the importance of distinguishing between types of activism (i.e., high- vs. low-risk types) in relation to mental health outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

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