Dance The Pain Away

By Cathy Cassata 04/10/15

How dance and movement therapy can be an effective form of ongoing treatment.

Emma Barton in the One Legged Inverted Staff Pose.

Scratch the image of Katy Perry dancing in unison with costumed sharks or the smooth moves of Usher in a music video (if that’s who came to mind). This type of dance isn’t the choreographed kind. In fact, it’s a psychology.

“While dance is the foundation of the work in dance therapy, it’s really about finding the movement of the body,” says Kris Larsen, dance therapist and instructor in the dance/movement therapy and counseling department at Columbia College in Chicago, Ill. “We’re not necessarily having people dance, but having them find an inner impulse or movement to bring them into a liveliness that expresses symbolically what they’re going through emotionally.” 

The American Dance Therapy Association (ADTA), which promotes the field of dance/movement therapy defines it as “the psychotherapeutic use of movement to further the emotional, cognitive, physical and social integration of the individual.” Based on the premise that the body, mind, and spirit are interconnected, the ADTA states that dance/movement therapy is effective for people with developmental, medical, social, physical, and psychological impairments.

A Dance for Addicts 

Dance/movement and yoga therapist Emma Barton, who practices body-based psychotherapy and teaches at Lesley University in Cambridge, Mass., uses movement to help those dealing with addiction. Barton works one-on-one with clients, but also holds a weekly mindfulness-based movement therapy session that teaches participants to witness both their internal and external experiences. The group-therapy content was developed from her 11 years living in Asia studying yoga therapy.

“People who are struggling with addiction are uncomfortable with change, and are used to repeating behaviors over and over again. At the same time, they are aware that these repeating behaviors don’t serve them, but they find it nearly impossible to stop the cycle without help," says Barton. "Movement-based therapies help them become aware of what they can and cannot control. When you learn to be a witness, you can begin to nonjudgmentally observe your internal emotional and sensory experiences, as well as recognize how your behaviors impact your external environment.”

During her sessions, addicts learn to be present in the moment through the process of movement. “A lot of times addictive processes are tied to anxiety about the future or something that hasn’t happened yet, or about how you think you are perceived through the eyes of someone else. When you ask a client to become aware of their physical or sensory experience in the moment, it reminds them to redirect out of that anxiety state into a more manageable and realistic place, the present moment,” Barton notes. 

Barton adds that while traditional psychotherapy tends to focus solely on cognitive processes, discounting the intelligence of the body, dance/movement therapists are trained to recognize the integration of both body and mind, and that the body has its own intelligence and can actually be more authentic in expressing an internal state. 

"Anxiety is a felt sense—there is something happening in the body, and that’s how it is recognized. We rarely pay attention to the sensory experiences that are informing us because we cognitively label them rather than fully explore them. What we should do is learn to stay more present to the intelligence of the body rather than get lost in thoughts of fear and mind-reading," says Barton. 

The best metaphor for this, adds Barton, is how people handle driving on an icy road. When the tail of the car starts to slip to the right, most people naturally turn away from the slipping direction, even though they need to turn toward it in order to better stabilize the car. "This is what we do with sensory experiences that scare us—we turn away. Rather, behavior change starts with the willingness to look at the thing that scares us. Turn towards your fear, and you’ll stabilize your car,” states Barton.

So is true for Mark, a 60 year old client of Barton’s, who began taking opiates at 13 to numb out abuse. Mark also struggles with post-traumatic stress disorder (PTSD) as a result of his childhood trauma. “I found that 12 steps, SMART recovery, and group therapies didn’t resonate with me. When I met Emma, she brought meditation and body-center movement to treatment,” he says. “I think PTSD is the real reason behind my drug problems, and so the physical body centered stuff seems to really be effective for me. After so many years of doing opiates I forget about basic needs like food, sleep, and being in the moment, and like many opiate addicts, I internalize the societal labeling of being a useless junkie. I get in my head too much and it just doesn’t work, but staying centered in my body brings me out of my head and forces me to work through unpleasant feelings from my past,” he says.

In a typical movement-therapy session, Barton offers clients, like Mark, directives that help them to better witness themselves in the present moment. When she asks them questions about their physical expressions, it prompts them to wonder within the present moment, and teaches them that they can change their internal experience through the combined effort of movement and self-awareness.

“People who experience substance addiction have a difficult time with self-regulation. Through experiential processes, a person experiencing substance addiction can learn methods to redirect uncomfortable sensations, feelings and thoughts back to the present moment, which is the only place that they can directly impact,” explains Barton.

Emma Barton teaching a workshop at Women's Health Day, May 2014 in Boston. Photo by Damian Shiner

Take a Peek

The theory behind dance/movement therapy seems sensible, but what does it actually look like? Larsen and Barton say that no two sessions are alike and that the energy and needs of the people attending, drive each group. However, the following may give an idea of what a typical session involves.

Larsen holds a monthly group at a dance studio for women dealing with issues including anxiety, stress, and depression. “For many people, not only addicts, the body is an alien thing. When I’m leading a group, a lot of work is about helping people understand the landscape of their body and how sensations are connected to thoughts and how thoughts might be connected to emotions,” he says. “Addiction is a cycling pattern and most of the time addicts don’t know they’re going to use so to bring that kind of consciousness or the impulse of the trigger to the forefront is what we’re working on. Let’s find that thing that keeps triggering it, be it a thought or something else and watch what happens in your body right when the trigger occurs.” 

During a typical session, Larsen sits against the wall while participants find a place in the room, close their eyes, and begin to move for about 15 or 20 minutes. Then he talks about what he’s observed based on the images he intuits from the group’s body movements. “It’s very improvisational and always comes from the client. I ask what’s going on with them and sometimes they’ll reveal something like stress, so I’ll make the session themed around stress and ask them to move or express with their bodies what that stress is about,” he says. 

By moving in this way, Larsen says clients learn to quiet their ego. “It’s attempting to allow the unconscious to come through and it trains the body and mind to observe. As the witness, I’m able to be an outside observer for the movers (my clients) so they can go inward and trust me to view and see them without judgment. By trusting me, they can let the body go and not let their ego criticize and direct; this allows the unconscious to emerge,” he says. 

After about 15 or 20 minutes, the group comes together and discusses what emotions and images came up while they were moving. The two-hour sessions consist of back-and-forth between movement and talking.

When Larsen is working one-on-one with clients in his office, he says movement therapy can take many forms. For instance, one of his clients was down on herself and Larsen decided to toss a pillow at her. “I told her to get up and throw the pillow back at me because when she gets really down she begins to speak softly and her body begins to hunch inward. I wanted her to open up and scream,” he says. “She began yelling at me and her body started shaking so I told her to move around the room. She starting saying, ‘I’m a peacock. I’m a peacock.’ Then we began talking about the beauty of the peacock. That’s when she said, ‘I have these beautiful feathers behind me that I never let anyone see because I always think I’m not.’ That’s how the session ended. We could say it was dance or movement cause she was moving around. Dance tends to happen on its own. The next time I see her, I might have her just dance like a peacock so she owns that part of herself.”

Barton’s yoga-based sessions incorporate movements and the practice of mindfulness. She provides clients with movement sequences that they can use anywhere. Her sessions aren’t limited to the confines of the therapy room, as she occasionally takes clients on movement-meditation walks outdoors.

“My goal is to get people out of their thinking process, and to focus on their lived, felt experience. Addiction is not about the drug or alcohol or even the behavior; it’s about coping with what’s naturally there and uncomfortable. Treatment should be less focused on the substance use and more focused on behavior change that’s present, mindful, and informed by sensory awareness,” she says.

Laura, a 29 year old client of Barton’s, who struggles with depression, attention deficit disorder, and alcohol abuse says Barton’s techniques help her. “Emma’s class has taught me to really sense how I’m feeling when I have urges to drink. I’m now able to notice how my body reacts—like my heart races—and to focus on how I can change those physical reactions that are going on when I have urges,” she says.

What makes Barton’s sessions different from typical yoga sessions? Laura says that they’re more casual and involve lots of talking. “We can ask questions and get feedback from Emma. Other traditional yoga classes I’ve taken are more silent and rigid.”

Emma Barton at the Cape Cod Behavioral Health Summit, October 2014. Photo by Damian Shiner.

Mute the Music

Dance-therapy sessions may or may not include music. Larsen's don’t. “The reason for this is if you turn music on, people start naturally moving to that rhythm, not what their body is going through,” he explains.

However, early in his career, Larsen worked at a mental health hospital, where he coordinated an outpatient addiction program that included a music component with dance therapy.

“These adults were severely traumatized, so if you have people who are really depressed or non-communicative, you want to wake them up a bit, so to speak, and music can help do this. But once they felt comfortable, I’d turn it off,” he says.

While music isn’t played at all of Barton’s sessions, she occasionally turns it on to create an experience in the room that brings people together.

No Do-si-dos

While many dance/movement therapy programs do not permit touch from the therapist or between participants unless a participant gives direct permission, Barton says she does use props like stretching bands or fabric. “I may pull the other side to create tension to give the person a feeling of being wrapped up, comforted, or contained without actually being touched,” she says.

Larsen says his role is to sit back and witness movements of his clients, but he may occasionally nudge them to move a certain direction, or the participants may happen to move together in some form. “For example, one woman was feeling very abandoned and lonely and she just seemed so young in her movements. I asked another woman to hold her hand and they began to slowly walk around the room. The lonely woman began to cry and said, ‘I never felt like I had someone to hold my hand.’ This allowed her to open up, and so began some deep work,” explains Larsen.

Give it a Whirl

If you’re ready to make the move, visit the ADTA website to find a certified dance therapist in your area.

Larsen notes that while all dance therapists certified by the ADTA are trained in similar ways, he says some might have different styles than others. “Some may be more dance focused while others more meditative or yoga-based. You definitely want to find a good fit for you just like you would when searching for any therapist,” he suggests.

Barton agrees and says comfort level is also a priority. “The individual process is important, but so is your relationship with the therapist. Keep in mind that you want a compassionate witness. The therapist isn’t fixing anybody, but creating a safe place so that you feel seen, heard, and felt without judgment. Many treatment programs don’t offer that now and it’s about structure and following rules and being compliant, which are all important parts of managed care, but for people who really want to change themselves they have to be curious and wonder, and that involves feeling safe.”

If you’re still weirded out by this therapy or think it’s just another hippy-dippy approach to healing, Barton’s client Laura leaves you with this final thought. “As addicts, we tend to forget about our bodies and how they feel. Movement is a way to get out of your head and figure out what’s going on in your body,” she says. “The best takeaway I’ve gotten is learning to stay in the moment when uncomfortable feelings and urges arise, and allow myself to really feel them until they pass.”

Cathy Cassata is a regular contributor to The Fix. She recently wrote about addictions to sugar and tanning and interviewed trauma advocate Tonier CainConnect with her on twitter—@Cassatastyle.

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Cathy Cassata is a freelance writer who writes about health, mental health and human behavior for a variety of publications and websites. She is a regular contributor to Everyday Health and Healthline. View her portfolio of stories at Connect with her on Twitter at @Cassatastyle.