A psychoanalytic perspective of endings in therapy: A dance movement psychotherapy case study

This paper is an account of time-limited dance movement psychotherapy in an inner-city London school during my final year of training for an MA in Dance Movement Psychotherapy. I describe the treatment of a traumatised 9-year-old boy using psychoanalytic theories, in particular Winnicott's ideas. This patient suffered at an early age from the drastic separation of his father and, when he was 6 years of age, various dramatic events led to the hospitalisation of his mother due to psychiatric problems. The impending ending of the therapy and the trainee's repetition of a ‘neglectful transference’ triggered powerful memories of traumatic past separations, which aroused deep-seated anxieties in the patient and trainee alike. The work towards a ‘good enough’ ending in the new therapeutic relationship was of great value to the patient's recovery. Parallels are drawn with the trainee's feelings of ending her dance movement psychotherapy course.     

Treatment modalities and self-expectancy of therapists: Modes,self-efficacy and imagination of clients in dance movement therapy

Body movement is the primary medium in which dance/movement therapists help clients to connect with implicit experience, to tolerate and express emotion, and thereby to continuously re-work, re-weave and integrate embodied experiences of self. This article explores the role of non-verbal vocalisation within the overall movement ecology of the body, and suggests ways that it can support the aforementioned processes in clinical practice. Three existing frameworks for understanding the non-verbal voice are reviewed, from within and outside the realm of psychotherapy, as are several comprehensive theoretical studies of the ‘self’ in dance/movement therapy. The author emphasises that voice is an integral part of the body's cross-modal capacity for expressive movement, and suggests that the non-verbal voice prioritises and gives form to the emotional content of other bodily movement. This article aims to provide a theoretical starting place for integrating the non-verbal voice into dance/movement therapy scholarship and practice.     

Orientating myself: A gay dance movement psychotherapist’s gender experience in training and practice

ABSTRACT

This paper offers a subjective account of the struggles and pleasures of being a gay dance movement psychotherapy (DMP) lecturer and therapist. The author shares stories of how this individual reality is informed by his life experience as a gay child and man. This gay intersubjective perspective of embodied therapeutic relationships posits a queer theory outlook that deviates from other DMP and embodied perspectives. The intention is to invite more critical reflection on diverse sexual and gender experience and relationships in the training and therapy space, in the hope of opening the door to more transparency with sexual orientation and gender diversity in the body, movement and dance in psychotherapy professions.     

Belly dance and its links to body psychotherapy

This paper describes the therapeutic use of belly dance therapy (BDT) for women, context and process, on its own and in relation to body psychotherapy and the Chakra system. It gives a brief history of belly dance, references the author’s personal journey and describes a case study. It illustrates how BDT can empower women to serve themselves in their pleasure and pain by awakening the dissociated, traumatised parts of the body and non-verbal body memories through sensing and feeling the body and verbally articulating this.     

Body awareness and mental health: a body psychotherapy case study

Dohsa-hou is a Japanese form of body psychotherapy that utilises body movement as a means of enhancing the psychotherapy process. Body awareness has recently been proposed as a potential contributor to therapeutic progress made in the course of body psychotherapy. This paper reports the utilisation of Dohsa-hou with a patient who had a history of outpatient and inpatient treatment for depression-related psychiatric symptoms. At the start of treatment, the patient had difficulty in releasing tension because of the harsh rigidity of her body; further, the patient did not know how to regulate tension. As the Dohsa-hou therapy progressed, the patient became aware of her tenseness and learned to self-regulate her bodily rigidity. Her severe depressive symptoms were alleviated along with the change in her physical rigidity. This study illustrates the process of the treatment and the contribution of body awareness to the therapeutic progress made.     

Discourse: Trudi Schoop and Vaslav Nijinsky,and dance as healer

Conceived as an entrée to discourse, this paper explores the phenomenon of dance as healer, to evoke rather than to answer questions. The intention has been to examine dance in its capacity of healer, scrutinising it in the absence of a formal intermediary intervention such as dance/movement therapy or other somatic models. The early lives of two former luminaries of the dance world are profiled: the first, Trudi Schoop, famed comic mime and early pioneer in dance/movement therapy; the other, Vaslav Nijinsky, renowned dancer and choreographer in the world of ballet. Disparate heritages and life circumstances carried them along radically divergent paths, although both struggled to overcome serious psychiatric issues. Schoop overcame her difficulties vis-à-vis obsessive-compulsive behaviours; Nijinsky's accumulated problems led, ultimately, to chronic schizophrenia. They shared, in common, an overriding passion for and commitment to dance. The discourse focuses on the role of dance, as healer, in their existential journeys.     

Integrative dance/movement psychotherapy and the aging process

The objectives of the investigation was reasoning and developing a strategy of implementation of integrative dance/movement psychotherapy in order to improve the life quality and psychosomatic adaptation of an aging person. 25 males and 25 females with some age-related emotional and psychological problems but with no marked mental disorders were examined. Clinical-psychopathological and experimental-psychological methods were used. Target symptoms for integrative dance/movement psychotherapy were determined. A repeated investigation was carried out in three months. The investigation findings show common and distinctive features of female and male psychosomatic state at the climacteric and partial androgenic deficiency period. The model of integrated experiences described elucidates the notion of age-related dissociation, which is a source of the aging persons’ inner conflict leading to the development and/or aggravation of their psychosomatic and social disadaptation. The integrative dance/movement psychotherapy course described results in the considerable improvement of aging persons’ psychophysiological dynamics, social adaptation and life quality.     

Marked hypertriglyceridemia in a woman receiving metoprolol succinate

β-blockers are commonly used therapies after acute myocardial infarction and in the management of congestive heart failure and hypertension. We report a case of a middle-aged woman with a history of mild hypertension who was placed on metoprolol succinate. Before initiation of the β-blocker, her triglyceride level was in the borderline-high range (150-199 mg/dL). On treatment, her triglyceride levels exceeded 1000 mg/dL. She developed fatigue and mild abdominal discomfort but without biochemical evidence of pancreatitis. After discontinuation of metoprolol succinate, her triglyceride levels receded. This case illustrates an uncommon side effect with a very commonly used therapy in clinical practice. Clinicians should closely evaluate medications and/or other therapies in patients presenting with new-onset hypertriglyceridemia especially when levels are sufficiently elevated to pose increased risk of pancreatitis.     

A case illustration of resistance from a psychodynamic perspective.

This clinical vignette illustrates a case of resistance during the course of a psychodynamic psychotherapy. The client is a chronically depressed woman struggling to expand beyond her familiar and, in many ways, gratifying role as a "good little girl" who seeks and often obtains reassurance and appreciation from paternalistic figures. She also has become increasingly aware of the cost of rigidly maintaining this role, which inhibits her experience of herself as a competent, assertive, and sexually mature woman. The client is at an advanced stage of her therapy, and in the vignette one sees her working through this conflict by addressing her experience both in her family of origin and in the therapeutic relationship. Her efforts to resolve this core issue, and her concurrent resistances, are exhibited in this presentation.     

Embodiment and embedment: integrating dance/movement therapy,body psychotherapy,and ecopsychology

This article presents a vision of an emergent ecosomatic psychology that integrates somatic psychology's theories and practices of embodiment with ecopsychology's insights about embedment. Branches within somatic psychology, dance/movement therapy, and body psychotherapy have honed therapeutic practices for embodying the self, engaging in embodied relationships, and opening up to possibilities of transpersonal experiences through the body and movement. Incorporating ecopsychology's emphasis on the development of an ecological identity, inspired by systems and relational views of health, and drawing from theories of participatory consciousness and reciprocity, an integrative framework of embodied embedment practices are proposed for developing an embodied ecological self.     

Psychodynamic Psychotherapy of a Child with Internalizing Symptoms: A Study of Outcomes

When psychopathology is considered as a developmental phenomenon, the data on child psychotherapy must be of interest to all therapists. The aim of this study was to assess the results of psychodynamic psychotherapy in a child with internalizing symptoms using data obtained from the patient, her mother, her teacher and her psychotherapist. A systematic single case study was performed. The data were obtained using the following tools: interviews, the Rorschach Method, the Child Behaviour Check List for Children and Adolescents, the Teachers Report Form and questionnaires completed by the patient's mother and therapist. The psychotherapeutic treatment lasted for 40 sessions and the patient was 8 years old at the start of therapy. She presented with head and stomach aches after the sudden death of her father, as well as difficulty adapting to her new school. The Rorschach results indicated improvement in cognitive triad variables, interpersonal relations and expressing affection. Data from the patient, mother and therapist converged to yield the clinical picture of a more spontaneous girl, dealing better with her feelings and more socially integrated. This points to the importance of using mixed methods to assess psychotherapies and of consulting multiple informants.     

DANCING WITH DEATH

The author reviews her 40-year professional career in forensic psychotherapy. She describes her formation at medical school in Argentina, the Menninger School of Psychiatry in Topeka, Kansas, and the Henderson Hospital in Surrey. She reflects on her work, for 30 years, at the Portman Clinic. 'Dancing with death' is a metaphor for seeking serious danger, and she offers an extensive clinical vignette from her early career to illustrate the complexities involved in the assessment and treatment of perversion, reviewing the case in the light of her more recent thinking. Perversion is seen as a manic defence against the dreaded black hole of depression but, as well as being associated with the death instinct, perversion secures survival. Both features have to be born in mind in therapeutic work, and she considers both technical and transference/countertransference aspects of treatment, emphasizing the particular advantages of group-analytic psychotherapy. The context in which Mother, Madonna, Whore was written is reprised. Lastly, she surveys the work of the International Association for Forensic Psychotherapy and our developing understanding of severe female psychopathology.     

Filling the form: Expressive Therapies Continuum-guided treatment of narcissistic personality disorder

Sara was a 65-year-old Caucasian woman who requested art therapy after the death of her partner. She had experienced incest by her father and verbal abuse by her mother until she left home at 21. Her life was characterized by broken relationships due to alienating anger outbursts and an interrupted work history; she met three criteria for narcissistic personality disorder. Sara initially was socially isolated and intellectualizing. She desired recognition but was fearful of exposure. The Expressive Therapies Continuum (ETC) theoretical framework, which consisted of a gradual progression from cognitively-dominated sessions to more emotionally focused processing, guided the therapeutic work. The ETC theory encourages transparency and collaboration between therapist and client regarding therapeutic tasks and goals, and provides a framework for addressing and repairing ruptures in the therapeutic alliance. Art therapy began with the cognitive tasks which Sara completed relatively comfortably, then encouraged integration of emotion via expressive writing, diagrams, and body mapping. Through careful attention to repair of ruptures by directly discussing and adapting the direction and tasks of therapy, Sara slowly was able to experience emotions other than anger. She integrated cognitive and emotional insights about her life and developed empathy for her childhood self. At termination Sara had cultivated two friendships and met only one criterion of NPD. Limitations of this case study include a lack of research evidence for ETC-guided art therapy with NPD clients and by the retrospective approach. Future research efforts could provide this support by encouraging clinicians to conduct prospective case study research.     

Healing through the martial way: Incorporating karate training into counselling and psychotherapy

This research paper describes lived experiences in dance therapeutic processes in the case of a woman called Asta. Rather than claiming results from therapeutic processes, the paper enlightens change processes through narratives about both Asta's bodily movement expressions and inner experiences. The paper focuses furthermore on illustrating the possibilities of using body language, movement and an energetic approach to therapy in Asta's case with the dance therapy form Dansergia. Asta moves through a shell of anxiety and into the dance of a gypsy, from an inner experienced black ring and hedgehog to a woman accepting difficult experiences in the past and new possibilities in the present. Asta's processes are analysed and interpreted in an energy-based theoretical framework, and are then reflected upon in terms of impact possibilities in a broader dance therapeutic and research oriented context.     

Dance therapy as form of communication activating psychotherapy for schizophrenic patients

This paper describes a method of dance therapy for the treatment of schizophrenic patients, based on a methodology from outside Russia and adapted to the conditions of Russia. Aims, purposes, and targets of dance therapy are considered as applied to the rehabilitation treatment of schizophrenic patients. The structure of the entire course of dance therapy consisting of 10 sessions is described, with 260 patients having been subjected to the course. Certain clinical cases of non-verbal communication development dynamics in the process of dance therapy are considered. Dance therapy is shown to be a form of communication activating psychotherapy treatment of schizophrenic patients. This therapy was developed and applied by the author of this paper.     

Dance movement psychotherapy for couples (DMP-C): systematic treatment guidelines based on a wide-ranging study

ABSTRACT

A new body of knowledge, growing out of the clinical and research fields, has been developing in recent years in the area of dance-movement psychotherapy for couples (DMP-C). Formulation of an intervention protocol based on a systematic review of theories and research is crucial to scientifically establishing the field and to implementing research findings in clinical practice. The present article reviews the results of a comprehensive qualitative research study in DMP-C, which addresses the following topics: couple intake, expectations of couples seeking therapy, a projective identification mechanism in the couple relationship, desires and expectations in the sexual relationship, synchrony in the non-verbal relationship, somatic mirroring, and kinaesthetic empathy in the couple relationship. Based on the findings of the research, a systematic intervention protocol for couples psychotherapy through movement and dance has been developed; its unique contribution will be examined alongside other interventions in couples therapy.     

CAN WE BE BRIEF?

The author explores the subjective and objective nature of time in relation to brief psychotherapy, the contemporary contexts for this work and the impact of research on the changing culture of provision of counselling/psychotherapy. She describes clinical treatment using a brief Dynamic Relational approach with a traumatized patient in primary care who presents with panic and depression. Through this case she illustrates the most significant points of technique in her interpretation of this approach: assessment through interactional aspects of the first and second meetings, further assessment through history-taking and the development of narrative, forming a collaborative focus based on a maladaptive relational pattern, selective inattention and benign neglect, interpretative ‘action’, termination and the collaborative therapeutic summary and use of other attachment figures available in the primary care team setting, particularly during the termination phase. The patient's unconscious and conscious internalization processes enable brief treatment to be durable, and it is argued that depth can be achieved. The author contends that brief therapy requires specific techniques but also makes connections with long-term analytic work, for example, the parallel between Bion's concept of the ‘selected fact’ and the ‘focus’ in brief therapy.     

Psychodynamic Movement and Dance Therapy (PMDT) in Hungary

The emergence of dance therapy in Hungary has been a long and organic process from the 1980s onwards. In those years, psychiatrist and psychotherapist Márta Merényi developed Psychodynamic Movement and Dance Therapy (PMDT), a psychoanalytically oriented psychotherapeutic method, based on the body-mind work, the movement improvisation and the psychodynamic working through of movement experiences and relations in the group. This article offers insight into the Hungarian PMDT: its history, theoretical roots, therapeutic practice, applications, training and organisation, with an outline of the special characteristics of body-mind work, the interpersonal dynamics, leader instructions, and the creative movement and verbalism in PMDT.     

SYNERGY OF VERBAL AND NON-VERBAL THERAPIES IN THE TREATMENT OF MOTHER-INFANT RELATIONSHIPS

ABSTRACT The patient in the treatment of troubled mother-infant relationships is understood to be the lived relationship between mother and infant with the infant being an active participant in the relationship. As the infant is communicating in a non-verbal mode, a treatment medium is used that allows for both the active non-verbal contribution of the infant and the contribution of the mother, thus enabling both to work as their own therapists. Two different types of treatment modalities were combined: a psychoanalytically informed individual psychotherapy of mother and baby and a non-verbal approach of mother-infant dance therapy groups. An introductory overview of dance therapy specific to mother and infant is included as well as one case vignette and one case study. That it was the mother-infant dyad's physically meaningful experiences in the dance therapy group which acted as a catalyst for change became evident. The verbal treatment modality, on the other hand, was the essential understanding, metabolizing and containing space that sustained and consolidated these changes.