Dance/Movement Therapy
Article Review

ARTICLE:
Krueger, D.W. and Schofield, E. (1994). Dance/movement therapy of eating disordered patients: a model. The Arts in Psychotherapy, Vol. 13, 323-331.

SUMMARY:
This lengthy article begins by giving some very interesting and significant background information on eating disordered patients (specifically anorexia nervosa and bulimia) such as how they present themselves, their issues and what some of their major issues really are.

The introduction discusses how these patients are different from others in that they have a limited ability to describe their feelings, they constrict emotional response, are secretive, yet yearn to be recognized. They are very appearance conscious, strive to be perfect, but are disconnected from their bodies like it is a separate entity from the self.

The authors hypothesize much of this has to do with a lack of early confirmation of the child being a separate body self from the mother. Krueger and Schofield claim this lack of separation is due to the mother's lack of accurate "mirroring" the child's special distinctness, aliveness, and body boundaries. To further make this point, one example was of a girl stating that her mother fed her when her mother was hungry, not when she was hungry. This was meaning that the child was seen as an extension of the parent(s), not a separate person. I look at this as the child having no control over her thoughts, feelings, or needs because the (controlling) parent is always stating them for the child. Hence the child isn't sure of what she really feels.

The authors go on to paint a more in depth picture of this lack of separateness leading to a disconnection of the child's own feelings, and how the child looks to external sources for validation, yet fears these sources, feels overwhelmed by them, invaded by them, but longs for approval from them. "Their bodies are not seen as vehicles for their own (self) expression, but rather as mirrors for the feelings of others." Authors state that what the eating disordered patient is really lacking is a clear sense of "self." I would refer to this also as a lack of having an internal locus of control.

The article then goes on to describe three phases of dance/movement therapy. Phase one begins with Relaxation and Centering. This is the beginning of helping these patients finds their "body center" (internal locus of control), where the energy radiates from. Patients are then instructed to allow this "energy" to evolve into some type of movement. This methodology sounds very similar to yoga and Tai Chi. These disciplines often, (if not always) begin with centering, grounding, and focusing on the internal self.

Phase two initiates Mirroring, were the patient faces the therapist, (both seated as it is less threatening) and mirrors without touching, a simple, yet continuous flow of hand movements, and opening/closing movements. Then the role is reversed with the patient taking the lead role. The authors mention there is a very good chance of the patient experiencing some separation anxiety that goes on with this role-reversal. I can see where this would be a good start for the patient in learning to not rely on external sources for direction but to take the lead from within.

Phase three is called Facing the Mirror. In this last phase mentioned, the patient faces herself in the mirror and follows her own body movements as the lead while the non-participating therapist is close by. This phase brings a quote to mind from Reebok: "I believe if you look at yourself (in the mirror in this case) and see what is right instead of what it wrong, that is the true mark of a healthy individual." These patients tend to have a love-hate relationship with mirrors. One interesting remark a patient made was that she looked in the mirror, even full-length, she only focused on one spot.

After each session, the patients are asked to draw what they experienced in the movement session. This is for several reasons. One important one is that the patients will have a visual re-creating of the experience, in addition to having something concrete for evaluation. The other extremely interesting technique used was videotaping sessions. The authors told of what a powerful tool this was in helping anorexics and obese compulsive eaters to establish an accurate body image that cannot be denied.

RESPONSE:
I personally found this article fascinating. I almost didn't even read it because I thought it was long and wouldn't be very interesting. It turned out to be the best article I've read so far for these reports.

After reading this article, I got a much clearer idea on where eating disordered patients are coming from. I have a feeling that many eating disordered patients had very controlling or rigid parents. I don't know how I feel about what they stated regarding early "mirroring" of the child's aliveness, but the way it was described I could relate it to control issues beginning to evolve early on. Eating disorders give the illusion of having control over something, food and emotions.

I was very intrigued by the movement therapy. As a movement specialist myself, I had a strong feeling this would interest me. I just didn't know how they would go about a session. The centering phase really hit home, as I tend to do this myself to become calm and relaxed and focused. I also feel it is very difficult for insecure individuals to take the lead, hence the reverse role in the mirroring phase is a very good beginning exercise in building confidence and self esteem.

The technique used that I was very surprised at learning about was videotaping!!! I guess I would have never thought of doing anything like this or would have thought this technique to be a big no-no. I don't know why I thought this, but now I can see where it could be a very powerful tool - as long as the patient would be willing.

I was very impressed with article. It gave me some valuable insight for techniques that I knew nothing about. Also, the article shed some light on some different psychodynamic aspects of eating disordered patients that I was not aware of. I will find this information to be very useful to me in the future.

QUESTION:
The article mentions little, if any, remarks on what resistance to dance/movement type therapy could be encountered when working with eating disordered patients. I am wondering of the patients are asked if this type of therapy interests them or if depending on the patient, they are sent to a dance/movement therapist. I am also wondering if for the population I want to work with - fitness (movement oriented individuals) if this would be the perfect match for therapy or just the opposite.