"I will not give up the ship." So proclaimed one of the participants in a recent DMT group with older adults and people with dementia, saying that these were words she's lived by. To which another person responded, "especialy when the ship was crossing the ocean from Czechoslovakia to the United States during World War II." This second person also spoke of the loss of her 2 husbands. These are some of the memories shared in the context of a dance/movement therapy group where movement evokes memories stored in all the muscles and cells of the body.
Another resident had little to add to the verbal sharing as her verbalization was greatly compromised. However, she too had much to contribute to the session, as her movement contributions were significant. She was the most nonverbally expressive as she pouted momentarily when she thought I had forgotten her or looked with great shock, after which she would laugh delightedly. Her movement was very rhythmic and playful. At one point, she began rolling her arms around one another, which quickly turned into alternating one arm up and the other down. She often uses movement in which it seems that one arm is playing or communicating with the other. From an LMA perspective, as the 2 sides of her body communicate with one another, the 2 hemispheres of her brain are communicating as well. She then added her shoulders, and leaned her upper body forward. One of my major goals as a dance/movement therapist working with older adults and people with dementia is for participants to use their torsos, for it is in the torso that emotions as well as feelings of vitality are strongest. I like Google's definition of vitality as "life, energy, spirit, vivacity, exuberance, buoyancy, bounce, elan, verve, vim, pep, zest, sparkle, dynamism, passion, fire, vigor, drive". This is what I see in my dmt groups. At one point, misunderstanding what I was asking of her, this woman stood up and took the parasol I was offering her. I stood and joined her to ensure her safety as she approached one person after another in the circle, dancing and making eye contact with each.
I mention these details because this was a stunning initiation of interaction with peers which required signficant motivation on her part, something I have rarely seen to such an extent in my years of leading groups. She rarely mirrors my movement, but she was mirroring the way that I engage the group. One of the other group members who came for the first time spontaneously offered how nice it was to see this woman so engaged and happy, something she had never seen in the milieu or other groups.
In the background of this group and this story, there was a subplot, one all too common during dance and expressive arts therapy groups with people with dementia. There were many distractions, including a request from the program director that a photograph be taken of each person in the group. The nurse assistant taking the photos apologized, but when told that she was obstructing my view of the group members and therefore my ability to lead the group, she said that she would be quick but that she needed to do this. At least she apologized. Not so the nurse practitioner who came in to get a couple of the residents to be seen by the consulting physician. She came in and loudly called out one woman's name. The woman did not respond, so she told the nurse assistant who quietly approached the woman and told her that the doctor wanted to see her. The woman attempted to stand with some difficulty. All of this was very disruptive to the group as you might imagine; the focus of everyone's attention was on this interruption. So I stood and danced over to the woman and danced her out of the group. I was modeling what I hope anyone would do who must interrupt a group; to sense the social-emotional environment and join with it.
Several minutes later, the resident returned, again disrupting the group. When the nurse practitioner entered the group to take another group member out, I told the her that she could not. Arrogantly she told me she was a nurse practitioner and came in just once a week to see the residents. I replied that I came in once a month, and that, in fact, the woman she was asking for was my primary reason for leading this group. The nurse practitioner left in a huff, telling me she would be speaking with some person of authority.
It is not only the nurse practitioner who is to blame here, nor whoever scheduled her. It is the fault of a medical model of care for older adults and people with dementia. Tom Kitwood called such a model a Malignant Social Psychology, one which emanates from "a general culture in which technical solutions are preferred, persons are used rather than valued, hypocrisy is taken for granted, and where extremely shallow notions of efficiency are the norm." Kitwood, T. (1995). Positive long-term changes in dementia: some preliminary observations. Journal of Mental Health, 4(2), 133-144. It is a culture which tends to relate and create public policies based on an "I-It" rather than "I-thou" way of relating, as Kitwood borrows from Martin Buber in Kitwood's tome, Dementia Reconsidered, a book I highly recommend to anyone interested in improving the care of people with dementia.
There are many people who do not understand that a therapeutic group is not simply a collection of individuals doing something at the same time. Particularly in a group of people with declining cognition, it takes a lot of energy for the group leader to provide a strong focus for attention. Every interruption weakens that focus. The group leader is attempting to create a structure to build connections between people so that each person's strengths may be recognized and appreciated and so that the group synergy shapes the experience. It is this synergy that reinforces the self-esteem of its group members and ultimately makes the group therapeutic.
The dance/movement therapy group plays to the strengths of its participants, in this case, to people with dementia. When people are engaged, enjoying themselves as they move to music, are playful, expressive, creative, spontaneous and interactive, they are actively engaged in their own brain health. Neuroscientists are just beginning to understand what dance/movement therapists, practitioners, have understood for decades ~ that when a person is creative and curious and engaged in psychosocial stimuli that are novel, surprising, arousing and meaningful, new neural pathways develop. We may not have always known what was happening in the brain, but it is clear to anyone who observes with an intention to see what is happening in the person.
I share this story in an attempt to reinforce recognition for the importance of the arts - for our individual health and for the health of our country, and the world.
In a just released Arts, Health and Well-Being across the Military Continuum White Paper And Framing a National Plan for Action:
"When we make, create, or repair something, we feel vital and effective. We are dissolved in a deeply absorbing task, lose self- consciousness, and pass the time in a contented state (Barron & Barron, 2012). Csikszentmihalyi (1990) defines this state as “flow,” an optimal state of intrinsic motivation. Lambert (2008) explains that when we do meaningful work with our hands, a neurochemical feedback floods our brains with dopamine and serotonin. We have evolved to release these chemicals both to reward ourselves for working with our hands and to motivate ourselves to do it some more."
As a Bostonian born and bred, I took President John F. Kennedy's enjoinder to heart, “My fellow Americans: Ask not what your country can do for you, ask what you can do for your country.”
JFK was remembered on the approach of the 50th anniversary of his assassination in Kelly Horan's and George Hicks' Kennedy Remembers Frost, Champions The Arts on NPR. “'Privilege is here,' Kennedy told his audience. 'And with privilege goes responsibility.'"
In his commencement address at Amherst University, Kennedy said of Robert Frost:
“For [Frost] saw poetry as the means of saving power from itself. When power leads man towards arrogance, poetry reminds him of his limitations. When power narrows the areas of man’s concern, poetry reminds him of the richness and diversity of his existence. When power corrupts, poetry cleanses.”
One could substitute the word art or dance for poetry.
“If sometimes our great artists have been the most critical of our society, it is because their sensitivity and their concern for justice, which must motivate any true artist, makes him aware that our nation falls short of its highest potential. I see little of more importance to the future of our country and our civilization than full recognition of the place of the artist.”
. . .
“[T]he nation which disdains the mission of art invites the fate of Robert Frost’s hired man, the fate of having nothing to look backward to with pride, and nothing to look forward to with hope.”
. . .
"Kennedy looked forward 'to an America which will reward achievement in the arts as we reward achievement in business or statecraft.' He laid out a vision for an America respected as much for its civilization as for its strength."
I would venture a guess that Kennedy would be greatly saddened by a nation corrupted, more concerned with protecting individual wealth and privilege than with our responsibility for those less privileged; one which rewards ceo's and investors exponentially greater than its artists.
The voices of artists have too often and for too long been quieted, ignored, dismissed and of little consequence. At the same time, the power of those gifted with words is greater than that of artists whose gifts are nonverbal.
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