Speaking at the recent Creative Movement Therapy Association of India (CMTAI) International conference, which was held in Pune in collaboration with Artsphere and Symbiosis, Nalini shared positive, impactful experiences of working with chronically mentally ill clients. Several decades ago, Marian Chace gave birth to the field of dance/movement at the historic Saint Elizabeths Hospital where Nalini works today.
“Clients repeatedly share how they struggle with the stigma of having a mental illness, and add to that the guilt from committing a crime” Nalini said. “Clients suffer from very low self-esteem as a result of the shame and grief, and these feelings are visible in their bodies. Most of them exhibit poor postures, collapsing in their cores, with sunken chests, their heads bent while gazing at the floor. They struggle to make eye contact and have a hard time making connections with others. Mental illness is very isolating and most of the clients rarely interact with each other, even though they see each other every day in the milieu.”
Nalini found that elements of classical Indian dance—like mudras and rasa—encourage clients to tell their real life stories that might otherwise be too painful to process verbally. Using imagery and symbolism, and drawing elements from storytelling and poetry, through dance and movement, she said her clients have successfully worked through a range of traumatic experiences. Nalini recalled how one of her clients symbolically used movements of a snake, a peacock and a fish to work through her painful past. She also gave an example of another client who used the imagery of a treasure chest that he said he found at the bottom of the ocean with a bunny in it, which he symbolically held and nurtured.
Founded in 1855, Saint Elizabeths Hospital was the first federally operated hospital in the United States where thousands of wounded U.S. Army and Navy soldiers were housed to recover from the trauma of war. The hospital was initially called the Government Hospital for the Insane. In the early 1960s, community-based healthcare led to the de-institutionalization of the hospital, and outpatient facilities were provided so clients could lead near normal lives in the community. The number of clients declined. Today, the hospital boasts of a state-of-the art-facility with 275 clients in the house.
One half of the hospital houses civilly committed clients who are either voluntarily or involuntarily admitted for psychiatric stabilisation, and the other half houses a forensic population of clients who are adjudicated to be criminally insane or committed Not Guilty By Reason of Insanity (NGBRI) by a court of law. Nalini works with both populations and facilitates fifteen dance therapy groups each week. She also works with clients on an individual basis as needed. Regardless of group or individual setting, her therapeutic practice is based on each client’s specific goals.
“Dance therapy groups at the hospital focus on sensory enhancement, anger management/impulse control, and creative self-expression,” Nalini said. “There are also gender-specific dance therapy groups for women and restorative care groups for the elderly. One of the main goals of the group is to increase social interaction and to create empowerment through making connections.”
Nalini’s workshop included an experiential to allow participants to experience how to target such goals using dance therapy interventions. They were instructed to stand in a circle and start moving in place to music. Participants were then encouraged to make eye contact with someone in the circle, and invite him or her non-verbally to exchange places by moving across the space. As a second layer, they were invited to engage in a non-verbal conversation in the middle of the circle for a few seconds as they exchanged places. This intervention elicited laughter in the group, and participants seemed to make connections with ease. Nalini said that such an experience is not common and that it does not happen very easily in her group. She said often such a process takes many weeks, and even months on occasion.
Tripura Kashyap, conference convenor, inspired Nalini more than a decade ago to further study dance therapy. Nalini received her masters degree in the subject from Drexel University in Philadelphia and has been working at Saint Elizabeths for more than 6 years.
Nalini’s workshop ended with participants asking her questions around any safety concerns she had when working with a forensic population. “I believe in Client Centered Therapy, which purports that all people are basically good human beings,” she replied. “And I strongly believe in that. Such an outlook has helped me treat them with unconditional positive regard and without judgment, and the feeling is often mutual. The work is gratifying and entirely fulfilling.”
Nalini Prakash, a U.S.-based dance/movement therapist, uses elements of classical Indian dance in her work with forensic clients at Saint Elizabeths Hospital in Washington, DC.
She believes mudras, hand gestures and rasas, emotions, though culturally specific to Indian expression, are powerful, universal tools to help enhance an individual’s self-expression through creative imagery.
Nalini is a board certified dance/movement therapist at Saint Elizabeths Hospital in Washington, DC. She provides direct clinical treatment services in dance/movement therapy to general and forensic psychiatry inpatients as a component of the hospital’s overall program of mental health care and treatment. Using creativity, spontaneity and sensitivity, Nalini facilitates recovery-based dance therapy groups that value and reflect cultural and ethnic diversity, thereby empowering individuals-in-care towards positive change. A classical Indian dancer, choreographer and teacher, Nalini integrates elements of her dance and creative movement in her work as a dance/movement therapist, and uses such tools as vehicles to help individuals re-experience emotions in safe and nonthreatening ways. Nalini has a masters in performing arts from MS University, Baroda, and a masters in dance/movement therapy from Drexel University, Philadelphia. She is also a Certified Movement Analyst (CMA) from the Laban Institute of Movement Studies (LIMS), New York and is certified by the Aquatic Therapy and Rehab Institute (ATRI).