Building Bridges: A Dance Movement Psychotherapy parent-child group, for children with multiple difficulties.

Tarana Khatri

Movement Therapist (R-DMP)

This article is based on a year long process of Dance Movement Psychotherapy with Parent- child groups of children with multiple difficulties. The therapeutic process focussed on interpersonal interaction of parent and child and importance of self regulation in both parties. The therapy process followed a semi-directed approach in which semi-structured activities were initiated by the therapist. This included mirroring activities, group, dyadic and individual movement exploration.

Existing literature has stressed on the importance of early experiences of a child in the development of Self and the ability to relate to others. While authors agree on the importance of early development (Tortora, 2006; Meekum, 2002; Chaiklin and Wengrower, 2009) the theoretical interpretations of what takes place during this period are varied (Weinberg, 1991). According to Stern’s theory, an infant has a clear differentiated sense of self almost from birth and this expands to a more complex sense of self in a multi layered fashion (Stern, 1985). Piaget’s view supports the development of self through the role of knowledge and experience in interpreting interactions with the environment (Cook and Cook, 2005).

While working with the Parent-child groups, through observations and Parent/Teacher interviews, it was observed that the parent and child spent very little time apart through the day. Aside from the primary role as a Mother, these parents took on multiple roles including that of a teacher, physical trainer and playmate. Research shows that the child develops their view of self and the environment primarily through interactions with the parent (Miller, 2011; Cooper et. al, 2002; Tortora, 2006). According to Hardy (2007), the infant attaches to the caregiver instinctively, but the quality of attachment depends on the quality of care given. This symbiotic relationship forms the basis for enabling the infant to differentiate and extend into space becoming aware of own body boundaries (Phipps 1995; Lewis, 1993).

Evidence suggests the importance of exploration in space and curiosity in early childhood development (Cook and Cook, 2005). In this therapy group most of the children were observed to be nonverbal and had limited mobility. Their dependency on the parents was high with regard to primary needs and comfort. In daily activities, the parents either instructed or performed the activity for the child. In therapy most interactive activities turned out to be parent led allowing little room for the child to express and explore on their own. This could lead to overlapping sense of self between mother and child with unclear differentiation. The therapeutic process focused on individuation of the mother and child as two separate entities.

Stern (1985), talks about the interactive element of the separation–individuation process focusing primarily on inter-affective sharing and inter-subjective relatedness. The importance of nonverbal communication within the early years has been studied widely (Stern 1985; Trevarthen 1998; Tortura 2006; Meekum 2002). An Enactive approach to inter-subjectivity shines light on generating meaning through a sensory motor engagement with the environment (Fuchs and De Jaegher 2009). These parents play the role of mediators facilitating the way the child navigates, interprets and processes new experiences in the world. The parent needs to change their role during the earlier interactions, moving from a consistent responsive presence to one that challenges and mismatches the infant’s behaviour (Tortora, 2006). Participating in this dialogue at a kinaesthetic level enables the client to gradually regulate affect and regulate kinetic qualities (Samaritter and Payne, 2013). A change in the aesthetic forms of body and movement, visible in space and time, results in a change in the psychic or imaginative aspect of oneself (Partelli, 1995). For this change to take a place a strong foundation needs to be established in the form of a healthy therapeutic relationship (Clarkson, 2003).

Observations during the first few sessions showed a high level of synchrony between movement patterns of parent and child. Indeed increased responsive parenting and matched affects have been linked to stronger sense of self regulation (Moore and Calkins, 2004; Haley and Stansbury, 2003). Although Matching is effective, it is important for the child to experience both positive and negative emotions through parental interactions to develop all aspects of personality (Miller, 2011; Winnicott, 1971; Bowlby, 1983). From a developmental point of view, Erikson’s stages of psychosocial development include conflicting forces that contribute to developing a healthy sense of self (Miller, 2011). Mahler (1975) supports this duality through her emphasises on the importance of experiencing interactions that promote clashing or mismatching by expanding on the role of attunement in building a strong relationship (Tortora, 2006; Levy, 2005).

Through the therapy process the parents explored interactive play based activities with the child. This helped parents to learn and explore the child’s movement range and pattern with minimal external influences. The most common way to establish this relationship in movement, especially with children, is mirroring which involves imitating qualities of the client’s movement to help enhance emotional understanding (McGarry and Russo, 2011). This can be used as a method of building a trusting relationship or even empathetic reflection in interactions (Levy, 2005). The neurological study of the Mirror Neuron System has provided neurobiological evidence of this body based phenomenon (Berrol, 2006). Eyeberg referred to the effect of undivided attention, describing, reflecting and expanding child’s imitations (McNeil and Hembree-Kigin, 2010). This also enhanced empathy by embodying the child’s posture to get a better understanding of the child’s experience.

By separating themselves to have this experience, they explored themselves as individuals with own feelings, emotions and experiences. Although, these feelings were initially a reflection of that of the child, they were encouraged to further explore and discuss their personal emotional and body based responses to the same. This brought to light the overlapping of individual identities and the importance of separating them. The parents’ ability to self regulate plays a vital role in the development of self-regulation in the child (Jacobs & Wachs, 2006).

As stated above, the therapy process focussed on the importance of self awareness of both parent and child. They were encouraged to separate themselves from the child and build a bridge of communication that allows the child to express and explore having a secure base with the parent. Post-therapy interviews with parents and teachers showed increased regulation of anxiety and stress in parents during review and assessments along with increased performance of the child in the same. The parents reported an increased level of understanding of their child and interaction with the child was more of a dialogue. The parents also reported realisation of importance of self care and self awareness.

 References

Berrol, C. F. (2006). Neuroscience Meets Dance/Movement Therapy: Mirror neurons, the Therapeutic process and Empathy. The Arts in Psychotherapy , 302-315.

Bowlby, J. ( 1983). Attachment . Basic Books.

Chaiklin, S., & Wengrower, H. (2009). The Art and Science of Dance/Movement Therapy: Life is Dance. London: Routledge.

Clarkson, P. (2003). The Therapeutic Relationship (2 ed.). London: Whurr Publishers.

Cook, J. L., & Cook, G. (2005). Child Development: Principles & Perspectives. Boston: Allyn & Bacon: Pearson.

Fuchs, T. D. (2009). Enactive intersubjectivity: Participatory sense making and mutual incorporation. Phenomenological and Cognitive Science , 465-486.

Haley, D. W., & Stansbury, K. (2003). Infant stress and parent responsiveness: Regulation of physiology and behavior during still-face and reunion. Child Development .

Levy, F. (2005). Dance Movement Therapy: A Healing Art (2 ed.). National Dance Association: AAHPERD.

Mahler, M. P. (1975). The Psychological Birth of the Human Infant: Symbiosis and Individuation. Great Britain: Hutchinson and Co. Pub. Ltd.

McGarry, L. a. (2011). Mirroring in Dance/Movement Therapy: Potential mechanisms behind empathy enhancement. The Arts in Psychotherapy , 178-184.

McNeil, C., & Hembree-Kigin, T. L. (2010). Parent-Child Interaction Therapy: Issues in Clinical Child Psychology (2 ed.). New York: Springer Science & Business Media.

Meekums, B. (2002). Dance Movement Therapy: A Creative Psychotherapeutic Approach . London: Sage.

Miller, P. (2011). Theories of Developmental Psychology (5 ed.). New York: Worth.

Phipps, K. M. (1995). A Place for My Self: Issues of Space in Dance/Movement Therapy with Women in a Homeless Shelter.

Samritter, R. a. (2013). Kineasthetic Intersubjectivity: A dance informed contribution to self- other relatedness and shared experience in nonverbal psychotherapy with an example from autism. The Arts in Psychotherapy , 143-150.

Slade, A. (2006). Representation, Symbolization, and Affect Regulation in the Concomitant Treatment of a Mother and Child. In L. Jacobs, & C. Wachs (Eds.), Parent-Focused Child Therapy: Attachment, Identification, and Reflective Function. Jason Aronson, Incorporated.

Smith, C., Upton, G., & Cooper, P. (2002). Emotional and Behavioural Difficulties: Theory to Practice. London: Routledge.

Stern, D. (1985). The Interpersonal World of the Infant. New York: Basic Books.

Tortora, S. (2006). The Dancing Dialogue: Using the Communication of Movement with Young Children. Maryland: Paul H. Brookes Pub. Co.

Weinberg, L. (1991). Infant development and the sense of self: Stern VS. Mahler. Clinical Social Work Journal , 19 (1), 9-22.

 

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s