Dance/Movement Therapy for Trauma Survivors: Theoretical, Critical, and Cultural Perspectives

The reviewers of this book are dance/movement therapy (DMT) educators who center on multicultural awareness, intersectionality, and their role in their clinical and educational experiences. They intend to parallel the framework put forth by editors Dieterich-Hartwell and Melsom (2022) by first identifying themselves. Tomoyo is a Japanese, East Asian immigrant cis woman. She recognizes the advantage of speaking English without an accent. Her clinical work focuses on adults and adolescents with acute and chronic mental illness in residential, inpatient, and outpatient recovery care in the United States. Chevon is an educator who strives to use an anti-oppressive practice in her clinical, pedagogical, and research work. She is a first-generation Jamaican American of African and Chinese ancestry, able bodied, cisgender woman of middle-class socioeconomic status. She has worked clinically in community and school based mental health settings with children and their families, forensic setting with adults and hospice, and internationally with children and adolescent female survivors of sexual violence. Their combined clinical experiences have helped them to approach this book with a deep understanding of how dance/movement therapists work with populations who have experienced trauma.

Co-edited by Dieterich–Hartwell and Melsom (2022), Dance/Movement Therapy for Trauma Survivors: Theoretical, clinical, cultural perspectives is a momentous book with a rich selection of topics that showcases the value of DMT in a variety of settings and populations. The book is organized in three sections starting with “Foundational Concepts in DMT and Psychological Trauma” that introduces DMT’s “core” (p. 1): historical roots and connection to indigenous and cultural practices, as well as neurobiological and relational theories that constitute DMT trauma work. From here, the second section “Clinical Applications with Various Populations” is developed to address more “wider-reaching concepts” (p. 1). The contributing authors are experts in the treatment of children with neurodiversity, adolescents, individuals with substance use, eating disorders, schizophrenia, medical illness, survivors of genocide, human sex trafficking and sexual abuse, and military veterans. Two of the chapters centered the context and relationships of adolescent development and power dynamics as well as the criminal justice system, employing a collaborative and macro- rather than micro-systemic lens. Dumaresq and Puloka in particular were explicit about their view that “trauma is understood as a symptom of broader, structural, and systemic oppression” (p. 165). Many of the chapters in this section highlighted resilience and/or strength-based models. The third section, “Widening the Scope of Dance/Movement Therapy,” has an assortment of topics ranging from emerging practices with telehealth, multigenerational trauma, compassion fatigue, and practical, pedagogical, and research directions for future practice.

Reflecting the diversity of the authors, the book offers a range in styles and scholarship. Chapter 2, “Embodied Conversations: Culturally and Trauma-Informed Healing Practices in Dance/Movement Therapy,” is a deeply personal reflective dialogue between three dance/movement therapy educators who recognize that the racial reckoning of the profession is being built on the works of BIPOC dance/movement therapists. Chapter 3, “Neurobiological Considerations in the Treatment of Trauma from a Dance/Movement Therapy Perspective,” provides a comprehensive overview of theories and models of neuroanatomical structures and their connections to DMT work based on the latest neuroscience research. Several authors referred to the neurosequential model, polyvagal theory, window of tolerance, and interoceptive awareness in subsequent chapters of the book. The connections made specifically to dance, such as: “synchronized rhythm, experiencing beauty, activation imagination, and motor learning” made by Barnstaple and Dieterich-Hartwell (p. 53) are deemed essential for facilitating neuroplasticity through DMT. This nuance is helpful, because many chapters referred solely to the sensory, somatic aspects of DMT work. The book clarifies that much of what we know about neuroscience is just a small aspect, that these are theories, and that these theories are still developing, which is important to remember. While exciting to pursue the neuroanatomical evidence-base for the work that many dance/movement therapists have been engaging in already, it is just as valuable to continue to sink into embodied, arts-based knowledge. Konopatch and Koch offer a phenomenological account in Chapter 11, “Refugees Dealing with Complex Trauma: Dance/Movement Therapy for Survivors of the Genocide of the Yazidi.” This is the only chapter that spoke to working with an interpreter and described in detail how they utilized the interpreter in sessions. Many authors provided client case vignettes; in Chapter 15, “Trauma-Informed Dance/Movement Therapy in the Age of Telehealth,” Coote and Ellyson gathered vignettes from the practitioners’ perspective. The final chapter by Young, Cruz and Robinson, “Trauma-Informed Dance/Movement Therapy: Implications for Healing-Centered Education, Practice, and Research,” cited the education and training standards that are currently being reviewed to suggest how one might engage in DMT pedagogy and evidence-based research as the profession moves into a care-based, healing lens that considers whom the research/therapy is for, and who the experts are in creating new knowledge.

The conceptualization of healing versus treatment is an essential dialogue to continue. Both in Chapter 7, “A Trauma-Informed Approach to Dance/Movement Therapy for Persons Living with Schizophrenia Spectrum Disorders,” and Chapter 8, “Dance/Movement Therapy: A Trauma-Informed Approach to Engagement in the Treatment of Substance Use,” the authors foregrounded the importance of “recovery” within the medical model of treatment. Patterson and Melsom described how the aesthetic elements of DMT can assist in the recovery-oriented model when working with individuals with substance use. Biondo and Bryl stated that recovery in treatment still requires practical application for individuals diagnosed with severe mental illness. This seems particularly pertinent for those from communities of color who are both under and over-diagnosed, lack access to healthcare, live with hypervigilance and are prone to receiving the diagnosis to begin with due to structural racism, as Biondo and Bryl discuss. In Chapter 9, “Dance/Movement Therapy: Renewing Purpose when Emerging from Sexual Abuse and International Human Sex Trafficking,” Chakraborty and Tant delineated steps for “healing and recovery” (p. 146) based on community empowerment (p. 144) that aligns with the social developmental settings in India. Gray and Fargnoli cautioned against the isolation of the dance/movement therapist and proposed a social justice-oriented “collective care approach” (p.16) for both the survivors as well as the therapists. An illustration of care-based healing can be found in Chapter 10, “Dance/Movement Therapy, Trauma, and Criminalization: Reflecting on Feminist and Participatory Approaches,” which demonstrated a decolonizing framework of creative, expressive storytelling and resistance. Dumaresq and Puloka shared ways of liberation through “vicarious resilience” (p. 162), which was simultaneously a critical counternarrative. Another care-based approach was the combination of “dinner in community” with DMT in working with individuals with eating disorders in Chapter 12, “A Return to the Body: Trauma-Informed Dance/Movement Therapy for Individuals with Eating Disorders”, by Tropea and Kleinman (p. 196). This chapter also included participant voices and art work for a reflexive account, which was intended to ultimately transform “practice-based evidence” into “evidence-based practice” (p. 196).

The theoretical and clinical applications knowledge held by the authors were substantial and vast and demonstrated the interdisciplinary nature of research that is common in the work. However, there were several chapters in which the reviewers felt overwhelmed with the amount of theoretical content being introduced for working with a population. Some of this may be related to the range of authors' professional identifications, which include dance/movement therapists as well as counseling educators and counselors.

Many chapters offer intervention ideas that may be useful for students and practitioners looking for immediate practical application. Eberhard-Kaechele and Goll-Kopkain presented ideas about the “Functions of Props in Relational DMT interventions” (p. 63), while Devereaux and Harrison provided a list of “neurobiologically-informed DMT interventions” (pp. 86–91) for working with children with complex trauma. In Chapter 14, Shim, Millrod, and Gaydos defined “seven key pathways toward resilience and holistic integration” (pp. 222–228) for people who have experienced cancer and chronic pain. Each pathway was informed by theory, DMT treatment techniques, and goals to guide the clinician working with this population. In Chapter 17, Morningstar and Ruzic offered the only in-depth discussion on self-care. Using the framework of trauma stewardship by van Dernoot Lipsky and Burk (2009), they integrated this model with DMT interventions to support dance/movement therapists in their experience of vicarious trauma and burnout. Their use of the “compassionate movement wheel for self care” (p. 274) is a three-step process that provides an array of interventions for dance movement therapists to use for self care. They stated that “‘being’ in the moment can be more valuable than ‘doing’ in the moment” (p. 274). The interventions were accessible and could be taught in supervisory relationships or practiced on one’s own.

Others proposed a more conceptually novel approach, such as Dumaresq and Puloka’s “Key Principles and Recommendations for DMT” for a “healing-centered engagement” of trauma care that expands “beyond the overly medical model focus” (p. 165), which can be found in Chapter 10. In Chapter 16, Coburn, Grayson and Zana Sterenfeld. discussed the importance of looking at intergenerational trauma within the Native American, African American, and Holocaust-descendant communities. They urged dance/movement therapists to “re-examine initial diagnoses from a cultural- and trauma-informed perspective” (p. 266). What these approaches have in common is that the understanding of culture is inherent and fundamental, rather than an “add-on” to the work.

There were several areas to heed in the framing of the book. One was in the introduction, in which the editors stated that the book was “conceived at a time before” (p. 1) systemic oppression and environmental disasters were intensified in the United States. The reality is that many of the community members/clients/patients that dance/movement therapists work with have been mistreated and are continuing to live with these injustices for decades. Dieterich-Hartwell and Melsom stated that one of the changes they made to the book to acknowledge the collective trauma of the COVID-19 pandemic was to “add a special section on cultural awareness” (p. 1). Adding a section on culture on the work of trauma may be well-intended but centers on the identities of white heteropatriarchy. An informative chapter on transgenerational and intergenerational transmission of trauma was inserted in the third section (rather than in Section 1), which was somewhat surprising given the fundamental impact of power dynamics in DMT work and the understanding of the systemic layers of trauma that might impact treatment and recovery. As noted by multiple authors, trauma also affects the therapist and the therapeutic relational dynamics, which Chapter 16 highlighted. Perhaps this decision reflects how culture, trauma, and therapist identities are regarded in the mainstream literature and how education is applied in the classroom and field training or internship settings.

Another area in the framing of the book that can benefit from clarification was what the editors meant by the “trauma-informed, consistent style,[…] and holding environment” (p. 2). The reviewers were excited to read that each chapter was to begin with an introduction of the authors “in order to convey a more relational and safe experience as they impart glimpses into their work” (p. 2). The way in which authors introduced themselves varied and were inconsistent about including their social locations. As Sherrell and Allen raised in their chapter, the ideas about who is “safe” and “unsafe” and “safer” (p. 107) are complex and a process. Locating oneself as an author can model vulnerability that can equalize power, joining in a collaborative, co-creative stance. This may in turn allow for a more empathic connection to the writing. Additionally, the use of a trauma-informed framework was discussed, but not clearly defined. This left the reviewers curious about how this information was conveyed and operationalized by each author.

As Winters Fisher and Freeman grounded the readers in the history of the American Dance Therapy Association in Chapter 13, DMT has been used with World War II military veterans since the late 1940s at St. Elizabeth’s Hospital in Washington, DC. “The meaningfulness of dance has persevered for many in later generations of veterans, often manifesting in DMT group members reminiscing about dancing with loved ones” (p. 202). The understanding of the work has evolved since Marian Chace danced with veterans to move through their “shell-shocked” states (ADTA, 2021). The work has expanded to gaining transdisciplinary and interdisciplinary knowledge of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), intergenerational trauma, complex trauma, and the many other forms of trauma that exist. Ultimately, Dieterich-Hartwell and Melsom have skillfully crafted a book that is aligned with dance/movement therapy, as a profession which supports and guides individuals who have experienced one or multiple traumas. The knowledge gathered in this book is a significant contribution to the field of dance/movement therapy and can support emerging dance/movement therapists, DMT experts, and trauma practitioners. This book provides a starting point and roadmap for dance/movement therapists and those curious about dance/movement therapy to delve deeper into the practice and expand on the care and research in the communities that can benefit from the work.

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