‘Moving to Longevity’ Dance Movement Psychotherapy Theory & practice in Dementia Care

‘Moving to Longevity’Dance Movement Psychotherapy

Theory & practice in Dementia Care

The importance of non-verbal embodied practices for people with dementia & their carers when cognition, language, orientation in space & time, memory and body movement are not what they used to be…

‘La Cathedrale’ Rodin Museum

Setting the scene

“Courage & creativity will be required to deliver services with less money, in innovative &

inspirational ways, drawing on the experience of clients and the skills of experts working in a

variety of different fields”

A Benjamin, Editor, Society Guardian 15/5/13

“Courage & creativity will be required to deliver services with less money, in innovative &

inspirational ways, drawing on the experience of clients and the skills of experts working in a

variety of different fields”

A Benjamin, Editor, Society Guardian 15/5/13

www.dancedementiahub.co.uk

+www.ageofcreativity.

co.uk+

www.dementia positive.co.uk

& many more!

www.dancedementiahub.co.uk

+www.ageofcreativity.

co.uk+

www.dementia positive.co.uk

& many more!

The Territory

Living to the fullIndependently

and Interdependently

Living to the fullIndependently

and Interdependently

De Kooning, Untitled

Accepting a premise that wherever there is de-

menting there is also re-menting…

Accepting a premise that wherever there is de-

menting there is also re-menting…Link to work of CG Jung on

‘The Compensatory Function’in Neurosis (Collected Works) ↵

W Utermohlen (1997)Self-Portrait (Yellow)

W Utermohlen Erased Self-Portrait (1999)Head (2000)

Artist’s exploration of his own condition….from ‘The later works of William Utermohlen 1995-2000’

‘A Who has a What – will the What overcome the Who? Will the Who emerge

through the What? Or will the two combine in a way that embraces and

transcends the Condition?’

Oliver Sacks (1996) Neurologist & Writer

‘A Who has a What – will the What overcome the Who? Will the Who emerge

through the What? Or will the two combine in a way that embraces and

transcends the Condition?’

Oliver Sacks (1996) Neurologist & Writer

The problem for the person ?

Dementia Syndrome

Alzheimer’s Type Vascular Type Lewy-Body etc

Dementia Syndrome

Alzheimer’s Type Vascular Type Lewy-Body etc

Essentially about extensive loss…

e.g. Memory, Communication, Behaviour, Movement, Social interaction, Cognition,

Orientation, Language + lots more

Essentially about extensive loss…

e.g. Memory, Communication, Behaviour, Movement, Social interaction, Cognition,

Orientation, Language + lots more

The problem for everyone else ?

Focusing on the condition / fear of unknown…seeing…

The person with DEMENTIA

Focusing on the condition / fear of unknown…seeing…

The person with DEMENTIA

Rather than the reality from their perspective…seeing…

The PERSON with dementia

Rather than the reality from their perspective…seeing…

The PERSON with dementia

“I am living with dementia, I am not dying of dementia’

Peter AshleyAlzheimer’s Society Ambassador

My main message

To go by way of the body if cognition is

impaired

To go by way of the body if cognition is

impaired

What does this mean?What does this mean?

Focusing on embodied practices including movement and dance because

Focusing on embodied practices including movement and dance because

Engaging strengths / remaining capacities on a daily basis (re-menting)

Engaging strengths / remaining capacities on a daily basis (re-menting)

Dementia closely associated with stasis“Being Slow” “Being Lost” “Being a Blank”

Phinney & Chesla (2003) ‘The Lived body in dementia’

Dementia closely associated with stasis“Being Slow” “Being Lost” “Being a Blank”

Phinney & Chesla (2003) ‘The Lived body in dementia’

This work & approach focuses on: on:The ‘Lived’ Body experience

…because…

It remains accessible when cognition impaired

Sense-making occurs thro body

Helps to maintain / re-build relationships thro the body

New paradigm for care practice

The ‘Lived’ Body experience

…because…

It remains accessible when cognition impaired

Sense-making occurs thro body

Helps to maintain / re-build relationships thro the body

New paradigm for care practice

Movement and the experience of the body moving are at the core of our life’s

experience ofbeing ‘in’ ,

connected ‘to’ in relationship ‘with’ our world

Movement and the experience of the body moving are at the core of our life’s

experience ofbeing ‘in’ ,

connected ‘to’ in relationship ‘with’ our world

Building Bridges between…

Known Not-yet-known

Sense Non-sense

Meaningless Meaningful

Mind Body

‘Rialto Bridge’ Venice FeelingThinking

‘The basic message is hopeful, people with dementia can communicate about their experience and the role of relatives and staff can be enhanced. The arts have an absolutely critical role since people often lose the ability to converse in a straightforward way. They can express themselves given other opportunities…’Emeritus Professor Mary Marshall, Living Arts Scotland correspondence; Unpublished 1998

‘The basic message is hopeful, people with dementia can communicate about their experience and the role of relatives and staff can be enhanced. The arts have an absolutely critical role since people often lose the ability to converse in a straightforward way. They can express themselves given other opportunities…’Emeritus Professor Mary Marshall, Living Arts Scotland correspondence; Unpublished 1998

Examples

‘Embodied Selfhood’ Kontos

Examples

‘Embodied Selfhood’ Kontos

Body (person) in Relationship

Body (person) in Relationship

Movement Music Dance Song

Reminiscence

Movement Music Dance Song

Reminiscence

Helping release that

which remains(ADL)

Helping release that

which remains(ADL)

Finding “ways in”

The triggers

Finding “ways in”

The triggers

Working with Metaphor & Symbolism

Working with Metaphor & Symbolism

Better understanding ‘difference’ & ‘ambiguity’

Better understanding ‘difference’ & ‘ambiguity’

Life-StoryLife-Story

Respect Trust & Fun

Respect Trust & Fun

‘Sense of adventure’‘Sense of adventure’

Dance Movement Psychotherapy

• ‘Hybrid of art of dance & science of psychology adapted to human service’ (Goodill, 2005)

•Embodied/phenomenological/psychosocial

•Used as treatment in remedial rather than curative sense

•Focus on residual capacity rather than disability

•Supports improvisatory nature of person’s response to condition

•Offers important skills & techniques for supporting ‘Personhood’ & new possibilities for caring

‘In psychotherapy old wounds are healed, hidden conflicts resolved, and unfulfilled potential brought out. Hence life becomes more satisfying, secure and productive.’(Kitwood, 1990:43)

‘In psychotherapy old wounds are healed, hidden conflicts resolved, and unfulfilled potential brought out. Hence life becomes more satisfying, secure and productive.’(Kitwood, 1990:43)

DMP Skills & Techniques1. Locating triggers – ‘ways in to furthering

relationship’ (Therapeutic Movt Relationship)

2. Body action

3. Using Reciprocity (Mirroring)

4. Rhythmic movement

5. Repetition & Validation

6. Re-membering identity (‘Personhood’)

7. Metaphor & Symbolism

1. Locating triggers – ‘ways in to furthering relationship’ (Therapeutic Movt Relationship)

2. Body action

3. Using Reciprocity (Mirroring)

4. Rhythmic movement

5. Repetition & Validation

6. Re-membering identity (‘Personhood’)

7. Metaphor & Symbolism

Identifying ways to connect

•‘Creatively Alert’ (Coaten)•‘Poetic Awareness’ (Kitwood)•‘High Quality Free Floating Attention’ (Kitwood)•‘Selfhood as…embodied dimension of human existence’ (Kontos) therefore go by way of the body where cognition is impaired•Working with embodied/non-verbal + cognitive•Accepting ‘Otherness’ & ‘Difference’ & Ambiguity as unique to person rather than exception

•‘Creatively Alert’ (Coaten)•‘Poetic Awareness’ (Kitwood)•‘High Quality Free Floating Attention’ (Kitwood)•‘Selfhood as…embodied dimension of human existence’ (Kontos) therefore go by way of the body where cognition is impaired•Working with embodied/non-verbal + cognitive•Accepting ‘Otherness’ & ‘Difference’ & Ambiguity as unique to person rather than exception

Benefits of the work

• Person with dementia helped to find and use remaining strengths & capacities

• Helps support ‘Personhood’ (Kitwood & Bredin)

• Gives hope to carers – RE-MENTING• Relationship thro movt means continual

adaptation to changing needs, behaviours, communications as condition progresses

• ‘Movement as life’ (‘embodied selfhood’) well supported

• Person with dementia helped to find and use remaining strengths & capacities

• Helps support ‘Personhood’ (Kitwood & Bredin)

• Gives hope to carers – RE-MENTING• Relationship thro movt means continual

adaptation to changing needs, behaviours, communications as condition progresses

• ‘Movement as life’ (‘embodied selfhood’) well supported

• GIVE PRAISE

• IMPORTANCE OF REPETITION

• SUPPORT INDIVIDUAL CONTRIBUTIONS

• DEVELOP A FLOW BETWEEN ACTIVITIES

• HAVE FUN / PLAYFUL / CHILDLIKE

• WORK IN PAIRS NOT SOLO

• USE LIFE-STORY TO INFORM WORK

• PLAN, PREPARE & DE-BRIEF / REVIEW WELL

• GIVE PRAISE

• IMPORTANCE OF REPETITION

• SUPPORT INDIVIDUAL CONTRIBUTIONS

• DEVELOP A FLOW BETWEEN ACTIVITIES

• HAVE FUN / PLAYFUL / CHILDLIKE

• WORK IN PAIRS NOT SOLO

• USE LIFE-STORY TO INFORM WORK

• PLAN, PREPARE & DE-BRIEF / REVIEW WELL

Reminders:

The Vision…

A network of dancers and dance therapists working throughout the country and around the world, in day centres, residential homes, Alzheimer cafes and people’s own homes; bringing the benefits of all styles and types of dance and dancing to people living with dementia and their carers and families

The Vision…

A network of dancers and dance therapists working throughout the country and around the world, in day centres, residential homes, Alzheimer cafes and people’s own homes; bringing the benefits of all styles and types of dance and dancing to people living with dementia and their carers and families

Finally…

The fragility of life and living processes are intimately bound up with the beauty of the body in movement. The dance helps bring us back from ‘Being lost’, ‘Being a blank’ and ‘Being slow’, so we can celebrate life to the full; releasing riches of our deep and abiding humanity, in spite of great loss and fragility. ‘Re-menting’, through the body, gives much hope for the future of innovative, inspiring, non-pharmacological approaches in dementia care.

The fragility of life and living processes are intimately bound up with the beauty of the body in movement. The dance helps bring us back from ‘Being lost’, ‘Being a blank’ and ‘Being slow’, so we can celebrate life to the full; releasing riches of our deep and abiding humanity, in spite of great loss and fragility. ‘Re-menting’, through the body, gives much hope for the future of innovative, inspiring, non-pharmacological approaches in dementia care.