Bridges between dance and health: how do we work with pain? #2

Emma Meehan: As a dance researcher, I have felt quite protective of somatic work and dance research methods. In health-led studies on somatics in chronic pain, often a practitioner has been brought in to deliver movement material rather than shape the research. This has left me wondering how to integrate dance and somatic researchers into the design of the study so it is collaboratively created. I have also queried why static measurements are taken of a complex movement process and what information is missing from this. However, being part of the network has made me see that health researchers face the same frustrations of wanting to do person-centred research, responding to traditional criteria and formats for credibility and ultimately to ensure that their findings get embedded in health institutions in the long term. I have learned the value of thinking through in a step by step manner some of the restrictions inherent within health settings and the need to make a clearer case for the work to be taken on board. 

Image by Christian Kipp

It has been much easier to engage dance artists and researchers in the network. Healthcare professionals can have last-minute work emergencies which means it can be difficult to commit. Somatic work can be hard to explain, so for those unfamiliar with it, it might seem like an unnecessary addition to an already full workload. At the same time, we have had a stable core group of health researchers and professionals, who are already curious or committed to the area. How do we bring in people who might be sceptical and challenge us? This has meant going into the healthcare setting, and adapting the material to time slots available, such as offering a pre-work morning session for staff at the Walton Centre Pain Management Programme in Liverpool. While there was interest, I realised that there is a need to match the somatic principles to the clinical needs in order for the approach to be better understood. The lived experience of people with pain is another important facet of the work but there are ethical issues when doing health research which need to be considered, such as the potential to do harm and expectations for recovery. We are developing ways to reach people living with pain for their viewpoints through a consultation process. 

The main challenge of working across disciplines for me has been in describing and conveying the value of somatic practices to people who have not experienced it before. We have spent a lot of time with network members trying to define these practices, with some comments as follows:

  • An attempt to open up a conversation with a body (dancer)
  • Somatic Practices: Easy word + easy word = confusing phrase (writer)
  • Listening to and working with the whole person – being empathetic, giving time (dance artist)
  • A form of mindful movement that requires the person to focus on the movement and have an awareness of their body & the movement within the environment (nurse) 
  • Allowing the body to move whilst experiencing the sensation of movement (physio) 
  • Reinforcing the ‘wonderment’ of the body (physio)

Another concern for me is how this network can feed back to and support dance artists, whether they are working in health settings or supporting their own health. It became apparent during the course of the network workshops that chronic pain was a daily experience for many dance practitioners, and I hope the network has something to offer back to them.

Bernie Carter: Despite being published over 50 years ago, many healthcare professionals are familiar with McCaffery’s (1968) statement that “pain is whatever the experiencing person says it is, existing whenever the experiencing person says it does.” However, familiarity with this person-centred statement does not mean that people living with chronic pain are universally believed. Outside of specialist centres or teams with expertise in chronic pain, there also remains a tendency towards a focus on the physical aspects of pain (intensity, duration, sensation). This network tries to bring in physical, emotional and social aspects of pain through dance and health approaches.

Image by Christian Kipp

My engagement with the network has been a real journey of discovery; it’s been liberating, exciting, confusing, challenging and wonderful. When Emma first spoke to me about being a co-applicant, I was gently sinking under the workload associated with existing research and I was tentative about committing to anything else but I’m so glad I did. Emma has been a good teacher, guiding my early and still developing understanding of somatic practice and laying the foundations for me to learn from the other somatic practitioners I’ve engaged with during the workshops.

My initial reserve about being a non-dancer undertaking movement activities with dancers was overcome by their warmth and absolutely non-judgemental response to how I moved within the activities. My concern about whether I would be doing something right, perhaps reflects a very health-oriented concern. The people I have ‘moved with’ have always been more interested in that ‘we were moving’ and that ‘we were being and experiencing movement together’. It’s a beautiful and liberating thing to experience, and learning about attending to your body has been intriguing.  I’ve become more curious about somatic practice and dance and how it can help people with pain. Like Emma, I would love to have had more health professionals attending the workshops but those who have attended have reflected on their practice and have shared their aspirations for enhancing how they care for and support people living with pain. 

The physical environment we are in and the props we use shape the way we think and act. Reflecting on this has led me to explore the way in which movement is approached within health and somatic practice/dance. Within health settings, movement activities for pain are often led by physiotherapists who wear uniform and whose environment is typically something like a gym – a place to work out – whereas the somatic practitioners wear looser, less formal clothing and the studios we have used for our activities have been made comfortable with mats, cushions, and blankets with instructions to be comfortable. The difference is palpable.

Image by Christian Kipp

Although I perhaps expected that tensions in thinking might arise between the two main ‘tribes’ (dancers and health professionals) it’s been fascinating to see the differences in thinking within the tribes (say between nursing and physiotherapy) and between members of these tribes (different somatic practitioners).  Some physiotherapists’ focus may be solely on improving mobility and function in a specific part of the body, using a validated, structured and objective intervention for that ‘part’ of the body. Nurses may take a wider more person-centred approach acknowledging the person’s aspirations, goals and the challenges of pain and consider a broader way of working with the person. In terms of somatic practices, people work with a range of distinct methods and individual styles and can describe their work differently.

Questions

We would like to ask blog readers to respond through the ‘Comments’ below, describing their work across disciplines of performing arts and health: What have you learned and what has been difficult? How do you describe your work with dance and performer training techniques in health contexts? Finally, as a performing arts professional, have you experienced persistent pain and if so, have you worked with your theatre and dance training techniques to manage it? 

More information can be found on our website

Bernie Carter, is Professor of Children’s Nursing at the Faculty of Health and Life Sciences, Edge Hill University

Emma Meehan is Assistant Professor in Dance at the Centre for Dance Research, Coventry University

 

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