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

By Bernie Carter and Emma Meehan

The Somatic Practice and Chronic Pain AHRC-funded network explores what somatic practices, such as Alexander technique and Feldenkrais, offer to people living with chronic pain. Somatic practices work with self-reflection on movement habits and opening up movement capacity, and have been integrated into many dance and theatre training programmes. In this network, we ask: how might the principles of these somatic movement practices be of value in supporting people living with pain? We also consider how the experience of working together can inform the practices of health professionals and dance artists, such as how they use touch and language.

Somatic Practice and Chronic Pain Network Video

In this series of two blog posts, we will firstly give an overview of some of the topics that we have explored to date in the hope that this may be of value to theatre and dance practitioners who work with health and/or live with pain. In the second blog post, we share our experiences of working across disciplines and reach out to readers to tell us about your experiences of 1) how you have worked across performing arts and health 2) how you have worked with pain through theatre and performing arts techniques. We aim to develop a larger project from the network in the longer term on somatic practices and pain, so your viewpoints, concerns and ideas will support this process. By posting on the TDPT blog, we want to interrogate arts-based perspectives on health topics, and also acknowledge that many performers suffer pain and injury throughout their career.

The network operates currently through a series of small and focused workshops to invite exchanges between researchers and practitioners in health, dance, and digital technologies. The first workshop focused on defining somatic practices through discussion and movement, thinking through how the practices might be understood by health professionals; and how they might support pain management. We also gathered opinions on somatics, chronic pain, assessment, and treatment. This was to gauge an initial understanding of members attitudes, for example on working across disciplines; or on observing/describing bodily movement as a form of pain assessment. 

Image by Christian Kipp

The second workshop theme was ‘dialogues across disciplines’, which included presentations and hands on sessions from dance, somatic practices, psychology, occupational therapy, physiotherapy, and nursing. Topics covered include the relationship between somatics and psychology; systematic reviews and arts based research methods; working with children in pain; qualities of touch in patient care; along with ideas of physical and social support in pain management.

The next workshop will focus on the role digital technologies could play in sharing somatic work with a wider number of people, such as those who cannot travel or have not yet accessed treatments. This is important since so much somatic work is currently only available in fee paying, one to one sessions, that exclude a large number of people. This workshop will also explore the different ways we could utilise technology, whether for patients to practice alone or to develop creative ways of expressing pain to family members and staff. In addition, there are impact and public engagement events such as an introductory session for pain management staff; and in future there will be a workshop for dance artists working with their own or other peoples pain.

Image by Christian Kipp

Central to the network is the enquiry into how to work across disciplines. As dance and health professionals come together, it is clear that we come from epistemologically different starting points. The way we use language is embedded in distinct frames of being and, typically, approaches to research tend to arise from differently framed research questions. Touch, movement and physical interaction in our disciplines arise from belief systems informed by the contexts we work within. Core to our network is valuing each other’s knowledge and expertise, using the meetings as opportunities to expand our horizons, challenge assumptions and think in new ways about our practice and praxis. Ultimately this brings surprises, new ideas and questions.

In the next post, you will find the voices of the two people leading the network, dance researcher Emma Meehan and professor of children’s nursing Bernie Carter. We share personal experiences of working on the network, and at the end will turn the invitation back to you to share your own experiences of working with dance and theatre training techniques in health contexts; and in working with pain.

More information can be found on our website

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

 

Reclaiming land- Rediscovering body

Sandhiya Kalyanasundaram

This post describes a class that I co-taught at Srishti Institute of Art, Design and Technology, Bengaluru, India during Aug-Nov 2018.

The students explored the idea of time as paradox and creating dance through site- specific gardening and land reclamation. Gardening creates a new order of mind-body connections and a new experience of time as the gardening process is internalized. The students who chose to create dance were previously untrained in any dance form and it was an experimental process for me as I tried to deepen and shape their mind -practice through the viscerality of gardening and being actively in touch with their emotions while creating movement sequences. Through the post, I also wish to open the discussion to how embodied dance practice can contribute in creating an ethical ecological consciousness in the individual amateur student and the question of process versus outcome oriented teaching of dance.

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Training Citizenship and Performance – Reflections

By Sarah Weston

“The idea of giving people a voice is the absolute basis; understanding what to say and enabling them to say it in the fullest way possible in a way that is connected and full of conviction” Max Hafler.

On Wednesday 24th April 2019 I organised a symposium at the University of Leeds called Training, Citizenship and Performance. Hosted by two research groups, Political Communication (Media and Communication) and Performance Training, Preparation and Pedagogy (Performance and Cultural Industries), the event was an interdisciplinary exploration of whether we can train citizenship, and more specifically, whether performance is the tool for this training. The day was composed of four parts: two talks, from Professor Stephen Coleman presenting an overview of citizenship and Miranda Duffy discussing her work promoting democratic values with primary school children through theatre; and two workshops, Proper Job Theatre taking us through their Lab Project workshop process and Max Hafler immersing us in voice technique inspired by Michael Chekhov. Curating these very different approaches into a one-day event perhaps was a bit of a risk, maybe even a bizarre decision. But underneath it was my own conviction that theatre and performance practitioners possess skills that can be utilised in the political sphere. These are both the skills that are more traditionally associated with socially engaged performance practices and the skills of acting and performance more associated with professional theatre, such as voice training. This symposium in essence then, was an experiment in whether bringing together these two spheres – political communication and performance training – could be a way of demonstrating the importance of sharing these skills.

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We shall not cease from exploration.

Dr Dana Mills, Oxford Brookes. (D.Mills@brookes.ac.uk)

The narrative of our life is punctuated with memories as well as voids of remembrance. Some events we can easily recall, some sensations lost to the passage of time, casualties to our need to make reason of the bombardment of information we encounter every day. Some hot summer days, playing barefoot outside, are, for some reason, part of our psyche, and some other people and events we cannot bring to consciousness despite constantly trying.

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Can you bottle it…?

By Sara Marie Jackson, Cast Theatre / The Joseph Rowntree Theatre (Sara.jackson@jrtheatre.co.uk)

This blog-post looks at the role of personal energy and intuition in Applied Theatre Practice and how this can be trained, reflecting on how training affects my practice as a freelance community director, director of The Joseph Rowntree Theatre (a community theatre) and as a practitioner at Cast Theatre.

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Encouraging selfishness in applied theatre students – surprises arising from a community project.

By Dr Kay Hepplewhite, Northumbria University (kay.hepplewhite@northumbria.ac.uk)

A recent undergraduate student project encouraged me to re-question approaches of training students to work in community and applied theatre contexts. This article considers how, in addition to the development of multiple skills required for applied theatre, encouraging selfish motivation enabled a deeper student learning experience. The project is discussed within a conceptualisation of applied theatre expertise and explores how my theory of responsivity informed the teaching of novice practitioners.

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Voicing resistance: training as a tool of political voice.

By Dr Sarah Weston, University of Leeds (S.E.Weston@leeds.ac.uk)

In the first year of my PhD I was trying to design a ‘political voice’ workshop for young people. And for some reason voice training came into my head. Like, proper actor training – drama school voice training. At first, I assumed it was a terrible idea. As a student of applied theatre who had largely left much of the technical training I had learnt in past behind, the idea of ‘training’ raised some alarm bells. Training, skills, telling others what to do and how to be, correctness – all these associations ran in opposition to what applied or participatory performance felt to be about – dialogue, reflection, agency and heterogeneity. But then, when I thought about it a bit more, I thought about Boal, and one of my favourite parts of the Theatre of the Oppressed:

To control one’s own body, we need to undo the ‘muscular alienation’ that is imposed on the body from work. Training can be used for this purpose, not to weaken or destroy the subject but to raise them to a level of consciousness about how labour has marked their body (Boal 2008: 103-104).

The undoing of muscular alienation always seemed such a powerful idea to me. That we can undo the marks that the world has left on us, the drudgery, the pain, the work, the reification and commodification of our bodies – theatre could help undo that, or at least begin to fight back against it. This was the principle that underpinned the decision to use practices of voice training and technique in a community context, specifically with young women around the question of political voice. In this context, the voice could be more than a metaphor for opinions, or a symbol of political representation. It could be a form of bodily apparatus that can be marked and investigating the voice could make the subject conscious of this vocal alienation. Voice training could be a tool of political intervention to undo this.

I will illustrate this further by discussing just one aspect of my voice practice. This practice was part of a doctoral research project that explored political voice as something material and embodied, rather than the ways in which the voice in the political sphere is a word used to symbolise broader ideas of representation and engagement. I worked with a small group of young women in different parts of the north of England. The workshops consisted of a combination of vocal technique with theatre exercises and political discussion, culminating in a short (aural) performance to a blindfolded audience. These performances were explicitly political, responding to a feeling of exclusion from politics that many of these young women felt. Their voices expressed these feelings of exclusion before making sounds of protest and resistance. We largely worked with the voice technique of Linklater and Rodenburg, thinking about their idea of habits and the habitual voice as something sociologically and culturally constructed.

One of the main aspects of the workshops was the creation of vocal soundscapes. This was the creation of a non-linguistic sound world, where the young women produced a series of vocalisations together to represent a theme or idea. They didn’t use any words and produced the sounds entirely through the voice. In one project, we produced a series of soundscapes in response to four themes that we had identified through a political discussion: being ignored, feeling helpless, feeling engaged, being active. The creation of these soundscapes happened quite late in the project, after the participants had already engaged in three days of both vocal technique and political discussion.

For the first soundscape, being ignored, one of the young women created a specific sound to represent this, a sound of being silenced. This was a kind of interrupted “B-uh” sound, as if she was trying to speak but the word got cut off; consonants never making it to a vowel. It was quite breathy, guttural, falling into sighs: a stopped voice. The other participants created the sounds of ignoring her: forceful “hah” sounds, elongated vowels that rolled over her stutters, clicks and other noises from the teeth and tongue.

In contrast to this, the soundscape for being engaged developed these cut off consonants to open vowels.  “C-uh” and “b-uh” became long “ah’s”, moving from the staccato to something with more flow. The “ah’s” began in tone as a series of questions, a form of discussion between the participants, which eventually became “ah’s” of agreement, enthusiasm and excitement. We worked on how this change happens, and how it felt to finally allow the cut off consonants to become fully vocalized vowels. This move from the consonant to the elongated vowel sound was reflective of Linklater’s sigh of relief exercise. The sigh of the relief is when the participant stretches her arms into the air on an in breath, holds the breath to experience the tension, and then releases the arms at the same time as exhaling deeply, producing a sigh-on-sound, relieving tension through the body and voice simultaneously. The frustration in the first soundscape of not being able to make the sound, and being stuck at the consonant, was like the tension of the stretched arms and held breath. Then, the feeling of release in the full vocalization was like the relaxation felt in releasing the breath and arms on a long ‘ah’ sound. Here the participants drew a direct comparison between a vocal representation of being silenced to being heard, with the physiological experience of vocal tension to vocal release.

In creating these two soundscapes, the young women drew on vocal technique to help them articulate specific political feelings. Voice training helped provide a vocabulary of sounds that could represent political ideas. This is because voice training helped make clear how being silenced or the opposite, feeling able to voice, is something that can be experienced in the body. Becoming aware of how their bodies have been marked by their experiences of politics, the young people used these marks to help them articulate this experience to the audience. By using the motifs of voice training: vowels and consonants, sighs of relief, the touch of sound or blocks and tensions (as some examples), the young people demonstrated how this training has helped them articulate the social restrictions on their voice, and furthermore, how to begin combatting this restriction, firstly, through the body.  

Boal, Augusto (2008). Theatre of the Oppressed. Trans. Charles A. McBride, Maria-Odilia Lead McBride and Emily Fryer. London: Pluto Press.

Training in the Community

Training in the Community investigates pedagogic approaches outside of professional practice, exploring how performance training is utilised in community and applied theatre settings as well as how practitioners train and prepare for those settings.

Training in the Community investigates the role of training in applied and community theatre. We are looking for contributions from practitioners, scholars, teachers and others interested in exploring the intersection between training and community for instance, how training might be used in relation to theatre for social change, the relationship between training and some of the prominent themes of applied practice, or how we train for working in the community.

Through the blog we want to explore the complicated relationship that training has to practice in non-professional settings, considering the broader questions that this practice raises in terms of representation, cultural recognition, power and domination and social change. On the one hand, training can be an act of consciousness raising, re-distributing skills and resources and accordingly giving participants the means of the production (bodily and vocal production). On the other, training can be a homogenising practice, eliminating cultural difference and perpetuating certain dominant ideas of ‘correctness’. The blog will explore the complexity of training, neither dismissing it as culturally domineering, nor fetishizing its value or social good.

We are interested in investigating where practices of performer training are still used in community and applied contexts. Is performer training used as a practice of social change? Can we understand training as a tool of transformation, resistance or political intervention? Furthermore, we are interested in how community and applied practitioners are trained. With a growth in undergraduate and postgraduate courses in applied theatre it seems especially important now to explore what constitutes “training” in this regard. Are applied programmes training theatre craft that is then “applied” to community contexts? Or are they training practices of how to work in the community, how to be a “facilitator”? Finally, we are interested in the politics of training itself, and how training practices relate to broader questions of community identity and representation, particularly with relation to social class, gender, race and sexuality.