When dance is therapy
Parkinson’s Disease is a a degenerative disorder of the central nervous system that often impairs a person’s balance and regular way of life. About 7 million people in India are said to be afflicted by it. Interestingly enough, researchers have found dance to be as effective as other forms of therapy for people with Parkinson’s Disease. To know more, Silvertalkies spoke to Devika Mehta, Dance Movement Psychotherapist and Clinical Psychologist. She conducts Dance and Movement Therapy sessions at Parkinsons Disease and Movement Disorder Society, Mumbai.
For people living with PD, exercise is vital in giving them a sense of balance and mobility. How does dance help in that regard?
Movements that I have employed in these past four years from initial exposure to dance to the current improvisational creative movement approach, all have in some way incorporated movements that are beneficial to their mobility as a primary objective. I have used rhythm to help with start hesitation and freezing, employing different body parts in isolated as well as synchronized body warm-ups and cool down activities. With the help of physiotherapists, some of the general basic movement patterns have been integrated with structured movements. This helps them to have a sense of routine with flexibility to move as much as their body allows.
Where are these classes held? Is there any special training you’ve taken on Dance and Movement Therapy (DMT) for Parkinsons?
The Dance and Movement Therapy sessions are held at all the support groups at the different venues which are hosted by Parkinson’s Disease and Movement Disorder Society (PDMDS) in Mumbai. We try and provide as much therapeutic benefit as we can in a community setting with both patients and their caregivers. I have a M.Sc in Dance Movement Psychotherapy from UK and am a registered professional member of the Association of Dance Movement Psychotherapy, UK.
Dance is seen as a joyful activity. For many people, exercise is a chore, something that has to be done because there’s no choice. Does dance help in creating a more positive mindset in them?
Dancing was seen initially as something that this generation (i.e., the elderly learners) would have enjoyed only at festive occasions. Seeing it as a potential treatment option was met with interest but hesitation at the same time. I initially started with very structured movements based on the research done by Madeleine E. Hackney in the United States of America, which employed the use of Tango to improve motility in Parkinson’s. I adapted it to the Indian cultural setting using Indian music and making use of my training in both Indian classical dance and MA Indian folk dance. This was met with enthusiasm by patients as well as caregivers attending the support groups and enjoying the ability to move and was evident in the full attendance that we had in the three months of intense movement therapy program offered. Patients are now able to feel confident in moving creatively and in a group setting.
What are the reasons that make you think people suffering from PD could benefit from dance therapy?
Since Parkinson’s is primarily a movement disorder, it is natural for the patients to see dance as a form to regain their movement. Apart from the physical motility aspect, which includes all the motor symptoms, like freezing, movement co-ordination and automaticity, Dance and Movement Therapy addresses co-morbid psychological issues as well. It helps with depression, social isolation, cognitive functioning, self esteem and self confidence. Research has supported all of the above. Parkinson’s Disease and Movement Disorder Society (PDMDS) did a pilot study within the organization to study the effect of dance on Parkinson’s. There was significant difference found in four out of the eight domains on the PDQ-39, a questionnaire used to assess different areas that are affected by Parkinson’s. These four were mobility, emotional well- being, activities of daily living and stigma. These clearly indicate that the dance program was successful if used effectively, keeping not only the physical but also psychological areas.
I have been involved in the use of dance with Parkinson’s with the support of PDMDS from the very beginning. My experience with it has inspired me to keep working with PD creatively and offer and develop different techniques that can benefit them psychologically and physically. The techniques which I have learnt in my training have got an encouraging response at home and are inductive to our cultural setting. After the intensive program, we received letters and positive feedback from both patients and their caregivers citing how dancing has changed their outlook, and movement. This program has given the patients a new lease of life and confidence to not shy away from social stigma. The caregivers have observed positive changes in their moods, and their motivation to come to the sessions. I have been a witness to see how every person has bloomed in the various sessions conducted, from tapping of the foot to music to encouraging each other to move and dance. It has been a positive change to accept dance therapy as a valid, complementary treatment option. It was fulfilling to see their faces lit up with joy and indulge in movements that were an effort for them before.
Is it difficult to convince the elderly PD patients to dance?
It is difficult to make anyone move whether it is elderly patients with PD or not. When we move in a group setting, we make ourselves vulnerable to the judgement of others and ourselves. Creating a safe space for the patients and caregivers, where they feel comfortable to move and are motivated, is crucial to the practice of Dance Movement Therapy. The idea of safe space is not just physical, where I make sure that they don’t fall or that they have the support of chairs and walls. Safe space also means making it safe for them to share emotions, to share memories that certain movements remind them of, to make sure that they don’t leave the space without feeling contained. Moving and Dancing taps into emotions and memories which the patients may not be ready to deal with or maybe find difficult. As a Dance therapist, my aim is to keep the space safe and contained. Once they feel accepted, comfortable and see others move, they attempt to move and many a times rediscover the love for movement.
What are the places where dance therapy for PD are held in India?
Dance Therapy is offered as part of the multidisciplinary model of (PDMDS) at the various support groups across Mumbai. For those patients who find it very difficult to move out of their house, Dance therapy can also be used to work within their home setting with creative means, which include art work, breathing and gestural movements.
For dance therapy and information about other cities contact:
Parkinson’s Disease and Movement Disorder Society
c/o Dr. B.S. Singhal
Room 131, Bombay Hospital
12 Marine Lines, Mumbai – 400 020
Tel.: 022-24977477; 9987216057
— Reshmi Chakraborty
We also spoke to David Leventhal, the founding teacher of Dance for PD, Brooklyn, New York. Dance for Parkinson’s is an innovative global program that has helped people with Parkinson’s as well as their caregivers. Watch this space for his interview next.