Jesse D. Geller

DANCE THERAPY AS VIEWED BY A PSYCHOTHERAPIST

     In this report I shall discuss some of the attitudes, concerns, and questions which psychotherapists, such as myself, are apt to have about dance therapy.   My observations and inferences are based upon eight months of experience as a "participant observer"* in dance therapy sessions conducted by Susan Sandel at the Yale Psychiatric Institute.

     The Yale Psychiatric Institute is a 46-bed inpatient hospital devoted to intensive psychoanalytically oriented psychotherapy with patients, particularly schizophrenics and severe character disorders with borderline psychotic features, in the 15 to 25 age group. Individual treatment is combined with an emphasis on milieu therapy, an extensive activities program, a special high school within the hospital, and whenever feasible, the families of patients are seen regularly.

      Dance therapy as practiced within this setting thus gives patients the opportunity to move freely in space, to discover or rediscover what it means to play, to risk abandoning themselves to compelling musical rhythms, to become a member of a cohesive group, to participate in communal rituals, to mobilize and maintain an adequate supply of energy, to spontaneously express or dramatize emotions, to gain a greater awareness of their bodies, to touch and be touched by others, and to watch others engage in sensual, tender, and aggressive movements.

                Psychotherapists, of whatever orientation, would undoubtedly agree that many direct and indirect benefits can be derived from such experiences.   Nevertheless, discussions with my colleagues indicate that their misconceptions about dance therapy, as well as their preference for methods of treatment derived from relatively well-developed theories of personality, continue to inhibit widespread acceptance of dance therapy as a complete, efficacious, scientifically respectable modality of therapy.

Psychotherapists' Assumptions About Dance Therapy

     Research indicates that satisfaction, continuation, and improvement in psychotherapy are linked crucially to the favorableness and accuracy of a patient's expectations regarding the rationale, procedures, and goals of treatment. Individuals with serious doubts and misconceptions about psychotherapy need to be "educated" for treatment and socialized into the patient role.   Without adequate preparation they tend to prematurely drop out of psychotherapy as a result of disappointment or confusion. (3)   Consequently, experienced therapists devote considerable attention, especially during the early stages of treatment, to achieving mutuality or congruence of expectations.

     I will now briefly identify some of the issues which necessitate comparable efforts on the part of dance therapists if they are to achieve a stable and productive alliance with their colleagues, as well as with their patients. To begin with, the word dance arouses a complex and emotionally charged constellation of associations in most people. Many of these associations can interfere with an intellectually objective examination of the therapeutic efficacy of dance therapy. If one's associations tend toward Ginger Rogers and Fred Astaire, the American Bandstand, junior proms or the twist, then it would be difficult to regard dance therapy as other than a frivolous enterprise. Images of Swan Lake, Nijinsky, and Martha Graham may predispose one to a more solemn but, nonetheless, theatrical and aesthetic vision of dance therapy. It is the rare and highly sophisticated individual who is familiar with the themes (e.g. , human conflict and crisis) and goals (e.g. , spontaneity and authenticity of expression) underlying modern dance.   Many people still share the view that dancing is for "sissies. "   Although the influence of Puritanism has declined in our culture,  middle-class professionals are still apt to subordinate bodily needs to mental, moral, and spiritual development. Some can think of dance only in sexual terms. Still others confuse dance therapy with mechanistic muscle exercises, competitive physical fitness programs, structured technique classes, sensitivity training, or even nude marathon groups. Whether consciously or unconsciously held, such attitudes must inevitably provide the context within which many psychotherapists as well as patients, initially approach dance therapy.

Theories of Psychotherapy and Their Relationship to Dance Therapy

     Einstein   once noted that to learn what physicists do, one must observe them at work rather than ask them what they do. This seems also to be the case with psychotherapists and dance therapists. Whereas competent psychotherapists representing different theoretical points of view seem to be similar in the way in which they relate to their patients, they may vary greatly in their descriptions, justifications and explanations of their behavior. Dance therapists, likewise, do not share a common vocabulary, nor do they employ a standardized repertoire of techniques. Unlike psychotherapists, however, their work is not premised on a comprehensive, elaborately formulated theory of personality. In the absence of such framework, psychotherapists are apt to evaluate dance therapy on the basis of their own preferred modes of conceptualizing psychopathology and behavior change. These theoretical biases can either predispose a therapist to a favorable or skeptical view of dance therapy.

Dance Therapy from an Interpersonal Perspective

     In his search for the sources of gain common to all psycho-Hir.rapies, Hobbs wrote the following about the impact of the psychotherapeutic relationship:

      The client has sustained experience of intimacy with another human being without getting hurt. He has an experience of contact, engagement, of commitment. He learns directly and immediately, by concrete experience, that it is possible to risk being close to another, to be open and honest, to let things happen to his feelings in the presence of another, and indeed, even to go so far as to include the therapist himself as an object of these feelings.  .  .  .  The risking and handling of intimacy are learned by immediate experiencing; talking about intimacy, acquiring insight about intimacy, do not help much. "

      Dance therapists clearly permit their patients to use them to learn how to be intimate.   By creating a nonthreatening emotional athmosphere, they encourage their patients to empathically participate in movement dialogues occurring in the "here and now."   Besides providing patients with such concrete, rewarding learning experiences, dance therapy can also unleash potentially anti-therapeutic group processes, e.g., competitive struggles for leadership, scapegoating, pressures to conform or rebel, and jealousy over the formation of dyads.   Thus,  if interpersonally-oriented psychotherapists are to be * convinced of dance therapy's efficacy, dance therapists must demonstrate the ability to transform these interactions, as well, into "corrective emotional experiences. "7   At the same time, most traditional psychotherapists can be expected to have serious questions about the extensive role of physical intimacy in dance therapy.

     A survey of the psychotherapy literature indicates that the potential benefits of physical contact for other than children and severely regressed adults, have been rarely discussed. The hazards and dangers associated with physical contact have been repeatedly and forcefully emphasized. Tarachow, for example, cautions that:

     When you shake hands with an hysteric it is a sexual overture.   When you shake hands with an obsessional neurotic it is a challenge.   With a paranoid schizophrenic it is an assault. (8)

      Fromm-Reichman acknowledges that:

     ... at times it may be wise and indicated to shake hands with a patient, or, in the case of a very disturbed person, to touch him reassuringly or not to refuse his gesture of seeking affection or closeness. (9)

      She too, nevertheless, always recommended that one be thrifty with the expression of any physical closeness in one's psychotherapeutic efforts, and that gestures of physical closeness should be carried out only for the well defined needs of the patient.

The Role of Frustration and Gratification in Therapy

     In general, psychoanalytic-therapies require each participant to have intense feelings toward one another yet not act on them. Freud believed that structural (i.e., permanent) changes in the personality could only be brought about by conducting therapy: ".  .  .  as far as is possible, under privation--in a state of abstinence," and that, "as far as his relations with the physician are concerned the patient must have unfulfilled wishes in abundance."  Moreover, psychoanalytic therapy requires the therapist to function as both symbol and real person, and the patient to conceive of him as both. Thus, depending on the clinical needs of the moment and the long-term goals of the treatment effort, psychoanalytically-oriented therapists strive to promote self-understanding rather than gratify, spurn, or manipulate their patients' love, demands, assaults, or misperceptions.

        The dance therapy relationship, by contrast, is essentially gratifying.   During an improvisation,  a dance therapist may, for example, assume the role of some past figure, real or fantasied, and thereby gratify some "infantile" wish of the patient's.   Dance therapists do not instruct their patients to conceive of them as the symbolic representatives of significant childhood figures or as the unwarranted recipients of displaced feelings.   Rather, they enter their patient's phenomenological world as real people, while encouraging them, albeit partially, to indulge their fantasies and to discharge their impulses.   As Brown(11) might state it, dance therapy is predominantly id-affirmative rather than ego-affirmative.

      From a psychoanalytic perspective such an approach can only promote temporary cathartic relief from pent-up emotions or "transference cures," that is, improvements which last only as long as the idealized relationship persists. Consequently, analytically-m-iented psychotherapists can be expected to regard dance therapy as an "ancillary" treatment modality.

     Furthermore, it is likely that psychotherapists who endorse the "rule of abstinence" would be concerned about patients discovering in dance therapy substitutive gratifications which diminish the energy, anxiety, or sense of frustration required to sustain a commitment to psychotherapeutic work.   My observations suggest that some patients

     do attempt to "use" dance therapy in this way.   Some "act out" conflictual issues in dance therapy so as to exclude these issues from their psychotherapy sessions.   Others "split off" various aspects of the transference in an attempt to set up a competitive relationship between their psychotherapist and dance therapist.

      Whenever patients are involved concurrently in several modalities of treatment, as is often the case when they are hospitalized, such defensively prompted maneuvers can be anticipated.   Consequently, it is essential for a patient's dance therapist and psychotherapist to maintain open communication. By encouraging patients to discuss in psychotherapy their experiences in dance therapy, it is possible for a hospital staff to reinforce the beneficial aspects of both approaches. For example, therapeutic discussion of the tactile components of dance therapy can provide patients with an important opportunity to differentiate between, what Scheflen has called, courting and "quasi-courting"(12) behavior.   According to Scheflen the presence of a variety of qualifying signals (i. e., communications about the communication) enable people to identify when a communication is not to be taken literally, e. g., as a seduction or as a hostile attack. Hysterics and certain schizophrenics are believed to regularly confuse courtship and quasi-courtship behaviors. Thus, ". . , they are seductive when they are not supposed to be and they constantly provoke and imagine sexual advances on the part of others.''"   Helping such patients become aware of the disclaimers and qualifying signals which accompany physical contact during dance therapy sessions can therefore yield important therapeutic mileage.

Authenticity and Nonverbal Communication in Therapy

     One of the most firmly rooted psychotherapeutic assumptions is that psychopathology, to a large extent, results from and is perpetuated by distorted and inadequate communication(14). Consequently, it is generally acknowledged that the personality changes that result from participating in any form of psychotherapy require incredible frankness and candor.   In psychoanalytic therapy patients must promise "absolute honesty"(15) while existentialists regard the establishment of a genuinely communicative relationship as the effective therapeutic change agent.( 16,17)

      Despite their conscious willingness to cooperate with these requirements, patients relentlessly flee in psychotherapy, as elsewhere, from authentic and spontaneous communication.   We all, at times, manipulatively engage in "impression management. "   The severely maladjusted, however, compulsively resort to dissimulation, concealment, and role-playing to safeguard their vulnerable self-images and to ward off threatening interpersonal involvement. Thus, the dramatic emotional displays of the hysteric appear insincere and shallow. The psychopath's communications are experienced as devious and exploitative.   Obsessives rigidly control their feelings and avoid all spontaniety, while the schizophrenic's affective reactions tend to be cryptic, fragmented, inappropriate, or flattened.

        The effectiveness of any psychotherapeutic enterprise resides in its ability to uncover and dissolve these patients' resistances to direct, honest communication. To this end, traditional psycho­therapists minimally structure the psychotherapeutic situation so that patients relieve and reenact rather than just talk about their feelings and conflicts be they inaccessible to awareness or consciously suppressed. In addition, although traditional psychotherapists do not instruct their patients to engage in expressive movements, a knowledge of the defensive implications of body language is essential to their work. 18   Psychotherapists recognize that nonverbal behavior, being under less conscious control than speech and therefore more likely to escape patients' efforts at concealment, can provide them with information which their patients are reluctant or unable to disclose verbally.(l9) As Freud noted:

     He that has eyes to see and ears to hear may convince himself that no mortal can keep a secret. If his lips are silent, he chatters with his fingertips; betrayal oozes out of him at every pore.

        These latter two strategies point to the essential continuity between dance therapy and "verbal" psychotherapies, as well as to the unique contributions which dance therapy can make to a patient's rehabilitation.

        In common with other psychotherapies, dance therapy is structured to liberate direct communication and to induce controlled regressions. The primary content of dance therapy sessions is the movement patterns of both patient(s) and therapist.   Nevertheless, communication in dance therapy is multi-channeled.   Patients make

     contact, shout, utter primitive noises, and attach concrete images and metaphors to their actions. In so doing, they risk appearing

     ridiculous, shameful, ungraceful.   Since dance therapy is so intimately associated in many peoples' minds with giving a creative performance, it permits patients to confront their exhibitionistic and narcissistic tendencies. The reintegration of still other primitive affects is fostered by a process which has been called behavioral contagion (21).   Observing less inhibited patients ventilate and motorically express strong feelings encourages constricted patients to do likewise.   Moreover, by reinforcing partial manifestations of a movement, dance therapists can guide their patients, via successive approximation, toward the full realization of that movement with its accompanying emotional and attitudinal equivalents. (This aspect of dance therapy lends itself readily to analysis in terms of operant conditioning).

     The resistances which impede affective expression and learning in psychotherapy similarly impede dance therapy. The above considerations suggest, however, that patients may unwittingly reveal to their dance therapists, via their improvised (gestures, posture, gait), movement disturbances and skills, defenses and feelings which they cannot disclose verbally to their psychotherapists. In this regard, Mahl (22) has concluded that the appearance of idiosyncratic nonverbal gestures during therapy sessions often prophecies the growing accessibility to awareness of critical therapeutic issues. Dance therapists may, therefore, be able to provide information about patients which anticipates or differs from that which is available to staff who know patients primarily by the words they speak. Observing patients in dance therapy also strikingly reminds one of the influential role which context and task have on the range of behaviors which patients manifest. A psychotherapist's efforts are typically premised on the assumption that the relationships which his patients attempt to establish with him are highly representative of the kinds of relationships they develop with other important figures in their lives. Our psychotherapeutic biases can, however, also limit the generalizability and range of behaviors which patients reveal to us. My impression is that many therapists would be surprised to see the strengths, talents, leadership abilities, humour, and adaptive capacities which their patients show in dance therapy.

Body Image Disturbances and Dance Therapy

     A broader implication of the ideas discussed above is that dance therapy may be ideally suited to help some patients revise their body images and reclaim their bodies.

       Healthy individuals have a strong sense of their bodies as an integral, essential part of their being and an accurate body image which enables them to correctly interpret bodily events.   Most  clinicians endorse some version of the hypothesis that one can only experience and "know" that which is compatible with or acceptable to one's self-image.   It is, furthermore, typically assumed that since the self-image, which prominently includes the body image, is only partially related to the body, it is possible for our bodies to register and react to far more than we consciously experience, In their fight for emotional survival many individuals evolve distorted body images and all but abandon their bodies.   Schizophrenics and obsessive-compulsive patients clearly exemplify the negative consequences of this process. Such distortions as multiple hypochondrical complaints, bizarre reports of body function, and feelings of depersonalization or alientation from one's body are among the most frequently occurring symptoms in these patients. Fisher and Cleveland  have reported that a theme having to do with the loss or destruction of the body boundaries pervades the body-image fantasies of the schizophrenic. The emotional give and take, the pushing and pulling, the contraction and expansion of muscles which occur in dance therapy can provide schizophrenic patients with direct evidence that their body boundaries are firm and definite, rather than fluid and easily violated.   In other words, because dance therapy provides immediate feedback regarding the distance and distinction between one's "body ego" and external reality, it may, more directly than any other modality of treatment, help schizophrenics redefine the limits of their bodies. This may be especially true for those severely regressed, inarticulate schizophrenics who can only communicate via "acting out."

      The utilization of therapeutic strategies which focus on body movement, muscle tensions, and body concepts can be equally important in the treatment of obsessive-compulsive patients.   Whereas schizophrenics tend to be confused about the limits of their bodies, obsessive-compulsive patients are characterized by their excessively defined body limits,   A strong sense of guilt and shame about their bodies leads many obsessives to defensively sacrifice the right to enjoy the warmth of human contact.   Many resent the limitations imposed upon them by their bodies, and regard themselves as disembodied intellects trapped within an impenetrable shell.   Whereas the schizophrenic's movements often appear aimless, retarded or autistic, the obsessive's motor behavior is marked by continuous tense deliberateness, effortfulness and rigidity.  Because of the over controlled and driven manner in which they behave, Reich described compulsive characters as "living machines."   It is because of these attributes that obsessives, if they are to change, need to be provided nonthreatening opportunities to abandon their intellectual controls and learn how to "give in" to the wisdom of their bodies. Given that we express in our movements the way in which we perceive our bodies, dance therapists can directly help obsessives get in touch with many aspects of their body images, e.g., the state of harmony among, their body parts, the degree to which they accept their sexuality, the basic mood quality of their body.   In dance therapy obsessives are also given the opportunity to play, to experience the pleasures of their bodies in close physical intimacy, to engage in spontaneous action, and to learn how to "let" movements occur rather than always trying to "make" them occur.   Dance therapy, it would appear, can pave the way toward expanding the range of emotions which obsessives permit themselves to experience and express.

Dance Therapy from a Psychobiological Perspective

     It is a commonplace assumption among traditional psycho­therapists that "the mind is not in the head, but in the whole body," yet their orientations lead them to be essentially concerned with the intracacies of verbal behavior. There are, however, a growing number of somatic or psychobiologically-oriented therapies which are challenging the assumption that "talking-it-out" is better than "acting-it-out. "   Like dance therapy, bioenergetic analysis of Reich, 26 the postural-relearning of Feldenkrais, 27' the structural integration of Rolf (28),  and psychomotor-training of Pesso, 29 all deal with personality as it is made manifest in movement and body structure, and attempt to effect therapeutic changes on this level.   Representa­tives of these approaches are, therefore, likely to be highly sympathetic to dance therapy.   By adapting the theoretical rationales and experimental data which are offered in support of these approaches, dance therapists, could substantially increase the "scientific respectability" of their work.

       All psychobiologically-oriented clinicians emphasize the functional identity of personality and the physical appearance of the body at rest and in movement.   Reich's innovative formulation of this hypothesis posited that:   "The rigidity of the musculature is the somatic side of the process of repression, and the basis for its continued existence. "  Thus, while Freud     dealt with the local and specific manifestations of repression (e. g., loss of feeling or paralysis of the extremities), Reich holistically conceived of muscular hypertension and psychic rigidity as functionally equivalent signs of a disturbance in the vegative motility of the total biological system. Reich further maintained that if the psyche and body of an individual express themselves concurrently and identically then, "Character attitudes may be dissolved by the dissolution of the muscular armor; and, conversely, muscular attitudes by the dissolution of character peculiarities. "32   Following Reich, the basic operational premise guiding the work of somatic therapists is that changes in personality can be brought about directly by modifying the body structure and its functional motility. This work may or may not occur within the context of verbal therapy. Ida Rolf33 claims that systematic realign­ment of the body structure ("Rolfing") alone is sufficient to produce greater self-awareness, new suppleness and flexibility, greater ease in handling interpersonal relations, a decrease in the physical tension found in chronically contracted and spastic muscles, and an increased reservoir of energy. Bioenergetic therapists, such as Lowen, 34 on the other hand, supplement analytic procedures with expressive movement exercises and direct work on muscular rigidity, i. e., physical manipulation of the skeletal musculature.   Observing that schizoid patients chronically hold their breath and pull in their bellies to suppress anxiety and other sensations,  Lowen also includes deep breathing exercises in his psychotherapeutic practice.   It is note­worthy here that early in the history of the psychoanalytic movement Ferenzi  advised relaxation procedures to overcome inhibitions and resistances to free association.

        Direct, physical manipulation or massage of the skeletal musculature is not an integral part of dance therapy. It is clear, however, that dance therapy does help patients to modify and expand their movement repertoires. There are several inferences regarding

      the  therapeutic efficacy of dance therapy which seem to follow from this fact.   If one accepts the hypothesis that an individual's characteristic posture and style of moving limits the range and intensity of his emotional experiences, then it seems reasonable to conclude that the new or freer movements elicited in dance therapy could help remove one of the obstacles which prevent the body from spontaneously expressing its feelings.    Alternatively, if, as psychoanalysts (e.g., Klein3"), have convincingly argued, children seek in play to master traumatic experiences, then in a comparable manner the improvised movements performed in dance therapy might revive or symbolically represent primitive ways of coping with traumatic experiences.   In other words, it can be argued that dance therapy not only provides temporary cathartic relief from excessive tensions but possibly, like dreams and the magic acting of children, facilitates the emergence of unconscious impulses, memories, and resistances.

Research on Emotions and Dance Therapy

     Laboratory attempts to interrelate emotional behavior and emotional experience may help to clarify the fundamental question raised by the body-centered therapies—can the range of emotions which an individual experiences and expresses be expanded, directly, by merely expanding that individual's movement vocabulary.   On the one hand, physiological studies have indicated that the same visceral and autonomic changes occur in various emotional and non-emotional states. (37).   On the other hand, several studies have demonstrated that if a person under hypnosis is instructed to assume a posture consistent with a particular emotion, a different emotion cannot be brought about unless the posture is altered. (38)

        Taken together, these findings led Schachter(39) to conduct a series of imaginative experiments to determine which cues permit a person to label and identify his own emotional state.   In these experiments Schachter discovered that it was possible to lead subjects who were "experiencing" precisely the same chemically induced state of physiological arousal, to believe that they were feeling angry, or euphoric, or merely showing the physical side effects of the chemical agent.   Schachter concluded on the basis of these results that a state of physiological arousal alone is not sufficient to induce an emotion and that cognitions exert a strong steering function in helping a person "decide" what he is feeling. That the same state of physiological arousal can be labeled in terms of a great variety of emotions suggeststhat patients must be given the opportunity to correctly label, discuss, and differentiate the ambiguous and often unfamiliar sensations (i. e., "feelings") which are aroused by dance therapy.   More broadly, Schachter's two-factor theory of emotion implies that all somatic therapies must include or be supplemented by cognitive work.   Other­wise, patients are likely to confuse, distort, or find it impossible to "get in touch with" feelings which for them may be uninterpretable in terms of past experience.   According to Lowen(40) patients who fear being punished for "good feelings" tend to react to genital excitation with exaggerated alarm. Thus, although pleasure demands a loosening of restraints, mere realigning of these patients' body structures might result in increased anxiety rather than greater emotional freedom. Whatever the arena in which this seemingly essential cognitive work takes place, Berger's (41) recent text indicates that videotape feedback facilitates patients' attempts to accurately identify the feelings aroused in treatment.

       There are many perspectives from which dance therapy could be appraised (e. g., orthopedic medicine, yoga, psychodrama).   In this paper I have tried to identify the criteria against which psycho­therapists would evaluate dance therapy.   Before concluding, however, there is one other issue which deserves special attention.

The Role Requirements and Training of a Dance Therapist

     Every system of psychotherapy specifies, more or less explicitly, the personality characteristics and technical skills which its practitioners must possess if they are to be effective. The relative importance given to these personality characteristics and techniques may vary across schools of psychotherapy, but all acknowledge that the psychotherapist's role is very demanding.    Psychotherapists, on the one hand, must be capable of encouraging the emergence of Intense transference wishes within the context of a humane, "tuned in," collaborative relationship.   On the other hand, they must be capable of judiciously frustrating their patients' provocations and implorings for extra-therapeutic gratifications.   At the same time, they must be capable of tolerating loneliness, withstanding deprivation, and restraining intense feelings. In the service of therapy it has also been suggested by several authors (e.g., Menninger,(42) Kaiser,(43) that while the therapist must sincerely want to get his patients "well," to accomplish this goal he must achieve an attitude of "desirelessness," i.e. , free himself from the desire to cure.   As Newton(44) has observed, these psychotherapeutic role requirements, and especially the rule of abstinence, place tremendous pressure on the therapist's capacity for disciplined motoric inhibition.   Given the inevitable strains in realizing these therapeutic role requirements, it is not surprising that counter-transference issues have assumed an increasingly important position in the training of psychotherapists.

     In my view, taking the role of a dance therapist entails many of these same rigorous and stressful personal and technical demands. In addition to the often contradictory requirements noted above, both enterprises demand the capacity to restrain exhibitionistic and narcisstistic impulses.   Just as the psychotherapist must renounce the wish to be seen as impressive (e.g., brilliantly insightful, lovable), dance therapists must learn to control the temptation to relate to their patients as if they represented a captured audience.   Wishes to appear creative,  to be applauded, or even the need to be graceful, can interfere seriously with a dedication to therapeutic tasks.

       Uncoordinated, apathetic, or constricted patients can easily be threatened by dance therapists who uninhibitedly give in to their own movement needs.   In other words, and somewhat paradoxically, dance therapists must be just as capable of imposing strict limitations on their own expressive behavior as psychotherapists. This obligation could be especially problematic for those dance therapists who were originally dancers or who still continue to perform.

     Sullivan maintained that because of the participant-observer nature of his role:

     . . . the psychiatrists has an inescapable, inextricable involvement in all that goes on in the interview; and to the extent that he is unconscious or unwitting of his participation in the interview, to that extent he does not know what is happening.   (45)

     Effective clinical work, as this quote suggests, demands both a highly developed alertness to the rapidly shifting and obscure cues which patients emit and an accurate understanding of the way in which one participates in interpersonal situations.   It is possible for psycho­therapists and dance therapists to increase their self-awareness, refine their observational skills, and overcome "blind spots" in their own therapy, during supervision or in sensitivity training workshops. The nature of the participation demanded of dance therapists, however, can limit their opportunities for self-scrutiny during ongoing sessions. In contrast to the relative anonymity, passivity, and affective neutrality of the psychotherapist's role, dance therapists are frequently called upon to be as active, exposed, and physically involved as their patients. Seeing their dance therapists move and reveal themselves in this way can provide patients with excellent opportunities to learn by modeling and imitation.   As Jourard     has argued, therapist self-disclosure begets patient self-disclosure. The infrequency with which dance therapists can reflectively detach themselves from ongoing movement sequences and group processes, however, could also make it difficult for them to sort out their unintentional contributions to their patients' reactions.

       The physical exertion required of dance therapists could similarly interfere with the empathic sensitivity which intuitively guides their responses to such frequently occurring questions as: Was the patient intimidated by the energy level which I used in performing that movement?   Did the directness of my movement provoke that hostile attack?   Did the patient withdraw because of the sexual implications of my gesture?   Are we performing this movement sequence because of my needs or the patient's needs?   It is clear that the training of dance therapists, like that of psychotherapists, must prominently address itself to the countertransference issues and role dilemmas engendered by their work.

      © 1974