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This is a post for fellow psychiatrists who practice dance therapy. I’m guessing there aren’t any on here, but if I post this it will become indexed by search engines and other psychiatrists who employ dance therapy might find this and chime in.
What do you do when a patient falls down during the dance? Do you yourself continue dancing and pretend not to notice? Do you help the patient up? Do you ask them how they feel about falling down? A few of my elderly clients have fallen over the last 6 months during interpretive dance. During one-on-one dancing, it’s very unlikely for them to have a fall as obviously two people brace each other. But during these three episodes of falling, I decided it was best to let the clients have their dignity and I continued dancing off in the corner with my back to them as they righted themselves.
In two cases, I turned back around when I could tell the clients were on their feet, and I ignored the fact that they weren’t dancing. In those instances, they picked up on my cue that nothing had happened and started dancing again, which I think was probably very therapeutic. However, those two started speaking and mentioned something about their falls after they started dancing again, and I just told them I hadn’t noticed anything and to keep dancing. (Speaking is discouraged during the dance.)
The third patient, however, would not right herself. I peeked and saw her fussing on the floor, and I danced out of my office to have my secretary check on her. I’m sure this will be obvious to other dance therapists, but for those who aren’t, it’s a very tricky boundary issue to address a patient in a non-dance way when you are in the middle of the dance, which is why I had to send in the secretary. If you don’t get it, think of it as any other form of frame deviation during psychotherapy.
An ambulance was called while I continued my interpretive dance in the waiting room as to not acknowledge the patient’s non-dancing behavior. As she was carried out, I continued dancing and was careful not to look in her direction. After she had been removed, I danced back into my office and continued dancing until our appointment was scheduled to end in order to maintain the frame.
That patient turned out to have a hip fracture, which was ascribed by another doctor, who was not present during the appointment, to the fall. I maintain that this particular patient suffers from somatoform disorder she refuses to acknowledge, which greatly increased her experience of pain. I unfortunately can no longer work with her as our work was always exclusively through the dance, not talk therapy. To address what happened now through talking would be to completely leave the frame, and so I had to release her.
But it just occurred to me that a temporary fall, as with the other two patients, could be a teachable moment. I just hate to leave the flow of the dance, though. I really try to attract a vibrant clientele and sometimes when you give in too much, you make a person weaker rather than stronger. If I pay attention to the fall, am I then just encouraging them to 1) leave the dance and 2) languish in self pity?
Also, does anyone have any suggestions on minimizing falls in the elderly? I find that interpretive dance is one of the best treatments for elderly depressives, but it’s also turning out to have a higher side effect profile than I anticipated. I can’t in good conscience promote adaptive interpretive dance (that’s a whole other conversation), but I am open to other dances that could help.
What do you do when a patient falls down during the dance? Do you yourself continue dancing and pretend not to notice? Do you help the patient up? Do you ask them how they feel about falling down? A few of my elderly clients have fallen over the last 6 months during interpretive dance. During one-on-one dancing, it’s very unlikely for them to have a fall as obviously two people brace each other. But during these three episodes of falling, I decided it was best to let the clients have their dignity and I continued dancing off in the corner with my back to them as they righted themselves.
In two cases, I turned back around when I could tell the clients were on their feet, and I ignored the fact that they weren’t dancing. In those instances, they picked up on my cue that nothing had happened and started dancing again, which I think was probably very therapeutic. However, those two started speaking and mentioned something about their falls after they started dancing again, and I just told them I hadn’t noticed anything and to keep dancing. (Speaking is discouraged during the dance.)
The third patient, however, would not right herself. I peeked and saw her fussing on the floor, and I danced out of my office to have my secretary check on her. I’m sure this will be obvious to other dance therapists, but for those who aren’t, it’s a very tricky boundary issue to address a patient in a non-dance way when you are in the middle of the dance, which is why I had to send in the secretary. If you don’t get it, think of it as any other form of frame deviation during psychotherapy.
An ambulance was called while I continued my interpretive dance in the waiting room as to not acknowledge the patient’s non-dancing behavior. As she was carried out, I continued dancing and was careful not to look in her direction. After she had been removed, I danced back into my office and continued dancing until our appointment was scheduled to end in order to maintain the frame.
That patient turned out to have a hip fracture, which was ascribed by another doctor, who was not present during the appointment, to the fall. I maintain that this particular patient suffers from somatoform disorder she refuses to acknowledge, which greatly increased her experience of pain. I unfortunately can no longer work with her as our work was always exclusively through the dance, not talk therapy. To address what happened now through talking would be to completely leave the frame, and so I had to release her.
But it just occurred to me that a temporary fall, as with the other two patients, could be a teachable moment. I just hate to leave the flow of the dance, though. I really try to attract a vibrant clientele and sometimes when you give in too much, you make a person weaker rather than stronger. If I pay attention to the fall, am I then just encouraging them to 1) leave the dance and 2) languish in self pity?
Also, does anyone have any suggestions on minimizing falls in the elderly? I find that interpretive dance is one of the best treatments for elderly depressives, but it’s also turning out to have a higher side effect profile than I anticipated. I can’t in good conscience promote adaptive interpretive dance (that’s a whole other conversation), but I am open to other dances that could help.