Dance Movement Psychotherapy with People with Learning Disabilities

Out Of The Shadows, Into The Light

Geoffery Unkovich, Céline Butté, Jacqueline Butler, Geoffery Unkovich, Céline Butté, Jacqueline Butler

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351727648
• Edition: 1
• Topic: Medien & darstellende Kunst
• Subtopic: Tanz

This book provides an overview of dance movement psychotherapy for young people and adults with learning disabilities. Contributors from a variety of backgrounds examine their work with clients from across the disabilities spectrum, ranging from mild to complex needs. The book chapters present theory and practice relating to the client group and subsequent therapy processes. This comprises psychotherapeutic interventions, dance movement interventions, theoretical constructs, case study material, practitioner care, and practitioner learning and development related to individual and group therapy work. The logistics of a Dance Movement Psychotherapy intervention, the intervention itself and the ripples of influence into the clients' wider socio-cultural context are discussed. This stance speaks to current research and practice discourse in health and social care.

The book champions acceptance of difference and equality in the health and social care needs for people with learning disabilities whilst emphasising the importance of dance movement psychotherapy for people with non-verbal communication.

Dance Movement Psychotherapy with People with Learning Disabilities: Out of the Shadows, into the Light will provide a practical and theoretical resource for practitioners and students of dance movement psychotherapy as well as allied health professionals, service providers and carers.

Chapter 1

Entering the world

Dance Movement Psychotherapy and the complexity of beginnings with learning disabled clients

Caroline Frizell

This chapter explores the significance of beginnings in relation to working as a dance movement psychotherapist (DMP) with learning disabled clients. I explore the nature of ‘beginnings’ for the learning disabled infant, illustrating that experience with one mother’s story as she faces the news that her child has Down’s syndrome. I am not suggesting that subjective experience can validate generalisations about learning disability and I have no wish to reinforce a zeitgeist that seeks to theorize through personal experience rather than empirical research, mistaking ‘personal belief … for public knowledge’ (Anastasiou and Kauffman, 2011: 369). In this chapter I explore how individual subjective experience of parents can bring into focus the uncomfortable and mixed feelings that confront us as we face learning disability as a lived reality. Through an analysis of that individual experience in relation to relevant literature, I identify issues that can help us to think about the implications for the transference when working as a DMP with learning disabled clients, in particular in relation to beginnings. I will finish with vignettes from my therapy practice to illustrate how the complex dynamics embedded in a client’s psychic infrastructure might manifest symbolically in the therapeutic relationship. I have full permission to share the stories in this chapter. Pseudonyms are used and some details have been changed to protect confidentiality.

A note on language

Throughout this chapter I use the term ‘learning disabled person’ (rather than people with a learning disability) to reflect discourses around discrimination and a ‘political expression of the fight for rights’ (Slorach, 2016: 24) regarding disability. This use of language supports a social model of disability and locates the disabling factors in the social and cultural contextual constructions (see for example Sinason, 1992; Slorach, 2016), rather than belonging to the person. The term ‘disabled people’ has been campaigned for and promoted by the disability movement (Slorach, 2016).

Beginnings

Beginnings, like endings, play a crucial role in therapy and our entry into this world is characterised by relational transactions that are nonverbal. Daniel Stern (2010: 110) notes how ‘the primacy of movement and its dynamic features’ forms the basis of our ‘developmental infrastructure’. As a DMP, I remain aware of the subtle nuances of beginnings as I meet with the particular developmental infrastructure of any particular client, the history of which becomes enacted in the intersubjective space from the moment he or she enters the orbit of my awareness. I pay close attention to my embodied felt-sense throughout the assessment and consultation process leading to the first encounter. I invest in my skills of observation and remain open to the way the client’s relationship with beginnings is characterised and evolves throughout the therapeutic process. Beginnings, like endings, hover continuously in the psychic space of the therapeutic process.

As a practitioner working with learning disabled people, I remain open to the inconvenient and uncomfortable truth of how many have experienced being welcomed into the world. These early relational experiences will shape the interpersonal dynamics at play and reflect wider socio-political perceptions. By listening to the dynamic processes emerging over time, I offer a therapeutic space for those complex experiences to be disentangled, felt, thought about, understood and perhaps replayed and reconfigured.

Learning disabled people have often experienced an a typical beginning. Sinason (1992: 146–7) notes how ‘(w)hen the wished-for baby does not appear it is hard for even the most loving, resourceful parent to feel deeply attached’. As illustrated in the following story, when a parent learns of his or her child’s diagnosis of learning disability, that ‘first mirror’ does not always reflect ‘beauty and joy’ (1992: 147). Instead, the parental gaze is tinged with disappointment and grief.

The story that follows is one mother’s account of her daughter’s birth. The mother-to-be is on a trip to a botanical garden when she goes into labour. A small girl skipping by comes to represent the mother’s idealised notion of the anticipated child. After the shock of an emergency caesarean, there is a sense that something isn’t right. The parents are avoided by nursing staff who await the paediatrician’s return after the bank holiday weekend. The parents begin to bond with the baby before they are confronted by the news that she is learning disabled. The news is delivered by a paediatrician who seems ill-equipped to hold the emotional impact of the news. A junior doctor is able to sit by the parents when their world is turned upside down by the shocking news. The baby is an unexpected guest and the parents too find themselves on the threshold of an unexpected and unknown world.

In the humid Palm House at Kew Gardens, a pregnant woman descended the spiral staircase. Her stomach tightened and she clutched the iron hand rail to pause. The contraction passed and she continued to spiral down, sensing the tailback of August bank holiday visitors stretching behind like a giant tendril.

She became absorbed in the sensorial world of the Palm House. Metal hoses hissed like giant anacondas and steaming droplets of water cascaded onto the leaves of banana trees and cocoa plants in the simulated, tropical atmosphere. A bulging droplet fell from a leaf as if in slow motion. The leaf rebounded with a shudder. She felt the shudder echo in her spine and put her hands protectively on her stomach, feeling the baby beneath the tightly stretched skin. A small child in a floral dress skipped by, calling to her father. The woman smiled, remembering her visits to Kew as a child. As she did so, she gazed into the crystal ball of her baby’s future: a carefree child, skipping into adulthood and sailing into the next generation. It was an uncomplicated vision.

Exotic scents hung in the hot air that brushed against her skin as sounds intensified in volume. The anaconda hissed at intervals from above. Conversation slithered in and out of earshot … ‘look daddy … did you see the …’ Her eyes followed the little girl with tousled ringlets, skipping back and forth as her parents wandered around the palm house. Her stomach tightened again.

Her partner turned to her.

‘I think we should go,’ she said.

In the maternity ward, they put her on a monitor. She saw the panic on the faces of the nurses.

‘The heart’s dipping,’ she heard. ‘Sign this form.’ She held the pen over the paper and watched it scribble illegibly. The anaesthetist peered at her over his green face-mask and the world went black. Her husband waited anxiously in an adjacent room. The baby was lifted into the world and wrapped in a blanket. As the woman came to, her partner greeted her, holding in his arms the tiny being with silky blonde hair.

That night the woman lay awake on her back, unable to shift position due to the caesarean. Her arm was tucked around a small bundle of white blankets.

‘Just hold her for a moment and I’ll be back to put her in the nursery …’ said the nurse, ‘she’s rather small and getting cold.’

The nurse threw the woman a fleeting glance and raced out of the room. She didn’t return.

The woman peered at the tiny baby, overwhelmed by the delicate softness and the delicious smell of new-born skin. The exquisite features and the thick mop of blonde hair held an unfamiliar wonder to the woman, who’d never seen anything quite so beautiful. The curtains were open and a full moon hung in a clear velvet-blue sky. She stroked the fine hair on the baby’s skin with the back of her hand.

Her husband phoned around with the news. Hearts warmed. Glasses were raised in celebration. Knitting needles crafted pink matinee jackets. Congratulations filled carefully chosen cards. The news echoed through the trees. The anaconda hissed a warning into the air, which hung suspended, waiting to fall from the edge of a leaf. Mother and baby drifted into a blissful sleep.

‘Don’t tell me you’ve had this baby in your bed all night!’ a nurse scolded, not long arrived on her Sunday morning shift.

The woman woke with a start. The bright sun shone through the window, making her blink. The baby was whisked into the nursery with talk of a bottle to top her up.

‘Please don’t give her a bottle,’ said the woman.

The nurse ignored her, ‘You get some rest now … we’ll bring the baby back later.’

The woman didn’t want to rest, she wanted her baby back. She had a strange sense of being avoided by staff. They raced in and out of her room, avoiding eye contact. Her husband arrived.

‘The baby is in the nursery; can you get her back?’ said the woman.

After a while, her partner wheeled the baby back into the room. The nurses had said they needed to consult the paediatrician. It was a bank holiday weekend and medical staff were mostly away. The baby was small and slightly blue, they’d said.

Visitors came with cards, flowers and presents. A helium balloon on pink ribbon wavered in the heat that shimmered from the hospital radiators.

The bank holiday weekend was over. The paediatrician entered the room with a junior doctor and some anxious looking nurses.

‘Well, how are we all?’ said the paediatrician brightly.

The room was lined with professionals, looking anywhere but in the woman’s eyes. The woman had made her way tentatively from the bed to a chair.

‘May I take the baby?’ asked the paediatrician, lifting the baby from the mother’s arms. She held the baby at arm’s length before placing her on her tweed lap. Unwrapping the blanket, she allowed the baby’s arms to flop down either side of her knees. The paediatrician’s natural-tan tights had a sheen, which caught the sun, causing a shaft of light to curve over her knee and follow the contour of her athletic calf muscle down to her black-patent court shoes.

‘Have you noticed anything about your baby?’ she asked, slowly shifting her attention from baby to mother.

The woman felt her chest tighten and her spine straighten. She shifted her glance from the paediatrician’s professional smile to the baby. As she did so, the paediatrician began to bounce the baby’s arms in her hands.

‘Can you see she’s a bit floppy?’

The woman wanted the earth to stop turning. She wanted to be back in bed with her arm round the baby, as the full moon shone through the window. The paediatrician put her fingers in the baby’s palms. The baby didn’t respond, but instead, moved her head to gaze towards the line of nurses, each standing upright, as straight-backed as Mary Poppins.

‘… and it would be usual for the baby to grip,’ she went on. The woman continued to stare, her blue eyes piercing the paediatrician’s charm, defying the theft of her dream.

‘… and have you noticed the shape of her eyes?’ the paediatrician went on, ‘the epicanthic folds, which are typical of a certain syndrome. Do you see what I’m getting at?’ She drew her finger-tips slowly together to indicate a thin, elliptical shape. The paediatrician was becoming unnerved by the woman’s expressionless stare, which gave nothing away. The woman sat silent in her chair. The paediatrician held her precious baby on her lap like a faulty specimen.

‘The baby obviously has Down’s Syndrome …’ the paediatrician paused. ‘… you hadn’t noticed? And I suspect there’s a problem with her heart, as she is blue around the mouth. It’s not uncommon … there can be little doubt, but obviously we’ll do tests … um … straight to the special care baby unit I think,’ said the paediatrician, over the woman’s head ‘we’ll get her to Great Ormond Street a.s.a.p. … oh, and can someone get mum and dad a cup of tea?’

With that she smiled with a sympathetic tilt of the head, put the baby in the plastic hospital cot and swept out of the room. The anaconda hissed a billion pieces of shattered glass into the hospital air. The professionals clicked their heels and stepped up their choreographed routine, reflecting back the paediatrician’s reassuring, professional smile. A nurse pushed the baby out and was followed by a procession of professionals, who jostled for a hasty exit.

Suddenly the room was empty, except for the woman and her husband. They stood staring at the open door. A shiny blue hospital floor led down an empty, silent corridor. They stood in a deathly silence. The paediatrician’s words echoed in the woman’s mind ‘… you hadn’t noticed?’ Why hadn’t she noticed? They stared at each other in disbelief. Tears welled up in their eyes and in their confusion they quickly averted their gaze from each other. The flowers spilled out of the hospital vase and the helium balloon blushed a deeper shade of pink. A baby began to cry from an adjacent room. The sound was unbearable and cut through the air, shattering any small illusions that remained. The beautiful baby with the soft skin and the shock of blonde hair, who’d slumbered in her arms by the...