In this webinar, Dr. Marybeth Weinstock discusses the use of dance movement therapy in eating disorder treatment. Marybeth is the DMT for Monarch Cove Eating Disorder Treatment Center in Pacific Grove, California

1. Dance/Movement Therapy
Groups for Clients with
Eating Disorders:
Jumping the Hurdle of Fear
into Conscious Embodiment
Marybeth Weinstock, PhD
Marybeth.Weinstock@castlewoodtc.com; 831-718-
9595
Monarch Cove Treatment Center for Eating
Disorders

2. Welcome
What we’ll be exploring today:
-Basic tenets of Dance/Movement Therapy (DMT)
and how they apply to Eating Disorders
-Focus on clients with severe, chronic diagnoses
who are challenged with grave fears of being
embodied
-DMT techniques that have been effective in
recovery process

3. Definition of Dance/Movement Therapy
 Dance/Movement Therapy
Based on the assumption that the body and
mind are interrelated, body movement
therapy is defined as the psychotherapeutic
use of movement to further the emotional,
cognitive, physical, and social integration of
the individual. The dance/movement
therapist focuses on movement behavior as
it emerges in the therapeutic relationship.
Expressive, communicative, and adaptive
behaviors are all considered for both group
and individual treatment. Body movement
as the core component of dance
simultaneously provides the means of
assessment and the mode of intervention
for dance/movement therapy.
American Dance Therapy Association

5. DMT
 Integrating ancient healing practices of movement,
meditation, and imagery, it is uniquely suited to take its
place as a cost-effective, interpersonal practice in a
newly reinvented healthcare system.
 Dance therapists provide treatment for people with
psychological and physical conditions, including anxiety,
depression, psychogenic somatic disorders, heart
disease, cancer and neurological impairment.
Dr. Ilene Serlin, The Corsini Encyclopedia of Psychology

6. DMT
 Dance has existed in every human culture and is used in ritual, rites
of passage, and as a cathartic healing tool. In early civilizations
dancing, religion, music and medicine were linked. Modern D/M
therapists use the power of dance and movement to help individuals
access their own natural ability to heal and grow.
Anne L. Wennerstrand, CSW, DMT
Eating Disorder Referral and Information Center
 With respect to the ancient roots of DMT, these are much older than
the roots of the modern medical/psychiatric model and go back to
the ancient healing practices in which circles, rhythm, images, and
energy were used for group transformation.
Dr. Ilene Serlin, The Corsini Encyclopedia of Psychology

8. Forms of DMT
 Chace Method, Marion Chace
 Authentic Movement, Mary Whitehouse
 Organic Movement, Alma Hawkins
 Dance as creative transformation, Blanche Evan
 Adler, Liljan Espenak
 Source/Core/Creativity, Norma Canner
 Folk Dance, Elizabeth Polk
 Mime, Trudi Schoop

9. Commonalities of Forms of DMT
 Dance therapists are trained in bodily attunement and attachment theories
that can open up powerful preverbal experiences. In their work, they
provide a safe space to contain, re-experience, and work through bodily
held blocks. They understand that movement is a language, an expression
of the self that expresses its coping style, defenses, leadership styles, and
capacities for intimacy. Movement is a special way of knowing.
Kinaesthetic intelligence is one of the multiple modes of intelligence, a way
of knowing in the body, a form of active imagination. Movement embodies
the creative process. The act of shaping raw material or emotion into
symbols or images is healing, as it helps objectify the emotions, creates
distance from them, and unleashes a powerful creative force. Movement is
healing and transformative. It can unlock primitive feelings and traumas that
are stored in the body, restoring our connection to our bodies and the earth.
And, in many cultures, dance takes us to the sacred.
Dr. Ilene Serlin, The Corsini Encyclopedia of Psychology

11. Chace Method
 Began in St. Elizabeth’s Hospital, 1940’s
 Basis in dance forms such as modern dance
 Circle
 Rhythm and music
 Mirroring
 Format of a dance class:
warm up
development of themes
cool down

13. DMT and assessment
Their attention is drawn to how they enter the
room, where they choose to place themselves in
the room, the attitude or posture they assume in
stillness, how they breathe, the degree of
tension experienced in their bodies, how they
move out in space, and how they relate to others
nonverbally through movement.
Dr. Erma Dosamantes-Alperson, Dance Movement Therapy: An
Emerging Profession

14. Laban and Effort/Shape: A Brief Overview
 Hungarian architect and dancer Rudolf von Laban
created:
 Movement choirs
 Labanotation
 Effort-Shape: method for systematic description of
qualitative change in movement in terms of the kinds of
exertions and the kinds of body adaptations in space
Cecily Dell, a primer for movement description

15. Effort/Shape
 Effort:
 Flow: free/bound
 Weight: light/strong
 Time: sustained/sudden
 Space: direct/indirect
 Shape:
 Growing/shrinking
 Vertical: rising/sinking
 Sagittal: advancing/retreating
 Horizontal: widening/narrowing

16. DMT and Assessment
Posture and gesture (Schilder)

17. Philosophy of Treatment
At Castlewood, we encourage an
exploration of the mind/body connection in
order to assist those struggling with eating
disorders to begin to forge a new
relationship with their bodies, one that is
compassionate, accepting and kind.

18. Eating Disorder Diagnoses
 Anorexia Nervosa
 Bulimia Nervosa
 Eating Disorder NOS
 Binge Eating Disorder

19. Co-existing conditions
 Body Dysmorphic Disorder
 Mood disorders
 Anxiety disorders, including panic, OCD, and phobias
 Substance Abuse and Chemical Dependency
 PTSD / Trauma

20. Eating Disorders and DMT
 DMT serves as a powerful medium for people suffering with eating
disorders to explore their relationship to their bodies. A
characteristic of eating disorders is the tendency to detach from
feelings and focus on body distortions, obsessive thoughts, and
concrete, black and white thinking. DMT provides a way to safely
become more aware of feelings that arise from the body’s
sensations, and teaches people with eating disorders how to listen
to their body’s needs. This is critical to recovery. People with eating
disorders can become socially isolated. The relationship focus of
DMT, both in group and individual formats, helps the individual risk
connecting to others in supported, honest, and meaningful ways.
Discoveries made in DMT-about one’s own mind/body connection
and about relating to others-transfer to other relationships and how
one moves through life.

21. Eating Disorders and DMT
 When everyday movements are transformed into expressive
movements, participants become able to release and externalize
their feelings. In this creative process it becomes possible to find the
metaphoric connections between the expressive movement and the
familiar patterns in their lives that may underlie the eating disorder.
DMT helps people understand how their feelings are given form
through their actions, and empowers them to take risks. Healing
cannot fully take place unless they are able to challenge themselves
to live in their bodies, a central component of their body image.
DMT provides a structure so this can occur.
American Dance Therapy Association

22. Definition of Body Image
A subjective experience of one’s own
physical appearance established both
by self-observation and by noting
reactions of others.
Merriam-Webster

23. DMT and Body Schema
 Dance is movement, and movement is essentially a
process of ongoing change. Moving with one’s whole
body, with and against gravity, one learns to both yield
and resist, to feel one’s strength and to feel one’s
vulnerability, to try on new qualities of action and
behavior. This is what it means to be fully human. DMT
can improve body image. Paul Schilder, a developmental
neuroscientist, once said that dance is a loosening up of
the body schema. He was describing how when we
dance, the movement activates a dynamic and constant
feedback loop back and forth between our brains and
our bodies, so that our experience of our felt and living
selves is one of change.
Sherry Goodill, NEA Blog

24. Definition of Body Dysmorphic Disorder
 Body Dysmorphic Disorder (BDD) is defined as a preoccupation
with an “imagined” defect in one’s appearance. Alternatively, where
there is a slight physical anomaly, then the person’s concern is
markedly excessive. The preoccupation is associated with many
time consuming rituals such as mirror gazing or constant comparing.
BDD patients have a distorted body image, which may be
associated with bullying or abuse during childhood or adolescence.
Such patients have a poor quality of life, are socially isolated,
depressed, and at high risk of committing suicide. The condition is
easily trivialised and stigmatized.
Dr. David Veale, Postgraduate Medical Journal

25. DMT and the Treatment of Body Image Problems
 DMT is effective as a technique to help those with eating and body image
problems. One of the most crucial tasks of any therapy is helping an
individual put her feelings and experiences into words. When an individual
does not allow herself to know or put her feelings into words she must be
helped to recognize and name feeling states in order to heal.
 Research shows that many patients with eating problems struggle with
alexithymia, which is defined as difficulty in putting feelings and fantasies
into words (Zerbe, 1995).
 Though eating disorders are incredibly complex, one way to think about the
“symptom” of the eating problem is to understand it as an individual’s best
attempt to cope in some way with internal or external stress. The eating
problem represents the individual’s difficulty in finding other more gratifying
ways to address key needs and issues which may or not be within the
individual’s awareness…Feeling states manifest in the body and the “site” of
the eating disorder is the body itself, making body-based therapies ideal in
helping those with eating problems.

26. DMT in the Treatment of Eating and Body Image Problems
For someone with an eating disorder, the bodily-felt sense of self is
distorted, frozen, traumatized, or too filled with shame to be known or
seen by another person. One of the ways DMT helps is through the
development of mindfulness of bodily sensations leading to a more
realistic sense of body boundaries. This can lead to greater ability to
know herself and recognize physical cues such as hunger and
satiation. DM therapists help clients to name and modulate strong
emotions. By attending to a bodily felt sensation, the individual can
start to notice different intensities of the sensation, and notice what
changes occur.
Anne L. Wennerstrand, CSW, DMT, Eating Disorder Referral and Information Center

27. DMT in the treatment of Eating and Body Image Problems
Experiential understanding begets cognitive
understanding and connection with feelings can
be translated into insightful cognitions. There is
always communication present. When therapists
can connect with and utilize their own feelings as
part of the therapeutic process, they can help
their patients decode their own inner experience
and transform them into opportunities for growth.
Susan Kleinmen, Eating Disorder Hope

28. Challenges: Just getting them in the room!
 Body image issues/Body Dysmorphia
 Feeling disembodied
 Dissociation/Trauma
 Social and general anxiety
 Challenges with sexuality
 Ambivalence about Recovery
 Inability/lack of permission to have fun and play
 Perfectionism
 Anhedonia
 Orthorexia/body checking
 Media bombardment
 Previous negative treatment experiences
 Exhaustion/heart issues
 Medication side effects
 Malnourishment side effects

29. Meeting the Challenges
Existential Dialectics meets DMT:
Validating existence through mirroring, shared
leadership, circle
Synthesis/Antithesis=Thesis via expanded
movement repertoire
Salomon Rettig, Existential Dialectics in Therapeutic Groups

31. Meeting the Challenges
Take them where they’re at!
CHOICE
Mirroring
Cognition

32. How??!!
 Begin with choice, respect the mood
 Begin with structure that’s safe, quiet, simple
 Breath
 Stretching
 Pass around/leadership
 Socialization
 Repetition
 Rhythm
 Humor

33. How??!!
 Gentle stretching
 Relaxation
 Creative Movement
 DMT
 Anna Halprin’s Movement Ritual

34. How??!!
 Chace structure
 Check in
 Warm up
 Development
 Cool down
 Check in

35. Goals of DMT
 Connection to/awareness of the body and its functions.
 Increased ability to be present with self and others.
 Increased awareness of safe and healthy expression through the
body
 Increased ability to utilize self soothing and affect regulation skills
 Increased connection to and acceptance of all parts of self
 Increased sense of physical and emotional boundaries
 Awareness and expansion of movement repertoire
 Experience of fun, play, humor
 Increased understanding of self through imagery, metaphor,
imagination
 Safe space to express full range of emotions
 Healing effects of creative art experience

36. How do we invite the client’s body into the
therapeutic process?
Ask regularly about what clients are
experiencing in their body during therapy. This
integrates the mind and body and dismantles the
familiar “talking head” syndrome, in which clients
are cognitively and intellectually insightful but
disembodied. The eating disorder lives in the
body. The only way out is through the body.
Deanna James, R-DMT, LPC, Castlewood DMT