Personal Motivation and Passion Toward Dance and Psychotherapy

We have been dancing since we were young girls: classical ballet, competitive ballroom, Argentine tango, Cuban salsa, swing, and ecstatic dance. As dancers and healthcare professionals, we find that the dance of human relationship is not merely a metaphor but an opportunity for embodied practice. Our meditation practice has deepened our capacity to speak the language of the body’s signals and improved the ability to attune to the movements of our partners. Likewise, years of training as dancers have enhanced our mindfulness practice and therapy skills. This lived experience forms the basis of our ongoing inquiry into the relationship between mindfulness, movement, and psychological well-being. Hence the fusion of our passion for dancing and movement with our professional focus on mindfulness and attentiveness can best be formulated in Rumi’s astute observation that “[i]n order to understand the dance one must be still. And in order to truly understand stillness one must dance” (Rumi).

It is tempting to conceive of mindfulness as a practice that takes place in the mind, but mindfulness is both a state of mind and an embodied way of being in the world. Though much of the literature focuses on the “mental” dimensions of mindfulness training , preliminary research evidence offers insight into the benefits of mindful movement as informal mindfulness practice. Below, we seek to explore these benefits with particular attention to the physiological and interpersonal dimensions of mindfulness that are enhanced by mindful movement. Research from multiple social science disciplines is beginning to show that dance training , for example, holds the potential to encourage prosocial behavior and improve emotional coherence. In a way that physical exercise alone does not, dance offers the opportunity to experience the embodied harmony of physical and emotional expression. We offer this exploration of mindful movement within the context of an intervention for patients/clients to increase mental well-being and social connectedness, and as a tool for therapists to develop skills essential to psychotherapy, including somatic awareness, empathy , and presence.

Defining Mindfulness

We begin our exploration of mindful movement and its clinical applications by offering an operational definition of mindfulness. Mindfulness is a “consciousness discipline,” a way of training the mind and body to be fully present with life. It involves bringing our full awareness to the present moment, and not just awareness of mental experiences but also training the mind to be fully present of somatic experiences. In his short story collection, Dubliners, James Joyce says of one character, “Mr. Duffy lived a short distance from his body” (Joyce 1914). Indeed, it is quite possible and common in the midst of our modern lives to be so absorbed in the life of the mind that one loses touch with the body, its signals, and its wisdom. Although often associated with mental training , mindfulness is much more than a mental exercise. Awareness of the body and somatic practices to help train this awareness have always been at the heart of mindfulness. In fact, the Buddha is quoted as stating that all of his teachings could be found in this “fathom long body” (Rohitassa Sutta, T. Bhikkhu Trans., 2013).

Although mindfulness is trained through formal meditation practices, it is a way of being, a way of living. As the poet David Whyte puts it, “The template of natural exchange is the breath, the autonomic giving and receiving that forms the basis and the measure of life itself. We are rested when we are a living exchange between what lies inside and what lies outside” (Whyte 2015, p. 181). This capacity to be fully alive and fully awake is at the heart of being human—and at the heart of working in a healing profession. A mindful clinician is one who is committed to listening deeply to her client, as well as to the embodied wisdom that arises when she senses what is beyond the words by listening in ways that transcend what ears alone can hear.

As we deepen our understanding of mindfulness and our ability to bring mindfulness into psychotherapy , it is imperative that we include an embodied lens as well as a mental one. Also important is exploring somatic practices that will help deepen our mindfulness of the body.

Three Core Elements of Mindfulness

In the model of mindfulness offered by Shapiro and Carlson (2009), mindfulness comprises three core elements: intention, attention, and attitude. Intention involves knowing why we are doing what we are doing: our ultimate aim, our vision, our aspiration. Attention involves attending fully to the present moment and to both our inner and outer experiences. Attitude, or how we pay attention, enables us to stay open, kind, and curious. These three elements are not separate—they are interwoven, each informing and feeding back into the others. Mindfulness is meeting all of our experience with wisdom and compassion. We commit to opening rather than closing, being rather than changing, engaging rather than rehearsing.

Intention

The first core component of mindfulness is intention. Intention is simply knowing why we are doing what we are doing. When we have discerned our intentions and are able to connect with them, our intentions help motivate us, reminding us of what is truly important. Discerning our intention involves inquiring into our deepest hopes, desires, and aspirations, listening deeply for the answers, and allowing them to arise organically. This deep listening, with trust in the process and the timing, allows one’s truth to emerge at its own pace. Mindful attention to our own intentions helps us begin to bring unconscious values to awareness and decide whether those values are really the ones we want to pursue.

Intention, in the context of mindfulness, is not the same as (and does not include) striving or grasping for certain outcomes for our patients or ourselves. Those who have practiced a form of mindful movement such as yoga might recognize intention as the conversation between the ideal that any one pose represents and the embodiment of that pose in one’s unique body. As Jack Kornfield puts it, “Intention is a direction not a destination” (personal communication 2012). We step readily in the direction our intention points, but we step lightly, with open eyes, ears, and heart as well as the consciousness that life has its own say in the matter (whatever the matter may be) and that there is much we have yet to learn.

Attention

The second fundamental component of mindfulness is attention. Remember, mindfulness is about seeing clearly, and if we want to see clearly, we must be able to pay attention to what is here, now, in this present moment. Paying attention involves observing and experiencing our moment-to-moment experience. And yet, this is not so easy. Recent research demonstrates that our mind wanders approximately 47% of the time (Killingsworth and Gilbert 2010). The human mind is often referred to as a “monkey mind,” swinging from thought to thought as a monkey swings from limb to limb. Mindfulness is a tool that helps us tame and train our mind so that our attention becomes stable and focused. In formal mediation practice, the breath is often treated as the anchor of our attention; we train our attention by returning the mind’s focus to the breath each time it wanders off. This practice already suggests the intimate connection between mind and body that is at the heart of mindfulness. However, other forms of mindfulness practice take the body directly as an anchor for attention, such as walking meditation in which one trains the mind to observe the movement of walking in exquisite detail.

Whatever the focus of our attention, what is essential is that the mind remains in a state of “relaxed alertness.” Often, as we try to pay attention, our attention becomes tense and contracted. This is because we mistakenly think we have to be stressed or vigilant to focus our attention in a rigorous way. However, the meditation traditions teach us of a different kind of attention, one that involves clarity and precision without stress or vigilance (Wallace and Bodhi 2006). Mindful attention is also deep and penetrating; as Bhikkhu Bodhi notes, “[W]hereas a mind without mindfulness ‘floats’ on the surface of its object the way a gourd floats on water, mindfulness sinks into its object the way a stone placed on the surface of water sinks to the bottom” (Wallace and Bodhi 2006, p. 7).

Attitude

Attitude, the third core component of mindfulness, comes into play once we have learned to intentionally pay attention in the present moment. When we do so, we may notice something: our mind is constantly judging. The attitude with which we pay attention is essential to mindfulness. For example, attention can have a cold, critical quality, or an openhearted, compassionate quality. In fact, the Japanese symbol for mindfulness combines the symbol for presence with a symbol that can mean mind, spirit, or heart depending on the context—in other words, the familiar concept of mindfulness could also be translated heartfulness. To be mindful is also to have presence of heart.

The transformation from mindless to mindful is catalyzed by the lovelight we shine on the dark corners of our inner world. If we want the bud to open, to smell, taste, live the benefits of mindful practice, the light of our own mind must be like the soft warmth of the sun. The invitation of mindfulness is not simply to pay attention, but to attend with kindness. This quality of kind attention is what brings out the best of our humanity and enhances our clinical work.

Attending without bringing the attitudinal qualities of curiosity, openness, acceptance, and love (COAL; Siegel 2007) into the practice may result in an attention that is condemning or shaming of inner (or outer) experience—our own or our client’s. This may well have consequences contrary to the intentions of the practice; for example, we may end up cultivating patterns of criticism and striving instead of equanimity and acceptance.

These attitudes of mindfulness do not alter our experience, but simply contain it. For example, if while we are practicing mindfulness impatience arises, we note the impatience and see if we can bring an energy of acceptance and kindness to the impatience. We do not try to substitute these qualities for the impatience, or use them to make the impatience disappear. The attitudes are not an attempt to make things be a certain way, but an attempt to relate to whatever is in a certain way. By intentionally bringing the attitudes of COAL to our awareness of our own experience, we relinquish the habit of striving for pleasant experiences, or of pushing aversive experiences away. Instead, we attend to whatever is here. Doing so within a context of curiosity, openness, acceptance, and love not only makes it much easier to stay present, it can also transform our capacity to foster well-being in those who seek our clinical care.

Cultivating Mindfulness

What we practice becomes stronger (Shapiro 2017). When we practice mindfulness, we strengthen our capacity to be present moment by moment in a curious, accepting, and loving way. Mindful practice can be categorized into formal and informal practice; each kind of practice supports the other. The formal practice will support the ability to practice mindfulness in day-to-day life, and informal practice is meant to generalize to everyday life what is learned during the formal practice.

Formal practices, like sitting meditation, are geared toward cultivating mindfulness skills in focused and systematic ways. These can involve relatively brief daily meditation woven into one’s day, or intensive days- or weeks-long retreats involving many hours of formal sitting and walking meditation based on centuries-old traditions. Informal practice involves intentionally bringing an open, accepting, and discerning attention to whatever we are engaged in—for example, reading, eating, dancing, or practicing therapy .

Both formal and informal practices have a role to play in clinical work. Below, we review research investigating how dance and other forms of movement when treated as informal mindfulness practice can enhance our somatic awareness, visceral awareness, and emotional coherence, in turn supporting our efficacy as clinicians. In addition to the role that mindful movement can play as a specific intervention , it is worth considering that all therapy and clinical work can be approached as informal mindfulness practice. Setting the intention at the beginning of each therapy session, each group, each clinical training or supervision to “intentionally pay attention with kindness, discernment, openness and acceptance” is a powerful and effective practice that can transform the clinical experience.

Dance as Informal Practice

Informal mindfulness practice offers one way to bring mindfulness into our day-to-day activities. Intentionally choosing activities that can cultivate mindfulness through our bodies in addition to our minds can be especially fruitful. Dance can be an informal mindfulness practice and offers a way to access our felt sense of equanimity, interconnectedness, heartfulness, and presence through the body. As Rumi says, “You dance inside my chest where no-one sees you, but sometimes I do, and that sight becomes this art” (Barks 1995).

Another benefit of choosing dance as an informal mindfulness practice is that it can explicitly help cultivate interpersonal mindfulness, as in partner dancing. Mindfulness is often narrowly conceived of as a purely intrapersonal practice. And yet, our interconnectedness as living beings is a central tenet of the wisdom traditions that inform mindfulness practice. Through the systematic cultivation of compassion, sympathetic joy, loving kindness, and acceptance, we come to understand that our sense of a separate self is an illusion that perpetuates unnecessary suffering. As Bien (2006) writes, “One great paradox of the spiritual life is rooted in the notion of nonself or interbeing: If you set out to heal the world, you will lose yourself. If you set out to heal yourself, you heal the world. The best way to take care of yourself is to cultivate…a calm, spacious, accepting, open awareness of what is happening in the impermanent, ever-changing world inside and outside our skin. By taking care of yourself in this way, you are at the same time of the most help to others” (p. 31).

Finding informal practices that help cultivate mindfulness within interpersonal relationships is important, especially for clinicians. The journey of becoming a mindful clinician is a rewarding one, but it is also of little use if we do not learn how to integrate the awareness and insights from our intrapersonal practice back into our work with clients. As Sharon Salzberg says, “The path may lead to many powerful and sublime experiences, but the path begins here with our daily interactions with each other” (Salzberg 1995, p. 171). Mindful movement such as dance not only enhances our awareness of what is happening in our own skin, but it enhances our awareness of energetic exchange between bodies in space and other forms of nonverbal communication, thus supporting our capacity as therapists to listen with our whole bodies to what is communicated by our clients.

Though psychological research on this topic is limited, research from multiple social science disciplines indicates that dance training holds the potential to encourage prosocial behavior and improve emotional coherence. Dance as a mindfulness practice offers the opportunity to experience the embodied harmony of physical and emotional expression.

Summary of Dance Research

In a study that investigated synchrony and cooperation in groups, behavioral scientists at Stanford found that “acting in synchrony with others can increase cooperation by strengthening social attachment among group members” (Wiltermuth and Heath 2009, p. 1). As Wiltermuth and Heath (2009) point out, synchronized movements including dance, chanting, singing, and marching are ancient cultural rituals that may have served an evolutionary function by promoting prosocial behavior. In experiments that required groups of three members to engage in varying degrees of synchronous and asynchronous behavior, Wiltermuth and Heath (2009) found that participants in the synchronous conditions felt more connected to their other group members, exhibited greater cooperation, and were more willing to engage in potentially costly social interaction for the collective benefit of the group (Wiltermuth and Heath 2009). Remarkably, participants in this study were merely asked to walk, march, or clap in synch, rather than more complex movements required by yoga or dance, and yet even these simple activities enhanced prosocial behavior.

In a novel mindfulness-based intervention aimed to enhance relationship quality for well-functioning, non-distressed couples, Carson, Carson, Gil, and Baucom (2004) adapted the yoga component of Mindfulness Based Stress Reduction (MBSR) to a partner format. Though the effects of this aspect of the intervention were not evaluated independent of the intervention’s other components (meditation, mindful touch, and other mindfulness skills training), a study by Carmody and Baer (2008) found that the yoga component of MBSR was associated with more changes in measures of mindfulness and well-being than body scanning or sitting meditation, providing support for the hypothesis that partner yoga may offer similar benefits to couples. For those who may not be willing to engage in a practice such as partner yoga or other practices with obvious nonsecular roots, dance may offer a rewarding and more accessible alternative.

Dance may, in fact, offer something more than partner yoga does to couples and individuals who engage in group dance classes and dance events. Haidt et al. (2008) propose that the highest levels of individual well-being require occasional opportunities to transcend the self and merge with a larger social organism. According to the hive hypothesis proposed by Haidt et al. (2008), the self—particularly the modern Western self plagued by isolating tendencies and the pressures of capitalism—poses an obstacle to the fullest realization of human happiness . In the language of mindfulness, clinging to our concept of a distinct and separate self obscures our access to the deeper fulfillment available through realizing the fundamental interconnectedness of all life. As mentioned above, the loss of self through group rituals involving dance, music , and other forms of synchronized movement is an ancient and perhaps evolutionarily advantageous facet of collective human experience. Durkheim (1915) described this phenomenon as “collective effervescence” and “considered the intense passion and joy generated by these periodic events to be essential in the long-term maintenance of a cohesive group” (Haidt et al. 2008, p. 140).

We know from positive psychology that positive emotions such as joy, connection, awe, and a sense of purpose are both indicators and causes of well-being (Shapiro and Carlson 2009). The benefits of collective effervescence may accrue to the individual directly through the cultivation of these states, or indirectly through the “social capital” and sense of belonging that engagement in collective action generates (Haidt et al. 2008). One implication among others of the hive hypothesis is that in the context of dance, synchronized styles of dance should offer greater benefits than freestyle dancing in which individuals move according to their own desires. However, the study by Wiltermuth and Heath (2009) found that large motor movements were not superior to singing alone and other subtler forms of synchronization in facilitating increased cooperation.

Furthermore, the merging of the self with a larger social organism is not the only mechanism by which dancers experience a transcendent state. As Tessa Cook, a former dancer with Nederlands Dans Theater, so eloquently expressed, “Through dancing I have experienced how fantastic it is to give. You are full of love and then you are given something, music , dance, and you are able to give that to other people. In dance you can express all your emotions . When I danced, I felt always relieved. I never needed to express myself with words” (Tessa Cook; Aalten 2004, p. 273). In an article examining embodied experiences in ballet, anthropologist Anna Aalten studied the practices, training methods, and life stories of a group of professional ballet dancers. Though in the corps de ballet, perfect synchronization is in fact a physical and aesthetic ideal, ballet is not generally conceived of as a group activity. Rather, the training and daily striving for perfection of a ballet dancer is more often compared to a lone runner racing against her own best time. And yet, her observations led Aalten to conclude that “even ballet with its technical rules and regulations… offers women the possibility to exceed the discontinuity of body, mind and emotions…In ballet women learn to control their bodies, but they also experience, even for a moment, the synchronizing of physicality, willpower and emotionality” (Aalten 2004, p. 274). This is what several dancers in Aalten’s (2004) study referred to as when “it all comes together.” Dance, as a mindfulness practice, offers us the opportunity to bridge our inner and outer worlds, to experience and embody the felt sense of interconnection between mind and body, self and other that enhances well-being and our capacity to facilitate transformation and healing in others.

Dance as Therapy

While dance has much to offer both practitioners and clients as an informal practice to cultivate mindful awareness of the body and mind, there is also evidence to suggest that it can be an effective therapeutic intervention for specific psychological disorders. Such potential can come from the evolution of somatic education and somatic therapy (Eddy 2009). As Eddy (2009) notes, “The goal of the somatic movement professional is to heighten both sensory and motor awareness to facilitate a student-client’s own self-organization, self-healing, or self-knowing” (p. 8). Among the pioneers in somatic therapies are the founders of the Feldenkrais Method and Rolfing, both alternative therapies that leverage the mind-body connection to facilitate healing. Though these approaches are not what is meant when we speak of dance as a therapeutic intervention , it is the intersection and cross-pollination of thought between somatic healers, dancers, and the world of psychotherapy that gave rise to various body-oriented psychotherapy modalities, including dance movement therapy (DMT) (Eddy 2009, p. 24; Röhricht 2009).

DMT was first founded in the 1950s by dancer and choreographer Marian Chase. By the 1970s, Chase and others had founded the American Dance Therapy Association (ADTA), and today DMT is regarded as an effective evidence-based intervention for the treatment of anxiety , depression , eating disorders, somatoform disorders, and chronic pain (Koch et al. 2014). In practice, DMT encompasses multiple dance styles and disciplines; it is not itself a unique “dance” or “technique” to be learned, but rather a process “viewing the human body as the vessel or container, and rhythmic movement as the medium, [wherein] the receptor systems—kinesthetic, proprioceptive, vestibular, auditory, visual—can be systematically manipulated for therapeutic ends” (Berrol 1992). As such, DMT practitioners work within a variety of dance styles, including modern dance, ballroom dance, social dances, and improv. Whereas in talk therapy, the client’s verbal and nonverbal communications are interpreted by the therapist in an effort to offer insight into the client’s behavioral and cognitive patterns, DMT takes movement as the source of such insight.

Mindful Dance

Though DMT could perhaps be described as a form of “mindful movement,” in practice mindfulness is not an explicit component of DMT. Likewise, “dance” has not often been incorporated into mindfulness-based interventions as a form of mindful movement. And yet, research exploring the benefits of such practices can help us understand what the union of mindfulness and dance can offer as a therapeutic intervention . In a study evaluating the effects of movement-based courses on self-regulatory self-efficacy, mood , stress, and sleep quality in college students, Caldwell et al. (2010) found that movement classes produced significant increases in mindfulness as measured by scores on the Five Facet Mindfulness Questionnaire (FFMQ). Moreover, changes in mindfulness were associated with improved mood , lower perceived stress, and better sleep quality (Caldwell et al. 2010). The movement-based courses included in the study (GYROKINESIS, Taiji Quan, Pilates) each offered an explicit component of mind-body awareness training , though the mechanisms of action by which these courses increased mindful awareness were not explored in greater depth. Nonetheless, these findings provide support for mindful movement as a possible intervention for a range of psychological disorders and as a form of self-care for practitioners.

Approaching dance as an informal mindfulness practice may significantly enhance the benefits of dance interventions , because mindfulness offers a kind, open, accepting attitude. The effects of dance on psychological well-being may be limited or confounded by the negative internal and external pressures that dancers can face at all levels. Rather than enhancing mind-body awareness, dance training can just as easily widen the gap between mind and body through the objectification of the dancer’s body as a “tool” for achieving a certain set of aesthetic and artistic ideals. In the pursuit of aesthetic ideals often at odds with the body’s natural structure and range of motion, dancers can develop harsher rather than kinder relationships to their own bodies. As neuroplasticity and mindfulness teach us, what we practice grows stronger (Shapiro 2017). Practicing dance does not promise to enhance psychological well-being if it reinforces rather than diminishes engrained habits of self-judgment, anxiety , perfectionism, and striving.

One innovative RCT sought to compare the effects of Argentine tango and mindfulness meditation to determine whether dance training could be as effective as mindfulness training in the treatment of depression (Pinniger et al. 2012). Participants were assigned to one of three groups: tango, mindfulness, and a wait-list control group. After six weeks of training , both the tango and mindfulness groups reported significant reductions in self-reported depression . However, the tango group also reported significant reductions in stress when compared to the other two groups. As Pinniger and colleagues (2012) note, “This suggests that dynamic physical activities may be more effective in reducing psychological stress than static activities such as mindfulness meditation” (p. 6). Another surprising result from the study found that the tango group reported greater increases in mindfulness than either the mindfulness or control group, suggesting that it may not be necessary for mindfulness meditation to be an explicit component of a movement practice for it to confer some of the same benefits.

A study by Sze et al. (2010) further explored the different effects of mindfulness meditation and dance, comparing experienced meditators to experienced dancers on measures of coherence between emotional experience and physiology. Sze et al. (2010) found that meditators exhibited greater levels of self-reported visceral awareness and higher levels of coherence between subjective emotional experience and heart period. Dancers displayed higher levels of coherence than did control group participants, and results for the control group were consistent with the assumption that a certain amount of coherence is built-in (Sze et al. 2010). The implication is that our inherent levels of emotional coherence may be improved by training such as dance, which tends to improve somatic awareness (muscle, tension, balance, posture), but are more likely to be maximized by training that also includes meditation’s focus on visceral awareness (breath, heartbeat). The benefits of such training offer fertile ground for future research.

The role of emotional response coherence in human relationships is the focus of a growing body of work demonstrating that “greater coherence is associated with increased positive affect and well-being” (Sze et al. 2010, p. 811). Mauss and colleagues (2011) argue that effects of emotional coherence on psychological well-being are mediated by social connectedness, a hypothesis supported by the results of a prospective longitudinal study evaluating 135 participants over a period of six months.

Benefits of Mindful Dance for Clinicians

We know that when therapists practice mindfulness it can improve patient outcomes and enhance practitioner effectiveness (Grepmair et al. 2007). Mindful movement may offer similar benefits beyond self-care that extend to patient outcomes insofar as such practices enhance qualities that are essential to effective therapy . Though this emerging field of research offers much territory yet to be explored, it suggests that movement training specifically designed to enhance both visceral and somatic awareness may not only increase positive affect, but may also improve the accuracy with which internal emotional states are communicated to others. This is especially important for those in the helping professions.

The client-therapist relationship is often described as a dance. It is an apt metaphor in that it captures the organic, unpredictable, fluid, and interdependent nature of the therapeutic relationship. As dancers must, both therapist and client are compelled to be equal partners in building the trust, intimacy, and connection that foster healing and create the art of a life well lived. It is the coming together with each other, but also with ourselves, that mindful movement offers, an opportunity to merge our inner and outer worlds—nurture the container and its contents—to achieve the integration that underlies an authentic and fulfilling life.

Future Directions and Conclusion

Expanding our understanding of mindfulness to include somatic as well as mental processes is essential. As we’ve discussed, one possible area of future exploration is to study informal practices of mindful movement. We offered dance as one such practice and reviewed the pioneering research suggesting its potential benefits for both patients and clinicians. There are a number of important future directions and research paths that merit attention in this new area.

It will be helpful to explore ways of integrating dance into already existing mindfulness-based intervention programs. It will also be helpful to develop dance-based therapies that integrate mindfulness. Future research could also investigate the impact of mindfulness and dance-based therapy on both patients and clinicians. Of particular interest is the extent to which mindfulness and dance can be used to help health professionals develop core clinical skills, and the impact on clinical outcomes. Also important is research investigating the mechanisms through which these effects occur.

Mindfulness-informed dance therapy has not been tested empirically. Studies that investigate the outcomes associated with mindful dance and other mindful movement in the therapeutic setting are needed.

Further research also needs to focus on the impact of mindful movement and mindful dance on self-care for healthcare professionals. We know that self-care is critical for health professionals, both in terms of protecting practitioners’ own health and well-being and for optimizing outcomes for patients. Accordingly, it is important to attend specifically to this dimension of clinician well-being.

The potential applications of mindful movement and dance for clinicians and patients are far-reaching. We are hopeful that continued research and exploration in this area will bring greater awareness of the richness and dimensionality of mindfulness as an embodied practice .