Movement Therapy

Definition

Movement therapy refers to a broad range of Eastern and Western movement approaches used to promote physical, mental, emotional, and spiritual well-being. Some forms of movement therapy that combine deep-tissue manipulation and postural correction with movement education are also known as bodywork therapies.

Origins

Movement is fundamental to human life. In fact movement is life. Contemporary physics tells us that the universe and everything in it is in constant motion. We can move our body and at the most basic level our body is movement. According to the somatic educator Thomas Hanna, "The living body is a moving body—indeed, it is a constantly moving body." The poet and philosopher Alan Watts eloquently states a similar view, "A living body is not a fixed thing but a flowing event, like a flame or a whirlpool." Centuries earlier, the great Western philosopher Socrates understood what modern physics has proven, "The universe is motion and nothing else."

Since the beginning of time, indigenous societies around the world have used movement and dance for individual and community healing. Movement and song were used for personal healing, to create community, to worship, to ensure successful crops, and to promote fertility. Movement is still an essential part of many healing traditions and practices throughout the world.

Western movement therapies generally developed out of the realm of dance. Many of these movement approaches were created by former dancers or choreographers who were searching for a way to prevent injury, attempting to recover from an injury, or who were curious about the effects of new ways of moving. Some movement therapies arose out of the fields of physical therapy, psychology, and bodywork. Other movement therapies were developed as way to treat an incurable disease or condition.

Eastern movement therapies, such as yoga, qigong, and t'ai chi began as a spiritual or self-defense practices and evolved into healing therapies. In China, for example, Taoist monks learned to use specific breathing and movement patterns in order to promote mental clarity, physical strength, and support their practice of meditation. These practices, later known as qigong and t'ai chi, eventually became recognized as ways to increase health and prolong life.

Benefits

The physical benefits of movement therapy include greater ease and range of movement, increased balance, strength and flexibility, improved muscle tone and coordination, joint resiliency, cardiovascular conditioning, enhanced athletic performance, stimulation of circulation, prevention of injuries, greater longevity, pain relief, and relief of rheumatic, neurological, spinal, stress, and respiratory disorders. Movement therapy can also be used as a meditation practice to quiet the mind, foster self-knowledge, and increase awareness. In addition, movement therapy is beneficial in alleviating emotional distress that is expressed through the body. These conditions include eating disorders, excessive clinging, and anxiety attacks. Since movements are related to thoughts and feelings, movement therapy can also bring about changes in attitude and emotions. People report an increase in self-esteem and self-image. Communication skills can be enhanced and tolerance of others increased. The physical openness facilitated by movement therapy leads to greater emotional openness and creativity.

Movement therapy is being studied more intensively as a useful adjunct to rehabilitation programs for victims of stroke or spinal cord injuries. Actor Christopher Reeves, who was paralyzed in a 1995 accident just below the two top vertebrae in his neck, has recovered feeling throughout most of his body and can even take small steps in a swimming pool. Reeves credits his improvement, which many doctors considered impossible, to exercising five hours every day. Some neuroscientists are studying Reeves and other patients with spinal cord injuries to test the hypothesis that movement itself can cause damaged nerves to regenerate.

Another important benefit of movement therapy that is increasingly recognized by mainstream as well as alternative practitioners is social support. Many people, particularly those suffering from depression related to physical illness or other forms of stress, find that taking a yoga class or other group form of movement therapy relieves feelings of loneliness and isolation. People who have taken therapeutic riding have reported that the positive relationship they develop with their horse helps them relate better to other animals and to people.

Description

There are countless approaches to movement therapy. Some approaches emphasize awareness and attention to inner sensations. Other approaches use movement as a form of psychotherapy, expressing and working through deep emotional issues. Some approaches emphasize alignment with gravity and specific movement sequences, while other approaches encourage spontaneous movement. Some approaches are primarily concerned with increasing the ease and efficiency of bodily movement. Other approaches address the reality of the body "as movement" instead of the body as only something that runs or walks through space.

The term movement therapy is often associated with dance therapy. Some dance therapists work privately with people who are interested in personal growth. Others work in mental health settings with autistic, brain injured and learning disabled children, the elderly, and disabled adults.

Laban movement analysis (LMA), formerly known as Effort-Shape is a comprehensive system for discriminating, describing, analyzing, and categorizing movements. LMA can be applied to dance, athletic coaching, fitness, acting, psychotherapy, and a variety of other professions. Certified movement analysts can "observe recurring patterns, note movement preferences, assess physical blocks and dysfunctional movement patterns, and the suggest new movement patterns." As a student of Rudolf Laban, Irmgard Bartenieff developed his form of movement analysis into a system of body training or reeducation called Bartenieff fundamentals (BF). The basic premise of this work is that once the student experiences a physical foundation, emotional, and intellectual expression become richer. BF uses specific exercises that are practiced on the floor, sitting, or standing to engage the deeper muscles of the body and enable a greater range of movement.

Authentic movement (AM) is based upon Mary Starks Whitehouse's understanding of dance, movement, and depth psychology. There is no movement instruction in AM, simply a mover and a witness. The mover waits and listens for an impulse to move and then follows or "moves with" the spontaneous movements that arise. These movements may or may not be visible to the witness. The movements may be in response to an emotion, a dream, a thought, pain, joy, or whatever is being experienced in the moment. The witness serves as a compassionate, non judgmental mirror and brings a "special quality of attention or presence." At the end of the session the mover and witness speak about their experiences together. AM is a powerful approach for self development and awareness and provides access to preverbal memories, creative ideas, and unconscious movement patterns that limit growth.

Gabrielle Roth (5 Rhythms movement) and Anna Halprin have both developed dynamic movement practices that emphasize personal growth, awareness, expression, and community. Although fundamentally different forms, each of these movement/dance approaches recognize and encourage our inherent desire for movement.

Several forms of movement therapy grew out of specific bodywork modalities. Rolfing movement integration (RMI) and Rolfing rhythms are movement forms which reinforce and help to integrate the structural body changes brought about by the hands-on work of Rolfing (structural integration). RMI uses a combination of touch and verbal directions to help develop greater awareness of one's vertical alignment and habitual movement patterns. RMI teacher Mary Bond says, "The premise of Rolfing Movement Integration … is that you can restore your structure to balance by changing the movement habits that perpetuate imbalance." Rolfing rhythms is a series of lively exercises designed to encourage awareness of the Rolfing principles of ease, length, balance, and harmony with gravity.

The movement education component of Aston-Patterning bodywork is called neurokinetics. This movement therapy teaches ways of moving with greater ease throughout every day activities. These movement patterns can also be used to release tension in the body. Aston fitness is an exercise program which includes warm-up techniques, exercises to increase muscle tone and stability, stretching, and cardiovascular fitness.

Rosen method movement (an adjunct to Rosen method bodywork) consists of simple fun movement exercises done to music in a group setting. Through gentle swinging, bouncing, and stretching every joint in the body experiences a full range of movement. The movements help to increase balance and rhythm and create more space for effortless breathing.

The movement form of Trager psychophysical Integration bodywork, Mentastics, consists of fun, easy swinging, shaking, and stretching movements. These movements, developed by Dr. Milton Trager, create an experience of lightness and freedom in the body, allowing for greater ease in movement. Trager also worked successfully with polio patients.

Awareness through movement, the movement therapy form of the Feldenkrais method, consists of specific structured movement experiences taught as a group lesson. These lessons reeducate the brain without tiring the muscles. Most lessons are done lying down on the floor or sitting. Moshe Feldenkrais designed the lessons to "improve ability … turn the impossible into the possible, the difficult into the easy, and the easy into the pleasant."

Ideokinesis is another movement approach emphasizing neuromuscular reeducation. Lulu Sweigart based her work on the pioneering approach of her teacher Mabel Elsworth Todd. Ideokinesis uses imagery to train the nervous system to stimulate the right muscles for the intended movement. If one continues to give the nervous system a clear mental picture of the movement intended, it will automatically select the best way to perform the movement. For example, to enhance balance in standing, Sweigart taught people to visualize "lines of movement" traveling through their bodies. Sweigart did not train teachers in ideokinesis but some individuals use ideokinetic imagery in the process of teaching movement.

The Mensendieck system of functional movement techniques is both corrective and preventative. Bess Mensendieck, a medical doctor, developed a series of exercises to reshape, rebuild and revitalize the body. A student of this approach learns to use the conscious will to relax muscles and releases tension. There are more than 200 exercises that emphasize correct and graceful body movement through everyday activities. Unlike other movement therapy approaches this work is done undressed or in a bikini bottom, in front of mirrors. This allows the student to observe and feel where a movement originates. Success has been reported with many conditions including Parkinson's disease, muscle and joint injuries, and repetitive strain injuries.

The Alexander technique is another functional approach to movement therapy. In this approach a teacher gently uses hands and verbal directions to subtly guide the student through movements such as sitting, standing up, bending and walking. The Alexander technique emphasizes balance in the neck-head relationship. A teacher lightly steers the students head into the proper balance on the tip of the spine while the student is moving in ordinary ways. The student learns to respond to movement demands with the whole body, in a light integrated way. This approach to movement is particularly popular with actors and other performers.

Pilates or physical mind method is also popular with actors, dancers, athletes, and a broad range of other people. Pilates consists of over 500 exercises done on the floor or primarily with customized exercise equipment. The exercises combine sensory awareness and physical training. Students learn to move from a stable, central core. The exercises promote strength, flexibility, and balance. Pilates training is increasingly available in sports medicine clinics, fitness centers, dance schools, spas, and physical therapy offices.

Many approaches to movement therapy emphasize awareness of internal sensations. Charlotte Selver, a student of somatic pioneer Elsa Gindler, calls her style of teaching sensory awareness (SA). This approach has influenced the thinking of many innovators, including Fritz Perls, who developed gestalt therapy. Rather than suggesting a series of structured movements, visualizations, or body positions, in SA the teacher outlines experiments in which one can become aware of the sensations involved in any movement. A teacher might ask the student to feel the movement of her breathing while running, sitting, picking up a book, etc. This close attunement to inner sensory experience encourages an experience of body-mind unity in which breathing becomes less restricted and posture, coordination, flexibility, and balance are improved. There may also be the experience of increased energy and aliveness.

Gerda Alexander Eutony (GAE) is another movement therapy approach that is based upon internal awareness. Through GAE one becomes a master of self-sensing and knowing which includes becoming sensitive to the external environment, as well. For example, while lying on the floor sensing the breath, skin or form of the body, one also senses the connection with the ground. GAE is taught in group classes or private lessons which also include hands-on therapy. In 1987, after two years of observation in clinics throughout the world, GAE became the first mind-body discipline accepted by the World Health Organization (WHO) as an alternative health-care technique.

Kinetic awareness developed by dancer-choreographer Elaine Summers, emphasizes emotional and physical inquiry. Privately or in a group, a teacher sets up situations for the student to explore the possible causes of pain and movement restrictions within the body. Rubber balls of various sizes are used as props to focus attention inward, support the body in a stretched position and massage a specific area of the body. The work helps one to deal with chronic pain, move easily again after injuries and increase energy, flexibility, coordination, and comfort.

Body-mind centering (BMC) was developed by Bonnie Bainbridge Cohen and is a comprehensive educational and therapeutic approach to movement. BMC practitioners use movement, touch, guided imagery, developmental repatterning, dialogue, music, large balls, and other props in an individual session to meet the needs of each person. BMC encourages people to develop a sensate awareness and experience of the ligaments, nerves, muscles, skin, fluids, organs, glands, fat, and fascia that make up one's body. It has been effective in preventing and rehabilitating from chronic injuries and in improving neuromuscular response in children with cerebral palsy and other neurological disorders.

Continuum movement has also been shown to be effective in treating neurological disorders including spinal chord injury. Developed by Emilie Conrad and Susan Harper, continuum movement is an inquiry into the creative flux of our body and all of life. Sound, breath, subtle and dynamic movements are explored that stimulate the brain and increase resonance with the fluid world of movement. The emphasis is upon unpredictable, spontaneous or spiral movements rather than a linear movement pattern. According to Conrad, "Awareness changes how we physically move. As we become more fluid and resilient so do the mental, emotional, and spiritual movements of our lives."

More recently, a form of movement therapy that involves horses has gained fresh attention. It is variously known as therapeutic riding or equine-assisted therapy. Therapeutic riding originated with a Swedish horsewoman who lost her ability to walk when she contracted polio in 1946, and was determined to recover by returning to horseback riding. She eventually won a silver medal in the 1952 Olympics. Therapeutic riding programs allow persons with physical, psychological, or learning disabilities to gain self-esteem and social growth as well as improved balance, body awareness, and physical strength.

Such Eastern movement therapies as yoga, t'ai chi, and qigong are also effective in healing and preventing a wide range of physical disorders, encouraging emotional stability, and enhancing spiritual awareness. There are a number of different approaches to yoga. Some emphasize the development of physical strength, flexibility, and alignment. Other forms of yoga emphasize inner awareness, opening, and meditation.

Precautions

Persons who are seriously ill, acutely feverish, or suffering from a contagious infection should wait until they have recovered before beginning a course of movement therapy. As a rule, types of movement therapy that involve intensive manipulation or stretching of the deeper layers of body tissue are not suitable for persons who have undergone recent surgery or have recently suffered severe injury. With regard to emotional or psychiatric disturbances, persons who are recovering from abuse or receiving treatment for any post-traumatic syndrome or dissociative disorder should consult their therapist before undertaking a course of movement therapy. While movement therapy is often recommended as part of a treatment plan for these disorders, it can also trigger flashbacks or dissociative episodes if the movement therapist is unaware of the client's history. It is always best to consult with a knowledgeable physician, physical therapist, or mental health therapist before a course of movement therapy.

Research & general acceptance

Although research has documented the effects of dance therapy, qigong, t'ai chi, yoga, Alexander technique, awareness through movement (Feldenkrais), and Rolfing, other forms of movement therapy have not been as thoroughly researched.

Training & certification

Training and certification vary widely with each form of movement therapy. Many approaches require several years of extensive training and experience with the particular movement form. Movement therapies that are also considered forms of bodywork have an umbrella national certification board, listed below under Resources. Therapeutic riding programs are accredited by the North American Riding for the Handicapped Association (NARHA), which also credentials riding instructors.

BOOKS

Halprin, Anna. Dance as a Healing Art: Returning to Health Through Movement and Imagery. Life Rhythm, 1999.

Hartley, Linda. Wisdom of the Body Moving: An Introduction to Body-Mind Centering. Berkeley, CA: North Atlantic Press, 1995.

Knaster, Mirka. Discovering the Body's Wisdom. New York, NY: Bantam Books, 1996.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part I: Sound Mind, Sound Body. New York: Simon & Schuster, 2002.

PERIODICALS

Bagnall, A. M., P. Whiting, R. Richardson, and A. J. Sowden. "Interventions for the Treatment and Management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. (Effectiveness Bulletin)." Quality and Safety in Health Care 11 (September 2002): 284-288.

Batty, G. David, and I-Min Lee. "Physical Activity for Preventing Strokes: Better Designed Studies Suggest That It is Effective." British Medical Journal 325 (August 17, 2002): 350-351.

Cottingham, John T., and Jeffrey Maitland. "Integrating Manual and Movement Therapy With Philosophical Counseling for Treatment of a Patient With Amyotrophic Lateral Sclerosis: A Case Study That Explores the Principles of Holistic Intervention." Alternative Therapies Journal (March 2000): 120-128.

Crandall, Melissa. "Healing Horses." ASPCA Animal Watch 22 (Winter 2002): 21-25.

Shute, Nancy. "A Super Feeling." U. S. News & World Report, September 23, 2002, 58.

Stanten, Michele, and Selene Yeager. "Kinder, Gentler Workouts: These No-Sweat Exercises Offer More Than Just Relaxation." (Fitness News). Prevention 54 (July 2002): 74-75.

Vidrine, M., P. Owen-Smith, and P. Faulkner. "Equine-Facilitated Group Psychotherapy: Applications for Therapeutic Vaulting." Issues in Mental Health Nursing 23 (September 2002): 587-603.

ORGANIZATIONS

American Yoga Association. <www.americanyogaassociation.org.>.

Canadian Taijiquan Federation. P.O. Box 421, Milton, Ontario L9T 4Z1. <www.canadiantaijiquanfederation.ca>.

Feldenkrais Guild of North America. 3611 S.W. Hood Avenue, Suite 100, Portland, OR 97201. (800) 775-2118 or (503) 221-6612. Fax: (503) 221-6616. <www.feldenkrais.com>.

The Guild for Structural Integration. 209 Canyon Blvd. P.O. Box 1868. Boulder, CO 80306-1868. (303) 449-5903. (800) 530-8875. <www.rolfguild.org.>.

International Association of Yoga Therapists (IAYT). 4150 Tivoli Avenue, Los Angeles, CA 90066.

North American Riding for the Handicapped Association (NARHA). P. O. Box 33150, Denver, CO 80233. (303) 452-1212 or (800) 369-RIDE. <www.narha.org>.

Patience T'ai Chi Association. 2620 East 18th Street, Brooklyn, NY 11235. (718) 332-3477. <www.patiencetaichi.com>.

Qigong Human Life Research Foundation. PO Box 5327. Cleveland, OH 44101. (216) 475-4712.

The Society of Teachers of the Alexander Technique. <www.stat.org.uk>.

The Trager Institute. 21 Locust Avenue, Mill Valley, CA 94941-2806 (415) 388-2688. Fax: (415) 388-2710. <www.trager.com.>.

OTHER

National Certification Board for Therapeutic Massage and Bodywork. 8201 Greensboro Drive, Suite 300. McLean, VA 22102. (703) 610-9015.

NIH National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse. P. O. Box 8218, Silver Spring, MD 20907-8218. TTY/TDY: (888) 644-6226. Fax: (301) 495-4957. Web site: http://www.nccam.nih.gov.

Linda Chrisman

Rebecca J. Frey, PhD