Elsevier

The Arts in Psychotherapy

Volume 75, September 2021, 101822
The Arts in Psychotherapy

Emerging wisdom through a traditional bon dance in group dance/movement therapy: A single case study of dementia

https://doi.org/10.1016/j.aip.2021.101822Get rights and content

Highlights

  • Dance/movement therapy can reveal the latent wisdom of elders with dementia.

  • A sense of oneness based on a relational sense of self characterizes group DMT in Japan.

  • A single case study focusing on the therapist's bodily experience was conducted.

  • Kinesthetic empathy and the felt sense can be used as frameworks for data analysis.

  • Traditional dance music that symbolizes people's daily lives can encourage spontaneous movement.

Abstract

The cultural and aesthetic rationale for utilizing a traditional dance form in dance/movement therapy (DMT) dementia research has not been articulated. Moreover, the geo-transcendent and invariant aspects of psychological functioning often referred to as the wisdom of elders, have been little studied in dementia care. This single case study explored the benefits of a Japanese traditional bon dance that inherently symbolizes Japanese cultural ideals, focusing on a female participant with Alzheimer’s dementia. Attention was given to the manifestation of her wisdom. The data were extracted from 43 group sessions conducted over a period of two years and three months in a group home for older adults with dementia. These were analyzed using a combination of constructs: kinesthetic empathy, a hallmark of DMT, and the felt sense, a Focusing technique. Of cultural significance was the spontaneous creative expression that was observed paradoxically in the structure of choreographed dances. The expression of wisdom was witnessed in the participant’s caring gestures towards one’s body and the community, with humor. An embodied relational understanding of the participant’s condition enabled a high level of empathy between the therapist and client. Implications for using traditional dances in DMT with elders with dementia are discussed.

Introduction

The purpose of this case study was to explore the benefits of the use of traditional bon dance in dance/movement therapy (DMT) for Japanese elders with dementia in relation to the manifestation of their wisdom. DMT is an embodied and artistic psychotherapeutic approach whose theories and techniques were developed and manualized in North America and Western Europe (Chang, 2016; Dosamantes-Beaudry, 1999; Machida, 2004). Yet, much of the philosophical underpinnings of DMT’s view of an integrated mind-body-spirit, that holds contrary to Cartesian dualism, is inherent in Japanese culture. Care must be given to culturally congruent aesthetics in DMT with those who embody and enact worldviews that may diverge from European-North American normative standards. In Japanese culture, wisdom is perceived to encompass both cognitive and affective dimensions of being wise and knowledgeable, but more importantly, discreet (Takahashi, 2000). To date, no research has been conducted on how DMT affects the wisdom of elders with dementia. For this study, the authors examined two key cultural features: (a) the nonverbal expression of wisdom; and (b) the implications of using a traditional folk dance. The data were analyzed using a combination of constructs: kinesthetic empathy, a hallmark of DMT, and the felt sense, a Focusing technique. This analysis process highlighted the relational significance of a Japanese dance/movement therapist’s body. The investigation of a Japanese culture-based intervention and analysis method that accesses the therapist’s embodied knowledge using a DMT lens is an important step to develop culturally relevant DMT knowledge.

Section snippets

Background and context

Dementia encompasses neurological symptoms of decline and loss that manifest in a variety of ways including physical and cognitive abilities, social roles, social connection and familiarity. According to a report by the International Association of Alzheimer’s Diseases (ADI) (2015), the world’s dementia population is projected to increase to 74.7 million by 2030 and to 131.5 million by 2050. In Japan, where the population of elders is particularly large, the prevalence of dementia in the total

Method

This study adopted a single case study design in order to examine the words and behaviors of a single participant in detail. Clinical psychology research in Japan has placed great emphasis on case studies (Iwakabe, 2015; Kawai, 2001; Yamamoto, 2018). Specifically, with the exception of behavior theory approaches, the emphasis has been on understanding the client through focusing on the relationship between the client and the therapist and interpreting the inter-subjective experiences that

Findings

Table 2, Table 3, Table 4 summarizes the secondary data obtained from a total of five analyses in six steps. Table 2 shows the notes of the researcher’s felt sense during the movement (step 3). Table 3 shows the notes of the researcher’s felt sense while watching the video (step 4). Table 4 shows the researcher’s empathic understanding for Analyses 1–5 (step 6).

Some of Emiko’s movements were characteristic of those with impaired visual-motor function and a narrowing of the visual field, such as

Discussion

This study showed that the wisdom of elders with dementia can come alive through DMT, and that traditional dance forms that symbolize cultural ideals, combined with the sensory and relational skills of the therapist, are useful for this purpose. In this model of DMT practice using traditional dances, spontaneous creative expression was seen paradoxically in the structure of choreographed dances. Given the Japanese participants’ desire to engage in spontaneous, dynamic movement while culturally

Funding

This study was funded by JSPSKAKENHI Grant Number 18K02599-3 and supported the author’s research presentation at the 2019 Research and Thesis Poster Session of the 54th Annual Conference of American Dance Therapy Association.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Declaration of Competing Interest

The authors declare that the authors have no conflict of interest.

Acknowledgements

This study is part of a dissertation submitted by the first author to Gakushuin University, Japan. We would like to thank the group home residents and staff for their participation. A big thank you to Kalila Homann for her insightful comments and suggestions on this practice and the poster presentation for this study.

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