Podcast Transcript

Episode 63: Healing Through Movement: The Power of Dance/Movement Therapy in Eating Disorder Recovery with Sara Earl, MS, NCC, R-DMT

[Bouncy theme music plays.]

Sam: Hey, I’m Sam.

Ashley: Hi, I’m Ashley, and you’re listening to All Bodies. All Foods. presented by The Renfrew Center for Eating Disorders. We want to create a space for all bodies to come together authentically and purposefully to discuss various areas that impact us on a cultural and relational level.

Sam: We believe that all bodies and all foods are welcome. We would love for you to join us on this journey. Let’s learn together.

Sam: What is dance movement therapy? Can moving our bodies help us feel and process our emotions? Can movement help us reconnect with ourselves? And can it actually help someone recover from an eating disorder? Who better to answer these questions than Renfrew’s registered dance movement therapist, Sarah Earle. Sarah is also a national certified counselor, primary therapist, and Assistant Clinical Program Manager at Renfrew’s Residential Treatment Program in Philadelphia, Pennsylvania. She has been doing this work for over two decades, and her clinical experience includes working with anxiety, depression, complex medical conditions, chronic pain, and now, of course, eating disorders and their co-occurring diagnoses.  She strives to reconnect people to their bodies, offer multi-dimensional awareness gleaned through movement, and remind every body of the inherent joy of dancing.  In this episode, Sarah truly captures the magic of dance movement therapy and why it’s such a powerful tool for those struggling with an eating disorder.  We’ll explore the concept of embodiment and discover how Sarah creates a safe, non-judgmental space for healing. We’ll even get a sneak peek into what a typical movement group looks like at Renfrew and how this type of therapy can help us break through the emotional walls many of us have built around ourselves. If you’ve ever felt disconnected from your body or maybe even intimidated by the idea of dance or movement, stick around. This conversation is going to open your eyes to the healing power of dance movement therapy, and reveal how it can reconnect us with ourselves  and others  in ways you may have never considered before.

Hello and welcome back to another episode of All Bodies. All Foods. I’m Sam and I’m here with Ashley and we’re very lucky today to have our dance movement therapist here with us, Sarah Earle. Welcome to the show.

Sara: Well, thank you for having me. I’m so excited to be here.

Sam: So we would love to learn more about you. You work at Renfrew. You’re a dance movement therapist. You’ve been helping out patients for so long now. What led you to Renfrew and the eating disorder field? And did you always know that you wanted to be a dance movement therapist?

Sara: Such a good question. So I have to start back when I was three years old and  I had these really incredibly smart parents who enrolled me in a ballet class  and it’s a little bit like learning a language. You know, if you learn French when you’re little, you’re really good at French. And so I think just by having those really early experiences, right, that language is just a part of who I am. And I think I had to learn that I wanted to be a mover forever because, you know, I was at a ballet company and that probably tells you a lot right there about where some of my interests in eating disorders came from, right? Because I was really subjected to a lot of those factors that can lead to an eating disorder. And so I kind of grew up in that culture, and there’s only so long really that you can do that before you kind of, you know, age out of that kind of intense activity. And so when I got to college, I had to start thinking about what do I want to do for a living? And so, I, you know, of course everybody’s like, what can I do to make money? Right? So I ended up actually going into visual communications. I found myself like sitting at a computer all day long, really still. Right? And I was just remembering thinking, how do people do this? Like, how do you sit still all day? Because I have all this in my body, right. This kind of language in my body that I’m not getting to use. So I remember at that point thinking I need to go back to doing some movement.  I think when the spark really hit me was when I found a Nia class. I don’t know if you’ve ever heard of Nia, but it’s a, it’s a kind of holistic version of fitness,  very mind-body, and when my first teacher walked in the room,  she walked in the room like a Panther. So in her body and so animalistic and sensual and just like owning it that I was like, “oh, I want that.”  And so that’s really when I decided that I’m going to be a mover. And so I taught Nia for a very long time. And as I was teaching and aging, my classes were becoming more therapeutic.  I had people in the room that were cancer survivors and Parkinson’s patients and people with chronic pain and so that kind of really led me to this place of dance movement therapy. So from there, I studied health laying  and  dance movement therapy. And my first job was down the road from Spring Lane, and I remember that I was in school and I was doing this internship and I was reading Susan Kleinman’s writing.  And Susan is at Coconut Creek and she’s really the first one to really marry dance movement therapy and eating disorders. And she’s been our most prolific writer about it too,  for a long time.  And so I’ve got, you know, Susan Kleinman and Renfrew in the back of my head and then I’m driving by Spring Lane every day on the way to work thinking, “oh, there’s that place, right?”  The magnet kept growing, you know, every day. so one day I just let, well, go look at the, you know, the job listings and there it was and the rest is history.

Sam: Wow. That’s awesome. That’s such a cool story.

Sara: It’s like magic.

Sam: I’m so curious to hear more about your experience in ballet. You know, there are people listening who are probably thinking, “wait, is being in ballet a risk factor for an eating disorder?” And I think it surprises a lot of people that certain sports, certain types of dance, especially any kind of sport with a lean aesthetic, any kind of weight sensitive type activity, these can be risk factors. And I would love to hear a little bit more about your experience.

Sara: It’s so different now, you know, than when I first started ballet. I mean, I think that so many ballet teachers and so many dance teachers are really waking up to this idea that we don’t all have to look the same and that we don’t have to look like that to be able to dance, that we all have that ability to express how we feel in movement and so there’s,  I think there’s even more of an attempt really for people to offer different kinds of techniques. I mean, ballet is still very much about the line and you know, that  there is a lot of pressure around body type. And I think that’s why it is still connected to eating disorders.  But also I think that the person who’s in charge really has the ability to frame that differently.  So there’s a different way to talk about bodies and movement that wasn’t  possible  when I was doing  it.

Sam: Yeah.  Sara, what would, for any dance instructors out there, what would your guidance be around switching that language?

Sara: Yes, we can change this.  We all have an inherent ability to move our bodies to rhythm and an expressive and artistic and pleasurable way, both, you know, in terms of being the mover and being  the observer, right? We can expand the idea of what that looks like.

Ashley: I love that because I think about folks in, you know, different sized bodies  and I’ll speak to my own experience. I grew up going to magnet schools when I was younger. So the particular school, they like focus on different things and the particular system that I went through was all arts magnet.  So every year from fifth grade until my senior year, we would have 12 weeks of dance, 12 weeks of theater, 12 weeks of art and things like that.  And hearing that language shift, I’ve always  kind of existed in a larger body.  And so there were sometimes with some teachers that I didn’t feel welcome necessarily,  you know, I couldn’t, there were, you know, those cute little like ballet skirts that you can wear with your leotard. Sometimes I couldn’t even wear those because they didn’t,  you know, fit my body. And so, but then there were teachers that I could, and like there were teachers that were inclusive of all body shapes and like anybody can move this direction and anybody can do this, and that gave me so much freedom and really what’s, I guess, like security, like, “oh, hey, I can get involved with this. It doesn’t matter that my body doesn’t look like some of my peers. I can still do this and have fun.”

Sara:  Yeah, and there’s the essence of what dance movement therapy does in the environment of an eating disorder or hospital, right? Like, we don’t all have to do it all the same way resonates in so many ways. Including how we move through the world. 

Ashley: Sara, so can you take us to the basics of what dance movement therapy is and kind of also help us understand maybe what it’s not and how it’s related to exercise or not? I feel like this concept of exercise there’s so many  thoughts  and feelings behind it, especially when we’re working in the eating disorder world. So yeah, I’ll just kind of put that big question out there.

Sara: Yeah, that is a big question. Well, we, you know, we have a, the professional organization of the  dance movement therapist at the American Dance Therapy Association, and we have a definition, right? Which is, I’m going to read it to you. Psychotherapeutic use of dance movement, body awareness, and embodied communication to foster healing and wellness for individuals, families, and communities.  So that’s kind of the standard definition.  So that being said, I will say that there is a lot of misunderstandings about what it is. I think that when you say that in your mind’s eye, people might be seeing dance class, or aerobics, or  sometimes people think it’s going to be physical therapy. So it’s really the focus is  on  emotional awareness and expression, right? So it’s kind of a matter of where the focus is with that, and going back to this, what you were saying about exercises that, you know, movement is a huge umbrella. Movement means so many things like it  can even just mean the way we breathe.

Ashley: Yeah, certainly.

Sara: It can be that nuanced.  And then exercise is really just one little silo under that umbrella.  And I think of exercise as being this intention to get stronger in some way. So maybe we want to build muscle or maybe we want to increase the, you know, our ability to have stamina when we, you know, do certain activities. And there’s a gamut right all the way from elite athletes down to just, you know, folks who want to build bone density, right? So movement means a lot to us, and sometimes people kind of get stuck on that word dance.  But I want to emphasize that really we’re talking about this whole umbrella, all the ways that we move.  And I know we’re probably going to talk about this later, but that really comes into play when we start talking about doing it at the residential level of care, which is, you know, the world that I live in. 

Ashley: Well, I was going to say to that. So you said like movement means a lot, right?  I would say that to the providers, but then also for the clients that come in.  The word movement can mean, I mean, there can be so many connotations attached to that. So it sounds like it would be really cool actually to be able to offer this at a residential level where there may be some really strong, like fearful, I would say, attachments to the word movement. Or this attachment to, “I have to keep doing this, I have to do this so much,” you know?

Sam: Yeah, like a compulsion almost.

Ashley: Yeah, like a compulsion.

Sara: Yeah, for sure. I think that’s, you know, the word dance also can be like that. Because it’s what I look like,  and that’s, really where we’re kind of pivoting, right, is that it’s not at all what we look like. It’s more about what we feel like. Kind of dancing from the inside versus this performative thing where we’re having to do it for other people. And it’s tricky at the residential level of care, right? Because of that, what you were talking about, that compulsion and sometimes people that are here are like really movement restricted. And so it’s both, you know, exciting and challenging to talk about that here because there is a lot of, a lot of feelings about movement and bodies and the mix, for sure.

Sam: Yeah. Yeah. Emotionally charged words, definitely in the eating disorder realm.  So how exactly can dance movement therapy help someone with an eating disorder? There might be people listening. They’re like, “what does our body have to do with our emotions? What does, you know, what does the body have to do with eating disorders, you know, moving the body?”

Sara:  You know, it’s all the same stuff. It’s all about avoidance and it’s all about approach and you know, on some level, can we even go beyond approach into curiosity? So it’s just about bringing the body into the mix, right? We spend a lot of time talking about our thoughts and our feelings and, you know, we talk about sensations a lot from a talk point of view, right? But dance movement therapy is where we actually go there and spend time in our body. I mean, how do you start talking about  embodiment until you’re actually like spending some time there with your body?

Sam: Right, right.

Sara: Yeah. So that’s what’s a little bit different about it, you know, is that it’s really experiential and through movement, we’re talking about a lot of the same ideas, right? And so, yeah, but there’s some, there’s some unique things about it too.  You know, we’re using space. We’re not going to sit down necessarily.  We will sit down if that’s kind of what’s called for in the moment, but we can use the space. We can use the idea of time.  So how long does it take to do that movement? Or do we do that movement quick? And what is that quality? And how does that relate to what we’re thinking and feeling?  We use a lot of like moving together.  So when someone is engaged in a movement, we might reflect that,  that sense of togetherness is a nonverbal activity as well.  We use rhythm.  This idea that that can be organizing and regulating and can just help us feel grounded.  Research about the value of rhythm, which is something that comes into movement and also through the music sometimes that we use. We use a lot of active imagination. And so when we’re moving, right, we’re thinking about what’s going on here, right? Because there’s something happening.  There’s something salient happening going on in our thoughts or our memories or the images or, you know, whatever is bubbling up. We use a lot of kind of really bringing the authentic self into relationship, right? Which is something that’s really lovely to do non-verbally, right? So we’re just here together  as ourselves.  So we have some kind of unique healing processes that we get to use because we’re not sitting down and we’re really paying attention to the signals that we’re feeling in our own bodies and what’s reflecting off of ourselves, right? 

Ashley: Yeah. Is that concept embodiment? Is that what you would describe as embodiment?

Sara: Yes. That’s huge.  Big umbrella, right?

Ashley: Yeah. Another big umbrella.  I’m just curious how?  So like, we can explain these concepts, but I’m thinking about somebody that has been just so disconnected for whatever reason. Like this sounds like it could be very big for them to just even just sit in this space, like you said, just sit in this space with the other people.  When  you’re trying to teach someone what it’s like to  be in their body, to just kind of exist,  like what are some of the, I guess, the barriers, so what do they have to overcome in order to kind of like  get into that space where they can  open up and be available to what you’re teaching?

Sara: Yeah. So we’re going to meet them where they’re at, right?  You know, we’re going to start very small and very slow, and part of the thing about dance movement therapy is that we’re watching for what the read is on the body. And we’re using that information that we’re sensing to check out what’s going on, you know, so it can be very interactive.  And this idea that we want to find that place of comfort first, so for a lot of people with eating disorders, they aren’t very comfortable being in their heads, right? So maybe that’s we’re going to start. Maybe we’re going to start with words. Maybe they’re more comfortable in one part of the room. So really finding out what the comfort level is, it’s different with individuals and groups, right? And then asking them, it’s a lot like exposure therapy, right? In what way can you stretch a little bit, can you put yourself into a little bit of discomfort?  Do we need to come back for comfort? And can we kind of do that in small growing ways over time? Can we spend more and more time with our body? Or maybe we can just kind of notice a little bit what it feels like to be in our neck or our fingers, right? The working from the outside in. And there’s a lot of like, you know, don’t do anything that doesn’t feel right to you, right? And that permission to adapt, right? If they’re, the group is doing something that they don’t want to do and they don’t feel comfortable doing, there’s always this implicit permission that they can wait it out or they can adapt. 

Sam: So that really encourages them to get in touch with their own needs  every moment of the group.  And what I’m hearing is that these groups, dance movement therapy, a lot of it is about improving your awareness  of what’s happening in your body every given moment. Yeah, and people might be thinking, again, what does that have to do with eating disorders? And what I would say to that, is connecting with your body is a huge part of the work because we’re asking our clients to start checking in with their hunger cues, their fullness cues, what’s happening in their body emotionally? Are there any signs that they’re feeling something emotionally? What is their body telling them in that moment?  So movement, dance movement therapy sounds like a way to really practice  getting in touch with what your body is telling you. 

Sara: So that’s well said. I like to think of it sometimes as a dynamic three-point check. What am I sensing in my body now? What am I sensing in my body now? What am I sensing? And, you know, and if I do that enough then I create a new habit, then I can become embodied. I can live in my body. 

Sam: Right. And so for people listening, they’re like, “what’s a three point check?” So we do this thing at Renfrew where it’s a way to organize what you’re feeling. It’s your thoughts, your sensations, and then your urges and your behavior. So those are the three points. And when you go into a dance movement group, it’s all about getting in touch with the sensations, what’s happening in the body.

Sara: Yes, and we like to think of it as bottom up processing. We’re not going to remember what happened just before lunch and try to remember what we were thinking, right? We’re moving our body, and as we’re doing that, there are things that are happening in my subconscious that are going to bubble up. Right? So that kind of awareness, so the sensation awareness, but also the awareness of what’s happening as I move is the salient work is going to show up, right? Kind of in a bottomup way.

Sam: Right. So I’m also curious about body image and how dance movement therapy might help people  who  are really struggling with body dissatisfaction or really struggling with really intense body image issues, even body image distortion. How might dance,movement therapy help with that?

Sara: Yeah. That idea of a body image is something that it’s really hard for me to get my head wrapped around because to me that’s such a cognitive process.  Like I’m walking through the world in this constant objective projection of what I look like, right? It’s like a triangle, right? You’re never really just focusing on what it feels like, right? So in a way I want to say forget about body image, right? And just live in your body, right? Like just be there.

Sam: Just be there.

Sara: Just be there.

Ashley: What a concept. Wow.

Sara: I know, but it’s really hard. I know.

Sam: I know. Yeah. It is hard. It’s such a shift, but that is such a good point that body image is cognitive, meaning a lot of it are just the stories we tell ourselves and the comparisons we make in our head all the time.

Sara: Yeah, what I’m seeing and what I’m taking in from the inside is not the same as what I’m sensing.

Sam: What I’m sensing.

Sara: Right? And I know we have a big definition of body image, but I feel like the words still matter. This idea of image, it’s like a snapshot in time, right? Very two dimensional, and we’re not like that. We have volume, right? And we can move in three dimensions, right? And so I like this idea of embodiment as an alternative to that concept because it’s just, it’s so different, right? I’m not a picture. I’m not a reflection in the mirror. I’m so much more than that.

Ashley: Yes.  I love that. We have volume. That feels so good to me.

Sara: Yeah.  It’s interesting too, because it shows up in groups that there’s this kind of predisposition to move in this really like X, Y space. And the idea that you might approach someone in the Z dimension, right? It just like, we have to kind of work towards that. What does it feel like to move towards something or away from something, right? That we have this third space available to us. Yeah.

Sam: And the idea of using space and taking up space can be really hard in eating disorder recovery because a lot of times there is sort of this belief at the root of the eating disorder that “I have to stay small in this world. I have to stay small and I can’t take up space and I need to be quiet and I can’t use my voice.” And dance movement therapy is a chance to literally expand your body and take up that space in the room.

Sara: And it’s interesting to me too, because that’s like a flip, right? Like we think of those as being, you know, metaphors that we imprint onto the body, but in a lot of ways it’s really the other way around, right? It’s this idea that taking up space is the body word and the metaphor is actually in the thinking process, if that makes sense. Same thing with the gut reaction, you know, that’s a body phenomenon, right? And we think of it as a metaphor for the body, but it’s the other way around, right? It starts with the body.

Ashley: Sara, are you familiar with who Amy Cuddy is and the power poses? Have you heard of them?

Sara: I haven’t heard the name, but I know about power poses.

Ashley: OK. Yeah. So Amy Cuddy was one of the researchers that really dug into power poses and gave a TED talk about it and specifically talked about how people would change their body, and then how the changing of their body, the way they positioned it, to be either open and powerful  or closed in and small,  how that literally had a direct effect on how they interviewed at different jobs,  and so giving folks the experience to expand and feel what it’s like to be in their body. I mean that can give them so much, you know?

Sara: Yeah. I don’t know if you guys, I know you know the name, the woman who wrote The Wisdom of the Body. She has a new book at Hillary, name escaping me.  Okay. It might come up later, but she’s just written a new workbook and there’s a page in the workbook about that. Like, if you feel creatively stuck, can you wiggle around? Will that help, right?  So that that’s one of those fundamental ideas around dance movement therapy, right, is that you can use the body to shift the mood and you can actually see the shift of mood on the body, right? We’re one unit. This thing’s all connected.

Sam: Yeah. So the book is the wisdom of your body, Hillary McBride.

Sara: Yes, thank you. 

Sam: Thanks for that resource.  Yeah, we teach all the time at Renfrew, I mean, the three component model is one of the first tools we give.  And part of teaching that is that all of this stuff is connected. Your thoughts are connected to your sensations and your sensations are connected to your urges and your thoughts are connected to your urges. And it just goes on and on. And to have a group like Dance Movement Therapy where you can really test that out, you know, to really experiment what happens to my thoughts when I change what I do with my body, what happens to my urges when I change what I do with my body. I mean, what an amazing way to experiment with how, you know, how those things are connected.

Sara: And this idea of alternate action is a beautiful fit with dance movement therapy, right? Can you actually imagine yourself doing something different? And then can you play around with what it looks like to actually do it in time and space. Yeah.

Sam: Very cool.  So at Renfrew at the residential level, you run movement groups. Would you be able to walk us through how you might lead a typical movement group? I would love to hear more about this.

Sara: Yeah, for sure.  So one of the things that’s really unique about what I do here is that the groups are not sequential. So every group is a new group of people. Some of them maybe have been in group before.  Some of them have never experienced it before. And so everything is a little bit like starting over. I’m really turning it on before they even walk in the room. Like, am I in my body, because I want my body to demonstrate what it looks like to be in it. And then, you know, as they walk in the room, I’m already thinking, doing some assessment work around, you know, what might be happening for this person, what might be happening for that person.  If I see somebody that’s been in the group before that kind of knows the deal, I’m like making a mental note that that person might be a helpful role model during the group. But they come in and so I’ve already kind of, I already know what’s in the mix because I’ve got that turned on. We have words for that, we call that attunements. I’m sure that gets used in a lot of approaches.  And this idea of a somatic countertransference, right, is that I’m reading that with my body. 

Sam: Okay, so you’re in touch with your own body because that’s giving you information about what someone else might be feeling in their body.

Sara: I mean, I’m sure that we’re all doing that. All clinicians are doing that all the time, right? Kind of checking in on this intuitive level. But for us, we have a vocabulary, right, and training for how to work with that. They come in the room and a lot of times they’ll sit on the floor. We don’t have chairs. This is the movement room here. We don’t really have chairs, but we have chairs for people if they want it. I’m telling them, make yourself comfortable. It’s already starting, right? Like, what do you need? What is your body telling you? How do you want to address that? We have pillows, we have blankets. Are you too hot? What can I do to adjust the temperature? We’re already working on that sense of comfort and acknowledging the signals that our bodies are telling us.

Sam: Yeah, that awareness.

Sara: Yeah. And then I’ll give a kind of a brief introduction about what we’re going to do just to dispel some of the fears that we’re not going to be doing aerobics, right? We’re not going to be doing physical therapy, that something different is going to go on and that I really am trying to tell them right there that we’re going to co-create something, you know, that this is not me in charge. All of us are going to make something totally unique together, right? And I don’t know what’s going to show up. We’re just going to go with it. So we’ll start with a gesture. A lot of times I like to say for really early groups, I’ll just say offer a gesture of hello. I’m going to get something pretty traditional. Hello or hello or even hello. All kinds of different things. And then sometimes I’ll throw something really weird in like, you know, hello,  right? Give them a little permission, right?

Sam: You’re just like, so just for our listeners, you’re like shrugging your shoulders as a hello, like something that someone probably wouldn’t usually do. But let’s go with it. Yeah.

Sara: Yeah. So it’s okay to be creative. It’s okay to be expressive, right? There’s no, you know, we’re not going to put a lot of limits to that kind of work. And then we’ll do a little warmup and I, you know, I’ll start it off. I’m usually doing a lot of talking in the beginning, cause that’s what people are comfortable with. And then we’ll warm up, you know, we’ll kind of like attend to what our body needs to warm up.  I’ll ask for, you know, where do you feel like you need that right now? You know, maybe somebody wants to do a little side stretch, you know, and letting that be okay as we transition into  what we call the theme of the group. And that’s that co-creating part. People will do something that’s a little bit different maybe within the rest of us and I’ll pick up on that and we’ll go with that for a while and then there’ll be something else across the room and we’ll go with that. And sometimes I’ll stop everybody and I’m like, what are you noticing or what’s showing up for you or what’s happening right now to try to encourage them to really grab on to what that thought that’s coming up or that feeling that’s in the room for them. And it’s really interesting because that’s where a lot of the symbolism will come in. I’m thinking about a time that we all,  we were putting things into the middle and  it turned into like this sparkly pink slime and  we stirred it together. And then I asked them, what do you want to do with that? And they wanted to drink it, right? It was just like, we made this healing elixir, right? Which is this great opportunity to kind of like express those feelings of how hard it is to be in treatment and you know, what an instant fix might feel like, you know? And then we’ll close it, you know, we’ll kind of come back together, have a little conversation and opportunity to share anything that felt poignant or challenging. You know, what questions might you be leaving here with? And a gesture of goodbye. And a lot of times too, at that point, I like to ask them if you were going to name that group, you know, by way of summary, what would you name that group? You know, we’ve had like ‘frogs under the sea.’ Yeah. All kinds of things.

Ashley: I love this so much. It sounds like something I wouldn’t get involved in. 

Sam: It sounds very soothing and it sounds safe, like such a safe place to be when, especially when you have an eating disorder where it often feels so unsafe to be in your body, to finally have a space where you feel like you can be together with people and just, there’s no right or wrong. You can just be right

Ashley: Or just move and be.  So it does feel safe and for those who may be intimidated by it, how do you start with them? How do you move with them? How do you support them?

Sara: Yeah, I mean, again, it’s patient-led. It’s what’s your goal. And that idea that we can come back to a comfortable place. Watching and suggesting and checking in, you know, when I can see the discomfort, I can offer the opportunity to come back into something smaller or maybe go to my toe, right? Cause my toe feels, you know, like a safe place for me to be right now. Whereas I don’t want to talk about my heart right now. You know, I want to talk about a different thing. And really just focusing on strengths. What can you do?  What feels like approachable and comfortable and something that I can have some success at.

Sam: It’s reminding me of neurodivergent folks who often talk about how much they struggle with identifying what they’re feeling in their body. It’s like they might have a therapist who asks them, where do you feel that emotion in their body? And they’re thinking, “I have no idea.” How would you support a neurodivergent client who might come into the group thinking, “I don’t know why I’m here because I don’t know what I’m feeling in my body at all.”

Sara: Well, that is one of the challenging things around it is trying to put words on the feelings, right, and put words on the sensations. So I just take the pressure off. I mean, one of the ideas in dance movement therapy is you might not actually have to verbalize it. Maybe just having that experience is enough. I think, you know, one of the beautiful things about it is that it does take some of the pressure off of having to put words around everything.

Sam: What a relief for so many people who might worry that there’s some kind of expectation where they have to, you know, verbalize what they’re experiencing.

Ashley: Yeah, they can just practice noticing or you use the word getting curious earlier and it probably does feel really good for you to say to them, “it’s okay, you don’t have to put words to that. Just be curious about it, just notice it.”

Sara: I think about a dance movement therapist that I know who worked with a gentleman on hospice and they never said a word to each other. They just took walks together.  And that idea of just being together and how therapeutic it is just to be kind of met, held, right? Without having to talk about it. I think so much about that here because we have four groups a day and they’re all talking groups.  And by the end of the day, right, like maybe I need a break from talking. Maybe I need to do something where I don’t talk. 

Sam: Yeah. I mean, sometimes I’m thinking back to my own therapy where sometimes the most therapeutic moments is when your therapist just sits there with you and lets you just cry or feel or be and those moments are so powerful. And I think sometimes we forget how therapeutic it can be just to exist in the same space with someone who is just holding that space for you.

Sara: Yeah. And we’re really acknowledging what’s happening in our body because really there’s a lot going on.   There’s all kinds of things being traded in that moment, right? And it sounds, you know, kind of hoo-hoo, but  you know, we know all of these finding the neuroscience are kind of like slowly proving, right? The idea that we have mirror neurons, right? That we can sense each other’s emotions without having to necessarily put words to it. 

Sam: Oh, absolutely.

Sara: And move our body in a certain way and that helps us calm down.  Yeah.  So much going on even in the quiet. 

Sam: Absolutely. I think, you know, those things are starting to catch on a bit. I see a lot of things online on social media about,  you know, ways to regulate your nervous system. That’s really a hot topic right now. And rhythm and movements and dance and all of these things are coping skills when we’re feeling dysregulated. And I do think it’s becoming a little more mainstream than maybe when I grew up, that really wasn’t something I was aware of as a child. I really didn’t realize how regulating movement can be to our nervous systems, but all of this is backed by research, which is so cool.

Sara:  I’m thinking about all of it as sensory, right? It’s all kind of activating that lower brain that we have to turn on our parasympathetic system, right? It’s all sensory, it’s all body-based. I mean, even the way that we see, the way we take information in through our vision, through our hearing, that’s a body base, that’s a sensorial process.

Sam: So we talked about what a group might look like. I know sometimes you’ll do individual work with people. So what does dance movement therapy look like one-on-one? 

Sara: They’re coming in with their own agenda, right? And so they’re wanting something, they come in wanting something. And so we really start there, and I think that just kind of like focuses the session more on what I’m looking for and what kinds of things I might offer as alternatives. Sometimes it looks like, well, a couple of examples maybe for our compulsive exercisers, sometimes we’ll divide the room in half. And this is what it feels like when we’re doing that thing that we do, right? Faster, stronger, better, harder, longer, you know, more, more, more, more, more. And then this side of the room is, what is the opposite of that looks like. We just kind of like go back and forth between sides of the room, kind of identifying what our thoughts are saying, what we might be sensing in our body, what our urges feel like, right? So we could do something that’s a little bit more of a bridge between like a talking and a moving. And then, you know, we might put music on and just kind of play and have some fun and feel free and have a good time and laugh and play. And right. It’s there’s quite a range of what might show up, but it’s guided by, you know, what they’re what they’re needing or what they’re asking for.

Sam: Yeah, I love that. It gives so much voice and choice in the session, and that can be so empowering.  I mean, to have a therapist as you ask you, what are you needing and wanting out of this?

Ashley: Okay, Sara. So thinking about eating disorders, thinking about Renfrew and the work that you’ve done over the years, is there a particular eating disorder that dance movement therapy works best with or a co-occurring disorder? You know, we see a lot of anxiety, depression, OCD here too. Or is there even a better place in the treatment process where we can incorporate dance movement therapy.

Sara: I’m biased on where. I think it looks different at different places along the spectrum. And what it like in the residential slice versus what it might look like, you know, down the road is very, very different.  You know, when they’re first here and we’re working on motivation, I feel like that’s where we could be talking about comfort.  It’s kind of a, you know, when there’s a lot of malnourishment in the mix, right, then it looks a little bit different. It might just be sitting with like, you know, maybe some self-compassion.  And so, you know, it starts to look a little bit different as things progress. I have groups that I lead with our E stage people, which are a little bit, I would say a little bit more about just tuning in. 

Ashley: And E-stage is the first.

Sam: The engaging stage. engaging stage. So working on motivation, working on awareness, all of those fundamental skills. 

Sara: Early recovery. And then, you know, we go to A and T stage, which is acquiring and transforming. These are folks that have been here for awhile. They kind of know this foundational set of skills and they’re beginning to learn skills that take us into the discomfort a little bit more. Then what we start doing is we’re, we’re doing a little bit more enacting of the skills. So we’re actually like taking this vocabulary that we’ve learned, and playing with it a little bit and more structured kinds of activities. So we might walk an arc. You might actually walk through a behavior across the room. So if that’s childhood and this is forever, right,  can you walk through that decision that you made? What would it look like before treatment and what is it going to look like after treatment?

Sam: Oh, wow. I didn’t even realize that was possible. Our ARC for folks out there listening, it’s a tool that we use to help people become more aware of their patterns.  And the ARC stands for antecedents, so sort of like what triggered it on, then Response, and then the C is for consequences. And oftentimes we’ll have patients fill these ARCs out so that they can really get to know themselves and really understand how their patterns play out and how those patterns get reinforced. And then in dance movement therapy, you actually have them act it out.  Wow. 

Sara: Or we might take the shape of an emotion that we would rather avoid, and kind of practice approaching it and living away.. We might really just kind of notice what’s coming up.  I’m trying to think of some of the other things. Yeah. But you get the gist. It’s kind of the, you know, how do we take these things and make them experiential to seal that. I think to put it in our bodies.

Ashley: This just feels so cool to me. It just makes me think like, like talk therapy is great, right? Talk therapy is awesome.  And it is so cool  when you can get in these spaces and really allow your body to get in these spaces because so much of what we process, like you said, Sara is sensory. It’s not just like, we’re not just in our heads all the time. Our bodies are taking on energy and we’re feeling things and hearing things. And  it could be clothing, it could be the weather, it could be all sorts of stuff. So being able to process our experience via literally moving our bodies just sounds so cool.  I want everybody to do this. 

Sara: Closest we can get to real time, right? Yeah. And we love to work with talk therapists. In fact, I do a lot of talk therapy myself, right? But it’s a good thing to put in the midst, right?

Sam: Absolutely. I would love to hear a little bit more about, I know we’re running out of time. So I did have this one question about acceptance and commitment therapy, because I you’re also a fan of that modality. And I was just wondering, how do you incorporate acceptance and commitment therapy into dance movement therapy.

Sara: So for me, it’s conceptual, right? Like act is about the idea that we have a self that’s so much bigger than our thoughts and our desires and our, even our body, right? That we have this kind of underlying, you know, sense of who we are. To me, the body kind of meshes with that idea a little bit. And the other thing that I like about  ACT is that we don’t have to litigate our thoughts, right? They’re there.  It’s okay. We can let them go by. We can say, thank you, brain, right? Because we’re more than that. It just, conceptually, it’s a good fit with bringing the body, and ACT does this physicalizing, has a physicalizing piece where you take emotional material and you externalize it as a way to kind of be able to get curious about it a little bit differently. And so that’s another good fit for me in terms of these two theories.

Sam: Yeah. There seems to be  a lot of practice  in dance movement therapy with noticing and accepting and just existing without judgment.  And that is really such important work, especially early on in treatment and as you continue the journey. So what a beautiful modality to practice those things.

Sara: We have evidence that people have been dancing to express themselves, to celebrate the seasons, to process their emotions and loss for like 9,000 years.

Ashley: I was going to ask Sara real quick, because I know we’re running out of time, is there a cool  success story or what have you found to be rewarding in this work when you’ve seen somebody lean into this, especially somebody that was maybe intimidated  or kind of nervous of  getting in touch with themselves?

Sara: You know what I love about it is the group synchrony. I do this Friday. It’s my favorite day. We do a Friday afternoon group. And really, the goal is just to release stress.  And there’s a mix of folks, there’s people that have come and it’s their favorite group and they come every Friday and then there’s people who have never done it before. We just kind of like slowly build to this place where they’re just having fun, know, they’re just  playing, they’re being silly,  judgment leaves the room.  You know, they’re just having a good time. Sometimes we bring out scarves and we do, and it’s just really lovely to watch them play. Right? To go into that state of joy, you know? Yeah. So that’s what’s rewarding is to see the group really doing that together. It’s just, it’s hard to put into words.

Ashley: Yeah.  And what freedom that is that somebody can exist in play and not feel trapped, I would say, in the constant yucky thoughts that they may have otherwise experienced.

Sara: Yeah. You can just give them a little taste of what’s possible. Right?

Sam: Yeah, right. What a break from the inner critic that tortures them all day in eating disorder recovery. Sara, what advice would you give someone who  might be on the fence about trying dance movement therapy? What do you hope they hear from this episode?

Sara: It’s you know, we’re whole beings, right? Sometimes we can be scared or intimidated of what about what we might find in our bodies. But really that’s where we find our sense of wholeness and who we are, right, is to bring that with us.  And that, you know, really develop trust in ourselves means, you know, having trust in our bodies also.

Ashley: I love that. Sara, thank you so much.  This has been just so lovely to, yeah, to speak with you and to learn a little bit more about dance movement therapy

Sara: Thanks for having me!

Ashley: Absolutely! And we want to say thank you to our listeners as well. Thank you for being here with us and learning with us today. We appreciate it.

Ashley: Thank you for listening with us today on All Bodies. All Foods. presented by the Renfrew Center for Eating Disorders.

Sam: We’re looking forward to you joining us next time as we continue these conversations.

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