The Effect of Dance/Movement Therapy on Affect: A Pilot Study

Diana Brooks Arlynne Stark

This pilot study was designed to show the influence of dance/ movement therapy on affect. The hypothesis was that a dance/ movement therapy session would effect significant change in affect. The tool used to assess change was the Multiple Affect Adjective Check List (MAACL), a self-rating checklist that specifically and exclusively measures hostility, depression, and anxiety. Results showed that the dance/movement therapy session significantly effect° ed the participants' affect. Depression and anxiety were effected more than hostility. No significant difference was found between the scores of the hospitalized and nonhospitalized populations. This study sup- ports the premise that dance/movement therapy can change how people feel. Suggestions for further research studies are included.

I t is a common bel ie f among dance /movemen t the rap i s t s t h a t dance/ m o v e m e n t t h e r a p y has an impact on affect. A n u m b e r of cl inicians have

wr i t t en about the the rapeu t i c benef i t of dance /movemen t t h e r a p y in ass is t ing cl ients to be in touch wi th the i r feelings. Sandel (1980) proposes t h a t one of the t r e a t m e n t goals of dance /movemen t t h e r a p y in a psychi- a t r ic se t t ing is to assist c l ients in "express ing feel ings in an appropr ia te and channe led way" (p. 22). "Movemen t thus serves as a vehicle for in te rac t ion and the sha r ing of powerful feel ings" (p. 23).

Schmais (1974) notes t h a t ~Dance t h e r a p y is expressive. Fee l ings of guilt , overdependency and lonel iness can be too ove rwhe lming to pu t into

American Journal of Dance Therapy © 1989 American Dance Vol. 11, No. 2, Fall/Winter 1989 ] 01 Therapy Association

102 Brooks CT Stark

verbal terms but they are expressed in movement. In dance therapy the shared expression of these feelings between therapist and patients can prevent further withdrawal and isolation" (p. 11). The relationship be- tween dance/movement therapy and affect is also discussed by other dance therapists (Chace, 1975; Chaiklin, 1975; Stark, 1982). However, to date, there has been only one published study which objectively measures whether or not dance/movement therapy effected affect (Kuettle, 1982).

Since its origin, the definition of affect has been controversial. Affect has been variously defined as moods, feelings, emotions, and desires. W. W. Smith (1922), an early psychological theorist, uses the terms emotion and affect interchangeably. He compares affect and emotion to electricity and current, stating that each is needed for the other to exist, yet they are distinct. He considers emotion to be the result of a physiological response to a stimulus situation.

James and Lange in James (1910) also linked bodily change with emotion. The James-Lange theory states that the experiences, feelings or states of mind which we call emotion are caused by and dependent upon bodily changes. If there are no bodily changes and the field of conscious- ness has no sensations of endosomatic origin there can be no emotion. This is not to say that emotions have definite and persistent characters. They are related to bodily functions and changes but these are variable:

The feeling of the emotion is itself variable in different persons and in the same person at different times; yet this conclusion only verifies the fact, clear to introspection, that the same emotion may at different times include different bodily sensations (Smith, 1922, p. 21).

Arnold (1960) at tempts to integrate the field of affect which she con- siders to be vast and chaotic. She states that in the past the term affect was used %o indicate a man's reaction to anything that effects him emotionally; this includes pleasure and pain as well as love, fear, anger and other emotions" (p. 9). She contends that in order to look at affective phenomena one needs to take into account psychological, neurological, and physiological aspects. To date no single theory has adequately cov- ered all of these areas.

In reviewing past theories on the etiology of emotions, Arnold (1960) proposes three basic causes and effects: 1) perception arouses emotion and emotion then causes bodily changes, 2) perception induces bodily changes that are felt as emotion, and 3) perception arouses both bodily changes and emotion. From this background of information, she suggests yet another solution to this problem.

Emotions are aroused, not by perception directly, but by an instan- taneous appraisal of what we perceive; that emotion is a tendency to

Effect of DIMT on Affect 103

some sort of action appropriate to this appraisal, and is therefore accompanied by a pattern of physiological changes (1960, p. 169).

This approach to affect is global ra ther than linear. Izard (1979) contends that in defining an emotion one must take into account the following three aspects or components: 1) the experience or conscious awareness of the emotion, 2) the process that occurs in the brain and nervous system, and 3) the observable expressive patterns. The lat ter refers primarily to facial expressions. Izard places the study of human emotion in context by suggesting that emotions ~constitute the primary motivational system for human beings" (p. 4).

A primary principle from which dance/movement therapists work is that of mind-body integration. This principle recognizes that the mind and the body are part of the same receptive-expressive central nervous system and therefore, influence one another. Stark (1982) writes:

• . . by working with muscular patterns and focusing on the interrela- tionship between psychological and physiological processes, clients are helped to experience, identify, and express feelings and conflicts• From this kinesthetic level, individuals and groups are led to further discovery of emotional material through symbolic representations, images, memories, and personal meanings of their life experiences. (p. 3O8)

Every thought, action, memory, fantasy, or image involves some innovative muscular tension. Individuals can be helped to discover how they change, alter, direct, destroy, or control these subtle muscu- lar sensations which affect the experience or expression of feelings• (p. 311)

Berger (1972) proposes that mind-body integration occurs on many levels such as sensory, neuromuscular, and emotional• Multisensory ex- periences through the use of movement can create greater awareness of ourselves. Gustatory, olfactory, tactile-kinesthetic, visual, and auditory senses help in the reception of information from the environment. This gathering of information influences perceptions of self and others. There is a relationship formed between these external sensory perceptions, and the individual's developing psychic structures and capacity to test reality. The initial external information is carried to the brain through the central nervous system (Izard, 1979). There is the potential for internal- ization by the individual of any affective or emotional quality that has been attached to the perceptual experience. Individuals may have differ- ent affective responses in relationship to the same external sensory information• The physiology of this experience occurs in much the same way; it is the interpretation attached to it that varies from individual to individual. J. Naess (personal communication May 1, 1983) suggests tha t

104 Brooks ~ Stark

the initial level of emotional organization is both external and sensory and related to internal organs. Berger (1972) has a similar view:

From the experimental evidence, it is apparent that emotional experi- ence arises largely from peripheral stimulation which is integrated by the entire nervous system . . . . The cutaneous sensitivity of the skin, the propriocepters in the muscles as well as the interocepters of the viscera, are constantly sending impulses to the central nervous sys- tem (p. 197).

Wilhelm Reich (1942) proposed tha t muscles provide skeletal support and may serve as storehouses of emotional information and responses. Theorizing this connection, he said tha t defenses were rooted in the body as chronic muscular tension. Reich wrote tha t ~every increase of muscu- lar tonus in the direction of rigidity indicates tha t a vegetative excita- tion, anxiety, or sexuality has become bound up" (p. 46).

Chaiklin (1975) suggests tha t there is potential for self-knowledge based on experience and muscle memory. ~By working with the muscular patternings related to an emotion, the feeling itself can be experienced cognitively merely from the muscular memory of such relationships" (p. 705). Thus a person could integrate an experience and gain informa- tion from his/her body movements.

Further, Schilder (1950) proposes that movement enhances propriocep- tive information and muscular activity, particularly tension or relax- ation, and plays a large role in the process of mind-body integration.

There is so close an interrelationship between the muscular sequence and the psychic attitude that not only does the psychic attitude con- nect up with the muscular states but also every sequence of tensions and relaxations provokes a specific attitude (p. 208).

Because everyday movement and emotional expression share the same neuromuscular pathways, dance/movement therapy helps to foster affec- tive expression in a seemingly easy way (Schmais, 1985). Movement patterns which may connect directly to emotions, such as punching with anger, are often used by the dance/movement therapist to reinforce emo- tional intensity and clarify affective content. Feelings which are often denied or repressed are more safely experienced, identified, and ex- pressed in a dance/movement therapy session.

In dance/movement therapy individual affect and movement are consid- ered reflections of internal states. Stark (1982) suggests tha t awareness of affect develops in two ways:

One is by learning the correct label or word that corresponds to the emotional state. Such learning has its beginnings in infancy and early

Effect of DIMT on Affect 105

childhood. The second way is by kinesthetically recognizing and inter- preting the motor actions of others. This is known as '%inesthetic empathy" and is frequently used by dance/movement therapists (p. 312).

Both of these ways offer a continual learning process. Further, as the ability to perceive and recognize emotional states in others increases, kinesthetic empathy may occur on an unconscious level. Such empathy contributes to the verbal and nonverbal communication between people.

As information is t ransmit ted to the brain it is interpreted in various ways. The physical mode, according to Fletcher (1978), represents both tangible physical events and their psychical components as they are represented in conscious, preconscious, and unconscious functioning. It is important to note tha t a movement does not equal an emotional or affective response but movement linked with an individual's memory or experience may produce affective awareness. Fletcher states:

Frequently the different physical expressions do not have a direct equivalent relation to a given perception, thought, or feeling. The physical expression may be a response or reaction to the initial feel- ing; it may be a defense against the feeling or a transformation of it (p. 134).

Hunt (1972) expresses the importance of emotions as individualized states. She writes:

Emotion is the deepest aspect of personality. The way in which we acculturalize the energy from emotion, or the way in which we use it, has a tremendous import upon how we behave and how other people interact with us. Emotion is not general. It is highly specific for each one of us (p. 17).

In summary, emotional or affective states are based on both our behav- ior and past experiences. The expression of affect is complex. A problem arises when trying to differentiate and define affect. When asking a person to experience a feeling and represent tha t feeling through move- ment a response unique to tha t individual may be given. That response does not necessarily evolve into a universal feeling or expression but ra ther can be an interpretation or expression of tha t feeling for tha t individual. We assume the person is having an affective experience. What we cannot do is give it a clear, universal definition.

The dance/movement therapist utilizes movement as part of a process to achieve therapeutic goals. This often includes helping the client expe- rience, identify and express feeling states. The l i terature on dance/ movement therapy, suggests tha t affect is a by-product of the sessions

106 Brooks C~ Stark

and that the experience of affect is universal; all people regardless of sex, age or diagnostic category experience affective responses.

However, to date only one researcher measured affective change as a result of dance/movement therapy. Kuett le (1982) designed two studies in which feeling changes in dance/movement therapy were measured through the use of a Feelings Questionnaire. The first study involved 17 nursing students. A pre- and post-test measurement of affect was used to compare the responses. The experimental group was given a one hour dance/movement therapy session. They reported fewer feelings of anxiety and depression and greater feelings of affection and somatic distress. The last measure was seen by Kuett le as a direct result of thirst or tiredness.

The second experiment involved 40 occupational therapy students. Dance/movement therapy was compared to a verbal T-group experience. The dance/movement therapy group reported significant differences in affect, specifically ~greater feelings of confidence, affection, and somatic distress than the T-group, along with lesser feelings of inhibition and anxiety" (p. 60). The amount and type of affect differed between experi- mental and control groups.

Whereas Kuettle 's research assesses the impact of dance/movement therapy on the subsequent feeling states of normal individuals the pre- sent study asks the questions: Will dance therapy produce a change in affect and will it be the same for patients and nonpatients?

This study addresses whether or not there is a change in affect. The concern is with the element of change itself rather than change in a particular affect.

Method

Subjects

Forty subjects consisting of hospitalized psychiatric clients (20) and non- hospitalized (20) people were divided into four equal groups (10 Ss in each) - two control groups and two experimental groups. The age range for the subjects was 18 to 60 years.

The hospitalized subjects who had a variety of psychiatric disturbances, were gathered from a short-term (30-day) unit. No at tempt was made to control for a particular psychiatric disturbance or age. The non- hospitalized subjects were solicited from the neighboring metropolitan area. All subjects had to meet the following criteria:

1. There were to be no physical handicaps that would prevent subjects from participating in a dance/movement therapy session.

Effect of DIMT on Affect 107

2. The subjects needed to be ambulatory and willing to participate. 3. None of the subjects were to be involved in any other dance/

movement therapy sessions at the t ime of the study. 4. Subjects' ages needed to fall within the age range of 18 to 60. 5. Participation was voluntary and all subjects had to have been will-

ing to sign a dated individual consent form they received and read an information sheet on the protection of for human subjects.

All subjects who participated in this study were guaranteed that their rights as human subjects would be protected and that the material ob- tained from this experiment would be kept confidential. Subjects were assigned to control and experimental groups in a random fashion. No at tempt was made to match for age, ethnicity, sex, or diagnosis.

Apparatus

The instrument used for this study was the Multiple Affect Adjective Check List (MAACL) (Zuckerman & Lubin, 1965) which was designed to measure affect as a state ra ther than a specific personality trait. The MAACL was selected because it was the only psychological test which met the following criteria: 1) The test is easily administered in a short period of t ime (10 minutes); 2) subjects with a variety of characteristics and controls (e. g. hospitalized psychotics, out-patients, veterans, college students) have been tested using this instrument; and 3) The scores can be analyzed statistically. In addition the MAACL measures the affects of anxiety, depression, and hostility. In this study affect is defined as feel- ings, emotions or mood.

The MAACL has been used in correlations with the Taylor Manifest Anxiety Scale, the MMPI, and other measures of personality trait. There are two forms to the MAACL, the ~Today" form and the ~General" form. In the "General" form the subjects are instructed to describe how they generally feel. In the ~Today" form the subjects are instructed to check the adjectives that best describe how they feel at the moment. For this study the '~Today" form was chosen as it could measure the immediate effects of a single dance/movement therapy session. In addition, Zucker- man & Lubin (1965) indicate that the ~Today" form has a test-retest reliability for psychiatric patients.

A number of research studies lend support for the use of the MAACL. Zuckerman and Biase (see Zuckerman & Lubin, 1965) indicated that age and educational background variables had no significant difference in the test scores of drug abuse patients, psychiatric patients, college stu- dents, and job applicants.

Zuckerman and Lubin (1965) reported significant results when the MAACL was used in correlations with the Taylor Manifest Anxiety Scale

108 Brooks CT Stark

(MAS) and the MMPI (subjects included college students, psychiatric patients, high school students, and normal males). In almost every in- stance correlations with the Taylor MAS and the MMPI was significant.

Procedure

Hospitalized and nonhospitalized subjects participated in the experiment one week apart in the same location on the same day of the week and at the same time of day. A dance/movement therapist who did not know the purpose of the study conducted the dance/movement therapy groups with the hospitalized subjects and with the nonhospitalized subjects.

The following procedure was followed on both days. The subjects were taken into the room where the dance/movement therapy sessions were to be held. They read and completed the information sheet for the protection of human subjects and signed the individual consent forms. Then, the MAACL was then administered to the participants. This checklist takes no more than 10-15 minutes to complete. After gathering the consent forms and the MAACL, the dance/movement therapist gave a brief lec- ture on dance/movement therapy. After this, half the subjects were asked to leave the room, thus randomly forming the control group. The control group went to the hospital lounge where they sat and relaxed until it was t ime to take the post-test, one hour later. A dance/movement therapy session was conducted with the other half experimental-group using a Chacian model of developing the group's themes and at tending to group process. At the end of each dance/movement therapy session all partici- pants were reunited and again took the MAACL. After completion of the post-test, the participants were thanked and dismissed.

Results

Because the MAACL does not yield one overall score, the subject had six scores, a pre-test and a post-test score for the variables of anxiety, depres- sion, and hostility. A two-factor analysis of variance was done for each of the three scales. There were no significant main effects for the hospital condition (control and experimental groups on any of the scales for anxi- ety, depression, and hostility (Table I).

For the dance/movement therapy (movement treatment) condition, however, there was a significant difference between the hospitalized and non-hospitalized subjects for anxiety and depression (F(1, 36) = 13.77, 20.41.

Effect of DIMT on Affect 109

Table 1 Analys is of Variance

Source of Sum of Degree of Mean Probability Variance Squares Freedom Square F (P)

Change in Anxiety

(H) 180.625 1 180.625 3.04 .0899 (M) 819.025 1 819.025 13.77" .0007 (HxM) 50.625 1 50.625 .85 .3623 Error 2140.500 36 59.45833

Change in Depression

(H) 4.225 1 4.225 .08 .7740 (M) 1030.225 1 1030.225 20.41"* .0001 (HxM) 27.225 1 27.225 .54 .4674 Error 1817.100 36 50.475

Change in Hostili ty

(H) 67.600 1 67.600 .91 .3470 (M) 280.900 1 280.900 3.77 .0599 (HxM) 57.600 1 57.600 .77 .3849 Error 2679.800 36 74.43889

(H): Hospital Condition (M): Movement Treatment (HxM): Interaction

*p ~.0007 **p ~ .0001

The statistical interactions of the three scales were not significant (Table 2). However, the movement t rea tment did show reliability in terms of influencing the affects of anxiety and depression. All partici- pants in the dance/movement therapy sessions showed a decrease on depression and anxiety scores.

Discussion

The results of this study support the hypothesis that dance/movement therapy effects change in affect as measured by the MAACL. There was no significant difference in scores between the hospitalized and non- hospitalized groups. When reviewing the scores for each affect some interesting pat terns emerged. Scores on the anxiety measure changed the most. This may be indicative of the test situation itself, in that the subjects' knowledge of their participation in a research study created an elevated pre-test score for anxiety. For the hospitalized group, the mean

1 10 Brooks ET Stark

Table 2 2 x 2 Factorial Design Table of Means

Change in Anxiety, Depression and Hostility Scores

Anxiety Depression Hostility

Movement Control Movement Control Movement Control

Hospitalized 8.60* - 2.70 8.50 - 3.30 1.50 - 6.20 (9.77)** (6.99) (8.72) (5.83) (9.19) (8.45)

2.95 2.60 2.35

Nonhospitalized 10.60 3.80 7.50 1.00 1.70 - 1.20

(6.31) (7.31) (6.75) (6.79) (7.30) (9.40) 7.20 3.25 .25

Marginal 9.60 .55 8.00 - 2 . 1 5 1.60 - 3.70 Means

* f distribution ** mean

score was in what Zuckerman & Lubin (1965) consider within the normal range for an expected exam. However, it is interesting to note that the nonhospitalized experimental group became less anxious than the hospi- talized group. This result might occur as Zuckerman & Lubin suggest, because the "Today" anxiety measure for psychiatric patients is more generalized than for normal subjects. In fact, normal subjects' anxiety scores seem to fluctuate ~'in response to environmental stresses while the patient 's anxiety is a response to persistent internal conflict" (Zuckerman & Lubin, 1965, p. 15).

The depression factor scores showed more change in the hospitalized than in the nonhospitalized subjects. This may lend support to the prem- ise that dance/movement therapy increases one's energy level and assists in the activation and mobilization of clients. Similarly, this may also help to explain the higher incidence of change in the hostility scores for the nonhospitalized Ss. While dance/movement therapy certainly seems to help energize and mobilize, it may be less problematic for the non- hospitalized to express hostility.

A major shortcoming of this study is that there was only one dance/ movement therapy session for each group. Another is that the authors did not control for all variables. It might be useful to approach future re- search in several stages. First, one might use the same testing format but extend the experiment over several weeks or months. Consideration would need to be given as to whether to use the "General" form of the MAACL instead of the "Today" form. Second, one could consider measur- ing the degree of change occurring over time. As the MAACL does not do this, another test would need to be found. Third, testing changes in affect for different diagnostic groups would assist clinicians in determining

Effect of DIMT on Affect 1 1 1

which clients or which affects would be most amenable to therapeutic change.

In addition to this, there were some limitations concerning matching of subjects and the self-selection of the control and experimental groups. Some confounding variables were the percentage of men to women (ap- proximately 25% male and 75% female), the medication tha t some of the hospitalized group was on, and the different educational and cultural factors that occur when randomly selecting subjects. All of these should be controlled more carefully should another study be undertaken.

Whereas this study provides a basis for comparing scores between the movement t rea tment and the control condition, fur ther research is needed using control groups engaged in different activities such as exer- cise, verbal therapy, music, etc. This would control for the specific ele- ments in dance/movement therapy. Obviously, a larger sample size would be a requirement. It might also be useful to compare different therapeutic modalities (e.g., art therapy, music therapy, with dance/movement ther- apy to help determine which ones most influence which affects.

This pilot study measured only short-term changes in affect. The au- thors' hope that future studies will include temporal factors as well as the other variables mentioned. What is shown in this study is that dance/ movement therapy has a significant effect in influencing affect of hospi- talization and nonhospitalized subjects.

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