By Laura Rathbone
I remember the first time I ever saw contact improv, it was about 5 years ago when physiotherapist and founder of Environmental Physiotherapy Association (EPA) Dr Filip Mariç engaged in this form of dialogue as part of a talk he gave in the Netherlands and it just blew me away. He used it to demonstrate the collaborative relationship of therapy when both parties are active members in the process. It was quite a moment and I’m happy to be able to share this form with you this month.
This month we are exploring the theme: Pain and Touch
This blog is written in reference to the Humanities piece linked below:
Contact improvisation dance is a captivating and unique form of contemporary dance that emphasizes the physical connection and communication between dancers. Originating in the 1970s with Steve Paxton and Nancy Stark, contact improv is said to be in a similar style to other improv, especially the ‘Yes, and…’ style, except through touch and physical connection.
Unlike traditional dance forms that follow predetermined steps or choreography, contact improv allows dancers to explore and experiment with movement in a collaborative and creative manner. At the essence of this form of communication and dance, is deep listening. Dancers engage in spontaneous and improvised movements, constantly adapting and responding to one another's energy and touch.
Through constant touch and physical interaction, dancers develop a heightened awareness of their own bodies and those of their partners.
Affordances
Affordances, the possibilities for action that the environment offers, play a crucial role in shaping movements and interactions in contact improvisation dance. Dancers rely on their bodily sensations and instincts to perceive and respond to the affordances presented by their partners. This dynamic exchange of cues and signals allows for a co-creation of movement, enhancing creativity and collaboration in the dance. Dancers are in a deep state of working with their body in space and time, working with the usual pull and push, flow and ebb, and fluctuating tone of the body. Working with interoceptive and proprioceptive cues, as well as physical touch cues from their partner and or environment.
For those of you trained in Bobath (or NDT depending on where you were trained), you may start to see an overlap in principles and techniques, and indeed, there is a small body of work exploring the role of contemporary dance in rehabilitation. Neurodevelopmental Therapy/Treatment (NDT) is posited on the premise that usual postural reflexes are fundamental to motor programming and action performance. Contact between the therapist and the patient is often fundamental to therapy to provide touch cues and movement guidance.
Because contact improv is about facilitating movement within the constraints of your own body, listening to touch and collaborating with the laws of the physical world, that incorporates the affective element of movement, the therapeutic potential and up-training is interesting. Through the constant physical connection and shared weight, individuals can practice weight shifting, proprioception, and spatial awareness, aiding in their rehabilitation journey and are elements of an evidence-based approach to neurorehabilitation approaches. But what about pain?
This blog is not going to attempt to convince you that Contact Improv is the new best treatment approach for chronic pain. We are all a little too long-in-the-tooth for band wagons and know all too well the futility of tryng to prove that ‘one way’ of doing therapy will cure pain.
However, as I watch this and seek out other research and works looking at principles of dance applied to rehab, I do wonder if there are important principles that can inform the creation of personalised approaches to pain management and pain reduction.
MSK Physio has moved so far away from therapeutic touch with its inventions of strict and restricting manual therapy treatments and programmes, but what if we were to think about touch through a more neuro-principled perspective?
Alterations in proprioception, tactile acuity, and body awareness when experiencing chronic pain have been explored within the literature, and restorative approaches to these skills have demonstrated a potential, although limited, role in reducing pain. Much of the work focuses on restoring an accurate sense of the body in space and time and relative to the environment.
And if we allowed for the affective/motivational elements of movement and considered co-regulation and movement facilitation within neuro approaches to promote wider learning of the self and body in relation to movement and gravity?
If chronic pain can facilitate an altered sense of self, how would we go about re-learning who we are embodied in space and time, and how would we facilitate that in others?
As always, more questions than answers, but what I know in myself is that watching these dancers both inspires me to explore new areas of evidence of skills, and makes connections for me across my existing knowledge in new and very human ways.
And, my very deep hope is that you explore contact improv with someone at some point this month, just to see what else is there that you can draw upon as we keep on keeping-on supporting people with their pain.
Laura x
We’d love to read your comments and reflections around the piece and this blog, head to Ask/Share/Reflect to post your thoughts and discuss with other Pain Geeks and Super Geeks!
References and other readings:
Joung, H.J., Yang, H.K. and Lee, Y., 2021. Effect of dance on balance, mobility, and activities of daily living in adults with cerebral palsy: a pilot study. Frontiers in neurology, 12, p.663060.
Marchant, D., Sylvester, J.L. and Earhart, G.M., 2010. Effects of a short duration, high dose contact improvisation dance workshop on Parkinson disease: a pilot study. Complementary therapies in medicine, 18(5), pp.184-190.
Bjorbækmo, W.S. and Engelsrud, G.H., 2011. " My Own Way of Moving"-Movement Improvisation in Children's Rehabilitation. Phenomenology & Practice, 5(1).
Moseley, L.G., 2008. I can’t find it! Distorted body image and tactile dysfunction in patients with chronic back pain. Pain, 140(1), pp.239-243.
Bellan, V., Wallwork, S.B., Gallace, A., Spence, C. and Moseley, G.L., 2017. Integrating self-localization, proprioception, pain, and performance. Journal of Dance Medicine & Science, 21(1), pp.24-35.
Moseley, G.L., McCormick, K., Hudson, M. and Zalucki, N., 2006. Disrupted cortical proprioceptive representation evokes symptoms of peculiarity, foreignness and swelling, but not pain. Rheumatology, 45(2), pp.196-200.
Harvie, D.S., Hillier, S., Madden, V.J., Smith, R.T., Broecker, M., Meulders, A. and Moseley, G.L., 2016. Neck pain and proprioception revisited using the proprioception incongruence detection test. Physical therapy, 96(5), pp.671-678.
Pathak, A., Gyanpuri, V., Dev, P. and Dhiman, N.R., 2021. The Bobath Concept (NDT) as rehabilitation in stroke patients: A systematic review. Journal of Family Medicine and Primary Care, 10(11), p.3983.
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