Dance/movement therapy with the substance abuser

Abstract

Although much has been written in recent years about substance abuse and the importance of identifying and treating the substance abuser, little has been written about treatment of this population through dance/movement therapy. Work in this area is still new and relatively undefined although dance/movement therapy offers a highly effective and unique approach to dealing with the substance abuser’s characteristic resistance, denial, isolation, and low self-esteem. Furthermore, this nonverbal, body-oriented approach is often extremely useful in addressing the substance abuser’s characteristic lack of body awareness, identifying the underlying issues, and allowing for the safe expression of affect. For the therapist and group leader, this work is challenging, necessitating strong assessment skills and a versatile repertoire of responses. It involves identifying and understanding the defenses so often employed by the substance abuser. It demands ongoing and honest consideration of the countertransferential reactions that emerge in response to the intense rage and dependency of the substance abuser. Work with such a population can be extremely difficult and frustrating, but can be tremendously rewarding. It is also important for the clinician to approach this population with some understanding of the differing theoretical perspectives on substance abuse. There is some disagreement in the field as to the etiology and nature of the problem and its manifestations. Included in this paper is a view of the substance abuser that has been shaped by the ideas of Heinz Kohut, Jerome Levin, and Leon Wurmser among others. Their approach views addiction as a process that occurs as a result of ego deficit and internal conflict. This approach differs significantly from others, notably the disease model of addiction, which holds that substance abuse and dependence is a biologically determined disease causing both psychological changes and physiological damage. Although these viewpoints do not disagree on various traits and characteristics found in the substance abuser, they do disagree on causes. It is not within the scope of this paper to explore this disagreement. Instead, a brief theoretical perspective, based on the work of Levin and others, is presented, as well as methods and interventions used in the dance/movement therapy context. The hope is to provide a framework for understanding some of the common features observed in the population, guidance for potentially effective interventions or approaches, and a departure point for future discussion.