A dance to the music of time

In our dance class one woman has bone-thin legs.

Another has a purple bruise on one side of her face. A third is shivering although the room is warm and a fourth is dancing in platform shoes. Tables and chairs are stacked around us.

We are in the dining room of H1, the hospital ‘detox’ unit of Holloway Prison, and the dancers are all women going through withdrawal from heavy drugs or alcohol or both.

The UK’s escalating drugs problem continues to alarm the authorities. While treatment orders or rehabilitation are being considered as an alternative to prison, prison staff, including nurses, are caught in the crossfire of society’s confusion about whether to punish or to heal.

Within the caring approach, our work suggests that dance therapy can play a useful role.

We have been running classes at Holloway twice weekly for over two years. The format is simple. We start with a warm-up, standing or seated depending on the health of the group, before teaching a short contemporary/jazz routine. We follow it by relaxation, lying on mats on the floor and end with a group karaoke.

With substance misuse it is the body that is abused, often repeating a history of early damage. Dance therapy helps to remedy this through listening to the body and giving it gentle exercise and care.

The aim is to raise self-esteem through an improved relationship with the body, giving women the strength to help combat their habit.

Calling the women by their first names and treating them with respect is an important first step. Providing a safe space and a non-judgemental atmosphere in which ailments and problems can be voiced gives the women a nourishing physical experience - if only for an hour - without drugs.

One in five people arrested in Britain are on heroin, and most of the women in H1 are charged or convicted of theft.

Some have also turned to prostitution to raise cash for drugs. They are aware of the irony of being punished for the symptom rather than being treated for the cause of their addiction. ‘They never ask you why you take the stuff in the first place, ’ one young woman told us. Histories of childhood abuse, neglect, domestic violence and rape slip out between the shoulder roll and the neck stretch.

When the women arrive at our classes their wounds, hidden and visible, are apparent. Their faces range from handsome to haggard, but they look malnourished.

Sometimes they are wearing the skimpy trousers and glamorous tops they were arrested in. After distressing experiences in police stations or court they are in shock to find themselves in detox, the first port of call for declared drug users.

We see women going through various stages of detox, usually via methodone. They are remarkably stoical considering that prison inevitably deprives them of normal hospital conditions and their dignity. Their extreme life situations have left them well-versed in the art of survival.

Withdrawal from heavy drugs is worse than the most debilitating flu. The women feel cold and cannot sleep.

They vomit and sweat and have diarrhoea. They feel suicidal and cry for their children being looked after by others or in danger of being put into care. Often they have recent physical injuries.

When the women who have volunteered or been chosen for our class come into the room some are very open and friendly; others are depressed or argumentative, dying for a fag, nauseous, mouthy and sometimes abusive. Most are in pain. Yet they usually find the courage and goodwill to take part with spirit, enjoyment and humour.

What can dance therapy offer?

The literature testifies to the success of dance movement therapy in a variety of settings, including psychiatric units.

1 As well as triggering memories of earlier, healthier body experiences, there are other positive side-effects: a short phase of energetic movement allows the women to relax more fully, and learning exercises for legs and back can help to relieve the aching which often accompanies withdrawal.

The starting point for the sessions is the women themselves, and dance therapy can be tailored to different personalities and problems. Many of the women are rave veterans; some have trained in dance, while others claim to have two left feet but move beautifully. We get away from the ‘physical jerks’ mentality and encourage them to treat their bodies gently rather than pushing them.

We use our collaboration as co-leaders to offer physical models of co-operation and mutual support: leaning, supporting, making movements that match or complement each other. Some sequences develop focus, with gaze and body moving slowly and purposefully in the same direction. These physical models are a metaphor for everyday behaviour.

During the relaxation sessions, we found that the usual images of lying on palm beaches were too poignant (‘It’s not fair when we’re banged up in here’) and that increasing physical awareness often increased the anguish of withdrawal.

It is more helpful to make the women aware of whatever is safe and protective in their lives and to value their own strength and resources to survive. They are encouraged to relax into the support of the floor, find a quiet place inside themselves despite prison noises and be aware of the part of their body which is strongest and keeps them going. Other techniques are to imagine the sun shining on their belly, filling it with warmth and strength, and to visualise a protective golden cocoon around their body.

There is often fierce resistance to lying quietly: conversations, giggles, heckling, flirting with each other, arguments - once we even had a water fight.

But when jitteriness does finally subside into silence , the women seem to enter it very deeply : ‘I was miles away, ’ ‘I fell asleep, ’ ‘I was thinking about my son.’

The experience of being even temporarily at peace with yourself, and with others in the same room, can be powerfully restoring, offering the women a glimpse of an alternative lifestyle to that of ‘frantic fixing’.

Despite their streetwise resilience, many of the H1 women have a certain innocent quality. One of the positions we teach to aid relaxation is curled on one side.

‘It’s like the baby in the womb, ’ commented one. ‘I wish I was back there now, mate, ’ responded another.

Sometimes the mellow mood will extend into the women giving each other a neck and back message. At other times, the more outgoing groups will find a moment of harmony in a different way, through the group karaoke.

The women dance, individually or collectively, and usually sing with abandon. Letting the voice flow out is a powerful way of getting things off your chest and claiming your place in the world.

Although the women come in ill and disaffected, it seems to give them back some of their sparkle. Sometimes on our return days we hear women singing some of the songs in repartee from cell to cell.

Response to the classes by the other workers within the prison has been good (see box). But the restrictiveness of the setting and the lack of continuity limits the impact of our work. Although some women return to the detox unit every few months, they do not usually stay longer than two weeks, and in the prison as a whole there is a rapidly changing population.

It is also difficult to create a safe therapeutic experience within the atmosphere of prison, with the sound of keys and doors banging, and when the women are embattled with the system.

Dance therapy could be part of rehabilitation schemes to pre-empt the prison sentences imposed at such great cost to society, the women’s children, and the women themselves. The potential of dance therapy in ongoing groups of drug users has been explored in other countries such as Israel. The self-esteem which accompanies a better relationship with the body can halt a vicious cycle of selfdestruction.

‘An experiment which worked out’: the staff response There has been a positive response to the dance therapy classes from other workers in the prison.

The nurses observe that the women are in better spirits and sleep better afterwards.

Jacqui Harvey, co-ordinator of the prison education service, who initiated the classes, describes them as ‘an experiment which worked out’.

Jan Palmer, clinical nurse specialist and detox programme manager, believes the programme’s success ‘is self-evident in its continued popularity’.

‘Observing the women relaxing or enjoying the physical activity is pleasing, ’ she says. ‘After the groups the women are more settled. Women work together and support each other both during and after the group, using exercises that they have learnt within the session.

‘The cohesiveness of the group is easily observable and beneficial to a group of women who at times find it difficult to be co-operative with each other, particularly during the distressing process of detoxification.’

Key points

Dance therapy can play a useful role in the treatment and rehabilitation of women with drug addiction.

It works by raising self-esteem through an improved relationship with the body, giving women the strength to help combat their habit.

The benefits of dance therapy for women at the detox unit of Holloway Prison have been confirmed by prison staff.

REFERENCE

1 Payne H. Dance Movement Therapy: theory and practice. London: Routledge, 1992.

Lucy Goodison trained in massage and physiology and ran body-based workshops at the Women’s Therapy Centre in London for 15 years. Helen Schafer trained as a dance therapist and has worked as a professional dance and mime performer and teacher.