Is Dance Therapy a Form of Psychotherapy?
4, Rue Lalande,
Psychologist, psychoanalyst, dance-therapist, Paedagogik director of the training in art-therapies at the university of Paris 5 René Descartes (FRANCE) (Master in Art therapy by the scenic arts).
Is it in the interest of dance therapists today to group themselves with the larger group of those practicing psychotherapy who hope to obtain the official status of psychotherapist from the State? Before addressing the advisability of this project (for which the level of feasibility varies according to the different European countries’ orientations with regard to professional legislation), let us first reflect on whether it is valid, and second on whether it is useful to assimilate art therapy to the field of psychotherapy.
Are the tools of art therapy psychotherapeutic in nature? Is art therapy a form of psychotherapy? If yes, must it be? Today, the problem seems to me so vast and as yet so little explored, that I will limit myself to a few thoughts on the matter.
1. The position of psychoanalysis in France
a. Questioning the illusion of understanding
Art therapists would do well to consider the position of psychoanalysis on this subject. Today, most psychoanalysts belonging to psychoanalytic associations refuse the assimilation of their profession to psychotherapy even though they would have the legislative right to do so. Psychoanalysts fear the willingness of psychotherapy, to track the unconscious in the name of logos, to explain causes at all cost, to subject language to a rationalizing faculty of reason and the id to the ego. This is viewed as an overly cerebral approach. Well, with regard to art therapists, artists formulate similar criticisms: subjugating art to psychotherapy, using it as a pretext to verbalize, interpret and rationalize. These criticisms have found such an echo within the French government, that, at this point in time, workshops led by artists (what some are calling “cultural aid”) are preferred to those organized by art therapists. An important budget was voted in favour of “art in the school” and “art in the hospital”. Workshops organized by artists, are proposed not only to those groups who show a high risk of engaging in antisocial behaviour (Jack Lang, the former Minister of National Education and Communication recommends the artistic workshop as a way to resolve, for example, the problem of violence in the classroom) but also within the hospital. The art therapist who is determined to unite the two functions, art and therapy, is getting bad press these days. On the other hand, the artist who finds the association of these two words incongruous and approaches his patients equipped solely with his art, without the psychological apparatus, has the full wind in his sails.
Now then, art therapists themselves have already been thinking about the “liaison dangereuse” (to use Jean Florence’s expression) between art and therapy. Their thoughts would have something in common with those of psychoanalysis: refusing to interpret artistic production in psychological terms, questioning the verbal rationalizing meant to “explain” to the subject the causes of his acts (and not only his artistic actions). The illusion of understanding, of explaining, of having access to rational knowledge, supposes a reduction of art that shocks not only artists but also many art therapists:
- on the side of the artists, one can cite the forceful criticism made against the psychologising of art by Antonin Artaud. He wished for the theatre, suffocated by psychology, to rediscover its dimension of shock. “Psychology, with its relentless effort to reduce the unknown to the known, that is, the daily and the ordinary, is the cause of this decline and this terrible loss of energy, which seems to me to have reached its lowest point. And it seems to me that both the theatre and we ourselves must have done with psychology.”
- on the side of the art-therapists, Jean-Pierre Klein, echoes Artaud: “It is in this way, that the dancer-therapist will not interpret verbally, but (doubly in the artistic and psychoanalytic sense) by his or her very own gesture.”
b. Taking into consideration the splitting of the subject
Freud showed that the psychic structure of the human being is not unified. There are the differentiated systems, locally organized that everyone knows: the conscious, the preconscious, and the unconscious or the ego, id and superego. Different psychic registers exist for the subject, certain of which are conscious (a large part of the ego, for example) and others unconscious (the id for example). A veil -the veil of repression that allows for one part to “know” or “understand” what the other ignores -separates the two registers.
Lacan, in this regard very close to the poet Rimbaud who wrote “I is another”, denominates this splitting of the subject into two parts, the I and the Other. He converges with the poet, first by emphasizing the alterity or otherness that inhabits us and governs us without our knowing, but equally by preserving, respecting and not psychologising it. There where Freud thought that the “ego must replace the id”, that is to say to render unconscious processes conscious. Lacan insists on the opacity of a real, ever unknowable, which allows us to exist as subjects and yet, remains hidden or veiled. How to approach this other register? Art opens us to the otherness of this “second world”, to the mystery of this alterity that traditional cultures attribute to the sacred, the beauty of which is the incarnation according to Daniel Sibony.
2. Art, art-therapy, or psychotherapy by artistic mediation
Does the difference between psychoanalysis and psychotherapy refer to the difference between these two registers one of which is conscious and obeys secondary processes, that is to say the speaking of a rational discourse, while the other is unconscious and governed by primary processes? According to Lacan, it is the discourse of the unconscious that is transformative: “Unconscious knowing is what changes, that which effects change, that which is capable of reducing the symptom.” Taking into account this unconscious register is what most concerns art therapy.
a. The two levels of meaning in art
Now, these two levels are inherent in art: there one can perceive a language capable of supporting a work of representation or narration, or an assembly of forms signifying nothing other than themselves.
Even if, as all humans, we are always tempted to see in form another meaning other than that which is directly apprehended in the form itself, and to confuse the notion of form with that of image (which implies the representation of the object) and especially with the notion of the sign. The sign signifies while the form signifies itself. Dance, like music refers only to itself. Their essential meaning (sens) is immanent. It refers “to their specific material organisation”, writes Umberto Eco, that is to say to their intrinsic nature, to the natural properties of their materiality (sound, movement with its time parameters, space, weight and energy). It is also what psychoanalysis does when it is not led astray: it listens to the grain of the voice, the rhythm of phrases, the taking flight, the breaks; it listens to the tongue’s dance.
No one contests the fact that the work of art, and dance in particular, can have a representative-narrative dimension, but this semiotic dimension is not proper to art in itself. Every artwork, like any object, may be understood directly, that is to say, in and of itself, without concept, or apprehended indirectly, in the place of another object for which it acts as a sign. Kant already said it, when he distinguished “free beauty” (with neither function nor signification) and “accessory beauty” (which adheres to a concrete being or an object from which it takes its meaning). This way of seeing is not at all outmoded even if Kant’s terms may appear so. Theodore Adorno affirms that “no work of art should be described or explained using the categories of communication”.
Certainly, everything can function as a sign; this is even a characteristic of the human being for whom “everything is language” as the French psychoanalyst Francoise Dolto says, seeing signs everywhere, investing every object of the world with a semiotic value. But we see very clearly in the case of dance that the semiotic dimension of the dancer’s motor skills in no way throws light on its artistic dimension. It is not because it is signifying, that a motor-form is artistic. The artwork is more than the ensemble of its signs. It procures a specific pleasure – artistic pleasure- released by the forms that constitute it in the most “substantial” way (the grain of sound, the dancer’s body and the natural laws of this body). With regard to music, Levi-Strauss observes that the ear enjoys immediate pleasure. One might say as much of the spectator’s eye, or of the coenaesthesia of the dancer.
The fact that dance has an ineffable meaning is not to say that it does not “speak” to us (in the way that before a painting, no matter how abstract, one might find it brimming with sense and empty of signification, one might exclaim “it speaks to me”). If it says nothing, it says it well. The coexistence of the two antinomic levels of art apprehension -a direct primary level and a secondary narrative level -is made discernable by these kinds of paradoxes.
The French dance therapist Benoît Lesage wrote an article a few years ago that seems to me fundamental with regard to this subject. The article clearly distinguishes two formal levels in artistic productions: one of primary forms made of forms (volume, space, relations, similarities and contrasts), of intensities and of rhythms; and one of secondary forms that serve narration, can be assimilated to signs and carry a discourse. If this second level can indeed translate the psychological register, the first is not reducible to it. It is other, heteronomous.
In dance, the primary forms correspond to the energies, vibrations, dynamics, and rhythms that animate movements. These are responsible for its radically enigmatic character. It is here, it seems to us, that lies the specificity of dance therapy; that in dance (the primary forms) which objects to psychologising and refuses reduction to a language.
b. Art therapy and its relation to psychotherapy
In order to speak legitimately about psychotherapy, one must speak of its goal as being psychic modification. The means used to achieve this goal must themselves be inscribed within the repertory of psychological techniques. This is not a priori the case for art, even if certain undeniable effects make themselves felt on the psyche.
Art therapy cannot be considered a psychotherapeutic technique if, as conventional psychotherapy demands, it must reside in one of the three major established categories of techniques: those that are founded on suggestion (persuasion, extortion, advice, moral directives), those that rest on catharsis (purging, discharge of repressed pathological feelings) and those that are based on analysis and the coming to consciousness of conflicts. Does art refer to one of these categories? It seems to me largely to exceed them. This in no way excludes the fact that it has therapeutic effects, but without a doubt we could recall what Lacan said about psychoanalysis: it heals by “surplus” and by other means.
It is true that Freud is the first to contribute to the psychologizing of art by the fact that he proposes rational interpretations of it. He admitted to understanding nothing of painting when he was unable to decipher the psychological contents: “I have often observed that the subject-matter of works of art has a stronger attraction for me than their formal and technical qualities, though to the artist their value lies first and foremost in these latter. I am unable rightly to appreciate many of the methods used and the effects obtained in art.”. This confessed “lack” was without doubt at the origin of the reductive interpretation that he made, for example, in the famous and very questionable analysis of Leonardo de Vinci’s phantasm. The image of the vulture hidden in the folds of St Anne’s dress in the famous painting, The Virgin and Child with St. Anne, is meant to represent the painter’s unconscious desire. Freud thus authorised in psychotherapy the psychological interpretation of art. However, if certain therapists are qualified to do it, one sees a good amount of abuse that throws suspicion onto the entire profession and subsequently justifies the favour shown today to artists by public institutions. However, this is to forget that, by the opposite excess, these artists might be dangerous: if fascinated by madness one forgets one’s service to the patient’s evolution towards autonomy, or by comporting oneself like a guru, using the patient for one’s own glory, to make oneself look good, using, without great ethical exigencies, what one believes to be a “healing influence” (Tobie Nathan’s expression underlines the importance, in traditional therapy, of the therapist’s personality, but the shaman, for his part, takes his inspiration from a long tradition and does not simply follow his own “feeling”).
At least psychotherapy by artistic mediation, when practiced by confirmed psychotherapists, avoids such deviations. Note that first Jung, who got his patients to draw, then other clinicians, like Gisela Pankow, use drawing or modelling clay with their adult patients. Child psychoanalysts continually employ these nonverbal forms of expression (see for example the work of Françoise Dolto) and story telling, puppetry, psychodrama etc. But they do not claim to be art therapists, not having the artistic skills. In such cases, the patient’s artistic production is used as the means of facilitating verbal associations. The artistic dimension occupies them much less than its ability to give rise to language. We wouldn’t call their activity art therapy, anymore than they would.
c. Art therapy between sense and signification?
Art therapy is a treatment by artistic mediation. At the same time, art therapists must be competent with regard to the relational and have the artistic know-how necessary to develop a therapeutic relation through this mediation. They are engaged in an activity that touches upon both psychology (the relational) and art. Nevertheless, according to their sensibility, their training, their choices, they will privilege one aspect or the other. One might see art therapy then, as a gradient scale that operates between two poles. Somewhat like psychomotricity, which also reunites two fields, the association of which might appear to be surprising and includes techniques coming from physical re-education to techniques practically psychotherapeutic (these themselves are spread between the looking for the causal links to past troubles and the treatment of the present symptom with a more re-educative aim), art therapy spreads out between the pole of artistic practice without interpretation and a pole of psychotherapeutic activities that try hard to decipher the signs produced by the subject’s movements in relation with the therapist ( one might define this process as semiotherapy, as does J.P. Klein).
This diversity was reflected in the debate regarding the name of our association, at the time of the general assembly a few years ago. Are we to call it “Dance therapy” or “Therapy through dance”? Opinions were split, some of us preferred to underline the artistic dimension by the expression “dance therapy,” which was finally chosen. Others wanted to privilege the relational aspect with the expression “therapy through dance”, an echo of the former name: psychotherapy through dance. It is very true, not only the words, but also their order bestows meaning. The first formulation was defended by the majority of dance therapists coming from a dance background, the second more by the dance-therapists having training in psychology.
The question remains that if, as certain artists think, artistic practice constitutes in and of itself a therapy (a number of them speak of art as having been their therapy and want others to benefit in the same way, one hears this often with regard to dance…), then along which path does its efficacy pass? Can one come to understand this efficacy using psychological concepts, using other theories? Let’s consider what is all the rage on the other side of the Atlantic, in particular what the new age movement proposes: explaining through notions of energy, through mysticism. Let us consider traditional societies that attribute the therapeutic effects to the divinities descending into the dancer’s body, etc. The question is far from simple: to which psychological mechanisms do we attribute, for example, the effects that music or a dance movement have on one’s disposition?
Jung, who had the idea to make his patients paint, wrote about it in this way: “It is not a question of art at all – or rather it should not be a question of art – but of something more and other than mere art, namely the living effect upon the patient himself”. “For instance, a patient needs only to have seen once or twice how much he is freed from a wretched state of mind by working at a symbolical picture, and he will always turn to this means of release whenever things go badly with him”. “The patient can make himself creatively independent through this method, if I may call it such. He is no longer dependent on his dreams or on his doctor’s knowledge…” Welcome these lines written by a precursor who had recognized the importance of art’s symbolic efficacy, and the irreducible otherness of artistic expression (even if his title “psychological” healing unfortunately ruins the revolutionary character of what he advances).
3. The symbolic efficacy
In reality, art and psychoanalysis are techniques that do not, properly speaking, refer primarily to psychotherapy, which works through signification, but rather to a symbolic efficacy which works through meaning: the effects of transformation are the result of the action of symbols that it put into play (words in the case of psychoanalysis; sounds, movements, and plastic forms in the arts). The mechanism of symbolic efficacy was elucidated and analysed by Claude Lévi-Strauss through his work on shamanism, the most ancient healing system in the world.
Insofar as a shamanistic system of healing, as one still finds it functioning in traditional societies like that of the American Indians and in numerous regions of Asia, use different artistic disciplines such as painting (recall the beautiful exposition of Navajo paintings at the Villette in Paris, three years ago, and the demonstrations of therapy work that accompanied it), music and dance (present in all therapeutic rituals), it is interesting for the art therapist to follow with regard to traditional practitioners Lévi-Strauss’s advice to psychoanalysts with regard to shamans: go there, observe, in order, at the same time, to better understand your own occidental practice and to enrich it.
a. The shamanic cure
In a well-known chapter, Lévi-Strauss makes comprehensible the work of a Cunas Indian Shaman from Panama who in this case treats a woman in danger of death at the time of giving birth. The shaman doesn’t touch her, but sings to her a mythical epic poem, making sense of her illness by transposing it into a story about how the shaman will deliver the foetus’s soul that has been captured by a spirit. After numerous, breathless adventures through dark grottos and viscous tunnels, he rediscovers the lost soul and brings it toward deliverance, having overcome the obstacles put in their path and the monsters who were stocking them. They make their way out to see the light of day, and at this moment, the baby is really born. The mother and child are saved.
Lévi-Strauss emphasizes that the Shaman’s words carry a sense that is not of the order of the real, but of the mythical. If they referred in ordinary terms the pathological manifestation, he specifies, they would lose their efficacy. The sick person doesn’t “know” that the cave and the tunnels symbolize her genital apparatus; nor that the shaman’s voyage represents the birthing process. Despite this non-knowledge, this non-thought, she “knows” it unconsciously and her body actively accompanies the twists and turns of the story right up to the delivery.
Here then, according to contemporary anthropology is a prime example of a shamanistic cure. How does it operate?
b. “Objective” truth and symbolic truth
From this exemplary cure, Lévi-Strauss highlights the essential therapeutic mechanism of the shamanistic system: the effectiveness of symbols. Citing Desoille, the inventor of Directed Daydreaming, he brings to our attention “that psychopathological disturbances are accessible only through the language of symbols”. He even emphasises the fact that it is because the myth is not rational that it heals. The words used by the shaman to describe the patient’s spiritual epic carry a mythical sense rather than a realistic one. The success of the cure demands the poetic “masquerade” of mythology. The anthropologist even suggests that the truth would be less therapeutic than the symbol. Why is it that speaking about viruses and germs does not heal the flu any more than the “rational” explanation of the parent’s misdeeds relieves the neurotic of his suffering, while a fabulation, a narrative about monsters can cure a sickness? He ventures an answer, almost apologising for its paradoxal character: “…the reason lies in the fact that microbes exist and monsters do not”.
The anthropological study of shamanistic cures thus frees the way to a level of unconscious therapeutic efficacy consisting of symbols speaking directly to the unconscious and referable to art. It works through sense rather than signification, a process that doesn’t get past the edge of consciousness. And because each listening, each encounter with art has its singular sense, one is not able to explain it objectively. It is only possible to speak of it poetically, artistically.
c. The symbolic reorganization
In this same chapter, Lévi-Strauss makes a comparison between psychoanalysis and shamanism, showing that both cures rely on the mechanism of symbolic efficacy; they offer the drives an exit by way of symbols. In this way the subject reorganizes itself. Anthropology fully agrees here with the psychoanalytic theory according to which the cure consists not only of discharging the repressed or conflictual drives but also of linking them to new representations. We prefer to say: to aesthetic forms. Both methods do this in their own way, yet in both cases, the words leave their ordinary register, they are poetic (etymologically speaking, words become active, effective words): fantastic beings in the shaman’s narrative (Uncle Alligator, the black tiger, the dust-coloured animal etc.), words sprung out of the unconscious during the analysand’s discourse or slips, unexpected associations, barmy, hallucinatory representations, creating a surreal and disconcerting speech. Lévi-Strauss doesn’t hesitate to say that what cures in psychoanalysis is less the remembering of past history than its mythic recreation.
Whether the myth is personal, elaborated by the analysand on his couch, or collective and received by tradition as in the case of shamanism, is of little importance. In the two cases the cure corresponds to a psychic reorganization of the subject due to the action of symbols. Moreover, symbols are not only images, but are structures (it is also in this way that Jung defines archetypes), that is to say, according to Lévi-Strauss “which mold the fluid multiplicity of cases”. The distinction between psychoanalysis and the shamanic cure is blurred again when one considers things from this point of view. Of little matter, the meaning of words, of little importance the fact that symbols are received by the patient (shamanism) or produced (psychoanalysis). The structure is more important than the contents and it is the structure that induces a positive therapeutic reorganisation.
Lévi-Strauss compares the shaman to the psychoanalyst who rejects being assimilated to the same category as the psychotherapist because what the psychoanalytic process “speaks” of is more on the side of the unconscious than of consciousness, of the id than the ego, of drives than feelings, of sense than signification. The art therapist who, like the shaman, treats with art, also offers symbols that address themselves directly to the unconscious. Therefore, if we follow Lévi-Strauss, one sees that it’s in the primary forms that the symbolic efficacy is situated and not in the signification. It seems to us in the interest of art therapy, then, to situate itself on this side rather than on the side of a psychologising semiotherapy: in effect, one can think that it is first these primary poetic forms, that do something, that act, that are effective while a psychologising discourse strips them of this efficacy.
Art is not reducible to feelings translatable by psychological terms, into ordinary, quotidian events, into narratives that, as Artaud says with regard to the theatre he combats are “stories about money, money anxieties, social climbing, throes of love untouched by altruism, sexuality sprinkled with an eroticism lacking in mystery”, it is because it has this other dimension “of cruelty”: shock-theatre where the spectator learns that “the sky can still fall on our heads”. What is it to say, if not that the transcendence of art that exceeds the individual puts him in contact with a force Other?
4. The relation to the Other in art
Art allows access to a “second world”, non-ordinary and poetic, which disables the ego’s intelligence. It functions like an unfathomable force that revokes the causal order of representation. The subject receives the shock of the sublime and this is not Freud’s sublimation, that refused the confusion that seizes thought before the enigma of shock provoked by the art works. Today, aestheticians, such as J-F. Lyotard, link the power of the work of art to this disabling effect. The subject is disarmed by the strike of the sensible on the soul, his intelligence is paralysed and it is when it finds itself thus confronted by this Other power of art that art can produce powerful effects on the subject.
Art therapy, seen in this way, builds upon the encounter with the alterity that traverses art. However, whatever the meaning given to this other (the sacred of supernatural entities in the case of traditional therapies, or the unconscious, the Other in psychoanalysis), it doesn’t concern the singular ego, but intensely mobilises the subject and the “getting out of oneself”. Art therapy cannot be reduced to a technique that advances the pure expression of one’s ego. From this point of view, it is not a form of psychotherapy. It revokes the causal order, affirms the presence of forces that exceed the subject and tear it from itself, conducting it to “the transcendental dimension of symbolic law, such as it is promoted by psychoanalysis”. In effect, it is only through this law, transcribed in the arts that the subject can articulate itself in a creation producing effects. Dance transforms the subject, if through art, the subject celebrates its laws, received through the music… if the subject accepts that art refers first to itself, instead of subordinating the art form to an expression of selfhood.
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JUNG Carl Gustav, The Practice of Psychotherapy, (The Collected Works of C.G. Jung, vol.16, trans. R.F.C. Hull, Bollingen Series XX Pantheon Books, NY., 1966).
KANT Emmanuel, Critique of Judgement, trans.Werner S. Pluhar, Hackett Publishing Company, Indianapolis, 1987.
KLEIN Jean-Pierre, Pour une psychiatrie de l’ellipse, PUF, Paris, 1993.
LACAN Jacques Séminaire inédit du 15.12.1977.
LEVI-STRAUSS Claude, Structural Anthropology, trans. Claire Jacobson and Brooke Gundfest Schoepf, Allen Lane The Penguin Press, London, 1968
RANCIERE Jacques L’inconscient esthétique, Galilée, 2001.