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On designing mental health interventions in dance

Tell me about yourself and your background.

I was a professionally trained ballet dancer. I was 14 when I left home

to train with Pittsburgh Ballet Theatre and after that I went to San

Francisco Ballet School when I was 17. So I was dancing at a very high

level, and at a very competitive level. I can say now that I was a very

good dancer! But I really couldn’t say that back then. I couldn’t see or

feel that; I was not a very confident dancer and I didn’t have a great

deal of self-esteem. I also lacked a lot of the skills that would have

supported my mental health, and part of that is because I left home so

young, so I was on my own at a very young age, but also I think we

just didn’t talk about mental health in dance spaces back then. We

sort of talk about it now, depending on where you are. But really, I was

never aware. So when I went through my first major depression, I

thought that I just wasn't strong enough, I really thought that dance

just wasn’t for me. I didn't understand that I had something that was

both treatable and preventable.


After leaving dance, I went to school for writing and, quite reluctantly, became a dance writer. I say reluctantly because I really didn't want to be part of the dance world anymore. I was quite hurt and upset and just wanted to put that part of me away. But of course when you're a young writer, you have to figure out how to get published, and getting published in Dance Magazine made sense because I had that context, that history and actually I fell in love with dance writing. I didn’t set out intentionally to write about mental health, but I only wanted to write about dance if I'm writing about what I wish I had known or, something that would have helped me. I was always writing from this lens of “what did I need that I didn't have and what didn't I know that I wish I had known”. And very quickly, it revealed itself that most of that for me was related to mental health. The first article I wrote on mental health in 2010 was on orthorexia. I shared a little bit of my experience being orthorexic and after that I was assigned a lot of mental health topics, because I had lived experience. And I think because I had abandoned the dance world, it didn’t feel as challenging to be vulnerable, and I didn’t care what dance thought of me anymore. 

So how did Minding the Gap come about?

Minding the Gap was formed through this discovery I experienced while writing about mental health for dancers: I realised that I now had a voice in a place where I had felt voiceless. The catalyst was an op-ed article I wrote in 2017 called Why are we still so bad at addressing dancers’ mental health? In it, I shared my story and also my frustrations and the things I'd been learning from the experts I was interviewing. The article went viral in the dance community. I had a lot of people reaching out to me and it felt like I had made a call to action, so you could say that Minding the Gap is my answer to that call. It’s when I transitioned from advocating through my writing to truly becoming an advocate; truly positioning myself as someone who wanted to be part of the solution. I also started to become very frustrated with the lack of data in this area. So part of the reason Minding the Gap came to be is because I wanted to have a modality to try to get some of the data that was needed.

The first thing I did was talk with Dr Brian Goonan, one of my advisers, and we decided to put out a survey via Dance Magazine. Almost 1000 dancers responded to it, and it was very short and informal, but it was something. From there, Brian encouraged me to present the results of that survey at the Performing Arts Medicine Association where I started meeting researchers and it just built from there. So initially, Minding the Gap was chasing information. But I also desperately wanted to do something with the information; I didn't want it to just sit there. So that’s the other function of Minding the Gap.

Can you tell me about this other function – the ‘doing’ part once you have the information?

The doing is incredibly important to me because I had that experience of writing this article and having dancers tell me about the difference that that article made. It made me think, “What would the difference be if I could actually bring these experts into the studio with you? What would that impact look like, and how could that change people’s lives and trajectories of their lives both inside and outside of dance?” After the Dance Magazine survey, I went to the IADMS Annual Conference for the first time in Montreal. I had in my mind that I wanted to do an empirical study, so that I could build a programme. It wasn’t about publishing or presenting – those things are wonderful and important, but the purpose of the study was to help me design the programme. After several years of work, I finally found an institution that would let me in to work with their dancers at Point Park University here in Pittsburgh, PA. It's a wonderful course, it's one of the top five dance collegiate programmes in the US. I was grateful for their trust, because I had many doors slammed in my face before I found them. They trusted me and were very much like, “Yes, get the data, let’s build this, let’s do this.”

So we took five different measurements, including general mental health, self-esteem, coping, resilience, and social physique anxiety. Essentially we took all of that data and together with my advisers Dr Brian Goonan and Dr Leigh Skvarla we thought about how we could strengthen the areas where we were seeing vulnerability in this group of dancers. We also presented the data to the dancers; that's something we always do: it's their data, it doesn't belong to me. It’s also an important part of the process to destigmatize difficulties with mental health. I want them to understand that they’re not alone, there are others struggling too. From there we created mental health skills workshops that we felt would provide skills to help support the dancers in those areas. At the same time we worked with faculty and teachers because I believe in systemic change, so the people at the front of the room need to participate.

Absolutely, it’s not just the dancers’ responsibility. Were the workshops compulsory or could the dancers choose whether or not to attend? And what sorts of skills did you teach in these sessions?

We've now replicated this programme elsewhere and it's been a little different everywhere we go. In the case of Point Park, the workshops were compulsory for both dancers and faculty, as much as possible. The university helped with scheduling, so we did the workshops and roundtables with faculty during their faculty meeting, so that we weren't adding another thing to their schedules.  

The biggest issue we’ve found that dancers struggle with – across the board, from different institutions – is anxiety. It’s a huge issue, we consistently see high rates of anxiety, so we tend to focus on how to manage anxiety and the different types of anxiety. The other area that is consistently concerning is self-esteem. We tend to find that dancers have high anxiety and low self-esteem. And self-esteem is correlated to every other measure.

We try and teach the dancers skills that will help them bolster themselves with more confidence in what they have agency over. For example we'll talk about goal setting and self-talk, we talk about competition and upward and downward comparison. It's all very skills-based. I tell the dancers that we’re going to practise skills here the same way you practise your technique in class: these are skills you can learn, but also that they are skills that will take time to develop. Finally again it’s about destigmatising these issues, although even in the last five years I've seen a huge change. Dancers are much more willing to talk openly about mental health. But just because they're willing to talk about it, that doesn't mean they're willing to address it, so we talk about help-seeking behaviours – I often say that you can’t take a mental health day to treat a mental illness. You have to attend to it in the same way as you attend to a physical injury.

It sounds incredible. How have students and faculty responded to these workshops?

I can say anecdotally, from casual surveys, and conversations with dancers in the room, that it does make quite a big difference. I have so many emails and quotes to affirm that. I’ve had moments with teachers who on Day One were quite combative, but a year down the line are having almost revelatory experiences and telling me, “I really have tried doing some of these things in my classes and it’s made my classroom better. It’s made my dancers better.” So those moments are all we need to keep going. Unfortunately we have not been able to replicate the clinical measurements. We did try to do it at Point Park but the participation in the survey the second time was really low. Doing the survey is not compulsory, it's at the end of the year, the dancers are in finals. I'm never going to be able to do this on the scale that I believe is necessary because frankly, scheduling is the hardest part of this work, just getting in the room.

Have there been any other challenges?

I would say that scheduling is the biggest challenge. Dancers are over-scheduled and dance teachers are over-scheduled, and nothing feels as important as preparing for whatever performance is about to come. I don't always have a lot of control over how frequently I see the dancers or if that timing aligns with when they really most need this work. And that is hard, feeling that lack of agency over my ability to connect with the dancers directly. The leadership have to be on board, because if they’re not, it won’t be a priority when it comes to scheduling.

Dance institutions also need to have a financial stake in the work. So if there is a grant, for example, that is paying for the work, that grant needs to be held by the dance institution and not by me. Because they need to be the ones responsible for reporting back to the funder that the work was done. They need to have that accountability and buy-in.

Other things that have been that have been challenging – well, I’ve never been in a dance space where there isn't at least one dance teaching artist or leader where I can just feel how much they don't like me! Sometimes the dancers can be very sceptical. They can feel like it’s just a box-ticking exercise to smooth over an issue. And it is hard, but to be honest, those moments of challenge have only strengthened my resolve.

So what’s next for Minding the Gap?

We're just coming up on our 5th anniversary, which feels huge. We've replicated what we did in Point Park now in Louisville Ballet, in their company, second company, and school. We’re in the process of replicating it with Alvin Ailey American Dance Theatre main company, second company, and pre-professional programme, and also at the University of Southern California Kaufman School. It’s really about refining the work. I am very proud of the fact that everything we do is highly customised to the space, to the specific organisation and to the specific culture of that organisation. I don't just walk in with my briefcase and bring in my panel of mental health professionals and go, “Here’s workshop one!” It always starts with a listening session: teach me how we can support you; teach me what you need. There's no blueprint for this, so it takes a lot of vulnerability to stumble through it and learn the hard things. Just like doing anything that matters.

We also do online workshops, mostly for teachers and educators. Because I recognise that many of them do want to be part of the solution and do want to be the change at the front of the room, but aren’t necessarily in places or spaces that are going to provide this kind of information for them.

One thing that's been interesting is learning the importance of sharing my story, and that is a very important part of my introduction to anyone, which is weird because I don't like talking about myself! But it is really important because they need to understand the “why”, and it enables me to be the person reaching a hand in both directions to the mental health professionals and clinicians on one side, and the dancers and faculty on the other. I’m the person saying, “we can all understand each other”.

Photo credit: Anita Buzzy Prentiss.

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