Anthropological Perspectives

for Dance/Movement Therapy

Judith Lynne Hanna

An anthropological perspective, because of its comparative, cultural

and holistic approaches, is critical to working effectively with the
unserved and the underserved people of other cultures. Recognizing
different cultural patterns can lead to adaptations that could enhance
the theory and practice of dance/movement therapy.

nthropological perspectives are critical to those working with individ-

uals or groups of other cultures. Dance/movement therapists need to
be aware of human differences and to be flexible in their work in order to
accommodate demographically changing populations. The comparative,
cultural, and holistic approaches in the discipline of anthropology can
provide dance/movement therapists with a context for understanding
behavioral patterns.
Anthropology emphasizes the comparability of all human cultures. The
anthropologist searches for similarities and differences among people in
order to understand what is universal to the human species and what is
culturally determined and unique to a group. Moreover, the discipline
studies variation within cultures by, for example, age, sex, social class,
and degrees of assimilation from one group to another. Anthropology's

This article is an updated version of paper originally prepared for the International Panel
Discussion of the International Conference of the American Dance Therapy Association,
Sheraton Centre, Toronto, Canada, October 27-29, 1977. The author gratefully appreciates
the helpful comments of the American Journal of Dance Therapy reviewers, and Daniel
Halperin, Celia Shapiro, and Joan Frosch-Schroder.

American Journal of Dance Therapy © 1990 American Dance

Vol. 12, No. 2, Fall/Winter 1990 115 Therapy Association
116 Hanna

comparative approach includes the study of humans today and yesterday,

in western and nonwestern societies, in remote tribes, and in sophisti -
cated urban settings. Key questions are: How do varying group experi -
ences generate different cultural patterns and what are the implications
of cultural diversity?
The essence of an anthropological approach is to understand the culture
of the individuals with whom one interacts. Culture is a dynamic ever-
changing phenomenon encompassing the values, beliefs, attitudes, and
learned behavior shared by a group. Anthropologists seek to understand
the meaning of the webs of significance humans spin from their perspec -
tives. Within this vantage, it is necessary to understand how individual
clients, as well as the cultures to which they belong, define a problem,
view its cause, and evaluate the progress of its resolution. Cultures, it
should be noted, may be based on age, sex, ethnicity, race, occupational
group, and so on. The handicapped, mentally disturbed, and mentally
retarded may sometimes be conceived of as having their own cultures.
Therapists also have a culture. It is conceivable that they might benefit
by occasionally viewing it from an outsider's perspective.
Cultural differences are usually reflected in movement (Birdwhistell,
1970; Brower, 1983; Cottle, 1966; Curt, 1976; Efron, 1941; Ekman &
Friesen, 1969; Hall, 1966; Hanna, 1976, 1978, 1979, 1983, 1984, 1987,
1988a, 1988b, 1988c; Kern, 1975; Kochman 1981; Pasteur & Toldson,
1982; Ramsey, 1984; Wolfgang, 1984) and attitudes about health (Acosta,
Yamamoto & Evans, 1982; Atkinson, 1989; Ho, 1987; Kleinman, 1980;
McElroy & Townsend, 1989). For example, among the Vietnamese, a
smile communicates not only happiness and assent, but also the senti -
ments of anger, embarrassment, stoicism, and rejection. To look directly
at a person with whom one is speaking is a sign of disrespect and
rudeness. A touch on the head is offensive (Brower, 1983).
There are also differences in preferred modes of communication. For
example, among American Indians (more than 400 tribes and 13 distinct
language groups), there is a preference for venues of communication
other than verbal interaction, such as the arts (Ho, 1987).
Another basic thrust in anthropology is the examination of the feelings,
thoughts, and actions of human beings, not as isolated bits and pieces but
in a holistic or systems context. An individual's health intermeshes with
other aspects of cultural and group life. Among many people, altered body
and mind states are not subsumed completely under a biologically de -
rived vocabulary and world-view. Sickness for them is the result of a
range of events and changes. Health and illness involve not only body
functions but also interpersonal relationships, cultural values, emotions,
and political, economic, and environmental factors that impinge on an
individual and group. Commonly sociomorally construed, illness is often
a way to explain or rationalize human conduct. Some people, such as the
 Anthropological Perspectives 117

Chinese, have difficulty in admitting social and emotional problems and

a reluctance to self-disclosure. Thus it is necessary to see physical and
mental symptoms as part of the personal history, politics, and ecology of
the individual.
Within a holistic perspective movement should be considered in the
context of how an individual learns to move and moves appropriately to
his or her culture, sex, age, and/or social class. As therapists know,
movements rarely have meaning in and of themselves. Rather, move -
ments reveal meaning only when they are identified and explained as
part of a larger pattern of behavior. The body has many components, each
of which may send a different message. For the purpose of analysis it may
be appropriate to isolate each unit. However, the actual meaning of body
language is found through seeing the whole pattern in the context of the
individual mover having a combination of personal, cultural, and envi -
ronmental experiences. There should be evidence for emphasizing one
component of behavior as significant rather than another. Furthermore,
movement as communication needs to be considered along with accom -
panying verbalization. Each kind of language adds a unique dimension to
the message.
Why are anthropological perspectives critical to those working with an
individual or group from another culture? Wherever and whenever peo -
ple are interacting, a sensitivity by a member of one culture to the
culture of another person will help in understanding the motivations,
behavior, and therefore the interpersonal relationships and therapeutic
goals. By studying other societies' cultural behavior, dance/movement
therapists can better help clients from cultures other than their own.
Moreover, they can gain insights through the reflective act of compari son.
Identifying and explaining differences in other groups' ways of doing, feeling,
and thinking may catalyze the redefinition of one's own perceptual fields.
Of course, it is important to dismiss the assumption of differ ent being
inferior (DeReuck & Porter, 1965).
Cross-cultural psychology is similar to anthropology in many ways.
However, it differs in critical ways such as using experimental rather
than holistic, ethnographic research. Ethnography, developed as a reac tion
to speculative history, entails a researcher engaging in participant
observations, living among a group (usually for a year to encompass
responses to seasonal changes) and asking questions and observing, in
much the same way as a child learns its culture. Always questioning
their own assumptions and apparent facts and observations, anthropolo -
gists attempt: To discover the insiders' ("natives") points of view, describe
their behavior, note the relationship between them, and convey informa -
tion about a group to other outsiders. The emphasis on universal aspects
of cognitive development assumes invariance. Yet there are culturally
mediated perceptions and understandings.
118 Hanna

Since the body is composed of universal features, most members of the

medical and therapeutic professions erroneously assume that the body is
experienced in a universal manner (Manning & Fabrega, 1973). Because
time, space, and energy are universals in human life, many professionals
mistakenly believe all people experience them the same way. However,
assumptions concerning the psychic unity of humans ignore the facts of
cultural learning. Therapists deal with disturbed and/or dysfunctional
persons who occupy positions in on-going sociocultural systems. For ex-
ample, with respect to space, Anglos refer to four directions: East, west,
north, and south. The Laguna Pueblo conceive of seven-directions: Up,
down, and center, as well as the four Anglo directions (Albuquerque,
Laguna spokesman, Pueblo Cultural Center, August 7, 1977). Whereas
Anglos finish products, the fear of spatial closure that underlies Navaho
culture leads Navahos to "always leave part of the design in a pot, a
basket, or a blanket unfinished" (Kluckholn, 1968).
It is necessary to accommodate the relationships between body and self
that are deeply rooted in biology and the relationships between body and
self that are rooted in the social and cultural forms in which phenome -
nological experience occurs. Cross-cultural and social class problems are
particularly evident in urban areas where most publicly and privately
supported professional therapy occurs. Misunderstanding in diagnosis
and treatment often results when the typical model of the middle-class,
white, verbally oriented, and nonverbally limited individual is applied to
individuals who belong to other groups.
Effective therapy requires an understanding of the cultural and ecologi cal
patterns governing a client's life, the different concepts of mind, body, parts,
time, space, effort, color, texture, and other properties found in everyday
life and the arts, as well as what movement is done where, when, how,
and with and to whom (Hanna, 1988a). A client's perspective, at odds with
the theory and method of the therapist, creates barriers to healing in
addition to placing new stress upon the client (Hanna, 1988b).
If a female therapist mirrors a man's movement, is this acceptable, an
insult, a sexual invitation? Invited to join the Ewe people's dance in
Nima, Accra, Ghana, I was quickly corrected by the women for following
the men's more energetic style. At a conference on Dance of India, held at
the University of Toronto, 1985, Professor Sunil Kothari, Head of the
Department of Dance, Rabendra Bharati University, remarked that In -
dians view a dancer in a leotard as if stark naked.
In a comparative study of artistic creation, Billig and Burton-Bradley
(1974, 1977) found what is suggestive for all therapies: The universal
occurrence of psychosis has culturally patterned thought and behavior.
However, these cultural variations in symptomatology are manifest until
the patient's personality becomes markedly disintegrated. In this stage of
disorder, the content and the structure of the psychosis are the same for
 Anthropological Perspectives 119

all individuals. Billig and Burton-Bradley report that various cultural

influences affect the content of New Guinean graphic creations as long as
patients are comparatively well-integrated. Thus a patient's culture must
be considered in diagnosis, treatment, and progress evaluation.
There is a variety of culturally conceived classes of afflictions, causal
agencies, means of diagnoses, and kinds of cures. Following are a few
examples of cultural difference from minorities who are unserved or
underserved by the dominant American mental health system.
Kochman (1981) described differences between some European-
Americans and African-Americans in the way perceived oppositions are
handled. The former tend to minimize antagonism, to encapsulate it in
"scenes" so that "bad feelings" are not carried away from the confronta -
tion. The latter, on the other hand, tend to view oppositions as constant
contrarieties that may affirm a sense of community through dramatizing
opposing forces. The implications for therapy may be that although both
groups have comparable feelings of hostility, one group may be culturally
permitted to express it more readily and openly. The inference that
African-Americans are angrier may not be correct (Hanna, 1988c).
Other stylistic differences exist. Compared to European-Americans,
African-Americans are more onstage than offstage in fabricating their
identities (Pasteur & Toldson, 1982). A common low-income style is char -
acterized by greater physicality, higher energy, faster response, and less
restrained emotion than that which is found among European-American
and middle-class African-Americans.
The use of dance in therapy varies among groups that are often thought
of as homogeneous in their way of life. For example, among the southwest
American Indians, the Apachean and Pima peoples conduct ceremonies
when something wrong occurs. Most of the Navajo Indian dances are
prayers to cure a particular person's illness (Fergusson, 1931). On the
other hand, the Pueblo groups have calendrically set ceremonials inti -
mately involved with the creative cycle, production of rain, and concepts
of like-cures-like (as in sympathetic magic). These Pueblo people are
group- rather than individual-oriented. Indians on their reservations use
their traditional healing methods. However, Indians in urban areas, who
have taken on many of the "white man's ways," might better respond to
therapies which bear similarity to deeply-ingrained traditional ways:
individualist and situationally determined; or group and calendrically
set sessions, depending on their particular cultural group.
The theory of illness that a group has is an another consideration in
cultural diversity. The Pima Indians, for example (Bahr, Gregorio, Lopez
& Alvarez, 1974), conceive of two kinds of illness. One is a wandering
kind that is common to all peoples. Another form of illness is specific to
the Pima. These ka:cim sicknesses are exempt from, or have little to do
with, the physical processes accepted by western medicine. Each Pima-
120 Hanna

specific sickness has a different procedure for diagnosis and cure. The
shaman's role is to guard Pima health and also to preserve "Piman
consciousness of their humanity as Indians" (Bahr, et al., p. 7). Movement
is used by the shaman or curing agent to press, blow, or massage the
body. "The body is a means for gaining access to the patients' past" (Bahr,
et al., p. 171). Art and music are used to please the spirits so that they
cease to be agents causing the illness. Sickness and morality intertwine.
Thus the violation of moral norms is generally thought to cause illness.
If a people believe the cause of stress is external to the self, the thera pist
needs to ascertain the perceived boundaries of the self. If illness is
punishment for transgression, then it is necessary to understand what is
considered deviance and what amends should be made. If a disease is
believed to result from sin, then expiation is necessary for a cure.
Farrer (1976) compared Anglo-American and Mescalero Apache Indian
patterns and concluded that teachers-and we would add therapists-
might provide familiarity and security for the Mescalero by drawing
upon their cultural patterns. Change agents could provide role models for
learning-by-observation rather than calling out rules, as in Anglo-
American culture. Therapists might also use the disciplinary tack of
removing an offender from the group rather than reprimand the person
verbally, permit physical closeness and group work among relatives
rather than have individual projects, and arrange desks and other pat -
terns in circles rather than in rows and rectangular shapes. Coinciden -
tally, many Anglo-American dance/movement therapists do work in cir -
cles.
Mexican-Americans in South Texas who were studied by the Hildalgo
Project on Differential Culture Change and Mental Health from
1957-1961 were found to have distinct notions about therapy (Madsen,
1973). Curing behavior is expected to involve direct eye contact, rapid
diagnosis, religious sanction, appreciation and respect for the patient's
self-diagnosis, respect for the patient's beliefs, minimal physical contact,
treatment in the family context, and consideration of male dominance
over the female. These notions are counter to Anglo-American practice.
Thus Anglo-American therapeutic approaches to serve this population
have minimal success. Nonetheless, generalization to all Mexican-
Americans is problematic. Attitudes toward therapy vary depending on
the person's social class, level of acculturation, gender, and whether the
patient is bilingual (Ruiz & Amado, 1983).
Therapists, particularly Anglo-Americans at this point in history, must
bear in mind different notions about creative individual expression.
Among Anglo-Americans, value is placed on each person shaping his or
her own destiny. The opportunity for individual self-actualization is con-
sidered unlimited. Among many American Indian and Asian groups,
 Anthropological Perspectives 121

however, value is placed on anonymity—accepting group sanctions and

routinized patterns. Spanish-Americans also tend to value routinized life
and obedience to the will of God.
In April 1988, dance/movement therapist Joanna Harris, was invited to
introduce dance/movement therapy to students at the National Academy
for the Arts in Taiwan (personal communication). They found the Anglo-
American model somewhat of an anathema. It was clear that the Chinese
individual does not initiate activity. The idea of the therapist as facilita tor
for the client to initiate movement out of one's inner being was
unacceptable. Rather the individual models the teacher. It was also
apparent that anonymity in a group process and the desire to stay unde -
fined were strong cultural norms. The verbal metaphors Anglo-American
therapists use to stimulate movement were not common in Chinese
culture. And there were problems of translation. In sessions teaching
improvisation, students relied on the technically skilled person to lead.
"The problem is," said Harris, "they're good; they conform totally." There
were no student verbal responses. But the students liked the group's
accomplishment.
Thus, a psychotherapist must work differently with members of groups
who find individuality antithetical to their cultural norms (see Green -
berg, 1968 for a summary of conflict in cultural values and Chilcott,
1968). Emphasis on creative self-expression in movement with a group
and/or dependency-oriented person could harm the individual. Having
the client imitate the therapist or act in unison with a group in which the
individual does not stand out would be more appropriate. Because some
groups are generally unaccustomed to change, therapy should be based
on experiences familiar to the client.
Prince (1969), a psychiatrist who has worked with different cultures in
several countries and among different classes within them, views the
problem this way:

There is a growing awareness that psychotherapeutic practices aimed

at independence and insight are not appropriate for a large and
important segment of our western population, the chronically
poor . . . the vast majority of the emotionally disturbed of the non -
western world can be successfully treated (and are being successfully
treated) by techniques that foster dependency and unreasoned belief
(p. 20).

A related problem is that the middle-class world view of many thera -

pists clashes with a lower-class client world view. Often, the lower-class
individual is capable of insight therapy that involves creative self-
expression but the lower-class client is unwittingly rejected in one way or
another by the therapist who has different verbal and nonverbal means of
122 Hanna

communication. Karon and Vandenbos (1977) discuss the need for a

therapist to be consciously aware of possible negative dynamics in work-
ing with people who have been economically poor throughout their lives:

Reality problems elicit proto-typic counter-transferences. The thera pist

from lower class origins may perceive the patient as his bad self, himself
as failure. The upper class therapist may . . . [have] guilt over never
facing such difficulties, or idealize poverty. Therapy can fail because
the patient is awed and does not want to reveal his own
"inadequacy" or "criticize" the authority by saying that he does not
understand the therapist or that the therapist does not understand
him (p. 169).

Because poor clients tend to have little education and may come from
an ethnic group other than the therapist's, client-therapist communica -
tion problems loom large. The client often does not understand the ther -
apy process. It is therefore imperative that the therapist educate the
client in a personal, nonbureaucratic way with language designed to
create trust and build rapport.
The therapist must be alert to elements of change. Individuals often
accept the values and behavioral patterns of groups other than the ones
to which they belong; however, they rarely accept those values equally.
Many acculturated individuals—those who have taken on dominant cul-
tural ways—may still conceive of illness in traditional terms. It is a
daunting dilemma because therapists cannot rely solely on the studies of
different groups. Nonetheless, an understanding of these studies is criti cal
in developing a sensitivity to diversity.
Several developments have catalyzed the need to take into account
anthropological perspectives. The law mandates equal opportunity for
all. A number of studies in the 1970's revealed the inadequate delivery of
health services (Braginsky & Braginsky, 1973; Bullough & Bullough,
1973; Lerner, 1972; Miller, 1974; Willie, Kramer & Brown, 1973; Wind -
ham, 1976). The situation has only worsened as the American population
has increased in diversity and federal and state spending budgets have
decreased. Groups heretofore unserved or underserved now demand ser -
vices. "Mainstreaming" in public school requires adaptive physical educa-
tion. Mental health services have moved from institutional to diverse
community-based facilities.
With the advent of the community health movement, mental health
workers have discovered and documented that both the incidence and
severity of psychological problems are highest among the lowest classes.
These classes commonly include members of minority cultures. Moving
beyond the medical "illness" model, "it becomes apparent that lower-class
people are generally more hampered in fulfilling their psychological and
social potential than are their middle and upper-class counterparts"
 Anthropological Perspectives 123

(Lerner 1972, p. 5). Because it has heretofore not been fashionable to

work with the poor, the people who need mental health care the most
receive the least. Moreover, lower-class clients have been regarded as
deficient in an aptitude for individual psychotherapy.

From its inception, psychotherapy has been, in essence, a medicine for

mandarins, desired and prescribed primarily for mildly to moderately
disturbed middle and upper-class individuals (Lerner, p. 3).

Mental health professionals are beginning to recognize the danger of

labeling behavior. What is acceptable in one culture may be inappropri ate
in another. Frank (1973), a psychiatrist, notes:

Cultural factors determine to a large extent which conditions are

singled out as targets of psychotherapy and how they manifest them -
selves. The same phenomena may be viewed as signs of mental illness
in one society, of demoniacal possession in another, and eccentricities
to be ignored in a third. Moreover, the behavior of the afflicted person
is greatly influenced by culturally determined expectations of how
persons so defined should behave (p. 318).

How people view a problem affects their attitude and behavior toward
solving it. Health practitioners are focusing on the social and cultural
aspects of health in order to identify factors that facilitate or impede the
utilization of a therapy (Cornyetz, 1972; Ho, 1987).
Therapists must choose among evocative or direct types of therapies on
the basis of the individual's cultural experience (Frank, 1973; Ho, 1987).
Evocative therapies help a person change his or her troublesome atti -
tudes and behavior by indirectly creating favorable conditions for change
but leaving the actual change up to the client. Directive therapies, by
contrast, seek to structure the therapeutic situation as much as possible
and reduce ambiguity to a minimum. Psychoanalyst Arthur S. Blank, Jr.,
(personal communication, November 20, 1977) would add interpretative,
or psychoanalytic psychotherapy, among choices. He notes that this ap -
proach has much in common with some traditional therapies in Africa.
There is a nondirective, evocative setting, but to this must be added
interpretations, i.e., statements from the therapist concerning a theoreti cal
system, whether expressed in terms of ego and id or ancestor spirit.
While therapy models based upon middle-class, Anglo-American cul ture
may be helpful and applicable, they can sometimes be impractical,
ineffective, and even harmful, creating stress and offending clients. Ther -
apists need to decide between creative and imitative techniques and
individual, family and/or group therapy on the basis of the individual's
personal and cultural milieu. Effective therapy may involve networks of
persons who radiate outward from the ill person and include family,
124 Hanna

friends, and neighbors. Curing in many societies is a mobilization of

personal networks.
In summary, it is critical for dance/movement therapists to know how
therapeutic activities are culturally conceived; what the criteria are for
who participates, when, where, how, and with whom; what is preferred,
prescribed, and prohibited; and what movements, postures, gestures, use
of space and transitions, phrasing, dynamics, etc. mean. In this brief
overview I have suggested that the perspective of comparability, cultural-
ism, and holism animate anthropological observations and explanations.
I attempted to indicate the importance of anthropology to therapy if it is
to be more than a "medicine for the mandarins." By becoming aware of
other peoples' belief systems and behavior, we can better serve them, gain
insights into our own culture and society, and draw upon the values and
techniques of other societies in order to improve our own.

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