Swarm and Mental Health

Movement and dance have been used as a form of healing for centuries. From the ritualistic dances used to influence fertility, birth, and sickness in pagan days (Molinaro et al., 1986), traditional medicinal movement therapies used in Far-East Asian cultures to address physical and mental illnesses (CITE), to the current uses of dance-movement therapy (DMT) as an adjunctive form of (psycho)therapy (Scarth, 2021). DMT was established and defined by the American Dance Therapy Association (ADTA) in the 1960’s as “the psychotherapeutic use of movement to promote emotional, social, cognitive, and physical integration of the individual, for the purpose of improving health and well-being” (ADTA, 2018);  the European Association Dance Movement Therapy (EADMT) added that DMT also promotes spiritual integration to the list previously provided by the ADTA (Koch et al., 2014).

Since the establishment of ADTA and EADMT, there has been a growing emphasis on evidence-based quantitative research within the field of DMT. This is evident in the rising quantity of research initiatives and the enhanced quality of studies, which incorporate specific group mechanisms for facilitating change. Examples of group mechanisms for change are group cohesion, mutual trust and support, probing social norms, enactive interpersonal learning and corrective emotional experiences, empowerment, and the experience of being part of something larger (Koch et al., 2014). DMT has been seen to be effective at decreasing depression and anxiety while additionally having limited but still positive impact on psychotic disorders (CITE) thus, highlighting the importance of the non-critical therapeutic setting.

The mechanisms identified to describe the arrival of participants at improved health and well-being are that DMT offers numerous pathways to heighten awareness of emotions and enhance emotional regulation by delving into movement exploration. The act of moving engages physiological processes linked to emotions, causing them to potentially be more accessible to conscious thought. Identifying emotional states becomes increasingly possible as individuals consciously monitor their body's sensations. Questions like, "How does my body feel when upset, angry, sad, or joyous?" guide this introspective process. Thus, the exploration of movement emerges as a potent tool, facilitating a conscious understanding of emotional experiences and enabling the expression of these feelings to others (Homann, 2010). This ability to understand oneself and sense and respond to others through congruent communication is a fundamental aspect of our humanity (Stern, 1995). In every interaction, we find ourselves in a continuous state of connection, adapting our reactions to the perceptions we hold regarding the thoughts and emotions of those we engage with. This empathetic capacity forms the cornerstone for establishing and sustaining attachments and interconnections throughout the course of our lives.

In the field of biomedical neurology, it is established that the mirror neuron system plays a crucial role in the interpersonal interaction process. This system coordinates the integration of auditory and visual cues in the perception of nonverbal communication by monitoring the movements and expressions of others, replicating corresponding patterns of brain activation in the observer. Essentially, mirror neurons establish the neurophysiological basis for essential human experiences such as empathy, love, and interpersonal interactions. DMT techniques involving mirroring and various forms of sensory stimulation, along with body-based regulation, appear to stimulate and bolster neuronal development. The act of nonverbal mirroring, including the synchronization of body language, contributes to a profound sense of being acknowledged by another individual. Methods centred around relational movement and mirroring also play a significant role in fostering self-awareness by allowing individuals to be recognized and accepted by others across the spectrum of emotions. Both this external acknowledgment and internal self-awareness have the potential to create a deeply impactful sense of emotional connection leading to substantial shifts and reducing feelings of emotional isolation (McGarry & Russo, 2011). As effective as DMT has been cited to be at positively impacting mental illness its limitation includes the heavy reliance on the client’s own processing, or the guidance of a therapist through the mirrored relationship. Both methodologies are limited due to the inclusion of a maximum of two people as change makers, the therapist, and the client. However, an individual does not live in isolation. Humans are inherently social where mental health suffers in periods of isolation (Hossain et al., 2020).

Another movement-based approach is Embodiment or Embodied Cognition. They were both conceptualised and introduced in 1970 and 1980 as a methodology that builds a connective understanding between the mind and the body. Embodied Cognitive theory posits that psychological phenomena are grounded in a person’s sensory-motor experiences and in their social interactions (Zatti & Zarbo, 2015). The body is not only a physical ‘object’ through which information flows, but also an active agent in shaping a person’s interaction with the world and the meanings ascribed to it (Orphanidou et al., 2023). More specifically, The Developmental Framework for Embodiment Research integrates agency and environmental methodologies by conceptualizing the body as a repository of experiences. It functions as a storage system, retaining a 'memory' of both experiences and capabilities essential for immediate action and mental functions which are activated and utilised in moments of interaction with the environment (Lux et al., 2021).

Embodied cognitive theory has been applied in the research of mental health and illness. In the study of depression, Orphanidou et al. (2023) emphasised the importance of studying the body as a subject and not just as an object in its experience of the physical symptomology of depressive aetiology and treatment. Interestingly, the findings also indicate towards a distorted relationship that arises between the body, the individual, and the environment. This occurs as a result of both the bio-medical changes within the body and the stated experience of the body being ‘hijacked’ by the experiences of depression. A struggle for control over the body ensues resulting in an oscillating state of feeling like oneself and feeling not like oneself. Only when one’s relationship with their body is re-established can a person and their sense of self be re-established (Orphanidou et al., 2023).

In schizophrenia, disembodiment phenomenology suggests that it is a disorder of embodiment (Zatti & Zarbo, 2015). The concurrent weakening of sense of self, the break of function of the body, and the disconnection of the relationship between one’s own body and that of others contributes to the severing of the link between the self and the world. Thus, schizophrenics are unable to affectively determine boundaries of peri-personal space or adapt to social and common norms leading to impaired social integration (Zatti & Zarbo, 2015). People experiencing schizophrenia may see themselves as outside observers of their own thoughts, behaviours, and perceptions where their body no longer behaves in a trustworthy or familiar manner (McCann & Clark, 2004). They frequently suffer from a sense of loss of presence that includes a disconnection from who they are, what they have done, and what they have experienced. In the worst situations, they may even feel empty, leading to a disintegration of everyday routines or automatic activities and the consequent organisation of elements into delusions that give the environment a rigid new coherence and significance (Zatti & Zarbo, 2015).

SWARM was created out of inspiration of the swarming of birds, the magical shifting of shape, form and shade that is dependent on each bird coordinating with the seven birds nearest to it. Each combined movement contributes to a total coordination change reliant on the smaller overlapping units of collective resonance (Ruiz & Vourloumis, 2021). Swarming as a performance is a constant listening and influencing of each other, while above all not 'losing oneself'. The choreographer is not interested in the idea of ​​swarms 'as one body' where all participants do the same thing and move in the same direction. The conventional dance routine involving a "swarm," where individuals shape themselves into a diamond and pivot according to a chosen leader's cue before passing on the leadership role was also a concept met with disinterest thus casting aside the follow-lead dichotomy. When a participant ‘follows’ in a swarm, they are not just passively adhering—they are amplifying that direction. However, despite the need to shed traditional notions of leaders and followers in a swarm, it seems that "following" actually embodies a form of "leading." Moreover, "following" within a swarm context could imply a capacity for "shifting"; a suggestion might inspire a veering slightly from the expected path, altering the dynamic in subtle but impactful ways. The exercise of who or what the participant is amplifying is political, it becomes a responsibility because what is amplified becomes more audible. This practice of listening, following, leading, and amplifying may have the potential of developing a balance between autonomy and collectivism, listening to, and influencing other members of the group.

Moreover, the idea of choreography as the organisation of movement is perceived as an activity that transcends beyond the confines of the theatre. Choreography can be seen in everyday life in numerous forms, such as a person standing at a traffic signal and only crossing the street when the pedestrian light changes from red to green is choreography. Furthermore, the social 1.5 meters distancing measures implemented at the hight of covid that inspired the protest element of Swarm can also be seen as a form of choreography, a collective interaction between macro level leading through mandates and measures and following by the people, and micro level movement of individuals within society as they listen, follow, lead and amplify their way through public space. To some extent, certain moments in the therapeutic process can also fall under the framework of the choregraphed. The client ‘performs’ within society while adopting a construct that is socially acceptable.

Swarm as a therapeutic tool is not a problem-based therapy but has its own trajectory. Sarah Ahmed states that “The work of inhabiting space involves a dynamic negotiation between what is familiar and unfamiliar, such that it is still possible for the world to create new impressions, depending on which way we turn, which affects what is within reach” (Ahmed, 2006). Swarm provides a public space setting that brings into focus the shared experience between the participant and their surroundings with the participant at the forefront, exercising their autonomy in decision making. The participant practices their individual processes of navigating through the group (which includes and is derived from both a collective cultural background i.e. Dutch, and diverse subcultures and identities). It is them and only them who have the power to choose how they interact with other SWARMers, nature, objects, infrastructure, people within the surrounding community, and the music the DJ plays. Additionally, that power extends to the choice to contribute to the ever-changing (unspoken) dialogue that guides the swarm as it moves through space. This act of contribution once again provides opportunities for participants to exercise autonomy thus empowering them to gain control over how they function within the micro-society that is SWARM while also practice self-actualisation. This practice is reflective of client-centred occupational therapy practices. 

Client-centred occupational therapy has been defined as a “partnership between the client and the therapist that empowers the client to engage in functional performance and fulfil his or her occupational roles in a variety of environments. The client participates actively in negotiating goals, which are given priority and are at the centre of assessment, intervention, and evaluation. Throughout the process the therapist listens to and respects the client’s values, adapts the interventions to meet the client’s needs and enables the client to make informed decisions” (Sumsion, 2000, p. 308). Following a non-directional and unconditional approach to providing positive regard and genuineness allows the client’s innate desire and capacity to self-actualise (Kensit, 2000). Sumsion (2005) adds that clients prefer to have the power and agency to identify which activities are useful for them to participate in rather than have mental health service providers make those choices for them. Therefore, it benefits both the client and the therapist to develop shared goals that results in the building of a consensual and effective partnership. In doing so, the client has the foundation to reach self-actualisation through the realisation and integration of their concepts of self thus reaching their fullest human potential (Guynn, 2021; Wilson & Hobbs, 1995). The value of self-actualisation can be further seen in a recent study identifying treatment processes that promote self-actualisation have the ability to lower anxiety and depression (Shahriary et al., 2021).

As part of the ongoing research on understanding the value of SWARM, an impact assessment was conducted. Participants were asked to sum up their mental state in one word at the end of each performance. Overall, 18% of participants respond with ‘happy’ when asked how they felt after taking part. All other responses were positive emotions that ranged from just one emotion to a statement. These results were shared not only in the setting of a psychiatric clinic but in other settings that include and are not limited to public policy protests, universities and cultural contexts. Thus, implying that SWARM has the propensity to facilitate positive mental health outcomes in a broader context.

SWARM’s vision is to further develop its multi-disciplinary approach by including citizen scientists as collaborators. In doing so, it hopes to advance the pushing of boundaries that delineate who the decision makers are in the treatment trajectory of the participants/clients. It further hopes to build a relationship of mutual trust and shared values with stakeholders to address hindrances to client involvement in client-centred practices and any reluctance or unwillingness of clients to be primary decision makers. Swarm’s multi-disciplinary team brings with it both a skill set and diverse points of resonance that allow for multiple points of connection for participants/clients. Participants/clients who are diversely aged, educated, gendered, come from diverse ethnic backgrounds and cultures, and have different histories of reliance on others, with each performance, can all be present in a way that respects the moment of performance. Furthermore, they can be part of something that not only contributes to their healing of self but flips the coin and provides a ‘exhibition’ of their process of self-actualisation for the more acute or severely cognitive impaired participants/clients as an empowering example of creativity and self-connection. 

With each performance, Swarm collectively learns and develops. It has grown into acting as a medium for bridging gaps between members of communities as well as in relationships between the client and mental health service provider. Seeking to promote pleasure activism, political activism, and overall act as an abundant source of positive energy, Swarm continues to advocate for a change of focus, purpose, and application methodologies in human interaction.