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A different tack

I recently witnessed a conference of psychiatrists who seemed to want to frame human distress in terms of clusters of neurones, and levels of dopamine and seratonin!

Pharma needs to start taking more than a biological approach to patient care.  I recently witnessed a conference of psychiatrists who seemed to want to frame human distress in terms of clusters of neurones, and levels of dopamine and seratonin! It was a depressing experience.

When we begin to understand the complexity of the brain and its connections to the rest of the body, we begin to realize how much more there is to understand.

The relationship between mind and body is full of varying hypotheses, but we are short on hard fact. Last month, in Japan, I witnessed the incredible nature of this link. I was in Osaka working with the Ashiya International Ballet School, led by Errol Pickford, a former principal dancer with the Royal Ballet. Our mission was to take high quality classical ballet and other dance to patients in Japanese hospitals.

I have a programme using dance here in the UK, working with the Arts Educational School in Hertfordshire, dancing primarily in mental health settings, but this work has never been done in Japan.

Ballet is popular in Japan, but the culture is very different, with great emphasis on formality. On my arrival I became quickly aware that there was a degree of skepticism from some of my Japanese colleagues about the validity of the project.

We took the best dancers from the senior school, aged 16 to 19 and began to prepare them for performing for patients in hospitals. A classical dancer is usually up on a stage, some distance from the audience with strong lights shining, occluding a clear view of the audience.

A dancer usually speaks with the body, not the voice. However, in the hospital setting, the dancers would be close to the audience and expected to interact verbally with the patients during and after the show.

As dancers are accustomed to performing in front of an audience that is fit and well, the success of the programme was dependent upon preparing young dancers for a performance for very ill patients in a clinical setting.

In addition to training the dancers, I undertook some training sessions with hospital staff, who had been given written materials explaining the project before my arrival. Staff included managers, nurses, therapists, doctors and care assistants. We explained that our primary task was to allow the patients to enjoy the magic of dance and to break the monotony of a stay in hospital. It was also an experience that patients and staff could enjoy together. We explained that if there was some therapeutic benefits we would be pleased about that, but pointed out that this was not our primary aim. The staff asked lots of questions and seemed interested in how it might work.

After the preparation came the acid test; we planned visits to three large hospitals across Ashiya. The first visit was to a unit with people living with Alzheimer's disease. We worked in a large open day room and around 200 patients and staff turned out for the first ever show in a Japanese hospital.

The atmosphere was one of excitement, with many elderly people pleased by our visit. The music started, the dancers were introduced and the audience transfixed for an hour. The show began by talking the audience through a ballet class, explaining how dancers train and prepare.

After this, the dancers donned full costume and performed solos and duos drawn from the classical repertoire, ending the show with a more contemporary piece, danced to Irish folk music.

During the performance one frail elderly lady started to lift her arms, in true balletic style, with a broad grin on her face. Another lady in the front row began to extend her legs in time with the dancers. Many were tapping out the rhythms of the music with their hands or feet.

The dancers then took questions from the audience and mingled with them after the show when refreshments were served. Questions afterwards were lucid and we discovered that for many of the audience this was their first experience of ballet and dance.

Some of the staff were amazed that patients with Alzheimer's could hold their concentration for an hour, but they all did. Many of the staff and the dancers were moved to tears by the experience. A staff member explained to me that the lady who had lifted her arms had limited mobility and that they would use music with the physiotherapist to work with her in the future - a little therapeutic breakthrough as an added bonus, which helped a staff member to think differently about her patient.

We went on to do two more shows in the following days, this time in a large general hospital and in a rehabilitation center for patients with strokes and other neurological problems. Both were a massive success and over two days we danced for nearly 700 patients and staff.

For me these experiences suggest that some in psychiatry who take a biological view of the human condition are missing the point. Our moods can be changed by all kinds of experiences, and when you allow a patient to have the stimulus of the beauty of music and dance, it is possible to help improve quality of life for people.

I have seen this many times in my work in the UK, but it was interesting to witness this in a totally different culture. Pharma companies manufacture products based on a biological approach to helping people find better health, but it is important that they remember the value of a holistic approach to healing and health.

My project in the UK is supported by an educational grant from Janssen-Cilag, and Sue Mason from Janssen is an integral partner on the project, working regularly with the dancers and myself. Janssen has realised that it is commercially sensible to be associated with a programme that is about offering top notch performance that can enhance the quality of life for patients. In the UK and Japan, media interest in this work has been high, again offering good opportunities to a sponsor for positive coverage.

This work is also of incredible value to young dancers at the start of their careers. Dancers train arduously to perform. This programme offers them real performance experience under challenging conditions. It builds their communication skills and stage confidence in a very powerful way. The patients and staff certainly benefit, but so do the dancers; so this work also adds value in educating young dancers in a fresh way.

Following our first experience in Japan, and extensive media coverage, many more hospitals in the region are contacting us for performances. We plan to expand the Japanese programme during the rest of this year and, as in the UK, we will be seeking support from a partner in the pharma sector.

The lesson for companies is to be more lateral in their thinking about sponsorship opportunities. So, when you are thinking about communicating with health professionals, remember it is worth considering ways in which your marketing budget can add real value to the quality of life for many patients, and to young performers in your communities.

Ray Rowden is adviser to Reach 4 Dance at the Arts Educational School, and training and organisational development adviser to the Ashiya International Ballet School, Japan

2nd September 2008


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