If You Are Stuck — Try Dancing

I had seen this woman as a patient only once before, but I had seen more like her than I could count. She was in her late fifties, like me. Her gray hair fell in waves down her shoulders, Alice-in-Wonderland style. All of her clothing was childlike, too. If her hair had been blonde (as she had insisted it once was and was still meant to be) she would have looked, from the back, like a little girl in her calico dress.

She had been “traumatized” by her family. She didn’t want to talk about details and was more than a little surprised that I made no effort to push her to divulge them. She wanted to tell me about all the types of psychotherapy she had studied and learned, or even more she wanted to tell me about all of the great and famous figures of psychology she had met personally, and how wonderful they were.

“I don’t care if you met God himself or—–herself.” She was not happy with my response, but by now she had enough sense not to be surprised. She was labeled as a “borderline personality disorder” as well as a “treatment resistant depression.” She had refused anything even remotely resembling an antidepressant; she was worried about all kinds of side effects. She was on diazepam (generic Valium) and would accept nothing else. Among other things, this drug would do a fine job of keeping her depressed. She would not consent to anything else and it seemed to have helped minimally with anxiety. The choice of medication had been only one in a garden of self-sabotaging choices. She had been a training patient for a couple of generations of therapists, none of whom seemed to have been able to do her the least bit of good.

I verified she was safe and not suicidal. She seemed to be. She cried every time I suggested life could be even a little bit better. The real problem was a simple one; whatever had actually happened during childhood she believed somehow something was terribly wrong with her, and she could not or would not do the slightest thing to help herself.

I gave up on any kind of structured interview. She had turned heaven and earth to obtain this appointment and I would try to answer these questions.

“I need somebody to love me so that I don’t die alone.” A frequent and normal concern for women her age. I answered. “You need a love that will last. Those do exist, but the strongest relationships are always between two healthy people. You need to do something to get healthy first, so a good relationship is possible.”

She nodded. She starting taking notes. “What is the best kind of therapy? I studied them all.” I gulped before answering. “The best kind is the kind you believe in. Anything can work if you want to be well and you believe in it. The most important thing is to try the therapy you believe in.”

More crying. “I can’t do anything. I can’t try.”

“Of course you can. You know enough about all of them and could even do some of them yourself without a therapist. ”

More crying. “What do I do if it doesn’t work?”

“You try something else. If you want and you try, it will work.”

She tried to switch the conversation to talking about me and my life. I cut that short. I did admit that I had my troubles sometimes, too, and there were lots of ways to deal with a “bad mood.” I had to get more directive. “Look, whatever you try, you can stop it if it makes you miserable. But you might be better off, and you probably couldn’t feel a lot worse than you do now. There is no reason not to try, unless you like things the way they are. A lot of people get stuck because they think decisions are final and you are stuck with them, but that is not true at all”

I suggested we try a quick mood picker-upper that I often used myself. If she would try it with me, she would lose no more than a few minutes. So I told her about, and demonstrated, my “antidepressant song and dance” from a tune by George and Ira Gershwin:

“Bad mood, go away;
Come back, some day;
In March or May;
I’m Dancing and I can’t be bothered now.”

She said my dance steps were too complicated, so I changed it to a simple heel and toe routine. She had to get the words right, but I made her stop asking questions about where the hands went or how to step. “Just do it. You can’t go wrong.”

There was a hint of a smile on her face when my nurse pulled her from the room, saying my dancing was probably not doing it. I had two patients in the waiting room.. The bureaucracy had won. I knew I would change facilities and I would not see her again.

I put the reference in the chart. “Patient seems to respond to and attempt to mimic the examiner performing a simplified rendition of “I am Dancing and I can’t be bothered now” by George Gershwin, from “Girl Crazy.”

Here is a link to the You tube video where I originally picked up this number.

This kind of therapy seems too simple and counter intuitive to people who have spent years in an office trying to fight their demons, but this is the sword. When I found out that the caudate nucleus of the brain, which plays a role in semi-automatic movements, lit up somewhere in studies of obsessionality, it occurred to me that dancing was a semi-automatic movement.

I have been using “happy dances” and other kinds of dance routines with various subtexts and situations in lots of circumstances. I believe if people repeat these behaviors, they may actually extinguish a fair amount of obsessionality. I have seen this with my eyes.

Publish my findings? I think that is what I am doing right now. I think anybody for whom it is physically appropriate, and that is pretty much anybody, ought to dance every once in a while. Nobody need be watching.