Moving Moments using DMP

'Moving Moments' using Developmental Movement Play (DMP)

Developmental Movement Play has been developed by Jan Filer over more than forty years of practice. The course 'Moving Moments' for mothers and babies/toddlers is based on the Developmental Movement (DMP) Experiences and philosophy of Veronica Sherborne and Rudolf Laban. Moving Moments is a child and family therapy for enhancing and building attachment, self-esteem, trust in others, and joyful engagement. It is based on the natural patterns of playful, healthy interaction between parent and child and is personal, physical, and fun. DMP provides opportunities for experiences and interactions that focus on four essential qualities found in parent-child relationships:

Structure
Engagement
Nurture
Challenge

Movement sessions create an active, emotional connection between the child and parent or caregiver, resulting in a changed view of the self as worthy and lovable and of relationships as positive and rewarding.

DMP is appropriate for children of all ages, including babies, and when combined with other techniques, it is a great therapy for teenagers too. With DMP, family interaction patterns improve. School professionals and pediatricians have reported positive changes in children’s behavior, self-esteem, and connections with others. DMP can help children who have experienced trauma begin to heal, can help children with developmental disorders feel more comfortable with social interaction, and can help families to experience happiness and connection.

'Moving Moments' specializes in helping children with:

Shy, withdrawn, or clingy behavior
Acting-out, angry, or disruptive behavior
Defiant, oppositional or controlling behavior
Behavioral problems at school or with peers
Attention Deficit Disorder
Attention Deficit Hyperactivity Disorder
Developmental disorders such as Asperger’s Syndrome
Autism Spectrum Disorders
A history of trauma, abuse, or neglect
Attachment disorder due to fostering or adoption
A history of social deprivation due to living in an institution
Attachment disorder due to multiple changes in living arrangements
A history of social deprivation due to poverty and/or neglect
History of Domestic Abuse and Violence
Psychological trauma due to medical care or serious illness

This therapeutic intervention enhances and builds attachment and relationships, self-esteem, trust in others, and joyful engagement. It is based on the natural patterns of playful, healthy interaction between parent and child and is personal, physical, and fun. The 'Moving Moments' early intervention focuses on four essential qualities found in parent-child relationships: Structure, Engagement, Nurture, and Challenge. The movement sessions create an active, emotional connection between the child and parent or caregiver, resulting in a changed view of the self as worthy and lovable and of relationships as positive and rewarding.

'Moving Moments' is appropriate for children of all ages, including babies, and when combined with other techniques, it is a great therapy for teenagers too. With 'Moving Moments', family interaction patterns have improved and school professionals and pediatricians have reported positive changes in children’s behavior, self-esteem, and connections with others. This intervention can help children who have experienced trauma begin to heal, can help children with developmental disorders feel more comfortable with social interaction, and can help families to experience happiness and connection. Taking part in 'Moving Moments' can help children with:

Shy, withdrawn, or clingy behavior
Acting-out, angry, or disruptive behavior
Defiant, oppositional or controlling behavior
Behavioral problems at school or with peers
Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder
Developmental disorders such as Asperger’s Syndrome and Autism Spectrum Disorders
A history of trauma, abuse, or neglect
Attachment disorder due to adoption or multiple changes in living arrangements
A history of social deprivation due to living in an institution
Psychological trauma due to medical care or serious illness

"A child enveloped in a particular style or relatedness learns its special intricacies and particular rhythms, as he distills a string of instances in the simpler tenets they exemplify. As he does so, he arrives at an intuitive knowledge of love that forever evades consciousness.” -A General Theory of Love

Attachment theory and attachment-based play are two foundational pillars upon which the 'Moving Moments' model is built. It assumes that a parent’s involvement in their child’s dance-movement sessions is an essential part of the child’s progress. The focus of 'Moving Moments' is the parent-child relationship with one of the primary goals 'giving parents new positive and healthy ways of interacting with their child'. (Booth & Jernberg, 2010)

How the work is assessed

Alongside Laban's movement analysis and detailed observations during movement sessions for a deeper analysis of parent-child attachment The Adult Attachment Interview (AAI; George, Kaplan & Main, 1996) is also used because some parents have difficulty being playful and attuned to their child in the ways the DMP (when used as a specific therapeutic) model requires. The Adult Attachment Interview (AAI; George, Kaplan, & Main 1996) gives the therapist significant insight into the internal world of the parent helping the therapist to understand why a parent may be behaving in certain ways in the DMP sessions. This information also sets the stage for MIM feedback to illuminate how the parent’s past impacts the parent’s ability to attach to their own child. Thus, the AAI may help explain why some parents may become “stuck” in treatment and are unable to “get into the mind of their child.” An understanding of the “parent’s state of mind with regard to the attachment” can also help the therapist predict what challenges may come up in sessions and allows the opportunity to tailor them in effective ways. (Bick & Dozier, 2008)

The Adult Attachment Interview protocol was developed in the early 1980s, along with an accompanying system for scoring and classification. The questions that comprise the interview are masterfully designed to “surprise the unconscious” and as a result the therapist is able to unearth information about the parent’s“state of mind with regard to attachment” that often would not have been shared with the therapist by traditional clinical interviews and assessments (Hesse, 1999). The AAI may be scored and interpreted by a professional trained for the task, or it may still offer useful insights without the time and expense of hiring a reliable coder for scoring. If the AAI is to be scored and classified, the interview is recorded and transcribed verbatim and the transcript is then scored by a person certified as a reliable coder (Hesse, 1999). This coding system offers the therapist a heightened sensitivity to various defensive strategies that may emerge in the interview. The text Clinical Applications of the Adult Attachment Interview (Steele & Steele, 2008) offers an excellent overview of many ways the AAI can be used in clinical practice, and Attachment In Psychotherapy (Wallin, 2007) outlines various ways for a therapist to alter his/her clinical approach based on the client’s “state of mind with regard to attachment.” Parenting from the Inside Out (Daniel Siegel, 2003) is a helpful book to share with parents and caregivers as they explore how their own history of being parented impacts their current parenting style.

Below is a modified list of the AAI questions (Hesse, 1999). Please note that this is a brief prècis of the AAI protocol taken from George, Kaplan, and Main (1996) The AAI cannot be conducted on the basis of this abbreviated version which omits several questions as well as critical follow-up probes. The full protocol, together with extensive directions for administration, can be obtained by writing Professor Mary Main, Department of Psychology, University of California at Berkeley, CA 94720. It is also available at:http://www.psychology.sunysb.edu/attachment/measures/content/aai_interview.pdf

The questions listed below can be very helpful for use in non-research-related clinical settings particularly early in treatment (Wallin, 2007)

Introduction of the interview:

I’m going to be interviewing you about your childhood experiences, and how those experiences may have affected your adult personality. So, I’d like to ask you about your early relationship with your family, and what you think about the way it might have affected you. We’ll focus mainly on your childhood, but later we’ll get on to your adolescence and then to what’s going on right now. This interview often takes about an hour, but it could be anywhere between 45 minutes and an hour and a half.

1. Could you start by helping me get oriented to your early family situation, and where you lived and so on? If you could tell me where you were born, whether you moved around much, what your family did at various times for a living?

2. I’d like you to try to describe your relationship with your parents as a young child… if you could start from as far back as you can remember?

3/4. Can you give me five adjectives or words that reflect your relationship with your mother/father during childhood? I’ll write them down and when we have all five I’ll ask you to tell me what memories or experiences led you to choose each one.

5. Now I wonder if you could tell me, to which parent did you feel the closest, and why?

6. When you were upset as a child, what would you do, and what would happen? Could you give me some specific incidents when you were upset emotionally? Physically hurt? Ill?

7. What is the first time you remember being separated from your parents?

8. Did you ever feel rejected as a young child? Why do you think your parent did those things – do you think he/she realized he/she was rejecting you?

9. Were your parents ever threatening with you in any way --- maybe for discipline, or even jokingly?

10. In general, how do you think your overall experiences with your parents have affected your adult personality?

11. Why do you think your parents behaved as they did during your childhood?

12. Were there any other adults with whom you were close, like parents, as a child?

13. Did you experience the loss of a parent or other close loved one while you were a young child or as an adult?

14. Were there any changes in your relationship with your parents after childhood

15. What is your relationship with your parents like currently?

Hesse (1996) emphasized that the interview questions demand that the interviewee engages in simultaneous tasks which include producing and reflecting on memories related to early attachment experience while also maintaining coherent discourse with the interviewer. The fact that their interview moves along at a fairly rapid pace while asking questions that demand careful reflection allows numerous opportunities for the interviewee to contradict themselves and lose coherence in various ways. The speaker’s ability or lack thereof to maintain coherence allows the AAI transcript to be judged into several different categories which are summarized below (Hesse, 1999):

Secure/Autonomous (F)

Coherent collaborative discourse. Valuing of attachment but seems objective regarding any particular event/relationship. The adjectives that are given to describe each parent are well supported by examples given.

Dismissing (Ds)

Not coherent. Dismissing of attachment-related experiences and relationships. Normalizing (“excellent, very normal mother”), with generalized representations of history unsupported or actively contradicted by episodes recounted. Transcripts tend to be excessively brief.

Preoccupied (E)

Not coherent. Preoccupied with or by past attachment relationship or experiences, speakers appear angry, passive or fearful. Sentences are often grammatically entangled or filled with vague usages (“dadadada,” “and that”). Transcripts are often excessively long.

Unresolved/Disorganized (U)

During discussions of loss or abuse, an individual shows a striking lapse in the monitoring of reasoning or discourse. For example, the individual may briefly indicate a belief that a dead person is still alive in the physical sense, or that this person was killed by a childhood thought. The speaker will ordinarily otherwise fit Ds, E, or F categories

In looking at the distribution of the above AAI classifications in samples of non-clinical mothers, Bakermans-Kranenburg & van IJzendoorn, (2009) found the majority of mothers were classified as securely attached (58%) with 23% of the mothers being classified as insecure-dismissing and 19% as preoccupied. In addition, some 18% of the non-clinical mothers displayed unresolved attachment representations. The importance of this for clinicians who are working with children with attachment difficulties and their caregivers is the strong correlation between a parent’s AAI classification and the classification of their child in the Strange Situation. Dozier, Chase-Stovall, Albus and Bates (2001) in one of the first studies to look at the connections between foster mothers attachment state of mind in the AAI and infant attachment as assessed by the Strange Situation, found a remarkable association. There was a 72% match between a foster care mother’s state of mind and child attachment. In the article, the authors propose that foster children may organize their attachment around the emotional availability of their foster parents. (Steele, Hodges, Kaniuk, Steele, Hillman, Asquith, 2008). This idea is central for therapists who are working with foster and adoptive parents using Theraplay. The Theraplay model’s success rests upon the parent’s ability to engage in attachment-promoting behaviors with their foster or adoptive child.

Setting earlyDMP sessions up for success:

Early DMP sessions are diagnostic regarding both the parent and the child. Based on initial case assessment and responses in the MIM, it is not uncommon for therapists to expect a child to act one way in DMP sessions even though they end up presenting in a quite different way. For example, children we may expect to be resistant in DMP sometimes seem to “soak up” the DMP experienceS like a sponge. Others surprise us with their staunch rejection of nurture or intense efforts to control all aspects of the session. Neither response may have been anticipated based on the MIM assessment.

This element of surprise in how children respond during initial DMP can also be true for parents. Few DMP therapists can say they have not experienced a movement session where a parent they expected to be nurturing and engaging was incapable of connecting their child in a playful, attuned manner. Use of the AAI early in treatment can give therapists useful information about what may be blocking a parent from being the “therapeutic” parent they need to be to address their specific child’s needs. It also assists the therapist in knowing more specifically how they may need to work with a parent prior to the parent joining the 'Moving Moments' group sessions. The task for the therapist in engaging a parent can be approached differently based on the parent’s “state of mind with regard to attachment” (Main, Goldwyn, & Hesse, 2003) The parent’s state of mind helps the therapist identify specific ways to help parents alter their view of parenting as well as assess how open the parents are to change. Information produced by the AAI allows the therapist to shape treatment strategies and approaches in ways that are most helpful for individuals (Bick and Dozier, 2008).

References:

Bakermans-Kranenburg, M.J. & van IJzendoorn, M.H. (2009). The first 10,000 Adult Attachment Interviews: distributions of adult attachment representations in clinical and non-clinical groups. Attachment and Human Development 11(3) 223-263.

Bick, J. & Dozier, M. (2008) “Helping foster parent’s change: the role of the parental state of mind” in H. Steele and M. Steele (Eds) Clinical Applications of the Adult Attachment Interview. New York: Guilford.

Booth, P., & Jernberg, A., Theraplay: Helping Parents and Children Build Better Relationships Through Attachment-Based Play, San Francisco: Jossey-Bass.

Dozier, M., Chase-Stocal, K., Albus, K., & Bates, B. (2001). Attachment for infants in foster care: the role of caregiver state of mind. Child Development 72(5) 1467-1477.

Fraiberg, F., Adelson, E., & Shapiro, V. (1975). Ghosts in the nursery: a psychoanalytic approach the problems of impaired infant-mother relationships. Journal of the American Academy of Child Psychiatry, 14(3) 387-421.

George, C., Kaplan, N., & Main, M. (1996). Attachment Interview for Adults (3rd ed.). Unpublished Manuscript, University of California, Berkley.

Hesse, E. (1996). Discourse, memory and the Adult Attachment Interview: A note with emphasis on the emerging cannot classify category. Infant Mental Health Journal, 17, 4-11.

Hesse, E. (1999) “The adult attachment interview: historical and current perspectives” In J. Cassidy and P. Shaver (Eds)Handbook of Attachment: Theory, Research and Clinical Applications. New York: Guilford.

Lewis, T., Armini, F., Lannon, R., (2000) A General Theory of Love, New York: Vintage Books

Siegel, D. (2003) Parenting from the Inside Out, New York: Jeremy P. Tarcher/Putnam.

Steele, M., Hodges, J., Kanuck, J., Steele, H., Hillman, S., Asquith, K., (2008) “Forecasting outcomes in previously maltreated children: the use of the AAI in a longitudinal adoption study” in H. Steele and M. Steele (Eds) Clinical Applications of the Adult Attachment Interview. New York: Guilford

Wallin, D. (2007) Attachment in Psychotherapy, New York: Guilford