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Reflections by Nimrod Levin

I was asked to write a little bit about what has been going on in the project from my own perspective. I admit that I try to avoid such statements, but I was encouraged to do so to help facilitate getting in touch with the other participants, to familiarize each other with our work, and hopefully – to make new collaborations possible. I don’t want to talk so much about myself and my work, but obviously there is not much escape from doing just that. Please forgive me.

About a week ago, in the last part of the second dance class in Israel, I presented to the Israeli participants the (scientific) study that I have been working on together with Dorit (Guy-Jelinek) and Tal (Shafir). One of the (PD) dancers asked me at some point what the name of our study is. We didn’t choose one, and I was a bit embarrassed for some unknown reason.

Embarrassment is a feeling that I experience relatively a lot in this project. Its occurrence has only increased since the beginning of the weekly dance classes in Israel: I meet new people; I expose myself; I dance; I fear that participants will question my intentions. I usually just smile when that happens.

In the last (third) dance class, I practiced capoeira with one of the PD dancers who is struggling to keep balance. She falls sometimes, so we all try to monitor the situation and catch her if we can. This last time I wasn’t quick enough, and she fell. It was not an easy experience for me, but she smiled when it happened, and she said she doesn’t mind it happening so much. I still feel that it is hard for me to explain exactly what happened there. I wonder if anyone has any suggestions or ideas what to do in such cases.

Going back to the rather formal side of this post, I want to tell you more about the (scientific) project I’m a part of. As I said earlier, one of my embarrassing moments was when I was asked about the name of the (scientific) project I presented. I don’t know why exactly I was embarrassed, but following that comment, Dorit and I chose the name “move-inter-action” for our study or paradigm (no capital letters because in line with the current zeitgeist we try to ignore hierarchies; please consider the possibility that I am using some irony). Together with Tal, we have designed a paradigm that includes three different parts: measurement of each participant’s motor ability, completion of questionnaires for a self-reported measurement of the psychological and motor consequences of their illness, and a move-inter-action part, which for us is the heart of our project.

The paradigm of move-inter-action is basically a 2-3 hour meeting with a PD dancer that includes three parts (in Israel, we like to say that the fundamental military doctrine is to split anything possible into three parts; is there an equivalent German explanation for this obviously universal behavior?). The first part is a 10 minutes physical warm up that all three will do together (the PD dancer being interviews, Dorit, and me). The goal of this part is to start to break the ice. The second part is a semi-structured interview that I will lead that will focus on four life periods (adulthood until the appearance of the first PD symptoms, appearance of first PD symptoms until diagnosis, diagnosis until joining the dance classes, and through the dance classes), and in different life domains (well-being, family life, social, and professional). The third and final part is a movement interview that Dorit will lead that will include an attempt to give rise to a dialogue through the body. We plan to meet with each PD dancer first in the next two months and again in the last two months of the project.

One of the goals of our project is to listen to the PD dancers and try to understand what they are taking from the classes, what do they find beneficial and what less so. To do so, I am also trying to meet with the different (younger/professional) dancers to hear about what they are trying to achieve in their classes. I hope that our findings will be put into use already within the scope of our project while still in process. Many other questions could be investigated through this paradigm, but one that Dorit, Tal and I are especially interested in is to see whether we can find any movement correlates or individual signature that corresponds to each PD dancer’s own experience and journey. Tal is helping us to adopt Laban’s movement analysis for this purpose (I highlight this specific contribution, but obviously she is helping us with many other issues).

Although we believe in our study, we don’t know at this point whether our study will yield any interesting results. Speaking for the three of us, we would be grateful for any comments and suggestions that you may have. I sincerely believe that it will only strengthen our project and I will surely be grateful for the willing to help. I did not mention many others that have spent hours (!!!) in discussing our ideas, and as I see it – this is a project that pretty much is inspired and shaped by all. Finally, I feel that our own little contribution to the larger project will have its (I think, positive) impact on the PD dancers (and others), and from where I am standing today, that’s more than enough. Feel free to write. Getting a message that relates to this project always makes me smile.

All the best,

Nimrod

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15 thoughts on “about move-inter-action

  1. Hello Nimrod, You’ve a really interesting project shaping up. I like the structure that you’ve created for this case study. (I haven’t heard of the 3-parts concept as a universal). I particularly found the move-inter-action interesting and I’m sure it will elicit some useful information for you. Arthur Frank talks of stages of living with an illness. The first is the ‘chaos’ of diagnosis (contrasted with life before – which will be interesting in a PD case as people with Parkinson’s often reflect back and realise they had Parkinson’s for way longer than they initially thought), the second is the journey to coming into some kind of acceptance (not everyone gets here). The way you are approaching this will foreground any perceived change for the person now dancing and any journey they might be taking/have taken.

    You have movement as a key component of the interview – good. Are you going to get any information beyond the Laban analysis? For example, are you going to listen to your participant talk about moving as well? Don’t forget the ability to move can fluctuate on a daily and hourly basis so factor that into what you are seeing. Are you doing this more than once with any individual participant?

    Regarding dealing with falling – don’t forget, although for normate people falling seems disastrous, people with Parkinson’s often deal with falling on a daily basis. Try not to pay it too much attention (thereby provoking potential embarrassment on the part of the faller) and conventional wisdom says don’t try to save the person from falling – you could hurt yourself and them.

    Dancing is exposing! I’m glad you are going for it though and smiling through it. Keep smiling!

  2. I recommend reading Michael Bury’s work on biographical disruption to find a way of theorising, should your participant talk about changes between how they saw themselves before being diagnosed and after.

  3. Hello!
    Lovely to read you here and experience someone else’s struggles, not only my own during this initial phase of the project!
    My question relates to the 3rd part of your study:
    “The third and final part is a movement interview that Dorit will lead that will include an attempt to give rise to a dialogue through the body.”
    How do you or does she plan to enter into physical dialogue with the patients? I’d be very interested to know what methods you plan on using for this.
    And I agree that all of what we are doing in this project is shaped by our collective wisdom that we need to share as often as possible. Good work to you all and can’t wait to hear more…
    Clint

  4. Dear Sara,

    I don’t know how but I initially missed your longer response. I just read it, and I am even more grateful for your thoughts and ideas. I feel I need some time to think about some of the things you said.

    Some answers for the time being:
    – Dorit and Tal are more responsible for the elaborated analyses of the movement. I assume that I be part of the discussion and think tank of how to analyze the information, but they are definetely the expert when it comes to the movement analysis. Do you have any additional recommendation for modes of analysis?
    One think we already noticed is that it would be interesting to compare the UPDRS scores of people when they are being tested compared to scores that can be elicited from the video recordings in the move-inter-action part. I suspect that the “testing” condition really distorts the results, and it would be interesting to contrast the two conditions.
    – We are asking our participants about moving in general and in the framework of the project specifically. We plan to conduct two move-inter-actions with each participant. One interesting issue that was raised this week by one of the participant is her ability to turn off her DBS for the move-inter-action. We asked her not to do it because we felt we need to think and consult others about the possibility of doing move-inter-action when it’s turned off. What do you think? Should we try to conduct an additional move-inter-action when the DBS is turned off?

    All the best,
    Nimrod

    • Dear Nimrod,
      I think that Laban Analysis is really, really useful and not used enough. Stick with this idea is my recommendation. It’s useful in being very clear in what you are looking at. Use Effort to start with if you aren’t used to using it. You’ll be able to talk about any qualities of change using this method and to describe the qualities of movement used in the interview. This is important when thinking about Parkinson’s, which gives people specific qualities of moving through time and space. (Know what these are for each person beforehand. Look at how they walk in the door on that day. Can you describe how they move using Laban’s Effort?)

      By UPDRS scores, you’re talking about the motor sub scale? How are you going to assess them by looking at the video? The UPDRS requires you to instruct them to do specific movements. Are you going to do these movements in the filmed interview? or are you more interested in general terms how movement might translate to some of the actions that the UPDRS assesses?

      You are right about testing potentially distorting results, but that’s the nature of research. You will always intervene thereby creating potential differences in the situation. Think about how you might consciously notice these distortions. In my project when our physiotherapist was administering the UPDRS I sat there with a notebook recording what people were saying as we realised that the UPDRS can miss things – we were missing so much of how people were interpreting the questions and what was affecting them specifically on that day.

      I’d agree with you about the DBS. Interesting to see her with it turned off but really not necessary for your project at this stage. We have to take people as they are and that means with DBS if they have it.

  5. Dear Sara and Clint,

    Thank you for your inspiring comments and for your genuine interest in our study. It is all very new and existing for me. As for the question about the movement part of the interview (move-inter-action) I can try to expend a little more about it.
    Actually, this third and last part of the interview also consist of three different parts (as Nimrod mentioned about the Israeli military doctrine 🙂 1) Structured physical warm-up. 2) Improvising motion together (first is a mirror game mostly with hand movements when sitting down and the second one is more like a leading exercises in space which includes simple elements like: walking, stopping, and changing directions). 3) I ask them to spontaneously create a self-portrait of themselves in movement.
    Later we are going to process this information using LABAN movement analysis looking at the changes in the movement quality (Effort, Shape & Flow). Another direction that we thought of was to look at the body language in the second part of the interview (semi-structured interview) and find connections between verbal content and body movement.

    Looking forward to hearing from you.
    All the best,
    Dorit

  6. Pingback: Clint Lutes – Intention/Action/Architecture | CLINT LUTES

  7. Hello Nimrod,
    My Name is Renée and I am one of the PD-Dancers in the classes in Freiburg / Germany. Maybe you don’t remember me (we talked about your firstname….), but I just want to say hello and hope you are smiling now while reading this!
    I cannot say much about your work, but it seems to me that it make sence.
    So I want to say “thanks a lot” to you and all the other (young) scientists and all the other people who are involved in this project, in Israel and in Freiburg as well, for what you all are doing for “us”!
    We really appreciate that so much!
    Thank you!
    So don’t stop asking questions! Don’t be afraid to ask “us” wathever you want to know, because : no quenstions – no answers!
    Wish you all the best!

    Renée M. Akargider

  8. Dear Renée,

    Thank you for writing, and please excuse me for not being able to respond earlier. Of course I remember our encounter and our talk, and I was so happy to hear from you. And yes, I was smiling reading this and also now while writing back 🙂

    I am really looking forward to meeting you again in the end of the year in Freiburg, maybe somehow before. Hope you are well and enjoying life, and not running late to too many meetings. It was a funny moment back then outside of the Freiburg Theatre (reminded me of myself).

    Yours truly,
    Nimrod

  9. Dear Nimrod,

    To my shame I have to admit that I’m still running 🙈!
    But i am told that moving is extremely important for me, so I guess that running is not so bad! 😜
    The worse part is not to be on Time, being to Late!
    But seriously: since 2-3 years my “timefeeling” is getting more and more lost…
    Sometimes that seens maybe not so bad…like “dreaming away”…
    But in “real life” you need this feeling to do the things you have to do!
    I think that as a Parkinsonian I am not so Stress resistant anymore (-Time Pressure??? – Pressure is Stress and Stress is Adrenalin – Adrenalin is Poison!!!) and that this could be the reason for loosing timefeeling! But that’s my Personal Theory…
    In your case: not so long ago I wrote a Poem “Pünktlich”, about being to late / being on time….I want to Share it with you! But please don’t be angry untill finish reading the Poem!😉

    Of course it is in German, but I’ll try to Translate / explaine…
    Here we go…

    Time is a construction
    you can surely Build on:
    Perfectly working
    but never stops

    Time is telling us
    how late it is.
    Day After Day
    for everything there’s a time

    But if you take your Time
    you may be / come to late…
    To late for the best!
    And you don’t now what they are tallking about…

    That’s where “life will punish you”! (1)
    Yes, that’s the very reason
    if “a dog suddenly bites you”… (2)
    And that’s not really healthy

    For you “only the rest” (3) (1-3 German Proverbs about be to late)
    from that’s what’s left behind…
    and that is not the best!
    So try to be on Time!

    I’ll say it once again,
    so you”ll understand:
    “to latecomers” nobody likes!
    A “no-Go” for coming to Late!

    So don’t you want to hurry up!?
    It’s Time to move your …
    Even you may think “I’ll be on Time”
    you wouldn’t and you know it!
    Time to be more consequent!

    Quickly I say “it’s OK”!
    I’m in a hurry now!
    So suprised of the fact that it works:
    Such a soliloguy ( selftalk) from time to time is a good thing!!!

    Renée M. Akargider
    03/2015

    Pünktlich

    Die Zeit ist ein Gebilde
    worauf man sich verlassen kann
    Alles perfekt geregelt
    Nur: sie hält leider niemals an

    Sie ist es die uns vorgibt
    wie spät es genau ist
    Jeden Tag aufs neue
    Für Alles gibt “s ‘ne Frist

    Und wenn du sie nicht einhältst
    Ja, dann kommst du zu spät
    Verpasst vielleicht das Beste
    Weißt nicht worum es geht

    Wirst dann “bestraft vom Leben”
    Genau das ist der Grund
    wenn dich plötzlich “ein Hund beißt”
    Und das ist nicht gesund

    “Bekommst nur noch die Reste”
    von was noch übrig ist
    Und das ist nicht das beste
    Sorg das du pünktlich bist

    Also sag ich es nochmal
    damit du es verstehst:
    Unpünktliche mag keiner
    Unpünktlichkeit nicht geht

    Drum mach dich auf die Socken
    Zeit das du Dich bewegst!
    Auch wenn du denkst “ich schaffe es noch”
    Du schaffst es nicht, das weißt du doch
    Zeit das du da mal Wert drauf legst!

    “Ist ja gut” sag ich noch schnell
    und zieh’ mich eilig an…
    was ab und zu so’n Selbstgespräch
    doch noch bewirken kann!

    Renée M. Akargider
    März 2015

    😜
    Best wishes,
    Renée

  10. Dear Renée,

    Again, I was so happy hearing from you, and I couldn’t stop smiling in the several times that I read (and reread) your post.

    It was really interesting for me to read about your personal theory. Would you mind writing some more about what stress does to you? Why do you see it as poison?

    I have to admit that I have a somewhat (I think) similar theory. Back in 2006, I was a “young officer” in the Israeli Defence Forces (sounds so dramatic) and it was the Second Lebanese War. I was under so much stress during those two months. Large parts of my hair turned into grey, and my hairline started to recede. So I try avoiding being stressed, hopefully thereby avoiding wars and loss of hair.

    You start your poem with the statement that time is a construction. Such a “postmodern” statement always reminds me of a beautiful and short essay by Michel Foucault “Of Other Spaces” originally published in 1968. Foucault writes there an early draft of the history (or genealogy) of the struggle between space and time. When I was in Freiburg, hearing the churchbell, I also thought a lot about that essay. It was the first time that I could experience that kind of reality. You can read it here – http://web.mit.edu/allanmc/www/foucault1.pdf

    and a short passage that I especially like and relates to what I wrote:
    “The daily life of individuals was regulated, not by the whistle, but by the bell. Everyone was awakened at the same time, everyone began work at the same time; meals were at noon and five o’clock, then came bedtime, and at midnight came what was called the marital wake-up, that is, at the chime of the churchbell, each person carried out her/his duty.” (Foucault, 1984 [1968], pp. 8-9).

    Warmly,
    Nimrod

  11. Dear Nimrod,

    What happened to you not just sounds dramatic…It is a drama! Or à traumatical expiereance! I am so sorry for you! For me it is stressfull to look at tv news about all the bad things that happens all the time all over the world! So it must be so much more stressfull to be in the situation by yourself. That what happend with your hair also happend to my Father in law when his daugther ( just married and in the age of 21) died. In one night his hair turned from black to white!!
    About my little theorie:
    My doctor told me that in case when i need any kind of anasthesy
    It must be free of adrenaline!
    I know that theres à physical reason for it…but i don’t nead to be a Doktor to understand that. Maybe I’m a good Observer?…and when i analize my symptomatic in times of harmony and in times of stress than the different is amazing!
    Look at:
    http://www.dopadoc.com/2011/06/10/discover-how-stress-affects-parkinsons/

    Of course I wrote a Poem about Stress too 😉 but in German.
    Maybe in a few days…
    Warmly,
    Renée

  12. A Little Late…but here we go!

    German / English

    Der Stressfaktor (bei M.P.)

    Früher hatte ich auch Stress
    Da hab’ ich ihn auch oft gebraucht
    Da hat er mich garnicht geschlaucht
    Da sagte ich nur: “Yes!”
    Wenn’s dauerte auch Stunden
    Ich hab’s als positiv empfunden

    Doch heute ist dem nicht mehr so
    Adrenalin ist Gift für mich
    Verstärkt Symptome fürchterlich
    Drum wurde aus dem “Yes” ein “No”

    Lass’ deshalb manchmal alles liegen
    Doch ganz kann man ihn nicht besiegen

    Versuch ihn aus dem Weg zu gehen
    Geh’ dafür über Stock und Stein
    Doch das kann auch sehr stressig sein
    Frier trotzdem ein,
    bleib einfach stehen…
    Das ist der pure Stress für mich
    und Ärgert mich ganz fürchterlich!

    Das mit dem Stress ist so ‘ne Sache:
    Nicht immer vermeidbar,
    egal wie ich’s oder was ich auch mache!

    Renée M. Akargider
    März 2015

    And this is the Translation (or something like that)
    I did my very best….

    The Stress Factor (?)

    In my life I’ve faced a lot of stress
    It seems as if I needed
    It didn’t matter to me at all
    I welcomed the Stress with a “Yes!”
    Even over days or hours
    It seemed to me like quite positiv!

    But now i have to admit that
    my yes turned into a big NO!
    Because of adrenaline is poison for me
    It makes my Symptoms terrible worse
    in such moments I try to keep it simple
    But I cannot escape…it’s impossible!

    Now I try to unstress my life
    Try less stressful ways to find
    Therefore I go over “Rough and Smooth”
    But you know what?
    That can also be quite Stressfull

    And even of the fact that I am more carefull with myself now
    When the Rigor lets my movement Freeze
    there is nothing I can do
    Nevertheless, when it is happening I have to wait untill it is over
    That is pure stress for me
    and annoys me quite horrible!

    This is a complicated thing :
    Not always avoidable,
    no matter what I do !

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