Jess's Interview with Uncovered aired on Monday 25.07.2022. (17:00 GMT)
In it, she chats to Steph about Mental Health and Pole. There was so much covered in such a short space of time that one blog post couldn't possibly cover it all! A transcript will be uploaded in due course - good old technology.
There have been so many wonderful messages from listeners who say the podcast resonates with them. Lots of questions and requests to explain some of the 'big words'. But most importantly, thank yous from so many who are glad that this conversation has begun, words of encouragement for my research and requests for more in-depth geek!
Those of you who have been in my Lectures, know that I can get a tad sweary (a trigger warning there for anyone who may be offended by my mildly blue shade) And before you all start emailing me about academic tone - this is a Blog!
So, make a beverage of your choice, sit comfortably and get your geek on... Let's introduce Pole as Mental Health Therapy.
Before we start, it is important to recognise here that the term mental health is positive. We have physical health; spiritual health and we have mental health. These things are on a continuum and at any given point, our mental health can slide, take a dip, or peak. This is normal and this is healthy. When we talk about Mental ill health or mental un wellness, this is a period of mental health which strays away from YOUR normal, where we may require intervention, additional support, or struggle to use our regular tools in our mental health tool kit to fix the issues. A range of stuff can cause this – finances, bereavement, loss, break ups, unprecedented change, abuse, bullying, or not having your neurodevelopmental or other individual differences correctly and effectively met. It can also be affected by things that you have control over – how you choose to feed your body, how you choose to move your body, who you choose to socialise with and how. (Blog about mental health aetiology on its way). The list is endless, and the more we are able to recognise what triggers us and affects our ‘homeostasis’ or our normal, the better we become at managing our mental health. This is called being emotionally literate. The same as physical health – you never forget the first time you pull a muscle or sprain something because you didn’t warm up before class – right? So, you learn that warming up before class is important for you. Equally, you learn how to treat the sprain should it occur again, so when sprains happen, they heal faster and we need less support to fix them or know when to seek help. This is resilience. (Blog about stress/resilience matrix on its way)
It is impossible to expose ourselves to the world from a Zorb (but how cool would THAT be?) We have to experience the rough and the smooth in order to have ‘sound’ mental health. A bed of roses, life is not, and from birth, our brains are exposed to stress which under the right conditions, has a positive impact on brain development and mental wellbeing. When unsupported or not supported effectively, or when exposed to excessive stress, we call this toxic stress and this is the bad stuff which has life long negative implications on humans, and MRI scans show changes to the physical brain structure in children who have experienced developmental trauma and adults with PTSD. Imagine body building – tearing muscle and repairing it to get bigger. Putting the physical body under too much stress without rest days or correct nutrition does what? It breaks it. Equally, putting the body through the same stress without branching out into other forms of exercise does what? It breaks it. Similarly, MRI scans and X-rays will show trauma in bones, discs, muscles and fascia in a human body that has not had time or support to heal from stress. This is how we make trauma in humans (blog about trauma on its way). My research focusses not only on promoting mental wellbeing through pole dance – promoting emotional literacy, teaching resilience, promoting physical and mental wellbeing, but actually treating trauma in both children and adults. The evidence is there to suggest that pole dance facilitates humans to move in very unique ways from other forms of physical exercise and which requires a unique connection between the body and the mind which can be beneficial to treating some of the neurological damage that occurs in the brain when we experience trauma.
So, what’s the latest stats on Mental Health and how does this apply to Pole?
Mental health is now acknowledged as a “sustainable development goal” by the WHO which proves that Mental wellbeing is a priority in terms of the socio-economic impact it has when left unsupported. Globally, we are finally seeing that if left unsupported, mental ill health is a financially costly issue and that some of those bigger world issues that we tried to fix by throwing charity at them, can’t be fixed because the issues run deeper. Psychiatry has always been the ugly sister of medicine, psychology – the poor cousin, and mental health – the unwanted child. Globally we are getting better at integrating those services and Mental Health’s status as a science is increasing. Before the pandemic in 2019 an estimated one in eight people globally were living with a mental disorder or mental ill health. And they are the ones we know about who haven’t faced the wrath of mental health stigma. Since C-19 WHO estimates a rise in both anxiety and depressive disorders at more than 25% during the first year of the pandemic. The collective trauma of the globe living through the pandemic is a reality, and the emergent research shows us that PTSD (in adults) and Developmental trauma (in children) is on the rise as a direct consequence of the pandemic. We are living in a Mental Health Pandemic, but without the celebrity status of COVID, and as with all Pandemics, we all have a part to play – This includes the pole community.
At the same time, mental health services have been severely disrupted with back logs not only for assessment but also for treatment, and most importantly, a delay in adequate provisions of early help and intervention from a preventative sense. We know that prevention and health promotion is the most effective way to support people – we know this from physical health sciences, yet, mental health promotion and prevention has not caught up with the demand. Additionally, on a global level, the treatment gap for mental health conditions has widened. In the UK our NHS provision is commissioned locality by locality, and there is a disparity in what services can be accessed by who and at what threshold of need. Globally, with the increase in privatisation of services, we see people taking a lottery of what medical treatment to prioritise based on affordability. Add to this that culturally, we still have a long way to go with reducing stigma around mental health. Despite progress in some countries, people with mental health conditions often experience severe human rights violations, discrimination, and stigma when they come forwards to seek help for their mental health. The Pole community has been found through research to be inclusive and supportive for people with a range of mental health and other needs, equally, we are seeing an increasing figure of people coming to pole in a bid to make a difference to their overall wellbeing – quite literally making pole a priority. This was reinforced with the increase of Home Poling during the pandemic, with X-Pole struggling to meet the demand for all their home poles. Polers claim that Pole is accessible, inclusive, supportive, and full of like-minded people. The research of Holland (2010) showed that there was something significant about the stigma associated with pole, and the attraction to it as a recreational sport. This, in my opinion, is a manifestation of the stigmatisation of mental health. Polers are more likely to have a clinical history of mental ill health and have experienced some stigma surrounding it and are therefore more likely to seek out other stigmatised individuals to ‘work out their shit’ doing a stigmatised activity. Joanna Nicholas (2019) found that Pole is characterised by a strong sense of community and acceptance including a safe and supportive environment whereby women can be physically active. Holland (2010) found that the top reason women continue to pole dance irrespective of the well documented stigma is that it is fun! Note to self – therapy is not generally described as being fun.
WHO states that Clinical Depression is one of the leading causes of disability around the globe. Either the disabling effects of the symptoms of depression or the co-morbid physical health conditions which are believed to be caused by depression. Chronic Fatigue, Cardiovascular conditions, and even some endocrine conditions have a strong causal evidence base in clinical depression. People with severe mental health conditions die prematurely – as much as two decades early – due to preventable physical conditions, and we are seeing emergent evidence now of the link between severe Covid, Long Covid and Covid deaths in people with chronic mental illness or those who have been psychiatrically medicated for many years. Equally stress has been shown to be a predisposing factor to physical illness and susceptibility to viruses. The case for ‘No Health without mental health’ has never been stronger. We cannot, as a population, continue to treat one aspect of our health in isolation. Our brains and bodies are symbiotically linked. The research of Joanna Nicholas (2019) found that recreational pole has a range of physical health benefits which are intrinsically linked to mental wellbeing. Pole (and Aerial) should be promoted as a recreational sport with undeniable health benefits.
Post-Traumatic Stress Disorders (PTSD), whilst relatively low in prevalence to other diagnosed Mental Health conditions, are reported to have high co-occurrence rates with other mental health illness (Bothe et al., 2020). The evidence suggests that people seeking support for depressive, anxious or mood related symptoms, are likely to have a clinical history that predisposes them to PTSD. The old ‘putting a plaster on the problem’ analogy – treating the surface wound is easier and more accessible than going deeper. Treatments for depression and anxiety are far more accessible than Trauma treatments, and often the outward symptoms are more problematic than Trauma. Trauma symptoms are often carried silently on the backs of their bearers, whilst anxiety and depressive symptoms have outward psychosocial consequences that are more readily identifiable. There are likely to be more adults living with PTSD than we (or they) realise. Add to this, that we have lived a collective global trauma through the pandemic, there will be millions of humans who are living with the symptoms of PTSD but presenting with other mental health concerns. Pole studios are likely to be the second home to a range of humans with a range of undiagnosed Post Traumatic Stress Disorders and we owe it to our community to understand that relationship better and know how to support it better.
Suicide is the fourth leading cause of death among 15-29-year-olds and according to the Mental Health Foundation, whilst suicide and self-harm are not mental health conditions in themselves, they are intrinsically linked to mental distress. Mental Health Foundation claim that men aged 40-49 have the highest suicide rates in the UK and are least likely to access psychological or mental health support, which suggests a link between accessing early help and prevention and lifelong outcomes. Promoting the transformative and healing properties of Pole (and Aerial) in children is important, as it opens up a recreational sport that boys and girls can access equally, which supports healthy sensory integration, physical health and mental health promotion.
Eating Disorders have the highest mortality rate of all mental health disorders. In the UK alone – a 50% increase in admissions to hospital for ED’s and some NHS Trusts reporting a 300% increase in referrals for ED symptoms, again with demand outstripping supply. Eating Disorders develop around pre-puberty as a complex consequence of childhood trauma. Research has found that early intervention and mental health promotion in very young children, reduces the risk of children developing cognitions (patterns of thought) that result in eating disorders. Children and young people who have increased emotional literacy and higher rates of resilience, and those who have strong support systems are less likely to develop eating disorders. The current Pole and Aerial research has consistently found that body image and self-perception is altered when engaged in pole dance and aerial. It also found a strong correlation with people who currently have, who are rehabilitating from or who are at risk of developing Eating Disorders or Body Dysmorphia. Instructors need specialist training on how to support people with Eating Disorders, rehabilitating, or those with early signs, as ED’s require exceptionally specialist support – consistent across all settings, and due to the extreme risks, they pose to the individual, if not correctly supported, there can be dire consequences. From an early intervention and prevention perspective, Pole has transformative powers in terms of embodiment and self-awareness. With the correct training and support, Instructors have the potential to lead a therapeutic role in the prevention of Eating Disorders. For her PhD, Dr Joanna Nicholl’s interviewed 38 women to understand how Pole affects human beings as a powerful form of exercise. Questions included what brought them to pole and how their minds/mindset/attitudes were affected by participation in 8 weeks of recreational pole. Her findings showed that pole dancing was associated with increases in body appreciation, body satisfaction, physical self-concept, muscular strength, and that the competence felt in class correlated to global esteem and perceived strength. It was proven that pole dancing has the potential to improve body image and physical self-concept.
And all of the research out there points to the friendships that are made in the studio and this sense of social identity needs further exploration as it may help us understand the impact pole has on our mental health better. Do home polers who do not attend class report the same improvements in their mental health as those who attend classes? The social aspect of pole alone cannot be enough to explain its popularity – or else why would Facebook pole selling pages be flooded with adverts of polers looking for 45 inches of chrome, like some sort of polers tinder? We know that positive and strong in-group identification leads to positive health outcomes, improved health behaviours and lower levels of depression. Do home polers consider themselves to have the same in-group identification? That whilst you are skilfully knocking out an Ayesha at home without booting the Labrador in the face, you are remotely connected to a wider community of cool misfits who love to hang out upside down? Self-determination theory suggests this sense of belonging and intrinsic self-satisfaction, leads polers to feel like their needs are met in and out of the studio, which in turn motivates them to continue in a more autonomous way than other forms of exercise and improves their wellbeing. It can explain why people feel more inclined to turn up and pole on the shittest of days, or why people feel more able to bash out some pole goals without their instructor yelling at them through a loud haler (yes, I have seen that in a Personal Training Session/Boot camp scenario)
A comparative study exploring traditional psychotherapies is needed, to understand if in-group identification and self-determination theory can explain why people do not report the same measures of success in their mental health therapy. Sure, we go to pole, we bleed, sweat, cry, and bruise. But we always seem to come away with a sense of accomplishment, motivation to return and a feeling that this is a life-long journey as opposed to an 8-week fix. Understanding what brings people back to the pole studio and whether there is a connection to the impact pole has on their brain, is important to developing mental health treatments. The psychological theories tell us a lot about why Pole is super awesome, but we don’t yet know if pole (as I predict) is having a neurological impact on our brains which we cannot see but can feel. The Kale and spinach smoothie of the sport world. Is it a ‘super’ sport, with hidden benefits?
Anecdotally, clients have told me that counselling and psychotherapy feels like ‘a lot of investment for little tangible gains’ whereas, pole-peers report epic ‘gains’ from poling, in spite of the stigma, in spite of the bruises, in spite of the financial cost, in spite of the fact instructors always whip out superman and titanic on hot days (you know you do instructors!). One common concern with trauma-focused treatment is dropout and rates of dropout appear to be similar across Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) and trauma-focused Cognitive Behavioural Therapy (T-F CBT) (Hembree et al., 2003) We don’t yet fully understand what is driving that, but it is believed there could be several reasons including; Timing and scheduling of appointments (getting childcare, rearranging life to fit therapy is not always doable), therapeutic alliance (relationship with the therapist), Adverse side effects (trauma focussed stuff makes you address the memories directly, and this can be extremely distressing), Financial cost (not all of these treatments are free at point of access, particularly around the globe) and therapeutic gains (its hard to see progress sometimes, especially when you come out of therapy feeling worse than when you went in). We know that not every treatment suits every individual and according to the Institute of Medicine (2014), matching treatment to the individual is the wave of the future. We need to compare interventions and determine if any treatment approaches are more or less effective for particular groups of people.
The Neuro Sequential Model of Therapeutics as pioneered by Bruce Perry, pulls from the Occupational Therapy work around Sensory Integration which was initially developed in the late 60s and 70s by Dr A Jean Ayres, an occupational therapist and psychologist with an understanding of neuroscience, working in the USA. This model of therapy, whilst not an exclusive treatment in itself, is having significant success in treating Developmental Trauma in children and PTSD in adults. Pole Dance and Aerial share so many NMT facets, that I believe they can be used in NMT to help treat trauma and that the neurological changes that take place during pole and aerial can explain why it is such a powerful tool for our mental health not just from a prevention and Mental Health promotion point of view, but as an active tool in treating conditions such as Trauma.
In my next Blog I will be looking at… What the heck is Sensory Integration and what does it have to do with Pole Dance?