Multidisciplinary Applications

Mark Sossin - Professor of Clinical Psychology, Pace University

Susan Loman - Director of DMT at Antioch University

Janet Kestenberg Amighi - Judith's Daughter

Psychology, Infant psychology, & Psychoanalysis

The KMP can be used as a comprehensive instrument in the context of psychotherapy, teaching, prevention and intervention, with children as well as adults. Because it assesses movement patterns indicative of intrapsychic and relational functioning within the dynamics of naturally occurring movement, it can aid in many different contexts, such as, i.e. in the understanding of dynamics between a clinician and a client. It can also be practical in the development of a dynamic formulation as it highlights areas of conflict, pathology, and character expressions as well as areas of harmony and ego strength. In addition, it can be employed to look at relational aspects in the therapeutic context such as bi-directional formation of empathy and attachment, matches and mismatches, and rupture and repair. KMP also has been applied in working with cross cultural comparisons, in educational approaches and even in engineering.
One of the advantages of the KMP is that it offers a clear and systemic description of an individual's movements, distinguishing between individual preferences and movement in relation to someone else. For these purposes, movement patterns can be made conscious, described, and eventually experienced differently. Any two, or more, profiles of people in relationship can be compared. If a profile, for example, of a child is compared with the caregiver's profile, it can help to detect individual preferences as well as areas of concern between parent and child: matches and clashes in the relationship, areas of harmony and conflict and shared repertoires can be described. The KMP equips the therapist and the parent with a tool that can be directly linked to empathy and attunement, providing a language that illuminates developmentally meaningful sequences and themes, in aid of primary prevention.

Clinical Applications

The KMP can be applied to clinical populations. Sossin & Loman (1992) outlined some clinical applications of the KMP. Loman (1995) describes a case study with a child with autism. Sossin (1993) explores the impact of developmental challenges on the evolving sense of self; Lewis (1993) develops an approach using the KMP with sexual abuse victims; other clinical applications include the treatment of borderline disorders (e.g. Levy, 1995) and psychotic disorders (e.g. Cruz, 1995). In these areas, the KMP provides a distinct way of describing and categorizing interactive processes within a unified developmental and psychodynamic framework. It is also useful as a guide in the prevention and treatment of psychological problems, especially in Infant/Parent Psychotherapy (e.g. Sossin, 1993, 1999a, b, 2002, 2003; Sossin & Loman, 1992) and in the arena of parent/child holding patterns (Romer & Sossin, 1991). One other application of the KMP application is "Movement Retraining". Here, the KMP aids in helping parents re-experience developmental movement patterns. By experiencing and learning about them, parents are better able to attune and support their child's developmental progress (Buelte, 1992).

The KMP in Dance/Movement Therapy

The KMP is widely used within the field of Dance/Movement Therapy (DMT) (i.e. Loman 1992, 1993, 1994, 1996, 1999, 2005; Lewis, 1986; 1987; 1993a;b; 1994;), where it serves as an assessment tool of non-verbal behavior which can then be processed verbally as well as through movement. Dance/ Movement Therapists who work within the psychodynamic/psychoanalytic traditions, can use the KMP for the observations of ego functioning, defense mechanisms, affect expression, and for the assessment and attunement in transference/countertransference matrix.

Bridging the KMP with other body-mind approaches, Loman, Ender and Burden (1994) discuss the KMP in relationship to the Body-Mind Centering (Bainbridge-Cohen, 1987), and develop a framework integrating the KMP with primitive reflexes, righting reactions, equilibrium responses and the Basic Neurological Patterns. Another paper looks at the KMP within a feminist relational model (Loman & Foley 1996). Loman (1994) investigates fetal body movements; and Loman & Kasovac (1997) used the KMP in the context of an infant heart transplant. In the field of anthropology, the KMP was used to investigate mother/child relationship and affect in Bali (Kestenberg-Amighi & Pinder, 1992).

Developmental

Dance/movement therapists have increasingly drawn upon psychodynamic and developmental models in framing their clinical interventions (Dosamantes, 1990; Goodill, 2005; Kornblum, 2002; Lewis, 1984, 1986, 1990, 2002; Loman, 1998, 2005, Loman & Foley, 1996, Loman & Merman, 1996; Sandel, 1982; Siegel, 1974, 1984; Tortora, 2006). The KMP offers a developmental framework that can be used to encourage and measure growth, and to integrate progressive interventions with the developmental process (LaBarre, 2001). It describes the typical developmental process in movement terms, which aid in identifying deviations from the norm, as well as strengths and latent potentials. The KMP' s psychodynamic framework provides information about drive development, affects, defenses against drives, defenses against objects, ego and superego functioning, object relations, narcissism, and areas of conflict or harmony in dynamics and object relationships.

The diagnostic/interpretive application of the KMP can lead to the detection of specific early developmental deficits and areas of psychic conflict, and suggests which movement patterns will be likely to foster resolution and growth. For example, the profile can indicate delayed, missed, distorted, or prematurely-induced developmental milestones by showing scanty or overabundant amounts of phase-appropriate movement patterns. Specific problems caused by trauma, such as abuse, separation or illness, during a specific phase of childhood, may affect the shape of diagrams in the KMP. When children experience these difficulties, they feel a sense of inadequacy that affects their self-image and often endures into later life. Body-image distortions, restrictions of movement, and accident-proneness may all be remnants of childhood trauma. The KMP identifies the specific movement patterns that are most relevant to the early conflicts between a specific caregiver and the child (such as inadequate holding and support or constitutional temperamental differences) that had, or are having, a formative impact upon the child's movement repertoire.

Once a deficit or challenge area in movement patterning is recognized in the KMP, various channels of intervention can be explored. By offering a systematic way to discern an individual's movement repertoire, and to correlate it with psychological experience, the KMP offers a stratagem for approaching treatment. Dance/movement therapists often use tension-flow attunement to develop affective empathy, and shape-flow responsiveness to develop trust (Kestenberg & Buelte, 1977a). These processes can evolve into more mature movement interactions when the patient is ready.

Dance/movement therapists operate in many different professional settings, and the KMP provides them with a powerful tool to assess patients in developmental and psychodynamic terms. To optimally use the KMP, the therapist would evaluate the patient's progress with a complete pre-treatment and post-treatment profile. In treatment planning, the KMP would be used to identify strengths as well as deficits, guide the therapists' movement approaches, and help the therapist determine whether to use attunement, mirroring, or affined movement patterns with the patient (Loman, 1994).

Anyhtopology

Theoretically the KMP is only attached to specific cultural settings in a marginal way. The movement qualities are descriptive and could refer to behavior in any cultural setting. Observation can take place anywhere and no specific movements are called for. So the KMP can travel from urban to rural, from western to eastern, from south to north. However, all medical diagnosis and treatment practices have their culture bound aspects.

Like developmental psychologist we must ask if the pattern of child development is universal and if we agree that there are variations, then we must ask to what extent would those variations trigger a clinical diagnosis? In a study of child development in Bali Indonesia Islene Pinder and Janet Kestenberg Amighi (1991) found evidence of parental shaping of children’s movement patterns to accord with cultural conventions. Upon reflection, we could hardly imagine otherwise. Although there are specific temperaments that seem strongly persistent throughout life reflected in movement, there is much transformation and evolution both due to internal developmental programs as well as influences of the external environment. Much more work needs to be done to better connect the therapeutic community with its clients.

Anthropologists have also been interested in the use of the KMP system in other cultures or other language communities. Do KMP terminology translate easily, keeping the same descriptive qualities and metaphoric associations with psychological and cognitive states that we find in English? For example, does the term “enclosing” translate into a term in the Yuche language of Oklahoma that captures the movement quality as it does in English. If terms cannot be meaningfully translated then what is it exactly that we are training?

Another concern is whether the body/mind connections that we experience in our own bodies and work with clinically are valid in other cultural settings. For example, when we speak of jumping rhythms, it is easy to associate such rhythms with interruption since we use “jump” metaphorically as in the phrase “he jumped right into our conversation.” Or, “he jumped from topic to topic.” Do the mind body connections which we use to interpret KMP movement qualities hold as well in cultures where such metaphoric use does not exist? This can raise a problem in translation, training, and in interpretation and treatment. Kestenberg Amighi interviewed native speakers of 8 different langauges to determine to what extent metaphoric use of English body movement qualities exists cross language boundaries (2010). She found that the closer the culture, the closer the pattern of metaphoric use. In Yuche for example, there were only 3 parallels uses in the case of 47 KMP terms. In Spanish there were many more and the amount depended on which Spanish language culture one was testing.

Education

The movement qualities in the diagrams, Pre-efforts and Directions have been found to often have a defensive, cautious quality, for example, someone trying to contain their anger might strain and look downward, someone worried about an issue may avoid it with flexibility and sideways movements. It was discovered that these types of movement are used often in learning experiences as well. In early stages of attempting a new task, qualities such as channelling (focusing) or hesitating, can be helpful in the learning process. However, when the learner does not move from channeling to direct action, from hesitation to acceleration or deceleration, then mastery of a task does not evolve. Sometimes learners get stuck in avoidance modes delaying with hesitation and then rushing forward with suddenness to overcome the delay. By studying movements qualities of students, educators can assess learning styles and when those learning styles may inhibit further progress.

Kestenberg Amighi studied the use of pre-efforts in learning in two rural communities, in Iran and among the Navaho. She found that it was common for learners to go from observation of a task to mastery without an intervening practice or pre-effort stage. More work is needed to study learning styles cross culturally.

Rebecca Burrill (2001) used the KMP in her doctoral research on "The effects of teaching/learning environments on the creative process of learning evidenced through a movement analysis tool: The Kestenberg Movement Profile." She employed the KMP to analyze preschoolers movement while they were engaged in formal actiities, improvisational dance, and art-making. Results showed formal activities less effective in accessing the creative process while bodily movement encouraged healthy self-identity.

Research Applications

So far, the KMP’s developmental model has been primarily based on hundreds of case studies, including longitudinal studies, of children, adolescents and adults (Kestenberg, 1965a & b, 1967; Kestenberg & Sossin, 1979). Recent studies have focused on the application of KMP regarding stress-transmission in parent-infant dyads (Sossin & Birklein, 2006; Birklein & Sossin 2006), depression (Brauninger, 2005), gender and leadership, (Koch, 2005), and mother-infant interaction in psychiatry (Koch & Brauninger, 2005). Future studies can produce norms for healthy and pathological populations across culture, age and gender, from which a statistical outline of diagnostic indicators can be drawn (Sossin, 2003). Longitudinal research with the KMP can advance psychodynamic theory by tracing specific developmental issues (such as aggression, narcissism, superego development or personality) from early infancy. Detailed studies of specific diagnostic populations are needed to establish the range of individual variation within groups. Other subjects for study could include premature infants, individuals with physical illnesses, role-dependent or context-dependent behavior. More research can also increase our understanding of risk factors, prevention and early intervention approaches with vulnerable infants and children (Kestenberg & Buelte, 1983).

Methodological research can examine the reliability of the current notation (Sossin, 1987; Cruz & Koch, 2004; Koch, Cruz & Goodill, 2002), and develop amended profiling procedures as needed for specific applications. Computer programs can facilitate scoring and correlation of profiles (Lotan & Tziperman, 1995, 2005). The validity of the current interpretive schema can be examined, and specific distributions can be related to clinically-relevant variables such as IQ, depression, neurological impairment, defense mechanisms, and systemic conflicts.