Performing Arts: Injury and Adversarial growth

Considering the term ‘athlete’, the majority of people might picture an Olympic medalist or a top-level Basketball player. Nevertheless, I would like to turn your attention to the athletes that may not come to mind as often, the dancers who train for hours every day on their stamina, grace and flexibility; and the acrobats that can take your breath with their strength and agility.

Did you know that a typical contract at the world-famous
Cirque Du Soleil can include around 450 performances per year?
(Menard & Halle, 2014)

Dancers and Acrobats present a unique population of athletes with very strong emotional bonds to their form of physical performance art. Like athletes, their occupation is an imbedded part of their identity and experiencing adversity* such as a physical injury can be a life changing experience. Following the adverse experience of an injury, the rehabilitation process is influenced by Psychological factors, which can in turn have a major impact on the rehabilitation timeframe and outcome.

If you are a teacher, or a performer yourself, then the following blog is for you.
I will look at

• the Psychology of the Performing Arts,
• the Psychological factors that influence the rehabilitation process,
• the potential for adversarial growth
• and how Sport and Exercise Psychology can have a useful application for the Performing arts.

*Adversity – refers to negative life circumstances that are associated with adjustment difficulties and distress (Howells, Sarkar, & Fletcher, 2017, p. 150).

Performance Psychology in the Performing Arts

Below are a few Performance Psychology traits and phenomena, inherent to the performing arts based on the work on Dr Kate F. Hays and her colleagues (Hays & Brown, 2004; Hays, 2002). Inevitably there are several crossovers with the Athlete performance world, however there are a few unique aspects to the Psychology and Psychopathology of the Performing Arts.

• Competition: Whilst there are Skill competitions in the performing arts world, the more common type of competition is casting for a role, or a contract. Acceptance in dance or circus schools can be particularly competitive. However, a key difference is that success in a competition does not in itself ensure the linear progression of an artist’s career.
• Relationship with the audience: Whilst in a sport performance the audience has little to do with the athlete’s performance, in the Performing Arts world relationship with and the judgement of the audience is an integral part of the performance.
• Vulnerability: In order to achieve the crucial relationship with the audience, a performer must be in a state of vulnerability. Leaving themselves at the mercy of the audience (or jury panel) and their subjective judgement of the performer based on a single performance. 
• Performance Anxiety/Stress: Arguably Performing Artists would experience significantly higher level of performance related anxiety and stress, due to the added vulnerability of their role. In certain pathological cases, Stage Fright can lead to substance and alcohol abuse in order to cope with the added pressure of performing.
• Quest for Perfection: The Performing Arts world is dominated by Talent, Aesthetic and Technical Standards. Artists that do not exhibit these in a subjectively judged performance, can have a hard time securing work or a place on a training course. Also, standards around body shape, fitness and flexibility in Dance and Acrobatics tend to lead to pathology like Eating disorders, Anorexia and Mental health disorders.
• Performing skills with minimal training: In some cases performing artists are required to perform skills with minimal training due to demands set by the competitive situation. In which case performers are often left vulnerable to failure and/or injury (Hays, 2002).
• Overuse Syndrome and Minor Injuries (Cumulative Stressors): Similarly, to professional sports, performing artists like dancers and acrobats, can experience injuries due to repetitive strain of the same muscle (Hays, 2002; Hays & Brown, 2004). Also, minor performance related injuries and strain can accumulate over months and years during an artist’s career. This would affect career longevity even in the absence of serious injury.
• Developmental background: Dancers and Acrobats, similarly to a lot of athletes, start practicing from an early age. Their age combined with all the above performance pressures can present developmental difficulties and pressures for young performers. They are likely to build a strong identity around their art, as well as experience extreme levels of involvement in their art from parents and family, or complete disengagement and lack of support. Also, Student performers have been evidenced to report higher symptoms of mental, physical and social pressure, compared to older, more established professionals (Donohue, et al., 2018). This can be due to fewer stable working opportunities within the performing arts and less opportunity to practice performing in front of an audience and general ease of performance (Hays & Brown, 2004, p. 64).

Adversarial Growth and Performance

As mentioned above, an adversity is a negative life event that can cause coping difficulty and distress. In Performance Psychology exists the notion that being vulnerable to pressure and adversity can be a key element in building resilience and coping experience (Fletcher & Sarkar, 2016). Put simply, one must experience adversity beyond what they can cope with and grow as a result of the experience. Trauma (in this case injury) can be an experience of learning about one’s body and effective functioning; re-evaluation and enhancement of social relationships; and building a new perspective (Fletcher & Sarkar, 2016).

*Important Note: Although adversarial growth can be beneficial, it should not be used as an excuse to implement unethical and inappropriate adversity with the aim of improving performance.

Psychological factors of Rehabilitation

Whilst an injury usually has a visible physical manifestation, the rehabilitation process and outcomes are influenced by psychological and psychosocial factors. The Biopsychological Model (Brewer, Andersen, & Van Raalte, 2002) and the Grounded theory of Sport Injury-Related Growth (Roy-Davis, Wadey, & Evans, 2017) highlight several overlapping categories of psychological factors that influence rehabilitation:

• Personality: Performer’s ability to understand and express emotions; their creativity and problem-solving approach; their ability to remain resilient and confident.
• Coping style: Performer’s typical thoughts and behaviours in response to stressful demands. Coping styles can be ‘emotion-focused (e.g., meaning making, emotional venting, seeking support for emotional reasons, and/or turning to religion) and problem-focused (e.g., planning, active coping, and seeking support for instrumental reasons).’ (Roy-Davis, Wadey, & Evans, 2017).
• Perceived social support: Awareness and appreciation of the social support available. Having a strong support network can aid coping and personality, reassuring the performer in moments of doubt and facilitating positive responses.
• Knowledge and prior experience:  Drawing on experience and lessons learned can help recognition and acceptance of an injury as part of the occupation. Sometimes, comparing with ‘worse’ event that have been overcome in the past, could provide a sense of confidence that the performer will come back from their injuries physically and mentally stronger (growth focus, rather than problem focus).

An injury can have a big influence on a peformer’s thoughts, feelings and behaviour, this influence can however be moderated and directed by external and internal factors. According to Roy-Davis, Wadey, & Evans, (2017), these factors have the potential to enable positive cognitive processes, and subsequent emotions and behaviours, leading to Sport Injury-Related Growth (SIRG) .

Putting the theory in to practice!

What can you do to increase your chances of experiencing Adversarial Growth following an injury?

Acknowledge and work with a potentially shifting identity.
There is a deep intimate relationship between a dancer and his/her occupation (Drury, 2018). Injury can have a negative psychological impact for a dancer’s identity. However successful interventions advise injured dancers to also think about their other identities, for example: the parent, the student or teacher, the woman/man, even the artist within another art (writer maybe). This technique can help lighten the crushing load of the present inability to fulfil the dancer identity.

Establish a supportive social network.
Injured dancers have reported going through a re-evaluation process regarding their social network (Drury, 2018). For some this takes the shape of finding a group or community where one’ feels they receive understanding and support. For others this means, abandoning relationships that bring about additional burden to their present situation.

Enhance the connection to your body.
Following an injury dancers and acrobats could have difficulty moving the same way they did before. That is not to say that beautiful moves cannot be achieved, rather any future movement would be modified by expanding their knowledge about their own bodies. Dancers and circus artists report, developing a passion for learning about their own physiology and finding new ways to achieve shapes within the same art. In some cases, dancers reported changing to a different art form, to discover an altogether new art of movement (Drury, 2018).

Talk about emotions.
Studies have found evidence that verbal disclosure of emotions can help promote sport injury-related growth (Salim & Wadey, 2018; Roy-Davis, Wadey, & Evans, 2017). Furthermore, disclosing positive emotions can lead to more positive emotions being experienced in the future (Salim & Wadey, 2018). Nevertheless, this should be executed with caution, in some cases, disclosure of strong emotions can lead to re-traumatisation for the performer. Also, conversation around emotions can be delicate and require a level of comfort within the environment and with the listener, as well as can be sensitive to outside pressure to disclose.

Learn from your past injuries.
For athletes and performing artists, injuries can occur more than once and with different severity. Nevertheless, they can always be a setback in performance. Acknowledging that injury can be a part-and-parcel of sport/performance could help with mentally normalising the experience of injury and aid confidence for recovery (Roy-Davis, Wadey, & Evans, 2017). Thinking back to strategies used during previous recovery processes or even non-injury-related adversity, can be a valuable tool. It is not always possible to rely on outside advice, however, reflecting on approaches to recovery based on past experience can help with taking active ownership of the recovery process and have a positive impact on feelings of self-efficacy and resilience (LaGuerre, 2016).

Make the most out of your time.
An injury can put a performer outside of their performing environment for the duration of recovery. For some this can be an opportunity to re-connect with friends and family, OR to work on skills or hobbies, that may have been left for a less busy time due to performance commitments (Roy-Davis, Wadey, & Evans, 2017).

Guidance to using the above advice:

1. This line of research and practice if in its infancy and warrants further research (Salim & Wadey, 2018).
2. There is no ‘one size fits all’ to reaching the point of Adversarial Growth following injury. Some thrive from enhancing their social network, others from internal empowerment of the self, or maybe you need both to reach your goals.
3. Based on your personality and experience you may not find all the above points helpful. Try the things that work for you and remember to apply the above knowledge from your subjective point of view.
4. You may find that certain strategies work better in certain situations.
5. The above strategies can be influenced by situational factors, such as time, location and other people.
6. You are not alone, there could be support networks available to you. If you are struggling, consider advising with a professional. They could have local knowledge or examples to help you cope.

Finally!

What are your experiences of coping with injury?

Did you go through any of the psychological methods mentioned in this blog?

Please consider leaving a public comment or sharing your thoughts with me via email!

References

Brewer, B. (2010). The role of psychological factors in sport injury rehabilitation outcomes. International Review of Sport and Exercise Psychology, 3:1, 40-61.

Brewer, B., Andersen, M., & Van Raalte, J. (2002). Psychological aspects of sport injury rehabilitation: Toward a biopsychosocial approach. . In D. Mostofsky, & L. Zaichkowsky, Medical and psychological aspects of sport and exercise (pp. 41 – 54 ). Morgantown, WV: Fitness Information Technology.

Donohue, B., Gavrilova, Y., Galante, M., Burnstein, B., Aubertin, P., Gavrilova, E., . . . Benning, S. D. (2018). Empirical Development of a Screening Method for Mental, Social, and Physical Wellness in Amateur and Professional Circus Artists. Psychology of Aesthetics, Creativity, and the Arts., Advance online publication. Retrieved from http://dx.doi.org/10.1037/aca0000199

Drury, C. (2018). A psychosocial approach to supporting injured dancers. Social Work with Groups. Retrieved from https://doi.org/10.1080/01609513.2018.1520672

Fletcher, D., & Sarkar, M. (2016). Mental fortitude training: An evidencebased approach to developing psychological resilience for sustained success. Journal of Sport Psychology in Action, 7:3, 135-157.

Hays, K. F. (2002). The Enhancement of Performance Excellence Among Performing Artists. Journal of Applied Sport Psycholog, 14:4, 299-312.

Hays, K. F., & Brown, C. H. (2004). Unique Aspects of the Performing Arts . In K. F. Hays, & C. H. Brown, You’re on! Consulting for peak performance (pp. 57-77). Washington, DC: American Psychological Association.

Howells, K., Sarkar, M., & Fletcher, D. (2017). Can athletes benefit from difficulty? A systematic review of growth following adversity in competitive sport. Progress in Brain Research, 234, 117-159.

LaGuerre, D. (2016). Helping an Elite Athlete move from 0 to 100 Post Injury. In J. Cremades, & L. Tashman, Global Practices and Training in Applied Sport, Exercise, and Performance Psychology: A Case Study Approach (pp. 28-34). NY: Routledge .

Levy, A., Polman, R., Nicholls, A., & Marchant, D. (2009). Sport Injury RehabilitatIon Adherence: Perspectives of Recreational Athletes. International Journal of Sport and Exercise Psychology, 7:2, 212-229. doi:10.1080/1612197X.2009.9671901

Menard, J. F., & Halle, M. (2014). Circus Also Needs Performance Psychology: Facts and Realities os Consulting at Cirque du Soleil. In J. Cremades, & L. Tashman, Becoming a Sport, Exercise, ans Performance Psychology Professional: A global Perspective (pp. 127-134). NY: Taylor & Francis.

Roy-Davis, K., Wadey, R., & Evans, L. (2017). A Grounded Theory of Sport Injury-Related Growth. Sport, Exercise, and Performance Psychology, Vol. 6, No. 1, 35–52.

Salim, J., & Wadey, R. (2018). Can Emotional Disclosure Promote Sport InjuryRelated Growth? Journal of Applied Sport Psychology, 30:4, 367-387.