Care to dance?
Metaphors as partners against Covid
The pandemic is nowhere near over. We’ve entered a whole new way of living, one with seemingly few guarantees and no clear exit. Until current vaccine rollouts in Australia and world-wide improve, the ongoing public health crisis will continue to impact on quality of life and mental health across generations everywhere (e.g., Ravens-Sieberer, et al., 2021).
Each country and each culture has their own way of handling this pandemic. I was inspired to think of the importance of metaphors in relation to communicating about Covid after reading a New York Times article entitled “As Virus Cases Speed Up, Seoul Tells Gym Users to Slow Down” which reports new regulations imposed in South Korea. People are now being told to conduct slower physical movements, while “treadmills can go no faster than a brisk walk [and all] songs must fall below 120 beats per minute”. These South Korean regulations got me thinking: is there any utility in using a physical movement metaphor such as “dance” to try to make sense of how to behave and think during this pandemic including when communicating to patients?
Metaphors can act as an effective communication tool during tough times. They make complex topics more relatable to the recipient and easier to comprehend. The fluidity of metaphors enable us to shrink large issues down to ordinary human concerns, and to do so creatively. Veit and Ney (2021) argue that the diversity of metaphors found in the sciences and arts are “an elegant set of ‘tools’” that have been underappreciated. Of course metaphors can be anything. For example, seismologist Dr Trevor Allen of Geoscience Australia used the pavlova, the iconic Australian cake, when trying to explain the earth’s behaviour during earthquakes on our continent.
The Covid pandemic is ubiquitous, highly complex and fast moving, and seeing it through the lens of a dance may help us handle and manage it in a more insightful, perhaps even pragmatic way. For instance, professor of viral immunology Cassandra Berry of Murdoch University advocates flexibility (don’t good dancers have flexible bodies?), and states: “Rather than our scheduled dance card where we are just looking at age groups and vulnerable people, we need to step up and adjust”. She asserts we’re being prescribed very tentative steps “… doing a slow waltz… we need to adjust and start doing a fox trot quick step”. Here, notions of dance act as shorthand for epidemiological, public health and other medical measures being advocated. Ordinary, relatable words that may efficiently translate the essence of the unfolding, complex moving parts of science’s response to the pandemic.
So how could metaphors aid doctor-patient rapport building all while psycho-educating? Naturally, which metaphor one uses depends on context. Since cultural sensitivity and communications has become a recent public health focus, why not consider incorporating preexisting cultural knowledge in your deliberate use of metaphors? For example, in my work with a patient of Middle Eastern background, I noted they were a keen folk dancer. Knowing this, when doing research on their cultural background, I made a point of looking into folk dances from the region with the purpose of not only familiarising myself but arming myself with a selection of metaphors that I knew my patient could readily relate to.
Folk dances the world over typically portray stories, emotions, aspects of daily life, even historical events. Those who grew up dancing these folk dances internalise not only the physical movements but the feelings and words that they felt and spoke over many hours moving around the dance floor. For me as the therapist, knowing the story behind the repertoire of dances, and the meanings expressed in the very dance moves allowed me to attempt metaphors that, to a considerable degree of success, facilitated communication with and cooperation from my patient.
A dance metaphor may be a quick practical portal into making something scary or unfamiliar feel more familiar, less threatening, offering more control. It may also aid in rapport building without needing to learn an entire language or even a specific dance. For instance, a quick YouTube search brought me to, among others, the Arabic Dabke dance. The Dabke evolved from stories about “cooperation” and “help”, two important themes in today’s Covid pandemic. No matter whether we ourselves would be inclined to join in such a dance, acquainting ourselves with it may offer a communication bridge whenever talking to a patient of that cultural background. If we’re trying to better engage “cooperation” and “help” from all communities in our united fight against Covid’s spread, then it may be useful, when working with people of Arabic speaking backgrounds for instance, to transpose the original meaning of the Dabke dance to other domains such as public health and the need for collective action. Partnerships can begin with just one patient at a time. As a more nuanced communication tool, metaphor may readily appeal to the cultural uniqueness of a given patient. It can also be used in situations involving an interpreter, to potentially short-cut and move forward.
A reliable and trusted metaphor may lend itself to ‘incidental’ preventative medicine. During the Covid pandemic, the general public needs healthcare practitioners to help make concrete what is invisible and seemingly abstract, and metaphors have this capacity. We’ve all stepped into a different type of identity, purpose and time and so have our patients. Selecting an appropriate metaphor, e.g., a dance style, may do the trick in helping us help others comprehend what they need to do and which attitude to adopt in such a fast changing Covid environment. So in an educational role, we can imagine a therapist as a dance partner, leading and influencing the movement (mental state) of their patients. Patients, in turn, “change partners” when they return to their world and so influence others. In the context of the pandemic, the doctor or therapist becomes an agent of change around certain behaviours, such as social distancing, the wearing of masks, and acceptance of the need for vaccines.
In conclusion, thinking more creatively might help us all adopt a more flexible stance in our style of communicating vital information to patients who may be hesitant or uncertain in the age of Covid. It might mean health professionals go one small extra step, i.e., beyond just dialling up an interpreter. By investing a little time in doing their own informal research regarding their patients’ unique culture of origin, they may be practising ‘incidental’ preventative medicine, with the downstream effect of possibly halting or averting complications. Thus the power of the humble metaphor may assist us in some way to get others in step so that we can collectively, and in sync, get through this slippery pandemic. And who knows, one may even have a little fun and laughter (together with the patient) along the way! Now during these sombre times isn’t that ‘just what the doctor ordered’?
This article was originally published in Mind Cafe, September, 2021, Issue 74.
Selected references:
Ravens-Sieberer, U., Kaman, A., Erhart, M. et al. (2021). Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adolesc Psychiatry.
Veit, W., Ney, M. (2021). Metaphors in arts and science. European Journal for Philosophy of Science. 11(44).
