KUNSTHØGSKOLEN I OSLO OSLO NATIONAL

KUNSTHØGSKOLEN I OSLO
OSLO NATIONAL ACADEMY OF THE ARTS
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plass
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Johanna Marthinsson
Mirror, mirror on the wall... What can I, as a ballet teacher, do to prevent eating
disorders or help a student with such a problem?
PPU —Dans
Balletthøgskolen 2013
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Johanna Marthinsson
Thesis
Practical Educational Dance Programme 2012/201 3
The Academy of Dance
Oslo National Academy of the Arts (K1110)
Mirror, mirror on the wall...
What can I, as a ballet teacher, do to prevent eating
disorders or help a student with such a problem?
TABLE OF CONTENTS
I.
Introduction
1
The Aesthetics
Introduction
to eating disorders
3.1 Anorexia
3.2 Bulimia
of Classical Ballet
nervosa
4
nervosa
3.3 Recognizing
3
4
the signs of eating disorders
Self perception
4
5
4.1 SeIf-image
4.2 Body image
6
4.3 SeI f-esteem
7
4.4 Identity
8
Case
llow
10
The Ballet Acaderny
at KI110 copes with eating disorders
12
What to do9
14
7.1 Feedback
14
7.2 Dialog and confrontation
16
7.3 PARK-model
17
7.4 An open environment
18
7.5 Weight loss
19
Summarv
19
References
1. Introduction
The mirror is not you. The mirror is you looking ut yoursell
- George Balanchine
In this thesis I intend to discuss eating disorders
in the world
of classical
what teachers can do to help their students stay healthy and overcome
nately common
cal ballet. which
illnesses. It is important
to acknowledge
consider a skinny body.
a job in a classical ballet company.
the fact that students are often thin and in their teens, it is important
aware of the risks of eating disorders,
these unfortu-
the aesthetic ideals in classi-
require a lean and what most people would
Such figure is also essential for obtaining
ballet and
Due to
for teachers to be
and learn to notice the early signs. But then
what, how should a teacher approach a student they are concerned about?
Therefore,
my thesis question
is:
What can I, as a ballet teacher, do to prevent
eating disorders
or help a
student with such a problem?
I will
start by describing
the aesthetics of classical
ballet and then introduce
various
eating disorders and the signs teachers should be aware of I will then research various
theories
of self-concept.
about teaching.
self-esteem
and identity
in order to link these to theories
I will also write about a casc where a student developed
order during her professional
school at the Oslo National
dance training.
Academy
an eating dis-
after which
I will discuss how the ballet
of the Arts (KHIO)
deals with eating disorders.
In light of the examples and theories. I shall then discuss my thesis question and finish with a summary
of the most important
students in professional
encounter
dance training.
aspects of my thesis. The focus will
be on
as that is where teachers will almost inevitably
students with eating disorders.
This is not to say that the methods and theo-
ries in this essay would not apply to students of any age.
1
2. The Aesthetics of Classical Ballet
-
The body culture of ballet dancers. whilst
developed
evitably
and held by those involved
greatly affected
with, and "inside-,
by the ideals and beliefs
the ballet world,
affected by the body culture of the society at the time.- (Walters
It is common knowledge
that classical
the norm in classical ballet. Most, if not all, professional
from and the physical
er attributes.
"lines"
required
With this said. the aesthetics started somewhere,
choose their dancers through
auditions.
They usually
in classi-
and has become
ballet schools and companies
have many dancers to choose
appearance plays a major role in addition
Many dancers experience
2000. p. 7)
ballet dancers are slim. The general thought is
that slim and long bodies create clearer and more beautiful
cal ballet technique.
is also in-
to technique
and oth-
pressure from school or the management
ballet companies
to loose weight. The issue of weight is unfortunately
in a humiliating
way, with inappropriate
comments
in front of other dancers instead of discussing
otten discussed
from the management,
the matter privately
of
and often
(Walters
2000). 1
believe. this negative culture has lasted lbr so long that it has become practically
ac-
cepted by dancers who often have to fight for work and are happy to be dancing ev en
if they are treated badly. I am sure that changing this culture will take a long time, but
every ballet teacher can make a small difference.
eating disorders
has slowly
my professional
training
ing disorders,
importance.
It seems like the atmosphere around
changed, both in the media and dance world,
10 years ago. There are more discussions
and dancers are more often compared
The fashion world
since I took
about fighting
eat-
to athletes, where strength is of
is also a sector where eating disorders
are very com-
mon and various big fashion events are now taking a stand by refusing
to use models
under certain
changing.
example
world,
size. It also seems that the shape of the ideal female body is slowly
I believe such a change is also starting to take place in the ballet world.
Prix de Lausanne,
one of the most prestigious
makes dancers sign a contract
dancers from competing
where the judges
if they have an eating disorder
believes they impose a health risk to themselves
er institute
actively
fighting
eating disorders
by example.
competitions
or the examining
physician
the competition.
in classical ballet is the National
various
They aim to combine
in the
reserve the right to prevent
by attending
School of Canada, where this is done by attending
ences and by leading
ballet
For
dance medicine
AnothBallet
confer-
the latest advancements
in
2
sports medicine,
ing. "They
science of movement
and childcare,
to the traditions
of ballet train-
`the time has come for the danee world to re-think the
are persuaded that:
way things haye always been done: " (Wuersten in Walters 2000, p. 27)
In addition
physically
to the culture
in classical
very demanding,
which
put less pressure on the joints
ballet, there is the aspect of the art form being
affects the aesthetics.
A lower
and decrease the risk of injury,
body weight
even though a low body
weight may induce other health risks. Ballet includes many complicated
of naturally
easier and less risky
for male dancers to lift
will
lighter
lifts and it is
women
(Walters
2000).
3. Introduction
The World
to eating disorders
Health Organization
of Diseases and Related Health
used in the Norwegian
has created the International
Statistical
Problems
is the diagnostic
(ICD-10),
disturbances
and physical
factors",
disorders.
1n science, it is more common
Statistical
Manual
can Psychiatric
of Mental
Association
with slight differences
for girls, which
there are cases where all other criteria
vidual
lacks some of the criteria
DSM IV-TR
(BED)
has the diagnosis
I will
not discuss further,
sional ballet training.
EDNOS,
spread in the ballet world.
clearly
suffers
created by the Ameri-
Both classifications
list as a symptom
many experts argue, because
but the patient still menstruates.
anorexia
nervosa
eating disorders;
specified
nervosa"
diagnosis,
namely
(EDNOS).
For
where an indi-
but is clearly
binge eating disorder
BED is an eating disor-
as it usually is not an issue to students in profesI believe is an eating disorder that is widely
is defined
from an eating disorder,
nervosa or bulimia
IV-TR),
and
are very similar,
of "Atypical
however,
EDNOS
mental
The classifications
are filled,
and eating disorder not otherwise
der which
that both are considered
is something
for anorexia
also lists two additional
physio-
(DSM
2000).
ner-
associated with
to use a system called The Diagnostic
Health Disorders
(Skårderud
syndromes
meaning
in the under categories.
the loss of menstruation
such cases ICD-10
system
health system for criteria of anorexia nervosa and bulimia
vosa. Both diseases are listed under "Behavioral
logical
which
Classification
as an eating disorder
but does not fulfill
where a patient
the criteria
for anorexia
nervosa (Treasure, Schmidt & van Furth 2005).
3
According
to Skårderud
(2000),
in aesthetic
sports. such as dance, gymnastics
figure skating, 46% of female athletes sufTer from eating disorders.
(2000) refers to research that the -average"
low the ideal considring
eatin2 disorders
their height. Statistics
are an issue in the classical
in females. with approximately
female (Skårderud
3.1 Anorexia
Anorexia
vary. but I think
ballet world.
90% of persons suffering
whereas Walters
weight
is 15% be-
it is safe to say that
It is also far more common
from eating disorders
being
2000).
nervosa
nervosa is a mental illness where patients refuse to sustain a normal weight
in comparison
to their age and height. h often starts by deliberate
ends up getting out of the patients. control.
normal weight or their body-mass
fear gaining
their
female ballet dancer's
and
weight
as a problem
limit their eating by ignoring
(Skårderud
loss. which
is at least 15% below
index is 17.5 or less. Patients with anorexia nervosa
and their body image becomes distorted.
low body weight
overeating
The patients weight
weight
(ICD-1 0 and DSM
They refuse to accept
1V-TR).
Most patients will
the feeling of hunger, but some patients have episodes of
2000). Temale patients often loose their menstruation,
but not
necessarily.
3.2 Bulimia
Bulimia
nervosa
nervosa is a mental illness where patients repeatedly
make themself
throw-up
or use laxatives
eaten earlier. For some patients throwing
er patients consider
wei2ht.
but are very
it shameful.
or other medication
about
to get rid of the food
up is the reason for overeating,
Patients with
concemed
overeat and then either
their
bulimia
body's
whereas oth-
nervosa are often of normal
shape and weight
(Skårderud
2000).
3.3 Recognizing
the signs of eating disorders
Early signs of eating disorders,
both for anorexia and bulimia
nervosa, can be that the
student is overly engaued about food. She may talk about it a lot, read about it or even
prepare food for others. but not for themselves.
i2noring
of control.
feelin2s
Often the person starts by dieting and
of hunger in order to lose weight,
but the habit ends up getting out
They limit what they cat, are very concerned about the calorie and fat con-
4
tent of the food they eat. and often exercise excessively
claim allergies
of various
to lose weight.
They may
foods, prefer to eat alone or start eating obviously
less or
more than before.
Food choices will often be of low calorie and low fat types and it is common
diet sodas and juices to neutralize
to drink
the feeling of hunger. A person with bulimia
sa will often leave the table during,
or immediately
nervo-
after, the meal to go to the bath-
room and may put on the TV or music to distract others. A person with an eating disorder will get easily agitated if meals do not take place at planned times and may refuse to eat then. "fhey may deny being hungry although
it has been a long time since
they last ate and may feel guilty
after eating. Weighing
ercise is excessive
baggy clothes to hide their body is common.
and wearing
may often exclude themselves
extra
helpful,
weight
due to their
themselves
is done often, ex-
from the group and they are easily agitated. Also being
guilt,
is common.
Physical
signs, beyond
loss that a teacher may notice, are unstable weight. dizziness
student may start growing
They
soft, thin hair called lanugo, especially
the obvious
or tiredness. The
on the face and on
the back, as well as that their hair on the head may turn flat and lifeless. Due to bad
blood circulation.
feeling cold is common,
work may heal slowly (Skårderud
and also sores such as blisters from point
2000).
4. Self perception
Eating disorders are considered
distorted
mental health problems,
images about theirselves.
for preventing
where the patient often has
The way students see themselves
may be crucial
risks of eating disorders.
4.1 Self-image
Both anorexic and bulimic
self-concept
thoughts,
uation
patients link their self-image
is the way a person sces him- or herself.
feelings and beliefs we have of ourselves.
and different
self-image
are affected
phases in life (Woolfolk
as reflections
to body image. Self-image
or
Self-image
of
which may vary according
2004).
Gunn Imsen (2005)
and beliefs a person has of themselves
by social interactions
hood. These social interactions,
starting
is constructed
from mother-baby
to sit-
describes
as an object, and that
relationship
and child-
wherc another person's reaction to your action, com-
bined with your own thoughts about yourself,
builds your self-image.
which continues
5
to evolve
throughout
life. George Herbert
This could be described
peoples
reactions.
portance
as a person cheeking
their mirror
a complete
image. at least not as strongly
reaction
being built by social interactions
and re-evaluates
ates individuals
will
not affect your self-
Askland
where an individual
social activity
these norms and habits. This socializing
as a part of a social group or culture.
ing unique traits. Their definition
lieve that culture
other
has to be of some im-
your teacher. (Imsen 2005).
and adapts to social norms and habits. Through
then redefines
through
as someone you know and even more so, if it is some-
one you look up to, for example
(2009) see self-image
stranger's
interactionism
reflection
In this process, the person you mirror.
to you. Normally
interprets.
Mead calls this symbolic
of self-image
and Sataoen
identifies.
the person
process cre-
as well as each individual
is very similar
hav-
to Meads, but they be-
and norms play a larger part in the socializing
process than what
Mead says.
4.2 Body image
Body image is very closely
related to self-image.
'Å
perstm's body image is thought
to be, in part, a product of his or her personal experiences, personali ty, and various
social and cultural .forces. A person's sense of his or her own physical appearance,
usually in relation to others or in relation to some cultural "ideat " can shape his or
her body image. A person's perception of their appearance ccm be different,from how
others actually perceive Nm or her.'' (Wikipedia)
links their self-image
thinking
A person with
an eating disorder
to their body image. As they often have a distorted
they are bigger than they really
are, I would
imagine
about themselves than they should. They may feel less worthy
body image,
they also feel worse
as a person due to feel-
ing that they have the wrong body shape. All these feelings are reflected
in their self-
esteem.
A dancers body is her tool for work. lt may be difficult
selves from work,
for a dancer to distance them-
when their body is the only tool they have. When being criticized
for being the wrong shape or size, having bad feet or for other body related issues, it
may be difficult
themselves
for a dancer to take this as a criticism
or their body. (Mastin
of their work rather than of
2009) "The matter of body shape is guaranteed
to
become a subject that a young dancer svill be faced with. time and time again. at various points in their career. Confidence
in body shape and food choices should be with
6
them alway s, and building
these relationships
not be stressed enough. Having
to food." (Mastin
a healthy,
at an early stage is priceless. This can-
lean body means having a healthy attitude
2009, p. 69)
4.3 Self-esteem
Self-esteem
is ones evaluation
self in comparison
of their worthiness.
A person will evaluate him- or her-
to his or her own standards, or standards set by the surroundings.
for example by friends or school. 1f a person feels that they succeed in what they are
doing. their self-esteem
feels to have failed
will
be boosted. and the opposite
(Imsen
2005).
standards for their own weight,
A person with
imposing
many patients with eating disorders
Schmidt
& van Furth 2005),
standards for themselves.
tion of yourself
Self-esteem
in various situations
chy of needs, everyone
hov- and "vekstbehov"
threshold
also indicates
is built through emotional
(Woolfolk
self-image.
version
are generally
Maslow
(translation
hierar-
divides
self-
of -mangelbe-
of success, whereas
and their talents and attributes.
and context (Askland
themselves
(Im-
pleased and have a realistic
They see their own weaknesses.
but accept them and wish to work on them. A person's
may feel "normar
(Treasure,
from: Wikipedia).
Persons with good self-esteem
ing to situation
(ICD- I 0). In
to Maslow's
in the higher version the person feels they have mastered something
image of themselves
set
reactions and evalua-
2004) According
the lower and higher
often
them setting very high goals and
The lower version means a person needs an external confirmation
sen 2005).
will
show signs of perfectionism
has the need for a positive
image into two categories,
happen if the person
an eating disorder
a very low weight
addition,
which
will
self-esteem
will
vary accord-
& Sataoen 2011). For example a dance student
size when surrounded
by family,
but feel "fat-
when comparine
herself to other dance students.
It is unfortunately
"break
common
them down to build
crush students'
self-esteems
types of dancers the institute
see this type of practice
need for a positive
practice
for ballet
them back up
or positive
to practice
Teachers will
thoughts
the thought
about themselves
to Maslow's
Respect and recognition
theory
of
use their power to
to then create the
or teacher aims for the students to be (Walter
in strong contrast
self-image.
schools
2000).
that everyone
I
has a
are crucial elements for a per-
7
sons self esteem. Seen as dancers bodies are their tool for work,
or respect in their dance training
confidence
(Walters
can have a damaging
lacking
recognition
effect to their self-esteem
and
2000).
4.4 Identity
Erik Erikson
describes
the teen ycars as a crucial
stage of life, a person makes conscious
also on their future career. Although
herselve's
seres i et konsistent
(Woolfolk
their identity.
meninger
og vår historie
in that those -inner
his- or
skal organi-
and feelings from
feelings"
will now have to
the teenager lives in (Imsen 2005). "Who
When a person is incapable of finding
know
who they are, Erikson
answers to these ques-
calls it identity
diffusion
2004).
Gunn Imsen (2005) divides
identity
and often
that many teenagers ponder about, and the answers are part of
and feels they don't
(Woolfolk
In this
is created throughout
2004, p. 90) The identity
with the social environment
am 1?" is a question
tions,
about values, obligations
identity
ferdigheter,
will affect a persons identity
be harmonized
molding
a persons'
building.
whole life, it is in the teens that it starts to set as a base for adult life. "Iden-
titet handler om at våre drivkrefter,
childhood
decisions
stage in identity
identity
into objective
includes aspects by which an individual
as their name, identity
scribed as something
number,
self and your values. choosing
Objective
officially,
such
side of identity
is dc-
where the society and social environ-
of a person's
to socialize,
identities.
would be recognized
gender and parents. Subjective
constant and invariable,
ment will affect the development
and subjective
identity.
and feeling
It is based on knowing
grounded
and included
yourin a
social environment.
Nina Winger
(1994) describes
an individual
and society.
and is molded through
identity
A person's
as a construction
identity
social interaction
varies according
where they identify.
into social norms and habits, while also redefining
is, therefore,
around us will
development.
dependent
on social interaction.
be used as building
A person will
to age and interest,
identify
The feedback
theirselves
fellow
between
to the surroundings
interpret
and changing
blocks to understand
for example through
of the relationship
and adapt to fit
these norms. Identity
we receive from people
ourselves
and for personal
as a part of a group often in relation
students at a ballet school. Through
8
socializing
in a group, a person tries to find their own identity.
group. Therefore.
ronment
a young dancers identity
which will
may vary a lot dependirm
fit into the
on which envi-
they are in. In a ballet school. they may try to fit the image of a sfim, good
girl often met in such environments,
whereas their
identity
around their childhood
friends. who have nothine to do with dancing, may be something
I believe it is important
to differentiate
tity outside dance. I believe
one's identity
in Wingers
different.
related to dance, one's and iden-
theory that a person's
ing to the surroundings,
and as a dance teacher it is important
derstand the difference
between their professional
identity
to help the students un-
and personal
identity.
pens in dance classes is part of the professional
identity,
riences such as a bad class or a choreography
a student is struggling
their work and does not need to affect their personal
varies accord-
and especially
What hap-
negative expewith,
is part of
life. 1 believe it is important
to
encourage students to have a social life outside school and outside their ballet friends,
because in such social situations
tions related to ballet.
the student may feel more successful
I also believe
it is the teachers job to create an atmosphere
class where students are active and their individual
often meets these -good girl-
than in situa-
characteristics
are welcome.
in
One
students, who seem to have suppressed their own identi-
ties away to fit into the ballet image, and in the long run I believe this can have bad
consequences on a persons identity
ence identity
development.
I believe such students may experi-
diffusion.
The environment
of a ballet
have experienced
earlier. A student may have been the most talented child in their lo-
cal ballet schools, possibly
bly moving
school will
a professional
to what they
ballet school, moving
will all affect the teenager's
these changes in life may cause confusion
of themselves
be very dilTerent
in a small town. The changes in their life situation,
to a new city, attending
home, friends and family,
most likely
identity
possi-
away from
development.
and the student may create distorted
I befieve
images
and their body, adding to the risk of getting an eating. They may then
desperately try to fit in, and a diet may get out of hand.
9
5. Case
10 years ago. I was part of many of the
This case is based on a student I studied with
events leading to the student becoming
on interviewing
sick. and the rest of the information
her (email and phone interview
8.5.2013).
Sarah was 16 years old when she was accepted
London.
arch. She was technically
I will call her -Sarah".
into a prestigious
She is 175 cm tall, has long swayback
is based
ballet
legs and beautiful
school
in
feet with a high
one of the strongest in class and it seemed like the teachers
had high hopes for her, but in their opinion,
60 kg when she started her professional
she needed to lose weight.
training.
She weighed
From the start Sarah was well aware
that she was one of the biggest girls in class. In addition,
from her teachers. She felt like a lot of the feedback
she felt immense pressure
she got from her teachers was
about her weight.
There were several incidents
meeting.
where a small group of girls were called in for a group
These were the -biggest"
tions we experienced.
girls
in class. Here are a few examples
The ballet teacher of the year picked out 6 girls (out of 22) to
write a food diary for a week and then meet the nutritionist.
that they needed to check our diets for not consuming
tionist gave us small adjustments
was. for example,
semi-skimmed.
of situa-
advised
too much fatty foods. The nutri-
for our diet. without
to use skimmed
All 6 girls were told to "work
milk
She says the reason was
tinding
big things to change. 1
in my breakfast
cereal instead of
on their muscle tone".
In second year, the same girls were asked to join
the ballet teacher for a talk. The
teacher told us that she had spoken to all the other teachers at the school and they all
differ
in opinion
on who needs to lose weight.
She listed each teacher telling
us how
many percentage of the class that teacher felt needed to lose weight. 'tatherine
thinks
75% of the class needs to lose weight.
may be because she is a contemporary
to lose weight...-
experiment
is a bit more open.
teacher. and thinks only 25% of the class needs
There were several such incidents
small group. In addition.
regularly
Megan thinks 40%. Lillian
where we were confronted
our weight was always a topic in individual
had with our teachers. During
where the students'
as a
meetings that we
the first year. the school decided to attend an
intake, calorie spending and body fat would be meas-
ured. The girl with the highest body fat amount had 18 %, indicating
that the whole
10
class was skinny
in -normal
suring us to lose weight.
terms-.
Even after these results. the teachers kept pres-
The atmosphere
Most students would eat in the changing
about eating in school was very negative.
room, the little they ate, because they knew
teachers would not come in there. The green room was mainly
work, drinking
used for doing home-
tea or napping.
The first two years passed with Sarah holding
a pretty steady weight,
losing a couple
of kilos, but gaining muscle tone. Second year came to an end and we were advised to
stay in shape during the summer. In the third year. we would join the school's
company
and casting and rehearsals for the numbers would
fall. During
touring
start immediately
in the
this summer Sarah decided to lose weight, as she did not want her weight
to prevent her from getting casted. When we returned to school in September, Sarah's
weight
had dropped drastically.
She was casted heavily,
She felt like she had succeeded and was in full control.
weight
loss and asked to talk to her. They said: -Are
thin." "I his. to her, was a confirmation
her that she was doing the right thing.
including
some soloist parts.
The teachers had noticed her
you ok? You are looking
of success. To hear them call her thin mcant for
l'herefore,
she continued
to restrict her eating.
She rarely ate at school, or if she did, it would be very little in comparison
During
the fall Sarah's weight kept dropping.
to before.
She was called in for various meetings
with her teacher and she was warned that if she lost more weight,
restrict her dancing.
very
She was sent to the nutritionist
they would
and a sport psychiatrist.
nately she had already lost control and her weight kept dropping.
have to
Unfortu-
In November.
Sarah
weighed only 46 kg, and her mother was asked to come for a meeting at the school. It
was the first time the school talked about her situation
ing her mother cry. This was a turning
using the word anorexia.
point for Sarah; she realized
lem. She was sent home, denied from dancing and appointed
None of the other students were informed
her roommate
Although
she had a prob-
a nutritionist
to help her.
about what happened, it was only through
that we found out she was sent home.
she could see it coming,
was missing
mak-
being sent home was tough for Sarah. It meant she
rehearsals and potentially
risking
roles. It was difficult
for her to lose"
control again by eating, when she felt like she had control by not eating. She says that
the things that helped her most, were people eating to2ether with her.
tionist
used calorie
content to gain \keiuht.
I had spent so long knowinu
nry nutrithe ealorie
11
value of everything
to lose weight - she did the reverse. She explained
order to gain just ONE pound in weight,
I need to consume
chocolate bar every day for 10 days. This worked.
things like, in
3000 calories.
That's a
It made it doable to eat more with-
out fear of exploding."
Sarah decided she wanted to return to school after Christmas.
was restricted
from dancing
full days. She slowly
and was allowed,
gained a little bit of weight.
this day she is still very slim. Upon return. she felt like her teachers didn't
all in the way they did beforc. The teachers most likely
regaining
her strength and weight.
but
but to
push her at
did it in consideration
to her
but she felt like they had given up on her. She got
to tour and dance a fair share with the company,
but not as much as she had initially
hoped for.
For her beating anorexia
is a never-ending
you say you where sick for?"
she replied,
story. When I asked her: "How
"Forever.
I lence. so many relapses in most patients. I luckily
Anorexia
long would
is an ongoing
hattle.
have never relapsed. but there isn't
a day that 2,0es by where yourre not tempted to restrict your intake of' food and challenge your willpower
the sports psychologist
again..."
She feels she got good help from her nutritionist
and
at school, but feels that the teachers had very little knowledge
on how to handle students with eating disorders.
Their attempts
to help, by voicing
their concerns. worked as boosters f6r her losing weight.
6. How The Ballet Academy at KHIO copes with eating disorders
I interviewed
Toini Kristensen,
emy of Dance at Oslo National
concerning
eating disorders
aspect of fighting
the Head of Studies for the ballet studies at The AcadAcademy
(interview
eating disorders
of the Arts (KHIO)
26.4.2013).
in professional
about their procedures
She said that the most important
dance training
is an open dialog be-
tween the students and the school, together with a support network
sionals. including
Approximately
disorders,
nutritional
experts, doctors and psychologists.
5 years ago, after they struggled
seriously
with a few cases of eating
they decided to create a system of routines to help sick students. They con-
tacted various doctors, psychiatrists
psychiatrist
of various profes-
specializing
and nutritionists,
among others Finn Skårderud.
in eating disorders. whose literature
a
I have used in this thesis.
12
The biggest difference
since building
these experts, Kristensen
says, is the attitude the school has towards eating disorders,
and how they have worked
accept themselves
to have an environment
at their institute
where students
for who they are. At the same time students should
voice their concern about a fellow
The school's
a support team and having various lectures with
feel safe to
student.
focus is on the hard work to reach the goal to create the best possible
dancers, and the school aims to have a healthy
environment
concerning
eating and
body image.
At the beginning
of the first year, the students have a course of lectures with an expe-
rienced nutritionist,
who has worked
approach topics such as: nutrition
ing and after training,
nutritionist
closely
with athletes and dancers.
for active training,
balanced energy through
also talks about the physiological
food suggestions
nutrition,
eating disorders,
height, which
may not keep up with
asked to write
for a period
a food and exercise
forms the basis for individual
cach student privately
diary
may cause
appointments.
it. Each student is
of time (usually
The nutritionist
one week).
is able to guide
towards healthy eating habits, and detect signs of eating disor-
ders. This way, each student has had a contact with a nutritionist.
a later stage, it will
etc. The
changes may cause weight gain or loss. Boys may sudden-
ly stretch a lot in height and their weight
which
for before, dur-
changes that take place as the students'
bodies grow from teens to young adults. Girls stop growing
weight gain, also hormonal
Ihe lectures
If problems
occur at
be easier for students to talk to someone they already
quainted with. The most common
advice the nutritionist
are ac-
gives the students is that they
need to eat more often.
Another
‘say the school encourages
a healthy environment,
dents spend their lunch breaks eating together.
their
social time, where everyone
themselves
skips lunch on a regular
must menstruate
regularly.
The students are advised to make this
eats and enjoys themselve's,
about what foods each individual
small (with approximately
is that they suggest stu-
is consuming.
without
concerning
llue to classes being very
6 students per year). students will easily notice if someone
basis. In addition,
Fhis is something
dents being honest. The school immediately
the school feels very strongly
that girls
they voice to students and rely on stusends students to the doctor if they have
missed 2-3 periods.
13
lt seems as if the environment
and atmosphere
in this school is very open. and stu-
dents feel safe asking their teachers for advice. Kristensen
difference
in how the school handles eating disorders
with the nutritionist.
Although
say s she has noticed a big
since they started the program
the school still has students with eating disorders,
she
feels the amount has decreased and the cases are caught at an earlier stage and they
able to help more.
The school encourages students to voice their concerns about their own bodies or other issues they may have, or if they arc concerned about a fellow
are handled confidentially
are worried
. Students are also encouraged
student. All concerns
to confront
the person they
about. even with the risk of various outcomes such as anger. denial or los-
ing a friend.
The school's
evaluate the situation
job after receiving
a notice
and talk to the person concerned.
to mect with the nutritionist,
from a fellow
student,
The student is quickly
is to
advised
who is the expert and know how to manage the situation
further. The teachers' job is not to evaluate whether or not the student has, in fact. an
eating disorder,
Kristensen
but rather to suggest for the student to seek professional
assistance.
is pleased to have a support system that the teachers can trust and says this
is essential in such delicate subjects.
7. What to do?
I do not believe this question can be fully answered, because each individual
be different
according
needs of each individual
and ethics in choosing
building
to the students'
will
identity,
self-concept
vary and a teacher will
how to handle the situation.
a safe and positive
environment,
which
case will
and self-esteem.
need to use their common
I believe
may prevent
The
sense
a teacher can help in
some potential
eating
disorders.
7.1 Feedback
Classical
ballet training
tions on their technique.
to differentiate
precise work and a student will
As mentioned
carlier,
it may be difficult
feedback given on their technique
age of themselves.
strengthening
requires
Therefore,
your student's
I believe
self-concept
hear many correcfor a dance student
as part of their work.
it is important
and self-esteem.
to look
Positive
from their im-
into building
and
self-concept
is a
14
result of feeling
portant
successful
and being noticed
(Woolfolk
to help every student feel this way. Noticing
class, making
2004). Therefore.
each student,
in every single
sure that you as a teacher give them at least one positive
help the student feel successful and noticed. Noticing
and encouraging
ognizing
(Woolfolk
success may boost the students'
self-esteem
it is im-
feedback can
effort and rec-
2004). It is only hu-
man to like some students better than others and for a teacher having to find positive
attributes
in each student. may help build a more positive
dent. lt is important
each individual.
Mead's
image of a less liked stu-
for a teacher to be aware of their prejudices
and expectations
for
and try to accept each student the way they are. This will then affect
social interaction.
where the student will
read into how the teacher reacts to
them.
A teacher must be precise in evaluating
of their
student.
achievements
Positive
feedback
their student and not exaggerate their opinion
needs to be real and based on the student's
(Steensaasen & Sletta 1996). The feedback given in class needs to be
related to what the students are working
on and the students need to feel that the
teacher means what is said. lt is easy to get into the bad habit ofjust
"well
saying -good"
or
done", but that will have little effect if the student hears this after every exereise
and has nothing
to base it on. Therefore,
important.
Positive
feedback will
therefore,
working
on giving
specifying
what was good in the exercise is
strengthen a person's
corrections
self-esteem
in a positive
manner
(Woolfolk
is vital.
dancers who become teachers. are used to hearing "no, no, no, you're
or at least -you need to liii your legs higher".
ference here. For example
can see you are working
rection and hopefully
by saying "It's
ex-
doing it wrong-
much better than last time"
very hard on this- will be a positive
in dancers is their "center-
A common
Many
I believe every teacher can make a dif-
help the student's self-esteem
An area often corrected
and back muscles.
starting
2004).
way to start giving
while improving
or "I
a cor-
their technique.
or core. meanin2 their abdominal
way to correct this is by saying, "pull
your stomach
in". I believe this may be a sensitive subject to a student with a negative body image,
and therefore.
it is important
to use specific
stomach in" may sound specific,
hearing
stomach
is too big".
here as well.
"Pulling
but for a person with an eating disorder,
what the teacher meant which
hear -your
feedback
was -engage
I believe
talking
your
instead of
your core muscles-,
they may
about the abdominals,
or center,
15
would
be safer. But. I also acknowledge
strength being such an important
7.2 Dialog
Having
that it is a difficult
issue, due to the core
part of classical ballet technique.
and confrontation
an open dialog with the students can help the students feel safe and included.
(Woolfolk
2004)
I believe
it is important
that cach student has a regular
meeting with their teacher, where they can discuss the student's
well as how the student feels they are doing socially
According
to Skårderud
(2000),
it is important
progress and goals as
and personally.
to address a student you may be wor-
ried about. A student may feel worse if not seen, than if confronted.
confrontation
it is important
help me to be less worried
During
that the student feels that they are invited
Using I-messages (Woolfolk
2004) such as saying
for you?"
think you have an eating disorder."
individual
am worried
is a considerably
the first
into a dialog.
about you, can you
better approach than saying
This way the student will not feel judged,
but ra-
ther see how their behavior affects you as their teacher. In most cases the student will
deny any problems
in the first meeting,
ing is to book another meeting
think
but the most important
(Skårderud
you should discuss your concerns
student and together decide who will
person who is of importance
2000). Before
goal Ibr the first meet-
confronting
with your colleagues,
confront
to you, will
the student,
1
other teachers of the
the student. Like Mead' s theory says, a
affect your self-image
more. Therefore,
it
may be best to choose a teacher who the student seems to look up to the most, but also
a person who she feels safe with to approach the issue for the first time. Like Sarah
said, seeing her mother cry affected
her the most. During
your first meeting
it is im-
portant that you share your concems with your student and then listen to them and try
to understand
how they feel about it. Giving
agree on. may encourage
positive
confirmation
the student to share more (Woolfolk
voice. choice of words and the way you welcome
about things you
2004).
Your tone of
your student into a dialog
will
be
crucial for the trust you need to have and build with your student (Bergem 201 I ). As a
teacher, it will be your job to evaluate whether you want to give the student a little bit
of time (for example a week) to think about what is happening
whether you try to book them in for either a nutritionist
meeting.
or a psychologist
Here I believe you need to evaluate each situation
mind that you, as their teacher most likely
and then mect again or
for the next
and student, keeping
have a closer relationship
in
to the student
16
than the professionals,
but at the same time your knowledge
be the same as theirs. 1n any case, I think
tionists,
psychologists
it is important
and competence
will
not
to use outside help of nutri-
and doctors, and guide the student to seek for help. You nnay,
as their teacher, book a time for them, but you cannot force them to go. I lowever.
most cases I would think a teacher booking
the time for them will
in
increase the chanc-
es of them going.
7.3
PARK-model
By confronting
a student you svill risk the student going into complete denial and feel-
ing misunderstood
and a victim
of a bullying
teacher (Woolfolk
2004). therefore,
crucial to plan your first meeting as well as possible. PARK-model.
Bergem (2011), may be a useful tool in approaching
difficult
it is
created by Trygve
ethical situations
related
to work. such as a student with a suspected eating disorder.
"P" stands for problem.
In the case of suspected eating disorders,
be a student with an eating disorder.
This. I believe.
something
"A"
which may have caused a reaction resulting
started?
in an eating disorder
2000).
stands for analyzing
situation,
1s it possible to say when the problem
would
is often hard to say in such cases unless the student has experienced
traumatic.
(Skårderud
the problem
the situation.
What do you know about the student's
social
how are they doing in school, etc. Is there someone who may know more
about the situation,
for example
the studenrs
parents, maybe a best friend or other
students in class? What elements are included
in the dilemma
and does it need to be
addressed.
means reaction.
Once you have a picture of the situation,
and have possibly
de-
cided you need to act, it's time to plan what and how to do it. Think about the various
possibilities;
do I, as her teacher, talk to her? Do I call the parents first? Do I ask a
professional
(i.e. nutritionist
or psychologist)
to join me for the meeting?
tion has started from a friend being concerned,
There may be various possibilities.
is important
to try and envision
If the situa-
do I ask the friends to approach her?
and to find out what may work best in each case, it
the possible outcomes
of various approach possibili-
ties.
17
The last action point,
stands for konsekvens (= consequence).
After
cvaluating
the outcome of various approaches you will land on an approach that you consider the
best for the situation.
term solution.
lt is also important
Eating disorders
to consider
whether
this is a short or long
are often illnesses that the patient will
for the rest of their lives in some way, so this would hopefully
struggle
with
be that start of a long-
term solution.
In situations
failed.
where you feel you cannot reach out to the student, or your attempt has
I believe you need to immediately
seek for outside help. If the student denies
having an eating disorder, maybe you can get her to meet a psychologist
to discuss the
pressure or upset you as her teacher have caused her. That way, you would be taking
the blame. but at the same time the student would
competence
to handle the situation.
be meeting
But as I mentioned
a person with
earlier, you cannot force your
students to seek help, you can only try to advise and guide them. When working
young
adults, the parents of a student under
better
18 have the right to know
with
about your
concerns. I believe you should also be open with the student and say you want to call
the parents. Even with students over
18, I would
suggest to the student that we in-
volve the parents.
7.4 An open environment
I believe it is important
on the importance
of correct nutrition
obsessed by weight.
part in decisions
to talk about the body's aesthetics in classical ballet, focusing
and trying
Not all students will
on food consumed
to create an environment
that is not
have come from a home where they take
in the house. Helping
students make healthy
choices in food and arrange for a nutritionist
who has worked with dancers or athletes
to give a lecture to all students. is important.
I think it is equally
fessionals,
such as nutritionists
sionals who have experience
and psychologists,
from
teacher you can lead by example.
eat, and the whole atmosphere
working
I don't
with
important
and where possible,
to use prouse profes-
dancers or at least athletes.
remember
As a
ever seeing any of my teachers
around eating at the professional
ballet school me and
Sarah went to, was negative and students would often hide food that they had gone to
buy during
lunch breaks. Based on my interview
seems that cating together with fellow
with Sarah and Toini
students is a very important
Kristensen.
it
form of support for
a person with an eating disorder.
18
Where possible.
I believe the school should have a cafeteria
or a lunchroom
where
students gather for lunch breaks and make it a social event every day. In case of suspected eating disorders,
a teacher should not try to be the students
therapist
in any
way, but seen as a ballet teacher is often the person who sees their students daily and
builds relationships
with students. I believe the teacher is in an important
role in guid-
ing and helping the students to understand they need help. A teacher's job will therefore. be more in preventing
eating disorders and creating a healthy atmosphere around
the subject. They are also in a central role in catching the early signs of a student with
an eating disorder and them helping them seek professional
7.5 Weight
loss
As a ballet teacher I strongly
lose weight.
help at an early stage.
I believe
disagree
in pressuring
or advising
in Sarah's case. that the pressure she felt from the teachers in
her first two years was partly the reason she developed
say she would
a young student to
anorexia
nervosa. It is not to
not have gotten sick if she had not been pressured.
but I do believe
such suggestions may push a student over the edge and be a part reason for the illness.
I laving myself experienced
being one of the "bigger"
we were all well aware of it without
girls in ballet school. I felt like
outside confirmation.
We all worked
weight and I believe the issue would have sorted itself out without
ing a point of our weight.
they do in professional
the teachers mak-
Most students will not have trained as many hours daily as
training,
so their calorie consumption
Unless they start eating drastically
believe
on losing
it is much more important
more, their weight will
to supply
nutritional
will
increase drastically.
probably
drop naturally.
information
and advice
I
for
students.
8. Summary
Eating disorders are a mental health problem that many ballet teachers meet. The way
teachers and choreographers
humiliate
and pressure dancers to lose weight,
come a bad culture in the ballet world that luckily
seems to be changing.
has be-
I believe bal-
let teachers play a vital role here and in this thesis I have aimed to answer the question: what can I as a ballet teacher do to prevent
cating disorders
or help a student
with such a problene
19
There is no one right answer to these questions,
and will
therefore
react differently
to various
because each individual
approaches.
is dilTerent
In the helping
a student
with eating disorders, a ballet teacher should not in any way try to be a student. s therapist or doctor. In cases of suspected or confirmed
as psychiatrists,
doctors and nutritionists
eating disorders professionals
should be used to help. The teacher's
such cases is to first of all notice the early signs of potential
to approach the student and help them get professional
such
role in
eating disorders and then
help. A teacher cannot force a
student to get help, but their job will be to approach the student and gently guide them
towards professional
to deal with
help. It is important
the problem
alone.
When
to voice your concerns as a teacher and not
approaching
the student,
using the PARK
method may be useful.
A person who develops an eating disorder
esteem to their body image. Therefore,
positive
body and self-image
disorders.
will
often link their self-concept
strengthening
with the help of positive
The teacher can lead by example
and helping
feedback,
and self-
a student to build a
may prevent eating
and help create a healthy
environment
about eating at school.
I think
it all comes down to you as a teacher being aware of the way you approach
and discuss the subject of body and eating disorders.
20
9. Referen ces
Literature
Askland, Leif and Sataøen, Svein Ole (2011). Utviklingspsykologiske
barns oppvekst.
perspektiv
på
Oslo: Gyldendal
Bergem, Trygve (2011). Læreren ietikkens motlys. Oslo: Gyldendal
Imsen, Gunn (2005). Elevens Verden. Oslo: Universitetsforlaget
Mastin, Zerlina (2009). Nutrition for the dancer. Hampshire: Dance Books Ltd
Skårderud. Finn (2000). Sterk svak Oslo: H. Aschehoug & co
Steensaasen Svein & Sletta Olav (1996), Gruppe prosesser. Oslo: Universitetsforlaget
AS
Treasure, Janet, Schmidt, Ulrike & van Furth, Eric (2005). The Essential Handbook of
Eating Disorders.
John Wiley & Sons Ltd
Walters, Dorcas (2000). Obsession? Body Culture. Nutrilion
SaarbrOcken, Germany: LAP LAMBERT
Winger, Nina (1994). Om identitetsforhandlinger
sumfunnet.
and the Ballet Aesthetic,
Academic Publishing
og selyfitrvaltning
i det moderne
in Aasen, P & Haugaløkken, 0 K (1994) Bærekruftig pedagogikk
(red). Ad notam Gyldendal
Woolfolk, Anita (2004). Pedagogisk psykologi.
Trondheim: Tapir akademisk forlag
Internet
American Psychiatric Association (2000). Diagnostic
tal Health
Disorders
and Statistical
Manual
of Men-
(4th ed., text rev.). doi:10.1176/appi.books.9780890423349
(Read: 25.3.2013)
21
World I Iealth Organization
(20 10).
International Statistical Classification of Diseases
and Related Health Problems:
http://apps.who.intlelassi
fications/icd
I 0/browse/2010/en#/F50-F59
(Read: 25.3.3013)
http://en.wikipedia.org/wiki/Rodyimage
(Read: 27.3.2013)
http://en.wikipedia.org/wiki/Maslow%27shierarchy_of
Other
needs (Read: 3.5.2013)
sources
Interview
with "Sarah"
Interview
in person
over email and phone, 8.5.2013
with
Toini
Kristensen,
Oslo,
The
Oslo
Academy
of
Arts,
26.4.2013
22