57. Alleviating Anxiety with Jo-Anne La Flèche

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00:00
Jo-Anne La Flèche
Because I have no control on what's going to come up tomorrow. I have absolutely no control. So I'm trying to have control on things that I can't control. 

00:22
Jennifer Milner
Welcome back to the Bendy Bodies podcast where we strive to improve well being, enhance performance, and optimize career longevity for every Bendy body. This is co host Jennifer Milner, here with the hypermobility MD linda Bluestein. 

00:35
Dr. Linda Bluestein
We are so glad you are here to learn tips for living your best Bendy life. This information is for educational purposes only and is not a substitute for medical advice. 

00:45
Jennifer Milner
Our guest today is Joanne Laflesch, a clinical and performance psychologist with an Ma in dance and graduate studies in Somatics. She's the resident psychologist at Lecol Superior de Ballet de Quebec, a professional dance school based in Montreal. She teaches performance psychology to students and psychopedagogy to dance educators, and she gives counseling sessions to students in need. She's written several articles and informational papers on dancer mental health issues. Joanne? Hello and welcome to Bendy Bodies. 

01:16
Jo-Anne La Flèche
Hi, I'm thrilled to be here today. 

01:19
Dr. Linda Bluestein
We're super excited to chat with you. 

01:23
Jennifer Milner
We are. We want to dig into this topic that is so near and dear, unfortunately, to so many artists hearts. But before we do, could you tell us just a little bit about. 

01:34
Jo-Anne La Flèche
Hello, everybody. I'm really thrilled to be here. And I'm a clinical and dance psychologist, as Jennifer mentioned, which means that I have a general practice with people from all walks of society. I work with teenagers and right up to people of a certain age, and that come with all kinds of mental issues, with adaptive problems of all sorts. And that gives me an awful lot of insight on what people go through in life. So I love my job. I also teach psychology and parallel. From that, I've always danced so for a long time in my life. Well, psychology and dance were like on two parallel tracks. And at one point in time, I decided to go back to school and try and merge those two passions together. So I went back to school and. 

02:35
Jo-Anne La Flèche
Eventually got an Ma in dance with. 

02:38
Jo-Anne La Flèche
Somatic studies, and I started working as a resident psychologist. And that gave me another perspective completely, which is more, I would say, psychosocial, where I began to get into the dance world not as a performing artist myself, even if I've never danced professionally, but I have semi professionally, but to really understand with dance science what goes on and listen to an awful lot of other artists also. So that gives me that double perspective on things individual and psychosa, social and cultural. 

03:17
Jennifer Milner
That's fantastic. And it's great that you can come at it from that point of view. So as a clinical psychologist, you have that one one skill, but as a dance psychologist, you see, like you said, the cultural aspect of it, and you see that big picture as well. And that's so valuable for someone who is working with dancers to be able to move back and forth kind of between the macro and the micro level. We want to talk today about anxiety. And I know that sometimes anxiety and stress can often get confused. And so let's start by sort of defining what is anxiety, what is stress? 

03:53
Jo-Anne La Flèche
What's the difference between them? 

03:55
Jo-Anne La Flèche
Okay, that's a very good question. Stress is an instinctive body response to a perceived threat to your well being. I say perceived, okay, because sometimes we can feel threatened by situations that actually are not really dangerous, but for us they are, okay? And usually that accompanies a situation where we feel challenged in some way. So stress responses are global. They're in our body, all over the place, in our sympathetic system, which means that everything fires off. So we'll get tense. Our heart will start pounding, our head starts buzzing. We've got all these bodily responses which actually are very adaptive because that gives us extra energy to face the polar bear that we think is there and that we need to fight, okay? So that is a really very adaptive response that we've had for millions of years. And then usually when we have that stress response, once we have satisfied the need or that the situation has been resolved, usually that stress signal will come down and will go back to our normal bodily response. 

05:17
Jo-Anne La Flèche
However, sometimes we can be going through a lot of stress factors, and especially dancers, because God knows how. Dance is a challenging passion and you go through all kinds of difficult situations. Well, then when those stress factors add up, well, then we can face different mental health issues. So one of the mental health issues that we can face is anxiety. So anxiety, it's contrarily to the instinctive and global body response. Anxiety is a specific reaction that we have both mentally and emotionally to anticipated future. We are fearful of something that has not yet happened, that may not yet exist or may not even be likely to exist. But in our own minds, boy, we have the impression that we are facing a problem. So anxiety disorders are very common right now, especially with the COVID years and all the challenges financially, wars, pollution, you name it, we've had it. 

06:35
Jo-Anne La Flèche
Well, anxiety has become, like, one of the major mental health issues in the Western world. And obviously, while anxiety can be like such a spectrum of intensity also okay, but imagine when you couple that with. 

06:56
Jo-Anne La Flèche
The dance world, which is objectively stressful, okay? 

07:01
Jo-Anne La Flèche
So that means that most dancers at one point in time will experience anxiety as like a very normal emotion to have, whether it before an audition, before a dance exam or a show that's particularly important for you. Well, then you may have anxiety at that time. So does that give you a little bit of a difference, makes it more clear for you? 

07:37
Jennifer Milner
Yes, that's fantastic. And as you said, the dance world is objectively stressful. Let's look at that for a second. You have given many lectures and done guest workshops on mental health in the dance world for dancers, dance teachers, directors, and more. You've been very active in the dance community on the issue of mental health for years. So what have you observed in the dance world in regards to anxiety? 

08:06
Jo-Anne La Flèche
Well, first of all, you've got to understand how anxiety works, okay? Now, that's the best way to start working on your own anxiety, is to understand what's going on for yourself and what is generating that anxiety outside of yourself also. So it's like it's a systemic network going on, right? So I like to have this systemic view on things. It makes it more complete, and that way I can understand myself, but I can also, at the same time, be in touch with the waters in which I am swimming in the fishbowl, you see, okay? Otherwise we get disconnected. 

08:53
Jo-Anne La Flèche
So I would say that, first of all, as a dancer, well, I've got. 

08:58
Jo-Anne La Flèche
To realize that there are a lot of physical and mental factors that can trigger anxiety, okay? So it's important to realize what's going on. First of all, physically, well, there's a lot of chemical changes going inside the brain. If you're starting to feel hyper about something and you're being worried about something, well, then that may trigger an awful lot of hormones in your body and stress hormones and physical responses, okay? So you may either want to fight something or you may want to flee something. Or while the worst situation that you can be in is to freeze about something, okay? So you're on stage, boy, and you're just, like, invaded with anxiety. You may just freeze there and not know what to do all of a sudden, even if you know exactly all the routine and everything. So those things can happen. You may also have family predispositions, okay? 

10:10
Jo-Anne La Flèche
Maybe you come from anxious family. That may happen because anxiety as a trait is hereditary. So that can be something to look at and to start reflecting on, especially as far as prevention is concerned, because that means that you are more likely to get hyped up about something than other people. And that may trigger different perceptions on things. That may make you blow things out of proportion, for example, or get really worried or anxious about something. So those are the things that you have to watch out for. Also, you can be anxious because of medication that you're taking also, if you're not taking the right sort of medication or you've taken drugs or you've taken alcohol or excess caffeine or excess Gatorade, those are all things that can trigger also anxiety symptoms. And psychologically, well, there are other things going on also, okay? So your family comes from a certain background of values and experiences that you've gone through in your family. 

11:29
Jo-Anne La Flèche
Nothing's ever perfect in families, and nothing's ever perfect in social life either. Okay, so maybe in your family situations, you've learned to deal with stressful situations, but maybe in other families you haven't. 

11:43
Jo-Anne La Flèche
So that depends. 

11:45
Jo-Anne La Flèche
And also, unfortunately, in certain families, dancers have gone through adverse childhood experiences that can also add an awful lot of anxiety through everyday living, never mind what's going on in the dance world, so all those things can be happening at the same time. So that's the first thing that you've got to ask yourself. Okay, when I'm feeling anxious, that means that I'm being very worried about something. I'm dramatizing something. I'm pulling things out of proportion, or maybe I've got this all or nothing kind of vision about things. I've made one mistake, and I'm sure that my life as a dancer is finished or I'm over focusing on how people are reacting to me. All those things can usually make you realize that, oh, okay, you're getting a bit too worried about something, and you've got to work on it. So by staying in tune with your bodily sensations and how you're feeling, if you're feeling tense and you're having difficulty breathing, well, then you've got to start saying to yourself, okay, what's going on inside? 

13:06
Jo-Anne La Flèche
How am I feeling about a certain situation? What are my feelings? What are my bodily states? How am I reacting to something? Sometimes we have behaviors that actually reinforce our anxiety. 

13:23
Jo-Anne La Flèche
For example, I'm sure that my best. 

13:28
Jo-Anne La Flèche
Friend is angry at me. 

13:30
Jo-Anne La Flèche
I'm really sure about that. 

13:32
Jo-Anne La Flèche
She hasn't said anything, but I'm sure about that. And then I start kind of fleeing our contact and not talking to her as much because I'm really fearful about how she's going to maybe tell me that she doesn't want to relate with me anymore. And then maybe by being in that situation of withdrawing, well, things are going to get worse in my mind, you understand? So we've got to really reflect on, oh, okay, what's happening inside and how am I reacting to that, which may help or maybe hinder my well being. Am I making sense? 

14:13
Jennifer Milner
Absolutely, you are making sense. I love that. And I appreciate sort of diving into how can we see these things happening within ourselves, like, as they first start and how can we start to recognize them? So what we've just looked at is the piece of whatever the circumstances, anxiety might come up and might start to manifest itself. Before we go further with that, though, we're talking about the dance world specifically and in a broader sense, all artists. What about the outside things that we don't have control over? Like why is anxiety a hot topic in the dance world specifically right now? I know mental health in general is a hot topic, but you mentioned earlier that sort of the state of the world and a fair amount of anxiety is coming up in general. But in the dance world, anxiety seems to be skyrocketing as well. 

15:02
Jennifer Milner
What have you observed over the past few years with the dance world contributing to anxiety? 

15:08
Jo-Anne La Flèche
Well, first of all, we've got to look at the dance culture. What are the values that are shared in the dance world? And most of the time, it's implicit. It's like a silent code going on. But as in any performing art, dance is something that attracts passionate people. And it's a never ending story of trying to get on top of things, but by definition, you can't. Okay? And that's what makes a performing art such a passionate thing. It's a never ending story. We can always do better. Normally, artists want to do better, want to better. And most of the time, artists are quite hard on themselves, so they'll be focusing an awful lot on what wasn't okay, what could better rather than what worked. 

16:17
Jo-Anne La Flèche
Okay? But the dance culture works that way. 

16:22
Jo-Anne La Flèche
Too, because for centuries well, let's face. 

16:27
Jo-Anne La Flèche
It, mentors were, first of all, pupils. 

16:32
Jo-Anne La Flèche
And they have received that perfectionistic education. They've received the stoicism about facing hardship and how we've got to survive. And it's the survival of the fittest. And that's part of the dance culture, right? And so the show must go on. We've got all these things that are there, and some dancers even, like, they've. 

17:06
Jo-Anne La Flèche
Learned from the dance world to kind. 

17:10
Jo-Anne La Flèche
Of hide or conceal discomfort or pain because they fear also being judged that they might be perceived as not being as motivated as other people or not being as tough as other people. So that's certainly part of that culture, is the striving for perfection and the fact that we are harsh with ourselves. 

17:37
Jo-Anne La Flèche
So typically well, the dancer, once they. 

17:41
Jo-Anne La Flèche
Become mentors, will usually research has showed us that many times, dance educators, unless they have gone through other kinds of training, that typically will teach the way they've been taught. So part of that is certainly very good, but not all the time and not on all things. So I would say that adds tremendously to the stress, and that will generate an awful lot of anxiety, performance anxiety, which is the fear of not being at par with the artistic challenges that we have to face. Now, that's a subjective fear. No matter how talented we are or no matter we may feel that fear because we want to do good and because we will be judged. 

18:38
Jo-Anne La Flèche
Now, dance as a performing art is. 

18:42
Jo-Anne La Flèche
Also judged by the public also. So we are judged by directors, by teachers. But it is a performing art. It is a visual art, and the audience is there, and the dancer will interact with that audience if the audience has certain amount of expectations, right? When you go to a show and you've paid a certain amount for your ticket, well, you are expecting something. So the dancer or the musician or the vocalist, whatever, wants to please, wants to communicate with that audience and share. 

19:22
Jo-Anne La Flèche
Something so that adds on also to stress. 

19:26
Jo-Anne La Flèche
One major factor also is the fact that the calling attracts many people. But the number of real contracts or artistic possibilities are relatively rare compared to the number of people who train in dance. So that opens the door to a lot of competition. And some of that competition can be really healthy and uplifting, but some of that competition can become really toxic. 

20:01
Jo-Anne La Flèche
So that adds on also and plus. 

20:05
Jo-Anne La Flèche
Financial insecurity because there's not many contracts going on. And usually dance in all the performing. 

20:13
Jo-Anne La Flèche
Arts is the least well paid compared. 

20:18
Jo-Anne La Flèche
To other performing arts. So usually that means that dancers will have to wait on tables or do other things just to make ends meet. So that can add also, on a personal level, an awful lot of stress. And plus the fear of being injured right, or injury can add the stress. So if you are stressed and very anxious, that can raise the injury risk. But at the same time, injury is also something that is stressful. 

20:52
Jo-Anne La Flèche
So all those things add on to. 

20:58
Jo-Anne La Flèche
A dancer's stress and may generate anxiety. 

21:03
Jo-Anne La Flèche
That is fantastic. 

21:04
Jennifer Milner
Thank you. I think you hit on so many. 

21:06
Jo-Anne La Flèche
Of the things that a lot of. 

21:08
Jennifer Milner
Dancers talk about so casually and just can't put into words the way that you just did. So that's great. Thank you. 

21:15
Jo-Anne La Flèche
You're most welcome. 

21:16
Dr. Linda Bluestein
I think we get used to it too. We're so used to that being the culture, and oftentimes we started when were so young that we don't realize anything different. 

21:27
Jo-Anne La Flèche
Well, we're like fish that can't see the water that we're swimming in, you see. So it sounds funny, but if I. 

21:36
Jo-Anne La Flèche
Start reflecting on what those waters are. 

21:40
Jo-Anne La Flèche
Made of and what am I made of in the dance world, but outside. 

21:44
Jo-Anne La Flèche
Of that, well, that can help me. 

21:47
Jo-Anne La Flèche
To start pinpoint and identify what's going on and eventually to prevent needless anxiety and needless stress. 

21:56
Dr. Linda Bluestein
It seems like anxiety is more the rule than the exception in the dance world. And especially our podcast is designed specifically for people that have hypermobility. And we know that people that have hypermobility are at greatly increased risks of having anxiety. So I think it's also really important that you're explaining how to identify these things. And I think it takes away some of the self blame that can happen because people feel anxious about being anxious and get upset with themselves or that kind of thing. Is there any time that anxiety can actually be helpful? Is there such a thing as good anxiety or times when having some worry or uncertainty can give you a helpful edge? 

22:40
Jo-Anne La Flèche
That's a great question, Linda, because yes, definitely. I think that when we have a certain amount of stress or arousal and that generates anxiety, I start worrying about what's going to happen. Well, that can really give me an added edge about a situation that is challenging for me and that I want to be at par with. 

23:08
Jo-Anne La Flèche
So we call that performance only anxiety, which is a social anxiety where I. 

23:16
Jo-Anne La Flèche
Fear not being quite at par with the artistic expectations or with social expectations. Okay? So when, for example, if I'm preparing for a show or for a dance exam, well, I will probably be more motivated if I have that performance anxiety, I will be more motivated to better prepared. So I may review my work a little bit more than maybe what I would have done if I feel really cool about and confident about something. So I'll really work on my stuff and I'll do my homework, and then after that, maybe I'll be asking for help, outside help, or can you correct me on something either to the mentor or even with peers? So that will give me that added oomph to really feel that I am a prepared warrior for what's going on. Now, another way also that I may be reacting positively to that stress is that I'm going to say to myself, well, I've got to really take care of myself. 

24:31
Jo-Anne La Flèche
So I'm going to go to bed. 

24:32
Jo-Anne La Flèche
Early and won't be too much on. 

24:36
Jo-Anne La Flèche
Social media, and I'll eat right and I'll hydrate properly, and all those self care measures that maybe we can talk about eventually, but that will make me try and be the best that I. 

24:50
Jo-Anne La Flèche
Can at that time. Okay? 

24:52
Jo-Anne La Flèche
And when I get on stage or when I get into the dance studio, if I'm auditioning for something, well, then that performance anxiety, because I'm feeling aroused to a certain degree will make me physically more conscious about everything going on. So when I'm a little bit stressed out, everything lights up. My brain becomes like the light bulb really lights up. So that gives me added concentration, added energy I'll feel in my muscles there that I'm ready to go. So I'll have all that extra energy that I'll be able to put and very aware about what's going on around me. So certainly that will be a challenge and an added ace to my card game, right? 

25:49
Jo-Anne La Flèche
Okay. 

25:50
Jo-Anne La Flèche
But typically when I have performance anxiety, that will lower during the performance and. 

25:58
Jo-Anne La Flèche
After, it won't stay there. So as soon as I dance, for. 

26:03
Jo-Anne La Flèche
Example, if I'm in the wings and I hear the music coming on, and then I've got all these butterflies in my stomach and I feel like urinating and say, oh my God, what am I doing here? Why do I dance? Okay, once the music starts, I go on stage, and then all that anxiety goes down. But if I'm completely overwhelmed by my anxiety because I'm worrying and I start saying negative things to myself and telling myself that I'm not as good as anybody else and I'm sure I'm going to fall off point or I'm going to fall on my face or whatever, well, then I can be overwhelmed. And that's when I'll start freezing. So that's why there's a certain degree. Usually it's like an inverted you level of arousal for more performance levels. 

27:00
Dr. Linda Bluestein
That makes perfectly good sense. So for the dancers who are at the higher end of the U and maybe really having more challenges with anxiety, are there some ways that they can lower the levels of anxiety on their own? 

27:15
Jo-Anne La Flèche
Oh, definitely. There's a lot of self care practices that can help. Okay, for example, the first thing basic thing here is breathing. Now typically if I'm fearful about something, you can just experiment it for yourself. But very often the first reflex that's going to happen, if I feel that there's a polar bear coming on to me and that I'm their next lunch, I'm going to stop breathing. I'm going to go like that, okay? And then once I do that, I'm even more tense. 

27:53
Dr. Linda Bluestein
Okay? 

27:53
Jo-Anne La Flèche
So the thing that I've got to do is maybe train maybe daily to. 

28:00
Jo-Anne La Flèche
Breathe deeply, calmly and breathe in for. 

28:06
Jo-Anne La Flèche
Five, 6 seconds with your nose. Breathe out with your nose, maybe five, 6 seconds also and really getting to calm myself so that my nervous system. 

28:21
Jo-Anne La Flèche
Starts calming down and then I can feel myself more grounded and more at ease and the tension is going to let go and especially work on letting. 

28:36
Jo-Anne La Flèche
Go your body weight while you're exhaling. That's so important. 

28:40
Jo-Anne La Flèche
And visualizing that you're like a big. 

28:44
Jo-Anne La Flèche
Rock that's like just sinking into sand. 

28:47
Jo-Anne La Flèche
Okay? 

28:48
Jo-Anne La Flèche
So you can use all kinds of imaging, which is another thing that you can do is to produce soothing, calming images that can help you. You can image a safe space while you're breathing. For example, it can beside the sea, it can be on the top of a mountain, in the middle of the woods, in your house, wherever, okay? And you just breathe calmly and deeply. Now, a breathing and meditation and relaxation is something that needs training. Just like dance. If you try and just breathe the day before a dance show or a dance event, that won't necessarily be very effective. That's the same thing as if you start training for an audition the day before, okay? So you've got to do that like on a daily basis. I generally advise people to do that before they go to bed and that way that helps them to calm down and to initiate a more restful night by just calming down, getting your system down a little bit. 

30:03
Jo-Anne La Flèche
So that's certainly something that you can use. And especially you can use that as a pre performance training. Also, very often a lot of dancers well, in their pre performance routine, they're focusing an awful lot on getting the muscles all warm and all that. But the first thing to do is to start breathing and calming down. So that's something that's very important. I would say positive self talk also, because when I'm anxious, I'm doing negative self talk, okay? I'm saying, oh, the audience won't like this, and I'm catastrophizing and anticipating on things that will probably not happen. So I've got to switch that around. 

30:53
Jo-Anne La Flèche
Into positive sentences such as, I'll do my best, I'm capable of doing this. 

31:02
Jo-Anne La Flèche
Positive things that can help an awful lot. You can also be using imaging as far as preparing yourself for dance. Also, like in mental rehearsal, using imaging is really important. And then you see yourself dancing in. 

31:22
Jo-Anne La Flèche
A positive and competent way, and you. 

31:25
Jo-Anne La Flèche
Can sense it in your body while you're going through step by step. Well, that'll make you feel more secure and that'll add focus and attention to what you're doing. So if you do that several weeks before and you keep on doing that just like before you go onto stage or in the dance studio, that's likely to help you. 

31:47
Jo-Anne La Flèche
Yes. 

31:48
Jennifer Milner
And I know we talk a lot about imagery as a training tool. So we've talked about breath and you've talked about positive self talk, which I think is so important for dancers because we practice positive, negative talk all the time. And I always tell the dancers in my class, if you're going to snap because they snap now instead of clapping. But if you're going to snap for a fellow dancer after she does a great Pirouette, why don't you snap for yourself? You snap for your friends, and then when you finish your dance, you tell yourself all the things that you did poorly. 

32:18
Jo-Anne La Flèche
So positive self talk so important. 

32:20
Jennifer Milner
Breathing so important. But you also referenced something earlier talking about the fishbowl and separating the fish from the water. Is there value in looking at the situation and sort of examining what is the worst case scenario, like what could be happening here and sort of bringing a reality check to yourself? Is there value with anxiety of examining the water in some way? 

32:45
Jo-Anne La Flèche
Certainly we'll be talking in those circumstances about mindfulness. So when I am in that breathing, I start by breathing and connecting to the here and now, right? Because anxiety is related to the future, depression is related to the past. 

33:06
Jo-Anne La Flèche
It's a simple way of putting things okay. And the present moment is the only place to be. 

33:14
Jo-Anne La Flèche
So a certain amount of anticipation is an adaptive response. It's interesting to know that I've got something to do tomorrow because that way I'm going to get ready for it. But when I'm more in the future than in the present moment, I'm generating anxious feelings because I have no control on what's going to come up tomorrow. I have absolutely no control. So I'm trying to have control on things that I can't control. So if I'm in mindful practice, which. 

33:44
Jo-Anne La Flèche
Means that I will take time to. 

33:46
Jo-Anne La Flèche
Meditate, I will take time to breathe. 

33:49
Jo-Anne La Flèche
And by doing that, I will also. 

33:52
Jo-Anne La Flèche
Take a stance of being a witness. 

33:56
Jo-Anne La Flèche
Instead of being a judge to what is my experience now, dancers are very. 

34:02
Jo-Anne La Flèche
Used to judging themselves, right? You just talked about that, jennifer oh, I did this, I did that, and judging other people. Dancers judge other people also for better, for worse, or they'll say, oh, they're a lot better than I am, and they compare themselves usually, which generates an awful lot of anxiety and negativity. But instead of being in that judge position, I try and be in the witness position. So I'm just like calming myself down and letting my thoughts go by as. 

34:35
Jo-Anne La Flèche
If they are clouds. 

34:38
Jo-Anne La Flèche
And I reflect on my thoughts, but. 

34:41
Jo-Anne La Flèche
Not as a reality, saying to myself, those are my thoughts, but I am not my thoughts. And my thoughts are not necessarily reality. 

34:55
Jo-Anne La Flèche
They come from me, but I can change them if they're not helping me. 

35:00
Jo-Anne La Flèche
Okay? 

35:01
Jo-Anne La Flèche
So that will help me an awful lot to see. Okay, now, what's happening in the fishbowl? What kind of water, what's happened this week? And that's going to start helping me to try and find what are the triggers of my anxiety. Why am I more anxious this week? So usually, as you said before, Linda, dancers will be anxious. 

35:28
Jo-Anne La Flèche
There's a certain baseline of anxiety you. 

35:31
Jo-Anne La Flèche
Just can't eliminate because it goes with. 

35:33
Jo-Anne La Flèche
The territory, especially if you're hypermobile. 

35:37
Jo-Anne La Flèche
Okay, but it does come with a territory. But that being said, after that, what's the added stuff? Okay, so if I'm breathing and I'm. 

35:47
Jo-Anne La Flèche
In this mindful set of thinking, I'm. 

35:51
Jo-Anne La Flèche
Not judging anything, and I'm just reflecting on what's happening, well, then I'll be able to say to myself, oh, okay, my teacher said this, that happened, my mother told me such and thing, my lover said something, I'm disappointed about myself, whatever, okay, whatever. My stomach hurts, whatever, okay? And then I'll be able to start reflecting on what's going on. And from there, then I can say to myself, supposing, what's making me anxious is all this negative talk. Well, then after that, I'll be able to say, okay, well, if that's like a thought that I have and it's not objective reality, well, how could I replace that negative thought by something that. 

36:37
Jo-Anne La Flèche
May be more realistic, maybe more constructive, so that can help me and that. 

36:45
Jo-Anne La Flèche
Can help me to develop what we call self compassion. Being my best friend. 

36:52
Jo-Anne La Flèche
Now, what would I say to my. 

36:54
Jo-Anne La Flèche
Best friend if they came up to me with certain things now that can. 

36:59
Jo-Anne La Flèche
Be really helpful, to be less harsh. 

37:02
Jo-Anne La Flèche
On ourselves, to say, what would I. 

37:03
Jo-Anne La Flèche
Say to my best friend? 

37:05
Jo-Anne La Flèche
Would I say that they're a terrible dancer and that they will never succeed? 

37:09
Jo-Anne La Flèche
I don't think so. 

37:11
Dr. Linda Bluestein
Right? 

37:11
Jo-Anne La Flèche
So what could I say? And then I'll try and find things that are maybe less all or nothing. 

37:18
Jo-Anne La Flèche
Like, okay, I haven't succeeded my pirouette yet, putting a yet there, reminding myself that I'm in evolution, that can be. 

37:31
Jennifer Milner
Something. 

37:34
Jo-Anne La Flèche
Or, oh, today, how do I feel today? And what was something that I liked. About myself today. So all those things can feeling grateful looking at what did I do that was correct? Or where am I proud of myself today? Or what can I say thank you to? Either from myself to other people to. 

38:02
Jo-Anne La Flèche
Situations that makes me be maybe less. 

38:06
Jo-Anne La Flèche
Focused on the nitty gritty that I didn't succeed or the things that I'm anticipating. 

38:15
Jennifer Milner
That makes a lot of sense. Those are all great ways that dancers can sort of work themselves on their anxiety and try to recognize it, try to practice for it ahead of time. As you said, you don't start preparing for an audition the day before. So we start preparing our anxiety practice and our self care before we need it, hopefully. But are there signs that a dancer may want to seek help in dealing with their anxiety and not try to handle it all themselves? 

38:41
Jo-Anne La Flèche
Oh, yes. 

38:44
Jo-Anne La Flèche
I think that if you feel anxious. 

38:50
Jo-Anne La Flèche
Most of the time and that's been lasting, I would say six months, that can be an interesting criteria. 

39:00
Jennifer Milner
Okay. 

39:01
Jo-Anne La Flèche
Say to myself, because I'm saying six. 

39:03
Jo-Anne La Flèche
Months because sometimes we can be in an objective difficult situation and we'll talk. 

39:12
Jo-Anne La Flèche
More about adjustment disorders at that time. 

39:15
Dr. Linda Bluestein
Okay? 

39:16
Jo-Anne La Flèche
So remember that anxiety is on a spectrum of intensity, and on the lighter end are adjustment disorders. So I've just moved. I've entered a new dance company. I just left my friends behind. 

39:36
Jo-Anne La Flèche
I've had an injury. 

39:38
Jo-Anne La Flèche
There's been different things. Well, normally adjustment disorders will subside after a few months once I get into sync with things. So that's something that's really important. 

39:52
Jo-Anne La Flèche
Is it? Most of the time that I'm feeling. 

39:56
Jo-Anne La Flèche
Anxious, most of the time I wake up with a rock in my stomach asking myself how I'm going to go through the day. That's something that's important to look at. And as I say, that's been like something that's chronic is really important. Have I developed eating disorders that go with that? My appetite can be affected. Either I'm eating compulsively or I'm not eating at all, or not eating enough, or I've become hyper aware of what I'm eating, or I'm checking my body weight three times a day. 

40:37
Jo-Anne La Flèche
Most compulsive disorders are also related to anxiety disorders. 

40:44
Jo-Anne La Flèche
Okay? So those are things that you can look at. Have you been withdrawing socially? You've stopped calling your friends. You've stopped calling your family. The gang goes out and has dinner together or after a show, but you don't go. You feel like you have to go home. Are your sleeping patterns, have they changed? 

41:12
Jo-Anne La Flèche
Are you sleeping less? 

41:13
Jo-Anne La Flèche
Are you sleeping more? Things like that. Those are things that can be difficult after a while. Sleep deprivation is something that's very terrible, that has an awful lot of impact. 

41:25
Jo-Anne La Flèche
On mental health and physical health. 

41:28
Jo-Anne La Flèche
So that can be like a vicious circle. I'm anxious, so that affects my sleep. But because my sleep is affected, I get more anxious. So if I'm feeling overwhelmed and not in control, and I'm feeling shameful. I'm saying negative things to myself all the time, or I've got outbursts of tears, or I'm angry, I'm aggravated, I'm screaming most of the time. Those are things, little signals there. And as I say, we've all had bad weeks, right? 

42:06
Jo-Anne La Flèche
Okay. 

42:06
Jo-Anne La Flèche
But if that's going on through time. 

42:10
Jo-Anne La Flèche
Then you've got to ask for help. 

42:14
Jo-Anne La Flèche
You won't get out of that alone. 

42:18
Jennifer Milner
Well, and I think, as you said earlier, dancers are so reluctant to admit that they are in pain or that they are struggling because we don't want to seem weak. We don't want to be looked over for casting. And so a step that a lot of dancers will take before they seek outside help will be to try to self medicate in some way, which as some of the things you've listed, compulsive behavior, self mutilation, disordered eating, turning to depressants or stimulants to help. And sometimes we'll do that without even realizing it. It'll just be instinctive, trying to sort of self manage. But some of those things don't work the way that we think they would. So if someone is self medicating with alcohol, for example, they may think that the alcohol is actually helping in the situation. But what actually could be going on when somebody is drinking alcohol and has anxiety as well? 

43:12
Jo-Anne La Flèche
Well, that's a very lethal combination because, well, alcohol is a depressant. 

43:20
Jo-Anne La Flèche
So if you're feeling more depressed at. 

43:23
Jo-Anne La Flèche
The beginning, you're going to feel more relaxed. 

43:26
Dr. Linda Bluestein
Okay. 

43:26
Jo-Anne La Flèche
So that's giving you immediate soothing. 

43:32
Jo-Anne La Flèche
Okay. 

43:33
Jo-Anne La Flèche
So that reinforces your behavior, right. Because you've just had a candy. There an emotional candy saying, oh, okay, I feel so much better. 

43:42
Jo-Anne La Flèche
Okay. 

43:42
Jo-Anne La Flèche
But alcohol is a depressant. So after a drink or two, well, then the depression kicks in, and then I'm going to start catastrophizing even more, or I'm going to feel even more tired, or I'll withdraw even more. So I get into that vicious circle where eventually, well, I don't feel as much energy, and then my performance is. 

44:10
Jo-Anne La Flèche
Being affected by that also. 

44:13
Jo-Anne La Flèche
I can't concentrate as much. I'm forgetting my routines. And then I get into that vicious circle with anxiety. I'm fearful of not being at Par because I forgot my dance routine, and my teacher told me that or my director told me that in front of everybody else, and I'm feeling humiliated. That's not a good idea. 

44:36
Dr. Linda Bluestein
Right. 

44:37
Jo-Anne La Flèche
Which is very different from having a beer or a glass of wine on Saturday night. That's fine. 

44:44
Jennifer Milner
Which is, again, an example of everybody has a bad week. Everybody has we all have these moods, as you said, huge difference between having a glass of wine on a weekend night and trying to self medicate. So if we've hit that point, we realize we need something more than ourselves. We've tried self medicating and realize that is not the place for it. What comes next? Is there a place for therapy then? 

45:11
Jo-Anne La Flèche
Well, I think that if you're feeling that everything you've tried before that is not really working, then it's time to ask for help. So I think that depending on your situation, if in your dance company, for example, you have a self care team, a wellness team, well, then maybe you can go and consult a wellness team and just talk about how you're feeling. And in certain circumstances that may be enough. Okay, if I'm sharing and I have a few counseling sessions with maybe somebody that's on the wellness team and to sort things out and everything and get a little plan about what I can do. And maybe the counselor there will, for example, propose that the person does some journaling or other maybe self care measures. 

46:11
Jo-Anne La Flèche
That they haven't thought about or help. 

46:14
Jo-Anne La Flèche
Them reflect on positive thinking and how to do that. So for certain people it may be enough. Sometimes dancers will stop confiding with other dancers and then maybe the counselor will just say, well, hey, if you talked about how you're feeling a bit more, that would help. If you haven't talked to your family that much in the last months, well, why don't you reconnect with them? Okay. So there are certain things like that, certain counseling tools that maybe the dancer needs at that time because their toolbox, there may be things that are missing there. So that's something that can be done. It can also go with resources. For example, reading resources, educational resources on mental health can help also. 

47:06
Jo-Anne La Flèche
But there are many other things that we can do. But at a certain point, if the. 

47:13
Jo-Anne La Flèche
General counseling has not worked and the resources have not really worked enough, then. 

47:20
Jo-Anne La Flèche
It'S time for psychotherapy. 

47:22
Jo-Anne La Flèche
And then the person should try and consult and find a certified psychologist that is specialized in psychotherapy. And then sometimes often well, that will be I will very often suggest also a physical exam at the same time to see if there's something physical going on. Because for example, maybe the dancer has a red syndrome where they're practicing so much and they're working so much. They may not have a disordered eating pattern, but maybe for all kinds of circumstances, they're not taking enough energy intake, they're not sleeping enough, they're not eating enough compared to all the energy they're spending and they're not realizing it. That can happen. Well, that can also generate an awful lot of symptoms as far as the endocrine system and the nervous system. So it's important to go and get that checkup so that the psychologist and the physician will work together because body, soul and mind is all connected. 

48:40
Jo-Anne La Flèche
It's not little boxes there with we've got to treat the person in that systemic mode, right? Remember the fish bowl and all that. That's like really important. 

48:52
Dr. Linda Bluestein
So I would suggest that also that's a great suggestion. And we know that sometimes depending on a person's circumstances, they may have difficulty finding a therapist. And I know you mentioned finding someone who is licensed to do psychotherapy. Do you have any suggestions for how someone can find a therapist who's a good fit? I sometimes have when I'm recommending that to someone and they'll say, oh, I tried that and it didn't work. And I tell them, it's like dating. You don't always find the right person on the first try. And I also tell them, you deserve to have a therapist. You deserve to work with a counselor. Do you have any suggestions for how someone could find someone who's going to be a better fit for them? 

49:35
Jo-Anne La Flèche
Well, I think that starts with strategic shopping for a therapist. 

49:41
Jo-Anne La Flèche
Okay. 

49:42
Jo-Anne La Flèche
So I think that one thing that can be certainly a plus. If that psychologist not only has a clinical background that has worked also in performing arts or I would say in sports psychology also, because athletes and artists often share this, it's not completely identical, but there are a lot of major issues that are the same, so that can help. So trying to find out about the background of that person can certainly help. And also asking yourself, first of all, if you want to save time, start by reflecting before you go see a psychologist. 

50:24
Jo-Anne La Flèche
What are your goals, what's the problem, and what are the symptoms, and what do you want to work on? 

50:32
Jo-Anne La Flèche
And you write that on a piece of paper, so that can be really helpful because first of all, it makes you reflect. It makes you get into that witness. 

50:41
Jo-Anne La Flèche
Position of trying to figure out what's going on. And that way, when you do shop. 

50:49
Jo-Anne La Flèche
Around for a therapist, you'll be able to meet that person and tell them right off the bat what you need. So that can help you evaluate pretty. 

51:00
Jo-Anne La Flèche
Soon, maybe in one session or two. 

51:04
Jo-Anne La Flèche
What you need and what that person also is expecting from the mental health professional. Now I've got patients in the dance world and outside the dance world who will tell me, I really like to work with you, Joanne, because we're more in an interactive mode. And I've seen other psychologists who just don't say anything and I feel alone. And that doesn't work for me, but because I'm more an interactive person in my way of relating to patients. But other people, it's the other way around. They need to blurt it out, and they don't need to have somebody react too much. So we're not all the same. 

51:54
Dr. Linda Bluestein
Okay? 

51:54
Jo-Anne La Flèche
So we've got to ask ourselves, what are my expectations also towards that psychologist? So that way you can shop around for that and ask them how do they work? Okay, some psychologists have specific ways and tools, and they're always working the same way, and they don't adjust to the patient necessarily, so the patient has. 

52:16
Jo-Anne La Flèche
To adjust to them. 

52:18
Jo-Anne La Flèche
Others psychologists will do the reverse. I'm mostly like that. 

52:22
Jo-Anne La Flèche
I will adjust to what I feel. 

52:25
Jo-Anne La Flèche
Is the need of the person. So those are things that can help. 

52:30
Jo-Anne La Flèche
You to shop around, but it's like. 

52:34
Jo-Anne La Flèche
Your metaphor is so relevant. Linda, I think that shopping for a psychologist is exactly like dating who am I and who are you? And can we make out together? Okay. It's as simple as that. And that has nothing to do with bad faith of the artist seeking negative attention or being in bad faith. And that has nothing to do with a judgment call on the psychologist's competence. It's just a question of the fit. It's, like, really important. 

53:15
Jo-Anne La Flèche
So it's worthwhile to shop around. 

53:18
Jennifer Milner
Absolutely. 

53:19
Dr. Linda Bluestein
Yeah, definitely. And I really like how the suggestion that you make for people in order to help them find that good fit, I think that's really smart. And in terms of as we're getting ready to wrap up here, in terms of if a person is feeling like they've tried a lot of the self help things, they understand about the self medicating and they're recognizing maybe that's not a good idea. And maybe they are not working with a therapist, but maybe they're feeling like medications are maybe going to be something that would be helpful. There are some times right, where medications are important, and those can be prescribed. 

53:58
Jo-Anne La Flèche
By a variety of doctors. 

54:01
Dr. Linda Bluestein
Right. That might be your PCP, might be a psychiatrist. Kind of depends on what's going on. 

54:06
Jo-Anne La Flèche
Exactly. 

54:07
Jo-Anne La Flèche
But that's why for me, it's so important to work in collaboration between the psychotherapist or the psychologist and the physician. Who can be a general physician or can be a psychiatrist? 

54:21
Jo-Anne La Flèche
It depends. 

54:23
Jo-Anne La Flèche
But yes, in some circumstances, especially if you come from anxious family and that you have that hereditary makeup, well, it's possible that you will need that little med that will help you. And a lot of patients, they see that negatively as like, a sign of weakness. And I say to them, for certain people, medication for anxiety or for depression is like taking a vitamin for the brain. Some brains they're lacking as far as neurotransmitters are concerned. So they need that kind of adjustment that may come from dance practice, because we secrete an awful lot of hormones in our brain while we're dancing. That's why dancing makes us feel good and makes us feel elated at times. 

55:17
Dr. Linda Bluestein
Okay. 

55:17
Jo-Anne La Flèche
A lot of times, actually, but sometimes we need that little boost for certain people. So I'm not saying everybody needs meds, but I'm not saying nobody needs meds either. So it's really like case by case. That's why you need that double evaluation. 

55:36
Jo-Anne La Flèche
All right. 

55:36
Jennifer Milner
That was so much information for me to take in and kind of process and think about and try to put it all together. I really appreciate the image of the fish and the fishbowl from so many points of view because I have been thinking about that since you first mentioned it, partly because dance is such a fishbowl sport. Anyway, we feel like we are in this complete glass container and everybody's staring at us and we're going nowhere trying to do the same thing over and over again and never succeeding. But also the importance of separating ourself from the water and learning the things that we can control and the things that we can't control. So that's hugely helpful for it. Thank you for talking through the difference between situational anxiety, like performance anxiety and more of a generalized long term anxiety. Ways that we can sort of practice self control and self care, signs that we may need to look for someone to help us with it, signs that we may be self medicating and not doing it successfully. 

56:31
Jennifer Milner
And ways to find a good person who can help us. There's been so much richness in here that I really appreciate you sharing your expertise on all of this. Is there anything that you wanted to add that we did not cover? 

56:45
Jo-Anne La Flèche
Yes. You have a couple of hours, eh? But I think at this point in. 

56:55
Jo-Anne La Flèche
Time, there's something that I often say. 

56:58
Jo-Anne La Flèche
To dancers that I see either individually. 

57:01
Jo-Anne La Flèche
Or in groups, is that no matter. 

57:04
Jo-Anne La Flèche
How passionate you are about your dance, no matter how you feel, good about it. No matter how you've loved this practice. 

57:12
Jo-Anne La Flèche
And that I hope that you will. 

57:15
Jo-Anne La Flèche
Have dance in your life for the rest of your life, you must keep in mind that you are much more than your dance. And that's part of a reflection that will help you at times to get. 

57:31
Jo-Anne La Flèche
Out of the fishbowl and in that witness stance, okay? To see am I happy in this and that's fine. 

57:41
Jo-Anne La Flèche
And if I'm not happy, I could do something else or I can do it another way, or I can do it another time, but I'm much more than that. And to preserve balance. That's why it's so important also that. 

57:57
Jo-Anne La Flèche
You do and think and talk about other things than dance because that makes it healthy. 

58:07
Jo-Anne La Flèche
It makes you stay in a harmonious passion instead of becoming obsessive about dance. So I encourage you to have non dancer friends and that when you talk to your family, you're talking about something else and not being forever looking at dance videos or things like or talking shop with your dancer friends, talk about knitting, talk about other things and do other things. Most dancers, because they get all overwhelmed in their dance, they consider that whatever is outside the dance world is a waste of time. That is very stressful way of thinking. It makes us off balance and that generates an awful lot of anxiety because my expectations towards my dance are like multiplied by 100 because I have nothing else. So I have the impression that all. 

59:09
Jo-Anne La Flèche
My end identity is fused with my. 

59:13
Jo-Anne La Flèche
Dance and that will make performance anxiety and perfectionism skyrocket. So it's very important walk in nature, do any other things. 

59:25
Dr. Linda Bluestein
It's like so important that is really fabulous. When I stopped dancing, I think it was particularly hard because so much of my identity was wrapped up in dance. I imagine that's true for a lot of people. And so what you're talking about is really kind of inoculating. It's like a vaccine for the day that may come when you're going to be doing something different in your life and really preparing yourself and making yourself a really well rounded person. 

59:57
Jo-Anne La Flèche
And I would say that what you do as a dancer outside of dance makes you dance better. It's not something that is taking you away from dance, it's getting you back into shape because you're balancing yourself with other things. 

01:00:16
Jo-Anne La Flèche
Okay. 

01:00:16
Jo-Anne La Flèche
So that's like really important as far as rest and recovery is concerned physically, but also mentally, emotionally, spiritually. So just to keep in mind that, yes, I'm much more than that. 

01:00:31
Dr. Linda Bluestein
Okay. 

01:00:32
Jo-Anne La Flèche
So it gives me that healthy perspective of the fishbowl, even if I enjoy what I'm doing tremendously. 

01:00:40
Dr. Linda Bluestein
Yeah. Wow, that's brilliant. And this has been such a great conversation. I've learned so much and I know our listeners are just going to really love getting to learn from you. And is there a place where they can find out more about the work that you're doing, articles that you've written and that kind of thing? 

01:00:58
Jo-Anne La Flèche
Well, I encourage them to go on the Healthy Dancer Canada website. 

01:01:03
Jo-Anne La Flèche
Okay. 

01:01:04
Jo-Anne La Flèche
There's an awful lot of informational papers that I wrote, but many other people have written also on all kinds of subjects and that can be very helpful physically and mentally. So I think that the more dancers are informed, that can help alleviate anxiety just by saying, okay, well, this is normal, or I can do this or I can do that. So the more I feel equipped, well, the less anxious I'm going to be. Or if I realize that a lot of other dancers are experiencing the same thing, I won't get so over conscious about things. That's one place to look at, I would say. Also the Dance USA papers, informational papers, the ones that are written by the task force members on Dancer Health. I've written several articles there and co authored those articles. So those are things that you can look out for. You can also look know like dance magazine or dance current. 

01:02:12
Jo-Anne La Flèche
There are more and more also very good articles on mental health that can really help you just to reflect on things and talk about subjects. Also with other dancers. It's so helpful to do that. And that helps to take away the culture of silence that's in dance, right? We don't hush, hush. We don't talk about things which just generates even more turmoil and injury risk also. Okay, so those are things that can help an awful lot. Journaling can help an awful lot. Also get my states into perspective by putting them on paper. 

01:02:55
Dr. Linda Bluestein
Great. Are you taking on new clients at all or is that something that is not really an option for people. They wanted to work with you directly. Is that an option or is that something that your practice is? I'm sure your practice is super busy, but I think people are going to ask that question. 

01:03:14
Jo-Anne La Flèche
Okay, well, thanks. That's really sweet of you as far as the vote of confidence is concerned. But I would say above all considerations of my practice, actually, there's ethical considerations, is that usually mental health practitioners have licenses only for the states or the countries where they practice. Like, for example, I'm under Quebec jurisdiction, so technically, I cannot have a patient from Ontario or British Columbia, and it's the same thing for the states. Or, you know, I can give a workshop, I can be on a podcast, I can do things like that, but not clinical work. So they would have to find resources in their own state. Sure. 

01:04:07
Dr. Linda Bluestein
And I'm really glad you brought up about the workshop, because I would love to have you teach a workshop for Bendy Bodies for our audience that we could dive even deeper and maybe even some subcategories like trauma that we talked about, we wanted to talk about more today, but that's such a big topic itself. We could talk about that for a couple of hours. So if you're listening to this podcast and you say, gosh, I would really be interested in a workshop like that, please let us know, you know, how to reach us. I'll mention that in a minute because we would love to put that together if people are interested. 

01:04:45
Jennifer Milner
Absolutely. 

01:04:46
Jo-Anne La Flèche
Well, that's possible. Obviously. It's just like the same thing as a podcast. A workshop does not replace psychotherapy, right? 

01:04:56
Jennifer Milner
Absolutely. Yes. 

01:04:57
Jo-Anne La Flèche
But it can really help identify issues, sometimes put things in perspective, and from there, then you can decide what you right. 

01:05:09
Dr. Linda Bluestein
Right. Well, very good. This has been such a fantastic conversation, and you've been listening to Bendy Bodies with the Hypermobility MD. Our guest today was Joanne Laflesch. And Joanne, we have just loved chatting with you. Thank you so much for coming on and sharing your vast wisdom with our listeners. 

01:05:29
Jo-Anne La Flèche
It's my pleasure. Always a pleasure. 

01:05:31
Jennifer Milner
Thank you so much. 

01:05:34
Dr. Linda Bluestein
We loved it. If you loved what you learned, follow the Bendy Bodies podcast to avoid missing future episodes. Screenshot this Episode tagging us in your story so you can connect. Our website is WW bendybodies.org and follow us on Instagram at bendy underscore bodies. Leaving a review following the Bendy Bodies Podcast and sharing the podcast helps spread the word about hypermobility and associated conditions. This information is not intended to diagnose, treat, cure, or prevent any disease. The information shared is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. We'll catch you next time on The Bendy Bodies podcast.