on October 28, 2026
When Words Are Not the Only Language of Care
Not all psychological experiences can be easily put into words.
Fear, pain, loss, loneliness, changes in body image, illness, and awareness of one's own finitude can involve levels of experience that precede verbal formulation. In these situations, the body, movement, rhythm, gesture, color, and artistic production can become complementary ways of observing and sharing what is happening.
This perspective gives rise to expressive psychotherapy, a psychodynamic approach that integrates verbal and preverbal codes and uses tools drawn, among others, from art therapy and dance-movement therapy.
It is not simply a matter of “making art” or engaging in physical activity. The therapeutic meaning derives from the relationship, the setting, the presence of a trained professional, and the opportunity to gradually attribute meaning to the bodily and expressive experience.
Dance-movement therapy uses movement as a tool to explore the relationship between the bodily dimension, emotions, cognition, and interpersonal relationships. Movement is therefore not considered exclusively as physical exercise, but as a possible form of communication.
The Body as Language
Breathing, swaying, approaching or moving away, pushing, pulling, changing rhythm, occupying space, or remaining still are bodily experiences that can take on psychological meaning.
In a therapeutic context, attention can be directed to the perception of breath, muscle sensations, posture, rhythm, and the surrounding space.
A very simple movement can thus become a starting point for a narrative.
The goal is not to automatically interpret every gesture, but to create conditions in which the person can recognize what they are experiencing and, when possible, transform it into a shareable representation.
This aspect is particularly important for frail, elderly, or easily fatigued people. In these cases, the intervention can be adapted to their remaining abilities, using small-amplitude movements, breathing exercises, mindfulness, and sensory stimuli compatible with their individual conditions.
Therapy therefore also becomes an exercise in attunement: the professional observes what the person is able to do, avoids imposing a performance, and builds the experience based on the possibilities that are actually available.
From Movement to Artistic Trace
The transition from the body to the mark can represent a further level of processing.
After a movement experience, a sheet of paper and simple materials can be offered, allowing what has been experienced to find expression through lines, shapes, colors, or spaces.
Artistic production does not necessarily have to be interpreted according to rigid codes.
A line does not necessarily have to “mean” anything.
Instead, it can become an opportunity to ask the person what they see, what they recognize, what meaning they attribute to that shape, or what memory they associate with that color.
In this way, the therapist does not replace the person in interpreting the experience, but accompanies them in constructing meaning.
This is a substantial difference.
The goal is not to decode a drawing as if it were a diagnostic test, but to use the expressive production as an intermediate object of the therapeutic relationship.
The sheet of paper can become a space in which the patient and therapist can meet without everything having to be immediately explained through language.
Movement, Parkinson's, and Integrated Rehabilitation
One of the areas in which dance research has produced particularly interesting results is Parkinson's disease.
Dance requires movement, rhythm, spatial orientation, attention, and coordination simultaneously. These characteristics can stimulate motor and cognitive systems differently than traditional repetitive exercise.
A meta-analysis of randomized studies found that dance can improve certain motor aspects, particularly balance and the severity of motor symptoms, in people with mild-to-moderate Parkinson's disease. However, the authors highlighted the need for further research to clarify the effects on non-motor symptoms and quality of life.
A randomized trial of an integrated dance and physiotherapy program also observed an improvement in the motor component compared to conventional physiotherapy in people with mild Parkinson's disease, suggesting that dance may represent an interesting complement to rehabilitation.
The most recent evidence confirms a promising but inconclusive picture. A systematic review in 2026 included 66 studies and over 1,200 participants, reporting potential benefits for both motor symptoms and certain cognitive and emotional aspects. However, the same authors emphasize the heterogeneity of the protocols and the need for larger, more standardized studies.
It is therefore more accurate to consider dance as a complementary intervention for rehabilitation and the promotion of well-being, not as a substitute treatment for neurological therapy.
Cognitive Decline and Dementia: Movement Can Involve Both Body and Mind
Another area of research concerns people with mild cognitive impairment, Alzheimer's disease, and dementia.
Dance has a particular characteristic: while the body moves, the brain must simultaneously process rhythm, sequences, space, balance, and interaction with others.
A systematic review and meta-analysis in 2023 included 29 studies, 13 of which were randomized, involving a total of 1,708 participants. The available studies highlighted favorable effects on overall cognition, memory, balance, and depressive symptoms, while no significant benefit emerged for executive function.
However, the Cochrane review specifically dedicated to dance-movement therapy in dementia also calls for caution: the available evidence was limited and of low certainty, with possible small benefits for depression but insufficient evidence to establish effects on cognition or overall well-being.
A comparative study published in 2026, comprising 209 randomized studies and 3,773 participants with cognitive decline or dementia, also showed that dance was not statistically superior to other forms of exercise for all outcomes. However, it ranked favorably for certain cognitive aspects.
The scientific message is therefore interesting: moving through dance can represent an engaging form of multidimensional stimulation, but it is not correct to present it as a specific therapy for dementia.
Oncology: The Body Changes and Must Be Able to Be Listened To
Cancer illness can profoundly change one's relationship with the body.
Surgical interventions, pharmacological therapies, hair loss, weight changes, pain, fatigue, and changes in body image can affect identity, self-esteem, and relationships with others.
In this context, dance-movement therapy can offer an experience in which the body is not perceived merely as the seat of the illness, but also becomes a tool for expression and relationship.
A systematic review in 2021 of women with breast cancer identified six intervention studies, five of which were randomized, highlighting interest in quality of life, physical activity, stress, and emotional and social well-being.
Subsequent literature has expanded the picture. A systematic review and meta-analysis in 2026 comprising 12 randomized studies found a significant improvement in quality of life and a reduction in depressive symptoms in women with breast cancer undergoing dance-based interventions. The effects appeared particularly evident in longer-duration programs, while no consistent overall benefits emerged for pain, fatigue, or body image.
A broader review and meta-analysis dedicated to oncology patients, however, included 16 studies and 893 participants. Favorable results emerged for certain aspects, including depression and fatigue in dance-based interventions, but the high variability of the protocols and the high risk of bias led the authors to judge the overall evidence as weak.
In this case too, therefore, the most interesting finding is not the promise of a “cure” through dance, but the possibility of integrating movement, relationship, emotional expression, and the recovery of bodily perception within oncology pathways.
The Time of Illness and the Language of the End of Life
The context of palliative care introduces an even more delicate dimension.
When a person approaches the end of life, some questions can become difficult to address verbally: what to leave to others, which memories to preserve, what it means to separate, which relationships to wish to repair, which values to transmit.
Expressive psychotherapy can offer a space in which these contents can also be approached through metaphors, images, movement, and narrative.
A gesture shared with a family member can become a memory.
A color can represent a relationship.
A shape can become the starting point for telling a part of one's story.
A movement can allow one to express something that at that moment finds no words.
This dimension can be particularly meaningful in constructing the legacy, that is, what the person wishes to leave of themselves to others: memories, values, words, images, objects, gestures, or meanings.
However, it is important to maintain a scientific distinction. Clinical experiences in palliative care can be extremely meaningful, but the number of controlled studies specifically dedicated to expressive psychotherapy and dance-movement therapy at the end of life is still limited. It is therefore not possible to attribute established therapeutic effects on anxiety, existential distress, or spiritual suffering to these interventions based solely on clinical experiences.
Their value can be more cautiously described as potential psychological, relational, and expressive support.
The Relationship with the Family
One of the most interesting characteristics of the expressive approach is the possibility of involving a family member when appropriate.
The therapeutic relationship can thus temporarily transform into a three-way space: patient, therapist, and caregiver.
Shared movement or drawing can allow memories and meanings to be evoked without immediately forcing the couple to formulate everything through rational speech.
This can be particularly important when family communication is dominated by illness.
Instead of talking only about symptoms, prognosis, and care needs, a space can be created to remember who the people are beyond the illness.
Therapy does not erase the suffering of the situation, but it can help create a different way to go through it.
A Possible Bridge Between Patient, Family, and Team
Expressive language can also take on a relational function.
In a group formed by a patient, family members, and healthcare professionals, artistic production or the bodily experience can become a common point of reference.
This allows attention to be temporarily shifted from the “problem to be solved” to the person's experience.
For healthcare professionals, it can also represent an opportunity to observe relational aspects that do not emerge during the traditional clinical interview.
Movement, silence, interpersonal distance, posture, and the ability to sustain contact can become qualitative information.
However, they are not independent diagnostic tools.
They must be included in a professional process in which observation is distinguished from interpretation, and interpretation is in turn distinguished from the clinical data.
Creativity and Burnout: A Possible Space Even for Those Who Care
The expressive dimension can also be directed at professionals.
Healthcare work, especially in contexts characterized by serious illness, chronic conditions, and the end of life, can involve prolonged exposure to emotional stress.
Activities based on movement, creativity, and relationship can help create spaces for decompression and sharing.
However, in this case too, it is important to avoid a misunderstanding: an expressive session cannot compensate for pathological organizational conditions, excessive workloads, or insufficient staffing.
Burnout is not merely an individual problem to be “managed” through relaxation techniques. It is also an organizational and professional phenomenon.
Expressive activities may eventually be a complementary tool, but they do not replace interventions on working conditions.
From the Casa della Salute to Daily Life
An intensive course in a facility dedicated to health can be valuable not only for the number of interventions received, but above all for what the person is able to take with them at the end of the experience.
The most important goal is not to accumulate treatments, but to develop transferable skills.
Learning to recognize the body's signs of stress.
Understanding how breathing can influence the state of activation.
Rediscovering movement as a daily component of health.
Improving sleep quality.
Building realistic routines.
Learning to eat more mindfully.
Recognizing the relationship between physical activity, mood, and well-being.
Experimenting with personal relaxation methods.
In this perspective, an immersive experience can become a lifestyle learning laboratory, provided that what is experienced can subsequently be transferred to everyday life.
A temporary stay in a healthcare or health promotion facility should therefore not create an artificial condition in which well-being depends exclusively on the treatments received. Rather, it should help the person develop tools that can continue to be used once they return to their own environment.
Body, creativity, and integrative medicine: where to place the evidence
Research on dance and expressive therapies is growing, but not all evidence has the same meaning.
In Parkinson's disease, there are numerous randomized studies and systematic reviews that support a possible complementary role of dance in motor rehabilitation and in some cognitive and emotional aspects.
In cognitive impairment, there are promising results on cognition, memory, balance, and depression, but Cochrane reviews highlight the low certainty of the evidence specific to dance-movement therapy in dementia.
In oncology, favorable signs are emerging especially for quality of life and some psychological aspects, but studies are still characterized by very different protocols and often small samples.
In end-of-life and palliative care, however, the clinical rationale is interesting especially for the approach's ability to create a space for communication, expression, and relationship, while specific studies are needed to establish how much these interventions affect clinical outcomes.
This does not reduce the value of the experience.
It simply means placing it correctly in the hierarchy of evidence.
Expressive psychotherapy must not be presented as a universal therapy, and dance must not be transformed into an alternative treatment for neurological or oncological diseases.
Its interest lies in the possibility of integrating what traditional medicine often tends to separate: body, emotions, movement, relationship, and meaning.
When this integration is entrusted to qualified professionals and incorporated into an appropriate clinical pathway, the body can become not only something to be treated, but also a space through which the person can continue to communicate, process, and construct meaning.
Bibliography
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