This week, we talk to Cai Tomos, a specialist in the psychological and psychosocial aspects of dance and movement. Cai has been working with CW+ for over 5 years as part of our Participatory Arts Programme, with his workshops specifically targeted at helping maintain and stimulate cognitive function in our older patients, whilst encouraging creativity and imagination. While we work to adapt our programme to the current climate and explore innovative ways of doing so, Cai reflects on his practice over the years and the wider contribution the arts make in patient health and wellbeing.
Tell us a bit about yourself and your work
My name is Cai – I am an independent dance artist, arts psychotherapist, and I am currently training as a Somatic experiencing practitioner.
I have worked in arts and health for over 10 years in participatory projects with all kinds of people from all walks of life. Much of my work has been with elderly members of the community, such as those living with dementia and their carers; veterans; those living with a chronic illness; and people in recovery or undergoing treatment for cancer. I am very lucky to have the opportunity to work with such a diverse range of people.
The main focus of my work within the hospital setting is supporting how people come into their relationship with their bodies. I work with the intent of bringing about awareness of resources such as breath, imagination, movement, and social engagement.
What made you want to work with CW+ and within hospitals more generally?
I have always felt called to use my skills in different contexts, particularly where I could bring creativity and imagination into a clinical setting. At a time in my life, I spent periods in hospital, and I realised how important creativity was as a resource. I feel that imagination can often support us the most when it is used toward potential and possibility, so much so that we can imagine ourselves into recovery.
The way to access this is often through the body. Many of the patients I work with have been in pain or have experienced great emotional distress. Finding a way to connect to what might feel ‘ok’, by paying attention to the senses and moving our attention towards something easier or more pleasurable somewhere in our body or imagination, we can gain relief. When we imagine walking for example, there are neurophysiological changes that occur in the brain and nervous system, it has been shown that this can help can delay muscle atrophy. The research surrounding the ways we can look towards health is particularly exciting.
Mostly my work is about listening as deeply as possible to people’s stories. Stories are how we make meaning. How we tell our story and how it is heard can make a real difference to how we feel.
Why is mindfulness and movement so important in a hospital environment?
I have noticed that simple movement to music, actioned alongside others, can have a profound impact of mood and sense of self. Part of the way we think about ourselves is organised directly by physiological state. So, when we connect to our body and movement and with others in a social way, we can really shift how we feel and think about our situation and ourselves.
Illness intrudes into life, disrupting our experience of time. The ground that we were standing on shifts. The sense of (I), our identity, is often in a process of re-negotiation. Within that, we can feel a loss of control that brings with it questions of mortality, fragility and uncertainty. Hospital patients often feel as though the story of themselves has fragmented and has been replaced by an unknown story imposed by illness, loss, or injury. I believe that the arts and movement can be a way to slowly re-trace steps to something that can be known again. A sense of physical security can support the deepening of a psychological security.
As humans, it is important to be in meaningful connection with others on a regular basis to help us regulate our nervous system and feel well. This approach is bespoke, as each person is a whole world unto themselves, with different ways of relating and different needs and tastes. So it always starts with meeting each other in the unknown then, through conversation, we build a relationship – in my work this is where movement and music come along and take that one step further.
What is it like working with patients? What is the impact on them/do they get involved?
I feel very lucky to have met some really wonderful people. I have had the privilege of some very profound encounters, some hilarious, some difficult, but mostly just receiving real sense of simple joy by being alongside someone. I have learnt so much, often from those at the end of life. Our need to have meaningful connection and relationships is key to feeling like ourselves, and the arts and imagination can often give us a feeling of freedom or expansion, even if our situation is difficult or painful.
Some patients are really keen to work with me and some are not; some don’t want to engage, and I trust that saying no is also really important. But most people are at least curious. I start with asking questions like ‘Where are you from? What is it like there?’. Every time we ask a question, be it through movement or words, one’s agency can be expressed. We can be drawing out the subjectivity of the body, where perhaps the body in illness, or through treatment, has become an object. Slowly the body might find its voice and, as it finds its voice, a slow trust begins to build. We can support development of that connection, and conversation between parts of the body, so that a map of the wholeness can begin to be woven.
I love what I do and feel so lucky to be able to do what I do.
How do you have to adapt to working in this environment?
You have to adapt the way you work and make it accessible. It can be challenging finding a way to articulate what you do clearly to patients and staff. Mainly, how it works and what are the benefits.
The reason many of us go into the arts is that often there are missing answers to important questions, and some things cannot always be explained. To find solutions it is vital that an artist hold both the left and right sides of the brain. The logical and the creative. The skills of being an improviser are essential. You must think on the spot, adapt to each new situation and be yourself. Ultimately, it is your humanity and warmth that matters in this environment, rather than the perfect answer.
What is your favourite aspect of working in hospitals?
It’s the people. I love working with other staff and being part of a team. My role is about the love for people, and my trust in the arts as a tool for supporting healing and wellbeing.
To work in this area, you have to be curious about others, and how they experience themselves and how you can exist alongside that. When I’m alongside someone who has trouble breathing, for example, and they take a deep spontaneous breath and their face lights up again, and the anxiety dissipates, it is a wonderful thing to witness. Small changes and steps make a huge difference. A patient once said, “I’ve been waiting to breathe that breath for years”, and he said it with such relief. Those moments are special.
How long have you been working with CW+?
I think it’s been 5 years now. I have been on different wards in that time, and my work has changed and grown through the years.
What advice would you give to other artists who might want to do similar work?
My advice would be to hold why you are doing what you are doing close to your heart.
Many of us go into this work to help, but that is not always helpful! When we let go of trying to help, somehow, paradoxically, we make space for being in the situation as it is, and people can feel that. When you’re there to be alongside someone, not to ask them to be other than they are, then an experience can happen. I always ask myself, where the spark of health or goodness be in could be in each situation, even in end of life. The process of questioning is constant. You have to be willing to not know, and to let go of what you think you know in order to keep learning.
A sense of humour is vital and being able to channel the clown is often useful too. In a clinical setting, it can often be difficult to hold what you do with real value against the medical interventions in play. Slowly, I have realised that I am there to offer something else, another approach to health and wellbeing.