Minding the Mental Health Gap with Kathleen McGuire Gaines

[00:36] Dr. Linda Bluestein: Hello and welcome to Bendy Bodies. This is your host, Dr. Linda Bluestein, here with my guest co-host Jennifer Milner for another episode of this dance-specific series. Today, we are so fortunate to be chatting with former dancer, writer, and fundraiser Kathleen McGuire Gaines. Kathleen trained at the Pittsburgh Ballet Theatre School, the San Francisco Ballet School, the School of American Ballet, and the Chautauqua Festival Program. Over the last 10 years, Kathleen has written more than 100 articles on dance for Dance Magazine, Pointe, Dance Spirit, and Dance Teacher magazines. As a result, she has had the opportunity to conduct nearly 1,000 interviews with dancers, teachers, and dance medicine professionals. In 2014, she was named a contributing writer to Dance Magazine. Kathleen is also a dedicated nonprofit professional Development Coordinator and is a member of the Development Committee for the International Association of Dance Medicine and Science. Minding the Gap was founded as a reaction to the outpouring of support Kathleen received after she posted the article, "Why Are We Still So Bad at Addressing Dancers' Mental Health?" on the Dance Magazine website in the summer of 2017. Her ambition is to enact a movement which results in mental health being regarded with the same seriousness as physical health in dance culture. She is also one of the millions of people who has battled depression. Kathleen, hello and welcome to Bendy Bodies.

[02:16] Kathleen McGuire Gaines: Hi, Linda, I'm thrilled to be here.

[02:18] Dr. Linda Bluestein: Wonderful. And hello, Jennifer.

[02:20] Jennifer Milner: Hello.

[02:21] Dr. Linda Bluestein: So great to have both of you here. Kathleen, you and I met at the PAMA conference at UCLA last summer, the Performing Arts Medicine Association, and I was so incredibly moved by your presentation. I thought this is somebody that I really want to get to know better. It's so great to have this opportunity to learn more about the fabulous work that you're doing. You started out as a dancer yourself, and at what point did you become aware of mental health problems in the dance world?

[02:52] Kathleen McGuire Gaines: Much later. I don't think it ever occurred to me to consider mental health issues as a dancer. I was dancing in late '90s, early aughts — when I was kind of at the top of my pre-professional training. Culture in general around mental health has changed quite a bit since then, and it's beginning to change a little bit in the dance world.
[03:21] I went through my first major depression when I was 17 years old, following my first major injury, which was a stress fracture to my second metatarsal. And I didn't know that I was depressed. I didn't know that anything that I was feeling was anything other than weakness. I thought that I just wasn't — I didn't have what it takes. I wasn't tough enough. And there were people that actually kind of said that to me. It was like, you're a beautiful dancer, but you might just not have what it takes mentally. So it didn't really occur to me.
[04:03] Even when I stopped dancing, people would ask, why did you stop dancing? And my answer continued to change. It was like, well, I was injured — which is true. I'm tall, I'm 5'10", that's a barrier. And then it kind of turned into, well, I guess I just wasn't very happy. Probably wasn't until close to a decade after I stopped dancing, after all these years of writing, that I started to realize that what I had experienced had a name, and that name is depression, and that it potentially could have been different.
[04:40] So I really came to the discovery of my own mental health journey through the process of writing. I'll never forget Wendy Perrin, when she was the editor-in-chief of Dance Magazine, kept assigning me mental health-related articles. I remember finally asking her, Wendy, thanks for the work, this is great — why do you keep asking me to write about mental health? And she said, well, you write it better than anybody else. And I laughed hysterically. I was like, Wendy, I'm a train wreck. I have no business informing people on mental health. And she very deadpan was just like, well, maybe that's why you're so good at it. And I think that's true.
[05:24] So that was a meandering answer to your question, but I figured it out much, much later. It was definitely in retrospect.

[05:36] Dr. Linda Bluestein: That's really fascinating. I don't know how many healthcare professionals you would have encountered along the way, but I feel like, as a healthcare professional myself, that's something that is very, very often missed. You can have lots and lots of people coming into clinics for various different reasons and nobody asks generally the right questions to identify that kind of thing. That's a huge part of the problem.
[06:04] In your career as a pre-professional dancer — I think you already kind of answered this question to some degree, but I would love to hear more — mental health sounds like it was not a big part of the conversation. What sort of unhealthy coping strategies did you see, if any?

[06:21] Kathleen McGuire Gaines: The dance world is rife with poor coping strategies. I think that's actually one of the biggest opportunities for the way that we adjust dance training — by encouraging and informing on correct coping strategies.
[06:42] What led to my injury to begin with was a pattern of disordered eating. I don't believe that I had a full-blown eating disorder, but I definitely had a very negative relationship with food, and I definitely was not fueling my body properly or resting it properly or doing any of those things that all you talented, loving health professionals tell us to do. I became injured, and being out — I felt invisible. I was completely separated from my identity as a dancer and my social group. And these are things that dancers right at this moment are feeling too.
[07:26] The disordered eating was definitely a coping strategy because of the fear I had of being too big. When you're a tall dancer — I'm already 5'10" — you can't be tall and big. You're already told that you're heavy for the boys and stuff. And then after I got injured, I went into this spiral. I definitely started drinking, I started abusing drugs. Anything I could do to feel happy and to eliminate the pain that I was feeling that I just couldn't really identify.
[08:04] It's been said that addiction is a solution to a problem you think you cannot solve. I think that's very accurate. And I actually think that drug abuse is a much bigger issue in the dance world than we discuss.

[08:24] Dr. Linda Bluestein: Absolutely. Mental health and drug abuse are so, so linked. And so if we can do a better job with mental health, that will help us so much in making progress with alcohol abuse, drug abuse, smoking — all of those things. I feel like mental health is absolutely at the root of everything else.

[08:48] Kathleen McGuire Gaines: Totally. The one thing that I think we accept and have accepted for a long time as a mental health issue is eating disorders, although I still see a nutritionist get called in and I'm like, where's the psychologist? And in the same way that it can impact addiction and drug use, it can also impact eating disorder rates to be more proactive in terms of the way that we are addressing the mindsets of dancers. We know that dancers are at least 3 times more likely than the general population to suffer an eating disorder. It's a staggeringly high rate.
[09:33] I distinctly remember — I believe it was in 1996 — when Heidi, the corps member with Boston Ballet, passed away from complications from her eating disorder.

[09:45] Dr. Linda Bluestein: I remember that too. And I was in a summer program, and to me, when I speak about mental health and dance, I often bring that moment up because to me it was the first shift. After that, you started getting all the boxes that get checked now — at the summer program, there's the one-hour session with the nutritionist, the session with the whole group. Sometimes there will be the one-hour session with a mental health professional. And those things didn't start until that happened, and unfortunately hasn't changed much since then.
[10:21] But if we can get to the root of things causing low self-esteem, perfectionism, depression, anxiety — if we can start to chip away at those — the reduction in eating disorders will surely follow.

[10:37] Kathleen McGuire Gaines: Yeah, I totally agree. Dancers are drawn to dance for specific reasons. If you're not a perfectionist, especially in ballet, you're probably not going to be drawn to it because you're not going to enjoy the nitpicking about your technique and everything. And we know that more dancers are hypermobile and we know that hypermobility and anxiety are very, very strongly linked. So it all kind of melts together.
[11:06] So once you'd become one step removed and started interviewing dancers and teachers, was it easier at that point to start to see the extent of the problem in the dance world?

[11:23] Dr. Linda Bluestein: Absolutely. When people ask me how I got here, my canned answer is: by accident. Because it was completely by accident. When I quit dancing, I wanted nothing to do with dance. I had no desire to go see a dance performance — zero desire. In school for writing, I wanted to be a fiction major because I thought I wouldn't have to write about dance.

[11:55] Kathleen McGuire Gaines: How did that turn out?

[11:56] Dr. Linda Bluestein: Avoiding that topic. I ultimately took the internship with Dance Magazine that led me to becoming a dance writer simply because I needed a foot in the door. I was like, I can get this internship, I can get published, and then I can be a writer. But once I was in that role and started interviewing dancers and medical professionals, mental health professionals, directors, etc., I went down the rabbit hole with it.
[12:27] I became so aware of the context of my own story and what I had dealt with, and then simultaneously realized how not alone I am in that experience. And how resistant some leadership is to changing that experience or feeling that it is in any way their responsibility to do so. The more dancers I talked to, someone would reach out and say, I read this article you wrote and it felt like somebody understood me for the first time. That is so motivating. So I just kept going, and it continues to be that way. I can't imagine doing something else.

[13:23] Jennifer Milner: Well, you're doing such great work. And I know that I was not alone when you gave that presentation — when I first met you last summer — because right after that, a lot of people were all talking about how moved they were. At the time, you think that you are experiencing something that is not a common experience, but it turns out to be more common than — we just don't talk about it like we need to.

[13:54] Dr. Linda Bluestein: Yeah. The article that I wrote in 2017, "Why Are We Still So Bad at Addressing Dancers' Mental Health?" — I shared my own story in that. Jenny Stahl, the editor-in-chief of the magazine, gave me an open invitation to write an op-ed type piece about something I cared about, and that's what came out. It was terrifying, and it took me 3 days to hit send. But I've never regretted it. I've never regretted being honest and open about my experience and my challenges with my own mental health because it is so common. This stigma we have in our head — it's like, this isn't real. The majority of people will relate to you. And even if they can't personally relate, they love someone that can.

Jennifer Milner: Yes, absolutely. And along the way, you've also conducted some really amazing interviews. What have you learned from speaking with experts in the field of mental health, especially as it pertains to dancers?

[15:07] Dr. Linda Bluestein: So many things. Some of the things I would consider major takeaways — if I could go back and grab Katie McGuire at 16 by the shoulders — one is goal setting. Dancers are frankly terrible at setting goals. My goal was to be in New York City Ballet. And here's the thing: there's nothing about getting into New York City Ballet that is in my control. So I really think an opportunity for dancers, in the way that they're framing the things that they want to do and accomplish, is to make sure that those goals are attached to things that they can actually control. It's not productive to tie your goal — and therefore your self-esteem — to something you have no power over.
[16:08] So it's something I definitely encourage dancers to do, based on conversations I've had with mental health professionals: really name the goal, say it out loud, write it down, and then think about it. Are there factors that are out of your control? It can be an aspiration, it can be a dream, but it can't be the measure of your accomplishment. I think that might be the biggest takeaway I get from talking to them. But there are so many others.

[16:41] Jennifer Milner: I think so much of dancers' mental health issues come back to control and that lack of control, because in general we feel like there's so much we do not have control over. If we don't have control over whether or not we're going to get cast, we will control whether or not we're the skinniest person up for the job. It's that desire to have control over something that I think leads to a lot of issues within dancers' mental health.
[17:14] Recognizing that there are things you cannot control, and then doing positive things about the things that you can control, is such a healthy step to take. So I think that's a huge takeaway for you to have from speaking with the different experts throughout your interviews, don't you?

[17:33] Dr. Linda Bluestein: Oh yeah, absolutely. The control aspect is deeply tied with the perfectionism we were just talking about. There was a research study done in Portugal on very young ballet dancers — I think between the ages of 6 and 9. What they found is that the young ballet dancers exhibited less psychological flexibility than their peers in music or in the general population. Psychological inflexibility — oh my gosh, that was me.
[18:19] These qualities that make someone potentially an excellent dancer — the willingness to work that hard on trying to be as close to perfect as you possibly can — are also things that make a person at higher risk for a mental health issue. We need to accept that reality. And to me it's plain as day. Sometimes when I'm talking to a leader in the dance field who doesn't want to see this, I'm just like, but it's right there. It's black and white. It's so obvious.

[19:01] Jennifer Milner: So you have gotten, as you said, some amazing responses to the articles that you've written, especially the one from 2017. Just the feedback that you have been receiving from all the dancers — is that what sort of led you to founding Minding the Gap?

[19:24] Dr. Linda Bluestein: Yeah. That article went viral. It's one of the most-read articles the magazine has published, I think still to this day.

Jennifer Milner: Wow.

[19:35] Dr. Linda Bluestein: Yeah, and that was a stunning thing. I will never forget the 48 hours after they posted it, watching social media and all the comments and people sharing their experiences. It was kind of dumbfounding. What it did was confirm for me: yes, this is as serious as you think it is. You're not being hysterical, you're not beating the dead horse of your experience — this is real. And then I also realized after that article, people started reaching out to me from all over the world — dancers, mental health professionals. And I was like, okay, I'm here. I have a microphone. I have a little stage. People are listening to me. What next? I literally had people reaching out to me going, okay, we're with you. What do we do next? And I was like, I guess I need to figure that out.

[20:36] Jennifer Milner: That just blew you away, that response?

[20:46] Dr. Linda Bluestein: It did. On the one hand, it was so incredibly validating to feel so seen, and to feel this giant community of human beings that were like, I see you, I hear you, I am you. And then it simultaneously just ripped my heart to pieces.
[21:07] So at the end of 2018, I quit my full-time job and I started dedicating myself to Minding the Gap full-time. It's been an interesting journey. Going to the PAMA conference where I met you, Linda, and presenting in front of medical professionals — that was one of the scariest moments of my life because I am not a medical professional. I'm an advocate, I'm a writer, I am a person with a lived experience. And to be accepted by the professional community in that way was incredible.
[21:48] I see my role and I see Minding the Gap as essentially a platform for combining and collaborating on the good work that is happening, because I truly want there to be community around this effort, because it's going to take all the water to raise this ship.

[22:12] Jennifer Milner: What a great analogy. So I'm sitting here digesting this. I love that you're describing it as a platform for combining and collaborating all the resources available. What made you come up with the name Minding the Gap, and what exactly does it do? Tell us more about Minding the Gap.

[22:36] Dr. Linda Bluestein: Well, the name — I love being a writer, I love words, and I love the multiple meanings of words. I love the word "minding" for obvious reasons: it references the mind, it references care, but also concern. And there's just a very clear gap. I came up with it and obviously thought of the London Tube and was like, is this a bad thing? And ultimately I was like, no — it's memorable, it's fine.
[23:12] So really at this point, Minding the Gap is an advocacy and research effort that I hope to transition into a platform of solutions. The advocacy portion is a lot of what I've been doing intuitively for almost 10 years now: talking to anyone that will talk to me about dancers' mental health and trying to sway hearts and minds that either don't want to see this problem or don't feel it's their responsibility to address it. And then obviously the social media platforms, etc.
[23:52] The research side of it — I get frustrated sometimes when I'm speaking to someone who is resistant to accepting how urgent this need is. Without data, you're another person with an opinion. There is some data out there on dancers' mental health, and there are some incredible researchers across the world dedicated to understanding these things. But I find that there are some very basic statements I can't make. Like, I can't tell you what the rate of depression is in dancers. I can't tell you what the rate of anxiety is in dancers.
[24:39] So I started off simply doing surveys. After that initial article in 2017, the magazine allowed me to post a survey on their website. I co-wrote that survey with Dr. Brian Goonan — he's a psychologist who is one of my collaborators. We got almost 900 responses.

Jennifer Milner: Wow.

[25:05] Dr. Linda Bluestein: Yeah. The questions were things like: have you dealt with a mental health challenge in the last 5 years? 75% said yes. Does your school or company have a psychologist or mental health professional that the dancers are referred to? 75% said no. It goes on and on. It's on my website, wearemindingthegap.org, if you want to look at it.
[25:34] So I started drilling down a little bit more into the seriousness of this and trying to create the parameters of what the what — how serious, how big, what is this experience? I followed that up with another survey I did last winter, and that one had about 350 responses. In that one, I was really interested in: what mental health topics or concerns are the most important to the dancers? And it's interesting. I think most people would expect that eating disorders would be in the top 3, but it wasn't. Their number one concern was self-esteem and confidence. Number two was depression and anxiety, and number three was dealing with rejection.

[26:30] Jennifer Milner: Interesting.

[26:32] Dr. Linda Bluestein: Right? And what that tells me is that dancers are actually quite intuitive about their needs. I don't think there's a dancer in the world who will claim that eating disorders aren't important or a problem, but all those things — self-esteem, depression, anxiety, and essentially coping, which is what you're doing when you're dealing with rejection — those are the seeds that can plant an eating disorder.

[26:32] Jennifer Milner: Absolutely.

[27:06] Dr. Linda Bluestein: Yeah. I was like, wow — they get it without even knowing it. They collectively get it, and we need to address those things.
[27:15] So that's where it is right now. For the last 2 years I've been working on a grant to do a really extensive 3-year longitudinal research study on dancers. It was essentially funded and then postponed indefinitely because of the COVID-19 crisis we're going through currently. And that absolutely makes sense — this is a mental health crisis that we're living through, and that foundation needs to address that right now. So the research portion is a little bit on hold at the moment, and I'm pivoting again. Entrepreneur life, I guess, is just constant pivoting.
[28:04] Actually, next week I am preparing to launch my first kind of direct interaction with dancers. I'm going to start hosting what I'm considering mental health education public meetings via the Zoom platform, where every 2 weeks I will moderate a discussion between a mental health professional and a well-known dancer. We're going to talk about what's happening right now, about this impossible situation dancers find themselves in. The entire dance world is collectively sitting at home with their foot in an ice bucket. Essentially everybody's injured right now.
[28:56] There are really serious implications for dancers' mental health. So I am looking at this loss of opportunity to continue my research as a direction — what I'm receiving is, okay, stop talking about it. You've got to get out there and connect the dancers with the people that can help them.

[29:17] Jennifer Milner: Absolutely. What you said about dancers staying at home with their feet in the proverbial ice bucket is so true, because every single dancer out there is trying to deal with the loss of a contract or even just that comfort, that ritual of being in class every single day in the studio. So even dancers who are normally pretty mentally healthy have to be struggling right now. As these dancers try to figure out the new normal of life in the time of coronavirus, it sounds like you're offering basically a mental health town hall meeting via Zoom. Is that fair to say?

[29:58] Dr. Linda Bluestein: That's a good way to put it. It's so new — I decided to do this 3 days ago and now I'm doing it. So I don't even know how to talk about it yet. But yeah, that's a good way to describe it. The idea is that I would moderate this discussion, I think I can have up to 100 dancers in the audience live, and they'll be able to ask questions that I can moderate to the guests so that we're addressing their real concerns. And then I'll put it up on YouTube so anyone can access it.

[30:35] Jennifer Milner: You can go back and watch it.

[30:36] Dr. Linda Bluestein: Yeah, and it's going to be completely free. We just need to help the dancers right now.

[30:43] Jennifer Milner: Well, I can say personally I think that's an extraordinary step. I think everybody's trying to figure out what to do and how to help. And I think that's going to be a huge thing.
[30:52] My guess is when the article came out, most of the feedback that you got was from the dancers — that whole thank you for putting a name on it and for acknowledging that the emperor has no clothes on. Just finally being the one to say, hey, wait, why is this not being discussed? Everybody can see the guy's naked — why are we pretending everybody's happy and healthy? And it wasn't so much from the artistic directors and the funding people saying, oh great, thanks for bringing that up, we'll get right on it. Not that they don't care, but the relief was coming from the ground up.
[31:34] And I think in that same way, this town hall that you're going to have is going to be hugely helpful for dancers because right now they all feel pretty alone. Do you have any other strategies that have come to your attention with Minding the Gap, or that you've heard of, for people who are feeling alone? Are there ways that they can address this in a healthy way?

[32:03] Dr. Linda Bluestein: Sure. As soon as shelter in place started happening, especially here in the US, I emailed every mental health professional I know that works with dancers — which is actually a lovely body of people, there are people out there. And I asked them that question: what do they do, what do we do? And I did put a blog up on the Minding the Gap website with specific mental health advice from those professionals for dancers.
[32:39] I think the analogy of thinking of this as a long-term injury is a helpful one. The thing I'm really worried about right now is this fanatical online dance class thing that's going on. On the one hand, it's lovely — Tyler Peck ballet class in the kitchen, awesome. But what I worry about is that we have dancers all over the world right now taking 4 or 5 dance classes a day in their kitchen and working out and probably not eating enough because they are, again, trying to control what they think they can control — but doing it in a way that isn't healthy. And exercise addiction is a real thing, and it is very much comorbid with eating disorders, as you both know.

[33:22] Jennifer Milner: Right.

[33:33] Dr. Linda Bluestein: I'm really concerned about that. I think dancers need to be kind to themselves. You do need to keep moving — the drop in endorphins that can happen from somebody who is so active suddenly not being active at all is a mental health concern. But to me, this is the time to reconnect with why you're dancing in the first place.
[34:04] Why did everybody start dancing? This is the most common beginning to every interview I've ever done: tell me a little bit about how you became a dancer. Well, when I was 2 or 3, I was dancing around the kitchen, and my mom was like, oh my gosh, you love to dance, and she signed me up. It's the beginning of 95% of the stories of dancers — and I have a 4-year-old daughter, so I watch it in real time. You started dancing because it was joyful. You started dancing because your body needed to move. You did it because it felt good and it made you happy.
[34:38] So now's the time to reconnect with that. Yes, keep moving, but do you have to have perfect Rond de Jambe en l'air? No, you don't. Put on Bruno Mars and shake your booty. I really hope that the dancers are trying to find a way to reconnect with that joyfulness and that primal aspect of loving dance.
[35:10] I also hope very much that they are recognizing that if they're feeling really upset and sad and angry about not being able to dance right now, that's a sign that you still love this. That's the sign that you're on the right path, you're doing the right thing, because you miss it with your whole body and your whole heart.
[35:35] And maybe you don't miss it. Maybe you feel better. Maybe there was a situation you were in that wasn't good for you. This is a reckoning, and it can be very positive if we can frame it that way.

[35:49] Jennifer Milner: Absolutely. And I think also just giving the dancers permission to grieve. Most of my dancers are pre-professionals and they're distraught over losing the summer intensive they were going to go to, or losing the chance at contracts for next year, or these auditions that have all been canceled. There's this sense of not knowing what's going to come next, and not necessarily being able to recognize that it's grief that they're feeling. It's okay to grieve that and know it's not the end of their story — but the next chapter may not look like what they thought it would look like, and that's okay.

[36:29] Dr. Linda Bluestein: Absolutely, yes. And going back to the big lessons I've learned from mental health professionals, this reminds me of one of those: you have to love the process. If you're a dancer because you want to go up on stage and be applauded all the time, you're not going to have a great time. And I'm not trying to minimize the loss of those performances — it's devastating. But the work that has been put into preparing for those performances is still worthwhile and it still matters and it still exists. The tree fell in the woods. You did it. And I think there's a lesson in that too, in loving the process and not the outcome.

[37:19] Jennifer Milner: Absolutely. I think that's a great point to make. So for these dancers who are struggling with these issues right now — which is pretty much all of them — are there resources out there available for people who need help right now, and how will they find them?

[37:33] Dr. Linda Bluestein: That's an excellent question — yes and no. There definitely are amazing organizations that have resources out there. The Actors Fund, based in New York, is amazing. It's not just for actors — it's definitely for dancers as well. And they do have small grants and funds that they give to dancers that are going through difficult times. There's also the National Coalition for Arts Preparedness and Emergency Response, which is an interesting website to look at. And depending on where you are — most insurance companies are waiving copays for mental health support right now.

[38:31] Jennifer Milner: That's fantastic.

[38:32] Dr. Linda Bluestein: Yeah, I have seen that. So if you're lucky enough to have insurance but no paycheck, you can talk to a therapist for free, very likely, right now. The other thing I like to remind dancers of is that mental health professionals — most of them do work on a sliding scale. They have an ethical requirement to support people that need support. It is always worth it to reach out and say, I'm really struggling and I need support — this is my situation.
[39:14] I think it's very important for people to look up the crisis lines in their area. The National Suicide Prevention Hotline is 1-800-273-8255. Most places do have more local resources available too. And honestly, I keep those phone numbers in my phone. Partly in case I were in a crisis, I have it. But I keep it even more for the situation where someone I care about is in crisis. It's a really scary thing to be speaking with someone you love and to hear their distress and not know what to do. Having a phone number is a really helpful thing in that moment — to be able to share it with them quickly.
[40:06] And there's something really powerful too about being like, hey, I keep this phone number in my phone — I'm going to send it to you. Because it normalizes it. I have this in my phone because I see it as a valid and important thing to have. It's hard for me to give a blanket response to the resources that are out there because it does depend quite a bit on where you are and what state you're in.

[40:37] Jennifer Milner: Sure.

[40:38] Dr. Linda Bluestein: But there are all kinds of ways to get online mental health support right now.

[40:43] Jennifer Milner: Yes, I agree. Thank you for that. And I —

[40:49] Dr. Linda Bluestein: Oh, I was just saying I love the idea of putting the phone number in your phone. I've never heard that before. I've never thought about it before, but it's one of those things where — as you said — it normalizes it, and when you need it, it's one less barrier, one less step to having to look it up. If you need it for yourself, if you need it for somebody that you love. I'm seriously going to do that as soon as we are done with this call. I'm going to put that number in my phone. I think that's a great idea. It's a simple thing that we can all do.

[41:18] Kathleen McGuire Gaines: Yeah, and it normalizes it as well. I love that.

[41:20] Jennifer Milner: I know we are just trying to get through this one day at a time right now, and everybody's trying to figure out what this all looks like. And I know that Minding the Gap was not started with the whole coronavirus thing in mind, but it certainly is helpful that it's already in place. And I know it needs support now. I love that you have so quickly tried to transition to how this can help in this situation with the town hall meetings. Are there other projects that you're working on? I know the research grant is on indefinite hold — is this where you're trying to shape things? What else are you hoping for for the future?

[42:02] Dr. Linda Bluestein: Yeah. The idea behind the research really is that we would follow a body of 150 dancers for 3 years, starting with a baseline of their mental health — measuring the things that I just desperately want measurements for, like depression, anxiety, and self-esteem. I have 3 psychologists that I'll be collaborating with in this research.
[42:37] Then over the course of those 3 years, we would implement a mental health program that by the end of the period would rival the physical health resources available to the dancers. In the same way that you can go in for a free physical therapy evaluation with a PT at a major school or company, I think you should be able to do the same with a mental health professional.
[43:05] And it really starts with working with the teachers and unpacking some of the baggage of hundreds of years of dance training that's been done a certain way. Most teachers are wonderful human beings that adore their students and want to care for them. They may not even realize that their approach is negative and potentially even abusive, because that approach was normalized for them as a dancer.

[43:38] Jennifer Milner: Right.

[43:39] Dr. Linda Bluestein: We've got to unpack some of that baggage.

[43:44] Jennifer Milner: Absolutely. I've had several teachers say, "I disagree — this is the way I was treated when I was a kid, and it's fine, it's just part of the history." And they're not bad people, and they would never speak to kids in such a way outside of that setting. That's the thing they have a hard time seeing. It's not okay just because it's in ballet and just because it's been handed down for 200 years — that you yell at the dancers and tell them they're fat and make them feel bad about themselves.

[44:15] Dr. Linda Bluestein: Yeah. No, it's absolutely not okay. It's so the opposite of okay. And I have that same conversation all the time and I just want to pull my hair out. I'm like, wait — so you were treated badly, and you believe that made you a better dancer? It just does not compute. Shame is a terrible motivator. Science proves it. And dance, I feel like, just relies on it so heavily in training so often.

[44:56] Jennifer Milner: Well, I love that idea. I hope that in 3 years we do see mental health resources that equal the physical health resources available to dancers. It's been an exciting, I don't know, 10 to 15 years for me, watching the dancers' physical health resources become so much more available. Just over the past 10 to 15 years, it's really grown — from just a few select top national companies to it being commonly talked about and every summer intensive offering Pilates and having PT on hand at least sporadically. It's trickling down.
[45:28] And I would love to see that sort of thing happen again — have another revolution in the mental health arena and have it trickle down and become so commonplace. There's a sports psychologist to talk to if you're stressed about YAGP. There's a counselor to talk to. Being able to help the dancers and direct them where they need to go and make it completely normalized.

[45:57] Dr. Linda Bluestein: Yeah, and that really is the goal. The idea of the research is that over the course of that time, we'll continue to measure and hopefully see if we can make a difference and ground-truth what we believe are the interventions that will help dancers. How do we build this program? How do we implement it in a way that the dancers will actually use it? You can't just plop a psychologist in the middle of a dance studio and expect them to go talk to that person. It's a culture shift. How do we work within a dance institution to create that shift and do it successfully?
[46:34] The idea is that after we've done that and learned all the lessons and hit all the walls and had our successes, we can then take those ground-truth efforts to other places that want that kind of change for their dancers and their institution. So that's the long-term vision when I say we're working toward solutions. These are delicate things, this is a difficult nut to crack. If you don't go in there with a surgical scalpel — you can't just go in there hacking around — you've got to do it the right way.
[47:18] I think another thing I'm thinking about, as you're describing this, is that when I am seeing a patient who often comes in with a lot of anxiety, I'll look at — usually it's mom that brings them in — and oftentimes mom has a tremendous amount of anxiety as well. I think it's even more important for mental health because once the tide starts to turn, I think it will be almost contagious. Mentally healthier dancers in groups are going to be able to impact each other. Once this movement is really more in process, I think it will be a really fantastic thing.

[48:09] Jennifer Milner: Yes.

[48:09] Dr. Linda Bluestein: Yeah.

[48:10] Jennifer Milner: And I can't wait to see it become the new normal. I appreciate that. What were you going to say?

[48:18] Dr. Linda Bluestein: Oh, I was just going to say my goal is to become completely irrelevant.

[48:22] Jennifer Milner: That is a fantastic goal — to work yourself out of a job.

[48:27] Dr. Linda Bluestein: I love that.

[48:28] Jennifer Milner: Yep. That's a great goal to have in this field. I really appreciate all that you have done and all that you are trying to do and the clarity of your vision. Is there anything else that you would like to share about what you're doing? And can you please make sure people know where they can find you?

[48:43] Dr. Linda Bluestein: Sure. In terms of what I've got cooking — keep on the lookout for these public town halls. Thank you for helping me with the branding of that. And the website is www.wearemindingthegap.org. There's a blog there, there's a resources page. I should have mentioned that when you asked about resources — on that page you'll find websites, phone numbers, and all kinds of stuff. I also have a catalog of articles I've written on related topics there in case they are helpful.
[49:32] I'm on Instagram, Twitter, Facebook, all those places. I'm grateful to anyone that's willing to follow along with me in this journey. Feel free to reach out through the website — I love talking to people about this. This is my passion. I spend a lot of time worrying about dancers and I'm deeply concerned right now. So we're going to do everything we can to support them, and hopefully someday I'll get to get back to hugging them.

[50:06] Jennifer Milner: Amen to that. Where specifically do people sign up for this town hall? Because I want to spread the word about that too. That sounds great.

[50:14] Dr. Linda Bluestein: Totally. I'm confirming the time right now. My first two guests — one is in Texas and one is in Belgium — so we're working on the time. As soon as I have the time confirmed, I'm going to put out an Eventbrite link so that people can reserve a spot, because the Zoom meeting can only handle so many. But I will start blasting it out on social media as soon as I have that ready, and it'll also be linked on the website.

[50:46] Jennifer Milner: Excellent — another reason to be following you on social media.

[50:50] Dr. Linda Bluestein: Yes. And I want to point out one thing, because having been involved in one of these Zoom things capped at 100 people — if you register and the meeting starts at a certain time, it's kind of first come, first served. So if 100 people enter the meeting and you're number 101 and you had signed up in advance but didn't enter right when it started, you might not be able to get in. I just want to mention that — registering doesn't guarantee a spot. I mean, unless you have a different system, Kathleen — I apologize, I should maybe ask you.

[51:30] Kathleen McGuire Gaines: No, that's my understanding of how those work. That's great — something I hadn't quite thought about. I hope everyone that comes to the first one will be gentle with me.

[51:41] Jennifer Milner: Well, that's why I'm mentioning it, because I've been involved in these and have seen some really upset people who really wanted to participate. This is a fantastic thing that you're doing. And as you mentioned, it's going to be available afterwards. But if you want to be one of the people who's actually there live and able to ask questions — there's going to be an interactive component, is that correct?

[52:07] Dr. Linda Bluestein: Yeah, to the best of my ability. It'll depend on the questions coming in. But if the questions can't be answered during the meeting, I'll do my best to gather those and put them on the blog with answers. So we'll see.

[52:24] Jennifer Milner: Fabulous. And everybody just needs to have grace towards everyone as far as social media and internet savvy goes right now, because we're all learning Zoom at an exponentially high rate.

[52:34] Dr. Linda Bluestein: Yes, absolutely. That's just the way it goes.

[52:40] Jennifer Milner: Well, I am so grateful that you joined us today. You have been listening to Bendy Bodies with the Hypermobility MD. Our guest has been Kathleen McGuire Gaines, former dancer, writer, and fundraiser, and founder of Minding the Gap. Kathleen, it has been so fabulous having you here, and we are so grateful. Thank you so much.

[52:57] Kathleen McGuire Gaines: Oh, thank you both. This was a lovely diversion today.

[53:04] Jennifer Milner: We're so excited about what you're doing and so excited to be able to share this information with people.

[53:10] Kathleen McGuire Gaines: Yes. Thank you, Linda.

[53:11] Jennifer Milner: Absolutely.

[53:12] Dr. Linda Bluestein: Please go to bendybodies.org for links to all the episodes and to access the show notes. If you enjoyed this podcast, please share, leave a review, and consider rating us 5 stars. Don't forget to subscribe so you will be notified of all new episodes. Feedback is greatly appreciated and can be emailed to [email protected]. Go to hypermobilitymd.com to sign up for my newsletter. My guest co-host Jennifer Milner can be reached at [email protected] — jennifer-milner.com, that's M-I-L-N-E-R. Thank you to Rhett Gill for production and sound editing, to Andrew Savino for composing our original music, and to Jennifer Arsenault for designing the Bendy Bodies website and cover artwork. This podcast is for informational purposes only and is not a substitute for medical advice. Please see your own medical team prior to making any changes to your healthcare. Thanks for tuning in, and we'll see you next time on Bendy Bodies — Bendy Bodies with the Hypermobility MD.