It was in Washington, when in the early 1940s returning World War II veterans were beginning to fill mental hospitals, that dance therapy got its start. Marion Chace, formerly of the Ziegfield Follies but at that time a member of the Denishawn company, started teaching ballroom dancing to shell-shocked veterans in St. Elizabeth's hospital, enlisting nurses and other hospital staff as dancing partners.

From these improvised beginnings, dance therapy has grown until there are now about 150 registered dance therapists in the country and many more in training or working for registration. Nine graduate programs have been established in dance therapy, all within the past 10 years, and dance therapy has been included in federal legislation for the education of the handicapped.

Armed with a battery of theories drawn from diverse sources (Freud, Darwin, Wilhelm Reich, Rudolf von Laban and R.L. Birdwhistell), the members of the American Dance Therapy Association are now fighting to have dance therapy recognized as an eligible service under government health programs.

"As a dancer, Chace started working with groups naturally at a time when people were just beginning to experiment with group therapy," says Sharon Chaiklin, a dance therapist who worked with Chace at St. Elizabeth's.

Dance therapists claim they can be particularly helpful to patients who cannot easily be reached by verbal methods: the severely psychotic, delinquent adolescents, the deaf. "A psychiatrist may sit for years, and the patient may never talk," says Sarah Oosterhous, a dance therapist at St. Elizabeth's, "but the therapist can begin working with him immediately, on a body level."

Methods and approach seem to vary widely. In Marilyn Greenberg's work with delinquent adolescents at Crownsville State Hospital, for instance, much of the patient interaction actually happens verbally-in "rap" sessions after the dancing. Greenberg says she uses the therapy sessions to let the patients work off energy and express their feelings through gesture and movement.

Not so the dance therapist working with psychotic patients.

"With psychotic patients, the primary process is out in the open," says Dr. Louis Tinnin, former head of a program at Prince George's Country General Hospital that included art and dance therapy in the treatment of patients in the period immediately following hospitalization. "You work on getting them to contain all the stuff that's coming out."

"Some of our patients wear bands around their heads to keep their thoughts in," says Karen Ruback, a therapist in the program. "We have them sit in acircle and move each part of the body separately." Ruback may have a patient hold his head and move it, while she describes what he is doing.

She calls this "giving the patient visual, tactile and kinesthetic feedback," but never mind that. Parents and pre-school teachers do much the same kinds of exercises with two and three year olds, and for similar reasons: to help them form an accurate body image and establish a clear distinction between what's inside and what's outside.

Dance therapists seem to like talking about their progress with catatonic patients, perhaps because the restriction of movement in these cases is so dramatic.

"When I started working with him," says one therapist of her experience with a catatonic patient, "his hands were clenched in fists. 'What can you do?' I asked him. 'Can you open your fist? Can you move a finger?' Opening his hand was like opening up his guts. Gradually we worked from peripheral movements to the center of the body, opening and closing."

Chaiklin, a past president of the American Dance Therapy Association tells of working with a catatonic patient who spoke for the first time during her dance session. "Maybe it's because I was the only one who wasn't trying to get him to talk," she says.

Dance therapists are trained in movement observation and tend to describe most interactions in terms of movement and spatial relations. "If a patient strikes out at a therapist," says Oosterhous,"this is his way of telling her, 'You came too close.' Mental patients need a lot of personal space; their kinesphere is very big." At the same time, Oosterhous warns against the kinds of facile generalizations about the meaning of movement popularized in Julian Fast's book "Body Language any more than you can read someone's mind. It's always important to check it out."

Here is another therapist, describing the presence of a photographer during a workshop on dance therapy held last month at Prince George's Community College:

"He took over the most prominant space in the room - the center of the circle - but the group handled it beautifully. His presence was physically disruptive and they responded, by kicking him." Her intention was humorous, but the habit of observation underlying the humor is almost automatic.

Viewed collectively, dance therapists seem ardent and a bit defensive about their professional status. They don't look wild and wooly, like dancers, and they don't sound like dancers either, with their talk of "therapeutic modalities" and "the therapeutic use of movement in the emotional and physical integration of the individual."

Although their methods are drawn from the art of dance, their goals are very different from a dancer's goals. Dance therapy is concerned with the impact of dance movement on ther performer, not on an audience. And the dance therapist is not particularly interested in the beauty of particular movements and shapes, but with how these may express a patient's conflicts or help resolve or contain them.

Dance therapy does have its roots in dance and performance, though. Early modern dance prepared the way with its emphasis on simple, expressive, natural movement that laymen could perform. The core ideas that Chace started out with were all well established techniques in modern dance pedagogy by the 1940's.

Like the other arts therapies(music and visual art), dance therapy stands in a tenuous postion between the fields of art and psychotherapy. Mental health professionals have often been hostile or skeptical, and the dance therapists have had a hard time gaining acceptance for what they do.

As one questioner put it, "Outings can play an important role in the treatment of adolescent patients, but you don't necessarily talk about 'outing therapy.'"

A psychiatric social worker who stopped using art therapy in her work with children felt it was, finally, a distraction: "something people made up to make it look like they knew what to do with kids." "No one likes to talk against it, because mental patients get so little, but the bottom line," she feels, "is responsibility - whether the adjunct therapies are willing to take responsibility for the failures."

No one doubts that dancing is good for you, and presumably anything that keeps the blood moving and keeps a patient from brooding about this problems is therapeutic. But at what point does a therapeutic activity become a psychotherapy?

"One thing we know," says Chaiklin, "we move. Or else, we're dead." (She leans forward, fingers interlacing in tension to make a point, or presses her clustered fingers repeatedly against her throat to emphasize the rhythms of her speech). "We go from ourselves (she describes an arc with her arm) through space to somebody else in order to interact."

It's curious how easily the figurative language of popular pyschology translates, through dance therapy, into direct action. One often isn't sure whether a dance therapist is speaking metaphorically or not - and it may not matter.

Movement is such a primary impulse and touches on so many areas of human development, that the distinctions between physical and psychic processes tend to recede. Psychologists working in child development have traced cognitive processes like counting and reading to motor activities - rocking, crawling, fitting big blocks into little blocks, etc. And pyschiatrists have observed how emotions, too, seem to have their origins in physiological sensations and responses.

We understand first and best what we can grasp with out senses, which means the body is where we start and what we keep coming back to.