UNIVERSITY OF CALGARY

The Embodied Work of Professional Dancers: Understandings of Pain, Injury and Health

by

Krista McEwen

A THESIS SUBMITTED TO THE FACULTY OF GRADUATE STUDIES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS

DEPARTMENT OF SOCIOLOGY CALGARY, ALBERTA SEPTEMBER, 2012

Krista McEwen 2012

ii ABSTRACT This qualitative study explores how the health and wellness of workers in a relatively low status physical occupation - - in this case professional dancers in Western Canada - - is understood, managed and negotiated within its specific occupational culture. These embodied workers are at risk of pain, injury and other body-related issues, including image and eating issues, in the pursuit of career goals. In-depth interviews with professional theatrical dancers employed in company settings and working as independent artists, and a limited number of clinicians who treat dancers, were conducted. Drawing upon literature from the sociology of dance, sport, health and illness, and work, and framing the discussion in terms of the dramaturgical, phenomenological, and art world perspectives, this project details the lived, embodied experiences of this specific group of workers. A number of important themes (e.g., how pain and injury are hidden and downplayed in a culture of risk, how impressions and potential stigmas related to damaged bodies are managed, how embodied identity is impacted by injury experiences, and how the relationship between dancers and clinicians is negotiated) are explored.

iii ACKNOWLEDGEMENTS

The completion of this research would not have been possible without the invaluable assistance and support provided by numerous people. I would like to take this opportunity to recognize and sincerely thank them. To begin with, I would like to thank my supervisor, Dr. Kevin Young, for his guidance, support, patience, and wisdom. Thank you for having confidence in my abilities throughout this process. I would like to thank you for enabling and encouraging me to continuing pursuing my passion for dance, and for being willing to venture into this world with me. Additionally, I would like to thank the members of my committee, Dr. Jean Wallace and Anna Mouat, for agreeing to be part of the project. Thank you also to the Canadian Institutes of Health Research for supporting this venture. Secondly, I would like to thank each and every one of the participants who agreed to take part in this research. Thank you for sharing your stories and for opening your lives to me for a brief moment. I feel humbled and honoured by your contributions and this research would not have been feasible without you. Finally, I would like to thank my friends and family for their ongoing and unwavering support. To Jaya and Britt - - thanks for your positivity and friendship. Thank you to my parents, Barb and John, and my sister Steph for always supporting me in my academic endeavours. To my partner Jesse - - thank you for your love and strength. You keep me grounded.

iv TABLE OF CONTENTS
ABSTRACT ................................................................................................................................. ii ACKNOWLEDGEMENTS ........................................................................................................ iii TABLE OF CONTENTS ............................................................................................................ iv CHAPTER 1: INTRODUCTION .................................................................................................... 1 INTRODUCTION ....................................................................................................................... 2 RESEARCH OBJECTIVES ........................................................................................................ 6 THEORETICAL AND RESEARCH APPROACH .................................................................... 8 STRUCTURE OF THE THESIS ............................................................................................... 10 CHAPTER 2: LITERATURE REVIEW AND THEORETICAL APPROACH ........................... 12 INTRODUCTION ..................................................................................................................... 13 DANCE: A WORLD OF ITS OWN.......................................................................................... 13 A Sociology of Dance ............................................................................................................ 15 An Occupational Culture: Explorations in Injury, Power, Competition, and Perfection ....... 17 THE SOCIOLOGY OF SPORT: SPORTING BODIES ........................................................... 20 The Culture of Risk and the Sport Ethic ................................................................................ 21 Pain and Injury in Sport ......................................................................................................... 22 Injury and Emotions ........................................................................................................... 23 Athletic Identities ............................................................................................................... 24 Body Pathology: A Sporting Injury? .................................................................................. 25 THE SOCIOLOGY OF HEALTH AND ILLNESS .................................................................. 26 Seeking Treatment: Interactions between Athletes and Sports Medicine Professionals ........ 30 THE SOCIOLOGY OF WORK ................................................................................................ 32 THEORETICAL CONSIDERATIONS .................................................................................... 35 The Dramaturgical Perspective: Impression and Stigma Management ................................. 37 The Phenomenological Perspective: Absence and Dys-Appearance ..................................... 44 The Art World Perspective: Conventions and Collectivity.................................................... 47 CONCLUSION .......................................................................................................................... 50 CHAPTER 3: RESEARCH DESIGN AND METHODOLOGICAL EXPERIENCES ................ 52 RESEARCH DESIGN ............................................................................................................... 53 In-Depth Interviews ............................................................................................................... 55

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Recruitment ............................................................................................................................ 57 The Dance World Participants ............................................................................................... 59 DATA ANALYSIS .................................................................................................................... 61 ETHICAL IMPLICATIONS ..................................................................................................... 63 METHODOLOGICAL EXPERIENCES .................................................................................. 64 CONCLUSION .......................................................................................................................... 67 CHAPTER 4: UNDERSTANDINGS OF THE BODY AND HEALTH IN THE OCCUPATIONAL CULTURE OF DANCE ................................................................................ 69 INTRODUCTION ..................................................................................................................... 70 ITS A GRUELLING LIFESTYLE ....................................................................................... 71 UNDERSTADINGS OF PAIN, INJURY, AND HEALTH ...................................................... 72 Presenting the Ideal Self ........................................................................................................ 75 Managing Impressions and Stigma: Presenting the Damaged Self........................................ 77 Passing in the Workplace ................................................................................................... 77 Pressures and Expectations: Injury in the Context of Work Organization and Culture .... 79 Moments of Contradiction: Taking Care, Divulging Information, and Ageing ................. 83 Impression Management when Passing is Impossible ....................................................... 84 The Stigmatized and the Stigamtizers: You Are Faking It ............................................... 85 Embodied Identity, Injuries and Emotions............................................................................. 88 The Mirroring Body: Appearance as Presentation of Self ..................................................... 92 Leders Absent Body Concept: Does it Fit or Fail? ............................................................... 94 THE HEALING QUEST: INTERACTIONS BETWEEN CLINICIANS AND PATIENTS ... 97 Occupational Health Care in the World of Dance.................................................................. 98 There is a Disconnect: Challenges in Treatment ............................................................... 100 Trust, Lay Expertise, and Negotiation ............................................................................. 102 A Note on the Sick/Injured Role ....................................................................................... 105 IMPROVING THE HEALTH AND WELL-BEING OF DANCE WORKERS ..................... 108 CONCLUSION ........................................................................................................................ 110 CHAPTER 5: DISCUSSION AND CONCLUSION .................................................................. 113 INTRODUCTION ................................................................................................................... 114 EMPIRICAL FINDINGS ........................................................................................................ 114 STUDY LIMITATIONS AND FUTURE DIRECTIONS ....................................................... 118

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CONCLUSION ........................................................................................................................ 120 REFERENCES ............................................................................................................................ 124 APPENDICES ............................................................................................................................. 139 APPENDIX A: INTERVIEW GUIDES .................................................................................. 140 APPENDIX B: PARTICIPANT CONSENT FORMS ............................................................ 145 APPENDIX C: CERTIFICATION OF INSTITUTIONAL ETHICS REVIEW ..................... 153

CHAPTER 1: INTRODUCTION

2 INTRODUCTION The world of dance has its own unique conventions, practices and principles that shape and are shaped by members of this societal enclave. For many, participation in this world is recreational and short-term and often takes the form of after-school classes for children, or classes focused on fitness and exercise for adults. Nettleton makes the argument that an imperative for healthy living is becoming increasingly evident in many areas of our lives; for instance, in the conceptualization of exercise and sport as healthy pursuits (2006: 33). Similarly, Waddington maintains that there are few ideas which are as widely and uncritically accepted as that linking sport and exercise with good health (2004: 287). Dance in Canadian society plays an exercise and recreation role, as evidenced by the 1 million adults who reported taking part in dance instruction and activities and the role of dance in school curriculum for children (T. J. Cheney Research, 2004). Additionally, dance has become increasingly popular in the media and film industries, with films such as Center Stage (2000), Billy Elliot (2000), Black Swan (2012), Maos Last Dancer (2010) and reality television programs such as So You Think You Can Dance and Dance Moms reaching large audiences. For a limited number of individuals, the world of dance represents more than a means of attaining a healthy lifestyle; for some it is an opportunity to be engaged in an active, specialized career. Just has been argued in the sociology of sport with the work of professional athletes (Roderick, 2006b: 30; Young, 1991: 3), professional dancers are workers engaging in the labour of producing dance for an audience. While historically considered to be a low-status occupation (Hanna, 1988: 120), professional dancers are committed to the belief that as an artistic and athletic endeavour, dance enhances the

3 quality of life (Brinson and Dick, 1996: 13). In this case, professional dancers may be considered men or women who are financially compensated for their work or who understand their dance work as their primary, or most significant, occupation1. This may include dancers who are contracted with companies on a seasonal basis, or independent artists who perform in varying styles, places, and performance opportunities. However, due to the often gruelling nature of such an occupation, professional dancers are ultimately engaging in risky behaviours, despite the fact that risk is not a concept that is typically associated with the world of theatrical dance (Adams, 2005: 83). The health and wellness of professional dancers is placed at risk as they immerse themselves in the occupational culture of dance, an occupation that is both physically and emotionally challenging. It is a world that is severe, all-consuming, and one that rewards the pursuit of perfection (Berardi, 2005: 195). In fact, only 5% of young students complete their training at the School of American Ballet due to physical and psychological problems, demonstrating how few make it in the profession (Berardi, 2005: 4). Journalist Joseph Mazo, after spending a season with the New York City Ballet Company, succinctly summarizes the types of stress experienced in the occupational world of dance: There is physical stress: speed, pain, the arbitrary acrobatics of their profession. There is emotional stress: the quest for perfection, the drive of ambition, the need to succeed here, in this theater, because no other arena of life exists. Meals are irregular, circles of friendship are limited, work is taxing (Mazo, 1974: 93). Involved in what is typically considered to be a youthful occupation, dancers start young and finish young (Mazo, 1974: 96). Training often begins as young as three years old, although males typically begin their training later in life (Adair, 1992: 87). The dance class is a cornerstone ritual of this world and the dancer can expect to study from

4 the very beginning stages of training and on into and throughout a professional career. Any dancer, regardless of dance style or occupational status, is expected to maintain and continue striving towards and beyond a certain level of physical acumen, skill, and precision in regards to technique. A dancers training is never finished and establishing control of the body, and gaining stamina, flexibility, strength and technique through repetition represent the principal dimensions of this learning (Adair, 1992: 35). Given the increased athleticism required of dancers today (Ewalt, 2010: 81; Tindall, 2006), and the fact that the boundaries between dance styles, especially ballet and contemporary work, are becoming more blurred (Hamilton, 2008: 4; Laws, 2005: 15), training and learning are of utmost importance in remaining an employable, versatile dancer. Even after years of schooling and training, long-term careers and short-term employment are uncertain given the competitive and physically risky nature of the work (Berardi, 2005: 6). Day-to-day life for a company dancer consists of classes, rehearsals, performing and often includes touring. For those dancers who are temporarily or selfemployed, it may be necessary to obtain secondary work in order to survive; according to Hamilton, teaching, or working at Starbucks and catering part-time can do wonders when it comes to extra income and additional sources of health insurance (2008: 28). Such a lifestyle, where the dancers body, their tool and instrument, must be crafted and honed constantly, ensures that professionals main concerns are their work and their bodies, and they are hard on themselves (Mazo, 1974: 103). As an art form focused on aesthetic appeal, a great deal of time and effort is spent on the moulding of the dancers body.

5 Specifically, the dancers body - - the very tool of a dancing career - - is at risk of pain, injury, and other body-related issues, such as image and eating issues, in the pursuit of career goals in this community. Injuries and chronic pain especially may be the result of overworking the body, pushing the physical limits of the body for choreographic purposes, excessive rehearsals, poor planning by dance management, the environmental conditions of the dance spaces (such as cold theatres and hard floors), and poor nutrition and food habits (Brinson and Dick, 1996: 19). Body and health-related issues pertaining to dance workers have been increasingly acknowledged and taken up over the past few decades both within dance (Brinson and Dick, 1996; Hamilton, 1998, 2005, 2008; Laws, 2005) and academic communities (Aalten, 2004, 2005, 2007; McEwen and Young, 2011; Novack, 1993; Tarr and Thomas, 2011; Thomas, 1995; Turner and Wainwright, 2003; Wainwright, Williams and Turner, 2005; Wainwright and Turner, 2006; Wulff 1998, 2008). In general, these studies point to the risks and dangers of the occupational culture of dance, adding strength to the assertion that in the shadows of the spotlight lurks an abusive world of eating disorders, verbal harassment, fierce competition, and injured, fatigued, malnourished dancers (Kelso, 2003: 1). The sociological study of risk, pain, injury and health-related experiences is much more developed in the sociology of sport subdiscipline, especially in relation to the experiences of professional athletes. The potential consequences of sport-related pain and injury demonstrates how it is an issue of great importance: Worldwide, the cost of athletic injuries is estimated to be $1 billion annually. Thus, preventing injuries has become a very important priority for healthcare providers, educators, and scientists, not only to avert the human downsides of pain and

6 disability, but also to reduce the deleterious economic impact of these injuries on society (Liederbach and Richardson, 2007: 45). Given that the study of the physical, lived experiences of athletes is an established area of research (cf. Young, 2004:1), and that Tarr and Thomas claim that both [s]port and dance are professional physical practices, in which the body is the primary tool of work (2011: 142), this literature has been extensively drawn upon in the development and interpretation of this research (e.g., Allen-Collinson, 2005; Donnelly, 2004; Donnelly and Young, 1988; Kotarba, 2001; Malcolm, 2006, 2009; Nixon, 1993, 1994, 2004; Pike and Maguire, 2003; Roderick, 2006a, 2006b; Sabo, 2004; Safai, 2003; Theberge, 2008; Young, 1993, 1997; Young, White and McTeer, 1994). While the worlds of dance and sport are ultimately different, valuable parallels can be drawn between these physical workers, as will be discussed in more detail in Chapter 2. In addition to literature from the sociology of dance, and the sociology of sport, this research also draws upon sociological inquiries into health and illness experiences (e.g., Bury, 1991; Charmaz, 1995; Lupton, 2003; Nettleton, 2006; Turner, 2004), and work (Budd, 2011; Freidson, 1990; Menger, 1999; Volti, 2012).

RESEARCH OBJECTIVES The primary aim of this research is to add to a growing body of literature that explores the physicality, pain, injury and health-related experiences of professional dancers, and to explore how these understandings and experiences shape, and are shaped by, a career within the occupational culture of dance. A great deal of the sociological and anthropological work related to dancers is undertaken primarily in European and

7 American settings, and thus this research not only contributes to a limited body of knowledge related to the embodied experiences of dancers, but it also contributes to a Canadian perspective. Additionally, the aforementioned literature deals chiefly with the experiences of ballet dancers who work for companies on a longer-term, contractual basis (Aalten, 2007; McEwen and Young, 2011; Turner and Wainwright, 2003; Wainwright, Williams and Turner, 2005; Wainwright and Turner, 2006; Wulff 1998, 2008). Professional performers in other forms of dance, such as contemporary, modern, or jazz dance, experience differing career trajectories; for example, working on a shorter-term contractual basis, and creating their own opportunities as independent artists. These dancers experience different pressures and work demands, including the likelihood of less accessible medical care, and thus this research aims to explore the experiences of both ballet dancers and other dancers, following the work of Tarr and Thomas (2011). An additional aim of this research is to explore what has been a relatively untouched area of inquiry in the social scientific research related to the study of dance - the interactions and negotiations that take place between dance workers and the health care professionals who provide their treatment. This research thus brings together the understandings of the dancers themselves and those clinicians and practitioners who treat them, drawing upon increasingly rich literature from the sociology of sport and sports medicine (Kotarba, 2001; Malcolm, 2009; Roderick, 2006; Safai, 2003). Given that dance medicine is a relatively new discipline and that few practitioners specialize in the treatment of dancers, this should be considered a modest attempt at filling this gap in social scientific and dance literature and knowledge.

8 The specific research questions which guided this study can be summarized as follows: How do professional dancers understand and attribute meaning to their workrelated, embodied experiences? o How do dancers understand and make sense of their physicality, pain, injury and other health-related experiences such as body image issues? o How are these understandings and experiences shaped by the occupational culture of dance and other members of the dance community? How do professional dancers approach and negotiate their treatment with dance clinicians and, subsequently, how do these interactions shape their embodied experiences?

THEORETICAL AND RESEARCH APPROACH Since the aim of this research was to gain a rich understanding of how dancers experience and attribute meaning to their physical and health-related experiences within the occupational culture of dance, an interactionist approach was utilized. Following Roderick and his study of the careers of footballers (i.e., professional soccer players), interactionism is an appealing approach in relation to the study of people whose daily work is situated among a relatively small, tight-knit group that is all but closed to nongroup member (2006: 5). This is especially important given the closed nature of the dance world in general, and ballet in particular (Novack, 1993: 46). From this

9 perspective, not only is it possible to study the physical, liminial experiences of professional dancers, but also how the social body is created and re-created through interaction, and attributed symbolic meaning specific to the dance world. In keeping with Waskul and Vanninis assertion that interactionists borrow freely from numerous conceptual frameworks to craft provocative analytical insights (2006: 4), this research drew upon different, yet related, threads of interactionist thought. For instance, the Goffmanesque (Atkinson and Housley, 2003: 12) dramaturgical perspective, specifically Goffmans work and other empirical studies (Atkinson, 2006; Pike and Maguire, 2003; Roderick, 2006) on the presentation of self, impression management, identity formation and the role of stigma and stigmatizing behaviour, was relevant for contextualizing the ways that professional dancers understand, manage, and negotiate their body and health-related experiences within the confines of their careers. Additionally, phenomenological thought (Kotarba and Held, 2006; Leder, 1990; Monaghan, 2006) and an art world perspective (Becker, 1982) help to situate professional dancers experiences in relation to the body, the self, and collective action in the dance world. In keeping with interactionist traditions, this research aimed to gain a thick description (Geertz, 2003) of the lived experiences of professional dancers rather than a mere account of the number and type of injuries or health-related issues experienced, and thus a qualitative research approach was utilized in the collection of data. Specifically, indepth, semi-structured interviews with professional dancers in varying styles of dance and in differing career stages were conducted, in addition to a number of interviews with health care practitioners with experience treating dancers. While the interviews were

10 guided to a certain extent, participants were encouraged to speak in their own terms and categories (Young, White and McTeer, 1994: 180) so as to gain a more complete and accurate understanding of their experiences.Methodologically, it is important to recognize my own role in the interactive research process. Interviews have been interpreted as cocreated social performances (Berg, 2009: 103), especially in light of my insider status within the dance community. As will be explored in more detail in Chapter 3, I acknowledge that I am not a neutral, objective interpreter but a social actor in the research process.

STRUCTURE OF THE THESIS Chapter 2 brings together literature from various frameworks, including substantive research from the worlds of dance, sport, health and illness, and work, to explore how pain, injury, and health-related experiences have been taken up academically. It highlights a number of important themes that were relevant in the planning and execution of this research. This chapter also outlines the theoretical framework of the thesis, and specifically explores relevant interactionist traditions and ideas including the dramaturgy, phenomenology, and art world perspectives. Following from this discussion of the specific theoretical perspectives employed, Chapter 3 outlines the research design that was utilized and the specific data collection and analysis approaches used. Additionally, the sample is briefly described, along with some of the particular methodological experiences that emerged throughout the course of the research process. Chapter 4 presents a detailed account of the research findings, first addressing

11 the specific understandings and meanings that dancers attributed to their embodied work experiences, and second, addressing the interactions which occur between dancers and health care practitioners. This chapter draws upon many of the themes identified in the literature in Chapter 2. Finally, Chapter 5 summarizes the thesis, takes a look at the strengths and limitations of the study, and identifies areas for future research.

NOTES 1. The use of the term professional in this research differs from typical sociological understandings of the term. A more in-depth discussion follows in Chapter 2.

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CHAPTER 2: LITERATURE REVIEW AND THEORETICAL APPROACH

13 INTRODUCTION This chapter considers both academic and non academic literature that is relevant to the study of professional dancers and the physicality and health-related experiences of their work. A review of the literature considers work from the world of dance, including a small, yet growing, sociological body of research, in addition to sociological research which investigates pain and injury in sport, experiences of health and illness, and the social relations of work and occupations. While these areas of research are overlapping and draw upon one another extensively, they have been discussed separately for the purposes of this review. In no way exhaustive, this review is intended to highlight important themes and ideas from varying areas of sociological inquiry that, when taken together, provide a more holistic and in-depth way to understand the experiences of professional dancers. This chapter will also review the theoretical approach used to consider these experiences - - symbolic interactionism. The use of this approach is inspired by the empirical work done concerning dancers and athletes and, as such, multiple frameworks (including dramaturgy, phenomenology and the art world perspective) have been drawn upon. This section will additionally focus on the ways that social theory and the sociology of the body interact.

DANCE: A WORLD OF ITS OWN Much literature, especially from within the dance world, addresses information such as historical accounts on the development of dance, instructional manuals on both practicing and teaching, autobiographical and biographical stories, and reviews of dance

14 performances themselves. While cursory mention is made of the physical and healthrelated experiences of dancers in these texts, in-depth and rich accounts of the lived experiences of dancers are less prominent and, when they do feature, these issues related to health are portrayed as inevitable elements of a dancing career that must be accepted. Often the corporeal and emotional issues that face working dancers, such as injuries, eating disorders, and ageing to mention a few, are stigmatized within the dance community and, as such, have been considered more taboo in nature (Langsdorff, 2006: 17). A number of key sources intended for a dance world audience demonstrate that perhaps these issues are becoming more salient in discussions and discourses surrounding professional dancers. Psychologist and former dancer Linda Hamiltons work recognizes the occupational stresses and hazards of a dancing career (1998, 2005, 2008). This selfhelp oriented literature, while drawing attention to health-compromising practices within the dance world, does little to question or examine the occupational environment that encourages and requires such behaviour. The reports Fit to Dance? (Brinson and Dick, 1996) and Fit to Dance 2 (Laws, 2005), funded by Dance UK and its Healthier Dancer Programme, are intended to present a comprehensive picture of UK dancers health and injury status, to raise awareness of the key factors affecting dancers health, and bring together views and recommendations from the worlds of dance, sport and medicine (2002: 6). These reports both employ a helpful definition of injury that is made use of throughout this research: [An injury is] a physical problem deriving from stress or other causes to do with performance, rehearsal, training, touring or the circumstances of dance life, which affects your ability to

15 participate fully in normal training, performance or physical activity (Laws, 2005: 10) 1. Brinson and Dick argue that an injury in the context of professional dance should be considered a work-related injury (1996: 19) and thus should receive treatment similar to those in other occupations. Through self-reported surveys it was found that 80% of respondents had experienced at least one injury in the last 12 months with fatigue, overwork, and repetitive movements viewed as the most common causes (Laws, 2005: 16-20). Both reports offer recommendations and, while a certain level of improvement was found between the two reports, there are still causes for concern (Laws, 2005: 4). These works demonstrate more willingness to discuss taboo, often hidden issues within the occupational culture of dance, a trend that parallels a more recent academic interest in the work experiences of professional dancers.

A Sociology of Dance Sociologist Helen Thomas writes of how dance has been historically dismissed as a productive area of inquiry due to the fact that as an art form it is a minority concern, and that even within the arts, dance is a marginalized form (1995: 2). While much of the dance research conducted to date is theoretical in nature, does not deal with the lives and bodies of the dancers themselves in Western culture (Wainwright and Turner, 2004a: 332), and while a dearth of empirical work on the sociology of dance remains in general (Wainwright and Turner, 2006: 239), a number of recent exceptions bring the dance worker, and their career, body and health-related experiences, into the foreground2. In her ethnographic study of ballet dancers from the Netherlands, Anna Aalten drew upon Drew

16 Leders (1990) phenomenological theory of the absent body (i.e., that the body remains absent to the self until such a time as it makes its presence known - - for instance, in the form of pain and injury), to frame an understanding of how dancers work within their bodies and careers (Aalten, 2004; 2005; 2007). Drawing upon both Aaltens work and Leders, Jen Tarr and Helen Thomas (2011) explored the embodied experiences of professional dancers in the UK, in classical ballet, contemporary and other dance forms. Steven Wainwright, Bryan Turner and colleagues ethnographically studied the Royal Ballet in London and provided various frameworks for understanding experiences of professional dancers. They elaborated upon the insights drawn from Helena Wulffs (1998) anthropological study of ballet companies, contending that her work focused little upon social theory and the body (Wainwright and Turner, 2006: 239). Drawing upon the work of Pierre Bourdieu (Bourdieu, 1984; Bourdieu and Wacquant, 1992), they explored the connection between the self and career, moments of epiphanies, physical and cultural capital, and experiences of injury and ageing (Wainwright and Turner 2004a; 2004b; 2006; Wainwright, Williams, and Turner, 2005). Turner and Wainwright (2003) also situated the dancers experiences within a Durkheimian framework to explore social solidarity and collective effervescence within a dance company (i.e., that a sense of attachment to the company mediates understandings and responses to injury). These works highlight one approach for carving out space for a sociology of dance: We believe that ballet is an important topic in the broader project of making sociology more cultural and cultural studies more sociological, and in producing more comprehensive social research on the reciprocal relationships between the body and society (Wainwright and Turner, 2004b: 118).

17 While other social scientific research related to the dance world and dancers themselves, in addition to work including literature aimed at the dance community, autobiographies and biographies, and media commentaries, contain valuable information and insights, the above pieces of research highlight how a sociology of dance can be both empirically and theoretically driven in relation to an exploration of career and the body for professionals. Taken together, these various sources highlight specific themes inherent in the dance world that shape the career, body, health and self experiences of professional dancers, as will be discussed below.

An Occupational Culture: Explorations in Injury, Power, Competition, and Perfection The omnipresence of the risk of injury led John Mazo to proclaim in relation to one performing season with the New York City ballet: its a hospital ward out there (1974: 234). According to Aalten, pain is a daily, inevitable part of the lives of professional dancers (2004: 60); they learn to consciously neglect the body in the pursuit of career goals. As Wulff points out, there is a rule against casting or promoting dancers who are injured (1998: 106) and thus one common approach is for dancers to ignore and hide their pain. The stereotypical saying the show must go on can become a personal mantra for those wishing to maintain career momentum. In Bourdieus terms, injury threatens to shatter the habitus of the dancer, and consequently throw the identity of the dancer into crisis (Wainwright et al., 2005: 51). In a similar fashion to injury, physical decline related to ageing also threatens the identity of dancers (Wainwright and Turner,

18 2004b: 107). It is not only concern for the self that generates emotional anxiety over injury experiences since a great deal of guilt can be experienced when a dancer adversely affects co-workers and the company (Wulff, 1998: 106). McEwen and Young (2011) point out the various ways that dancers understand and respond to their injury and pain experiences. In their study of Canadian dancers, it was found that dancers decentralized pain from their lives using strategies related to hidden, disrespected, unwelcomed, and depersonalized pain (McEwen and Young, 2011; Young et al., 1994). Additionally, it was found that pain is often welcomed by dancers as a sign of improvement, a concept that is echoed in Pickards description of Zatopekian pain (2007: 45), and Thomas and Tarrs distinction between good and bad pains (2009: 56). For Gelsey Kirkland, the risk of injury was related to training, working styles and the power structures of the dance world: Balanchine and his teachers unwittingly encouraged young dancers to self-destruct, rationalized as part of the sacrifice that must be made to the art ... The risk of injury was ignored. I watched many of my friends become casualties and fall by the wayside (Kirkland, 1986: 34). Evolving from the historical roots of ballet especially, where dance was an ethical code that taught manners and respect for social standing (Van Delinder, 2005: 1440), it is no surprise that the dance classroom and workplace are ideal climates for authoritarian behaviour (Smith, 1998: 128; Forte, 2010: 42)3. The dancers body becomes the artistic tool for choreographers ideas, and when told to jump, the dancer asks only, How high? (Sarte cited in Pickard, 2007: 39). Authority figures in the dance world, to a certain extent, wield absolute power over workers (Smith, 1998: 130) in an effort to

19 mould bodies in their image, and given that dancers have an insatiable craving for approval (Mazo, 1974: 105) the body is often placed at risk. While Wulff did to a certain extent witness defiance and resistance against such authority, it was mostly hidden in nature so as to avoid jeopardizing ones career (2008: 529). Such authoritarian behaviour is often justified as necessary for achieving success in the world of professional dance (Smith, 1998: 135). The Fit to Dance 2 report indicates that finding and securing work as a dancer is a major concern since the number of jobs is very limited (Laws, 2005:32), and Hamilton asserts that competition is simply a fact of life in dance (1998: 78). Such competition can take numerous forms - - for example in terms of attaining work (Hamilton, 1998: 103), in terms of comparing oneself to others in class and striving to do more pirouette turns, to have higher legs at the barre, (McEwen and Young, 2011: 156; Wulff, 1998: 80), and in terms of competing for roles and renewal of contracts (Adair, 1992: 19; Wulff, 1998: 80). Competitive atmospheres often push dancers to physical extremes. Linked with the notion of comparing is the dancers concern with achieving perfection, be it in terms of technical skill or appearance. McEwen and Young found that perfectionist attitudes were a major pressure in the world of dance and that while such an attitude may be beneficial in terms of success, it often left the dancers feeling defeated since the ideal seems always out of reach (2011: 157). Canadian ballerina Karen Kain speaks of how dancers are all naturally such perfectionists (1994: 15) despite the fact that the balletic ideal (and body) is actually impossible to achieve. As Vincent pointedly claims, if obsession with fat is a national pastime, then surely dancers are Olympic contenders (1979: 6). Aalten documented how the dancers in her study viewed dieting as

20 part of the constant work that must be done to the body (2007: 117), and in a recent article published in Italy, one dancer suggested that one in five ballerinas she knew was anorexic (Kington, 2011). Perfectionist attitudes, often linked with the notion of weight control and achieving slimness, can potentially harm the self and body of dance workers. Overall, understandings and manifestations of health-related issues in a dancing career are shaped by numerous pressures and ideas embedded within the occupational culture of dance, as will be explored in relation to this studys participants in Chapter 4. For Mazo, the nature of such a lifestyle allows dancers to construct the idea that they are different from everyone else, that they are chosen(1974: 103)4. While to a certain extent the world of dance has many unique elements and could be called a world of its own, it is not the only body-centred career we may explore to gain an understanding of how the body and health is understood in relation to work. For instance, Tarr and Thomas argue that the pressure on dancers to continue working through pain and injury is ... not unique to their professional situation (2011: 143), and that looking to studies of the sporting career can help deepen and flesh out understandings of such issues.

THE SOCIOLOGY OF SPORT: SPORTING BODIES A number of concepts and directions from the sociology of sport literature emphasize some of the ways that the association between health and work has been taken up in relation to body-centred occupations. While it could be said that dance is not a sport in the technical sense, the very fact that both athletes and dancers depend on their physical skill and acumen to attain occupational success suggests that valuable insight can be drawn from the knowledge and experiences present in the sociology of sport. As

21 Mayes claims, the physically demanding nature of their work demonstrates that dancers are elite athletes for all intents and purposes (1995: B1); the embodied and healthrelated experiences of athletes have been explored sociologically in various ways that are applicable to the study of dancers.

The Culture of Risk and the Sport Ethic While sport and exercise are often linked with discourses surrounding good health and healthy bodies (Waddington, 2004: 287), research indicates that frequently athletes place their bodies at risk, paradoxically creating unhealthy bodies. For Donnelly, sports constitute a culture in which taking risks is encouraged, sometimes coerced, and rewarded both materially, and emotionally within particular social formations (teams, subcultures) which value character, a shared identity, and comradeship (2004: 47). Initially applied to the world of sport by Howard Nixon (1992, 1993, 1994, 1996, 2004), and taken up by others in the sociological literature (Allen-Collinson, 2005; Howe, 2004; Malcolm, 2009; Malcolm and Sheard 2002; Pike, 2004; Pike and Maguire, 2003; Roderick, 2006a, 2006b; Safai, 2003, 2004; Theberge, 1997; Young 1993, 1997; Young, White and McTeer, 1994; Young and White, 1995) the notion of a culture of risk can be understood to encourage the normalization of pain and injury. According to Nixon (1992), the sportsnets, or the social networks inherent in the world of sport, often give biased social support to athletes that rationalize and normalize pain as part of the game, and foster self-abusive patterns of subsuming risk and playing hurt. Members of these

22 sportsnets encourage such behaviour in different ways - - for instance, in terms of socialization among fellow athletes (Nixon, 1993), the influence of coaches in reinforcing the culture of risk (Nixon, 1994, Ryan 1995), reinforcement of gendered assumptions related to playing sports (Young 1993; Young et al., 1994), and media glorifications of those who sacrifice for their team (Nixon, 1993). Robert Hughes and Jay Coakleys (1991) concept of the sport ethic and what it means to be an athlete is linked with this concept of the culture of risk. The sport ethic outlines that being an athlete involves making sacrifices for the game, striving for distinction, accepting risks and playing through pain, and refusing to accept limits in the pursuit of possibilities (Hughes and Coakley, 1991: 309-310). Athletes deviantly overconform to this sport ethic and willingly accept the associated risks that may result in unhealthy bodies, the very tools relied upon to be good athletes. The institutional elements of the culture of risk and the sport ethic are embedded within the world of sport and encourage the normalization of risk, pain and injury.

Pain and Injury in Sport Much of the ethnographic, in-depth research which address the body and healthrelated experiences of athletes describe numerous ways that pain and injury is rationalized, managed, and responded to by the athletes themselves and other actors in the sportsnets. For instance playing through pain is often seen as an indication of a players ability and an affirmation of the commitment held towards the team and the sport (Theberge, 1997: 311). Continuing to play while hurt is a common way to manage pain

23 and injury in the sporting world, and Charlesworth and Young outline a number of rationalizations and motivations underlying such behaviour (including group bonds, pressure from coaches and teammates, body confidence, ambition, team re-selection, routine pain, camaraderie, questionable medical advice, financial incentives, and disrupted routines) (2004: 166-177). Roderick and colleagues found that professional footballers demonstrate their good attitude by playing hurt (2000: 169) and Young and colleagues found that managing injuries can reinforce hegemonic notions of masculinity in sport (1994: 188). In response to injury, players can be inconvenienced, and effectively punished, in terms of routines, scheduling and promotion (Roderick, 2006b: 74), and the player can also feel pressure to produce the goods or else face rejection by management (Roderick, 2006a: 80). In addition to this pressure from management, Roderick found that players were often accused of malingering or of faking an injury if they did not push through and continue to play (2006b: 70). While a number of studies indicate that players acknowledge the health threats of playing through pain (Theberge, 2008:209), and Malcolm and Sheard found a reluctance on the part athletes in English rugby union to place themselves at risk (2002: 167), playing while injured is a dominant experience in the sporting world. The emotions experienced by the injured athlete and the associated threat of disrupted identities and stigmatization have also featured heavily in the sociological sport literature. Injury and Emotions For Nixon, participation in the sports world, aided by the omnipresence of the culture of risk, can foster many different emotions such as guilt, shame, uncertainty, job

24 insecurity, frustration and even depression (1993: 188). Emotional experiences related to pain and injury can be especially salient in the athletes experience given that injury has been found to be lonely and isolating (Thing, 2004: 204). Snyder points to the emotionwork and self-dialogues that gymnasts engage in to manage their emotions, especially their fears in relation to pain and injury (1990: 262; see also Podlog and Eklund, 2006). Allen-Collinson writes of the emotion management associated with injury, including dealing with the fear and anxiety when injury becomes hard to ignore, and the optimism and subsequent doubt and anger that accompanies seeking medical treatment (2005: 226230). In general, the fears surrounding the uncertainty of an injury is a principle theme in the literature (cf., Roderick, 2006b: 52), since the threat of injury can render the maintenance of the athletic self ambiguous, difficult, or even impossible. Athletic Identities Internalization of the ideas and behaviours associated with the aforementioned culture of risk and sport ethic, and the action of continuing to play while hurt, are often linked to notions of establishing and verifying identities. Donnelly and Young (1988) combine the concepts of career and identity to explore how members in sporting subcultures achieve identities and membership in such groups. In general, they argue that identities are constantly undergoing revision and change due to a variety of processes (1988: 237) that involve both construction/reconstruction and confirmation/reconfirmation. Similarly, Hughes and Coakley argue that it is often during this process of confirming and reconfirming identities that athletes overconform to the sport ethic (1991: 311).

25 When this overconformity leads to health-hazardous behaviour, injury and identity can collide. Just as injury can shatter or disrupt the identities of professional dancers (Wainwright and Turner, 2004a; Wainwright, et al., 2005), the experience of pain and injury in sporting realms can threaten the athletic identity. Fears of stigmatization and the potential for athletic identities to be spoiled by an injury can help to explain some of the management techniques and responses, such as hiding injuries, or playing hurt, as well as some of the identity work engaged in to avoid disruption to the athletic self (Pike and Maguire, 2003; Roderick, 2006a, 2006b; Roderick et al., 2000). Allen-Collinson and Hockey (2007) auto-ethnographically write of the work they did to manage their disrupted running identities, such as relying on clothing, vocabulary and associations in order to feel as though they were still themselves throughout the injury period (pp. 389392). This management of identity represents one part of what it means to live with injury in a sporting world. Body Pathology: A Sporting Injury? Just as dancers struggle with issues of weight, achieving slimness and an ideal body type, athletes can experience body pathology in relation to the prescriptions of their own particular sports (Davis, 2007). Rail and Harvey (1995) point to the influence of Michel Foucault in the sociology of sport, and in particular his writings on the body, disciplinary power, surveillance and technologies of the self - - concepts which have been used to frame an understanding of the body and weight-related experiences of athletes. Johns (2004) and Jones and Glintmeyer (2005) draw attention to the disciplinary power inherent in sport, and how this interacts with the sport ethic to produce disordered eating

26 and self surveillance on the part of the athlete, often at the encouragement of coaches. Importantly, Johns conceives of severe weight management as an injury with the potential to injure both the mind and the body (2004: 129), and one that can be understood in relation to the sporting culture and the interactions taking place within the sportsnets. In sum, the body of literature related to sociological understandings of athletes, and how health and the body is understood in relation to a sporting career, the sportsnet, and identity, demonstrate that there are numerous overlapping, and potentially overlapping, experiences with those of professional dancers. While a discussion of the health-related experiences of athletes is in no way complete without addressing the reception of medical care, especially taking into consideration the literature that has emerged surrounding the sports medicine discipline, such a discussion will follow in relation to a more general overview of the sociology of health and illness.

THE SOCIOLOGY OF HEALTH AND ILLNESS The following section is meant to highlight the general concepts and themes from the sociology of health and illness that have been used to inform this research, and while it in no way is intended to be an exhaustive review, it emphasizes how empirical research related to those with acute and chronic illness can be used to help define and refine an understanding of the health and body-related experiences of professional dancers. Taking more of a social constructionist stance, contrary to the biomedical conception which treats the mind and body as separate entities, disease, illness and the body can be

27 understood as products of social activity and socially constituted knowledge. This approach takes into account the multiplicity of truths, accounts and experiences related to health and illness and thus, according to Nettleton, has implications for the relationship between medical experts and lay people (2006: 31). The importance of the lay perspective and lay beliefs when it comes to illness, disease, and health is a prominent theme in the literature. As argued by Deborah Lupton, lay health beliefs are dynamic, sometimes incoherent, and vary according to place and time, often stemming from mass media, common-sense understandings from personal experience or consultation with family and friends, or alternative medical practice (2003: 108). Such beliefs are important for the ways patients understand and take action in relation to their own health and bodies. Embedded within these beliefs are the notions of lifestyle choice and taking individual responsibility for health risks (Lupton, 2003; Nettleton, 2006), thus moral meaning, and even imputing of blame (Lupton 2003: 100) call into question how individuals live their lives. The experience of the patient and what it means to live through and with illness is another marked theme within the sociology of health and illness. From a functionalist perspective, Talcott Parsons delineation of the sick role clearly articulates both the rights and obligations of what it means to be sick in Western society. The sick person is exempt from normal responsibilities; they are not to be held responsible for the illness, and in return they must want to get well and cooperate with medical professionals (Parsons, 1951: 436-437). The sick role is, however, an ideal-type that does not necessarily reflect empirical experiences of health and illness. It is a concept that has

28 been critiqued by sociologists on numerous counts, one being that the everyday life of the ill person is more complex than the sick role would suggest (Nettleton, 2006: 80). An additional critique of Parsons sick role contends that the concept does not adequately recognize conflicts in doctor-patient interactions; thus, according to Bryan Turner, the sociology of the experience of illness was an important alternative to Parsons approach (2004: 141) in that it took into account the lived reality of the patient. Illness, and especially chronic illness, has been found to be biographically disruptive and can lead to a loss of self and self-identity (Bury, 1991; Charmaz, 1983, 1995; Turner, 2004). For Charmaz (1983), this loss of self can be related to issues such as isolation, daily restriction, discrediting definitions of the self and becoming a burden to others. Bury points out how the aspect of uncertainty is key in this disruptive experience and indeed how this has consequences in terms of the self and social relations (1991: 454; see also Charmaz, 1983; Lupton, 1996; Turner, 2004). A common way to conceive of these experiences, and to understand how patients make sense of them, is through the illness narrative. For Turner, the ill construct accounts of their lives in an implicit attempt to make sense of the disruptions in their life course (2004: 148). Kleinman (1988) explores this concept of the illness narrative, emphasizing the cultural and social meanings of illness. Frank identifies three types of illness narratives: the restitution narrative closely resembles the sick role in which the person seeks help and gets well; the quest narrative highlights the persons belief that something can be gained from the illness experience; and the chaos narrative is one of contingency, where the individual feels swept along, with no clear end in sight (Frank, 1995). Taken up alongside this notion of illness narratives is Goffmans work on stigma

29 and management of the self, as will be discussed below (Kleinman, 1988; Nettleton, 2006: 95; Scambler, 2004). Kleinman argues that it is crucial for practitioners to understand and take heed of the lay persons illness narrative (1988: 49). Whereas traditional doctor-patient interactions were characterized by unequal power and a meeting between the knowledgeable professional and the ignorant individual, increasing interest in and access to medical information has resulted in meetings between experts (Nettleton, 2006: 138). While the unbalanced relationship between professionals and lay persons is not problematic for functionalists such as Parsons (Lupton, 2003: 113), others have argued for a more patient-centred approach that recognizes the conflict that can occur when these separate worlds collide (Mead and Bower, 2000). Conceptions of good and bad doctors and issues of trust (Lupton, 1996), the frustrations felt when doctors fail to acknowledge that patients might know more about their conditions than practitioners do (Nettleton, 2003: 140), the strategies patients engage in to attempt to control interactions, such as rehearsing or presenting partial symptoms (Nettleton, 203: 151; Strong, 1979), and the occasional resistance and challenge to medical dominance that patients engage in, depending on factors such as social class, age, gender, and ethnicity (Lupton, 2003: 125), represent issues from the patient perspective. From the perspective of the practitioner, the ways that medical training encourages doctors to diagnose and respond in certain ways to patients (Lupton, 203: 127), and the often unacknowledged emotional labour of treating others (Bolton, 2001; Nettleton, 2003: 160) are also explored.

30 Seeking Treatment: Interactions between Athletes and Sports Medicine Professionals Much of the literature related to the health care experiences of athletes is rooted in the sociology of health and illness. While interactions between professional dancers and those in the profession of medicine have been briefly discussed and attended to (Ewalt, 2010; Holmes, 2008), dance scholars have been relatively slow to explicitly analyze such encounters. For Young sports workplaces are simultaneously sites of medical mastery and extraordinary medical neglect (1993: 376). Many themes related to athletes directly parallel what has been found to be the experience of, for instance, the ill and chronically ill. However, in many cases the interactions between athletes and sport clinicians5 are somewhat different than the interactions between lay individuals and more conventional doctors. Roderick argues that professional football players must act in accordance with a Parsonian injured role in the context of their sport (2006a: 79). However, Thing found that female handball players acted in opposition to the sick roles prescription that patients are free from obligations and that these athletes in fact had an obligation to be active and autonomous in the treatment process (2004: 199). Other themes from the sociology of health and illness, such as issues related to trust in the doctor-patient relationship (Allen-Collinson, 2005), and how uncertainty shapes medical encounters (Malcolm, 2009), are also reflected in the sociology of sport. The type of patient-centred health care that sociologists argue for, as mentioned above, has been found to exist in interactions between athletes and sport clinicians, in the form of open communication, and processes of negotiation, bargaining, and exchange (Howe, 2004; Malcolm, 2006; Roderick et al., 2000; Safai, 2003; Theberge, 2006).

31 Theberge categorizes sports medicine as a consumer based, athlete focused model (2006: 4) where the athlete challenges authority by relying on their own lay knowledge and self diagnosis (Malcolm, 2006; Safai, 2003). This athlete focused level of care is reinforced by the relative weak or subordinate role of sport clinicians as compared with conventional physicians (Malcolm, 2006: 377). In other words, athletes needs and the needs of the team shape interactions between clinicians and athletes. In Roderick et als study of professional footballers, the aim of treatment was to get the athlete fit to play as soon as possible (2000: 173). Malcolm found that team doctors minimized conflict by allowing pressures from the sporting world to direct their diagnosis (2009: 204) and that clinicians were able to tolerate compromised diagnoses in order to maintain their medical expertise and selves (2009: 206). Often the decision to play or not play is left in the hands of athletes, leading Safai to ponder the potential hazards: We need to question whether placing the burden of responsibility on the shoulders of athletes is fair considering that athletes may be immersed in a culture of risk, and often make their choices under the influence of their coaches, teammates, and injurylegitimating attitudes (2004: 281). Joseph Kotarba (2001) conceives of sport medicine as a form of occupational health care. His typology divides this type of occupational health care into three categories: elite care, which is allocated to highly valued workers, managed care, which is reserved for the bulk of workers and is managed in such a way to reduce costs, and primitive care, which is delivered mostly to marginal workers (2001: 767). This conception of occupational health care in sport, along with the above empirical findings related to the clinician-athlete relationship, have informed this research and thus shape an analysis of what can be termed the clinician-dancer relationship. Kotarbas work also

32 highlights how sport (and dance) can be understood in terms of being an occupation, a topic that will be discussed in more detail in the following section.

THE SOCIOLOGY OF WORK Sociologist Rudi Volti states that work is a central activity in the lives of most people and one that is highly social (2012: ix). Similarly, John Budd argues that one way to think about work is to consider it a social relation that is experienced in and shaped by social networks, institutions, and power relations (2011: 108). Budd argues for a much broader definition of work and he goes on to state that for those with fulfilling careers (like those of professional dancers) the boundary between work and personal life can often be blurred (2011: 3). Conceiving of professional dance as work, and situating it within some of the sociological research related to work, orients and guides an understanding of the ways dancers work on and with their bodies in a dancing career. The term profession and to be a professional is defined in a very specific way within the sociological work literature. Professions are typically understood to be occupations that require specialized knowledge and training, contribute great value to society, involve roles and skill that confer power and require adherence to ethical standards, and in general function with relative autonomy and self governance (Volti, 2012: 154-156). While the work of dancers does not fit with this specific definition, my use of the term professional dancer is reflective of how dancers conceive of themselves; in the dance world it is a term that means an individual has moved beyond the training portion of their career and is now compensated for their dance labour.

33 As Budd points out, often the first question asked in a new social encounter is what do you do? (2011: 143), demonstrating how work can become a key part of an individuals identity (Volti, 2012: 137). Drawing upon an interactionist perspective, Budd additionally contends that social roles attached to occupations and careers are a major source of our identity and self presentation (2011: 149; Grey, 1994; Padavic, 2005). Rodericks research demonstrates how issues of work and identity are taken up in relation to a body-centred trade. Drawing upon the ideas that work, and in this case the work of football, can be a labour of love (Freidson, 1990) as well as a calling (see also Bunderson and Thompson, 2009; Wainwright et al., 2005), Roderick demonstrates how intertwined the relationship between work and self can be. He additionally points to the importance of contingencies and turning points in understanding identity transformation within careers (2006b: 20). The creation, negotiation and maintenance of self-identity in relation to work occurs within the context of occupational, or organizational, cultures. Budd draws attention to a number of aspects of occupational cultures - - for instance, how such cultures can reflect the power differentials in hierarchical workplaces, and how organizational culture can be a mechanism of normative control, particularly in relation to sanctioning violators of workplace norms (2011: 113-114). Volti views occupational culture as a significant socializing agent that creates and reinforces occupational identities through distinctive appearances and vocabularies (2012: 138-139). While work issues of those in various occupations (for instance, the above-cited work of professional footballers) are applicable to the study of professional dancers, it is important to remember that dancers work within an artistic labour market. Pierre-Michel

34 Menger (1999) emphasizes some general characteristics of artistic occupations, as well as numerous arguments related to the rationale of those in artistic careers. While Mengers review is detailed and complex, a number of important sensitizing features, applicable to the world of dance, have been articulated here: Artists as an occupational group are on average younger than the general work force, are better educated ... show higher rates of self-employment, higher rates of unemployment and of several forms of constrained underemployment (nonvoluntary part-time work, intermittent work, fewer hours of work), and are more often multiple job holders. They earn less than workers in their reference occupational category (1999: 545). Like the work engaged in by professional footballers, the work of artists has been conceptualized of as a labour of love in which commitment and achievement cannot be matched by monetary compensation (Menger, 1999: 554; Freidson, 1990). Ultimately, Menger argues that artistic occupations are inherently defined by uncertainty and risk, and that one way to manage this risk is to remain flexible, and diversify (Menger, 1999: 569). In many occupations there is also risk associated with health and well-being in terms of becoming injured or ill as a result of the social organization of the workplace. Eakin and MacEachen distinguish multiple approaches to explaining the relationship between illness and injury and the social dimensions of work: the exposure to harmful conditions through the social organization of work, experiences of occupational stress, and the ways in which injury and ill-health are socially produced through interaction (2000: 897). Dodier (1985) speaks of the ways in which workers engage in impression management in order to properly display signs of being sick to co-workers and superiors, and how there is often a moral evaluation of being sick in the workplace that can lead to

35 conflict. Volti points out that in addition to being physically hazardous to health, work can also be psychologically demanding, especially in the form of stress and resulting burnout (2012: 218). Ultimately, an understanding of how occupational cultures and identities shape and are shaped by notions of health, well-being, and injury in the workplace result in a more intricate and in-depth understanding of how those in bodycentred trades work with and on their bodies.

THEORETICAL CONSIDERATIONS The above review highlights themes and ideas from sociological research related to dancers, athletes, experiences of health and illness, and work and occupations that are of significance for an in-depth, fleshy understanding of how dancers relate to their bodies and careers in terms of pain, injury and health. This research aims to build upon our existing knowledge of professional dancers by focusing upon how they construct understandings of their body and health-related experiences, and how such experiences are shaped by interactions with others in the dance community, including colleagues and authority figures, as well as those in the medical profession. Consequently, a symbolic interactionist approach is utilized to account for the meanings that dancers ascribe to their dancing bodies and lives. Roderick argues that interactionism is an appealing approach in relation to the study of those in small workplaces that are closed to non-members, such as the workplace of professional dancers (2006b: 5). My research thus follows Roderick and others from the worlds of sport and dance (Aalten, 2007; Allen-Collinson, 2007; Charlesworth, 2004; Howe, 2004; Pike, 2004; Pike and Maguire, 2003; Snyder, 1990;

36 Tarr and Thomas, 2011; Turner and Wainwright, 2003, Wainwright and Turner, 2004a) and engages with the interactionist tradition. In general, Atkinson and Housley argue that interactionist sociology has never been a single tradition (2003: 32) and that it is an area of inquiry that is broad, overlapping, parallel and ambiguous. While it may be the case that there is no one symbolic interactionism, it is certainly possible to recognize basic premises of the perspective. Of utmost importance, and originating from the pragmatist roots of interactionist frameworks, is an understanding that human beings are active, creative agents (Waskul and Vannini, 2006: 3). As such, a core assumption of symbolic interactionism is that social actors continuously negotiate the social world and the everyday world is consequently produced by their collective strategies (Turner, 2004: 133; Waskul and Vannini, 2006: 3). This assumption connects experiences of personal troubles to institutional settings (Turner, 2004: 140), thus allowing a consideration of the micro and macro social contexts in which a group negotiates daily life (Roderick, 2006b: 5). While theory and concepts have always been important, symbolic interactionism is a perspective driven by an engagement with empirical work, often accompanied by the inclusion of an array of ideas - - for instance from Cultural Studies (Atkinson and Housely, 2003: 26; Thomas and Ahmed, 2004). Atkinson and Housley argue that the work of Norman Denzin, and his incorporation of aspects of Cultural Studies, is a source of revitalization for symbolic interactionism (2003: 31). This research on the lived experiences of professional dancers is thus part of Denzins call to renew interactionism by studying the lived cultures and lived experiences which are shaped by cultural meanings that circulate in everyday life (quoted in Atkinson and Housely, 2003: 32).

37 Waskul and Vannini explicitly link the symbolic interactionist tradition to the vast, and growing, work in the sociology of the body, claiming that the body is a vessel of meaning of utmost significance to both personhood and society (2006: 3). This section, following Waskul and Vannini, draws from numerous conceptual frameworks from the interactionist tradition, focusing on the ways that social theory and the body interact and overlap (2006: 4). More specifically, dramaturgical, phenomenological, and social world perspectives are explored below, describing both the theoretical and empirical works that draw upon these perspectives.

The Dramaturgical Perspective: Impression and Stigma Management The dramaturgical perspective, and specifically the work of Erving Goffman, emphasizes how the metaphors and ideas related to the stage and the theatre can be used to account for social behaviour in everyday life. The connection between the dance world and a dramaturgical perspective may seem rather obvious given the theatrical nature of dance work. However, it is a perspective that has not been systematically used to understand the experiences of dance workers and how they relate to their bodies. For Crossley, the metaphors of the stage remind us that we do not always wear our hearts and minds on our sleeves and that we often manipulate our corporeal expressivity to create certain impressions (1995: 146). Such a perspective understands the body as a performance, as something that is worked on, sculpted and negotiated. In other words, people actively do a body (Waskul and Vannini, 2006: 6).

38 Goffmans work The Presentation of Self in Everyday Life (1959) is concerned with the ways that individuals create and manage certain impressions of themselves in the presence of others, often with the aim of evoking a specific response. He is primarily interested in the techniques that persons employ to sustain such impressions and with some of the common contingencies associated with the employment of these techniques (1959: 15). One example of a specific performance is that of the ideal; the idealized presentation is one in which a performance is socialized, moulded, and modified to fit into the understandings and expectations of the society in which it is presented (1959: 34). Thus, the presentation of self that a professional dancer gives in the workplace is suited for such a workplace and is intended to give the proper and expected impressions associated with the dance world. Maintaining the idealized version of oneself often entails concealing and underplaying activities, facts, or motives that are incompatible with such a performance (1959: 48). Goffman is also clear on the fact that impressions are fragile and subject to disruption, a concept which he explores in his later work Stigma, as will be discussed below. Another useful concept from Presentation is that of the front-stage and backstage regions. The front region is the space where the performance is given and it is in this region that the individual maintains and embodies certain standards (1959: 107). On the other hand, the back region is the space where the performer can relax and step out of character, often contradicting the impressions fostered in the front region (1959: 112). For the purposes of this research, front and back regions can be understood in the literal theatrical sense, in terms of the dancers performing on-stage and interacting back-stage, and it can also be understood in terms of the front region performances given in class and

39 rehearsal before directors, choreographers and colleagues, and the back regions of nonwork settings or interactions between trusted individuals. In general, the concept of impression management is of utmost importance for understanding how social actors dramaturgically manage their interactions with others and present certain ideas of the self. As Goffman states, any social organization or establishment may be studied profitably from the point of view of impression management (1959: 238) and the world of dance is no exception. Additionally, Shilling draws our attention to the ways in which impression management is central to a corporeal presentation by arguing that the moulding of the body has become increasingly central to a self-image presentation in a world that is keen to diet and keep fit (2003: 81). In Stigma (1963), the concepts of impression management and presentation of self are developed further. Goffman understands stigma as an attribute that is deeply discrediting. However, an attribute that may be stigmatizing for one may be usual and normal for another (1963: 3). Shame and embarrassment, as well as self-hate and selfderogation can occur as a result of the individuals perceived possession of this defiling attribute. For Goffman, it is the discrepancy between an individuals virtual social identity, or the ways in which others perceive and categorize them, and the individuals actual social identity, or the real attributes and categories they possess, that spoils the social identity (1963: 19). In an attempt to correct such a failing, the stigmatized may engage in a quest, often indicating the extremes to which the stigmatized are willing to go to gain acceptance among normals (1963: 9). It is during interactions with these normals that the stigmatized will feel the need to be on and to be conscious about the impressions being made, or performances being given (1963: 14).

40 Goffman also makes an important distinction between the discredited, or those who assume that their stigma is immediately evident, and those who are discreditable, or those whose stigma is perhaps not readily perceivable. The visibility of a potentially stigmatizing attribute will affect whether an individual is already discredited or just potentially discreditable. For the discreditable in social interaction, it is not so much the managing of tensions that must be attended to, but the management of information about the self and ones stigma: To display or not to display; to tell or not to tell; to let on or not to let on; to lie or not to lie; and in each case, to whom, how, when, and where (Goffman, 1963: 42). Goffman labels this management and concealment of discrediting information passing. The stigma and this effort to conceal or remedy it becomes fixed as part of ones personal identity, or the identity pegs and unique life history of an individual. For Goffman, personal identity refers to the assumption that an individual can be recognized and differentiated from others based on a record of biographical and social facts (1963: 57). Personal identity is bound up in stigma management for the discreditable individual. A number of information control techniques are outlined in Stigma. One technique is to conceal signs associated with a stigma, and another is to present the stigma sign as a different, less significantly stigmatizing attribute. The discreditable person may also choose to conceal information from everyone save a small group from whom help is needed, and the maintenance of social distance in relationships helps to avoid the obligation to divulge information (1963: 92-100). A final technique mentioned by Goffman is that of voluntary exposure; changing the scenario from one of information management to one of situational management. For this person who chooses not to pass

41 and to instead divulge, or simply acknowledge an apparent stigma, the process of covering may be engaged in, relying upon similar techniques as outlined above. Covering reduces tension, and allows attention to be diverted from the stigma (1963: 102). In general, both social and personal identity are part of other peoples definitions and concerns regarding an individual. It is the felt identity that is an individuals subjective sense of their own situation and character (1963: 105); it relates to what an individual may feel about stigma and the management often required. Goffman argues that for the individual who applies identity standards to themselves and yet fails to conform to them, a sense of ambivalence towards the self can occur (1963: 106). Overall, Goffmans study of stigmas allows us to understand how maintaining certain impressions and identities can be disrupted and spoiled by discrediting information, often resulting in feelings of embarrassment, shame and uncertainty about the self. An important caveat to his work is that in reality individuals cannot be separated into concrete groups of the stigmatized and the normal; he views stigma as a two-role social process in which every individual participates, at least in some connection and in some phases of life (1963: 137). To give an example from the dance world, all dancers are potentially discreditable and will at times play the role of the spoiled and the accepted in occupational interactions. The concept of stigma management, as has been seen previously in this chapter, has been taken up by sociologists of sport and health (Allen-Collinson, 2007; Charlesworth, 2004; Nettleton, 2006; Roderick, 2006; Scambler, 2004) and yet it is a concept that has been relatively overlooked in the study of dancers.

42 The experience of emotions such as embarrassment, shame, and self-feelings as a result of social interactions is central to Goffmans work (Crossley, 2006; Scheff, 2005). As Scheff claims, it is the experience of such emotions that causes action such that it is managed through avoidance or denial if possible (2005: 159). Denzins approach to emotions and emotionality places the body at the centre and for him emotions are embodied, interactional experiences: they are embodied self-feelings which arise from emotional social acts persons direct to self or have directed toward them by others (1983: 404). Crossley also argues that the study of self-feelings can facilitate a deeper understanding of reflexive embodiment and how we are concerned with our bodies as objects of perception by others: we have a deep seated urge to be perceived in ways that we desire (2006: 27). It is this concern with emotions and how we think others perceive us that links the Goffmanesque tradition with that of Cooleys looking glass self (1902). The looking glass self includes three characteristics: the imagined image of how we appear to others, the judgements we imagine that they make, and the feelings about the self that are inspired by this imagined judgement (such as shame, for instance) (Charmaz and Rosenfeld, 2006: 36; Cooley, 1902). Scheff also links Goffman to the looking glass self, arguing that Goffman explores its consequences and develops the idea further, proposing impression management as a fourth characteristic (2005: 159). Clearly, the work of Goffman has been linked with, and taken up, in terms of how embodied actors reflect on their identities and self-feelings in interactions with others. Arthur Frank also sees the value of Goffmans work in relation to the body, and particularly, he extends some of Goffmans insights into an understanding of the body as a component of human agency and action (Frank, 1995; Shilling, 2003: 82). He proposes

43 four general problems of embodiment and out of these emerge four ideal typical bodies. The problem of control places the body on a continuum from predictability to contingency (1995: 30). Frank draws upon Goffman to show that loss of control can be stigmatizing and that special work is needed to manage this loss (1995: 31). The problem of body-relatedness places the body on a continuum from the associated, or being in touch with and at home with body, and dissociated, or feeling disconnected from corporeality (1995: 33). The problem of other-relatedness concerns the body as a monadic entity, one that is closed in and isolated, or a dyadic entity that is a basis for shared relations (1995: 35). Finally, the problem of desire organizes bodies into those that produce desires and those that lack desires (1995: 37). It is as bodies respond to these problems that ideal types of bodies emerge. The disciplined body experiences crisis in loss of control and it becomes a monadic it separate from the self (1995: 41). The disciplined body attempts to achieve predictability and control through treatment regimes. The mirroring body attempts to recreate itself in the image of other bodies and is thus associated, while the dominating body is dissociated from the self yet defined by force against others (1995: 46). Finally, the communicative body accepts its contingency as part of life and is dyadic in that it sees the reflection of its own suffering in the bodies of others (1995: 48). Frank is careful to point out that the body types he describes are ideal types and no body actually fits the specifications of one type for long (1995: 48). Stephens and Delamont (2006) use Franks body theory to account for the embodied, dramaturgical performances given by students and teachers of capoeira, the Brazilian martial art, focusing specifically on the disciplined body. They demonstrate how the dramaturgical influence of Goffman and Franks understanding of

44 the body can be effectively used together to analyze how those engaged in an intense physical activity, such as capoeira or professional dance, relate to their own corporeality and the corporeality of others. In general, a dramaturgical perspective can be productively applied to an interactionist understanding of the experiences of professional dancers.

The Phenomenological Perspective: Absence and Dys-Appearance Phenomenology is an additional theoretical perspective of use in an examination of the health and body-related experiences of professional dancers. This approach places importance on the everyday activities in which people engage and the meanings invested in such activities (Lupton, 2003: 84). For Waskul and Vannini (2006), phenomenology and symbolic interactionism complement one another. The phenomenological approach concerns thick descriptions of lived experience that reveal meaning in the life-worlds of individuals and groups. Meaning is embedded in our experiences within the world; meaning is not apart for either those embodied experiences or that world - - an approach evocative of classic interactionist arguments (Waskul and Vannini, 2006: 8). Hockey and Allen-Collinson maintain that the phenomenological understanding of the here and now presence of the body acknowledges the relationship between the body and self (2007: 116) and Monoghan similarly articulates that agents meaningfully engage in processes of re-interpreting and re-signifying the brute materiality of fleshy bodies (2006: 126). In general, a phenomenological approach allows for a detailed and rich understanding of the embodied meanings that dancers create and draw upon.

45 Specifically, the phenomenology of Drew Leder (1990) and the absent body provides a valuable tool for understanding the lived experiences of dancers. As shall be seen, his perspective is both in line and at odds with the experiences of dancers and is in many ways congruent with the above described dramaturgical perspective. For Leder the body is characterized by absence; it disappears from our understanding and consciousness as we focus on the task at hand. In other words, the body is rarely the thematic object of experience (1990: 1). It is part of our corporeal background and fades in the context of lived experiences (Shilling, 2003: 184) and it is only when the bodys normal functioning is disturbed that it comes to the foreground of awareness. Pain is one such disturbance that demands conscious attention: [Pain] places upon the sufferer what I will term an affective call. Ones attention is summoned by the gnawing, distasteful quality of pain in a way that it would not be by a more neutral stimulus (Leder, 1990: 73). This affective call is described by Leder as having the qualities of a compulsion, or something that is hard to resist (1990: 73). For Leder, pain can encourage self-reflection and isolation (1990: 75), a phenomenon that echos Franks description of the monadic body. To again connect Franks analysis of the body with Leders understanding of pain, the body can dissociate from the self and become an alien presence, an entity that is foreign (1990: 76). The body in pain is an it, an object of awareness that exerts a telic demand upon the self. Leder describes this demand as the need to be free from pain, and thus the sufferer embarks upon a quest to either rid the self of or master suffering, often through the reading of books, self diagnosis, and consultation with others including friends and family or medical help (1990: 78). This quest is reminiscent of those

46 described by Goffman (1963), in terms of the actions engaged in by stigmatized individuals to pass as normals. Leder terms the appearance of the body in times of pain dys-appearance, taking the prefix dys to mean a state that is bad, hard, or ill (1990: 84). Thus the body comes into awareness in times of dysfunction such as pain and illness. Dys-appearance may also be understood from the point of view of affectivity, or as embodied self-feelings. As Leder claims, anger can twist the body and depression can leave one limp, suggesting that emotions hold physical sway (1990: 84). Aside from the painful and emotional dysappearance of the body, it is important to recognize how the role of others may play a role. Leder understands the body as a profoundly social thing (1990: 92) which arises out of the corporeal experiences of others as well as their gaze directed back towards us. Thus, in a way that is evocative of Goffman, social dys-appearance can occur when there is a disruption to social interaction resulting in shame for instance. A specific example given by Leder is particularly of interest for this research - - the instance of discrepant power in the doctor-patient relationship can cause the individual with less power to be in a heightened state of self-awareness (1990: 98). Shilling highlights a failing of Leders work, stating that it tends to marginalize those people for whom the body is a regularly foregrounded and essential part of their identity, such as professional dancers (2003: 186). As discussed previously in this chapter, the body is the dancers essential instrument and tool and as such it is constantly being worked on in a highly conscious way. While Leder does allow that the experience of pain can be congruent with some life projects, such as in the case of athletes who prescribe to a no pain, no gain attitude, he is quick to assert that this is the exception

47 rather than the rule (1990: 77). Aalten (2005, 2007) and Tarr and Thomas (2011) claim that Leders theory fails in relation to dancers and that instead dancers must actively absence their bodies, to separate themselves from the daily pain of dance in order to achieve career goals. Shilling proposes that an alternative way to examine how the body can be a prominent part of awareness is to recognize the body as a project that must be worked upon (2003: 187). Regardless of its limitations, Leders theory of the absent body and dys-appearance, the places where it exists in conjunction with or is disconnected from empirical findings, and more generally the phenomenological perspective focused on meaning and lived experience, all provide useful theoretical tools for examining how body and self interact.

The Art World Perspective: Conventions and Collectivity Dramaturgically managed performances and phenomenological understandings of lived experiences occur within organized networks of activity. These networks can be called social worlds, or the collaborative activity that ties individuals into a set of relations that have meaning for them (Gilmore, 1990: 149). Gilmore argues that with their dual focus on structural and cultural elements, social worlds are a useful element of interactionist thought (1990: 150). Additionally, McCall and Becker recognize that worlds occur wherever a stable organization of collective activity is to be found (1990: 9). With its focus upon the routine, collective action that a particular group of individual engages in, the social world perspective bridges micro and macro levels of analysis, buttressing the criticism that symbolic interactionism is too focused upon micro

48 elements of society. This concept of the social world has been implied throughout this chapter, especially in the use of terms such as the dance world and the sport world. Not only is it a concept that is repeatedly used in the literature surrounding dance and sport, but it is also one that emerged out of the interview process with professional dancers, as will be discussed in more detail in Chapter 3. In general, the dancers understood that their lives and the activities engaged in on a daily basis were unique to them, and that only someone who has been a member of the dance world can truly understand. Howard Beckers (1982) specific work concerning the study of art worlds is of particular use for understanding the dance world6. For him, an art world represents the network of people whose collective activity, organized via shared knowledge of the common and accepted ways of doing things, produces the type of art work that the group is known for (1982: x). It is what Becker terms the conventions that organize this network and dictate the acceptable and expected action that is to take place. Sociologically, the concept of convention can be understood as being interchangeable with terms such as norm, rule, shared understanding, or custom and it is through this shared understanding that cooperative activity takes place (1982: 30). The conventions, or the occupational culture, of the art world is learned through training and the experience of the day-to-day activities of the world; thus only practicing professionals know this culture (1982: 59). While what artists learn in their initial training is still useful since it is based on the general conventions of the world, this training may not be as up-to-date as that of the professional culture (1982: 60).

49 Becker argues that conventions can constrain artists, using the example of photography to show that the conventions surrounding the judgement of a good photograph embody not only the aesthetic that is mostly accepted, but also the constraints built into the equipment and materials used (1982: 33). To extrapolate from this example to the world of dance, it could be said that the conventions of this world are both embodied in and constrained by the dancing body. Becker goes on to further state that when conventions are standardized and embodied in practice and equipment in a way that is taken for granted, a certain basic knowledge is expected: most modern dance, designed not to be like conventional ballet, ends up presupposing that recruits will have had some ballet training and have acquired the muscles, habits, and understandings that come with such training (1982: 57). In other words, it is often expected that even unconventional activity is to be described and understood in relation to the conventional language. Crossley explicitly links reflexive embodiment to the art world concept, giving examples from the worlds of tattooing, dieting and bodybuilding to demonstrate that presupposed norms, ideas and knowledge result in specific corporeal experiences that are coordinated by a specific division of labour (2006: 26). He also argues that all body projects must be negotiated within the context of social networks, and that resources, desires, power, and meaning come into play (2006: 27). The study of specific conventions is thus relevant to the study of the physical and daily experiences and interactions that occur in the dance world. While Becker takes a broad and general look at the conventions and organization of various art worlds, his work provides a valuable framework for thinking about how the

50 organization of the dance world impacts the interactions, relations, and understandings that take place. In summary, the dramaturgical perspective concerning the presentation of self and stigma management, the phenomenological perspective focused upon the lived body and how it can recede and intrude upon awareness, and a general social/art world perspective outlining the importance of conventions and collective action, are all useful interactionist frameworks that when taken together allow for a unique understanding of the corporeal lives of professional dancers.

CONCLUSION Sociological understandings of the health and body-related experiences which occur in specific social worlds, and the consequences that these experiences can have for those in a body-centred trade in terms physicality and the self, have been explored above. The literature related to dance, sport, health and illness, work, and theories and concepts from embodied symbolic interactionism, inform and are informed by one another. Thus a consideration of all of these related works has been used to formulate an understanding of how the dancers in this study relate to their bodies and their careers. A number of important, and sometimes overlapping, themes from this literature, such as the management and rationalizations of pain and injury in cultures of risk, and how this management is influenced by sportsnets and occupational cultures, how injury can affect identities and emotional experiences, how the body is understood in terms of image and shape, and how the doctor-patient relationship is negotiated, will all be revisited in

51 Chapter 4 within the frameworks of dramaturgy, phenomenology and an art world perspective. Given that the interactionist tradition inspires the use of certain approaches to acquire empirical data, a discussion of the methodological approach used in this research will be explored next in Chapter 3.

NOTES 1. In the original definition in the 1996 report, a psychological component was included. In the 2005 report the psychological component was removed from the definition of injury and dealt with in separate survey questions. 2. A great deal of anthropological and sociological work attends to the gender relations at work in the world of dance, and how male and female dancers do gender in relation to their careers (Aalten, 2004; Adair, 1992; Adams, 2005; Fisher, 2009; Hanna, 1988; Novack, 1993). 3. An issue often talked about in relation to authoritarian power structures in the world of dance is the infantilization of dancers. Dancers are often referred to as obedient, dependent, unquestioning, and vulnerable children with ballet masters, choreographers, and teachers as the parent figure in the relationship (Forte, 2010; Kirkland and Lawrence, 1986; Langsdorff, 2006). 4. Rudi Volti, in his sociological inquiry into work, contends that isolated, inclusive occupational cultures can often result in an us and them mentality, setting workers in such cultures apart from the rest of the social realm (2012: 142). 5. Malcolm (2009) uses the term sport clinicians to encompass sports medicine doctors, physiotherapists, athletic trainers, and others who treat athletes. 6. Becker asserts that an art world analysis should include an examination of the production, distribution, and consumption of the art work. The current study primarily deals with the production aspect of the dance world.

52

CHAPTER 3: RESEARCH DESIGN AND METHODOLOGICAL EXPERIENCES

53 RESEARCH DESIGN In order to explore how the health of professional dancers was understood and negotiated in relation to the dance and the medical world, this research employed a symbolic interactionist perspective, focusing on the subjective understandings and the perceptions of and about people, symbols, and objects of interest (Berg, 2009: 9). This chapter details the research strategy employed in this project to reveal the injury, pain, body and health-related understandings and perceptions of dancers and the health professionals who treat them in the dance world. Given that the primary sources used to inform, guide and structure this research were qualitative in nature (Aalten, 2004, 2005, 2007; Pike, 2004; Pike and Maguire, 2003; Roderick, 2006a, 2006b; Tarr and Thomas, 2011; Wainwright and Turner, 2004a, 2004b, 2006), this project followed suit and aimed to produce data that are socially relevant for both the sociological and dance communities. Interviews were the primary form of data. However, in an effort to explore the issue of dancers and their health from multiple lines of action and increase the validity of my findings (Berg, 2009: 6), a brief analysis of additional data1 as well as insider knowledge of the dance community was utilized, thus making this research somewhat multimethod in focus (Denzin and Lincoln, 1994: 2). Before delving into the specifics regarding the research design, it is first important to recognize my role in the interactive research process, in terms of my personal history and experience and how this necessitates the need for reflexivity (Berg, 2009: 198; Denzin and Lincoln, 1994: 3). As an individual who has had over 20 years of experience in the dance community as a student, performer, and currently as a teacher, I have inevitably brought certain presuppositions, experiences, and interpretations to the

54 research. In his study of professional footballers, Roderick draws attention to how his insider status may have affected the research process in multiple ways, especially in terms of the types of questions asked in interviews, his reactions to athletes responses, and the patterns he expected to identify, to name a few (2006b: 8). Methodologically, and following Roderick, I acknowledge that I am not a neutral, objective interpreter but a social actor in the research process. Many dance scholars (such as Aalten, Novack, Wulff, etc) who write about the dance world were previous participants at various levels and now make use of their life experiences in their work (Wulff, 1998: 5). Helena Wulffs experience seems to closely mirror my own; she started dancing as a young child and stopped in her youth. Returning to the dance culture as an ex-native, she was familiar with many of the phenomena she observed and yet recognized her limitations: There were aspects of the ballet world that I had been ignorant of when I was still dancing. This can be explained partly by the fact that I never was a professional dancer, and that I was quite young when I left (1998: 6). Therefore, while my insider status in this community was accompanied by certain advantages (as will be explored in more detail later), I must reflectively recognize how my own interpretations colour the research and also that my status did not make this research any more simple or easy. As an illustration, the questions asked during interviews were influenced by my own experiences with dance-related pain and injury as a young dancer. It was expected that issues of income and salary would factor into the daily lives of professional dancers, but given that I never had to derive my sole income from dancing, the importance of this issue was underestimated on my part. As will be

55 explored in more detail in Chapter 4, dancers consistently spoke of their money struggles and how this influenced their decision-making processes.

In-Depth Interviews In-depth interviews were the primary source of data for this exploration of how dancers understood their health in relation to the dance and health communities. The data produced in the interviews can be understood as constructions of experiences, thoughts and feelings rather than an excavation of literal facts or truth (Mason, 2002: 64). This construction is not dependent on the participant alone; specifically, these interviews can be understood as dramaturgical encounters, a perspective which recognizes the symbolic action that passes between interviewer and interviewee as one of social performance or co-created performance (Berg, 2009: 103). As Silverman notes, interviewers do not attempt to monopolize the conversation, [yet] neither do they fade into the background (2006: 112). Berg (2009: 135-136) suggests that the interviewer must play several roles simultaneously. As an actor, the interviewer must be prepared to perform lines, in terms of asking and responding to questions, and to listen to cues of the co-performer; as a director, the interviewer must reflect on her own performance during the interview encounter as well as that of the interviewee; and finally, as the choreographer, she will manage the interview process by blocking out, or arranging, movements and responses. According to Berg, to take on all of these roles entails that the interview becomes a selfconscious social performance (2009: 136). In order to successfully act out interviews

56 in this way, I ensured that I was well versed and practised in my roles and my lines, which required a great deal of pretesting, rehearsal and evaluation during the process. A total of 16 individuals were interviewed for this research. The majority of these participants were current and former professional dancers, and three of the individuals interviewed were health care professionals with experience medically treating dancers. A more in-depth discussion of the sample is located below. A question guide, informed by literature in the area as well as my own research questions and aims, was used for each group of interviewees. A copy of this guide can be found in Appendix A. The interviews themselves were semi-standardized, conversational in nature, and open-ended. While the dancers and health care professionals were asked similar questions so as to allow for comparisons between these groups, participants were also asked varied questions such that situated and context-specific knowledge was generated and constructed in all of the interviews (Mason, 2002: 65). Dancers were asked a wide array of questions ranging in type from essential questions, extra questions, and probing-questions, to throw away questions (Berg, 2009: 112). For instance, they were asked: to answer basic demographic questions, to describe their career developments and highlights, to give a history of their health-related experiences, including pain, injuries, and body management issues, and finally, to describe or recall how these health experiences were influenced by peers, coaches and choreographers, and health care professionals. They were asked to recall specific instances or interactions that took place between themselves and professionals administering their treatment. The health care professionals were asked to talk about their affiliations with dancers or dance companies, the types of treatment that they

57 typically perform, and the negotiations and relations that take place between themselves, the dancers, and administrative staff or coaches. In general, and following Roderick, all participants were encouraged to speak about the drama of the work that they do on a daily basis such that a clear comprehension of the [dancers or health care professionals] meanings and interpretations of events could be obtained (2006: 81). Additionally, all participants were encouraged to speak in their own terms and categories (Young et al., 1994: 180). The interviews took place during the fall and winter months of 2011/2012 and lasted between approximately 30 and 90 minutes in length. All of the interviews were tape recorded, with the permission of the participant, and transcribed in full.

Recruitment In terms of the core participants in this research - - the dancers - - I sought out professionals who were either employees of dance companies or independent artists working full time. While many of the previously cited studies of dancers focus specifically on ballet, I was in search of professionals working in various dance disciplines. Following Gard (2006: 6) and Thomas and Tarr (2009: 52), I sought performers in theatrical dance which includes Western styles such as classical ballet, contemporary, and jazz dance which are performed for audiences. As Gard explains, this is a term which is recognizable by dancers and scholars and it is consistently used in dance scholarship (2006: 6; Thomas, 1995). This term tends to exclude forms of social

58 and participation dance. Admittedly, theatrical styles of dance are those that I have the most experience in and thus my knowledge of these communities aided in recruitment. A purposive sampling technique was initially utilized in order to recruit individuals based on their membership in the dance or health communities, and their experiences and expertise (Rubin and Rubin, 2005). In terms of the dancers, I sought out those professionals who had not only experienced varied career trajectories (Roderick, 2006: 7), but those who had experienced serious, or career threatening, health issues, based on the argument that those who experience the phenomenon of interest in concentrated form reflect processes of interest more obviously (Palys and Atchison, 2008: 125). From there, a snowball technique, relying on connections with key members of the dance community, was utilized in order to access additional dancers. In their study of rugby players, Malcolm and Sheard argue that when researching into elite sport, [purposive] and snowball methods [are] often the main basis of selection (2002: 152). While participant observation is a possible research method that may have been used in addition to interviewing to augment the findings of this research, it was felt that due to its time-consuming nature, the often closed structure of the dance community, and additionally the hidden, taboo nature of the issues of interest, interviews were the most appropriate way to explore the health-related experiences of members of this working community. In terms of health care professionals, a similar strategy was employed and only those with extensive experience treating dancers were sought out. A purposive sample based on personal contacts with a number of these professionals was utilized here, in addition to a snowball technique whereby recommendations of other participants came

59 from health care professionals, or from the dancers. This group of participants was rather small given the highly specialized nature of treatment for the dance community, as will be discussed in more detail in Chapter 4. As Palys and Atchison point out, the danger with using a snowball sample is that ones first snowball may well influence the shape of the snow figure that results (2008: 126). In other words, participants may recommend others with whom they share similarities, and thus a more homogeneous sample may be created. In an effort to create a more heterogeneous or varied sample, I utilized different points of access, or started different snowballs. As a result, I believe that the rich and detailed data collected from this sample is valuable sociologically in terms of wider discourses in dance, sport and health, in addition to the information it can provide to the dance community in terms of improving the health and care of dancers.

The Dance World Participants A total of 16 individuals were interviewed including 14 current and former professional dancers and three clinicians who specialize in the treatment of dancers (one clinician identified herself as both a dancer and a health care professional). It is important to note that the health care professionals interviews were used to augment the findings related to dancers and the interactions that occurred between dance workers and those who treat them. The dancers themselves represented a rather varied group in terms of dance style and work status; four participants danced with ballet companies, one having recently retired, three were jazz company dancers, two of whom were also retired, and

60 seven were independent dancers, with two having started their own small companies, two working for a part-time contemporary company, and one who performed and had a chiropractic practice. In general, all of the participants were experienced members of the dance community who started training as young children. The majority of dancers had trained extensively in ballet, jazz and contemporary or modern styles of dance, and some had also trained in tap, musical theatre, and hip hop. In addition, many dancers had trained in a number of cultural, folk, or specialized dance forms including West African, Cuban, Flamenco, Classical Indian, Bollywood, Ukrainian, swing dance and aerial acrobatics. This vast array of training speaks to the fact that todays dance worker must be a hybrid dancer and ready to pick up and perform whatever is asked of them. Furthermore, nine out of the 14 dancers had some variety of formal anatomy training, including yoga and Pilates certifications, a recently graduated physiotherapist, a nonpractising massage and Active Release therapist, and a chiropractor. Of the health care professionals interviewed, participants were employed as a physiotherapist, and podiatrist, in addition to the individual who described herself as both a working dancer and a chiropractor. The average age of dance participants was 29 with a range from 21 to 51 years of age. Thus a wide range of career trajectories was captured, including those just beginning their careers and those who had moved on to second careers. As will be seen in more detail in Chapter 4, ageing can lead to differing perspectives when it comes to understandings of health and the body. Of the dancers interviewed only two were male. However, this gender distribution is reflective of the distribution that exists in the femaledominated dance world in general (T. J. Cheney Research, 2004). Just as Roderick

61 (2006b) found in his study of professional footballers, the dancers interviewed represented a rather homogeneous group in terms of race and ethnicity and thus these issues could not be sufficiently attended to. Finally, while issues related to money and income were a major theme among the dancers, especially those independent artists who struggled to find enough work, these dance workers came from relatively privileged backgrounds and families, especially given the amount of economic capital needed to achieve the appropriate level of training required2.

DATA ANALYSIS The main source of data for this study - - the interviews with professional dancers and a limited number of health care professionals - - were tape recorded and immediately transcribed in full. In addition to transcription, brief field notes were recorded. These notes were taken both during and after the interview and included any details, ideas, themes or impressions that were apparent. The looks, body postures, long silences, the way one dresses all are significant in the interactional interview situation (Frey and Fontana, 1994: 371). Following Atkinson, these field notes were also transcribed and stored electronically, and were filled in considerably (2008: 74) as the text was analyzed for themes and comparisons. As Berg contends, qualitative analysis does not begin when all of the data have been collected; it is an ongoing process as categories and codes begin to emerge (2009: 356). Each piece of data, whether an interview, or an autobiography or media article, was open-coded holistically and then open-coded separately and comparatively around

62 emergent themes (Atkinson, 2008: 74). While my approach to the coding process is somewhat deductive, given both my previous research experience in the area of dance and pain as well as patterns that have been identified by other scholars (Aalten, 2007; McEwen, 2009; McEwen and Young, 2011; Wainwright and Turner, 2006; Wulff, 1998, etc.), a number of the categories emerged more inductively. By way of illustration, it was expected, as was found in the above-cited works, that instances of pain and injury may incite a flurry of self-feelings, such as fear, depression and frustration and thus these emotion categories were deductively derived. However, a number of concepts and categories emerged from the data. For instance, as mentioned in Chapter 2, the concept of the dance world was one that the dancers consistently used to talk about their unique experiences. As a result, I chose to conceptualize of the dance community as an art world and to focus on its associated conventions and understandings (Becker, 1982). During the analysis process it was important to analyze the data literally, interpretively, and reflexively in such a way that goes beyond the language and dialogue used, to include how my role impacts the process of interpretation (Mason, 2002: 149). For instance, it cannot be assumed that a particular meaning is intrinsic in the text since the reading depends on the social position of the decoder (White and Gillett, 1994: 22). Additionally, in terms of interpretation, Roderick raises the issue of impression management in that an interviewee may respond in a manner in which they present their self in more credible ways (2006: 10). Similarly, Wulff cautions that in the dance world impression management may be second nature: I was aware that I had to be extra careful in this setting, where people were trained to act (1998: 12). My interpretations of the phenomena of interest then cannot be separated from the social interaction in

63 which it took place. In general, I was conscious of being thorough, careful, honest, and accurate throughout the data analysis portion of the research process.

ETHICAL IMPLICATIONS This research was granted ethics approval by the University of Calgary Conjoint Faculties Research Ethics Board. In keeping with ethical standards, I avoided scenarios that placed participants in harms way, physically or emotionally (Berg, 2009: 60). That said, this was a minimum risk study. Interview participants were required to read and sign informed consent slips so as to ensure that this participation was an exercise of their choice, free from any element of fraud, deceit, duress, or similar unfair inducements or manipulation (Berg, 2009: 87). This informed consent slip describes the purpose of the study - - in this case to explore how health is negotiated within the dance and health communities, information related to their participation and protections, and any pertinent contact information ( a copy of the informed consent slip can be found in Appendix B). Interviewees were advised that they did not have to answer any questions that they do not wish to and that they may withdraw at any time. However, any data collected up until that point could be used in the study unless otherwise specified by the interviewee. Informed consent slips will be stored in a secure location for three years. At all points during the research process the confidentiality of the participants has been protected. Participants were informed that any identifying information, such as the names of people or organizations, would be replaced by pseudonyms in this written dissertation. Additional identifying information or details have been omitted as well.

64 The interviewees were given the option of choosing their own pseudonym or having one assigned to them. Roderick speaks of a residual fear for athletes that they may be viewed either as openly criticizing their teammates or team management or identified, more simply, as complainers (2006: 7). Professional dancers presumably have a similar fear in terms of their colleagues and organizations. The researcher must consider what happens as a direct result of the research (Berg, 2009: 94) and identification in these scenarios could potentially negatively impact career trajectories. Thus an assurance of confidentiality put participants at ease and provoked more unguarded responses to questions. My supervisor and I are the only individuals that have access to the interview notes and transcripts. These transcripts will be archived indefinitely and stored anonymously on the chance that they may be important for future studies.

METHODOLOGICAL EXPERIENCES A number of experiences and issues emerged as the interview process began and progressed. For instance, and as was found in my previous research in the dance community (McEwen, 2009; McEwen and Young, 2011), it can be challenging to interview dancers during their performance season. Not only are they difficult to make contact with, but confirming a time and place to conduct an interview proved at times near impossible. Company artists had very full, hectic schedules which often included long periods of travel, and independent artists frequently had to work secondary jobs, leaving very little free time. Often it was those I was personally acquainted with, or who had heard about the project from friends, who made the time and agreed to meet for an

65 interview. Locations for interviews were selected by the interviewees and included places such as the participants home, place of work, or a public space. For a number of individuals, it was only possible to conduct a telephone interview. Two interviews took place over Skype, an online form of audio/video communication, for individuals who were overseas at the time. These video chats felt more personal in nature; however, it was often hard to gauge peoples responses and body language in these interviews, making them slightly more challenging to navigate and make sense of. In order to accomplish these co-created interviews, a certain amount of rapport needed to be built and maintained (Berg, 2009: 130). When it came to building rapport with the dancers especially, I believe that sharing the knowledge of my insider status proved to be helpful. Wulff emphasised how her ex-native status in the ballet world was something that won her the respect and trust of the dancers she wished to study: having grown up in the ballet world I possess the kind of social capital that structures the idiom in the theatre, both frontstage and backstage (1998: 5). Similarly, in his study of professional footballers, and as an ex-footballer himself, Roderick found that the sharing of his insider status with players was not only important for rapport building, but that this information also lent greater legitimacy to his interview questions (2006: 8). Those unacquainted with me were told a short story of my personal dance history, my own experience with injury, and my current academic interest in the dance world. Like Aalten, I found that dancers gave a presentation of self that was usually less polished and more multidimensional than the published autobiographies (2005: 59). In terms of my own presentation of self, I made every effort to convey a sense of informality and familiarity. My dress was casual, yet professional in nature and the interview usually

66 began with greetings and small-talk. I made every effort to be clear that although I had questions in mind, the interviewee was free to bring up any desired topic of interest. The notion of rapport in interview settings is linked with Luffs (1999) work related to fractured subjectivities. In her study that takes a feminist perspective on antifeminist participants, Luff describes moments of rapport in her interviews. It was in these moments that the subjectivity of the participant may have come into conflict with the researchers own assumptions or expectations and in these situations it may be difficult to resist judgement when trying to build rapport. Additionally, the researchers own personal subjectivities, or perspectives, feelings, aesthetic beliefs and desires (Uhlmann, 2004: 80), can be fractured in moments of rapport. For example, as a dancer I often identified with an interviewees willingness to sacrifice the body for ones art, and yet as a researcher I felt perhaps critical of such behaviour. Overall, the notion of fractured subjectivities highlights the importance of being reflexive and open-minded as a researcher. Especially as an insider, I recognized that during the interviews I would have to be careful not to let my own subjectivities and assumptions affect how I reacted to the stories being told. Luff argues that it is helpful to think in terms of moments of rapport [or moments of disjuncture] within the interview context, and to explore these moments as potentially rich sources of insight (1999: 701). In general, being an insider was advantageous in other ways beyond rapport building. I consistently found that interviewees anticipated questions I was going to ask or issues that were to be discussed at a later time. For instance, dancers spoke of perfectionist attitudes, ignoring pain and injury, how ageing and maturing had changed personal relations to the body, frustrations associated with medical treatment, concerns

67 about body image and shape, and how financial situations affect health-related experiences, before I was able to specifically ask about them. This adds a certain amount of validity to the types of questions asked. However, being an insider was sometimes a disadvantage: interviewees would glaze over topics or perhaps not explain things in the same amount of detail as they would for an outsider. Phrases such as oh you know how it is, you are dancer were common. It took extra probing to reveal what the dancer had assumed was a shared meaning between us. Overall, interviewees were incredibly well spoken, and gave thoughtful, seemingly honest, answers to questions. This may be somewhat surprising given that dance is an art form where voice is primarily silenced. I was given the impression that many enjoyed speaking about their experiences, and was told on multiple occasions how important such research is in order to improve the dance community.

CONCLUSION In sum, in-depth interviews were the primary source of data collection in the exploration of how the health and wellness of professional dancers is understood and negotiated within the dance community and the related health care community. Interviews with dancers and health care professionals were interpretively coded and analyzed. It is the hope that the findings will result in a thick description of the professional dance community and how the issue of health is taken up in varying ways by different social actors in diverse contexts (Geertz, 2003). The following chapter returns to

68 the themes and patterns identified in the literature from Chapter 2 to explore the embodied understandings of dance work for this specific group of dancers.

NOTES 1. In addition to interviews, a number of supplemental forms of data were collected. These included autobiographies from North American dancers Gelsey Kirkland and Karen Kain given that the use of ethnographic and biographical materials complement each other well (Aalten, 2007: 113). The number of autobiographies used was limited given that often issues related to physicality are downplayed in these accounts. Additionally, given that the media play an important role in defining and shaping social problems (Young, 1986: 255), an analysis of how the media frame and disseminate information about dancers health has proven to be valuable. As mentioned in Chapter 1, a number of films over the last 2 decades, such as Center Stage, Billy Elliot, Black Swan, Maos Last Dancer, and reality television programs such as So You Think You Can Dance and Dance Moms all highlight aspects of the world of dance. Also, news and magazine articles, ranging from local, national and international sources, were drawn upon. These articles were selected also over the last 2 decades and were chosen based on themes of interest, such as eating disorders, injuries, wages, and comparisons of athletes with dancers. It should be made clear that these additional sources of data were used as background information and aided in the formulation of ideas in the early stages of this research project. They helped to confirm and disconfirm some early ideas and themes related to the dance community. 2. Wainwright and Turner (2006: 249) claim that while in the nineteenth century ballet was a working-class career, today it is a middle-class activity. While they speak specifically of ballet careers, their assertion may logically be applied to those involved in other dance careers given the expense associated with training.

69

CHAPTER 4: UNDERSTANDINGS OF THE BODY AND HEALTH IN THE OCCUPATIONAL CULTURE OF DANCE

70 INTRODUCTION This chapter explores the findings of this project and how the professional dancers and clinicians interviewed attributed symbolic meaning to their body, pain, and injuryrelated experiences in the context of their careers. The existing literature from the worlds of dance, sport, health and illness, and work reviewed in Chapter 2 are woven together within the frameworks of dramaturgy, phenomenology, and the art world perspective to paint a picture of how dancers understand and experience their bodies in a dancing workplace. Firstly, dance as an occupational lifestyle is considered, and secondly the numerous understandings of pain, injury and health are explored in relation to the desire to present ideal and appropriate versions of the self in the workplace. These understandings centred around the managing of impressions on a daily basis, and how pressures in the context of work organization and culture, including how cultures of risk and the expectations of members of the dance community influenced decisions to pass, or hide pain and injury. Additionally, the issues of stigma, and the stigmatization of others, how injury impacts embodied identities, how physical appearance as a component of self presentation is managed, and the utility of Leders work are explored. Thirdly, the quest for healing is addressed, focusing upon the occupational health care of professional dancers and the issues that arise in the dancer-clinician relationship. Finally, the issue of improving the health of dancers is attended to. While a number of common themes and patterns of behaviour emerged, often the experiences and understandings of dancers varied by dance style, status as a company dancer or independent dancer, and age. In general, there were many moments of

71 contradiction where the accounts of some challenged the accounts of others, and even moments where dancers contradicted themselves, suggesting that these understandings of the working body are contingent and fluid.

ITS A GRUELLING LIFESTYLE Although interviews were primarily focused upon the body and health-related experiences of the dancers, many comments were made in general about the occupational lifestyle of dance workers, especially the fact that it is particularly gruelling. For Carmen, a young independent contemporary dancer, as a dancer you are guaranteed three things; you are guaranteed to be poor, you are guaranteed to be tired, and you are guaranteed to be sore. This statement echoes the concerns of other dancers who complained of the long hours for little pay and the resulting physical and emotional exhaustion that is the product of daily class, rehearsal and performing schedules. For Jaclyn one of the most draining aspects of the job is that you are always judging yourself, never feeling satisfied with your abilities, and retired dancer Heather explained how her workaholic tendencies and the daily grind are not aspects of dancing that she misses. In fact both Jaclyn and Heather went so far as to state that (as women) they would never wish such demanding, consuming careers upon their daughters. In general, dancers employed with companies spoke of the rigidity of their lives, and the feeling of being a tool or a cog in the company machine, whereas independent dancers spoke of the uncertainty in their lives, of trying to work other jobs while still finding the time to commit to their dancing careers. Half of the dancers spoke of their parallel teaching

72 careers which, for some, was a really enjoyable aspect of their work. Valerie and Jaclyn loved teaching and nurturing the next generation of dancers, and Talia and Amelia both expressed their love and passion for teaching. However, for others teaching was simply a means to an end: I love to teach as well, but it was really about the money (Heather). In a manner reminiscent of Beckers art world (1982), teacher and contemporary dancer Amelia argued that dance is a unique world and once you are in that world it can be either great or it can be really dangerous especially in terms of physical and mental health. Consistent with Mazos assertion that a demanding lifestyle can allow insiders to feel like they are chosen (1974: 103), many dancers in this study adopted an us versus them mentality to describe how what they do is very different from the work of the average Joe. Numerous dancers drew upon the phrase love/hate relationship to describe how they felt about their careers. For instance, Heather commented: I always say I wouldnt wish it on anybody, but when you are living it its the best thing ever, demonstrating how the occupational culture of dance is at once rewarding and exciting, and rife with struggle and hardship, as will be explored below in relation to body experiences.

UNDERSTADINGS OF PAIN, INJURY, AND HEALTH When asked to discuss instances of pain and injury in relation to their careers, dancers responded with an extensive list of complaints, including bruised toenails, blisters, chronic pain in the back, neck, hips, wrists and feet, sprains and tears, especially in the hamstring region, strained and torn hip flexors, Achilles tendonitis and tendonitis

73 in other regions, arthritis, bursitis, rotator cuff issues, a labrum tear, multiple instances of torn meniscuses, patella femoral syndrome, anterior snapping hip syndrome, a cracked tailbone, broken ankle, fractured foot, and a stress-fractured spine. One participant also suffered a serious case of Chronic Fatigue Syndrome as a result of her dancing career. In general this sample represents a group of workers that consistently placed their bodies at risk in pursuit of career goals. Primary causes of pain and injury in a dancing career were considered to be overuse from repetitive movements and long, strenuous periods of activity, poor execution of dance technique, which may or may not be influenced by level of fatigue, and trauma which in many cases included accidents involving partnering and stage equipment. Ballet dancer Isabel spoke of the sound of the baby rattle, or the shaking of the bottle of anti-inflammatory pills, in the morning that could be heard before class began, and both Heather and Jared could not think of a joint that was pain free, or a time when they felt one hundred percent healthy. However as Sierra put it: we are trained to deal with pain everyday of our lives since it is an inevitable, constant presence for the working dancer. In addition to being asked to speak about their experiences with pain and injury, dancers were asked to discuss other factors that may affect their overall health and wellbeing in relation to their careers. For instance, good nutrition and sleeping habits were mentioned by numerous dancers as important parts of a healthy lifestyle in order to maintain a certain level of performance. However, both were sometimes elusive; independent dancers maintained that eating a consistently appropriate diet was challenging on their budgets and, in addition, getting enough sleep could be difficult to obtain when working odd hours and multiple jobs. Physical working conditions were also

74 considered important for both company and independent dancers, especially in terms of appropriate flooring so as to avoid shin splints and foot problems, and suitable temperatures and ventilation in working spaces. However, according to independent dancer Nina, these factors were less important since obtaining affordable rehearsal space at all could be difficult - - she noted that she would be happy to get any space. A final issue related to health and general working conditions that as a researcher I expected to be prominent was the issue of overtraining. However the topic rarely came up spontaneously in interviews and, when asked about it, dancers had more varied and ambiguous responses than I expected. Many did not think that overtraining was even an issue in the dance world at all, and Carmen described how overtraining in her region was almost impossible to achieve given the limited training and performance opportunities available. While Kai did recognize that overtraining could be somewhat hazardous, it was a difficult issue to negotiate for her since you can lose things in terms of strength, muscle memory and dance technique if you do not train a certain amount per week. For her, constant (over)training was necessary to maintain a properly functioning dance body. Typically, dancers began by describing a few injuries in their own terms, and as the interviews progressed, more emerged as they started to reflect upon their experiences, demonstrating how pain and injury can be normalized and marginalized in the dance world. In the world of sport, as was explored in Chapter 2, this normalization of injury is bound up in the notion of a culture of risk (Donnelly, 2004; Nixon, 1992, 2004; Roderick et al., 2000; Safai, 2003) and it could be said that dancers similarly adhere to a dance occupational culture of risk, as is evidenced by the use of theatrical argot such as the show must go on. As a result of this normalization, a frequent response to an

75 instance of pain or injury was to deny, ignore, hide, or push through it as will be discussed in more detail below.

Presenting the Ideal Self Professional dancers are constantly presenting their bodies and their selves in ways that are deemed appropriate in the world of dance (Goffman, 1959). They must manage the impressions given in the workplace so as to signal to those in the dancenets (Nixon, 1992) (for instance artistic directors and choreographers, co-workers and peers, and audience members) that they are competent and successful career-focused individuals. The term dancenets has been adapted from Nixons (1992, 1993, 1994, 1996, 2004) concept of the sportsnet and is used here to describe the social networks which influences dancers choices and decisions, often reinforcing conventions associated with a culture of risk. The ideal presentation of self in the dance world is bound up in numerous impressions, one of the most basic being that the dancer is willing and able to do what is required on the job: You are here as a tool. Its an emotionally exhausting job, so thats what you get into. But what choreographer in the world holds your hand and says are you ok? Walk in this room and be ready to move the way they want you to move, even if your dog just died this morning. Its the nature of things (Jaclyn). While Jaclyns comments were directed specifically towards working in a dance company setting under the direction of a choreographer, they indicate that it is the nature of things in the dance world to demonstrate commitment and dedication on a daily basis to those in the dancenets, despite whatever else may be going on in an individuals life.

76 This display of commitment is reminiscent of the good attitude required of footballers which often encouraged them to play hurt (Roderick et al., 2000: 169). For Jaclyn, this convention of displaying commitment, while encouraged during training, is expected and required of the working, professional dancer (Becker, 1982: 59). The expectation to demonstrate commitment, passion and work ethic was a common theme among the dancers. As ballet dancer Sierra explained it, morning class was optional. However, dancers would be judged if they were not in class, and others would take note of who was slacking off. Another common convention described by dancers relates to the notion of constantly seeking improvement - - a norm that goes hand-in-hand with perfectionist attitudes and the idea of being addicted to dance, as has been found with elite athletes (Charlesworth and Young, 2004; Hughes and Coakley, 1991; Jones et al., 2005; Nixon, 1993; Pike and Maguire, 2003). Dancers frequently spoke of being people pleasers, high achievers and driven, Type A personalities, and while it is difficult to say whether the world of dance attracts a certain type of person, or simply encourages the internalization of such qualities, it is clear that adherence to conventions surrounding the pursuit of perfection and overcoming limitations are rewarded in terms of achieving career goals and milestones. As has been found in the world of sport, subcultural rewards encourage adherence to a culture of risk in which the sacrifice of the health and safety of the body is valorized (Donnelly, 2004; Nixon, 1993; Sabo, 2004; Young, 1991). The ability to demonstrate that one is a hard-working, dedicated dancer hinges upon being physically able-bodied. Thus in order to maintain an appropriate presentation of self in the workplace the dancer might push physical boundaries:

77 I guess there is probably some expectation out there in the dance world that if you have just pain, that is not a traumatic injury, that you kind of dance through it unfortunately. Which is really sad I think, but also I guess kind of part of life and if you are dancing professionally that is what your life is and your job is and you have that pressure (Talia). Injury can threaten to discredit the ideal presentation of the dancer and could thus be considered a potentially stigmatizing state (Goffman, 1963). Paradoxically, professional dancers were at once embodied and disembodied, living and working in damaged bodies, focused upon refining the precise firing of muscles and coordination of movements, and yet they suppressed their physicality in the hopes of maintaining appearances and impressions of competence.

Managing Impressions and Stigma: Presenting the Damaged Self

Passing in the Workplace In the world of dance, to admit to an injury is to admit to being a damaged, unreliable, un-able body. Pain and injury can threaten and discredit the dancers presentation of self and, given the physical risk of acute and chronic injury in the world of dance (Laws, 2005), it could be said that all dancers are potentially discreditable (Goffman, 1963). It is those who dancers interact with, such as their teachers, artistic directors, choreographers, colleagues, and medical team staff, who determine the extent to which they may be stigmatized and, as Sierra simply stated, you are judged for being

78 injured. Brant further articulated that the need to manage this discreditability may be just as much for the benefit of the self as for others: There is that inherent want of people who have an emotional investiture in something they believe in, they dont wanna just throw up their hands and walk away from it. Its an admission of defeat for a lot of dancers that they are injured. Its an admission that they are fallible, right. And you know, its hard to admit even to yourself that you are not perfect. The severity, visibility and manageability of an injury determined how this potentially discrediting information would be managed in day-to-day interactions with those in the dancenets. Since, for Goffman, maintaining the idealized version of oneself often entails concealing and underplaying activities, facts, or motives that are incompatible with such a performance (1959: 48), the professional dancers in this study often chose to conceal or downplay instances of pain and injury so as to maintain an appropriate presentation of self: I kind of push through sometimes, and its not really good (Valerie). Injury ... has never stopped me. Its frustrating at times and painful, but I am never ok to say well this is how I am. There has got to be another way (Jaclyn). I would put things off as long as possible because I didnt even want to admit that there was a problem (Madeline). You know you shouldnt work through injuries, but you just find ways to make it work - - you take Advil (Nina).

While the above excerpts indicate that, to a certain extent, dancers understood that working through pain could be detrimental, it was an expectation of the occupational culture of dance to persevere and get the job done. In Goffmanesque terms, the dancers

79 were engaging in passing behaviour to conceal information that threatened the impression that they were healthy and able bodied workers (Goffman, 1963: 42). As described in Chapter 2, passing refers to the management or concealment of potentially discrediting information and in the case of professional dancers, an injury or physical ailment could discredit the working dancer. Just as has been found in the sociology of sport in relation to athletes playing through pain (Charelsworth and Young, 2004; Nixon, 1992; Roderick et al., 2000; Roderick, 2006a, 2006b), denying, hiding, and pushing through pain, or passing, was a common response among the professional dancers in this study.

Pressures and Expectations: Injury in the Context of Work Organization and Culture Numerous pressures and expectations inherent in the occupational culture of dance influenced perceptions of the body and health-related experiences in relation to work, and thus influenced dancers decisions to pass at work. The issue of income, especially for independent dancers who were more likely to take on short-term contractual work that is unstable and unpredictable as well as low-paying, was salient in terms of working through injury: In the professional world we are in now, you put on your game face and you go for it, otherwise you lose money because now we are working for money. If I was in a company things would be a little different, but as an independent artist I just never sit down (Nina). Similarly, Amelia chose to avoid surgery since the prospect of recovery time would result in a period with no pay. Performance-related pressures also encouraged passing behaviour and impression management. Dancer Carmen admitted to having the tendency

80 to work through pain in performance situations, but not in class: I know that I have to do this, I have a performance coming up and its just necessary. While Valerie claimed that nothing would get in the way of her meeting a performance deadline, Jaclyn understood that when an injury occurs during a show, this fact must be concealed from the audience, and the crying and rehabilitation is reserved for time at home. Jaclyns comment demonstrates how often the dancers life can be segmented into front-stage and backstage regions. As noted in Chapter 2, the front regions are made up of the spaces and times where dancers interact with those in the dancenets and are expected to maintain certain standards and impressions, and the back regions are those spaces that are away from the workplace where behaviour is often more relaxed and unguarded (Goffman, 1959). The back-stage was considered the appropriate place to contend with pain and injury issues for these professional dancers. As has been found in the world of sport, team pressures and dynamics also affect how pain and injured were managed on a daily basis (Charlesworth and Young, 2004; Theberge, 1997). Retired dancer Heather expressed that when she was dancing, her companys attitude was to suck it up because we need you. While she thought that things had changed and that dancers are no longer engaged in the era of no pain, no gain, stories from other dancers suggest that the loyalty and accountability felt towards colleagues was still prevalent in the decision to pass in moments of pain. For Diane, the knowledge that others were depending on her, and the guilt that resulted from her incapacity, was a force that encouraged her to return to work after an injury (Wulff, 1998: 106). On a related note, dancers also feared for their job security if they could not be relied upon (Nixon, 1993; Roderick et al., 2000). Ballet dancer Sierra returned to work

81 with a stress-fractured spine, risking paralysis, because her job was at stake. Stories of artistic directors letting go those company dancers who are frequently injured was enough to encourage adherence to the dance culture of risk: Why are we paying for this guy who is always injured? So eventually my boss let him go ... he wants reliable dancers (Isabel). While dancers do rely upon one another in work settings and many dancers spoke of supportive relationships with colleagues, this cooperation did not negate the competitive atmosphere that is a prominent feature of the culture of dance (Adair, 1992; Hamilton, 1998; Laws, 2005; McEwen and Young, 2011): [There are high numbers] of talented people and people who know how to be successful in this business, so that in itself is constant motivation because I never feel completely safe and comfortable. You always have to fight for your spot and your place in the company and you have to fight for roles and things like that (Jared). This competitive atmosphere, present in the narratives of both company and independent dancers, along with the knowledge that there are other professionals waiting in the wings to replace damaged bodies, ultimately influenced decisions to dance through pain and to return from injury. For instance, Kai did not want to look weak in comparison to her fellow dancers, and Sierra understood that it was this competitive streak that sometimes pushed dancers to extremes which were unhealthy and potentially hazardous in terms of injury. Since a great deal of competition does exist in terms of procuring and maintaining employment, authoritarian behaviour in the dance classroom and workplace become justified and necessary means for achieving success (Forte, 2010: 42; Smith, 1998: 128;

82 Pickard, 2007: 39). As mentioned in Chapter 2, authority figures in the dance world, to a certain extent, can wield absolute power over workers (Smith, 1998: 130), in a way similar to that identified in the world of sport (Charlesworth and Young, 2004; Jones et al., 2005; Nixon, 1994; Ryan, 1995; Sabo, 2004; Young, 1991): When I danced in the company it was Go! Work your butt off, be the best you can, be as strong as you possibly can, I dont care if you are tired, I dont care if you are sick, I dont care if you get injured, get in here and dance your best. There was no sympathy; that wasnt the concern of the artistic staff at all (Jaclyn). While a number of dancers suggested that this power structure was changing and that teachers, artistic directors and choreographers are more aware of physical dangers and try to be more accommodating of physical needs, often it was dancers own fears of the reaction of authority figures, in light of the above-mentioned concerns surrounding job security and competition, that encouraged them to engage in passing, hiding behaviour. Jared wrestled with the decision to inform superiors of his physical state because you dont wanna give off the impression that you dont want to do their class, or that you are lazy or something. Sierra claimed that authority figures maintained that they wanted their dancers to be open and forthright about injuries but that whether they admit that or not, for sure look at us differently, so I wanted to hide it for as long as I could. In general, concealing potentially discrediting information to maintain appropriate impressions was a common response of these professional dancers, and while pressures related to performance runs, team dynamics, job security, competition and perceived retribution from authority figures were prevalent among the majority of professionals, the issue of income was of more importance for independent artists1.

83 Moments of Contradiction: Taking Care, Divulging Information, and Ageing While many dancers claimed to pass during instances of pain and injury, there were moments in their narratives that contradicted such behaviour. Just as Malcolm and Sheard found an increased reluctance to play with injuries among rugby players (2002: 159), some of the dancers reported listening to and taking care of their bodies. Despite saying previously that she worked through pain even though she should be resting, Valerie claimed that she would suck up her pride and let people know if she was injured. In general, she believed in taking care of your body first, a sentiment shared by others: This is our tool, you have to take care of it (Isabel). Sierra described her habit of hiding a problem as long as possible and then went on to describe her feelings of responsibility towards her dancenet: You have a right to say whats happening to you. I have a responsibility to myself and my job and the other people in the company to report how I am doing, so I cant be selfish, I cant be scared, I have to take responsibility and tell them. This comment suggests that perhaps alongside a culture of risk there exists a culture of responsibility and precaution. This sense of responsibility, both to those in the dance world and to the self, was more evident among the older dancers in this study. Carmen said that although she works through injury, she has begun to get smarter in recent years and, at age 27, Amelia has starting to think of the future and taking care of her body: What am I going to be like at 40, what am I going to be like at 60? I think when you are 15 to even 22 you are not looking into the future yet. At age 51, Heather has gained a new perspective on her body and wishes that she had taken care of it better from a younger age:

84 I try to tell younger dancers when they are injured, sit down, dont get up again until you feel better, its not worth it, dancing will be here when you are 22, next month, its just not worth it. If I had to live it over again, thats the one thing I would do differently, I would stop when I was injured. When you are young you cant have that perspective. Among this group of dancers, while passing was a primary response to injury and pain that did not severely constrict the functioning of the body, the sometimes contradictory responses of older dancers suggest that at times perhaps divulging discrediting information can be an affirmation of being a responsible dancer to both members of the dancenet and to the self.

Impression Management when Passing is Impossible When an injury is so severe as to halt the work of dancers, or when it is readily visible and knowable to others, passing can prove to be an impossible form of impression management. A number of additional information control techniques were utilized by the dancers to maintain appropriate presentations of self in the eyes of others in the dance world. For instance, Nina pointed out the importance of marking in dance. Marking is the execution of dance steps at a fraction of the effort normally required. Marking also enables the dancer to go through the motions and it allows colleagues and choreographers to understand where dancers are on the stage if they are rehearsing for a performance. Thus for Nina, as long as I was still there and I was putting in an effort she was able to manage her potential discreditability and perform her commitment to her profession for others. Kai chose to cover (Goffman, 1963: 102), or to divulge information pertaining to her physical condition in order to downplay the potential

85 stigmatization. As described in Chapter 2, covering, or acknowledging a potential stigma, can reduce tension in social encounters: With your friends, because they see you dance all the time and they know how you dance, and then say your leg is really sore, you cant get it as high today, you tell them oh my leg is so tight and then when they watch you oh, her leg is tight, she cant get it as high - - thats why. Covering was one way to mitigate the risk of being perceived as weak, lazy, or incapable. Sierra tried to manage her stigma after an injury sidelined her for six months: I felt bad to have someone else go in and have to learn my spot, there was a shame in that for me. And I tried, I was there helping them learn choreography, I took it upon myself after hours just to make sure that they knew, got them a little gift to show them how appreciative I was. I think if other dancers see how appreciative you are of the extra work they are doing to fill in for you there is a mutual respect there. Thus for this dancer, extra impression management was needed to counteract her spoiled identity. Despite the above described techniques, in addition to passing, often the dancers described scenarios where stigmatization was unavoidable.

The Stigmatized and the Stigamtizers: You Are Faking It As has been explored above, the dancers in this study described scenarios in which they either felt stigmatized, or at risk of stigmatization by others in the dance world. An additional issue related to the process of stigmatization that emerged was the potential accusation that dancers were faking it (or stretching the truth) when it came to the extent and seriousness of their injury. A small number of dancers spoke of scenarios in which friends and colleagues did not believe them. However, a much larger number

86 (that is, 10 out of the 14 dancers interviewed) actively stigmatized the behaviour of fellow dancers in their narratives. The fact that dancers consistently spoke of working through injuries whenever possible in their interviews suggests that they rarely invent physical complaints, and yet it is a myth of the profession that others are continually looking for ways to slack off. While Roderick similarly found that professional footballers spoke of the malingering behaviour of fellow players, none of the athletes he interviewed admitted to actually engaging in this behaviour (2006b: 70). One dancer in this study readily conceded that she, and in her perception everyone, had participated in such behaviour: every one of us has faked an [injury] to get out of class. You dont feel like dancing that day, so you sit down, or you are really tired so you have a headache. While Nina admitted to stretching the truth, this type of behaviour was, by and large, understood to be something that others engaged in. In general, and aside from the above comment from Nina that everyone does it, faking it was perceived by the participants to be something that lazy dancers, drama queens, or wimps engaged in. Diane found it annoying to have to work with and accommodate injured colleagues, and Kai believed that her fellow dancers made an ailment sound worse than it was in order to garner sympathy. Amelia did not believe her friends any more since they had injury after injury, and Isabel found herself asking again? of a co-worker who was continually injured, suggesting that perhaps the more injuries a dancer has suffered, the more prone they are to being potentially stigmatized. The idea of the drama queen or overly dramatic dancer was also mentioned by numerous dancers:

87 I think of a gentlemen who was often quite opinionated and quite rude, and thought he was much better than he actually was. There was a pile-up in rehearsal, which is bound to happen, and he bounces off someone else and lands on this guys hand. And oh, oh, oh, lots of crying out, like I will be in my trailer kind of reaction. So this provides an atmosphere where everyone looks at him with one raised eyebrow and we are sort of thinking what is your problem, lets try it again. We are all ok, we all fell over (Brant). Brants story is suggestive of another convention that accompanies the appropriate way to manage oneself in the workplace: a dancer in pain is expected to suffer in silence and remain stoic in the face of physical hardship. Isabel recounted a story of a colleague who consistently adhered to this stoic presentation and thus was more easily believed by other company members: There is one guy who is such a hard worker and the other day all of a sudden he stopped and had this pain and we were like ok, he must really be hurting to have that pain. He is never injured and never complains. In a similar vein, Talia believed that if a dancers love and desire for movement is displayed and obvious in daily interaction, then it is easier to truly believe or accept that they are nursing an injury in some way. Goffman articulated that stigma is a two-role social process in which all, at some point, play the part of the normal and the stigmatized (1963: 137). It could be said of the dancers in this study that they oscillate between the stigmatized or potentially stigmatized, and the stigmatizers. Overall, the dancers narratives suggest that this notion of faking it or over-exaggerating an injury is part of the mythology of professional dance which is reproduced as an as aspect of the occupational culture to ensure [dancers] do not shirk (Roderick, 2006b: 77) and maintain appropriate presentations of

88 self. This stigmatizing of others could thus be seen as a form of social control, encouraging adherence to the dance culture of risk in which pain and injury is normalized and kept hidden or quiet (Budd, 2011: 114).

Embodied Identity, Injuries and Emotions Throughout their training and initial stages in their careers, dancers are engaged in a process of constructing and confirming appropriate identities. As stated by Donnelly and Young (1988), dancers (and athletes) are continually engaged in processes of identity construction/reconstruction and confirmation/reconfirmation throughout the entire career. Implied in the above discussion surrounding the impression management and presentation of self techniques engaged in by dancers is the understanding that a specific dancing identity hangs in the balance. Just how important is dance work to this group of professionals? In response to the common question in social situations what do you do? (Budd, 2011: 143), Kai claimed to always respond I am a dancer. For Valerie, dancing provided a sense of belonging that she could not find anywhere else and Nina claimed that once you are dancer, you are always a dancer to a certain extent. Just as Roderick found that professional footballers spoke of their careers as though they were a labour of love (2006b: 17; Freidson, 1990), so too did this group of dancers: One of the things that actually made me fall in love the most was that at ballet school [you are able] to see your own progress. When you start applying yourself, and you start to see results, that part is really addictive (Jared). I love moving, I love any physical activity ... I like to see myself evolve and grow, I like to feel, its such a personal internal

89 growth that nobody else can even touch and thats why I do it. Its so special (Sierra). My perception for the most part is that most dancers do it for the love of the form, the art form, and thats I think pretty typical of any art form whether it be dance, painting, whatever, its because of the love and absolute passion for that art (Henry, physiotherapist). The comments of both Jared and Sierra suggest that part of the love derives from the satisfaction and improvement that comes with hard work. As many of the dancers claimed, they were not in it for the money but for the sense of self-fulfillment (Freidson, 1990: 151). Dancing was their lifes passion and was thus an essential element of self identity. For some, this love was more complex; as was explored above, many dancers spoke of the love/hate relationship they have with their careers given the challenging and demanding nature of what is required. Thus for some, dancing was not so much a passion as it was a calling, or a compulsion: Its a crazy career and I dont think that anyone should do it ... if you absolutely have to dance, then yes. If you can think of anything else that you would rather be doing, do that first and dance second because dance is brutal (Nina). Similarly, Heather said that she would not wish this career on anyone, and yet she went on to claim that you dont choose dance, dance chooses you. When asked to describe why she dances, Kai claimed I do love it, I dont think I can stop, you know, that sort of thing, and people always say that dancing is like breathing. To state that dancing is like breathing implies that it is a central part of existing; just as Wainwright and colleagues found in their study of ballet dancers (Wainwright et al., 2005), for the dancers described here their careers were essential to their sense of self and in many ways were a calling, or something they felt compelled to do.

90 The dancing identity is inherently embodied and thus a threat to physicality is a threat to the self. In Goffmanesque terms, it is the felt identity, or a persons sense of their own character, that is affected when injury threatens to spoil an appropriate presentation of self (Goffman, 1963: 105). As Goffman states, a sense of ambivalence, or uncertainty about the self can occur when one fails to conform to identity standards set for themselves (1963: 106), and thus when a dancer is prevented from presenting the image of a fit and able worker, a crisis of self can occur. Just has been found in other dance studies (Wainwright and Turner, 2004a; 2006; Wainwright et al., 2005), and the health (Charmaz, 1983, 1995; Turner, 2004) and sport literature (Allen-Collinson and Hockey, 2007; Charlesworth and Young, 2004; Jones et al., 2005; Pike, 2004; Podlog and Eklund, 2006; Thing, 2004), these dancers spoke of how their identities were threatened and disrupted. As Jared clearly articulated, I think [injury] definitely impacts you as a person because who you are in many ways as a professional is who you are in life in general. The dancers comments below demonstrate how the dancing identity is bound up in her embodiment and her physical capabilities. Her body is her identity: Diane: It is incredibly disheartening, and what I have come to realize is its because you dont have an instrument. When the only thing that you can give to people is yourself, its kind of a double whammy in terms of when you get injured because you no longer have yourself to give ... Interviewer: So does an injury impact the way you feel about yourself as a person? Diane: Yeah, because thats your persona, thats your identity. In a similar manner to Diane, Amelia took her injuries to heart since she was unable to maintain the impression of a strong and fit dancer:

91 I get into a negative space with an injury that then puts me in a negative space with everything and I definitely start putting myself down, like with my technique in dance, my ability, why I am dancing, my body, comparing myself to others ... So yeah, I would say thats what it does to me, it brings me down and then I have to get out of it and fight against the injuries and fight against those thoughts. Amelias comments demonstrate the amount of emotion-work that goes into fighting against negative thoughts associated with instances of debilitating pain and injury. For Crossley, it is the embodied self-feelings of individuals that help to gain a deeper understanding of how the body and the self is perceived, and the emotions reported by the dancers demonstrate how threatening injury can be to the self (2006: 27). Dancers described the various emotions that they experienced, ranging from depression, uselessness, helplessness, and frustration, to fear, uncertainty, and anger at the body (Allen-Collinson, 2005; Nixon, 1993; Pike and Maguire, 2003; Snyder, 1990; Thing, 2004). A number of dancers, however, claimed that beyond the physical discomfort and frustration with a lack of full capabilities, they did not feel that injury threatened their sense of themselves. As Isabel claimed, I would never call myself a bunhead as we call these ballerinas that just live and breathe and sleep and dream ballet, and both Talia and Jaclyn articulated that they had other elements in their lives, such as other activities, hobbies, a family, that fed them in terms of what they do and who they are. It could be said that identifying the self with elements in addition to those associated with the world of dance helps to alleviate the sense of crisis that can arise from injury. In addition, it was evident that the severity of the injury influenced how threatened dancers felt. While Jared did talk of how injury might affect his self-feelings, he went on to describe how he turned injury into a positive identity experience:

92 In some ways I guess it has boosted my self confidence, that when I am faced with a hardship or something that you really cant control once it has happened, that I can overcome it and find benefit from it somehow. This statement is reminiscent of the sport ethic, and how athletes/dancers are expected to overcome physical limitations (Hughes and Coakley, 1991). Additionally it could be interpreted as Jareds efforts to reconfirm his identity as a hardworking dancer (Donnelly and Young, 1988). Overall, it was found that the experience of pain and injury can threaten the dancing self, resulting in more negative self-feelings for some and opportunities to explore other parts of self identity or reaffirm notions of self.

The Mirroring Body: Appearance as Presentation of Self The outward appearance of the body is of utmost importance for dancers given the focus on aesthetics in the world of dance. Cooleys looking glass self (1902), and especially the self feelings that can result from how dancers imagine they appear to others, was a common motif among dancers. For Sierra, your own self image and your body are a reflection of you and you want to perfect every little thing. In most interviews dancers were asked specifically to comment on their ideal bodies. However, quite often the topic of physical appearance emerged naturally in conversation. While the focus for female ballet dancers was on leanness and slimness and not looking like a bodybuilder, the contemporary and jazz dancers were also consumed by thoughts related to body image: You know, perfectionism, standing in front of a mirror with not very many clothes on for many hours a day, often with other

93 people around you so there is always that opportunity for comparison, whether you take it or not (Talia). Youre out of shape and you see somebody else more in shape than you and you get a little competitive that way. Sometimes you take it too far (Sierra). In both of the above extracts, concern with weight and body image was linked to what have been identified as elements of the occupational culture of dance - - feelings related to perfectionism and competition. Applying Franks notion of ideal bodies to dancers understandings, it could be said that in these moments of comparison with both an unreachable ideal image and the bodies of others around them, dancers take on the role of the mirroring body (1995: 46). Both Nina and Isabel focused on the presence of mirrors in rehearsal spaces that allowed opportunities for easy comparisons with colleagues and self criticism. Carmen took the body type of her teacher or mentor at the moment as her ideal body and Kai spoke of striving to emulate both the skill and appearance of dancers in the media and on Youtube videos. Jared admitted to wanting to measure up to the body types of other men in his company, demonstrating that body image and physical presentation of self is just as important for men as it is for women2. For Nina this mirroring has been a recent struggle: If I put something in [my mouth] that I shouldnt, I do regret it immediately and I am like why did I do that? I definitely find that I am a lot more obsessed with food than I have ever been. And I look at the dancers who are successful and I am like wow, I dont look anything like you guys. Other dancers also spoke of the meticulous manner in which they monitored their shape through dieting, suggesting that Franks mirroring body works in conjunction with the disciplined body where self-surveillance and self-regulation are key (1995: 44).

94 A number of dancers explained that their concerns with their image has become less of an issue with age, but as a dancer also speaking from a clinical perspective, Madeleine argued that almost every dancer has struggled with some form of disordered eating in their dance careers. While the dancers did not admit to me that they had specifically suffered from eating disorders or that concerns with body image led to the type of injury to the body and mind described by Johns (2004), possibly due to the stigmatization associated with anorexia in the dance world, their comments on self-feelings related to body image suggest that dancers are indeed Olympic contenders when it comes to obsession with fat (Vincent, 1979: 6).

Leders Absent Body Concept: Does it Fit or Fail? As mentioned in Chapter 2, Drew Leders concept related to the absent body is both in line and at odds with the experiences of the dancers in this study. Leder argues that in everyday life the body and corporeal awareness exists in the background of our consciousness. However, the professional dancers discussed here spoke of their bodies in such a way as to indicate that they live in hyper-awareness of their bodies on a daily basis. Many dancers spoke of how conscious they are of every little twitch, twang, and pull in their bodies, and from the perspectives of both her dance career and her chiropractic practice, Madeline understood that dancers in general are very in tune: Dancers are more aware of their bodies. So they are aware when something is slightly tender, lets say on the inside of their ankle, they notice that when they point their foot they can also sort of feel it in the calf. The average person, though, is not that in tune with their body ... dancers are also trained throughout their training to listen to their body, to look at their body all the time,

95 and they can see and feel those tiny little changes, which, being a dancer yourself, you know that those small little tweaks make a huge difference when you are turning, when you are jumping, your balance, whatever. As Madeline pointed out, as an insider in the dance community and as a dancer myself, this hyper-awareness was something that I had personal experience and knowledge of. Leders understanding of the absence and disappearance of the body under normal circumstances fails when it comes to the highly embodied work of professional dancers since they always monitor and acknowledge the physical sensations and changes experienced on a daily basis. An aspect of Leders theory that holds true based on the empirical findings of this study is the fact that pain can render the body an it, an alien presence in the lives of dancers (1990: 76). Frank similarly describes how the disciplined body experiences crisis in loss of control and becomes an it distanced from the self (1995: 41). My respondents distanced themselves from the weaknesses of the body using phrases such as my body is limiting me, not my self and your body is doing this to you. Comparably, athletes have been found to manage their pain in disembodied and distancing ways (Theberge, 2008; Young et al., 1994). This was typical of rather severe and traumatic injuries that necessitated a break from working or strictly modified ways of working. In reference to the most typical response to pain and injury as described previously, passing, Leders theory again fails to stand. Just as Aalten (2007) and Tarr and Thomas (2011) found, dancers actively silenced and absented their bodies from themselves in order to continue working: When you are in class or in choreography, I just dont think about it. I mean, its always easy to not think about it because you are

96 concentrating on other things, like where you are and what you are learning. Its after the fact that you are like oh my gosh, my leg really hurts! (Kai). Similarly, Talia described how often times there were numerous problem areas in the body at once and how it was only possible to focus on one at a time: Its just a matter of picking and choosing. My knees dont bother me as much as my back, so my focus is my back right now and so I havent been good at keeping up with the knee. In addition to actively absenting bad pain, the dancers also spoke of the good pains (Pickard, 2007: 45; Thomas and Tarr, 2009: 56) that can result from pushing the body. In contrast with the pain spoken of by Leder that the individual wishes to be free from, dancers described some pains as feel-good pains and in the words of Diane, there is a real satisfaction in knowing that you pushed yourself to the point of being sore. Other pains that were harder to absent became the source of a quest in order to master this suffering in an effort to maintain the accepted presentation of self (Leder, 1990: 78; Goffman, 1963: 9): I am not ready to give in and say that I am going to have a sore back for the rest of my life every time I dance - - I know there is a solution, I just havent quite gotten to the bottom of it yet (Talia). For many, managing the tensions between listening to and actively absenting the body in pain was a precarious balancing act between continuing to push the body, as is required by the profession, and knowing when to pull back and seek medical help. In general, Leders concept of the absent body fails in relation to professional dancers. However, there are pieces of Leders thought that do fit with the experiences of those interviewed, such as the need to embark on a quest to rid the body of pain that can no longer be

97 absented. This quest, in terms of seeking advice and treatment to heal the body, will be discussed below.

THE HEALING QUEST: INTERACTIONS BETWEEN CLINICIANS AND PATIENTS In order to manage the discrediting potential of an injury in the dance world, dancers may step into the disciplined ideal body and embark on a quest, often in the form of treatment regimes, in order to heal and regain control over the body (Frank, 1995: 41). Dancers were asked to explain this quest and their experiences in terms of interacting with those in the medical profession. Throughout these conversations it became clear that not only did opinions vary on the type of professional that should be seen (dancers reported going to a vast array of clinicians including general practitioners, sports medicine specialists, orthopedic surgeons, chiropractors, physiotherapists, massage therapists, acupuncturists, osteopaths, naturopaths, etc.), but that opinions on the subjective evaluations of the value and success of such encounters also varied. As was explained at the beginning of this chapter, interviews were obtained with a chiropractor, physiotherapist, and podiatrist who have extensive experience treating dancers. While it was the original intent to speak with as many dance clinicians as possible, it was felt that only those with considerable and comprehensive experience treating dancers should be included. As explained by chiropractor Madeline, dance medicine is a small discipline, especially in Western Canada where the dance community is continuing to grow and

98 become more established. The narratives of these clinicians are meant to augment and reinforce those of the professional dancers.

Occupational Health Care in the World of Dance In her opinion, podiatrist Nancy believed that the stigma associated with seeking treatment has improved in the world of dance. For Kotarba, the quality of occupational health care is a function of the relative value of workers, and the style and meaning of this health care delivery are a function of the work culture (2001: 767). The level of care and quality of treatment received by professional dancers is thus shaped, first, by their relatively low status in terms of occupational choice (Hanna, 1988: 120) and, second, by the structure of their specific workplaces as either company dancers or independent artists. While the conventions associated with the company work culture and the independent work culture both encourage the normalization of pain and injury, those who work in company settings often have more resources at their disposal to seek and receive quality care, despite the fact that ultimately both types of working dancers are individually responsible for their own health and well-being. Drawing upon Kotarbas typology of occupational health care systems as outlined in Chapter 2, it could be said that dancers employed by companies generally receive care along the continuum from managed to primitive care (2001: 767). The ballet dancers in this study had access to company-associated practitioners, including chiropractors and physiotherapists, who were present on a part-time basis to treat at rehearsal spaces given that, in the words of company administrator Brant: we want to protect our investments

99 and keep them healthy. In their coverage plans, these dancers were allotted a certain amount of money to spend towards treatment annually, but once this coverage ran out dancers paid out-of-pocket for additional treatment. Isabel described how she would hold off on seeking treatment if she knew that her money was running low. For her as much as being a company dancer I do have good health care, we still need more. While the ballet dancers had coverage through the Workers Compensation Board if a work-related injury occurred, the jazz company dancers spoke of having only basic health coverage as part of a benefits package. For them it was often the gratis work of members of the health care community, such as the work of physiotherapist Henry, that allowed them to seek regular treatment. In the words of Heather, people often wanted to be associated with the company and have their names printed in the programs. All company dancers had access to primitive, on-site gratis treatment when in the theatre during a performance run. Independent dancers did not even receive primitive care since they were often not part of an organized, structured workplace. They must rely on coverage from other sources of income, pay for their coverage themselves, or as was most common, they tried to get by without any health care coverage. This lack of financial aid acted as a barrier for many dancers when it came to seeking treatment: Now, because I dont have that coverage, I would only go if I badly needed it. And even then, when they say come two times a week I would go once a month because it is just impossible. And its kind of sad when your career and your life revolves around your body being physically capable of doing things and you cant afford to help keep your body up to its physical maximum ability (Kai).

100 Previously, it was mentioned that level of income and salary affected dancers decisions to work through pain. In a similar fashion, income, quality and availability of medical coverage, and the expense associated with alternative, specialized treatments (e.g., craniosacral therapy sessions for $90.00 per visit) all affected the ways that dancers, especially independent dancers, approached their health care regimes.

There is a Disconnect: Challenges in Treatment Dancers described interactions with clinicians that were both positive and negative. However, in general they highlighted a number of ways in which the cliniciandancer relationship could be challenging. The word frustration was frequently used to describe how dancers felt about these interactions and in many ways what they seemed to be describing was a disconnect between the needs and goals of the dancers, and the approach of the clinician. For Talia, many clinicians are symptom-focused and apply Band-Aid solutions to long-term, chronic problems, whereas Kai felt irritated when her clinician started to treat other issues when all she wanted was that one thing fixed. Carmen was frustrated by egotistical attitudes and she and numerous other dancers commented on the fact that health care professionals did not understand their lifestyles. As an illustration, Heather recounts an interaction that took place between herself and her surgeon after foot surgery: He says, What are you still doing on your crutches? and I said, well can I dance? because of course I wanted to hear yes. He said yes but he thinks we fluff around; he doesnt really know how much stress and strain that puts on the foot, so I went back [to work] thinking the doctor knows best and it took me years to get over it.

101 Also, Sierra felt that doctors are not used to dealing with patients who are so accustomed to pain: We have a really high pain tolerance and doctors are used to people crying if they are in pain or screaming or whatever if it hurts, and we are so used to dealing and working in pain. If we dont have that reaction they dont take us seriously and that actually happened to me. Dancers and the dance clinicians interviewed also spoke of differing expectations when it came to healing times since the clinicians were more likely to err on the side of caution and the dancer wished to return to work as soon as possible. The dance clinicians described an in and out approach to their treatment of dancers, focusing on getting them back as fast as possible without subjecting them to further injury. Such an approach is reminiscent of the athlete focused treatment model associated with sports medicine (Theberge, 2006: 4) where treatment is focused upon the specific needs of athlete/dancers and not upon their general well-being. However, a number of dancers still perceived that there was a disconnect between their own focus and expectations and those of clinicians. An additional issue from the perspective of clinicians was raised by Henry; when he treated primarily ballet dancers he found that they were reluctant to do the exercises out of fear that they would become too bulky in terms of musculature. He described the great amounts of emotion-work he engaged in to calm these fears and assure dancers that their treatment would not in any way impede their desired physical presentation of self. In general, both Henry and Madeleine spoke of their role as psychologist and felt that dealing with the emotional well-being of dancers was the most demanding and

102 challenging aspect of their jobs. For Henry, it all comes down to the trust that needs to be earned between the dancer and the healer.

Trust, Lay Expertise, and Negotiation As an important theme in the sociology of health and illness, the issue of trust was pertinent when it came to discussions of experiences with good and bad doctors (Lupton, 1996; Nettleton, 2003). As a recently retired dancer, Brant understood what it meant to hand over your temple to someone else: I know how it is ... with any athlete who is a high performance athlete. Before an event you are very superstitious, very guarded of your health and well-being because that is what you are all about. You are there to do your best show as a dancer and if somebody is changing the physiology of your body, which is what they are doing when they are facilitating healing as a medical practitioner, you have nothing to go on but trust, which is earned based on credentials, approach, and referrals. For dancers to entrust the instrument of their craft to clinicians required a leap of faith, and one that was often based on the advice of others. Predominantly, dancers perceived that dance clinicians, or those with extensive experience in the dance and sport worlds, could be entrusted with the care of their bodies (Holmes, 2008). For Jared, seeing random doctors, or those who had not specialized in sports or dance medicine, garnered generic, unhelpful feedback, whereas doctors or practitioners associated with the dance community were more understanding and helpful: A doctor who knows ballet will say, you know, you can do this, you can do this step, you can do this, and you should probably be back in this amount of time. A doctor who doesnt know anything will probably say oh, you should take six months off,

103 just rest and you are like, uh, I could never take six months off in my life if I wanted to! In the words of numerous other dancers, dance-specific clinicians know what needs to be done. As both a chiropractor and a dancer, Madeline understood how her dance knowledge created better clinician-patient communication: The dancers are very picky about the care that they get and they have had a few people come in there before that didnt know anything about dancers so it was very difficult cause when the dancers say oh, when I do a tendu, when I do a grande battement, they dont know the terminology. It just makes for harder communication between doctor and patient. So when I came in there obviously I knew everything that was going on. I could watch and say oh this is why this is hurting you so they accepted me right away. Podiatrist Nancy was also a semi-experienced member of the dance community and while physiotherapist Henry had a background in sport, his work with dancers over the last decade or so, as well as extra work he engaged in by watching performances and rehearsals, gave him the experience needed to be trusted. Both Brant and Talia trained as health care practitioners and became interested in treating others as a result of their experiences with clinicians (a positive experience in Brants case, and a negative one in Talias). Isabel described a friend whose career was ended by following the poor advice of a physician and how he was currently attending medical school to prevent what happened to him from happening to others. Similarly, Heather spoke of the broken down ballerinas who end up in medicine. It is the notion that only a member of the dance community can truly understand what damaged dancers need from clinician-patient interactions that allows dancers to place more trust in

104 clinicians with first hand, insider knowledge, and also encourages dancers to break into the field of medicine in order to help the community more generally. As mentioned previously, many of the dancers, in addition to experiential knowledge of the body, had some form of anatomical training. All of this experience and knowledge culminated in the attitude that I know my body best and it could be said that interactions between dancers and clinicians were akin to meetings between experts (Nettleton, 2006: 138). Brant called this attitude the dancer ego and many dancers spoke of their disgruntlement that practitioners did not take their knowledge seriously. Diane spoke of the necessity of self diagnosis and the efforts to present the self in certain ways to doctors, especially general practitioners, in order to receive referrals to specialists: Suck it up and look stupid so that they will send you. Like, oh really, is that what it is, ok. Work it, you need to work it. It sounds a bit conniving in a way, but when nobody understands your job you have to figure it out. In a Goffmanesque manner, Diane felt as though she needed to act dumb and downplay her body knowledge in order to control her interactions with certain professionals (Nettleton, 2006: 151; Dodier, 1985). Jared took a diagnosis with a grain of salt and used his previous experience and knowledge to determine if a recommended treatment course was right for him and Amelia claimed that, in interactions with one practitioner, she felt as though she was the one who was more knowledgeable and had more training. For Carmen, this lay expertise and knowledge of the body was sometimes an asset in the clinician-dancer relationship: I am really thankful that I took an anatomy course not only do I have experience in my body and knowledge of my different

105 injuries that I have had and stuff, but I also have this general knowledge of anatomy so I really appreciate when I am able to have more of a dialogue with whoever is treating me so I understand what they are doing and what muscles that impacts I find that then I am able to trust them a little bit more. And so I have become more vocal. I dont like people working on me without knowing what they are trying to do. An open dialogue and the opportunity to negotiate treatment regimes and work together as a clinician-dancer team was an experience described by some dancers, but one that most would consider to be an ideal relationship. Dance chiropractor Madeline liked this give and take aspect of her job, and while all three clinicians said that they encouraged dialogue in the treatment room, there were certain occasions where they would put their feet down and maintain control over these interactions. Overall, interactions between professional dancers and health care practitioners entailed complex negotiations and bargaining processes since both parties approach these interactions with their own agendas and goals (Howe, 2004; Roderick et al., 2000; Safai, 2003, 2004).

A Note on the Sick/Injured Role In the words of Heather, dancers are not good patients and, just as Parsons notion of the sick role has been criticized for simplifying and overlooking the empirical, everyday experiences of the ill person (Nettleton, 2006: 80), it would seem that dancers understandings of their responsibilities and obligations as injured patients were in general more complex, and sometimes at odds with, those outlined by the sick role ideal type. For Parsons, the sick person is exempt from their normal responsibilities. However, in the case of dancers this does not necessarily jive. At the very least, dancers were expected to

106 maintain their physical bodies in terms of strength, stamina and appearance. Additionally, the ballet dancers described scenarios in which they were required to work on-site at the company during a prolonged period of injury-induced absence in order to continue being paid: They had me sewing costumes or doing office work or whatever, but at the same time - - is this appropriate for my healing process? I need to get back to my job as quickly as possible and sitting on my tailbone is probably not a good idea. So that was the struggle, that there were all these rules that you have to follow to get covered and we dont make a lot of money as dancers so we do what we have to do (Sierra). The above comment demonstrates how dancers were not exempt from their responsibility to their company. In the opinion of Sierra, this work requirement often worsened, or at the very least did not help, her physical condition. Lastly, in terms of this freedom from obligations, it was found that dancers were required to be active, autonomous patients in the treatment process (Thing, 2004: 199). As an illustration, Jaclyn felt that it was her job, and not the job of her doctors or medical practitioners, to find health solutions: Its my job to say thank you for that information and now I am going to keep searching for what works for me ... I have to be the one who is going to figure it out. In general, the dancers in this study were certainly not exempt from responsibilities and obligations. While the ideal sick patient is not held responsible for their illness, often there was a sense of imputing of blame (Lupton, 2003: 100) and it was perceived that injured dancers were in some way responsible for their weaknesses. Often it was understood that those with poor technique (Brant), or those who had failed to master the body, were the most likely to become frequently injured (and potentially stigmatized). In other words, injury was perceived to result from a lack of skill or laziness when it came to executing

107 movement properly. Parsons prescription that patients must want to get well in general does fit with the lived experiences of this group of dancers. As Isabel claimed, When we get injured, we want to get back. However, understanding how dancers fit with the last component of the sick role, in terms of cooperating with medical professionals, was more complex. As was found in the prevalence of the attitude that I know my body best (Jared) as well as the amount of self diagnosis and negotiation that occurred between dance patients and dance clinicians, the extent to which dancers cooperated with medical professionals was more unclear. For Malcolm, this reliance on lay knowledge could be a challenge to the authority of medical figures (2006: 385). As an illustration, Carmen spoke of being more assertive in her dancer-clinician relationships: I have become more vocal and I have ... questioned [them] to be curious about what is going on ... I dont like people working on my body without me knowing what they are trying to do. While this comment suggests that at times there may have been reluctance to blindly accept the treatment provided, others like Heather and Amelia described how they would often do exactly what they were told to do. Just as the lived experiences of the ill are not encapsulated by the sick role, the pain, injury and body-related experiences of professional dancers and the interactions that occur with clinicians suggests that the injured role (Roderick, 2006a) entailed maintaining obligations to the self and to others, taking responsibility for physical failings, embarking on an active quest to get well, and using ones own judgement when it came to medical advice.

108 IMPROVING THE HEALTH AND WELL-BEING OF DANCE WORKERS At the end of the interviews, participants were asked the following question from the Fit to Dance 2 report: If you had a magic wand and could change one thing that would do most to promote the health, well-being, excellence, and longevity of dancers - - what would it be (Laws, 2005: 43)? While responses were varied, a number of suggestions were commonly cited. Just as Laws (2005) found that money issues were highly cited among dancers from the UK, the dancers in this study spoke of the desire to be paid more, and to be treated as normal workers (Heather), thus allowing them to take better care of themselves. Valerie spoke of her desire to advocate for improved insurance for dance workers and others spoke of the need for better health care coverage plans, as well as the need for less expensive treatment options: Funding for the arts means increased salaries for dancers, choreographers, [and everyone] all the way through the chain, which would allow them more money for care (Madeline). [Health care should be] more readily available and less expensive, because dancers dont get paid very much. Like even if they are working in a full time scenario they need to pay rent and they need to buy food and they also need to keep their tool working (Kai). The next most common recommendation was related to issues of appearance, weight, and body image. Physiotherapist Henry recognized that the aesthetics associated with dance can cause problems: Sacrificing your body for a certain body type is not healthy - - that would be the biggest thing I would change. The dancers spoke of the need to draw attention to the risks associated with eating disorders and the desire to change pressures and expectations related to weight given the physical and emotional consequences of

109 such obsessions. Another response to this question included comments on the quality and qualifications of those teaching young children since potentially harmful habits can set a dancer up for injury later in life: I want there to be some overriding, judging, police force that goes into studios and critiques teachers and fines them and makes them quit if they are not eligible teachers. I would say that is the biggest thing that drives me crazy, seeing the teachers that are out there. I work at a dance store and knowing what goes on in some studios, like its just scary to know who is out there teaching. Girls who have hardly any dance background are teaching. And then I watch kids come in for pointe shoes, and you say do a pli, and they dont know what a pli is but they are buying pointe shoes! Its sickening what is happening (Amelia). Finally, this question produced comments on the need to speak more openly about the psychological challenges a dancing career can pose, and overall the need for more education and awareness of health-related issues both within the dance community and the medical community. In general, however, the older dancers commented on how they believe that the industry is improving in terms of openly speaking about such healthrelated issues as well as taking steps to ensure that dancers are working in safer ways. Dancers were also asked to consider whether they believed that a dancing career has long term implications (Theberge, 2008). Responses to this question were varied and while some dancers admitted that this was something they had never really thought about, others conceded that they were aware that their bodies may pay a price in the long run. Both Kai and Sierra joked about needing hip replacements by the age of 30 and of having arthritis in their joints. Largely, however, the physical risks were downplayed or brushed off, and indeed a number of dancers spoke of the natural degradation of the body with age, and how they believed that dancing careers aside, the body is already at risk of injury

110 and chronic pain later in life. Jaclyn appeared to conform to the standards of the profession: If you are trying to be this really great, strong dancer, guess what, you are going to hurt. And you are gonna be doing things that hurt your body. You made that choice. This comment suggests that the daily punishment of the body is a choice made by working dancers. However, given the pressures and expectations of the occupational culture of dance, and the drive and passion of dancers to achieve goals in this rather short lived career, the ways in which these choices are framed and shaped need to be critically examined.

CONCLUSION In summary, the physical and health-related understandings of the professional dancers in this study both influence and are influenced by the conventions, pressures, and expectations of the occupational culture of dance and those in the dancenets, including colleagues, authority figures and health care practitioners. A number of important themes were explored in this chapter. To begin with, dancers spoke of how dance really is a world of its own (Becker, 1982) with a unique, and at times gruelling, occupational lifestyle. Next, the specific, and at times contradictory, understandings of pain, injury and health were explored. It was found that the necessity of maintaining an appropriate and ideal presentation of self (Goffman, 1959) at the workplace often encouraged adherence to a culture of risk (Donnelly, 2004; Nixon, 1992, 2004; Roderick et al., 2000; Safai, 2003) in a work environment that routinely normalized pain and injury. Presenting and demonstrating appropriate impressions for those in the dancenets (Nixon, 1992) - - for

111 instance, that one was a dedicated, committed and hard working dancer - - was a significant concern for the participants. In an effort to manage their impressions and avoid being stigmatized or discredited for their damaged status as un-able bodies, dancers passed (Goffman, 1963: 43), ignored, and danced through their injuries for as long as possible. Pressures and expectations in the context of work organization and culture, such as income, performance schedules, team dynamics, job security, competition and power relations, were aspects of the occupational culture of dance that additionally encouraged passing behaviour. While at times the dancers accounts expressed moments of contradiction, and this culture of risk seemed to exist alongside a culture of responsibility, especially for older dancers, the myth surrounding the lazy, untruthful dancer who fakes an injury acted as a form of social control that further encouraged adherence to the notion that pain and injury are reserved for the backstage regions of a dancers life. Dancers expressed how their embodied identities were affected by injury (Charmaz, 1995; Pike, 2004; Thing, 2004; Wainwright and Turner, 2004a, 2006), and the accompanying emotional experiences that resulted from the threat to their labour of love (Allen-Collinson, 2005; Freidson, 1990; Nixon, 1993). The management of appearance as part of presentation of self (Johns, 2004; Vincent, 1979) and the relevance of Leders (1990) work for understanding how dancers interpret pain were also explored. Another major theme of this chapter was an examination of the interactions that occur between dancers and the clinicians who treat them. It was found that there was a disconnect between the needs and expectations of these groups, and that issues of trust, lay knowledge, and negotiation were pertinent (Howe, 2004; Lupton, 1996; Nettleton, 2003; Roderick et al., 2000; Safai, 2003, 2004).The following chapter addresses some

112 final remarks on how this study adds to the growing body of literature surrounding dancers, as well as some conclusions, implications and future directions for further research that arose from these findings.

NOTES 1. Income was of more importance for independent artists when it came to decisions regarding passing or hiding instances of pain and injury. However, the issue of income was important for both company and independent artists when it came to procuring medical treatment. 2. The men in this study were also concerned with weight and body image, although muscularity and tone were concerns that were additional to weight. They spoke of a need to go to the gym and watch what they eat since costuming on stage often includes exposed upper bodies and generally tight apparel.

113

CHAPTER 5: DISCUSSION AND CONCLUSION

114 INTRODUCTION This final chapter briefly reviews the research presented thus far, re-examining the objectives of the study and how the empirical findings parallel and add to existing sociological literature and knowledge. In addition, this chapter will also touch upon some of the limitations of the current study and identify areas for future research. The primary aim of this research was to add to a growing body of literature that explores the health, physicality, pain and injury experiences of embodied dancers in the context of the occupational culture of dance. While the health and body-related issues cited by dancers were ultimately physical concerns, this study aimed to garner an understanding of the social aspects that shaped how these physical concerns occurred, and were understood, negotiated, and managed by the dancers themselves and by others in the dancenets - including colleagues, authority figures, and medical practitioners. In an effort to explore these aims, and in keeping with an interactionist perspective that produces a rich account of the lived experiences of those of concern, in-depth, qualitative interviews (conceived of as co-created performances between social actors) were secured with theatrical, professional dancers of various styles and occupational statuses, as well as a limited number of health care professionals with extensive experience treating dancers.

EMPIRICAL FINDINGS Dance workers were enmeshed in the occupational culture of dance, and the body, injury, pain and health-related experiences of these workers both shaped and were shaped by this culture. As explained by scholars Wainwright and Turner, dance remains an extraordinarily neglected topic within research on the body, and arguably within research

115 on the working body since dance is seldom seen as work (2006: 250); thus it is hoped that this research can add to a sociological understanding of dance workers. In keeping with other sociological and anthropological studies that address these issues, the dancers described here tended to downplay and actively absent their bodies from conscious thought in order to keep working (Aalten, 2004, 2005, 2007; Tarr and Thomas, 2011), and in some cases where injury was severe enough to disrupt daily routines, often the dancing identity was thrown into crisis (Wainwright and Turner, 2004a, 2004b; Wainwright et al., 2005). The empirical findings explored in Chapter 4 parallel many of the findings of the aforementioned dance-related studies. However, the current study varies from these works in a number of important ways. Firstly, much of the research that has been conducted to date focuses specifically upon the experiences of ballet company dancers since they are often the largest, and most easily identified and located body of dance workers. Only a small fraction of the dance community can fit into this category, and indeed todays dancer has difficulty fitting into any one category given the increased industry need for the flexible, increasingly athletic, jack-of-all-trades dancer (Ewalt, 2010). Thus a large portion of working dancers, such as those who are independent, or self-employed, are ignored by studies that focus only upon ballet dancers. The common conventions and expectations associated with the occupational culture of dance allow that dancers from various backgrounds (for instance, ballet, contemporary, tap, jazz, or hip hop artists) may have similar embodied concerns. While the dancers did share common understandings, there were times when the organization of the workplace, either in terms of a longer-term company setting, or an uncertain independent setting, produced differing beliefs and conduct, especially where financial considerations influenced decisions

116 related to health. The concerns of ballet company dancers are important, but so too are the concerns of the dancers who do not work in environments with the same amount of privilege and access to resources. A second way in which this project varies from existing research on the embodied experiences of dancers is the theoretical focus of the work. Aalten (2004, 2005, 2007) and Tarr and Thomas (2011) make use of the work of Leder and the absent body, as is used here as well, and Wainwright and colleagues (Wainwright and Turner, 2004a, 2004b, 2006; Wainwright et al, 2005) make use of the perspective of Bourdieu to talk of the habitus of the ballet dancer. While the above studies briefly cite the work of Goffman, the research presented here centrally demonstrates the utility of Goffmans work and the dramaturgical perspective for making sense of social phenomena. While Goffman was primarily concerned with dramaturgically detailing the ways that people behave in everyday life, it could be said that applying his work to the theatrical world of dance results in an exploration of the everyday life of dramaturgy (Atkinson, 2006: 105). Just as has been found in the sociology of sport and the sociology of health and illness (AllenCollinson, 2007; Charlesworth, 2004; Nettleton, 2006; Pike, 2003, 2004; Roderick 2006a, 2006b; Scambler, 2004), a Goffmanesque approach can produce useful ways for understanding the social behaviour of actors, especially in terms of front and back stage regions, and presenting and managing the self, impressions, and stigmas. This is not to say that other theoretical understandings of dancers (using the work of Bourdieu, for instance) are any less important or useful, but that a Goffmanesque approach is one very useful way to construct knowledge about this occupational culture and the workers engaged in it. It is also a logical choice of perspective given that dancers lives are

117 embedded in the language of theatre and performance. In addition, this Goffman-inspired approach enriches our understanding of some of the pressures and expectations that dancers place upon themselves, and those that are laid upon them by others, to present themselves in certain ways and to engage in actively absenting the body (Leder, 1990). Overall, combining the Goffmanesque, dramaturgical tradition, Leders absent body concept, and a general art world perspective provides a unique theoretical base for examining how the conventions of the dance world work upon and are created and reinforced by dance workers. In addition to drawing upon multiple theoretical perspectives, this research also drew upon a variety of empirical studies from varying sociological disciplines, including the sociology of sport, health and illness, and work. While Tarr and Thomas recognize the utility of the sociological literature on the risk, pain and injury experiences of athletes for the study of dancers, they go on to argue that dance and sport differ in a number of key ways, including the level of competition, less access to healthcare, and a lack of cultures of hegemonic masculinity in a female-dominated profession (2011: 143). While it is true that this study found that company dancers had limited access to health care and independent dancers had little to no access, and that hegemonic masculinity could not be considered a factor in the reasons why dancers work through pain, it was found that competition, both with the self to always be improving, and with others for contracts, roles, and the attention and praise of authority figures was a prominent feature when it came to decisions to pass in the workplace and continue dancing through pain. In general, this work parallels that of Roderick (2006a, 2006b), combining the perspectives of sport, health and work to gain a social appreciation of what it means to work in a body-centred,

118 athletic trade. Like Roderick, I argue that such an approach enhances our understanding of the pain, injury, body and health-related experiences of those in body-centred trades and that narrative accounts of these experiences have their place alongside evidencebased medicine (2006a: 94).

STUDY LIMITATIONS AND FUTURE DIRECTIONS While it is hoped that this research will enhance our understanding of the embodied experiences of professional dancers, a number of cautions must be made about the scope and limitations of the study. Only 16 individuals from the dance community, including 14 dancers, two medical professionals, and one dancer and medical professional, were interviewed. While larger, survey-based reports such as Fit to Dance? (Brinson and Dick, 1996) and Fit to Dance 2 (Laws, 2005) are more representative of a certain population of dancers, interviews with a small number of dancers has produced in-depth and rich accounts of the lived experiences of an internally varied group that I believe to be both representative of and generalizable to the dance community in general. In terms of methodology, participant observations and being present at the rehearsals and performances of these dancers would have added a further layer to the understandings produced; however, and as mentioned in Chapter 3, given the potential difficulty of gaining entrance to these normally closed places, as well as pragmatic concerns including time constraints and the scope of the project, interviews were considered the most efficient approach. Additionally, my personal understanding of the dance community as

119 an insider has added to the validity of the questions asked as well as to the validity of my interpretations of the data. In terms of the make-up of the sample, only two males were interviewed, leaving the group largely female. While a report prepared for the Canada Council for the Arts (T. J. Cheney Research, 2004) claims that 85% of Canadian dancers are women (a statistic which mirrors the gender distribution of this sample with 86% being women), a more equal sample of male and female dancers would have allowed for a more symmetrical gendered exploration of how the body is understood in the context of dance work. However, in keeping with my previous research in the area (McEwen and Young, 2011) as well as some of the work on injured male and female athletes (i.e., Young and White, 1995), the male and female dancers in this study produced extremely similar accounts of their pain, injury, and body-related experiences. A further limitation of the sample concerns the number of dance clinicians interviewed. While it was the intent to speak with as many clinicians as possible and to address their concerns and accounts more directly, only a small number of individuals in Western Canada specialize in the treatment of dancers and thus only three clinicians were interviewed. These interviews were used to augment the findings related to the dancers rather than as their own group of study. In general the data available on dance and dancers in Canada is limited (T. J. Cheney Research, 2004) and while this study goes some way towards filling this gap, further research is needed. To address some of the limitations described above, further studies could more explicitly explore the embodied concerns of male dancers, given that the male danseur has become a topic of increasing interest in recent years (e.g., Burt,

120 1995; Gard, 2006; Fisher and Shay, 2009). In addition, the relationship between dancers and dance clinicians and the experiences of dance clinicians in general could be more extensively explored. This may be more easily accomplished by expanding the area of study to include Canadian cultural centres such as Toronto and Vancouver, as well as other North American centres such as New York and Los Angeles. Dance-specialized clinicians are more likely to work in these areas and thus a larger sample could be obtained. In general, an exploration of the embodied, work-related experiences of professional dancers could be expanded to other regions beyond Western Canada. Finally, the art world approach employed in this study was only partially utilized, focusing solely upon the production of dance art and leaving an exploration of the consumption and distribution of such art relatively untouched (Becker, 1982). Future research could look at the ways in which dance art is taken up by audiences, the ways in which these audiences have access to the dance community, and how the consumption and distribution of their work influences the everyday experiences of the dance workers themselves.

CONCLUSION It is hoped that this research can contribute to the subdiscipline of the sociology of dance (Thomas, 1995) in particular and, in general, to a sociological understanding of how the working body is socially constructed by the social actors engaged in the work as well as by the existing occupational culture. It is also the hope that this work will go some way towards improving the dance community, especially in terms of gaining an

121 awareness of the lived reality of being a professional dancer and breaking down barriers in terms of the stigma associated with body and injury issues in the world of dance. However, this increased understanding and knowledge can only go so far, especially when culture work in general is seen as less important. The recent cancellation of the federal Cultural Capital Program (Beneteau, 2012), which awards funding for arts and culture community activities, is one demonstration of how the arts communities are devalued in Canadian society. Speaking of the debate surrounding arts funding in Canada, Macfarlane argues that artists need to be valued since they represent who we are as a society but that: the debate will remain unresolved until the public, and not the politicians we elect, decide that artists deserve to be honoured: not as products consumed but as miracles celebrated (2012: E1). Returning to Thomas assertion that dance is marginalized in the art world (1995: 2), that it is often considered the poorest art with low salaries compared to other fields (Darst, 2012), and the fact that most of the sociological and anthropological work conducted on dancers has been undertaken in Europe, it is clear that dancers are an undervalued population in Canada. While the work that dancers do continues to be undervalued, the ability for dancers to improve their health and well-being and to gain access to important resources, such as accessible and affordable health care, remains a challenge. In addition to the challenges associated with working in a lower-status occupation, the occupational culture of dance, and the pressures and expectations embedded in this culture, also present a challenge to improving the health of dancers. While in general I found that the attitude was to accept the risks and conventions of the dance world, dancers, especially older participants, spoke of how the industry is

122 improving in terms of health care provision and more understanding and willingness to accommodate damaged dancers on the part of company management, choreographers and artistic directors. As previously mentioned, literature aimed at the dance world brings about more awareness of the physicality and health-related issues faced by working dancers and encourages working in more healthy ways (Brinson and Dick, 1996; Hamilton, 1998, 2005, 2008; Laws, 2005). Additionally the Dancer Transition Resource Centre (2012), a Canadian-wide organization that helps and prepares dancers for transitions into and out of dancing careers, and the Art Workers Health Insurance Program (cultureONE, 2011) that offers coverage for dance companies and selfemployed independent artists, both demonstrate how some resources are becoming more readily available for Canadian dancers. At a time when the increasing popularity of dance shows, such as So You Think You Can Dance, is encouraging more participation in dance, a trend that is expected to continue (Service Canada, 2011), it becomes increasingly important to consider and draw attention to the potentially negative consequences of a dancing career. As a researcher and a member of the dance community I felt somewhat conflicted, and my subjectivity was fractured (Luff, 1999), when it came to the understandings of pain, injury and health described by the dancers in this study. On the one hand, I questioned the choice to commit ones life to a world that is so potentially abusive both physically and emotionally. To what extent were these injured dancers victims of a demanding occupational lifestyle, unthinkingly (Adair, 1992: 15) conforming to common conventions and requirements of the profession (Sabo, 2004; Young, 1991)? And in the words of Pickard, if dance is so painful, risky and potentially abusive, why

123 would anyone subject themselves to it (2007: 50)? On the other hand, my own experiences with the exhilaration, joy, and self-fulfillment that pushing the body in the name of art can produce allows me to understand that in many ways a dancing career is worth it. As explained by ballerina Karen Kain, this calling, or labour of love and the sacrifice required is ultimately worthwhile and rewarding: A dancers life may be hard, but I wouldnt have chosen any other. All the pain, the exhaustion, the injuries, the depression, the dieting, and the hardships of touring have been negligible compared to the joys of creating a new role or learning an established classic and then out on the stage and performing, and the older I get, the more I relish it all (Kain, Godfrey, and Doob, 1994: 223). Following Roderick (2006b: 10; see also Young, 1991), these dancers could be considered social actors who actively engaged in the damaging of their tools in the pursuit of career goals and in affirmation of their sense of self. It is hoped that a sociological consideration of these issues enhances our understanding of the ways that pain and injury are understood by those in body-centred performance trades. However, this increased awareness does not necessarily mean that dancers will alter their behaviour in a career in which perseverance and sacrifice are still valued and rewarded. Furthermore, in a world where the perceived benefits and subcultural rewards outweigh the physical risks and hazards, and where a generally unreflexive view is taken by the relatively powerless few (Young, 1991), wishing to make it in this competitive, demanding, youthful, and here-and-now focused occupation, large-scale change may be slow in coming.

124

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130 Kington, R. (2011, December 4). One in five ballerinas at La Scala is anorexic, leading dancer claims. The Observer. Retrieved January 18, 2012 from http://www.guardian.co.uk/world/2011/dec/04/ballerinas-la-scala-anorexic-claim. Kirkland, G., Lawrence, G. (1986). Dancing on My Grave. New York, NY: Doubleday. Kleinman, A. (1988). Illness Narratives: Suffering, Healing and the Human Condition. New York, NY: Basic Books. Langsdorff, M. (2006). Ballet and Then? Biographies of Dancers Who No Longer Dance. Stuttgart, DE: Books on Demand. Laws, H. (2005). Fit to Dance 2: Report of the Second National Inquiry into Dancers Health and Injury in the UK. London, UK: Dance UK. Leder, D. (1990). The Absent Body. Chicago, IL: Chicago University Press. Liederbach, M., Richardson, M. (2007). The Importance of Standardized Injury Reporting in Dance. Journal of Dance Medicine and Science, 11(2), 45-48. Luff, D. (1999). Dialogue Across the Divides: Moments of Rapport and Power in Feminist Research with Anti-feminist Women. Sociology, 33(4), 687-703. Lupton, D. (1996). Your Life in Their Hands: Trust in the Medical Encounter. In V. James and J. Gabe (Eds.) Health and the Sociology of Emotions (157-172). Cambridge, MA: Blackwell Publishers. Lupton, D. (2000). The Social Construction of Medicine and the Body. In G.L. Albrecht, R. Fitzpatrick and S.C. Scrimshaw (Eds.) The Handbook of Social Studies in Health and Medicine (50-63). London, UK: Sage. Macfarlane, D. (2012, April 12). Its Time to Stop Treating Artists like Hired Help. Toronto Star: E1.

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137 Waddington, I. (2004). Sport, Health and Public Policy. In K. Young (Ed). Sporting Bodies, Damages Selves: Sociological Studies of Sports-Related Injury (287-307). Oxford, UK: Elsevier Press. Wainwright, S., Turner, B. (2004a). Epiphanies of Embodiment: Injury, Identity and the Balletic Body. Qualitative Research, 4(3), 311-337. Wainwright, S., Turner, B. (2004b). Narrative of Embodiment: Body, Aging, and Career in Royal Ballet Dancers. In H. Thomas and J. Ahmed (Eds.) Cultural Bodies: Ethnography and Theory (98-120). Oxford, UK: Blackwell Publishing. Wainwright, S., Turner, B. (2006). Just Crumbling to Bits? An Exploration of the Body, Ageing, Injury and Career in Classical Ballet Dancers. Sociology, 40(2), 237-255. Wainwright, S., Williams, C., Turner, B. (2005). Fractured Identities: Injury and the Balletic Body. Health: An Interdisciplinary Journal for the Social Study of Health, 9(1), 49-66. Waskul, D., Vannini, P. (2006). Introduction: The Body in Symbolic Interaction. In D. Waskul and P. Vannini (Eds.) Body/Embodiment: Symbolic Interaction and the Sociology of the Body (1-18). Burlington, VT: Ashgate Publishing. Wulff, H. (1998). Ballet Across Borders: Career and Culture in the World of Dancers. Oxford, UK: Berg. Wulff, H. (2008). Ethereal Expression: Paradoxes of Ballet as a Global Physical Culture. Ethnography, 9(4), 518-535. Young, K. (1986). The Killing Field: Themes in Mass Media Responses to the Heysel Stadium Riot. International Review for the Sociology of Sport, 21(2/3), 253-267.

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APPENDICES

140 APPENDIX A: INTERVIEW GUIDES

Interviews with Professional Dancers Background: Age, gender, ethnicity, SES etc. How did you first get involved in dancing? (How old were you, how did you first become interested, what attracted you?) How many years of experience do you have? What is your current position, level of involvement, primary style? What sort of training did you undergo? What styles are you trained in? What is your typical schedule during the peak of your performance season? (How many times/hours do you train or practice per week?) Describe career highlights

Understanding pain and injury: Describe your history of injuries or health-related experiences? (Specifically major injuries) How many have you experienced overall / in the last year? How did the injury impact your ability to perform? How do you deal with minor experiences of pain such as bruising, cuts, sore muscles? How can you tell if something is an injury or if it is pain? What are some of the coping strategies that you use or used to deal with your injury? (Did you seek medical treatment, what kind of treatment etc.) How does timing / upcoming events influence injury management? How does competition play into your experiences?

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How do your peers or colleagues react when you are injured? Do you feel pressure to continue performing / working? (For older dancers) How has working with your body changed?

Identity: What were some of the emotions that you experienced during and or after your injury? How was your sense of self impacted? (How did you feel about yourself as dancer / as a person?) Health: Is there an ideal body type in your discipline? How do you achieve it? How do elements of perfectionism play into the way you work? How do working conditions play into your overall health and wellness? (flooring, heating, overwork, fatigue, etc.) How does nutrition play into your overall health? How does training / overtraining influence your health experiences? How important is it for your career to keep your body healthy? Do you think there are any long term health implications of being involved in dance at this level? Overall, was your injury a positive experience or negative experience?

Influence of Authority: Did you tell your choreographer or director when you were in pain or injured? (How did they react?) Does your company have any specific policies in place to promote health? Or to assist with health care?

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Is there a focus on prevention of injuries? Is there a difference between training and working?

Medical Treatment: Is there a medical professional on staff with your company that you can see regularly? What sort of professional do you seek treatment from (phsyio, chiropractor, massage etc)? What have your experiences been with treatment regimes recommended by these professionals? Do you think your doctors understood your needs as a dancer? Describe your rehabilitation process Describe a positive encounter with a medical professional Describe a negative encounter with a medical professional How is payment for your treatment handled? Is your choreographer or director directly involved in your treatment?

Other: Have your experiences changed the way your work / will work? If you had a magic wand and could change one thing that would do most to promote health, well-being, excellence and longevity of dancers - - what would it be? Do you think that you are more of an artist or an athlete? Do you think the dance profession has improved in terms of health awareness and management? Despite issue what is it that keeps you going? Why stick with it?

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Interviews with Dance Clinicians Background: Age, gender, ethnicity, SES etc. What type of professional would you describe yourself as / what are the techniques that you utilize in your practice? Do dancers make up a significant portion of your clientele? Are you associated with any professional companies or groups? If so, how did this association come about? Is dance medicine its own discipline, how has it developed, where is it going? Would you consider what you do sports medicine? What is the purpose of your treatment?

Treating Dancers: Describe the dancers who seek treatment from you (this can be in terms of disciplines, level of training, age, gender, social class, etc) What are the most typical types of health concerns that you are treating dancers for? How often do they see you? How is treating dancers different than (or similar to) treating other athletes / regular clientele? Negotiating Treatment: Are there specific protocols that you follow when deciding upon a treatment regime? Is the dancer involved in the creation of this regime? Do you find that dancers stick with their treatment regimes? How do you work specifically with the dancers to accommodate their needs?

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How do events, like an upcoming performance, play into treatment decisions?

External Forces: How do you see other pressures playing into the negotiation of treatment? Are the choreographers or coaches actively involved? How do working conditions factor into the health of your patients? ( heating, flooring, hours, etc) If you had a magic wand and could change one thing that would do most to promote health, well-being, excellence and longevity of dancers - - what would it be?

145 APPENDIX B: PARTICIPANT CONSENT FORMS

Name of Researcher, Faculty, Department, Telephone & Email:

Krista McEwen, Faculty of Arts, Department of Sociology (403) 863-6636; klmcewen@ucalgary.ca

Supervisor:
Dr. Kevin Young, Department of Sociology

Title of Project:
Negotiating Occupational Health: The Case of Professional Dancers

This consent form, a copy of which has been given to you, is only part of the process of informed consent. If you want more details about something mentioned here, or information not included here, you should feel free to ask. Please take the time to read this carefully and to understand any accompanying information. The University of Calgary Conjoint Faculties Research Ethics Board has approved this research study.

Purpose of the Study:

This research is being conducted for a Masters thesis project at the University of Calgary. The outcome of this research will be Masters dissertation that will be submitted to my supervisor and will remain on file with the Department of Sociology.

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The purpose of this project is to explore how the health and wellness of professional dancers is understood and negotiated within the occupational culture of dance and within the medical community. You are invited to participate in this project because of your first hand experience in the dance community and your personal health and wellness experiences, such as injuries and chronic pain.

What Will I Be Asked To Do? Your participation will take the form of an interview which will last approximately 45 to 90 minutes. With your permission, the interview will be audio-recorded. If you do not want to be audio-recorded, written notes will be taken during the interview. You do not have to answer any questions you do not wish to answer, and you may end the interview at any time. Should you choose to end the interview, any data collected up to that point may be used unless you specify that you do not want it to be used.

What Type of Personal Information Will Be Collected? Should you agree to participate, you will be asked to provide basic information such as your gender and age. There are several options for you to consider if you decide to take part in this research. You can choose all, some or none of them. Please put a check mark on the corresponding line(s) that grants the researcher permission to:
I grant permission to be audio taped: I wish to choose my own pseudonym: The pseudonym I choose for myself is: Yes: ___ No: ___ Yes: ___ No: ___

You may be asked to recommend any persons you know who are eligible and would be willing to participate in this study, which would require you to provide their contact information. This portion of the study is completely optional. If you choose to recommend a potential participant please indicate whether or not your name can be used when contacting potential recruits. It is also asked that you contact this potential participant before passing along any information to the researcher.
I grant permission for my name to be used when contacting a potential participant I have recommended: Yes: ___ No: ___

147 Are there Risks or Benefits if I Participate? You will not be paid or otherwise rewarded for taking part in this study. There is no known risk associated with your participation.

What Happens to the Information I Provide? Participation in this research is voluntary and you may choose not to answer any question or to end the interview at any time. This research is designed to protect your confidentiality. Your name and the names of any people or organizations you mention during the interview will be replaced by pseudonyms in the interview notes, transcripts, and the dissertation written about this research. Any identifying details will be omitted when quotations from your interview are used in the dissertation. Despite the fact that a pseudonym will be used, a possible risk to anonymity may be that individuals familiar with your specific situation and experiences may recognize you from details provided in the thesis document. Only the primary researcher and her supervisor will have access to the interview notes and transcripts. The audio tapes will be erased upon completion of the Masters thesis. Interview notes and transcripts will be stored on the hard drive of the researchers computer, but will not contain any personally identifying details. The coding guide which identifies the real names that correspond with the pseudonyms will be stored separately from the data. The transcripts will be archived indefinitely and stored anonymously on the chance that they may be important for future publications or studies.

Signatures (written consent)

Your signature on this form indicates that you 1) understand to your satisfaction the information provided to you about your participation in this research project, and 2) agree to participate as a research subject. In no way does this waive your legal rights nor release the investigators, sponsors, or involved institutions from their legal and professional responsibilities. You are free to withdraw from this research project at any time. You should feel free to ask for clarification or new information throughout your participation. Participants Name: (please print) _____________________________________________

148
Participants _______________ Signature __________________________________________Date:

Researchers Name: (please print) ________________________________________________ Researchers Signature: ________________ ________________________________________Date:

Questions/Concerns
If you have any further questions or want clarification regarding this research and/or your participation, please contact: Ms. Krista McEwen Department of Sociology, Faculty of Arts (403) 863-6636, klmcewen@ucalgary.ca And Dr. Kevin Young, Department of Sociology (403) 220-6509, kyoung@ucalgary.ca If you have any concerns about the way youve been treated as a participant, please contact the Senior Ethics Resource Officer, Research Services Office, University of Calgary at (403) 2203782; email rburrows@ucalgary.ca. A copy of this consent form has been given to you to keep for your records and reference. The investigator has kept a copy of the consent form.

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Name of Researcher, Faculty, Department, Telephone & Email:

Krista McEwen, Faculty of Arts, Department of Sociology (403) 863-6636; klmcewen@ucalgary.ca

Supervisor:
Dr. Kevin Young, Department of Sociology

Title of Project:
Negotiating Occupational Health: The Case of Professional Dancers

This consent form, a copy of which has been given to you, is only part of the process of informed consent. If you want more details about something mentioned here, or information not included here, you should feel free to ask. Please take the time to read this carefully and to understand any accompanying information.

The University of Calgary Conjoint Faculties Research Ethics Board has approved this research study.

Purpose of the Study:

This research is being conducted for a Masters thesis project at the University of Calgary. The outcome of this research will be Masters dissertation that will be submitted to my supervisor and will remain on file with the Department of Sociology. The purpose of this project is to explore how the health and wellness of professional dancers is understood and negotiated within the occupational culture of dance and within the medical

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community. You are invited to participate in this project because of your first hand experience with treating professional dancers.

What Will I Be Asked To Do? Your participation will take the form of an interview which will last approximately 45 to 90 minutes. With your permission, the interview will be audio-recorded. If you do not want to be audio-recorded, written notes will be taken during the interview. You do not have to answer any questions you do not wish to answer, and you may end the interview at any time. Should you choose to end the interview, any data collected up to that point may be used unless you specify that you do not want it to be used.

What Type of Personal Information Will Be Collected? Should you agree to participate, you will be asked to provide basic information such as your gender and age. There are several options for you to consider if you decide to take part in this research. You can choose all, some or none of them. Please put a check mark on the corresponding line(s) that grants the researcher permission to:
I grant permission to be audio taped: I wish to choose my own pseudonym: The pseudonym I choose for myself is: Yes: ___ No: ___ Yes: ___ No: ___

You may be asked to recommend any persons you know who are eligible and would be willing to participate in this study, which would require you to provide their contact information. This portion of the study is completely optional. If you choose to recommend a potential participant please indicate whether or not your name can be used when contacting potential recruits. It is also asked that you contact this potential participant before passing along any information to the researcher.
I grant permission for my name to be used when contacting a potential participant I have recommended: Yes: ___ No: ___

151 Are there Risks or Benefits if I Participate? You will not be paid or otherwise rewarded for taking part in this study. There is no known risk associated with your participation.

What Happens to the Information I Provide? Participation in this research is voluntary and you may choose not to answer any question or to end the interview at any time. This research is designed to protect your confidentiality. Your name and the names of any people or organizations you mention during the interview will be replaced by pseudonyms in the interview notes, transcripts, and the dissertation written about this research. Any identifying details will be omitted when quotations from your interview are used in the dissertation. Despite the fact that a pseudonym will be used, a possible risk to anonymity may be that individuals familiar with your specific situation and experiences may recognize you from details provided in the thesis document. Only the primary researcher and her supervisor will have access to the interview notes and transcripts. The audio tapes will be erased upon completion of the Masters thesis. Interview notes and transcripts will be stored on the hard drive of the researchers computer, but will not contain any personally identifying details. The coding guide which identifies the real names that correspond with the pseudonyms will be stored separately from the data. The transcripts will be archived indefinitely and stored anonymously on the chance that they may be important for future publications or studies.

Signatures (written consent)

Your signature on this form indicates that you 1) understand to your satisfaction the information provided to you about your participation in this research project, and 2) agree to participate as a research subject. In no way does this waive your legal rights nor release the investigators, sponsors, or involved institutions from their legal and professional responsibilities. You are free to withdraw from this research project at any time. You should feel free to ask for clarification or new information throughout your participation. Participants Name: (please print) _____________________________________________

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Participants _______________ Signature __________________________________________Date:

Researchers Name: (please print) ________________________________________________ Researchers Signature: ________________ ________________________________________Date:

Questions/Concerns
If you have any further questions or want clarification regarding this research and/or your participation, please contact: Ms. Krista McEwen Department of Sociology, Faculty of Arts (403) 863-6636, klmcewen@ucalgary.ca And Dr. Kevin Young, Department of Sociology (403) 220-6509, kyoung@ucalgary.ca If you have any concerns about the way youve been treated as a participant, please contact the Senior Ethics Resource Officer, Research Services Office, University of Calgary at (403) 2203782; email rburrows@ucalgary.ca. A copy of this consent form has been given to you to keep for your records and reference. The investigator has kept a copy of the consent form.

153 APPENDIX C: CERTIFICATION OF INSTITUTIONAL ETHICS REVIEW

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