Moving for mental wellbeing – the central role of attention and focus

This years’ Mental Health Awareness message is “Moving for our mental health”. It’s well-known and well documented that movement is central to balancing physical and mental health and yet for many today, simply the idea of embarking on a physical activity, confronting the body and meeting others, represents a major obstacle. For teachers of movement – from dance educators to health educators, athletic trainers and  physical therapists – it’s essential that we unpick the component parts of that major obstacle, if we are to be inclusive of those in most need of moving.

The language of movement  – the importance of conscious cueing

It’s not just moving for the sake of moving per se, that promotes mental health – it doesn’t matter what kind of activity you consider to embark on – what most impacts mental health is how it is delivered and instructed. How instructors typically speak about movement and about the body when it comes to learning a physical activity can often create more barriers to engagement, motivation and staying power.

The unconscious language and attentional focus used by many coaches and instructors – or indeed, our own negative self-talk – heightens difference, reinforces self-consciousness, diminishes self-worth, increases a sense of isolation and promotes expectations of failure.

Choice of instructional language used to guide the attention and focus of the learner has the power to boost strength and stamina, promote successful physical outcomes and enhance wellbeing – or alternatively, to deplete energy levels, undermine strength and sabotage our best efforts (Guss-West, 2021). Managing the focus of attention in movement is the make or break mental skill of successful Olympic athletes and professional performing artists – and yet this same mental training and techniques are rarely applied or understood where they are most needed – as key physical and mental strategies for motivating successful movement with all publics.

The transformative power of shifting focus of attention

According to the science of motor skills learning, there are two basic ways of engaging the focus of attention when approaching movement activity and movement learning. In the absence of specific attentional training, teachers and coaches typically draw the attention to the person and the control or correction of their body parts, referred to as Internal Focus of Attention (IFA). Although it’s a very common approach to movement coaching, directing the focus on to the person and their body, significantly deteriorates movement efficiency and renders learning more challenging in professionals and beginners alike. It interferes with automatic motor control processes and triggers a movement paralysis – a freezing reaction that spreads from the part to be controlled, throughout the body to produce a more global movement dysfunction in all movers (Wulf, 2007).

There is a question of magnitude of course. A high-performance athlete might experience a micro freeze that affects their performance stability, strength or coordination as they shift their focus to correct a body-part (IFA), whereas a recreational mover or older adult would experience a much more significant freezing or paralysis of coordination, cognition overload, impaired breathing, and increased difficulty to grasp the movement. Not to mention attempting to focus on or control a body-part for an individual managing a neurological challenge such as Parkinson’s Disease, which can result in total standstill, in which the individual is unable to take even one step further.

Strategies for unfreezing entail a deliberate shift of the focus of attention away from self, self-related thoughts and self-control of body parts, to facilitate fluid, optimal movement. This approach, known as External Focus of Attention (EFA) is evidenced scientifically to boost strength, stability, speed, stamina, multitasking, managing stressful conditions and promoting optimal mental wellbeing for all movers (Chua, 2021; Bjørneboe, 2023).

The Virtuous Circle of External Focus of Attention

The use of EFA instruction language, promotes immediate benefits such as: deepening of the breathing, lowering of heart rate, reduction of muscular hypertension, increasing flexibility and range of motion, improving movement quality and fluidity and promoting automatic micro-adjustment to diminish postural sway and reinforce movement confidence (Wulf 2013). These benefits apply to all ages, all skill levels, abilities or disabilities, from the complete beginner, to the older adult mover, dancer in recovery or mover managing physical or neurodegenerative challenges or special needs.

IFA language is personal, it focuses on the control of body parts and instructions are intolerant of difference, containing a single, instructor-centric, corrective action. e.g. stretch your leg. Even with the best intentions, this approach implies consistently that the individual and their body are wrong. The instructor holds the keys to the right movement and the right body.

An IFA vicious circle ensues in which self-consciousness is heightened, the movement and the learning are less successful, failure is reinforced, Dopamine production is blocked and motivation and staying power are low.

EFA language is not personal, it focuses on the desired movement, it describes the desired movement pattern, trajectory, quality, rhythm, musicality. Instructions might refer to physical objects, partners, sensations, sounds or to imagery to offer a learner-centric process that promotes implicit learning e.g. create a strong diagonal line or like a lazer – imagine sending energy out. This non-personal language is inclusive of difference, implying multiple possible solutions to empower the learner. Everyone can imagine and can successfully respond to EFA cues. The mover holds the keys to the learning process and to freely explore the desired movement.

An EFA virtuous circle ensues in which movement outcomes are enhanced, the learner experiences a sense of success, the learning process is lighter, Dopamine is promoted and motivation and staying power are high.

Deploying EFA in movement might consist of such choices as a focus on the movement qualities, sensations and intentions or a focus on the musicality in dance or on partner movers or might involve exploring the movement through creative imagery.

Taking a very simple EFA example using geometrical shapes: If the desired movement has a spiralling trajectory – suggest a focus only on the smooth, spiral shape, nothing else. This will promote all of the physical benefits associated with EFA, whilst the brevity and simplicity of the image and instruction provides an anchor for the mind and brain, helping to keep disruptive thoughts at bay.

The broad holistic benefits of an EFA teaching approach

The current epidemic of mental health issues is most prevalent in the adolescent and young adult population. From 2023 data we know that one in five young people are coping with a diagnosable mental health challenge, 23.3% of 17-19-year old (EPI, 2023). There is a gender gap too and adolescent girls are more likely to develop mental health issues than boys. This population, more than any other, needs help to break down the barriers to moving and to increase social contact to support their mental health and resilience. This support will come from movement coaches, dance teachers and educators, physical therapists who can evolve their practice to shift their approach and adapt their instructional language to use EFA as a strategy to promote inclusivity, dissolve difference and validate and empower the learner.

In today’s culture of self-focus, self-recording, rewinding and incessant reviewing of images, the fact that negative self-talk is not a constant when teaching with EFA is already progress, suggests Swedish dance educator Agnieszka Dlugoszewska. The IFA bubble of perpetual self-critique and negative self-talk that isolates learners from one another, dissolves when EFA is introduced. Learners suddenly see one another and whatever their skill level, are united in a common movement task that involves EFA elements outside of their stream of thoughts. They find themselves moving or dancing together, rather than alone.

Over and above the well documented benefits to physical performance and learning, recent research reveals surprising emotional, mental and social wellbeing benefits of implementing EFA as a teaching strategy. In Katja Bjørneboe’s study, young adult dance students describe how engaging in EFA processes and tasks, allowed them to feel mentally present, focused and engaged in the activity, reducing feelings of anxiety and stress. They describe as a result, being less harsh and judgmental on themselves and with the group. They felt EFA allowed them the freedom to experiment and to be less afraid to make mistakes. Self-esteem increased and EFA dissolved the barriers of self-doubt, allowing students to skip the phase of I can’t. They reported feeling more nurtured and taken care of, as if the environment became a safer place to move and dance in (Bjørneboe, 2023).

The same physical movement outcome, learning and wellbeing benefits are experienced by those managing mental health conditions such as Attention Deficit Hyperactivity Disorder (ADHD), Mild Cognitive Disability and neurodegenerative conditions (Wulf, 2013). Mika Cigic, a dance student studying online and managing ADHD, says that working with EFA immediately gets her out of her head and into the present moment. Guiding her attention to images, textures, sounds, kinaesthetic touch, is grounding she says, and she feels like one whole moving, dancing being, rather than split into multiple parts (IFA) by constantly trying to micromanage her body in some kind of fragmented multitasking that only serves to exacerbates her ADHD challenges. (Cigic, 2024).

“This external focus uses your body’s innate wisdom. It doesn’t interrupt or hijack it like IFA does” Mika Cigic, a dance student managing ADHD.

Moving for mental wellbeing, yes definitely – and . . .

• mindful delivery of movement with a conscious choice of inclusive language,
• adopting an external focus of attention to dissolves barriers and difference,
• to promote a sense of success, enhance physical outcomes and mental wellbeing through movement for all.

Available on LinkedIn Articles – published by Clare Guss-West for Mental Awareness Week 2024

References and Further Reading

Bjørneboe, K. (2023). External focus of attention applied to motor learning and performance aspects in dance training [Unpublished master’s thesis]. Bern University, Switzerland.

Bress, S. (2022). Dancing with ADHD: The challenges, surprise benefits and tools to cope. Pointe Magazine. https://pointemagazine.com/dancing-with-adhd/ 14th Nov 2022.

Chua, L.-K., Jimenez-Diaz, J., Lewthwaite, R., Taewon K., & Wulf, G. (2021). Superiority of External Attentional Focus for Motor Performance and Learning: Systematic Review and Meta-Analyses. Psychological Bulletin 147-6: 618-645

Cigic, M. (2024). Personal communication. Dancer, actor, member of IADMS. March 16th, 2024.

Dea, G. (n.d.). Feedback and Cueing Part 2 – Reliable Strategies. On Target Publications. Retrieved from https://www.otpbooks.com/greg-dea-feedback-and-cueing-2/

Dlugoszewska, A. (2024). Personal interview. International teacher and coach, rehearsal director, Cullberg (Ballet), former professional dancer, educated National Ballet School, Poland. January 22, 2024.

EPI. (2023). Education Policy Institute Four Charts which explain the state of children’s mental health in 2023. Retrieved from https://epi.org.uk/publications-and-research/four-charts-which-explain-the-state-of-childrens-mental-health-in-2023/

Guss-West, C. (2021). Attention & Focus in Dance. Champagne: IL. Human Kinetics Books.

Guss-West, C. & Becker, I. (2021). Ballet for All – shifting focus to adapt practice. IADMS.org. [Blog post]. December 18, 2020. Retrieved from https://iadms.org/resources/blog/posts/2020/december/ballet-for-all-shifting-focus-to-adapt-practice/

Guss-West, C., & Leventhal, D. (2024). Attention and focus strategies for dance educators. Online resource and professional development course. Champagne: IL. Human Kinetics Books.

Lewthwaite, R., & Wulf, G. (2016). Optimizing Performance Through Intrinsic Motivation and Attention for Learning: The OPTIMAL Theory of Motor Learning. Psychonomic Bulletin & Review 23: 1382-1414.

Wulf, G. (2013). Attentional focus and motor learning: A review of 15 years. International Review of Sport and Exercise Psychology. 6:77-104

Wulf, G. (2007). Attention and motor skills learning. Champaign, IL: Human Kinetics