Current Applications The KMP can be used as a comprehensive instrument in the context of psychotherapy, teaching, prevention and intervention, with children as well as adults. Because it assesses movement patterns indicative of intrapsychic and relational functioning within the dynamics of naturally occurring movement, it can aid in many different contexts, such as, i.e. in the understanding of dynamics between a clinician and a client. It can also be practical in the development of a dynamic formulation as it highlights areas of conflict, pathology, and character expressions as well as areas of harmony and ego strength. In addition, it can be employed to look at relational aspects in the therapeutic context such as bi-directional formation of empathy and attachment, matches and mismatches, and rupture and repair. One of the advantages of the KMP is that it offers a clear and systemic description of an individual's movements, distinguishing between individual preferences and movement in relation to someone else. For these purposes, movement patterns can be made conscious, described, and eventually experienced differently. Any two, or more, profiles of people in relationship can be compared. If a profile, for example, of a child is compared with the caregiver's profile, it can help to detect individual preferences as well as areas of concern between parent and child: matches and clashes in the relationship, areas of harmony and conflict and shared repertoires can be described. The KMP equips the therapist and the parent with a tool that can be directly linked to empathy and attunement, providing a language that illuminates developmentally meaningful sequences and themes, in aid of primary prevention. The KMP can be applied to clinical populations. Sossin & Loman (1992) outlined some clinical applications of the KMP. Loman (1995) describes a case study with a child with autism. Sossin (1993) explores the impact of developmental challenges on the evolving sense of self; Lewis (1993) develops an approach using the KMP with sexual abuse victims; other clinical applications include the treatment of borderline disorders (e.g. Levy, 1995), psychotic disorders (e.g. Cruz, 1995). In these areas, the KMP provides a distinct way of describing and categorizing interactive processes within a unified developmental and psychodynamic framework. It is also useful as a guide in the prevention and treatment of psychological problems, especially in Infant/Parent Psychotherapy (e.g. Sossin, 1993, 1999a, b, 2002, 2003; Sossin & Loman, 1992) and in the arena of parent/child holding patterns (Romer & Sossin, 1991). One other application of the KMP application is "Movement Retraining". Here, the KMP aids in helping parents re-experience developmental movement patterns. By experiencing and learning about them, parents are better able to attune and support their child's developmental progress (Buelte, 1992).
The KMP in Dance/Movement Therapy The KMP is widely used within the field of Dance/Movement Therapy (DMT) (i.e. Loman 1992, 1993, 1994, 1996, 1999, 2005; Lewis, 1986; 1987; 1993a;b; 1994;), where it serves as an assessment tool of non-verbal behavior which can then be processed verbally as well as through movement. Dance/ Movement Therapists who work within the psychodynamic/psychoanalytic traditions, can use the KMP for the observations of ego functioning, defense mechanisms, affect expression, and for the assessment and attunement in transference/countertransference matrix. Bridging the KMP with other body-mind approaches, Loman, Ender and Burden (1994) discuss the KMP in relationship to the Body-Mind Centering (Bainbridge-Cohen, 1987), and develop a framework integrating the KMP with primitive reflexes, righting reactions, equilibrium responses and the Basic Neurological Patterns. Another paper looks at the KMP within a feminist relational model (Loman & Foley 1996). Loman (1994) investigates fetal body movements; and Loman & Kasovac (1997) used the KMP in the context of an infant heart transplant. In the field of anthropology, the KMP was used to investigate mother/child relationship and affect in Bali (Kestenberg-Amighi & Pinder, 1992). Dance/movement therapists have increasingly drawn upon psychodynamic and developmental models in framing their clinical interventions (Dosamantes, 1990; Goodill, 2005; Kornblum, 2002; Lewis, 1984, 1986, 1990, 2002; Loman, 1998, 2005, Loman & Foley, 1996, Loman & Merman, 1996; Sandel, 1982; Siegel, 1974, 1984; Tortora, 2006). The KMP offers a developmental framework that can be used to encourage and measure growth, and to integrate progressive interventions with the developmental process (LaBarre, 2001). It describes the typical developmental process in movement terms, which aid in identifying deviations from the norm, as well as strengths and latent potentials. The KMP' s psychodynamic framework provides information about drive development, affects, defenses against drives, defenses against objects, ego and superego functioning, object relations, narcissism, and areas of conflict or harmony in dynamics and object relationships. The diagnostic/interpretive application of the KMP can lead to the detection of specific early developmental deficits and areas of psychic conflict, and suggests which movement patterns will be likely to foster resolution and growth. For example, the profile can indicate delayed, missed, distorted, or prematurely-induced developmental milestones by showing scanty or overabundant amounts of phase-appropriate movement patterns. Specific problems caused by trauma, such as abuse, separation or illness, during a specific phase of childhood, may affect the shape of diagrams in the KMP. When children experience these difficulties, they feel a sense of inadequacy that affects their self-image and often endures into later life. Body-image distortions, restrictions of movement, and accident-proneness may all be remnants of childhood trauma. The KMP identifies the specific movement patterns that are most relevant to the early conflicts between a specific caregiver and the child (such as inadequate holding and support or constitutional temperamental differences) that had, or are having, a formative impact upon the child's movement repertoire. Once a deficit or challenge area in movement patterning is recognized in the KMP, various channels of intervention can be explored. By offering a systematic way to discern an individual's movement repertoire, and to correlate it with psychological experience, the KMP offers a stratagem for approaching treatment. Dance/movement therapists often use tension-flow attunement to develop affective empathy, and shape-flow responsiveness to develop trust (Kestenberg & Buelte, 1977a). These processes can evolve into more mature movement interactions when the patient is ready. Dance/movement therapists operate in many different professional settings, and the KMP provides them with a powerful tool to assess patients in developmental and psychodynamic terms. To optimally use the KMP, the therapist would evaluate the patient's progress with a complete pre-treatment and post-treatment profile. In treatment planning, the KMP would be used to identify strengths as well as deficits, guide the therapists' movement approaches, and help the therapist determine whether to use attunement, mirroring, or affined movement patterns with the patient (Loman, 1994). Research Applications So far, the KMP's developmental model has been primarily based on hundreds of case studies, including longitudinal studies, of children, adolescents and adults (Kestenberg, 1965a & b, 1967; Kestenberg & Sossin, 1979). Recent studies have focused on the application of KMP regarding stress-transmission in parent-infant dyads (Sossin & Birklein, 2006; Birklein & Sossin 2006), depression (Brauninger, 2005), gender and leadership, (Koch, 2005), and mother-infant interaction in psychiatry (Koch & Brauninger, 2005). Future studies can produce norms for healthy and pathological populations across culture, age and gender, from which a statistical outline of diagnostic indicators can be drawn (Sossin, 2003). Longitudinal research with the KMP can advance psychodynamic theory by tracing specific developmental issues (such as aggression, narcissism, superego development or personality) from early infancy. Detailed studies of specific diagnostic populations are needed to establish the range of individual variation within groups. Other subjects for study could include premature infants, individuals with physical illnesses, role-dependent or context-dependent behavior. More research can also increase our understanding of risk factors, prevention and early intervention approaches with vulnerable infants and children (Kestenberg & Buelte, 1983). Methodological research can examine the reliability of the current notation (Sossin, 1987; Cruz & Koch, 2004; Koch, Cruz & Goodill, 2002), and develop amended profiling procedures as needed for specific applications. Computer programs can facilitate scoring and correlation of profiles (Lotan & Tziperman, 1995, 2005). The validity of the current interpretive schema can be examined, and specific distributions can be related to clinically-relevant variables such as IQ, depression, neurological impairment, defense mechanisms, and systemic conflicts. Summary of the KMP The KMP contains nine categories of movement patterns representing two lines of development. System I, or diagrams on the left side of the KMP, documents a line of development beginning with movement patterns available to the fetus and newborn and continuing throughout life. Tension-flow rhythms and tension-flow attributes describe inner needs, feelings and affects. The System evolves to pre-effort and effort diagrams reflecting more advanced patterns in response to learning modes and environmental challenges. System II, diagrams on the right side of the KMP, documents a line of development dealing with relationships to people and things. The top diagrams, bipolar and unipolar shape-flow, represent movement patterns available to the fetus and newborn that continue throughout life. They describe, respectively, symmetrical and asymmetrical dimensional body expansion and contraction. Next, shape-flow design represents movement pathways towards and away from the body, followed by shaping in directions representing patterns that form linear vectors and finally shaping in planes represents elliptical designs within one or more spatial planes. The KMP graphically depicts 120 distinct movement factors (across 29 polar dimensions) and includes a body attitude description and qualifying numerical data. Each of the nine KMP diagrams refers to a specific kind of movement pattern (Figure 1 is an example of a blank KMP profile). The observational, developmental and interpretive characteristics of the KMP' s movement patterns are summarized below. Tension-Flow Rhythms The KMP' s view of development proceeds through a sequence of developmental phases, reflecting the tension-flow rhythms (see Kestenberg Amighi, et. al, 1999). As development proceeds through each phase, preferences for different movement patterns surface and change and are reflected in the qualities of movement that are most likely to be used. Variations between free and bound flow are rhythmic, although irregular, in their intervals. Ten rhythmic patterns have been identified, corresponding in pairs to the five major developmental phases: oral, anal, urethral, inner-genital and outer genital (Kestenberg, 1975). The ten basic rhythms are sucking, snapping/biting, twisting, strain/release, running/drifting, starting/stopping, swaying, surging/birthing, jumping, and spurting/ramming. At the height of each phase, we expect to see the largest proportion of rhythms typical for that phase, but all of the rhythms are still available to the individual. For example, the oral/sucking rhythm would be most prominent rhythm in the oral indulging phase. All body parts can show all rhythms, and all rhythmic patterns are evident (to greater or lesser extents) at all phases. Frequency distributions appear to reflect consistent individual differences. Other body parts, such as the fingers or toes, may also show these rhythms, and the different areas of the body may express consistent or inconsistent rhythmic patterns. In addition to the ten basic rhythms, there is great variety of mixed rhythms, combinations of two or more rhythms. Individuals preferences for specific tension-flow rhythms indicate their preferred methods of drive discharge. Comparison of tension-flow rhythm patterns in interpersonal relationships, such as between mother and child, reveals the areas of potential complementarity or conflict in the relationship, in terms of needs. Tension-Flow Attributes Tension Flow is a manifestation of animate muscle elasticity. Bound flow is a restraining movement that occurs when agonist and antagonist muscles contract simultaneously. Free flow is a releasing movement that occurs when a contraction of the agonist muscles is not counteracted by the antagonists. Neutral flow refers to a limited range of flow observed in limpness, de-animination, illness or numbing. Tension-flow can also be classified in terms of its attributes (or intensity factors), which describe tension changes along three dimensions: even or adjusting; high or low intensity; abrupt or gradual. Tension-flow attributes are preferences for fighting or indulging patterns of arousal and quiescence. These preferences are present from birth (and even before); they show increasing stability as the individual matures, influenced both by developmental factors and by individual temperament. Although tension-flow patterns continue throughout childhood and into adulthood, they tend to become subordinated to more advanced movement factors. Interpretively, tension-flow is linked to affect regulation: bound flow and fighting attributes are associated with cautious feelings, while free flow and indulging attributes are associated with carefree feelings. More subtle or complex affects are related to combinations of tension-flow attributes. Precursors of Effort Laban used the term effort (1960; Laban & Lawrence, 1947) to describe movement changes (including tension-flow) in relationship to space, weight and time. Efforts are developmentally preceded by precursors of effort, affectively charged ways of manipulating the external environment, which become motor counterparts of defense mechanisms and styles of learning. The KMP uses six pairs of precursors of effort: channeling vs. flexible, straining and vehemence vs. gentle, and sudden vs. hesitating. The first element of each pair is fighting, while the second element is indulgent. For example, channeling keeps tension levels even to follow precise pathways in space; this has a fighting character. Its opposite, the flexible precursor of effort, changes tension levels to meander around in space and is thus more indulgent. In terms of defense mechanisms, isolation can take the form of channeling, using an even flow of tension. Avoidance may be put to defensive use in the form of flexibility. Like defenses, the precursors of effort can be either problematic or constructive--isolation can be either affective disassociation or objective thinking. The precursors of effort are both body-oriented, in terms of tension-flow, and reality-oriented, in terms of space, weight and time; hence, they mediate between tension-flow and effort. Effort Efforts are the motor components of coping with external reality in terms of space, weight and time. In space, these are direct and indirect; in weight, strength and light; and in time, acceleration and deceleration. Direct, strength and acceleration are fighting effort elements, while indirect, light and deceleration are more accommodating ways of dealing with space, weight and time. The line of development of an effort element may be traced back to a specific precursor of effort and, even further, to a specific tension-flow attribute pattern. The individual's mature constellation of effort elements shows their preferences in terms of attention, intention and decision-making. Bipolar Shape-Flow Changes in shape-flow express shifts in affective relations with objects in the environment. Bipolar shape-flow is the symmetrical growing and shrinking of the body in response to environmental stimuli. In terms of breathing, for example, we grow with inhalation and shrink with exhalation. Growing and shrinking occur in three dimensions: horizontal (width), vertical (length) and sagittal (depth). Bipolar shape-flow expresses the individual's emotional response to the environment, and structures their discharge of fighting and indulging drives. Unipolar Shape-Flow In unipolar shape-flow, the body grows and shrinks asymmetrically, expressing attraction or repulsion toward discrete stimuli. Unipolar shape-flow also occurs in three dimensions: horizontal (lateral vs. medial), vertical (cephalad vs. caudal) and sagittal (anterior vs. posterior). In a vertical unipolar movement the body grows only upward or downward (vs. a vertical bipolar movement which lengthens both upward and downward). Unipolar shape-flow evolves from reflexive behavior and becomes a system of extending the body in space (shaping of space in directions). Shape-Flow Design Along with changes in body shape, body movement also creates designs in personal space. These movements can be either away from the body (centrifugal) or toward the body (centripetal). They are classified in terms of their linearity, their degree of amplitude and their angularity. Shape-flow design is notated somewhat like tension-flow, but utilizing spatial rather than tension parameters. Shape-flow design patterns reflect the individual's style of relating and feelings of relatedness. They are influenced by cultural conditioning, congenital preferences, developmental stages and situational factors. Shaping of Space in Directions Shaping in directions is formed by the linear projection of the body into dimensional space. These directional movements bridge distant objects with the self. Directions in space include moving across the body and moving sideways (horizontal), moving downward and moving upward (vertical), and moving backward and moving forward (sagittal). Directional patterns are associated with precursors of effort, defenses against external stimuli, and environmental learning responses. Closed-shape directions (moving sideways, upward and forward) form the outer limits of bodily access, creating new boundaries. For example, moving across the body creates a shield against frontal and side attack, while moving sideways eludes attacks from the back and side. Learned responses are linked to these defenses; for example, moving backwards, a defense against frontal attack, is associated with suddenness, allowing the mover to quickly avoid an aggressor.
Shaping in Space in Planes Shaping in planes configures space by creating concave or convex shapes. Horizontal shaping encloses or spreads; vertical shaping descends or ascends; sagittal shaping retreats or advances. However, each spatial plane includes a principal and an accessory dimension. In the horizontal plane, the accessory dimension is sagittal; spreading and enclosing are used in exploration. In the vertical plane, the accessory dimension is horizontal; ascending and descending are used in confrontation. In the sagittal plane, the accessory dimension is vertical; advancing and retreating are used in anticipatory actions. Interpretively, shaping of space in planes expresses multi-dimensional relationships with objects and their internalized images. The Two Systems The tension-flow/effort system (System 1), shown by the diagrams on the left side of the KMP (Figure 1), depicts developmentally evolving patterns of dealing with internal and external reality. The shape-flow/shaping system (System 2), shown by the diagrams on the right side, depicts developmentally evolving patterns of spatial movement expressing growing complexity of object relations. The two systems resonate interpretively: fighting tension-flow/effort patterns are affined (fit well), with shrinking shape-flow and closed shaping; pleasant and indulging tension-flow/effort patterns are affined with growing shape-flow and open shaping. Other Integral Features of the KMP The KMP is statistically constructed, and organized to optimize its use as a descriptive tool; however, it can only summarize the complex processes involved in human movement. The raw notational data supplements the profile, especially with the individual's characteristic patterns of phrasing. Certain patterns may appear more in the introduction, main theme, ending or transition of a phrase. Movement can occur in gestures, using just one part of the body, or in postures, involving the entire body (Lamb, 1965, 1987; Ramsden 1973). Movement phrases sometimes show the same patterns, first in a gesture and then in a posture, or vice versa. These sequences are called gesture-posture or posture-gesture merging , and are generally not integrated until adolescence. Interpretively, postures indicate a more whole-hearted involvement than gestures, since they require greater bodily participation. The load factor is a statistic that shows the complexity of movements in each subsystem by indicating how many elements are included in an action. The range of the load factor is between one (33% load factor) and three (100% load factor). It compares the relative complexity of each subsystem. Another important statistic is the gain-expense ratio , that compares the number of movement elements (gain) per subsystem to the number of movement flow factors (expense). 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