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Belly dance in the United States

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Belly dance in the United States cultural productions of alternative health narratives and practices
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Sweitzer, Elizabeth ( author )
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English
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Belly dance -- United States ( lcsh )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

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Belly dance, which has predominantly been studied in the context of post-colonialism and Orientalist frameworks, has recently been gathering academic steam as an embodied practice with significant effects on body image. However, it has not previously been investigated as to whether the dance as a cultural form influences or changes ideas of health, nutritional practices, or self-care modalities. Based on participant observation and interviews with professional and semiprofessional dancers, the physical and nutritional self-care practices of American belly dancers are examined as to how these are incorporated into personal regimens as either complementary or alternative narratives to the traditional biomedical model. Results indicate that control of the body frequently acts as an embodying feature of the dance, which has pervasive ramifications for understanding the self and the needs of the body, the acceptability of physicians and biomedicine, conceptions of illness, and systems of healing that are determined to be appropriate.
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Thesis (M.A.)-- University of Colorado Denver
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Includes bibliographical references.
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by Elizabeth Sweitzer.

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University of Florida
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999820527 ( OCLC )
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Full Text
BELLY DANCE IN THE UNITED STATES: CULTURAL PRODUCTIONS OF
ALTERNATIVE HEALTH NARRATIVES AND PRACTICES
by
ELIZABETH SWEITZER B.A., University of North Carolina Asheville, 2013
A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirements for the degree of Master of Arts Anthropology Program
2017


This thesis for the Master of Arts degree by Elizabeth Sweitzer has been approved for the Anthropology Program by
John Brett, Chair Sarah B. Horton Donna Mejia
Date: May 13, 2017


Sweitzer, Elizabeth (MA, Anthropology Program)
Belly Dance in the United States: Cultural Productions Of Alternative Health Narratives and Practices
Thesis directed by Associate Professor John Brett
ABSTRACT
Belly dance, which has predominantly been studied in the context of postcolonialism and Orientalist frameworks, has recently been gathering academic steam as an embodied practice with significant effects on body image. However, it has not previously been investigated as to whether the dance as a cultural form influences or changes ideas of health, nutritional practices, or self-care modalities. Based on participant observation and interviews with professional and semiprofessional dancers, the physical and nutritional self-care practices of American belly dancers are examined as to how these are incorporated into personal regimens as either complementary or alternative narratives to the traditional biomedical model. Results indicate that control of the body frequently acts as an embodying feature of the dance, which has pervasive ramifications for understanding the self and the needs of the body, the acceptability of physicians and biomedicine, conceptions of illness, and systems of healing that are determined to be appropriate.
The form and content of this abstract are approved. I recommend its publication.
Approved: John Brett


ACKNOWLEDGEMENTS
This writing could not have happened if not for the many women of this study who shared their personal stories, I am forever grateful for the trust and participation those women gave me. I would like to thank the many other dancers who helped to shape this study through countless conversations across several years. I would also like to thank my many teachers, both in the world of dance and the academic world who shaped my abilities and passions. I am grateful for the proof reading provided by Ray Mcpherson and Sami Harvey, and to my committee members, John Brett, Sarah Horton, and Donna Mejia for their support and engagement in my research. Thank you to Connie for being infinitely patient and helping students navigate the bureaucracy of graduate school. Finally, I would like to thank my family, who always supported my pursuit of knowledge. This research, protocol number 16-1927, was approved by Colorado Multiple Institutional Review Board in October, 2016
IV


Table of Contents
I. INTRODUCTION................................................1
II. METHODS.....................................................8
III. FINDINGS/DISCUSSION........................................14
Control and Embodiment.................................14
Understanding of the Self: A Cartesian Holistic Fusion.19
Rejection of Physician Knowledge and Biomedicine...23
Adrenal Fatigue as an Idiom of Distress................30
Healing through Herbalism, Supplements, and Alternative Treatments.............................................37
IV. CONCLUSION.................................................53
BIBLIOGRAPHY.................................................56
APPENDIX.....................................................61
v


CHAPTER I
INTRODUCTION
Belly dance classes occur throughout the United States, ranging from those that cater to a casual hobby designed for fitness to serious and focused training courses intended to create professional dancers. The term belly dance itself is an umbrella term originating in the United States that describes multiple sub genres occurring all over the world, many of which have little to no resemblance to the Orientalized image of a scantily clad harem girl. Vast arrays of regional folk dances, both casual and stylized, are also part of the frequently seen repertoire of the average belly dancer. Some genres look identical to the commercialized imagery of the dance, while other genres rarely reference any Middle Eastern or Arab culture and more closely resemble genres such as Hip-Hop or Modern Dance.
While common rhetoric cites belly dance first occurring in the United States at the 1893 Chicago World Fair, it actually was first documented to appear in Philadelphia in 1876 in celebration of the anniversary of the signing of the Declaration of Independence (Burnam 2012; Monty 1986). Since this time, there has been a complex history of politicized sexual anxiety and racial marginalization that cannot be separated from how the public and scholars have interacted with the dance form. Contemporary dancers in this form regularly have to navigate various forms of stigma associated with performing the dance (Krauss, 2010).
Most professional dancers in this genre create a living by teaching classes as well as engaging in a huge underground network of dance festivals both in the United States and internationally. Within festivals and classes, information is
1


regularly shared about self-care, conditioning, and strength training to become better at dancing. Narratives are steadily transmitted about ideas of proper ways to warm up and cool down the body for mitigation of the impact of dancing as well as other messages related to ways that certain movements and positioning can maximize health of the body. Individuals can often be seen taking tinctures, or liquid herbal blends, drinking specialty teas, and discussing their diets.
Inside the belly dance community, this rhetoric of health is very commonplace. Ideas are shared, many of which might be considered atypical to average western delivery systems. Based on my own experiences as a belly dancer,
I felt that this rhetoric and relation to health care warranted further study as to why this population seemed to prefer many complementary and alternative medicines and treatment systems while largely rejecting western biomedicine.
I argue that the control of the body emphasized in how American belly dancers are trained, which allows for the unnatural serpentine movements and precise muscle control that have become iconic in the dance form, often translates into other arenas of the dancers life, such as their relationship with healthcare. Control of the body becomes a central motivator in how dancers interact with biomedicine, choose alternative practitioners, accept or reject diagnoses by others, self-diagnose, identify with illness, and incorporate treatment regimens.
Belly dance has a sparse presence in the academic literature. The bulk of study has primarily served to understand the historical Orientalization of the imagery of dancers in Hollywood media. It is portrayed typically as a falsification or cartoonish rendition of Arab culture and an excuse for American women to sexualize
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their bodies for male audiences in the wake of the nations feminist sexual revolution
during the 1960s and 1970s (Downey et al. 2010; Karayanni 2004; Moe 2013; Shay 2005; Shay and Sellers-Young 2003; Tiggemann et al. 2014; Maira 2008). Since the 1960s and 70s, the art form has progressed in its engagement and dialogue with numerous cultural histories and modernities after leaving the gaze of Hollywood. The academic study of this dance has continued sporadically but has yet to critically engage with health aspects of these communities, with the closest studies being those which view how this dance form may act as a therapeutic tool for individuals that have suffered certain forms of violence (Moe 2013), or how the ascription of spirituality on the practice influences identity formation (Downey et al. 2010; Karayanni 2004; Kraus 2014; Shay 2005; Shay & Sellers-Young 2003). Some work has been done to utilize the frameworks of medical anthropology in regards to athletes, and even somewhat about dance forms such as ballet or African dance forms where dancing is identified as integral to concepts of ritual and healing; however, belly dance has not been previously examined within these constructs (Monteiro and Wall 2011; Toy 2009; Twitchett 2009).
Recent estimates put the use of complementary and alternative medicine (CAM) at around 40% in the United States, however this estimate may arguably be low as indigenous systems of health in largely invisible populations may not be properly represented in health statistics that primarily look at services such as acupuncture and chiropractic manipulation (Thompson and Nichter 2015). CAM is used both by those with access to biomedical healthcare as complementary or
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supplementary care, as well as those that find the American health care system either inaccessible or indigestible to their worldview.
Predominantly, the markets that CAM systems find themselves in are largely self-regulated and paid for directly by consumers. In self-reported health assessments, individuals that turn to alternative or complementary treatments report having more health problems than their non CAM using peers while at the same time consistently report their health as improving from the prior 12 months (Nguyen et al. 2001). This figure could either demonstrate that those who face more illness tend to seek out additional care outside of biomedicine and recognize some amount of benefit from it, or indicate the embodiment of additional idioms of distress (Nichter 1981) that patients otherwise would not have been exposed to and identified with in biomedical treatments.
My own engagement with belly dance began in 2012. I began belly dancing as a hobby and it quickly turned into a fascinating outlet in which I was exposed to many different cultures. My dance training included education on culture, music, dress, food, politics, history, language, and self-care practices from places such as Egypt, Tunisia, Libya, Lebanon, Egypt, Saudi Arabia, Turkey, The Balkans, Spain, Iraq, and the Rajasthan and Orissa states of India. Education was also given about specific nomadic groups such as the Bedouin or the Romani. Once my hobby of dancing transformed into specialized performance preparation, I tapped into the national circuit of professional training for belly dancers. Since then, I have traveled all over the country participating and observing training events with professional
4


dance teachers from all over the world. I continuously noticed patterns of self-care, alternative medicine use, and interesting relations to the body.
In 2014 and 2015, I began working with a prominent professional belly dancer. My specific job entailed assisting in running her studio and providing personal assistant work to aid in her own work as a traveling professional dancer. During this time, I would meet dozens of dancers each week, varying from hobbyists to those in training to make dance their permanent profession. I observed countless classes from many different teachers in different genres of dance and noticed the same patterns of communication in regards to health and nutritional information.
In 2015 and 2016, I attended three training events and began inquiring about the topic of my proposed research and gained a lot of interest from key stakeholders in the community, including multiple dancers that are also academicians. I piloted my research idea at an event in April 2016 with 15 dancers from across the United States who traveled to study with a top international dancer. The individuals were both receptive and excited about my proposed research.
While conducting a qualitative or ethnographic study in a population one also resides in may be a potential site of criticism on issues of objectivity, I tend to take the stance of Lila Abu-Lughod, who has written extensively about the process of conducting research as a feminist or a halfie anthropologist (Abu-Lughod 1991). She articulates the inherent issues of power that derive from differentiating the self from the Other, and that a professional discourse of objectivity and expertise, is inevitably a language of power (Abu-Lughod 1991, 150).
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Phillipe Bourgois, an acclaimed anthropologist who has developed several groundbreaking ethnographies of the vulnerable affirms, only by establishing longterm relationships based on trust can one begin to ask provocative personal questions, and expect thoughtful, serious answers (Bourgois 2003, 13). My relationship with the belly dance community allowed me in the short time I had to conduct this research, to dive immediately into personal questions that I firmly believe would have been difficult, if not impossible to elucidate in the available time if there was not already an established mutual trust based on my identity as a belly dancer. While I did not personally know all of my participants, the national community of belly dancers is rather small. Thus most dancers who are dancing professionally have at least passing knowledge of each other, which meant that all of my participants knew who I was, and I knew of all of them to some extent prior to this study. While being a potential detail of criticism of this study, this established an instant repertoire that allowed for many of the dancers to feel comfortable in sharing rich and emotional stories about their personal health, vulnerable incidents seeking health care, and bodily experiences.
As I have been immersed in this culture since 2012, I acknowledge that I did have preconceptions of what I would get out of interviews and participant observations. Some of my preconceptions were validated, while others turned out to be false. I continuously reassessed data against my own assumptions and my own internal beliefs to decipher when I held opinions that should be placed on the back shelf of being an observer and when I held opinions because / was a part of this culture.
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The following chapter will provide an overview of the methods of this study, including sampling and limitations. Chapter III ellaborates the findings of this study, exploring how professional and semiprofessional belly dancers frequently embody the control that is quintessential to the dance form itself. This embodied control has pervasive ramifications for understanding the self and the needs of the body, the acceptability of physicians and biomedicine, conceptions of illness, and systems of healing that are determined to be appropriate.
The Appendix provides a brief overview of the history of belly dance as it relates the United States and its presence in academic literature. This is supplied so that the reader may better understand the culture of this population and not rely on the typical assumptions about belly dance and belly dancers that are a product of colonial, exotified, and often racialized fantasy histories. Throughout the process of constructing this study, carrying out the research, and analyzing the data, my stance grew more certain that not providing a historical perspective as a foundation to this study seemed irresponsible, both as an academic and to the population of dancers. As the normalized images of most Western audiences are steeped in the racialized, imperial histories of colonialism, the reader is implored to think of belly dance for the duration of this paper not by the images that typically come to mind when the word is evoked, but as a set of movement practices that share key markers in movement quality and extend out of the same transnational history (Burnam 2012, 4).
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Chapter II METHODS
This study was conducted to fulfill, in part, the requirements for a Master of Arts in Anthropology from The University of Colorado Denver. The study was approved by the Colorado Multiple Institutional Review Board in October 2016.
Twelve female belly dancers from across the United States were interviewed about their diet and health practices, experiences with health care, and their lives as dancers. Dancers were recruited through convenience sampling, snowball sampling, and a single ad placed on a social media site with information about the study. All dancers were either professional or semi professional dancers, being that they frequently were paid to perform belly dance. While some dancers had multiple sources of income, including what several identified as their muggle job, others made their entire income from dancing professionally, teaching dance, or owning dance studios. On average, participants made 70% of their total income from dance. While one could expect to find a gradient of embodiment across students to professional dancers, I made the assumption that those relying on the dance form for a living would be the ones most acculturated into the community, and thus exemplify the behaviors and relationships that I was interested in more readily than those taking belly dance classes as a casual hobby.
Extensive discourses could be supplied on the particular histories, problems, and uses of many different terms regarding belly dance in several languages. In some contexts, certain terms could be interchangeable, while others refer to specific genres. Such dance taxonomies include Raqs Sharqi, Oriental dance/danse
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Orientale, danse du ventre, Raqs Arabi, Raqs Masri, tsifteteli, dances of the Ghawazi, Awalim, Kochecks, and Khawals as well as the sub genres of cabaret belly dance, tribal fusion, American Tribal Style (ATS), Improvisational Tribal Style (ITS), transnational fusion, belly dance, and bellydance. These are just some of the vast styles and titles that for the sake of digestibility, are referred to as belly dance unless specifically articulated otherwise.
Many sub genres of belly dance were represented in this study, with all but one dancer responding that they routinely trained and performed in multiple styles of belly dance. When asked about what genre of belly dance they performed, participants responded with the following styles: Raqs Sharki, American Tribal Style (ATS,) American Cabaret, Tribal Fusion, Fusion, Theatrical, Modern Egyptian Style, Egyptian Oriental, Datura Style, Improvisational Tribal Style (ITS,) Oriental fusion, and Turkish Oriental. Many of the dancers also mentioned being trained and frequently incorporating various folkloric styles of dance from North Africa, the Middle East, and the Balkans into their movement vocabularies.
Interviews ranged from thirty minutes to two hours and were conducted over the phone, in person, and over online video conferencing services. Dancers were not monetarily compensated for their participation, however participants were promised a copy of this manuscript upon completion.
During some of the interviews early in the study, I recognized the internalized normalcy of using complementary and alternative medicines and made a more concerted effort to probe about any use of herbs or supplements via store bought capsules, concoctions other people had made for them, or casual usage of self-
9


made remedies until the interviewee began to mentally take note of all the substances they took and for what purposes. Another tactic that I found to be extremely helpful in eliciting this information was to offer self-reflexive conversation about my own usage of various supplements, herbal tinctures, and teas. I talked about my use of Glucosamine, which was more-or-less prescribed to me by another dancer to take for my joints as a sort of primer when dancers passed over my inquiry. This repeatedly spawned engaging and in-depth discussions around whether the participant had tried that, if they found that it was effective, what else they have tried, what they currently use, and why. These experiences lead me to believe that conducting focus groups of belly dancers would have been an extremely valuable data collection method, as it seemed the act of one dancer (in all instances but one being myself) discussing herbal and supplement use sparked excited conversation about practices in the belly dance community at large. This lead me to further believe that the behaviors I was interested in studying are largely driven by the community culture of the dance, as much information is shared, taught, disseminated, and critiqued in social settings among other dancers.
Ten of the dancers identified as being white, one dancer as white and Hispanic, and another dancer identified as Asian American. There is currently no comprehensive demographic information about the racial and ethnic diversity of American belly dancers, however white women do seem to be the majority of this dance style currently in the United States, with African American and Latina dance communities slowly growing.
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The average age of the women interviewed was 36.75 years old. All women thought of themselves as being somewhere in the middle class category except one who identified as being low income or poor. Several women specified they believed that they were low middle class, high end of poverty or low, low middle class." Similarly, comprehensive data on socioeconomic status for American belly dancers does not exist. Again, on a surface observation, the field seems to primarily be middle class women.
Due to the nature of the sample of this study, being predominantly middle class white women, the findings should not be understood as representative of other populations within American Belly Dance culture. This study should speak about the experiences and culture of dancers that fit the particular social statuses represented in my sample. It is recognized that very wealthy, very poor, or dancers of color may have different relationships with the themes explored based on different historical, economic, and political experiences. In particular, it has been shown that racial identity can heavily influence perceptions of body image (Molloy and Herzberger, 1998), bodily behaviors and methods of care(Parker et al., 1995), and standards of beauty (Watson et al., 2013). Additionally, there remain culturally noteworthy differences in how many communities of color relate to biomedicine based on histories of unethical medical exploitation (Gamble 1997; Thomas and Quinn, 1991). This is a recognized limitation of the study and should be seen as an area requiring further investigation as to how women of different racial or socioeconomic identities relate to the dance form and the body.
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Furthermore, my own identity as a white woman brought up in a middle class setting inherently influence my interpretations as well as how my participants interact with me.
Interviews were recorded, transcribed, and then analyzed using NVivo QSR International Software. Transcripts were inductively coded several times to reveal salient themes. Direct quotes were sometimes edited when identifying information was present, however this was done minimally to ensure both my participants confidentiality and the integrity of the stories they were telling.
Participant observation was also conducted. One dance teacher, with the approval of her students, allowed me to actively study one of her weekly classes as well as her dance troupe rehearsal. Being that I have been an active belly dancer myself for years, separating myself as a dancer and myself as a researcher posed some initial challenges. While I attended many trainings, dance classes, performances, haflas (casual dance parties meant for dancers and their families,) and workshops, I did not actively engage in participant observation for the purpose of including data in this manuscript from events where I did not have explicit permission from everyone present. I did however frequently take notes on experiences in these events, which I would then bring back to consented interview participants or dancers involved in my participant observation to get their thoughts on the topic at hand. I also attempted to make it clear at both the local and national level that I was engaging in research, which served to inform the community, and sparked many valuable conversations by both participants and those outside my
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study that helped to guide the evolution of analysis and to insure my understandings were appropriate to the community at large.
While male, androgyne, and transgender professional belly dancers exist in the United States (as well as all across the world), I did not feel confident in including their stories while simultaneously ensuring confidentiality of my participants due to how relatively rare and prominent they are in the professional belly dance setting. As their perspectives would provide valuable viewpoints from different social spaces and different contextual understandings of their bodies, future investigation should be conducted with these individuals.
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CHAPTER III
FINDINGS/DISCUSSION Control and Embodiment
In all aspects of the interviews conducted, one theme remained consistent with most of the dancers that of control. Control was explicitly mentioned by the interviewees, alluded to, and characterized as being a prime motivator for participation in the dance, health seeking behaviors, and conscious representations of the self. I argue that it is the bodily control of the torso required of the dance form itself, placed within the context of a general American culture that becomes embodied in the dance form, thus influencing their attitudes towards health and healing. Dancers concern with control then influences their engagement, choice, and level of cooperation with systems of healing.
The dance form of belly dance trains dancers to utilize their bodies in ways that are often counter to how the individual has been socially conditioned to move, specifically that of the hips and the stomach. Belly dance calls for a dancer to be able to articulate rolls and undulations of the abdomen by sequencing both the release and contraction of muscles, display parts of the body that many Anglo American women typically have anxiety over, and allow flesh to shake in full view of any audience. These archetypal movements of belly dance have historically been received as controversial and sexualized since its first documented performance in 1876 at the Philadelphia Centennial Exposition, where the dancer was arrested and charged for being immodest in character (Burnam 2012; Monty 1986). This cultural anxiety over the movement vocabulary in belly dance continues to this day in the
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United States and often acts as a barrier to academically study or participate in the dance form.
A shimmy is a prime example of physically training social conditioning out of the body. Shimmies can be executed with multiple parts of the body but primarily are performed with the hips. While there are many variations of a hip shimmy, both articulated to certain timings or more freely performed separate from musical timing, they always sustain a rapid and repetitive movement similar to a vibration. This movement simultaneously requires one to powerfully exert force to create the rapid movement while also relaxing much of the body, such that the motion can ripple through the dancers flesh and not be halted by engaged muscles. Based on my own experiences in belly dance classes, this is commonly a conceptually difficult movement for many white dancers to learn, often with these women having anxiety over their stomach, thighs, and buttocks not only being allowed to relax, but to also shake, slap together, and be the focus of attention a central move of the dance form.
In training dancers in the movement vocabulary of belly dance, there is often a conceptual hurdle for many individuals to not only feel comfortable moving their body in undulations and shimmies, but it can be very difficult to guide individuals in gaining the ability to engage or relax isolated muscles or muscle groupings. Numerous movements in the belly dance vocabulary require simultaneously training to obtain a level of deep muscular control of the torso while also cognitively training oneself to allow a disregard of imbedded social norms of appropriate movements. I have previously heard of this synergistic process referred to as training the natural out of the bod/ by dance instructors.
15


Many of the dancers interviewed who were also dance instructors talked about how they educate students in their classes about control. While any weight or size, which is often equated with female health, was not explicitly sought after or taught in these classes as being tied to achieving a higher level in dance, power and muscular articulation was discussed as being necessary. One dancer expressed that she felt that her muscles needed to be visible enough that when teaching, she could more clearly demonstrate isolated contractions of the abdominal muscles, hip flexors, and obliques.
I talk to them a lot about their muscle groups, like you really need to engage your psoas muscle and if they dont know what that is, Ill print little pictures out and bring them and be like this is your psoas muscle, this is where it goes, this is where its running down in your pelvis, and thats really useful when youre doing a jewel for instance. Thats really where you need to be pulling in. You know, pulling that in so it kind of gives them a visual of what muscle they need to be using. I do a lot of that because ladies in this area, I dont know if its true across the board, they dont know what muscles are what, what does what, where it is, and what muscle is what. They have no clue. So I do a lot of that-educating them about their pelvic floor, their abdominals, their hip flexors, obliques. You know, the things that you really need to use in belly dance. They dont know where they are or what they are. And they-l dont know if they always know how to access them, so I do a lot of that.
-Dancer
One dancer articulated her passion for the dance form as learning complete and absolute control over my entire body. That is one particular thing that drew me to belly dance, was how much control I saw in the dancers... I assert that this fixation with control of the body becomes embodied into the self, translating into other aspects of the individuals life, including that of illness, healing, and healthcare seeking behavior.
Being able to develop the control over my body and being able to teach my body to do those things has been so empowering for me. Because Im [that]
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personality type, Im a control freak and so being able to master my own shell as a human being that is so satisfying. And I feel like belly dance is totally [about] being able to do multiple things at once and move different body parts at different timings in different ways through different pathways. Its the ultimate form of control over oneself."
-Dancer
The incorporation of the theory of embodiment is not new to dance or even specific to belly dance. However previous literature on belly dance and embodiment tends to lack descriptions as to how the dance form is embodying, the pathways by which this process works, and what that means beyond feel-good sentiments of positive body image.
Control of the body is not unique to belly dance. Most dance forms and athletic practices train the practitioner to develop various levels and types of control of the self. However, the control taught in belly dance is characterized specifically by micro articulations of the torso, something which is rarely developed without specific training. These micro articulations create a unique relationship between dancer and the body, where the dancer often adopts an acute fixation on the torso. In my own experiences as a dancer, I have frequently heard dance instructors reference certain belly dance movements as having a direct and immediate impact on internal organs, chakras, and emotional centers of the body. Conversely, many other athletic or dance forms can be described as tolerant of pain, with common rhetoric supporting the idea that pain equals gain." Belly dance training in America, however, refutes this strongly. Training is often characterized by developing pathways and methods to execute moves that work with the particular needs and alignment of the individual body. Pain while executing a move is frequently communicated as a sign that the
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dancer is not using proper technique or needs to reassess their alignment or muscle motivation. This pain negating characteristic of the dance form fosters a culture where dancers pay special attention to somatic cues and learn to understand bodily states and sensations as deeply meaningful experiences.
As the bodily movements and representation of dancers have been so heavily contested and as belly dance is recognized to provide practitioners access [to] a more self-aware and expansive notion of their own body and identity, (Burnam 2012, 17) does this increased relationship then rely on different understandings of body maintenance? Are there reflections of these representations in the internalized understandings of the body?
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Understanding of the Self: A Cartesian Holistic Fusion
The belly dancers of my study employed a contradictory blend of Cartesian dualism and holistic preferences when determining appropriate methods of medical diagnosis, treatment, healing, and maintenance. While the dancers, in both interviews and during participant observations, continuously compartmentalized the self as being made of two separate essences body and mind the vast majority of interviewees preferred holistic approaches to care. This paradoxical understanding of the self can be contextualized as a result of the nature of belly dance training itself, which emphasizes obtaining a control of the torso above and beyond that of daily life.
Materialist interpretations of the self can be traced as far back as Aristotles De Anima, which viewed the human soul as fundamentally needing a biological base. Hippocrates furthered this train of thought in the Hippocratic Corpus, which aimed to stamp out religious based healing traditions in favor of clinical practices that acted on the rational treatment of only that which was tangible and observable. Rene Descartes articulated a framework that would later become the foundation by which clinical Western medicine understands the self and human as an organism. His writings contended that there were two fundamentally different substances that composed a human being: the palpable body and the intangible mind. This separation, known as Cartesian dualism, paved the way for science and medicine to take domain over the body while leaving the mind to the realm of theology. This dualism has not only defined how the West understands the body, but also how it defines sickness and thus treatment. Pain, it seems, was either physical or mental,
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biological or psycho-social-never both nor something not-quite-either (Scheper-Hughes and Lock 1987, 10).
A holistic approach to care is usually considered dichotomously opposed to the Cartesian split of body and mind. Nancy Scheper-Hughes and Margaret Lock identify two traditions of holism. The first is a conceptualization of all entities being a single unit from the universe to the organs within the human body, all being understood as one. The second tradition of holistic thought is based on complementary dualities, which focuses largely on the connections and relationships of different parts to a whole (Scheper-Hughes and Lock 1987). This tradition is exemplified by the yin/yang cosmology, which is based on the ever fluctuating and opposing states of yin and yang. Dating back to the / Ching just before the third century B.C., this tradition understood the body as patterned after the healthy state: in both there is an emphasis on order, harmony, balance, and hierarchy within the context of mutual interdependencies. A rebellious spleen can be compared to an insubordinate servant, and a lazy intestine compared to an indolent son (Scheper-Hughes and Lock 1987, 12).
My interviews were filled with conversations on holistically thinking about caring for the body, while simultaneously conceptualizing the body as something separate from the mind or the self.
I think it is wonderful that as we get more attuned into our bodies, people are being more open to more non-mainstream options for everything-emotional, spiritual, physical needs for our bodies, what it might be telling them, or what it needs. I have studied so much with [dancer] because she talks so much about the body being a sentient being and being open to that back and forth communication with it. I think it is exceptional, that our community is shifting in that or has shifted in that way.
-Dancer
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This linguistic mixing of holism and Cartesian duality was prominent in the interviews, the participant observation, as well as my own experiences as a dancer. During one training I attended, the instructor discussed how to establish habits and practices in order to create a routine necessary for advancing a dance career. In the training, dancers were taught to treat the brain as separate from the self in order to separate behaviors or lack of behaviors from guilt. Once the brain is separated from the self, a dancer is then able to create plans to help if accomplish goals, with an example given of what can I do to make if drink more watef? This language aligns with the Cartesian legacy of an observing and reflexive T, a mindful self that stands outside the body and apart from nature (Scheper-Hughes and Lock 1987).
During a weekly class I participated in, after an exceptionally tricky and intricate combo was taught and practiced, the instructor stopped the music, turned to her students and asked, Even if your body wont cooperate, does it make sense in your mind? A student responded, My mind gets it but my body is giving me the middle finger.
While the coexistence of both a Cartesian and a holistic understanding of the body may seem oppositional and paradoxical, the pattern follows the rationale of control of the body that was a constant theme among the women interviewed. As Americans, these women have been socially conditioned both philosophically and medically to treat their body and mind as inherently separate entities. However, while biomedicine employs a dualism between the mind and body, it also requires patients to submit to the physicians privileged knowledge of the body as well as treatments that may alienate a woman from her internalized knowledge of her body.
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Robbie Davis-Floyd has written extensively about the technocratic model of health and birth, which primarily positions the body as a machine, the male body as an idealized norm, and thus the female body as a deviation from normal (1994, 2014). Under this model, knowledge of the self in almost any context is made extraneous to the biomedical diagnosis of illness and the course of treatment following.
Although the belly dancers I interviewed compartmentalized the mind and body as separate entities, it was the act of relinquishing of control to biomedical practitioners and the abstraction of their bodily knowledge that was incompatible with their understanding of healing. Because of this, dancers tended to look to systems of healing that allowed them to retain some, if not all, control of their diagnosis and treatment and privileged their knowledge of their body as superior to the practitioner.
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Rejection of Physician Knowledge and Biomedicine
I dont get sick because I can feel it before it happens. I can feel. I can tell you that Ive had a lot of issues and Ive never been wrong. But the doctors have been wrong a lot.
-Dancer
When questioned about their health seeking behaviors, most dancers expressed a vehement opposition to receiving care through Western medical systems. Dancers frequently cited physicians as either not caring about patients or not being knowledgeable as primary reasons why they often chose to not work with Western medicine. While they brought up financial resources a few times, finances were secondary to the perceived quality of care a dancer felt she could get from a physician.
They spend less than 10 minutes with you, they look you over and dont really ask you any personal questions with whats going on, they just ask you very specific medical stuff. Much like all of Western medicine, they treat the symptom and not the root cause, so they dont even bother to see why you are experiencing what you are experiencing. And its so expensive!
-Dancer
I just dont think doctors know as much as they used to for one thing. And moreover I dont really believe they care. I feel like they are owned by the pharmaceutical companies, so if you go to the doctor theyre pretty much just going to give you a pill, and Im not interested in healthcare that gives me a pill to mask my symptoms. Im interested in health care where people are looking at me as a whole person and pinpoint the root of whats really going on...I just dont go to the doctor.. .Im not going to go to the doctor unless Im dying. And I think that if Im dying I might have a better idea of whats going on with me than the doctor.
-Dancer
Feeling cared for, both physically and emotionally, was articulated as primary need by the women interviewed. They tended to reject and have feelings of disdain for systems of care in which they felt they were submitting to a system that did not care about them as an individual or held their bodily knowledge and experiences as
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irrelevant to diagnosis and healing. The ability or inability to identify a singular root
cause of what was ailing dancers was also a major factor in how dancers
determined the validity of a practitioners skill, in both biomedicine as well as in
complementary and alternative modes of treatment. Stories were frequently told
about dancers seeking care from a physician, only to be left with no idea as to what
caused the bodily problem in the first place.
I dont even know the last time I went to a doctor because I hate them. I actually dont go in that often... I have just had bad experiences with medical professionals because there have been multiple instances where I have gone to the ER in the past [because] Ive had pains. I didnt know what they were, and they still couldnt diagnose them. I ended up talking to other people who gave me a better idea of what it could be than the doctors could. Theyre just disappointing to me.
-Dancer
I feel like thats the way that the medical system has forced people of our generation to work, because we dont get enough time with them, especially for serious things that have a higher incidence rate like autoimmune diseases or allergies. I had an allergy and they were pretty much like, we cant test for those. If its a food allergy I dont know what to tell you. And its expensive, no one has proper health care so you have to go on a Google/lifestyle experimentation until you are like Okay, this is tolerable for now. But Ive never gone to- its rare that Ive gone to a western medicine doctor and had an experience where I was like ok cool, this is handled, done. Usually they dont know and I have to do other stuff on my own. I dont know, Ive had bad experiences. You pretty much [have to] Google it so you know what you want, what you want to get tested for, and go in and tell them, because they are not going to actually try to figure out what you want or they do a million other tests.
-Dancer
An interesting distinction to make is that dancers were not overly concerned with the immediate success of a treatment, but more so the identification of illness that aligned with the dancers bodily knowledge. Dancers frequently cited having one or two bad experiences with a physician or hospital, usually regarding not being able to identify anything biochemically wrong with the dancer, that caused them to write
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off Western medicine in most situations. Simultaneously, the same dancers were willing to experiment and do a sort of trial-and-error course of action with alternative practitioners and treatments. Once dancers were able to create or co-create a framework of illness with an alternative practitioner, they were more willing to try the same therapies multiple times until they found a practitioner who they felt provided effective healing.
Now I have a lot of shoulder pain and have seen 14 different massage therapists, and none of it really works. I just had to see this one person, and now I study with her because its like she knows what shes doing.
-Dancer
Dancers were also keenly interested in receiving treatment that was
customized and tailored to their bodies, while simultaneously expressing
dissatisfaction with receiving treatments that felt routine or one size fits all.
Treatments that were tailored to the individual were widely regarded as more
effective, regardless of the duration of treatment or often the outcome.
Western medicine doctors dont really seem to care about what I do, and most of the people I know that do naturopathic medicine are friends of mine.. .you know my acupuncturist was a belly dancer of mine. Which I think made it easier for her to treat, because she knew so much about my personality already. And since acupuncture works from those really subtle energetic frequencies, and her already being in tune with me, I think it made it work better. Because it was personalized.
-Dancer
When they did have to seek our traditional biomedical care, often in the case of physical therapy after serious injury or surgery, dancers also repeatedly spoke about feeling the need to train or educate practitioners about their bodies. This was typically framed as perceiving biomedical practitioners as having a poor understanding of what belly dance is, the way the body moves during the dance, and
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the intensity. This ultimately translated to a conception that the biomedical practitioners did not understand the needs of the individuals body.
Im so nervous about moving forward with my injuries that I will actually demonstrate the most strenuous activity on that part of the body that I do. So, you know I just had my hip done, so I would go into 3A twist in a grapevine or something. So that way they are seeing me open chained versus close chained exercises, because anyone can just stand there and be safe, but once you start traveling that puts a whole other level of strain on your body.
So I dont know. I dont honestly think they have a very good understanding of it.
-Dancer
Its usually just met with confusion. Theres a realization that its not what their mind immediately goes towards which would be some form of sexually stigmatized dance. That is where their mind immediately goes.. .but they dont know what it is. They have no understanding.
-Dancer
One dancer shared a story on feeling shocked that a doctor she was seeing was uneducated or unaware about the perceived efficacy and purpose around some of the over-the-counter supplements she was taking, and the ritual she devised to increase the efficacy.
But whats interesting too is-1 have a good doctor that I am seeing now for the spine that didnt even know what MSM was, and to me that blows my mind! I take L-glutamine for my gut and MSM, and Ill take all these whatever and then three hours later Ill get on my inversion table to separate my spine. They will ask why do I do that. If Im putting all these beautiful, wonderful things in my body to help my bones and inflammation, doesnt it make sense to get on the inversion table to separate your joints so that all that blood can go in there and feed with the nutrients that youve taken? And it blows their mind!
-Dancer
Many of my participants spoke about self-diagnosing their own illnesses. In
the process of both my official research as well as in my years as a belly dancer, fellow dancers have volunteered diagnosing my body with a range of structural, chemical, and created ailments, often unsolicited and coupled with lectures on how
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that diagnosis affects the bodys performance as a dancer. Dancers utilized several methods to self-diagnose illness, including the Internet and comparing somatic symptoms with other dancers. The women interviewed tended to hold their somatic experiences as being superior to biomedical knowledge, and tended to not be as rigorous in assessing the validity of their social network or the Internet in the search for diagnosis.
Im an obsessive researcher for certain things and I was trying to figure out why I was feeling some of the ways I was feeling. Usually they do tests and that sort of thing to see if you have adrenal fatigue, but we all know I hate going to the doctor So, I just looked at my symptoms and self diagnosed that I was probably in the beginning stages or heading towards adrenal fatigue. Which is kind of terrifying because once you are in adrenal fatigue other things just start.
-Dancer
There were two notable exceptions to this with dancers that routinely did
engage with Western biomedicine over community-based holistic practitioners. One
dancer suffered from a chronic and incurable autoimmune sleep disorder, and due to
the nature of the treatment, she had to see a specialist every three months. Other
than this and a yearly checkup, she stated that she did not see doctors that often
and typically mitigated her condition by eating quality foods, strength training, and
maintaining low levels of stress. When asked about her experiences seeing the
specialist, she responded that it had become an almost uncomfortable necessity in
order to receive the medication needed for her to manage the illness.
My specialist, he called it socially inappropriate. .Hes older, hes from this area and hes just kind of urn... we always talk about it, every time I go he asks about it and he says something about how his wife made him take ballroom lessons or something. And he just started talking about something thats more socially acceptable or socially appropriate than, like, what Im doing.. .Its awkward but I dont challenge him on it because I just dont really want to with him, you know...Otherwise Id be like, hell no! But with him, its
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just like eh. There arent a lot of [type of specialist] in my city, so I dont want to piss him off and then him be like, oh, well Im not going to give you your medicine.
-Dancer
In this instance, the dancer articulated submitting to a specialized physicians moral critiques on her employment out of a feeling of being constrained by her medical choices in the care of her chronic and life-altering autoimmune illness. So while this dancer did not reject systems of Western medicine for alternative systems of care that put her in control, she recognized that by being under the care of the specialist, she relinquished control of herself in a sub-optimal relationship. She later described how, because she was a belly dance studio owner in a conservative town, she felt compelled to project an image of health and fitness as a driving motivation for many of her health seeking behaviors. She explained this projection was not measured by thinness, but rather strength and stamina. She felt that, as a studio owner and dance teacher, she needed to be perceived as healthy, energetic, and strong not only by her students but also by the conservative community around her that often did not view the dance in a positive or serious manner.
This experience of shaming by a biomedical practitioner upon sharing ones profession as a belly dancer was not ubiquitous throughout the interviews. However, the few dancers that have had this occur recounted the stories as having a negative impact on their opinion of the practitioners or even the practitioners field of medicine.
One dancer acted out an experience she had during a physical therapy treatment, in which her therapist mocked the dance in an effort to tie the participation to inherent injury. [My therapist told me,] well the reason you are like this is
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because you guys are all like this [makes erratic movements] and she kind of like went into a spasm that looked like, I mean she had poor posture because shes not trained, but she was wiggling her body all over and Im like, thats not what we do! During the story, the dancer got up, wound her hips around aimlessly while throwing her arms around herself much like how a toddler would throw a tantrum. The experience of witnessing this story being retold caused a visceral reaction for me, as in my own experience I have seen almost identical displays of erratic movement when a layperson discusses belly dance.
The other dancer who was an exception to the pattern of seeking holistic medicine operated in an interesting liminal space between modern biomedicine and holistic models of health care. Having successfully gone into remission from cancer, the dancer was eloquent in detailing her rationale on when to accept what physicians prescribed as a course of healing, when she ignored their advice, and when her body and behavior became a site of negotiation. Everything from her training and performing schedule, diet, supplement use, and complementary or alternative medicine use was up for negotiation, and in several instances where the physicians in charge of her cancer treatments remained firm, the dancer discussed employing her own systems of care anyways. While this dancer is unique in the sample population for not largely rejecting western medicine, she still valued many holistic treatments and tended to pick treatments and systems of self-care from both opposing medical models.
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Adrenal Fatigue as an Idiom of Distress
During the course of interviews, a phrase surfaced several times of a
condition that was plaguing both my participants as well as other dancers in the
community, as noted by interviewees. This mirrored what I encountered though my
own experience as a belly dancer, with the phrase been thrown around in classes,
workshops, and casual dance gossip. The condition was that of adrenal fatigue.
In regards to adrenal fatigue, its definitely hard to get out of once you are in it. Essentially whats happening is youve put your body in a constant state of stress response. As human beings, our bodies havent caught up to how we operate in industrial societies, so all of our Fight or Flight responses are still firing in our bodies as if we are in the savannah and lions are trying to eat us. We are not letting the hormones like cortisol and all of that jump back because we are constantly stressed. The body is in a constant state of stress, which means its having to produce these hormones all the time. Whats happening is certain glands in the body are flooding your body with all these hormones, and they are doing it all the time. Essentially for lack of a better term- its not the medical term- but you are burning out. Theyve linked chronic stress to pretty much every single disease; I mean obviously autoimmune but things like cancer, heart disease, respiratory issues, and the inflammation process. In effect, what happens is your body just gets so exhausted from doing all of that all the time, you are essentially running yourself on empty. Your sleep patterns are disrupted, you dont have any energy, and then your body just cant keep up with the level of stress you are putting in.
-Dancer
This illness, which several of my participants brought up, has become a narrative often heard at training workshops. It is an illness where the body can no longer keep up with the will of the self. It has burnt out. I offer the explanation that the concept of adrenal fatigue has been adopted by the community as an idiom of distress in response to the cultural and economic morals that exist in the American belly dance community.
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The term idioms of distress was coined by Mark Nichter in the late 1970s and published in the early 80s to refer to the socially and culturally resonant means of experiencing and expressing distress in local worlds. They are evocative and index past traumatic memories as well as present stressors, such as anger, powerlessness, social marginalization and insecurity, and possible future sources of anxiety, loss and angst (Nichter 2010, 405). It has been included in the DSM IV as well as the recent DSM V as part of an attempt to include culture-bound syndromes, which has been met with a mix of excitement and critique from social scientists for years (Nichter 2010).
Adrenal fatigue is a heavily debated condition in biomedical and endocrinology societies. While some physicians recognize adrenal fatigue as a recognizable illness with a prescribed course of treatment (Wilson 2014), a systematic review of biomedical research shows no such official diagnosis or recognition of adrenal fatigue currently in existence being accepted by either the American Board of Medical Specialties or the Association of American Medical Colleges (Cadegiani and Kater 2016). This so far unsubstantiated condition in the medical arena is rationalized as a set of symptoms that indicate the overuse of the adrenals stemming from frequently experiencing stress, sleep deprivation, lack of proper nutrition, and being overworked. Symptoms cited during interviews included exhaustion, fainting, problems with focus or mental clarity, digestion issues, irregularity of menstruation, weight fluctuations, and circulation issues; however, it was always presented as a condition that can manifest in many ways as well as be the root cause for many additional ailments.
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Several dancers explained that this condition can arise from both the arduous training and work schedule required to be a professional dancer, as well as the challenge of trying to balance this with the demands of family and other job requirements (if there were any).
/ think being a driven dancer too, we drive ourselves into the ground. We are staying up late, making our costumes, we are drilling, and we are pushingpushing through pain and drills to get the choreography in our bodies. There is a correlation between adrenal fatigue and how it talks to your thyroid and the pituitary gland, because its all connected. Then it can start Hashimotos, which is hypothyroid or can go the other way into hyperthyroid. And thats what causes lack of sleep, and then its just a snowball [effect] that starts with your hormone imbalance. But theres something we have to figure out how we can find a balance between rest, nutrition, exercise so we dont become adrenal fatigued.
- Dancer
Dancers referenced adrenal fatigue as being a condition resulting from ones body being incapable of keeping up with the will of the self, or in other words, pushing the body too hard for too long. This conceptualization inherently references a value system that privileges intensive physical regimens as healthy and looks at the inability of bodies to maintain such regimens a deficient. However, the social construction of adrenal fatigue as an illness narrative around a set of symptoms removes the social judgment of amount of physical work from a Protestant ethic framework to that of a somatic sickness of the body.
Robert Crawford explores how the concept of the Protestant ethic, which was first described by Max Weber in the early 1900s, fundamentally shapes Americans conceptions of health, the body, and sickness. Health has become a symbolic status and moral imperative that must be attained or achieved through active modification of lifestyle and behavior. To be healthy requires work and intentional action, and
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moral value inheres in such work (Crawford 1984). While Crawford further explains the morals of the Protestant ethic bleeding into the quest for health being characterized by denial and restraint, the women I interviewed were characterized more by the fixation on self-control.
If health and illness is shaped by the Protestant work ethic, Crawford argues that illness can then carry intrinsic guilt, disappointment in the self, judgment, and a moral failing to society (Crawford 1984).
Adrenal fatigue offers an illness narrative that simultaneously reinforces Protestant ethics in health cosmology while also offering a prescribed illness category that relieves an individual from moral judgment or guilt when the self cannot keep up with the physical and economic outputs required for being a dancer. The following excerpt details one womans average schedule as a full time professional belly dancer.
During my busy months I can be traveling up to four times a month, once a week. And thats usually on the weekends, because people have their events on the weekends. For example my schedule next year, in January Im just going somewhere for fun, so I'm only traveling once in January. And Im teaching regularly at home for the entire month. February Ive got two gigs that are out of the state. And then March Ill be at [National Festival] for a week and a half and then Ill be in Spain for two weeks, and then April I have two gigs that are out of town. Then in May Ive got four gigs in the month, so every weekend. I think May through August is pretty much like that where its really packed and busy. Summer months are typically busier for me. Then back into the Fall it starts to slow down a little bit. November and December are usually pretty slim. Im usually home for most of those months, but regularly teaching. I teach classes on Monday nights for two hours, and then I will go take a contemporary dance class at another studio thats just up the street from my studio. Then on Tuesdays I will teach two hours of classes and again go to [the other studio] for [another] class. Then on Wednesdays I have rehearsal with [another dancers] troupe, for an hour from 6:30-7:30, and then Ill usually take her class from 7:30-9. Ill usually stay after and rehearse for a little bit at the studio. Then Thursdays I take two hours of aerials class, and then Ill teach a dance class from 8-9 p.m. And then Fridays, I usually dont
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teach anything unless its a special workshop in the evening. I will maybe go to the studio unless I have a gig or unless I have a date with my husband. Fridays are supposed to be our date night. Saturday I will teach for two hours in the morning, then I will usually go to my studio and rehearse for two to three hours and then Sunday I rehearse from 1-4 p.m. at my studio. Thats what my schedule looks like.
-Dancer
This particular average schedule was on top of daily stretching and strength training. While every dancer had a different average schedule, each one had to use quite a bit of time to explain just how much they were fitting into their days, weeks, and months. None of the dancers explained their schedules in more simple terms of x amount of hours in training and class.
While arguably most individuals with similar schedules would feel exhausted, dancers pathologized feeling fatigued as something that could be avoided and treated with proper scheduling, diet, and herbal and supplemental supports. Feeling tired thus becomes internalized as illness.
Adrenal fatigue as an idiom of distress communicate[s] experiential states that lie on a trajectory from the mildly stressful to depths of suffering that render individuals and groups incapable of functioning as productive members of society (Nichter 2010, 405). with society being that of the larger belly dance community and economy. Nichter argues that such illnesses are culturally and interpersonally effective ways of expressing and coping with distress, and in other cases, they are indicative of psychopathological states that undermine individual and collective states of well-being (2010, 405). Adrenal fatigue consequently can be interpreted as a recognized, accepted, and community sanctioned response of resistance to the lifestyle of being an American belly dancer.
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While official diagnoses of adrenal fatigue are not widely accepted in Western biomedicine, there is a protective and scientific wisdom embedded into the rationale behind the narrative of adrenal fatigue in the context of the belly dancers interviewed. The science behind studying the embodied effects of continuous stress has been growing.
Chronic activation of the stress-response system, the hypothalamic-pituitary-adrenal axis (HPA axis), can lead to a multitude of ailments, including insulin-resistance, muscle atrophy, fatigue, hypertension, ulcers, impaired physical growth and cellular repair, cardiovascular disease, impairment of synaptic plasticity of the brain, immune suppression, and reproductive dysfunction in both males and females (Sapolsky 2004). There is also growing evidence that psychosocial stress can have long term impacts on health across generations through the process of epigenetic modification (Thayer and Kuzawa 2011).
In a review of the biomedical literature about the topic of adrenal fatigue, Cadegiani and Kater (2016) found no studies that tied the function of the HPA axis to the term adrenal fatigue. Instead, the biomedical literature uses diagnoses such as adrenal insufficiency, sleep obstructive apnea syndrome, chronic pulmonary obstructive disease, chronic fatigue syndrome, burnout syndrome, specific hormone deficiencies, or dysfunction in one of the major internal organs (Cadegiani and Kater 2016).
As adrenal fatigue has yet to receive wide acceptance from epidemiological groups or recognized medical boards, this idiom of distress spawning from the broader contexts of the lifestyles of these dancers should not be interpreted as being
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simply an invented notion of illness in this population. Nichter contends with a critique of how labeling embodied emotional expressions as metaphors or idioms leads us to think of them as figurative, and not genuine, and to valorize meaning above the lived experience of sensations linked to emotional states (2010, 406). Adrenal fatigue as an idiom of distress is the embodied psychosomatic protest to the demands of their lifestyle. This allows dancers to reinforce the importance of the value and morality of hard work, while also creating parameters for dancers to negotiate these demands, judgment free, through an illness that is conceptualized as the will of the self outpacing the biochemical capacity of the body.
Nancy Scheper-Hughes and Margaret Lock state that illness somatization has become a dominant metaphor for expressing individual and social complaint (1987, 27). However, the disturbances to health that the dancers described, such as disruption to the menstrual cycle, extreme exhaustion, fainting, and digestion issues are tangible symptoms experienced, for which adrenal fatigue provides a narrative of causality.
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Healing through Herbalism, Supplements, and Alternative Treatments
Herbalism is practiced by an estimated one third of adults in the United States, with the highest population being that of Anglo American females of higher socioeconomic status (Waldstein 2015). Prior to the 19th century, it was commonplace for health to be in the hands of females who created home remedies as part of their gendered roles in the home. As biomedicine became more widespread in the 19th and 20th centuries, the associated narratives supported that model as dominant via discrediting all other competing knowledge and forms of care. Movements of alternative medicines and systems of self-care regained popularity in the 1960s and 1970s as not only supplemental to biomedicine but also as a means of self-reliance outside of the dominant system (Waldstein 2015). Currently, the herbal and supplements industry is booming across America, with little to no regulation.
The vast majority of dancers interviewed habitually took some forms of herbal medicines or supplements routinely, with the rest having tried them or consuming them infrequently.
Pharmacologically, herbal remedies tend to be comprised of multiple active compounds, and typically science has not documented which compound or compounds create the wanted effect (Ernst 2005). Due to the multitude of compounds interacting in plant medicines, it can be difficult to isolate the beneficial source when testing for efficacy.
Nichter and Thompson conducted a pilot ethnographic study of American supplement use, nothing that the vast majority of available information on the subject
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came from surveys that provided limited information on the ways that Americans think about or use dietary supplements (2006, 175). Their work aimed to get at the considerations of patterns of use in context, user expectations, and measures of perceived effectiveness. Notably, they acknowledged that their sample included very few individuals out of alternative lifestyle[s] or performance sports, in which I would place most, if not all, of my sample.
As patterns of supplement use also need to be understood as cultural phenomena in their own right (Nichter and Thompson 2006, 176), I offer this rich and detailed excerpt from an interview conducted during this study that details one womans supplement use.
Dancer- / take like 17 pills a day. I mean, I have a whole list online. I do a lot of gut repair, thats another thing, too. I dont take any drugs. I dont even take ibuprofen. And I dont take antibiotics. I have not been ill for over 6 years, not even a cold.. .1 take a lot of supplements, I take a ton, I mean anything from gut to immunity- like vitamin C is really good, vitamin D, I mean the normal stuff. Then I take stuff for my hair like biotin, stuff for the joints like Glucosamine and Chondroitin, all the fish oil for the anti-l could just go on and on. And then I kind of tweak it, I have a base of supplements that I use and then I tweak it depending on whats going on. Like right now Im doing a lot of bone broth for my joints, like a ton. I eat bone broth soup every day twice a day. I make it myself. Its all organic. ..Im always trying to heal my whole body system and get away from that. [I take] milk thistle for liver cleansing, its really good for that. Its so hard cause theres so much. Maca root depending on, you know. Motherwort depending on... Mugwort for estrogen, like balancing out because Im peri menopausal. Also slippery elm and marshmallow for the gut, I have to think of the systems cause theres so many that its hard to remember.
Me- Are you pretty regular with taking these?
Dancer- Yeah, I mean I have a whole pill box, I sound like I get irritated but people dont understand how important health is, and when they have it how beautiful and amazing their life is. ..And I tweak stuff according to what I need... Then bromelain for anti-inflammatory, Arnica montana, there are so many things! Now Im going through my head. Its just, you tweak it, but its so important. And its so important to know what to take with what so you absorb it, cause thats another thing too. You can take whatever you want but if you arent taking it with specific things its not going to [work.] And so you have to
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keep a list or diary. I get my concoctions going and then, get the system going.. .1 mean I dont worry about it. I also consult. I have a lot of friends that do want to take care of me, so if they have a friend thats an herbalist or naturalist or whatever Ive done phone conferences with them. And I dont even know who these people are; they are out in Cincinnati or something. But I dont care, Ill take whatever, Ill listen to whoever wants to share even if I dont think they are even if they are crazy. I dont care because I will learn something. Its just like dance or anything else, you can team a lot from people. I dont know if there are any more herbs, Im trying to thinkthere are so many. I love it, and it makes me so angry too how the FDA wants to shut all this shit down, because they dont want people to be healthy, they want them to be sick. They dont want them to make their own natural ingredients, taking away from big corporate. They dont want the herbalists in the world... There should be a whole system of care, and I kind of feel like no matter what sport you do-because the reason Im in this position is Ive been an athlete my entire life. Ive played high school sports, done all this stuff, and I was just one of those people who was just above average. I was never amazing. I was a part of the team but I never had anyone follow me and look at my bone structure and say wow youre knock kneed, youre super hyper mobile, these are the things you need to stay away from, these are the things you need to do to help strengthen and here are the dietary and herb things that can help you. I dont know why theres not more of that in our country or our system, and I think that if there was a more proactive approach instead of a reactive approach, we would decrease our whole health care cost across the board by I dont know by how much percentage. Its mind-blowing.
Several interesting themes and contradictions surfaced. First and foremost,
the dancer, after saying she takes 17 pills a day also says she does not take any
drugs. This clearly demonstrates that the interviewee does not consider her herbal
supplements drugs"] however, they are still brought up in the context of healing,
self- maintenance, and self- promotion. This can be understood, that while many of
this individuals supplements came from a store and in pill form, they are still
categorically different from what a physician would give. Saying Im always trying to
heal my whole body system" shows an inclination for holistic healing modes of the
body, while also commodifying herbal products for particular uses in particular bodily
systems. This dancer also sought to represent health through herbal supplements as
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something that is challenging and requiring careful planning, requiring a list to know what to take with what so you absorb it. This articulation shows that the field of supplements is considered a complex system one has to navigate in order to maximize its benefits.
The dancer additionally demonstrated trust in the knowledge of practitioners of alternative medicine, such as the mentioned herbalists or naturalists. This was demonstrated over and over again during the interviews. Dancers routinely got their information regarding health and illness from other dancers or alternative practitioners-both specifically trained or self taught, took concoctions created by friends, and engaged in healing practices, such as massage and acupuncture, under the care of practitioners who were also friends or fellow dancers. This was consistently seen as far superior care than what physicians would be able to provide. This is similar to a finding from Nichter and Thompsons study (2006) that users of supplements and herbs habitually got their health information from those in close social circles to them, noting that it was considered especially credible and trustworthy particularly if it came from someone to be deemed like them in some important way (2006, 202). In my study, the important connective similarity was the culture of belly dance.
Systems of self-care through cultural food, herbalism, and supplement use are often largely disregarded by the biomedical system, regardless of either the chemical or psychological efficacy it holds for the practitioners of these modalities and their patients.
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When alternative health practices such as herbalism and other folk medicines are positioned as a deviation by the dominant biomedical model, heterogeneity in beliefs can become pathologized, ignoring the benefits of these systems that act as coping strategies to antagonistic social environments (Viladrich 2006).
Interventions that fall under the Complementary and Alternative Medicine (CAM) classification, such as acupuncture, herbalism, Ayurvedic medicine, and other traditional medicine practices tend to provide a patient-centered experience where the same variables identified as social determinants of health are traditionally addressed as part of both the patient history as well as the context for illness. These systems, by and large, acknowledge the patients internal awareness of their body as an important aspect of diagnosis and healing and frequently invite the patient to retain some level of control and agency in their treatment.
Medicinal herbs and supplements currently reside in a paradoxical and liminal state as being recognized as neitherfood nordrugs (Nichter and Thompson 2006). The Dietary Supplement Health and Education Act (DSHEA) was passed in 1994, creating an environment where neither the Food and Drug Administration, manufacturers, nor retailers are obligated to substantiate claims made by commercial herbal products or supplements. Thus, as these products are barred from making specific health or disease statements, the market has evolved particular and often vague language about maintaining, supporting, and promoting the health and function of various bodily systems and conditions (Nichter and Thompson 2006). Consequently, it has become a common practice for those that seek
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manufactured herbal remedies to reinterpret labels and experiment with products in the effort to address perceived needs (Nichter and Thompson 2006, 177).
As the FDA does not study the chemical efficacy of most herbs, significant obstacles remain in identifying the value of folk medicines, establishing safe processing mechanisms in an unregulated market, and ascertaining the safety of mixing with other substances. While clinical testing of herbal medicines is technically feasible, usually only one to two compounds can be characterized at a time, making the majority of medicinal herbs extremely difficult to study. Additionally, many herbalists argue that isolating individual chemical components of herbal medicines in fact reduces their efficacy, citing the holistic healing properties as being due to complex micro interactions. Some plants such as Allium sativum (garlic), Ginkgo biloba (gingko), and Panax ginseng (Asian ginseng) have been fully described pharmacologically and demonstrated to be effective towards treating certain conditions in clinical settings (Ernst 2005).
Economic investigation of the financial benefits of the large-scale incorporation of complementary and alternative medicine systems such as herbalism into courses of treatment are extremely limited. One review that evaluated 31 cost analysis studies found that almost 30% of these studies resulted in lower cost health improvements (Herman et al. 2012). As most herbs are legally classified as dietary supplements rather than medicinal, little research is conducted into the outcomes of habitual use in medicinal contexts. Furthermore, the legal status ensures that there are few mandated obligations of this industry either in stores such as Whole Foods
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that sell herbal remedies to upper class individuals or urban botanicas that sell to indigenous and migrant populations.
Although each woman interviewed had a different regimen of herbal and supplement use, ranging in intake level, consistency, source, and purpose, the sample largely was remarkably articulate in their deconstruction and assessment of their own supplement use (Nichter and Thompson 2006, 178), which mirrors that of the study conducted by Nichter and Thomson (2006). One noticeable difference, however, was that this articulate self-assessment of use often had to be prompted and pressed to get at, as the intake of use was so normalized in my participants that many of the women did not initially think of these behaviors as anything special to talk about. Two interviews in particular highlighted the need to further press to get at herbal and supplemental behaviors when initial answers skipped over meaningful conversation about the behavior.
The first was an interview in which two dancers participated together. These
women frequently trained and performed together, and out of convenience to their
schedule, requested that I interview both of them at the same time, which was one of
the several happy accidents of this study.
First Dancer- / forgot, when I start having joint pain, which is starting to happen more, I will actually dose myself with Magnesium, so Im starting to get more of that in my diet and through supplements.
Second Dancer- Oh yeah, I take a magnesium bath."
First Dancer- Oh, I havent tried a bath! I also take calcium to balance it out because I know Magnesium flushes you out."
A second interview that clearly demonstrated this normalization of herbal remedies and supplement use was one in which I was fairly familiar with the
43


participants lifestyle, and thus was able to plainly recognize when the dancer did not appreciate some of her own behaviors as being noteworthy in the context of the interview.
Me-" What do you do to take care of that pain?
Dancer- Nothing. Im working on plans to do it, but then I actually have to do them. The shoulder pain is a repetitive motion issue and that isnt all of these arent constant. They crop up here and there. Im not in any constant state of pain. The shoulder is from learning how to do and hold arms posturally incorrect. Its not even the expanded open [position] of ATS, because you can do that safely within the range of motion of your joints. Its just creating flexibility in your body in this area vs. pulling it back. But it was more like what you would call countertop or Close Second, and instead of starting with my arms in front, I did it with my arms behind and tried to do shit. So when Im doing a lot of shoulder work, and Im tired, and I havent had any sort of massages or anything like that at all, it will come up and really get sassy with me. It hasnt happened in a bit.'
Me- Dont you make an herbal muscle rub? Do you ever use that?
Dancer- Oh yeah, I use my own muscle rub, Ill get massaged, when I have money. I used to get Rolfed, which was amazing. Instead of how massage works generally on a very basic level which with muscles, Rolfing is all about the fascia. A lot of people dont like it because they claim its painful. Well its bodywork. Its not relaxation."
Nichter and Thompson identified several categorical types of herbal and supplemental use, none of which are necessarily mutually exclusive or hierarchical with one another. These categories are Health Management and Enhancement, Harm Reduction, Resisting Illness, Illness Management, and Ideology (Nichter and Thompson 2006). These categories of usage are exceptionally useful for classifying, understanding, and explaining some of the behavior patterns seen in the belly dancers interviewed in this study.
Health management and enhancement, is conceptualized as the use of these products as tools for projects of the self, where individuals feel a charged sense of attentiveness to their body and a duty to monitor their health. Supplement users in
44


this category also often frequently cite wanting to even out the embodied effects of an overly hectic life (Nichter and Thompson 2006, 183).
This idea of personal health management or enhancement emerged out of a movement in the second half of the twentieth century in the United States, where self-management of health became a chief ethical value following the wave of public health initiatives in the nineteenth and early part of the twentieth century that tackled issues related to food quality, sanitation, and clean water on a large scale (Rose 2007). Under this self-care model, the corporeal existence and vitality of the self has become the privileged site of experiments with the self (Rose 2007, 26). Dancers whose herbal and supplement use fell in this category felt a duty to maintain their own health, often feeling that they could not rely on anyone but themselves. There was also a sentiment that there was no end point to health, it could be commodified and always improved upon through further scrutiny of herb and supplement use, exercise, and the diet. One dancer answered the following in response to a general inquiry into her health, My health is Id say good. Im constantly working to improve areas that I know are weak points for me. Many of the women in this category continuously spoke of weakness that needed to be dealt with, whether that was physical weakness or a behavioral area in need of improvement. The pattern of weakness is interesting in a population of professional and semi-professional dancers, who are fundamentally athletes that operate on a much higher threshold of strength, flexibility, and stamina than most sedentary Americans.
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Nichter and Thompsons (2006) category of health management and enhancement aligns with the model of enhancement described by Nikolas Rose (2007). Enhancement... is future oriented. Almost any capacity of the human body or soul-strength, endurance, attention, intelligence and the lifespan itself seems potentially open to improvement by technological intervention (Rose 2007, 20). Rose defines these technologies of optimization as the contemporary medical technologies [that] do not seek merely to cure diseases once they have manifested themselves, but to control the vital processes of the body and mind (Rose 2007,
16). Technology is further defined not only as machinery for medical enhancement but also any assembly structured by a practical rationality governed by a more or less conscious goal (Rose 2007, 16) such as over the counter supplements or homemade herbal potions.
Several women brought up the concept of creating health in the present, to better ensure their ability to dance in the future at an older age. Belly dance, unlike many other dance forms in the United States, frequently allows for middle aged and older women to maintain their careers as performers, with many prominent professional dancers being 40 and above. This is in stark contrast to professional careers in many other concert-based forms of dance, where any performer would age out of their dance career in their the twenties.
The next style of herb and supplement use described by Nichter and Thompson (2006) is that of harm reduction. In this model citizen consumers are compelled to adopt a reflexive mode of conduct whereby they attempt to negotiate and minimize risks as best they can. This is also an age of rising anxiety about what
46


evidence to believe and who to trust (Nichter and Thompson 2006, 184). In this usage pattern, society is perceived as inherently risky, and individuals must negotiate ideas of exposure, susceptibility, resistance, and vulnerability to environmental harm and illness. Similar to the first usage pattern, individuals feel that they must manage and take responsibility for their health and their future. After an extensive run down of the supplements in her medicine cabinet, one dancer described some of the risks she perceives in her environment and how she manages these risks.
[My food is] all organic, non -GMO. Im a freak, super clean. I dont even drink water unless its purified, and Im trying to get the point where I have my own water system and Im not having to rely on jugs with the BP A in the plastics. I wont use plastic at the stores. I take all my vegetables, throw them in a basket and then wash them when I get home. I dont like plastics. And Ive done a lot of blood tests too to see what Im allergic to. A lot of the preservatives are in there, so I know I have leaky gut because of [that], so Im always trying to heal my whole body system and get away from that. ..And also with the diet, there are so many things. Environmental toxins. There are so many things you can do so even if its really bad, you fix some other things that dont make it as bad, so you can keep dancing. What the hell, that sounds crazy! Lets manipulate your diet; lets change all the screws in your showerheads to clear out the chlorine so you can dance longer! Thats what Im doing right now. Literally everything I do is so I can keep moving. I watch my diet, I watch my water, and I watch the environmental toxins.
-Dancer
As nearly all of the women interviewed made most, if not all, of their income from dance, sickness itself was perceived as an economic risk that had to be mitigated through any means necessary. Since the body is the prime tool of their trade, illness, injury, or falling short of set performative standards was understood as taking both a physical and an emotional toll on the self. Illness represented a physical and moral failing of the self with severe economic impact. Narratives such as this follow the model of resisting illness (Nichter and Thompson 2006). Individuals
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in this category often discuss their health seeking behaviors as trying to boost the
immune system, strengthen resistance to disease, and mitigate [their] economic
vulnerability (Nichter and Thompson 2006).
I dont really get sick a lot. If my son is sick with the cold or the flu, Ill immediately start taking olive leaf, which is a natural immune boost,
Echinacea is one of those immune boosters thats become really popular- but once youre sick it does very little. Olive leaf or oregano will, once youre sick, really boost up your immune system to fight whatever you have going on. Im a big fan of letting viruses run their course. I dont take a lot of over the counter meds or anything like that to try to mask my symptoms, because I feel like those are there for a reason. If my nose is running its because it wants to get the ick out of my nose, not because I need to take a pill and have the ick just stuck in my face. So I dont have a tendency to do stuff like that.
-Dancer
The above quote employs both a model of resisting illness as well as an evolutionary understanding of health, wherein the bodys natural responses to sickness are held to be an important part of healing. There was a frequently cited desire that dancers did not want any treatments that masked symptoms and typically preferred to allow sicknesses to run their course.
Nichter and Thompson (2006) describe individuals who have the usage pattern of illness management as largely feeling that alternative treatments, such as herbalism or over the counter supplements, were safer and more sustainable long term than prescription drugs. Patients taking dietary supplements to treat illness may also feel themselves to have more direct agency: they may have more control over their diagnosis...and treatment regimen (Nichter and Thompson 2006, 189).
As control was continuously a central theme in talking about the dance form, the body, illness, and healing, this model of illness management is especially useful in understanding the motivation of the dancers in choosing holistic modes of healing
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while simultaneously employing a Cartesian understanding of the self being made
up of separate body and mind substances. Individuals in this category also are
typically interested in treatments involving herbs, supplements, and other alternative
practices due to the ability to tailor treatments] to fit their needs at specific points in
time (Nichter and Thompson 2006, 190).
Im doing some experiments because I think Im having thyroid or adrenal things going on. I know I said I was in great health, I feel good most of the time except for Im tired a lot which makes me feel like Im having problems with that. So Im getting ready to do some experiments with some herbs for thyroid issues... Ive started taking an adrenal supplement thats been really helpful for focus and being awake but Im still, I still have this dip every day at two oclock which I know is generally normal, but Ill just get so tired Ill pass out, I will fall down and pass out... .Almost every single day I take the adrenal fatigue fighter and that has got a wide variety of B vitamins, Biotin, Eleuthero root, ginseng, Schizandra, Suma root, another kind of ginseng, Astragalus, another kind of ginsing, Taurine, Ashwagandha, Sensoril Ashwagandha, Holy Basil, black pepper, habanero, fish oil-thats all the ingredients in that. [Its] kind of flexible how you can take that. Sometimes I just take two pills once a day, you can go up to four pills four times a day if you are feeling particularly stressed or extremely exhausted, but Ive never done that many."
-Dancer
The final category of supplemental use defined by Nichter and Thompson (2006) is that of ideology. In this model, patients often hold beliefs about alternative medicines beyond the practical benefits, and use becomes a political and ideological statement about health and the body. Individuals often equate natural with safe and view health is a commodity that can be obtained through consumption of products (Nichter and Thompson 2006). This last category in particular bleeds into the motivation of all the other categories combined. Most of the dancers interviewed in this study had a fundamental ideology that Western medicine was typically not the best source of care for their needs.
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If I get a flare-up or an issue -1 know thats not going to be taken care of through western medicine, so Ill go to acupuncture or work on my diet or whatever.
-Dancer
A few of the women cited political frustration with the American health care
system and navigating insurance policies that were interpreted as being
counterproductive to the pursuit of health. Participation in western biomedicine was
then framed as an unnecessary obstacle when other forms of health care, such as
acupuncture and herbal medicines were available.
So lets pretend that I decided that I was going to go with what everybody loves to call Obamacare, and Im paying $100 a month right because thats an affordable number. Im paying $100 a month for my insurance, but really, that doesnt get me anywhere. Because then I have a $10,000 deductible, its what they call catastrophic insurance. So then you have a $10,000 deductible. I just see no reason to spend $100 a month and ultimately $1,200 a year to not get anything, and have to turn around and spend $10,000 before theyll pay for anything... But I have a tendency to just go to bodywork therapists that I trust and go to acupuncturists, and thats just a couple hundred dollars. So I have much more faith in that, and I dont have to spend $11,200 dollars before my insurance will even pay for anything. I just pay for the services I want. And I really think thats how health care should be, you know to be honest...Thats a whole other thing that our country is just duped into thinking we cant function without our doctor, who doesnt know or care.
-Dancer
Herbal remedies in contexts such as urban Latino botanicas, as studied in New York City by Anahi Viladrich, may surpass their own biochemical efficacy for curing and act as a social metaphor for repairing both strained relationships and rebalancing environmental stress (Viladrich 2006). In this context, medical encounters typically act as a social and physical space for the sharing of knowledge bidirectionally between practitioner and patient. Patients, community members, and other practitioners are welcomed into therapeutic spaces to bring in new knowledge that is positioned on an equal ground as the knowledge of the healer. Healing is
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conducted through herbs and rituals that address multi-dimensional aspects of an ailment. Validation of grief, stress, and emotional disturbances are often paramount to understanding illness. This is in stark contrast to the culture of biomedicine that privileges the practitioners knowledge of the body over the internalized experience of the patient, and where curing is typically produced from the patients submission to a material cure designed to target a bacterial or viral invasion into the body. Biomedicine as a structure fails to holistically address the ailments of cultures that internalize illness as poly-functional conditions (Viladrich 2006). This aligns with the dancers preference for having their bodily knowledge utilized in healing and maintaining some level of control in their treatment.
Western biomedical treatments often require the subordination of womens embodied knowledge to technical knowledge which reinforces the ideology of women as passive, subordinate, dependent, and inherently inferior (Pylypa 1998, 32). The women of this study largely found these qualities of western biomedicine to be incompatible with their embodied tendencies towards somatic control, and instead chose to utilize medical systems, regardless of timely evidence of efficacy, that allowed them to create or co-create illness and healing with a practitioner that integrated their bodily knowledge into the health cosmology.
Currently, economic drivers are central to the propagation of belly dance in the United States. Unlike classic concert-based dance forms, belly dancers rarely operate via art grants or through institutional support. Many belly dance events in America are produced by current or former dancers for fellow dancers. The profit margin also tends to be much higher for professional belly dancers as compared to
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other types of dance, as there are rarely managers or multiple middle men standing between a dancers income and the audience or students payments. Professional or even semi-professional dancers in this genre stand to make substantially more money teaching workshops than their Ballet or Modern dance counterparts. This has helped to foster a Do-It-Yourself mentality in much of the American belly dance culture, with dancers frequently making their own choreographies, their own costumes, planning their own events, and running their own dance businesses. This DIY mentality can be seen translating into these womens interaction with health care, with most of them choosing to take their care into their own hands.
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CHAPTER IV
CONCLUSION
This study explored the beliefs and behaviors surrounding health and sickness amongst a subset of American women employed as professional or semiprofessional belly dancers in the United States.
Through their participation in belly dance as a primary form of employment, the women of this study have embodied the somatic control of the torso that is iconic to the dance training itself. This embodied fascination with control of the self creates a paradoxical understanding of the self and medicine, as dancers employ a Cartesian dualistic split of perceiving the mind and body as being separate substances, yet they largely prefer holistic models of healing that view these as either one or inseparably connected. This ideological contradiction can be explained by the embodied somatic control gained from the dance form translating to their understanding of appropriate forms of medical intervention for their bodies. Holistic medicine often allows patients to maintain some levels of agency in determining a diagnosis category, make use of their bodily knowledge, and retain more control over modes of healing. This control of the body and its care was not seen possible by these women if they submitted to western biomedicine. While citing several reasons for tending to reject the care of a physician, dancers largely turned to seeking care through friends, other dancers, alternative practitioners, or caring for themselves through herbal and supplement interventions.
Adrenal fatigue presented itself as a salient condition dancers applied to a series of tangible symptoms, which simultaneously reinforced Protestant ethics of
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health while also offering a prescriptive loophole for subverting those ethics without moral implications.
Does it matter if a subculture of largely middle class white women is rejecting western health care? This study showed that this particular population, who have economic and cultural resources available to them to access biomedicine feel as if that model is culturally inappropriate to their understanding of illness and healing. This demonstrates a cultural failing of biomedicine to reach this population, and while professional belly dancers remain a very small portion of the total population, this shows one of many potential fissures in the acceptability and appropriateness of the western biomedical model in treating its own people those who would otherwise find this model acceptable.
As this study included some participant observation in weekly dance training sessions and twelve qualitative interviews of varying length, further research into the relationship between belly dance as a profession in the U.S., the body, and health could be conducted at the many training festivals that occur all over the country (and the world), as these events are full of dancers sharing all types of knowledge geared towards executing the dance, history, personal presentation, and health. Because these training festivals often balance these messages of self care juxtaposed against hedonistic fueled late nights of performing and partying, this paradoxical setting may elucidate rich information about relations with the body. Further research should also be conducted to examine how differences in gender expression might intersect with the embodying aspects of belly dance as a profession, as male, transgender, and androgyne professional dancers exist in the U.S. This study also
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was limited in exploring how African American or Latina women, who are a growing subset of American belly dancers, interact with the dance form, their body, and healthcare. Furthermore, other geopolitical areas where belly dance exists would be expected to have a different relationship to the body and health care, as each country has huge variation in its history with the dance form, gender politics, health care systems, and economic factors.
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REFERENCES CITED
Abu-Lughod, Lila. "Writing Against Culture." In Recapturing Anthropology: Working in the Present, 137-62. Santa Fe, NM, 1991.
Allen Ness, Sally Ann. "Being a Body in a cultural way: Understanding the Cultural in the Embodiment of Dance." In Cultural Bodies: Ethnography and Theory, 123-44. Blackwell Publishing, 2004.
Blacking, John. "Movement and Meaning: Dance in Social Anthropological Perspective". Dance Research: The Journal of the Society for Dance Research (1982).
Barry, Christine Ann. "The Body, Health, and Healing in Alternative and Integrated
Medicine: An Ethnography of Homeopathy in South London." Doctoral Thesis Brunei University (2003).
Barry, C. A. "The Role of Evidence in Alternative Medicine: Contrasting Biomedical and Anthropological Approaches." Soc Sci Med 62, no. 11 (Jun 2006): 2646-57.
Bloom, Sol. The Autobiography of Sol Bloom. New York: G.P. Putnams Sons. 1948.
Bourgois, Phillipe I. In search of respect: selling crack in El Barrio. Cambridge: Cambridge University Press, 1997.
Browner, C. H. "On the Medicalization of Medical Anthropology." Medical Anthropology Quarterly 13, no. 2: 135-40.
Bukovcan, Tanja. "Through and Hourglass: Re-Thinking Ethnography of the Relationship between Biomedicine and Complementary and Alternative Medicine in Croatia."
UDK 43 (2013): 90-98.
Burnam, April Rose. "Bellydance in America: Strategies for Seeking Personal Transformation." UCLA Electronic Theses and Dissertations (2012).
Cadegiani, F. A., and C. E. Kater. "Adrenal Fatigue Does Not Exist: A Systematic Review." BMC Endocr Disord 16, no. 1 (Aug 24 2016): 48.
Crawford, Robert. "A cultural account of "heath": control, release, and the social body."
In Issues in the Political Economy of Health Care. New York: Tavistock Publications, 1984.
Davis-Floyd, Robbie. "THE TECHNOCRATIC MODEL OF MEDICINE." DavisFloyd.com. April 11,2014. http://davis-floyd.com/uncategorized/the-technocratic-humanistic-and-holistic-paradigms-of-childbirth/.
Davis-Floyd, Robbie. "The Technocratic Body: American Childbirth as Cultural Expression." Social Science & Medicine 38, no. 8 (1994): 1125-140.
Downey, Dennis, Justine Reel, Sonya SooHoo, and Sandrine Zerbib. "Body Image in Belly Dance: Integrating Alternative Norms into Collective Identity." Journal of Gender Studies 19, no. 4 (2010): 377-93.
Dumit, Joseph, and Joseph Dumit. Drugs for life: how pharmaceutical companies define our health. Durham, NC: Duke University Press, 2012.
56


Ecks, S. "Bodily Sovereignty as Political Sovereignty: 'Self-Care' in Kolkata, India." Anthropol Med 11, no. 1 (Apr 1 2004): 75-89.
Ernst, E. "The Efficacy of Herbal Medicine--an Overview." Fundam Clin Pharmacol 19, no.
4 (Aug 2005): 405-9.
Fruhauf, Tina. "Raqs Gothique: Decolonizing Belly Dance." The Drama Review 53, no. 3 (2009): 117-38.
Gamble, VN. Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health 87, no. 11 (1997(): 1773-1778.
Giovannini, P., V. Reyes-Garcia, A. Waldstein, and M. Heinrich. "Do Pharmaceuticals Displace Local Knowledge and Use of Medicinal Plants? Estimates from a Cross-Sectional Study in a Rural Indigenous Community, Mexico." Soc Sci Med 72, no. 6 (Mar 2011): 928-36.
Guthman, Julie. "Doing Justice to Bodies? Reflections on Food Justice, Race, and Biology." Antipode 46, no. 5(2014): 1153-71.
Jarmakani, Amira. "Veiled Intentions: The Cultural Mythology Of Veils, Harems, And Belly Dancers In The Service Of Empire, Security, And Globalization." Imagining Arab Womanhood, 2008, 139-84.
Kaeppler, Adrienne L. "Dance in Anthropological Perspective." Annual Review of Anthropology 7 (1978): 31 -49.
Kaeppler, Adrienne L. "Dance Ethnology and the Anthropology of Dance." Dance Research Journal 32, no. 1 (2000): 116-25.
Karayanni, Stavros Stavrou. Dancing Fear & Desire Race, Sexuality and Imperial Politics in Middle Eastern Dance. Waterloo, Ont.: Wilfrid Laurier University Press, 2004.
Keft-Kennedy, Virginia. "How Does She Do That? Belly Dancing and the Horror of a Flexible Woman." Women's Studies 34, no. 3-4 (2005): 279-300.
Kenneth McLeroy, Barbara Norton, Michelle Kegler, James Burdine, and Ciro Sumaya. "Community-Based Interventions." American Journal of Public Health 93, no. 4 (2003): 529-33.
King, Tracey. The Final Veil: Early 20th Century American Dancers Confront Victorian Morality through the Appropriation of Oriental Romanticism. Unpublished Paper.
The University of Texas at Arlington, 2015.
Kleinman, Arthur, and Peter Benson. "Culture, Moreal Experience and Medicine." The Mount Sinai Journal of MedicinelZ, no. 6 (October 2006): 834-39.
Kleinman, Arthur. The illness narratives: suffering, healing, and the human condition. New York: Basic Books, A Member of the Perseus Books Group, 1988.
Krauss, Rachel. "Transforming Spirituality in Artistic Liesure: How Spiritual Meaning of Belly Dance Changes over Time." Journal or the Scientific Study of Religion (2014).
Krauss, Rachel. "Straddling the Sacred and Secular: Creating a Spiritual Experience through Belly Dance." Sociological Spectrum 29, no. 5 (2009): 598-625.
57


Krauss, Rachel. ""We Are Not Strippers": How Belly Dancers Manage a (Soft) Stigmatized Serious Leisure Activity." Symbolic Interaction 33, no. 3 (2010): 435-55.
Krieger, Nancy. "Embodiment: a conceptual glossary for epidemiology." Journal of Epidemiology & Community Health59, no. 5 (2005): 350-55.
Lewis, John Lowell. The Anthropology of Cultural Performance. Palgrave Macmillan, 2013.
Locke, Margaret. "Cultivating the Body: Anthropology and Epistemologies of Bodily Practice and Knowledge." Annual Review of Anthropology 22 (1993): 133-55.
Maira, Sunaina. "Belly Dancing: Arab-Face, Orientalist Feminism, and U.S. Empire." American Quarterly 60, no. 2 (2008): 317-45.
Molloy, BL, and SD Herzberger. "Body Image and Self-Esteem: A Comparison of African-American and Caucasian Women." Sex Roles38, no. 7 (1998): 631-43.
Mansbridge, Joanna. "Fantasies of Exposure: Belly Dancing, the Veil, and the Drag of History." The Journal of Popular Culture 49, no. 1 (2016): 29-56.
McEwen, B. and Sapolsky, R. "Stress and Cognitive Function." Current Opinion in Neurobiology 5 (1995): 205-16.
Micozzi, Marc S. "Anthropology, and the Return of "Complementary Medicine"." Medical Anthropology Quarterly 16, no. 4 (2002).
Moe, A. M. "Healing through Movement: The Benefits of Belly Dance for Gendered Victimization." Affilia 29, no. 3 (2013): 326-39.
Monty, Paul Eugene. Serena, Ruth St. Denis, and the Evolution of Belly Dance in America (1876-1976). New York University Dissertations (1986).
Nichter, Mark. "Idioms of Distress Revisited." Culture, Medicine, and Psychiatry34, no. 2 (2010): 401-16.
Nichter, M, and J. J. Thompson. "For My Wellness, Not Just My Illness: North Americans' Use of Dietary Supplements." Cult Med Psychiatry 30, no. 2 (Jun 2006): 175-222.
Nichter, Mark. "Idioms of distress: Alternatives in the expression of psychosocial distress: A case study from South India." Culture, Medicine and Psychiatry5, no. 4 (1981): 379-408.
Parker, Sheila, Mimi Nichter, Mark Nichter, Nancy Vuckovic, Colette Sims, and Cheryl
Ritenbaugh. "Body Image and Weight Concerns among African American and White Adolescent Females: Differences that Make a Difference." Human Organization54, no. 2 (1995): 103-14.
Popp, Ashley M., and Chia-Ju Yen. "The Global Transformation of Belly Dancing: A Cross-Cultural Investigation of Counter-Hegemonic Responses." Physical Culture and Sport. Studies and Research 55, no. -1 (2012).
Pylypa, Jen. "Power and Bodily Practice: Applying the Work of Foucault to an Anthropology of the Body." Arizona Anthropologist, no. 13 (1998).
Rose, Nikolas. The politics of life itself: biomedicine, power, and subjectivity in the twenty-first century. Princeton, NJ, etc.: Princeton University Press, 2007.
58


Said, Edward W. Orientalism. New York: Vintage Books, 1979
Sapolsky, R. M. "Social Status and Health in Humans and Other Animals." Annu. Rev. Anthropol. 33 (2004): 393-418.
Sapolsky, R. M. "Stress Hormones: Good and Bad." Neurobiol Dis 7, no. 5 (Oct 2000): 540 2.
Schechner, Richard. Performance Theory. Rev. and Expanded ed. New York: Routledge, 1988.
Scheper-Hughes, Nancy, and Margaret M. Lock. "The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology." Medical Anthropology Quarterly1, no. 1 (1987): 6-41.
Sellers-Young, Anthony Shay and Barbara. "Belly Dance: Orientalism: Exoticism: Self-Exoticism." Dance Research Journal 35, no. 1 (2003): 13-37.
Shay, Anthony. Belly Dance: Orientalism, Transnationalism, and Harem Fantasy. Costa Mesa, Calif.: Mazda Publishers, 2005.
Shay, Anthony, and Barbara Sellers-Young. "Belly Dance: Orientalism: Exoticism: Self-Exoticism." Dance Research 35, no. 1 (2003): 13-37.
Thayer, Zaneta, and Christopher Kuzawa. Biological memories of past environments: Epigenetic pathways to health disparities. Epigenetics 6:7 (2011).
Thomas, Deborah A. "Democratizing Dance: Institutional Transformation and Hegemonic Re-Ordering in Postcolonial Jamaica." Cultural Anthropology 17, no. 4 (2002): 512-50.
Thomas, SB,., and SC. Quinn. The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV education and AIDS risk education programs in the black community. American Journal of Public Health 81, no. 11 (1991): 1498-1505.
Thompson, J.J., and M. Nichter. "Is There a Role for Complementary and Alternative
Medicine in Preventive and Promotive Health? An Anthropological Assessment in the Context of U.S. Health Reform." Medical Anthropology Quarterly 00, no. 0 (2015): 1-20.
Thompson, J. J., C. Ritenbaugh, and M. Nichter. "Reconsidering the Placebo Response from a Broad Anthropological Perspective." Cult Med Psychiatry 33, no. 1 (Mar 2009): 112-52.
Tiggemann, Marika, Emily Coutts, and Levina Clark. "Belly Dance as an Embodying
Activity?: A Test of the Embodiment Model of Positive Body Image." Sex Roles 71, no. 5-8 (2014): 197-207.
Viladrich, Anahf. "Botanicas in Americas Backyard: Ucovering the World of Latino Healers Herb-Healing Practices in New York City." Human Organization 65, no. 4: 407-19.
Waldstein, A. "Popular Medicine and Self-Care in a Mexican Migrant Community: Toward an Explanation of an Epidemiological Paradox." Med Anthropol 29, no. 1 (Jan 2010) 71-107.
59


Wall, Nicole M. Monteiro and Diana J. "African Dance as Healing Modality Throughout the Diaspora: The Use of Ritual and Movement to Work through Trauma." The Journal of Pan African Studies 4, no. 6 (2011): 234-52.
Watson, Laurel B., Julie R. Ancis, D. Nicholas White, and Negar Nazari. "Racial Identity Buffers African American Women From Body Image Problems and Disordered Eating." Psychology of Women Quarterly37, no. 3 (2013): 337-50.
Wilson, James L. "Clinical Perspective on Stress, Cortisol and Adrenal Fatigue." Advances in Integrative Medicine 1 (2014): 93-96.
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APPENDIX
PERSPECTIVES ON HISTORY AND ACADEMIC LITERATURE
The genre of belly dance is one of the most perfect examples of how affects and fantasies get translated into history (Mansbridge 2016, 35). From images of ancient and sacred birthing rituals of goddess cults to sexually depraved prostitutes, this dance form has a largely unknown and contested history, with even academics falling victim to undocumented tropes about the source or intent of the dance. Most dance scholars agree to some extent on it being an amalgamation of various folk dances from India, Turkey, Greece, the Middle East, North Africa, southern Spain, and the Balkan regions, largely following trade and immigration routes (Downey et al. 2010; Karayanni 2004; Shay 2005; Shay and Sellers-Young 2003).
Scholastic attention on the dance form often tends to focus on the concept of authenticity; with movements located the Middle East being uniformly authentic while any expression of the dance in the west as the hybrid, appropriated antithesis. (Burnam 2012) The underlying assumption by scholars, such as Anthony Shay (2005), in assigning authenticity presupposes spatial, cultural, and temporal stagnation. As Burnam states, this approach assumes the stability and relative stasis of traditional dances, eschewing any changes made to them as a result of nationalizing reform movements or intercultural exchange (2012, 6). This assumption of stasis, either in the Middle East or within American contexts, is a common methodological failure that has dominated the academic and popular rhetoric on the genre, and that Burnam points out in many essentialist sources, such as Anthony Shay (2005) and Sunaina Maira (2008).
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While the relationship between the West and much of the Middle East become ever more tense and complicated through transnational politics, migrations of people both voluntary and through diasporas of refugees, as multiculturalism is labeled treacherous by nationalist political movements all over the United States, the European Union, and the Middle East, as Muslim women in America must contend with a society that does not recognize their norms and femininities, and as modern politics pits the monotheistic religions in a war against each other, practices such as belly dance that have complex intercontinental histories will continue to be largely viewed as mythic tropes for the oppression, objectification, and colonialized sexualities of the Other. Because of this complexity, it is essential to engage with sites of cultural intersection, such as American belly dance, as multifaceted products of history and politics, which may reflect values from their founding cultures and/or novel hybrids which use similar symbolism to respond to different social cues.
April Rose Burnam, who is simultaneously an internationally renowned professional belly dancer as well as an academic scholar on the subject, has been one of the few to contextualize the historical and cultural nuances of the dance forms entrance into the United States. She contends that bellydance serves as a site for practitioners to transform their sense of self, transgress social boundaries, and build community, but that this transformation potential is compromised when the Orientalist assumptions that have historically been embedded in the practice are not recognized or challenged (Burnam 2012, ii). Her work serves to document the bidirectional exchanges and sociopolitical influences that occurred interculturally between Egypt and the United States in the 19th and 20th centuries that laid the
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groundwork from which contemporary belly dance emerged. While it is commonly assumed by both the lay person and academics that American styles of belly dance are referential to styles seen in places such as Egypt, the research of Burnam indicated that many dance traditions under the term belly dance have evolved simultaneously and interdependently through continuous cultural and artistic exchange.
The first documented instance of publicly performed belly dance in the United States was at the 1876 Philadelphia Centennial Exposition. In celebration of the anniversary of signing the Declaration of Independence, more than 50 countries participated, including exhibits from Turkey, Tunisia, and Egypt. At an exhibit designed to replicate a Turkish coffeehouse, local police conducted a raid after a spontaneous dance performance occurred. The dancer was arrested and charged for being immodest in character (Burnam 2012; Monty 1986). This event set the tone for these dances to be viewed as immoral prior to the official introduction at the 1893 Chicago World Fair.
At the time, this dance was commonly referred to as the hootchy-kootchy dance or danse du ventre for dance of the belly in French,), and immediately became the focus of national attention. Dancers from North Africa, the Middle East, and Central Asia frequented World Fairs and exhibits all over the United States and Europe in the 19th century. These fairs took place at a time of colonial development in Asia, Africa, Latin America, and the Middle East. Fairs were frequently set up to support nationalist rhetoric of expansion, with displays of living peoples performing
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cultural oddities in created natural settings to demonstrate a lack of civilization in
comparison to the West (Burnam 2012; Shay and Sellers-Young 2005).
Sol Bloom, an American businessman in the entertainment industry and U.S.
congressman, recognized a potential opportunity after becoming interested in the
Algerian display of dancers, acrobats, and daredevils at the Paris International Expo
of 1889. Bloom later became manager of amusement concessions for the 1893
Chicago World Fair. He curated and exhibit called A Street in Cairo featuring some
of these Algerian performers alongside other dancers performing danse du ventre.
He rebranded the dance as belly dance and capitalized on the huge response to
the salacious and seemingly immoral dance (Monty 1986; Burnam 2012). These
initial performances, while carefully constructed as a carnivalesque display of
otherness (Burnam 2012, 38) specifically designed to capitalize on the shock value,
complete with sword swallowing and men walking over coals and sticking needles in
their skin, have become widely representative as an accurate representation of the
dance form yet to be touched by American sensibilities. Burnam writes,
Bellydance appeared in America not in some pure authentic form but as carefully crafted entertainment acts designed to represent the East in a microcosmic model of the world in which the West was progressive and civilized and the East was backward and dangerous but mysterious and alluring. The emerging field of social science, which purported to prove the superiority of the Anglo-Saxon race by way of scientific evidence, had a large presence at the fairs and shaped how the general public viewed bellydance, which was presented as an amoral practice from the inferior Orient. The danse du ventre, or the hoochie-koochie as it became known at the A Street in Cairo exhibit and Algerian Theater, was the most popular attraction at the Chicago Fair, famed for its ability to tantalize working class men and according to the press, disgust women (Burnam 2012, 35).
The public defamation of belly dance in the 19th century was closely linked
with racialized anxieties of the relatively new political and cultural interactions with
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the Middle East; with the imagined predatory exoticism of Eastern women acting as the poster child for the cultural depravity that the West was trying to both consume and dominate (Keft-Kennedy 2010). Descriptions of dancers were diametrically opposed to the ideological archetype of Western femininity at the time, which honored controlled, corseted bodies that were restrained and submissive. Thus the dances that became known as belly dancing posed a threat to the acceptable cultural norms of appropriate femininity (Keft-Kennedy 2010, 287). Contextualized in the eras Victorian sensibilities, sexuality was framed as the pathologized Otherness of the Orient.
A woman in public without a corset presented a set of social transgressions: she was physically mobile and healthy, her body was self-supporting and she established for herself a certain self-sufficiency in her refusal of social pressures to corset her body. A dancing woman, however, particularly one imitating the allegedly wanton Oriental dancer, not only embodied these transgressions but also presented the very unstable and threatening element of sexuality communicated in the bodily language of dance movement: a troubling movement, I would argue, that is inextricably bound up in fears of a flexible waist and of womens sexuality (Keft-Kennedy 2010, 288).
Bodies seen as uncontrolled and uncontrollable dominate the early understanding on belly dancers, which creates a foundation by which the discourse on the dance form continues into the 20th and 21st century.
Images from and inspired by the performances of the Chicago World Fair went on to adorn posters, cigarette cases, post cards, paintings, and even one of Thomas Edisons first films called Coochee Coochee Dance displaying the dancer known as Little Egypt, a character who was then replicated by numerous dancers.
These performances created a huge demand by which vaudeville and burlesque shows hired on migrant kooch performers as local entertainers adopted
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many of the serpentine movements. Coney Island became a prominent location for continued performances of danse du ventre. Freak shows and peep shows began incorporating performers assuming Orientalized identities, with many claiming to be the original Little Egypt. Once this exhibit closed in Coney Island, Oriental kooch dancing became a national trend in burlesque as well as in the theatrical precursors to modern dance. Performers such as Ruth St. Denis, Isadora Duncan, Loie Fuller, La Belle Fatima, Mata Hari, and Maud Allen took these images of the Orient, and added elements of mysticism, danger, allure, and feminine spirituality to present them in staged performances (King 2015; Burnam 2012).
At the dawn of the 20th century, Salomania swept United States, with countless dancers reinterpreting the Oscar Wilde character in a form that was interpreted as simultaneously profane and sacrilegious for the biblical reference, as well refined and feminist (King 2015). Many Salome dancers, such as Maud Allen were afforded celebrity status and became icons for the Womens Suffrage for representing a character that was dangerous, sexual, and able to defend against male powers. Dancers such as Ruth St. Dennis integrated imagined spirituality in the dance to both allow for it to be more acceptable in high class circles, but to also employ specific political statements through movement. The imbuement of spirituality into the dance continued with the iconic Mata Hari who intertwined Eastern religion into the dance in order for to get deserved reverence for her work rather than it [to be interpreted as] being vulgar (King 2015, 16). The added invention of spirituality allowed for a form of legitimization of the movement as art, separating it from the hypersexualized vaudeville styles (Burnam 2012).
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Keft-Kennedy explores the transformation of the depiction of the dance as immoral in the 19th century through the current state of the genre in the 20th and 21st century as being a powerfully enduring and resonant strategy in the counter production of knowledge concerning the display of womens bodies (2010, 280).
Hollywood movies quickly obtained an interest in the dance form, with the American movie industry sourcing ideas, imagery, and performers from Egyptian films at the time. Sarnia Gamal and Tahia Carioca were seen in countless films and have become the mental representation for what most Americans know of as belly dance. This period of belly dance in the media has come to be known as The Golden Era. Many of the dancers were trained by the Syrian dancer Badia Massabni, who opened the Casino Opera House in 1927 in Cairo and is credited with creating the imagery of what much of the world understands to be belly dance. Her dancers wore halter tops with skirts, belts, and high heels to mimic what Egyptians viewed Western music hall dance performance attire to be and the normally improvised dance was choreographed for stage performances with multiple dancers (Burnam 2012).
Oriental themed cabarets and restaurants featuring live belly dancers became popular in the United States beginning in the 1950s and 60s following the influx of Arab, Greek, and Turkish immigrants into the United States. The demand for belly dancers in these clubs and restaurants became so great that often, non-trained dancers would be hired. The first American based belly dance school, Stairway to Stardom, which was soon renamed Serena Studios, opened in 1964 in New York City following a wave of demand for the dance form (Burnam 2012).
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Dancers in the 1970s began putting concerted effort into heightening the legitimacy of the dance and removing the sexualized image of the club dancer by traveling to Africa and Asia to ground the dance in folkloric traditions. Dancers of these period published articles attempting to rebrand the dance; many also becoming ethnologists. Groups such as Bal Anat, directed by Jamila Salimpour, and Ibrahim Farrahs Near East Dance Group, focused on performing versions of North African and West Asian folk dances, often covering much more skin than the night club dancers of the previous decade. These versions were a blend between the dances and costumes found of the performed local, as well as with a hybrid version, often exaggerating and blending various elements. Dance magazines focusing on belly dance started to be available to both consumers and dancers interested in cultural heritage and fads in different subgenres.
Jamila Salimpour was one of the first dancers to attempt to codify steps and movement vocabulary of the dance form. To this day, the dance remains internationally uncodified, meaning that there is not consistent terminology for moves or even consistent muscle motivation to get the same visual look of a movement.
The terminology that Jamila, as well as her daughter, Suhaila Salimpour created are the most commonly used vocabularies in the U.S. dance form currently.
One of Jamila Salimpours dancers, Masha Archer became an iconic figure that helped to shape modern American genres. As a dancer and a designer, she recreated the visual aesthetic of both dance and movement to resemble living sculptures, adding turbans not as a cultural reference but to expose the next and jaw line and covering dancers with textiles and heavy jewelry from all over the world.
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She shifted the staged focus to be that of an imagined regality to a group of dancers, where the audience owed some homage to witness the movements rather than a solo performer acting to entertain the audience. In 1974, Carolena Nericcio because a student of Archer. Nericcio later developed a cued improvisational style of the dance known as American Tribal Style (ATS), where groups are able to prompt spontaneous movements with specific gestures with the hand or head, allowing for an improvised piece to look planned and unified. This continued and depend the focus on group performance as opposed to solo dancing. This particular lineage made concerted effort to largely remove sexuality from the dance, covering much more skin and deriving aesthetics from different sources than the traditional Oriental Cabaret dancers. The first ATS troop was called FatChanceBellyDance, a name specifically designed to confront male voyeurism (Burnam 2012).
This genre of dance then birthed back the same visual aesthetic in solo dancers, known as Tribal Fusion or simply Fusion Belly dance. This form tends to be hyper technical, with intricate muscle articulations of the hips and torso, utilizes alternative archetypal aesthetics, or experiments with fusing other dance forms such as Flip-Flop, Classical Indian dances, Modern Dance, or Latin dances.
The dance form in America has largely been seen as exploitative, with echoes of colonial and imperial histories with no possibility for productive restructuring (Burnam 2012, 6) by many writers that have had limited encounters with the different cultural contexts of the dance or who privilege the common rhetoric of the debated history of the dance without investigating the dubious line between fantasy reconstruction and reality. Sunaina Maira argues, the performance of belly
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dance by American women represents not so much their ambivalence about Middle Eastern culture, but their ambivalence about their own cultureits individualism, materialism, or restrictive body image ideals (2008, 334). While the dance, no doubt, has the potential for problematic representation of Otherized cultures, especially when practitioners do not scrutinize the sociopolitical histories, immersed research into the current state of the dance largely produces the image of dancers hungry for contextualized education while creating artistic expressions that reply to their own cultural ecologies using a transnational movement vocabulary.
Virginia Keft-Kennedy raises a perspective through which to view the intricate intersectionalities of the dance in the lens of performance, display, and grotesque bodily movements. She argues that the dance, which has been largely overlooked by cultural studies... can be seen as a potent weapon for feminist politics and a potentially transgressive practice for women (2010, 280). Keft-Kennedy views the dance primarily as a variety of body modification, in that the body is both physically modified by nature of the extent of flexibility, dexterity, and strength needed to execute the dance as well as symbolically modified from the socio-cultural expectations of appropriate public manners of movement for women. Several dancers interviewed referenced that they felt their dance form was seen as taboo, primarily because the dance form focuses largely on movements of the hips, which is atypical of many accepted dance forms in American culture.
Keft-Kennedy utilizes a conceptual framework from Mikhail Bakhtin initially applied to Carnival for understanding the varied social reactions to belly dance. In separating parts and movements of the body as either classical or grotesque, this
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framework usefully helps analyze responses to the dance outside of the simplistic labeling of it as sexually lewd. The classical body is that of integrity, intellectualism, and security. The lower body thus is conceived as excessive, sexual, and grotesque. As belly dance primarily focuses on what many writers, both historical and contemporary, call the jerking, contorting, quivering, undulating, and writhing of the hips and stomach, ideals of the female body are challenged through a transgression of aesthetics as well as the perceived limits of the body.
This physical modification of the body in relation to itself symbolically modifies the body within the expected social construction of appropriate ways for a body to behave (Keft-Kennedy 2010). Keft-Kennedy further goes on to examine how the dance has been written about in historical accounts, demonstrating how male writers imperially viewed the dance form as completely devoid of artistic value or talent and instead racialized the grotesque movements of the body as an alien and Orientalized Other.
Many movement traditions of the Middle East and North Africa were denounced as sexually gratuitous by the Victorian sensibilities of the 19th century and Eurpean travelogues. These movements became symbolically representative of the lewd, sensual abandon of the Eastern Other. Even today, many practices that focus on movements of the lower body are discredited as sexual and devoid of artistic merit.
In the book, Dancing Fear and Desire: Race, Sexuality, and Imperial Politics in Middle Eastern Dance, Stavros Stavrou Karayanni describes the power of the dance by explaining that it signifies] transgression by giving voice to parts of the
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body that are expected to remain silent, unobtrusive, and discomfited in their postcolonial posture (1965, xiii). Because of a consistent erasure of the history of the dance, belly dance operates in a liminal and illusory space of timeless fantasy that endorses a larger narrative of the publicly evident and sexualized female body as a mark of modernity (Mansbridge 2016).
Studies like Tiggeman et al. (2014) position belly dance as an erotic performance of embodiment, likening the practice to heterosexual women kissing for the visual pleasure of men in public settings. As the research questions of that study entailed learning if female belly dancers enjoy sexual objectification more than their college age non-dancing counterparts, a foundation that understands the patriarchal gaze upon the dance is continuously set forth and is privileged over the internalized experience of the practitioner. Practices that are of the body and dominated by females are often weighted with the social reality that womens bodies are used as sites onto which multiple differences-political, religious, sexual, and cultural-are either imaginatively resolved...or reinforced (Mansbridge 2016, 30).
Angela Moe investigates the apparent disconnect between public perception and practitioner standpoint and the potentiality for healing trauma from gendered victimization. Through the ability to self-define creative discovery, Moe argues that the dance form is a mode of movement-based therapy with particular holistic efficacy in reducing the long term harm of the types of violence that disproportionately affect women (2014, 326). Moe takes a framework of feminist standpoint theory to privilege the voices of the studys participants about their experiences over other dominant discourses on the matter. Interpersonal harm
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afflicted onto the lives of the participants organically surfaced unprompted in her study. Moe also analyses her qualitative data with phenomenological ideas of embodied meaning, a practice which was utilized in the analysis of my own data about the belly dance, the body, and health seeking behaviors.
Burnam argues that the art of belly dance has the potential for practitioners to be able to expand their sense of self beyond societally-imposed boundaries and to form inter-subjective community and that the genre provides the rare ability for women to intentionally construct their own body and identity in ways that everyday life does not often allow (2012, 9). The transformative properties of the dance do, however, become problematic when the locale is placed in fanaticized imagery birthed from imperialist histories. The capitalistic commodification of sexuality and gender exists concurrently with the poststructural destabilization of these concepts, allowing belly dance as a practice and culture to present either real or imagined agency in their body and gendered expression (Mansbridge 2016).
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BELLY DANCE IN THE UNITED STATES: CULTURAL PRODUCTIONS OF ALTERNATIVE HEALTH NARRATIVES AND PRACTICES b y ELIZABETH SWEITZER B.A., University of North Carolina Asheville, 2013 A thesis submitted to the Faculty of the Grad uate School of the University of Colorado in partial fulfillment o f the requirements for the degree of Master of Arts Anthropology Program 2017

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ii This thesis for the Master of Arts degree by Elizabeth Sweitzer has been approved for the Anthropology Program by John Brett, Chair Sarah B. Horton Donna Mejia Date: May 13, 2017

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iii Sweitzer, Elizabeth (MA, Anthropology Program) Belly Dance in the United States: Cultural Productions Of Alternative Health Narratives and Practices Thesis directed by Associate Professor John Brett ABSTRACT Belly dance, which has predominantly been studied in the context of post colonialism and Orientalist frameworks, has recently been gathering academic steam as an embodied practice with sig nificant effects on body image. However, it has not previously been investigated as to whethe r the dance as a cultural form influences or changes ideas of health, nutritional practices, or self care modalities. Based on participant observation and interviews with profess ional and semiprofessional dancers, the physical and nutritional self care practices of American belly dancers are examined as to how these are inco rporated into personal regimens as either comple mentary or alternative narratives to the traditional biomedical model. Results indicate that control of the body frequently acts as an embodying feature of the dance, which has pervasive ramifications for understanding the self and the needs of the body, t he acceptability of physicians and biomedicine, conceptions of illness, and systems of healing that are determined to be appropriate. The form and content of this abstract are approved. I recommend its publication. Approved: John Brett

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iv A CKNOWLEDGEMENTS This writing could not have happened if not for the many women of this study who shared their personal stories, I am forever grateful for the trust and participation those women gave me. I would like to thank the many other dancers who helped to shape this study through countless conversations across several years. I would also like to thank my many teachers, both in the world of dance and the academic world who shaped my abilities and passions. I am grateful for the proof reading provided b y Ray Mcpherson and Sami Harvey, and to my committee members, John Brett, Sarah Horton, and Donna Mejia for their support an d engagement in my research. Thank you to Connie for being infinitely patient and helping stu d ents navigate the bureaucracy of graduate school. Fina lly, I would like to thank my family, who always supported my pursuit of knowledge. This research protocol number 16 1927, was approved by Colorado Multiple Institutional Review Board in October, 2016

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v Table of Contents I. INTRODUCTION ................................ ................................ ............................ 1 II. METHODS ................................ ................................ ................................ ...... 8 III. FINDINGS/DISCUSSION ................................ ................................ ............. 14 Control and Embodiment ................................ ................................ 14 Understanding of the Self: A Cartesian Holistic Fusion ................ 19 R ejection of Physician Knowledge and Biomedicine .................... 23 Adrenal Fatigue as an Idiom of Distress ................................ ......... 30 Healing through Herbalism, Supplements, and Alternative Treatments ................................ ................................ ......................... 37 IV. CONCLUSION ................................ ................................ ............................. 53 BIBLIOGRAPHY ................................ ................................ ................................ ...... 56 APPENDIX ................................ ................................ ................................ ................ 61

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1 CHAPTER I INTRODUCTION B elly dance classes occur throughout the United States ranging from those that cater to a casual hobby designed for fitness to serious and focused training courses intended to create professional dancers. The term "belly dance" itself is an umbrella term originating in the United States tha t describes multip le sub genres occur ring all over the world, many of which have little to no resemblance t o the Orientalized image of a scantily clad harem girl. Vast arrays of regional folk dances, both casual and stylized, are also part of the frequently seen repertoire of the average belly dancer. Some genres look identical to the commercialized imagery of the dance, while other genres rarely reference any Middle Eastern or Arab culture and more closely resemble genres such as Hip Hop or Modern Dance. While common rhetoric cites belly dance first occurring in the United States at the 1893 Chicago World Fair, it actually was first documented to appear in Philadelphia in 1876 in celebration of the anniversary of the signing of the Declaration of Independ e nce ( Burnam 2 012; Monty 1986) Since this time, there has been a complex history of politicized sexual anxiety and racial marginalization that cannot be separated from how the public and scholars have interacted with the dance form. Contemporary dancers in this form re gularly have to navigate various forms of stigma associated with performing the dance (Krauss, 2010). Most professional dancers in this genre create a living by teaching classes as well as engaging in a huge underground network of dance festivals both in t he United States and internationally. Within festivals and classes, information is

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2 regularly shared about self care, conditioning, and strength training to become better at dancing. Narratives are steadily transmitted about ideas of proper ways to warm up and cool down the body for mitigation of the impact of dancing as well as other messages related to ways that certain movements and positioning can maximize health of the body. Individuals can often be seen taking tinctures, or liquid herbal blends, drinki ng specialty teas, and discussing their diets. Inside the belly dance community, this rhetoric of health is very commonplace. Ideas are shared, many of which might be considered atypical to average western delivery systems. Based on my own experiences as a belly dancer, I felt that this rhetoric and relation to health care warranted further study as to why this population seemed to prefer many complementary and alternative medicines and treatment systems while largely rejecting western biomedicine. I argue that the control of the body emphasized in how American belly dancers are trained, which allows for the "unnatural" serpentine movements and precise muscle control that have become iconic in the dance form, often translates into other arenas of the dancer s' life, such as their relationship with h ealthcare. Control of the body becomes a central motivator in how dancers interact with biomedicine, cho o se alternative practitioners, accept or reject di agnoses by others, self diagnose identif y with illness, and incorporate treatment regimens. Belly dance has a sparse presence in the academic literature. The bulk of study has primarily served to understand the histo r ical O rientalization of the imagery of dancers in Hollywood media. It is portrayed typically as a falsification or cartoonish rendition of Arab culture and an excuse for American women to sexualize

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3 their bodies for male audiences in the wake of the nation's feminist sexual revolution during the 1960s and 1970s (Downey et al. 2 010; Karayanni 2004; Moe 2013; Shay 2005; Shay and Sellers Young 2 003; Tiggemann et al. 2014; Maira 2008). Since the 1960s and 70s, the art form has progressed in its engagement and dialogue with numerous cultural histories and modernities after leaving the gaze of Hollywood. The academic study of this dance has continued sp oradically but has yet to critically engage with health aspects of these communities, with the closest studies being those which view how this dance form may act as a therapeutic tool for individuals that have suffered certain forms of violence (Moe 2013) or how the ascription of spirituality on the practice influences identity formation (Downey et al. 2 010; Karayanni 2004; Kraus 2014; Shay 2005; Shay & Sellers Young 2003). Some work has been done to utilize th e frameworks of medical anthropology in regards to athletes, and even somewhat about dance forms such as ballet or African dance forms where dancing is identified as integral to concepts of ritual and healing ; however belly dance has not been previously e xamined within these constr u cts ( Monteiro and Wall 2011; Toy 2009; Twitchett 2009). Recent estimates put the use of complementary and alternative medicine (CAM) at around 40% in the United States, however this estimate may arguably be low as indigenous sys tems of health in largely invisible populations may not be properly represented in health statistics that primarily look at services such as acupuncture and chiropractic manipulation (Thompso n and Nichter 2015). CAM is used both by those with access to bio medical healthcare as complementary or

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4 supplementary care, as well as those that find the American health care system either inaccessible or indigestible to their worldview. Predominantly, the markets that CAM systems find themselves in are largely self re gulated and paid for directly by consumers. In self reported health assessments, individuals that turn to alternative or complementary treatments report having more health problems than their non CAM using peers while at the same time consistently report their health as improving from the prior 12 months (Nguyen et al. 2001). This figure could either demonstrate that those who face more illness tend to seek out additional care outside of biomedicine and recognize some amount of benefit from it, or indicate the embodiment of additional "idioms of distr e ss" ( Nichter 1981) that patients otherwise would not have been exposed to and identified with in biomedical treatments. My own engagement with belly dance began i n 2012 I began belly dancing as a hobby and it quickly turned into a fascinating outlet in which I was exposed to many different cultures. My dance training included education on culture, music, dress, food, politics, history, language, and self care practices from places such as Egypt, Tunisia, Libya Lebanon, Egypt, Saudi Arab ia, Turkey, The Balkans, Spain, Iraq and the Rajasthan and Orissa states of India Education was also given about specific nomadic groups such as the Bedouin or the Romani. Once my hobby of dancing transformed into specialized performance preparation, I tapped into the national circuit of professional training for belly dancers. Since then, I have traveled all over the country participating and observing training events with professional

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5 dance teachers from all over the world. I continuously noticed patterns of self care, alternative medicine use, and interesting relations to the body. In 2014 and 2015, I began working with a prominent professional belly dancer. My specific job entailed assisting in running her studio and providi ng personal assistant work to aid in her own work as a traveling professional dancer. During this time, I would meet dozens of dancers each week, varying from hobbyists to those in training to make dance their permanent profession. I observed countless cla sses from many different teachers in different genres of dance and noticed the same patterns of communication in regards to health and nutritional information. In 2015 and 2016, I attended three training events and began inquiring about the topic of my proposed research and gained a lot of interest from key stakeholders in the community, including multiple dancers that are also academicians. I piloted my research idea at an event in April 2016 with 15 dancers from across the United States wh o traveled to study with a top international d ancer. The individuals were both receptive and excited about my proposed research. While conducting a qualitative or ethnographic study in a population one also resides in may be a potential site of criticism on issues of objectivity, I tend to take the stance of Lil a Abu Lughod, who has written extensively about the process of conducting research as a feminist or a "halfie" anthropologist (Abu Lughod 1991). She articulates the inherent issues of power that derive from dif ferentiating the self from the Other, and that a "professional discourse of objectivity' and expertise, is inevitably a language of power" (Abu Lughod 1991 150 ).

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6 Phillipe Bourgois, an acclaimed anthropologist who has developed several groundbreaking ethn ographies of the vulnerable affirms, "only by establishing long term relationships based on trust can one begin to ask provocative personal questions, and expect thoughtful, serious answ e rs" ( Bourgois 2003 13 ). My relationship with the belly dance communi ty allowed me in the short time I had to conduct this research, to dive immediately into personal questions that I firmly believe would have been difficult, if not impossible to elucidate in the available time if there was not already an established mutual trust based on my identity as a belly dancer. While I did not personally know all of my participants, the national community of belly dancers is rather small. Thus most dancers who are dancing professionally have at least passing knowledge of each other, which meant that all of my participants knew who I was, and I knew of all of them to some extent prior to this study. While being a potential detail of criticism of this study, this established an instant repertoire that allowed for many of the dancers to feel comfortable in sharing rich and emotional stories about their personal health, vulnerable incidents seeking health care, and bodily experiences. As I have been immersed in this culture since 2012, I acknowledge that I did have preconceptions of what I would get out of interviews and participant observations. Some of my preconceptions were validated, while others turned out to be false. I continuous ly reassessed data against my own assumptions and my own internal beliefs to decipher when I held opinions that should be placed on the back shelf of being an observer and when I held opinions because I was a part of this culture.

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7 The following chapter wil l provide an overview of the methods of this study, including sampling and limitations. C h a pte r III ellaborates the findings of this study, exploring how professional and semiprofessional belly dancers frequently embody the control that is quintessential t o the dance form itself. This embodied control has pervasive ramifications for understanding the self and the needs of the body, the acceptability of physicians and biomedicine, conceptions of illness, and systems of healing that are determined to be appro priate. The Appendix provides a brief overview of the history of belly dance as it relates the United States and its presence in academic literature. This is supplied so that the reader may better understand the culture of this population and not rely on the typical assumptions about belly dance and belly dancers that are a product of c olo n ial, exotified, and often racialized fantasy histories. Throughout the process of constructing this study, carrying out the research, and analyzing the data, my stance g rew more certain that not providing a historical perspective as a foundation to this study seemed irresponsible, both as an academic and to the population of dancers. As the normalized images of most Western audiences are steeped i n the racialized, imperia l histories of colonialism, the reader is implored to think of belly dance for the duration of this paper "not by the images that typically come to mind when the word is evoked, but as a set of movement practices that share key markers in movement quality and extend out of the same transnational hist o ry" ( Burnam 2012 4 ).

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8 Chapter II M ETHODS This study was conducted to fulfill, in part, the requirements for a Master of Arts in Anthropology from The University of Colorado Denver. The study was approved by the Colorado Multiple Institutional Review Board in October 2016. Twelve female belly dancers from ac ross the United States were interviewed about their diet and health practices, experiences with health care, and their lives as dancers. Dancers were recr uited through convenience sampling, snowball sampling, and a single ad placed on a social media site with information about the study. All dancers were either professional or semi professional dancers, being that they frequently were paid to perform belly dance. While some dancers had multiple sources of income, including what several identified as t h eir muggle" job, others made their entire income from dancing professionally, teaching dance, or owning dance studios. On average, participants made 70 % of th eir total income from dance. While one could expect to find a gradient of embodiment across students to professional dancers, I made the assumption that those relying on the dance form for a living wou ld be the ones most acculturated into the community, an d thus exemplify the behaviors and relationships that I was interested in more readily than those taking belly dance classes as a ca sua l hobby. Extensive discourses could be supplied on the particular histories, problems, and uses of many different terms regarding "belly dance" in several languages. In some contexts, certain terms could be interchangeable, while others refer to specific genres. Such dance taxonomies in c lude Raqs Sharqi, Oriental dance/danse

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9 Orientale, danse du ventre, Raqs Arabi, Raqs Mas ri, tsifteteli, dances of the Ghawazi, Awalim, Kochecks, and Khawals as well as the sub genres of cabaret belly dance, tribal fusion, American Tribal Style¨ (ATS¨), Improvisational Tribal Style (ITS), transnational fusion, belly dance and bellydance Thes e are just some of the vast styles and titles that for the sake of digestibility, are referred to as belly dance unless specifically articulated otherwise. Many sub genres of belly dance were represented in this study, with all but one dancer responding th at they routinely trained and performed in multiple styles of belly dance. When asked about what genre of belly dance they performed participants responded with the following st y les: Raqs Sharki, American Tribal Style¨ (ATS¨,) American Cabaret, Tribal Fus ion, Fusion, Theatrical, Modern Egyptian Style, Egyptian Orie n tal, Datura Style, Improvisational Tribal Style (ITS,) Oriental fusion, and Turkish Oriental. Many of the dancers also mentioned being trained and frequently incorporating various folkloric styl es of dance from North Africa, the Middle East, and the Balkans into their movement vocabularies. Interv iews ranged from thirty minutes to two hours and were conducted over the phone, in person, and over online video conferencing services. Dancers were not monetarily compensated for their participation, however participants were promised a copy of this manuscript upon completion. During some of the interviews early in the study, I recognized the internalized normalcy of using complementary and alternative m edicines and made a more concerted effort to probe about any use of herbs or supplements via store bought capsules, concoctions other people had made for them, or casual usage of self

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10 made remedies until the interviewee began to mentally take note of all t he substances they took and for what purposes. Another tactic that I found to be extremely helpful in eliciting this information was to offer self reflexive conversation about my own usage of various supplements, herbal tinctures, and teas. I talked about my u s e of Glucosamine, which was more or less "prescribed" to me by another dancer to take for my joints as a sort of primer when dancers passed over my inquiry. This repeatedly spawned engaging and in depth discussions around whether the participant had t ried that, if they found that it was effective, what else they have tried, what they currently use, and why. These experiences lead me to believe that conducting focus groups of belly dancers would have been an extremely valuable data collection method, as it seemed the act of one dancer (in all instances but one being myself) discussing herbal and supplement use sparked excited conversation about practices in the belly dance community at large. This lead me to further believe that the behaviors I was inter ested in studying are largely driven by the community culture of the dance, as much information is shared, taught, disseminated, and critiqued in social settings among other dancers. Ten of the dancers identified as being white, one dancer as white and His panic, and another dancer identified as Asian American. There is currently no comprehensive demographic information about the racial and ethnic diversity of American belly dancers, however white women do seem to be the majority of this dance style currentl y in the United States, with African American and Latina dance communities slowly growing.

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11 The average age of the women interviewed was 36.75 years old. All women thought of themselves as being somewhere in the middle class category except one who identif ied as being "low income or poor." Several women specified they believed that they were low middle class, high end of poverty or low, low middle class ." Similarly, comprehensive data on socioeconomic status for American belly dancers does not exist. Aga in, on a surface observation, the field seems to primarily be middle class women. Due to the nature of the sample of this study, being predominantly middle class white women, the findings should not be understood as representative of other populations wit hin American Belly Dance culture. This study should speak about the experiences and culture of dancers that fit the particular social statuses represented in my sample. It is recognized that very wealthy, very poor, or dancers of color may have different r elationships with the themes explored based on different historical, economic, and political experiences. In particular, it has been shown that racial identity can heavily influ ence perceptions of body image (Mollo y and Herzberger, 1998), bodily behaviors and methods of care(Parker et al., 1995), and standards of beauty (Watson et al., 2013). Additionally, there remain culturally noteworthy differences in how many communities of color relate to biomedicine based on histories of unethical medical exploitati on (Gamble 1997; Thomas and Quinn, 1991). This is a recognized limitation of the study and should be seen as an area requiring further investigation as to how women of different racial or socioeconomic identities relate to the dance form and the body.

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12 Furt hermore my own identity as a white woman brought up in a middle class setting inherently influence my interpretations as well as how my participants interact with me. Interviews were recorded, transcribed, and then analyzed u sing NVivo QSR International S oftware. Transcripts were inductively coded several times to reveal salient themes. Direct quotes were sometimes edited when identifying information was present, however this was done minimally to ensure both my participants' confidentiality and the integr ity of the stories they were telling. Participant observation was also conducted One dance teacher, with the approval of her students, allowed me to actively study one of her weekly classes as well as her dance troupe rehearsal. Being that I have been an active belly dancer myself for years, separating myself as a dancer and myself as a researcher posed some initial challenges. While I attended many trainings, dance classes, performa n ces, haflas (casual dance parties meant for dancers and their families,) and workshops, I did not actively engage in participant observation for the purpose of including data in this manuscript from events where I did not have explicit permission from everyone present. I did however frequently take notes on experiences in thes e events, which I would then bring back to consented interview participants or dancers involved in my participant observation to get their thoughts on the topic at hand. I also attempted to make it clear at both the local and national level that I was enga ging in research, which served to inform the community, and spark ed many valuable conversations by both participants and those outside my

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13 study that helped to guide the evolution of analysis and to insure my understandings were appropriate to the community at large. While m ale, androgyne, and transgender professional belly dancers exist in the United States (as well as all across the world) I did not feel confident in including their stories while simultaneously ensuring confidentiality of my participants due to how relatively rare and prominent they are in the professional belly dance setting A s their perspectives would provide valuable viewpoints from different social spaces and different contextual understandings of their bodies, fut ure investigation should be conducted with these individuals.

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14 CHAPTER II I FINDINGS/DISCUSSION Control and Embodiment In all aspects of the interviews conducted one theme remained consistent with most of the dancers that of control. Control was explici tly mentioned by the interviewees alluded to, and characterized as being a prime motivator for participation in the dance, health seeking behaviors, and conscious representations of the self. I argue that it is the bodily control of the torso required of the dance form itself, placed within the context of a general American cu lture that becomes embodied in the dance form, thus influencing their attitudes towards health and healing. Dancers' concern with control' then influences their engagement, choice, a nd level of cooperation with systems of healing. The dance form of belly dance trains dancers to utilize their bodies in ways that are often counter to how the individual has been socially conditioned to move specifically that of the hips and the stomach Belly dance calls for a dancer to be able to articulate rolls and undulations of the abdomen by sequencing both the release and contraction of muscles, display parts of the body that many Anglo American women typically have anxiety over and allow flesh to shake in full view of any audience. These archetypal movements of belly dance have historically been received as controversial and sexualized since its first documented performance in 1876 at the Philadelphia Centennial Exposition, where the dancer was arrested and charged for being "immodest in charac t er" ( Burnam 2012; Monty 1986). This cultural anxiety over the movement vocabulary in belly dance continues to this day in the

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15 United States and often acts as a barrier to academically study or participate in the dance form. A shimmy is a prime example of physically training social condition ing out of the body. Shimmies can be executed with multiple parts of the body but primarily are performed with the hips. While there are many variations of a hip shimmy, both articulated to certain timing s or more freely per formed separate from musical timing, they always sustain a rapid and repetitive movement similar to a vibration. This movement simultaneously requi res one to powerfully exert force to create the rapid m ovement while also relaxing much of the body, such that the motion can ripple through the dancer's flesh and not be halted by engaged muscles. Based on my own experiences in belly dance classes, t his is commonly a conceptually difficult movement for many w hite dancers to learn, often with these women having anxiety over their stomach, thighs, and buttocks not only being allowed to relax, but to also shake, slap together, and be the focus of attention a central move of the dance form. In training dancers in the movement vocabulary of belly dance, there is often a conceptual hurd le for many individuals to not only feel comfortable moving their body in undulations and shimmies, but it can be very difficult to guide individuals in gaining the ability to engage or relax isolated muscles or muscle groupings. Numerous movements in the belly dance vocabulary require simultaneously training to obtain a level of deep muscular control of the torso while also cognitively training oneself to allow a disregard of imbedded social norms of appropriate movements. I have previously heard of this synergistic process referred to as training the natural out of the body by dance instructors.

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16 Many of the dancers interviewed who were also dance instructors t alked about how they educate students in their classes about control While any weight or size which is often equated with female health, was not explicitly sought after or taught in these c l as s es as being tied to achieving a higher level in dance power and muscular articulation was discussed as being necessary One dancer expressed that she felt that her muscles needed to be visible enough that when teaching, she could more clearly demonstrate isolated contractions of the abdominal muscles hip flexors and obliques. "I talk to them a lot about their muscle groups, like you really need to engage your psoas muscle' and if they don't know what that is, I'll print little pictures out and bring them and be like this is your psoas muscle, this is where it goes, this is where it's running down in your pelvis, and that's really useful when you're doing a jewel for instance. That's really where you need to be pulling in.' You know, pulling that in so it kind of gives them a visual of what muscle they need to be using. I do a lot of that because ladies in this area, I don't know if its true across the board, they don't kn ow what muscles are what, what does what, where it is, and what muscle is what. They have no clue. S o I do a lot of t hat educating them about their pelvic floor, their abdominals, their hip fle x ors, obliques. You know, the things that you really need to use in belly dance. They don't know where they are or what they are. And they I don't know if they always know how to a ccess them, so I do a lot of that." Dancer One dancer articulated her passion for the dance form as learning complete and absolute control over my entire body. That is one particular thing that drew me to belly dance, was how much control I saw in the d ancers" I assert that this fixation with control of the body becomes embodied into the self, translating into other aspects of the individual's life, including that of illness, healing, and healthcare seeking behavior. Being able to develop the control o ver my body and being able to teach my body to do those things has been so empowering for me. Because I'm [that]

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17 personality type, I'm a control freak and so being able to maste r my own shell as a human being t hat is so satisfying. And I feel like belly dance is totally [about] being able to do multiple things at once and move different body parts at different timings in dif ferent ways through different pathways It's the ultimate form of control over oneself ." Dancer The incorporation of the theory of embodiment is not new to dance or even specific to belly dance. However previous literature on belly dance and embodiment tends to lack descriptions as to how the dance form is embodying, the pathways by which this process works, and what that means beyond feel good sentiments of positive body image. Control of the body is not unique to belly dance. Most dance forms and athletic practices train the practitioner to develop various levels and types of control of the self. However, the control taught in belly dance is characterized specifically by micro articulations of the torso, something which is rarely developed without specific training. These micro articulati ons create a unique relationship between dancer and the body, where the dancer often adopts an acute fixation on the torso. In my own experiences as a dancer, I have frequently heard dance instructors reference certain belly dance movements as having a dir ect and immediate impact on internal organs, chakras, and emotional centers of the body. Conversely, many other athletic or dance forms can be described as tolerant of pain, with common rhetoric supporting the idea that pain equals gain ." Belly dance trai ning in America, however, refutes this strongly. Training is often characterized by developing pathways and methods to execute moves that work with the particular needs and alignment of the individual body. Pain while executing a move is frequently communi cated as a sign that the

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18 dancer is not using proper technique or needs to reassess their alignment or muscle motivation. This pain negating characteristic of the dance form fosters a culture where dancers pay special attention to somatic cues and learn to understand bodily states and sensations as deeply meaningful experiences. As the bodily movements and representation of dancers have been so heavily contested and as belly dance is recognized to provide practitioners "access [to] a more self aware and expa nsive notion of their own body and identi t y," ( Burnam 2012 17 ) does this increased relationship then rely on different understandings of body maintenance? Are there reflections of these representations in the internalized understandings of the body?

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19 Und erstanding of the Self: A Cartesian Holistic Fusion The belly dancers of my study employed a contradictory blend of Cartesian dualism and holistic preferences when determining appropriate methods of medical diagnosis, treatment, healing, and maintenance. W hile the dancers, in both interviews and during participant observations, continuously compartmentalized the self as being made of two separate essences body and mind the vast majority of interviewees preferred holistic approaches to care. This paradox ical understanding of the self can be contextualized as a result of the nature of belly dance training itself, which emphasizes obtaining a control of the torso above and beyond that of daily life. Materialist interpretations of the self can be traced as far back as Aristotle's De Anima which viewed the human soul as fundamentally needing a biological base. Hippocrates furthered this train of thought in the Hippocratic Corpus, which aimed to stamp o ut religious based healing traditions in favor of clinical practices that acted on the rational treatment of only that which was tangible and observable. Rene Descartes articulated a framework that would later become the foundation by which clinical Wester n medicine understands the self and human as an organism. His writings contended that there were two fundamentally different substances that composed a human being: the palpable body and the intangible mind. This separation, known as Cartesian dualism pav ed the way for science and medicine to take domain over the body while leaving the mind to the realm of theology. This dualism has not only defined how the West understands the body, but also how it defines sickness and thus treatment. "Pain, it seems, was either physical or mental,

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20 biological or psycho social never both nor something not quite eit h er" ( Scheper Hughes and Lock 1987 10 ). A holistic approach to care is usually considered dichotomously opposed to the Cartesian split of body and mind N ancy S cheper Hughes and Margaret Lock identify two traditions of holism. The first is a conceptualization of all entities being a single unit from the universe to the organs within the human body all being understood as one. The second tradition of holistic t hought is based on "complementary dualities," which focuses largely on the connections and relationship s of different parts to a w h ole ( Scheper Hughes and Lock 1987). This tradition is exemplified by the yin/yang cosmology, which is based on the ever fluct uating and opposing states of yin and yang Dating back to t he I Ching just before the third century B.C., this tradition understood the body as "patterned after the healthy state: in both there is an emphasis on order, harmony, balance, and hierarchy with in the context of mutual interdependencies. A rebellious spleen can be compared to an insubordinate servant, and a lazy intestine compared to an indolent s on" ( Scheper Hughes and Lock 1987 12 ). My interviews were filled with conversations on holistically thinking about caring for the body, while simultaneously conceptualizing the body as something separate from the mind or the self. I think it is wonderful that as we get more attuned into our bodies, people are being more open to more non ma instream options for everything emotional, spiritual, physical needs for our bodies, what it might be telling them, or what it needs. I have studied so much with [dancer] because she talks so much about the body being a sentient being and being open to tha t back and forth communication with it. I think it is exceptional, that our community is shifting in that or has shifted in that way. Dancer

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21 This linguistic mixing of holism and Cartesian duality was prominent in the interviews the participant observat ion, as well as my own experiences as a dancer. During o ne training I attended the instructor discussed how to establish habits and practices in order to create a routine necessary for advancing a dance career. In the training, dancers were taught to trea t the brain as separate from the self in order to separate behaviors or lack of behaviors from guilt. Once the brain is separated from the self, a dancer is then able to create plans to help it accomplish goals, with an example given of what can I do to make it drink more water ?" This language aligns with the Cartesian legacy "of an observing and reflexive I', a mindful self that stands outside the body and apart from nat u re" ( Scheper Hughes and Lock 1987). During a weekly class I participated in, aft er an exceptionally tricky and intricate "combo" was taught and practiced, the instructor stopped the music, turned to her students and asked, "Even if your body won't cooperate, does it make sense in your mind?" A student responded, "My mind gets it but m y body is giving me the middle finger." While the coexistence of both a Cartesian and a holistic understanding of the body may seem oppositional and paradoxical, the pattern follows the rational e of control of the body t hat was a constant theme among the w omen interviewed. As Americans, these women have been socially conditioned both philosophically and medically to treat their body and mind as inherently separate entities However, while biomedicine employs a dualism between the mind and body, it also requires patients to submit to the physician's privileged knowledge of the body as well as treatments that may alienate a woman from her internalized knowledge of her body.

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22 Robbie Davis Floyd has written extensively about the technocratic model of health and birth, which primarily positions the bo dy as a machine, the male body as an idealized norm and thus the female body as a deviation from normal (1994, 2014). Under this m odel, knowledge of the self in almost any context is made extraneous to the biomedical diagnosis of illness and the course of treatment following. Although the belly dancers I interviewed compartmentalized the mind and body as separate entities, it was th e act of relinquishing of control to biomedical practitioners and the abstraction of their bodily knowledge that was incompatible with their understanding of healing. Because of this, dancers tended to look to systems of healing that allowed them to retain some if not all control of their diagnosis and treatment and privileged their knowledge of their body as superior to the practitioner.

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23 Rejection of Physician Knowledge and Biomedicine "I don't get sick because I can feel it before it happens. I can fee l. I can tell you that I've had a lot of issues and I've never been wrong. But the doctors have been wrong a lot. Dancer When questioned about their health seeking behaviors, most dancers expressed a vehement opposition to receiving care through Wester n medical systems. Dancers frequently cited physicians as either not caring about patients or not being knowledgeable as primary reasons why they often chose to not work with Western medicine. While they brought up financial resources a few times, finances were secondary to the perceived quality of care a dancer felt she could get from a physician. They spend less than 10 minutes with you, they look you over and don't really ask you any personal questions with what's going on, they just ask you very specif ic medical stuff. Much like all of Western medicine, they treat the symptom and not the root cause, so they don't even bother to see why you are experiencing what you are experiencing. And it's so expensive! Dancer "I just don't think doctors know as much as they used to for one thing. And moreover I don't really believe they care. I feel like they are owned by the pharmaceutical companies, so if you go to the doctor they're pretty much just going to give you a pill, and I'm not interested in healthcar e that gives me a pill to mask my symptoms. I'm interested in health care where people are looking at me as a whole person and pinpoint the root of what's really going on ... I just don't go to the doctorI'm not going to go to the doctor unless I'm dying. A nd I think that if I'm dying I might have a better idea of what's going on with me than the doctor ." Dancer Feeling cared for, both physically and emotionally was a rticulated as prim ary need by the women interviewed. They tended to reject and have feelings of disdain for systems of care in which they felt they were submitting to a system that did not care about them as an individual or held their bodily knowledge and experiences as

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24 irrelevant to diagnosis and healing. The ability or inability to ide ntify a singular "root" cause of what was ailing dancers was also a major factor in how dancers determined the validity of a practitioner's skill, in both biomedicine as well as in complementary and alternative modes of treatment. Stories were frequently t old about dancers seeking care from a physician, only to be left with no idea as to what caused the bodily problem in the first place. I don't even know the last time I went to a doctor because I hate them. I actually don't go in that often I have just had bad experiences with medical professionals because there have been multiple instances where I have gone to the ER in the past [because] I've had pains I didn't know what they were, and they still couldn't diagnose them. I ended up talking to other peo ple who gave me a better idea of what it could be than the doctors could. They're just disappointing to me." Dancer "I feel like that's the way that the medical system has forced people of our generation to work because we don't get enough time with the m, especially for serious things that have a higher incidence rate like autoimmune diseases or allergies I had an allergy and they were pretty much like, we can't test for those. I f it's a food allergy I don't know what to tell you .' A nd it's expensive no one has proper health care so you have to go on a Google / lifestyle experimentation u ntil you are like O k ay this is tolerable for now. But I've never gone to it's rare that I've gone to a western medicine doctor and had an experience where I was like ok cool, this is handled, done. Usually they don't know and I have to do other stuff on my own I don't know, I've had bad experiences. Y ou pretty much [have to ] G oogle it so you know what you want what you want to get tested for and go in and tell them, because they are not going to actually try to figure out what you want or they do a million other tests." Dancer An interesting distinction to make is that d ancers were not overly concerned with the immediate success of a treatment, but more so the identification of illness that aligned with the dancer's bodily knowledge. Dancers frequently cited having one or two bad experiences with a physician or hospital usually regarding not being able to identify anything biochemically wrong with the dancer, that caused them to write

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25 of f Western medicine in most situations. Simultaneously, the same dancers were willing to experiment and do a sort of trial and error cours e of action with alternative practitioners and treatments. Once dancers were able to create or co create a framework of illness with an alternative practitioner, they were more willing to try the same therapies multiple times until they found a practitione r who they felt provided effective healing. "Now I have a lot of shoulder pain and have seen 14 different massage therapists, and none of it really works. I just had to see this one person, and now I study with her because it's like she knows what she's do ing." Dancer Dancers were also keenly interested in receiving treatment that was customized and tailored to their bodies, while simultaneously expressing dissatisfaction with receiving treatments that felt routine or "one size fits all." Treatments that were tailored to the individual were widely regarded as more effective, regardless of the duration of treatment or often the outcome. "Western medicine doctors don't really seem to care about what I do, and most of the people I know that do naturopathic me dicine are friends of mine you know my acupuncturist was a belly dancer of mine. Which I think made it easier for her to treat, because she knew so much about my personality already. And since acupuncture works from those really subtle energetic frequencie s, and her already being in tune with me, I think it made it work better. Because it was personalized." Dancer When they did have to seek our traditional biomedical care, often in the case of physical therapy after serious injury or surgery, d ancers als o repeatedly spoke about feeling the need to train or educate practitioners about their bodies This was typically framed as perceiving biomedical practitioners as having a poor understanding of what belly dance is, the way the body moves during the dance, and

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26 the intensity. This ultimately translated to a conception that the biomedical practitioners did not understand the needs of the individual's body. I'm so nervous about moving forward with my injuries that I will actually demonstrate the most strenuou s activity on that part of the body that I do. So, you know I just had my hip done, so I would go into twist in a grapevine or something. So that way th ey are seeing me open chained versus close chained exercises, because anyone c an just stand there and be safe, but once you start traveling that puts a whole other level of strain on your body. So I don't know. I don't honestly think they have a very good understanding of it. Dancer "It's usually just met with confusion. There's a realization that it's not what their mind immediately goes towards which would be some form o f sexually stigmatized dance. T hat is where their mind immediately goes but they don't know what it is. They have no understanding." Dancer One dancer shared a story on feeling shocke d that a doctor she was seeing was uneducated or unaware about the perceived efficacy and purpose around some of the over the counter supplements she was taking, and the ritual she devised to increase the efficacy. "But what's interesting too is I have a good doctor that I am seeing now for the spine that didn't even know what MSM was, and to me that blows my mind! I take L glutamine for my gut and MSM, and I'll take all these whatever and then three hours later I'll get on my inversion table to separate my spine. They will ask why do I do that. If I'm putting all these beautiful, wonderful things in my body to help my bones and inflammation, doesn't it make sense to get on the inversion table to separate your joints so that all that blood can go in there and feed with the nutrients that yo u've taken? And it blows their mind!" Dancer Many of my participants spoke about self diagn o sing their own illnesses. In the process of both my official research as well as in my years as a belly dancer, fellow dancers have volunteered "diagnosing" my body with a range of structural, chemical, and created ailments often unsolicited and coupled with lecture s on how

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27 that diagnosis affects the body's performance as a dancer. Dancers utilized several methods to self diagnose illness, including the Internet and comparing somatic symptoms with other dancers. The women interviewed tended to hold their somatic experiences as being superior to biomedical knowledge, and tended to not be as rigorous in assessing the validity of their social network or the Internet in the search for diagnosis. "I'm an obsessive researcher for certain things and I was trying to figure out why I was feeling some of the ways I was feeling. U sually they do tests and that sort of thing to see if you have adrenal fatigue, but we all know I hate going to the doctor. So, I just looked at my symptoms and self diagnosed that I was probably in the beginning stages or heading towards adrenal fatigue. Which is kind o f terrifying because once you are in adrenal fatigue other things just start." Dancer There were two notable exceptions to this with dancers that routinely did engage with Western biomedicine over community based holistic practitioners. One dancer suffer ed from a chronic and incurable autoimmune sleep disorder, and due to the nature of the treatment, she had to see a specialist every three months. Other than this and a "yearly checkup," she stated that she did n o t see doctors that often and typically miti gated her condition by eating quality foods, strength training, and maintaining low levels of stress. When asked about her experiences seeing the specialist, she responded that it had become an almost uncomfortable necessity in order to receive the medicat ion needed for her to manage the illness. "My specialist, he called it "socially inappropriate"He's older, he's from this area and he's just kind of um we always talk about it, every time I go he asks about it and he says something about how his wife mad e him take ballroom lessons or something. And he just started talking about something that's more "socially acceptable" or "socially appropriate" than, like, what I'm doingIt's awkward but I don't challenge him on it because I just don't really want to wi th him, you knowOtherwise I'd be like, hell no!' But with him, it's

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28 just like eh.' There aren't a lot of [type of specialist] in my city, so I don't want to piss him off and then him be like, oh, well I'm not going to give you your medicine.'" Dancer In this instance, the dancer articulated submitting to a specialized physician's moral critiques on her employment out of a feeling of being constrained by her medical choices in the care of her chronic and life altering autoimmune illness So while this dancer did not reject systems of Western medicine for alternative systems of care that put her in control, she recognized that by being under the care of the specialist, she relinquished control of herself in a sub optimal relationship. She later described how, because she was a belly dance studio owner in a conservative town, she felt compelled to project an image of health and fitness as a driving motivation for many of her health seeking behaviors. She explained this projection was not measured by thin ness, but rather strength and stamina. She felt that, as a studio owner and dance teacher, she needed to be perceived as healthy, energetic, and strong not only by her students but also by the conservative community around her that often did not view the d ance in a positive or serious manner This experience of shaming by a biomedical practitioner upon sharing one's profession as a belly dancer was not ubiquitous throughout the interviews H owever the few dancers that have had this occur recounted the sto ries as having a negative impact on their opinion of the practitioners or even the practitioner's field of medicine. One dancer acted out an experience she had during a physical therapy treatment, in which her therapist mocked the dance in an effort to tie the participation to inherent injury. [My therapist told me,] w ell the reason you are like this is

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29 because you guys are all like this [makes erratic movements] and she kind of like went into a spasm that looked like, I mean she had poor posture because she's not trained, but she was wiggling her body all over and I'm like, that's not what we do!" During the story, the dancer got up, wound her hips around aimlessly while throwing her arms around herself much like how a toddler would throw a tantrum. The experience of witnessing this story being retold caused a visceral reaction for me, as in my own experience I have seen almost identical displays of erratic movement when a layperson discusses belly dance. The other dancer who was an exception to the pattern of seeking holistic medicine operated in an intere s ting liminal space between modern biomedicine and holistic models of health care. Having successfully gone into remission from cancer, the dancer was el oquent in detailing her rational e on when to accept what physicians prescribed as a course of healing, when she ignored their advice, and when her body and behavior became a site of negotiation. Everything from her training and performing schedule, diet, s upplement use, and complementary or alternative medicine use was up for negotiation, and in several instances where the physicians in charge of her cancer treatments remained firm, the dancer discussed employing her own systems of care anyways. While this dancer is unique in the sample population for not largely rejecting western medicine she still valued many holistic treatments and tended to pick treatments and systems of self care from both opposing medical models.

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30 Adrenal F atigue as an Idiom of Distre ss During the course of interviews, a phrase surfaced several times of a condition that was plaguing both my participants as well as other dancers in the community, as not ed by interviewees. This mirrored what I encountered though my own experience as a b elly dancer, with the phrase been thrown around in classes, workshops, and casual dance gossip. The condition was that of adrenal fatigue In regards to adrenal fatigue, its definitely hard to get out of once you are in it. Essentially what's happening is you've put your body in a constant state of stress response. As human beings, our bodies haven't caught up to how we operate in industrial societies, so all of our Fight or Flight responses are still firing in our bodies as if we are in the savannah and l ions are trying to eat us. We are not letting the hormones like cortisol and all of that jump back because we are constantly stressed. The body is in a constant state of stress, which means it's having to produce these hormones all the time. What's happeni ng is certain glands in the body are flooding your body with all these hormones, and they are doing it all the time. Essentially for lack of a better term it's not the medical term but you are burning out. They've linked chronic stress to pretty much eve ry single disease; I mean obviously autoimmune but things like cancer, heart disease, respiratory issues, and the inflammation process. In effect, what happens is your body just gets so exhausted from doing all of that all the time, you are essentially run ning yourself on empty. Your sleep patterns are disrupted, you don't have any energy, and then your body just can t keep up with the level of stress you are putting in ." Dancer This illness, which several of my participants brought up, has become a narrative often heard at training workshops. It is an illness where the body can no longer keep up with the will of the self. It has burnt out. I offer the explanation that the concept of adrenal fatigue has been adopted by the community as an idiom of distres s in response to the cultural and economic morals that exist in the American belly dance community.

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31 The term "idioms of distress" was coined by Mark Nichter in the late 1970s and p ublished in the early 80s to refer to the "socially and culturally resonant means of experiencing and expressing distress in local worlds. They are evocative and index past traumatic memories as well as present stressors, such as anger, powerlessness, soci al marginalization and insecurity, and possible future sources of anxiety, loss and an g st" ( Nichter 2010 405 ). It has been included in the DSM IV as well as the recent DSM V as part of an attempt to include "culture bound syndromes," which has been met wi th a mix of excitement and critique from social scientists for y e ars ( Nichter 2010). Adrenal fatigue is a heavily debated condition in biomedical and endocrinology societies. While some physicians recognize adrenal fatigue as a recognizable illness with a prescribed course of treatment (Wilson 2014), a systematic review of biomedical research shows no such official diagnosis or recognition of adrenal fatigue currently in existence being accepted by either the American Board of Medical Specialties or the As sociation of American Medical Coll e ges ( Cadegiani and Kater 2016). This so far unsubstantiated condition in the medical arena is rationalized as a set of symptoms that indicate the overuse of the adrenals stemming from frequently experiencing stress, sleep deprivation, lack of proper nutrition, and being overworked Symptoms cited during interviews included exhaustion, fainting, problems with focus or mental clarity digestion issues, irregularity of menstruation, weight fluctuations, and circulation issues ; however it was always presented as a condition that can manifest in many ways as well as be the root cause for many additional ailments.

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32 Several dancers explained that this condition can arise from both the arduous training and work schedule required to be a professional dancer, as well as the challenge of trying to balance this with the demands of family and other job requirements (if there were any). I think being a driven dancer too, we drive ourselves into the ground. We are staying up late, makin g our costumes, we are drilling, and we are pushing pushing through pain and drills to get the choreography in our bodies. There is a correlation between adrenal fatigue and how it talks to your thyroid and the pituitary gland, because it's all connected. Then it can start Hashimoto's, which is hypothyroid or can go the other way into hyperthyroid. And that's what causes lack of sleep, and then it's just a snowball [effect] that starts with your hormone imbalance. But there's something we have to figure ou t how we can find a balance between rest, nutrition, exercise so we don't become adrenal fatigued. Dancer Dancers referenced adrenal fatigue as being a condition resulting from one's body being incapable of keeping up with the will of the self, or in other words, pushing the body too hard for too long. This conceptualization inherently references a value system that privileges i ntensive physical regimen s as healthy and looks at the inability of bodies to maintain such regimen s a deficient. However, th e social construction of adrenal fatigue as an illness narrative around a set of symptoms removes the social judgment of amount of physical work from a Protestant ethic framework to that of a somatic sickness of the body. Robert Crawford explores how the concept of the Protestant ethic, which was first described by Max Weber in the early 1900s, fundamentally shapes American's conceptions of health, the body, and sickness. Health has become a symbolic status and moral imperative that must be attained or achieved through active modification of lifestyle and behavior. To be healthy requires work and "intentional action and

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33 moral value inheres in such work (Crawford 1984). While Crawford further explains the morals of the Protestant ethic bleeding into the quest for health being characterized by denial and restraint, the women I interviewed were characterized more by the fixation on self control. If health and illness is shaped by the Protestant work ethic, Crawford argues that illness can then carry intrinsic guilt, disappointment in the self, judgment, and a moral failing to society (Crawford 1984). Adrenal fatigue offers an illness narrative that simultaneously reinforces Protestant ethics in health cosmology while also offering a prescribed illnes s category that relieves an individual from moral judgment or guilt when the self cannot keep up with the physical and economic outputs required for being a dancer. The following excerpt details one woman's "average schedule" as a full time professional be lly dancer. During my busy months I can be traveling up to four times a month, once a week. And that's usually on the weekends, because people have their events on the weekends. For example my schedule next year, in January I'm just going somewhere for f un, so Im only traveling once in January. And I'm teaching regularly at home for the entire month. February I've got two gigs that are out of the state. And then March I'll be at [National Festival] for a week and a half and then I'll be in Spain for two weeks, and then April I have two gigs that are out of town. Then in May I've got four gigs in the month, so every weekend. I think May through August is pretty much like that where it's really packed and busy. Summer months are typically busier for me. The n back into the Fall it starts to slow down a little bit. November and December are usually pretty slim. I'm usually home for most of those months, but regularly teaching. I teach classes on Monday nights for two hours, and then I will go take a contempora ry dance class at another studio that's just up the street from my studio. Then on Tuesdays I will teach two hours of classes and again go to [the other studio] for [another] class. Then on Wednesdays I have rehearsal with [another dancer's] troupe for an hour from 6:30 7:30, and then I'll usually take her class from 7:30 9. I'll usually stay after and rehears e for a little bit at the studio. Then Thursdays I take two hours of aerials class, and then I'll teach a dance class from 8 9 p.m. And then Fridays, I usually don't

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3 4 teach anything unless it's a special workshop in the evening. I will maybe go to the studio unless I have a gig or unless I have a date with my husband. Fridays are supposed to be our date night. Saturday I will teach for two hours in the morning, then I will usually go to my studio and rehears e for two to three hours and then Sunday I rehears e from 1 4 p.m. at my studio. That's what my schedule looks like." Dancer This particular "average schedule" was on top of daily stretching and strength training. While every dancer had a different average schedule, each one had to use quite a bit of time to explain just how much they were fitting into their days, weeks, and mon ths. None of the dancers explained their schedules in more simple terms of "x amount of hours" in training and class. While arguably most individuals with similar schedule s would feel exhausted, da n cers pathologized feeling fatigued as something that coul d be avoided and treated with proper scheduling, diet, and herbal and supplemental supports. Feeling tired thus becomes internalized as illness Adrenal fatigue as an idiom of distress "communicate[s] experiential states that lie on a trajectory from the mildly stressful to depths of suffering that render individuals and groups incapable of functioning as productive members of soci e ty" ( Nic h ter 2010 405 ) with society being that of the larger belly dance community and economy. Nichter argues that such ill nesses are "culturally and interpersonally effective ways of expressing and coping with distress, and in other cases, they are indicative of psychopathological states that undermine individual and collective states of well being" (2010 405 ). Adrenal fatig ue consequently can be interpreted as a recognized, accepted, and community sanctioned response of resistance to the lifestyle of being an American belly dancer.

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35 While official diagnoses of adrenal fatigue are not widely accep ted in Western biomedicine, t here is a protective and scientific wisdom embedded into the rational e behind the narrative of adrenal fatigue in the context of the belly dancers interviewed. T he science behind studying the embodied effects of continuous stress has been growing. Chronic activation of the stress response system the hypothalamic pituitary adrenal axis (HPA axis), can lead to a multitude of ailments, including insulin resistance, muscle atrophy, fatigue, hypertension, ulcers, impaired physical growth and cellular repair, c ardiovascular disease, impairment of synaptic plasticity of the brain, immune suppression, and reproductive dysfunction in both males and fem a les ( Sapolsky 2004). There is also growing evidence that psychosocial stress can have long term impacts on health across generations through the process of epigenetic modification ( Thaye r and Kuzawa 2011). In a review of the biomedical literature about the topic of adrenal fat i gue, Cadegiani and Kater (2016) found no studies that tied the function of the HPA axis to the term "adrenal fatigue." Instead, the biomedical literature uses diagnoses such as adrenal insufficiency, sleep obstructive apnea syndrome, chronic pulmonary obstructive disease, chronic fatigue syndrom e, burnout syndrome, specific hormone deficiencies, or dysfunction in one of the major internal or g ans ( Cadegiani and Kater 2016). As adrenal fatigue has yet to receive wide acceptance from epi demiological groups or recognized medical boards, this idiom o f distress spawning from the broader contexts of the lifestyles of these dancers should not be interpreted as being

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36 simply an invented notion of illness in this popula t ion. Nichter contends with a critique of how "labeling embodied emotional expressions as metaphors or idioms leads us to think of them as figurative, and not genuine, and to valorize meaning above the lived experience of sensations linked to emotional states" (2010 406 ). Adrenal fatigue as an idiom of distress is the embodied psychosomatic p rotest to the demands of their lifestyle. This allows dancers to reinforce the importance of the value and morality of hard work, while also creating parameters for dancers to negotiate these demands, judgment free, through an illness that is conceptualize d as the will of the self outpacing the biochemical capacity of the body. N ancy Scheper Hughes and Margaret Lock state that "il l ness somatization has become a dominant metaphor for expressing individual and social complaint" (1987 27 ). However, the dist urbances to health that the dancers described, such as disruption to the menstrual cycle, extreme exhaustion, fainting, and digestion issues are tangible symptoms experienced, for which adrenal fatigue provides a narrative of causality.

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37 Healing th r ough Herbalism, Supplements, and Alternative Treat m ents Herbalism is practiced by an estimated one third of adults in the United States, with the highest population being that of Anglo American females of higher socioeconomic status (Waldstein 2015). Prior to t he 19 th century, it was commonplace f or health to be in the hands of females who created home remedies as part of their gendered roles in the home. As biomedicine became more widespread in the 19 th and 20 th centur ies the associated narratives supported th at model as dominant via discreditin g all other competing knowledge and forms of care. Movements of alternative medicines and systems of self care regained popularity in the 1960s and 1970s as not only supplemental to biomedicine but also as a means of sel f reliance outside of the dominant sy s tem ( Waldstein 2015). Currently, the herbal and supplements industry is booming across America, with little to no regulation. The vast majority of dancers interview ed habitually took some forms of herbal medicines or supplements routinely, with the rest having tried them or consum ing them infrequently. Pharmacologically, herbal remedies tend to be comprised of multiple active compounds, and typically science has not documented which compound or compounds create the wan ted effect (Ernst 2005). Due to the multitude of compounds interacting in plant medicines, it can be di fficult to isolate the beneficial source when testing for effi c acy. Nichter and Thompson conducted a pilot ethnographic study of American supplement use, nothing that the vast majority of available information on the subject

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38 came from surveys that provided limited information "on the ways that Americans think about or use dietary supplements (2006 175 ). Their work aimed to get at the "considerations of patterns of use in context, user expectations, and measures of perceived effectiveness." Notably, they acknowledged that their sample included very few individuals out of "alternative lifestyle[s]" or "perf ormance sports," in which I would place most, if not all, of my sample. As p atterns of supplement use also need to be understood as cultural phenomena in their own ri g ht" ( Nichter and Thompson 2006 176 ), I offer this rich and detailed excerpt from an in terview conducted during this study that details one woman's supplement use. Dancer I take like 17 pills a day. I mean, I have a whole list online. I do a lot of gut repair, that's another thing, too. I don't take any drugs. I don't even take ibuprofen. And I don't take antibiotics. I have not been ill for over 6 years, not even a coldI take a lot of supplements, I take a ton, I mean anything from gut to immunity like vitamin C is really good, vitamin D, I mean the normal stuff. Then I take stuff for m y hair like biotin, stuff for the joints like Glucosamine and Chondroitin, all the fish oil for the anti I could just go on and on. And then I kind of tweak it, I have a base of supplements that I use and then I tweak it depending on what's going on. Like right now I'm doing a lot of bone broth for my joints, like a ton. I eat bone broth soup every day twice a day. I ma ke it myself. It's all organic I'm always trying to heal my whole body system and get away from that. [I take] milk thistle for liver clea nsing, it's really good for that. It's so hard cause there's so m uch. Maca root depending on, you know. Motherwort depending on Mugwort for estrogen, like balancing out because I'm perimenopausal. Also slippery elm and marshmallow for the gut, I have to t hink of the sys tems cause there's so many that it's hard to remember. Me Are you pretty regular with taking these? Dancer Yeah, I mean I have a whole pill box I sound like I get irritated but people don't understand how important health is and when they have it how beaut iful and amazing their life is And I tweak stuff a ccording to what I need.. Then bromelain for anti inflammatory, A r nica m ontana, there are so many things! Now I'm going through my head. It's just you tweak it, but it's so important. And it's so important to know what to take with what so you absorb it, cause that's another thing too. You can take whatever you want but if you aren't taking it with specific things it s not going to [work ] And so you have to

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39 keep a list o r diary. I get my concoctions going and then, get the system going I mean I don't worry about it. I also consult I have a lot of friends that do want to take care of me, so if they have a friend that's an herbalist or naturalist or whatever I've done ph one conferences with them. And I don't even know who these people are; they are out in Cincinnati or something. But I don't care, I'll take whatever, I'll listen to whoever wants to share even if I don't think they are even if they are crazy I don't car e because I will learn something. It's just like dance or anything else, you can learn a lot from people. I don't know if there are any more herbs, I'm trying to think there are so many. I love it, and it makes me so angry too how the FDA wants to shut all this shit down, because they don't want people to be healthy, they want them to be sick. They don't want them to make their own natural ingredients, taking away from big corporate. They don't want the herbalists in the worldThere should be a whole system of care, and I kind of feel like no matter what sport you do because the reason I'm in this position is I've been an athlete my entire life. I've played high school sports, done all this stuff, and I was just one of those people who was just above average I was never amazing. I was a part of the team but I never had anyone follow me and look at my bone structure and say wow you're knock k need, you're super hyper mobile, these are the things you need to stay away from, these are the things you need to do to help strengthen and here are the dietary and herb things that can help you. I don't know why there's not more of that in our country or our system and I think that if there was a more proactive approach instead of a reactive approach, we would decreas e our whole health care cost across the board by I don't know by how much percentage. It's mind blowing. Several interesting themes and contradictions surfaced First and foremost, the dancer, after saying she takes 17 pills a day also says she does not take any drugs. This clearly demonstrates that the interviewee does not consider her herbal supplements drugs ; however they are still brought up in the context of healing, self maintenance and self promotion. This can be understood, that while many of this individual's supplements came from a store and in pill form, they are still categorically different from what a physician would give. Saying I'm always trying to heal my whole body system shows an i nclination for holistic healing modes of the body, while also commodifying herbal products for particular uses in particular bodily systems. This dancer also sought to represent health through herbal supplements as

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40 something that is challenging and requiring careful planning, requiring a list to know what to take with what so you absorb it ." This articulation shows that the field of supplements is considered a complex system one has to navigate in order to maximize its benefits. The dancer additionally demonstrated trust in the knowledge of practitioners of alternative medicine, such as the mentioned herbalists or naturalists. This was demonstrated over and over again during the interviews. Dancers routinely got their information regarding health and illness from oth er dancers or alternative practitioners both specifically trained or self taught took concoctions created by friends, and engaged in healing practices, such as massage and acupuncture, under the care of practitioners who were also friends or fellow dancer s. This was consistently seen as far superior care than what physicians would be able to provide. This is similar to a finding from Nichter and Thompson's study (2006) that users of supplements and herbs habitually got their health information from those i n close social circles to them, noting that it was considered especially credible and trustworthy "particularly if it came from someone to be deemed like them in some important way (2006, 202). I n my study, the important connective similarity was the cult ure of belly dance. Systems of self care through cultural f ood, herbalis m, and s upplement use are often largely disregarded by the biomedical system, regardless of either the chemical or psychological efficacy it holds for the practitioners of these modali ties and their patients.

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41 When alternative health practices su c h as herbalism and other folk medicines are positioned as a deviation by the dominan t biomedical model, heterogeneity in beliefs can b e come pathologized, ignoring the benefits of these systems t hat act as "coping strategies" to antagonistic social environm e nts ( Viladrich 2006). Interventions that fall under the C omplementary and Alternative Medicine (CAM) classification, such as acupunc t ure, herbalism, Ayurvedic medicine, and other traditional m edicine practices tend to provide a patient centered experience where the same variables identified as "social determinants of health" are traditionally addressed as part of both the patient history as well as the context for illness. These systems, by and large, acknowledge the patient's internal awareness of their body as an important aspect of diagnosis and healing and frequently invite the patient to retain some level of control and agency in their treatment. Medicinal herbs and supplements currently re side in a paradoxica l and liminal state as being recognized as neither food nor dr u gs" ( Nichter and Thompson 2006). The Dietary Supplement Health and Education Act (DSHEA) was passed in 1994, creat ing an environment where neither the Food and Drug Adminis tration, manufacturers, nor retailers are obligated to substantiate claims made by commercial herbal products or supplements. Thus, as these products are barred from making specific health or disease statements, the market has evolved particular and often vague language about "maintaining," "supporting", and "promoting" the health and function of variou s bodily systems and condit i ons ( Nichter and Thompson 2006). Consequently it has become a common practice for those that seek

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42 manufactured herbal remedies t o "reinterpret labels and experiment with products in the effort to address perceived ne e ds" ( Nichter and Thompson 2006 177 ). As the FDA does not study the chemical efficacy of most herbs, significant obstacles remain in identifying the value of folk medi cines establishing safe processing mechanisms in an unregulated market, and ascertaining the safety of mixing with other substances. While clinical testing of herbal medicines is technically feasible, usually only one to two compounds can be characterized at a time, making the majority of medicinal herbs extremely difficult to study. Additionally, many herb alists argue that isolating individual chemical components of herbal medicines in fact reduce s their efficacy, citing the holistic healing properties as being due to complex micro interactions. Some plants su c h as Allium sativum (garlic) G i nkgo biloba (gi ngko) and Panax ginseng (Asian ginseng) have been full y described pharmacologically and demonstrated to be effective towards treating certain conditions in clinical settings (Ernst 2005). Economic investigation of the financial benefits of the large scal e incorporation of complementary and alternative medicine systems su c h as herbalism into courses of treatment are extremely limited. One review that evaluated 31 cost analysis studies found that almost 30% of these studies resulted in lower cost health imp rovements (Herman et al. 2012). As most herbs are legally classified as dietary supplements rather than medicinal, little research is conducted in to the outcomes of habitual use in medicinal contexts. Furthermore, th e legal status ensures that there are fe w mandated obligations of this industry either in stores such as Whole Foods

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43 that sell herbal remedies to upper class individuals or u rban bot‡nicas that sell to indigenous and migrant populations. Although each woman inte rviewed had a different regimen of herbal and supplement use, ranging in intake level, consistency, source, and purpose, the sample largely was "remarkably articulate in their deconstruction and assessment of their own supplement u se" ( Nichter and Thompson 2006 178 ), which mirrors that of the study conduct e d by Nichter and Thomson (2006). One noticeable difference, however, was that this articulate self assessment of use often had to be prompted and pressed to get at, as the intake of use was so normalized in my participants that many o f the women did not initially think of these behaviors as anything special to talk about. Two interviews in particular highlighted th e need to further press to get at herbal and supplemental behaviors when initial answers skipped over meaningful conversati on about the behavior. The first was an interview in which two dancers participated together. These women frequently trained and performed together and out of convenience to their schedule, requested that I interview both of them at the same time, which w as one of the several happy accidents of this study. First Dancer I forgot, when I start having joint pain, which is starting to happen more, I will actually dose myself with Magnesium, so I'm starting to get more of that in my diet and through supplemen ts. Second Dancer Oh yeah, I take a magnesium bath ." First Dancer Oh, I haven't tried a bath! I also take calcium to balance it out because I know Magnesium flushes you out ." A second interview that clearly demonstrated this normalization of herbal remedies and supplement use was one in which I was fairly familiar with the

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44 participant's lifestyle, and thus was able to plainly recognize when the dancer did not appreciate some of her own behaviors as being noteworthy in the context of the interview. Me What do you do to take care of that pain ? Dancer Nothing. I'm working on plans to do it, but then I actually have to do them. The shoulder pain is a repetitive motion issue and that isn't all of these aren't constant. They crop up here and there. I'm not in any constant state of pain. The shoulder is from learning how to do and hold arms posturally incorrect. It's not even the "expanded open" [position] of ATS, because you can do that safely within the range of motion of your joints. It's just crea ting flexibility in your body in this area vs. pulling it back. But it was more like what you would call "countertop" or "Close Second," and instead of starting with my arms in front, I did it with my arms behind and tried to do shit. So when I'm doing a l ot of shoulder work, and I'm tired, and I haven't had any sort of massages or anything like that at all, it will come up and really get sassy with me. It hasn't happened in a bit. ` Me Don't you make an herbal muscle rub? Do you ever use that?" Dancer Oh yeah, I use my own muscle rub, I'll get massaged, when I have money. I used to get Rolfed, which was amazing. Instead of how massage works generally on a very basic level which with muscles, Rolfing is all about the fascia. A lot of people don't like it because they claim it's painful. Well it's bodywork. It's not relaxati o n Nichter and Thompson identif ied several categorical types of herbal and supplemental use, none of which are necessarily mutually exclusive or hierarchical with one another. These categories are Health Managemen t and Enhancement, Harm Reduction, Resisting Illness, Illness Management, and Ideo l ogy ( Nichter and Thompson 2006). These categories of usage are exceptionally useful for classifying, understanding, and explaining some of the behavior patterns seen in the belly dancers interviewed in this study. H ealth management and e nhancement is conceptualized as the use of these p roducts as tools for projects of the self where individuals feel a charged sense of attentiveness to their body and a duty to monitor their health. Supplement users in

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45 this category also often frequently cite wanting to "'even out' the embodied effects of an overly hectic l i fe" ( Nichter and Thompson 2006 183 ). This idea of personal health management or enhancement emerged out of a movement in the second half of the twentieth century in the United States, where self management of health became a chief ethi cal value following the wave of public health initiatives in the nineteenth and early part of the twentieth century that tackled issues related to food quality, sanitation, and clean water on a large scale (Rose 2007). Under this self care model, "the corporeal existence and vitality of the self has become the privileged site of experiments with the self" (Rose 2007 26 ). Dancers whose herbal and supplement use fell in this category felt a duty to maintain their own health, often feeling that they could not rely on anyone but themselves. There was also a sentiment that there was no end point to health, it cou l d be commodified and always improved upon through further scrutiny of herb and supplement use, exercise, and the diet. One dancer answered the foll owing in response to a general inquiry into her health, My health is I'd say good. I'm constantly working to improve areas that I know are weak points for me. Many of the women in this category continuously spoke of weakness that needed to be dealt wit h, whether that was physical weakness or a behavioral area in need of improvement. The pattern of weakness is interesting in a population of professional and semi professional dancers, who are fundamentally athletes that operate on a much higher threshold of strength flexibility, and stamina than most sedentary Ameri c ans.

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46 Nichter and Thompson's (2006) category of health management and enhancement aligns with the model of enhancement described by Nikolas Rose (2007). "Enhancementis future oriented. Almost any capacity of the human body or soul strength, endurance, attention, intelligence and the lifespan itself seems potentially open to improvement by technological intervention" (Rose 2007 20 ). Rose defines these technologies of optimization as the "contemporary medical technologies [that] do not seek merely to cure diseases once they have manifested themselves, but to control the vital processes of the body and mind" (Rose 2007 16 ). Technology is further defined not only as machinery for medical en hancement but also any "assembly structured by a practical rationality governed by a more or l ess conscious goal" (Rose 2007 16 ) such as over the counter supplements or homemade herbal potions. Several women brought up the concept of creating health in th e present, to better e nsure their ability to dance in the future at an older age. Belly dance, unlike many other dance forms in the United States frequently allows for middle aged and older women to maintain their careers as performer s with many prominen t professional dancers being 40 and above. This is in stark contrast to professional careers in many other concert based forms of dance, where any perform er would age out of their dance career in their the twenties. The next style of herb and supplement us e describ e d by Nichter and Thompson (2006) is that of harm r eduction In this model "citizen consumers are compelled to adopt a reflexive mode of conduct whereby they attempt to negotiate and minimize risks as best they can. This is also an age of rising a nxiety about what

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47 evidence to believe and who to tr u st" ( Nichter and Thompson 2006 184 ). In this usage pattern, society is perceived as inherently risky, and individuals must negotiate ideas of exposure, susceptibility, resistance, and vulnerability to en vironmental harm and illness. Similar to the first usage pattern, individuals feel that they must manage and take responsibility for their health and their future. After an extensive run down of the supplements in her medicine cabinet, one dancer described some of the risks she perceives in her environment and how she manages these risks. [My food is] all organic, non GMO. I'm a freak, super clean. I don't even drink water unless it's purified, and I'm trying to get the point where I have my own water system and I'm not having to rely on jugs with the BPA in the plastics. I won't use plastic at the stores I take all my vegetables, throw them in a basket and then wash them when I get home. I don't like plastics. And I've done a lot of blood tests too to see what I'm allergic to. A lot of the preservatives are in there, so I know I have leaky gut because of [that] so I'm always trying to heal my whole body system and get away from that And also with the diet, there are so many things. Environmental toxi ns. There are so many things you can do so even if it's really bad, you fix some other t hings that don't make it as bad, s o you can keep dancing. What the hell, that sounds crazy! Let's manipulate your diet; let's change all the screws in your showerheads to clear out the chlorine so you can dance longer! That's what I'm doing right now. Literally everything I do is so I can keep moving. I watch my diet, I watch my water, and I watch the environmental toxins. Dancer As nearly all of the women interviewed made most, if not all, of their income from dance, sickness itself was perceived as an economic risk that had to be mitigated through any means necessary. Since the body is the prime tool of their trade, illness, injury, or falling short o f set performati ve standards was understood as taking both a physical and an emotional toll on the self. Illness represented a physical and moral failing of the self with severe economic impact. Narratives such as this follow the model of resisting ill n ess ( Nichter and Thompson 2006). Individuals

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48 in this category often discuss their health seeking behaviors as trying to "boost the immune system," "strengthen resistance to disease," and "mitigate [their] economic vulnerability (Nichter and Thompson 2006). I don't really get sick a lot. If my son is sick with the cold or the flu, I'll immediately start taking olive leaf, whic h is a natural immune boost, Echinacea is one of those immune boosters that's become really popular but once you r e sick it does very little. O live leaf or oregano will, once you r e sick, really boost up your immune system to fight whatever you have going on. I'm a big fan of letting viruses run their course. I don't take a lot of over the counter meds or anything like that to try to mask my sym ptoms, because I feel like those are there for a reason. If my nose is running it's because it wants to get the ick" out of my nose, not because I need to take a pill and have the "ick" just stuck in my face. So I don't have a tendency to do stuff like th at. Dancer The above quote employs both a model of resisting illness as well as an evolutionary understanding of health, wherein the body's natural responses to sickness are held to be an important part of healing. Th ere was a frequently cited desire t hat dancers did not want any treatments that masked symptoms and typically preferred to allow sicknesses to "run their cou r se." Nichter and Thompson (2006) describe individuals who have the usage pattern of illness management as largely feeling that altern ative treatments, su c h as herbalism or over the counter supplements, were safer and more sustainable long term than prescription drugs. "Patients taking dietary supplements to treat illness may also feel themselves to have more direct agency: they may have more control over their diagnosisand treatment regi m en" ( Nichter and Thompson 2006 189 ). As control was continuously a central theme in talking about the dance form, the body, illness, and healing, this model of illness management is especially useful i n understanding the motivation of the dancers in choosing holistic modes of healing

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49 while simultaneously employing a Cartesian understanding of the self being made up of separate body and mind substances. Individuals in this category also are typically int erested in treatments involving herb s supplements, and other alternative practices due to the ability "to tailor treatment[s] to fit their needs at specific points in t i me" ( Nichter and Thompson 2006 190 ). "I'm doing some experiments because I think I'm having thyroid or adrenal things going on. I know I said I was in great health, I feel good most of the time except for I'm tired a lot which makes me feel like I'm having problems with that. So I'm getting r eady to do some experiments with some herbs for thyroid issues I've started taking an adrenal supplement that's been really helpful for focus and being awake but I'm still, I still have this dip every day at two o'clock which I know is generally normal, b ut I'll just get so tired I'll pass out, I will fall down and pass out.Almost every single day I take the adrenal fatigue fighter and that has got a wide variety of B vitamins, B i o tin, Eleuthero root, g inseng, S chizandra, S uma root another kind of ginsen g, Astragalus another kind of ginsing, T aurine, A shwagand h a, Sensoril A shwaga nd ha, H ol y B asil, black pe p per, h abanero, fish oil that's all the ingredients in that. [It's] kind of flexible how you can take that. Sometimes I just take two pills once a day, you can go up to four pills four times a day if you are feeling particularly stressed or extremely exhausted, but I've never done that many Dancer The final category of supplemental use defin e d by Nichter and Thompson (2006) is that of ideology. In this model, patients often hold beliefs about alternative medicines beyond the practical benefits, and use becomes a political and ideological statement about health and the body. Individuals often equate "natur al" with "safe" and view health is a commodity that can be obtained through consumption of prod u cts ( Nichter and Thompson 2006). This last category in particular bleeds into the motivation of all the other categories combined. Most of the dancers interview ed in this study had a fundamental ideology that Western medicine was typically not the best source of care for their needs.

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50 I f I get a fla re up or an issue I know that's not going to be taken care of through western medicine, so I'll go to acupuncture or work on my diet or whatever." Dancer A few of the women cited political frustration with the American health care system and navigating insurance policies that were interpreted as being counterproductive to the pursuit of health. Participation in western biomedicine was then framed as an unnecessary obstacle when other forms of health care, such as acupuncture and herbal medicines were available. So let's pretend that I decided that I was going to go with what everybody loves to call Obamacare, an d I'm paying $ 100 a month right b ecause that's an affordable number. I'm paying $100 a month for my insurance, but really, that doesn't get me anywhere. Because then I have a $10,000 deductible it's what they call catastrophic insurance. So then you have a $10,000 deductible I just see no reason to spend $100 a month and ultimately $1,200 a year to not get anything, a nd have to turn around and spend $10,000 before they'll pay for anything But I hav e a tendency to just go to body work therapists that I trust and go to acupuncturists, and that's just a couple hundred dollars. So I have much more faith in that, and I don't have to spend $11,200 dollars before my insurance will even pay for anythin g. I just pay for the services I want. And I really think that's how health care should be, you know to be honest ... That's a whole other thing that our country is just duped into thinking we can't function without our doctor, who doesn't know or care." Da ncer Herbal remedies in contexts such as urban L a tino bot‡nicas, as studied in New York City by Anahi Viladrich, may surpass their own biochemical efficacy for curing and act as a social metaphor for repairing both strained relationships and rebalancing e nvironmental st r ess ( Viladrich 2006). In this context, medical encounters typically act as a social and physical space for the sharing of knowledge bidirectionally between practitioner and patient. Patients, community members, and other practitioners are w elcomed into therapeutic spaces to bring in new knowledge that is positioned on an equal ground as the knowledge of the healer. Healing is

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51 conducted through herbs and rituals that address multi dimensional aspects of an ailment. Validation of grief, stress and emotional disturbances are often paramount to understanding illness. This is in stark contrast to the culture of biomedicine that privileges the practitioner's knowledge of the body over the internalized experience of the patient, and where curing is typically produced from the patient's submission to a material cure designed to target a bacterial or viral invasion into the body. Biomedicine as a structure fails to holistically address the ailments of cultures that internalize illness as poly function al condit i ons ( Viladrich 2006). This aligns with the dancers' preference for having their bodily knowledge utilized in healing and maintaining some level of control in their treatment. Western biomedical treatments often require the "subordination of women 's embodied knowledge to tec hnical knowledge" which reinforces the ideology of women as passive, subordinate, dependent, and inherently infer i or ( Pylypa 1998 32 ). The women of this study largely found these qualities of western biomedicine to be incompatible with their embodied tendencies towards somatic control, and instead chose to utilize medical systems, regardless of timely evidence of efficacy, that allowed t hem to create or co create illness and healing with a practitioner that integrated their bodily knowledge into the health cosmology. Currently economic drivers are central to the propagation of belly dance in the United States. Unlike classic concert base d dance forms, belly dancers rarely operate via art grants or through institutional support. Many belly dance events in America are produced by current or former dancers for fellow dancers. The profit margin also tends to be much higher for professional be lly dancers as compared to

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52 other types of dance, as there are rarely managers or multiple "middle men" standing between a dancer's income and the audience or students payments. Professional or even semi professional dancers in this genre stand to make subs tantially more money teaching workshops than their Ballet or Modern dance counterparts. This has helped to foster a "Do It Yourself" mentality in much of the American belly dance culture, with dancers frequently making their own choreographies, their own c ostumes, planning their own events, and running their own dance businesses. This "DIY" mentality can be seen translating into these women's interaction with health care, with most of them choosing to take their care into their own hands.

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53 CHAPTER IV C ONC LUSION This study explored the beliefs and behaviors surrounding health and sickness amongst a subset of American women employed as professional or semiprofessional belly dancers in the United States. Through their participation in belly dance as a primar y form of employment, the women of this study have embodied the somatic control of the torso that is iconic to the dance training itself. This embodied fascination with control of the self creates a paradoxical understanding of the self and medicine, as da ncers employ a Cartesian dualistic split of perceiving the mind and body as being separate substances, yet they largely prefer holistic models of healing that view these as either one or inseparably connected. This ideological contradiction can be explaine d by the embodied somatic control gained from the dance form translating to their understanding of appropriate forms of medical intervention for their bodies. Holistic medicine often allows patients to maintain some levels of agency in determining a diagno sis category, make use of their bodily knowledge, and retain more control over modes of healing. This control of the body and its care was not seen possible by these women if they submitted to western biomedicine. While citing several reasons for tending t o reject the care of a physician, dancers largely turned to seeking care through friends, other dancers, alternative practitioners, or caring for themselves through herbal and supplement interventions. Adrenal fatigue presented itself as a salient conditi on dancers applied to a series of tangible symptoms, which simultaneously reinforced Protestant ethics of

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54 health while also offering a prescriptive loophole for subverting those ethics without moral implications. D oes it matter if a subculture of largely middle class white women is rejecting w estern health care? This study showed that this particular population, wh o have economic and cultural resources available to them to access biomedicine feel as if that model is culturally inappropriate to their understanding of illness and healing. This demonstrates a cultural failing of biomedicine to reach this population, and while professional belly dancers remain a very small portion of the total population, this shows one of many potential fissures in the acceptability and appropriateness of the western biomedical model in treating its own people those who would otherwise find this model acceptable. As this study included some participant observation in weekly dance trainin g sessions and twelve qualitative interviews of varying length, further research into the relationship between belly dance as a profession in the U.S., the body, and health could be conducted at the many training festivals that occur all over the country ( and the world), as these events are full of dancers sharing all types of knowledge geared towards executing the dance, history, personal presentation, and health. Because these training festivals often balance these messages of self care juxtaposed against hedonistic fueled late nights of performing and partying, this paradoxical setting may elucidate rich information about relations with the body. Further research should also be conducted to examine how differences in gender expression might intersect with the embodying aspects of belly dance as a profession, as male, transgender and androgyne professional dancers exist in the U.S. This study also

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55 was limited in exploring how African American or Latina women, who are a growing subset of American belly danc ers, interact with the dance form, their body, and healthcare. Furthermore, other geopolitical areas where belly dance exists would be expected to have a different relationship to the body and health care, as each country has huge variation in its history with the dance form, gender politics, health care systems, and economic factors.

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56 REFERENCES CITE D Abu Lughod, Lila. "Writing Against Culture." In Recapturing Anthropology: Working in the Present 137 62. Santa Fe, NM, 1991. Allen Ness, Sally Ann. "Being a Body in a cultural way: Understanding the Cultural in the Embodiment of Dance." In Cultural Bodies: Ethnography and Theory 123 44. Blackwell Publishing, 2004. Blacking, John. "Movement and Meaning: Dance in Social Anthropological Perspective". Dance Res earch: The Journal of the Society for Dance Research (1982). Barry, Christine Ann. "The Body, Health, and Healing in Alternative and Integrated Medicine: An Ethnography of Homeopathy in South London." Doctoral Thesis Brunel University (2003). Barry, C. A "The Role of Evidence in Alternative Medicine: Contrasting Biomedical and Anthropological Approaches. Soc Sci Med 62, no. 11 (Jun 2006): 2646 57. Blo om, Sol. The Autobiography of Sol Bloom. New York: G.P. Putnam's Sons. 1 948. Bourgois, Phillipe I. In se arch of respect: selling crack in El Barrio Cambridge: Cambridge University Press, 1997. Browner, C. H. "O n the Medicalization of Medical Anthropology." Medical Anthropology Quarterly 13, no. 2: 13 5 40. Bukovcan, Tanja. "Through and Hourglass: Re Thinking Ethnography of the Relationship between Biomedicine and Complementary and Alternative Medicine in Croatia." UDK 43 (2013): 9 0 98. Burnam, April Rose. "Bellydance in America: Strategies for Seeking Personal Transformation." UCLA Electronic Theses and Disse rtations (2 0 12). Cadegiani, F. A., and C. E. Kater. "Adrenal Fatigue Does Not Exist: A Systematic Review." BMC Endocr Disord 16, no. 1 (Aug 24 2016): 48. Crawford, Robert. "A cultural account of "heath": control, release, and the social body." In Issues i n the Political Economy of Health Care New Y ork: Tavistock Publications, 1984. Davis Floyd, Robbie. "THE TECHNOCRATIC MODEL OF MEDICINE." DavisFloyd.com. April 11, 2014. http://davis floyd.com/uncategorized/the technocratic humanistic and holistic paradig ms of childbirth/. Davis Floyd, Robbie. "The Technocratic Body: American Childbirth as Cultural Expression." Social Science & Medicine 38, no. 8 (1994): 1125 140. Downey, Dennis, Justine Reel, S onya SooHoo, and Sandrine Zerbib. "Body Image in Belly Dance: Integrating Alternative Norms into Collective Identity." Journal of Gender Studies 19, no. 4 (2010): 37 7 93. Dumit, Joseph, and Joseph Dumit. Drugs for life: how pharmaceutical companies define our health Durham, NC: Duke University Press, 2 0 12.

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57 Ecks S. "Bodily Sovereignty as Political Sovereignty: 'Self Care' in Kolkata, India." Anthropol Med 11, no. 1 (Apr 1 2004): 75 89. Ernst, E. "The Efficacy of Herbal Medicine -an Overv i ew." Fundam Clin Pharmacol 19, no. 4 (Aug 2005): 4 0 5 9. Fruhauf, Tina. "Raq s Gothique: Decolonizing Belly Dance." The Drama Review 53, no. 3 (2009): 117 38. Gamble, VN. "Under the shadow of Tuskegee: African Americans and health care." American Journal of Public Health 87, no. 11 (1997(): 1773 1 778. Giovannini, P., V. Reyes Garci a A. Waldstein, and M. Heinrich. "Do Pharmaceuticals Displace Local Knowledge and Use of Medicinal Plants? Estimates from a Cross Sectional Study in a Rural Indigenous Community, Mexico." Soc Sci Med 72, no. 6 (Mar 2011): 928 36. Guthman, Julie. "Doing Ju stice to Bodies? Reflections on Food Justice, Race, and Biology." Antipode 46, no. 5 (2014): 115 3 71. Jarmakani, Amira. "Veiled Intentions: The Cultural Mythology Of Veils, Harems, And Belly Dancers In The S ervice Of Empire, Security, And Globalization." Imagining Arab Womanhood 2008, 13 9 84. Kaeppler, Adrienne L. "Dance in Anthropological Perspective." Annual Review of Anthropology 7 (1978): 3 1 49. Kaeppler, Adrienne L. "Dance Ethnology and the Anthropology of Dance." Dance Research Journal 32, no. 1 (2000): 11 6 25. Karayanni, Stavros Stavrou. Dancing Fear & Desire Race, Sexuality and Imperial Politics in Middle Eastern Dance. Waterloo, Ont.: Wilfrid Laurier University Press, 2004. Keft Kennedy, Virginia. "How Does She Do That?' Belly Dancing and the Horror of a Flexible Woman." Women's Studies 34, no. 3 4 (2005): 279 300. Ke n neth McLeroy, Barbara Norton, Michelle Kegler, James Burdine, and Ciro Sumaya. "Community Based Interventions." American Journal of Public Health 93, no. 4 (2003): 529 33. King, T racey. The Final Veil: Early 20th Century American Dancers Confront Victorian Morality through the Appropriation of Oriental Romanticism ." Unpublished Paper. The University of Texas at Arlington, 2 015. Kleinman, Arthur, and Peter Benson. "Culture, Moreal Experience and Medicine." The Mount Sinai Journal of Medicine 73, no. 6 (October 2006): 83 4 39. Kleinman, Arthur. The illness narratives: suffering, healing, and the human condition New York: Basic Books, A Member o f the Perseus Books Group, 1988. Krauss, Rachel. "Transforming Spirituality in Art i stic Liesure: How Spiritual Meaning of Belly Dance Changes over Time." Journal or the Scientific Study of Religion (2014). Krauss, Rachel. "Straddling the Sacred and Secular: Creating a Spiritual Experience throug h Belly Dance." Sociological Spectrum 29, no. 5 (2009): 598 625.

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58 Krauss, Rachel. ""We Are Not Strippers": How Belly Dancers Manage a (Soft) Stigmatized Serious Leisure Activity." Symbolic Interaction 33, no. 3 (2010): 435 55. Krieger, Nancy. "Embodiment: a conceptual glossary for epidemiology." Journal of Epidemiology & Community Health 59, no. 5 (2005): 350 55. Lewis, John Lowell. The Anthropology of Cultural Performance Palgrave Macmillan, 2013. Locke, Margaret. "Cultivating the Body: Anthropology and Ep istemologies of Bodily Practice and Knowledge." Annual Review of Anthropology 22 (1993): 13 3 55. Maira, Sunaina. "Belly Dancing: Arab Face, Orientalist Feminism, and U.S. Empire." American Quarterly 60, no. 2 (2008): 317 45. Molloy, BL, a n d SD Herzberger. "Body Image and Self Esteem: A Comparison of African American and Caucasian Women." Sex Roles 38, no. 7 (1998): 63 1 43. Mansbridge, Joanna. "Fantasies of Exposure: Belly Dancing, the Veil, and the Drag of History." The Journal of Popular Culture 49, no. 1 (2016): 29 56. McEwen, B and Sapolsky, R. "Stress and Cognitive Function." Current Opinion in Neurobiology 5 (1995): 20 5 16. Micozzi, Marc S. "Anthropology, and the Return of "Complementary Medicine"." Medical Anthropology Quarterly 16, no. 4 (2002). Moe, A. M. "Healing through Movement: The Benefits of Belly Dance for Gendered Victimizat i on." Affilia 29, no. 3 (2013): 326 39. Monty, Paul Eugene. "Serena, Ruth St. Denis, and the Evolution of Belly Dance in America (1876 1976)." New York University Diss ertations (1 9 86). Nichter, Mark. "Idioms of Distress Revisited." Culture, Medicine, and Psychiatry 34, no. 2 (2010): 40 1 16. Nichter, M, and J. J. Thompson. "For My Wellness, Not Just My Illness: North Americans' Use of Dietary Supplements." Cult Med Psychi atry 30, no. 2 (Jun 2006): 175 222. Nichter, Mark. "Idioms of distress: Alternatives in the expression of psychosocial distress: A case study from South India." Culture, Medicine and Psychiatry 5, no. 4 (1981): 379 408. Parker, Sheila, Mimi Nichter, Mark Ni chter, Nancy Vuckovic, Colette Sims, and Cheryl Ritenbaugh. "Body Image and Weight Concerns among African American and White Adolescent Females: Differences that Make a Difference." Human Organization 54, no. 2 (1995): 103 14. Popp, Ashley M. and Chia Ju Y en. "The Global Transformation of Belly Dancing: A Cross Cultural Investigation of Counter Hegemonic Responses." Physical Culture and Sport. Studies and Research 55, no. 1 (2 0 12). Pylypa, Jen. "Power and Bodily Practice: Applying the Work of Foucault to a n Anthropology of the Body." Arizona Anthropologist no. 13 (1998). Rose, Nikolas. The politics of life itself: biomedicine, power, and subjectivity in the twenty first century Princeton, NJ, etc.: Princeton University Press, 2007.

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59 Said, Edwa r d W. Orienta lism. New York: Vintage Books, 1979 Sapolsky, R. M. Social Status and Health in Humans and Other Anim a ls ." Annu. Rev. Anthropol. 33 ( 2004 ): 393 418 Sapolsky, R. M. "Stress Hormones: Good and Bad." N eurobiol Dis 7, no. 5 (Oct 2000): 540 2. Schechner Richard. Performance Theory. Rev. and Exp a nded ed. New York: Routledge, 1988. Scheper Hughes, Nancy, and Margaret M. Lock. "The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology." Medical Anthropology Quarterly 1, no. 1 (1987): 6 41. Sel lers Young, Anthony Shay and Barbara. "Belly D a nce: Orientalism: Exoticism: Self Exoticism." Dance Research Journal 35, no. 1 (2003): 13 37. Shay, Anthony. Belly D a nce: Orientalism, Transnationalism, and Harem Fantasy. Costa Mesa, Calif.: Mazda Publishers, 2005. Shay, Anthony, and Barbara Sellers Young. "Belly D a nce: Orientalism: Exoticism: Self Exoticism." Dance Research 35, no. 1 (2003): 13 37. Th a yer, Zaneta, and Christopher Kuzawa. "Biological memories of past environments: Epigenetic pathways to health disparit i es." Epigenetics 6:7 (2011). Thomas, Deborah A. "Democratizing Dance: Institutional Transformation and Hegemonic Re Ordering in Postcolonial Jamaica." Cultural Anthropology 17, no. 4 (2002): 512 50. Thomas, SB,., and SC. Quinn. "The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV education and AIDS risk education programs in the black community." American Journal of Public Health 81, no. 11 (1991): 1498 1505. Thompson, J.J., a n d M. Nichte r. "Is There a Role for Complementary and Alternative Medicine in Preventive and Promotive Health? An Anthropological Assessment in the Context of U.S. Health Reform." Medical Anthropology Quarterly 00, no. 0 (2015): 1 20. Thompson, J. J C. Ritenbaugh, a nd M. Nichter. "Reconsidering the Placebo Response from a Broad Anthropological Perspective." Cult Med Psychiatry 33, no. 1 (Mar 2009): 11 2 52. Tiggemann, Marika, Emily Coutts, and Levina Clark. "Belly Dance as an Embodying Activity?: A Test of the Embodim ent Model of Positive Body Image." Sex Roles 71, no. 5 8 (2014): 197 207. Viladrich, Anah’. "Bot‡nicas in America's Backyard: Ucovering the World of Latino Healers' Herb Healing Practices in New York City." Human Organization 65, no. 4: 40 7 19. Waldstein A. "Popular Medicine and Self Care in a Mexican Migrant Community: Toward an Explanation of an Epidemiological Paradox." Med Anthropol 29, no. 1 (Jan 2010): 71 107.

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60 Wall, Nico l e M. Monteiro and Diana J. "African Dance as Healing Modality Throughout the D iaspora: The Use of Ritual and Movement to Work through Trauma." The Journal of Pan African Studies 4, no. 6 (2011): 234 52. Watson, Laurel B., Jul i e R. Ancis, D. Nicholas White, and Negar Nazari. "Racial Identity Buffers African American Women From Body I mage Problems and Disordered Eating." Psychology of Women Quarterly 37, no. 3 (2013): 337 50 Wilson, James L. "Clinical Perspective on St r ess, Cortisol and Adrenal Fatigue." Advances in Integrative Medicine 1 (2014): 93 96.

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61 APPENDIX PERSPECTIVES ON HISTORY AND ACADEMIC LITERATURE The genre of belly dance is one of the most perfect examples of how "affects and fantasies get translated into hist o ry" ( Mansbridge 2016 35 ). From images of ancient and sacred birthing rituals of goddess cults to sexually d epraved prostitutes, th is dance form has a largely unknown and contested history, with even academics falling victim to undocumented tropes about the source or intent of the dance. Most dance scholars agree to some extent on it being an amalgamation of var ious folk dances from India, Turkey, Greece, the Middle East, North Africa, southern Spain, and the Balkan regions, largely following trade and immigration routes (Downey et al. 2 010; Karayanni 2004; Shay 2005; Shay and Sellers Young 2003). Scholastic atte ntion on the dance form often tends to focus on the concept of authenticity; with movements located the Middle East being uniformly authentic while any expression of the dance in the west as the hybrid, appropriated antithe s is. ( Burnam 2012) The underlying assumption by scholars, such as Anthony Shay (2005), in assigning authenticity presuppos es spatial, cultural, and temporal stagnatio n As Burnam states, "this approach assumes the stability and relative stasis of traditional dances, eschewing any changes made to them as a result of nationalizing reform movements or intercultural exchange" (2012 6 ). This assumption of stasis, either in the Middle East or within American contexts, is a common methodological failure that has dominated the academic and popula r rhetoric on the genre and that Burnam points out in many essentialist sources, such as Anthony Shay (2005) and Sunaina Maira (2008).

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62 While the relationship between the West and much of the Middle East become ever more tense and complicated through trans national politics, migrations of people both voluntary and through diasporas of refugees, as multiculturalism is labeled treacherous by nationalist political movements all over the United States, the European Union, and the Middle East, as Muslim women in America must contend with a society that does not recognize their norms and femininities, and as modern politics pits the monotheistic religions in a war against each other, practices such as belly dance that have complex intercontinental histories will co ntinue to be largely viewed as mythic tropes for the oppression, objectification and colonialized sexualities of the Other. Because of this complexity, it is essential to engage with sites of cultural intersection, such as American belly dance, as multifa ceted products of history and politics, which may reflect values from their founding cultures and/or novel hybrids which use similar symbolism to respond to different social cues. April Rose Burnam, who is simultaneously an internationally renowned profess ional belly dancer as well as an academic scholar on the subject, has been one of the few to contextualize the historical and cultural nuances of the dance form's entrance into the United States. She contends t hat bellydance serves as a site for practitio ners to transform their sense of self, transgress social boundaries, and build community, but that this transformation potential is compromised whe n the Orientalist assumptions that have historically been embedded in the practice are not recognized or chal len g ed" ( Burnam 2012 ii ). Her work serves to document the bidirectional exchanges and sociopolitical influences that occurred interculturally between Egypt and the United States in the 19 th and 20 th centuries that laid the

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63 groundwork from which contemporary belly dance emerged. While it is commonly assumed by both the lay person and academics that American styles of belly dance are referential to styles seen in places such as Egypt, the resear c h of Burnam indicated that many dance traditio ns under the term belly dance have evolved simultaneously and interdependently through continuous cultural and artistic exchange. The first documented instance of publicly performed belly dance in the United States was at the 1876 Philadelphia Centennial Exposition. In celebration of the anniversary of signing the Declaration of Independence, mo re than 50 countries participated, including exhibits from Turkey, Tunisia, and Egypt. At an exhibit designed to replicate a Turkish coffeehouse, local police condu cted a raid after a spontaneous dance performance occurred. The dancer was arrested and charged for being immodest in charac t er ( Burnam 2012; Monty 1986) This event set the tone for these dances to be viewed as immoral prior to the official introductio n at the 1893 Chicago World Fair. At the time, this dance was commonly referred to as the hootchy kootchy dance or danse du ventre ( or dance of the belly in French ) and immediately became the focus of national attention. Dancers from North Africa, the Middle East, and Central Asia frequented World Fairs and exhibits all over the United States and Europe in the 19 th century. These fairs took place at a time of colonial development in Asia, Africa, Latin America, and the Middle East. Fairs were frequently set up to support nationalist rhetoric of expansion, with displays of living peoples performing

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64 cultural oddities in created "natural" settings to demonstrate a lack of civilization in comparison to the W est ( Burnam 2012; Shay and Sellers Young 2005). S ol Bloom, an American businessman in the entertainment industry and U S congressman, recognized a potential opportunity after becoming interested in the Algerian display of dance rs, acrobats, and daredevils at the Paris International Expo of 1889. Bloom l ater became manager of amusement concessions for the 1893 Chicago World Fai r He curated and exhibit called "A Street in Cairo" featuring some of these Algerian performers alongside other dancers performing danse du ventre He rebranded the dance as "belly dance" and capitalized on the huge response to the salacious and seemingly immoral dance (Monty 1 986; Burnam 2012). These initial performances, while carefully constructed as a "carnivalesque display of otherness" (Burnam 2012 38 ) specifically designed t o capitalize on the shock value, complete with sword swallowing and men walking over coals and sticking needles in their skin, have become widely representative as an accurate representation of the dance form yet to be touched by American sensibili t ies. Bu rnam writes, Bellydance appeared in America not in some pure authentic form but as carefully crafted entertainment acts designed to represent the East in a microcosmic model of the world in which the West was progressive and civilized and the East was back ward and dangerous but mysterious and alluring. The emerging field of social science, which purported to prove the superiority of the Anglo Saxon race by way of scientific evidence, had a large presence at the fairs and shaped how the general public v i ewed bellydance, which was presented as an amoral practice from the inferior Orient. The danse du ventre, or the hoochie koochie as it became known at the "A Street in Cairo" exhibit and Algerian Theater, was the most popular attraction at the Chicago Fair, fa med for its ability to tantalize working class men and according to the press, disgust w o men ( Burnam 2012 35 ). The public defamation of belly dance in the 19 th century was closely linked with racialized anxieties of the relatively new political and cultu ral interactions with

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65 the Middle East; with the imagined predatory exoticism of Eastern women acting as the poster child for the cultural depravity that the West was trying to both consume and domi n ate ( Keft Kennedy 2010). Descriptions of dancers were diam etrically opposed to the ideological archetype of Western femininity at the time, which honored controlled, corseted bodies that were restrained and submissive. Thus the dances that became known as belly dancing "posed a threat to the acceptable cultural n orms of appropriate feminin i ty" ( Keft Kennedy 2010 287 ) Contextualized in the era's Victorian sensibilities, sexuality was framed as the pathologized Otherness of the Orient. A woman in public without a corset presented a set of social transgressions: she was physically mobile and healthy, her body was self supporting and she established for herself a certain self sufficiency in her refusal of social pressures to corset her body. A dancing woman, however, particularly one imitating the allegedly wanton Oriental dancer, not only embodied these transgressions but also presented the very unstable and threatening element of sexuality communicated in the bodily language of dance movement: a troubling movement, I would argue, that is inextricably bound up in f ears of a flexible waist and of women's sexua l ity ( Keft Kennedy 2010 288 ). Bodies seen as "uncontrolled and uncontrollable" dominate the early understanding on belly dancers, which creates a foundation by which the discourse on the dance form continues i nto the 20 th and 21 st century. Images from and inspired by the performances of the Chicago World Fair went on to adorn posters, cigarette cas e s, post cards, paintings, and even one of Thomas Edison's first films c a lled Coochee Coochee Dance displaying the dancer known as Little Egypt, a character who was then replicated by numerous dancers. These performances created a huge demand by which vaudeville and burlesque shows hired on mi g rant kooch performers as local entertainers adopted

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66 many of the serpentine m ovements. Coney Island became a prominent location for continued performanc e s of danse du ventre Freak shows and peep shows began incorporating performers assuming Orientalized identities, with many claiming to be the original Little Egypt. Once this exhi bit closed in Coney Island, Ori e ntal kooch dancing became a national trend in burlesque as well as in the theatrical precursors to modern dance. Performers such as Ruth St. Denis, Isadora Duncan, Loie Fuller, La Belle Fatima, Mata Hari, and Maud Allen took these images of the Orient, and added elements of mysticism, danger, allure, and feminine spirituality to present them in staged performances (King 2 015; Burnam 2012). At the dawn of the 20 th cent u ry, Salomania" swept United States, with countless dancer s reinterpreting the Oscar Wilde character in a form that was interpreted as simultaneously profane and sacrilegious for the biblical reference, as well refin ed and feminist (King 2015) Many Salome dancers, such as Maud Allen were afforded celebrity statu s and became icons for the Women's Suffrage for representing a character that was dangerous, sexual, and able to defend against male powers. Dancers such as Ruth St. Dennis integrated imagined spirituality in the dance to both allow for it to be more accep table in high class circles, but to also employ specific political statements through movement. The imbuement of spirituality into the dance continued with the iconic Mata Hari who intertwined Eastern religion into the dance in order for to get "deserved r everence for her work rather than it [to be interpreted as] being vulgar" (King 2015 16 ) The added invention of spirituality allowed for a form of legitimization of the movement as art, separating it fro m the hy persexualized vaudeville styles (Burnam 2012)

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67 Keft Kennedy explores the transformation of the depiction of the dance as immoral in the 19 th century through the current state of the genre in the 20 th and 21 st century as being a "powerfully enduring and resonant strategy in the counter producti on of knowledge concerning the display of women's bodies" (2010 280 ). Hollywood movies quickly obtained an interest in the dance form, with the American movie industry sourcing ideas, imagery, and performers from Egyptian films at the t ime. Samia Gamal an d Tahia Carioca were seen in countless films and have become the mental representation for what most Americans know of as belly dance. This period of belly dance in the media has come to be known as The Golden Era. Many of the dancers were trained by the S yrian d a ncer Badia Massabni who opened the Casino Opera House in 1927 in Cairo and is credited with creating the imagery of what much of the world understands to be belly dance. Her dancers wore halter tops with skirts, belts, and high heels to mimic what Egyptians viewed Western music hall dance performance attire to be and the normally improvised dance was choreographed for stage perf ormances with multiple dan c ers ( Burnam 2012). Oriental themed cabarets and restaurants featuring live belly dancers became popular in the United States beginning in the 1950s and 60s following the influx of Arab, Greek, and Turkish immigrants into the United States. The demand for belly dancers in these clubs and restaurants became so great that often, non trained dancers wou ld be hired. The first American based belly dance school, Stairway to Stardom which was soon renamed Serena Studios, opened in 1964 in New York City following a wave of demand for the dance f orm ( Burnam 2012).

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68 Dancers in the 1970s began put ting concerted effort into heightening the legitimacy of the dance and removing the sexualized image of the club dancer by traveling to Africa and Asia to ground the dance in folkloric traditions. Dancers of these period published articles attempting to rebran d the dance ; many also becoming ethnologists. Groups such a s Bal Anat, directed by Jamila Salimpour, and Ibrahim Farrah's Near East Dance Group, focused on performing versions of North African and West Asian folk dances, often covering much more skin than the night club dancers of the previous decade. These versions were a blend between the dances and costumes found of the performed local, as well as with a hybrid version, often exaggerating and blending various elements. Dance magazines focusing on belly d ance started to be available to both consumers and dancers interested in cultural heritage and fads in different subge n res. Jamila Salimpour was one of the first dancers to attempt to codify steps and movement vocabulary of the dance form. To this day, the dance remains internatio n ally uncodified, meaning that there is not consistent terminology for moves or even consistent muscle motivation to get the same visual look of a movement. The terminology that Jamila, as well as her daughter, Suhaila Salimpour cr eated are the most commonly used vocabularies in the U.S. dance form currently. O n e of Jamila Salimpour's dancers, Masha Archer became an iconic figure that helped to shape modern American genres. As a dancer and a designer, she recreated the visual aesthe tic of both dance and movement to resemble living sculptures, adding turbans not as a cultural reference but to expose the next and jaw line and covering dancers with textiles and heavy jewelry from all over the world.

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69 She shifted the staged focus to be t hat of an imagined regality to a group of dancers, where the audience owed some homage to witness the movements rather than a solo performer acting to entertain the audience. In 1 974, Carolena Nericcio because a student of Archer. Nericcio later developed a cued improvisational style of the dance known as American Tribal Style (ATS), where groups are able to prompt spontaneous movements with specific gestures with the hand or head, allowing for an improvised piece to look planned and unified. This continued and depend the focus on group performance as opposed to solo dancing. This particular lineage made concerted effort to largely remove sexuality from the dance, covering much more skin and deriving aesthetics from different sources than the traditional Ori ental Cabaret dancers. The first ATS troop was c a lled FatChanceBellyDance, a name specifically desig ned to confront male voyeu r ism ( Burnam 2012) This genre of dance then birthed back the same visual aesthetic in solo dancers, known as Tribal Fusion or sim ply Fusion Belly dance. This form tends to be hyper technical, with intricate muscle articulations of the hips and torso, utilizes alternative archetypal aesthetics, or experiments with fusing other dance forms such as Hip Hop, Classical Indian dances, Mod ern Dance, or Latin dances. The dance form in America has largely been seen as exploitative, with echoes of colonial and imperial histories with "no possibility for productive restructur i ng" ( Burnam 2012 6 ) by many writers that have had limited encounter s with the different cultural contexts of the dance or who privilege the common rhetoric of the debated history of the dance without investigating the dubious line between fantasy reconstruction and rea l ity. Sunaina Maira argues, "the performance of belly

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70 dance by American women represents not so much their ambivalence about Middle Eastern culture, but their ambivalence about their own culture its individualism, materialism, or restrictive body image ideals" (2008 334 ). While the dance, no doubt, has the p otential for problematic representati o n of Otherized cultures, especially when practitioners do not scrutinize the sociopolitical histories, immersed research into the current state of the dance largely produce s the image of dancers hungry for contextualiz ed education while creating artistic expressions that reply to their own cultural ecologies using a transnational movement vocabulary. Vir g inia Keft Kennedy raises a perspective through which to view the intricate intersectionalities of the dance in the le ns of performance, display, and "grotesque" bodily movements. She argues that the dance, which has been "largely overlooked by cultural studiescan be seen as a potent weapon for feminist politics and a potent i ally transgressive practice for women" (2010 2 80 ). Keft Kennedy views the dance primarily as a variety of body modification in that the body is both physically modified by nature of the extent of flexibility, dexterity, and strength needed to execute the dance as well as symbolically modified from t he socio cultural expectations of appropriate public manners of movement for women. Several dancers interviewed referenced that they felt their dance form was seen as taboo, primarily because the dance form focuses largely on movements of the hips, which i s atypical of many accepted dance forms in American cul t ure. Keft Kennedy utilizes a conceptual framework from Mikhail Bakhtin initially applied to Carnival for understanding the varied social reactions to belly dance. In separating parts and movements of the body as either "classical" or "grotesque," this

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71 framework usefully helps analyze responses to the dance outside of the sim plistic labeling of it as sexually "lewd." The "classical" body is that of integrity, intellectualism, and security. The lower body thus is conceived as excessive, sexual, and "grotesque." As belly dance primarily focuses on what many writers, both histori cal and contemporary, call the "jerking," "contorting," "quivering," "undulating," and "writhing" of the hips and stomach, ideals of the female body are challenged through a transgression of aesthetics as well as the perceived limits of the body. This phys ical modification of the body in relation to itself symbolically modifies the body within the expected social construction of appropriate ways for a body to be h ave ( Keft Kennedy 2010). Keft Kennedy further goes on to examine how the dance has been written about in historical accounts, demonstrating how male writers imperially viewed the dance form as completely devoid of artistic value or talent and in s tead racialized the "grotesque" movements of the body as an alien and Orientalized Other Many movement t raditions of the Middle East and North Africa were denounced as sexually gratuitous by the Victorian sensibilities of the 19 th centur y and Eurpean travelogues. These movements became symbolically representative of the lewd, sensual abandon of the Eastern Other. Even today, many practices that focus on movements of the lower body are discredited as sexual and devoid of artistic merit. In the book, Dancing Fear and Desire: Race, Sexual ity, and Imperial Politics in Middle Eastern Dance, St a vros Stavrou Karayanni describes the power of the dance by explaining that it "signif[ies] transgression by giving voice to parts of the

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72 body that are expected to remain silent, unobtrusive, and discom fited in their postcolonial posture" (1965 xiii ). Because of a consistent erasure of the history of the dance, belly dance operates in a liminal and illusory space of timeless fantasy that endorses a larger narrative of the publicly evident and sexualized female body as a mark of moder n ity ( Mansbridge 2016). Studies like Tiggeman et al. (2014) position belly dance as an erotic performance of embodiment, likening the practice to heterosexual women kissing for the visual pleasure of men in public settings. A s the research questions of that study entailed learning if female belly dancers enjoy sexual objectification more than their college age non dancing counterparts, a foundation that understands the patriarchal gaze upon the dance is continuously set forth and is privileged over the internalized experience of the practitioner. Practices that are of the body and dominated by females are often weighted with the social reality that "women's bodies are used as sites onto which multiple differences political, rel igious, sexual, and cultural are either imaginatively resolvedor reinfor c ed" ( Mansbridge 2016 30 ). Angela Moe investigates the "apparent disconnect between public perception and practitioner standpoint" and the potentiality for healing trauma from gender ed victimization. Through the ability to "self define" creative discovery, Moe argues that the dance form is a "mode of movement based therapy" with particular holistic efficacy in reducing the long term harm of the types of violence that disproportionatel y affect women (2014 326 ). Moe takes a framework of feminist standpoint theory to privilege the voices of the study's participants about their experiences over other dominant discourses on the matter. Interpersonal harm

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73 afflicted onto the lives of the par ticipants organically surfaced unprompted in her study Moe also analyses her qualitative data with phenomenological ideas of embodied meaning, a practice which was utilized in the analysis of my own data about the belly dance, the body, and health seeking behavi o rs. Burnam argues that the art of belly dance has the potential for practitioners to be able to "expand their sense of self beyond societally imposed boundaries and to form inter subjective community" and that the genre provides the rare ability f or women to "intentionally construct their own body and identity in ways that everyday life does not often allow" (2012 9 ). The transformative properties of the dance do, however, become problematic when the locale is placed in fanaticized imagery birthed from imperialist histories. The capital i stic commodification of sexuality and gender exists concurrently with the poststructural destabilization of these concepts, allowing belly dance as a practice and culture to present either real or imagined agency in their body and gendered expres s ion ( Mansbridge 2016).