7. Findings

Movement as a dosage.

The overarching finding from my Fellowship travel was that there appears to be a threshold, a point I cannot yet fully define, beyond which the dosage of movement begins to have an inverse effect on adolescent mental health.

My question of what movement equals what emotional state remains unanswered - although I am sure there is more research to be done specifically in that context.

It was not what movement, but how much movement:

Around the age of nine or ten, movement often shifts from being exploratory and joyful to being performative and competitive. You either win, achieve, or perform, or you stop altogether. Beyond this point, there seem to be very few avenues for movement as joy.

Case Study: Cape Town — The School of Hard Knocks

Breaking Down Barriers Through Visible Vulnerability

When I was in Cape Town, I spent time with the School of Hard Knocks, an organisation providing touch rugby in commuter schools. These schools primarily serve adolescents from townships; young people from socioeconomically deprived backgrounds, living in poverty, and often facing extremely long commutes, usually over an hour each way just to get to school. Resources are low and mental health is poor.

SOHK offered rugby sessions within school hours - not as an adjunct or elective activity after school or as part of a club, but part of their school day. Attendance was mandated, but participation was not. Within about two weeks, however, all of the adolescents were participating fully.

The key to this success was not the sport itself, but the people leading it: every coach was also a trained therapist — either a psychologist or a mental health counsellor — equipped to spot red flags in adolescent behaviour.

From my anthropological ethnography on the sidelines, I observed something powerful. Children were sometimes pulled out of the game by a counsellor, and sometimes they volunteered themselves to step out for one-to-one sessions.

We’ve always squirrelled away the shame of therapy - taking it to the “counselling room” or a “safe space”, which also suggests the space that is safe, is separate to all the other spaces we exist in.

It is not. It is any space that we place ourselves in: safety is not a feeling, it is an unconscious state governed by our ventral vagal system.

Each coach has their own lived experience story (which are theirs to tell - not mine); and so bring vastly different skills to the side of the pitch.

What was remarkable was that this happened in full view of their peers. The coaches and children together broke down the barrier of shame and secrecy that so often surrounds talking about mental health. Here, they were happening out in the open. Not audible, but visible.

That visibility — the sight of someone stepping aside to speak, to seek help — made emotional support tangible. It normalised help-seeking behaviour. It embedded empathy into the culture of play.

Case Study: Toronto — When Movement Turns from Healing to Harm

The Threshold Where Performance Replaces Connection

In striking comparison, in Toronto, Canada, I spoke with Chris Coulter, founder of MentorWell, a mentorship scheme for adolescents. His daughter, Maddy, took her own life when she was just 14 years old.

Maddie was hilarious, kind and non-conforming. She was also a competitive swimmer, a loving sister and daughter. She sounded like a pretty brilliant young woman to me.

Chris recalls the one time he watched Maddie swim in what would be her last race - “She was fighting in the water. But she wasn’t fighting the water. She was fighting herself.”

Maddie never swam in the water again. She drowned whatever it was she was feeling with alcohol. She was 13 years old.

Chris thinks for a minute, and tells me he’s terrified to today’s teens unbridled access to cannabis. The legal age to purchase these candy-store drugs in Canada is 19, but how is that being enforced, if at all?

Decriminalising drugs diminishes the dark side of drug dealing - cartels, gang violence and trafficking of vulnerable people and minors.

Regulation is the safeguard for the end user. We don’t issue pharmaceutical drugs without prescription, so why are we so laissez faire regarding recreational drugs?

I asked Chris if Maddie had considered the competitive element too unbearable for her to continue swimming? The proliferation of pressure on young minds is anguish-inducing.

Anxiety presents in much the same way as ADHD - lack of executive dysfunction, emotional dysregulation, impulsivity (including self medicating with drugs and alcohol), hyperactivity and inattention.

The neurobiological commonalities between ADHD and anxiety are dysregulated dopamine and norepinephrine systems - these are neurotransmitters affecting attention, motivation, mood and executive function.

I often wonder how many teens are being prescribed amphetamines for anxiety mistaken as neurodiversity. When you exist constantly in fire-fighting mode due to stress, it puts you in a state of indeterminate hyper-vigilance. Your ability to concentrate on anything other than threat is decimated. Prolonged stressors, such as preparing for an exam, competition or event, results in listening to the noise but not the words - focus is decimated. It’s either chaos or total collapse.

Excessive competition in sports during adolescence can place significant stress on the developing brain, particularly affecting executive function. The adolescent brain, especially the prefrontal cortex - responsible for decision-making, emotional regulation, and impulse control - is still maturing and highly sensitive to stress hormones like cortisol. Chronic exposure to competitive pressure can impair this region’s development, potentially leading to difficulties with attention, planning, and emotional regulation. Instead of fostering resilience, intense and unrelenting competition may increase anxiety and reduce intrinsic motivation.

Intrinsic motivation refers to doing something because you find it inherently interesting, enjoyable, or personally satisfying. This is what we feel when we move for fun - a game of frisbee on a beach; a spontaneous tug of war.

Extrinsic motivation is driven by external factors - doing something to earn a reward (or avoid punishment).

Young people need to find joy > competition in movement or the motivation to move transcends from intrinsic to extrinsic. If they choose to elevate to a performance / elite level, then we must resource them well so they can understand and manage the stress element of the external validation / criticism loop.

There were many aspects of Maddy’s life — her parents’ separation among them — and we can never know precisely what led to her death. But it occurred to me, through speaking with Chris, that perhaps being pushed into such a competitive state by the age of thirteen, when the cortical structures of the brain are still developing, may have contributed to that disconnection.

I recognised something of myself in that story. I had anorexia while training fulltime at ballet school, also while my prefrontal cortex was still developing. The drive for control, precision, and perfection — all expressed through the body — can become both an anchor and a cage.

It was this meeting with Chris, and the devastating loss of Maddy, that deepened my inquiry:

Is there a threshold where movement switches from medicinal to morbid?

Case Study: Cape Town — When Movement Stops Moving You

The Threshold of Movement and Meaning

After meeting with Chris in Toronto, I was drawn back in my mind to my time in South Africa, where I had reconnected with an old ballet school friend, Tanya. Her husband, T, and I had trained together when we were sixteen years old.

T was born and grew up in the townships of Cape Town. Through his incredible, prodigious talent as a young dancer, he managed to work his way out of the townships and into an elite, high-performing ballet school in London — alongside more privileged children like myself.

T had a wonderful career. He married Tanya. They moved back to Cape Town. They had children. They set up their own dance company, iKapa, which went back into the townships and did for young people what had once been done for him — offering opportunity, discipline, and hope through movement.

For more than a decade, they enjoyed great success.

Then, one day, T walked away from his whole life and went back to the townships.

Another example of that invisible threshold: a point where movement no longer works.

Case Study: Toronto — Movement as Medicine, Without Joy

Rehabilitation, Prescription, and the Absence of Joy

In Toronto, I spoke with Margot at Together in Movement and Exercise, (TIME), a rehabilitation clinic working primarily with children who have catastrophic brain injuries — including cerebral palsy and other conditions that impair development from birth or early childhood.

Margot was eager to hear about my outcomes with young people, and our conversation illuminated a different side of the movement spectrum.

For these children, movement has always been administered as medicine. It has been something necessary, functional, and often painful — something done to them, rather than for or with them.

Because of this, movement has never been associated with joy. It has been synonymous with difficulty, strain, and correction — not expression, connection, or play.

This raised a crucial question for me: If movement has only ever existed as a form of rehabilitation, how can we reintroduce joy into it?

How do we help children who have only known movement as treatment to experience it as freedom?

Margot’s work made me reflect on how we approach movement in clinical contexts. In many ways, the issue is not the movement itself but the emotional frame we place around it. When movement becomes purely prescriptive — a task, an intervention, a medicine — it loses its potential to heal holistically.

Perhaps the challenge in these settings is to reframe movement not only as a means to an end, but as a source of agency and delight.

12. Case Study: Örebro, Sweden — Dance for Health

Reclaiming Joy, Re-embodying Movement

Perhaps the most powerful and the most productive intervention I witnessed was at the University of Örebro in Sweden, where I met Anna Duberg — a former dancer and the founder of Dans för Hälsa (Dance for Health), a nationwide intervention scheme for adolescent girls.

Anna, a physiotherapist, had observed a surge in adolescents presenting with psychosomatic symptoms — abdominal pain, headaches, fatigue — with no clear physiological cause. Clinical review revealed that these were manifestations of deeper mental health conditions such as depression and anxiety.

In response, she developed a dance-based programme aimed at supporting emotional regulation and wellbeing in young people.

During my time in Sweden, Anna and I collaborated to run a workshop for practitioners who were carrying other people’s trauma — helping them process it through the medium of dance.

Dance has been shown to induce profound neurochemical and biological changes. It is one of the most effective forms of exercise for elevating mood and has been demonstrated to produce outcomes in reducing depression equal to — and sometimes exceeding — SSRIs and cognitive behavioural therapy.

One participant reflected at the end of our workshop:

“I always want to feel like this in my body.”

That single statement encapsulated what this Fellowship has come to mean for me.

Across every country, culture, and context I visited, I observed the same phenomenon: at some point, movement becomes external. It shifts from something we inhabit to something we perform. It becomes extrinsically motivated — driven by validation from peers, coaches, instructors, or audiences.

This work is about bringing movement back inside — to its intrinsic state.

Movement as embodiment.

Movement as life.

Movement IS life

Because without movement there is only stillness — and in stillness, is that not equal to death?

My motivation post-Fellowship is to bring movement:

1. Back to joy, and

2. Back to our environment.

Much of what I’ve witnessed — from prisons to classrooms to clinics — are maladaptive environments. In those spaces, the brain struggles to function, to feel, to survive. So how can the body support the brain within such environments?

If we return movement to where it belongs — as an embodied experience — we reconnect the brain with the body it lives in. We are embodied creatures. We are incarnate.

This means integrating movement not as a spectacle, nor a medicine, but as a micro-dose practice within everyday life: in classrooms, in communities, in corridors.

It is not about equipment or facilities — it is about education and awareness. Helping young people understand that their body exists to be moved — not to perform, not to be perfected, not to be medicated, but to support the mind that lives within it.