P is for Pleasure

I just returned from a fabulous Speaking of Women’s Health event in Columbia, Missouri. The event planners were wonderful at helping me convey the message that women need more Vitamin “P” (Pleasure) in their diets. As you may know from reading my book “Create the Body Your Soul Desires,” the original meaning of the word “diet” is “a manner of living.”

What I loved about this event is that they opened with a performance by the belly dance troup “The Dragonflies.” These dancers, under the direction of an amazing woman named Kandi Grossman, mesmerized the 550 women in attendance. Their movements were graceful, powerful and filled with pleasure. What a great way to set the tone for a presentation on women’s health!

Midway through my presentation I invited the women to join me in simple dance movements – and the event organizers came through the audience with boas. Imagine 550 women dancing with boas! Red boas, black boas, pink boas, white boas, purple boas….what a sight!

Scientifically I know that we collectively produced enough serotonin and beta-endorphin to completely shift every woman’s mood. In my heart I know that if women will continue to dance like there’s nobody watching and enjoy the pleasure of being in their bodies, we can create a positive shift in the world….one woman at a time.

A Comparison of a Mind/Body Approach Versus a Conventional Approach to Aerobic Dance

by Deborah Kern and J. B. Baker

Women’s Health Issues, Vol 7, No.1 Jan/Feb 1997

This study compared the effect on women of using a mind/body approach in teaching aerobics classes versus a conventional approach on the following variables: general self-esteem, physical self-esteem, and state-trait anxiety. Sixty-eight female college students participated in the study. The experimental treatment group received a mind/body teaching approach based on the neuromuscular integrative action model while the standard treatment control group received a conventional teaching approach based on current aerobic dance instructional methods. An ANCOVA analysis of the data showed that the treatment group receiving a mind/body approach scored significantly lower on trait anxiety measures than the standard treatment control group which had received a conventional approach. Qualitative analysis of focus groups supported the finding that women in the mind/body approach group had improved their anxiety coping skills as a result of the mind/body aerobics class.

Over the past 15 years Americans have begun taking a more active interest in health than ever before. The physiological benefits of exercise are now well-documented and substantial evidence indicates that aerobic activity performed on a regular basis will aid in the reduction of risk factors that may lead to cardiovascular disease.1 Recently, however, a new emphasis is being placed on the psychological benefits of aerobic activity. Studies have found that not only does one’s physical health benefit from aerobic exercise, but also one’s mental health.2 Earlier anecdotal reports of post-exercise positive effects have been confirmed by numerous scientific investigations.3 Specifically, exercise appears to have a tranquilizing and antidepressant effect on participants.4

Due to the lack of research examining the psychological effects of different types of aerobic dance instruction, this study focused on the effects of two different teaching methods in aerobic dance classes on general self-esteem, physical self-esteem, and state-trait anxiety.

Background and Significance

Three centuries after Descartes, the sciences of medicine and health promotion are still based on “the notion of the body as a machine, of disease as the consequence of breakdown of the machine, and of the doctor’s task as repairer of the machine.”5 This paradigm has led to a prominence of “healthism” in the United States, a belief in which a physically fit body is equated with total health and wellness. Not only is a physically fit body considered the key criterion for health and wellness, it has become a moral imperative.6 Therefore, in their efforts to promote health, fitness professionals have focused on changing physical characteristics such as body fat percentage, weight, resting heart rate, and aerobic capacity.

By emphasizing physical goals, fitness programs teach individuals to value discipline, self- restraint, denial, and external control. This value system has led to the development of countless diet programs and books which espouse restrained eating, self-discipline, and a regimented eating style in order to achieve a desired physical state. It has also led to the increase in personal fitness trainers who are hired to design exercise programs and motivate their clients who seek desired physical outcomes. In the arena of aerobics classes, this value system has led to a teaching style in which the instructor leads the class in uniform movement, focusing on isolated parts of the body in order to achieve desired physical outcomes.7,8 There are many criticisms of this approach to health promotion: the increasing number of individuals who exercise excessively,9 the rising incidence of eating disorders10, and the promotion of a thinness standard of body attractiveness as a panacea for life’s difficulties.11

Aerobic Dance Instruction Guidelines

We followed aerobic dance instruction guidelines from The American Council on Exercise Aerobics Instructor Manual 12 and The Exer-Safety Association 13 when teaching the standard treatment control groups. For the experimental groups, we followed a mind/body approach based on Neuromuscular Integrative Action (NIA) that was designed specifically for the purpose of this study. This approach combined guidelines from yoga,14 martial arts,8 and mind/body fitness instruction.15

Mind/body Approach to Aerobic Dance Instruction

The mind/body approach as defined in this study is represented in the literature by Yoga, martial arts, and Mind/Body Fitness instruction. Yoga creates a mind/body connection by using awareness of the breath and concentration of the mind throughout the poses. Unlike the conventional instructional approach in aerobic dance class, participants are encouraged to move according to their own breathing patterns instead of to the beat of the music. Also, unlike the conventional instructional approach, there is not a list of contraindicated movements. Instead, participants are encouraged to move within their own comfort zone in order to prevent injury.14

In a mind/body approach, exercises are drawn from ancient disciplines such as yoga, tai chi, and aikido as well as from modern systems, such as Feldenkrais and Alexander techniques, and from dance movement therapy. Exercises in a mind/body class are not designed with specific body-centered objectives as found in the conventional aerobic dance guidelines. Instead, objectives include, but are not limited to, enhancing awareness of breathing, increasing ability to breathe, feeling the connection of feet to the ground, experiencing the interplay among the physical, mental, emotional, and spiritual aspects of well-being, feeling powerful and feeling graceful.15

The aerobic portion of this type of class allows creativity and spontaneity to emerge in students. Instructors are encouraged to design choreography to inspire a sense of letting go, and to remember that students have individual rhythms. Therefore, choreography is simple in order to allow students to explore how the movement feels rather than just go through the motions. If possible, instructors are to have students turn away from the mirrors in order to help them feel the movements rather than watch them. It is more important in this type of class that students feel the movement rather than learn complicated steps.15


Population and Sample Selection

The population used for this study was female students, 18 years of age and older, enrolled in aerobics classes at Texas Woman’s University. From this population, a convenience sample of 77 subjects was recruited from four physical activity classes. Subjects in two classes were designated as the experimental group and subjects in the other two classes were designated as the standard control group. The 37 subjects in a standard control group were divided into two classes: one class of 18 and one class of 19 students. The 40 subjects in an experimental group were divided into two classes of 20 students each.


Both groups, two classes per group, participated in a one hour aerobics classes twice a week for seven weeks. Classes were canceled for two days during the treatment period due to weather conditions; therefore, the treatment consisted of 13 sessions. The same instructor taught the experimental group using a mind/body approach and the standard treatment control group with a conventional approach.


The following three instruments were used in this study: Field and Steinhardt’s Physical Self-Esteem Scale, the Rosenberg Self-Esteem Scale, and the State-Trait Anxiety Inventory . The Physical Self-Esteem Scale was developed by Field and Steinhardt.16 It is an 11-item scale constructed to measure physical self-esteem. Using data collected in this study, the alpha coefficients for the pretest and posttest were .87 and .91 respectively.

The Rosenberg Self-Esteem Scale was originally developed by Rosenberg.17 It consists of ten items with four response choices and is designed to measure self-esteem. A reliability analysis of Rosenberg’s Self-Esteem Scale using data collected in this study produced satisfactory alpha coefficients in the pretest and posttest of .85 and .91 respectively.

The State Trait Anxiety Inventory (STAI), developed by Speilberger, Gorsuch, and Lushene18 was used to measure the dependent variables, state and trait anxiety. The alpha coefficient calculated in this study for A-State was .93 in both the pretest and posttest. For the A- Trait scale, the alpha coefficient was .91 in both the pretest and posttest.

Treatment of the Data

Using pretest scores as covariates, ANCOVA was calculated to determine differences in posttest means. The level of significance used for all analyses was .05. Also, the effect of years of prior aerobic dance participation was used as a factor in an ANOVA analysis of the total pretest and posttest scores. In the two scores that were significantly affected by the number of years of aerobic dance participation, a post-hoc analysis using the Student-Newman-Keuls test was conducted to determine which groups were significantly different. For the purpose of this analysis, the participants were divided into three categories of participation level: 1) participants who had no prior aerobic dance experience, 2) participants who had one to two years of experience, and 3) participants who had more than two years of experience.

Focus groups were held at the end of the treatment phase. The tape-recorded content of the focus groups was analyzed by discerning prevailing themes in the discussions and counting the frequency of statements made per theme group.

Descriptive Characteristics of the Sample

The age of the participants in this study ranged from 18 to 51 years with a mean age of 22.2 years, a mode of 18 years, and a standard deviation of 5.89. The 31 participants who were assigned to the standard treatment control group had a mean age of 23.2 years with a standard deviation of 6.9, and the 37 participants assigned to the experimental treatment group had a mean age of 21.32 years with a standard deviation of 4.72.

Tests of the Hypotheses

ANCOVA analyses were conducted to compare the posttest scores of the two treatment groups using the pretest scores as covariates. The results showed no significant difference between group scores on physical self-esteem, general self-esteem or state anxiety. However, there was a statistically significant difference between group scores on trait anxiety.

In an ANOVA, it was determined that the pretest score means for trait anxiety of 46.13 for the standard treatment control group and 45.95 for the experimental treatment group were not significantly different, p>.05. However, an ANCOVA analysis found that the posttest score means of 47.29 for the standard treatment control group and 45.05 for the treatment group were significantly different, p< .05.

Focus Group Analysis

Following Krueger’s19 suggested format, a focus group was conducted at the end of the last class for each of the four classes. The standard treatment control focus groups had 14 and 15 volunteers respectively, representing 78% of the total group. There were 13 and 14 volunteers respectively in the experimental treatment focus groups representing 67% of the total group.

When asked how they felt right after this class, 71 percent of the standard treatment control group responses referred to physical conditions, such as being out of breath, tired, or hungry. Eighty-seven percent of the experimental treatment group responses dealt with emotional conditions, such as feeling awake, less stressed, relaxed, calm, uplifted and light. They also said they felt like they had more energy and strength, and felt more energized. All of the experimental group responses to the question, “How did you feel right after class?” were positive in nature.

When asked how participation in this class had affected other areas of their lives, the majority of the standard treatment control group’s answers, 75%, had a physical condition theme and were positive in nature. The responses included: “I slept better; I ate better; and I lost weight.” Of the responses that were emotional in nature, half were positive, such as “I felt good about myself for working out,” and half were negative, such as “I felt guilty if I ate bad food because I had worked out”. The experimental treatment group responses were evenly divided between positive physical statements and positive emotional statement. Their responses included: “during stressful times it has helped me to lengthen my body and breathe; I stretch when I feel stressed while working on the computer; I am able to concentrate in class better; I use the breathing when I get mad and it helps calm me down.”

When asked what feelings they experienced during this class, the majority of the standard treatment control group answers, 75%, dealt with emotional issues. Forty-four percent of the responses mentioned frustration. For instance, they expressed feeling “confusion; frustrated because I couldn’t keep up; stressed to keep up with everyone else; incompetent; uncoordinated; and struggling.” There were a few, however, who felt accomplished when they finally “got” the steps, and that the class was a release of frustration and aggression. Conversely, 77% of the experimental treatment group’s answers focused on feelings of “joy, hope, appreciation for my body, moving freely, rejuvenation, power, and grace.”

Aerobics instructors can learn from this study that when participants are encouraged to listen to their own mind and body signals, the movement in class can accomplish more than the physical goals of increasing aerobic capacity and burning body fat. Hopefully, aerobics instructors and health educators alike will be encouraged to learn teaching techniques that enable the participants in their classes to find direction from within themselves rather than from external sources.


Although studies have shown the positive effects of aerobic activity on psychological well- being, the literature fails to provide documentation of the effect of different styles of teaching aerobic activity on psychological variables. The analysis of the data in this study uncovered information regarding the effect of a mind/body teaching approach as compared to a conventional teaching approach on selected psychological variables.

General Self-Esteem

Although there were no significant changes in general self-esteem as a result of the seven- week exercise sessions, several studies have shown improvements in general self-esteem following exercise programs.20 These studies ranged in duration from 12 weeks to one year, as opposed to the study cited in this paper, which was seven weeks. This indicates that a seven week treatment period may not be sufficient to result in changes in self-esteem.

The post-hoc analysis of general self-esteem posttest scores showed a significant difference between the group of participants who had zero years of aerobic dance (mean = 23.33) and the group that had more than two years of experience (mean = 25.17). Because there were no significant differences in the pretest scores among these groups, the post-hoc analysis suggests that those with prior aerobic dance experience are more likely to improve general self-esteem as a result of involvement in aerobic dance than those without prior aerobic dance experience.

This finding is supported by Dishman 2 who stated that “it seems unlikely that all types, volume, and settings of exercise will affect all aspects of mental health for all people.” Also, we noted that the focus group members who made comments such as “I wouldn’t have done it if I hadn’t have had to come to class” and “I was frustrated because I couldn’t keep up” were those who had not participated in aerobic dance classes in the past.

Physical Self-Esteem

The analysis of Physical Self-Esteem posttest scores indicated no significant difference between the treatment and standard treatment control group. Considering the enormous social pressures for women to achieve unrealistic beauty standards, a 14-session intervention was probably not long enough to impact physical self-esteem attitudes, and perhaps only heightened body awareness.

Interestingly, the post-hoc analysis did show that there was a significant difference in the mean pretest scores for Physical Self-Esteem between the group with zero years of aerobic experience (mean = 30.93) and the groups with one to two (mean = 35) and more than two years (mean = 37.22) of aerobic dance experience. These results indicate a relationship between participation in aerobic dance and physical self-esteem, however, causality cannot be established.

State Anxiety

A review of the literature shows that aerobic exercise ranging in duration from eight weeks to one year positively affects state anxiety.21 Contrary to the procedure used in this study, the researchers in previous studies have measured the effect of aerobic activity on state anxiety by administering the pretest and posttest immediately following an exercise session. In this study, the tests were administered prior to an exercise session. Because the participants in this study were college students, state anxiety may have been impacted by the pressures of school. Many of the students had mid-term examinations on the day of the posttest administration. This could be the reason that there were no significant differences in posttest state anxiety scores.

Trait Anxiety

In this study, the Trait Anxiety posttest scores were significantly different, p< .05) between the treatment and standard treatment control groups. Both groups’ trait anxiety scores did not decrease, however. Instead, the standard treatment control group score increased while the treatment group score decreased.

Results from the focus groups support the findings in this analysis. Whereas members of the standard treatment control group stated that they felt “rushed” when class was over, “guilty” if they ate a fattening food, “stressed to keep up with everyone else”, the members of the treatment group stated that they felt “less stressed”, “relaxed”, and “calm” when class was over, and that they had learned to “use the breathing” techniques whenever they felt angry or stressed outside of class, and that they had learned to “let go” while participating in this class.


Berger and Owen22 compared the relative mood benefits of swimming and Hatha yoga and found that yoga participants focus inward to physical sensations in order to stretch their muscles as far as possible and yet avoid reaching a point of painfulness. Although yoga is not an aerobic activity, Berger and Owen23 found that both swimming and yoga were effective in reducing stress. They theorized that the fact that both activities facilitated abdominal breathing was the mechanism that helped lower stress in the groups.

The mind/body teaching approach used in this study also used abdominal breathing and emphasized tuning inward and moving in comfort. The focus group responses from the mind/body groups support the theory that abdominal breathing and noticing internal stress cues is helpful in reducing trait anxiety.

Based on the results in this study, recommendations can be made for health educators and aerobics instructors. Health educators should be aware that when they are teaching people to increase physical activity that some activities may be more conducive to helping people cope with stress more effectively in their lives, and other activities may actually add stress to their lives.

Recommendations for Further Study

On the basis of the data and findings presented in this study, the following recommendations for future study are made:

  1. Replicate the study using a larger and randomly selected sample in order to increase the power of the study.
  2. Replicate the study with a treatment duration of at least six months in order to increase the effect of the treatment.
  3. Replicate the study using other aerobic activities that are led by an instructor to determine if the results of this study can be generalized to other activities.

Implications for Health Educators and Aerobics Instructors

This study has several implications for health education in general, and fitness education in particular. Based on the results of this study, and fitness professional may wish to learn how to deliver mind/body aerobic dance programs, and health education professionals may wish to act as a resource in directing clients to these programs.

This study is the first quasi-experimental design research to compare a mind/body teaching approach in aerobic dance to a conventional approach. In this way, the results contribute to the literature which examines the relationship between aerobic activity and psychological variables. Furthermore, this study provides qualitative insight into the assumptions that aerobic activity improves psychological well-being by showing that the positive psychological effects may differ depending on the teaching approach that is used in the aerobic activity.


  1. Kasch F, Wallace J, Van Camp S, et al.: A longitudinal study of cardiovascular stability in active men aged 45-65 years. Physician & Sport Med 1988; 16:117- 126.
  2. Dishman RK: Exercise Adherence: It Impact on Public Health. Champaign, IL Human Kinetics, 1988.
  3. Morgan WP: Psychological benefits of physical exercise. In F Nagle, H Montoye (eds) Exercise, Health and Disease. Springfield, MO Charles C. Thomas, 1981.
  4. Berger BG: Reunning away from anxiety and depression: A female as a well as male race. In ML Sachs, G Buffone (eds), Running as Therapy: An Integrated Approach. Lincoln, NE University of Nebraska University Press, 1984.
  5. Engel GL: The need for a new medical model: A challenge for biomedicine. Sci 1977; April 8: 377.
  6. Colquhoun D: Images of healthism in health-based physical education. In D Kirk, R Tinning (eds) Physical Education, Curriculum and Culture: Critical Issues in the Contemporary Crisis. New York Palmer Press, pp. 225-251, 1990.
  7. Johnston J: Appearance Obsession. Deerfield Beach, FL Health Communications, Inc., 1994.
  8. Rosas D, Rosas C: Non-impact aerobics: The NIA Technique. New York Avon, 1987.
  9. Davis C: Weight and diet preoccupation and addictiveness: The role of exercise. Personality & Individual Difference 1990; 11:823-827.
  10. Yates A: Compulsive Exercise and the Eating Disorders: Toward an Integrated Theory of Activity. New York Brunner/Mazel, 1993.
  11. Silverstein B, Perdue L, Peterson B, et al: The role of the mass media in promoting a thin standard of bodily attractiveness for women. Sex Roles 1986; 14:519-532.
  12. American Council on Exercise Aerobics Instructor Manual. San Diego, CA. American Council on Exercise, 1987.
  13. The Exer-Safety Association: The Basic Training Program for Safety Certification: Seminar in Aerobics, Fitness and Exercise. The Exer-Safety Association, 1986.
  14. Radha SS: Hatha Yoga: The Hidden Language. Boston Shambhala, 1978.
  15. Eckstein D, Keeling G: Principles of health from eastern disciplines are finding their way into western workouts: East meets west. IDEA Today 1991; January: 47-50.
  16. Field LK, and Steinhardt MA: The relationship of mind/body behavior to self-reinforcement, self-esteem, and expectancy values for exercise. Am J Health Promotion 1992; 1(1): 6-13.
  17. Rosenberg M: Society and the Adolescent Self. Princeton, NJ Princeton University Press, 1965.
  18. Speilberger CD, Gorsuch RL, Lushene RE: STAI Manual. Palo Alto, CA Consulting Psychologists Press, Inc, 1970.
  19. Krueger RA: Designing and Conducting Focus Group Interviews, Social Marketing in Public Health Conference, Tampa, FL, 1992.
  20. Sonstroem RJ: Exercise and self-esteem. In RL Tregung (ed) Exercise and Sport Sciences Reviews Lexington, MA The Collmore Press, pp. 123-155, 1984.
  21. Berger BG, Owen DR: Anxiety reductions with swimming: Relationships between exercise and state, trait, and somatic anxiety. International J Sport Psychology 1987; 18:286-302.
  22. Berger BG, Owen DR: Mood alteration with yoga and swimming: Aerobic exercise may not be necessary. Perceptual and Motor Skills 1992; 75:1331-1343.
  23. Berger BG, Owen DR: Preliminary Analysis of a causal relationship between swimming and stress reduction: Intense exercise may negate the effects. International J Sport Psychology 1992; 23(1):70-85.

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