Posted on Website July 5, 2002: (These are sections from 2nd edition of Acting-In, (1988) Chap 9, that are not in the 3rd edition (1996)!):
PSYCHODRAMA THEORY--FURTHER ISSUES
Adam Blatner, M.D.
Emotional Problem SolvingMany of the decisions that we face daily require some consideration of the nonrational factors in our lives. Skills of introspection are needed in order to properly weigh and include the emotional dimensions of any situation. In order to gain a perspective on the unconscious determinants of one's choices, it is necessary to find ways of developing insight into interpersonal relationships. The use of psychodramatic methods can complement verbal methods in facilitating the analysis of the many different dimensions of emotional problem solving (Lebovici, 1957). The process of psychotherapy or education about feelings thus can be viewed in terms of: (1) establishing a context that maximizes the conditions of personal growth and (2) partially analyzing the modes of problem solving.
The Context of GrowthOne of the most fundamental principles of any form of psychotherapy is the establishment of a healthy helping relationship. So much of what transpires in this context is based on the factor of suggestion, which, in turn, is affected by role behavior of the helper, the expectation of help, and by the client's acceptance of his own role as the one who is to be helped (Shearon, 1978). The presence of others who share the client's belief in the healing system (e.g., in a group setting) heightens the effectiveness of the suggestion factors of psychotherapy. The director who uses psychodramatic methods increases these suggestion factors by her active self-disclosure and skillful use of the dramatic dimensions of her approach.
A second psychotherapeutic factor begins to operate when the director establishes norms for the group: acceptance, permissiveness, honesty, self-observation, expectations of risk-taking, expressions of emotion, self-disclosure, discussion, mutuality, and so forth (Yalom, 1985). In psychodrama the director models these behaviors, as well as talks about them. The group process then functions on a fail-safe basis; the level of judgment by peers is reduced, and support for creativity and spontaneity is reinforced.
A further factor of therapy is the use of a specified time in a setting of sufficient length for each person to get involved. The use of psychodramatic methods demands more time than other approaches, because it recognizes the role of the warm-up. Time for warming up to the point of creativity and spontaneity is necessary in order to reach a level of emotional expression (catharsis) that will produce insight (Mintz, 1971).
The last point in establishing a context for growth is the use of the individual-centered format. Dealing with the problems of one protagonist at a time within a group setting has several advantages over the group-centered approach, in which the director deals primarily with issues of total group process (Perls, 1967). In the individual-centered approach, the protagonist presents a concrete example of a problem that is often representative of the group theme at the time; enactment helps to go beyond abstract discussion into the deeper feelings relating to a problem. The director then uses the group to facilitate the protagonist's emotional problem solving in several ways: as a source of confrontation, support, consensual feedback, concern, and reinforcement of the protagonist's adaptive behaviors (Sakles, 1973). Certainly the attention of the group increases the factors of positive concern and expectation (i.e., suggestion) for the protagonist's growth processes.
Clarification of the ProblemWhether or not a group is used, the process of exploring and integrating the emotional dimensions of any problem is facilitated in many ways by using psychodramatic methods:
1. When the problem is presented, an enactment can help to bring out the concrete behavior that is involved. So many protagonists tend to habitually explain, intellectualize, or be defensively vague or circumstantial; concrete presentation circumvents these defenses. "Diagnosis" (i.e., seeing-through) is most effective when the director discovers some of the dimensions of the situation that the protagonist might ignore or avoid in a verbal narrative. Recreating the event in an enactment can help the protagonist to stop explaining and just show what happened.
2. Once the situation is presented concretely in an enactment it usually becomes obvious to the observer that the protagonist is engaging in and/or reacting to nonverbal communications, many of which he is only dimly aware of. Using psychodramatic methods, the director helps the protagonist to become explicitly aware of these gestures, expressions, and postures. Incongruities between verbal and nonverbal communications often account for a major portion of the difficulties encountered in interpersonal relationships. For example, a mother's statement to her children, "Go ahead and have a good time—don't worry about me," if accompanied by a pained expression, usually evokes a response of feeling guilty and worrying about mother. Furthermore, the exploration of the meanings of the protagonist's own nonverbal communication can become an avenue for self-confrontation of character defenses—an essential step toward insight (see Chapter 5). There are many other action methods that can be utilized to help the protagonist to view his own behavior more objectively, as well as to think about the impact that the behavior has on others.
3. Psychodramatic methods rapidly move the protagonist into the emotional levels of his problem. Through dramatization, the use of supportive doubling, and the judicious use of physical contact in an enactment, the protagonist experiences the feelings as well as talks about them. Of course, the use of touching, whether it be in holding, patting, or shoving, must be carefully applied, for it is a very powerful avenue to the evocation of emotion (Forer, 1969; Mintz, 1969). Yet, if the director is skillful and works in a mutual relationship with the protagonist, she can greatly extend the effectiveness of the participatory learning experience.
The many methods noted in Acting-In's Chapters 4, 5, and 6 can help the protagonist not only to discuss but also to actively experience the issues at hand, which is the whole point of participatory and experiential education.
4. The process of emotional problem solving requires consider-ation not only of the protagonist's feelings, but also of the feelings of the others with whom he is interacting. The development of an empathic understanding can be facilitated by actually having the protagonist enact the role of the other person. Through role reversal, the protagonist discovers many viewpoints that expand his own insight and help him to choose more adaptive responses.
5. Finally, the discussion as to possible solutions in problem-solving can be extended into active working through; not only are the new ideas talked about, but by using psychodramatic methods, they are tried out in a simulated situation. The group members can then model the behaviors they suggest. Successful and spontaneous behaviors are reinforced, while ineffective adaptations become immediately apparent and are gradually extinguished (Sturm, 1970). The group's tolerant support provides a corrective emotional experience. All of these components of working through are made more vivid through adding psychodramatic to the verbal-analytic methods.
Function of Surplus RealityIf the use of psychodramatic methods in dealing with emotional problem solving seems "artificial" or "gimmicky," it may be due to a common misunderstanding as to the role of surplus reality in our lives. The view of human beings as only existentially being-in-the-world, with one unified core of authenticity, denies the phenomenon of imagination. It is our imagination that accounts for the self-reflective dimensions
of our consciousness, the ability to see ourselves at a distance. Humans are the only animals who become embarrassed, who consider their own death, who do not learn from experience (because they cling to their illusions). These aspects of our essential humanity are manifestations of the imagination.
The imagination represents that dimension of our lives that is our surplus reality. We are kings, we are slaves; we are again children, we exist 10 years in the future. The invitation to utilize our imagination, to say, "if..." is the essence of play, hypnosis, and psychodrama (Blatner & Blatner, 1997).
I maintain that the willingness to suspend disbelief in order to permit a period of fantasy is not artificial. Nor, when explicitly chosen, is the involvement in imagination a regressive function. Indeed, the modality of play is a powerful and, at times, essential vehicle to (1) provide some distance and ego protection, (2) change attitudinal set, (3) function as an intermediary between the polarities of fully committed action and passive reflection; subjectivity and objectivity; the aesthetic and the pragmatic; spontaneity and calculation, etc.; and (4) especially, through use of imagery, play serves as an avenue for entrance into the complex world of feelings, mythologic complexes, and spiritual dimensions.
The use of psychodramatic techniques is thus becoming an important approach for the use of imagination as a function in personal development.
Expansion of the Role RepertoireA second major argument for the use of psychodramatic methods rests on the basis not of psychodynamic theory, but of role theory. The view of humans as evolving along many simultaneous dimensions is a basic premise (Moreno, 1961). Furthermore, psychopathology reflects not only a distortion of one of these aspects of personality, but often represents a compensatory expression of one facet of the personality primarily due to a lack of development of another. For example, a person with few opportunities, or validation for building skills in the realm of imagination and feelings, tends to become over intellectualized. The intellectualization is a "vacuum activity" (a term borrowed from ethology, referring to the time-filling behavior of animals when their normal outlets are frustrated, such as by being in a cage.)
Psychotherapy and education viewed from the position of role theory would emphasize the training of the person's capacity in a variety of roles that can balance and complement each other. The normal function of play in childhood is to at least symbolically enact a wide variety of roles that then become a core of identifications and ego strengths (Sarbin, 1943). For example, the child must play at being a mother before he or she can convert internalized nurturing behaviors given by the parents into an active sense of nurturing others.
A more comprehensive exploration of role theory has been presented in my Foundations of Psychodrama (4th edition). Suffice it to say that I believe it is necessary for people to build a wide role repertoire, including a variety of forms of skills (see Table 1, p. 121).
The use of psychodramatic methods can be an effective form of engaging in learning about these many roles, rather than simply talking about them. Psychodramatic role playing is a major form of experiential and participatory education, and education is a major aspect of a total psychotherapeutic program...
(examples in pp 151-2, 3rd ed.)
Integrations with Other Psychotherapeutic Methods(parts not included (or conflated with other sections): 1988, p 141:)
...Moreover, the synthesis of two methods often can result in significantly greater effectiveness than could be obtained from either method being used alone. For example, the psychodynamics of the Oedipal conflict as described by psychoanalytic theory sometimes emerge spontaneously within a psychodrama. This phenomenon has been capitalized upon by some orthodox psychoanalysts in France, who use several therapists in creating psychodrama for selected patients (Lebovici et al., 1952). The interactional dynamics as described by Sullivan, Adler, and Eric Berne can often be illustrated to a family or group by recreating the conflict situations in a psychodramatic enactment (Jacobs, 1977; Naar, 1977).
The theoretical concepts relating to ego-splitting (in object relations theory), complexes (in Jungian theory) (Whitmont, 1984) and autonomous body language (in Gestalt therapy) all can be made more demonstrable by objectifying parts of the person's psyche in psychodramatic enactment (Orcutt, 1977). The conflicting facets of the personality are then helped to symbolically encounter each other in an effort to reach a constructive resynthesis of the personality.
Other therapeutic systems that have much in common with the psychodramatic method include George Kelly's role prescriptions in his Theory of Personal Constructs (Bonney & Scott, 1983) and the ritualized activities of traditional practitioners of non-Western medicine in other cultures (Fryba, 1972; Harmeling, 1950).
In addition to therapies that are dramatic in their quality, there are also many approaches that utilize subtler aspects of role playing or other psychodramatic techniques. The techniques of assertion training in the behavior therapies, and of "sidetaking" in conjoint family therapy are both essentially psychodramatic in their process. In addition, psychodramatic methods are frequently being used as an integral part of many therapy groups that use transactional analysis, reality therapy (Greenberg & Bassin, 1976), psychosynthesis, or bioenergetics as their main orientation. Indeed, I am aware of professionals in almost every facet of education, organizational development, and psychotherapy who have been able to creatively adapt psychodramatic methods to the requirements of their tasks.
SummaryThe theoretical basis of the use of psychodramatic methods rests on a foundation of eclecticism in the choice of psychotherapeutic and educational approaches. Psychodramatic methods may be more specifically applied for two purposes: analysis and synthesis. As an analytic agent, psychodrama can be invaluable in clarifying the person's dynamics at every stage in the process of emotional problem solving. In the task of ego synthesis, psychodramatic methods may be applied to facilitate the development of a widened repertoire and as an aid in generating skills for using the imagination. Finally, by enabling the participants to engage in trial behaviors within a fail-safe context, symbolic ventilation and reinforcement of new learning can occur.
Many of the contemporary psychotherapies utilize a combination of analytic and synthesizing processes. Most of these approaches may become even more effective through the use of psychodramatic methods, either as an adjunct or as an integral component of their therapeutic practice.
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