by Dr. Lawrence Wilson and Friends
© August 2017, L.D. Wilson Consultants, Inc.
All information in this article is for educational purposes only. It is not for the diagnosis, treatment, prescription or cure of any disease or health condition.
Uses For Psychodrama
Reasons For Therapeutic Value
What Does Psychodrama Require?
Keys To Success
Meet And Greet
The New Perception
A Method Of Forced Retracing
Nutritional Balancing Vs. Psychodrama
The Psychodrama Process
A Play Therapy
1. Psychodrama is not approved by the Christian community.
2. Psychodrama can spread disease if there is body contact, and perhaps sexual contact.
I recommend that the actors shower and soap up a lot right before and right after each scene, and spray down everything, as much as possible, with peroxide, and have an ozone air purifier in the room and perhaps ultraviolet lights, as well, to kill germs. All clothing worn by actors should also be washed each day or preferably after each scene.
3. Psychodrama must be done totally professionally or a person can be made worse through re-traumatization. Psychodrama is also an action and contact therapy, and if not done perfectly it can cause injury and disease.
It is not for beginners, and it is not “an office procedure”. It requires highly trained and very mature therapists to run it, and support help that is also highly trained. Psychodrama is not used much on earth because it is very difficult to do properly.
4. Psychodrama is possibly sexy, which is never the goal of this website. I include this article because psychodrama, if done correctly, is a powerful therapeutic method.
Definition. Psychodrama is a method of releasing traumas. It involves re-enacting the crime or incident that gave rise to the trauma.
The basic idea is to duplicate the scene of the trauma as much as possible in a well-controlled, totally voluntary, assisted and fun environment. The client acts out the incident or event with the close help of a trained therapist, or others who together enact a series of scenes that begin very gently and become more intense as the person is able to handle it.
Play therapy. Psychodrama is a form of play. It is as though after a trauma, a person goes back to the scene of the trauma and “plays” in the scene. This alone seems to have powerful therapeutic effects. This can change one’s attitude and perception of the trauma. By so doing, the re-enactment has great benefit.
By “playing” with what happened, including varying the scene and “trying out” various options, play helps a person retrace and process the event or situation.
The steps in the process. First, the director meets with a prospective client to decide if the client is suitable for psychodrama. The client also needs to decide if this therapy and the director are the right ones.
If this goes well, the director or therapist meets with the client to learn the details of the incident. Then they agree to the idea of slowly re-enacting the incident by repeating the scene, each time a little more intensely to the degree the client can handle it. There may be as few as 10 repetitions, or as many as 30 or 40 repetitions or more.
Then the client and helpers set up the scenes, find actors, if needed, and find a monitor or observer. They then act out the repetitions of the scene in a fun way, slowly, gently and becoming more intense as they go along.
After enacting each scene, the client and therapist review what occurred, and decide what to do next.
Usually, after enacting 10 to 30 scenes, the client decides to end the psychodrama. The entire process requires a full day or perhaps several days.
What psychodrama is not. Psychodrama is not simply role-playing. It is a much more detailed and lengthy process.
It is also not just acting or street theater. These are done mainly for the benefit of the audience. Psychodrama is done only for the benefit of a client, who acts one of the parts.
Psychodrama is a form of reality therapy. However, it is very flexible. For example, scenes can be purposely set up that are fantasies so that the client can “try on” various roles and scenarios.
Safety must always be the first priority of everyone involved with psychodrama. This must never be compromised for any reason at all.
This applies to choosing the client, meeting with him or her, hiring actors and other personnel, setting up the scenes, and acting out the scenes.
Using a woman’s husband, for example, is much safer than using any other male actor. She trusts him and he loves her, so he is much less likely to get carried away or make mistakes.
USES FOR PSYCHODRAMA
Most of this article discusses the use of psychodrama for healing. It is essentially a forced retracing of an incident that helps a person remember, review and process an old trauma.
However, the concept of psychodrama – an imitation, duplication or simulation of reality done in a controlled way – can be used for other purposes. They include:
1. Psychodrama can be used for training and preparing a person for a future situation.
2. Psychodrama can be used for one type of initiation or rite of passage, which is to put a person through a difficult situation, but one that is done with controls to make it safe.
3. Psychodrama can be used to warn a person about a possible future situation by simulating the danger in a controlled way.
In these three uses of psychodrama, a difference from the use for healing is that the atmosphere needs to be more serious. One still needs to be careful, and usually a few repetitions of the scene in a graduated way are needed, but fewer than when psychodrama is used for retracing a trauma.
THE THEORY OF PSYCHODRAMA
Perception equals reality. We know that events can be interpreted in many ways. We can literally create reality with our perception of events.
Therefore, if a person’s perception of an event can be shifted, then the “reality” of the event will change for that person, perhaps drastically. Psychodrama is a way to shift perception quickly and deeply, if it is done correctly.
Out of fantasy. One reason psychodrama works is that most people, when they experience a trauma, create their own version of it. They typically omit the most painful parts, emphasize other details such as “the attacker smiled at me”, and they often change other details to minimize their embarrassment, shame, and other discomfort.
This is understandable. However, it often wrecks any possibility of completely processing and releasing the trauma because too many facts are incorrect or missing.
Therapists know this, and try to get the truth and the whole story from their clients. However, this is often not easy. Psychodrama is a way to get to the facts quickly in a non-threatening way that usually works.
The points. After a trauma such as rape, the person will have a number of points on the body that are super-sensitive. Psychodrama is one way to find these points and release the trauma that they contain. It is done in psychodrama by imitating the original action.
This is not always easy, however, especially with rape or other complex trauma. It is easy with some accidents or a beating, for example, in which the person knows the area that was traumatized.
There are other methods of doing the same thing that are easier, in fact. They include using a shower massager, just touching the points yourself, or using a special machine that can find the points and release them.
Aspects of psychodrama that bring up the truth. These include:
1. Setting up the scenes of the incident, with the help from a team of theater experts. The client is forced to recall as much information as possible about the incident so that the theater staff can create the set.
2. Acting out the scenes itself. This often triggers memories because the body is placed in positions, postures, clothing, and physical contact that remind him or her of the incident. This includes smells, sights, sounds, and feelings associated with the action.
4. Watching a video recording of the action afterwards can bring up a lot more memories and clarify memories. This is not required, but some therapists do this.
Isn’t it all fake? Interestingly, while the re-enactment is fake, the effect is that of a reality therapy. The reason is that the psychodrama is actually more real than the false version of the incident that the client has usually concocted.
REASONS FOR THERAPEUTIC VALUE
1. Truth. As explained above, psychodrama helps replace partial and incorrect memories with more correct and more complete memories of an event. This greatly facilitates processing and clearing of the event.
In contrast, getting to the truth about an event can be quite slow or impossible using regular psychotherapy alone.
2. Triggers. Physical action acts as a trigger for thoughts, emotions and memories. Sight, sound, touch, taste, smell and pressure senses all come into play. Body posture, body position, heat, cold, pressure on the body, and more may also come into play.
These physical triggers are not nearly as strong or present with regular counseling.
3. Fun. Psychodrama should be fun for the client, even if it brings up painful memories and feelings. A job of the director is to assure that the experience is not too serious.
Reality can be viewed any way we like, and keeping the perception of the incident light-hearted helps shift many attitudes and feelings about it.
The fun aspect also helps “break the spell” of the trauma, and allows the client to revisit the incident much more easily.
In contrast, regular psychotherapy for trauma is often very serious. This is sometimes necessary, but it can slow resolution of a trauma.
It is very important during a psychodrama session that the person giggles all the time. In fact, all the actors should giggle continuously. If they look serious, something has been brought up for review and it should be addressed before resuming the scene.
4. Retracing. Retracing is a vital therapeutic principle. To clear traumas, one must go back into “the scene of the crime” in a mental sense. This is the only way a person can fully explore, re-examine, reframe, review, redo, and finally move on from the incident. This is what is called “processing” in its fullest extent.
Doing this generally requires a safe, controlled environment and loving guidance, which psychodrama can provide.
Retracing is complex and can be dangerous because one does not know when, and to what degree, a client is ready and willing to retrace the incident. It does not matter if the client says they are ready.
Retracing comes into play with regular psychotherapy. Psychodrama tends to push the process along faster by literally re-enacting the scene.
5. Community healing. Psychodrama tends to involve a number of people, all of whom participate with the client in the healing process. This helps the client not to feel alone and isolated, as is so often the case after a trauma.
One is accompanied by “friends” on the journey back into the darkness. They may be trained and loving people who have studied your trauma intimately.
It is closer to tribal healing where the community is brought in because they know you and they love you dearly.
In contrast, regular psychotherapy maintains some isolation. This is true even in most group therapy. Here the other participants often don’t know much about your trauma and don’t really care, either. Most often, they listen, but they are mainly waiting their turn to be the center of attention.
6. Play. In the context of psychodrama, play is the ability and act of changing a story, and bringing imagination to life. The purpose is to experience many possibilities, which is the truth about life. The play aspect is vital in psychodrama, as it opens the door to a new life.
Psychodrama is particularly well-suited for play therapy because:
- The setting is informal and not too tidy.
- Plenty of “toys” or props are easily available.
- The therapist(s) and client do not work on a tight time schedule.
- The mood is that of a creative play.
Play also helps get rid of inhibitions, fears, hidden desires and hang-ups that keep a person serious and often keep one stuck, as well.
In contrast, a normal counseling office is not a good setting for play. Playrooms and play therapy are used in regular psychotherapy, but not often with adults.
7. A very yang therapy. The word yang, in this context, means intense. That is an excellent word to describe psychodrama.
This is a great secret of its success. In fact, one of the challenges to keep it from becoming too intense.
Yang also means closely packed together. It means everything happens in close quarters, “up-close” or “in your face”. This contributes to success, as well.
DIFFICULTIES WITH PSYCHODRAMA
Psychodrama must be done in a very careful and professional way. Otherwise, a person can be made worse. Please exercise extreme caution and read the procedure below carefully to have the safest possible experience.
Problems that can occur with psychodrama include:
1. Retraumatizing. Re-enacting any trauma can just bring up the problem and make it worse, instead of better. This is like tearing open an old wound.
It will occur if things are not well-planned, if the actors are not sensitive enough or not mature enough, if the scene is not properly set up, or if the action proceeds too rapidly. This is a serious problem, and one reason to exercise great caution with this method.
2. The client may not be ready. Even if the client says he or she wants to experience psychodrama, in reality he or she may not be able or willing to do it properly. In this case, the process will stall, or it just won’t work well.
Lack of readiness can be due to impaired health, impaired mental processing ability, bad memory, or another problem with the client.
3. Carelessness by the actor, director, monitors or others. This can easily ruin a scene or ruin the entire process. The job of director, in particular, is very physically and mentally demanding. He or she must be alert and on the job at all times.
If the director needs a bathroom break, for instance, then the scene must be stopped. A moment without supervision in a delicate scene can ruin the entire psychodrama. The same applies to the other support people.
4. Sexy aspects, especially re-enacting a rape. The reasons for this are:
a) Pretty young women must be abused. The attractive client may have to be beaten up, made filthy or bloody (with fake blood, but it looks real), or her body put into contorted positions or postures. Watching this, or worse, helping do it can be hard on men, and even on other women.
b) Men will be attracted to scantily clad pretty women. This is a fact, not a theory, even if they are happily married. This is a problem for some men. Married people, by the way, generally are better as psychodrama support people.
c) Attractive women tend to be more of the showoff type. This can worsen the problem above.
d) Sexual contact such as grabbing and fondling the body. This is often part of a rape, so it needs to be re-enacted, at least to a degree. It is usually okay with the client, but can be embarrassing for the actor and other support people.
e) Disease transmission. Any touching or handling items, and definitely kissing or any sexual contact, exposes the client and male actor to sexually-transmitted disease.
f) Nakedness. If the trauma occurred with the client and/or attacker naked, this complicates re-enactment of the scene because it worsens all the problems above.
Women. Some psychodrama organizations allow female nakedness. Other groups say it is not wise and not needed. Some allow the woman to be topless, but not naked, while others say even that is not needed and not wise.
Men. Most groups allow male actors and clients to be naked. Women who experienced rape often say this is needed for realism, and the male actors usually don’t object. It does increase the risk of disease transmission, and even pregnancy, possibly, for a female client.
Nakedness also adds possible legal and moral complications to the process. It also increases the chance for retraumatization, and is more of a problem for the support staff who must watch the scenes.
Here are some solutions:
1. Have the woman always wear a small, tight-fitting, secure bikini. She can pretend she is naked. Also, the bikini could be painted flesh-color, even with nipples and pubic hair added for fun effect. This actually works well.
There is still danger of disease from any physical contact with the male actor, and it is still certainly sexy. But it is better – much better – than total nakedness in some ways.
2. For a rape trauma, do not use a stranger as a male actor. Secure the help of the woman’s husband, boyfriend, brother, father or another male friend as the male actor. This is even more important if there will be any nudity at all.
This is not always possible, but some groups say it is by far the best. The woman usually prefers it, there is less chance of re-traumatization, and it adds to her community of friends who know about the trauma, understand it, and love her through it.
g) Sex, itself. This is done in some psychodrama re-enactments. However, it is the most dangerous of the sexy problems, and best avoided. Most women say it is not needed, and psychodrama can work well without it.
Unfortunately, some women clients want sex during the session for the wrong reasons. They are often lonely, depressed, and there are half a dozen other reasons for wanting sex after a rape. These are listed in the Rape article on this website.
This is not the idea of psychodrama, and the director must keep this in mind! Psychodrama can easily degenerate into a pornographic display, and this must be avoided to prevent legal and other difficulties.
5. Time constraints. For example, a rape often goes on for half an hour or much longer. This cannot be safely duplicated with actors because it is too much for the woman, in particular, and maybe the male actor, as well. So the scene is cut short to a few minutes, which is not as real but much safer.
One answer for this problem is that during the review, the video footage of the actual rape can be cut and pasted so that it lasts half an hour or an hour, if necessary, to duplicate what really occurred. The client is made to watch this entire sequence, and thus experiences it, though not physically.
6. Not real enough. If the action is not set up right, the client may not have enough of an experience to really “enter the action” and relive it. This happens often in psychodrama with young or inexperienced directors. They are afraid to really set up the scene in a powerful way. As a result, the outcome is not very helpful.
7. Not well-acted enough. The scene or action might be real enough, but the client or the helpers may not act out their parts well enough. As a result, even if it seems real, the outcome will not be very good.
In other words, for psychodrama to work, one needs fairly good actors and actresses! Otherwise, it will all seem fake, or in some other way it will not work. This is another problem with this technique.
8. Timing must be right. Too long a session will wear out the client and the actors. Never go over 1.5 hours, some say. Also, never go shorter than about 20 minutes or it won’t seem real. Rarely, a scene can be completed in less time.
9. Lack of trust. This will ruin the scene. The client must trust the actors, director, and monitors, and any other support people. Be sure there is trust before proceeding. If trust is not present, deal with the problem before beginning the acting.
10. The client cannot remember enough details.
11. Cost. Hiring directors, monitors and others adds significant cost to psychodrama. In addition, one must rent the space, buy the props and other equipment, and pay related costs.
In addition, much time is required of the directors, monitors and perhaps other staff for even a single psychodrama. For the client, however, psychodrama is very time-efficient, yielding fast results.
12. Hiring the right people. Finding qualified directors, actors and people to monitor the process is also difficult.
13. Legal problems. Psychodrama may open the therapist to more legal difficulties than regular psychotherapy because:
a) The acting involved in the scenes carries a slight risk of physical injury.
b) Some clothing may be removed, presenting a slight possibility of sexual accusations.
c) The subject matter is often very delicate, such as rape and beatings.
d) The entire process is rather intense, and moves fast.
e) Psychodrama is unfamiliar to the public and to the authorities. This can cause misunderstandings.
Signing a well-written legal agreement is essential, for these reasons.
14. Not enough action. Some traumas cannot be safely duplicated. Examples are a hard or long rape, a whipping, a long or hard beating, or a car accident. To deal with this problem, one must improvise and add scenes of other fill material to take up more time.
The best fill material is often silly and humorous because it keeps the action going along the correct lines. A main idea of psychodrama is to be gentle and somewhat fun, even if it is a beating or something quite horrible. This allows the person to relax and things go better.
Remember, the main objective is to release the points. Relaxing and duplicating the original action of the trauma helps do this.
Shamanistic use. The concept of psychodrama was and is practiced by traditional healers and shamans in some native cultures. For example, if a member of the tribe falls ill physically or mentally, the medicine man or traditional healer may gather the entire community or a group.
Together they set up and act out a scene, or a number of scenes, to help the ill person process the trauma or illness. This form of healing is widely practiced in parts of Africa and Asia.
Children learn this method of “community healing” from a very young age. Therefore, by the time they are adults, they know how to do it safely. They are also familiar with the process, in case they need healing.
By contrast, in the Western nations the idea of gathering a groups of actors and props to assist one person with his or her healing is unknown and a rather unusual idea. It is also costly because one cannot simply call together the entire community to show up for a healing session.
The closest thing to this type of “community healing” in the Western nations may be some Christian religious revivals or gatherings. Here many people focus their attention on a few people who come up to the front of the room or stadium to receive healing.
Modern psychodrama. The founder of modern psychodrama is Jacob L. Moreno, MD, (1889–1974). He was a student of Sigmund Freud, MD and the other early psychoanalysts. However, rather than analyze a person’s problems for years, as is done in regular psychotherapy and psychoanalysis, he had a different idea.
He found one can move through the process of healing much faster by acting out a scene, perhaps with the help of others. This can raise the core issues and allow the client to respond creatively and spontaneously.
He developed psychodrama in the early 20th century, and soon began training what he called directors who were trained to lead psychodrama sessions. He continued this work continuously until his passing in 1974. A few psychodrama directors continue to be trained today, but overall this method is not used as much today in the psychiatric, psychological or counseling fields. This is likely due to its cost and time requirements of the therapist.
WHAT DOES PSYCHODRAMA REQUIRE?
1. Lots of love and patience. This is for reasons of safety and effectiveness.
2. A willingness to be intense. Psychodrama is fast-moving and quite intense. It is not for everyone! Some clients and therapists love participating in it. Others do not feel comfortable doing this type of therapy.
3. Personnel. These generally include a board of directors or supervisors, a technical director who is usually a licensed psychotherapist, actors, and technical staff to help set up the scenes.
Some groups also employ two monitors, a man and a woman, to watch all the acting carefully. This is more important if some clothing will be removed during a scene.
4. A suitable location. This can be simply a room, or a more elaborate location.
5. Props. These are needed to make the scene(s) realistic. They may include weapons, furniture, specific clothing, or other objects.
6. Other equipment. This may include lighting, audio-visual or other equipment.
7. A legal consultant. This is not necessary if you are doing psychodrama in your home with your husband or wife, primarily. If it is a professional psychodrama, it might be helpful to have a legal consultant. This person’s role is to draw up a suitable legal agreement that everyone involved signs. This is discussed later in this article.
DETAILS ABOUT THE PARTICIPANTS IN A PROFESSIONAL SETTING
The board of supervisors. The board oversees the entire operation. It should ideally consist of at least three people. They need not be psychotherapists, although this may be helpful. The board’s tasks are:
- Set up all legal agreements.
- Keep all records and recordings.
- Hire the director(s) and perhaps oversee other hiring.
- Budgeting and resource allocation.
- Liason with authorities.
- Receive feedback from the director, actors, clients and support staff.
- Deal with problems and resolve conflicts.
This may seem like a lot of work, but it is not usually that much. The board need not be full-time, and could meet once a week, and more, only if needed.
The director. The job of the director is to coordinate everything and keep the process going. It can be a man or a woman, but often if the trauma was a rape, the client will request a male director. The director should be happily married. He or she ideally should be also a credentialed counselor, psychologist, or social worker.
Ideally, the director should be a different person than the monitors or the actors. One person could serve in several roles, but this is not ideal because there is plenty for the director to do.
The director can work with more than one client at a time for efficiency. Usually, however, he or she should not work with more than two or three at the same time so as not to split his attention excessively.
The director’s tasks are:
- Interview and select the clients.
- Hold meetings and conversations with the client to find out the details of the trauma, and how the client wants to act out the scenes.
- Perhaps hire the actor(s) and monitors.
- Coordinate the meet-and-greet meeting, and make sure all participants agree to all the scenes.
- Carefully monitor the acting.
- Conduct the reviews that occur after each scene.
- Help decide when the process is over.
- Handle all day-to-day problems that may arise.
The actors. The actors are a critical part of the scenes. Great ones are not easy to find!
It is not necessary to hire professional actors. In fact, some groups much prefer to use as actors friends of the client or even a client’s family members. They are often more loving and supportive of the client, which helps the therapy process.
Choosing good ones is challenging, at times. The reasons are:
1. Psychodrama is much more difficult than standard acting. Acting in a psychodrama is really a combination of acting and doing psychotherapy. The actor is not the subject of the action, as occurs with most acting. Instead, the actor(s) must watch the reactions of the client constantly, since the scenes are really therapy sessions.
2. One false move, or even a careless word or glance, could derail everything. A mistake could even do some harm to an already-traumatized person.
3. Acting a trauma scene may involve very delicate actions such as sexual or other physical attacks or violence. Some actors are accustomed to this, but others are not.
Therefore, the actors must be extremely mature, responsible and loving people. The best are very sensitive men and/or women.
The actors will often be villains such as angry parents, mean friends, enemy soldiers, or perhaps rapists. It is critical to interview the actors carefully to make sure they understand the job they are to do, and can handle it.
The engineering or technical staff. Their important job is to produce sounds, sights, smells or other special effects to add realism to the scene or scenes. This is a real skill, so choose them carefully.
Monitors. If monitors are employed, ideally have one mature man and one mature woman. They need not be marriage partners, but this is helpful. It is best if they are well-trained and experienced psychotherapists or counselors.
Their job is to carefully observe the acting and make sure all is going well. If they detect problems, they must stop the action quickly to avoid any possible harm to the client. Please choose the monitors carefully if you decide to use them.
KEYS TO SUCCESS
1. Safety first. Everything must be done as carefully as possible. Do not tolerate any lax or cavalier attitudes. This can easily ruin the entire psychodrama.
2. Be sure to have a separate monitor or observer, (not one of the actors) who observes the scene, especially with any intense scene. Their job is to stop the action immediately if any sign of trouble arises.
3. Be sure the client directs the set up of the scenes, not anyone else.
4. Keep things light and fun, even silly, to help everyone relax. This is critical, in fact!
5. Always go slowly and gently through the scenes, depending upon how the client is handling everything. Never force or push the client. This will not work. If pushed, a client will usually withdraw and the entire procedure will fail.
6. If problems arise, do not hide them, as they can easily ruin a scene. Instead, try to incorporate them into the action.
For example, let us say that in acting out a rape scene, the actor’s body odor is objectionable to the client. This is common. Have the actor wear deodorant, and if possible, use a deodorant that resembles the odors of the attacker.
7. It helps a lot if the scene is realistic, so take your time setting it up. It is worth spending another day painting the room, for example, if the client thinks the color of the walls is important.
8. You may vary the action and change roles. It can be very therapeutic.
For instance, if the client perceives herself as a victim, then have her switch roles at some point and play the role of aggressor, initiator or leader.
9. Try to involve as many senses as possible in the scenes, such as smell, taste, sound, sight and touch. This requires careful checking with the client regarding these aspects of the trauma scene.
10. Psychodrama is definitely nitty-gritty or earthy. Do not try to make everything neat, tidy and pretty. Life just is not like that.
11. Discuss how things went after each repetition of the scene. Otherwise you may miss new details that need to be incorporated, and you may miss problems that are stopping healing.
12. Put the person on a complete nutritional balancing program. It will nourish the brain, improve processing ability, improve one’s memory of the incident, strengthen the body, and help heal all traumas of all kinds. This is a safety matter, as well as a practical matter.
13. Be creative. This is often helpful because it is not safe or possible to completely recreate the original scene or incident in a safe way. Experiment. At times, a fake or partially fake setting, clothing or something else works very well.
This includes: Choosing the client, The Meetings, The Gathering, and Meet And Greet.
No surprises. The idea is to avoid surprises, which stops the lighthearted nature of the psychodrama, in most cases. Psychodrama is really deprogramming, and surprises tend to ruin the effort.
Planning, and including the subject of the psychodrama, helps avoid all surprises of every kind.
THE INITIAL INTERVIEW(S) TO SELECT THE CLIENT
Pre-intake checklist. All the following must be done before the first interview:
1. Explaining psychodrama. All prospective clients must be clearly informed about psychodrama – the risks, the possible benefits, the procedure, and the personnel and staff who will be present during the acting of the scenes. Some groups are developing materials to help facilitate this step.
Only if the person agrees in writing by signing the explanatory sheet can the director proceed with the next step of information gathering.
2. Information gathering. The director needs to ascertain the following:
a. The full name, address, phone number, email address, website, Facebook and Twitter account names, and the names and phone numbers of at least two people who know the person well. The director must check all of these carefully for any inconsistencies.
Both reference people must be called on the phone. The director should ask a few personal questions that the reference person should be able to answer, and must be satisfied that all answers are plausible.
If you cannot obtain all this information, do not proceed. This is critical, and ignoring it has caused problems. Once, it turned out the person was faking the whole trauma, and instead was working for the police as an undercover agent. It nearly cost us our entire operation.
b. The person does not have high blood pressure or heart disease. These just make the experience too dangerous.
c. The person does not use marijuana or any other drug or alcohol on a regular basis. Occasional use is okay. This is sometimes difficult to assess.
d. The director needs to know about ALL prescribed and over-the-counter medications the person takes. If the director does not know what a medication is used for, he or she must research it.
Do not depend on the person to tell you its use. Ask for clarification if you are not sure about a medication. This is critical to avoid problems, and is often a tipoff that severe physical or mental illness if present. This does not necessarily disqualify an applicant, but it must be taken into consideration.
e. Psychiatric drugs often interfere with the success of the psychodrama. They dull the mind or alter consciousness in other days that can interfere with the process. A person on one or more of these drugs can be accepted for psychodrama, but this must be considered.
THE INITIAL INTERVIEW
1. The initial interview must be in a very safe and secure location, with the door locked.
2. One man and one woman must be present in the room.
3. There can be no mirrors or other hidden observation cameras anywhere, as some traumatized people are extremely sensitive and aware of such items.
4. The director must begin by assuring the person that absolutely nothing of the interview will be recorded or shared with anyone.
5. The director then tells the person that this is only the first interview, and there could be a second and perhaps a third one if we are not sure that the person would make a suitable candidate for psychodrama. This is essential to avoid surprises for the person when he or she is told that we want a second or third interview.
Things to watch out for are:
1. Is the client really ready to let go of the trauma? This may sound obvious, but some people are not really ready. They will object to going deeply, for example, and this is one tip-off that this person is not really ready for psychodrama.
2. Can the client handle psychodrama? It will be intense, not very clean and tidy, direct or blunt, and highly stimulating to all or most of the senses.
There can be surprises, but extremely sensitive clients will not able to handle the intensity. The process seems to work best on certain personality types who are not too sensitive, more intelligent and aware, and probably somewhat healthier.
We are still researching this subject and will report on our findings in the future in this article.
3. Can the person work with others? For example, he or she must like people, be willing to work closely with strangers, and be able to communicate reasonably well.
4. Does the client have some vivid memories of the trauma scene? This is desirable. If not, one can still go forward, but things will often move slower.
5. Will the client take full responsibility for letting us know if a scene must end immediately, or if there is any other problem? This is essential, and not always simple to assess.
For example, the client may agree to this requirement, but as the intake interview proceeds, it may become apparent that this person does not want to take much responsibility for own welfare. In this case, it is best to choose someone else.
6. Age. Psychodrama works best in a person over the age of 10 or so. Attempts to do it in younger children are more dangerous, less effective, and should be avoided.
7. Gender. Psychodrama seems to work better in women. We don’t know why this is so. Perhaps women are more group-oriented and more sensitive to stimulation of the senses. However, some men do just fine with psychodrama, so that gender should not be a barrier to accepting a client.
8. Likeable. While it may seem biased, psychodrama often works better if the director and monitors find the client more likeable. This is not a fixed criteria. However, if the director or others who participate in the intake interview do not feel comfortable with the prospective client, there may be a good reason to pass on this person.
9. Anger. A person who is very angry may not do as well with psychodrama. Those who do best have often forgiven their attacker, at least partially, and have a forgiving attitude.
This, however, can be difficult to ascertain, as all people tend to minimize and alter traumatic events somewhat. The reality may not be as it seems.
An even better client is one who has made peace with the entire episode. This must include accepting any physical, emotional or mental damage that has been done to him or her. These people are often easy to help.
10. Emotional people. A person who cries easily during the intake interview will often make a good client.
11. Willingness to share intimate details during the first intake interview. A person who is willing to share intimate details calmly usually make the best clients.
Those who cannot share any details until they “get to know you better” are more difficult to work with.
Whom. The initial meetings involve the client, the director and main facilitator(s) who are running the psychodrama center.
What is discussed. During these conversations and meetings:
a) The client first describes the trauma that he or she wishes to clear. This is necessary so that the facilitators understand what needs to be acted out and what are the major issues to be handled.
b) The client then explains the specifics of the incident. This needs to include plenty of detail about the location, the people involved, the time of day, climate, odors, sounds, sights, and feeling of the place, and other details.
It needs to include drawings, diagrams, descriptions of people, and anything else needed to construct the set or the stage.
For example, if the trauma involved a beating, the actor who plays the attacker must ideally dress, look, sound, smell and act just like the real attacker. Otherwise, the psychodrama session has less chance of success. Of course, safety must always be the first priority, but finding the right actor can be most helpful.
All the details enable those in charge of hiring actors, gathering props and building or setting up the scene to go to work. This phase of the psychodrama must be directed almost entirely by the client, not by facilitators, for the scenes to work.
Recall problems. At times, the client may not recall the details, but they are important, in most cases, so try to obtain them. If the client has serious memory lapses with regard to recall of the scene, the psychodrama may not work as well, but is worth doing, anyway. Often, as the acting proceeds, the client will recall more details.
Also, at times, recalling the details of the scene(s) may become extremely painful for the client. Then the recall process becomes an integral part of the client’s healing.
If this occurs, the entire psychodrama may need to be delayed until recall and reconstruction of the scene can be completed. Rarely a trained counselor may be needed to assist the client with recall.
c) Then the client, with the help of the director, decides upon the details of the types and sequence of the scenes to be acted out.
For example, if the client was beaten up at work, the sequence might begin with a mock beating or just sharp words between the client and her boss. Then, if the client handles this well, the scenes can progress to a real beating with a rubber rod or club.
Scripting. The client may request that certain words, phrases, sentences or strings of sentences be spoken by the actor, or perhaps by herself. This requires writing out script for this part of the scene.
This is more difficult because the actor(s) or even the client will need to memorize the words and phrases. Some professional actors can do this fairly easily, but non-professional actors will usually have more difficulty with it.
How many scenes. We find that about 20 to 50 scenes are often best. Too few will have less impact. Too many will tire out the client and the actors, and usually does not produce better results.
The reason for the large number is because one must begin very gently and safely. Later scenes, if the client can handle them, are more intense, physically painful or otherwise unpleasant.
All must agree to everything. The client, director, actors and monitors must agree to the entire list of scenes that will be acted out, and how they are to be acted. This is an essential step for success.
For example, an actor might say that he or she will not do certain things to another person like beat them. This is understandable, but not acceptable if the client wants it and needs it for healing. Another actor must be found, in this case.
Don’t push the client. For example, if the trauma was a beating, the client must decide if there will be any physical contact with the actor, in which scene it will occur, how hard will be the blows, where on the body the beating will occur, over clothing or on bare skin, with what object, and how much there will be.
Another example is that if the scene to be acted out was a rape, the client must decide if she will remove any clothing, during which scene or scenes it will come off, when it will come off, what clothing will come off, and how it will come off. Also to be decided is how much light there is in the room, how long the clothing will be off, if the actor will touch the naked skin, if the room will be cold or warm, and perhaps other details.
These details are absolutely essential or the entire psychodrama will fail because the client will often be re-traumatized and may become even worse.
So please work hard to think of all the embarrassing, humiliating and painful details before beginning to act the scenes.
If possible, discuss these details in a humorous and light-hearted manner. It works best this way.
Scene variations. The client might also decide to act out variations on the original scene if she cannot process the entire incident with the scenes above. Typical variants are:
1. Changing roles. For example, she might beat up the boss, just to see what it would feel like. Or she might fight back instead of passively cowering in fear. Or she might talk the boss out of hitting her.
2. Acting out a fear or fantasy. This is a variant that did not actually occur, but could have occurred. She might have bled to death because no one cared enough to stop the fight and help her.
3. Acting out a wish. This variant is usually a different resolution. A possible one in this example is that her boss would come to her and apologize giving her a warm hug.
4. Use of surrogates. For example, if the scene was of a beating, a delicate and sickly woman might not want to receive an actual blow or beating. It might be best to have another woman act out the beating scene and receive the blows, and the client would observe the scene at close range instead of experiencing the blows herself. This can work.
It is also done with some rape scenes in which the client does not want to re-experience the horror of the act. Instead, the wife of the actor, for example, might be brought in to have her clothes stripped off and experience intercourse with the rapist, while the client looks on.
This can work almost as well as having the client experience the action, especially if the other woman does a good acting job.
5. Other. A client might have had a dream or something else that makes him or her want to explore a different possible scenario or ending.
This phase involves:
- Choosing a suitable location, and setting it up for the scenes.
- Hiring the actors and perhaps monitors.
- Acquiring all the props, and any needed audio, video or other equipment needed for the scenes.
Time. This may require several days for a more complex scene, and usually less for a simpler scene. The time depends upon how many staff are assigned to the task.
The suitability of the location, the props, and other details should be checked frequently with the client to make sure they are the acceptable.
Video equipment. Some groups insist upon videotaping all the scenes. The recordings are used during the reviews.
They also suggest using professional video equipment, and running two video cameras at all times to assure a quality recording.
Communication equipment. Some groups have the actor(s) wear a radio receiver with an ear plug so that the monitors can whisper instructions to the actor during the scene.
This is to assure that the action proceeds in an orderly way, and that the actor(s) do not overlook nothing of importance is overlooked. The monitors should have a list of words, actions, gestures or other things to include in the scene. This is most helpful for success.
Research. At times, the director, monitors and actors must do research to become familiar with the language, gestures, speech or other aspects of the trauma.
MEET AND GREET
The client must meet and ideally get to know the monitors and the actors who will enact the scene with him or her. This is imperative. The procedure will not work without trust on the part of the client, and the purpose for meeting beforehand is to establish trust.
If, for some reason, the client does not like the monitors or the actors, do not proceed further until this problem has been worked out.
Perhaps the client just needs more time to get to know the monitors and actors. One idea is to schedule a lunch or other outing so that everyone can get to know everyone else. Perhaps the client needs to read the resume or see the website of the monitors or actors. Rarely, a monitor or actor may decide to bow out for some reason.
If the problem cannot be resolved, then different monitors or actors much be chosen.
III. THE PROCEDURE – PART II. ACTING OUT AND REVIEWING THE SCENES
Once everyone is assembled, the scenes agreed upon, the props gathered, and everyone comfortable with each other, the active part of psychodrama can begin.
This part of the procedure consists of two main parts: acting out scenes and reviews that take place after acting out each scene.
ACTING OUT THE SCENES
Here are some tips about the acting the scenes:
1. Make sure everyone is feeling well, comfortable, well-hydrated and well-fed. However, don’t do a scene right after a large meal. Be sure all involved have used the restroom and are ready to proceed.
2. The best time for acting the scenes is in the afternoon or in the evening. Psychodrama seems to work best when the client is somewhat tired. We are not sure why this is so. However, the scenes tend to flow better at these times.
3. Acting the scenes is actually the shortest part of the entire psychodrama process. Setting up the scenes and reviewing the scenes takes more time. This is important to know.
4. The director and perhaps the monitors need to get close to the action. These support people should never just sit back in their chairs during the scene. The director, at least, needs to stay close to the client at all times.
He or she should prompt the client and the male actor to keep the action going smoothly. The director should also observe the client, and look for signs of trouble. It is a demanding job!
5. The director and monitors need to remain silent during the scenes. The reason for this is because of the video recording. When the recording is played back during the review, the voice of the director will ruin the scene.
Therefore, the director and other support personnel should agree on a set of hand signals or hold up signs to signal the client and the actor(s). Speech should be used only in an emergency, such as a need to stop the entire session. Here voice is fine because the session is over.
6. “You are on the verge”. This is a message used by some directors to urge the client to continue with the scene. At times, when the client is just about to have a breakthrough or insight, he or she asks to stop the scene. This breaks the intensity and the client often misses the opportunity for a breakthrough.
At this time, the director or a monitor should hold up a sign that says “On the verge.” This means just keep going, please, if you can. It is an important sign or hand signal to use.
7. The first scene. Always begin with a fairly benign scene. Always begin with everyone fully clothed if the trauma was a rape or molestation. Always begin with all the lights on, and in a relaxed manner.
This is to make sure the client can really handle the scene at all. Some clients will have trouble even entering such a scene, even though they are surrounded with supportive helpers.
8. Look for signs of trouble. While acting the scene, the monitors should look for signs of trouble. They should note if there is too much crying or fatigue of the client, or insensitivity of an actor, or excessive discomfort of the client.
Another trouble sign is if the client begins to stare vaguely off into space. This often means the client is very uncomfortable. Another trouble sign is if the client does not answer questions immediately, and instead “goes silent”.
If the trouble seems very mild, the actor can just slow things down. However, at the first sign of real trouble, it is often best to stop the scene and have a review. Often, the trouble will subside. If it does not go away, then the group may have to wait until the next day to continue.
Stopping a scene is not usually difficult or a problem. Just “rewind” and start again. In fact, this can be very therapeutic for a client to know that everything can be done again, perhaps a little differently, to make the most of the scene.
9. Sand, grit and dirt are good. Psychodrama is a somewhat dirty, or nitty-gritty type of therapy. While observing normal rules of cleanliness, trying to “clean up” the scenes can ruin it.
For example, no real body secretions should be used in a scene, such as blood, urine, feces or others. However, one can simulate these with red dye, tomato ketchup, mayonnaise or other products. Do not hesitate to use these, as needed, to duplicate a real trauma scene.
Use plenty of 3% hydrogen peroxide as a spray before, during and after acting the scenes to clean up the actors.
At times, directors or other support personnel may not want to “dirty up” a client for the scene. This is a mistake. Often, the client does not mind it. She, usually, has been through it before, so it is not new, and it is not nearly as intense as the first time it occurred.
10. Make changes along the way, if needed. Scenes may need to be altered in many ways, depending upon the client’s response to them.
At times, having the client “try on” or act out various ways of handling the event or situation is a very important aspect of psychodrama. It allows the client to think and act creatively and spontaneously about the event.
8. Take frequent breaks, if needed. This is also very important. One reason is simply to make sure everyone remains rested. Another reason is to allow time for processing the scenes. At times, the client may need to rest overnight and process the scenes overnight.
Holding a review after every scene is sometimes helpful for success. I suggest it begin with the director and the client watching the video of the scene together. This can be therapeutic because it is another reactment of the trauma. Some people have trouble with recording the scenes, so it is an individual matter.
By recording each scene well and having the client watch the video from start to finish, some groups find that the number of scenes needed can be reduced, at times from 20 or more to about 5. This is how powerful the review can be.
After viewing the videotape of the session, the client and director discuss how the scene went, and what to do next.
If all went well, the next scene will be more intense to desensitize more points, and more feelings and emotions associated with the trauma.
If the scene that was just completed was rough on the client, it may be best to repeat it again – even several times – until the client feels comfortable with the scene. Then, and only then, is it best to move on to a more intense scene.
THE NEW PERCEPTION
Psychodrama seeks to create a new perception of a traumatic incident. A way to summarize the new perception is:
Open, not secret
Fun, not serious
Loving, not cruel
Healing, not damaging
Empowering, not disempowering
Super, not weakening
Sexy, not sexual
Pulling or drawing, not pushing
Happy, not sad
Loving, not hateful
No points of increased sensitivity
A METHOD OF FORCED RETRACING
I believe psychodrama works because it places the client back in the scene or situation from the past, at least to some degree. Then the client is forced to work through the emotions, thoughts and perhaps also the actual physical situation.
However, it is done with the mind of a more mature adult and with hindsight. Also, the client has the loving support and help of others who presumably one trusts, at least enough to allow the event to be replayed with their help.
NUTRITIONAL BALANCING VS PSYCHODRAMA
Psychodrama sounds similar to the retracing that occurs during a nutritional balancing program. A client is afforded an opportunity to review (to view again), reframe (put in context), redo, process and hopefully release an old event.
Differences. An important difference between retracing that occurs with a nutritional balancing program and psychodrama is that the latter has to be set up ahead of time in a careful manner. Otherwise, things can go wrong and the session may not be effective.
In nutritional balancing, the souls plan the retracing based upon improved nutrition and the other procedures. The outer person cannot see and cannot participate in this, so the retracing action comes as a surprise.
Nutritional balancing is much more about biochemistry, nutrition, structure and channel therapy. Psychodrama is about activity and some mental and emotional effects. Therefore, their results will not be the same.
Nutritional balancing as psychodrama. Nutritional balancing also employs or involves psychodrama, to a degree. For example, putting coffee in one’s rectum may retrace having something put inside the vagina or near the penis. The heat and sweat of the sauna may bring up memories of a hot, sweaty trauma.
Provoking pain in the feet by rubbing them hard may remind a person of a trauma, just as does psychodrama. The pushing down exercise may also bring up memories.
Re-traumatizing does not seem to occur with retracing on a nutritional balancing program. I believe the reason is that the “re-enactment” only occurs when the body and brain are ready for it, and not before. The body seem to know when it can see the process through to its conclusion.
Psychodrama sessions do not have this advantage. For example, the client’s ability to process the old trauma may be very limited to poor mental clarity, memory problems, slow mental processing speed, or other mental or emotional problems. The psychodrama director won’t often know about all this, even if he or she is well-trained.
If problems arise during a psychodrama session, sometimes the only thing to do is to end the session. To avoid this problem, it is most important to end a psychodrama session if the client feels that he or she is not ready or able to handle it for any reason. Reasons why this might occur include the reasons above, such as a faulty memory or inability to comprehend the situation correctly. However, other reasons might simply be embarrassment, shame, intense guilt or fear, or something else.
A number of legal issues must be considered with psychodrama. All personnel need to sign a legal agreement detailing the following:
1. General. The statement should give the names, addresses and phone numbers of the director, monitors and board of supervisors.
The psychodrama personnel agree that this therapy does not violate any local, state or national laws, to the best of their knowledge.
2. Release of information. No information about the sessions may be released to anyone without the written permission of the client. This even applies to the client’s husband or other family members, or authorities who may ask questions about the therapy.
This is for safety and builds trust between the client and the psychodrama personnel. For example, the psychodrama personnel may be the only ones who know about the trauma, and exactly what occurred.
The client may have reasons to keep this secret from family members and others. Sharing this information without the client’s permission can be a serious breach of trust that could derail the process.
Sharing information with the wrong people could also put the client or other in physical danger for their lives.
3. The video recordings. The recordings of all scenes will be kept for at least seven years. This is so that if a legal case is brought against the psychodrama personnel, they have evidence of exactly what was done or not done with the client. Also, the client may want to review the video later as she matures or as more healing takes place over time.
A video recording may be used for teaching purposes. However, no one may know or be able to figure out who the client is. Therefore, the face and any other identifying features of the person must be deleted before any video is used for teaching purposes.
4. The HIPAA medical privacy law in the USA. All parties are informed that this does not apply to this psychodrama organization.
5. Confidentiality agreement. All personnel agree not to share names or any details about psychodrama sessions with anyone, not even their wives, husbands, children or friends. Any breach will mean immediate loss of job and perhaps other penalties.
6. Integrity agreement. if any client or other personnel has a conflict with the director or anyone else that cannot be resolved through discussion, he or she agrees to first bring the conflict to a mediator whom the two parties agree upon.
If mediation is not successful, then the parties agree to bring the conflict to arbitration to resolve the conflict. In no case may clients or psychodrama personnel seek legal help first, before going through these much simpler and less costly steps.
There may be other legal aspects of psychodrama that need to be included, depending on one’s location and type of organization.
At times, it is not possible or advantageous to re-enact the exact scene of a serious trauma from the past. What is helpful, however, is to re-enact or experience part of the trauma again, but with a new twist, such as humor. This is a very powerful psychotherapeutic technique that is a form of psychodrama.
The client is brought back to the trauma scene by something such as a tone of voice, an odor, a location or a physical action such as a mild beating. However, this is mixed with odd music, silly speech, wearing an unusual outfit, or something else that breaks the tension and allows the client to relax and thereby process the actual trauma much better.
In fact, a light-hearted attitude throughout the psychodrama session serves this purpose, and may be absolutely essential for success. Too much seriousness is much more likely to re-traumatize the person.
Another good method is to use something simple to bring the person back to the scene of the trauma, but not put them through the whole thing, as it is often not needed. For example, just hearing a voice like the one that hurt you years ago might be sufficient. Just smelling a person’s beard next to your skin might be enough. Once this is done, the person might recall more about the incident and can retrace or process the rest by himself or herself.
Examples. Just visiting an ocean, and smelling the salt water and walking on the beach, could be enough to bring up a flood of childhood memories of a trauma that occurred at the beach, or just at the same age as when you visited the ocean as a child. This could allow one to cry, scream, be sad, and to process a traumatic childhood event.
Another simple example that occurs now and then is that simply hearing a song on the radio that dates back to one’s childhood is enough to trigger a profound memory and healing process.
Vaginal coffee implants. Another unusual example I have observed is the use of vaginal coffee implant to help retrace physical problems such as an old infection, or an emotional trauma having to do with this area. It is as though the old trauma numbed this area of the body, and we know this happens after a molestation or rape, for example.
Putting coffee in the vagina somehow “wakes up” the nerves and brings back the memory of the event, in many cases, so that the person can process if fully. Coffee can also help undo points.
Part of the beauty of the coffee procedure is that it is mild, harmless, clean and the coffee itself has healing properties. It is also done in the privacy of one’s bathroom and one is in total control of the procedure.
This combination seems to make this procedure very powerful and it works in a way that is like psychodrama. You could say that you are “acting out” the same event, but in a safe and somewhat comical or strange enough way that it is not threatening.
Some of this is complex, and I don’t know exactly how it works. However, it is important to mention these methods because they sometimes work when nothing else will work. This is part of the mystery of psychodrama.