Routledge International Handbook of Dramatherapy 9781138829725, 9781138838413, 9781315728537

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Routledge International Handbook of Dramatherapy Routledge International Handbook of Dramatherapy is the first book of its kind to bring together leading professionals and academics from around the world to discuss their practice from a truly international perspective. Dramatherapy has developed as a profession during the latter half of the twentieth century. Now, we are beginning to see its universal reach across the globe in a range of different and diverse approaches. From Australia to Korea, to the Middle East and Africa, through Europe and into North and South America, dramatherapists are developing a range of working practices using the curative power of drama within a therapeutic context to work with diverse and wide-ranging populations. Using traditional texts in the Indian subcontinent, healing performances in the Cameroon, supporting conflict in Israel and Palestine, through traditional comedic theatre in Italy, to adolescents in schools and adults with mental ill health, this handbook covers a range of topics that show the breadth, depth and strength of dramatherapy as a developing and maturing profession. It is divided into four main sections that look at the current international: • • • •

developments in dramatherapy; theoretical approaches; specific practice; new and innovative approaches.

Offering insights on embodiment, shamanism, anthropology and cognitive approaches, coupled with a range of creative, theatrical and therapeutic methods, this groundbreaking book is the first congruent analysis of the profession. It will appeal to a wide, diverse, international community of educators, academics, practitioners, students, training schools and professionals within the arts, arts education and arts therapies communities. Additionally, it will be of benefit to teachers and departments in charge of pastoral and social care within schools and colleges. Sue Jennings PhD is a Play and Dramatherapist, social anthropologist and author. She has pioneered Dramatherapy in the UK, Greece, Israel, Czech Republic and Romania. She has established ‘Neuro-Dramatic-Play’ and ‘Embodiment–Projection–Role’ as a basis for understanding both attachment and dramatic development across cultures. She was Visiting Professor at HELP University, Kuala Lumpur, and is President of the Romanian Association for Play Therapy and Dramatherapy. Sue is a prolific author of 40 books (six by Routledge) and many chapters and is currently preparing her selected works for publication by Routledge. Her PhD thesis was published as Theatre, Ritual and Transformation: The Senoi Temiars, by Routledge, in 1995. Clive Holmwood PhD is a Dramatherapist with 20 years’ experience working with children and adults in the public, private and voluntary sectors. He is currently Senior Lecturer in Dramatherapy and Deputy Programme Leader in Creative Expressive Therapies at the University of Derby and a Director of Creative Solutions Therapy Ltd. He gained his PhD from the University of Warwick, and his thesis was published by Routledge in 2014 as Drama Education and Dramatherapy – exploring the space between disciplines.

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Routledge International Handbook of Dramatherapy

Edited by Sue Jennings and Clive Holmwood

First published 2016 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2016 selection and editorial matter, Sue Jennings and Clive Holmwood; individual chapters, the contributors The right of the editors to be identified as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Names: Jennings, Sue, 1938- editor. | Holmwood, Clive, editor. Title: Routledge international handbook of dramatherapy/edited by Sue Jennings and Clive Holmwood. Description: Hove, East Sussex; New York, NY: Routledge, 2016. | Includes bibliographical references and index. Identifiers: LCCN 2015043050| ISBN 9781138829725 (hbk) | ISBN 9781138838413 (pbk) | ISBN 9781315728537 (ebk) Subjects: LCSH: Drama – Therapeutic use. Classification: LCC RC489.P7 R68 2016 | DDC 616.89/1653 – dc23 LC record available at http://lccn.loc.gov/2015043050 ISBN: 978–1–138–82972–5 (hbk) ISBN: 978–1–138–83841–3 (pbk) ISBN: 978–1–315–72853–7 (ebk) Typeset in Bembo and Stone Sans by Florence Production Ltd, Stoodleigh, Devon, UK

We would like to dedicate this collection from around the world to the late Roger Grainger: dramatherapy pioneer, researcher, priest and professional actor. His writings will continue to inspire us.

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Contents

List of figures List of tables Notes on contributors Foreword – Sue Jennings Preface – Roger Grainger Acknowledgements

xi xii xiii xx xxi xxii

PART I

International developments in dramatherapy 1 The development of Korean drama therapy: from a latecomer to the leading special practical human science in arts therapy Miri Park 2 The development of drama therapy in Taiwan Hsiao-hua Chang

1 3

8

3 Converging lineages: arts-based therapy in contemporary India Aanand Chabukswar with Zubin Balsara

19

4 Embodying Ramayana: the drama within Bruce Howard Bayley

26

5 Culture and mental health: an evaluation of Esie performance as a community-based approach to dramatherapy in Cameroon Paul Animbom Ngong

36

6 A bridge over troubled waters: ‘Play can break the mask of silence’ Ioana Serb and Magdalena Cernea

45

7 The history, trends and future of North American drama therapy Andrew M. Gaines and Jason D. Butler

52

vii

Contents

PART II

Internationalism and theoretical approaches

65

8 ‘Dramatherapists believe that they must be both artist and therapist’: an exploration Alida Gersie

67

9 How do dramatherapists understand client change? A review of the ‘core processes’ at work Phil Jones

77

10 Instilling cultural competence in (the raising of) drama therapists Renée Emunah

92

11 Creative integration in practice Anna Chesner

106

12 Embodiment in dramatherapy Ditty Dokter

115

13 Shamanism, theatre and dramatherapy John Casson

125

14 From brains to bottoms: the preoccupations of the very young and the very old Sue Jennings

135

15 A critical aesthetic paradigm in drama therapy: aesthetic distance, action and meaning making in the service of diversity and social justice Nisha Sajnani

145

16 Dramatherapy and theatre: current interdisciplinary discourses Clive Holmwood

160

17 The brain as collaborator in dramatherapy practice Jude Kidd

170

18 Open Sesame and the Soul Cave Mary Smail

180

PART III

Internationalism and specific practice

189

19 The contribution of dramatherapy to the reconnection of abused Palestinian females with their bodies and feelings Alia Safadi Zoabi and Natalie Hayek Damouni

191

viii

Contents

20 Drowning . . . but waving: children today Penny McFarlane 21 ‘I am a black flower’: the use of rituals in dramatherapy work with a special education class in Arab–Israeli society Amani Mussa

200

208

22 Attachment-informed drama therapy with adolescents Anna Marie Weber and Craig Haen

218

23 Stevie and the Little Dinosaur: a story of assessment in dramatherapy Sarah Mann Shaw

230

24 Evaluation of dramatherapeutical process for clients with neurotic disorder Milan Valenta and Ivana Listiakova 25 Sparks of hope: Dramatherapy with people with a terminal illness Dorit Dror Hadar 26 Life stage and human development in dramatherapy with people who have dementia Joanna Jaaniste

240 250

262

PART IV

Internationalism and new and innovative approaches

273

27 The dramatherapy commedia: improvisation, creativity and person-making Salvo Pitruzzella

275

28 Spagyric dramatherapy: a transcendental perspective Demys Kyriacou 29 Breaking through the walls of shyness: overcoming shyness, self-consciousness and social anxiety through dramatherapy Claire Schrader

285

294

30 Dramatherapy and the feminist tradition Susana Pendzik

306

31 Yogadrama – ‘As if I were a mountain’ Jenelle Mazaris

317

32 Ritual theatre in short-term group dramatherapy Steve Mitchell

325

ix

Contents

33 Meditation and dramatherapy Grace Schuchner

335

34 Redefinition, restoration, resilience: drama therapy for healing and social transformation Warren Nebe

348

Afterword – Clive Holmwood Appendix Index

360 362 365

x

Figures

2.1 2.2 2.3 2.4 4.1 4.2 5.1 9.1 13.1 13.2 16.1 16.2 16.3 17.1 17.2 17.3 17.4 17.5 25.1 25.2 25.3 29.1 30.1 33.1 33.2 33.3 33.4

The role of Ji-gon in a group for the therapeutic play production The most helpful character who wore the cap of Ji-gon Masks with older people at County Senior Citizen Home for Compassion Taipei Children at the home for people with disabilities, Taipei The seven chakras: centres of consciousness within the human body Ramayana enacted within the human body Traditional performance space How individual dramatherapy with a client on the autistic spectrum might be recorded Mahasohon, the demon of death A shamanic map on the Communicube As a trainee dramatherapist, I was influenced by these innovators As a lecturer, these theatre innovators currently influence me Order of most importance as a lecturer in dramatherapy The human nervous system Cell body, axons and dendrites The synapse Homunculus Wow The dramatic structure of the mind Vulnerability Mandala of the therapist Rebecca’s Breakthrough image Dramatic Resonances Day-to-day reality Meditation Hanna Shira’s image

12 13 16 17 32 33 39 84 130 132 165 165 165 171 172 172 175 176 251 252 253 301 312 337 339 345 346

xi

Tables

7.1 24.1 24.2 24.3 24.4 30.1 33.1

xii

Drama therapy approaches Evaluation rating Sample description Results of single-factor analysis of variance with correlation transfer Results of statistically significant items Dramatic Resonances summary Rituals for children

58 244 246 247 247 313 342

Contributors

Paul Animbom Ngong, PhD (Cameroon) received his PhD on Information and Communication Sciences from Université Libre de Bruxelles. He focuses his research and practice on therapeutic theatre. He is Chair, Department of Performing and Visual Arts, University of Bamenda and President of the Centre for Research and Practice of Art-related Therapy, Cameroon. Zubin Balsara (India) has had training in music and rhythm for more than 18 years. He trained

in Drum Circles in the USA and worked there with the New Rhythms Foundation. He is the Projects Director of WCCL Foundation. Jason D. Butler, PhD MA, RDT/BCT, LCAT (USA/Canada) is a registered drama therapist on

the faculty at Concordia University, and has also taught in the drama therapy program at New York University. Currently he is training director at the Montreal Institute for Developmental Transformations and maintains a private practice. John Casson, PhD (UK), researched shamanism in Sri Lanka before he trained as a dramatherapist (he is now retired). He was a dramatherapist for 30 years and a psychodramatist for 22. He has published a book, Drama, Psychotherapy and Psychosis (2004, Routledge), and invented the Communicube (see www.communicube.co.uk; www.creativepsychotherapy.info). Magdalena Cernea (Romania) is a psychologist, dramatherapist and audiologist. She has over

15 years experience in working with deaf children, with cochlear implant and hearing aids in Bucharest, Romania. From 2014 she initiated a Romanian national project by play and dramatherapy for children with cochlear implant. She is the national clinical director ‘Healthy Hearing’ for Special Olympics Romania and the vice president of the ‘Audiosofia Association’ and ‘Audiology Association of Romania’. Aanand Chabukswar (India) is an arts-based therapy (ABT) practitioner and Project Head of the ABT course with the WCCL Foundation. He trained in dramatherapy with Rowan Studio, UK. He has led workshops in many places, including Europe and South East Asia. He has also designed and teaches the Applied Theatre course at the University of Pune. Hsiao-hua Chang (Taiwan) was the first Asian to train as a dramatherapist at New York

University, in 1987. He started to set up the selective course of Dramatherapy for undergraduate students in the Department of Drama, National Taiwan University of Arts, in 2000. He then set up the first MA programme in Dramatherapy Theory and Practice for graduate students in 2005. xiii

Contributors

Anna Chesner (UK) is co-director of the London Centre for Psychodrama Group and

Individual Psychotherapy, which runs training programmes at the Maudsley Hospital London. Her special interests are one-to-one psychodrama and the training of creative supervisors. Her training work takes her regularly to Switzerland, Germany and Hong Kong. She maintains her creative engagement with playback theatre and runs a private psychotherapy and supervision practice in London. Ditty Dokter, PhD (UK/Netherlands), is course leader of MA Dramatherapy at Anglia Ruskin University. She has 30 years’ clinical experience in adult and young people’s psychiatry and has taught widely in many countries. Her research interest is in intercultural practice. Her most recent publications include the co-edited volumes Dramatherapy and Destructiveness and Supervision in Dramatherapy, published by Routledge in 2012 and 2009, respectively. Dorit Dror Hadar, PhD (Israel), is a dramatherapist and psychotherapist with a graduate degree

in dramatherapy. Dorit recently completed her PhD on the subject of ‘personal development (self-efficacy and expressive capabilities) among dramatherapy students during a course that deals with their personal autobiographic materials’. Dorit has managed the extension of the drama and art therapist training centre at Tel Hai College for the Arab sector over the past 8 years. She has been working as a therapist and teaching dramatherapy for many years. Dorit specializes in group and individual dramatherapy, mainly using tools of theatre, bibliotherapy and guided imagery. Renée Emunah, PhD, RDT, BCT (USA), is a Registered Drama Therapist and Board Certified

Trainer of Drama Therapists. She is the author of the book Acting for Real: Drama therapy process, technique and performance and co-editor of the book Current Approaches in Drama Therapy; she is also the Founder/Director of the Drama Therapy Program in the graduate Psychology Department at the California Institute of Integral Studies. She is a recipient of the Gertrude Schattner award for Outstanding Contribution to the Field of Drama Therapy (the highest honour awarded by the North American Drama Therapy Association). She is the author of numerous publications and has taught internationally – including in Hong Kong, Japan, Taiwan, and Israel. Andrew M. Gaines, RDT-BCT, LCAT (USA), is a registered drama therapist, board-certified trainer and licensed creative arts therapist, and he has designed, conducted and evaluated artsbased curricula for numerous organizations across the United States, Japan and Israel. Mr Gaines is an adjunct instructor of psychology and drama therapy at several universities while pursuing his PhD in Educational/Applied Theatre. Alida Gersie, PhD (UK/Netherlands), is a writer and senior consultant in the arts therapies and applied arts. She has held innovative leadership positions in arts education, family action and community development and was for many years Director of Studies of the Postgraduate Arts Therapies at the University of Hertfordshire, UK. In the late 1970s, Alida pioneered a narrative approach to improving individual and social resilience. This method is now used in more than forty countries. She has lectured at universities worldwide, served on several boards and is the author of acclaimed (translated) books including Storymaking in Education and Therapy (with Nancy King), Dramatic Approaches of Brief Therapy, Storymaking in Bereavement, Reflections on Therapeutic Storymaking: The use of stories in groups and Earthtales, Storytelling in Times of Change. xiv

Contributors

Craig Haen, MA, RDT, CGP, LCAT (USA), is Assistant Clinical Director for Andrus Children’s

Center, in Yonkers, NY, and has a private practice working with children, adolescents, adults and families in White Plains. He serves as Adjunct Faculty at New York University and Lesley University. Craig is contributing co-editor of Clinical Applications of Drama Therapy in Child and Adolescent Treatment and contributing editor of the 2011 book Engaging Boys in Treatment: Creative approaches to the therapy process. Natalie Hayek Damouni (Israel) is a dramatherapist and a social worker who was born and

raised in Nazareth. She has worked for many years with adolescents all over the world and, for the last few years, with abused adolescent females and sexually abused children at schools, from the Palestinian Arab society in Israel. Clive Holmwood, PhD (UK), works within a children’s services organization and is Director of Creative Solutions Therapy Ltd, UK. He gained his PhD in Drama Education and Dramatherapy from the University of Warwick, UK, and has worked as a Dramatherapist for almost 20 years with children and adults, in the public, private and voluntary sectors. He has written a number of Dramatherapy articles, and his first book, Drama Education and Dramatherapy, was published by Routledge in 2014. Bruce Howard Bayley, PhD (India/UK), was born in Mumbai, India, and is an Anglo-Indian

dramatherapist, based in central London, who has been working widely in the voluntary sector, specifically with addictions, sexuality, self-harm, sexual and physical abuse and trauma. He has facilitated dramatherapy workshops in the UK, Milan, Chennai and Mumbai. He has been associated with a number of UK universities as trainer, supervisor and external examiner, with a special interest in the development of multicultural clinical practice and marginalized populations. Joanna Jaaniste, PhD, AthR (Drama) (Australia), has been practising dramatherapy for more than 20 years. She teaches and practices at the Dramatherapy Centre and lectures at the University of Western Sydney. Sue Jennings, PhD (UK), is a Play and Dramatherapist, social anthropologist and author. She

has pioneered Dramatherapy in the UK, Greece, Israel, Czech Republic and Romania. She has established ‘Neuro-Dramatic-Play’ and ‘Embodiment–Projection–Role’ as a basis for understanding both attachment and dramatic development across cultures. She was Visiting Professor at HELP University, Kuala Lumpur, and is President of the Romanian Association for Play Therapy and Dramatherapy. Sue is a prolific author of 40 books (six by Routledge) and many chapters and is currently preparing her selected works for publication by Routledge in 2016. Her PhD thesis was published as Theatre, Ritual and Transformation: The Senoi Temiars, by Routledge, in 1995. Phil Jones, Institute of Education, University of London (UK), has publications that include Drama as Therapy (1996, 2007, Routledge), The Arts Therapies (2005, Routledge), Rethinking Childhood (2009, Continuum) and Rethinking Children’s Rights (with Welch; 2010, Continuum). His books on the arts therapies have been translated and published in China, South Korea and Greece. He is editor of Drama as Therapy 2: Clinical work and research into practice (2010, Routledge), Supervision of Dramatherapy (with Dokter; 2008, Routledge), Children’s Rights in xv

Contributors

Practice (with Walker; 2011, Sage) and Childhood: Services and provision (with Moss, Tomlinson and Welch; 2007, Pearson) and is series editor for Continuum’s ‘New Childhoods’. His research articles have been published in many journals, including the European Journal of Counselling and Psychotherapy, Research in Drama Education, Counselling and Psychotherapy Research, The Arts in Psychotherapy and Body, Movement and Dance in Psychotherapy. He has given keynotes in many countries, including South Africa, South Korea, the USA, Italy, Greece, the Netherlands and, recently, at the prestigious Triennial World Congress for Psychotherapy, in Sydney, Australia. Jude Kidd (UK) has a career that spans four decades working with creativity, in health, business

and management. She is an Arts Therapist (dramatherapy) registered with the Health Care Professions Council (HCPC) and works with drama and creative action as a supervisor in private practice in London. She has a special interest in neuroscience. Demys Kyriacou, MA (Greece), is a psychiatrist, dramatherapist (RDTh-UK), DTh supervisor, homeopath and writer. Founder and training director of dramatherapy courses in Northern Greece and Cyprus, he runs regular dramatherapy and supervision groups. He is the originator of the concept and form of Spagyric dramatherapy. He is an editorial consultant and frequent contributor to a magazine, Avaton, dealing with spiritual quest and personal development; he has also contributed chapters in a variety of books (Archetypo publications) on alchemy, nature of the psyche, human typology and others. Additionally, he has written two books of his own, a book of poems, The Purple Compass, and a spiritual diary, Martiria. He has also created points of contact for dramatherapy on the Internet (www.dramatherapy.gr). His main research interest involves the bridging and fusion, through dramatherapy, of the spiritual path and that of psychotherapeutic theory and practice. He lives and works in Thessaloniki, Greece. Ivana Listiakova, PhD (Czech Republic/Slovakia), is a therapeutic pedagogue. She works in a research team of dramatherapists in the POST-UP II project at the Faculty of Education, Palacky University, in Olomouc, Czech Republic. In 2013, she was a visiting scholar at an MA dramatherapy programme at New York University. She also teaches at the Faculty of Education, Comenius University, in Bratislava, Slovakia. The areas of her professional interest are: expressive therapies, multisensory approaches, early intervention and the topic of mental health in families. She works with children who need learning support and their parents, as well as in the further education of teachers and helping professionals. Penny McFarlane (UK) is an ex-teacher and has spent more than 15 years working as a dramatherapist in education. She is an author of four books on this subject. Sarah Mann Shaw (UK) is a dramatherapist and psychotherapist in private practice. She has

extensive experience of working with children and adolescents alongside statutory and private agencies. She works with the impact of disrupted attachments and trauma using dramatherapy. Sarah has contributed to Drama as Therapy, Theory, Practice, Research, vol. 2 (2007, Routledge) and has had two articles published in the Dramatherapy Journal, ‘Metaphor, symbol and the healing process in dramatherapy’ (1996, vol. 18, no. 2, pp. 2–5), and ‘The drama of shame’, co-written with Di Gammage (November 2011, vol. 33, no. 3, pp 131–143). Jenelle Mazaris, MA, LLMFT, RDT (USA/Romania), is a dramatherapist (trained in the U.S.),

yoga instructor and theatre artist. She is an active board member, trainer and supervisor for the Romanian Association of Play Therapy and Dramatherapy in Romania. She currently works xvi

Contributors

internationally between the USA and Romania in private practice, as a certified yoga teacher and dramatherapist with children, teens and adults. She is an alumnus of the Psychology and Drama Therapy Program at the California Institute of Integral Studies. Steve Mitchell (UK) has worked as a full-time Dramatherapist in the NHS (for 26 years) in

Lancaster, England. For 13 years, he was also a trainer and, for 9 years, Course Director of dramatherapy training at the Institute of Dramatherapy at Roehampton in London (1993–2002), now the University of Roehampton. Additionally, for the past 30 years, he has been part-time Project Director of Pathfinder Studio, conducting annual workshops researching a new form of theatre-making combining the craft of acting with techniques of self-cultivation. Theatre productions have included adaptations of: Wilde’s Salome (2005), Strindberg’s Miss Julie (2006), Genet’s The Maids (2007), Ibsen’s The Doll’s House (2008), Miller’s The Crucible (2010) and Daphne du Maurier’s Rebecca (2013–14). He has presented work in Denmark, Greece, Israel, Ireland, Norway and the USA, as well as numerous events in the UK. Amani Mussa (Israel) is 30 years old and mother to a little girl. She is a Muslim Arab, born in a village in Northern Israel. Her village has a unique composition: most of the population is of Circassian origin, and the Arabs are a minority of a minority. For that reason, the school she attended was multicultural and multilingual (she has three mother tongues: Hebrew, Arabic and Circassian). She worked as a special needs education teacher for 7 years with children with learning disabilities and behavioural problems, included in an ordinary school. In addition, she has been a drama therapist for the last 5 years. She has worked with different populations, some of them children and adolescents with learning disabilities and behavioural problems in schools and other mental health and welfare frameworks. She has worked a lot with groups of Arab women and elderly women. She also teaches courses for teachers and instructors practising drama therapy with children and adolescents. This is a chance for parents and teachers to experience and get to know drama therapy up close through their personal experience. In 2016, she started as an instructor of first-year students studying for their Master’s degree in Tel Hai College. Warren Nebe (South Africa) is the founder and director of Drama for Life, a division of postgraduate studies in Applied Drama, Drama Education and Drama Therapy at the University of the Witwatersrand. He is an award-winning theatre director, a senior lecturer, an HPCSA and NADT Registered Drama Therapist and a Fulbright Alumnus. He was awarded the ViceChancellor Award for Transformation in 2013. Miri Park (Korea) is Professor in the Department of Theatre in Yong-In University. She gained a doctorate degree in French Literature (she majored in Paul Claudel at Ewha Women’s University) and received her Diplôme d’études appliquées from the University of Paris 10. A Chairperson of the Korea Association of Drama Therapy (KADT) in Korea, she created a Master’s degree in Dramatherapy and a doctoral programme of art therapy. She has been in charge of training dramatherapists in the KADT (a state-recognized private institution that issues certificates) for 10 years. About ninety dramatherapists from the Association are actively engaged in drama therapeutic practice. Susana Pendzik, PhD, RDT (Israel), is a dramatherapist and supervisor, lecturing at the

Department of Theatre Studies at Hebrew University of Jerusalem, the Drama Therapy Program at Tel Hai College (Israel) and the Swiss Institute of Dramatherapy. Susana has done extensive international work and teaching in Europe, Latin America and the USA. She is the author of xvii

Contributors

a book on Action Techniques for Working with Battered Women (published in German and Spanish), co-editor of a book on Assessment in Drama Therapy (2001, Charles C. Thomas) and author of many papers on dramatherapy and two poetry books. Salvo Pitruzzella (Italy) is Dramatherapy course leader at the Arts Therapy Centre, Lecco, Italy. He is a lecturer in Arts Education at the Fine Arts Academy of Palermo, Italy, a member of the Editorial Advisory Board of Dramatherapy Journal and a member of the Executive Committee of the European Federation of Dramatherapy. He is the author and editor of many books and articles on dramatherapy, drama in education and creativity theories, including Introduction to Dramatherapy: Person and threshold (2004, Brunner-Routledge). Alia Safadi Zoabi (Israel) worked in food engineering for about 6 years and then, in 1998,

after the birth of her first child, she started to study drama therapy. She gained her Master’s degree in 2010. Today she works as a dramatherapist, a professional facilitator, a group facilitator and ADHD coach. Working with children gives her much energy and hope, especially working with women and female adolescents who share a difficult social status. Nisha Sajnani, PhD, RDT-BCT (USA), is the coordinator of the Drama Therapy programme

and on faculty in the Expressive Therapies PhD programme at Lesley University. She is visiting faculty at New York University and in the Harvard Program for Refugee Trauma. Dr Sajnani is the editor of Drama Therapy Review, the journal of the North American Drama Therapy Association (NADTA). She is past-president of the NADTA. Claire Schrader (UK) is director of Making Moves, a personal development company offering

workshops and programmes since 1997 helping shy, reserved and introverted people to break out of their shell and build a natural self-confidence that comes from a deep place within. Before qualifying as a dramatherapist in 1995, she worked as a performer, playwright and director of devised theatre in UK drama schools. Her first play, Corryvreckan (produced at the Old Red Lion Theatre, London, 1990), was short-listed for Best Play at the 1991 Charrington Fringe Theatre Awards. For 6 years she was coordinator of the performance programme at the Studio Upstairs, where she developed and directed numerous therapeutic performance projects. She is editor of Ritual Theatre: The power of dramatic ritual in personal development groups and clinical practice (2011, Jessica Kingsley) and of Ritual Theatre (2012). She has contributed to Emotions: Experiences in existential psychotherapy and life, by Freddie Strasser (Duckworth). Grace Schuchner (Chile) is an actress and a dramatherapist and graduated from Tel Hai Regional College, Israel (2000). She has been living in Buenos Aires, her country of origin, since 2005. She returned, after 21 years, to find her own roots. She is currently researching meditation and drama therapy for groups and individuals, especially with women who find it difficult to get pregnant. She regularly teaches Drama Therapy at EDRAS University, Chile. As an actress, at the moment, she is representing ‘Hanna’s Prayer’, Samuel 1.1 from the Bible, created and directed by herself, presenting it by means of Therapeutic Theatre. Most important of all, she has been Shira’s mother since 2007. Ioana Serb (Romania) is a play therapist and dramatherapist, working in Romania with young

people from children’s homes, adults with mental health illness, sexually abused people and children with behavioural, emotional and learning difficulties. She is the Vice President of the Romanian Play Therapy and Dramatherapy Association and Vice President of the European xviii

Contributors

Federation of Dramatherapy. Ioana is a trainer and supervisor of students of play therapy and dramatherapy in Romania and she organizes the annual international conferences of the association. Mary Smail (UK) is a dramatherapist and Psychotherapist. She was Director of the Sesame Institute UK and International. She specializes in and teaches myth enactment in dramatherapy and co-authored the book Dramatherapy with Myth and Fairytale – The golden stories of Sesame (2013, Jessica Kingsley London). She is the founder of the Psyche and Soma (Soul through Sesame) training course. Milan Valenta, PhD (Czech Republic), has studied education, special education and drama

education and has studied dramatherapy in London, Prague and New York. He is a Full Professor at the Faculty of Education UP Olomouc and has been the Head of Department of Expressive Therapy since 2008. Anna Marie Weber, MA, RDT, CDVC, LCAT (USA), Licensed Creative Arts Therapist,

Certified Rape Crisis Counselor and nationally Certified Domestic Violence Counselor is co-editor of the book Clinical Applications of Drama Therapy in Child and Adolescent Treatment. Ms. Weber is the former Director of Children’s Services at VIBS – Family Violence and Rape Crisis Center. Along with supervising a staff of creative arts therapists, social workers and interns she specialized in the treatment of children who had witnessed familial homicide, suicide or experienced severe sexual abuse for 27 years. She received the 1995 Award for Special Leadership in Domestic Violence Prevention. Ms. Weber chaired the legislative appointed Suffolk County Advisory Board on Child Protection. She serves as an adjunct faculty member at New York University teaching, ‘Play and Drama Therapy for Children and Adolescence’ in the Applied Psychology Department graduate program. Anna Marie received the 2013 North American Drama Therapy Association, Teaching Excellence Award and the 2016 Child Abuse and Neglect/ Family Violence Professional Award for Outstanding Leadership in the areas of Sexual Abuse and Family Violence.

xix

Foreword

It is with the greatest pleasure and pride that I am writing the Foreword to the Routledge International Handbook of Dramatherapy. The book brings together practitioners from all over the world who work and play with diverse populations. I still have some amazement that the early tentative beginnings in the 1950s and 1960s could have grown into something so vibrant and strong. The late Gordon Wiseman and I discussed how theatre with special populations could develop from the work he was doing in Theatre in Education, which began to work in special schools, and my work ‘doing drama’ in adult psychiatric institutions, some of which had started in 1955. We were both very mindful of the work of the late Peter Slade, who was the first person to put the two words, drama and therapy, together in his seminal paper ‘Dramatherapy as an aid to becoming a person’ (1959, Guild of Pastoral Psychology). The journey from Remedial Drama to Dramatherapy was realized with the formation of the Dramatherapy Diploma training at Hertfordshire College of Art and Design in 1977, which complemented the transition from Remedial Art to Art Therapy. This was also parallel to the Sesame Diploma training, ‘Drama and Movement in Therapy’, in London. Thirty-seven years on, the dramatherapy landscape has changed considerably, as training courses are formalized as Master’s programmes (in the UK and US), and practitioners need to be stateregistered in the UK and have regular supervision of their practice. Higher-degree research is now a part of the dramatherapy landscape, and there are increasing numbers of doctoral studies and dramatherapists with PhDs. What reassures me greatly, as a pioneer, is that the dramatherapy field is avoiding an imperialistic approach. Other countries are developing their own models of training and practice that reflect their own cultures and value systems. Having undertaken an anthropology training myself, during my formative dramatherapy years, I think it shows in the current attitudes towards dramatherapy growth and development. It does not have to follow a single root or route. We need to keep reminding ourselves that theatre changes through time and culture and is reflective of the age. Dramatherapy as a branch of theatre needs to do just that. It is organic and evolving, and I take credit for having provided some of the starter structures and thinking, and now it is for others to continue to move it forward. That is why this book is important and relevant to our time, as it demonstrates the wondrous state of dramatherapy across populations and cultures. We may complain about funding being cut and jobs being under threat. However, the very people that make such good dramatherapists will find ways and means. Dramatherapy is a therapy of optimism and survival. Welcome to this new offering in this exciting landscape. Sue Jennings, PhD Wells, Brasov and Kuala Lumpur xx

Preface

Dramatherapy is an expanding profession. I can think of several reasons why this should be so. First, drama itself is species-characteristic, essential to our identity – not just an aspect of our behaviour, something we can do. Drama is something we must do in order to be ourselves. Dramatherapists know this better than most people; otherwise, they would already have succumbed to the pressure imposed by fundamentalist scientists in order to exclude anything that resists definition from serious scrutiny. The second reason, which is connected with this, is the association between art and science consistently shown to work in practice, however difficult it may be to tie down (or rather because of that!). This, of course, is the most important reason for scientists’ involvement in art, and artists’ in science. The relationship needs to be considerably more even-handed than our current culture will let it be; but such things take time, and we are still a young profession. In my own years as a dramatherapist, I have seen signs of movement. A third reason might be something to do with the inspirational influence of dramatherapy itself, specifically because its presence, what could be called its effective power, may often be difficult to focus on. When dramatherapy happens, it is unmistakeable, although the moment itself may have passed. Dramatherapists are well aware of this. They do not document all that happens, for fear of ‘treading on the throat of their song’. They are very often simply people who have been caught unawares; who went along to find out what it was like and are still there . . . These are just some reasons, then, why the profession is growing. Evidence of its extent is to be found in the Contents of this book. I thought of drawing attention to some of the contributors here in this Preface, but there are too many; in any case, in order to make my point I should have to list them all, which would defeat my object, as the most important thing that I know about dramatherapy is its capacity for being not so much a skill as a way of life, or a way of viewing the world in which we are involved in living. I would like to end, however, by saying how much I appreciate the honour of being allowed to contribute to what will certainly be a very important book. Its editors must be very proud of it. Roger Grainger

xxi

Acknowledgements

There are many people to thank in a project like this without whom this book could not have been published. First and foremost, we would like to thank the thirty-nine contributors, all of whom gave of their time and energy. Our international colleagues all lead extremely busy lives as practitioners, writers and academics, and we are extremely grateful for their commitment to this project; without them, there would be not be an International Handbook of Dramatherapy. Thank you. We also extend our thanks to Joanne Forshaw – our editor at Routledge – for her patience during the incubation of this project. Additionally, thanks to Kirsten Buchanan at Routledge for her constant support throughout the development of the book. Clive would especially like to thank Clare for her patience over the last 2 years in editing this book. We would like to thank the following for their permissions: Chapter 2: Hsiao-hua Chang, for permission to publish photos (Figures 2.1 and 2.2) of the Ji-gon performance (2006); Tasi-miao Hsieh, for permission to print Figure 2.3, of the County Senior Citizen Home for Compassion; and Yi-shiuan Lin, for his permission to publish the photo taken at Pai-hsin Home for people with Disabilities (Figure 2.4). Chapter 4: Thanks to Mr G. L. Narayan and Vakils, Feffer and Simons (Private Limited) for permission to publish Figures 4.1 and 4.2, originally published in Understanding Ramayana as Rama Within (2006).

A note from the editors on spelling Dramatherapy has two internationally recognized spellings: as one word, dramatherapy, in the UK, and, as two words, drama therapy, in North America. For the purposes of this publication, as befitting an international handbook, both spellings are used. Those who are from, trained in, or influenced most by, North America use the two-word spelling. Those who live, trained in, or are influenced most by, the UK use the one-word spelling.

xxii

Part I

International developments in dramatherapy

In the first section of this International Handbook we take a trip around the world to explore current developments in dramatherapy from an international perspective. We begin by tracking east, starting in Korea and Taiwan, where dramatherapy is relatively new. We pass through India, before flying across Africa into Romania in central Europe and then crossing the Atlantic and finishing this first part of the Handbook in North America. This section gives us a sense of the vastness of practice in a range of cultures, but, as importantly, also hints at levels of development of the profession as it continues to mature globally. In Chapters 1 and 2, Miri Park (Korea) and Hsiao-hua Chang (Taiwan) share similar experiences of the development of a profession in its ‘infancy’ within their societies; influenced by the Western perspective of dramatherapy, they show how their own developments of dramatherapy are influenced and affected by their own sociocultural and societal perspectives, acknowledging that how they practise within their own unique cultures should take precedent. We follow this with the arts based therapy approaches being developed in the vast country we know as India, as discussed by Aanand Chabukswar and Zubin Balsara (India). British-based Bruce Howard Bayley (Anglo-Indian) discusses the intricacies of dramatherapy within the classic Indian story of the Ramayana. Paul Animbom Ngong (Cameroon) takes us to where the concept of dramatherapy, in a Western professional context at least, doesn’t exist – in that there is no formal training or state registration. He compares traditional ritual practices as a potential dramatherapy approach. In central Europe, we meet Ioana Serb (Romania), who describes the complexities and connections between dramatherapy and play therapy within her specific culture and society from a dramatherapy perspective. Finally, we travel to North America to get a sense of the historical development and current state of play of dramatherapy, as described by Andrew M. Gaines (USA) and Jason D. Butler (Canada). This first, introductory part of the International Handbook gives us a sense of the vast approaches, current developments and culturally specific uses of dramatherapy as it exists in all its contexts today.

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1 The development of Korean drama therapy From a latecomer to the leading special practical human science in arts therapy Miri Park

An overview of recent Korean drama therapy Where drama exists, so does drama therapy. However, it has only been a decade since drama therapy has been acknowledged as an academic specialty in Korea. It started spontaneously with two different groups – the first group included students who studied drama therapy in the USA and UK; the second group involved drama and psychodrama specialists in Korea. Ever since its introduction, it has developed at a significantly rapid pace compared with other countries, mainly owing to the unique cultural background of Korea. Koreans are open-minded about accepting new theories and practices in the academic field; therefore, various alternative medicines have been adopted without intense resistance. In addition, owing to the positive, dynamic nature of Koreans, the medical effect of other forms of therapy, such as art therapy, music therapy and dance and movement therapy, had already been widely acknowledged, even before the introduction of drama therapy. This rapid growth of drama therapy in Korea can also be seen in the curriculums of many universities. Currently, there are more than ten universities with arts-therapy departments, offering drama therapy courses at postgraduate level. Furthermore, many universities have started providing related courses for undergraduates and PhD students as well. In addition, the number of private institutions training drama therapists is also rapidly growing, as people with appropriate qualifications can establish their own institutions in Korea much more easily than in other countries.

The current trend of drama therapy practice in Korea Korean drama therapists work in a various places, including schools, hospitals, community centres and arts-therapy centres. In the earlier stages, there was no specific distinction between drama therapy, educational drama and dramatic plays, but today they tend to be implemented in separate settings, because each activity has different effects. In the case of drama therapy work, there is usually assessment of participants and intervention by therapists. 3

Miri Park

In the discretionary creative activities in primary and secondary schools, drama education and educational drama work are provided generally; sometimes, special drama therapy classes are offered in a more specific setting for children with specific needs, upon the request of individual schools. These students have mostly experienced school instability, violence or bullying, or have emotional difficulties, mental health problems, learning disabilities, ADHD or suicidal ideation. General drama courses usually include twenty to thirty students per class, whereas drama therapy courses have no more than five students, and the whole process usually consists of ten to twenty sessions per semester. Welfare centres provide a much wider variety of programmes according to the main users of the institutions – the general public, disabled people or senior citizens, etc. Drama therapy work in welfare centres mostly offers individual or group sessions, according to the participants, from children to older people with their various difficulties. In general, teachers, counsellors and social workers, in schools and welfare centres, request specific drama therapy courses to be led by professionals. The voucher system initiated by the Ministry of Health and Welfare is one of the key factors that has significantly contributed to the expansion and development of art therapy. This is a social service system that aims for the enhancement of the well-being of individuals within the general welfare system. It was introduced as part of welfare policy, and the government provides vouchers that directly aid purchases related to welfare services such as education, housing, medical treatment and travel. Art therapy is generally intended for juveniles, seniors and disabled people in the education and medical treatment sectors. The number of art therapists working in hospitals as full-time workers is increasing, followed by music therapists, dance therapists and drama therapists. Even though there is only one hospital, the Myung-ji hospital, that has an arts-therapies centre, here there is still remarkable progress, because this is the first attempt by a medical department to acknowledge art therapies as an individual sector. Other hospitals have also paid attention to similar facilities, and some art therapists have established their own institutions. Many drama therapists in Korea have adopted various methods from precedents set by drama therapists in other countries, especially from the USA and the UK. These include the Embodiment–Projection–Role (EPR) model by Sue Jennings (1998; Jennings et al. 1994), Role Profile and TAS by Robert Landy (1994), the Developmental Transformation model by David Read Johnson (Johnson and Emunah 2009), and the five-step model by Renée Emunah (Johnson and Emunah 2009). They have also adopted other methods from art therapies and psychotherapies, and these methods especially put emphasis on role and emotion as the most important principles. For a diagnostic assessment, the most frequently used methods include the six-part story method proposed by Mooli Lahad (2013), Robert Landy’s role checklist (1993) or the Diagnostic Role-Playing Test by David Read Johnson (1988). Sometimes, modified versions of existing assessment tools, such as the measures of dramatic involvement by Phil Jones (1996) and the six-key model by Susana Pendzik (2008), are also used, according to the subject. As diagnostic assessment tools have not been acknowledged as objective tools, they are often used together with psychological tests. Thus, many drama therapists have recently been working on the development of more suitable drama therapy assessment tools for Korean cultural settings. Their primary interest lies in the development related to physical movement. Currently, they mostly use EPR analysis and self-images of role and emotion. They are trying to get useful statistical sources, based on data from these tools. The drama therapy process typically involves improvisation and it includes dramatisations of well-known stories using projective objects, such as figures, materials, puppets and masks, etc. However, the most effective improvisation involves spontaneous movement without 4

The development of Korean drama therapy

specific fixed formats in the ‘here and now’. Playback theatre, autobiographical performance and other psychodrama methods are also frequently used. The unique character of drama therapy as a performance continues within public ‘therapeutic performances’. Recently, the Korean Drama Therapy Association has presented annual therapeutic performances for suicide prevention. The procedure includes: auditioning of performers – actors/actresses and therapists; a drama therapy workshop with performers in which each character is cast; and training, rehearsals, performance and, finally, feedback and co-work with the audience (including a conversation between performers and audiences or brief drama therapy work). The storyline is based on the performers’ own stories. This therapeutic performance has two positive impacts on the popularisation of drama therapy. The general public can enjoy the process of participation in activities and get better opportunities to understand the healing power of drama itself. Second, people who are in need of drama therapy, but have not experienced it before, get a proper chance to learn and engage in further work.

The academic trend of drama therapy in Korea As already mentioned, doctoral programmes in drama therapy have been provided for the last 3 or 4 years. As the demand for drama therapy keeps growing, the number of universities with a department of drama therapy is expected to increase as well. In other words, there are a myriad of academic approaches to drama therapy in Korea; therefore, researchers are trying to establish a theoretical basis for drama therapy by implementing concepts from various related subjects, such as drama, literature, philosophy, anthropology, social sciences and psychology. There is a heavy emphasis on the multidisciplinary study of Eastern and Western philosophy, especially with a link to Korean traditional studies. Recently, there has been a strong movement in humanistic therapies focusing on philosophy and literature in Korean academic society, which has certainly encouraged the development of drama therapy as well. A lot of academics and therapists are working on developing their own assessment tools and therapeutic methods to use, not as subdivisions of psychotherapy, but as independent domains. However, these rather newly developed assessment tools and methods have only been used in limited cases on a trial basis for qualitative evaluation. For them to be acknowledged as objective assessment tools, there need to be more efforts in pursuing in-depth studies based on large-scale statistical data. In 2011, professors from the theatre departments of various universities set up the Korean Drama Therapy Association in order to contribute to the academic development of drama therapy in Korea. It publishes an annual journal and also planned to hold an international academic symposium every 2 or 3 years, starting from 2015. Researchers focus on the development of drama therapy as a cross-disciplinary practical study integrating various studies, such as emotionfocused Eastern and Western philosophy, the philosophy of imagination of Gaston Bachelard, and Gilbert Durand, the psychology of emotion and self-psychology. Emotional Model in Drama Therapy (Miri Park, 2013) explains more specifically how emotions can be used as the key element of drama therapy. This recently published academic work explains emotion-based drama therapy based on dramatics.

Emotional model in drama therapy Some researchers emphasise the importance of emotional happiness as a primary reason for emotion-focused perspectives in drama therapy. Happiness is not only the ultimate goal in our lives, but should also be the way we live currently. Many people believe that ‘happiness’ equals 5

Miri Park

‘well-being’ and ‘healthiness’. At the same time, it is a matter of ‘feeling’, and so, eventually, the goal of therapy becomes for clients to be able to actually ‘feel happy’. For this reason, it is quite natural to use emotions in the field of therapy, and in fact many therapists have already carried out emotion-focused approaches. However, this has worked as a secondary function in most cases, and not enough research work has focused on how to use emotion in the overall drama-therapeutic process. Drama therapy is focused on emotion as a main tool. It refers to the importance of seeing emotion as a physical reaction; we can feel and express emotions instantly through our body when we encounter a stimulus. These feelings and the possibility of expression can also actualise invisible emotions; therefore, this can function as a tool. In particular, the diagnostic assessment of self-images of role is useful for understanding the real problematic emotion of the client. With regard to the classification of emotions, there are seven main emotions from Korea’s past – joy, anger, sorrow, fear, love, hate and desire. These are undoubtedly the most familiar emotions in Korean culture. Based on this, clients can realise each emotion at a different stage throughout the process of drama therapy. There are two ways to figure out these emotions: a comparative understanding of their pure and impure emotions and an understanding of the object of their emotions. Pure emotion is universal and belongs to the prototype category-like role, as discussed by Pendzik (2008). It does not depend on our experiences and it is an a priori emotion that spontaneously creates aesthetic contents from the very origin of our conscience. On the other hand, impure emotion includes distinctive characters, and only ‘I’ can feel this specific emotion, owing to its complexities in regards to various circumstantial factors. The process of understanding the object of emotion is quite close to the self-psychology of Heinz Kohut (2009); therefore, it has the advantage of the characteristics of self-psychology, which means it is also easier to dramatise and experience an encounter between oneself and the object more directly, self-object, which can be formed as a mirror and idealisation, and empathic reaction and optimum frustration. Using emotion as a tool in drama therapy significantly helps to make the process much easier and more comfortable from the perspective of clients. Taking out the problematic emotion is a generalised activity; therefore, they seldom show resistance to the process. Furthermore, the whole process of examining the intricacies of the problematic emotion might ironically bring about positive impacts. Clients feel a sense of security and support when they realise that therapists take their negative sides more seriously, and this leads them to being better focused on their further therapy process. This is similar to the process of getting to know oneself in psychotherapy. In addition, working with familiar fairy tales or legends can double this effect. My work mentions six primary emotions, based on my previous studies in literature – selfpity, anger, fear, self-hatred, love and altruistic sorrow. In addition, I discuss a general outline of old stories and myths in Korea and Western countries in order to explain how to experience each emotion and the flow of these experiences. This method is mainly designed to make clients feel more secure and comfortable throughout the process. These stories are later overlapped with their own personal stories, which enables self-realisation and role expansion. It is also closely linked to various theories of psychology, especially object relations theory, humanistic psychology and existential psychology.

Prospects In relative terms, art therapies have been developed in Korea later than in other countries. However, they have been growing at an impressively rapid speed in both quality and quantity, owing to the cultural background. In addition, there has been a movement integrating different 6

The development of Korean drama therapy

sectors of art therapies in which drama therapy is certainly expected to play a pivotal role. There have already been significant attempts to integrate art and drama, music and drama, art and music, art and dance, humanities and drama, and so on. For drama therapy to have a more central role in this integration process, more careful attention should be paid to the following aspects. First, the impact of drama therapy according to each subject’s symptoms should be more clearly presented in both qualitative and quantitative aspects. Second, the possibility of adopting the medical point of view in drama therapy needs to be examined more carefully. For example, adopting a new academic theory such as brain science might have a positive effect on the development of drama therapy. Third, there should be more opportunities for academic interchanges with other art therapy areas. Fourth, therapeutic performances need to be more encouraged for the popularisation of drama therapy. Fifth, there should be more chances to exchange knowledge regarding drama therapy with other countries, academically and clinically. Hopefully, in the near future, there will be more opportunities for Korean drama therapists to share their academic knowledge and experiences with the global community. Based on their own lessons from practice along with understanding of Western and Eastern philosophies, they will be able to develop their own assessment tools and methods. Through the process of this academic attempt, they will be able to pursue more in-depth studies integrating lessons from their work in Korea and existing theories from the Western world, so that they can share their knowledge, which will work as a bridge for greater understanding between the East and West.

References Jennings, S. (1998) Introduction to Dramatherapy. London: Jessica Kingsley. Jennings, S., Cattanach, A., Mitchell, S., Chesner, A. and Meldrum, B. (1994) The Handbook of Dramatherapy. London: Routledge. Johnson, D. R. (1988) ‘The diagnostic role-playing test’, The Arts in Psychotherapy, 15, 1, 23–36. Johnson, D. R. and Emunah, R. (2009) Current Approaches in Drama Therapy. Springfield, II: Charles C. Thomas. Jones, P. (1996) Drama as therapy. London: Routledge. Kohut, H. (2009) The Analysis of the Self: A systematic approach to the psychoanalytic treatment of narcissistic personality disorders. Chicago, IL: University of Chicago Press. Lahad, M. (2013) The ‘BASIC PH’ Model of Coping and Resiliency: Theory, research and cross-cultural application. London: Jessica Kingsley. Landy, R. (1993) Persona and Performance: The meaning of role in drama, therapy, and everyday life. London: Guilford Press. Landy, R. (1994) Drama Therapy: Concepts, theories and practices. Springfield, II: Charles C. Thomas. Park, M. (2013) Emotional Model in Drama Therapy. Seoul: Hakjisa. Pendzik, S. (2008) ‘Using the 6-Key Model as an intervention tool in drama therapy’, The Arts in Psychotherapy, 35, 5, 349–54.

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2 The development of drama therapy in Taiwan Hsiao-hua Chang (張曉華)

The beginning Drama therapy was still a newfangled academic subject to the students of drama and theatre during the 1980s in Taiwan. While I was an instructor at Fu Hsing Kung College (FHKC), in the Department of Theatre and Film in 1987, I got a scholarship from the government to study an MA programme in Educational Theatre at New York University, where I took some courses with Robert Landy. It is believed, as Landy said, that I was the first Asian scholar from Taiwan to study in this field. From that time on, I not only learned about use of drama therapy in treating individuals with emotional, physical, social and developmental disabilities, etc., but also recognised the importance of contributions to people with special needs. I believed that drama therapy was a new domain and worthwhile developing in Taiwan. So, after completing my MA programme in Educational Theatre1, I went back to Taiwan in 1988 and carried on the research, giving an impetus to the field of drama therapy. I hope that what I have done in Taiwan is similar to what Peter Slade2 did in England. This chapter is my overview of the development of drama therapy in Taiwan.

The college courses The first workshop in Taiwan was started by myself, in 1990. I conducted a drama-therapy workshop in a symposium at the Graduate School of Psychology, FHKC. Because my workshop was welcomed by most participants, I was invited to do a series of drama therapy workshops for many other colleagues. The workshops were so successful that, the next year, in 1991, a selected course of drama therapy was added to the general curriculum of undergraduate students in FHKC. Then, in 1997, I transferred my full-time employment from FHKC to the National Taiwan University of Arts (NTUA), in the Department of Drama. After being elected the chair of the department, I started drama therapy as a selective course for undergraduate students in 1998. After promotion to a full professor in 2004, I offered an advanced, three-credit selective course, ‘Drama Therapy, Theory and Practice’ for the graduate students on an MA programme in the department, in 2005. 8

The development of drama therapy in Taiwan

No sooner had that happened than drama therapy unexpectedly became a training course to develop a pre-teacher training programme in the colleges of Taiwan, because, in 1997, the Arts Education Act (藝術教育法, 1997)3 had been approved by the parliament, the Legislate Yuan of Taiwan. It led to the curriculum of performing arts being enacted in Public Education Grades 1–9 in 1998 (教育部, 1998),4 and a course of arts and living in high school in 2005 (教育部, 2004).5 I was appointed as the convener of the curriculum guideline committee for performing arts and was invited to draft the performing arts domain study outline. Then, the Ministry of Education issued Performing Arts Study for Public Primary and Junior High Schools 1–9 Curriculum Guideline in 2003 (教育部, 2003),6 and the Public High School Curriculum Guidelines in 2008 (教育部, 2008).7 According to the Guidelines, the courses of performing arts were arranged for 1 hour a week in primary and junior high school, and two credits in high school. Now, all students in Taiwan have to study performing arts in public schools. As drama therapy is one of the subjects in arts applications, the teaching content for performing arts should include the basic knowledge, activity and appreciation, as in the guidelines. Therefore, drama therapy has become a required training course of two to four credits for pre-teachers. Many teachers’ colleges in the universities, such as National Taiwan University (NTU), NTUA, Taipei National University of the Arts (TNUA), the National University of Tainan (NUTN) and the Private Chinese Culture University employed qualified drama therapists to teach the drama therapy courses. This educational policy also allows registered drama therapists (RDTs)8 with at least a qualifying Master’s degree, such as Chih-Hao Chang (張志豪), Ching Yuan Su (蘇慶元), etc., to have the chance to teach drama therapy in colleges. Besides the drama therapy courses, there were also general curriculum in some colleges and universities; for example, the National College of Performing Arts listed the course of Expressive Arts Therapy – Drama Therapy. Some other schools, such as Fu Jen Catholic University, FHKC and Taiwan Theological College, also set up drama therapy as one of their selective courses for the general curriculum, because they believed drama therapy benefited personal growth. Drama therapy is now within the scope of knowledge of the students in some colleges.

Courses in private institutions Some private institutions have also provided courses for people who were interested in drama therapy. The Taiwan Applied Rehabilitation Association invited Chen Wei-Fang (陳巍方) to lead workshops that introduced clinical experiences in children’s difficulties. Cai Yuan Arts Culture and Education Foundation invited Monique Wu (吳怡潔) and Mindy Gui (桂旻恒) to teach dramatherapy techniques that could be applied in actors’ training projects on physical and oral expression. The Asian Creative Art Popularise Association held a series of drama therapy courses in Taipei, Kaohsiung and Chiar Yi, including: potential energy activity, self-exploration, the building of personal relationships, and dealing with the experience of trauma, etc. The programme was trying to let the participants know how to improve children’s abilities in expression and creativity. The Fu Rong Combination Education Promotion Foundation held a children’s drama therapy class once a week for a total of eleven lessons and hoped the parents would learn some drama therapeutic methods to deal with their children’s problems, such as: learning difficulties, emotional and behavioural difficulties, Asperger syndrome, etc. Another notable official workshop was named the ‘Youth X Magic Journey: The Youth Drama for Self Exploring Workshop’ and it was held by China Youth Corps in Taipei, in 2014. 9

Hsiao-hua Chang

The workshop was conducted by Chih-Hao Chang, RDT. He started each workshop with physical warm-up exercises. After the participants had been put into groups, they were asked to tell their personal stories as the main action. Then, he worked on the creation of their autobiographies and performances. At the closure of each workshop, he let all members share their feelings and write down their addresses to keep in contact with each other afterwards. The end of the workshop was very touching and also proved that he was welcomed and appreciated by the young participants. A different workshop was run at the Garden of Hope Foundation; a series of long-term courses for professionals were regularly held in the Dandelion Consultation and Guidance Center. The workshops for women who had been sexually abused were conducted by Su-Chen Hung (洪素珍). These regular workshops still continue to run every year. Above all, most workshops or lectures have been held for a variety of purposes at the institutions and are quite often held for both short and long periods of time. This information is easily available on websites in Taiwan.

The research In recent years, many Taiwanese scholars have released their studies in periodicals and collections at conferences. Some of the representative articles in periodicals are ‘The brief introduction to drama therapy’, in Performing Arts Journal (2004), and ‘The possibility of developing drama therapy in Chinese society’, in The Journal of Drama and Theatre Education in Asia (2012), by Hsiao-hua Chang, ‘Drama therapy applied to children with ADHD in the resource class of a primary school’, in The International Journal of Arts Education (2006), by Wen Long Chang (張文龍) and Wei Min Liu, and ‘Exploring the recovery process of the former Taiwanese comfort women through drama therapy group’, in Asian Journal of Women’s Studies (2010) by Su-Chen Hung. Also ‘Art therapists are also artists – Utilising the drama therapists’ professions’, in Tai Yi Drama Journal, by Yi Shiuan (林怡璇), and ‘Earthquake, trauma, and therapeutic theater: Taiwan’s experience of the 921 earthquake’,9 in Anthropological Performance and Sociology (2008), by I-Chu Chang (張藹珠). From 2005 to 2014, there were already about fifteen thesis with the title of ‘Drama Therapy’, and 170 therapeutic drama discussions have been placed on the website of the National Digital Library of Thesis and Dissertations in Taiwan. These pieces of research covered many areas; some were about approaches, methods and techniques, such as: role method, psychodrama, creative drama, improvisation, mask, puppets and theatre, etc. Others were about subjects in drama therapy, including the role of the collaborative leader in workshops, children of alcoholic families, the effects of mental health for groups of high-risk youths, reducing loneliness in institutes for elderly, applications for junior high-school dropout students, the children of new inhabitants of Taiwan, and enhancing the social abilities of elementary ADHD students in resource classes. Although there are many thesis about drama therapy in Taiwan, we still do not have a graduate school for drama therapy in our colleges. How we begin studies for a Master’s degree of drama therapy still needs some effort and time.

Publications Drama therapy publications have been in many forms: books, videos and websites. Only four books in this field had Chinese translations, and one local edition. The Chinese versions, which were translated and published here in Taiwan, are: 10

The development of drama therapy in Taiwan

1

2 3

4

Robert Landy (1994) Drama Therapy, Concepts, Theories and Practice (2nd edn; trans. (1998) by Guang-Yuan Hong (洪光遠), Bai-Lin Li (李百麟), Shi-HongWu (吳士宏), Hui-Yu Zeng (曾蕙瑜) and Zhi-Yi Wu (吳芝儀)). Taipei: Psychology. Renée Emunah (1994) Acting for Real: Drama therapy process, technique, and performance (trans. (2006) by Adeline Chan (陳凌軒)). Taipei: Living Psychology. Phil Jones (1996) Drama as Therapy: Theatre as living (trans. (2002) by Su-Chen Hung, DaHe Yan (楊大和), Ji-Zhong Xu (徐繼忠) and Wen-Ling Kuo (郭玟伶). Taipei: Wu-Nan Book. Sue Jennings (2012) Creative Drama in Groupwork (2nd edn; trans. (2013) by Hsiao-hua Chang, Zhao-Ling Ding (丁兆齡), Xian-Ren Ye (葉獻仁) and Fan-Yi Wei (魏汎儀). Taipei: Psychology.

These four translated versions are commonly used as references or textbooks for the courses of drama therapy in Taiwanese colleges. These books have offered important knowledge and practice techniques and have also influenced academic studies here. The local edition, of the book Ji-gon Asked for Rehabilitation, edited by Hsiao-hua Chang, was published by the Chinese Theatre Association in 1996. This book recorded all of Robert Landy’s workshops in Taiwan, including the introduction of drama therapy, Landy’s speeches, theatre productions, local news reports and participants’ feedback. The Chinese Theatre Association not only published the book, but also edited the workshop videotape for the public.

Academic conferences Following the issue of Grade 1–9 Curriculum Guidelines of Arts and Humanities by the Ministry of Education, the National Taiwan Arts Education Institute held an International Drama and Theatre Education Conference for Primary and Junior High Schools in 2002. During the keynote speech I introduced the drama courses and activities in public schools and mentioned the importance of drama therapy. As the convener of the curriculum guideline committee for performing arts for the Ministry of Education, I explained the official point of view: that teachers of the performing arts should have a basic knowledge of drama therapy10 and all pre-teachers should study two to four credits of the courses for the psychology of performing arts. The other two international drama therapy conferences were hosted by the Department of Drama, NTUA, in 2012 and 2014. The first was titled, China, Hong Kong and Taiwan, The Conference for Drama Therapy and Education. The conference had nine lectures and six workshops that were presented in 3 days, and the subject of discussion was a focus on the analysis of drama therapy, therapeutic drama and related activities, including psychodrama, playback theatre, forum theatre and therapeutic theatre, etc. The second conference was on Applied Drama – the International Conference of Drama Therapy (2014). Some important scholars were invited from Japan, England and Mainland China. Drama therapy was used as a case analysis. Sue Jennings was the eminent VIP from England who introduced Neuro Dramatic Play in her keynote speech and shared some of her experiences in workshops. Some conferences have been held in hospitals. The first Expressive Art Therapy Center was opened in Taiwan at the Adventist Hospital in 2005. This centre held an International Expressive Art Therapy Conference in 2012. There was a drama therapy lecture, ‘Drama therapy with emotionally disturbed children’, led by drama therapist, Chen Wei-Fang, RDT. Other conferences have been regularly held in Wan Fang Hospital. The Expressive Art Therapy – Theory and Practice Application Symposium had already been held three times by the Taiwan Medical Building and Affairs Communication Association at the hospital, every 11

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2 years from 2010 to 2014. The conference in 2014 arranged a lecture by Chih-Hao Chang, RDT, on ‘The practice image of drama therapy’.

International communication In order to let more people know about the international trends in drama therapy, some important pioneers of the field were invited to Taiwan. The first expert was Robert Landy in 1995,11 invited by Margaret Young Mar, the president of the Chinese Theatre Association. The Conference included lectures, activities, rehearsals and therapeutic theatre productions of Ji-gon Asked for Rehabilitation.12 The collection and videotape of the production were released in 1996. The one idea that has impacted on me most has been Landy’s role method, demonstrated in the performance. He applied the role of Ji-gon to run through four groups’ stories and solve all the problems touchingly and reasonably. Feedback from one audience member was that: ‘The role in the play explains a new traditional culture, and I just need to open my mind’.13 The production led me to recognize the power of theatre in the therapeutic function. Therefore, in my graduate school, in the Theory and Practice of Drama Therapy course, I ask my students to arrange a final theatrical performance at the end of the semester. These pieces of performance have always been the climax of their study. In 2010, I also led another project, sponsored by the Wen Shi-ren (溫世仁) Foundation, and invited Robert Landy to come to NTUA to conduct the 3-day workshop of Three Approaches to Drama Therapy. Landy introduced the theories and practices of the role method, psychodrama and developmental transformations and analysed the cases we worked with. In this Conference, more than 200 participants came from all over Taiwan. At the end, many participants suggested that we should organize a Drama Therapy Association for Taiwan. In August of the same year, another pioneer drama therapist, Renée Emunah from the California Institute of Integral Studies, USA, was invited by the Teacher Chang Foundation to preside over a workshop entitled Acting for Real, for 2 days, at the China Youth Corps in Taipei. She introduced and worked with her five-phase model of drama therapy: dramatic play, scene work, role play, culminating enactment and dramatic ritual. The workshop was very successful, not only for proving her theory, but also for treating a current case.

Figure 2.1 The role of Ji-gon in a group for the therapeutic play production Source: Photo by Hsiao-hua Chang, 28 December 2006

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The development of drama therapy in Taiwan

Figure 2.2 The most helpful character who wore the cap of Ji-gon Source: Photo by Hsiao-hua Chang, 28 December 2006

Another important visiting scholar was Sue Jennings, who was one of the founders of the drama therapists’ group, the Remedial Drama Group, in England, in 1962.14 Sue was invited by Hsiao-hua, who arranged this 2-week academic journey. Sue attended the Conference of Applied Drama – the International Conference of Drama Therapy 2014, at NTUA. She took visiting lectures at the Department of Drama Creation and Application in NUTN, the Department of Childhood Education in Pington University of Education, the Arts and Living Teaching Center in the Senior High School of the National Taiwan Normal University, and the Humanities and Arts School in TNUA. Most lectures were on the topic of Neuro Dramatic Play; her workshops were on storytelling and working with infertility, dementia and forensics. Some Taiwanese scholars and RDTs were also invited to go to Mainland China and Hong Kong. I went to Shanghai Theatre Academy three times, in 2009, 2012 and 2014, and Hong Kong once, in 2010. I demonstrated the teaching of creative drama and drama therapy for the students of the Drama in Education Professions class, graduate students and college teachers in October 2009. Then, at the Third International Conference of Performance Studies in September 2012, I applied the role method with some psychodrama techniques in the theatre of the Academy. In June 2014, I was invited by the Shanghai College students of the Psychological Health Education Centre to conduct creative drama, story drama and mask workshops for a group of consultants, psychologists and guidance teachers at Shanghai colleges for 5 days. We also communicated with other Chinese societies, including the Centre for Community Culture Development (CCCD) and the Hong Kong Drama Therapist Association in Hong Kong. It was in August 2010 that the Drama Therapy in Psychiatric Services: Workshops and Symposia were held in Kwai Chung Hospital. I was invited to introduce our experiences from Taiwan. Then, in August 2014, Taiwanese RDT Chih-Hao Chang was invited by CCCD to hold a 1-day workshop in the Jockey Club New Life Institute of Psychiatric Rehabilitation. He introduced the elements, phrases and activities of drama therapy and let participants experience the sense of humour, self-esteem, social skills and concepts of absolute acceptance and values of life. As the speeches and workshops from Taiwan were all concerned with Chinese society, the participants responded enthusiastically.

The therapeutic performances for public The first theatre performance of drama therapy was the production of Ji-gon Asked for Rehabilitation. As discussed earlier, the play was directed by Robert Landy on 29–30 December 13

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1995, in the theatre of NTPAS. Hundreds of audience members joined this interactive performance, and this also led some TV news reporters to record parts of the production on the spot. The productions were very successful. Not only did the audience enjoy them, but they also demonstrated Landy’s role method in a play production. Could You Love Me? was a unique production by the Le Théâtre de l’Eau Dessous. The play was written and directed by Chia-Jung Chang (張嘉容) and performed in the Ark Theatre in Taipei between 27 and 30 March 2012. She created all the stories taken from the parents of autistic children and directed the actors who rehearsed the play in the workshops. As the subject of the performance was very touching, it led to tremendous feedback in the newspapers and on the websites concerning the problems of depression, Asperger syndrome, family violence and disabilities. Two other productions were presented by the Garden of Hope Foundation. The Vagina Monologues originated from Eve Enster and were edited and directed by Shu-Ling Lin (林淑玲). The play was performed once a year in performances that travelled from north to south Taiwan, from 2005 to 2014. In these years, the content and plot of the play had already changed into Taiwanese stories. As the subject is very bold with respect to female physical rights, it has allowed many people to discuss this topic, and some publicly renowned ladies even expressed their opinions and experiences in public. The production also led to many Taiwanese versions being performed by other troupes. The other production presented by the Garden of Hope foundation was a shadow puppet show, Dark of Light: Anti-sexual Violence Forum Theatre: Shadow Action, directed by Evan Hastings, the Gender Shadow drama therapist from USA. He used puppets, dance, improvisation, masks and sound effects to illustrate the social problems of sexual harassment and violence. As the shadow implied the metaphor of the issues, the forum theatre could let the audience participate in the show and go deep into the issues and individual experiences. This production was also performed in the theatres of island-wide Taiwan and could be seen at any time on the website of the foundation. The productions with therapeutic subjects always provoke great concern in the people of Taiwan. We hope such productions will continue to be performed in our theatres.

The therapists15 There is no licence legally issued for drama therapists in Taiwan. The Psychologists Act was issued on 21 October 2001, and the Physicians Act was amended on 13 May 2009; there has been no article concerning therapists. According to the law, there are only two kinds of psychologist, counselling and clinical, and anyone arbitrarily practising as a psychologist or physician without having obtained a licence will be sentenced or fined. The scope of therapists overlaps with that of psychologists and psychiatrists in many ways, such as the actual consulting and psychotherapy and dealing with emotional and behavioural disturbances and neuroses. The law reflected problems with how therapists carry out their business. The physician and psychologist laws redefine the role of therapists and prepare them to set their own defining law in the future. Under these conditions, what can drama therapists do? From interviewing some of the therapists here in Taiwan, I have reflected on four kinds of working situation, which are quite different. Maybe we could classify them into the following four approaches: 1

14

The first approach is for those who have gained both RDT and Taiwan psychologist licences. These therapists mostly have a Master’s degree in drama therapy and psychology. Their

The development of drama therapy in Taiwan

2

3

4

qualification in psychology could allow them to take the professional and technical exams held by the Ministry of Examinations to obtain the licence. These therapists are most welcome in Taiwan. Because very few psychologists have the RDT licence, the legal status could permit them to do unique and special drama therapy work everywhere, such as: Jing-Yi Zhu (朱靜怡), Su-Chen Hung and Chih-Hao Chang. The second approach concerns those who have an RDT licence from abroad. They studied abroad and got their RDT licence, but they have no MA degree in psychology. So, these therapists could not take the examination qualification for psychologists. But, they are still welcomed by charities, organizations or colleges. For example, Pen-Lu Yang (楊秉儒), RDT, who graduated from the Department of Drama and Theatre, National Taiwan University, holds an MA degree from New York University’s programme of drama therapy and a licence from the National Association of Drama Therapy in the USA. He is employed by the Eden Social Welfare Foundation as a full-time faculty member of staff doing rehabilitation work, thanks to his RDT qualification. Ching Yuan Su, RDT, has an undergraduate degree from the Department of Theatre, TNUA, and his graduate school was the Central School of Speech and Drama in the UK. His degree allowed him to teach drama therapy and also theatre courses in many colleges. The third type of qualification is for those who have completed graduate studies in drama therapy. They have a Master’s degree but no drama therapy licence. These therapists are also welcome in some institutes. For example: Wen-Ling Kuo (郭玟伶), from the graduate school of the University of Hertfordshire, is a part-time therapist who worked for Wizcare Hospital, Domestic Violence and Sexual Assault Prevention Center, and lectured for Tunghai University. Ying-May Liu (劉映梅) graduated from New York University’s MA programme in drama therapy and she works for the charity Bethany Children’s Home and the Social Welfare Department in Taipei City as a guide or tutor. The fourth and final approach is for those who have taken drama therapy courses or studied by themselves. These therapists were scholars or leaders of the troupes, such as myself and Wen Long Chang as scholars, and Ya-Ling Lang and Chia-Jung Chang, who were the theatrical troupe leaders. These therapists’ contributions were to academic research and to promoting and popularizing drama therapy to the general public.

So far, we still have not built up a suitable system and a business for therapists. Although some advanced systems have already been established in other countries, we could learn from their experiences and overcome our difficulties.

Community The community theatres in Taiwan are quite active. With support from the Culture or Social Welfare Bureaus, drama therapy activities are brought into different nursing homes and elderly rest homes. An example is my experience in 2010,16 when the drama therapy programme was brought into Taipei County for disabled children in nursing homes and for elderly rest homes. I was invited by the Culture Bureau of Taipei County to carry out the project ‘Doctor of Expressive Arts Therapy Group for Social Welfare’ in order to help the disadvantaged minority. It was arranged that we would go to two institutes, Pai Ai-Hsin Home for Persons with Disabilities in Taipei and the Taipei County Senior Citizens Home for Compassion. The purpose of the 4-week drama therapy workshop was to use masks to explore the role position of the participants, in order to let them build positive and optimistic values in life. The 15

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Figure 2.3 Masks let older people interact with their feelings Source: Photo by Tsai-miao Hsieh, at the Taipei County Senior Citizens Home for Compassion

reason I used mask work with the role method was because masks can easily lead participants into a fictional world, so that they gain a sense of security, and provide a projective effect. It was found that the participants were timid and anxious at the beginning, but, after the activities, they gradually lowered their defences and fully involved themselves in the role playing and creative work. Drama therapy was welcome in these communities, and the government organizations offered the budgets to support these activities regularly. So, we could see many of these activities in our communities.

Conclusion From this overview of drama therapy in Taiwan, we can see that there is a need for the promotion of training courses, research, conferences, performances and international communication with colleagues around the world, and for a system for the professional organization of drama therapy in Taiwan. Here are some of the actions that could assist with this: 1

2 3 4

Establish a Master’s degree drama therapy programme for students who would like to be a therapist (psychologist) in their future career. Courses in school should include, not only psychology, but also drama therapy. Organize an association for drama therapy in order to allow drama therapists to come together, to form a stage for communication and to do more for therapist themselves. Communicate with other therapist associations that are trying to find ways to develop a legal framework for therapists. Publish more books, periodicals and media materials for the public to build up higher academic levels to form a therapeutic position for drama therapy in society.

Surely the field of drama therapy should be expanded. We know many important pioneers in this field offered their life work to contributing research and publications, such as Peter Slade 16

The development of drama therapy in Taiwan

Figure 2.4 The children are happily introduced to the idea of expressing their feelings with each other Source: Photo by Yi-shiuan Lin, at Pai Ai-Hsin Home for Persons with Disabilities, Taipei

and Sue Jennings in England, Robert Landy, Renée Emunah in the USA and Richard Courtney in Canada. Their achievements have established a complete system for the field of drama therapy. Who will be the pioneer to lead Taiwan to develop the future field of drama therapy? Now, I would like to take the initiative, to be the man. Hence, some colleagues and I will be planning to apply to the government to set up the Taiwan Applied Drama and Theatre Association. We can definitely do more drama therapy work for people in Taiwan.

Notes 1 The field study of drama therapy was in the Educational Theatre programme of New York University, during the 1980s. 2 Peter Slade, the pioneer of dramatherapy, started a dramatherapeutic practice for children with learning difficulties in the 1930s (Courtney 1989, p. 83). He was the first one to apply the one word dramatherapy in a speech to the British Medical Association in 1939 (Jones 1996, p. 44) and worked for the Ministry of Education, setting up the first Working Party on Drama Education (1948), which allowed a ministry policy to emerge in England (Bolton 1999, p. 120). The work for the children could be seen in Peter Slade’s Child Drama (1954/1976) and Child Play, its Importance for Human Development (1995). 3 藝術教育法, 總統公佈法律令 (1997). 4 教育部 (1998), 台北: 教育部. 5 教育部 (2004), 台北: 教育部. 6 教育部 (2003), 台北: 教育部. 7 教育部 (2008), 台北: 教育部. 8 In Taiwan, there is no licence legally issued for therapists. In this article, RDT only refers to therapists who got their licence from abroad, such as in the USA or UK. 9 According to news reports, the 921 Earthquake (on Tuesday, 21 September 1999, hence, ‘921’), which measured 7.6 on the moment magnitude scale, caused a serious disaster in central Taiwan. There were 2,415 people killed, 11,305 injured and 50 missing, 51,378 houses collapsed, and damage costing NT$300 billon (US$10 billion) was done. 17

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10 In Taiwan, drama therapy is listed as one of the courses in psychology of the performing arts for junior and high-school pre-teachers. 11 Landy 2001, p. 154. 12 Ji-gon is a Chinese monk god, a trickster heroic figure in Chinese culture. Margaret and I suggested that Landy apply the role to run through the story, because Ji-gon has supernatural powers of healing and he always treats difficult sickness in a strange way. 13 張曉華 1996, p. 118. 14 Jones 1996, p. 90. 15 The ‘therapist’ in this article means any person who engages in any drama therapy work with individuals. 16 See Landy and Montgomery 2012, pp. 194–5.

References Bolton, G. (1999) Acting in Classroom: A critical analysis drama. Portland, ME: Calendar Islands. Courtney, R. (1989) Play, Drama and Thought (4th edn). Toronto: Simon & Pierre. Jones, P. (1996) Drama as Therapy: Theatre as Living. London: Routledge. Landy, R. (2001) How We See God and Why it Matters. Springfield, II: Charles C. Thomas. Landy, R. and Montgomery, D. (2012) Theatre for Change. New York: Palgrave Macmillan. Slade, P. (1954/1976) Child Drama. London: Hodder & Stoughton. Slade, P. (1995) Child Play, its Importance for Human Development. London: Jessica Kingsley.

References in Chinese 張曉華 (1996) 主編。《濟公問『症』》. 台北: 中華戲劇學會. 教育部 (1998) 《國民教育階段九年一貫課程總綱綱要》. 台北: 教育部. 教育部 (2004)〈普通高級中學必修科目「藝術生活」課程綱要〉. 《普通高級課程暫行綱要》. 台北: 教育 部, 台中（一）字第 0930112130 號令. 教育部 (2003)《國民中小學九年一貫課程綱要：藝術與人文學習領域》. 台北: 教育部. 台 (92) 國字第 092006026號. 教育部 (2008)《普通高級中學課程綱要》. 台北: 教育部, 台中（一) 字第 0970011604B號函. 藝術教育法 (1997) 總統公佈法律令. 華總（一）義字 860060070號.

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3 Converging lineages Arts-based therapy in contemporary India Aanand Chabukswar with Zubin Balsara

Arts-based therapy (ABT) is the name of a practice that has evolved in contemporary India from the need to reach out to those who can directly benefit from art forms in a healing context. The study and practice of ABT is based on the ‘view’ of systems and practices in health, psyche and the arts from an Indian perspective. It is shaped dynamically by realities of space and time, poignant details of specific contexts and some aspects that are greater and subtler than descriptions. To narrate this formation is no more than an attempt to write on the surface of a lake. Traditionally, in India, all art forms, including drama, are strongly ‘integrated’. This integration at one level is the coming together of all arts in performance. Natyashastra presents theatre as inclusive of sound, song, gesture, movement, plot and story to represent the sentiments or emotions on stage (Gupta 2010). Most folk forms that have emerged over millennia, many of them still extant, do not distinguish between dance, music, drama and visual arts as separate. They are multisensory extravaganzas that create an aesthetic and entertaining joy. Integration also indicates another level of synthesis – that of everyday life and rites, rituals, performances. Significant artistic and aesthetic experiences cannot be separated from events or occurrences of social, personal and psychospiritual or sacred significance. In fact, Indian theatre is ‘not confined to neat, narrow categories’ (Richmond et al. 1990, p. 3). All the arts – from crafts to painting to dance to storytelling and more – formed the dimension of the ‘extra-daily’ (natyadharmi) marked by rituals, ceremonies, festivals and such, within the workings of the daily (lokadharmi) life of the community. Entire villages, castes, functions – from farming to manufacturing, marriages to meditation and renunciation – were governed by a pantheon of customs, worship, offerings, recitations, performance routines and divergent sets of multidimensional belief systems with philosophical bases. In this sense, what mattered most in the Indian life of antiquity was the exploration, depiction and bridging between the subtle, unknown, unexpressed and the lived, daily, expressed. The strands of the material and non-material were cognized as a continuum of existence, touched and transcended by the occasions and performances, designated now as ritual, theatre/drama and the arts. The ancient and customary life in India was also oriented towards a very refined human aspiration to reach ‘wisdom’ about existence. Complex and dynamic systems of thought and practices flourished. From monotheism to pluralism, cosmologism, sensualism, annihilism, eternalism and materialism, among many others, all were being vigorously debated and practised 19

Aanand Chabukswar with Zubin Balsara

more than 2,500 years ago, in the pre-Buddhist period (Sharma 1987). Jain thought, Buddhist schools, Vednata and branches of theistic and non-theistic Hindu paths, Sikhism, Sufi practices – all these and many more hold within their folds a wide variety of dynamic schools of metaphysics, which in their own way define and deal with human existence, suffering (dukkha) and the liberation from it. The quest for freedom from suffering was a pervading theme. In addition to the obvious grief and misery, pleasure too is characterised as a part of suffering (Palsane and Lam 2011). There are extremely sophisticated methods or paths that practically guide one to the end of this suffering. There are many unbroken lineages and whole range of siddhas (accomplished beings), fakirs, saints, yogis and gurus who have lived and liberated, who have demonstrated and taught, right until the present day and age. The world-view is so grand and yet so specific that each activity, each task, from eating food to commerce, from the gaze of the eyes in different activities to complex hand gestures (mudras) in ritual practices, is codified and infused with meanings to remind about ‘paying attention to your existence’ (Trungpa 2005, p. 161). Life itself is an integrated system of seeing, accessing, creating and participating in reality. Health and well-being were integrated with the dynamic world-view and practices, like everything else. For example, we find Ayurveda prescribing remedies for depression that include, not only dietary and herbal treatments, but also meditation, massage and music (Simoes 2002)! Medical as well as non-medical treatments focused on the person, not the disease alone. Traditional folk healing practices, although taking several forms and methods, had elements of chanting, rhythm, aroma, music, (re)telling of narratives and stories, invocation of ‘other’ dimensions, participation of family and community. They were not only remedial, but also served as preventive social medicine. In some cases, they became elaborate rituals involving whole villages, with masks, or trance states and story enactments. The process is holistic and does not cut the physical off from the mental, elemental, social and spiritual. The person is seen as a composite of body, mind and consciousness. The larger context is freedom from suffering and the state of moksha or nirvana as the ultimate state. ‘No matter what are the perceived causes of the problem, be it organic, emotional or social, the suffering is viewed as a state of mind, a subjective experience’ (Dalal 2011, p. 27) and, as such, it is dealt with by solutions ‘deeply entrenched in folk wisdom and sound theories of mind’ (p. 22). Deconstruction of ego is a necessary prerequisite for this undertaking. We come from a tradition that doesn’t uncover or strengthen the ego; we train to be free of its grasp on us. It is a persistent theme of millennia of saints, philosophers and teachers to study the roots of the ego construct – to study the mind and the consciousness. It is undoubtedly a thoroughly subjective, inner, contextual study, and no one method binds it. The actual action or forms of practice are easily made and unmade. That explains, in part, the manifestation of uncountable methods to suit equally diverse, subjective, context-bound human tendencies and traits. Even theatre was one more method, ‘one of the disciplines of contemplation by which peace was established in the soul’ (Wells 1963, in Tarlekar 1975/1991, p. 53). The use of art forms for healing was entrenched in the view of the aesthetic as the vehicle for the psychospiritual. In fact, the capacity of art forms to engage and energise made them central in all endeavours; they are inseparable from the cultural design of Indian life. Their transformational potential was recognized and played out, like folk stories changing meanings and values, depending on the ‘context-sensitive designs that embed a seeming variety of modes and materials’ (Ramanujan 1999, p. 42). The subjective, the individual, is at the centre of this process, woven within an overarching theme of journey to the other shore of existence. Much of this altered in form and function by the twentieth century. Degeneration of the classical and folk philosophies and paths into items of blind faith, rituals beaten senseless by habit, colonial rule, changes in speeds and scale and many such factors corroded the world-view 20

Arts-based therapy in contemporary India

and practices based on wisdom. These changes were consolidated by systems that adopted a model of development that is not indigenous. A case in point is the establishment of psychology as a discipline in modern India. The first Department of Psychology was established at the University of Calcutta in 1916. The start came from colonial, circumstantial factors, but it continued expanding in the same vein, while ignoring ‘a hoary Indian tradition of a long line of philosophers and medical researchers’ (Rao 2008, p. 4), and it cannot be denied that we were enamoured by Western presentation of ideas and practices, appealing for their ‘deceptive simplicity and apparent objectivity’ (Rao 2008, p. 5). The colonial shadow left its mark in ‘western methods of analysing the problem and treating it’ (Kumar 2004, p. 179), and what this import did was eventually displace people from the centre of their suffering, and it objectified them into progressively longer lists of illnesses considered ‘treatable’ with medicine and therapeutics acting within an extraneous, clinical paradigm. It is almost forgotten, though not entirely, that the construct of illness is only a part of a more ‘correlative and integrated system’, the person (Salema 2002, p. 7). The official discourse on health and medicine in modern India did not cipher between the corrupted versions and meaningful origins of traditional modes, methods and materials. A materialist, positivist, biomedical view became prevalent, as it is worldwide. Today, in India, we have psychiatrists trained only in Western categories and medicine who prescribe drugs for ADHD to very small children, while a whole range of methods on mindfulness and attention designed and practised for millennia by several Buddhist schools lie fallow, without the effort to research, revive or explore through experimentation for the particular purpose. The paradox is that Western civilizations, in turn, have turned substantial attention towards the study of classical Indian languages, wisdom traditions and practices, using them as antidotes for human suffering not sorted by material advancement. Abandoning native systems of knowledge and practices created a deficit in the increasingly demanding scenario of mental health and disability needs. In the pre-independence period, apart from the building of ‘asylums’, there was no clear strategy for the care of the mentally ill. In the post-independence period, the need for a different approach was recognized: ‘first, trained mental health professionals alone would be inadequate . . . second, the need to develop services beyond mental health institutions’ (Kumar 2004, p. 174). However, these insights have not been followed up by systematic action, and the situation has not improved. The paradigm of categorizing and treating is itself problematic: ‘the legal definitions view dis-ability strictly from the medical and/or psychometric perspective. This ends up reinforcing a medical model of intervention’ (Bhagat 2008, p. 41). There are only forty-three state mental health care institutions, unevenly dispersed across this vast country. The human resources are woefully inadequate to cater for a rising need; for example, as of 2013, there were only 898 clinical psychologists, against the need for 17,250 (Press Information Bureau 2013; Seervai 2013). In such a scenario, the private sector vies to take over health and medical facilities, with unfavourable consequences for the majority of relief seekers (DNA 2014). Despite the statistics, however, in what is termed the ‘outcomes paradox’, markedly better outcomes for schizophrenia patients in India have been reported in WHO’s long-term studies (Jablensky and Sartorius 2008, Padma 2014). The better results are attributed to sociocultural factors, such as family, community and local conditions. The erosion of local and community care on one hand and institutionalisation of disability and mental health in the national health policy and programmes on the other shouldn’t have been inevitable. Those of us who had the intent to use the arts for healing systematically had to forge ahead in the face of these complex realities. One of the encouraging facts was the manifestation of dramatherapy, music therapy and art therapy in their modern avatar in the West. They have carved out existence through astute diligence in research and practice. In dramatherapy, pioneers 21

Aanand Chabukswar with Zubin Balsara

have made it their lifelong mission to demonstrate the healing power of drama as valuable (Jennings et al. 1994; Lindkvist 1997). Music therapy evolved with models of treatment including neurological models and several applications (Riley 2012, Thaut 2005, MacTavish and Balsara 2012). Being equipped with Western training did not, however, ensure any actual practice in India. Even basics such as information on the client’s exact diagnosis, space for sessions and support staff were, and still often are, a far cry. Add to that the huge number of clients an institution or therapist is expected to cater for. The issues were compounded by wrong views on the illness or disability and lack of resources, leading to rigid notions, low capacity and even neglect. But, despite all limitations, there are several institutions and people with an exceptional devotion to care, hope, persistence, hard work and compassion. As we had a commitment to consistently take the arts to institutions and did not expect to get paid for it, we were welcomed! Following the norm, we did initially try categorising the work as dramatherapy, improvisational music therapy, counselling and such, but soon came face to face with what was really taking shape. A variety of artistic tools and techniques were required to cater for the heterogeneous backgrounds and tastes of clients. For one group, bhajans (devotional songs) worked far better than romantic numbers, whereas, for others, Hindi film songs from a specific period did it! The same with stories, games and improvisational materials. Different groups of clients related to different arts in a variety of ways. In palliative care, story circles fitted better, whereas drumming and rhythms were far more useful for those going through withdrawal symptoms in de-addiction. Groups exposed to a variety of artistic forms simultaneously benefited from them (WCCL Foundation 2004). With the focus firmly on the particular needs of clients that are to be addressed, in practice, we crossed the so-called boundaries between art forms very easily. Art forms merged and emerged from each other, complementing the steps in a therapeutic alliance. Why, then, was a particular identity – say a dramatherapy practitioner – needed, when it was not so in fact? The critical enquiry of our practice showed us that breaking down barriers between art forms and our individual identities to form a continuum of possibilities, which could be offered according to the needs of the clients, was far more important than going by the training or need for identity of the therapist. A generic vocabulary of stories, songs, roles, rhythms, colours and images is accessible and replicable. It speaks simply and directly to the client, spontaneously bounding across artificial barriers, outer and inner. It also frees the therapist, who is not trained intensively in any single art form, but is an artist in the therapeutic space, to explore, play freely with a richer variety of resources, more methods, media and magic. More fundamental was the investigation of the paradigm of therapy. We were faced with the question of congruence between what was ‘theoretically’ available and the actuality of our Indian lives. In the adventurous mix of our contemporary life we are taught Western sciences as objective, accurate, but, at the most critical points in life, we seem to rely on a different set of guidance, often coming from the wisdom lineage of masters, values, views and practices embedded in culture. Which one to follow – the external, learned, or the internalized, intuitively more accurate? A structure or practice useful elsewhere was questioned in our own context. It was essential to investigate, reinvent and reintegrate what was seemingly objectified and separated. The Indian inheritance beckoned. We had to look back at the astute studies of the mind by yogis. These are accessible through multiple pathways, through analysis, devotion, practices, and all paths together. Their findings and assertions, millennia old, are so important that scientists are inviting practitioners to laboratories to study and understand them (Mingyur Rinpoche and Swanson 2007). The sophistication of these scientists of the mind is astounding. It inspired us to study and practise ‘Buddhist mind-training’ and ethics as the foundation for the ABT practice and practitioner 22

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alike (Pillai-Balsara 2013a, 2013b). With this ‘view’, it was essential to work through questions of the values of the practitioner/healer – first and foremost, in simple but most pragmatic terms. Concerns about funding (or the lack of it), maintaining integrity in actions and the actual, keeping awareness for a sober, non-self-centred outlook, these were the real challenges, rather than the outer, more visible matters. In an already hostile environment, the standing of the arts and healing was null, and dramatherapy and music therapy sounded like nice new words needing their own separate niche. Artists found the idea of arts in therapy interesting, but the rigour and lack of attention in the social sector scary. We found that the glamour and attraction of artistic success cast shadows on therapeutic work. Even within the therapy framework, traps abounded – fame, gain, praise. There’s a belief that not having some of these alluring things would mean forsaking pleasure in life itself! As these concerns dominated the unschooled mind, we were fortunate to be guided in a fierce community by an authentic leader. It was a rare conjunction that constantly reminded us of our own mind. The hard work over years meant being vigilant about what one was seeking to create. Being responsible for co-creating with others is what kept individual desires in check, often through the fear of breaking the inconceivable bond of kindness nurtured between us. ABT constantly evolved because a choice was made between following one’s own lead and the path that needed paring of individualistic ambition. It was bright as daylight, which is the Indian way! Examining and refining the mind, keeping awareness and acting out of concern for all, for one’s own freedom and others’, these are the essentials for claiming the Indian legacy, in practicum. Luminous examples of these principles in action in other spheres of life abound within our reach and knowing (Mackenzie 1998), not myths or legends, but living proof that these approaches are critically important. The traditional healing practices emphasise the intention or resolve and deep aspiration to help and heal (Paranjape 2014) as fundamental. Without the constant clarity of mind to recollect the intent, no amount of putting together of technologies or methodologies would be effective as a meaningful healing practice. The shifting points of identity were turmoil. But, it simply made sense. In ABT, the person and their well-being are reinstated at the centre, with the art forms coming together in coherence with a healing intention. ABT maintains a non-religious but decidedly spiritual framework. The subjective is balanced with the objective – established modes are used in diagnosis, in research and assessment, and sought to promote authenticity and veracity of the discipline. ABT relies on evidence-based use of art forms. A recent study of ABT in deaddiction, for example, showed that experimental and control groups were significantly different for measures of advance warning of relapse (AWARE; t = 1.84, p < 0.03), purpose of life (t = 4.92, p < 0.001), group therapy record (t = 5.27, p < 0.01), and on all domains of the rating scale (t = 7.29, p < 0.01) showing improvement in relapse patients undergoing ABT sessions over relapse patients undergoing only group therapy and art activities (Daniel et al. 2013). The balance in this amalgamation is emerging as community-centred care, and healing is slowly taking steps to reclaim its place. It’s not a nostalgic revivalism, but dynamic reintegration for sake of the present. The success of projects such as Medicine–Prayer (Dawa-Dua), where psychiatrists work in tandem with traditional faith healers (mujawars) – ‘a project to link spirituality with medicine to cure people of behavioural disorders’ (Vijay Kumar 2013) – shows that this could be one of the ways to bridge the gaps in health care in India (Smitha 2012). Social workers, psychologists, psychiatrists and special educators have turned to the ABT training course to bridge the gap and to reach out to their clients in a friendly, balanced and accessible way. The ABT training course has been studied as an innovation that can benefit future education infrastructure ideas in India (Machado et al. 2009). ABT meets the needs of local practitioners, handholding and sustaining practice over a period of time. It is important to note that short workshops to train people in India have been tried, but, without a long-term 23

Aanand Chabukswar with Zubin Balsara

commitment to developing human resources, these are not useful. A shift in hypothesis is advocated for anyone coming from a so-called ‘developed’ country; check ground realities, crosscultural competency and soundness of the philosophical foundation applicable here before imparting your knowledge. When we set out to reinstall the art forms as therapy systematically, it was a dream. It took nearly 15 years of action and research to make a place for ABT. Today, there is a bustling community of ABT practitioners spread across the length and breadth of the country, reaching out to thousands in a year, and the mainstay of their practice is consistent service (WCCL Foundation 2010; Sapatnekar 2012). None of us could have come close to this outcome without the helping hands of numerous philanthropists, foremost among them the Sir Dorabji Tata Trust and Allied Trusts. They supported the vision, mission and its manifestation in the field. ABT has now taken root in India. This has been made possible, to the small extent that it has succeeded, by the principles being distilled into refined action. It has the potential here to allow non-medical, safe interventions supported by and within the community. ABT stands on the ground consecrated by many lineages that dynamically converge to make it a traditional, yet contemporary, practice for human welfare.

References Bhagat, M. (2008) ‘Mental disability: From institutional control to family care’, Combat Law, 7, 5 (September–October), 39–41. Dalal, A. (2011) ‘Folk wisdom and traditional healing practices: Some lessons for modern psychotherapies’, in Cornelisson, M., Misra G. and Verma, S. (eds), Foundations of Indian Psychology: Practical applications (vol. 2), pp. 21–35. New Delhi: Pearson. Daniel, D., Balsara, Z., Pillai-Balsara, A., Chabukswar, A., Kulkarni, S. and Gohil, P. (2013) Best Practices in ABT: An action research study. Pune: WCCL Foundation. DNA. (2014) ‘India’s healthcare system is in poor health’, Editorial, July 2. Online. Available at: www.dnaindia.com/analysis/editorial-dnaedit-india-s-healthcare-system-is-in-poor-health-1999141 (accessed 3 July 2014). Gupta, M. (2010) A Study of Abhinavbharati on Bharata’s Natyashastra and Avaloka on Dhananjaya’s Dasarupaka. New Delhi: Gyan. Jablensky, A. and Sartorius, N. (2008) ‘What did the WHO studies really find?’, Schizophrenia Bulletin, 34, 2, 253–5. Jennings, S., Cattanach, A., Mitchell, S., Chesner, A. and Meldrum, B. (1994) The Handbook of Dramatherapy. London/New York: Routledge. Kumar, A. (2004) ‘History of mental health services in India’, Journal of Personality & Clinical Studies, 20, 1–2 (March–September), 171–80. New Delhi: Association of Clinical Psychologists. Lindkvist, M. (1997) Bring White Beads When Calling On The Healer. New Orleans: Rivendell House. Machado, N., Kaur, A. and Pant, N. (2009) Education Infrastructure for Complementary Health Practice in India. Mumbai: School of Management & Labour Studies, Tata Institute of Social Sciences. Mackenzie, V. (1998) Cave in the Snow. London: Bloomsbury. MacTavish, H. and Balsara, Z. (2012) Songs, Science and Spirit. San Francisco, CA: Provident. Mingyur Rinpoche, Y. and Swanson, E. (2007) The Joy of Living: Unlocking the secret and science of happiness. London: Bantam Books. Padma, T. (2014) ‘The Outcomes Paradox’, Nature, 508, S14–S15. Palsane, M. and Lam, D. (2011) ‘Stress and coping from traditional Indian and Chinese perspectives’, in Dalal, A. and Misra, G. (eds), New Directions in Health Psychology, pp. 77–94. New Delhi: Sage. Paranjape, A. (2014) ‘Healing and counselling in a traditional spiritual setting’, in Cornelissen, M., Misra, G. and Varma, S. (eds), Foundations and Applications of Indian Psychology, pp. 227–46. Delhi, Chennai: Pearson. Pillai-Balsara, A. (2013a) Subtle Energy Guide. Pune: WCCL Foundation. Pillai-Balsara, A. (2013b) Applied Mahayana Buddhist Psychology and Ethics. Pune: Department of Pali, University of Pune. 24

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Press Information Bureau. (2013) Print Release on National Mental Health Programme. Government of India: Ministry of Health and Family Welfare. Online. Available at: http://pib.nic.in/newsite/Print Release.aspx?relid=101742 (accessed 5 March 2014). Ramanujan, A. (1999) ‘Is there an Indian way of thinking? An informal essay’, in Dharwadker, V. (ed.), The Collected Essays of A. K. Ramanujan, pp. 34–52. New Delhi: Oxford University Press. Rao, K. R. (2008) ‘Introducing Indian psychology’, in Rao, K. R., Paranjape, A. and Dalal, A. (eds), Handbook of Indian Psychology, pp. 1–18. New Delhi: Foundation Books, Cambridge University Press India. Richmond, F., Swann, D. and Zarrilli, P. (eds) (1990) Indian Theatre: Traditions of performance. Honolulu, HI: University of Hawaii Press. Riley, J. (2012) Approaches to Music Therapy. Online. Available at: http://prezi.com/pov1d8ffey2a/ approaches-to-music-therapy/ (accessed 14 September 2014). Salema, A. (ed.) (2002) Ayurveda at the Crossroads of Care and Cure. Lisboa/Pune: Centro de Historia de Alem-Mar, Universidade Nova de Lisboa. Sapatnekar, D. (2012) ABT Survey Summary. Pune: WCCL Foundation. Seervai, S. (2013) India’s Mental Health Challenge. Online. Available at: http://blogs.wsj.com/INDIAREAL TIME/2013/10/21/INDIAS-MENTAL-HEALTH-CHALLENGE/ (accessed 14 August 2014). Sharma, H. (1987) The Theatres of the Buddhists. Delhi: Rajlaxmi. Simoes, M. (2002) ‘Reflections of a psychiatrist on Ayurvedic medicine’, in Salema, A. (ed.), Ayurveda at the Crossroads of Care and Cure, pp. 188–95. Lisboa/Pune: Centro de Historia de Alem-Mar, Universidade Nova de Lisboa. Smitha, R. (2012) ‘Medicine takes a leap of faith at Gujarat’s Mira Datar Dargah’, Ahmedabad: DNA News, 6 February. Online. Available at: www.dnaindia.com/india/report-medicine-takes-a-leap-offaith-at-gujarat-s-mira-datar-dargah-1646412 (accessed 5 September 2014). Tarlekar, G. (1975/1991) Studies in the Na¯tyasa¯stra. Delhi: Motilal Banarsidass. Thaut, M. (2005) Rhythm, Music, and the Brain: Scientific foundations and clinical applications. London/New York: Taylor & Francis. Trungpa, C. (2005) The Sanity We Are Born With. Boston, MA/London: Shambhala. Vijay Kumar S. (2013) ‘Fusion of prayer and medicine for healing’, National – Tamilnadu, December 7 News. Chennai: The Hindu. WCCL Foundation. (2004) Wellsprings: Music, drama, and dance therapies at Sadhana Village. Pune: WCCL Foundation. WCCL Foundation. (2010) Bridging Fields: ABT student project work in light of relevant research. Pune: WCCL Foundation.

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4 Embodying Ramayana The drama within Bruce Howard Bayley

This chapter looks at the potential for dramatherapy practice within the epic of Ramayana as classical mythology from India, but, also, as having universally human implications. I am not presenting it in a scholastic manner in order to seek to persuade, but rather in the spirit of suggesting ‘points’ and ‘signs’ by which we might discover a synthesis between the notion that we, as individual humans, are part of a developing species facing choices and the belief in our essential spiritual natures. As an Anglo-Indian who was born and spent the first 20 years of my life in India, Ramayana had an enormous impact on my own development and learning. Now, I offer this chapter as a resource within a multicultural agenda. Ramayana, one of the great Sanskrit epics of Hinduism in India, consists of 24,000 verses (slokas) in seven books (kandas) and is traditionally attributed to the sage Valmiki. It tells the story of a prince called Rama, who is banished from his kingdom of Ayodhya, and his wife, Sita, who is abducted by Ravan, the rakshasa (demon) King of Lanka (the City of Gold). She is eventually rescued and recovered by Rama and his brother, Lakshman, with the help of the Monkey deity, Hanuman, and armies of monkeys and bears. There are many retellings and regional translations of the epic, including Rama-charita-manas, a retelling in Hindi by Goswami Tulsidas, and Adhyatma Ramayana, which is traditionally ascribed to the sage Vyasa and ‘is a direct elaboration of its spiritual implications’ (Tapasyananda 1985, p. iv). The story has reached the world’s masses mainly through dance-dramas, songs, storytellers, theatre performances, cinema and television. Themes, stories and characters in Ramayana are found all over South East Asia – in the Lakhon Kohl masked dance theatre of Cambodia, where the narrative is adapted to Buddhist themes as the basis of Reamker (The Glory of Rama); in the Mappila Songs of the Muslims of Kerala (The Hindu, August 2005); in the masked dance-dramas and performances of Burma, Thailand, Java and Bali; and in the Wayang shadow puppet performances of Indonesia (ORIAS, UC Berkeley n.d.). For the central argument of this chapter, I draw on the ideas of sculptor Giduturi Lakshmi Narayan, from his illustrated book Understanding Ramayana as Rama Within (2006). When presenting specific elements of the narrative, I refer to Romesh Dutt’s The Ramayana and Mahabharata Condensed into English Verse (2002), Dr Devadutt Pattanaik’s The Book of Ram (2012); A. G. Atkins’ translation of The Ramayana of Tulsidas (1987); Swami Tapasyananda’s translation 26

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of Adhyatma Ramayana (1985); and Robert Goldman’s The Ramayana of Valmiki: An epic of Ancient India: Balakanda (1990). When spelling proper names in my text, I use the spelling employed by Romesh Dutt (2002), except when quoting directly from other sources, when I leave the spellings as they appear in the texts of those translators. Focusing on Rama’s exile from Ayodhya and the abduction of Sita, I shall employ Narayan’s (2006) model, in which the events and main characters in the Ramayana narrative can be meaningfully viewed as aspects enacted within the human body – Rama (soul), Sita (mind), Lakshman (body), Hanuman (breath) and Ravan (the ego’s multiple desires and appetites). I shall suggest that they are of valuable use in dramatherapy practice as metaphors and symbols of the processes of disconnection and recovery. I will reference some of my work with clients recovering from addictions and a presentation/workshop with Pehchaan, a women’s community group in Mumbai, India.

Ramayana – the story: The beginning Both Tulsidas’ Rama-charita-manas and Adhyatma Ramayana begin in the realm of the gods. In Rama-charita-manas, the author invokes the gods and asserts that, ‘in God’s world together both good and ill dwell | Joy and pain, right and wrong, night and day, all things dual’ (Atkins 1987, p. 11). Whenever there is an imbalance in this system, and men ‘In their goodness may fail, by illusion allured’, then God, ‘to reform them, their body assuming | Gives cleanness and glory, all evil consuming’ (p. 12). In Adhyatma Ramayana, this is presented as a conversation between the God Shiva and his consort, Parvati. Shiva tells her of how, during the earthly reign of King Dasa-ratha in the kingdom of Ayodhya, the Earth-Deity found the Earth was sinking under the tyranny of the hosts of demons (rakshasas) headed by Ravan, King of Lanka. Ravan was born of a rakshasi (demoness) mother and a Brahmin father who had taught him to pray to the gods. In the past, he had been a devotee of the God Shiva and had prayed so dutifully to the gods that the God Brahma had granted him anything that he asked for as a special wish. Ravan had asked to be made invulnerable and totally powerful over both gods and demons. He was granted his wish and is, therefore, usually portrayed with ten heads and twenty arms because he had the strength of ten men. With the powers that he had gained, Ravan had begun to abuse his power by humiliating the gods and forcing them to do menial tasks for him. He was becoming ‘a menace to the world at large, subjecting the three worlds and the celestials protecting them to terrible oppression’ (Tapasyananda 1985, p. 12). The Earth-Deity appealed to the God Vishnu to intervene. As the granting of Ravan’s wish had given him total power over gods and demons, but not over humans, Lord Vishnu agreed to be born as a human – Rama, the first-born son of King Dasa-ratha and his Queen Kausalya – to bring about the end to the rakshasa tyranny over the Earth.

The kingdom of Ayodhya, conflict and Rama’s exile Once upon a time, King Dasa-ratha ruled the kingdom of Ayodhya. It had been an ideal age – ‘Truth and Justice swayed each action and each baser motive quelled; | People’s Love and Monarch’s duty every thought and deed impelled’ (Dutt 2002, p. 2). However, there was a sense of lack. King Dasa-ratha had three queens – Kausalya (his first and senior wife), Kaikeyi (his favourite wife) and Sumitra, his third and junior queen – but no sons. As he desired a son to continue his dynasty, Dasa-ratha asked the sage Rishyashringa to perform a fertility ritual fire ceremony – a putra kameshthi yajna. Towards the end of the ritual, ‘a celestial 27

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Being arose from the fire-pit. Dark and dressed in red, he offered Dashrath a celestial potion. “Offer this to your wives and they will bear divine sons”, said the Being before disappearing’ (Pattanaik 2012, p. 22). Dasa-ratha divided the potion between Queen Kausalya and Queen Kaikeyi, who, in turn, divided their shares, giving half each to Queen Sumitra. In due course, all three queens gave birth to sons – Kausalya to Rama, Kaikeyi to Bharat, and Sumitra gave birth to twins, Lakshman and Satrugna. ‘Lakshman, born from the share given by Kaushalya to Sumitra, grew up devoted to Ram while Shatrugna, born from the share given by Kaikeyi to Sumitra, grew up devoted to Bharat’ (Pattanaik 2012, p. 23). These sons of Dasa-ratha all had within them portions of the essence of the God Vishnu – the celestial potion that was offered during the ritual – who had incarnated into their human bodies in order to fight the demons who had been oppressing the gods and humans (Goldman 1990, p. 7). Rama, together with his brothers, grew up under the tutelage of the sages Vasishtha and Viswa-mitra and successfully defended their hermitage against the assaults of several demons. Now, King Janak of the neighbouring kingdom of Videha had two daughters – Sita, described as ‘peerless’ and ‘best of women’ (Dutt 2002, pp. 3, 10), and Urmila, ‘of stainless love’ (p. 10). Sita had reached marriageable age. The king was in possession of an immensely heavy, giant bow that had once belonged to the God Shiva. He invited princes from all over the land to compete for Sita in marriage by stringing Shiva’s bow at a ritual ceremony (swayamvara). Rama was the only prince who succeeded in stringing the bow and, breaking it into two pieces, he won Sita as his bride. Marriages were arranged for Sita to Rama, Urmila to Lakshman and for King Janak’s two nieces – Mandavi and Sruta-kirti – to Bharat and Satrughna: ‘a rain of flowers descended from the sky serene and fair, | And a soft celestial music filled the fresh and fragrant air’ (Dutt 2002, p. 11). Twelve years later King Dasa-ratha wished to retire and had the approval of the council, the people and all three queens to crown Rama king. However, on the evening before the coronation, Queen Kaikeyi’s old maidservant, Manthara, poisoned the Queen’s mind by inciting her jealousy of Queen Kausalya and Rama and stimulating Kaikeyi’s greed and desire. Seduced by Manthara, Kaikeyi claimed two boons that Dasa-ratha had once granted her on an occasion when she had saved his life. She now demanded them both of Dasa-ratha – that her son, Bharat, be crowned king, and that Rama should be exiled into the forest for 14 years. Heart-broken, Dasa-ratha honoured his promise to Kaikeyi (Goldman 1990, p. 7). Rama heard and accepted his father’s ruling: ‘grief not anger touched his heart, | Calmly from his father’s empire and his home prepared to part’ (Dutt 2002, p. 31). Rama left Ayodhya with Sita and his loyal brother Lakshman, who refused to leave his side. Soon after his exile, King Dasaratha died. Bharat refused to accept the crown and followed Rama into the forest to persuade him to return. Rama, however, refused as he was resolved to honour his father’s promise to Queen Kaikeyi. Bharat returned to Ayodhya and, placing Rama’s sandals symbolically on the throne, served as Rama’s regent (Goldman 1990, p. 8).

The symbolism and its use to practice The significance of Ramayana has been the subject of much analysis and political debate – as the story of an ideal human being who triumphed over all obstacles ‘to become a hero first and then a god’ (Pattanaik 2012, p. 16); as a narrative that seeks to ‘establish Rama’s divine status as an object of worship’ (Tapasyananda 1985, p. vi); as devotional literature in which Rama is ‘enshrined by the devout imagination in the faith, love and worship of the Heart’ (Atkins 1987, 28

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p. xi). For G. L. Narayan, ‘it represents the symbolic interplay of cosmic forces and the understanding of Ramayana as Rama within the man’ (Narayan 2006, p. ix). It is this universality of the potential inner symbolic meanings in Ramayana that makes it useful to dramatherapy practice. Within the overarching theme of addressing the imbalance between dualities such as ‘good and ill’ in a world in which both co-exist, we can find specific themes relating to a conflicted and a divided Ayodhya: lack – a sense of lack feeds Dasa-ratha’s desire for a son; desire and duty – ‘it is desire that makes Dashrath give two boons to his favourite queen, the beautiful Kaikeyi, which results in the exile of Ram’ (Pattanaik 2012, p. 23), and Dasaratha struggles between desire and duty in honouring his promise to Kaikeyi; loss and disconnection – Ayodhya passes from a harmonious Golden Age into one of disharmony and loss; Dasa-ratha, Kausalya and all of Ayodhya lose Rama, who, in exile with his wife and brother, is disconnected from his home and kingdom.

Embodying Ayodhya – the divided self The divided kingdom of Ayodhya presents us with a universal symbol of a conflicted and disconnected sense of one’s self. At some time or other, all of us may experience circumstances that cause us to put ourselves in the control of powers that disconnect us from health, love and a sense of goodness. It could be that there never was a sense of goodness; or that there is loss, deep pain or anger; or that we are following a desire that causes division in our lives and leads to further conflict. Facilitating clients to create and sustain a renewed sense of self begins with therapist and client both acknowledging the painful feelings arising from the original loss and disconnection – feelings from which the client, in turn, had sought to disconnect. Much of my dramatherapy practice with clients with addiction issues has involved addressing and mediating a sense of disconnection. This can be internal to the client (fear, self-loathing, powerlessness over addiction) or disconnection from feeling, itself, where the client has built a fortress against the pain or vulnerability that feelings bring, or from the external world (rejection, isolation, distrust). In one-to-one sessions, clients have worked through the struggles within them brought about by the conflicts between desire and duty. Using the metaphor of the divided city, clients have been facilitated to re-experience the sense of a lost time when all may have appeared to be well (an imaginal Golden Age), which then developed into a darkness and division within themselves. Through movement, small object projective play, story making and role-play, clients have, in the contained dramatherapy space, embodied and re-enacted conflicts between polarized parts of themselves (subpersonalities) and gradually moved towards a sense of internal integration. In group dramatherapy sessions at Hammersmith & Fulham Drug and Alcohol Aftercare Services and the Cranstoun Supported Housing Project in London, clients transformed the dramatherapy room to represent the divided city, using furniture and materials available on site. Group members would occupy different geographical areas within the ‘city’ in which they roleplayed conflicting characters in scenarios depicting self-sabotage, division and destructiveness. Through these enactments and self-reflection, clients can then move towards mediation and potential redemption by re-establishing a new ‘city’ of trust and nourishment, through drama games, trust exercises and sharing feelings and insights into those feelings. I see recovery from addiction and self-harm as a spiritual journey from disconnection and a dark sense of powerlessness towards a connection with a spiritual source of wholesomeness and light – the universal struggles of the human spirit. This sense of connection to a spiritual source is the basis of the Twelve Steps Programme, which many of my dramatherapy clients who also 29

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attend Narcotics Anonymous (NA) and Alcoholics Anonymous groups follow. Secular in form but with spiritually oriented philosophical foundations, the Twelve Steps are structured and formulated as affirmations that people adopting the programme choose to follow. Articulated as a ‘spiritual awakening’, the first three steps are acknowledgements of the individual’s powerlessness over addiction and the establishment of a sense of connection with a power (source) of goodness: ‘Step 2: We came to believe that a Power greater than ourselves could restore us to sanity’ and ‘Step 3: We made a decision to turn our will and our lives over to the care of God as we understood Him’. In Ramayana, this spiritual source is presented by the Earth-Deity appealing to Lord Vishnu to intervene in restoring the Earth from the tyranny of the demons and by Vishnu incarnating within the human Rama. Ritual enactments within dramatherapy sessions can facilitate a client to establish this sense of connection/reconnection with a spiritual source. G was a client recovering from multiple addictions and attending NA. He was wrestling with turbulent states of mind and feelings, restless desires, anger and self-loathing. Although he valued the Twelve Steps, he struggled with the first two steps owing to having internalized a tyrannical, persecutory god-image that resulted from some of his early experiences – a struggle that increased his anxiety and conflict. In the dramatherapy space, I narrated briefly the Ramayana story of the Earth-Deity appealing to the gods to intervene. G acknowledged his difficulty in reaching out to any kind of god/higher power, given his internalized god-image, which he named a demonic judge. We explored together alternative images that G might associate with the sense of universal goodness and cleanliness. G identified the colours white and yellow, pink rose quartz stones and candlelight. Over the following weeks, we established a spectogram in which a large candle was surrounded by small rose quartz stones and whatever white and yellow objects G would bring with him to the sessions. This became the centrepiece for a series of ritual enactments that G developed – involving walking, moving, dancing, talking, offering poems and songs. This process helped G to restore a sense of universal goodness with which he could begin to connect. He could now begin to reach out towards a higher power that was no longer simply a dark, persecutory, demonic judge, but a benevolent source of goodness and light. This work helped G to find a new way of being.

Ramayana – the story: The abduction of Sita Rama, Sita and Lakshman, in exile, lived off the land, making temporary homes along their journey, and were steadily subjected to attacks by the rakshasas. In the forest, Surpa-nakha, a female demon, attempted to seduce Rama and kill Sita. Lakshman wounded her and, in retaliation, Surpa-nakha appealed to her brother, Khara, who organized an attack against them but was defeated (Goldman 1990, p. 9). Ravan, the rakshasa King of Lanka, was Surpa-nakha and Khara’s eldest brother. In addition to the total invulnerability that had been his reward from the God Brahma for his devotion in times past, he had also inherited powers of trickery, magic and shape shifting from his demoness mother. Hearing of Sita’s beauty, Ravan decided to abduct her. He sent his uncle, Maricha, in the form of a golden deer to enchant Sita, who was charmed on sight and pleaded with Rama to capture it for her. Rama failed to persuade her that it was an illusion of the demons, gave in to her desire and chased the deer, leaving Sita in Lakshman’s care. The illusions continued; Sita believed she heard Rama’s voice calling to her in need and she pleaded with Lakshman to go and help him. Lakshman reminded her of his promise to Rama to protect her, but, in the face of her insistence, he carried out her wish. Before leaving, he marked a chalk boundary around the cottage, insisting that she remained within it and did not entertain any strangers. 30

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He cast a spell to lock the boundary, so that entrances were blocked but exits were allowed. Once Lakshman left, Ravan appeared in the form of a travelling monk requesting Sita’s hospitality. Sita, again seduced, left the circle of protection and was forcibly carried away by Ravan to Lanka (Goldman 1990, p. 9). Learning about Sita’s abduction from Jatayu, a vulture, Rama and Lakshman set out to recover her from Ravan. They were aided in this by Hanuman, the greatest of monkey heroes. Hanuman was ‘the son of Vayu, the Wind God who could fly anywhere he wished’ (Pattanaik 2012, p. 99) and change his shape and size at will. In gargantuan form, he leapt across the ocean to Lanka, where he found Sita and reassured her, giving her Rama’s ring as a sign of good faith. He offered to carry Sita back to Rama, but she was reluctant to be touched by a male other than her husband. Hanuman attacked the city, killing Ravan’s warriors and demanding Sita’s release, but he was captured, and his tail was set on fire. He leaped away from his captors, setting fire to Ravan’s fortress and, with a giant leap, returned with the news to Rama. Rama and Lakshman invaded Lanka, with the help of an army of monkeys and bears. After a lengthy battle, Rama killed Ravan, recovered Sita and returned to his throne as King of a reunited Ayodhya.

The symbolism and its application to practice The story of the abduction of Sita archetypally portrays separation, loss and recovery. G. L. Narayan (2006) interprets this story as being enacted within the human body. As he bases his work on the Vedic chakra system, I will, briefly, outline that system before looking at Narayan’s interpretation of the story. The Vedic system identifies seven centres of consciousness (chakras) within the body, all of which are aligned with each other and have their own sites in the human body, starting from the base of the spine up to the central point in the crown of the head (Figure 4.1). In this system, the quality of the energy and consciousness within these chakras influences and impacts on the organs of the human body, depending on where the chakras are located. There are three universal qualities (gunas) – activity (rajas), inertia (tamas) and equilibrium (sattva) – that are attributes of the ego or ‘I-creator’ (ahamkara; Svoboda 1993, p. 42). Generally inactive, the centres are activated by the Prana Vayu – inner wind – when it flows through the nerves (nadis), which in turn activates the qualities (gunas), impacting on whichever part of the human body is connected to that specific chakra. This inner process impacts on the individual ego (ahamkara), giving rise to different desires, fears or actions in different situations and at different times (Narayan 2006, p. xi). We may see the three lower chakras as being concerned with procreative/sexual energy, desires/passions and security/power, and the three top chakras with thoughts/thinking, perceptions/seeing and expression/communicating. The middle or fourth chakra is the heart centre, the seat of compassion, love, harmony, mediation and equilibrium. In this view, then, it is the breath/breathing, as the physical expression of the Prana Vayu (inner wind), that can impact on an individual’s state of mental, emotional, psychological and physical being. In Narayan’s work, the story of the abduction of Sita is an enactment of the system outlined above within the human body (Figure 4.2). Lord Rama is the sovereign soul within, Laksmana is the body in which the soul lives, Sita is the mind that can lead the soul into blind alleys of bondage and Hanuman is the Prana Vayu (breath) the control of which finally elevates the soul to self-realization. (Narayan 2006, p. 37) 31

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Figure 4.1 The seven chakras: centres of consciousness within the human body

Narayan sees the story as the ‘battle of Rama, the Soul, to get Sita, the mind, to be released from the captivity of Ravan’ (Narayan 2006, p. 37), where Ravan symbolizes the negative aspects of egoistic desire for power, aggrandisement, sexual appetite – the multiplicity of these being represented by Ravan’s ten-headedness. Here, we can see a different metaphor of loss and disconnection from the divided Ayodhya. Sita, the individual mind (the top three chakras), has been deceived by illusory desire (the simulation of the golden deer) presented by Ravan (the lower three chakras) via his uncle. Rama (the soul), for love of Sita, goes in pursuit of the illusion, leaving Sita (the mind) in the care of Lakshman (the now somewhat-weakened body), who is, in turn, subjected to the mind’s further delusions (Sita’s imagined voice of Rama). He leaves her to follow Rama (the soul), but not before placing her in a safe boundary (the protective circle), which she breaks by being further deceived by Ravan, leading to her abduction and captivity. This loss can be made good, and the restoration of the unity of Rama (soul), Sita (mind) and Lakshman (body) can only be achieved with the help of Hanuman (breath) and his allied armies. Much of my dramatherapy work with addiction and self-harm has involved a journey of recovery from losses incurred by clients who may have spent years ‘flying with demons’ that hold out illusory promises. Without necessarily employing the specific language and images 32

Embodying Ramayana: the drama within

Figure 4.2 Ramayana enacted within the human body

from Ramayana, clients are facilitated, through the use of guided imagery, inner visualization, breathing and movement, to access imbalances or conflicting states of mind or feeling and work towards their mediation.

Embodying Hanuman: Working through the breath Y had been in recovery from long-term drug usage and bulimia for 18 months. Following a fairly traumatic upheaval in her marriage, she had begun to have recurring, persecutory and self-loathing thoughts, together with distressing feelings of insecurity, emptiness and generalized anxiety. She began to feel the urge to return to her previous behaviours. In sessions, I asked Y to locate her distressing feelings within her body and to observe her breathing during these times. She identified the regions of the solar plexus and stomach and that her breath was shallow, fast and ‘tight’. In the Vedic system, these regions are located within the three lower centres – personified by Ravan. Over a few weeks, we worked with Y revisiting the feelings while visualizing the solar plexus area in her body and then shifting her attention to her breathing, consciously extending the breaths into a longer, slower, deeper rhythm. As her breathing began to expand and slow down, I asked her to let it (the breath) lead her body to move around the 33

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room. Y developed this into simple dance movements that were light, large and flowing. This led her to create a character that she called the Flying Bird. Over the following weeks, she developed this character, using her breathing and movements to role-play short scenes that she called ‘Enjoying the clear blue sky’, ‘Flying from the dark pit to the high mountain’ and ‘Rescuing the young girl from the wolf’ – images and themes that are also found in the flying, size-changing Hanuman. Gradually, her feelings of anxiety and emptiness decreased. She began to talk about a developing sense of calm that she located in her chest area, located within the fourth chakra (heart centre), the seat of Rama, and fewer restless, turbulent thoughts. This, in turn, allowed her to begin to experience changes in the quality (guna) within the top three chakras, the location of the mind (Sita), enabling her to see herself and her life in a more compassionate and harmonious light. There is a sense in which any one of us may need to undertake a journey of recovery from loss – lost lives, lost opportunities, lost potential or lost status. To reclaim their sense of personal identity and their own lives, there is a need for people to reclaim their own personal stories in their own voices – telling of who they are as people, of how the problems they are dealing with first arose in their lives, of how they can explore possibilities of moving on in their future pathways. This is, often, a journey of self-discovery. My dramatherapy work in India has included a presentation/workshop on Ramayana for Pehchaan, a women’s social and community organization based in Mumbai. Pehchaan functions as a network and community group for women, many of whom are facing changes in their lives and circumstances. Pehchaan can have several nuances of meaning, including ‘to introduce’, ‘to know’, ‘to know yourself’, ‘to know others’. Although it has social and recreational functions, Pehchaan’s founder, Geeta Patel D’Souza, prioritizes the group’s objectives as being to facilitate women to empower themselves and be able to create changes in themselves and in their lives.

Embodying Sita There were sixty regular Pehchaan members who participated in my presentation/workshop, all of whom were familiar with the chakra system and the story of the abduction of Sita. After presenting Narayan’s interpretation of the story, I led them in dramatherapy exercises focusing on Sita as symbolizing thoughts and perceptions. In response to the question, ‘What concerns and thoughts do you find yourself pre-occupied with most of the time?’, the majority of the answers tended to be questions reflecting the needs of family members – ‘What will I do now that my son has left home?’, ‘Will my daughter make a good marriage?’, ‘What will the future bring for us now that my husband has retired?’. A few responses involved their own self-images and aspirations – ‘I want to be happier than I have been’, ‘I would like to be free to spend my time more usefully in the community’, ‘I am usually worrying about starting my own business’. I guided them to focus only on their thoughts as they arose in their minds, without holding on to any of them, and then to visualize this activity as it took shape naturally. Images arising from this included those of disempowerment, captured-victim-type roles – ‘a really fast train running away with me’, ‘a whirlwind’, ‘suffocating hands’, ‘someone pressing my head down’, ‘a prison’, ‘making me feel anxious and afraid’ – indicative of the abducted Sita. Introducing the role of Hanuman into the exercise, I asked them to visualize him flying through the air and then shift their attention to their breathing, gradually slowing it down by lengthening the breath, and to observe any changes in their bodies and movements. Reflecting in pairs, their reported observations now included ‘lighter head’, ‘more relaxed’, ‘my chest is not so tight’. They then went on to focus on the heart centre, while continuing to breathe 34

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deeply and slowly and visualizing whatever images arose naturally from within them. There was now a marked change in their responses – ‘a lovely rosebud’, ‘blue water’, ‘green grass and trees’, ‘feeling at home’, ‘warm food’ – indicative of Sita restored. Not all of the participants’ responses reflected the changes I have presented. Some were not as responsive to working with the imagination, and others would need a period of time in which to feel comfortable with these kinds of dramatherapy intervention, but those who were able to enter the experience expressed an active interest in further workshops working with Ramayana.

Concluding remarks I have not sought to present a scholastic, academic analysis of Ramayana or of dramatherapy. Nor have I intended to present numerous evidential outcomes, apart from the specific illustrations from my clinical practice. However, my main intention has been to suggest that the universality of the symbolic meanings within the Ramayana story, as interpreted by Narayan within the Vedic system, is a valuable resource in attempting a synthesis, within dramatherapy practice, between our natural humanity and our essentially spiritual selves.

References Atkins, A. G. (1987) The Ramayana of Tulsidas (Ramacharitamanas). Mathura, India: Shri Krishna Janmasthan Seva-Sansthan. Dutt, R. (2002) The Ramayana and The Mahabharata Condensed Into English Verse. New York: Dover. Goldman, R. P. (1990) The Ramayana of Valmiki: An epic of Ancient India: Balakanda. Princeton, NJ: Princeton University Press. Narayan, G. L. (2006) Understanding Ramayana as Rama Within. Mumbai: Vakils, Feffer & Simons. Pattanaik, D. (2012) The Story of Ram. Haryana, India: Penguin Ananda. Svoboda, R. (1993) Ayurveda: Life, health and longevity. Penguin India. Tapasyananda, Swami. (1985) Adhyatma Ramayana: The spiritual version of the Rama saga. Chennai, India: Sri Ramakrishna Math. The Hindu. (2005, 12 August) ‘A different song’. Online. Available at: www.thehindu.com/thehindu/fr/ 2005/08/12/stories/2005081201210200.htm (accessed 21 May 2009).

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5 Culture and mental health An evaluation of Esie performance as a community-based approach to dramatherapy in Cameroon Paul Animbom Ngong

Introduction Cultural practices are generally considered as the manifestation of a culture or subculture. These practices include, but are not limited to, medical treatments, artistic manifestations, religious and spiritual practices or everyday life and patterns of social behaviours or interactions. In the practices, cultural products considered as the tangible or intangible creations of a particular culture are used in the context of a medical treatment of mental illness (Attigui 2012). This latter, viewed as a level of psychological well-being or state of someone functioning at a satisfactory level of emotional and behavioural adjustment, can be combined with an artistic manifestation or aspects of the manifestation to remedy the health conditions of community members. Dramatherapy is one of the artistic manifestations that can be employed in mental health (Reiss et al. 1998). Dramatherapy, as a Western conception describing an artistic form of intervention in mental health, is mostly present in modern settings. The absence of a similar conception in the Cameroonian culture does not, however, signify the inexistence of dramatic or theatrical forms to serve the same purpose. In nonconventional spaces, therapeutic performances are part of the community, with two settings identified: the non-sacred, open to every community member, and the sacred, open only to the initiated (Oyie Ndzie 1985). These performances employ and manipulate theatrical techniques. Considering that these traditional healing performances are used within the context of mental health, and considering that dramatic and theatrical techniques are employed in a similar manner in dramatherapy, there is a presupposition of a possible relationship between these two. If this affirmation is true, then one can hypothesise that they constitute a community-based form of dramatherapy. This hypothetical statement is examined with examples drawn from traditional healing performances such as Esie,1 performed to remedy mental health in the centre region of Cameroon. In this examination, particular focus is laid on the application of some basic dramatic and theatrical elements, such as space, directing and acting. The utilisation of these theatrical elements in traditional practices will heal, not ‘of theatre’ but ‘by theatre’ or ‘through theatre’ 36

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techniques. Jones’ affirmation that, ‘the drama does not serve the therapy’, but ‘the drama process contains the therapy’ (1996, p. 4) supports this point of view. The problem, therefore, is to show how theatricality is found in the centre of traditional psychiatry deeply rooted in culture, and how this can be constituted into a community-based form of dramatherapy. This implies choosing healing methods that use scenic elements of complete theatrical essence and value, and showing how traditional healing, as a cultural practice, heals psychiatric affections. By what psychotherapeutic means, therefore, is traditional healing a representation compared with dramatherapy in Cameroon? To examine this, I review the practice of Esie, which is a healing performance used in mental illness, to show the link between dramatherapy and traditional healing.

Traditional healing as an integral dramatherapy modality The therapeutic process in traditional healing, such as Esie, proceeds in an original theatricality, which can be qualified as an African model. In order to heal, these performances employ theatrical methods of local authenticity. They permit one to trace a dramatherapy method, typically community-based, at the limits of rituals and ordinary performance, profane and artificial. These are apparent through indices and interrogations that pop up in a theatrical performance. Four major constitutive elements of a theatre performance, such as the text, actors, audience and the spatial setting in which the practice takes place, are highlighted.

Spatial setting: Space dynamics in traditional healing performances Space has a profound influence on the way a play is performed, viewed and received. The term can be applied to describe dimensional aspects that exist between other significant phenomena. Because of this, the semiotics of space is considered as a descriptive process enquiring into the relevant significance of the relationships between objects and their spatial contexts. Space in this case stands as the background to other objects of attention. In semiology, space is not understood separately but in relation to other concerns (Helbo et al. 1991; Besbes 2007). In accordance with this perspective, a performance is not a translation from one language to another (Ubersfeld 1996). This implies that space is defined by its physical relationship with all the society, by its material characteristics between the stage and hall, and by its sociocultural role in each particular time in the community. Theatre space generally has a character that is much bigger; ‘it can be defined as the total of spatial signs of a theatre representation’ (Ubersfeld 1996, p. 51). In yet another perspective, it is considered that: Performance space – whether it is the stage of the live theatre [. . .] transforms the most ordinary and everyday trivia of existence into carriers of significance. Hang an empty picture frame on the wall – and suddenly the texture of the wall makes anything within it significant. (Esslin 1987, p. 38) This affirmation is true of physical theatre space, as it is of total abstract space. The former is that of the performers in their relationship with the audience, and the latter is that of the real or virtual signs of the representation. From this, it can be noted that space in its essence is double. No matter the form of the relation between the categories of the public occupying this space, there should be a relation between the two subtotals: lookers and looked, practitioners and spectators. 37

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The theatrical space in Esie is first and foremost a gift of nature, not limited to a fixed and fictive location. Performed in the village square, the space is live, delimited by a circle of participants. The dimensions and sphere are determined by the importance of the participants. No emphasis is laid on edifice apart from the natural needs against weather, though these are basically provisional sheds. This is so because Esie is a rite, an exceptional manifestation that is almost accidental, and not a game or simple artifice that can take place without a vital object. It cannot be transformed into a permanent performance without losing its name and essence and missing out its raison d’être. In this space, one also identifies the presence of some seats, which help in mapping out the playing area. This acting space is organised without respect to many conventions. Esie usually brings together an important number of people. It relies on the popular communion in the same way as an ordinary community theatre performance. However, the phenomenon of communion is not lived in an ordinary classical manner. Because it is vast and full of particular dynamics, the stage space does not produce unity, but an exploded and globalised space. It is filled by many superposed and juxtaposed performances, thereby restoring the difference between a manifestation and a spectacle/performance. Esie hereby becomes a plural cultural performance, a manifestation made up of many small units of performances, which intervene in the second degree but, in reality, have a considerable importance. These small performances of the main performance humanise and add rhythm to the solemnity and heavy atmosphere in the healing. It is the composition or the re-composition of these subperformances that maintains the necessary and indispensable ambience of the main performance. Here, the performers are both the patients and the healer, and the assistants mostly constitute the audience. They move in or out of this performance space when needed, as regulated by the healer during treatment or to assist in the healing process. In this light, Howard states that, ‘theatre is combustible, riotous and often dangerous. It needs to support itself with the right kind of space that will allow for the magic and transformation that best characterise theatrical events’ (2009, p. 8). In as much as there is no fixed structure destined for representations, a traditional healing ceremony is theatre that does not take into account the boundaries of a building such as a theatre hall, and does not exceed its particular spatial limitation. This form of healing does not go to the streets, neither does it go to theatre halls. It allows ‘an anonymous congregation to become a community, and provides a platform for their need to speak, to hear and to enjoy themselves’, in Howard’s view. In another traditional healing in Bafut,2 Pa Ayamah holds that treatment can only take place in his compound. Situated in the outskirts of the village, he has houses built around the main courtyard, with space in the middle. In this setting, there is a bamboo bench on which the patients lie for concoctions to be dropped into their nostrils. A bamboo chair is placed close to the centre on which the traditional healer sits, and others are placed on the verandas for the patients’ family members. This setting is typical of a traditional performance arena or theatre in the round, where people sit in a circle-like arrangement, with the performers in the centre. The audience is placed quite close to the action, thereby provoking a feeling of intimacy and involvement (Figure 5.1). In this type of setting, as opposed to a proscenium stage: • • • • 38

the scenery does not obscure the performers and the rest of the stage from parts of the audience; there is the absence of backdrops and curtains; no lighting is required, as in a theatre hall; entrances and exits are made through the audience.

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King, wives and elders

Performing Area

Ordinary people or community members

Figure 5.1 Traditional performance space. This performance space is arranged in a setting that accommodates the king and his entourage. However, with traditional healing performances in which community members are called upon to interact, the king’s or the elites’ space is eliminated, and the entire audience space is occupied by the community members, as in Esie and Pa Ayamah’s settings

In Pa Ayamah’s healing practice, wherever a patient is presented to him, nothing is done until the former is brought to his compound. This setting makes the healing process sacred, thereby adhering to the theory of a safe space or the liminal space in dramatherapy (Holmwood 2014). In a similar way as in dramatherapy, there is the absence of professional secrets. These are replaced by a much more effective notion of taboos and prohibitions that punish in a very serious manner without distinction as to the transgressor. The material organisation of the stage space marks a trait of the manifestation wherein the symbolic utilization of a circle is preferred. All participants are given equal importance with a plain configuration, with everyone horizontally level, so that equality of all the scenic elements and actions is signified. The main actors, the traditional healer and the patients, find themselves generally in the middle of the circle. They can only move when they want to quit the playing area. In contrast, the audience is at liberty to move and circulate to whatever position they feel more comfortable in. The circle around the healer and the patients is an unstable one, mobile and alive, for the people constituting it can move at will. From this, it is noted that space in traditional healing performances, in a way, interacts in all three essential descriptive categories of signs in semiotics. The first of them, according to Gaines (2006), is firstness, signifying that which is ‘as it is independently of anything else’. Secondness is that which is ‘as it is relative to something else’, and thirdness is that which is ‘as it mediates between two others’. To Gaines, space in a performance transits through these three categories. 39

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When an analysis looks at the specific qualities of space, it is firstness that is being considered. However, considering the quality of space in a room, for instance, already permits the conceptualization of the enquiry in terms relative to something else, thereby loosing firstness to secondness, because the meaning of space in the room is necessarily dependent upon the relevance of other objects within that space. As for thirdness, it is mediated by a third party, such as a person in a particular space. Meanings are interpreted from a specific point of view, indicating the practical consequences of qualities and relationships within a spatial sign system (Gaines 2006, p. 173). In this space, therefore, messages are equally transmitted through the text.

The text The primary goal of healing and purification rites is the transmission of precise messages. As a rite, Esie seeks to render the health of the soul, spirit and body. From the onset, the therapeutic quest is not ordinary: it is triple, physical and psychospiritual. The dimensions of the message go beyond the traditional frame, physiological or psychophysiological. The performance has a precise and particular human value. It contains a human three-dimensionality that is situated above Artaud’s aesthetic conception in The Theatre and its Double (1995). Answering the question as to whose work is the text, a three-dimensional response is observed. It is the masterpiece simultaneously of history, the society and the participants who guide the healer. It is the society that creates the custom that, for its part, is the source of the rite. Esie would not exist without a society to fashion it by fixing structures and constitutive elements and installing the necessity or the importance of the rite. The ceremony and ceremonial (liturgy) of the performance of Esie are particular because it is a social, sociological and moral conventional realization. It is also historical, because it is transmitted and transformed, slowly and imperceptibly, over the course of time. Through relying on ritual acts that are taboo, Esie has evolved over time, permitting it to repeat itself identically while, at the same time, renewing. Esie is also a non-literary text. It is oral with fluidity, transitory in nature and subject to reevaluation as the cultural context shifts. Looking at the discourse produced or transmitted orally by Esie within social, cultural and aesthetic conventions further gives weight to this tradition, which is neglected by scholars, to look at the healing potentials therein. Following this perspective, Esie is a cultural text with a rich and appealing body of material for scholarly attention, and it is worth approaching its performance with an artistic lens. As a rite, cultural celebration and performance, Esie only has a constant structure of incantations and dances. Its content and particular value change with the subject matter of the day. It purifies to heal a mental problem caused by a heavy fault or a suspicion (such as rape, the transgression of prohibitions, crimes and incest). The leader of the day indicates the day’s object, and its form depends uniquely upon his talents: a mastery of the ritual and an improvisational gift that is clearly identified under communicational skills and a relevant element in dramatherapy. The quality of Esie is linked to the artistic and dramatic qualities of the leader, who has to know how to recite the incantations, improvise the presentation, talk distinctively and transport the crowd, whose active participation, essential to the performance, goes beyond the artificial phenomena and dummy state of the public, the group of spectators and the amalgam of performance consumers. Alone on a large stage (village courtyard), he engages in a vast oratory and dramatic demonstration that makes him the master of the entire manifestation. He is master of ceremony, author and preacher, or officer at the same time, thereby accomplishing the cumulative solution recommended by Appia in L’œuvre d’art vivant, Artaud in Theatre and its Double, and Copeau in Mise en scène. However, a study of performance goes beyond looking 40

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at the text and space. The participants who partake in the rite also constitute a point of focus, most especially for understanding the therapeutic mechanism.

Participants Participants, employed here as opposed to clients in ‘mainstream’ dramatherapy, denote the ‘performers and audience’. This covers all who partake directly or indirectly in the realisation of the healing performance. Traditional healing performances, carried out in the context of mental health, such as those mentioned earlier, take place in non-hierarchical structures, and the subjects operate with personal experiences. During these performances, participants have a special ability to take on or adopt the roles of others. They generate experiential understandings by adopting an intensely participatory stance that is central to the understanding that traditional mental healing is predominantly collective. It is through their participation that therapy is achieved. Though such empathetic performances may be artistic, as noted in the artistic qualities exhibited by the healer, their primary aim or interest is to deepen ethnographic insights, not from an ethnographic perspective, but from a therapeutic view exploiting ethnographic notions. What, therefore, are the insights that are derived from observing the participants in these performances? In Esie, for instance, the performers are not different from the author, director or the public. The spectator is a protagonist, because he or she is a craftsman of the performance and not simply a consumer. Each character present in the performance is a participant and active element, for he or she dances, sings and chants songs and incantations following the leader. A popular unanimity is constantly sought by the leader, who receives it through enthusiastic clamour in the form of ‘eeeh’. The leader does not individually have a therapeutic gift; it is the opinion of the participants that confers on him the authority and power. Still unknown to modern practice, the therapeutic power in Esie, on which Beti medicine is based to treat mental disorders triggered by a curse, participates in what can be termed ‘collective psychiatry’ (Oyie Ndzie 1985). An illness by and of the community, it is by and for the community that the patient obtains his or her treatment and purification. Esie hereby becomes a community-based therapeutic performance comparable to dramatherapy. When everyone present is an actor/performer/participant, community-based dramatherapy borrows a new phenomenon from indigenous theatricality: that of co-creation or the enunciating collective (Helbo 1981). The participants though, do not participate in the same manner. Their roles are set in order of hierarchy. It is a structured performance, with the playing area on which the participants intervene organised following a scale of values that attribute to each protagonist an indispensable function. It is a rite, sacred, immutable and live, with each participant intervening in an irreplaceable and unique way and with power given to him/her alone. It is noted from such perspectives and insights that there is a new view of the participants’ role in what can be considered a ‘mere rite’. The participant is further seen as a social actor who exists in the dramatic mode – a participant in the social dramas of everyday life. He/she also exists as a personal text, thereby suggesting the lyric mode, offering a personal, individually creative utterance, a cry emerging from private consciousness, shared in intimacy. The participant is also seen as a social activist or ethnographer who lives in the epic mode, not only adopting the objective stance of the researcher to tell or to narrate a particular story, but electing to show or enact a given vision and ensure that the undergoing therapy achieves its aims and objectives. Through these collective and cumulative roles played by participants, therapeutic performances as such present a reception process compared to none. 41

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The reception process Be it Esie or Pa Ayamah’s healing performance, the reception relies highly on the potential for the public to actively partake and understand the ongoing actions. When observed closely, it is notable that the public of Esie at one moment illustrates the affirmation that it is not a unique performance but an integration of subspectacles. While the leader exposes the genealogy of the patient, the group of women responsible for feeding are busy with preparations, and the orchestra plays a less tense rhythm. Despite the distractions centred on the lead singer’s performance and that of the audience itself, all participants make sure they keep an eye or ear on the main event. Indigenous spectators follow the performance without tension and without paying much attention. They listen and watch at ease, without stressing the brain, and in all freedom. Esie can, therefore, serve as a stress reliever to the audience. Finally, the patient for whom the healing and purification performance is meant, healed and purified, equilibrates the participants without knowing. Esie then transforms into a reciprocal psychiatry, where the patient and his/her participants are mutually and simultaneously healed. This is a process easily identified in community forms of theatre wherein participants transform spectators into spect-actors, which heightens the receptive process. It is a receptive process compared with the ‘interactive’ participation employed in most performances (Pelias and VanOosting 2003). Interactive participation portrays both performers and audience as co-producers, each contributing to the production of the event in a manner likened to the process of enunciating collective described by Helbo (1981; Helbo et al. 1991). The distinction between the performer and audience becomes less important with the performer being the author, actor and audience. This notwithstanding, the performers maintain the authority to initiate interaction and to select particular subjects (a role played mainly by one person in Esie, the lead performer or healer, and played by two or more in Pa Ayamba’s practice), and the audience is invited to create within an established framework. Within the theatrical space, the performer and audience codetermine possible directions for the event, which further reinforces the notion of collective therapy or a community-based therapeutic process rooted in the culture of a people.

Concluding remarks: A community-based dramatherapy or therapeutic theatre model? The intention of this chapter was to show how traditional healing performances are related to dramatherapy, and how these can be appropriated to either develop a community-based model or to justify the existence of one in Cameroon. Of interest was the zeal to portray how these performances apply dramatic and theatrical techniques in mental health. The performances examined show that the spectacle that is at the centre of the treatment of mental illness is a specificity of a Negro-African domain (Oyie Ndzie 1985). It is at the limits of rituals and ordinary performances. The text, for instance, enables a message to go beyond the traditional frame and call into play psychophysiology. As for the participants, the healing performances are centred on them. Just like an ethnographer, therefore, the participants in traditional mental healing performances fluctuate between the realms of the performer and the observer. There is an active participation that enables them to cross the separating line between the viewers and the viewed. Participation here stands as the core for the success of the healing performance in the same way as it does in dramatherapy. At this stage, the reflection portrays a certain number of noticeable points that I consider to be central to the evolution of African/Cameroonian psychiatric interventions and to the 42

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contribution of traditional mental healing performances to this branch of science. It orients towards a hypothesis held by Oyie Ndzie that ‘traditional African medicine is fundamentally psychosomatic, notably when it concerns the treatment of mental illness’ (1985, p. 71). This implies that psychiatry can have recourse more and as exclusively to psychotherapy, thereby affirming itself in essence as a drama/theatre-based treatment. It is a vast specialty in which the spectacular and the secular, medicine and charlatanism, objectivism and naivety, science and art, medication and spectacle/performance all merge to produce a therapeutic effect or affect on the patient, and so, traditional psychiatry can be termed a complete, pluri-disciplinary therapeutic intervention. Its symphonic and philharmonic character renders the practices confusing and difficult to understand using scientific methods and imported foreign criterion. Theatrical elements of an amazing, spectacular nature and sensational artistic qualities are central, thereby making the treatment of mental illness a rich form of performance. The ceremonial of indigenous psychiatry transmutes the science of the rite, the technique of art, and renders therapy in spectacle. Faced with the constraints that dramatherapy has, basically concerning the licence to practise as a dramatherapist, and added to the training that dramatherapists are expected to undergo, it will be preferable to consider these healing performances as pertaining to a community-based form of therapeutic theatre. This is as a result of the largesse that therapeutic theatre offers by incorporating diverse practices into its realm. Drama as an art form is strict and limited, whereas theatre is a much broader notion. This permits hybrid practices to find their way into this category of performances more easily than will be the case within dramatic practices. Therefore, traditional mental healing performances in Cameroon, as seen in this study, without doubt contribute to the development of a community-based form of therapeutic theatre that is typically Cameroonian.

Notes 1

2

Esie is a healing rite practised by the Beti community of Cameroon, in which dramatic and theatrical techniques are employed. This rite is practised when a member of a family, despite all forms of medical treatment, has not healed. The rite will be organized by the entire lineage in a public place, with one or more mingengañ (healer who intervenes in the rite) conjuring the illness. The patient makes a public confession of all the evil he or she has done. In the case of a minor, the parents confess on his/her behalf. The older people of the family invoke the ancestors so that they can heal the patient who has confessed his/her acts. After the confession, the older participants will leave for the forest in search of herbs and medicinal plants that will be mixed in a large medicinal bowl with water from the spring. The patient is sprinkled with some of the water by his/her relatives before bathing him/herself. From that instant, the healer can diagnose the illness and go ahead with treatment. More on this rite can be found in Oyie Ndzie’s article, ‘Psychiatrie et théâtrothérapie dans la médicine traditionnelle en Afrique Noire’ (1985). Bafut is a locality found in the north-west region of Cameroon, situated about 15 minutes’ drive from the capital town of Bamenda.

References Artaud, A. (1995) The Theatre and its Double (trans. J. Calder). Melksham, UK: Redwood Books. Attigui, P. (2012) Jeu, transfert et psychose: de l’illusion théâtrale à l’espace thérapeutique. Paris: Dunod. Besbes, K. (2007) The Semiotics of Beckett’s Theatre: A semiotic study of the complete dramatic works of Samuel Beckett. Boca Raton, FL: Universal. Esslin, M. (1987) The Field of Drama. London/New York: Methuen. Gaines, E. (2006) ‘Communication and the semiotics of space’, Journal of Creative Communications, 1, 173–81. Helbo, A. (1981) ‘The semiology of theater or: Communication swamped’, Poetics Today, 2, Drama, Theater, Performance: A Semiotic Perspective, 105–11. 43

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Helbo, A., Johansen, J. D., Pavis, P. and Ubersfeld, A. (1991) Approaching Theatre. Bloomington/ Indianapolis, IN: Indiana University Press. Holmwood, C. (2014) Drama Education and Dramatherapy: Exploring the space between disciplines. London: Routledge. Howard, P. (2009) What is Scenography? (2nd edn). London: Routledge. Jones, P. (1996) Drama as Therapy: Theatre as living. London: Routledge. Oyie Ndzie, P. (1985) ‘Psychiatrie et théâtrothérapie dans la médicine traditionnelle en Afrique Noire’, in Quel théâtre pour le développement en Afrique?, pp. 60–71. Dakar: Les Nouvelles Editions Africaines. Pelias, R. J. and VanOosting, J. (2003) ‘A paradigm for performance studies’ in Auslander, P. (ed.), Performance: Critical concepts in literary and cultural studies (vol. 1), pp. 215–31. London/New York: Routledge. Reiss, D., Quayle, M., Brett, T. and Meux, C. (1998) ‘Dramatherapy for mentally disordered offenders: Changes in levels of anger’, Criminal Behaviour & Mental Health, 8, 139–53. Ubersfeld, A. (1996) Lire le théâtre III: Le dialogue de théâtre. Paris: Belin SUP Lettres.

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6 A bridge over troubled waters ‘Play can break the mask of silence’ Ioana Serb and Magdalena Cernea

Introduction Any description of dramatherapy and play therapy in Romania has to take into account the social and historical context, in particular the backdrop of a very harsh communist regime. Romania went through a long period of restriction, isolation and lack of information, as Communism created segregation between our society and the progress made by Western culture. Psychology and related areas were ostracised by a totalitarian, persecutive political regime, to the point where the university specialization of psychology was closed in 1977, and the Institute of Psychology and Pedagogy Studies was closed in 1982. These closures were accompanied by very strict control of any activity by any humanists, inside or outside the academic field, suffocation of all initiatives that would have fallen outside the communist ideology, and isolation and persecution of those who kept in touch with Western developments in these fields, including the arts therapies. Romania was cut off from the outside world and started wearing its mask of silence. In these conditions, creativity was for a long time in the troubled waters created by the dysfunctional political, social and cultural structures of one of the most oppressive systems in the history of our world. Following the 1989 revolution and fall of Communism, the dam was opened, and the first bridge was created with the re-opening of the Faculty of Psychology, together with an increased interest in all related fields. There was also the exposure of the harsh regimes in orphanages and ‘homes’ for young and old alike, which hit the Western media before Romanians themselves knew what had been happening. The 1990s were buoyant with initiative, information and the creation of structures, but it took a decade for dramatherapy to make its entrance in Romania. Everything started with Sue Jennings coming to Romania and starting short courses, together with international volunteer projects for homeless people, children on the autistic spectrum, children in institutions and people in penitentiaries. For several years, she gave workshops to hundreds of professionals, including psychologists, teachers, social workers, carers and child protection staff. The foundations of a very important bridge were laid, and people here started to have their first contact with dramatherapy and its methods. 45

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As of 2008, the Romanian Play Therapy and Dramatherapy Association was founded, and, in 2010, the first intake of students started their journey on the 3-year accredited training to become play and dramatherapists. In 2013, the Romanian Association became a founder member of the European Federation of Dramatherapy. We could say that this delayed our start (compared with other parts of the world); however, it worked to the advantage of the development of Romanian dramatherapy, as we could access decades of experience in other countries (both the successes and the failures), and we had the opportunity to begin at a completely different level (e.g. the training was built taking into consideration the UK standards). More than that, Romania had the huge opportunity to receive the full support and involvement of Sue Jennings and her colleagues, to whom we owe the vision of the development of the training and the design of the curricula. Romania is one of the few places in the world to combine dramatherapy and play therapy in one structured, coherent and effective therapeutic approach. The entire course and its curriculum were designed to offer joint training in play therapy and dramatherapy, so that future therapists would be able to use the processes from both disciplines, which we believe are interrelated and connected. Romanian training is attachment-based and action-oriented, working on the basic idea that play therapy and dramatherapy are situated on a creative continuum along which the therapist can move according to the client’s needs and resources. The core paradigm of this approach is Embodiment–Projection–Role (EPR; Jennings 1990, 1998), a developmental paradigm that charts the development of dramatic play in children from birth to 7 years. From birth to 12–14 months, the child is in the embodiment stage (E): we can observe that the child’s early experience is physical, expressed mostly through body movement and senses. Any action and play focus on their own body. This stage is essential for the development of the body self and, subsequently, of self-identity. The projection stage (P) develops from the embodiment, after a time of transition, usually marked by what Winnicott (1964) describes as the transitional object, the child’s first symbol. From 14 months, the child responds to the world beyond the body, to things outside the body. The child’s responses may well be physical, but mostly involve a medium outside the body boundaries. An increasing use of stories through objects such as puppets and dolls houses can be observed. As the projection stage develops, children not only relate to different objects and substances, they also place them together in shapes and constellations. The projection stage merges into the role stage (R) at about the age of 3–4 years, after another time of transition, when the child decreases projecting roles through outside objects and starts being the characters. This transition may be marked with different kinds of object, maybe an object of authority (an object/specific costume that allows the child both to direct the action and be in the action). The role stage is characterised by a prevalence of the child taking on roles: as it develops, the child directs the story, sets the stage, shapes the characters and plays the roles. The body is the primary means of learning (Jennings 1990); every other means is secondary to body learning. From birth, throughout the embodiment stage, the child’s focus is centred on their own body, moving during the projection stage to outside objects. Through the role stage, the action moves the focus from the outside to the inside, but now the inner world of the child is enriched by the tools given by the world outside the body and the permanent connection to it. Usually, at the age of 7 years, the child has completed the three stages, has fully integrated embodiment, projection and role and has established a feedback circuit between themselves and the world. 46

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More recently, Dr Jennings has expanded and developed the embodiment stage in more detail with ‘Neuro-Dramatic-Play’ (NDP), which starts from conception, rather than birth, and includes the very intense, attachment-focused time immediately after the birth. This includes sensory, rhythmic and dramatic play between mother and newborn until 6 months old (Jennings 2011). However, throughout pre-teen and teenage development, the child revisits all these stages, not necessarily in the same sequence. They experiment with the stages, as their identity continues to develop, so that, as an adult, they make choices based on the stage that they have dominance in, usually taking up jobs and hobbies accordingly. Life choices based on something else (e.g. the pressures and expectations of others) can generate conflict or distress. EPR and NDP can be used as assessment tools in order to observe the resources or needs of the child’s, teenager’s or adult’s development in these stages. These two developmental paradigms offer means for exploring and developing within therapeutic play and drama. Magdalena Cernea’s work with non-hearing children and with children with cochlear implants illustrates the attachment and developmental model of Romanian dramatherapy and play therapy. I want to hear, but I can’t. I want to speak, but I can’t hear. I want to listen, but I can’t understand. I want to make myself understood, but I can’t put it. I’d like to have a group of friends, but I’m different. Frustration, inhibition, distrust, fear, revolt . . . I conceal them all under the mask of my silence and deafness. Current Romanian cultural space, which, by default of any valid alternative, has passed from communist extremism to religious dogmas, is dominated by creeds, habits and superstitions meant to influence public opinion. As these dogmas are appropriated without being filtered by people’s own convictions, a great many aspects of contemporary social life are altered. The Romanian traditionalistic creeds lead to the idea that disability stands for punishment, for sin or for a family shame, which leads to social exclusion. If we drew an analogy with the original myth of Adam and Eve that Christian faith is based on, we could understand its influence upon Romanian folk culture. Just like Adam, who, after having been punished and expelled from Eden, stood naked and humiliated in front of the Creator, the needy child considers him or herself unworthy of parental love, feeling responsible for all the troubles of family isolation and marginalisation. This does not take place explicitly, though the child is able to decipher the parents’ facial expressions almost from birth. We would like to consider the difficulty of deaf children with cochlear implants or hearing aids. Owing to the advanced techniques, highly specialised medical devices and updated surgical methods used since their infanthood, the process of verbal–auditive (re)enabling may disturb the attachment relationships between children and their families and make them dysfunctional. This happens when deaf children wear hearing aids attached behind the ear, which capture and amplify sounds that are then passed into the middle and inner ear. However, deaf children with cochlear implants are in a special category, having suffered the trauma of surgery. A cochlear implant system helps to restore the sense of hearing for individuals with severe-to-profound sensorineural hearing loss. A cochlear implant is the only medical device capable of replacing that sense. It works by bypassing non-functioning parts of the inner ear and providing electrical stimulation directly to nerve fibres in the cochlea. A cochlear implant system consists of two parts: an externally worn audio processor, which sits comfortably behind or off the ear, and an internal cochlear implant, which is surgically placed just under the skin. Hearing for children in both categories is obtained artificially, but the means are different. From their early years, these children are taught to speak by following various techniques of special therapy; therefore, their language is artificially acquired. They are instructed to speak 47

Ioana Serb and Magdalena Cernea

‘at command’, a fact that increases their inhibition, frustration and anger. Their speech uses verbal language like an instrument, not as a way to express emotions. The difficulties of expression entail either isolation (deaf children adopt defensive strategies that can lead to shyness, excessive dependence on parents, flight from group situations, fear of committing mistakes or struggling to choose). However, the complete opposite can happen, with strong aggression (manifested via offensive strategies, fury, violent behaviour between the child and the others). Generally speaking, deaf children’s thinking is very concrete, and the fact that their mental structure is highly precise diminishes their opportunity to show creativity, inventiveness and artistry. These children are not able to find adequate ways to share their thoughts and emotions socially. They are prisoners of two worlds – both of the deaf and of normal-hearing individuals – they risk developing identity crises later on, and this could increase their anxiety and block them emotionally. Difficulties in accepting their own self and body (modified by hearing aids or cochlear implants) can appear during adolescence. Fifteen years’ professional experience, developed gradually in domains such as audiology, psychology, child welfare, play therapy and dramatherapy, has permitted a sound approach to these children and their families’ condition. Members of the team dealing with multidisciplinary evaluation of deaf children and within the organization of national camps for cochlear-implanted children have noticed that experts in charge of children’s recovery often neglect their emotional aspects. With our willingness to rehabilitate their hearing and language, the children’s families working closely with us as specialists maintain a permanent pressure in this work. In 2007, in order to bring together as many specialists (ENT doctors, specialists in child neurology and psychiatry, surgeons, audiologists, speech therapists, psychologists, teachers) working in this area of recovery as possible, we started to organise national camps for cochlearimplanted children in Romania. It was appropriate that these children’s parents founded their first association. Participating constantly in the camps, I aimed to implement and spread new emotional therapeutic approaches, while respecting the children’s rights. If we were the children and able to choose ‘freedom of expression’, we would vote for play therapy and dramatherapy. We come to this view after our close observation of children’s difficulties in expressing themselves, especially as far as their articulated language was concerned. Our project involved both children who are deaf and children with normal hearing, and this eased the deaf children’s integration into the wider community. The techniques helped children externalise their emotions, use various means of expression and ‘access’ their inner feelings. Therapy sessions were adapted to children’s age and period of intervention. In case of long-time interventions, the groups benefited from fifteen 60-minute meetings over fifteen consecutive weeks. In case of short-term interventions, the meetings occurred every day (lasting 4 hours a day) during the whole period allotted at the national camp organised for cochlearimplanted children. Through a range of new and familiar experiences, the children learned that, within a secure space and environment, surrounded by people they can trust, it is normal to try things out and get them wrong. All the above elements allowed us to launch a national research–action–training project based on play and dramatherapy. The project was implemented in 2014 through the Audiosofia Association. The ‘Play can break the mask of silence’ project was mainly for 3–18-year-old deaf children with either cochlear implants or hearing aids. Forty-five deaf children and eighty-one normalhearing children participated. The project aimed to achieve several objectives: mental-illness prevention; normalisation and acceptance of deaf children in normal-hearing communities; supervision and education of specialists (students at the School of Play and Dramatherapy of 48

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Romania were able to conduct some of these sessions); as well as the development of deaf children wearing cochlear implants/hearing aids. They also had the opportunity to develop other communication skills: meeting and playing with normal-hearing children allowed the hearing-impaired children to be valued within the group and to learn how important team work could be. They enjoyed bringing their contributions to the group and learned the way certain rules must be observed. Having the possibility to share common experiences, they were stimulated, and this pushed them to reveal their artistic and creative natures. The deaf children who participated in the project have improved and diversified their strategies of communication with their normal-hearing friends. They were able to discover both themselves and the others within the context of groups. In turn, by playing with deaf children, normalhearing children discovered new ways of communicating. They all experienced team-work – a wholly different vision from their school experience, which was based on competition. Within a secure environment, introverted and anxious children had the opportunity to safely show their creative selves in front of and together with the group, and extrovert and hyperkinetic children had to adjust their behaviours in order to be accepted by the group. The latter learned that they could ‘discharge’ their aggressiveness and anger in a nonviolent manner, and that they need not challenge the other children with their excessive behaviours. The ritual–risk (Jennings 1998) balance was thus equalised in both cases. The specific EPR games could break down certain barriers and support the development of the children’s needs by consolidating their confidence and creativity. These children were compelled to shift from day-to-day reality to dramatic reality (Jennings 1990), which facilitated a better self-knowledge. The new means of expression permitted participants to confront different emotions that, adequately managed, had to be accepted by the group and the therapeutic framework. Though these emotions were externalised, children could concomitantly access their inner experiences and become aware of their personal resources. The team of professional volunteers we coordinated were prepared to manage and face the children’s emotions, irrespective of how they might present. When the main steps of the therapy project were finalised, a play was performed in front of the children’s parents, relatives, friends, experts, guests and the press. The performances attempted to solve, in a complex way, many of the children’s struggles (inhibitions, allowing them to adapt previous emotional blockage and frustration), and their chosen themes were presented thorough musical pieces; costumes, masks, make-up, preparation of rehearsals and the show itself all contributed. In the three theatre performances, we organized performances entitled The Four Elements, In Pursuit of Happiness and The Wandering Mask. The deaf children played alongside their normalhearing friends and the volunteers. In the first performance of The Four Elements, eight deaf children, six volunteers and sixty-five normal-hearing children participated; some had language disorders, autistic spectrum difficulties or hyperkinesia. Children who were 3–7 years old were divided into four groups, each group representing one of the four elements: water, air, earth and fire. The performances, accompanied by music (modern arrangements after Vivaldi’s Four Seasons, Webber’s Phantom of the Opera and the Radetzky March), rhythmic dances and movement, were ‘decorated’ by the lively colours of children’s costumes and masks. We attached coloured stickers to their white gowns: copper for earth, blue for water, pink for light, blue for air and yellow-orange for fire. The preliminary activities included sensory play, playing with water and flour or with soap and balloons, painting, drawing, modelling coloured clay, role-play (favourite heroes), dialogues among puppets, playing with scarves, corporeal games, pair games, rhythmic games, painting 49

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and wearing masks, and expansion activities using the parachute. The therapeutic effects were mainly noticed with the groups of young children: at the beginning, they used to cry and reject most group activities, but, towards the end, they became the most involved participants. A performance’s theme was not established from the start; it was developed over time, together with the children. As we were advancing, we could implement the new ideas changing our minds. The four primordial elements were at war until they were able to lower their masks and turned the urge of war into an invitation to peace. The first performance was intensely coloured; the other two were black and white shows. In Pursuit of Happiness was played in a camp for children with cochlear implants; there were eight deaf children and teenagers, four 10–17-year-old normal-hearing subjects and three volunteers. We mostly approached embodiment activities, dance and role-play games. The main theme related to the idea of ‘unhappy masks’. A merry clown wished to breathe life into the masks and started to use them, but the masks were ‘blocked’ within by their sadness. The clown did not give up: he began to dance, following the sweet rhythms of Anthony Hopkins’ And the Waltz Goes On, and finally succeeded. The climax was reached when, startled by the sounds of the music, the masks began to rouse, to come to life little by little, and were willing to get out of their tight and isolated situation. They looked for communication bridges with the outside world. Every mask sought his or her own happiness and, by discovering their self, was able to share their talents with the others. Each child could freely choose their role and music according to what they preferred and knew best. Some children chose to dance, others to paint, play chess, perform special exercises of rhythmic gymnastics, take photos, be reporters or look for new species of birds. Each child made his or her own stage costume – i.e. a black T-shirt with a white letter stuck on the breast. Each subject chose a letter from the Romanian word fericire (‘happiness’), and, as the number of children surpassed the number of letters in the word, the others stuck exclamation marks on their T-shirts. For more than 45 minutes, the stage ‘quivered’ with slow and quick rhythms, the sound and intense images expressing joy and sadness, smiles and colours, delicacy and tenderness. In the end, lined up in one row in front of the public, the audience could read what the ‘actors’ wished to share – namely, the happiness they acquired after leaving behind sadness and recovering their own self. Children were so delighted by the performances and rehearsals that, the next day following the final representation, they wished to go on. The ‘actors’ approached their parts so seriously that they even asked us to use break time for rehearsals. The strong message the children conveyed made the public applaud loudly, again and again at the end of the show. The last performance, The Wandering Masks, was an incursion into the world of contrasts, performed by twenty-eight children – twenty-one of whom wore cochlear implants – and three volunteers. Considering teenagers’ capacity to understand, we could approach appropriate abstract themes: life cycles, darkness and light, happiness and sadness, dreams and spirits. Carefully chosen, the music had a significant influence on the perfomance. The story was about a malefactor and wicked witch who, riding a broomstick following Khachaturian’s Sabre Dance rhythms, cursed a whole enchanted realm. Her witchcraft made the realm freeze and be peopled by masks only. The place was inhabited by a gifted painter. The scar on his face obliged him to wear a mask. The surrounding masks did fascinate him, but, solely under moonlight, when nobody could see him, did he dare take off his own mask. The painter met the masks’ vitality, energy, lust for life, and courage and desire for freedom. He would have liked to touch them, but his mask stopped him drawing near to the others. He retired into his lonely and misty world using Ciprian Porumbescu’s Ballad rhythm. His sad soul made the Sun and Moon (interpreted by a pair of cochlear-implanted twin boys) put on a face in which the day turned into night and the night into day, all this aiming to tempt the painter to show his face. His real beauty could thus be 50

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admired by everybody, during the daytime too. The twins succeeded in giving rise to great confusion: they appeared and disappeared on the stage as often as before, but in interchanging parts. The image of the rhythmic lowering and raising of masks on children’s faces symbolized day-and-night sequences. Dressed in white and moving according to Ravel’s Bolero, the ‘actors’ impressed the audience deeply. At the end of the play, all the characters threw their masks into the rhythms of the Zorba dance. The part of the painter was played by a 20-year-old architecture student who was remarkably gifted at drawing. In 2000, he had been the first child in Romania to have a cochlear implant. Summing up, each of the three quoted performances made the children smile and increase their confidence and their desire for team-work (in spite of their differing ages). They approached the plays seriously, but they felt free to act and share their joy. If one hadn’t known that these ‘actors’ were deaf children, one wouldn’t have realised it. The barriers between the normalhearing and deaf children fell down from their first meetings, and both categories surpassed their expectations. The connections between scenes were achieved by a storyteller. This helped many of the children, as they were unable to express themselves verbally. We and the other volunteers took main actor roles. Playing our parts close to the children, we could better feel the pulse of the moment and experience the emotions together with them. The stage offered them the possibility ‘to see themselves’ and ‘be seen’ by others. They ‘were seen’ through their possibilities, not through their difficulties. During the performance, parents and experts could appreciate the children’s value, and not consider them just objects of their work. These performances somehow changed the public’s perception of the children. The problem with deaf children’s integration stands as an ‘invitation’ addressed to parents, physicians, speech therapists, audiologists, educators and all those belonging to their social and cultural environment, to self-knowledge and self-perfection through direct relationships. The performances offered by these children made this challenge and raised emotional communication bridges between the ‘actors’, parents and experts. The positive outcomes of the ‘Play can break the mask of silence’ project granted us the ability to continue in 2015. So now, an even greater number of children can benefit from the advantages of the larger participation of professional volunteers (play therapists, dramatherapists and students at the Romanian School of Training in Play and Dramatherapy). In 2015, the project was to be extended to ‘Play and colour with wandering masks’ as a model of good praxis in other areas of the country. The ‘masks of silence’ were thrown away. The children have already acquired the power to change themselves and set forth anew in the world of games and colours. The children and young people’s inner worlds allowed them to discover the universal language of creative expression and stimulated them to look further and deeper. I can hear. I strive to speak and understand. I can make myself understood and express myself. I have a group of friends, though I am different. I am confident, bold and cool. I succeeded in lowering the mask of silence and changing it.

References Jennings, S. (1990) Dramatherapy With Families, Groups and Individuals. London: Jessica Kingsley. Jennings, S. (1998) Introduction to Dramatherapy: Ariadne’s ball of thread. London: Jessica Kingsley. Jennings, S. (2011) Healthy Attachments and Neuro-Dramatic-Play. London: Jessica Kingsley. Winnicott, D. V. (1964) The Child, the Family and the Outside World. London: Pelican. 51

7 The history, trends and future of North American drama therapy Andrew M. Gaines and Jason D. Butler

In November of 1986, Richard Courtney presented a paper entitled ‘A Whole Theory of Drama Therapy’ to the National Association for Drama Therapy (NADT) at its seventh annual conference in San Francisco, California, at Antioch University wherein he concluded: It would be a brave philosopher who tried to pigeon-hole such a field into one of the great traditions of the past . . . nor can it be classified as psychology or art, anthropology, or aesthetics. Rather, it rests firmly on a holistic attitude to human beings and the fundamental beliefs that: 1. 2.

dramatic action is a meaning-giving operation; and persons can help one another to become more of human beings. (Courtney 1986, p. 200)

While Courtney offered an essentialist way to forge the field’s disparate identity by rooting its theory and practice in human nature, his perspective simultaneously echoed the field’s ‘plurality of frameworks’ (p. 199), referencing interdisciplinary origins and a postmodern body of knowledge, although several scholars suggest that the origins of drama therapy reach back to tribal and ancient religious rites. Johnson (2009a) argued that the turn of the twentieth century set the stage for the birth of drama therapy with three major movements: ‘psychotherapy, occupational therapy, and the acting training of Stanislavski’ (p. 11). However, Landy (1994) built upon Courtney’s (1974) pioneering work, Play, Drama, and Thought, by further articulating the forebears of the field to include: play and play therapy; ritual, magic and shamanism; psychodrama and sociodrama; psychoanalysis; developmental psychology; sociology and symbolic interactionism; performance theory; and educational drama and theatre. As Johnson (2009a) explained it, early tolerance for such a wide multiplicity was integral to how the original steering committee of the NADT could even broach the idea of uniting ‘nascent drama therapists’, let alone survive as an association: ‘if we drew the lines too narrowly, few present would qualify’ (p. 8). Although there was a strong desire to welcome individuals who were engaged in similar pursuits, there was simultaneously a need to draw lines and begin defining the field, beginning with psychodrama/sociodrama. But this approach also created a space where early practitioners under the same wide umbrella were granted freedom to cultivate their own ideas, each interpreting the same human phenomenon, healing through play, through unique 52

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lenses. This trend ultimately led to the potential for insularity that limited our thinking and our ability to consolidate our practices into corresponding concepts – what Landy and Montgomery (2012) called ‘splits within splits’ (p. 176). For example, disagreements about the appropriate role and timing of reflective verbal processing in drama therapy, or if it should occur at all, remain strong. With the initial North American pioneers fleshing out their own theories across the continent, their focus seemed to be inward and proprietary. This isolationism was particularly amplified before the advent of the Internet. But such a trend is not limited to drama therapy, nor is it solely a characteristic of North America; when scholars do not read across bodies of work, it can lead to incommensurability, which is considered ‘problematic because it leads to provincialism and fragmentation’ (Kezar 2006, p. 335). In 2006, Robert Landy compared the field of drama therapy in North America to a growing person undergoing a kind of identity crisis, caught between ‘post-adolescence’ (p. 141) and the inevitable loss of its parental founders. According to Johnson et al. (2009), this predicament is compounded by the field’s relatively small size and a ‘passion for autonomy’ (p. 19). Perhaps Johnson’s (1982) conceptualization of how human development becomes blocked mirrors our field’s developmental stage: drama therapists might be resisting greater complexities of practice, intensity of affect and the interpersonal demand inherent in scholarly exchange that, if surmounted, could move us forward. Similar ideas could be drawn from Landy’s (1993) articulation of development through role theory, where identity is formed through exploration and acceptance of roles. Indeed, early drama therapists each asserted their individuality from other fields and approaches by declaring which theories and practices were ‘not me’, but have yet to embrace the full complexity of being ‘me’ and ‘not me’ at the same time (p. 11). With much of the field still entrenched in fragmentary views, it is also maturing towards a growing edge of greater awareness, complexity, cooperation and mastery. Through researching the topic of North American drama therapy, we have made speculations about why drama therapy on this continent tends to be more split than unified. What causes the splits within splits, the drive for individuality? Jones (2007) suggested that practitioners have avoided internal cross-referencing or distinguishing among peers’ methods, to avoid ‘undercutting the precious commodity of uniqueness that provides some of the impetus for the work’ (p. 20). Perhaps this is what is at play, and a future paper could broaden our exploration, further linking drama therapy competitiveness (or the lack thereof) with theories of North American ideology and culture embedded in forging a revolution against colonizers (Lipset 1964; Grabb and Curtis 1991), American exceptionalism, Hoover’s (1928) rugged individualism, the rise of global capitalism, or even how modern selfies reiterate the United States’ other themes of egocentricity. However, we will use this chapter to specifically frame the professional evolution of drama therapy in North America as a circuitous journey, punctuated by dialectical phases of individuation and collectivism. We first aim to summarize and augment previously offered timelines and summaries (Casson 1997; Bailey 2006; Blatner 2007; Jones 2007, 2013a; Landy 2008; Johnson 2009a), while also updating them with more recent developments. Next, we will review recent updates in education and training that are impacting the field’s development. We conclude by looking to the future, when the field will hopefully be ready to resolve differences by assuming a more critical stance and further define its scope of practice.

A contentious genealogy The field of drama therapy worldwide is suffused with anecdotes of people thinking they had each discovered drama therapy on their own. We believe that it is unlikely one person invented 53

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drama therapy and tend to side with Casson (1997), who characterized the emergence of drama therapy as a kind of global zeitgeist, akin to a ‘courtship dance [between independently] recurring strands of theatre, psychology, drama and therapy . . . [developing] until the marriage occurs mid-century simultaneously in the USA, Britain and Europe’ (p. 10). Jones (2013a) summarized that the genesis of the term drama therapy in North America was previously thought to have been imported from Peter Slade’s use of dramatherapy in 1939. Yet, in Slade’s interview with Jones (2007), he revealed his inspiration came, in part, from reading Moreno in the preceding decade. However, Johnson (2009a) alluded to occupational therapy literature entitled drama therapy ‘early in the century’ (p. 12), and Phillips (1996) outlined specific publications on how puppets and drama were used as therapy dating back to the 1920s and 1930s. Yet, when Holmwood (2014) and Jones (2013a) discovered one of the earliest-known published books on drama therapy in the US, entitled Principles of Drama-Therapy, by Stephen F. Austin (1917), previous genealogies required reassessment. Austin’s basic definition of dramatherapy generally resembled our modern understandings: ‘the art or science of healing [the soul] by means, or through the instrumentality, of the drama, or . . . dramatic presentation’ (pp. ix–x). One of Jones’ (2013a) central points seemed to be that Austin’s conceptualization of the term ‘is fully formed and theorized’ (p. 356), without drawing upon other concepts or couched within other contexts, which challenged widely held understandings that the field grew gradually from interdisciplinary cross-fertilizations. However, as Jones noted, Austin credited a literary group called the Sopherim in the development of his ideas, in addition to ‘drawing on accounts and contemporary understandings of hypnosis’ (p. 355). Therefore, although Austin’s book is a remarkable relic from North American drama-therapy history, it still probably does not represent the field’s fountainhead. The same year Austin’s book was released, MacKaye (1917) described the therapeutic value of community drama in reference to the settlement movement at Hull House in Chicago, previously written about by Jane Addams (1910). Hull House served as a testing ground for Neva Boyd (1934) and Winnefred Ward’s (1930) ‘Kathartic’ (p. 9) creative dramatics, the source from which Viola Spolin (1963) synthesized her understanding of applied improvisation. According to Bailey (2006), ‘many founders of the National Association for Drama Therapy began as creative drama teachers’ (p. 216), and among them was Eleanor Irwin. Irwin published extensively about using drama in speech and play therapy and continues to teach and supervise trainees in child psychiatry at the University of Pittsburgh. To further elaborate on Casson’s theory, 1917 also marked the year Caldwell H. Cook’s (1917) The Play Way in England posited how dramatic recreation in classrooms can improve ‘health and well-being’ (p. 15), and Nikolai Evreinov published The Theatre for Oneself in Russia, while Vladimir Iljine developed therapeutic theatre in a Russian psychiatric hospital, and, according to Garcia and Buchanan (2009), Moreno had already begun hypothesizing about his role theory and self-help groups with Viennese prostitutes. Despite the fact that these instances represent drama’s reparative effects in other contexts, they signify a kind of widespread collective consciousness about what Courtney (1986) called a ‘deeply human activity’ (p. 193) and that Landy (1994) proposed to be ‘at least as old as the first appearance of human life on earth’ (p. 6).

The impact of Moreno Moreno continued his European experiments with early versions of sociodrama and psychodrama at New York City’s Carnegie Hall from 1929 to 1931. By 1942, he had opened the New York Theatre of Psychodrama on Park Avenue (renamed the Moreno Institute in 1952) where, most weekend evenings he would host open sessions through the early 1970s (Scheiffele, n.d.), attended 54

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by future ‘leaders of the humanistic and encounter movement (e.g. Fritz Perls – Gestalt Therapy; Eric Berne – Transactional Analysis; and Arthur Janov – Primal Scream)’ (Johnson 2009a, p. 5). According to Zerka Moreno (2006), her husband taught at New York University (1949–66), and among his students was Lewis Yablonsky (1992), who would eventually introduce psychodrama to Landy while they both taught at University of California Northridge. Gunz (1996) suggested Moreno also indirectly influenced Kurt Lewin’s field of action research, because they shared students. Under Lewin’s direction, research at the National Training Laboratories (NTL) in Maine on group dynamics and leadership skills used role-play for assessment strategies and testing out interpersonal solutions. According to Yalom (1975), encounter groups grew out of NTL’s sensitivity training groups (T-groups) and rapidly expanded in California during the 1970s, which was fertile ground for the flourishing of self-help groups in personal growth centres. Tom Wolfe (1976) dubbed this time in US history as the ‘Me Decade’, a period Landy (2008) recalled being saturated with ‘rampant narcissism’ (p. 61). In 1964, Fritz Perls popularized Gestalt therapy through the Esalen Institute (2014), where, according to its website, ‘he would live and teach for five years’. Meanwhile, 260 miles south, at the University of Santa Barbara, Thomas Scheff’s (1979) experiences with Gestalt therapy and re-evaluation counseling (Jackins, 1965) would largely inspire his doctoral student Robert Landy’s (1983) own aesthetic distancing theory.

Founding of the NADT According to Johnson (2009a), Gertrud Schattner recruited him at a psychodrama conference in 1974 to contribute a chapter to her upcoming co-edited volume on drama therapy, a project that led the pair to collect an eclectic group of US practitioners to split away from psychodrama as a unique profession. Yalom emphasized how the field of mental health already had ‘a long tradition of territoriality’ (1975, p. 482), and the safety and effectiveness of encounter groups (among which Yalom categorized psychodrama) were now facing serious attacks on legal and ethical grounds by clinical psychologists, whom Yalom believed were irrationally ‘protecting their turf’ (p. 482). Today, psychodrama seems to hold a paradoxical status within North American drama therapy, greatly influencing the work of many drama therapists, but Johnson and Emunah (2009) acknowledge it as one among several subtypes. It is noteworthy that, as opposed to the British Association of Dramatherapists, the NADTA requires specific training in psychodrama. Regardless, it seems clear that psychodramatic techniques are embedded in both North American and UK practices. According to Johnson (2014), one of the many ways in which drama therapists demarcated their field from psychodrama was by also requiring theatre training (based on similar requirements held by the dance and art therapy associations). The North American trend of drama therapists splitting away from other related practices (educational theatre, applied theatre, experimental theatre) not only points to a kind of individuation from a hodgepodge of parents, but also reflects a passion for invention. The goal of creating the NADT was to bring some of the broad mix of individuals who had been doing their own styles of theatre together under the same umbrella. This was not an easy process, involving multiple individuals with multiple agendas, perspectives and identities, perhaps demonstrating the epitome of individualism, each hoping to maintain their unique approach, while simultaneously seeking to join a broader collective. Johnson (2009a) described the various meetings, gatherings and efforts that were made, eventually culminating in the creation of the NADT in 1979. Three years later, Robert Landy launched a drama therapy Master’s degree programme at New York University (NYU). Meanwhile, on the other side 55

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of the country, Renée Emunah was beginning another Master’s programme in drama therapy at Antioch University West, in San Francisco, setting the stage for two of the foundational organizations for drama therapy in North America.

Canada Although there has been a great deal written on drama therapy in the United States, the development of drama therapy in Canada has not received as much attention. Canada also had an early tradition of practitioners applying drama and theatre for therapeutic purposes. In 1974, Richard Courtney brought his developmental drama from the UK to Canada, where he became a professor in the Graduate Centre for Drama at the University of Toronto. In 1981, Courtney, in Canada, and Gertrud Schattner, in the US, came together to co-edit a two-volume set entitled Drama in Therapy. The path of the profession of drama therapy in Canada was further paved by Barbara MacKay (1990) at Concordia University in Montreal. Having attended drama classes with Sue Jennings, Brian Way and Ann Cattanach in the UK in the late 1960s, MacKay moved to Montreal in 1970 and began teaching drama-in-education at what was then Loyola College. MacKay brought with her a passion for using theatre for healing, which she had experienced while working at Dame Alice Owen’s School for Boys in the London Borough of Islington. In 1978, in connection with the art therapy programme at Concordia University, a panel of drama therapists and art therapists from NYU, including Robert Landy, was brought to Montreal to talk about starting a Master’s programme. MacKay later took a sabbatical and went to NYU in 1982 and studied drama therapy with Landy. While there, one of her classmates in a psychodrama course was Stephen Snow. At the time, Snow was a doctoral student working on a degree in performance studies, looking at theatre anthropology and drama therapy under the mentorship of Richard Schechner. With the encouragement of MacKay, Snow came to Canada in 1992 to teach in the theatre department at Concordia, where he created a year-long ‘Introduction to drama therapy’ course. Despite the lack of a formal programme, the interest in drama therapy was so extensive that another eclectic group was formed, called the Drama Therapy Circle of Montreal, which met frequently to discuss and practise drama therapy techniques. Many of these individuals would go on to become drama therapists, with some moving to the UK to study, and others waiting for an official programme to open at Concordia. Five years later, Snow and MacKay negotiated many bureaucratic hurdles to finally start a Master’s programme in drama therapy in 1997, becoming the third programme approved by the NADT. It was then that MacKay retired, and Christine Novy, a UK-trained drama therapist, was hired as core faculty. The combination of instructors from both the US and UK gave Concordia a unique perspective, continuing the field’s history of multiplicity. In a country with vast geography but a small population, many new practitioners fanned out across provinces and territories and became isolated, whereas some clusters formed in large metropolitan centres such as Montreal and Toronto. As more individuals practised drama therapy north of the US border, they increasingly looked for professional connections, if at times with mixed emotions relative to the US. The high profile of the US, with its large population and wealth, presented a source of frustration and something for the other neighbouring countries to rally against. There was a desire, at least on the part of Canadians, not to be consumed within the identity of the US. In order to not be cannibalized by the US system of drama therapy, during the early 1990s, Canadian drama therapists initially wanted to use the term ‘drama-therapy’, to set them apart from ‘drama therapy’ in the US and ‘dramatherapy’ in the UK (Snow 2014, personal communication). Although the disparate strands of drama therapy in North America resembled 56

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more of a cohesive tapestry, this discourse revealed the ongoing desire to be seen as separate, with an independent identity and a unique perspective on the work, further suggesting a drive for independence and identity in the development of drama therapy.

Merging US and Canada Although Concordia University became approved by the NADT in 1997, there was no Canadian representation on the NADT board of directors, continuing what could have been seen as US domination. After some discussion, this changed in the year 2000, when a nonvoting position was added to the board. After a few years, through an official change to the organizational bylaws, the official position of Canadian Regional Representative was created in 2003, with Susan Ward serving as the first representative. The increased Canadian profile in the NADT led to the first NADT conference held in Montreal in 2007. Since 2003, Canadian members have taken on many roles, on committees, on the board of directors and as president. Fifteen years after Concordia’s programme was approved, in 2012, the NADT membership voted to formally become the North American Drama Therapy Association (NADTA). Aside from satisfying multiple requests for Canadian drama therapists to be represented, the new union fulfilled growing pressure from American constituents for increased inclusivity, a further indication of a growing desire and need to unify as a profession.

Mexico The field is still in a very early form in Mexico. Psychodrama has been well established, with several training programmes, some going back as far as 1983 (Blatner 2012). The Playback Centre (www.PlaybackCentre.org) also lists multiple playback troupes in Mexico. But, although there is a long history of playback theatre and psychodrama, very little has been written about drama therapy practices in Mexico. An exception was Susana Pendzik’s (1988) examination of drama therapy’s connection to shamanism several years ago. Recently, there has been an increased effort to create a certificate programme in drama therapy in Xalapa, Veracruz, through the Universidad Veracruzana, led by Rosalinda Ulloa Montejo and Pendzik. Although a formal designation of a field of drama therapy has not been officially established in Mexico, there does appear to be a long-standing interest in the therapeutic impact of applied and experimental theatre. A brief survey of the journal Latin American Theatre Review revealed many articles about Mexican theatre with references to experimental and progressive theatre pioneers such as Grotowski (2002), and Boal (1985) and others with related ties to drama therapy. A recent book entitled Terapeia Teatral: Las prácticas teatrales y su aplicación en acompañamientos terapéuticos (Theatrical Practices and Their Application in Therapy), edited by Gabriel Yepez and Ireli Vázquez (2013), revealed a growing interest in therapeutic theatre and drama as therapy. That being said, to date, there has been very little connection between drama therapy practices in Mexico and those in the US and Canada. This disconnection might be due in large part to the US and Canada sharing English as an official language, which has allowed for stronger collaboration and a more fluid exchange of ideas. In sum, the identity of drama therapy in Mexico is still emerging.

Current state of the field Alongside the Canadian narrative, the year 2000 also marked the publication of the first edition of Current Approaches in Drama Therapy (Johnson and Lewis 2000), revealing a vast variety of 57

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models of drama therapy practice in North America. Although not an exhaustive list of all approaches used in North America, it conveyed a sense of the field’s broad expanse and diversity. In 2009, Johnson and Emunah edited the second edition, which even more vividly illustrated the tension between individualism and unification in developing a professional identity (see Table 7.1), with twenty-three contributors, fourteen unique approaches and four ‘related approaches’. In essence, this volume’s inclusiveness echoed a strategy used in 1979 of setting the tent posts far enough apart that multiple voices could be heard. However, given the history of each approach being so intent on staking its claim, Johnson and Emunah (2009) insisted that each chapter make reference to other practitioners’ work, to help advance the body of knowledge, arguing that: The absence of noncompetitive dialogue in the literature among drama therapy practitioners and scholars remains a significant reminder of how early in development the profession is. In this new edition, chapter authors were asked to include comparisons to other methods within the field . . . [as] an effort toward mutual referencing, acknowledgement of influence, and respectful dialogue about our similarities and differences. (p. 20) Table 7.1 Drama therapy approaches (Johnson and Emunah 2009) Chapter/approach

Author

The integrative five-phase model of drama therapy

Renée Emunah

Role theory and the role method of drama therapy

Robert Landy

Developmental transformations: Towards the body as presence

David Read Johnson

Ritual/theatre/therapy

Stephen Snow

Healing the wounds of history: Drama therapy in collective trauma and intercultural conflict resolution

Armand Volkas

Narradrama: A narrative approach to drama therapy

Pamela Dunne

Omega transpersonal approach to drama therapy

Saphira Barbara Linden

Psychoanalytic approaches to drama therapy

Eleanor Irwin

The developmental-themes approach in drama therapy

Penny Lewis

The enact method of employing drama therapy in schools

Diana Feldman, Fara Sussman Jones and Emilie Ward

The stop-gap approach to drama therapy

Don Laffoon and Fionnauala Kenny

The Bergman drama therapy approach: Creating therapeutic communities in prisons

John Bergman

Rehearsals for growth: Drama therapy with couples

Dan Wiener

Performance in drama therapy

Sally Bailey

Related approaches Psychodrama

Antonina Garcia and Dale Buchanan

Sociodrama

Patricia Sternberg and Antonina Garcia

Playback theatre: A frame for healing

Jo Salas

Theatre of the oppressed: Drama therapy as cultural dialogue

Nisha Sajnani

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Training and competency Each drama therapy university programme across the continent to some extent espouses a particular frame or approach to drama therapy, while situated under a disparate range of academic departments, metaphorically reflecting the interdisciplinary influences of drama therapy itself, but also highlighting the ongoing identity crisis for the field as it matures towards a potential consensus of practice. The California Institute of Integral Studies programme is situated within the counselling psychology department, Concordia placed drama therapy under fine arts, and Lesley University’s programme found a home in the school of arts and social sciences. Landy originally offered NYU drama therapy courses through the programme in educational theatre, until he established his own programme, both of which remain housed under the department of music and performing arts professions within the school of culture, education and human development. In 2014, the drama therapy programme at Lesley University in Cambridge, Massachusetts, became the fourth programme approved by the NADTA. Several other universities in North America have created basic introductory courses in drama therapy, and some are looking at the possibility of creating new Master’s programmes. Along with these university-based programmes, alternative training institutions under the direction of the NADTA have also begun working together to establish a set of standards. With all of the various education programmes and continued growth, there is a simultaneous need to come together in order to have some sense of clarity and consistency within the profession. How do we know what skills and competencies a drama therapy student should be gaining? While each programme strives for its individual identity and focus, they all must also work towards a unified focus on refining core competencies and skills. Currently, the NADTA’s guidelines for education programmes serve this purpose but do not specify clear competencies, pointing to a need for further collaboration. The NADTA requires approved programmes to offer courses that fall under broad headings such as ‘Introduction to drama therapy’ or ‘Drama therapy with special populations’, but it does not establish specific skills or competencies students should have upon graduation. Outside forces also contribute to the splitting within the field and between education programmes. As well as being designed to meet NADTA requirements for becoming a registered drama therapist (RDT), the programmes are also designed to meet the regulatory standards of their region, each focusing on different competencies and establishing unique clinical frames.

Professional licensure Similar to many organizations in the international drama therapy community, North American drama therapists face a broad spectrum of legal and political challenges. This complexity is amplified in North America because there are three countries, totalling 474 million people across ninety-four territories, provinces and states, with each jurisdiction determining its own licensure regulations and delineating a professional scope of practice to regulate who can do what kind of work where and with whom. This legal and regulatory melange also contributes to the possible sense of split and difference. After more than 20 years of effort, in 2006, New York State drama therapists earned the title of Licensed Creative Arts Therapist (LCAT), along with art, music and dance therapists, with the aim of protecting consumers. Californian drama therapists are recognized under the umbrella of Licensed Marriage and Family Therapist; and in other states, some drama therapists can become Licensed Professional Counselors or Licensed Mental Health Counselors. 59

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In the Canadian province of Quebec, battles are currently being waged where laws have been written that limit who can practise psychotherapy. Drama therapists and other creative arts therapists are not currently included within the Quebec law. For the most part, the law limits diagnosing and working with severe mental illness and trauma to individuals with degrees in psychology (and almost exclusively doctoral degrees). Creative arts therapists and others who have historically worked with these populations are currently being excluded and, at the same time, told that they can continue doing work that does not cross over into what they perceive as boundaries to psychotherapy. With this exclusion, without extra degrees, organizations and institutions are no longer hiring creative arts therapists because of the new regulations and restrictions, thus limiting the places where drama therapists can work and where clients might access drama-therapy services. More legislative battlefronts are coalescing in New Jersey, Maryland, Wisconsin and Ontario. Should drama therapy be further excluded from licensure, the results could severely limit the development of the field. Meanwhile, artists who work in health care settings are working towards their own form of professional recognition – but without therapeutic training. Although in some ways these artists can be seen as allies, their move towards professionalization also has the potential to confuse consumers and replace the more expensive services of Master’s-level drama therapists. These legislative battles necessitate a coming together of drama therapists: we must bridge our differences and collectively advocate for the profession. One way of coming together is through the creation of an exam to evaluate drama therapy knowledge. Many state/province licensing bodies require applicants to take some form of exam in order to be eligible for a license. Unlike the art therapy and music therapy associations of North America, the NADTA has yet to established an exam that tests the knowledge, skills and competence of its practitioners. Hence, licensing bodies, such as the one in New York State, require a generalized exam for all mental health workers (currently consisting of two written case studies). The process of creating and validating such a comprehensive instrument for drama therapy is extensive. An NADTA subcommittee has been undergoing a practice analysis to review and determine the tasks and processes that reliably represent what a drama therapist actually does. This analysis can then potentially lead to the creation of an exam that will help measure an individual’s knowledge and ability within these drama therapy processes. Part of the complexity of this process, though, is the challenge it presents to a position of individual identity within the field. By necessity, an exam will determine, to some degree, the extent to which various approaches and individual perspectives are included or excluded under the umbrella of drama therapy.

Future directions and conclusions The field of drama therapy in North America is in a time of growth. Antioch University’s programme in Seattle recently received NADTA approval, and additional programmes are on the horizon. However, NADTA still finds itself ripe with various tensions emanating from both within the field and from external forces of licensure, university politics and funding. These tensions can cause drama therapists to struggle internally with questions of allegiance, practice, competence and definition of the profession. Whereas Jones (2007) emphasized that a diversity of approaches simply reflects the variety of ways distinct client populations are helped, Johnson (1994) previously connected the field’s drive towards individuality to shame dynamics within the profession, where ‘collaboration is experienced as merging or fusing’ (p. 176), which had often led ‘to a need to protect the self from intrusion from others’ (p. 175). 60

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As much as drama therapy has asserted itself as a bona fide approach to psychotherapy, by and large, it remains an underappreciated adjunct to more mainstream approaches. Such marginalization, compounded by shame dynamics, has heightened an experience of isolation, defensiveness and splitting. On this continent, the field has evolved but still wrestles with an unresolved developmental conflict between independence and affiliation. To this end, Jones’ (2013b) keynote address to the NADTA called for more inner-disciplinary dialogue to counteract solipsism and myopic practices. Similar to Jones’ (2007) core processes, Landy (2008) compared his role method with Johnson’s (2009b) developmental transformations and psychodrama along polarities of ‘emotion and distance, fiction and reality, verbal and nonverbal expression, directive and nondirective action, [and] transference and countertransference’ (p. 203). Such critical analysis can help foster connection and cohesion within the field, and potentially mitigate the internal conflict of individual drama therapists by clarifying practice and giving room for a multiplicity of alliances and perspectives. Perhaps future discussions of North American drama therapy will be able to include the full range of countries technically considered part of our continent (Greenland, the offshore groups of the Arctic Archipelago, West Indies, Haida Gwaii and the Aleutian Islands). Although there may not be official drama therapy associations, programmes or institutions in those countries, it is virtually assured that there are individuals and groups carrying out related practices. An exploration of their practices could help in gaining a broader understanding of North American drama therapy, as well as continuing to foster a sense of connection and collaboration. As of 2014, there were more than 700 active members of the NADTA, a 33 per cent increase in about 10 years, and, since its founding, more than 550 people have become designated registered drama therapists (RDTs). Meanwhile, some RDTs have not maintained their registration because they have transitioned to other professions, non-clinical supervisory roles or retirement. Johnson (2009a) warned that such ‘professional drift’ (p. 14) will persist, unless we continue to mature through writing more books, creating PhD programmes and conducting more rigorous research, both qualitatively and quantitatively. These actions would create more opportunities and room for more depth, growth, credibility and sustainability. Hopefully, our local corner of drama therapy is ready to address the remaining vestiges of its metaphorical adolescence. Those formative years were undeniably crucial for our field’s growth in North America, testing roles, trying alliances and exploring boundaries. It remains unclear if the myriad drama therapies that comprise North America should become one ‘monolithic approach’ that Jones warned against (2007, p. 58). However, as our field faces the next stages of growth and maturity, we hope that this chapter has displayed a critical reflection that honours and integrates the best of those qualities.

References Addams, J. (1910) Twenty Years at Hull-House. New York: Macmillan. Austin, S. F. (1917) Principles of Drama-Therapy: A handbook for dramatists, dealing with the possibilities of suggestion and the mass mind. New York: Sopherim. Bailey, S. (2006) ‘Ancient and modern roots of drama therapy’, in Brooks, S. (ed.), Creative Arts Therapies Manual: A guide to the history, theoretical approaches, assessment, and work with special populations of art, play, dance, music, drama, and poetry therapies, pp. 214–22. Springfield, IL: Charles C. Thomas. Blatner, A. (2007) A Historical Chronology of Group Psychotherapy and Psychodrama. Online. Available at: www.blatner.com/adam/pdntbk/hxgrprx.htm (accessed 13 October 2014). Blatner, A. (2012) International Psychodrama News. Online. Available at: www.blatner.com/adam/pdntbk/ internatnews-f-m.html#Mexico (accessed 30 August 2014). Boal, A. (1985) Theatre of the Oppressed. New York: Theatre Communications. Boyd, N. L. (1934) ‘Play as a unique discipline’, Childhood Education, 10, 8, 414–16. 61

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Casson, J. (1997) ‘Dramatherapy history in headlines: Who did what, when, where?’, Dramatherapy, 19, 2, 10–13. Cook, H. C. (1917) The Play Way: An essay in educational method. New York: Frederick A. Stokes. Courtney, R. (1974) Play, Drama, and Thought: The intellectual background to dramatic education. New York: Drama Book Specialists. Courtney, R. (1986) ‘A whole theory of drama therapy’, reprinted in Booth, D. and Martin-Smith, A. (eds), Recognizing Richard Courtney: Selected writings on drama and education. Ontario, Canada: Pembroke. Esalen Institute. (2014) Gestalt at Esalen. Available at: www.esalen.org/page/gestalt-esalen (accessed 13 October 2014). Evreinov, N. N. (1917) Teatr Dlia Sebia [Theatre for Oneself], Part 3, St Petersburg: Izdanie N. I. Butovskoi. Garcia, A. and Buchanan, D. R. (2009) ‘Psychodrama’, in Johnson, D. and Emunah, R. (eds), Current Approaches in Drama Therapy (2nd edn), pp. 393–423. Springfield, IL: Charles C. Thomas. Grabb, E. and Curtis, J. (1991) ‘English Canadian–American differences in orientation toward social control and individual rights’, Sociological Focus, 21, 2, 127–40. Grotowski, J. (2002) Towards a Poor Theatre. New York: Routledge. Gunz, J. (1996) ‘Jacob L. Moreno and the origins of action research’, Educational Action Research, 4, 1, 145–8. Holmwood, C. (2014) Drama Education and Dramatherapy: Exploring the space between disciplines. New York: Routledge. Hoover, H. (1928) The New Day: Campaign speeches of Herbert Hoover, 1928. Redwood City, CA: Stanford University Press. Jackins, H. (1965) The Human Side of Human Beings. Seattle, WA: Rational Island. Johnson, D. R. (1982) ‘Developmental approaches in drama therapy’, The Arts in Psychotherapy, 9, 3, 183–9. Johnson, D. R. (1994) ‘Shame dyanmics among creative arts therapists’, The Arts in Psychotherapy, 21, 3, 173–8. Johnson, D. R. (2009a) ‘The history and development of the field of drama therapy in North America’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy (2nd edn), pp. 5–15. Springfield, IL: Charles C. Thomas. Johnson, D. R. (2009b) ‘Developmental transformations: Toward the body as presence’, in Emunah, R. and Johnson, D. R. (eds), Current Approaches in Drama Therapy (2nd edn), pp. 89–116. Springfield, IL: Charles C. Thomas. Johnson, D. R. (2014) Personal communication. Johnson, D. R. and Emunah, R. (2009) Current Approaches in Drama Therapy (2nd edn). Springfield, IL: Charles C. Thomas. Johnson, D. R., Emunah, R. and Lewis, P. (2009) ‘The development of theory and methods in drama therapy’, in Johnson, D. R., and Emunah, R. (eds), Current Approaches in Drama Therapy (2nd edn), pp. 16–23. Springfield, IL: Charles C. Thomas. Johnson, D. R. and Lewis, P. (eds) (2000) Current Approaches in Drama Therapy. Springfield, IL: Charles C. Thomas. Jones, P. (2007) Drama as Therapy: Theory, practice, and research (2nd edn). New York: Routledge. Jones, P. (2013a) ‘An analysis of the first articulation of drama therapy: Austin’s “Principles of DramaTherapy: A Handbook for Dramatists” (1917)’, The Arts in Psychotherapy, 40, 3, 352–7. Jones, P. (2013b) ‘The juggler’s science, the clinician’s art’, paper presented at North American Drama Therapy Association Conference, Montreal, November. Kezar, A. (2006) ‘To use or not to use theory: Is that the question?’, in Smart, J. C. (ed.), Higher Education: Handbook of theory and research (vol. XXI), pp. 283–344. New York: Springer Science & Business Media. Landy, R. J. (1983) ‘The use of distancing in drama therapy’, The Arts in Psychotherapy, 10, 3, 175–85. Landy, R. J. (1993) Persona and Performance: The meaning of role in drama, therapy, and everyday life. New York: Guilford. Landy, R. J. (1994) Drama Therapy: Concepts, theories, and practices. Springfield, IL: Charles C. Thomas. Landy, R. J. (2006) ‘The future of drama therapy’, The Arts in Psychotherapy, 33, 135–42. Landy, R. J. (2008) The Couch and the Stage: Integrating words and action in psychotherapy. New York: Jason Aronson. Landy, R. J. and Montgomery, D. T. (2012) Theatre for Change: Education, social action and therapy. New York: Palgrave Macmillan. Lipset, S. M. (1964) ‘Canada and the United States – A comparative view’, Canadian Review of Sociology/Revue Canadienne, 1, 4, 173–85. 62

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MacKay, B. (1990) ‘Drama therapy with female victims of assault’, The Arts in Psychotherapy, 16, 293–300. MacKaye, P. (1917) Community Drama: Its motive and method of neighborliness. Boston, MA: Houghton Mifflin. Moreno, Z. (2006) ‘The many faces of drama’, keynote presentation to the National Association of Drama Therapists, November 15, 1997; reprinted in Horvatin, T. and Schreiber, E. (eds), The Quintessential Zerka: Writings by Zerka Toeman Moreno on psychodrama, sociometry and group psychotherapy, pp. 365–72. New York, NY: Routledge. Pendzik, S. (1988) ‘Drama therapy as a form of modern shamanism’, Journal of Transpersonal Psychology, 20, I, 81–91. Phillips, M. E. (1996) ‘Looking back: The use of drama and puppetry in occupational therapy during the 1920s and 1930s’, American Journal of Occupational Therapy, 50, 3, 229–33. Scheff, T. J. (1979) Catharsis in Healing, Ritual, and Drama. Berkeley, CA: University of California Press. Scheiffele, E. (n.d.) A J. L. Moreno Chronology. Available at: www.fepto.com/publicationsprojects/articles/a-j-l-moreno-chronology-by-eberhard-scheiffele (accessed 13 October 2014). Snow, S. (2014) Personal communication. Spolin, V. (1963) Improvisation for the Theatre. Evanston, IL: Northwestern University Press. Ward, W. (1930) Creative Dramatics: For the upper grades and junior highschool. New York. Appleton. Wolfe, T. (1976) ‘The “me” decade and the third great awakening’, New York Magazine, 23 August, 26–40. Yablonsky, L. (1992) Psychodrama: Resolving emotional problems through role-playing. New York: Routledge. Yalom, I. D. (1975) Theory and Practice of Group Psychotherapy (2nd edn). New York: Basic Books. Yepez, G. and Vázquez, I. (2013) Terapeia Teatral: Las prácticas teatrales y su aplicación en acompañamientos terapéuticos. Mexico City: Godot.

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Part II

Internationalism and theoretical approaches

In Part II, we begin to think about some of the fundamentals of dramatherapy; we focus on the historical, social, cultural and specifically theoretical approaches to dramatherapy practice from an international perspective. How do theoretical precepts and concepts differ within differing societies and cultures, and how have they altered over time with the development of the profession? This part begins where Part I left off, from a historical perspective, with Alida Gersie (UK/ Netherlands) revisiting the early years of the profession’s development in 1977. What was the understanding then of dramatherapists as both artist and therapist? This is followed by Phil Jones (UK) revisiting his influential core processes in dramatherapy from a client change perspective. Renée Emunah (US) begins to consider the cultural competences of therapists from her many years of practice and experience teaching at the California Institute of Integrative Studies, as an educator of dramatherapists. Anna Chesner (UK) considers the interweaving of creative threads during her 30 years of practice, in Chapter 11. This is followed by Ditty Dokter’s (UK/Netherlands) consideration of the theory of embodiment within dramatherapy. John Casson (UK) reminds us of the shamanic perspectives of dramatherapy practice and theories connected with this, from an anthropological point of view. Sue Jennings (UK) revisits her seminal work on Neuro Dramatic Play and relates this to her work with both the very young and the very old and to theories of embodiment. This work is particularly relevant in a climate of ‘child protection’ and a world of older generations living longer and longer. Nisha Sajnani (US) visits the idea of critical theory in dramatherapy from a social justice perspective. She visits a range of dramatherapy and other theories, while considering the training of dramatherapists drawing on her many years of teaching experience at New York University. Clive Holmwood (UK) engages us in a discussion around whether drama theorists such as Stanislavski and Brecht are as important as the psychotherapeutic theories of Freud and Jung. Jude Kidd (UK) follows this with a discussion on the importance of dramatherapists’ gaining a greater understanding of the theories of neuroscience and their relationship to the profession. We complete this part on international theoretical concepts by allowing Mary Smail (UK) to consider a soulful perspective of the ‘Sesame Approach’ – one of the major dramatherapy approaches within the UK. Sesame focuses on Jungian movement-based approaches to dramatherapy and has been heavily influential in the field since its founder, Marian Lindkvist, began this work at a similar time as Sue Jennings’ work in the 1960s.

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8 ‘Dramatherapists believe that they must be both artist and therapist’ An exploration Alida Gersie

This chapter focuses on the fifth point of the definition of dramatherapy as formulated by the newly established British Association of Dramatherapy (BADTh) in 1977. It confidently asserts that, ‘Dramatherapists believe that they must be both artist and therapist’. Some time before 1982, Point 5 simply ceased to be part of BADTh’s definition of dramatherapy. No protest was raised. It never reappeared. Here I will discuss what might have inspired its original inclusion. I close by considering its contemporary relevance.

Becoming aware of Point 5 I first met Dr Sue Jennings the day of my interview for a postgraduate teaching position in dramatherapy at Hertfordshire College of Art and Design (HCAD), in St Albans. It was July 1982. She was the course director. If I were appointed, I would be her deputy. Though we had moved in similar professional circles in London, where I arrived from the Netherlands in September 1975, we had, surprisingly, never met. There we were: two strangers with strong professional pedigrees and two flaming red heads, one tall – one small. When I accepted the job, Sue Jennings gave me twenty issues of the Dramatherapy Journal, which the full and associate members of the newly established Association of Dramatherapy had until then received. Sue was its editor. At the time, she was also the secretary of the Association, which Dr Roy Shuttleworth, a clinical psychologist, chaired. (Other members of the BADTh executive committee included Joel Badaines – a psychodramatist; John Evans – a visual artist by training and head of department at HCAD in St Albans, where the dramatherapy course was delivered; Judy Ryde, an occupational therapist and group analyst; and Gordon (Gordi to colleagues) Wiseman, actor, director and dramatherapist.) The journal’s first issue, Volume 1, Number 1 (Autumn 1977), contained BADTh’s first definition of dramatherapy. It comprised five points: 67

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Point 1 states that dramatherapy is: a means of helping to understand and alleviate social and psychological problems, mental illness and handicap, and facilitating symbolic expression through which man may get involved with himself both as individual and group through creativity structures involving vocal and physical communication. Point 2 describes the dramatherapist’s skills, such as theatre/mime/movement/role-play/games, etc. Point 3 highlights their theoretical understanding (informed by theories of creativity, drama, psycho- and group dynamics, analytic group psychotherapy, ritual, symbolism, the growth movement and the new therapies). Point 4 notes that dramatherapists recognise the preventive value of drama in the community and schools. Point 5 observes that, ‘Dramatherapists believe that they must be both artist and therapist’ (Jennings 1977). When I read the journal prior to starting my new job, this final point particularly intrigued me. Did British dramatherapists truly believe that they were obliged to have and to maintain the dual identity of artist and therapist? And, if so, how did this belief manifest itself in their training and professional practice? I planned to ask Sue Jennings about this, but somehow it was never the right time to do so. Instead, I engaged with my query through the immediacy of teaching, in the creation of the postgraduate diploma and MA in dramatherapy course documents, in writing the validation materials for the Council for National Academic Awards, as well as the then CPSM, now the Health and Care Professions Council, and by setting benchmarks for dramatherapy training on behalf of the UK Higher Education Quality Assurance Agency. Throughout the years, the complex issue of which identities applicants to the dramatherapy training should have presented itself for resolution. Because I held professional responsibility for the ultimate quality of several postgraduate dramatherapy training programmes in the UK and abroad (1982–2010), I had to grasp, somewhat like touching the nettles that reappear in our garden, the delicious vagueness of what Point 5 actually meant for the training, practice and continuing development of dramatherapists.

Some historical background pertinent to Point 5 The period of optimism that followed the end of World War II was permeated by a nearuniversal horror at what people had done to people during that war, as well as an intense desire to avoid a third world war. This complex intermingling of hopefulness, shock and fear underpinned the burgeoning interest in the arts, especially drama and music. It was commonly accepted that participation in the arts could heal psychological and physical trauma, rebuild broken communities, enhance people’s confidence in a time of confusion and nurture benign expectations of the future. During the war, many individuals and organizations realized, not only that participation in the arts made it easier to cope with war’s multiple stressors, but that it accelerated recovery from trauma and prolonged stress. It was, therefore, not surprising that the 1950s and 1960s saw a significant increase in the building of arts facilities (compared with pre-war years) and the initiation of arts-for-change projects in hospitals, churches and community halls, schools, holiday camps, theatres and adventure playgrounds. Notwithstanding significant differences in the purposes of these projects, their ‘facilitators’ broadly aimed for personal growth and pro-social change. They happily noticed the ‘amazing’ effects that participation in such projects had on ‘their’ adults and children. ‘Being involved in drama for change’ helped people rebuild disrupted communities, enabled shattered families to recover from tension and aided conflict resolution in diverse environments. This wave of enthusiasm for arts-inspired change 68

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increased research into the ‘how and why’ of its effectiveness. This in turn led to conferences, public workshops and talks in countries as diverse as the former USSR, Poland, Western Europe, Australia, Portugal and the Americas. The first full-length books about the subject saw the light of day. However, most professionals in the drama-for-change field wrote in their language of origin, not always English, and baptized their ‘method’ with a culture-appropriate name. Methods were described in terms such as (translated into English): theatre pedagogy, applied psychodrama, playful therapy, dramatic interaction, therapeutic theatre, improvisation for change, therapeutic poor theatre, action drama, recreational drama, games for action, therapeutic play, drama and movement in therapy, theatre therapy, puppet therapy, ritual theatre and therapeutic role-play. It took time for this multiplicity of change-oriented, drama-for-change practices to gather beneath the umbrella term dramatherapy. The 1960s also saw the establishment of the first training-programmes in dramatherapy. Middeloo in Amersfoort, the Netherlands, for example, started its 4-year dramatherapy training in 1965. The Remedial Drama Centre in London, directed by Sue Jennings, offered a plethora of training programmes, and the Sesame course for practitioners in drama and movement therapy, led by Billy Lindqvist, commenced in 1974. However, little agreement existed about the standards of good practice for dramatherapists, the skills that trainees ought to bring to dramatherapy training, how long such training should be or about the proposition that dramatherapists must be both artist and therapist. No wonder my interest was piqued.

Exploring answers to the questions about Point 5 that I did not ask at the time Prior to starting this investigation into what might have inspired Point 5’s formulation in 1977, I recalled advice formulated by Paolo Freire, the eminent Brazilian pedagogue exiled for 15 years from his native country because his theories, when implemented, educated the poor, illiterate masses too effectively. In his famous book Pedagogy of the Oppressed (1970), Freire observes that it is good to explore a ‘statement of obvious fact’ made by an authority, in this case the BADTh, by asking questions such as: • • • • •

Who is making the statement? For whom is he/she making it? Whom does it benefit and/or harm? Why is this statement made here and now? What can we do to explore its truth?

I will use this guidance to inform my enquiry.

So, who made the statement? It was, to all intents and purposes, made by the newly established BADTh, or at least on behalf of it. I checked my assumption with the Association’s first chair, the clinical psychologist Dr Roy Shuttleworth. When asked about his memory of its origins, Roy replied, without a moment’s hesitation: That statement was created by Sue Jennings. She really believed that, and probably also Gordon Wiseman. They were very hot on the artist bit. That’s what they stood for. I was interested in their work because I wanted to know what drama offered that sitting and 69

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talking therapies didn’t. I was the clinical straight guy. They were the artists. They needed me and I learned a hell of a lot from them. I really believed in what they did. In 1977, Sue Jennings already had many years of high-level acting experience. She had taught drama to children and adults in different countries and contexts and had facilitated countless remedial drama groups in a wide variety of places, institutions and contexts. Hundreds of people had participated in evening, weekend or one-week courses in dramatherapy facilitated by Sue, Gordi, Roy, Judy, Joel and others. The ‘energizing force’ called Sue Jennings fascinated co-facilitators and participants alike. Roy Shuttleworth again: At one point we went to a kind of hippie community near Cheltenham for the weekend. It was the ’70s remember. Sue suggested that we run our dramatherapy training-group through the night. We thought that some experimentation with sleep-deprivation and what that would do to your ability to deal with stuff would offer us some important insights. I trusted her completely. All of us did. We had an amazing time. I learned a lot from that weekend. Although he sadly did not elaborate what he learned from his night in the commune, as stated above, Roy did declare that it was safe to assume that the person behind the artist/therapist statement was Sue Jennings: actress, group worker with people who faced major challenges, anthropology student with field experience in Malaysia and bountiful mother of three young(ish) children. Maybe, he wondered aloud, this busy woman, who by then worked primarily as a trainer and dramatherapist, and who was studying for a higher degree in anthropology, felt that – especially in the light of Gordi’s departure to set up the M6 Theatre in Education Company in Rochdale – her identity as an artist risked getting lost. Did the ‘believe’ statement have a hint of a ‘last stand’ about it? I thought that there was probably much more to the statement contained in Point 5 than a simple reflection of ‘a woman in search of identity’. But let me make my way through Freire’s questions before I return to this point.

For whom did Sue Jennings make the statement, and whom did it benefit? As said before, the Association formulated the definition of dramatherapy in 1977, its foundational year. Although it was important to Sue (and Gordi) – who I will from now on identify as the statement’s originators – I am confident they realised that a declaration about the dramatherapist’s identity needed to have wide ‘brand appeal’ in order to establish the new association and attract members. Let’s therefore explore who might have been attracted to Point 5 and why. 1

2

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Without a doubt, the fifth point’s wording increased the attractiveness of the idea of offering a short or longer course in dramatherapy to educational establishments that were in search of both innovation and a new category of student. The point made it clear that future students could have diverse professional backgrounds and interests. This significantly widened the pool of potential applicants to dramatherapy workshops and/or training programmes. Widespread appeal is appreciated by any course provider. The relatively new associations for art and music therapists would have liked it, because the point appeared to underscore the similarity between themselves and future dramatherapists. Applicants to courses in art therapy and music therapy had to be visual artists or

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3 4

musicians, respectively. Note, however, that Point 5 does not identify what kind of ‘artist’ dramatherapists believed they must be. Organisations that intended to employ dramatherapists would also have liked it. The point’s very ambiguity offered scope to demand a wide range of roles from future dramatherapists. Future and practising dramatherapists would have liked it because they could now claim the glamour of the artist as well as the healing mantle of the therapist.

From a branding and recruitment perspective, Point 5 was thus cleverly constructed: it was sufficiently open to be of interest to a wide range of people and parties, and sufficiently tight to generate a sense of what dramatherapy might be about.

But was it empirically true? The claim that dramatherapists believed that they must be both artist and therapist, and were therefore in the possession of a dual professional identity, was audacious to say the least. All the more so in light of the fact that, in the same Volume 1, Number 1 that contained this definition, Roy Shuttleworth (chair) and Judy Ryde (executive member) reported that the bulk of people who studied dramatherapy in their training groups were psychologists, social workers, occupational therapists, medical students, psychiatrists and community workers. In Volume 1, Number 4 (July 1978), John Evans, head of department at HCAD, noted that the sixteen students enrolled on the new 30-week, day-release course in dramatherapy had qualifications in occupational therapy, social work, marriage guidance, speech therapy and psychiatric nursing. These actual dramatherapy trainees were clearly not professionally trained artists. To what kind of dual identity were they therefore committed? In order to address this query, I will tackle Freire’s next question:

Why was the statement made at that time and in that place? I explore this query by examining our point’s constituent words, ‘believe, must be, artist and therapist’, and see what these throw up.

Believe The noun ‘belief’ and the verb ‘believe’ are delightfully ambiguous. They convey a commitment to something as being true, while conveying at the same time a degree of uncertainty about its actual truth quality. Why, I wondered, did Sue Jennings and Gordon Wiseman introduce this element of doubt? They could, after all, have asserted that dramatherapists are both artists and therapists. Might they have posited a shared belief in a ‘required dual identity’ in order to absorb actual or potential tension among members of the executive committee, who, as stated earlier, had different professional training and affiliations? Alternatively, the vague formulation might be a case of theoretically motivated imprecision. A quick perusal of the definition’s Point 3 (which concerns the dramatherapists’ theoretical understanding) suggests that the field of dramatherapy was being built on very heterodox foundations. That said, the impetus towards heterodoxy might have been wise. Evolving practices need to be informed by evolving bodies of knowledge and practice. Viewed through an evolutionary lens, heterodoxy presents significant advantages over orthodoxy. In our Point 5, the intentional combination of ‘believe’ with ‘must be’ generated an apposite dynamic tension. Its very inexactness granted each dramatherapist and every training programme the responsibility to interpret its meaning in their own way. Although 71

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this opened the door to significant variety in dramatherapy training and practice, it also necessitated constant negotiation of what constituted best training and practice with regard to the dramatherapists’ dual professional identity as both artist and therapist. In 1977, dramatherapy was an emerging form of therapeutic practice in the UK. Few British and American dramatherapists read German, Dutch, French, Italian or Russian. They therefore could not avail themselves of the extant literature in those languages. From their perspective, English-speaking dramatherapy trainers were inventing the wheel. In this light, the deliberate ambiguity of the statement that dramatherapists were both artist and therapist can be perceived as an expression of a very British hope that this dual identity could be achieved, rather than as a restriction to be obeyed. According to Roy Shuttleworth, it was self-evident that dramatherapists would need to acquire and maintain the dual identity of both artist and therapist. Moreover, they would ‘obviously’ work out what exactly this meant in due course.

So, let’s move on to ‘must be’ What ‘must be’ is by no means the same as what ‘will be’. It has none of the willing surrender immortalized in Doris Day’s 1956 song ‘Que sera, sera’. ‘Must be’ has a commanding ring-tone. Its two words convey in no uncertain way that the hearer is expected to comply with the ‘must be’ in a spirit of obligation and with the urgency of ‘unquestioned necessity’. Must is after all deontic – duty is its originator, and the requirement to comply is its examiner. If ‘believe’ emerges from the cradle of uncertainty, ‘must’ suckles at the breasts of asserted sureness.

What then must dramatherapists be? First and foremost they must be artists In common parlance, the word artist is and was, even in 1977, primarily used to refer to visual artists. Those in the know, however, would have been aware that impresarios and theatre directors used the word ‘artist’ in contracts of employment to refer to any actors, musicians and other performers whom they engaged for professional duties. For these artistic professionals, the word ‘artist’ was indelibly associated with success, opportunity, income and, especially, relief. As one careers guide for actors recently put it: ‘Training as a dramatherapist allows you to give up the dream of being an artist while keeping the passion’. And what did these ‘theatre’ artists do in 1977? Trevor Nunn directed a memorable Macbeth at the RSC in Stratford-upon-Avon. The play Abigail’s Party (Mike Leigh) saw its first performance in London’s West End. The Cockpit Theatre paid homage to the Yarrow and Cable Street Marches. I directed an innovative, artsbased community centre on a notorious sink estate and chaired the funding and policy panels for community arts and festivals on behalf of the Greater London Arts Association, as well as its working party on disability arts. Here, we were able to create core arts funding for SHAPE, which Gina Levete had newly established. SHAPE is a London-based organization that, to this day, aims to increase access to the arts and cultural industries for disabled and deaf people, as audience members, participants and artists. In 1977, too, John O’Toole published his book Theatre in Education, and Gordon Wiseman co-founded the now famous M6 Theatre Company in Rochdale. Sue Jennings, meanwhile, not only commenced the very first 30-week, day-release training in dramatherapy at HCAD in St Albans, she also set up innovative training programmes in dramatherapy in other colleges across the UK. She did what ‘artistes’ do and tirelessly and creatively engaged with her art form, whether she was well paid for the effort or not. But, by 1977, by no means all people who called themselves artists were still artists in the way suggested above. During the 1960s and 1970s, ample research into the role of the arts in 72

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human development and well-being had convincingly established that, ‘being an artist’ mattered to young and old, amateur and professional alike. Not only were people of any age strongly encouraged to participate in arts education, the liberation of the ‘inner artist’ was virtually regarded as a moral duty. The unleashing of one’s locked-up creative energy was greatly valued. As mentioned above, it had become widely acknowledged that active participation in the arts had an energising, liberating and healing effect on both unwell and well people. Might this ‘inner, expressive artist’ be the artist that Sue and Gordi talked about? I wondered. I will, however, for the time being let this wonder rest and turn my attention to the other required identity.

What about being a therapist? In 1977, in the UK, the word ‘therapist’ only rarely referred to psychotherapists. The general public, as well as employers in health, education and social care, thought of therapists as occupational therapists, speech therapists or physiotherapists. Such staff worked, after all, in a ‘therapy department’, headed by an occupational therapist, in which creative therapists, music therapists, etc., also did their work. In the UK, suitably qualified ‘therapists’, educators and social workers then undertook further training in psychosynthesis, primal screaming, Gestalt, behaviour modification, implosion, Rogerian therapy, psychoanalysis, systematic desensitization, group dynamics, primal integration, sexual attitude restructuring, voice liberation, psychodrama, or drama and movement in therapy (the ‘Sesame’ course accepted its first intake of students in 1974–5). Graduates from these ‘therapy’ courses rarely called themselves ‘therapists’, let alone ‘psychotherapists’. They were Gestalt therapists, practitioners, group workers, change agents, social workers and marriage, debt or career counsellors. Psychoanalysts and clinical psychologists fiercely guarded their professional denominations. It is also worth remembering that, until 1977, the UK Standing Conference for the Advancement of Counselling comprised a miscellaneous collection of voluntary organizations, including Marriage Guidance. Individual membership only became possible when the Standing Conference changed its name to the British Association for Counselling (BAC) in, indeed, 1977. The new BAC didn’t add the term psychotherapy to its name until 2000. The same year that Sue Jennings taught the first 1-year training course in dramatherapy at HCAD (1977, to remind you) saw the start of 1-year training courses in family therapy at the Institute of Family Therapy and in hypnotherapy at the Institute for Professional Hypnotherapy. The zeitgeist of the late 1970s clearly gave rise to a desire for more solid training than evening or weekend workshops could offer, as well as recognition of the need to differentiate between good and bad practice in a field. Moreover, burgeoning numbers of health and education professionals were trying to make new sense of the plethora of short workshops offered. It was in their bones to try to help their clients or patients to cope or to flourish. But cope with what? Was there anything special about this year and the preceding ones that might have led to so many therapy and counselling programmes starting around that time?

The year 1977 in Britain It is easy to forget that, at this time in British history, ‘belief’ and ‘believers’ were in short supply. In the preceding years, violent conflicts, commonly referred to as the Troubles in Northern Ireland, had reached mainland Britain and especially London, where they caused death, mayhem and let’s name it, profound social unease. In 1977 alone, seven bombs exploded in London’s West End, causing death, widespread injury and collateral damage. Hundreds more bombs were discovered and defused. To add to the prevailing sense of disquiet, 40,000 striking toolmakers 73

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were about to be sacked by British Leyland. There were repeated brutal clashes between National Front supporters, local protesters and the police. In less than 3 years, the pound had lost 70 per cent of its value. There was voluntary pay restraint. Undertakers and firefighters stopped work for more than 3 months, and the famous bell, Big Ben, did not ring for 9. For many people and organizations, it was all in all a pretty grim picture: politically, socially and economically. But all was not lost, partly thanks to the ‘believers’.

Let us briefly return to that crucial word ‘believe’ In his famous essay ‘The will to believe’, William James (1896) offers a clear defence of having faith. James not only concludes that it is inevitable that our passionate, non-rational nature does, under specific conditions, determine our belief, he argues, with Socrates, that such a belief may be worth risking if the risk is a noble one. In his terms, the option to believe is momentous when a great deal depends on how we choose. James particularly upholds the role of belief in circumstances where faith in a fact can help create the fact. In a discussion of the requirements of belief and rationality, the philosopher Gideon Rosen examines this notion and suggests: Suppose that you are involved in an important political struggle like the civil rights movement and you know from hard experience that struggles of this sort succeed only if people have faith that they can and will succeed, no matter what the objective evidence says. In this sort of case James holds that it is morally permissible for you to believe that the struggle will succeed, because this belief makes it more likely that you will achieve some great good. In this case, the noble desire for racial equality generates a faith that the movement will succeed. (Rosen 2015) In James’ view, people who dare not commit to a moral faith are depicted as cowards, petrified by the prospect of believing something false and concerned to avoid this sort of embarrassment at any cost. For his own part, James says, there are worse things in the world than being a dupe. People should be willing to go out on a limb, to risk being wrong, as this is the only way to place oneself in a position to know the truth. I suggest that Sue Jennings’ personal conviction that dramatherapists must be both artist and therapist resonated strongly with James’ ethical stance. In an article entitled ‘Dramatherapy: The anomalous profession’, which appeared in that same 1978 issue of Dramatherapy (from which the definition of dramatherapy was omitted), Sue Jennings observes that it: has been the experience of many dramatherapists (who – I want to add, are people with direct responsibility for the wellbeing and healing of their clients, pupils or patients) . . . that they are neither fish nor fowl, neither belonging to theatre nor therapy nor craft. After listing some signs that this ‘anomalous position is changing’, she notes, ‘it would seem that dramatherapy is becoming almost respectable. Almost, but not quite’ (1978, p. 6). At this point, some hesitancy creeps into her argument. Maybe, the reader picks up, it wouldn’t be such a good thing after all if a dramatherapist were to become either a recognizable fowl or a straightforward fish. But, rather than showing her cards, she takes refuge in the words of Thoreau, the man who, just like her, went into the woods to learn to live deliberately. Thoreau says, ‘If a man does not keep pace with his companions, perhaps it is because he hears a different drummer. Let him step to the music he hears, however measured or far away’ (BADTh 2012, p. 11). 74

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Is Point 5 still relevant today? It is a widely known fact that meta-studies of therapeutic outcomes have until recently found it extremely difficult to prove that one bona fide psychotherapy is better than another. When psychotherapies that are intended to be therapeutic are compared in terms of their efficacy in the long term, the true differences in outcome among all such treatments are close to zero. In 1977, this phenomenon was called the Dodo conjecture (Smith and Glass 1977). Its name is derived from Chapter 3 of Alice’s Adventures in Wonderland. Here, the author Lewis Caroll tells us how several bedraggled, wet animals accept the Dodo’s suggestion that they could try to get warm by running a Caucus-race. The Dodo draws a circle on the ground and places each animal somewhere along its circumference. Soon, everyone has started to run. Every animal runs and runs until it can run no more. When they have stopped running, the Dodo declares that everyone is a winner and all will get prizes. I refer to the Dodo race because it can all too easily seem that the near-invisible merging of Point 5 with the entry requirements of most dramatherapy training programmes across the world creates the impression that the differences between them are marginal (which they are not), and that they anyhow don’t matter (which they do). Moreover, it is easy to observe that ‘intentional multiplicity’ is writ large in all theatrical adventures. None of the contemporary dramatherapy training programmes in Europe and the English-speaking world mentions the word ‘artist’. Nor do existing professional associations insist that practising dramatherapists need to remain professionally active in the non-applied sectors of theatre and drama in order to safeguard their continuing registration as a dramatherapist. Despite this lack of emphasis on the dramatherapist’s dual identity of artist and therapist, all training programmes are proud to vouchsafe the quality of their graduates. In a strong literature review of research into the personal creativity of creative-arts therapists, Yasmine Iliya recently noted that, even though the importance of such creativity is anecdotally accepted by arts therapists as essential for their personal and professional development, very few actually practise (Iliya 2014). This, she observes, should be a matter of significant concern to the field. There is convincing evidence that arts therapists who are no longer committed to an artistic professional identity are more likely to suffer burn-out, to stop work as an arts therapist or to switch careers. They also generally fail to keep up with research in their field (Allen 1992). I think it is high time to disambiguate Point 5 as formulated by Sue Jennings and Gordon Wiseman in 1977. Soon, more than 40 years will have passed since its original formulation. In this age of diversity, the benefits of the dramatherapists’ proposed dual identity can perhaps finally be celebrated. Many studies have shown that children who belong to multiple social groups and score highly on social identity complexity are more open to change and have lower scores on anxiety mood states than those with low social identity complexity (Rocas and Brewer 2002). Such children are also more accepting of out-group members, while showing a low level of inter-group bias. When we combine this finding with the results of studies that demonstrate the dangers of the arts therapist’s abandonment of the artist within, we can hope that maybe, just maybe, dramatherapists are at last openly able to celebrate that they are both artist and therapist.

References Allen, P. B. (1992) ‘Artist-in-residence: An alternative to “clinification” for art therapists’, Art Therapy, 9, 1, 22–9. BADTh. (2012) A special edition of The Prompt, based on day that considered and celebrated the work of Professor Sue Jennings, in the tradition of the ‘Festschrift’. BADTh: UK. 75

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Freire, P. (1970) Pedagogy of the Oppressed. New York: Continuum. Iliya, Y. A. (2014) ‘The purpose and importance of personal creativity for creative arts therapists: A brief literature review’, Journal of Applied Arts & Health, 5, 1, 109–15. James, W. (1896) ‘The will to believe’, The New World, 5, 327–47. Jennings, S. (1977) ‘Editorial’, Dramatherapy, 1, 1, i. Jennings, S. (1978) ‘Dramatherapy: The anomalous profession’, Dramatherapy, 1, 4, 1–7. Rocas, S. and Brewer, M. B. (2002) ‘Social identity complexity’, Personality & Social Psychology Review, 6, 88–106. Rosen, G. (2015) The Will to Believe. Available at: www.princeton.edu/~grosen/puc/phi203/will.html (accessed 11 February 2015). Smith, M. L. and Glass, G. V. (1977) ‘Meta-analysis of psychotherapy outcome studies’, Amercican Psychologist, 3, 752–80.

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9 How do dramatherapists understand client change? A review of the ‘core processes’ at work Phil Jones

Introduction Does dramatherapy work? How can we account for its effects? How do we theorise and communicate change? Since the modern emergence of drama as therapy, these questions have been a natural part of its presence and of the reactions of those who have come into contact with it. One response has been the proposal that dramatherapy can be effectively understood as a series of connected core processes that interact to create opportunities for change. The most cited text on dramatherapy (Jones 1996, 2007; citation index Google Scholar) has, at its heart, this concept of interconnected processes. This explanation developed from my initial work and research as a practitioner, when I reviewed my clients’ experiences and tried to find a language that would form a basic framework, akin to the way Yalom (2005) had explained the ‘therapeutic factors’ in psychotherapy. This chapter offers a review of published accounts of the ways in which therapists in different parts of the world have drawn on the description of the ‘core processes’ to research and account for the effect of dramatherapy. It then uses these to create a simple, practical recording structure that can be used to describe and explain how change is happening within dramatherapy clinical work.

The core processes defined The core processes aimed to: define the key processes which operate within Dramatherapy and show how they can be used in different ways according to the needs of the clients group or context . . . I aim to provide a substantial base to all dramatherapy practice and to provide theory which facilitates work with clients. (Jones 1996, pp. 14–15) Karkou and Sanderson, in Arts Therapies: A research based map of the field (2005), adapted the core processes to create a table form denoting the nature of change in the arts therapies (Karkou and Sanderson, 2005, p. 203). They offer the following analysis: 77

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according to Jones (1996, 2005) most of the so-called ‘models’ do not constitute comprehensive theoretical frameworks. Instead, they stress a particular idea and area of work over another. Alternatively, he attempts to define what is common across different approaches. . . . He suggests nine core processes, otherwise known as ‘therapeutic factors’, that are relevant to all . . . approaches. (Karkou and Sanderson, 2005, p. 201) Langley (2007) analyses them as a framework that foregrounds process over method in understanding the nature of therapeutic change, and she sees the ‘core processes . . . as (a) guide for dramatherapy’ (2007, p. 22). The core processes have never been claimed to be an ‘original’ or named brand, and, as the following material indicates, they easily dialogue with the field’s developmental ideas (Jennings 1997, 2011; Johnson and Emunah 2009) and concepts, such as distancing and empathy (Landy 1994). However, the core processes might best be described as an attempt to form an inclusive framework to engage with, and account for, change. This may explain their popularity in the literature. In addition, as the following brief review of literature demonstrates, researchers and practitioners have enthusiastically adapted them to respond to the specific contexts in which they are working. A review of research literature shows that the text Drama as Therapy (Jones 1996, 2007) has received more than 450 citations in publications. Many of these relate to the ways researchers in different fields have drawn on, and adapted, the core processes. The breadth of this usage and adaptation varies between discussions of frameworks for practice involving the arts in the Journal of Systemic Therapies (Berger and McLeod 2006), the use of role in the Journal of Family Therapy (Wiener 2000) and research in therapy with asylum seekers in the Journal of Occupational Science (Horghagen and Josephsson 2010). Developments over the past 20 years have seen the core processes take on new, localised meanings. So, another quality that explains their frequent use seems to be that they can develop new contextual relevances that feed back into the field’s overall understanding of the core processes. They enable commonality and communication across the community while being versatile enough to be adapted to fit specific client situations and different international needs linked to the variety of models of health care. These core processes are defined as: ‘dramatic projection’, ‘playing’, ‘role’, ‘empathy and distancing’, ‘embodiment’, ‘active witnessing’, ‘the life–drama connection’, ‘transformation’ and the ‘triangular relationship’ (Jones 1996, 2005). The following selects some of the most frequently cited processes, drawing on a summary by Chen (2013): •

•

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Dramatic projection: Clients project their inner conflicts into drama to produce space for dramatic exploration and dialogue. The process helps clients to realise their inner conflicts, enable change, create new relationships with others, and readjust the issues projected into the drama. Playing: Dramatherapy creates new possibilities through creating a playful relationship with reality. The client is empowered to deal with events, concepts and consequences with an attitude of creativity, experimentation and flexibility. Decisions and actions are experienced without judgement. Clients are free to make mistakes, because it is play. A collaborative environment helps the client to explore life experiences in a playful way, without the consequences of a real-life situation. Playing in dramatherapy can also help a client revisit developmental stages that they have missed, or have had trouble negotiating, and the therapist works with them to visit, revisit or renegotiate stages in play, assisting in the development of cognition, emotion and relationships with others.

How do dramatherapists understand client change?

•

•

• •

•

•

Dramatherapeutic empathy and distancing: Empathy encourages emotional resonance, identification and emotional involvement. During dramatherapy, clients develop their empathic response and improve their relationships with others. This might be through playing a character or depicting them in object play, witnessing others in an enactment, or using techniques such as ‘doubling’. Distancing encourages an involvement that is more oriented towards creative thought, reflection and perspective. Gradually, the clients develop and transform by working with the therapist to explore and balance these two processes. Embodiment: dramatising the body: Embodiment entails a process through which clients recognise their physical potential and body language during dramatic expression and exploration. Examples of this process, including the way the client can change personal identity by entering a role, induce a new observation, perspective and release, and explore the image, emotional hurt or distress as it relates to their body. Active witnessing: Clients encounter and affect each other during the dramatic expression and the reflection process. They can offer and receive supportive feedback. Life–drama connection: This is the process where clients can express and explore their life experience without creating serious consequences. The life–drama connection reflects the real life of the client to be reflected in constructed drama. Dramatic representation flows between the objective and subjective, creating safe access to real life experiences in the session, while enabling the client to go on a ‘creative adventure’ to share and explore issues. Transformation: Transformation can be seen within the many aspects of dramatic processes. We observe clients develop and transform, and these changes are therapeutic. The clients develop new capacities for verbal expression, feeling and response through dramatherapy. They participate in the production process of drama, satisfy their desire to create, rearrange their thoughts, values and emotions, and finally respond to themselves and the world. The relationships that the client forms with their dramatherapist and other group members are also transformative. The triangular relationship: The art form and process allows an additional factor to enter into the relationship between client and therapist. This creates a triangle – therapist, client and drama – offering the client opportunities to express and explore themselves and the therapeutic relationship. This triangle offers unique properties in mediating and working with the therapeutic process.

Core processes in practice The following section illustrates the ways the core processes are used by different therapists in researching and evaluating the nature and effect of specific pieces of clinical practice. Though the processes are interconnected often, within practice, a therapist and client foreground some processes over others. The material is selected to illustrate the meanings of aspects of the processes and their relevance to understanding change in different contexts and client groups.

Core processes in practice: Embodiment and transformation Pilutik draws on the core processes in evaluating his clinical work: Jones (2007) highlights the power of embodiment . . . three key areas . . . contribute to development. First, clients are able to discover their own physical potential. This helps [the client] communicate more effectively and express him or herself via the body. Secondly, 79

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Jones addresses the therapeutic potentials of trying on a different embodied identity. This transformation can result in a new perspective and release. And finally, embodiment allows the client to explore their own feelings about their body, body image, and how others view their body. (2010, p. 11) He develops this idea in his drama work with teenagers, ‘for emotional and social development’, connecting it to access, distancing and control: The actor can engage in problem solving scenarios that may mirror his or her own life through the metaphor of the character, but still internalize the experience and gain insight. By integrating these intellectual components with embodiment through the safety of the hypothetical situation, young actors enhance their sense of control over these elements, resulting in increased self-confidence. (2010, p. 11) In this way, Pilutik creates connections between the original description of embodiment, showing how his interpretation connects to understanding of both the potential and impact of dramatherapy with teenagers, linked to specific issues of involvement, control and selfconfidence.

Core processes in practice: Active witnessing Lu and Yuen (2012) draw on the process of active witnessing in their analysis of art therapybased work with eight individuals who are First Nation, Inuit or Metis. This work explored experiences and stories involving a ‘decolonizing’ framework through the creation of largescale body-map images. At the end of the therapy, the body maps were made accessible to group members, and participants ‘did a walk round so that everyone could view each image’ (2012, p. 198): Artists were invited to share and explain their body-maps and . . . silences were respected. . . . Lucy invited the other artists to answer the question, ‘What do you see?’ in order to encourage a deep looking and witnessing of the image and the artist who created the image. This kind of seeing is looking with the eyes of an active witness (Jones 2007) with presence and suspended judgment that supports and acknowledges the artist and her story, [another aspect involving] reflect[ing] back to the artists that their stories were being seen and heard and to offer insights that may not yet have been revealed. (2012, p. 196) Lu and Yuen add to this: Attention to the art work and an active witnessing of the individual (Jones 2007) provided the potential for a deep understanding of the artist’s experience so that meaning was created from the act of honouring her journey. Initially the artist was her own witness, which was followed by the therapist, researcher and the other artists involved in the project also giving witness . . . a building of circles of connection. (2012, p. 198) 80

How do dramatherapists understand client change?

Core processes in practice: Transformation Novy cites the core processes in developing her research into narrative work with children, published in different international journals such as The Arts in Psychotherapy (Novy 2003) and the Journal of Systemic Therapies (Novy et al. 2005). A specific illustration of this is in her research into work with preadolescent boys: Jones explains this transformative process in dramatherapy as follows: ‘The process of being involved in making drama, the potential creative satisfaction of enactment, can be transformative. In part this is due to a transformation of identity – the artist in the client is fore-grounded within dramatherapy. The creation of dramatic products, the involvement in dramatic process, can bring together a combination of thinking, feeling and creativity (Jones, 1996, p. 121). This, Jones further explains, has transformative potential in the way an individual apprehends and responds to themselves and their world. This transformative potential was most evident in the dramatic stories that Andrew and Ben devised together. Against a backdrop of threat, suspicion and danger these stories plot their characters’ progress from enemy to friend and from victim to agent as they demonstrate competence and heroic resourcefulness in the face of adversity. (Novy 2003, p. 206) Novy refers to the core processes within this body of work as a way of conceptualising change and creating dialogue between different disciplines, including educational practice, systemic approaches (Novy et al. 2005) and narrative ways of working with children experiencing emotional and behavioural problems (Novy 2003).

Core processes in practice: Empathy, distancing and role Rowe refers to the core processes of empathy and distancing as being of use for the therapist in responding to the ways a client can evoke and explore material in a dramatherapy session, connecting them to Landy’s ideas of distancing: Jones for example, shows how, according to the client’s needs, the therapist can devise dramatic structures in order to promote close empathetic identification with the material or allow distance or perspective upon it. In dramatherapy the ‘dramatic paradox’ (Landy, 1993, 15) – we come closer to ourselves through the distance that theatre provides – has proved to be a key concept in establishing and understanding the therapeutic possibilities of drama. (Rowe 2005, p. 178) Rowe shows how the core processes of empathy and distancing can be used, not only to understand impact, but also to assist therapists in devising specific activities within their practice to assist clients in their specific route within the dramatherapy. If the therapist is clear on the nature of the processes at work within an activity, it becomes easier and clearer to evaluate whether the processes have had the desired effect in the lived interactions between therapist and clients. Smyth adopts the processes of empathy and distance in her work with children in Sri Lanka: The everyday real-life characters of group members were changed into masked characters who debated until agreement on a new social strategy. The safe distance created by metaphor 81

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enabled the children to speak directly and truthfully for the first time about their experience of conflict at home, where they felt overburdened with family responsibilities. Here the dramatic worked enabled access and allowed ‘explorations which clients might censor or deny in everyday life’ (Jones 2007, 95). (Smyth 2010, p. 107) Here, the therapist is, again, using the core processes to understand the way the therapy is effective. However, this also illustrates how the same core processes are adapted to fit a specific context, enabling safety through dramatic metaphor for traumatised children.

Core processes in practice: Playing, distancing and transformation Hughes, in work in the township of Imizamo Yethu and Cape Town, argues: Jones (1996, 2005) promotes dramatherapy for fostering integration and inclusion by suggesting methods of promoting communication and awareness of others. The act of ‘play’ is proposed for its safe ways of examining difficult situations and relationships; allowing patients the opportunity to re-examine stunted stages of development. This method is particularly useful in terms of negotiating trauma and post-traumatic stress disorder, a crucial issue faced by a large portion of the refugee population as well as individuals living in violent environments. He further suggests play as a useful method ‘of learning about and exploring reality’ (Jones, 1996: 172). (Hughes 2013, p. 13) Here, Hughes (2013) both cites and expands the core process of play in work fostering the inclusion of refugees and asylum seekers living in host communities, dealing with issues related to social exclusion, xenophobic sentiment and violence. Hughes works with young township people, facilitating a ‘re-visitation of personal timelines and discussion generated through the creation of new, yet similar, timelines addressing major events in the history of Imizamo Yethu’ (2013, p. 52). He described a ‘final task’: to create a 3 minute scene depicting one of the major events found on their timeline which was presented to the entire group as a performance; transforming the life event into a representation of said event (Jones, 1996: 120), thus allowing critical distance and the opportunity for critical reflection and discussion. This exercise sparked the first conversation about foreigners in Imizamo Yethu which was a major breakthrough as prior to this lesson there was no mention of ‘the others’’ existence. It was a guarded conversation yet led to more comprehensive discussions over the following weeks. (Hughes 2013, p. 52) Hughes draws on the aspects of play defined in the core process, which argues that dramatherapy can enable a playful relationship with reality, allowing the expression of painful or previously silenced material in a safe, representative dramatic expression. Here, he shows how it can be adapted to understand processes responding to the specific silencing connected to trauma and social exclusion. Here, the playful, safe dramatherapy space enables access to material, opening it to expression, but – he argues – this also creates a space to enable reflection and critical examination. So, he uses the core process of play, but connects it to other core processes of distancing and transformation to enable insight into the specific context of his clients’ change. 82

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Core processes as a way of recording and evaluating clinical practice Smyth adopts the core processes to create a means of summarising change:

Core processes relating to changes noted by the therapist and child 1

Core process: embodiment – dramatising the body •

Therapist observes: increased body awareness and confidence in using voice and gestures

•

Child states: ‘I can say “No!” and put out my hand to stop someone pushing me. Then

to express a range of feelings. I feel better.’ 2

3

Core process: playing •

Therapist observes: offering and receiving honest feedback.

•

Child states: ‘I liked your trust game . . . (in reply) now I trust you.’

Core process: role playing and personification •

Therapist observes: recognition and management of feelings of inadequacy and

•

Child states: ‘When I feel scared, I talk to my doll or draw a picture then tell my teacher.’

vulnerability. 4

5

6

7

Core process: dramatherapeutic empathy and distancing •

Therapist observes: capacity to empathise and engaging meaningfully with peers.

•

Child states: ‘I think she is sad in the group today. We can help her play with us.’

Core process: transformation •

Therapist observes: expansion of role repertoire for psychological and social benefits.

•

Child states: ‘I am small but now I can play a big person.’

Core process: transformation •

Therapist observes: conflict management leading to conflict resolution.

•

Child states: ‘Now I say “sorry” and people like me again.’

Core process: life–drama connection •

Therapist observes: co-operative play.

•

Child states: ‘It’s important to play well with my friends today. They will help me tomorrow.’ (Smyth 2010, pp. 110–11)

In this example, Smyth uses the core processes as a structured way to help her create an account of the session, but also to consider the different processes at work creating change. The core processes form both a descriptive and evaluative frame for her to identify, evaluate and communicate what is happening. The following section develops Smyth’s idea of using the core processes as a structure to evaluate dramatherapy’s efficacy and provides a format for use in clinical practice.

The core processes as an evaluative structure for dramatherapy This section adapts Smyth’s idea and shows how the core processes can be used to structure recordings to evaluate specific sessions in dramatherapy and to evaluate ongoing process in dramatherapy. 83

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The first example is a session structure, consisting of a brief narrative overview, and then the core processes are used to create a structured evaluation of the processes at work in the therapy. If these are kept for each session, then they can be used to evaluate processes over time, by looking at how the client’s use of the processes has altered over the course of the therapy. The second sample is an example of an evaluation of a series of dramatherapy sessions.

•

For variety, the first example is an illustration (Figure 9.1) of how individual dramatherapy with a client on the autistic spectrum might be recorded, whilst the second is of an evaluation of an individual client’s work in group dramatherapy within a mental health context. dramatic projection triangular relationship

playing

transformation

role

life–drama connection

embodiment

witnessing

empathy and distancing

Figure 9.1 How individual dramatherapy with a client on the autistic spectrum might be recorded

Example 1 Core processes to structure session evaluation Client: Peter Session: 4 of 15 Aims: •

to enable Peter to express his feelings;

•

to support Peter in developing relationships with others;

•

to develop Peter’s capacity to communicate.

Narrative summary Peter became involved in a sequence that increased his involvement in the session. Initially, he sat still and refused to take part, as with last week, but when I played with a ball and rolled it towards him he stretched out and began to play, using the ball to roll it back to me and say my name. This paralleled what happened last week, but this time he did this without encouragement. This marked

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a positive use of the triangular relationship – as the ball seemed to provide a way to relate to me through playing where direct eye contact and engagement were not necessary. Building on this I invited him to return to the object box that he had used in the last session. He took out a number of objects and threw them around the room for a while, then moved three of them together and started to screw up paper and then he buried them. I asked him about the three, and he said that they were rabbits and a weasel. As he said this he smiled and then said the weasel was hungry and started to chase it round the room making growling noises followed by squeaking. The play continued with the rabbits sometimes escaping, sometimes being caught. I invited Peter to become the creatures and said I would be happy to join in, but he didn’t reply and carried on playing with the objects. He brought in another object, which started to make a ‘meow’ noise; I asked who this was, and he said a bad cat. He added that the cat was trying to catch the naughty weasel. This was followed by the objects being hurled in the air for a while. As the end of the session was coming, I reminded Peter that our time was coming to a close and said that soon the objects would need to go back into the box. He carried on playing; I invited him to sit on the cushion and place the objects near to the box so we could say goodbye to them. He did this, placing the rabbits down each with smash and the weasel and cat more quietly. I asked him if he wanted to say anything to the rabbits, weasel or cat by way of goodbye. He didn’t respond verbally and put the objects back into the box.

Session evaluation structure Processes noted in session Dramatic projection: •

Peter used object play with ball to move into play that seemed to project feelings and

•

He used his own body to create expressions of feelings as part of the dramatic projection –

relationships into his imagining the objects as animals. throwing using his arms to push the creatures in the air, and using his voice to express growling, which seemed to be a threatening noise, and squeaking, which seemed to express fear. •

The dramatic projection into objects, his play with them and his embodiment seemed to have a theme of being seen, being chased, being caught or catching, aggression and fear.

Playing: •

Peter initiated play with objects on his own, and responded to play with the ball with me –

•

Peter was involved in his solitary play, and was content with my being a witness. Whilst he

one seemed to flow from the other and to help establish relationship between us. allowed me to see all play activities he developed he declined my offer of co-play and also any suggestions that involved entering his play world beyond initiating and closing. •

He seemed to use the objects in throwing to express himself, but also to explore the boundaries

•

I also wonder if power and powerlessness was a theme in the play and in our relationship –

of the room by throwing them against it. co-operation. Role: •

Peter seemed very involved in the roles he created with the objects – he did not keep them at a physical or emotional distance but was very active in manipulating and expressing movement using his body and voice, and his visual attention was always on the objects.

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•

He did not enter into an identity change that was acknowledged – for example he did not enter into role where he acknowledged that he ‘was’ the rabbit or weasel.

Embodiment: •

Peter used his entire body, arms, legs, trunk and head to move and animate the objects, he

•

He used voice and movement together to express the emotions of the object animals.

•

Within the throwing Peter seemed to be playing with being out of control with rapid throwing

moved around most of the room, seemed to use space.

in seemingly random directions, rather than targeted throwing, though about a half hit the walls; I did not know if this was deliberate, but it didn’t seem so. •

He related to me physically though the ball and in sitting with me in parallel at the start and close of the session, with legs crossed as mine were.

Empathy and distancing: •

The animals were, perhaps, used to express feelings through movement and sound; as noted above, Peter seemed very connected with their expressions, and his body echoed the emotions being experienced/displayed by and through the animals – the projections of feelings seemed to be into the drama of the objects and into the physical movements and sounds Peter made in his play with them.

•

He didn’t directly use any of the opportunities offered to address the objects, but was aware of time boundaries to bring the involvement to a different stage and changed from active involvement in imagination and embodiment to sitting and leaving the objects and the world he’d created with them.

Witnessing: •

Peter witnessed the object play and the feelings and relationships within the animals.

•

Peter seemed comfortable with me as witness and did not hide or shield any of his play.

Life–drama connection: •

There were no verbal connections made by Peter, though the themes of the animals may connect with issues experienced by him outside the session.

Transformation: •

Peter moved quickly from rolling the ball to imaginative play with objects representing animals; he moved from animal to animal quickly.

The triangular relationship: •

Peter seemed to be aware of me throughout in that he did not turn away from me during any of the play. He did not initiate any interaction, but responded to the invitation to play ball and to my suggestions about starting and ending the object play, respecting me as ‘boundary setter’ – but did not verbally respond at times.

•

I was unsure whether he wanted me to stop the throwing/whether he was testing the boundaries of our relationship and the therapeutic space and/or his own capacities for throwing/expressing emotions.

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Example 2 Core processes to structure evaluation of dramatherapy process over time Client: Rani Evaluation of sessions 1–10 Group size: 12 Overall group aims: •

To help clients to engage co-operatively in a group.

•

To enable client to use dramatherapy to express and explore personal issues.

•

To support clients to work with experiences that have led them to attending the day centre.

•

To enable clients to understand their personal process, to develop insight, to explore ways of recognizing unhelpful patterns in behaviour and to see how to change them.

Evaluation: Rani – Sessions 1–10 Dramatic projection: •

Rani used dramatic projection to depict her life situation; initial work used small space and objects creating images that seemed expressive, but initially kept the meaning to the images themselves without comment.

•

The major change for Rani was from dramatic projection that seemed potentially expressive but not acted on or explored, to the use of projection to be more open to exploration and more direct, with its meanings made very explicit by her. Her later work shifted, and she drew on very specific life situations, and the projections echoed themes from the earlier images but connected them to the life situation itself, and these were worked with to explore the situation from different perspectives and to look at change.

Playing: •

Initially Rani would only briefly engage in warm-up activities and sit and watch the rest of the group. Weeks four and five saw her move in and out of solitary and co-play and within this work she continued to show imagination and was able to contribute through entering into role with other people’s improvisations, engaging in sustained co-operative play.

Role: •

The initial work saw her witnessing others take on role, but she did not take on roles beyond some brief work involving sculpting still photographs. This appeared to be a prolonged warm up for Rani: she may have been waiting for the group to feel safe enough, to see others test the space, method and my role or capability as therapist to work with group members and to trust herself.

•

She then began to work in other people’s improvisations in supportive roles, perhaps reflecting themes she wishes to explore in choosing to play roles in group members’ lives. Playing emotions of anger and regret and another in relation to Andy’s work was an example of this.

•

This then saw her more fully inhabit and use role. This involved her directly bringing a key life dilemma for her. Rani played herself, her husband, and she was able to role reverse and develop dialogue with others in the group about their perceptions of her situation as reflected

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in the role plays. She began to use this role work to explore potentials for change. •

Personal change was also reflected in the confidence she developed to offer insight to their situations and to share and explore her own material.

Embodiment: •

Initial work involved Rani using her body to work with objects and drawings – for example piling objects on top of the other material – her moves were quiet and brief. The body featured in images such as the sewn-closed mouth, which she drew and showed but did not embody directly. In games and warm ups she initially would be involved but with a minimum of movement such as gesture and taking up space. These actions seemed to have a function in themselves but also to have an anticipatory role for what she would go on to do.

•

Such themes seemed to be later embodied in the situations she enacted in role: so the sewnup mouth drawn image was later echoed by her physicalised role playing herself as silenced in her own life. She became able to express herself physically and emotionally and to draw on her embodiment to gain and share insight. Her depiction of her husband was an indication of the level of involvement, his stuffy formal movement being commented on by her and this seemed a trigger for expression and exploration of her own feelings.

•

Rani also embodied others’ roles; her movements altered to depict characters, and this seemed to indicate a physical empathy with the group members needed to interact with a depiction of others in their lives.

Empathy and distancing: •

After the initial weeks of silence, and rejection of involvement through any verbal commentary, Rani began to show connection with others through comments about their situation. This showed an emergent combination of insight, empathy and growing confidence in the group. This process seemed connected to later comments on negative self-worth, on being silenced and her experience of finding voice. In her play of others’ roles, she seemed to build empathy with situations as well as exploring aspects of herself. In the later work she showed a capacity to enter into her husband’s situation, to gain insight into his perspective and to begin to use this to explore ways of changing her situation and how she experienced her being silenced.

•

Her final reflections talked about being changed by the experience of being on the receiving end of empathy: of safety, of being listened to and understood. She talked about time: that the group were willing to take time with her. She said that this was the first ocasion since her marriage that she felt worth taking space. Her final sculpted image of a large mirror and reflection, in part, seemed to connect to these experiences of empathy.

Active witnessing: •

The first phases of Rani’s work involved a great deal of silence broken only by minimal verbal contributions that mostly concerned a denial of involvement or significance. However, later contributions suggest that this was part of a process whereby her lack of self-worth seemed to make commentary difficult and was a reflection of her accommodating herself to the group. This shifted significantly and she was able to firstly comment on others’ work, and then to allow herself and her life situation to be witnesses more fully and to use dialogue and perceptions from group members.

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•

Being validated as a witness of worth was directly acknowledged by her: for example, on the work with Andy where she said felt heard and appreciated and that she never experienced this in her life outside. Being noticed and being ‘shut up’ became a focus of her work. Rani’s capacity to see herself and to be seen as a witness of worth was core to change in her participation and testing of the group’s perceptions. The group involved her trying out a new aspect of herself and to emerge, be seen and validated by the group’s witnessing.

•

Her becoming a lively commentator on others and being involved in dialogue about her own work was a ‘remaking’ of relationships of being witnessed and witnessing. The final image of the mirror also connected to this aspect of the changes in her: she said she felt worth taking space.

Life–drama connection: •

Rani initially and frequently commented that she couldn’t see the point of the work and had

•

Her first overt discussion of any life–drama connection followed on from her role in Andy’s

only come because she was told to. She did not comment on others’ work. work. The theme emerging here was that she was letting her children down as a mother by being unwell and that her husband was no support to her. •

The dynamic of the group was commented on by her: that she felt heard and appreciated and that she never experienced this in her life outside. Here she was starting to make connections between the dynamics of the group and those in her life outside.

•

This dynamic became a focus of her work, and she used role-play to directly depict her husband

•

Nosmul and Rani’s dialogue about how women in Rani’s culture were expected to behave

and herself in relation to this ‘pattern’. was also a life–drama connection, developing an aspect of Rani’s experience of being silenced. Nosmul’s challenge to her that the silencing of women was not the whole story and she could say things to make her relationship with her husband more honest seemed to have an effect on Rani. Here she was able to use the life–drama connection to bring issues into the space and relationships within the group and also started to be aware of the transformative possibilities of the group. She used this to try out new possibilities and reflections on her home situation. Transformation: •

Rani used the group to create access to her life in ways that she could not develop in her life outside the group. The safety of the group and the distance from her actual life enabled her to begin to show aspects of herself and her life situation. She was able to share issues that she experienced as being silenced about in her life.

•

The group and she worked together to look at her relationship to her husband. Drama enabled her to present the situation as she experienced it, to create it as malleable, open to comment, exploration and to try out alternative ways of being and behaving. Cultural and personal dimensions were opened up, explored and used to create new ways of seeing herself and acting.

•

The dynamic of the group was also transformative for her, and she experienced it as validating aspects of herself in ways that were not occurring elsewhere. She began to gain confidence, feelings of self-worth, of being validated by others and by herself. This she began to try to

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develop in life outside. The drama gave her opportunities to express and explore this through roles and also in the reflection phase of the drama. Triangular relationship: •

Rani initially seemed to avoid interaction with me, at times saying that she did not want to

•

She seemed to develop more trust and experienced suggestions as opportunities rather than

•

She seemed more able to allow comments by others and myself to connect with her use of

answer or respond to questions. something to be suspicious of. the group, after initially saying that she couldn’t see significance. •

She later connected this, and her relationship to me as facilitator, to her feelings of not being worth attention, her experience of her family, especially her husband, and to learning to trust the group and me.

In this way, the core processes can be used to describe and evaluate how clients use individual sessions and to evaluate dramatherapy over time. This builds on the uses therapists have made of the processes to gain insight into, and communicate, dramatherapy in a variety of contexts.

Conclusion As dramatherapy develops internationally, it is important to recognize the need to create a clear understanding of change to enable therapists to communicate their ideas across, and beyond, the field. In addition, there is an important need to recognize that, although there may be parallels between the various cultural and professional situations, there are also important contextual differences. The chapter has illustrated how the core processes have been used in the literature to communicate understandings of change across different continents, but also to be flexible and adaptable to reflect localized needs and differences. The chapter has described the ‘core processes’ and has shown how they have been used in the literature. This has illustrated something of their original meaning, but also how they have been enriched by the many ways in which therapists have drawn on them to account for why and how change happens in dramatherapy. Using Smyth as a starting point, the chapter has also shown how the core processes can be used as a structure to describe and evaluate both single sessions and longer processes in dramatherapy.

References Berger, R. and McLeod, J. (2006) ‘Incorporating nature into therapy: A framework for practice’, Journal of Systemic Therapies, 25, 2, 80–94. Chen, F. (2013) The Theory and Practice of Expressive Art Therapy: Drama therapy. Taiwan Medical Architecture and Healthcare Management Association. Online. Available at: www.cchsu.com.tw/ en/interview-detail.php?act=detail&id=14 (accessed 3 February 2016). Horghagen, S. and Josephsson, S. (2010) ‘Theatre as liberation, collaboration and relationship for asylum seekers’, Journal of Occupational Science, 17, 3, 168–76. Hughes, S. (2013) Complex Associations: Facilitator, host and refugee, a ‘round-about’ way of drama for inclusion. University of Cape Town. Online. Available at: http://uctscholar.uct.ac.za/PDF/169580_Hughes_ Shannon.pdf (accessed 23 August 2014). 90

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Jennings, S. (1997) Introduction to Dramatherapy: Theatre and healing – Ariadne’s ball of thread. London: Jessica Kingsley. Jennings, S. (2011) Healthy Attachments and Neuro-Dramatic Play. London: Jessica Kingsley. Johnson, D. R. and Emunah, R. (eds) (2009) Current Approaches in Drama Therapy. New York: Springer. Jones, P. (1996) Drama as Therapy: Theatre as living. London: Routledge. Jones, P. (2005) The Arts Therapies. London: Routledge. Jones, P. (2007) Drama as Therapy: Theory, practice and research. London: Routledge. Karkou, V. and Sanderson, P. (2005) Arts Therapies: A research based map of the field. New York: Elsevier. Landy, R. (1993) Persona and Performance: The meaning of role in drama, therapy, and everyday life. London: Guilford Press. Landy, R. (1994) Drama Therapy: Concepts, theories and practices. New York: Charles C. Thomas. Langley, D. (2007) An Introduction to Dramatherapy. London: Sage. Lu, L. and Yuen, F. (2012) ‘Journey women: Art therapy in a decolonizing framework of practice’, The Arts in Psychotherapy, 39, 2, 192–200. Novy, C. (2003) ‘Dramatherapy with pre-adolecents: A narrative approach’, Arts in Psychotherapy, 30, 4, 201–7. Novy, C., Ward, S., Thomas, A., Bulmer, L. and Gauthier, M. (2005) ‘Introducing movement and prop as additional metaphors in narrative therapy’, Journal of Systemic Therapies, 24, 2, 60–74. Pilutik, T. (2010) Shakespeare’s Door: Drama with teens for emotional and social development, a qualitative research study. New York: Broadway Bound Fund. Online. Available at: www.bbfnyc.org/Knocking_on_ Shakespeares_Door.pdf (accessed 23 August 2014). Rowe, N. (2005) Personal Stories in Public Places: An investigation of Playback Theatre. Centre for Playback Theatre. Online. Available at: www.playbacktheatre.org/wp-content/uploads/2010/04/RowePersonal-Stories-in-Public-Places.pdf (accessed 23 August 2014). Smyth, G. (2010) ‘Solution-focused brief dramatherapy group work: Working with children in mainstream education in Sri Lanka’, in Karkou, V. (ed.), Arts Therapies in Schools: Research and practice, pp. 97–113. London: Jessica Kingsley. Wiener, D. J. (2000) ‘Struggling to grow: Using dramatic enactments in family therapy’, Journal of Family Psychotherapy, 11, 9–21. Yalom, I. D. (2005) Theory and Practice of Group Psychotherapy. New York: Basic Books.

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10 Instilling cultural competence in (the raising of) drama therapists Renée Emunah

Introduction It is imperative that new generations of drama therapists emerge with cultural awareness, savvy and competence, in order to work responsibly and skillfully with clients from a wide range of backgrounds and value systems in our increasingly multicultural world. This chapter examines how we can utilize and expand our own modality of drama therapy to promote diversity sensitivity in our practitioners. Based on initiatives and processes developed at the California Institute of Integral Studies (CIIS) drama therapy programme – an internationally recognized graduate programme that I founded 31 years ago and have since directed – this chapter discusses: (1) a Theatre for Change (TfC) project, in which troupes of students create original theatre pieces aimed at raising consciousness about the complexities of diversity; and (2) using drama-therapeutic methods within the classroom to open dialogue related to difference, privilege and oppression, as well as to tackle related conflicts that may arise among students. Two other important aspects of our efforts are the use of self-revelatory performance, a form of drama therapy and theatre that is a capstone project option – in which students theatrically explore and attempt to heal a core and immediate personal issue, but also examine sociocultural and multigenerational dimensions that interface with or inform the personal (Emunah 1994, 2015; Emunah et al. 2014); and clinical skills training that emphasizes open-mindedness, perspective and the avoidance of assumptions and examines how to intervene in the dramatic mode in ways that not only further therapeutic growth but also honour cultural roots. This chapter, however, revolves around only the first two areas (above) – TfC and classroom methods using drama therapy to address diversity. A specific example drawn from two (3-hour) class sessions is described. The need to integrate multicultural awareness in psychotherapeutic training has been widely discussed, particularly in the field of cross-cultural counselling (a few examples are Sue and Sue 1990; Davis-Russel 2002; Murphy-Shigematsu 2002; Bronstein and Quina 2003; Cushner et al. 2006), and there are resources on experiential approaches to developing multicultural competencies (such as Cushner and Brislin 1996; Arthur and Achenbach 2002); however, there 92

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are far fewer resources within our field of drama therapy. Boal’s Theatre of the Oppressed (Boal 1979/2000; Schutzman and Cohen-Cruz 1994), an inspiring cousin to drama therapy, reminds us how we can use theatrical techniques to promote social justice. Drama therapist Nisha Sajnani (2004, 2009, 2012), whose work integrates feminist and multicultural lenses, has contextualized Boal’s work within the field of drama therapy. She writes, ‘The aesthetic space within the group as well as in public performance becomes a platform for cultural negotiation and dialogue as existing realities are grappled with, challenged, and confronted in vivo’ (2009, pp. 480–1). Armand Volkas’s ‘Healing the wounds of history’ (2009) uses drama therapy and playback theatre to examine collective trauma and resolve intercultural conflict. Although creative arts therapists, including drama therapists, have discussed the need to further cross-cultural competence (Coseo 1997; Lewis 1997; Stepakoff 1997; Dokter 2001; Jones and Dokter 2008; Emunah and Johnson 2009), as well as pointed to biases within our field, including the lack of discussion of white privilege (Mayor 2012; Hadley 2013), and examined the way culture shapes identity (Dosamantes-Beaudry 1997; Jennings 1997), little has been written specifically about using drama therapy to raise diversity awareness within academic institutions. This chapter focuses on such endeavours within a graduate drama-therapy programme, in the hope of instigating further research and practice related to drama-therapeutic methods to foster and deepen cultural competence in the training of drama therapists.

Theatre for Change In 2003, the drama-therapy programme at CIIS initiated a project called Theatre for Change. The aim of the project has been to create original pieces of theatre designed to educate and raise consciousness about diversity at CIIS and beyond; to give voice and representation to people of colour and LGBTQ people; to invite dialogue about privilege, oppression, (in)equality and alliance; and to encourage audiences to combat injustice on personal, institutional and societal levels. A select and multiracial group of drama-therapy students work for 6–8 months, facilitated by a drama therapist (typically a programme graduate), to form a trusting and collaborative troupe, dialogue and play with relevant material (drawn from members’ experiences, stories heard at our university and current challenging diversity issues), and to co-create a theatre piece. The facilitator works in collaboration with the troupe and project director (myself) to develop and hone the script and artistically direct the piece. Performances are held at the university, to full houses attended by staff, faculty, administrators and students. TfC productions have also been performed at North American Drama Therapy Association conferences. In 2012, TfC was honoured by receiving the NADTA Raymond Jacobs Memorial Diversity Award for outstanding contribution to diversity in the field of drama therapy. TfC performance pieces grow out of improvisation; methods of drama therapy, self-revelatory performance (Emunah 1994, 2015), educational theatre, autobiographical and autoethnographic performance and Theatre of the Oppressed (Boal 1979, 2000); listening to stories within the group and at the university (including conversations with the Dean of Students and Director of Diversity); and a lot of dialogue. Some productions have veered towards the autobiographical and self-revelatory realm, whereas others more have been more reminiscent of Theatre in Education or Theatre of the Oppressed. Several productions have provided a theatrical mirror to our institution, and many have reflected elements of the troupe’s process in working on the piece (a process that invariably evokes deep feelings and dynamics related to diversity). Regardless of genre and style, all productions have aimed to be works of high artistic quality. The following examples of excerpts from various TfC productions will illustrate some of the range of content and style. 93

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Autobiographical and self-revelatory elements in Theatre for Change The production of In Transit: Braking at the Intersections (directed by Alexis Lezin and Renée Emunah) explores the intersections and complexities of identity, along with the challenge of having more than one cultural or racial identity, and the impact of assumptions. In one scene, a Korean–American woman, Aileen Cho, is literally pulled in two different directions – toward her Korean roots and toward her Western upbringing in the US – along with conflicts between contradictory values of collectivism and individualism. Growing up as a translator for her immigrant parents, she felt herself to be a bridge. Taking on the role of the bridge, she poignantly conveys the weight she has carried and her sense of not fully belonging to either cultural identity, along with feeling marginalized even within marginalized bicultural groups. Her scenes are deepened as she embodies the roles of each of her parents, utilizing Anna Deavere Smith’s (2000) documentary theatre method of interviewing and then delivering verbatim their experiences of immigrating to the US and their expressions of hope for their two daughters. Later in the performance, she interfaces with another troupe member, Sarah Pizer-Bush, who relates to Aileen’s expression of being in two worlds. Sarah explores the ‘bis’ in her life: she grew up moving back and forth between two cultures and coasts – one, a Hassidic Jewish community in New York (to which her father belonged); the other, a secular and artistic community in California (with her mother). She expresses her love for the former, along with the pain of not being able to show all parts of her being within that insular world. The troupe around her expands the circle, as Sarah poetically speaks of her expansive sense of sexuality, as a bisexual woman who has also explored gender identity. Singing an original song in the style of a beautifully haunting Hassidic melody, she expresses her longing to be fully seen, accepted, and to belong. In another scene that also addresses the complexities of identity and belonging, an African– American woman explores leaving her inner-city community and family to get the higher education she was encouraged to pursue, but, when she returns, being told she has changed, too much – and her resulting feeling of no longer belonging in that community, nor in her newer, whiter, more affluent world. After a scene in which several students of mixed race either are offensively asked ‘what are you?’ or have an encounter in which a white person assumes they are non-American, they angrily approach a white man and insist he tell them what and who he is. Revealing the complexities of assumptions, the man surprises them by sharing that he was raised in Nepal, where ‘I walk the mountains. I swim in the rivers. This is where my heart lives’. A student of colour who is also gender fluid expresses her response to him, being both touched by the personal story he tells of his upbringing and drawn to his masculinity (expressed physically and humorously), but also personally hurt by the colonial aspect to his story and his family’s position of privilege. There are no simple solutions or accurate viewpoints, but rather honest dissecting of interpersonal and cross-cultural clashes and commonalities.

Theatre in Education elements in Theatre for Change In a scene from the production Scene Unseen (directed by Emily Burkes-Nossiter), a teacher wears colourful ethnic garb. When a male African–American student gingerly approaches her, telling her that her shawl is actually an African wedding garment, and that wearing it to class offends him, she tells him that she embraces all cultures, and that it is not appropriate for him as a male student to discuss her attire. In an imaginary subsequent scene, he dramatizes an analogy of a teacher using a Jewish menorah as Buddhist chimes to end a class. Another scene, entitled ‘Oppression Olympics’, humorously and exuberantly depicts competition between 94

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African–Americans, Native Americans, Jews and women for who has suffered the most oppression and historical violence. In a scene from the production of Acts of Resilience, there is a ‘do-over’: a subtle microaggression occurring between two students is replayed. The well-intentioned but yet insensitive student is guided towards understanding the impact of his comment and, by ‘Take 3’, he has demonstrated increased awareness; his third interaction is well received and appreciated. In the most recent TfC production, Don’t Rock the Boat (directed by Marissa Snoddy in collaboration with Aileen Cho and Renée Emunah), the troupe enacts the process of gaining awareness and taking action, even through the stormy times – of interpersonal struggles, conflicting agendas, doubt about whether efforts are making any difference, and personal shame. Using water imagery and metaphor, one scene involves a Caucasian woman diving into deeper sea levels, each level representing another aspect of the ongoing work in becoming an authentic ally to people who have been oppressed. Along the way, the ‘people of coral’ have various responses to her efforts, including suspicion, support, frustration and appreciation.

Audience reaction to Theatre for Change These productions catalyse conversations within our programme and at our university. Over many years, the CIIS Dean of Students and Diversity showed DVDs of TfC productions at new-student orientations. Many faculty members have incorporated portions of TfC films in classes, and TfC has been invited to perform at faculty diversity trainings. The performances naturally spark dialogue within drama-therapy classrooms. Although topics revolving around diversity and inclusion have been discussed at our university for years, including at numerous faculty meetings, conversations have often been intellectualized. TfC productions reach the heart as well as the mind, so that the impact of racism or other forms of oppression can be felt, as well as understood on deeper levels. Change cannot occur only through cognition. Dramatherapeutically oriented theatre allows emotional components to be at the forefront, at the same time conveying multiple perspectives, examining subtleties of interaction and inspiring audiences to feel moved towards fighting injustice. The following are some examples of audience reactions to TfC shows. (The quotes are from anonymous feedback forms that have been distributed after many of the productions.) • • • • •

‘Seemingly “unplayable” topics (race, cultural responsibility, historical trauma) played out through beautiful personal narratives.’ ‘Deeply moving, brave, full of creatively expressed complexity. Perfectly blocked and paced. I cried, I laughed, I seethed.’ ‘Engaging, disturbing, compelling . . . Further reminder to look beyond, take the time, challenge assumptions.’ ‘Wonderful, evocative, honest, challenging. It brought us into a more open, vulnerable, and honest dialogue.’ ‘It restored my faith in humanity.’

Drama therapy and diversity in the classroom Regardless of the differences in training approaches, all drama-therapy programmes utilize experiential methods in teaching. The experiential nature of our programmes facilitates and nurtures peer interaction and interrelationship. In this context, placing an explicit value on difference and diversity and on various ‘ways of knowing’ is fundamental. 95

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Although the majority of students are well intentioned, there are subtleties in nonverbal interaction or verbal comments that can be insensitive, hurtful or even perpetuate stereotyping or marginalization. Admittedly, there may be more charge in the United States, given its history of slavery, which has multi-generational repercussions (DeGruy Leary 2005), combined with ongoing racism. But in all groups, there are people who grew up with privileges and advantages (that have often gone unrecognized), or with experiences of hardship or bias based on their race, class, sexual orientation, disability, etc. There are participants whose backgrounds involved limited exposure to difference. There are students who claim that they ‘don’t see colour; everyone is the same’ to them. Such (‘we’re all human’) statements are in fact experienced as a dismissal of ethnic roots, if not an erasure of central and obvious parts of the identities of the people they profess to embrace. On the other end of the spectrum are participants whose interactions with people who are visibly different from them are overly rooted in that difference. I find this quote (anonymous source) useful to introduce in the classroom: ‘The truth is that we are all the same; the reality is that we are not.’ Many students will in fact be in targeted, oppressed or minority groups, and also in positions of privilege, and it is important to help students recognize the ways in which they both. To help demonstrate this, I show students a 5-minute segment from a TfC production, Acts of Resilience, in which an Indian woman, Maitri Gopalakrishna (now back in India, where she practises as a drama therapist), dramatizes being both privileged – with the financial resources to study in the US, security that she will never go hungry or homeless, acceptance when she walks down the street with her boyfriend – but also oppressed, as a woman in her country who is expected to cater to men and marry young, with fears of sexual assault, and as a dark-skinned person in the US. After viewing this excerpt, I ask students in small groups to discuss and then create a simple aesthetic or dramatic representation, such as a ‘fluid sculpture’, of some of the ways they may be in positions of privilege, oppression, or both, or to depict ways in which they as a group possess similarities or differences. For example, one group of four women formed a circle, gracefully and repeatedly coming together with the refrain, ‘I am a woman’, in between individuals stepping outside the circle and facing away as they stated, respectively, ‘I am black’, ‘I am queer’, ‘I am Jewish’, ‘I am invisibly disabled’. Such examples can serve as a non-threatening and simple but often poetic manner of bringing awareness, visibility and voice to diversity, or, in psychotherapeutic terms, to ‘naming’ what may be obvious but unspoken. Another action-oriented process, which leads to more concrete ‘naming’, involves having one person in the centre of a circle state something about their identity, or an aspect of their identity, that holds privilege or has led to being targeted. Others in the group briefly enter the circle if that statement is also true for them. To insert a playful element, the group can be seated, and those who enter into the centre must then grab a new chair. With one chair short, whoever remains in the centre offers the next statement.

Conflict revolving around diversity: A case example When conflicts arise related to diversity, there is a tendency to step away from the heat, rather than ‘standing in the fire’;1 this tendency is especially true for people in privileged positions. Below is a detailed example of stepping into, rather than away from, such a conflict – using our own action-oriented, dynamic modality. As it is an example from a particular group, there are no replicable formulas or even necessarily techniques, but yet principles and ideas can be derived. The example is from a graduate class on drama therapy and is, therefore, particularly relevant to similar settings, but also applicable to most educational and clinical group settings. Of primary relevance is using our own modality of drama therapy to invite engagement, even 96

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at a time when participants have shut down. When there has been a micro-aggression or culturally insensitive or offensive interaction (which are more common than outright forms of oppression, though sadly these too occur), we as drama therapists need to model responding rather than ignoring. As a preface to the specific example that follows, there are several general and significant points to keep in mind: •

•

•

•

•

A majority of people seem to have a rigid or limited way of responding and view occurrences from their own perspective – and yet diversity conflicts can become opportunities to facilitate viewing from someone else’s perspective, or to access new perspectives within oneself – and, in so doing, get out of one’s comfort zone and patterned response. At times, targeted people are understandably angry, and people in positions of privilege freeze or shut down, fearful of saying the wrong thing or saying something that will be misconstrued. This is a very delicate point in time – especially in terms of helping a group to ‘hold’ and understand the anger, and also to help everyone stay engaged. In a verbal discussion, one person speaks at a time, and yet everyone has some kind of visceral response concurrently, exhibiting (or attempting to conceal) nonverbal responses. In the dramatic mode, we can work on the confluence and variety of reactions concurrently. Most discussions, dialogues, conflicts and upheavals around diversity take place verbally and can become intellectualized, whereas, in drama therapy, the ‘processing’ transpires on multiple levels, including somatically; learning derived from the experience is likely to be digested, integrated and embedded in a fuller way. My first goal is to acknowledge what is going on in the moment, the process. I then invite engagement, in a joint playing field. In action, people’s feelings and needs are conveyed and clarified and are less likely to be misinterpreted. Next, we work on content, in a way that elicits perspective, understanding, compassion, healing and transformation.

In my Drama Therapy Process and Technique semester course with a new cohort of eighteen students, 3 weeks into the semester, I had an unusual situation in which I had to be away for 2 weeks (to give a keynote speech and teach an intensive short course in Japan). In addition to adding make-up classes when I returned, I organized a guest speaker, as well as the viewing of a TfC performance on DVD during the classes I would miss. Naturally, the students were also taking other drama-therapy and psychology courses during this period. During my second week away, I heard by email that issues related to diversity had been brewing in the cohort. By the time I returned, these had escalated into a sense of unrest, distrust and retreat. Students described the conflict that began during my absence as follows: • • •

• •

A micro-aggression occurred in the cohort during another class. The naming of the micro-aggression procured further micro-aggressions, along with fears and anxiety. After the cohort watched a DVD of a TfC performance, a person of colour in the cohort ‘called out the racism’ (from the original and subsequent incidents), as the issues were pertinent to the content of the TfC performance. No one knew how to respond. Discussions in various classes followed, but they were all verbal.

The dramatic work that occurred in the first and second sessions with this group upon my return will now be described, from my perspective, interspersed with the perspectives, 97

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descriptions and journal reflections of three students in the class (two students of colour – one of whom was the target of the micro-aggression – and the third white) – Aileen Cho, Truc Nguyen and Sarah Pizer-Bush. Journal reflections are italicized.2 (Much of this case example was presented at the 2011 North American Drama Therapy Association Conference by myself, along with these three graduate students (who are now practising drama therapists). Our presentation was entitled, ‘Alchemy of Accountability: Acting with Response-Ability to Diversity in the Classroom’ (Emunah et al. 2011).) Renée: Sitting on the floor in a circle, I begin with a brief verbal check-in, asking for just a line or two, or an image or two – related to thoughts or feelings about the event/s of the past two weeks, and how people feel now. I need a bit of information about the state of the group and each of its members at this point in time. Aileen: When it is my turn to share, I am feeling overwhelmed. Instead of trying to formulate a statement, I describe an image: ‘It’s like there was this deep swimming pool we had been playing around in. While there was no lifeguard on duty, we accidentally fell in. Ever since we’ve been walking around in circles, at the edge of the pool, thinking about what it would be like to get into the water. But we are not getting into the pool.’ Renée: I am eager to move into action, but do not have a predetermined plan. Here is my cue – a relevant image! I stand up, motioning for the group to join me, stating, ‘Here is a pool’. The cushions we have been sitting on are moved to become the borders of the pool. I immediately invite the group to get up and walk around the perimeter of the pool. I then enquire, ‘Where are you in the pool?’ I ask students to sense their positions in and around the pool, and to then stand in that place. My question pertains to the process at this point in time (rather than to the original incident/content). Many people stand outside the border of the pool, or on the edge. A few people are in the pool. I ask everyone to speak, one at a time, stating one line, from his or her position. Some of the lines are: • ‘I’m in the water, but I want to be able to feel the ground. I don’t want to drown.’ • ‘I’m in the pool area – but I’m not going in the water.’ • (at edge of diving board) ‘I’m just going to run straight across and jump!’ • (sitting on the edge with feet dangling in the water) ‘It feels safer here.’ • (in line for the diving board) ‘I’m going to watch the person in front of me go first.’ I now ask students to take on someone else’s place and line, as their own – to see what that other person might feel like, and to voice that person’s line as they recall hearing it. For the third ‘round’, I ask people to take on a role/placement that is different from their original one (but not necessarily one of someone else in the group), to see what it would feel like to be in a different position, and to say whatever emerges spontaneously. For example, one student, assuming a new position, says: ‘I’ve never dived before, so I’m going to go for it this time!’ Through these three rounds of work (or play) around the imaginary pool, the group members and I view (literally, visually!) a variety of stances concurrently. Using imagery – which I so often find evocative and clarifying – we begin with what already exists in the process (Round 1). The focus then becomes gleaning a visceral sense of what others in the class might feel from their positions (Round 2), followed by experiencing a hypothetical revision of one’s own stance (Round 3). Aileen (journal reflection): From the pool exercise, I learned that rather than sticking to a pre-imposed agenda or an unrelated exercise separate from the issues brought up in the here-and-now, the facilitator 98

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can use the metaphors and images generated by the group as an entrance to dive right into the work of what is most relevant and energetically charged in the moment. This experience illustrated the simple, yet powerful world of the imagination. After two weeks of acting ‘grown-up’ about issues around racism/diversity issues and being completely ‘play-deprived’, it was invigorating and freeing to be able to ‘play it out’, as opposed to ‘working it out’. Renée: I now ask the group to come together and to mirror my sounds/motions/words, focusing on being in complete sync with me (as opposed to following and echoing me). Once there is a high level of synchronicity and attentiveness, I play with some of the feelings I sense that members have been experiencing, consciously and unconsciously, over the past two weeks. These include feelings expressed, directly or indirectly, in the prior pool process. Sarah (journal reflection): Renée began a group mirroring process, having the entire class mirror both her sounds and movements. Through this process she vocalized that a lot had happened since she had left, acknowledging that we may have felt abandoned by our leader, repairing our trust. Within the mirror, she led us to the diving board, depicting both the urgency of the need to dive as well as the urgency of the fear of diving. We ran away from the board, decided it wasn’t important to dive, but this decision couldn’t last because although the board was scary, it was a reality for people. We had to jump. We went back to the diving board and jumped in. Renée: The Group Mirror technique (Emunah 1994) can be used to highlight, underscore or name (by the leader, via play) themes, underlying feelings or dynamics, about which participants may have varying degrees of awareness and consciousness. A multiplicity of emotions, including paradoxical ones, can be dramatically articulated – concisely and potently. The Group Mirror is unifying, and yet also brings forth individual expressions. The process of joining each person’s expressions invites a psychological joining; everyone is in the conversation, accepting and experiencing each other’s stances, and sustaining engagement with each other. When I am leader within the Group Mirror, I can not only reflect and play with what I feel exists in the group dynamic, but I can also take stances – that is, I can both reflect and initiate. In the case of drama therapy that aims to further social-justice issues, I can let the group know, through play, that ‘we are going there’. And this is what I said during the end of this mirroring process, when I returned to being the leader. As leader of the Group Mirror, I led the group back to the pool. I reflected the fear and hesitancy, but ultimately insisted that we have no choice but to tackle the issues. We jumped in. Following the Group Mirror, participants form dyads, continuing the Mirror (Partner Mirror), with a focus on further expressing new and pent-up emotions, all the while building empathy and attunement with one another. I then initiate a process called Join the Emotion (Emunah 1994), in which participants voluntarily enter a performance area (one at a time), showing/sharing feelings and inner states of mind through any combination of embodied expression, movement, action or words. After watching and witnessing, students are invited to join – this time not necessarily by precise mirroring, but by doing something similar, or amplifying the essence of what is being conveyed, or adding another layer or aspect to that expression. In some cases, I invite the original person to sit and watch the others continue to play with what s/he initiated. Sarah (journal reflection): The felt content of what was shared was intense and emotional. This process continued to bypass much of the psychological distancing that was happening in the group, bringing more affect into the conversations. When I went up, my movement was about pulling what felt like endless scarves/material from my belly. Then getting tied up in it, feeling caught and bound by my baggage. Cohort members joined in to interpret and build on my imagery. As I moved off stage to witness, it was helpful to also see the humour of a situation that I had been feeling very caught up in. 99

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Renée: Sustaining the action in this now warmed-up and interactive group, I ask students to mill about the room, and to think about group agreements that are important to them and would help them to ‘move forward’ in this process, especially given the sense we have just gotten about existing feelings. As soon as someone states an agreement, the rest of the group is to physically represent this agreement, in clusters, forming a spontaneous sculpture that physically expresses and embodies the essence of this agreement. The person that named the agreement can view the different poses/sculptures and briefly voice why any particular ones are resonant, accurately depicting his or her intention. Sarah (journal reflection): At first, our group agreements were mostly about the need for positivity and safety (which was the culture of the group – conflict avoidant). Renée asked us to think of agreements that allowed for conflict and the recognition of anger. The final sculpture (acknowledging difference and conflict, and yet not running away from it) came after that intervention. Renée: In four subgroups, participants are now asked to create a sculpture (directed by one member of the subgroup) that revolves around this last agreement – and what may be an underlying challenge in confronting difference and conflict. For example, one of these resulting sculptures addresses the hidden messages a student received that encouraged ignorance, denial of (the recognition of) privilege, and resistance to look at difference. Another deals with the bias a student of color has felt in interviews. Another depicts a person of color’s internalized response to a sense of subjugation, and exhaustion at having to point out the dynamic. Our time is running out. After our closing ritual, I let students know that we will be returning to the work, continuing where we left off at the next class, and therefore not to ‘shake it off’. At the following class, we return to these sculptures, adding lines to each of the roles. Those viewing the sculptural depiction discuss their associations and responses, and collaboratively consider and experiment with making several small, incremental changes in the physical stances, positions, postures or words within the sculpture, analyzing the effect of each of these changes. What is apparent is that even seemingly simple modifications can make a significant difference. The work is somewhat cognitively oriented and distanced, but is nonetheless inviting needed analysis. Aileen (journal reflection): When I observed the process of working through the first sculpture, it was like watching a drama therapy version of CBT (cognitive-behavioural therapy)—the breaking down of automatic thoughts. As someone who has utilized CBT as a client, I learned how drama therapy can be incorporated with other non-creative arts based therapeutic modalities. Renée: I intentionally reserve the most emotional and directly relevant sculpture for last, knowing we will be spending time with it, and that the process will shift from intellectual to personal. The sculptor is the person who had been targeted. Her sculpture has a person of color in a subjugated position on the floor; a white man hovering above her – one foot in the direction of her face, and his face turned away and reading a book; a bystander who does nothing; a person trying to reach out and speak but is silenced by another person whose hand is placed near her mouth. The group looks at the sculpture, and there is a palpable silence; people appear to be taken aback by the directness and impact of the visual image before them, and the knowledge that the ‘creator’ is depicting what the micro-aggression felt like to her. The group seems to feel moved but helpless. Slowing our pace, I invite students to ‘take in’ the depiction, and then to tap out any of the parts/people, and place themselves in that position. I then ask for verbalization of thoughts or feelings from within that position. These verbalizations change as different people assume the various roles, but there is an increasing 100

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level of insight as we linger with this sculpture. Some examples of lines emerging from the roles are: Oppressor: I feel righteous. I feel like I can get away with it. I don’t know my own ignorance. I did not choose to be here. I feel guilty and responsible. Silenced: I feel trapped, stuck. I’m angry at myself for not changing this. I don’t know what I would say if this hand wasn’t here. I feel like my words are stale and useless but at least I’m trying to do something. The silencer: Oh it’s not such a big deal, right? If I ignore it, it will go away. I’m getting kind of used to this position. I have nothing to do with this. I don’t want to be involved. It’s none of my business. I don’t want anyone else to get involved either. Oppressed: I feel like no one cares. I feel like waste. I don’t want to talk about it. I feel like I want to melt into the ground – become a rock. I feel desperate. I feel hopeless. Time is running out. Truc: The sculptures gave me an outlet for expression. Although it was activating for me to be in this position in the enactment, I was also able to understand and articulate what was happening to me in my role in the cohort, instead of operating from a fight or flight stance. The encounter and the embodiment of the encounter increased engagement and investment in the process. There were visceral responses to power dynamics. It was not an intellectual process, and defenses were down. We were marinating in the moment of struggle together and then found the will for a different narrative to emerge. Sarah (journal reflections): The connection and intensity was palpable. For me, the biggest insight was seeing how much energy it takes to maintain the position of oppressor and silencer, and to watch how hard it was to actually change this position. I saw the paralysis that comes with privilege, the stuckness that lingers even after awareness and recognition have been achieved. My commitment is to notice that stuckness, and do my best to act through it, to respond with action rather than silence. I think it’s better to try to be an ally and do it wrong than to allow my fears to paralyze me. In this part of the session, I could feel a sense of hope in myself and in the room that we wanted to shift it, that we were willing to shift it. Renée: The sculpture process deepens when I ask students to enter the sculpture to double for parts, voicing internal thoughts and feelings – with each part gradually having multiple doubles. The process becomes more nuanced and also emotionally laden. 101

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At a certain point, I sense within the group a natural desire – ripening into an urgency – to change the dynamics. I ask for incremental changes, small and plausible modifications, authentic re-visioning. The process does not feel forced and the changes do not seem pat, but rather to emerge from an understanding of what it feels like to be in an oppressed position, along with an understanding of some of the internal forces in other roles. Truc: The embodiment of the encounter became more nuanced, sitting in the pain together. Everyone was engaged. The experience was named and validated. From there I created a different narrative for myself. Renée: The most poignant moment comes as the two central players – the person in oppressed role and the person in oppressor role – both now assumed by the two students who had been in these roles when the micro-aggression had first occurred – face each other, their eyes gazing at the other (the book is long gone), and the woman moves the man’s hand and her own to his heart. After a few moments, he moves his other hand above her heart. The other members of the class who are not in the ‘scene’ but watching, spontaneously enter, one by one, taking some part in the interweaving tapestry of support and transformation. When I join too, I notice that there is not a dry eye in the class. Many are touching someone else’s heart, or their own, or reaching toward someone, holding someone’s shoulder. I ask everyone to glance around, but also to stay as they are, to breathe, to register this point in time. In some ways, we are in the midst of a kind of group meditation. And indeed there is a long silence, but a different kind of silence, a silence that seems to speak, ‘we are all in this together’. Aileen (journal reflections): In the end, the emotional intensity was extremely high and palpable for every member of the group. One by one, each member joined the sculpture – breaking the fourth wall – until eventually all of us were touching, hand-in-hand, interlaced and intertwined – creating a web. This was a collective process. Renée instructed us to make eye contact with everyone. It was a moment that visually and physically reminded us of our interconnectedness. Aileen: This overall process made the ‘unspeakable’ become playable. Personally, as a person of color who had no prior experience of questioning or challenging racism, it was not only ‘unspeakable’ because it was scary or uncomfortable, but I did not even have the words or language to express myself. During this process, the drama therapy modality was an agent of change, which allowed me to experience the possibility of expressing beyond words and communicating what is in between the lines of the ‘textbook script’ around diversity. Renée’s facilitation allowed me to feel safe enough to access and express myself in a way I had never done before. Although the experience of waking up to internalized oppression is painful, I felt like the embodiment, dramatic realm and action-oriented exercises helped clarify my confusion and encourage movement towards further awareness. Sarah: People were coming in with different target/agent statuses, differing investment/ resistance to the process, differing levels of awareness. It was important to really embody and explore where each of us are at – not a quick and disconnected response but an embodied and compassionate process in which we could engage with our own relationship to oppression. Renée’s facilitation style had an important and strategic balancing of a directive and following style. In key ways she had to be very directive – creating moments of leadership such as the need for us all to dive into the pool and the need to make room in our agreements for anger and conflict. In other ways, she really created the process through following especially the imagery of folks of color. Truc: The impact (of this experience) went beyond this class. It catapulted the group (into greater consciousness about diversity and cultural sensitivity) . . . and continues to have reverberations even now in our 2nd year of the program. 102

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Renée: The above description of two sessions is an example of bringing language, awareness, and visibility – in a creative, aesthetic, and interactive form – into a group process at a challenging point in time. Such efforts often feel like measly drops in the bucket, but they are nonetheless significant, appreciated, and ultimately coagulate toward some sense of hope for repair and change. I believe that we can and must use our own modality – with its ingredients of play and expression, its components of holding, witnessing, and being with pain, and its capacity for generating transformation – to grapple with heated issues pertaining to diversity.

Further discussion and conclusion In Multicultural Encounters, Stephen Murphy-Shigematsu writes: Exaggerating cultural differences results in a stereotyped, exclusionary, politicized and contentious perspective. On the other hand, focusing on cultural similarities can lead to the exploitation of less powerful groups, the denial of diversity, a pretense of homogeneity, and dismissal of ethnic identity. (Ivey et al. 1997, in Murphy-Shigematsu 2002, p. 7) I appreciate this articulation of the dangers in overlooking either perspective, and the underlying call to keep track of both, if not of a full spectrum. Fortunately, many therapists, actors and drama therapists are naturally intrigued both by the universality of human experience and by the particularities of individual difference. Developing approaches to fostering an acknowledgement of bias and a deeper understanding of difference enhances training programmes in drama therapy. However, to add to the complexity, it is important to recognize that opening the gate to the examination of cultural difference, oppression and privilege can at times inadvertently lead to the singular focus and one-sightedness Murphy-Shigematsu cautions against – as people revisit their own wounds, get in touch with internalized oppression or gain passion about becoming allies. In clinical programmes, some students may unconsciously use their sociopolitical awareness to bypass self-awareness, avoiding personal accountability. The hope is for students to become more aware – both culturally and personally, neither at the expense of the other. A sometimes thorny or at least delicate arena is helping students distinguish between the two. Although many matters incorporate layers of both the personal and the cultural, there are occasions when a matter (such as an interaction, dynamic or response) may in fact be simply personally or culturally based, and it is important to recognize this. The premise here is to train drama therapists who are culturally savvy and sensitive, and also personally aware and accountable. There is a need for further research and dialogue, among educators, clinicians and students, pertaining to best strategies in promoting a sophisticated and compassionate discourse around diversity. Such dialogues should include openness to expanding perspective and an examination of bias and assumptions. For example, some American students who have a strong background in social justice may paradoxically be unaware that they are making assumptions about race from an American perspective, with little international awareness (for example, making an assumption that a dark-skinned student from another country will automatically relate to the term ‘student of colour’ and the experience of oppression). A non-defensive examination of assumptions in the service of growth and learning, via our own perspective-inducing and embodied drama-therapy tools, is a worthy focus in the continued development of our dramatherapy training programmes. 103

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Although faculty and students within our programme at CIIS continue to deepen and enrich our efforts, we still have a long way to go. It is my hope that sharing some of our endeavours might contribute to an increasing intentionality in our field to sensitively embrace diversity and skillfully work in a multicultural world. Let’s raise the next generation of international drama therapists to be broad-minded, open-hearted, culturally competent, personally and sociopolitically aware, awake to pervading and continuing issues of injustice and inequality, and ready to foster action towards social change. The author gratefully acknowledges the contributions of Aileen Cho, Sarah Pizer-Bush and Truc Nguyen.

Notes 1

2

The theme of the 2011 North American Drama Therapy Association conference was ‘Will You Stand with Me in the Fire?’. The case example was presented at this conference – by myself along with three graduate students (who are now practising drama therapists): Aileen Cho, Truc Nguyen and Sarah Pizer-Bush. Students took detailed ‘process notes’ on every session, which was a required assignment. Most of the students’ comments and descriptions came from these journal/process notes. When not italicized, the students’ comments are drawn from our presentation at the NADTA conference.

References Arthur, N. and Achenbach, K. (2002) ‘Developing multicultural counseling competencies through experiential learning’, Counselor Education and Supervision, 42, 1, 2–14. Boal, A. (1979/2000) Theatre of the Oppressed (trans. A. Charles, M. A. McBride and E. Fryer). London: Pluto Press. Bronstein, P. and Quina, K. (2003) Teaching Gender and Multicultural Awareness. Washington, DC: American Psychological Association. Coseo, A. (1997) ‘Developing cultural awareness for creative arts therapists’, The Arts in Psychotherapy, 24, 2, 145–57. Cushner, K. and Brislin, R. (eds) (1996) Intercultural Interactions (2nd edn). Thousand Oaks, CA: Sage. Cushner, K., McClelland, A. and Safford, P. (2006) Human Diversity in Education: An integrative approach. New York: McGraw-Hill. Davis-Russell, E. (ed.) (2002) Multicultural Education, Research, Intervention, and Training. San Francisco, CA: Jossey-Bass. DeGruy Leary, J. (2005) Post Traumatic Slave Syndrome: America’s legacy of enduring injury and healing. Baltimore, MD: Uptone Press. Dokter, D. (2001) ‘Intercultural dramatherapy practice: A research history’, Dramatherapy, 22, 3, 3–8. Dosamantes-Beaudry, I. (1997) ‘Embodying a cultural identity’, The Arts in Psychotherapy, 24, 2, 129–35. Emunah, R. (1994) Acting for Real: Drama therapy process, technique, and performance. New York: Routledge, Taylor & Francis, Brunner-Mazel. Emunah, R. (2015) ‘Self-revelatory performance: A form of drama therapy and theatre’, Drama Therapy Review, 1, 1, 71–85. Emunah, R., Cho, A., Nguyen, T. and Pizer-Bush, S. (2011) ‘Alchemy of accountability: Acting with Response-Ability to Diversity in the Classroom’, conference presentation, North American Drama Therapy Association Conference, San Francisco, CA. Emunah, R. and Johnson, D. R. (2009) ‘The current state of the field of drama therapy’, in Johnson, D. and Emunah, R. (eds), Current Approaches in Drama Therapy (2nd edn), pp. 24–30. Springfield, IL: Charles Thomas. Emunah, R., Raucher, G. and Ramirez, A. (2014) ‘Self-revelatory performance in mitigating the impact of trauma’, in N. Sajnani and D. Johnson (eds), Trauma-Informed Drama Therapy, pp. 93–121. Springfield, IL: Charles Thomas. 104

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Hadley, S. (2013) ‘Dominant narratives: Complicity and the need for vigilance in the creative arts therapies’, The Arts in Psychotherapy, 40, 373–81. Ivey, A. E., Ivey, M. B. and Simek-Morgan, L. (1997) Counseling and Psychotherapy: A multicultural perspective. Boston, MA: Allyn & Bacon. Jennings, S. (1998) Introduction to Dramatherapy: Theatre and healing – Ariadne’s ball of thread. London: Jessica Kingsley. Jones, P. and Dokter, D. (eds) (2008) Supervision of Dramatherapy. London/New York: Routledge. Lewis, P. (1997) ‘Multiculturalism and globalism in the arts in psychotherapy’, The Arts in Psychotherapy, 24, 2, 123–7. Mayor, C. (2012) ‘Playing with race: A theoretical framework and approach for creative arts therapists’, The Arts in Psychotherapy, 39, 3, 214–19. Murphy-Shigematsu, S. (2002) Multicultural Encounters: Case narratives from a counseling practice. New York/London: Teachers College Press. Sajnani, N. (2004) ‘Strategic narratives: The embodiment of minority discourses in biographical performance praxis’, Canadian Theatre Review, 117, 33–7. Sajnani, N. (2009) ‘Theatre of the Oppressed: Drama therapy as cultural dialogue’, in Johnson, D. and Emunah, R. (eds), Current Approaches in Drama Therapy (2nd edn). Springfield, IL: Charles Thomas. Sajnani, N. (2012) ‘Response/ability: Imagining a critical race feminist paradigm for the creative arts therapies’, The Arts in Psychotherapy, 39, 3, 186–91. Schutzman, M. and Cohen-Cruz, J. (eds) (1994) Playing Boal: Theatre, therapy, activism. London/New York: Routledge. Smith, A. D. (2000) Talk to Me: Listening between the lines. New York: Random House. Stepakoff, S. (1997) ‘Poetry therapy principles and practices for raising awareness of racism’, The Arts in Psychotherapy, 24, 2, 261–74. Sue D. W. and Sue D. (1990) Counseling the Culturally Different: Theory and practice. New York: Wiley Interscience. Volkas, A. (2009) ‘Healing the wounds of history: Drama therapy in collective trauma and intercultural conflict resolution’, In Johnson, D. and Emunah, R. (eds), Current Approaches in Drama Therapy (2nd edn), pp. 145–71. Springfield, IL: Charles Thomas.

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11 Creative integration in practice Anna Chesner

Integrate what you believe into every single area of your life. Take your heart to work, and ask the most and best of everybody else too. (Meryl Streep 1983)

It is now more than three decades since I started my journey with dramatherapy and related disciplines. Looking back, I can see the interweaving of a number of threads, which have led to a personal integration of practice. In this chapter, I shall explore some of these threads and what they mean for me as an integrative and integrating creative practitioner. The first thread is play. The spirit of play is not uniquely human, but experiencing the delight, surprise and absorption of play puts us in touch with a deeply human value. Play brings perspective, structure and transcendence of structure, experimentation, communication and interplay, release, laughter and freedom. Let’s play! We’re alive! In the Hindu religion, lila or play is a cosmic force, the nature of life itself, characterised by spontaneity and drama and, according to the Encyclopaedia Britannica, ‘focusing in one way or another on the effortless or playful relation between the Absolute or brahman, and the contingent world’ (n.d.). Moreno’s twin theories of creativity and spontaneity, so essential for play, form the foundation of both his clinical and cosmic philosophy of psychodrama. Watch a child engaged in imaginative play, and it is clear that play is a serious business. My personal memories of childhood play underline for me the richness of the world of the imagination, both in solitary play and in shared dramatic play. Later, when studying drama at Bristol University, at a time when Brook and, particularly, Grotowski were role models in terms of experimentation, I was part of a group inspired by Grotowski’s theatrical and paratheatrical work. We often worked outside in the natural world, engaging in all-night improvisational structures. This experience brought home to me the potential of improvisation (a form of play) to bring us into contact with ourselves, each other and the environment. At peak moments, we experienced heightened awareness, an expanded sense of the moment and the capacity for spontaneous action within it. I have not gone on to develop this kind of work directly in my clinical practice, nor indeed in performance. It relies too much on pushing oneself to a limit to be suitable for clinical work, 106

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but it played a key role in my ongoing commitment to improvisation. I went on to use improvisation as the basis for devised performance pieces when I worked as a drama lecturer at St John’s College York, in the early 1980s. Ten years later, as a dramatherapist, I used a similar approach to facilitate adults with learning disabilities and mental health problems to put on a piece of their own devising, Waiting, to an invited audience (Chesner 1995, pp. 149–57). Over the past 20 years, my passion for improvisation has found a home in the world of playback theatre. This form places itself clearly in the realm of non-scripted theatre rather than therapy. Its balance of ritual and spontaneity and its capacity to address personal story in the context of communities and groups make it a natural companion to dramatherapy, psychodrama and other creative interventions. Indeed, it is currently taught as part of the curriculum in dramatherapy and psychodrama formation. The process of playback theatre training, for its part, requires experience of psychodrama psychotherapy for its leaders. Although each of these disciplines is distinct, there is wide recognition of a mutually supportive relationship between them. I have written about playback theatre elsewhere in terms of its ritual dimension, its particular capacity to facilitate communication within a group and its relationship with dramatherapy and psychodrama (Chesner and Hahn, 2002). Here, I want to emphasise its ludic base. Playback performers train to develop their playfulness and complicity. For many people, the idea of performing personal stories for an audience without any prior discussion or planning would be terrifying. For playback practitioners, it is an opportunity to trust their deep listening to story and each other, and their capacity for spontaneous play. There is a clear parallel with Morenian (psychodramatic) theories of spontaneity training and the notion of expanding our role repertoire. This brings me to the second thread of my integration, which is psychodrama psychotherapy, including sociometry and Morenian role theory. I came across psychodrama at the same time as my initial dramatherapy training and was deeply impressed with its capacity to hold difficult themes and work through painful issues in an intentional way, supported by a clear philosophical and methodological base. It is itself an improvisational form, in which protagonist, director and group co-create a unique piece of therapeutic theatre. It was some time after training as a dramatherapist that I made a commitment to undergo the training in psychodrama psychotherapy. I had stayed in touch with the method for my personal development and support over the years. During that time, I found myself looking for a way to deepen my clinical foundation, to enhance my dramatherapy practice without having to shift away from the core commitment to creativity and play. For me, psychodrama psychotherapy gave me precisely this opportunity. I am struck by the extent to which psychodramatic role theory supports and is confirmed by both attachment theory and, later, neuroscience. I refer here to Moreno’s ideas about child development: the stages of the double, the mirror and role reversal through which the infant and child develops a sense of self in the context of relationship with other (Moreno 1952, cited in Fox 1987, p. 129). The concepts of somatic, social and psychodramatic (or psychological/ phantasy) roles and the acknowledgement that roles have both a personal and collective dimension further enrich his role theory, offering a systemic and holistic view of the individual (Moreno 1961, cited in Fox 1987, p. 62). If role is understood to be a way of being, or, as he puts it, ‘the functioning form’ the individual takes in a particular moment, then the notion of roles being underdeveloped, overdeveloped or adequate (appropriate to the moment) is a useful diagnostic tool. As an experiential therapy, psychodrama works with the ‘as if’ of present and past experience and the sense we make or have made of it. In attachment terms, this is our assumptive world or internal working model. The stage becomes the place where the inner and outer world of 107

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the protagonist or group can be represented, viewed and played with, and the beliefs about self, other and the world that are usually out of conscious can come into awareness. There is the possibility of experimenting with distance and emersion, through role taking, role reversal and the mirror technique, and thus of generating perspective and insight. Through role reversal, doubling and viewing a scene from mirror, group members are able to develop their capacity to mentalise – both themselves and others. Crucially, this occurs within the therapeutic container of the relationship with the psychotherapist and the group. Even with poor mentalisers, the playful and reflective aspects of psychodrama support change (Napier and Chesner 2014, p. 44). The psychodramatic stage is a place for play. The Morenian concept of surplus reality (Moreno 1946, cited in Fox 1987, p. 16) means that the mythic dimension can be brought alongside the personal. A protagonist may dialogue with Buddha, or reverse roles with Batman, all within the context of a family scene. Personal metaphors are concretised, given form and voice on the stage. The burden of guilt, the cloud of shame, the defensive brick wall, the glimmer of hope – all these and endless more metaphors are given form on the stage. The protagonist and other group members can reverse roles with them, experience them in an embodied way and explore new responses in a spontaneous and creative way. At best, this is both serious play and riveting theatre. Metaphor and the world of the imagination have always been central to psychodrama. Those dramatherapists who point to the use of metaphor as the distinguishing factor between the two methods may be missing this point. The third thread is group analytic psychotherapy, a modality I trained in alongside psychodrama psychotherapy. It was the vision of our trainers, Jinnie Jefferies and James Bamber, that these complementary forms of group practice could dance together. We learned and practised each method separately and, at times, explored ways of integrating them. The shadow side of psychodrama (and dramatherapy) might be the hunger for action at the expense of reflection, whereas the shadow side of group analysis could be the over-reliance on words and thinking. I was struck that the group analytic method of saying what comes to mind with as little censorship as possible, a kind of free association within group, has elements of improvisation and play. Group members have the chance to pick up on (in improvisational language, say ‘yes’ to) what has been offered or not. There is generally an abstinence from action, movement and physical contact. Nonetheless, the method relies on, and helps develop, spontaneity and authenticity, core values of psychodrama. As someone who had come to the world of therapy via theatre and drama in the first place, I welcomed the opportunity to conduct analytic groups. I experienced the role of conductor as surprisingly active, with its moment-to-moment choices and its continuous stream of reflection. It gave me the role flexibility, in all areas of my therapy practice, to ‘be with’, to give attention to the group process and, at times, make an active choice to do much less ‘doing’ in a group. As expressed in the title of a chapter on supervision (Chesner 2008, p. 132), it gave me ‘a passion for action and non-action’ as legitimate and active clinical choices. In terms of the work with people who have difficulty mentalising, this distinction has developed into considering psychodrama itself as both a ‘passionate’ (Williams 1989) and ‘dispassionate’ technique (Napier and Chesner 2014, p. 52). Foulkes uses language from the theatre to depict the processes within group analytic psychotherapy and describes the role of conductor boldly in terms of creativity: ‘Our work then becomes a creative activity, more artistic than that of a mere producer on the stage or film, or that of a sculptor or painter’ (Foulkes 1964, p. 287). He writes about the interplay between group and individual, where the focus is sometimes on what is happening within the group as a whole and sometimes on the individual within the group, in a way best understood through 108

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the notion of figure and ground (Foulkes 1990, p. 230). The interplay of group and individual focus is pertinent also to dramatherapy, psychodrama and playback theatre, where there are subtle connections between individual and group. In playback theatre, this relationship is conceptualised through the concept of the red thread that emerges when one story from the audience at some level speaks to or evokes another. In psychodrama, the emergence of a protagonist, through sociometric choice, in order to best represent the group concern ensures that the protagonist who becomes the dominant individual focus for a piece of work is working not only for themselves but also for the group. Having named some of the threads informing how I work and think, I now give some examples of my practice in different fields.

The field of clinical practice Keeney, a systemic therapist with a commitment to creativity in clinical practice, writes about the therapy session as a three-act drama (Keeney 2009). He invites the practitioner to keep an eye open to move from the first act, characterised by habit, complaint and a fixed narrative, into a second act, where there is the opportunity for creativity. I recognise this approach as that of a kindred spirit.

The improvising integrating individual therapist In my one-to-one practice, I accept that there may be whole sessions, or longer periods of time, that could be described as Act 1-type dialogues. I see the value of or necessity for building a relationship, gathering information, creating some kind of norm in the therapeutic frame. Nothing strikingly creative is taking place, but some kind of preparation is going on. There comes a moment when something outside that ‘cultural conserve’ (Karp and Farrall 2014, p. 20) arises as a possibility. Perhaps a metaphor pops into the dialogue, or maybe the client’s urgency to get the story told quietens and there is space for something different. These moments offer an opportunity for creativity and spontaneity. Vignette 1: A small moment of embodiment A young woman has come into short-term therapy to look at relationship issues. She has fallen in love with a man who is unavailable. She is driven at first by a need to tell her story of the past relationships that form the background to what is happening in her life now, and of how the current situation arose. For the first few sessions, the need to tell the story predominates, and my role is primarily to listen. There comes a point where there is a pause, and I reflect back the dilemma I have heard: ‘It seems that right now you are torn between putting your energy into finding a way to bring the relationship to an end or fighting for it’. I find myself spontaneously using my hands to illustrate the weighing of options. I invite her to do the same. We are still in our chairs, but we have moved into action. As she gives attention to the embodied experience of weighing her options, she is able to say clearly and almost immediately which of the two options she is warmed up to, and, through this statement, we clarify our task and focus together for the upcoming sessions. Reflection This small intervention sits within the frame of verbal short-term psychotherapy, but is informed by my experience as a dramatherapist and psychodrama psychotherapist. In terms of my countertransference, there had been something about the quality of the monologue in the 109

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preceding sessions whereby I had felt not quite in contact with the client. Her state of preoccupation was not only keeping me at a distance, but was holding her back from being fully in contact with herself. Significantly, this short exercise in embodiment also brought with it a moment of more direct and sustained eye contact than had previously been the case, and a gear change in the therapeutic alliance. Vignette 2: Metaphor and concretisation A young man suffering from depression and anxiety has begun an open-ended psychotherapy. He sits in a tense posture, speaks quietly and with a strangulated voice and picks at his hands. The content of the material is primarily present-focused, not so much on the here and now of the consulting room, but on issues from work and social life. There are occasional allusions to difficulties from the past, which are touched on very briefly and glossed over, rather than settled into or explored. On this occasion, he speaks through metaphor: ‘I know I keep things boxed up, compartmentalised, so I don’t have to think about them’. He returns to the metaphor again a few minutes later. At this point, I invite him to explore through action. There are a number of decorative boxes on the shelves, and he chooses three of them to represent the internal boxes he uses to keep things compartmentalised. I offer him a selection of stones, buttons and small shells and suggest he might place these inside the boxes and reflect on what thoughts, memories and feelings they represent. What follows is an extended moment of deep reflection, as he feels his way both externally (which stone, shell or button in which box) and internally (allowing memories and feelings to rise) into what has been compartmentalised where. It is difficult and painful for him to name some of the themes, and, at times, the silence is accompanied by a physical frozenness. Reflection This was the first piece of action work in the sessions. It was key that the metaphor was his, had come up in conversation and, indeed, had been mentioned twice. Perhaps he was unconsciously making sure it had been heard. The psychodramatic technique of concretisation allowed him to externalise what had been internalised and to develop his reflective function by being able to look from the outside at his internal mechanisms for dealing, or not dealing, with his issues. My hypothesis was that his ‘boxing things up’ strategy was both a defensive response to, and a contributory factor of, the anxiety he suffered from. In terms of role theory, the intervention was helping him build up a new role, what Blatner calls the meta-role (Blatner 2007, p. 53). The concept relates to that of the observing ego and also to the beginnings of the capacity to self-regulate, in itself a precursor to considering other role responses. Vignette 3: Sometimes only role will do A mature female client in open-ended, one-to-one psychotherapy is exploring her tendency in intimate, family and work relationships to present as compliant and ‘nice’. She has already explored through concretisation the role of her unexpressed anger (a roaring hippo figurine) and her false self (a child-like smiling mask). These have come up several times and are part of a shared psychological/symbolic language between us. She reflects, ‘I know what my pattern is, I can talk about it here until the cows come home. It’s time I stood up for myself and did something different. There’s stuff I need to say to my brother that I never get round to saying.’ I invite her to stand up, picking up on the ‘stand up for myself’ metaphor that she has used and understanding it as a request for an embodied experience. We negotiate the distance for the encounter between her and her brother, and she begins in role of brother: 110

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You’re pathetic, always whining about your life. You’re incapable, always have been . . . don’t pull that face! You always were a cry-baby. It might work with others, getting them to feel sorry for you, well it won’t work with me. Her manner in role as brother is sneering, and the posture is quite menacing. The words flow easily and loudly, words that have been heard many times over the years, have been introjected and become part of her current self-doubt about taking risks in her life and taking herself more seriously. As she speaks the words, she begins to cry, tears that belong to her own role rather than the role of her brother. Reversing her back into her own role, where the tears belong, I invite her to hear internally what her brother has just said. Her first response is to lower her head, turn away slightly and smile. We note the ‘false self’ mask has come into play, and she identifies the fear that if she does answer back she will be further attacked. The belief is, it is better to present a false mask and at least know that she has a true self that she is protecting (see Winnicott 1990). The cost is that she is not seen by the other and feels trapped by the mask and the expectations of her that it brings with it. These reflections are made as an aside and in dialogue between her and myself. I invite her to try again, using the hippo symbol to empower her, at least within the safe place of the consulting room, to speak her truth to her brother in the ‘as if’ of the psychodramatic encounter. She is able to do so, with more energy and spontaneity. Reflections This is a typical example of the use of an interpersonal encounter within the confines of the one-to-one frame. For me, it is a matter of psychological hygiene that I remain in role as director/therapist, managing the frame, rather than going into role as antagonist (role of brother). I might briefly ‘double’ her, but even that I would tend to do as a suggestion from the side-lines when possible, rather than coming alongside, as we would see in classical group psychodrama psychotherapy. My rationale for this is to do with holding the frame, a commitment to avoid merging with the protagonist or, worse, jeopardising the therapeutic alliance by becoming merged with the antagonist in her eyes. By holding a position somewhat outside the action, I am able to include elements of dialogic reflection, e.g. the observations about her role response, which foster the development of the meta-role and mentalisation. This position also allows me to encourage her as director to fully experience each role distinctly, in an embodied and authentic way. It is important that I am sufficiently outside the action to think creatively. I apply a role analytic approach to understanding the client, the approach we use and teach at the London Centre for Psychodrama Group and Individual Psychotherapy. The approach involves using an initial scene (or account of a scene) to identify the context of role, the behavioural and feeling responses, the implicit driving belief systems and the consequences. In this case, the context is a situation where the client is facing an attack on her way of being. Her behavioural response is that she avoids confrontation, turns away, cries and blocks her impulse to stand up for herself. Her feeling response is one of distress and fear. The underlying belief about herself that is activated is that it is better to wear a mask than risk the consequences of standing up for herself. She also believes that the attacking other might be right about her. The consequences are that she feels stuck, and frustrated with herself for not feeling authentic or strong enough as she faces the world.

Group psychotherapy and the improvising juggler In my group psychotherapy practice, integration between psychodrama, dramatherapy and group analytic approaches has occurred in subtle ways. In addition, I regularly use elements from playback theatre as warm-ups and energisers and for spontaneity training. 111

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My preferred frame for group psychotherapy is psychodrama, with its three-part structure of warm-up, action and sharing and its capacity for tracking the individual’s psychological journey through role analysis. I began this chapter by reflecting on the importance of play and improvisation. As facilitator, I see it as vital that I too am able to move spontaneously between various emphases within this structure. The question for all group psychotherapists is how we respond to the unique given circumstances of the moment. For example, at times where the group dynamic needs to be the focus, I will consider using an extended sociometric structure to facilitate opening up blocked communication within a group. Alternatively, I may set out two cushions within the containment of the group circle and initiate a structured ritual for short, direct and authentic moments of encounter between group members, including myself. A further alternative may be just to give space for the group to be together and talk, more in the spirit of a group analytic session. In this case, the use of words, with the letting go of any pressure or expectation to follow an action-based structure, is in itself an active and creative choice. The principle here is one of improvisation. The challenge is to respond to the perceived needs of the group in an informed and spontaneous way and to be able to spot the risks of missing something important if there is too rigid a default structure. When I practised in Germany during the 1990s, I learned to appreciate the German psychodramatists’ culture of differentiating between Protagonistenspiel (protagonist-centred psychodrama) and Gruppenspiel (group-centred psychodrama). This is an option I use myself now from time to time and is an area where dramatherapy and psychodrama meet. As improvising group psychotherapist I juggle multiple considerations and choices: the balance of individual and group focus; of reflection and action; the level and depth of the work for the individual. This might be exploratory in terms of taking an initial look at a theme, or cathartic and transformative where there is sufficient readiness, or behavioural in terms of practising for a new life role. The form may be a shorter vignette, allowing for several individual protagonists to work in one session, or a full, classical psychodrama where the group gives itself over to the work of one individual protagonist. I favour sharing these decisions within the group and allowing group members to choose sociometrically between various options. I contract explicitly with individual protagonists in terms of the purpose of each piece of work. My aim here is to foster a participative and empowering group climate.

The field of supervision and training The creative supervisor across modalities The field of supervision offers an opportunity to dialogue with practitioners from various professional backgrounds. There is something improvisational about the task of being with the supervisee and together finding ways to reflect, unpick and play with the themes and issues of their practice. Both parties may experience delight in discovering ways to articulate and understand the complexities of something that had been on the periphery of awareness. Having developed a training in supervision that focuses both on creative methods, informed by an understanding of theory, and on the value of engaging with diverse professional perspectives (see Chesner and Zografou 2014), I recognise this work as integration through dialogue. This is not a simplistic task. It is important to acknowledge that each distinct psychological modality has its own language, frame of reference and underpinning philosophy. A concept from one frame does not simply equal a different concept from another frame. In this sense, it might be simpler to restrict our supervisory conversations to those who work within the same modality, and to become ever more specialised in one area. For me, the more 112

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creative choice is to engage with difference. The supervisory encounter with someone from a different modality, particularly when using a creative action technique, brings opportunities for a fresh perspective. If the supervisee brings their language of dance-movement therapy, Gestalt or systemic family therapy as their default perspective, and I bring my languages of dramatherapy, psychodrama and group analytic psychotherapy as mine, we have the conditions for an encounter that might surprise us both. In other words, we may access more spontaneity and creativity than if we stayed within the security of the familiar.

The role of creative and integrating trainer Is training playful? From my role as trainer, on the above-mentioned supervision training and the psychodrama psychotherapy training, both of which take place at the London Centre for Psychodrama Group and Individual Psychotherapy, the answer is yes. It is possible to adhere to a curriculum and yet to teach with spontaneity and creativity. This is an expression of the integration of theoretical understanding with creative technique and serves as a model of the integration we are asking our trainees to make as they develop their competencies. The field of education and training is a great opportunity for the application of creative and experiential techniques. Visual and kinaesthetic learners can engage with otherwise quite abstract and obtuse psychological theories through this style of teaching. For example, the way different object relations theorists have conceptualised early experience can be explored through a series of sculpts using group members. Speaking from role, doubling or concretising the different experiences helps with understanding preverbal experiences in a more direct and interactive way. This approach brings a new dimension into the learning/teaching environment. As experiential learning is interactive and more spontaneous, there is also the creative challenge for the teacher to find the moment-to-moment balance between experience and reflection, while holding the frame and the learning agenda for the session in mind. This too has elements of improvisation.

The field of experiential experimentation The therapeutic triad Some years ago, I developed the idea of the therapeutic triad, a combination of my three core modalities in interaction with each other. I have twice run a 5-day residential workshop in Greece to put this idea into practice, with participants from Greece, the UK and other countries attending for personal development and CPD hours. The overriding structure for the workshops was informed by my experience working in and supervising therapeutic communities. We all stayed in one building, where there was an indoor/outdoor workspace. We were the only people in the building, and so it was our community. We were based in a seaside village, so that we were also interacting with a larger community. Sessions were timetabled for the morning, early evening before the communal evening meal and again after the evening meal, in the cool of the evening. This left us with a long break in the heat of the day for beach, rest, play and unstructured time. Morning and evening slots were used for dramatherapy and psychodrama sessions, and each free afternoon ended with our coming together for a community meeting/analytic session where the focus was on the spoken word, individual reflections and group dynamic or interpersonal issues. These sessions gave us a chance to reconnect after the afternoon sessions, where people had been alone, in pairs or subgroups. 113

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The balance between indoor and outdoor time, work and rest, action approaches and verbal approaches, individual and group focus was really refreshing, both for myself and for the participants. The spirit of the work was improvisational, the starting point of each session informed by what had gone before and the mood and state of the group in that moment. It was integrative in that the playful experimentation from the dramatherapy sessions fed into the more focused psychodramatic personal work, and there was a useful interplay between community life, the analytic sessions and the emerging themes for creative exploration.

Conclusion This chapter has been an opportunity for me to look at my present practice in the light of a through line of interest that has informed the various areas of my practice over time. Integration seems to be something that happens over time, through a commitment to core values – in my case, these values have emerged as play, creativity and spontaneity, and a commitment to dialogue.

References Blatner, A. (2007) ‘The role of the meta-role, an integrative element in psychology’, in Baim, C., Burmeister, J. and Maciel, M. (eds), Psychodrama Advances in Theory and Practice, pp. 53–65. London: Routledge. Chesner, A. (1995) Dramatherapy for People with Learning Disabilities: A world of difference. London: Jessica Kingsley. Chesner, A. (2008) ‘Psychodrama: A passion for action and non-action in supervision’ in Shohet, R. (ed.), Passionate Supervision, pp. 132–49. London: Jessica Kingsley. Chesner, A. and Hahn, H. (2002) Creative Advances in Groupwork. London: Jessica Kingsley. Chesner, A. and Zografou, L. (eds) (2014) Creative Supervision Across Modalities. London: Jessica Kingsley. Encyclopaedia Britannica (n.d.) Lila. Online. Available at www.britannica.com/EBchecked/topic/1549146/lila (accessed 25 August 2014). Foulkes, S. H. (1964) Therapeutic Group Analysis. London: Maresfield. Foulkes, S. H. (1990) Selected Papers, Psychoanalysis and Group Analysis. London: Karnac. Fox, J. (ed.) (1987) The Essential Moreno: Writings on psychodrama, group method, and spontaneity. New York: Springer. Karp, M. and Farrall, M. (2014) ‘Glossary’, in Holmes, P., Farrall, M. and Kirk, K. (eds), Empowering Therapeutic Practice: Integrating psychodrama into other therapies, pp. 9–22. London: Jessica Kingsley. Keeney, B. (2009) The Creative Therapist. London: Routledge. Napier, A. and Chesner, A. (2014) ‘Psychodrama and mentalization’, in Holmes, P., Farrall, M. and Kirk, K. (eds), Empowering Therapeutic Practice: Integrating psychodrama into other therapies, pp. 35–59. London: Jessica Kingsley. Streep, M. (1983) Graduation speech given at Vassar College, New York. Online. Available at: www.graduationwisdom.com/speeches/0044-streep.htm (accessed 24 August 2014). Williams, A. (1989) The Passionate Technique, Strategic Psychodrama with Individuals, Families and Groups. London: Routledge. Winnicott, D. W. (1990) ‘Ego distortion in terms of true and false self’, in The Maturational Processes and The Facilitating Environment, pp. 140–152. London: Karnac.

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12 Embodiment in dramatherapy Ditty Dokter

Introduction: Embodiment in the arts therapies Sabine Koch (2006), a dance movement therapist, has researched embodiment across the arts therapies. She stresses the emerging recognition of embodiment paradigms in the cognitive sciences, originating in Merleau-Ponty’s phenomenology of perception (1962), and their importance for the theoretical underpinning of the arts therapies. She quotes Lakoff and Johnson (1999) to show that human embodiment, the human experience and the use of metaphor and imagination make science possible, and that the arts therapies have a contribution to make to this science. Coming from an anthropological perspective in my own research (Dokter 2010a, 2010b), I wonder whether the differences in human experience, as personified by cultural variables, may not influence the perception of, and ability to use, symbolic embodiment. Koch does not look at differences in embodiment and perception of embodiment between the arts therapies; Karkou and Sanderson (2006) and Jones (2004) took a comparative approach to their study of the arts therapies in identifying the main theoretical and psychotherapeutic influences. In relation to embodiment, Jones (2004) sees embodiment in the arts therapies relating to the ways someone’s body relates to their identity. It embraces the ways in which clients (un)consciously communicate through their body; the arts therapies can also focus on aiding the client to use their body more effectively. Issues can be encountered and realised through physicalisation, and physical engagement can, through reflection, be connected to cognition. Jones also stresses the exploration of personal, social and political forces on and through the body. Karkou and Sanderson (2006) relate embodiment more to linking embodiment and metaphor in dance-movement therapy and dramatherapy, with reference to Jennings’ Embodiment–Projection–Role paradigm. The dance therapist Fran Levy (1995) took an early comparative approach and stressed the more functional embodiment in art therapy and music therapy as different from the more symbolic, improvisational embodiment in dramatherapy and dance-movement therapy. In the final section of this chapter, I will fleetingly look at embodied empathy (Cooper 2001) on the part of the therapist; although researched in dance-movement therapy, it would be another interesting area for research across the arts therapies. Symbolism in the arts therapies is understood in a variety of ways. The understanding of the symbolic aspect of art is that all images are considered as indirect client communications about 115

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the relationships in the therapy session (Springham 1998). Schaverien (2000) discusses similar symbolic processes when discussing diagrammatic (type of icon) or embodied (symbol) images. Jones (2004) and Karkou and Sanderson (2006) mention a range of understandings related to symbolism, from a psychodynamic perspective of giving form to the unconscious to the triangular transference to semiotic understandings of sign and symbol. There are a similar multitude of understandings in relation to the symbolism of embodiment. Jones (2007) constructs the dramatic body threefold: The first area in which dramatherapy develops working with the body is in helping the client to develop the potential of their own body. The second concerns the area of the client taking on a bodily identity that is different from their own. The third concerns work that explores the personal, social and political influences and forces that affect the body. There has been past critique from within dance-movement therapy that dramatherapy should not use movement as a medium for its own sake (Payne 1988). In my opinion, this stemmed from an attempt to delineate professional territory. The fact that dramatherapy in the UK was established earlier than dance-movement therapy meant that those with dance and movement as a specialism placed ourselves in alliance with ‘the closest ally in our isolation’ (Payne 1990, p. 8). In that same article, Payne stipulates that, in the US, where ‘Dance Therapy’ was established before ‘Drama Therapy’, there is little evidence that the literature of dance and movement is used in dramatherapy. There is an overlap in early developmental uses of movement, such as the use of Sherborne (2000) and other aspects of developmental movement play, as well as many differences. In practice, drama and dance-movement therapists have co-worked cases (Casson et al. 1995); several of us have been registered as both drama and dance-movement therapists, and, in my own PhD research fieldwork, a dramatherapist and dance-movement therapist cofacilitated a therapy group. The focus of this research was in another overlap area, Jones’ third work (2007), which explores the personal, social and political influences and forces that affect the body. Similar considerations played a role in my clinical work with clients with eating disorders (Dokter 1994) and refugees (1998, 2000, 2005). In the next sections of this chapter, I will connect embodiment in dramatherapy to work with different client groups.

Embodiment in dramatherapy: Developmental play Play is a very important core concept in dramatherapy, and the understanding of the way play contributes to child development has been highlighted by dramatherapists such as Jennings and Jones. Jennings (1994, 2011) distinguishes the stages of embodiment play, projected play and role-play: EPR. During the embodiment stage, the child’s early experiences are physicalised and are mainly expressed through bodily movement and the senses. These physical experiences are essential for the development of the ‘body-self’: we cannot have a body image until we have a body-self. The child needs to be able to ‘live’ in his or her body and to feel confident about moving in space. The changeover from the embodiment stage to the projection stage is a time of transition, which is also a marker where Winnicott (2005) describes the ‘transitional object’. It can be a piece of cloth or soft toy: both texture and smell are important, therefore being linked to the child’s sensory experience. It is usually considered to be the child’s first symbol – usually representing the absent mother figure. The transitional object is both ritualised and creative: it has to stay the same, even though it might become grubby, and it is named; but it also changes and becomes a ‘mask’ to hide behind, a blanket for a doll or a scarf for a costume. Other dramatherapists have written about the importance of the transitional object in the therapeutic relationship (Jenkyns 1996; Pelham et al. 2001). 116

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Assessment through EPR is written up in various of Jennings’ publications (1998, 2001, 2011). Above all, the approach to play and dramatherapy through EPR focuses on the playful attachments and resilience developed through playing.

Vignette 1 As a beginning dramatherapist, one of my earliest work experiences was in a residential setting for children with multiple disabilities. Picture a large, rather bare ward, populated with children aged 4–12, preverbal, with severe learning and physical disabilities. Many of them are wheelchair users whose ability to initiate movement is limited. Their physical care dominates the environment. Having been trained more in the direction of drama on the play–drama continuum (Jones 2007), I found myself wondering what interventions to use. One of the children self-mutilated and had her hands permanently in gloves, as well as spending most time in her wheelchair or bed; I wondered how and if she might enjoy interacting with me on the floor. I created a mat-covered surface and used balloons and cloth to initiate rocking and touching via playing with the objects. She often reacted adversely to human touch, most of which, for her, was related to being fed, washed, dressed, etc. – i.e. having things done to her. I aimed to provide opportunities for her to indicate her own choices directly, rather than expressing her distress via self-mutilation. Over several sessions, we made slow progress towards establishing eye contact and her letting me know whether she enjoyed something or not by pushing the object away. The choice of objects, sensory and embodiment play was stimulated by Jennings’ (1978) remedial-drama suggestions about working with this client group. I also found the developmental-drama checklist (Sandberg 1981) an invaluable help to think of early-play interventions. Sandberg breaks down the types of developmental play from infant through to 12-year-old levels, including the nature of interaction with others in play: playing alone, in parallel to others, in interaction with others. I did various workshops with Veronica Sherborne at the time, who used Laban efforts to help stimulate what she called developmental movement in the context of relationship play (Sherborne 2000). Sherborne proposes that movement experiences are fundamental to the development of all human beings, but are particularly important to people with special needs. The input or ‘feeding in’ of movement experiences has to be more concentrated and more continuous if people who are challenged in special ways are to realize their full potential. Her method places great importance on the equal development of both physical abilities and positive relationships with others through shared experiences. The approach is based on the philosophy and theory of human movement created by Rudolf Laban (pioneer and founder of modern European movement analysis). It was devised by Veronica Sherborne over a period of 30 years, initially in her work with children with severe learning difficulties, but has now been extended to people of all ages and with all types of special need. The development of trust, born in ourselves and others, and creative self-expression are fundamental themes throughout this type of movement. Sherborn suggests using a variety of movement structures based on weight, space, time and flow (Laban’s factors). There are two basic objectives: awareness of self and awareness of others. The aim of the relationship play is to develop self-confidence, body knowledge, physical and emotional security, and communication. There are three types of play, carers and children are asked to engage in: caring or ‘with’ relationships, shared relationships and ‘against’ relationships (Sherborne 2000). Sherborne’s emphasis on building a trusting relationship was crucial for me in my work with the children.

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Vignette 2 One of the children I was working with, an 11-year-old girl with Down’s syndrome, spent a lot of time rocking in her chair. I wondered whether I might be able to establish contact by mirroring her rocking. I sat next to her and started to rock in the same rhythm. She stopped abruptly, stood up, walked to the other side of the ward, looked at me with an expression that communicated ‘Stay there!’ and resumed her rocking. It was only after I had worked with her for quite some time that she could allow me to mirror her, without feeling intruded upon. The enormous importance of interventions within the context of a therapeutic relationship was brought strongly home to me in this early dramatherapy experience. However, other clinical work also brought home to me that a relationship takes place within a wider sociocultural context, and, if this is not taken into account, that relationship may never become established or may be disrupted.

Sociocultural aspects of embodiment When looking at sociocultural aspects of embodiment, it is important to explore personal, social and political forces that affect the body. I have become aware of this in my work with clients with eating disorders and those who have a history of migration. When working with a group of clients with eating disorders (Dokter 1994, 1996), I was aware of the dissociation from the body in my clients when they wished to exert control, with both anorexia and bulimia. For many of them, the problem started in adolescence, when they felt dissatisfied about themselves. This dissatisfaction was sometimes exacerbated by a social emphasis on ‘perfect bodies’. Aiming for a perfect body was the only concrete way to assert control, which they often felt unable to assert in their relationships. They then lost that control when the eating disorder took over. In the multidisciplinary work, it was important to consider the sociocultural and cognitive aspects of body image, as well as the nature of the clients’ relationships. My work was predominantly with women, and I needed to pay attention to the sociocultural impact of gender expectations and also the fact that the prevalence of eating disorders varies in different cultures (Dokter 1994, 1996, 1998). As a ‘foreign’ therapist, I was made aware of sociocultural pressures and expectations in different cultural backgrounds in relation to eating, whether in the form of fasting, a strong ethos of hospitality, expectations around body shape or role expectations for women in particular. In clinical work, I was also confronted with the impact of migration on identity and mental health. Jennings (1994) writes movingly about her role as a community midwife with a young woman who migrated to the UK for marriage and ended up being seen in an infertility clinic, owing to fertility problems related to eating distress. The impact of migration across generations and how the presence of a foreign therapist can highlight this were illustrated by a group of young women with mild learning disabilities who were getting ready to leave secondary school.

Vignette 3 The group takes place in a community centre, with eight young women and two female co-therapists: one an art therapist, the other a dramatherapist. The young women are very loud, speaking over each other and over the therapists, the latter two experiencing a sense of helplessness in the face of rebellious resistance. The dramatherapist’s ‘foreignness’ is disparagingly commented upon; her clothing, smell related to eating, body shape and accent are all found wanting. At the same time, one young woman in the group is also ‘teased’ for her way of walking; she has light cerebral palsy. We work with a problem box at the beginning 118

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of the session and a book of likes/dislikes at the end of the session, to try and empower the young women to feel that this is their group, different from their school experience. Interestingly enough, the young women complain that, as therapists, we do not challenge their acting out enough. The two therapists wonder about the dynamic of splitting and scapegoating and speculate that issues around difference, in particular ethnicity, nationality and disability, may be defended against and projected out on both the therapist and the group member experienced as ‘different’. We decide to work with the clients creating their family trees individually, and two groups created characters called ‘Miss can’ and ‘Miss can’t’. It emerges that all girls, except the scapegoated young woman, are second-generation migrants. When the therapists reflected this back to the group, the young women discuss their fears about the upcoming summer holidays, returning to the parents’ country and being encouraged to marry ‘over there’. They also talk about whether they feel accepted in the UK and in their parents’ country, owing to their perceived ‘disability and foreignness’. I was interested in the projections about identity on the body and the fact that projection proved a better way of working with this concretisation than embodiment. I found this similarly in the group of women with eating disorders (Dokter 1996): working with the myth of Persephone enabled issues to emerge around to whom her body belonged: did it belong to Hades or Dimitra. Did Persephone have any choice or control in the matter? The projective work led to a lively discussion in the life–drama connection. The clients connected this to their own lives in relation to the influence of carers (professional and familial) over their bodies and also reflected on how the eating disorder had taken over the control. Whether the body is a concrete or symbolic expression of distress is a regular consideration in my work with refugees. One of the issues in psychotherapy with this client group is whether people are ‘psychological minded’ enough to use psychotherapeutic intervention when they express their mental distress physically (Dokter 2000, 2005; Blackwell 2005). Following the embodiment route, by clarifying when the symptoms occur and since when they have been around, often elicits material concerning psychological problems.

Vignette 4 The client, a 42-year-old, male, Kurdish refugee, is seen individually as part of a charitable refugee support group. He was referred for depression and PTSD symptoms, but expressed his complaints somatically through asthma, pain in his legs/mobility problems and severe headaches (in addition to the PTSD problems concerning sleep disturbance and concentration). When tracing and tracking these problems, he described how his existing asthma had worsened after prolonged confinement during the flight; the pain in his legs and head resulted from torture during imprisonment. He had not mentioned this to his GP and was on increasing doses of painkillers. Other embodied cultural differences to be aware of concern taboos around body language between genders, as well as differences in symbol interpretation (Dokter, 2005). An example was a client dreaming about a new house, which I equated with a renewal of hope, the client with death (an empty house was a symbol for death in his culture). The importance of repeated explanations for symptoms and treatment cannot be underestimated, especially if you take into account the need for the client not to be reduced to passive patient status. As therapists, we need to recognize interacting understandings on a personal, psychological and sociopolitical level (Turner and Kahona 1992). Intrapsychic, interpersonal and political dynamics have been identified more recently by Blackwell (2005), particularly in working with refugees. I have found the ‘person in culture interview’ very useful in assessing the interacting subjective, pathological and ideological processes (Ponterotto et al. 1995). This questionnaire does not include questions about the body or bodily experiences, and so it is important to add these. 119

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The dance-movement therapist Boas (2004) calls for the development of concepts of movement-based cultural dimensions. Embodiment needs to be considered interculturally and intergenerationally. He states: ‘The body reveals its knowledge to the mind. Movement releases transgenerational, cellular memory and it becomes clear that we don’t know how much we know, about ourselves, our ancestors, our stories and our histories’ (Boas 2004, p. 124). Chang (2009) gives a good personal example of how interpreting movement behaviour, such as pushing against the teacher in movement, depends in part on the cultural context of the viewer and reinforces Boas and Reeves’ statement of how culture is often communicated, internalized and expressed at an unconscious, nonverbal level (Schelly-Hill and Goodill, 2005). Subtle ethnocentric monoculturalism (Sue 2003), rather than conscious discrimination, can bias the interpretation of movement. This brings me to the penultimate section of this chapter: what role does the interpretation of embodiment play in helping clients make life–drama connections in dramatherapy?

Embodiment and interpretation When researching whether the cultural backgrounds of clients and arts therapists affected their perception of arts therapies groups, I came across an interesting, and for me surprising, finding. The research took place in a young-people’s psychiatric day-centre therapeutic community setting (Dokter 2010a, 2010b). The young-people’s service provided outpatient and day-patient treatment: outpatients were seen individually, and day patients received group treatment. The day-patient unit was run along therapeutic community lines for a client group of twelve young people, aged 18–25. Their average expected stay was 2 years. The arts therapies groups formed 1 day in the group programme. The morning group took place after the community meeting (a daily start of the programme) and was co-facilitated by a dance-movement therapist and a dramatherapist; the afternoon group was facilitated by the art therapist and a nurse therapist. Each group lasted 1.5 hours and took the format of discussion, followed by action. In dance movement/dramatherapy, this was usually group interactive movement-based work, whereas, in art therapy, it tended to involve individual image making, followed by a sharing of the images. The most common client diagnoses were personality disorder (45 per cent) and adjustment disorder (45 per cent); 50 per cent of clients also suffered depression, and 50 per cent self-harmed. The co-morbidity with addiction was 45 per cent, including alcohol and/or drug abuse and/or eating disorders. The smaller diagnostic groups were obsessive-compulsive disorder and bipolar affective disorder (11 per cent each). Eleven per cent of clients were known to have mild learning difficulties. The main identified stressors in clients’ lives were experiencing parental separation and death (45 per cent), bullying at school (40 per cent) and sexual abuse (20 per cent). Smaller numbers of clients had experienced stress through adoption and fostering (18 per cent), being a single parent to young children (11 per cent), somatic problems (11 per cent) and family employment problems (11 per cent). Many clients received previous treatment in child and adolescent services before coming to the young-people’s psychiatric service. In terms of gender, 60 per cent were young women, and 40 per cent were young men. In the data analysis, I found a different attendance in the dance-movement therapy/ dramatherapy group (68.6 per cent) in the morning and the art-therapy group (61.5 per cent) in the afternoons, with a higher attendance of male clients in the morning (dance-movement therapy/dramatherapy) and female clients in the afternoon (art therapy). This was a finding I had not expected, and I wondered what contributed to this attendance. All clients were expected to attend all groups, and so it appeared a matter of choice. Interviews and questionnaires with therapists and clients showed that helpful aspects of the dance movement/dramatherapy group 120

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were group contact, having fun and playing, and the use of certain structures was useful. Absences were felt to be unhelpful. Clients and therapists disagreed on other aspects. If clients did not join in the movement, was this a useful choice or an attack on the group? Were using humour and joking about the same as playful interaction? Whether movement could or should be interpreted symbolically was also a bone of contention. In previous case studies (Dokter 2010a, 2010b), I illustrated the gender difference in expectations for young people, which might form a basis for the different preferences for embodiment (drama/dance) or projection (art). After I had listened to clients’ perceptions of helpful and hindering processes around group art, drama and dance-movement therapy, different influencing factors emerged. Group-as-a-whole or individual-in-the-group structuring, the effect of audience/witness, the freedom to play and client preference for direct rather than symbolic expression all affected a client’s ability and willingness to join the dance. Being witnessed in embodiment is strongly present in dance-movement therapy and dramatherapy, where there are no images or instruments to distract the attention. Interpreting the symbolism of embodiment adds to the self-consciousness of clients and their reluctance to be seen. Sometimes, movement can be an abreaction of stresses and frustrations, and clients experience this as a useful channel and medium in which to interact and engage in play. The therapist can be concerned that the play becomes a distraction rather than helping to create insight; however, interpretation of potential symbols in the embodiment only serves to create greater resistance. Fran Levy’s (1995) connection in the introduction about more functional movement in music and art therapy might usefully be extended to drama and dancemovement therapy, using a carefully balanced assessment of client needs. Although this was a co-worked group using both dance and dramatherapy interventions, there was little use of role and character, which might have provided a better container at greater aesthetic distance (Landy 1986) for the clients. A related, but different, aspect is the importance of the relationship to help navigate the obstacles in the therapeutic journey.

The embodied relationship As a migrant with multiple personal identities, I have mirrored this in my professional identities as dramatherapist, dance-movement therapist and group-analytic psychotherapist. Maybe, as migrants, we feel we have to prove extra hard that we are worthy of acceptance (personal), especially as we have encountered a lack of recognition for qualifications obtained in our country of origin (sociopolitical). These multiple identities have in common a psychodynamic orientation in my work. Jones (2004) calls this the psychoanalytic framework; he and Karkou and Sanderson (2006) show this orientation across the arts therapies, emphasizing links between present and past through transference relationships. In my case, this means that I aim to work in the therapeutic relationship with past, earlier-life experiences re-enacted in the current relationship. This orientation often means that the therapist aims to stay opaque, to allow the client to ‘project/ transfer’ to maximum effect. However, I have found that my body reveals aspects of my identity that undermine the relationship if I am not prepared to work with these explicitly with my clients. My body does not directly reveal me as someone from a mixed background. Although my way of dressing can be according to the fairly colourful Dutch clothing style, it can be treated as a personal idiosyncrasy. When I open my mouth, my (ever fainter) accent still tends to show that I am not ‘from here’. My body shows my gender and, in younger days when I was pregnant, my sexual activity, in the same way as it reveals my age. All evoke projections from clients. What my body reveals about me thus plays a role in the therapeutic relationship and can make 121

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the issue of difference often very explicit. My migrant clients now tend to assume I am British, and it is up to me whether I use self-disclosure to make my background explicit. It can be useful to explore assumptions about each other’s background, related to what we have seen and heard from each other early on. The bodily presentation is important to consider in this process, but I also have to be aware that my Dutch, direct style of communication, although somewhat moderated after 30 years in the UK, can cross cultural boundaries about what is considered appropriate to discuss between genders and age groups. Authority issues are increasingly important to address as my ageing process advances, just as they needed to be explored when I was a young therapist. The body plays an important part in the way we establish relationships, from our earliest to subsequent ones throughout our different life stages. In my psychodynamic and developmental ways of understanding, Daniel Stern’s (1998, 2012) approach to attunement via the body-self and physical interaction is crucial, not just in mother–infant interaction – something it is important for us, as dramatherapists, to know about, so that we have insight into the early, nonverbal aspects of relationship play – but also in the way our physical interaction with our clients establishes and influences the therapeutic relationship. Dance-movement therapists have considered kinaesthetic empathy and transference more consistently than dramatherapists. In her work with eating disorders, Kleinman (2009) shows how rhythmic synchrony, kinaesthetic awareness and empathy collaborate to promote relationships that foster empowerment and mutuality (Kleinman and Hall 2006). Kinaesthetic empathy represents the therapist’s ability to encourage shared expression. Self-attunement can help therapists to become aware when they are overidentifying with clients, but also to be in touch with clients’ issues in an unconscious, embodied way (Gerstein et al. 2004). Fischman (2009) connects to Kohut (1990) when looking at three fundamental aspects involved in transference: mirror (looking for appreciation), idealization (from injury, looking to idealize, but linked to feelings of grandiosity) and twin transference (looking to share). These three ways involve the basic needs of individuals searching for acceptance, relationship and personal worth. She also shows how kinaesthetic empathy has evolved from post-war psychoanalytic thinking trying to address war trauma, through humanistic concepts from people such as Carl Rogers, to current interacting neuroscience, developmental and cognitive research. Kinaesthetic empathy is a form of knowledge, of contact and shared construction that may take many forms. It may appear through direct mirroring and affective attunement in dance movement therapists’ movements – the forms, qualities and tones of the body language. It might also make use of analogy, metaphor, the telling of a . . . story with movement or the patient’s verbalisation. (Fischman 2009, p. 48) It is important for us dramatherapists to be aware of our own bodies and the way we use them in interaction with the client, the developmental shaping of identity through embodiment, but also to understand the different cultural meanings of embodiment for the client we are working with. As therapists, we need to be aware of how different physical experiences (be they positive, as in relationships, dance, sport and orgasm, or be they negative, as in pain, illness, bodily trauma and death) impact on our professional as well as our personal lives. I have found that continuous involvement in movement practices has enriched my awareness and relational embodied interaction with clients. When I was younger, this was in the form of sport and different forms of dance/movement; now, it is more through yoga practice and movement improvisation (Reeves 2011; Bloom et al. 2014). 122

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Conclusion In this chapter, I have discussed the concept of embodiment across the arts therapies and aimed to illustrate its practice in dramatherapy in applications with a variety of client groups: children with multiple disabilities, young people with mild learning disabilities or mental health problems, and refugees. I have looked at the issue of symbolism and interpretation and how, for some clients, embodiment may take a more direct, expressive, functional form, rather than a symbolic one. Needing to contextualize embodiment within its cultural context is a theme running throughout the chapter. Through my research and clinical practice, I highlight that the distance created through taking on roles and moving in the ‘as if’, as well as working through projection, can be a more appropriate method for certain clients. In the final section, I have argued that embodiment is always present in our therapeutic relationships and, as such, needs to be an integral part of the dramatherapist’s ongoing training, practice and research.

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Jennings, S. (2011) ‘Assessment and EPR’, in Johnson, D., Snow, S. and Pendzik, S. (eds), Assessment in Drama Therapy, pp. 177–96. Springfield, IL: Charles C. Thomas. Jones, P. (2004) The Arts Therapies. A revolution in health care. London: Routledge. Jones, P. (2007) Drama as Therapy: Theatre as living. London: Routledge. Karkou, V. and Sanderson, P. (2006) Arts Therapies. A research-based map of the field. London: Elsevier Press. Kleinman, S. (2009) ‘Becoming whole again. Dance/movement therapy for those who suffer from eating disorders’, in Chaiklin, S. and Wengrower, H. (eds), The Art and Science of Dance Movement Therapy, pp. 125–44. London: Routledge. Kleinman, S. and Hall, T. (2006) ‘Dance movement therapy: A method for embodying emotions’, in The Renfrew Centre Foundation Healing Through Relationships Series: Contribution to eating disorder theory and treatment, vol. 1: Fostering Body–Mind Integration, pp. 2–19. Philadelphia, PA: Renfrew Centre Foundation. Koch, S. (2006) ‘Embodiment and creative arts therapy: From phenomenology to cognitive science’, in Scoble, S. (ed.), European Arts Therapy. Grounding the vision to advance theory and practice, pp. 186–95. Plymouth, UK: University of Plymouth Press. Kohut, H. (1990) The Search for the Self: Selected WRITINGS of Heinz Kohut: 1978–1981 (vol. 3.; ed. Ornstein, P.). Madison, CT: International Universities Press. Lakoff, G. and Johnson, M. (1999) Metaphors We Live By. Chicago, IL: University of Chicago Press. Landy, R. (1986) Dramatherapy Concepts and Practices. Springfield, IL: Charles C. Thomas. Levy, F. (1995) Dance and Other Expressive Art Therapies: When words are not enough. London: Routledge. Merleau-Ponty, M. (1962) Phenomonology of Perception. London: Routledge. Payne, H. (1988) ‘The role of movement and dance in dramatherapy’, in The State of the Art of Dramatherapy conference proceedings. St Albans, UK: Hertfordshire College of Art and Design. Payne, H. (1990) ‘Movement – Dramatherapy or dance movement therapy territory?’, Dramatherapy, 12, 2, pp. 7–10. Pelham, G., Stacey, J. and Morgan, L. (2001) Counselling Skills for Creative Arts Therapists. London: Worth. Ponterotto, J. G., Casas, J. M., Suzuki, L. A. and Alexander, C. M. (eds) (1995) Handbook of Multicultural Counselling. London: Sage. Reeves, S. (2011) Nine Ways of Seeing a Body. Axminster, UK: Triarchy Press. Sandberg, B. (1981) ‘Developmental drama checklist’, in Courtney, R. (ed.), Drama as Therapy, Volume 1, Children, pp. 29–54. New York: Drama Books Specialists. Schaverien, J. (2000) ‘The triangular relationship and the aesthetic counter transference in analytical art psychotherapy’, in Gilroy, A. and McNeilly, G. (eds), The Changing Shape of Art Therapy, pp. 55–83. London: Jessica Kingsley. Schelly-Hill, E. and Goodill, S. (2005) ‘International students in American dance/movement therapy education: Cultural riches and challenges’, paper presented at the 39th Annual American Dance Therapy Association Conference, Nashville, TN, October. Sherborne, V. (2000) Developmental Movement. London: Worth Reading. Springham, N. (1998) ‘The magpie’s eye: Patient’s resistance to engagement in an art therapy group for drug and alcohol patients’, in Skaife, S. and Huet, V. (eds), Art Psychotherapy Groups, pp. 133–55. London: Routledge. Stern, D. N. (1998) Interpersonal World of the Infant: A view from psychoanalysis and developmental psychology. New York: Basic Books. Stern, D. N. (2012) Forms of Vitality: Exploring dynamic experiences in psychology, the arts, psychotherapy and development. Oxford, UK: Oxford University Press. Sue, D. (2003) Overcoming Our Racism: The journey to liberation. San Francisco, CA: Jossey-Bass. Turner, E. and Kahona, S. (1992) Experiencing Ritual. Philadelphia, PA: University of Pennsylvania Press. Winnicott, D. W. (2005) Playing and Reality (Routledge Classics). London: Routledge.

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13 Shamanism, theatre and dramatherapy John Casson

Shamanism is the ancient, worldwide culture of dramatic ceremonies for healing individuals and communities. In these trance rituals, ‘there is usually a change of role for either the shaman and/or the patient and a symbolic enactment of the malady and its roots’ (Jennings, in Cox 1992, p. 235). Shamanism is still practised in North and South America, Tibet, Russia and South East Asia. In many cultures, there are traces of shamanism in folklore and theatre. We can date these activities back to the Palaeolithic era, as cave paintings more than 30,000 years old in France show several animal-masked figures in dance rituals. We can thus see the origins of theatre in shamanism. Many of the tricks of theatre were developed by the shamans: ventriloquism, for example, enabled the shamans to simulate the presence of spirits in dramatic séances; masks and puppets enabled them to present the spirits who spoke to the people about the spiritual dimension. A puppet, made from mammoth ivory and dated to about 29,000 years old, found in a shaman’s grave near Brno, was displayed in the 2013 Ice Age Art exhibition at the British Museum (Cook 2013). This was created more than 20,000 years before the rise of civilization. Such ancient and continuous cultural practices must have been necessary and effective for their survival over millennia, and they may thus inform modern dramatherapy. I now offer a brief analysis of shamanism that sets the shaman in his/her environment, establishing their methods and aims. The shaman’s environment is a community in which individuals have psychological and physical illnesses and within which, in the role of a wounded healer, the shaman has been educated in a spiritual culture. The natural landscape, flora and fauna, provides the shaman with a spiritual cosmology. The shaman’s methods include ritual dance-drama in which rhythm (drumming, rattles, chanting) promotes trance and entry into altered states of consciousness. The shaman’s aim is to travel in spiritual realms to encounter deities/demons/helping animals to rescue the lost or stolen soul of the patient, or to resolve community distress, and so achieve healing. Shamans use trance as their main technique, deliberately entering into an altered state of consciousness with the purpose of healing others. The shaman has learned to control this process and is able to journey to other spiritual realms, negotiate with and control spirits and demons, and not be possessed by them. The shaman learns this technique through a prolonged, often 125

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arduous initiation. A shaman’s patient and members of the audience may also go into trance, but they may do so involuntarily, without self-control. The central role of trance in shamanism offers us a window into the evolution of human mental and spiritual life. ‘Many of man’s higher mental functions, such as empathy, rapport, group identification, imagination, creativity are either derived from or are intimately related to his capacity for trance’ (Arnold Ludwig, in Inglis 1990, p. 16). In entering altered states of consciousness, shamans have access to psychospiritual worlds and are able to travel through this dramatic reality, which has sources of information not available in everyday reality. Dramatherapists and their clients enter dramatic reality, similarly, to access sources of power and information not normally available to the client. Some light trance may also occur in creative sessions. This is evident in the way clients often express surprise at how much time has elapsed as the therapist draws the session to a close. This may be an effect of creative activity being more engaged with the right brain hemisphere, which does not have a sense of time, or through the client being in a light trance. However, dramatherapists do not use trance in the way shamans do: they neither enter trance themselves nor propel their clients into it, though a dramatherapist may use relaxation, guided fantasy and imaginary journeys, which can result in altered states of consciousness. One aim of therapy, after all, is to alter the client’s state of consciousness from that of victim/ill/disabled to that of an empowered, well person. The shaman’s initiation often follows sickness or an injury. The shaman is the original archetype of the wounded healer. Most therapists will acknowledge that it is their own woundedness that brings them to the work and from which they gain their insights and compassion. Among the Dyak of Borneo, the initiation of a young shaman is a series of ceremonies: They cut his head open, take out his brains, wash and restore them to give him a clear mind to penetrate into the mysteries of evil spirits and the intricacies of disease: they insert gold dust into his eyes to give him keenness and strength of sight powerful enough to see the soul wherever it may have wandered. They pierce his heart with an arrow to make him tender hearted and full of sympathy for the sick and suffering. (Eliade 1989, p. 57) In this ritual drama, the neophyte’s head is symbolized by a coconut that is split open. From the very start of his career, the would-be shaman is involved in a symbolic drama of transformation. ‘Ceremonial ritual is an outer enactment of an internal event’ (Drury 1989, p. 320). Invisible inner experiences are externalized in concrete objects, symbols and dramatic encounters. Furthermore, as with modern trainee therapists, the aim is to develop the neophyte’s empathy, compassion and insight. If we look at the patterns of shamanic initiation, we see an archetypal process of facing the forces of destruction, disease, death and disintegration, an intimate personal experience of horror, pain and breakdown, followed by a period of reintegration, the discovery of new insights, healing power, strength and confidence. This process can be seen to recur in our own time in the therapy that trainee therapists must undergo. There are two major shamanic views of disease: 1 2

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that it is caused by the theft, rape or loss of the person’s soul; that it is caused by the introduction of some pathogenic object into the body/soul of the person: some evil has been visited upon the person by an outside agency.

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Eliade (1989, pp. 289, 305) also lists: 3 4

terror caused by the apparition of monsters; breaches of taboo. Before we dismiss these as primitive ideas, let us consider the following parallels: •

•

• •

In the late 1980s I worked with a woman who survived an appalling car accident. Trapped upside down in the car which she expected to explode, she suffered a near death experience. Her presenting symptom was her sense that she had ‘lost her soul’ (these were her very words). In a psychodrama training workshop a man with no previous experience of therapy said, when asked about his fears, ‘I was wondering what demons I have lurking that might be dragged out’. A psychotic woman speculating on the source of her voices said she thought they might be spirits. A young woman said, ‘When I was adolescent I feared to sleep because dead people look at me and judge me – ancestral spirits’. (Casson 1998, pp. 64, 59)

Thus, we may find our clients using this ancient shamanic language to describe their ills. Let us take one of these central concepts and apply it to our current practice as therapists. The shamans speak of the loss or rape of the soul as a source of illness. Eliade (1989, p. 295) described a shaman’s séance in which the shaman journeyed in trance ‘to the bottom of the ocean to visit Takanakapsaluk, Mother of the Sea Beasts’. After a difficult journey, he arrived to find the way blocked by a wall: the Goddess was angry. Her hair hung down over her face, and she was dirty and slovenly. This was the effect of men’s sins and breaches of taboo, which had made her ill. This example recalls a young psychotic woman who presented with her long, greasy, lank hair hanging like a veil over her face. She had certainly put up a wall of mute anger, which blocked the way. The clinical team suspected that, in her case, the incest taboo had been broken: her father controlled her, and she had lost her sense of self. Sexual abuse may be regarded as soul rape or soul murder, and many abuse survivors speak of themselves as having died as a child or experience themselves as containing a dead child, a frozen inner self, buried. The introjection of the abuser’s evil (many abusers tell their victims that they are naughty, dirty, bad or deserve how they are treated) is a problem that survivors struggle with. Shamans speak of illness being due to the introduction of a pathogenic object into the body of the patient. This symbol of the source of illness needs to be expelled to heal the person. An abuse survivor needs to eject the pathogenic introject of the abuser. Eliade listed ‘the terror caused by monsters’ as a cause of illness. Dr Anne Bannister wrote of her use of puppets to help children work through monstrous experiences: Most children when they start to re-enact, like to take the part of the abuser, the one with most power. Sam aged 4 did it with puppets. He enjoyed being the wicked wolf who stole the little dog and little cat and threw them in the prison, while he terrorised them and threatened to eat them. The therapist played the dog and cat (one on each hand). She showed fear, indeed terror and called someone to help. Sam picked up an angel puppet 127

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and flew into the prison. ‘We will have to be very strong,’ he said reversing roles with the angel. ‘We will have to do this together.’ He ordered the therapist to reverse roles: ‘You be the bad wolf,’ he said. Somehow Sam managed to play the angel, the dog and cat (who had become a magic dog and a magic cat who were the angel’s assistants). After a great struggle (literally) the three managed to vanquish the wicked wolf who was buried under a large cushion in the therapy room. ‘Sit on it,’ Sam ordered the therapist and handed her the angel puppet. ‘Now the magic dog and the magic cat will tell the angel all about the wolf.’ Sam quickly picked up the puppets. ‘It’s really my dad,’ he said. ‘He’s doing rude things to me and my brother.’ (Bannister 1991, p. 84) This example of dramatherapy practice is full of shamanic images. The spontaneous healing ritual drama moved from facing the terror of the monster, through flying from heaven (the angel) to the infernal prison to rescue the stolen soul; the fight with evil; death and burial; the helping animals; the helping spirit (the angel); and the identification of the taboo that had been broken. Sam discovered his own healing power and, extrojecting the abuser (wolf), found his own power to help himself. The reclaiming of personal power and selfhood is the central purpose of therapy now and in shamanism. Likewise, Susana Pendzik, a dramatherapist working at that time in California, described a women’s theatre group creating a play about abuse in which they confronted a Minotaur. ‘Our journey through the labyrinth could easily be compared to a shaman’s descent, our purpose, like that of the shaman, was to restore the abused woman’s lost soul’ (Pendzik 1988). She found that the Minotaur not only represented the abuser but became a power animal: by confronting the monster, the women were able to rediscover their own power. She noted that one woman used two rattles as her weapons against the Minotaur, and that shamans used rattles to restore a person’s power animal (Harner, 1982). Indeed, Pendzik found that shamanic practices and insights illuminated the way through a difficult process, enabling her to make sense of psychological and interpersonal problems. Jennings (1987) and Pendzik (1988, p. 27) concluded that knowledge of shamanic beliefs and rituals can enhance the modern therapist’s understanding and practice. In 1974, Sue Jenning travelled to Malaysia to do her doctoral research fieldwork. Her study was of a small community of settled hunter–gatherers and cultivators living in thatched bamboo huts in jungle clearings. They performed dramatic trance ceremonies for healing purposes. Jennings’ research was published as Theatre, Ritual and Transformation: The Senoi Temiars (1995). Aspects of the Temiars’ cultural practices and their meanings illuminate a wider theoretical examination of the human impulse to play, enact and so trance-form experiences. Jennings explained that ritual builds a bridge between the different realities experienced by shamans and all of us in dream, fantasy and theatre. I maintain that the terms ritual, drama and theatre are all means of trying to describe the various forms of larger than life representations involving dominant cultural symbols, artistic media and changes in role, in a designated space set apart. The roots of these creative forms are in early play experience involving embodiment-projection-role, emphasising the fundamental nature of the embodied dramatic act. They establish the important separation between dramatic reality and everyday reality: i.e. the imagined world and the real world. The séances performed by the Temiar are the means whereby the private material of dreams may be transformed into public acceptance and experience. (Jennings 1995, p. 23) 128

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In his paper on medical clowning, Amnon Raviv described the links between shamanism, clowning and dramatherapy, showing how the practitioners ‘must be liminal figures with the ability to pass over, or bridge, realities’ (Raviv 2014, p. 20). Shamans use a bewildering variety of images to describe their trance journeying, and these images often are about connecting different worlds, joining opposites, such as bridges, ladders and rainbows. This imagery is archetypal and recurs in modern cultures, including in the repertoire of dramatherapists. These images are metaphors and so are bridges, enabling meanings to be conveyed between worlds, communicating between parts of the self, crossing from the right to the left brain hemispheres (Casson 2004, p. 117). Ritual and dramatherapy build bridges between inner and outer, self and other, dramatic and everyday reality. Metaphor (literally meaning ‘to carry across’) enables transitions. Both dramatherapists and shaman make use of dramatic ritual and multiple media to enable unwell people to embark on a therapeutic journey. They provide ritual boundaries of time and space set apart to contain undifferentiated experience that is expressed through multiple layers of metaphor. The core of this experience is the embodied and enacted ‘world’ through which the polysemic qualities of drama enable profound inner experience and epic metaphors to resonate, reveal and achieve resolution. (Jennings 1995, p. 190; italics in the original) Through the analysis of her research, Jennings showed that the dramatic trance rituals of the Temiar enable them to transform inner experiences into shared experiences, and achieve healing in a form of song and dance theatre. My own MA research was into the dramatic healing rituals in Sri Lanka in 1976–9. My focus was on the shamanic elements in the ceremonies, the therapeutic processes inherent in the rituals, the combination of serious and comic, and rediscovering the forgotten mother goddess behind the fertility ceremonies (Casson 1979, 1984). The ceremonies have both a collective and individual nature: even exorcisms performed for individual patients have an enthusiastic audience of villagers who wish the patient well and enjoy the show. I witnessed the exorcism of the demon of death from a woman who was depressed following the sudden accidental death of her husband. Like all Sri Lankan dance ceremonies, this was powered by the rhythm of drums. The drum is the quintessential equipment of the shaman and enables him to travel between worlds. Indeed, shamans describe their drum as a horse or boat. In the late 1980s, I was running a dramatherapy group for depressed clients in a mental health day centre. One day, I offered them percussion instruments, and slowly the group built up a rhythm together until they were dancing around the room. A student who was observing the group said afterwards that she could not believe they were depressed. The patient in the Sri Lankan Thovil ceremony was confronted at the climax of the ritual by a horrific masked figure of the demon of death. The technique was of catharsis and confrontation: the emotions were stimulated, and her deepest fears were faced, not only in trance when the patient was possessed by the demon, but consciously, in confronting demons played by masked dancers. I was told that, if the patient did not experience real shock and terror in these encounters with the demons, then she would not be cured. I can vouch for the powerful effect of these masked figures, lit by fire torches, appearing suddenly in the night. I was never so frightened in any theatre. I take up my notes made at the time, just after 1.00 a.m. The ceremony lasted all night. 1.04 a.m.: The patient sits up, watchful, possibly anxious. 1.09: The patient rearranges things, tidies up, prepares . . . and then sits back. 129

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1.10: A mat is brought in. A figure suddenly appears. He has a black face (make up of lamp black), big teeth and a red mouth. He throws fire flashes, thrusts the torch into the patient’s face; lies on the mat; pretends to go into a violent trance, shaking his whole body on the mat. He gets up and repeats this, three times. He takes the cockbird and a pot in his arm. Incense. He sways and trembles causing the bells on his ankles to jingle. He rushes off out of the stage area. All this happens very suddenly and rapidly and is a shock of excitement after the calmer hour that has passed since the patient’s own trance during which she had been possessed by Mahasohon, the demon of death and graveyards. (The exorcist had been able to interview the patient in the role of the demon, negotiate, placate and finally expel the demon. It was now external to her.) This new masked figure represents Mahasohon. 1.20: The dancer impersonating Mahasohon returns and collapses into a violent trance seizure. After two minutes he rises, dishevelled and dirty. The area is half wrecked.

Figure 13.1 Mahasohon, the demon of death 130

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After a pause: 1.50: Drumming and chanting begin again. Suddenly a wolf-like masked figure appears in a flash of flames. The sight is truly horrific and disturbing. The patient hides her face from the apparition, shivering. Slowly she comes to look at him. (Casson 1979, pp. 73–4; 1984, p. 15) These confrontations were followed by others, but the terror of the demonic gradually degenerated into comedy, until the demons became grotesque clowns, obscene and childish. The patient was able to face her fears and eventually laugh at them. Her adult status was confirmed in comparison with the ludicrous demons, and she enjoyed the show. The ritual utilized the therapeutic value of humour, play and the release of tension in cathartic laughter. This was a therapeutic theatre that had developed from ancient shamanic practice. At the end of the night, the patient was transformed, relaxed, happy and smiling. Casson (2004, p. 215) and Raviv (2014, p. 23) suggest such clowning may help clients by distancing them from overwhelming experiences. ‘The power of humour lives in its different perspective and alternate viewpoint from which to look at reality. Laughter makes reality seem less threatening, dwarfing the fear and restoring the patient’s own inner empowering forces’ (Raviv 2014, p. 23). Some shamanic clowns literally turn topsy-turvy, turning the world upside down, radically altering people’s perceptions and so freeing them from fixed patterns of thought and feeling. Such anthropological research informs our therapeutic practice. Dramatherapists, indeed all therapists, need an anthropological dimension to our awareness, because we work within multicultural contexts with people who may not share our own frames of reference. We must be equally able to work with a committed Christian, a Muslim, an atheist, an offender or refugee and achieve a helicopter view while also empathizing and entering their world. We must not project our ideas on to the clients, but be curious and puzzled, like a good anthropologist who enters the world of a tribal group and joins the people, without losing his or her ability to think and reflect. The ever-present danger is to project, as some very famous anthropologists have unwittingly done, on to the people being studied our own distorting perspective. Jennings was alert to this, and she warned against romanticizing native peoples. Sue learned from the Temiar people, brought back her learning and integrated it with her own perspective in a respectful way. The above image of the helicopter offers metaphors of journey, flight and height. Shamans use altered states of consciousness to travel in spiritual realms. They are thus able to journey under the earth, down to the bottom of the sea or into the sky. Their cosmos is layered, above and below: heaven, earth and underworld. Shamans explore these different levels to find the lost soul or encounter sources of power. In this potentially bewildering spiritual cosmos, they orient themselves, knowing where they are according to dimensions and directions, having a map of north, south, east, west and upper or lower worlds. This layering of experience is archetypal and can be described by mandala maps drawn in sand or painted. In modern dramatherapy practice, the three-dimensional mandala of the Communicube (www. communicube.co.uk) enables clients and therapists to orient themselves in the confusion of the psyche, symbolizing parts of the self within the containing structure using buttons, stones and miniature figures. Shamans have long used stones, bones and small objects in diagnosing and treating their patients, exploring patterns they make on the ground or examining the different facets of a single stone (Achterberg 1985, p. 48; Walsh 1990, p. 179). 131

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Figure 13.2 A shamanic map on the Communicube

Tom placed three figures, which he called demons, on the bottom level and a dark figure on the second level. He was ambivalent about the dark figure, as he said he felt drawn to it, whereas he rejected the demons who told him to harm his daughter. They were in a landscape of fang-like peaks and a hole he said was the bottomless pit of his depression, hinting it led to suicidal feelings. He feared he could not stop himself falling through another hole on the fourth level and at these times he did not feel strong enough in himself (the white castle) but needed his dog and music (the Greek coin, which has a harp on it, on the second level) to help him cope. He sometimes called on his angel (a memory from childhood in church) when he was desperate. One day he created a story of a frog (he had found one in his garden) that told him that his nature was essentially good and he must look up at the stars and hear their songs. Being a bright frog, he also knew the anger expressed by the fangs and the red button was Tom’s own anger and when he could voice his rage it would be less fearful and the demons would lose their power. (Tom is a compilation of more than one client.) The Communicube was invented during research with people who hear voices. The voices were experienced as coming from different levels, and so the five-level structure was created to symbolize this experience. Some voice hearers to this day attribute their voices to spiritual beings, including angels and demons (Casson 2004). These figures can be represented by miniature objects on the structure, as see in Figure 13.2. The Communicube and the circular Communiwell are archetypal structures that are three-dimensional mandalas and recall the shamans’ cosmology, 132

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the ziggurats of ancient Assyria, the Hindu temples of India and the Buddhist temple at Borobudur in Java (which is a gigantic mandala). Religious images in literature and art, such as Dante’s Divine Comedy, Bunyan’s Pilgrim’s Progress, the Jewish Kabbalah and the myths and legends of many cultures present us with concentric designs that integrate different levels in a mandala. The imagery is ancient and was first realized by shamanic cultures that predate all higher civilizations. Jung regarded the mandala as an image of the Self. The Communicube enables clients to explore other levels of experience and plot these within a containing structure and so make sense of chaos, gaining a greater understanding of themselves. Viewing the structure from above, the client is able to gain a helicopter view of their whole Self. The shaman’s original wound may be caused by an animal that later becomes a helping spirit. Dramatherapists use animal imagery, toy animals and masks, enabling clients to explore their stories and to gain energy and wisdom not normally available to them. Jung showed that the helping animal may also be a symbol of the Self: that greater whole that is wiser than the ego. Although some shamans have animals such as polar bears and lions as helping animals, we must ensure that small animals such as frogs are not dismissed as lacking the supposed grandeur of the Self. The ego may seek grandiosity to compensate for its weakness. The Self knows that, in the small, humble creatures, there are aeons of experience, knowledge and skill in surviving. (Frogs can travel on land, swim under water and leap into the air: in other words, travel in the three realms.) The helping animal brings sources of wisdom and power previously unavailable to the troubled ego. One of the main aims of trance journeys is to find a helping animal as part of restoring the lost soul. There is also the meeting with a power figure, whether this is an animal, demon, deity, a spirit guide or wise one. In dramatherapy, these encounters can be dramatized, as they are in shamanism and in psychodrama, when the protagonist may role reverse with such a figure and so internalize their power. Indeed, Jennings stated, ‘lasting transformation can only take place if the patient has been able to internalise the wise person, and let go of the parental relationship and establish a peer friendship of trust’ (Jennings 1990, p. 121; italics in the original). Modern therapists must not play at being shamans. Although knowledge of shamanism may inspire and inform our practice, we are not operating in a shamanic cultural context and must not give ourselves magical pretensions. We cannot transplant ancient practices into our consulting rooms. The shaman journeys in an altered state of consciousness, leaving his patients behind, to negotiate with and overcome supernatural forces and rescue the lost soul. In contrast, the dramatherapist shares the journey with the client, empowering them to find their own healing. Dramatherapists can use imagery, dramatic ritual, journeys through magical landscapes, stories of helping animals and encounters with wise beings, without falsely claiming to be shamans.

References Achterberg, J. (1985) Imagery in Healing, Shamanism and Modern Medicine. Boston, MA: Shambhala. Bannister, A. (1991) Learning to Live Again: Psychodramatic techniques with sexually abused young people. In P. Holmes and M. Karp, Psychodrama, Inspiration and Technique, London: Routledge, pp. 77–93. Casson, J. (1979) Shamanistic Elements of Oriental Theatre. Unpublished MA thesis, Birmingham University, UK. Casson, J. (1984) ‘The therapeutic dramatic community ceremonies of Sri Lanka’, Dramatherapy, 7, 2, 11–18. Casson, J. (1998) ‘Shamanism, dramatherapy and psychodrama’, lecture published over four issues of Cahoots magazine, 62, 63, 64, 65, Levenshulme, Manchester. Casson, J. (2004) Drama, Psychotherapy and Psychosis: Dramatherapy and psychodrama with people who hear voices. Hove, UK: Brunner-Routledge. Cook, J. (2013) Ice Age Art: Arrival of the modern mind. London: British Museum. Cox, M. (1992) Shakespeare Comes to Broadmoor. London: Jessica Kingsley. Drury, N. (1989) The Elements of Shamanism. Michigan, Element Books. 133

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Eliade, M. (1989) Shamanism, Archaic Techniques of Ecstasy. London: Arkana, Penguin. Harner, M. (1982) The Way of the Shaman: A guide to the power and healing. New York: Bantam Books. Inglis, B. (1990) Trance, A Natural History of Altered States of Mind. London: Paladin. Jennings, S. (1987) ‘Dramatherapy: Symbolic structure, symbolic process’, Dramatherapy, 10, 2, 3–7. Jennings, S. (1990) Dramatherapy With Families, Groups and Individuals. London: Jessica Kingsley. Jennings, S. (1995) Theatre, Ritual and Transformation: The Senoi Temiars. London: Routledge. Pendzik, S. (1988) ‘Dramatherapy on Abuse: A descent to the underworld’, The Journal of British Association for Dramatherapists, Autumn, 11, 2, pp. 21–8. Raviv, A. (2014) ‘The healing performance: The medical clown as compared to African !Kung and Azande ritual healers’, Dramatherapy, 36, 1, 18–26. Walsh, R. (1990) The Spirit of Shamanism. London: Mandala, Grafton, Hooper-Collins.

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14 From brains to bottoms The preoccupations of the very young and the very old Sue Jennings

One that converses more with the buttock of the night than with the forehead of the morning (Shakespeare, Coriolanus II.1.36) And thy law is within my bowels (Psalms xl, 9)

Introduction This chapter focuses on issues of control and freedom within dramatherapy and play and how this is reflected through attitudes towards the human body, and society. The importance of the body as metaphor for regulating beliefs and practices has long been understood. The work of anthropologists such as Mary Douglas (1966/2002) highlights the ease with which we fall into comparative traps between cultures and between the ancient and the modern. However, all societies have beliefs and rules about what goes into and out of the body, and these can reflect the attitudes and beliefs towards bodies of knowledge and the boundaries of space itself. This understanding is important for dramatherapists, as we become more and more in a controlling environment, both for the profession itself and for the larger world of therapy, medicine and, indeed, ‘treatment’. Individual choices are more and more limited! The physical space for dramatherapy and play practice is also shrinking, and we have to contend with furnished and carpeted rooms and the multiple uses of rooms that have to stay neutral. Education itself is shrinking in space and diversity, and the curriculum is becoming increasingly prescribed. Metaphoric space is also shrinking, as the very media, the arts, which are needed for exploring metaphor, symbol and ritual, are constantly being reduced.

Preoccupation 1: Brains Parents, teachers and the government itself are exerting increasing pressures on pupils to be ‘bright’. There are rules about what they must know at certain age stages (what happens if they don’t?), and there are hierarchies of learning. 135

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Parents invest in educational aids, and they are introduced very early; there are also CDs that pregnant women can strap on to their bellies to encourage early learning! The UK also insists that children start school at 5 years old. Yet educationalists and clinicians know that learning takes place at optimum times. UK children and young people start schooling earlier and legally have to stay later, when compared with other countries. As it is not for educational reasons, what other value system is the benchmark? There are confusing politics and varying economic decisions at work. A clear pathway for the learning of the brain is not yet formed, or rather, it keeps changing, and there are many conflicting issues, such as the lack of funds for higher education that can develop the potential of ‘bright people’. If higher education is unaffordable, what is the point of staying at school? The study of Shakespeare may be encouraged in order to develop language and writing skills, especially for the brighter learners. However, it is the experience of Shakespeare, both as audience and participant, that makes an impact on child development (Hunter 2014). Shakespeare needs to be understood at a sensory and visceral level, and from there will come the intellectual understanding. Furthermore, there is an idea that ‘soft’ subjects (such as drama) should be dropped, in order to give more time for ‘real’ (not hard!) subjects, such as maths and science! Drama in schools and therapy is suffering from educational neglect, as the race for the league tables continues. Drama specialists know that increasing drama, especially at times of stress, such as exam time, can actually assist in reducing stress levels, enhancing confidence and contribute to the growth of competencies. Dramatherapists know that they have an important function in schools when major issues arise, such as anorexia, self-harming, bullying and other personal and social disruptions. Yet exclusion, medication or CBT treatments are given preference over artistic strategies that are known to succeed. Where is the proof, is the cry? Just look at the research! None of the exclusions/medications or CBT is a proven method for long-term recovery.

Preoccupation 2: Bodies Contrastingly, as more pressure is exerted on brain learning, less and less attention is given to body learning. Sports fields are sold off, facilities and choices are reduced, dance is often not on the secondary curriculum, and, only if you are very skilled and can be a credit to the school, is expertise in ‘body-work’ championed. I have discussed the primacy of the body in learning (Jennings 1998) and the importance of the developing senses in order to facilitate physical, intellectual and social development. As accusations of children becoming couch potatoes, or computer dependent, are made at earlier and earlier ages, where and how are they encouraged to be active? Space for moving about or playing is severely restricted. There are also anxieties about children’s safety if they play outdoors or in the street. Contrastingly, there is a new ‘diagnosis’ for children who are too active: it allows children to be put on medication if they are deemed to have ADHD. Children who cannot sit still or fidget because they are bored or daydream of life without abuse can be given medication that damps down their sensory system so that they can concentrate without distraction. However, I discuss below the crucial role that our senses play in our lives: we need our sensory system for survival. We can again trace these decisions back to political and economic priorities.

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Budgetary restrictions mean keeping learners in one place Not only must learning take place without action, it would also seem that bodily control is considered the more important physical achievement. Parents of infants want them to be ‘trained’ as soon as possible, and there is huge commercial interest in marketing all types of padded nappy, pull-up and pull-down. There is a strong movement in the Forest School organization and advocates of outdoor learning that is trying to counter these restrictions. But it is with difficulty. Many children and young people need space, especially outdoor space, in order to learn effectively, and this is being denied to them. Increasing fears about health and safety are keeping children indoors. Each year, there are schools that close down if it starts snowing, rather than seeing it as a wondrous, playful opportunity. I have a very warm memory of my rural primary school, when there was house-high snow and many villages were cut off for weeks, food being air-dropped and my father, the local GP, picking his way across fields in waders to deliver a new baby in the next village. A small number of children were able to reach the school, and we sat round the coke stove, drinking cocoa and eating biscuits. It was a wondrous time and an opportunity to play. I recall that, although much of the teaching and learning was very formal, nevertheless there were many times for play, and children were allowed time out to help with the harvest and fruit gathering! As Chown (2014) points out when discussing the influences of several organizations, including Octavia Hill, the Quakers and their tramps, the Scout Movement and Forest School Camps: Although there are some unique differences in each of these organisations, what unites them is that in order to develop their full potential, children and young people need to be in the outdoors. They need to be active participants in their learning and leisure and to be challenged physically, mentally and emotionally in a supportive environment where they are respected and valued. (2014, p. 45) Chown’s approach, aimed primarily at play therapists, is an essential tool for dramatherapists to rethink their position in relation to space, especially outdoor space. To my knowledge, Steve Mitchell is the only dramatherapy trainer who has a module that specifically emphasises working in the outdoors, known as the Dartmoor Experience (see Mitchell in this volume, Chapter 32). This moves us on to the idea of nature being an active ingredient in the play and dramatherapeutic process. In their new publication The Healing Forest in Post-Crisis Work with Children, Lahad and Berger (2013) suggest that there is a different therapeutic triangle to be considered. They suggest that nature is introduced as a third element in the client–therapist dyad, with individuals and with groups: In the ‘A Safe Place’ program, in which the identities of participants are developed mostly through interpersonal relationships and creative play, the major part of the facilitator’s role will revolve around the first axis of the triangle – emphasizing interpersonal interaction and using nature as a backdrop and a supplier of materials for play and the creative process. With this approach the facilitator can present the intimate and experiential possibilities of nature to the children, allowing them to experience the type of creative play that develops in the immediate present. This type of facilitation may largely be required when nature is 137

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perceived by the children as new or threatening. In time, with a sense of growing familiarity and security, the facilitator can step back and highlight their direct connection with nature. This is particularly emphasized at the end of the program, when the children plant trees and build birds’ feeding boxes and nests. At this stage, the connection with and contribution to eternal and universal nature gives the children a sense of meaning, value, belonging and continuity. (2013, p. 44; my emphasis) Surely this is a clear exposition of our intentions for play therapy and dramatherapy? A sense of meaning when so much has lost any meaning; value – including a value of self as well as others and nature; belonging as it is needed in attachment deficit and lack of resilience; and a feeling that life and the universe continue. No easy task when working with children who have been abused physically, sexually and emotionally, or who seek to end their own lives as everything seems pointless. Nevertheless, I am convinced that Chown (2014), and Lahad and Berger (2013) are right in their exposition of the therapeutic role that nature plays in therapy, and that it should be central to our thinking and planning. I would also comment, though space does not allow me to elaborate, on the destructive decision to close the farms where people with mental health issues could live and work as a community. The highlight of my work in a psychiatric hospital in Eastern Europe was the journey into nature for a group of twelve people who were long-term residents, with various diagnoses, including schizophrenia. We packed a large picnic and materials for a barbecue, as well as staff and residents, into two horse-drawn carts and went into the countryside. It was a time of wonder! One man stood still with amazement as he saw a cow being milked and called us all to come and see. Everyone helped to gather wood and cook the food, and then we looked at different plants and trees and birds. We culminated in storytelling round the fire. I was left with a sense of joy, and ‘All is well and all will be well’. As well as major concerns for the survival of the planet and protection of the environment, there is a serious political question to be addressed. Why are children and young people being prevented from developing their creativity, especially their playfulness and drama, and why is this being excluded from having an outdoor milieu? What are the real issues about keeping children caged in classrooms with a forced form of learning? Is the development of clones the humane goal of education in the broadest sense?

Preoccupation 3: Older people Bodily control, especially of the body fluids, is a constant preoccupation for older people. Various precautions are taken that can have the opposite effect on incontinence (water intake is restricted, despite the fact it has an anti-toxin effect). Anxiety is raised that people might ‘disgrace’ themselves. Young and old alike are shamed because of wetting. Dance and drama are important means of learning bodily control, and yet they are perceived as encouraging loss of control and mayhem! There is a similar commercial drive for continence pads for older people and the possibility that they might lose control. (In between the young and the old, there is a fear that women might ‘leak’, and so we have even invented pads with wings!) ‘I’ll warrant him for drowning, though the ship were no stronger than a nutshell and as leaky as an unstanched wench’ (Shakespeare, The Tempest, I.1.45–7). 138

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Although there is much more understanding of dementia and Alzheimer’s, nevertheless, they have also raised other concerns. Once older people start to forget even trivial things, there is increasing panic that maybe they are beginning to develop dementia, and that deterioration has set in, and little can be done about it. It is fortunate that drama specialists and dramatherapists are now beginning to work with dementia – albeit in a handful of places.

A new consideration: Sense and nonsense Throughout history, we have needed to ‘make sense’ of the world around us: we discover the rules of the universe and the need for the social group. So we tell stories (Storylore, Jennings 2003a) and imitate, through rhythm and ritual, drama and dance, our view of the world and our shared place within it. However, this starts much earlier, when we start to make sense of our world a few months after conception. Awareness of rhythm happens through the earliest of heartbeats and rhythmic music and singing during pregnancy. We can also sense temperature, sound, light, touch and emotional changes while we are still in the womb, and our mother has a profound effect on our well-being through her own sensory experience. The increase in the use of birth pools and mothers wanting to give birth at home illustrates our desire for a less sanitized and technological birth experience (Hill 2014). The birthing pool creates a continuation of the ‘safe waters’, helps to alleviate some of the extreme pain, and provides an immediate context for warm bonding and attachment through smell, touch and sound. After birth, the baby begins to make sense of the world through the sensory experience with the mother. If these experiences are chaotic, then the baby experiences ‘non-sense’, and nothing is predictable or joined up. The physical and emotional surge, which is the focus of the early weeks and months, creates the joyousness and excitement of primary play through the senses, especially through smell and touch. Dramatic play starts a few hours after birth, when baby and mother imitate and echo facial expressions and sounds. These sensory experiences, a kind of proto-play, create the primary attachment between mother and child, but they also have a biological basis. As Cozolino states: The warm and happy feelings; the desire to hold, touch, and nurse; the pain of separation and the joy and excitement of reunion all have neurochemical correlates that allow us to experience these wonderful feelings. Through a bio-chemical cascade, mother–child interactions stimulate the secretion of oxytocin, prolactin, endorphins, and dopamine, which create positive and rewarding feelings. (2002, p. 176) This sensory proto-play is necessary for the development of healthy attachment and the expansion of the child’s place in the social world. However, the senses themselves need to continue to develop, as they did in our primitive past. For example, we need our sense of alertness, our sense of intuition, our sense of fear of as yet invisible danger. We need our early experience to teach us about the world and our responses to it. We need to be able to authenticate our senses in the real world, without the artificiality of chemical stimulus such as air-fresheners. However, through constant, exaggerated visual and sound stimulus, we are in danger of ‘sensory overdose’. The bombardment of the senses that happens through very loud music and sound and constantly moving pictures on computers and television can affect us in ways that 139

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are still being discovered. If our senses are bombarded with external synthetic stimuli, we are being removed from our basis in reality where our senses can still function, where we are reassured and can feel safe. Psychotherapists will say ‘Trust the process’ – I would say ‘Trust the senses’! Is there something even more basic, from which humanity grows and develops, that can pre-exist creative play and the arts and their therapeutic emergence, and indeed our social and cultural world? I am certain that we need to pay more attention to the most basic sensory development in babies and young children, and not to neglect it in adulthood, or with older people. We need to be alert to infant and child disorders that can emerge, not only through lack of sensory stimulation, which can lead to apathy and being ‘shut down’, but also through ‘sensory overdose’ and undifferentiated sound and light. This is a primeval sensory experience where all the senses are highly differentiated and exist in our real world. Based on early sensory development, I have developed an understanding of sensory play processes, called NeuroDramatic-Play (NDP; Jennings 2011).1 What is missing in all these concerns is the importance of playfulness. Control of the body is set in opposition to play, which might just get out of control, whereas, in reality, play for the young is a means of developing control, as well as learning; play for older people is a means of keeping brains active and improving memory. The physicality of playing is crucial. Nevertheless, parents seem to rely more and more on technological play, rather than human playful interaction, and much of education is being taught through technology. NDP recaptures the human-interactive core of playfulness.

NDP emphasises that playfulness and sensory development are at the heart of human growth and well-being The focus of my work during the last 30 years has been the development of the developmental paradigm Embodiment–Projection–Role (EPR; 1990–2011). Initially, it was called the Play and Dramatherapy Method, and it developed into both application and evaluation (Jennings 2010). EPR is taught on many dramatherapy courses in many countries. In 2004, I began to ask myself important questions about the ‘embodiment’ stage, as, although I emphasised the body in all of my writing and practice, it seemed to be a gross category for a multiplicity of physical developments. The answers to these questions became the emergence of NDP (sensory– rhythmic–dramatic play), commencing 6 months before birth and continuing for 6 months after birth. NDP is the early subsection of the embodiment stage and emphasises the importance of sensory development in play. NDP is a very intense period in the infant’s growth that is at the core of the attachment between mother and baby. It involves messy and sticky playing, rocking and singing, and dramatic interaction. It establishes the sensory system and is the start of healthy body development. NDP develops 6 months before birth and 6 months after birth, and consists of simultaneous: • • •

sensory play rhythmic play dramatic play.

Through physical playing, we are developing trust, encouraging confidence and selfassurance, and building resilience and risk-taking. This can be enhanced by the great outdoors, which is important for awareness of all the senses, messy and mud-puddle play and literally being ‘in touch’ with nature. Outdoor playing also heightens a sense of adventure and discovery. 140

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Symbolic play emerges from sensory play, which develops the right hemisphere of the brain, stimulates the imagination and encourages hypothesising. This leads into storytelling in active form, which in turn becomes drama! However, it is also common to make sensory experiences synthetic or sanitized, such as by overuse of wipes, or artificial smells in houses, cars and toilets, as if natural smells are not acceptable and need to be imitated with chemicals! This results in children having distorted sensory experiences (and sometimes allergies). This in turn affects attachment and most certainly reduces resilience, as we lose our primitive sense responses to the world around us. Our senses are our coping mechanisms in the world. Through this distortion of the senses, we can see that it makes no sense – or nonsense – to a person’s experience of the real world. People become lost or disoriented, not only through sensory deprivation or distortion, but also through sensory overdose. We lose the capacity to fine-tune our senses when they are bombarded. Added to which, we are not even being taken into our imaginary world where the senses still operate; we are being forced into a state of overload, where our response is either to disengage or to start bombarding others ourselves. We have all witnessed the child who cannot stop shouting or lashing out. The child is beginning to bombard others, just as he or she has been bombarded, or has been deprived of sensory stimulus and is struggling to communicate through a sensory deficit. However, the unfortunate response is to put the child in isolation, ‘until you have calmed down’, rather than hold him or her in order to re-establish some body boundaries. The child who is out of control is very frightened and needs physical support, not punishment, to rediscover their self. This bombardment of the senses through sight and sound can become addictive and just as destructive as other addictions. We can overdose on sensory input like any other substance. NDP also influences our imagination and its growth, and our contemporary understanding of child development (Jennings 2011, 2013). It is also applicable with older people, especially those who are suffering from dementia. I want to emphasise that NDP is important with young and old alike.

I am certain that we need to pay more attention to the most basic sensory development in babies and young children Come to your senses! It can be a sharp rebuke when we are not making sense to someone else or are making a decision based on emotion, when others think logic has gone out of the window. It also describes a slow waking state after someone has been unconscious. To ‘come to our senses’ we need to have a fully operational sensory system!

Vignette 1: George George is an elderly man who has been institutionalised for many years. He accepts fairly placidly the routine of bland food, life in pyjamas and no stimulus for weeks on end. This is Eastern Europe, and there are no resources for any activities in this long-stay psychiatric hospital for 150 patients, with a staff of two trained nurses and four nursing assistants, and a general physician who visits once a week. Some weeks there is not enough money for adequate food, and the nurses supplement it from their own money. Sometimes the neighbours hand plastic bags with cake over the wall to alert patients. George watched intently as I played with the babushka dolls with Maria. He moved closer and then leaned over, staring intently and then burst into laughter. His smile stayed as he continued to watch. When 141

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I offered him the dolls, he initially drew back, but then gently took them. Slowly he opened them, one by one, and stared with incredulity. And then he looked at the dolls with the intense joy of a new sensory experience.

Vignette 2: Dina Dina is a very angry and spiteful child who attacks anyone who comes near her; she grabs food and stuffs herself, and spends time rocking and head-banging. Sitting nearby and humming, the therapist slowly began to rock backwards and forwards; initially, Dina ignored her, but became curious; after a while, she joined in the rocking, but had difficulty in rocking slowly; the therapist increased her speed to join Dina, who then laughed and clapped her hands. This formed the basis of a very simple communication based on rhythmic movement and music that eventually assisted Dina to regulate her harsh and repetitive movements and impulsive lashings out at others. The therapist was able to demonstrate genuine care through joining Dina in her movement, before introducing simple changes. She gave her full attention during these short sessions that started and ended in a ritualistic way of singing and rocking. Later, it was able to lead into hand massage with sensory hand cream (smell and touch) and very simple action songs. When the therapist introduced hand puppets, a wolf and a lamb, Dina was initially very scared and prodded them with a finger and then jumped back, and, when the therapist demonstrated the wolf puppet that could open and close its mouth, she grabbed it and bit the puppet so fiercely that chunks of fur fabric fell away! Slowly, she introduced the lamb puppet to interact with the wolf, although Dina was not able to connect the actions of putting the wolf puppet on her hand. She bit it again, and then threw it aside. The lamb puppet just stroked Dina’s hands and cheek, and she accepted the touch. The therapist picked up the discarded wolf puppet and let them do a little dance together to a familiar tune. Dina clapped her hands again and stroked the puppets.

Vignette 3: Ted Ted is 12 years old and on the autistic spectrum. He spends long periods of time ripping newspaper into strips and then making them flap up and down repetitively. The dramatherapist recognised this rhythmic playing and asked Ted if she could sit near him and learn to do the same activity. She took time to learn the ripping and flapping, and this was quite genuine, as he was very precise with this activity. However, once it became a shared rhythm, they were able to play together. Playfulness needs to continue throughout childhood and teenager-hood if we are to develop trusting, resilient, aware, caring and independent adults. It is arrived at through initial sensory experiences, the development of trust. This will lead to storytelling and make-believe, through which humans can truly flourish.

Teenage playfulness Many unhappy and distressed teenagers have difficulty with playfulness and creativity. Often, the borders between imagination and reality are blurred, and actions can become destructive towards self and others. Teenage self-harming is often a response to overwhelming feelings and an attempt to establish ‘real’ feelings. Unfortunately, it is sometimes easier to avoid dealing with self-harming behaviour, because it is also very painful for us to witness. However, once cutting or starvation becomes established, it takes a lengthy intervention to change the patterns. It is helpful to consider that, in European cultures, there is less emphasis on prescriptive teenager-hood, or ‘between-age-hood’. In many traditional cultures, teenage years are a time for preparation for adulthood and for learning the skills necessary to be a fully functioning member 142

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of the community. This learning takes place with senior adults or within the family. However, our teenage period is much more open and less well defined. As many teenagers ask, ‘What is the point?’. There is no guarantee of a job, there is no foreseeable follow-on to the teenage time, and no rituals to show that one is now an adult, with clear expectations of roles and responsibilities. However, if we look at this time as an anarchic period where rules are challenged and turbulence is enacted in various forms, it is possible to see that teenager-hood could be viewed as a developmental stage of the trickster. Myths and stories are peopled with heroes, villains, fools and tricksters, both male and female. How many human dilemmas, codes of conduct and the triumph of good over evil are portrayed in myths, fairy tales and stage plays (especially those by Shakespeare)? However, the trickster is not often talked about in a positive way. Yet the trickster is a character that knows how to play and is often able to connect: • • • • • •

young and old; pompous and foolish; controlled and uncontrolled; restriction and freedom; well-being and unwell-being; this world and other worlds.

The famous trickster from A Midsummer Night’s Dream, Puck, possesses many teenage qualities; he is: playful, anarchic, vigilant, and a wanderer, challenger (especially of the status quo) and reconciler; usually he is ultimately fair. Puck admits some of his attributes: Thou speak’st aright. I am that merry wanderer of the night. And then he proceeds to describe all the mischievous tricks he has played (Shakespeare, A Midsummer Night’s Dream, II.1. 42–57). Perhaps it would be helpful to view teenager-hood as an anarchic and trickster period that is playful and challenging, but is ultimately resolved. NDP and EPR swirl in their developmental stages and eventually settle into adulthood.

Closing thoughts What is the solution? I have painted a somewhat dismal picture of the deficits in our society that make for difficult child and teenage stages of development. More and more rules are made in an attempt to control more and more behaviour. However, it is not working! We need to change focus to a body-oriented approach that allows for overall growth of body and brain together, through the arts and play. And we need to find opportunities for this to take place in nature, where possible. The most important aspect of early play is sensory play and the development of trust. NDP encapsulates early play experience, both pre-birth and post-birth, and is an important means for the practice of creative care, which can be applied with older people. Themes from ancient stories and plays can help people learn to play again and increase their capacity to be self-reliant and resourceful. 143

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Thus, we have made the journey from bottoms to brains, or, from the sensory and physical to the thinking and the conceptual, through the body. The journey is from young childhood to older people. The body is supporting the brain! I close with final words from the Bard: My charms I’ll break, their senses I’ll restore And they shall be themselves. (Shakespeare, The Tempest, V.1.31)

Note 1

Neuro-Dramatic-Play has developed out of my early work on the Play Therapy Method (Jennings 1999), Playlore (2004a) and Storylore (2004). A fuller version of this will be available on www. creativecareinternational.org

References Chown, A. (2014) Play Therapy in the Outdoors. London: Jessica Kingsley. Cozolino, L. (2002) The Neuroscience of Psychotherapy. London: W.W. Norton. Douglas, M. (1966/2002) Purity and Danger. London: Routledge. Gerhardt, S. (2004) Why Love Matters: How affection shapes a baby’s brain. Hove, UK: Brunner Routledge. Hill, M. (2014) Water Birth: Stories to inspire and inform. Dursley, UK: Lonely Scribe. Hunter, K. (2014) Shakespeare’s Heartbeat: Drama games for children with autism. London: Routledge. Jennings, S. (1998) Introduction to Dramatherapy: Ariadne’s ball of thread. London: Jessica Kingsley. Jennings, S. (1999) Introduction to Developmental Playtherapy: Playing and health. London: Jessica Kingsley. Jennings, S. (2003) Training Syllabus for Care Workers. Wells, UK: Healing Tree. Jennings, S. (2003a) ‘Playlore: the roots of humanity’, in ‘Play for Life’ Journal, Play Therapy UK. Jennings, S. (2004) Creative Storytelling with Children at Risk. Bicester, UK: Speechmark. Jennings, S. (2004a) ‘Playlore: The Sensory Foundation’, in The Prompt, Winter 2003/2004. Jennings, S. (2010) Creative Drama in Group Work (2nd. edn). Milton Keynes, UK: Speechmark. Jennings, S. (2011) Healthy Attachments and Neuro-Dramatic-Play. London: Jessica Kingsley. Jennings, S. (2013) 101 Activities for Social and Emotional Resilience. Buckingham, UK: Hinton House. Lahad, M. and Berger, R. (2013) The Healing Forest in Post-Crisis Work with Children: A Nature Therapy and Expressive Arts Program for Groups. London: Jessica Kingsley. McCarthy, D. (2007) ‘If You Turned into a Monster’: Transformation through play: a body-centred approach to play therapy. London: Jessica Kingsley. Shakespeare, W. (1967) Coriolanus. Harmondsworth, UK: New Penguin. Shakespeare, W. (1967) A Midsummer Night’s Dream. Harmondsworth, UK: New Penguin. Shakespeare, W. (2005) The Tempest. Harmondsworth, UK: New Penguin.

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15 A critical aesthetic paradigm in drama therapy Aesthetic distance, action and meaning making in the service of diversity and social justice Nisha Sajnani

There are these two young fish swimming along, and they happen to meet an older fish swimming the other way, who nods at them and says, ‘Morning, boys, how’s the water?’ And the two young fish swim on for a bit, and then eventually one of them looks over at the other and goes, ‘What the hell is water?’ (Wallace 2008, p. 1)

What is the water in which we are swimming? We are always swimming in it, in that we are located in a particular historical moment and, like the two fish in the story, we often do not become aware of the influence of our ideological contexts until faced with circumstances that cause us to question our own assumptions and everyday realities. The therapeutic encounter is one place where this questioning occurs. Within that ‘water’, we are influenced by powerful philosophical currents, assumptions that underlie the theories and approaches that comprise our practice, which inform, for example, how we understand the ‘problem’, what to notice, how to intervene, how to determine and evaluate desired change, and what roles are available to us and to persons served in the process (e.g. providers/consumers or collaborative partners). Although we may not always claim the presence of these paradigms overtly, some of the influences that converge in our field include humanism, psychoanalysis, cognitive-behaviourism, constructivism, existentialism, neuroscience, feminism and several twentieth-century aesthetic movements and theatre practices (Emunah 1994; Jennings et al. 1994; Jones 2008; Johnson 2009; Johnson and Emunah 2009; Sajnani 2012a). This chapter builds upon earlier writing about the need for a critical aesthetic paradigm in our field: a way of orienting our arts-based practice in relation to an understanding of power, present-day inequalities and humanity’s struggle with diversity and co-existence (Sajnani 2003, 2004, 2009, 2012a, 2012b, 2013, 2015; Sajnani and Nadeau 2006; Sajnani and Kaplan 2012; Sajnani and Johnson 2014; Johnson and Sajnani 2015). By calling attention to the presence of a critical aesthetic paradigm in our field through a survey of 145

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practitioners whose written work reflects this philosophical orientation, I hope to contribute another option to how the ‘practice and the process of therapeutic change is understood’ (Jones 2008, p. 231) in drama therapy.

A brief history of critical theory Although the word critical carries negative overtones in English, my use refers to the ‘analysis and evaluation of an issue in order to form a judgment’ (Oxford Dictionary n.d.). This is not to be confused with being judgemental. Rather, critical theory is concerned with a discernment of power relations and its practical application towards ‘emancipating human beings from the circumstances that enslave them’ (Horkheimer 1982, p. 244). It is a perspective that acknowledges the presence and influence of often undesirable, socially constructed and politically reinforced constraints in our lives and in the lives of those we work with. This idea is effectively illustrated in this excerpt from the Hans Christian Andersen tale, The Emperor’s New Clothes: So off went the Emperor in procession under his splendid canopy. Everyone in the streets and the windows said, ‘Oh, how fine are the Emperor’s new clothes! Don’t they fit him to perfection? And see his long train!’ Nobody would confess that he couldn’t see anything, for that would prove him either unfit for his position, or a fool. No costume the Emperor had worn before was ever such a complete success. ‘But he hasn’t got anything on’, a little child said. ‘Did you ever hear such innocent prattle?’ said its father. And one person whispered to another what the child had said, ‘He hasn’t anything on. A child says he hasn’t anything on’. ‘But he hasn’t got anything on!’ the whole town cried out at last. The Emperor shivered, for he suspected they were right. But he thought, ‘This procession has got to go on’. So he walked more proudly than ever, as his noblemen held high the train that wasn’t there at all. (The Hans Christian Andersen Center, n.d.) It is perhaps fitting that it is a child who, early in their socialization, is able to bring his/her own experience and discernment to bear upon what the adults in this story have been trained not to notice or are afraid to expose. In this story, the struggle to ‘speak truth to power’ is met with an even greater effort by those in power to maintain the illusion of their superiority. The noblemen reflect our own collusion in maintaining the status quo, especially when we stand to benefit from it. Of course, our everyday experiences of power are rarely this explicit, but the need for vigilance remains. Although a detailed account of the history of critical theory is beyond the scope of this chapter and may be found elsewhere (Conquergood 1991; Wiggershaus 1994; Calhoun 1995; Bohman 2005), it is important to understand that this philosophical orientation does not constitute a unified vision but emerged from two main strands and multiple perspectives. The first strand is concerned with hermeneutics: a branch of philosophy that evolved from the study of knowledge produced via the authorized interpretation of sacred texts to the study of everyday, mutable, symbolic (i.e. gesture, sound, speech, image, text, meme) interaction in the service of social liberation (Heidegger 1962; Derrida 1974; Ricoeur 1981; Habermas 1988; Gadamer 1994). From this strand, we can surmise that language, understood as verbal and nonverbal signs and symbols, is the pool that we are swimming in as we come to ‘understand ourselves as situated in a linguistically mediated, historical culture’ (Ramberg and Gjesdal 2005). Concepts such as 146

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‘fact’ and ‘truth’ become relative to subjective, relational experience and expressed through the body. Horkheimer puts it this way: The facts which our senses present to us are socially performed in two ways: through the historical character of the object perceived and through the historical character of the perceiving organ. Both are not simply natural; they are shaped by human activity, and yet the individual perceives himself as receptive and passive in the act of perception. (1976, p. 213) The second strand is the formal articulation of critical theory that emerged from the Frankfurt School, in which thinkers such as Marcuse, Adorno, Horkheimer, Benjamin and Fromm sought to apply Karl Marx’s dialectical materialism to reveal and explain how dominant understandings (i.e. metanarratives) generated and disseminated by the ruling class misrepresented actual human interactions in the real world and functioned to justify the domination of people through capitalism and other forms of hegemony (Horkheimer and Adorno 2003). Theirs was a call to democratize ‘all conditions of social life that are controllable by human beings’ (Horkheimer 1982, pp. 249–50). When we weave these strands together, we see that the practice of critical theory involves engaging our senses in discerning discrepancies between content and form in order to actively reflect upon and remain vigilant to the historically mediated, socially constructed appearance of reality and to develop pragmatic, consensus-driven social alternatives. Otherwise put: Critical theory must meet three criteria continuously: It must be explanatory, practical, and normative; it must ‘explain what is wrong with current social reality, identify the actors to change it, and provide both clear norms for criticism and achievable practical goals for social transformation’ – a task achievable only through interdisciplinary research that includes psychological, cultural, and social dimensions, as well as institutional forms of domination. (Bohman cited in Pritchard 2014, p. 2) For example, from a critical perspective, the proliferation of the narrative that the United States is a post-racial society that has transcended its history of racism and slavery through a free market and the election of a Black president (Schorr 2008) is a manipulative myth that functions to deny ‘the very real racism that continues to operate as a daily part of American culture from the cells of our prisons to the color of our Band-aids’ (Lang 2014, p. 4). Whereas the postracial myth might generate passivity, the latter understanding makes present-day racism a collective problem necessitating collective dialogue, deliberation and action. Today, the umbrella term of ‘critical theory’ allows for multiple analyses of power relations based on intersections of class, race, ethnicity, geography, legal status, gender identity, gender expression, sexual orientation, education, religion, age and other social differences, as well as context-specific calls to action. The lack of further specificity with regard to what constitutes critical theory is actually what is thought to create room for disagreement and relevance (Kincheloe and McLaren 2000). Feminism (Brown 1994; hooks 1994; Evans et al. 2011; Sajnani 2012a, 2012b), postcolonial studies (Fanon 1963; Said 1978), indigenous studies (Tuhiwai Smith 2012; Yee 2011), critical race theory (Bell 1995; Hua, 2003; Delgado and Stefancic 2012; Sajnani 2012a), queer theory (Haraway 1989; Halperin 1990), critical disability studies (Colligan 2004; Davis 2013), gender studies (Butler 1990; Cranny-Francis et al. 2003), childhood studies (Jones 2009; Qvortrup et al. 2011) and writings on intersecting oppressions (Crenshaw 1989; Asche 147

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2004; Razack et al. 2010; Sajnani 2013) are all examples of efforts to disrupt how we are trained to perceive difference and value some lives over others, by calling attention to the historical and current processes by which people are rendered invisible or come to be imagined and treated as ‘others’: threats or victims in need of social control and/or protection or sick/abnormal and in need of healing versus normal/adjusted and healthy. In the field of mental health, critical advocates have been concerned with how mainstream psychological practices, in an attempt to explain, predict and control affect expression and behaviour at an individual level, have failed to take into account how power imbalances in society and social struggles between competing groups manifest as psychological distress and anxiety (Foucault 1988; Coppock and Hopton 2000; American Psychological Association 2002). Focusing on symptoms without acknowledging systemic and institutionalized forms of violence leads to interventions that inappropriately personalize problems. For example, DeGruy (2005), in her groundbreaking book Post Traumatic Slave Syndrome, noted that multigenerational and continued institutionalized racism, coupled with an absence of opportunities to heal or to avail oneself of the benefits of society, leads to adaptive survival strategies that include some behaviours that work against health and well-being. In particular, her research highlighted how some African Americans in the United States and in the diaspora suffer from symptoms such as anxiety, vacant esteem, a propensity for anger and violence, and internalized racism and shame about their own cultural identity. Thus, in this example, to treat the anxiety or related symptoms alone would be to miss the bigger injury – an injury necessitating public health education, advocacy and justice. A similar analysis might be applied to lesbian, gay, bisexual and queer (LGBQ),1 transgendered, gender-non-conforming, refugee and other marginalized communities who continue to seek basic civil liberties amid societies that continue to conflate aspects of identity with deviance and illness.2 Proponents of a critical orientation in the arts therapies and related caring professions advocate for the inclusion of multicultural education in training contexts, so that clinicians are better able to actively reflect on how implicit and explicit biases are expressed in their own lives and in the lives of their clients, within and beyond the therapeutic encounter. They advocate shifting our attention from the individual to society in the construction, treatment and prevention of psychopathology, and privileging transparency and shared authority in the therapeutic relationship (Hogan 1997; Allan et al. 2003; Worrell and Remer 2003; DeGruy 2005; Kaplan 2006; Toporek et al. 2006; Mayor 2010; Levine and Levine 2011; Sajnani 2012a, 2012b; Sajnani and Kaplan 2012; Whitehead-Pleaux et al. 2013; Curtis 2012; Hadley 2013; Hahna 2013). Critical perspectives are also reflected in aesthetics including visual art, literature, film, music, dance and theatre practice. This critique is characterized by an acknowledgement of how power relations influence artistic expression and circulation, a critique of the eurocentricism evident in the canon of art history, including theatre studies, reimagined relationships with audiences, an engagement with the politics of representation, participation and intervention, and reappropriations of classical forms and platforms to address contemporary concerns (Bernstein 1992; Adorno 1997; Prentki and Preston 2008). This critique has also been expressed as a shift from the democratization of culture, a political stance that assumes that ordinary people should have access to ‘high’ (i.e. valuable) art, to a true cultural democracy in which ‘vision, relevance, interpretation, and authenticity proceed from localized cultural expression rooted in a communal sense of utility, participation in art and public life’ (Little n.d.). Indeed, there is much to explore here with regard to how the postmodern, performative and affective turns in the performing arts and social sciences have created fertile ideological ground from which to consider a relationship between drama therapy and social justice (Jennings 2009; Hurley 2010; Knowles 2010, 2014; Mayor 2012; Sajnani 2012a, 2012b, 2013; Schechner 2013). 148

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To summarize, critical perspectives, although varied in scope, reflect a commitment to remain vigilant and responsive to the ‘everyday’ ways that people are ‘othered’ in discourse, decisionmaking and aesthetic practices, challenging norms that reinforce social exclusion, and promoting diversity and social justice.

Critical perspectives in drama therapy In his second volume of Drama as therapy: Clinical work and research into practice (2010), drama therapist Phil Jones argues that therapy ‘does not occur within a sealed environment’ (2010, p. 22). His edited collection provides examples of how ‘factors, such as poverty, inequality and the system of health provision relate to what occurs in the therapy room’, with who, when, why ‘and how dramatherapy relates to issues, including social justice, empowerment, and a rightsbased perspective on therapy’ (2010, p. 22). Although these perspectives have yet to be fully integrated, a survey of practice reflects an intentional attempt to grapple with dynamics of power, privilege and oppression in drama therapy. This survey is limited in that it is not an exhaustive review, but I believe that it highlights an emerging presence of a critical aesthetic paradigm in our field.3 I will begin in Scotland, where drama therapist Susan Cassidy and her colleagues from the University of Glasgow, Sue Turnbull and Andrew Gumley (2014), sought to identify metaprocesses underlying the practice of drama therapy through a grounded theory approach. Their findings, culled from an analysis of thirteen eligible studies, suggest that, when working with adults, drama therapists privilege ‘establishing safety’, ‘maintaining the playspace’, working ‘alongside’ their clients, ‘offering control and choice’, while being ‘actively involved’, working ‘without interpretation’ and in the ‘here and now’, ‘within or outwith the drama’ (p. 359). They also noted that, ‘in order to work with clients’ individual contexts [drama therapists] acknowledged a number of different factors including mental health difficulties, severity of symptoms, and wider cultural context’ (2014, p. 359). Their discourse analysis is an excellent example of needed research in the field and opens up a necessary pathway to investigate just how drama therapists integrate their clients’ ‘wider social context’ within the therapeutic encounter. Although they did not draw this conclusion, their study also seems to point to the willingness, on the part of the drama therapist, to adopt an attitude of cultural humility, which is to say that, by following the lead of their clients, they attempt to ‘maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the person’ (Hook et al. 2013, p. 2). British drama therapist and educator Anna Seymour sees possibilities in working ‘within the drama’ by extending the influence and political intentions of playwright Bertholt Brecht in our field. It was Brecht who criticized contemporary theatre practice for constraining a direct relationship between the audience and the stage, by showing ‘the structure of society (represented on stage) as incapable of being influenced by society (in the auditorium)’ (Willett 1964, p. 189). Seymour refers to Brecht’s response to this dilemma: His conception of ‘distancing’ or Verffremdungseffeckt is entirely political in its intentions. The audience must judge what is going on, on the stage. Feelings will be engaged otherwise why would we care about the play but in the end what is presented must invite scrutiny. It must ask questions. Most of all it must present stories where the outcome is not inevitable. . . . Central to Brecht’s thinking was the concept of a materialist dialectical process whereby what was done could represent opposites in tension. In aesthetic terms the highly refined 149

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and detailed physicality of a form could at the same time release the potential for individual expression because of its precision. (2010, p. 4; original emphasis) Seymour suggests that Brecht’s anti-naturalistic approach provides drama therapists with the ‘potential to apply a different theatrical vocabulary and therefore evolve different methodological approaches’ (p. 5). One such approach would involve ‘working “from the outside”, that is the social construction of reality’, so as to encourage the ‘possibility of creating a character without the expectation of having to feel for or identify with that character’ (p. 5; original emphasis). From my reading of Seymour, the practice of drama therapy from a Brechtian perspective would derive its healing potential, not from engaging with the performance space as ‘sanctified or holy’, but from an understanding that the drama offers individuals an experience of being a part of a whole – in a ‘workshop where things are put together and pulled apart, hammered and honed, “made do” to function and revisited to be lovingly crafted’ (p. 5). Here, criticism, craft and care are intertwined. Greek–Austrian drama therapist and sociologist Elektra Tselikas (2009) draws on Latour’s Actor Network Theory to posit the idea that performance is what assembles the ‘social’, a fluid entity that can only be made visible through an examination of the material traces it leaves behind in the bodies of actors and actants: objects, animals, environments, systems and technologies that inform and shape human activity and that, together, comprise the social. Like Seymour, she advocates working from the outside in and the importance of imparting an experience of possibility: Instead of looking for the feelings and having them expressed through the body, we go the other way around: we bring the body into the position required by the play and the role and the feelings will follow. . . . This is why it is so important to keep focused on the tasks rather than on the psychological states of the players. And this is why players are so often surprised about their capacity for alternative actions, expressions and feelings during the play when this happens. (Tselikas 2009, p. 21) Tselikas discusses how these approaches seem antithetical to the principles that have influenced our thinking as therapists, social workers and related mental health professionals, where: It is believed that as soon as relationships are analysed verbally and tensions have been cleared, the group will proceed to solve the given tasks without problems. What we very often observe, though, is that more often than not groups get addicted to relationship discussions, spending lots of time on those and avoiding confronting the tasks to be tackled. (Tselikas 2009, p. 21) Tselikas’ writing suggests that a critical aesthetic paradigm in drama therapy would involve a commitment to resolving the tasks presented within a dramatic frame as a means of awakening capacities in groups to consider how their actions contribute to their environments. This calls to mind the work of Augusto Boal, who, as I have previously argued, is central to the evolution of a critical aesthetic paradigm in drama therapy (Sajnani 2009). At the core of his practice was the belief that theatre can enable everyday individuals, enrolled as spectactors, to effect change in society. His Theatre of the Oppressed initiates participants in a process of re-awakening their senses to disarticulate the body from its passive historical conditioning, 150

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towards engaging participants in a process of embodied reasoning through the creation and deconstruction of physical images and scenes (Boal 1979). Building on the work of Brecht, who focused on stimulating the critical faculties of his audiences, Boal urged audiences to move their thoughts into action upon the stage. He writes: The poetics of the oppressed is essentially a poetics of liberation: the spectator no longer delegates power to the characters either to think or to act in his place. The spectator frees himself; he thinks and acts for himself! Theatre is action! Perhaps the theatre is not revolutionary in itself; but have no doubts, it is a rehearsal of revolution! (1979, p. 155; original emphasis) Chen Alon co-teaches autobiographical performance in a drama-therapy programme at Tel Hai University, Israel, and is also an applied theatre practitioner with Combatants for Peace, a joint movement by Palestinians and Israelis who have ‘decided to put down [their] guns, and to fight for peace’ (cfpeace.org). He shared his observations about the apprehension that some drama therapy educators seem to have about incorporating Boalian techniques into their curricula, claiming that it addresses political rather than psychological aims (personal communication, June 2014). His work reveals a conscious effort to intertwine the personal with the political and the professional. Drama therapist Ben Rivers (2013) embodies this ethic in his work with the Freedom Bus, an initiative of the Freedom Theatre, a theatre and cultural centre based in Jenin Refugee Camp. The Freedom Bus ‘utilizes Playback Theatre and cultural activism to bear witness, raise awareness and build alliances throughout occupied Palestine and beyond’ (freedombuspalestine.wordpress.com). What is important to note about Rivers’ work is his focus on place and his call to see justice as a part of healing: As recognized by virtually all trauma specialists, a fundamental precondition for effective recovery includes the establishment of an environment that is relatively safe and free from the perpetrating influence – a requirement that is far from the current reality in Palestine. In addition to the cessation of organized violence, the experience of justice is also crucial to the healing journey. When ‘justice needs’ are met, the oppressed population can finally sever the psychological stranglehold of shame and helplessness, and move more readily towards feelings of personal power and collective dignity. . . . One might say, then, that until the bare demands for freedom, justice and equality have been met, the therapeutic endeavour will always be partial and incomplete. (Rivers 2013, p. 173) My recent work with Kim Jewers-Dailley, Ann Brillante, Judy Puglisi and David R. Johnson, among others (Sajnani and Johnson 2014), shares a similar commitment to acknowledging and addressing perpetrating influences from a systemic perspective with a view towards public health and local development. Animating Learning by Integrating and Validating Experience (ALIVE) in New Haven, USA, brings together Freirean critical pedagogy, which assumes the primacy of students’ lived experiences, a Boalian emphasis on artful, community-engaged activism and David Read Johnson’s trauma-centred Developmental Transformations (DvTs), which involve direct enquiry about past and present stressful life experiences and mutually agreedupon, imaginative, relational play. ALIVE assumes a broad understanding of violence as involving intersecting forms of historical and systemic oppression (slavery, racism, classism, sexism, ageism, homophobia, etc.), interpersonal violence and internalized distress. Core ideas in this programme include: (1) an understanding that health and healing are connected to disrupting 151

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oppressive dynamics of power and control that contribute to a culture of silence about abuse; (2) that drama therapists can be effective along a continuum of practice, from direct clinical care to psycho-education and advocacy; and (3) change takes time, flexibility and a willingness to work in partnership with students, parents, teachers, administrators, city officials and state policymakers. Bermudian drama therapist Christine Mayor, together with Canadian studies scholar Stephanie Dotto, also draws on Boalian techniques among other approaches in the De-Railed Theatre Collective, which they describe as: An ongoing youth theatre project in one of Toronto’s priority neighborhoods [that] uses drama therapy techniques to challenge traditional narratives of Canada, address often invalidated personal and traumatic stories, and provide opportunity for self-expression among young Torontonians who find their stories or neighborhoods left off the map of official Canadian history. (Mayor and Dotto 2014, p. 306) ALIVE and the De-Railed Theatre Collective illustrate how drama therapists consider an analysis of social inequity as necessary to a fuller understanding of suffering, and both attempt to disrupt oppressive dynamics by creating pathways for participants to tell their own stories and to connect these stories to meaningful, relevant programming and policy development. Mayor also observes how ‘our assumptions about race and the process of othering are crucial in the therapeutic relationship’ (2012, p. 214; original emphasis). Her review of literature pertaining to race in the arts therapies reveals that, ‘existing writing often problematically includes essentialist discourse, colour-blind statements, unqualified suggestions that the arts transcend difference, or “how to” instructions for working with particular racialized groups’ (p. 214). She discusses how the specific use of drama therapy, specifically Johnson’s DvTs, may be used to disrupt dominant narratives about race by reconceptualizing race as ‘roles that are produced and performed, embodied and created in the encounter’ (2012, p. 214). American drama therapist Fred Landers also draws on DvTs in his approach to disrupting constraining notions of masculinity (2002). He positions the drama therapist as having a role to play in treating both individual and social violence: If indeed the playspace in drama therapy has the potential to reduce men’s violence by allowing men to express violent impulses and play with the roles of perpetrator and victim within the safety of the imaginary realm, then conditions of the playspace may offer a means not only to treat individual men’s violence, but also to dismantle violent forms of masculinity. (2002, p. 28) He takes this a step further when he considers neo-liberalism as the target illness of his Urban Play, an intervention that involves ‘the use of DvT in public places as a form of activism’ (2009, p. 201). Drama therapist Armand Volkas, who identifies as Jewish, Jewish–American, American, French and the son of Polish and Lithuanian Jewish Holocaust survivors and resistance fighters (Volkas 2003), positions his work as a drama therapist as a form of activism and social change. His ‘Healing the wounds of history’ (HWH) draws on dramatic techniques drawn from psychodrama, Playback Theatre and sociodrama, among other forms, to work through the psychological tasks associated with groups that share a historical legacy of conflict. These include ‘breaking the taboo against 152

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speaking to each other, humanizing each other, exploring and owning the potential perpetrator in all of us, moving deeply into grief, [and] integration through performance and rituals of remembrance’ (2014, p. 47). Volkas explains: The HWH process is organized around how people feel about their culture and its history and how these feelings affect their identity, self-esteem and psychological wellbeing. . . . What do the descendants of perpetrators and victims feel about their collective trauma? How do they carry it in their psyches, and what do they need emotionally from themselves and from each other to transform this trauma? I believe that these considerations are too often overlooked when searching for diplomatic and political solutions to intercultural conflict. (2014, p. 43) By uncovering the emotional terrain of intercultural conflict, Volkas aims to disrupt the repetition of collective violence and impart a sense of shared responsibility for reconciliation. In a similar vein, Native Hawaiian drama therapist Rachel Lee Soon asks drama therapists to consider how ‘we conceptualize the power dynamics present in the therapeutic encounter from a post-colonial paradigm and how is this applicable to the ethics and practice of drama therapy?’ (2014, p. 10). By deconstructing the roles of therapist and client and integrating her Native Hawaiian heritage with drama therapy techniques drawn from role theory (Landy 2009) and DvT (Johnson 2009), Lee Soon advocates for an increased awareness of how historical trauma influences practice. South African drama therapist Sinethemba Makanya also grapples with a history of colonization as she seeks to create a ‘dialogue between the Western world and the indigenous African world’, being careful to note that the latter ‘can no longer be exploited for western gain’ (2014, p. 305). Like Lee Soon, she writes of mobilizing her own indigenous knowledge to question notions of health, illness and community in a quest to articulate for herself, as a drama therapist trained in America and exposed to a Western canon, what a distinctly South African drama therapy might look like. Also relevant to this discussion is the work of American drama therapist Maria Hodermarska, who undertakes a deeply personal investigation to problematize the social construction of disability. In her clinical commentary about her son, ‘who functions somewhere on the autism spectrum’ and uses drama ‘as a self-therapy to raise and examine questions about his identity’ (2013, p. 64), Hodermarska works against the patronizing discourse that often surrounds disabilities: I love that David (pseudonym) considers identity to be a ‘project’, a course of study, an experiment. Perhaps, it is his disability that affords him the postmodern ability to see identity as a construction, like a scaffold, a role system, and not as an essence. It is for him an autoethographic process to ‘use the self to learn about the other’ and to use the other to learn about the self. (2013, p. 70) Here, Hodermarska’s work reflects Jones’ thoughts on connecting social attitudes with policy and the provision of health-care services: The patronising or hostile treatment of disabled people in society comes from deeply embedded ideologies . . . that disability is a personal tragedy and that individuals are afflicted by disabilities. In this way society denies responsibility for the conditions in which disabled 153

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people live. Disabled children have been historically segregated and isolated in separate schools and institutions. (Moss, cited in Jones 2010, p. 22) Addressing the historical and current practice of segregating people who are thought to be inferior or dangerous is also at the heart of Lebanese drama therapist Zeina Daccache’s performance praxis. Daccache has been working with male and female prisoners to create personally and politically compelling performances that ‘hold up a mirror to Lebanese society implicating all of us in oppression that often leads to crime’ (catharsislcdt.org). What is relevant about her work is that, like Lee Soon and Makanya, she draws on Lebanese cultural expression to contextualize her use of drama therapy and, like Rivers, she situates justice as a central part of healing. Although best practices in therapeutic theatre often call for the audience to be composed of compassionate friends and family (Bailey 2009), Daccache extends the invitation to the lawyers and judges responsible for the adjudication of each prisoner’s case. For example, following the performance of Scheherazade in Baabda, at least six women’s cases received attention resulting in their release from prison (personal communication, November 2014). Daccache extended the benefits of therapeutic theatre by video-documenting the process. The women who were released now host each screening of the resulting documentary film entitled Scheherazade’s Diary. In so doing, they embody a move from prisoner to educator and advocate for women’s rights and the realities of patriarchy as expressed through the prison industrial complex. Incidentally, Scheherazade’s Diary opened to critical acclaim in mainstream cinemas across Lebanon in November 2014.

A critical aesthetic paradigm The prevalence of social exclusion and its interference with mental health requires a vision of drama therapy that can articulate social justice as necessary to healing. To this end, I surveyed literature that clarified various tenets of critical theory and brought these into conversation with the practices of a small, geographically and otherwise diverse sample of drama therapists. What I discovered in the process is that, like critical theory, we are not left with a singular prescription for practice but a variety of perspectives on how drama therapists draw on their skills to attune to issues relating to power and social inequality. What they appear to share in common is an acknowledgement that an analysis of power is critical to the process of empowerment. They also share a commitment to aesthetic processes, theories and techniques drawn from drama and theatre. From my perspective, this reinforces the sine qua non of drama therapy, which assumes that dramatic reality is the crucible of change. Where they differ is in their emphasis on dramatic versus psychological tasks or what Cassidy et al. (2014) referred to as working within or outwith the drama. Similarly, they differ in the degree to which they emphasize the body in practice. They also appear to differ in the degree to which they intentionally enquire about and seek to address the experience of oppression and injustice in the lives of those they work with. Finally, they differ in their emphasis on direct clinical care, psycho-education, public health, advocacy and direct action. Not surprisingly, these differences reflect tensions in the dominant narratives surrounding mental health care at the moment, which include an emphasis on the mind over the body, cognition over emotion, the present over the past, brief pharmaceutical intervention over long-term, relational treatment, and an emphasis on symptom reduction rather than social change (Johnson and Emunah 2009; Sajnani and Johnson 2014). We need to advance ideas that are already present in the field that challenge us to work with and against these currents towards practices that can respond to the crises of our times. For 154

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example, drawing on Buber (1970), Casson (2004), Grainger (1990), Landy (1994), Seigal (2005) and Pitruzzella (2007), among others, Jones surmises that ‘aesthetic distance and meaning-making is the philosophical and practical heart of drama and drama therapy: I am not the other, but with the other’ (2008, p. 231). Implicit in this statement is a recognition that the intimate work that we do with individuals and groups is predicated on an understanding of the self that is ‘formed through relationship with expression and connection with others’ (p. 231). What I read in this articulation of drama therapy is an opportunity to view the challenge of co-existence through this relational lens and to draw on our skill with aesthetic distance and meaning-making to extend circles of compassion and solidarity and to mobilize action where warranted. Further research is needed to explore the value of a critical aesthetic paradigm in dramatherapy training, research and practice. Discourse analyses of accounts of therapy with specific attention to how drama therapists engage with the wider cultural contexts of their clients would aid this effort. We also need theoretical research into how critical aesthetic practices such as those developed by critical/feminist theatre scholars and playwrights might be more fully integrated in drama therapy. Finally, we would benefit from spaces to engage in ongoing conversation about these ideas. Perhaps this is where I find the greatest evidence for the presence of this paradigm already at work in our field. Between 2014 and 2015, the British Association of Dramatherapists, the North American Drama Therapy Association (NADTA), the German Association for Dramatherapists, and the European Consortium for Arts Therapies Education each dedicated their annual conference to an exploration of identity, borders, diversity, culture, social justice and related topics. Here is an excerpt from the call for papers from the 36th annual NADTA conference, which I believe reflects the spirit of a critical aesthetic paradigm in our field: The action methods embedded in drama and improvisation have much to offer the field of social justice. What are the mechanisms through which we express and work through the strong affects of shame, guilt, anger, and fear that may emerge? As drama therapists, how can we use embodiment, metaphor, tele, expression, transformation, roles, and containment as strategies for creating a space for encounter, reflection, and performance of change? In what ways could we begin to adjust our ethics, approaches, and expectations to transform our roles to that of allies or advocates? How do the arts allow for richer expression of harm and greater possibilities for hope? (North American Drama Therapy Association, n.d.) To borrow a phrase from Karl Marx, ‘philosophers have interpreted the world in various ways – the point is to change it’ (Marx 1845). A critical aesthetic paradigm in drama therapy offers a framework within which we might understand social justice as a valuable goal. We can then mobilize our skills as artists, therapists and scholars towards noticing, embodying and transforming the presence and impact of social inequality on our bodies and minds, our relationships and the lives of others.

Notes 1

2

Sometimes this acronym is written LGBTQ to include transgendered communities. I have elected to separate these two for the sake of clarity in this chapter, as sexual orientation, gender identity and gender expression are not the same thing. Although the civil rights movement and the movement to recognize the humanity and protect the dignity of LGBQ and gender non-conforming individuals share some similarities, it is important to acknowledge how ‘passing’ might mitigate the effects of oppression. ‘Passing’ refers to protecting oneself 155

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against prejudice by availing oneself of the benefits of the dominant group. Thus, some people who are lesbian or gay, for example, may be able to pass as straight where needed, whereas a person of colour may not necessarily avail themselves of the same protection – they cannot easily ‘pass’ for White. This phenomenon becomes increasingly complex when one takes into account the experience of intersecting identities (e.g. being Black and gay), oppressions and forms of privilege. This survey of practice is limited to the work of colleagues whose work I am somewhat familiar with. There are undoubtedly many more examples in our field.

References Adorno, T. (1997) Aesthetic Theory (trans. R. Hullot-Kentor). Minneapolis, MN: University of Minnesota Press. Allan, J., Pease, B. and Briskman, L. (eds) (2003) Critical Social Work: An introduction to theories and practices. Crows Nest, Australia: Allen & Unwin. American Psychological Association. (2002) Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists. Online. Available at: www.apa.org/pi/oema/resources/ policy/multicultural-guidelines.aspx (accessed 5 February 2016). Asche, A. (2004) ‘Critical race theory, feminism and disability: Reflections on social justice and personal identity’, in Smith, B. G. and Hutchison, B. (eds), Gendering Disability, pp. 9–44. New Brunswick, NJ: Rutgers University Press. Bailey, S. (2009) ‘Performance in drama therapy’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy, pp. 374–89. Springfield, IL: Charles C. Thomas. Bell, D. (1995) ‘Who’s afraid of critical race theory?’, University of Illinois Law Review, pp. 893–910. Bernstein, J. M. (1992) The Fate of Art: Aesthetic alienation from Kant to Derrida and Adorno. University Park, PA: Pennsylvania State University Press. Boal, A. (1979) Theatre of the Oppressed. New York: Urizen Books. Bohman, J. (2005) ‘Critical theory’, in Stanford Encyclopedia of Philosophy. Online. Available at: http://plato.stanford.edu/entries/critical-theory/ (accessed 5 February 2016). Brown, L. S. (1994) Subversive Dialogues. New York: Basic Books. Buber, M. (1970) I and Thou. Edinburgh, Scotland: T&T Clark. Butler, J. (1990) Gender Trouble: Feminism and the subversion of identity. New York: Routledge. Calhoun, C. (1995) Critical Social Theory: Culture, history, and the challenge of difference. Oxford, UK: Blackwell. Cassidy, S., Turnbull, S. and Gumley A. (2014) ‘Exploring core processes facilitating therapeutic change in Dramatherapy: A grounded theory analysis of published case studies’, The Arts in Psychotherapy, 41, 353–65. Casson, J. (2004) Drama, Psychotherapy and Psychosis. London: Routledge. Colligan, S. (2004) ‘Why the intersexed shouldn’t be fixed: Insights from queer theory and disability studies’, in Smith, B. G. and Hutchison B. (eds), Gendering Disability, pp. 45–60. New Brunswick, NJ: Rutgers University Press. Conquergood, D. (1991) ‘Rethinking ethnography: Towards a critical cultural politics’, Communication Monographs, 58, 2, 179–94. Coppock, V. and Hopton, J. (2000) Critical Perspectives on Mental Health. London: Routledge. Cranny-Francis, A., Waring, W., Stavropolous, P. and Kirkby, J. (2003) Gender Studies: Terms and debates. London: Palgrave Macmillan. Crenshaw, K. (1989) ‘Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics’, University of Chicago Legal Forum, 1, 139–67. Curtis, S. L. (2012) ‘Music therapy and social justice: A personal journey’, The Arts in Psychotherapy, 39, 3, 209–13. Davis, L. (2013) The Disability Studies Reader. New York: Routledge. DeGruy, J. (2005) Post Traumatic Slave Syndrome: America’s legacy of enduring injury and healing. Portland, OR: Uptone Press. Delgado, R. and Stefancic, J. (2012) Critical Race Theory: An introduction (2nd edn). New York: New York University Press. Derrida, J. (1974) Of Grammatology (trans. G. C. Spivak). Baltimore, MD: Johns Hopkins University Press. Emunah, R. (1994) Acting for Real: Drama therapy process, technique, and performance. New York: Brunner/Mazel. 156

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Evans, K., Kincade, E. and Seem, S. (2011) Introduction to Feminist Therapy: Strategies for social and individual change. Thousand Oaks, CA: Sage. Fanon, F. (1963) The Wretched of the Earth. New York: Grove Press. Foucault, M. (1988) Madness and Civilization: A history of insanity in the age of reason. New York: Vintage. The Freedom Bus. (n.d.). Available at: https://freedombuspalestine.wordpress.com/freedom-ride-2/ (accessed 18 February 2016). Gadamer, H. G. (1994) Literature and Philosophy in Dialogue. Albany, NY: State University of New York Press. Grainger, R. (1990) Drama and Healing. London: Jessica Kingsley. Habermas, J. (1988) Inclusion of the Other: Studies in political theory. Cambridge, MA: MIT Press. Hadley, S. (2013) ‘Dominant narratives: Complicity and the need for vigilance in the creative arts therapies’, The Arts in Psychotherapy, 40, 4, 373–81. Hahna, N. (2013) ‘Towards an emancipatory practice: Incorporating feminist pedagogy in the creative arts therapies’, The Arts in Psychotherapy, 40, 4, 436–40. Halperin, D. (1990) One Hundred Years of Homosexuality and Other Essays on Greek Love. New York: Routledge. Hans Christian Andersen Center. (n.d.) Hans Christian Anderson: The emperor’s new clothes. Online. Available at: www.andersen.sdu.dk/vaerk/hersholt/TheEmperorsNewClothes_e.html Haraway, D. (1989) ‘The biopolitics of postmodern bodies: Determinations of self in immune system discourse’, Differences: A Journal of Feminist Cultural Studies, 1, 1, 3–43. Heidegger, M. (1962) Being and Time (trans. J. Macquarrie and E. Robinson). San Francisco, CA: Harper. Hodermarska, M. (2013) ‘Autism as performance’, Dramatherapy, 35, 1, 64–76. Hogan, S. (1997) Feminist Approaches to Art Therapy. New York: Routledge. Hook, J. N., Davis, D. E., Owen, J., Worthington Jr., E. L. and Utsey, S. O. (2013) ‘Cultural humility: Measuring openness to culturally diverse clients’, Journal of Counseling Psychology, doi:10.1037/a0032595 hooks, b. (1994) Teaching to Transgress: Educating as the practice of freedom. New York: Routledge. Horkheimer, M. (1976) ‘Traditional and critical theory’, in Connerton, P. (ed.), Critical Sociology: Selected readings, pp. 206–24. Harmondsworth, UK: Penguin. Horkheimer, M. (1982) Critical Theory. New York: Seabury Press. Horkheimer, M. and Adorno, T. (2003) Dialectic of Enlightenment (trans. E. Jephcott). Stanford, CA: Stanford University Press. Hua, A. (2003) ‘Critical race feminism’, Canadian Critical Race Conference: Pedagogy, and practice. University of British Columbia, Vancouver, BC. Hurley, E. (2010) Theatre and Feeling. London: Palgrave Macmillan. Jennings, S. (ed.) (2009) Dramatherapy and Social Theatre: Necessary dialogues. Hove, UK: Routledge. Jennings, S., Cattanach, A., Mitchell, S., Chesner, A. and Meldrum, B. (eds) (1994) The Handbook of Dramatherapy. London: Routledge. Johnson, D. R. (2009) ‘Developmental transformations: Towards the body as presence’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy, pp. 89–116. Springfield, IL: Charles C. Thomas. Johnson, D. R. and Emunah, R. (2009) Current Approaches in Drama Therapy. Springfield, IL: Charles C. Thomas. Johnson, D. R. and Sajnani, N. (2015) ‘Developmental transformations and social justice’, A Chest of Broken Toys: The Journal of Developmental Transformations, 1, 1, 57–80. Jones, P. (2008) ‘The active self: Drama therapy and philosophy’, The Arts in Psychotherapy, 35, 3, 224–31. Jones, P. (2009) Rethinking Childhood: Attitudes in contemporary society. London: Bloomsbury. Jones, P. (ed.) (2010) Drama as Therapy Volume 2: Clinical work and research into practice. Hove, UK: Routledge. Kaplan, F. (2006) Art Therapy and Social Action. London: Jessica Kingsley. Kincheloe, J. L. and McLaren, P. (2000) ‘Rethinking critical theory and qualitative research’, in Denzin, N. K. and Lincoln, Y. S. (eds), Handbook of Qualitative Research, pp. 279–313. Thousand Oaks, CA: Sage. Knowles, J. (2010) Theatre and Interculturalism. London: Palgrave Macmillan. Knowles, J. (2014) How Theatre Means. London: Palgrave Macmillan. Landers, F. (2002) ‘Dismantling violent forms of masculinity through developmental transformations’, The Arts in Psychotherapy, 29, 1, 19–29. Landers, F. (2009) ‘Urban Play: Imaginatively responsive behavior as an alternative to neoliberalism’, The Arts in Psychotherapy, 39, 201–5. 157

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Landy, R. (1994) Drama Therapy: Concepts, theories and practices. Springfield, IL: Charles C. Thomas. Landy, R. (2009) ‘Role theory and the role method of drama therapy’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy, pp. 65–88. Springfield, IL: Charles C. Thomas. Lang, N. (2014) ‘It’s time to wake up from the myth of a post-racial America’, The Daily Dot. Online. Available at: www.dailydot.com/opinion/ferguson-michael-brown-post-racial-myth/ (accessed 5 February 2016). Lee Soon, R. (2014) Nohona i Waena i na¯ Mo’olelo (Living between the stories): Situating the practice and ethics of drama therapy within a historical narrative of colonialism. Unpublished Master’s thesis, New York University. Levine, E. and Levine, S. (2011) Art in Action: Expressive arts therapy and social change. London: Jessica Kingsley. Little, E. (n.d) Towards an aesthetics of community-based theatre: Part II Avoiding the missionary position. Online. Available at: www.thismaddesire.com/Community_Engaged_Theatre/Ted%20Little%20article.pdf Makanya, S. (2014) ‘The missing links: A South African perspective on the theories of health in drama therapy’, The Arts in Psychotherapy, 41, 3, 302–6. Marx, K. (1845) Feuerbach: Opposition of the materialist and idealist outlook. Online. Available at: www.marxists.org/archive/marx/works/1845/german-ideology/ch01b.htm (accessed 5 February 2016). Mayor, C. (2010) ‘Contact zones: The ethics of playing with “the other”’, Poiesis: A Journal of the Arts & Communication, 12, 82–90. Mayor, C. (2012) ‘Playing with race: A framework and approach for creative arts therapists’, The Arts in Psychotherapy, 39, 3, 214–19. Mayor, C. and Dotto, S. (2014) ‘De-railing history: Trauma stories off the track’, in Sajnani, N. and Johnson, D. R. (eds), Trauma-Informed Drama Therapy: Transforming clinics, classrooms, and communities, pp. 306–28. Springfield, IL: Charles C. Thomas. North American Drama Therapy Association. (n.d.) Magnetic forces: Working with attraction and aversion to difference and social justice. Online. Available at: www.nadta.org/about-nadta/nadta-news/2015_ Conference_CfP.html (accessed 5 February 2016). Oxford Dictionary (n.d) Critical. Online. Available at: www.oxforddictionaries.com/definition/english/critical (accessed 5 February 2016). Pitruzzella, S. (2007) ‘Dramatic identity: The challenge of complexity’, Dramatherapy, 28, 3, 21–25. Prentki, T. and Preston, S. (2008) The Applied Theatre Reader. New York: Routledge. Pritchard, S. (2014) Critical theory. Online. Available at: https://colouringinculture.wordpress.com/ 2014/05/23/critical-theory/ (accessed 5 February 2016). Qvortrup, J., Corsaro, W. and Honig, S. (2011) The Palgrave Handbook of Childhood Studies. London: Palgrave Macmillan. Ramberg, B. and Gjesdal, K. (2005) ‘Hermeneutics’, in Stanford Encyclopedia of Philosophy. Online. Available at: http://plato.stanford.edu/entries/hermeneutics/ (accessed 5 February 2016). Razack, S., Smith, M. and Thobani, S. (2010) Critical Race Feminism for the 21st Century. Toronto, ON: Between the Lines Press. Ricoeur, P. (1981) Hermeneutics and the Human Sciences: Essays on language, action and interpretation (trans. J. B. Thompson). Cambridge, UK: Cambridge University Press. Rivers, B. (2013) ‘Playback theatre as a response to the impact of political violence under occupied Palestine’, Applied Theatre Research, 1, 2, 157–76. Said, E. (1978) Orientalism. New York: Pantheon. Sajnani, N. (2003) ‘The body politic: Four conversations on gender and the nation’, Graduate Researcher: Interdisciplinary Journal, 1, 1, 9–18. Sajnani, N. (2004) ‘Strategic narratives: The embodiment of minority discourse in biographical performance’, Canadian Theatre Review, 117, 33–7. Sajnani, N. (2009) ‘Theatre of the oppressed: Drama therapy as cultural dialogue’, In Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy, pp. 189–207. Springfield, IL: Charles C. Thomas. Sajnani, N. (2012a) ‘Response/ability: Towards a critical race feminist paradigm for the creative arts therapies’, The Arts in Psychotherapy, 39, 3, 186–91. Sajnani, N. (2012b) ‘The implicated witness: Towards a relational aesthetic in drama therapy’, Dramatherapy: Journal of the British Association of Dramatherapists, 34, 1, 6–21. Sajnani, N. (2013) ‘The body politic: The relevance of an intersectional framework for therapeutic performance research in drama therapy’, The Arts in Psychotherapy, 40, 4, 382–5. 158

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Sajnani, N. (2015) ‘Reflection-in-action: An argument for arts based practice as research in drama therapy’, in Hougham, R., Pitruzella, S. and Scoble, S., (eds), Through the Looking Glass: Dimensions of reflection in the arts therapies. Plymouth, UK: Plymouth Press. Sajnani, N. and Johnson, D. R. (2014) Trauma Informed Drama Therapy: Transforming clinics, classrooms, and communities. Springfield, IL: Charles C. Thomas. Sajnani, N. and Kaplan, F. (2012) ‘The creative arts therapies and social justice’, The Arts in Psychotherapy, 39, 3, 165–7. Sajnani, N. and Nadeau, D. (2006) ‘Creating safer spaces with immigrant women of color: Performing the politics of possibility’, Canadian Woman Studies, 25, 1–2, 45–53. Schechner, R. (2013) Performance Studies: An introduction. London: Routledge. Schorr, D. (2008) ‘A new “post-racial” political era in America’, National Public Radio. Online. Available at: www.npr.org/templates/story/story.php?storyId=18489466 (accessed 5 February 2016). Seigal, J. (2005) The Idea of Self. Cambridge, UK: Cambridge University Press. Seymour, A. (2010) ‘Brecht’s anti-naturalism in the service of drama therapy’, Dramatherapy: Journal of the British Association for Dramatherapists, 32, 1, 3–7. Toporek, R. L., Gerstein, L. H., Fouad, N. A., Roysircar, G. S. and Israel, T. (2006). Handbook for Social Justice in Counseling Psychology: Leadership, vision, and action. Thousand Oaks, CA: Sage. Tselikas, E. (2009) ‘Social theatre: Trusting the art’, in Jennings, S. (ed.), Dramatherapy and Social Theatre: Necessary dialogues, pp. 15–26. Hove, UK: Routledge. Tuhiwai Smith, L. (2012) Decolonizing Methodologies: Research and indigenous peoples. New York: Zed Books. Volkas, A. (2003) ‘Armand Volkas keynote address’, Dramascope: The Newsletter of the National Association for Drama Therapy, 23, 1, 6–9. Volkas, A. (2014) ‘Drama therapy in the repair of collective trauma’, in Sajnani, N. and Johnson, D. R. (eds), Trauma-Informed Drama Therapy: Transforming clinics, classrooms, and communities, pp. 41–67. Springfield, IL: Charles C. Thomas. Wallace, D. F. (2008) Plain old untrendy troubles and emotions. Online. Available at: www.theguardian.com/ books/2008/sep/20/fiction (accessed 5 February 2016). Whitehead-Pleaux, A., Donnenwerth, A. M., Robinson, B., Hardy, S., Oswanski, L. G., Forinash, M., Hearne, M. C., Anderson, N. and Tan, X. (2013) ‘Music therapists’ attitudes and actions regarding the LGBTQ community: A preliminary report’, The Arts in Psychotherapy, 40, 4, 409–14. Wiggershaus, R. (1994) The Frankfurt School. Cambridge, MA: MIT Press. Willett, J. (1964) Brecht on Theatre: The development of an aesthetic. New York: Hill & Wang. Worrell, J. and Remer, P. (2003) Feminist Perspectives in Therapy: Empowering diverse women (2nd edn). Hoboken, NJ: Wiley. Yee, J. (2011) Feminism for Real: Deconstructing the academic industrial complex of feminism. Ottawa, ON: Canadian Center for Policy Alternatives.

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16 Dramatherapy and theatre Current interdisciplinary discourses Clive Holmwood

This chapter seeks to update current thinking around the interdisciplinary connections between dramatherapy and theatre, by re-examining some of the great theatrical innovators and looking at current literature that connects theatrical approaches to dramatherapy. This includes acknowledging the original impact of such writers as Aristotle and the place of ‘catharsis’ (McLeish 1999) in a theatrical as well as therapeutic context. I will also examine other theatrical innovators on a continuum from the internal ‘emotion memory’ of Stanislavski (1980) through to a more overt, objective perspective considering the work of Brecht (Willett 1984) and Boal (1992) and their impact upon dramatherapy theory, thinking and training. I shall acknowledge current writings on the interdisciplinary fields of theatre, therapeutic theatre and dramatherapy. I shall also report on findings from a very brief quantitative/qualitative survey that examines theatrical innovators and their impact upon current dramatherapy trainers, their original training and current training courses they teach. I myself currently lecture at the University of Derby. In conclusion, I shall briefly consider current trends such as the neuro-developmental approaches to dramatherapy and the impact this has upon current and future practice. I will finally conclude with a keyword analysis of the literature in relation to theatrical innovators.

Introduction According to a previous survey I carried out, which asked qualified dramatherapists about their undergraduate training, 40 per cent of them had studied drama/theatre at undergraduate level (Holmwood 2014, p. 73). Much smaller percentages of people had come from medical/health backgrounds: psychology, 18 per cent; and nursing and occupational therapy, 3 per cent. This appears to indicate that, despite the historical changes to dramatherapy over the last 30 years, fitting into a more medical model aligned with the Health and Care Professions Council (HCPC, for registration in the UK), a considerable number of dramatherapists come from drama and theatre backgrounds. For someone who identifies with this majority myself, having studied drama at undergraduate level and then educational theatre at Master’s level, I am particularly interested in how dramatherapists utilise their skills and knowledge from their undergraduate/ theatre/drama training in their present therapy practice. How much do some of the great theatrical innovators, Aristotle, Stanislavski and Brecht, play a role in the day-to-day practice and praxis 160

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of dramatherapists and their training? Additionally, how does the work of more modern theatrical innovators such as Boal fit into this? Valante and Fontana (1993, p. 56) carried out some quantitative studies among leading dramatherapists of the time to find out current implications for training. ‘Listening’ topped a list of eighteen hierarchy skills (p. 59), and self-insight topped a list of eighteen personal qualities required by the therapist. Theories of theatre and educational drama came twelfth and thirteenth out of a list of twenty-eight hierarchies of theoretical influences on dramatherapists (p. 62). Group dynamics came first, followed by psychotherapy second and theories of play third. However, out of a table of eighteen ‘Hierarchy of authorities relevant to the understanding of dramatherapy’, Jung is first, Stanislavski comes fourth, Peter Brook fifth and Brecht comes ninth.1 It seems interesting that drama and educational-theatre practitioners come part way down the list and not at the top. The authors also state: The emphasis given to Jung and Freud brings face to face with a further consideration, namely to what extent can trainee dramatherapists be given true insight into the work of such profound thinkers. Both Jung and Freud were voluminous writers (the collected works of each run to over 20 large volumes), and there is a risk that students may obtain only a superficial grasp of their psychological theories and therapeutic practices. (Valante and Fontana 1993, p. 64) Although I in no way disagree with the facts of this statement, it appears to suggest that greater weight here (in 1993) at least appears to be given to psychoanalytic/psychotherapeutic writers. Indeed, the works of Stanislavski, Brecht and Aristotle could be described as being equally ‘voluminous’, especially Stanislavski’s major works. This also seems to contradict the initial idea of dramatherapists being both ‘artist and therapist’, as originally conceived by Sue Jennings in 1977, as discussed by Alida Gersie in Chapter 8 of this International Handbook. There would appear then to be a greater bias towards psychotherapies, in at least the discussion of the above quantitative studies, written two decades ago, with no reference to the position that Stanislavski came, in fourth place, and Aristotle not appearing at all.

Catharsis and Aristotle: An ongoing debate The position of catharsis (McLeish 1999), as originally discussed by Aristotle as a form of purging of the soul, continues to be a debate within the worlds of theatre, drama and specifically dramatherapy. I have already debated this issue within a dramatherapy/theatre context (Holmwood 2014, p. 21). However, I feel the significance and centrality of this are due to Aristotle’s wider concern in developing further his critical arguments on ‘dramatic art’ that gives greater credence to theatre, drama and dramatherapy. The North American Dramatherapy Association uses the word ‘catharsis’ in its description of dramatherapy, stating: ‘Drama therapy is active and experiential. This approach can provide the context for participants to tell their stories, set goals and solve problems, express feelings, or achieve catharsis’.2 The British Association of Dramatherapists refers to dramatherapy in its description as being ‘a form of psychological therapy’3 and avoids the word catharsis altogether in its official description. There has been much debate about catharsis and its true meaning and also the reticence of some academics, scholars and practitioners to use the word more widely. Winston, in his article ‘Emotion, reason and moral engagement in drama’, states: 161

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Aristotelian theatre stands condemned for its oppressive or coercive use of emotion, principally through the process of catharsis, because it prevents rational thinking and obfuscates moral understanding. This conclusion, however, hinges upon two assumptions, both of which are debatable: that there is a stable, agreed definition of catharsis, despite the fact that this has eluded scholars for centuries; and that there is a strong dichotomy between emotion and rationality, with rational cognition being the qualitatively superior of the two. (Winston 1996, p. 191) The very emotiveness of the word itself suggests it could have no use in rational thought, and yet Winston argues whether ‘rational cognition’ should be greater than ‘emotion and rationality’. Duggan and Grainger suggest ‘emotion that is purged by encounter promotes encounter’ (1997, p. 72), thus suggesting a degree of reflexivity is possible during emotive cathartic experiences. They go on to suggest that: The experience of catharsis only takes place where there is an intention of self-giving, a sympathetic impulse of encounter and involvement directed towards another person. . . . This cathartic art, the art of staged meetings and artificially induced encounters, promotes relationship because it is an artificial arrangement of ideas and things which expresses and embodies our human need to give and receive, ceaselessly to rediscover our own true being in an exchange of life. (1997, p. 72) Thus Winston, Duggan and Grainger appear to agree in one key area that, just because catharsis deals with emotive experiences, it does not negate relationship or rational thought and discussion; indeed, within the context of the ‘artificial arrangement’, it helps to somehow amplify thought and discussion. Therefore, a more general misconception that catharsis is somehow unhelpful because it deals with pure and raw emotion without cognition needs to be re-examined. Indeed, I would suggest that, within the art form of drama, there is time and place for emotion, discussion and rational thought. In a dramatherapy context, the therapist can provide empathy and distancing (Jones 1996) to assist with this clarity of emotion, thought and discourse.

Stanislavski and Brecht To continue this dichotomy around empathy and distancing within theatre, drama and indeed dramatherapy, it is helpful to examine the work of Stanislavski and Brecht, who are usually presented as being ideologically opposed in both practice and intention. From the point of view of this chapter, it is about how we revisit this in the context of both training and practice for dramatherapists and the place these two theatre practitioners should have within the theory and practice of our work, acknowledging, as discussed above, that there is space and connection between ‘raw emotion’ and ‘cognition’, and that they are not necessarily dialectically opposed. In his nine core processes (1996), Jones discusses dramatic empathy and distancing. He states that, ‘dramatic empathy refers to the creation of a bond between actor and audience. It relies upon the audience being able to identify with and engage their emotions in the character portrayed’ (1996, p. 104). He also states that: Distancing refers to a way of approaching drama and theatre related to Brecht’s Verfremdungseffekt.4 . . . Rather than developing empathy and strong identification, the actor 162

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or actress is asked to empathise their critical response, what they think, judge or wish to say about the role. (1996, p. 104) Jones is clearly making direct connections between a Stanislavski approach and that of Brecht within the context of dramatherapy, and, as discussed above with regard to catharsis, just because emotion is used greatly or a little does not mean that cognition and thought are used less. The connection between Stanislavski and Brecht within a dramatherapy context is not a new debate. The ideas discussed above are not particularly new, but I would assert these ideas may have weakened in a world where monogamous ideas are preferred. It is important to continue the debate that cognition is viable in both empathy and distancing, and to say that we often hold these two theatrical pioneers apart and do not consider them as being on the same continuum. The debate here concerns how their work is used in both training and practice for dramatherapists, and that their work deserves equal a weight to that of Jung and Freud. As Valante and Fontana suggest, Freud’s and Jung’s weighty volumes are worthy of dissection; so too, I would argue, are those of Stanislavski, Brecht and Aristotle, alongside the psychotherapeutic approaches.

Theatrical approaches to dramatherapy Jessica Williams-Saunders states that, ‘drama and therapy are both reflective processes. Theatre provides a vehicle through which the audience is invited into the lives and events of the characters before them’ (1996, p. 8). She goes on to say that, within the context of the therapy space: The as-if phenomenon in the transference and counter-transference forms the story between therapist and client that provides much of the material for psychological exploration. The interactions and contact between these two and the ability to play with the internal script of the client, requires the same truth, spontaneity and trust that is needed in improvisation. In the theatre of Brook, Grotowski and Stanislavsky and in the consulting room there is a common aim to encounter and explore the internal/unconscious script of the client role being played and to form a deeper understanding of the motivations underpinning behaviour and role relationships that are played out in life or on the stage. (1996, p. 8) To all intents and purposes, a therapy space can be perceived in a similar way to a theatrical space: the playing with internal scripts is akin to playing with theatrical scripts, and (I would argue) the therapist and client become director and actor. Lippe (1992) advocates using Stanislavski techniques directly within dramatherapy. Grainger also discusses the use of dramatherapy techniques from Stanislavski’s ‘emotion memory’ perspective (2011, p. 171), stating that the memory itself and the way the dramatherapist practically approaches its use are both equally important. It is clear from these brief examples that Stanislavski’s theories are relevant and useful within both the training and practice of dramatherapy. Brecht, as briefly mentioned earlier by Jones (1996) used the vehicle of ‘Verfremdungseffekt’ or the ‘alienation effect’ within his therapeutic repertoire as a way of distancing an audience from the emotion of a particular scene. These ideas are used widely within dramatherapy, when a client may step out of role and make comment on a character, or in a doubling technique in which group members observing a scene externalise the thoughts of the main character – thus creating a degree of distance. These distancing approaches are often used when clients find it 163

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too difficult actually to play the role or character, because of triggers or emotions that they feel may overwhelm them. Metaphor and symbol can also be used to represent a specific character or role, so that the qualities of a particular person are taken on, without the role being literally played. Additionally, projective techniques in which clients use small objects, toys or puppets can be an extension or can also be representational of a real-life situation. I have previously argued (2014, p. 23) that Boal is also on a continuum with Stanislavski and Brecht.5 Boal’s place as theatrical–political activist is closely aligned, not only to the theatre of the social and political Left, but also to dramatherapy, through his development of forum theatre and the idea of the ‘specactor’. The audience are invited to witness re-enacted moments of oppression and to stop the play and interject at moments where they feel they can stop the oppression. This leads to debate and discussion around individual rights and civil liberties, where a dramatherapist may work with clients to achieve emotional congruity to past or present interpersonal issues from an intrapersonal perspective. Boal’s praxis as a performer could be considered, therefore, to be closely aligned to the work of the dramatherapist – albeit from a more sociopolitical perspective. Indeed, Boal argues that, ‘a good empathy does not prevent understanding’ (1992, p. 103). He goes further by arguing that: At no time does Brecht speak against emotion, though he always speaks against the emotional orgy. He says that it would be absurd to deny emotion to modern science, thus clearly indicating that his position is entirely favourable to that emotion which is born of pure knowledge. (1992, p. 103) Boal thus agrees with the premise discussed earlier that catharsis, emotion and cognition are not opposites, poles apart, but form part of a continuum in which all are both necessary and useful in the ‘tool bag’ of the dramatherapist. I would, therefore, claim that the works of Stanislavski, Brecht and Boal are as important in the training and praxis of dramatherapy as the work of Freud and Jung, because they practise, in varying dramatic contexts, emotion, thought and cognition.

Survey To balance this current argument that the work of theatrical innovators is as essential an element as understanding the work of Freud and Jung, within both the training and praxis of dramatherapy, I carried out a small survey among current dramatherapy lecturers. Twenty-two international university Master’s lecturers were asked to take part, and eleven responses (50 per cent) were received. The data has not been scrutinised from a statistical-significance perspective, mainly owing to the smallness of the sample size – eleven participants. The very nature of the fact that the dramatherapy profession is small dictates that the number of people currently teaching on such training courses will be even smaller. The following data should be considered more as an expression of lecturers past and current thinking around dramatherapy theory and as a way of elucidating the current debate a little more, while considering future implications for training and praxis. Respondents were asked three main questions: first, lecturers were asked about the impact of seven theatrical innovators on their own development and training as a dramatherapist, as shown in Figure 16.1. Second, they were asked who they felt currently influenced their lecturing and practice (see Figure 16.2). Finally, respondents were also asked to place six specific areas 164

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Grotowski 15%

Stanislavski 17%

Artaud 11%

Brecht 16% Brook 18%

Aristotle 9%

Boal 14%

Figure 16.1 As a trainee dramatherapist, I was influenced by these innovators

Artaud 10%

Grotowski 16%

Stanislavski 13% Brecht 17%

Aristotle 11%

Boal 18%

Brook 15%

Figure 16.2 As a lecturer, these theatre innovators currently influence me

11%

10%

Psychotherapy

21%

Theatre

14%

21% 23%

Drama Psychology Counselling Psychiatry

Figure 16.3 Order of most importance as a lecturer in dramatherapy

of teaching practice in order of importance, as shown in Figure 16.3.6 Additionally, they were also given space to qualify further comments, which I shall come to later. The survey was kept purposefully brief, with a suggestion it would take less than 5 minutes to respond to, in the hope that as many as possible would do so. Question 1 (Figure 16.1) and Question 2 (Figure 16.2) appear to show that the majority of therapists’ views and influences have changed very little between their original training and 165

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their own current teaching/practice. Stanislavski, Brecht and Boal remain fairly constant, dropping by no more than 4 per cent in current thinking, as do all the other innovators. The majority of respondents had been practising for a number of years – in some cases more than 30, though some much less. Therefore, they appear to be heavily influenced by their own initial training/background, and this appears to alter little over the passage of time. This is interesting and would appear to suggest that dramatherapists are heavily influenced by their initial training and, by default, the initial training of their trainers, and that these influences appear not to alter over the passage of time, and, in some cases, significant passages of time. A following question (Figure 16.3) in this short survey also asked dramatherapy lecturers to place in order the most important aspects of their teaching practice out of six areas given to them. Psychotherapy and theatre appear equally weighted at 21 per cent, with drama being fractionally higher at 23 per cent of the responses. As I have already noted, these percentages are not quantitatively significant (therefore, their accuracy cannot be guaranteed statistically), owing to the very small number of responses (eleven). However, they do appear to suggest that, broadly speaking, most of the lecturers of dramatherapy who took part in this survey give equal weighting to psychotherapy, theatre and drama, which I would argue does appear to be positive. To counterbalance the statistics gathered above, I also asked the lecturers to suggest any other major theatrical influences upon their current teaching practice that impact upon the training they deliver. The respondents mentioned a wide range of additional influences that cut across theatrical, educational, movement-based and academic influences. Box 16.1 lists these.

Box 16.1 Additional influences as suggested by survey respondents Dorothy Heathcote, Jonathan Fox, Viola Spolin, Keith Johnson, William Shakespeare, Rudolph Laban, Dario Fo, commedia dell’arte, Sandford Meisner, Veronica Sherbourne, Pina Bausch, Richard Schechner, Jacques Lecoq, Vsevolod Meyerhold, Mosies Kaufman, Eugeno Barba, DV8, Chaos Theatre

Additionally, respondents made several qualitative comments. One respondent suggested: I don’t know that there is a specific individual – but the over-the-top aspects of melodrama and commedia have definitely influenced how I teach. In particular, they teach ways of performing in a more discrepant, broader, less tied-to-reality kind of way, also with the inclusion of specific reoccurring role types. I suppose in this same way musical theatre has also informed my work with students. The theatrical forms that teach us the potential of lifting real life representations into a higher, more performative, more presentational approaches. This serves to highlight the various distancing aspects of the art form. (Interview response) A further respondent discussed adapting the work of Dorothy Heathcote from educational drama. It would appear that respondents have found unique and individual ways of adapting the work of individual theatrical innovators, as well as adapting whole approaches to certain theatrical styles and genres within their practice. To distil this idea further, an additional respondent stated:

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My teaching is not influenced by a theatrical influence. It is motivated by the embodiment of imagination seeing these as a means of working with the Jungian/post Jungian model of enacting the unconscious. The tools which enable me to do this are Rudolph Laban’s observation of movement releasing physical inhibition so the body is able to respond to imagination spontaneously. Thus new stories are birthed and the narrative changed. (Interview response) It appears to be a synthesising of theatrical approaches at a deeper and more profound level, in which ‘imagination’ and ‘movement’ appear to be key. The above respondent, it would appear, is able to acknowledge the dual process of what they describe as not being a traditional theatrical influence but one that connects the body through movement and imagination with the unconscious processing of the psychotherapeutic. Thus, what the respondents all appear to be clearly showing is that they are able to take ideas that, I would suggest, have a basis in a theatrical tradition and adapt and adopt these concepts in a dramatherapeutic way. Each respondent does this in a unique and bespoke way, based on their own original training and current, unique teaching practice. I would argue that this, then, provides us with newly qualified dramatherapists who all have their own unique styles that they develop as their practice does. Thus, an ongoing process of continual development and refinement is highlighted here. As suggested in this brief survey, their core, original training remains with them throughout their career and does not appear to shift to any degree. However, the way in which they adapt their core training, post-qualification, appears to be significant here, as well as the way in which this is continually refined, generation after generation.

Some conclusions At the beginning of this brief chapter, I wanted to consider the influences of theatre and some key theatrical innovators on the current development and practice of dramatherapy. I purposefully looked at innovators who had been important to me, namely, Aristotle, Stanislavski and Brecht. In a Western world (at least) in which there is a legal requirement to practise as a ‘therapist’ in a legitimate way, there is an ever-pressing need to require examination and registration with an appropriate body. My concerns have been that there may have been an unconscious bias towards scientific legitimacy, which relies more on psychotherapeutic/scientific approaches and less on theatrical ones. For example, in an article in The Arts in Psychotherapy, David Read Johnson discusses the rise of: the neuroscience paradigm. This paradigm, which basically states that processes fundamental to the creative arts therapies have specific correlates in our brains, is now mentioned in almost all creative arts therapy publications, including three out of the five articles in this issue. Though viewed only a few years ago in a critical light by many psychotherapists, due to its privileging physical processes over transcendent ones such as mind, feeling, relationship, art, and the spiritual, the neuroscience paradigm has now been widely embraced. (2009, p. 116) Although Johnson is not necessarily against the discussion and use of neuro-developmental approaches within a dramatherapy context, he is critical of how a variety of brain science research 167

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‘is lumped together as a neuro scientific basis for a particular field’ (2009, p. 116).7 He also states that the brain science discussion is being used across all psychological therapies, not just the creative arts. His conclusion is that maybe we should be focusing on a more ‘aesthetic paradigm’ that more appropriately expresses our specific artistic and creative approaches to therapy. The above example adds some validity to my own argument that we often try societally to justify within a more overtly scientific paradigm rather than less scientific ones, such as the drama, theatre and arts-based practice for which I advocate being at the centre of dramatherapy and other creative arts-based professions. It appears that the respondents to my survey in this chapter all echo this in the way in which they continue to develop their own creative practice as lecturers, educators and practitioners of dramatherapy. However, it may also be used in less overtly theatrical and subtler ways than I might have recognised in my undergraduate days as a drama student. In November 2014, I carried out a brief analysis of keywords in the British Association of Dramatherapy Journal.8 Of the 786 articles in total, thirty-two referenced Stanislavski, fortytwo referenced Brecht, thirty-six referenced Aristotle, and sixty-one cited Boal. However, theatre was cited 480 times, whereas drama was referenced 645 times, and psychotherapy was referenced only 384 times. Although, again, this is not a scientific analysis, it suggests that the ideas of drama and theatre are being debated in a healthy way, and that psychotherapy is debated substantially, but a little less. Specific theatrical innovators do seem to be mentioned and discussed, but considerably less. Maybe this is, as I have already said, connected with the idea that, whereas dramatherapists do see drama and theatre as central to their repertoire, it is the adaptation of these forms and their various innovations that are key here, which may lead to less direct discussion of key figures in the world of drama and theatre and more refined and continuing debate. Writing in a handbook such as this, I am aware that, although dramatherapy is developing around the world exponentially, there are many areas in the world where dramatherapy in its legalised form does not yet exist. There are many, many cultures that use the curative effects of drama and other arts-based practices without reference to Brecht, Stanislavski, Jung or Freud. It is the way in which individual practitioners practise and the effect their work has that is key here. Although I will continue to have some concerns about the ‘scientification’ of dramatherapy as an art form or practice, maybe we do not give enough credence to the way in which we, as lecturers and practitioners, continually adapt theatrical traditions in differing, culturally specific forms to bring about a space where potential curative creativity can take place.

Notes 1

2 3 4 5

6

7 8

It is worth pointing out that Grotowski comes in eleventh position in this list and Artaud in fifteenth position, out of a possible eighteen. I note this here, as it is not possible in a chapter of this size to explore the vast array of theatrical innovators in more detail. www.nadta.org/what-is-drama-therapy.html (accessed 11 November 2014). http://badth.org.uk/dtherapy (accessed 11 November 2014). Literally meaning ‘alienation effect’. Interestingly, Boal was not mentioned at all in Valante and Fontana’s 1993 surveys. One could argue that, in the early 1990s, his work was not as influential as it might be seen to be today in Westernized theatre. Questions 1 and 2 were based on seven theatre innovators of my choosing, and answers were on a scale of 1–10, 1 being little/no influence and 10 being greatest influence. Question 3 was based on six specific areas of my choosing, on a scale of 1 being least important and 6 being most important. I note there are some excellent discussions on brain science in this handbook, and by no means do I wish to take away from these continuing debates. www.tandfonline.com/

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References Boal, A. (1992) Theatre of The Oppressed. London: Pluto Press. Duggan, M. and Grainger, R. (1997) Imagination, Identification and Catharsis in Theatre and Therapy. London: Jessica Kingsley. Grainger, R. (2011) ‘Reflections on “sensation memory”’, Dramatherapy, 33, 3, 170–5. Holmwood, C. (2014) Drama Education and Dramatherapy. The space between disciplines. London: Routledge. Johnson, D. R. (2009) ‘Commentary: Examining underlying paradigms in the creative arts therapies of trauma’, The Arts in Psychotherapy, 36, 114–20. Jones, P. (1996) Drama as Therapy: Theatre as living. London: Bruner Routledge. Lippe, W. A. (1992) ‘Stanislavsky’s affective memory as a therapeutic tool’, Journal of Group Psychotherapy, Psychodrama & Sociometry, 45, 3, 102–11. McLeish, K. (trans.) (1999) Aristotle Poetics. London: Nick Hern Books. Stanislavsky, C. (1980) An Actor Prepares. London: Methuen. Valante, L. and Fontana, D. (1993) ‘Research into dramatherapy theory and practice. Some implications for training’, in Payne, H. (ed.), Handbook of Inquiry in the Arts Therapies, One River Many Currents, pp. 56–67. London: Jessica Kingsley. Willett, J. (1984) Brecht on Theatre. London: Methuen. Williams-Saunders, J. (1996) ‘A meeting place – Drama and therapy’, Dramatherapy, 18, 3 (Winter), 8–11. Winston, J. (1996) ‘Emotion, reason and moral engagement in drama in research in drama education’, The Journal of Applied Theatre & Performance, 1, 2, 189–200.

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17 The brain as collaborator in dramatherapy practice Jude Kidd

My intention for this chapter is to share knowledge of neuroscience with professionals, colleagues and students of dramatherapy in an accessible way and to explain my view of how the two disciplines relate and collaborate. Demand for creative action learning is increasing as people feel the benefits of knowledge acquisition through embodied experience. Learning experientially involves a holistic experience and automatic brain collaboration. Collaboration by way of a feeling sense of brain and body enlists extensive neural networks in many parts of the brain.

Measuring action My evidence of the brain’s involvement in dramatherapy is a work in progress and does not fit neatly into an analytical format, despite my having read both subjects at Master’s degree level. Dramatherapists have plied their art form over decades, often with little recognition from commissioners or key decision-makers in organizations. The desire to come up with a reliable measure of what we do is of enormous research interest for me. I want dramatherapy to survive as an intervention and passionately believe that dramatherapists should be paid on an equal basis to other senior clinicians working in the National Health Service (NHS). In the UK, the Health and Care Professions Council (HCPC) is the regulatory body for professions with protected titles, and they list arts therapist (drama, music and art) with clinical psychologists and physiotherapists. Practitioners of dramatherapy who have been working for many years have a ‘known sense’ that the therapy works, and there is heaps of qualitative evidence to support this. The difficulty arises when we have to try to explain how the process works, and in what numerical format we might measure outcomes and results of a treatment that we have facilitated or collaborated with over many years. Psychological approaches such as cognitive behavioural therapy (CBT) and its various derivatives have commandeered centre stage in the NHS and related social agencies for some time now. Patients who are referred for behavioural therapy via their general practitioner are currently offered a 6-week intervention, after which there is the assumption that they are cured or, paradoxically, incurable. Questions of psychological well-being and ethical responsibility towards patients and clients are foremost in my mind when reading about the 170

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CNS ENS

PNS Figure 17.1 The human nervous system

intentionality of such short-term and purportedly cost-effective interventions. I am curious as to the process involved in commissioning departments: how are criteria for funding decided upon? And, is the core belief system of commissioners, individually and collectively, based solely on CBT evidence? Gilbert acknowledges that, although CBT has brought us some way in proving that, ‘psychological therapies are major players in health care . . . there are concerns . . . that CBT . . . only addresses a specified range of psychological processes’ (2009, p. 403). Humans have three nervous systems: the central nervous system (CNS), consisting of the brain and spinal cord; the peripheral nervous system (PNS), where nerves from the spinal cord journey down to our extremities (hands and feet); and the enteric nervous system (ENS), the intestines and bladder (see Figure 17.1). The brain is made up of trillions of nerve cells (neurons), and it is important to understand the communication process between them. Neurons communicate with each other via axons and dendrites, thin structures that grow out from the cell as the infant brain develops. As the axons and dendrites grow, they form extensive neural pathways along which electrical signals and chemicals known as neurotransmitters travel. Dendrites form synaptic connections in the neural circuitry of the brain (see Fig 17.2).

Neural games workshops During the past 5 years, I have devised and delivered creative action workshops highlighting the basic structures and functions of the brain. This has enabled participants to embody the complexities of the brain in an experiential way through the use of action and materials. The signalling transmission is depicted as a game, with signals travelling at speed along neural pathways. The more the game is rehearsed, the more growth and learning take place in a healthy brain. The reader is invited to pause here for a moment and visualise signals flowing speedily through the axons and dendrites in the early developing brain. Make an image of a tree, its branches and twigs reaching out, as the sap rises and spreads out. Compare this to neuronal signalling. The process of transmission is further enhanced when the signal jumps across the gap between one nerve ending and another. In neurobiology, this gap is known as the synaptic cleft, into which chemicals from nerve endings are released when stimulated by interactional behaviour. The synaptic cleft might be imagined as a river with banks on either side, and chemical molecules depicted as ducks or buoys floating in the water. In order to get out of the river, the molecule has to lock to a receptor on the opposite bank of the cleft (see Figure 17.3). 171

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Figure 17.2 Cell body, axons and dendrites

Figure 17.3 The synapse 172

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This fundamental action of synaptic connection is instrumental in the maintaining of a healthy nervous system. Chemical molecules such as serotonin and dopamine, responsible for depression and Parkinson’s disease, respectively, undergo this floating activity in the synaptic cleft on a massive scale. Trillions of molecules are constantly flowing through our brains, but, in brains that are damaged or unable to grow, the process is interrupted or faulty. The process of chemical transmission, however, can sometimes be replaced with medication (pharmaceutically), which, in certain cases, helps to restore (to an extent) the signalling mechanisms to their designated path.

The neurobiology of the attachment process The neuronal connections are important through pregnancy, birth and onwards for healthy brain development. One neuroscientist speaks eloquently of how mother and baby interactions are vital for attachment and neuronal development to take place (Allan Schore: see youtube.com), reiterating the importance of connection and subsequent reinforcement by way of care-giving between parent/carer and child during the first stages of life up to the age of 3 years (and beyond) and maintaining its importance for the attachment process. As mother and baby communicate through visual, verbal and tactile interaction, chemicals are released in the baby’s brain, assisting growth and enhancing the learning process. Early interaction is vital for the development of precious structures of the brain, the amygdala and the hippocampus. Jennings (2011) likewise fosters the importance of this early attachment process between mother and child. She names this interactive process between mother and child Neuro-Dramatic-Play (NDP) and has developed a succinct teaching programme on the model that encompasses primary circles (Jennings 2011, p. 14). Recent research has shown that this process is crucial in the earliest stages of pregnancy. Scientific researchers are beginning to identify the source of maltreatment and abuse through studies of the amygdala and the hippocampus using magnetic resonance imaging (MRI) techniques with children who present with behavioural issues. An increase in amygdala size (volume) correlates with the mother’s stress levels and chemical release of hormones during the first few months of pregnancy (Buss, cited by Pechtel et al. 2014). And Lupien et al. (2011) found the same outcome with children who had been exposed to their mother’s depressive symptoms, as well as those brought up in orphanages. Both studies, however, have reported no change in hippocampal structures. The amygdala (the little almond) is considered to be sensitive to insult at a very early stage in development, which further reinforces the absolute need for consistency of love and care in the early attachment relationship. These scientific studies inform the dramatherapy work we undertake with children and adults who present with distress challenges. My recent work at Kids Company, the London charity, was all about supporting children who had been maltreated; there were many of them. Teams of therapists and keyworkers offered basic needs – food, clothing and emotional support – to thousands of vulnerable children and young people across London, aiming through relationships to provide a sense of well-being and stability mirroring close family ties. During dramatherapy sessions, brain structures most likely to be involved in the relational process are components of the limbic system, the oldest part of our brain, which consists of three layers. Within these layers, you will find the amygdala, the size of an almond, which is highly sensitive to emotional experience. Nearby is the hippocampus, which is responsible for memory, learning and stress levels, and the insula, a less-documented structure responsible for emotion and face recognition. As you look at the brain from the outside, imagine three more layers on top of the three in the old brain. These latter three are known as the neocortex, a phylogenetic development. 173

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The layers of the brain all communicate with each other via neural networks, sending signals from the upper layers down to the lower, deeper levels. The Communicube, designed by John Casson (www.communicube.co.uk), is an ideal tool for teaching and showing these layers in a three-dimensional way.

Neurobiology of dramatherapy The definitive neurobiology of dramatherapy work is difficult to assess, owing to ethical and practical restrictions. I have given this a considerable amount of thought over the years. We cannot use invasive methods with clients engaged in a dramatherapy session, nor can we place the client in a supine position in an MRI scanner to see which parts of their brains light up as they imagine a solution-focused scenario unique to their personal life story. I concur with Anna Abraham on the point of developing a classification system to approach ‘various aspects of creativity’ (2013, p. 7). As a researcher interested in the neuroscience of dramatherapy, I am also keen to advance this theme. Measuring the neuroscience of creativity is proving challenging for other researchers, including arts therapists (McGarry and Russo 2011; Abraham 2013): The findings associated with creativity, particularly the neuroscience of creativity, can appear cluttered, inaccessible and even contradictory. One reason for this is that while this definition of creativity is readily applicable in tasks that call for some form of creative problem solving it is not as simple to apply this definition in the context of the arts. (Abraham 2013, p. 6)

Exploration Dramatherapists use the concept of exploration in the course of their clinical work with clients. Similarly, doctors of medicine explore when they ask questions and obtain a verbal history of newly referred patients. History taking is the way I get to know my client, gathering facts on many levels. Dramatherapy is often referred to as an alternative to a talking therapy; however, this is not entirely true. Dramatherapists do engage in conversation with their clients, but, by nature of their training, they mostly engage in a relational process through creativity and action methods. The work I undertake requires getting to know my client(s) intellectually, physically and emotionally. Engaging in a positive attachment relationship, building rapport in order for change and healing to take place, is essential. Working creatively, the client projects their feelings and thoughts on to small-world objects, symbolically depicting problems, issues or situations, and acts out the difficulty in relationships through role-play, movement and drawing. Engagement in a positive attachment relationship builds rapport and generates trust between therapist and client. This relational building process is the foundation for change to take place, which is essential to healing and well-being. It goes some way to making amends, enhancing reparation in brain structures that may have been subject to onslaught in early development. The relationship-building process cannot be rushed, although I have known a few clients state that they feel different, safer, unburdened or better after participating in just a few sessions. My observation of brain activity during dramatherapy sessions consists of facial cues, eye movements, nonverbal movements and individual movement behaviours, which manifest as a result of interactive dramatherapy techniques. Observing the level of eye contact people make during a one-to-one session with the therapist or in a group situation might be a clue as to their capacity for social and emotional engagement. 174

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I am not a neurophysiologist and so am unable, in my role as a dramatherapist, to measure the electroencephalogram (EEG) responses by pasting electrodes on scalps while clients are embroiled in adventure or exploring an image that resonates through sound or tactile stimuli. However, with my neuroscience hat on, I can closely witness and observe behaviour and assess the brain functions and activity most likely to be collaborating during a dramatherapy session. For example, the amount of time a person is able to engage with material might inform me of their frontal lobe functioning; attention span and concentration can be measured by observation. Their ability to mirror action might be indicative of empathy and a level of emotional understanding co-existent between us. Embodying a new experience or getting into role in dramatherapy requires the use of imagination, remaining focused and staying attuned to personal feelings and sensations. Dr Sue Jennings has innovated dramatherapy practice by conceptualising this work in the model known as Embodiment–Projection–Role (EPR). I suggest the brain structures and functions involved in this model are located in several parts of the brain, both old and new: the frontal lobe structures of the dorsolateral prefrontal gyrus (DLPFG), well documented for involvement in creativity, together with the amygdala, hippocampus and insula, longstanding limbic brain structures that play their part in emotional and feeling states. The insula is connected with the function of facial recognition and emotion and has neural connections with the olfactory, auditory and ‘somatic sensory areas of the cerebral hemisphere’ (England and Wakeley 1991, p. 258). Across the cerebral cortex of the human brain, there are clusters of neurons that represent different parts of the human body. In the homunculus (Figure 17.4), you will see anatomical representations of functional neurons involved in muscle movement. You will see that the mouth, hands and feet are accentuated; this is because there are larger quantities of neurons for these body parts. The image of the homunculus has fascinated me for three decades and is readily available on the Internet. During a dramatherapy session, I propose that sensory neuronal activity in both hemispheres is activated through sensory tactile stimulation, and thus plays an important part in promoting growth and reparation. Figure 17.4 shows the degree to which sensory areas are represented in

Figure 17.4 Homunculus 175

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the brain. This is indicative that motor systems are part of the old brain, the limbic system, and represent phylogenetic development. During the assessment period, the dramatherapist might, for example, be able to gauge the degree to which a person has the ability to focus through observation of facial cues, eye gaze, indicative of functions such as attention, concentration and planning – functions of the frontal lobe. How the person uses meaningful language as they engage in creative work might be indicative of increased activation in the left hemisphere as well as the right, whereas the willingness and preference of a person to engage in nonverbal creative symbolic play could be an indicator of a preferred comfort zone, nestling and snuggling in the right hemisphere. In dramatherapy and supervisory sessions, people often appear lost for words at given moments. At this point, they begin gesticulating with their hands and arms, in what, I believe, is an effort to verbalise feeling. This behaviour may be indicative that they are recounting a memory or visualising a significant life event. This loss of words is, in my opinion, an all-important moment in the context of the client’s issues. It might well mean that neuronal pathways are firing, or a biofeedback loop between the old and new brains. Or, another explanation might be that, in the psyche (mind), it is symbolic of the bridge between the conscious (known) and unconscious (unknown) material. As people gesticulate, the image becomes stronger and more accessible, and it is my experience that, within moments, a person chooses their preferred method of representation in symbolic play. As a therapist holding the space, I remain a silent witness to this process and place no time limit on the activity (within 50 minutes). In role as witness to the process and action of my client, I am fully present in every respect. My body language is still, and I am quiet but present in the space, observing client affect and aware of the interactive process between us on my own internal radar (see Figure 17.5). Mirror neurons are so called because of their firing pattern history over three decades, discovered by chance in the monkey brain. The brain of the monkey is similar to that of the human, albeit reduced in size. Thirty years ago, in a laboratory in Italy, a neurophysiologist got up from their chair and walked across the room. A monkey, sitting quietly between experimental tasks, with electrodes pasted to her scalp and cables wired to a computer, was watching as the person moved around the room. The computer showed a burst of neuronal activity occurring in the monkey brain, simultaneous with the movement of the scientist. The monkey remained sitting still. The important fact is that the monkey was observing the action of the person who

Figure 17.5 Wow 176

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was moving. From this initial observation, many authors have gone on to show that mirror neuron activity is the way we interact with each other (Iacoboni 2008, p. 10). The representation of a movement action occurs prior to execution of movement, such as grasp and grip. My (unpublished) neuroscience research looked at the neuronal activity in the brain during precision grip in humans (Kidd 1995). There is a growing body of researchers who concur that empathy is elicited via neural circuitry called the mirror neuron system (MNS) (McGarry and Russo 2011, p. 178). Dramatherapists and dance therapists imitate the movement of each other working in harmony and synchronicity. Stern notes: the pattern of firing in the observer mimics the pattern that the observer would use if he were reaching for that glass himself . . . the visual information received when watching another gets mapped on to the equivalent motor representation in our own brain by the activity of these mirror neurons . . . ‘participation’ in another’s mental life creates a sense of feeling/sharing with/understanding them, and in particular their intentions and feelings . . . the reading of another’s intentions is cardinal to intersubjectivity. (Stern 2007, cited by Hess 2012, p. 406) In my dramatherapy practice, spanning four decades, I employ several models and tools, including the technique of ‘mirroring’ as taught to me by Marian (Billy) Lindkvist, the founder of the Sesame method. Mirroring using movement and mime is where two people of a similar height face each other and use the hands and body in a dance of communication. This tool is a nonverbal way of enhancing rapport between two people, building to four and eight people, respectively, until an entire group is sharing the same pattern of movement. Interestingly, as people move together, they attune to each other in a silent, human sculpt until the group reaches a consensus of stillness. As I reflect on my lifetime experience both as a participant in, and facilitator of this mirroring activity, I consider the relationship between movement, empathy and mirror neurons. During the activity, it is my experience that each and every person participating in the exercise becomes highly attuned to the other through perception; this is observed by facial cues, reduced verbal communication and synchronicity, and has always felt to me to be a deeply empathic experience. However, Dan Hughes states that, ‘Whilst these neurons have an important part to play in the experience of empathy, they do not constitute empathy themselves’ (Golding and Hughes 2012, p. 178). These authors go on to observe that, ‘our brains are ready for empathy’, but, before we can fully develop the ‘capacity to empathise with the inner experience of another person’ (p. 179), we need to have experienced empathic relationships with others. The capacity to empathise with inner experience may be viable through the psychodramatic technique of role-reversal. Moreno was the first person, almost 80 years ago, to conceptualize this technique, which differs from role-play. Kellermann (1994), proposes a phased [psychodramatic] technique in role reversal which involves ‘perception of some subtle cues from the other and proceeds through a coordinated use of certain mental abilities, including memory, fantasy and awareness of one’s own feelings and thoughts in the role of the other. (Yaniv 2012, p. 72) Insight pops up at any given moment through exaggeration of features as a character is embodied in role, and, in psychodrama, hidden aspects of personality are exacerbated by way 177

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of doubling. This technique involves a therapist reflecting back to a person feelings, emotions and characteristics previously hidden. These moments of realisation and awareness are the jewel in the crown at times and what moves a person on in their journey. Anna Chesner, a colleague who I consider to be the expert on role-reversal in the UK, will, I am sure offer further insight on this topic. I propose that the actual brain systems involved in dramatic role-reversal include specific groups of neurons from the cortical surface of all four lobes of the brain, as well as specific subcortical pathways. These might include the DLPFG and the interaction of emotion and language by the amygdala and left precental gyrus. The latter has recently been demonstrated by Chun-Ting Hsu et al. (2015, p. 292) through EEG studies when imaginative language-based tasks are being undertaken. Researchers of creativity and their attempts to locate relevant brain functions have analytical and cognitive paradigms as their main focus, but less studied are dance, movement or drama. Abraham points to the conundrum and observes the flaws in such designs involving creativity: ‘in general . . . the duration of a single [creative] trial is much longer compared to other cognitive paradigms’ (2013, p. 2). Working creatively when helping people to problem-solve encompasses an expansive skill set. The ‘light-bulb moments’ that occur in a dramatherapy session are part of the therapeutic process, and I savour these moments as absolute golden nuggets in the change process. Writing about such moments, Azis-Zadeh et al. refer to the Gestalt process and insight strategy, wherein a person is encouraged to think about solving a problem in a different way (2009, p. 908). She recounts the story of Archimedes, who had been struggling for days to find a solution to a problem. A king had commissioned someone to make him a crown, but when the crown was presented to him, he was doubtful of the amount of gold that had been used in the making, as the weight did not seem great enough to him. His peers offered reassurance and advice to Archimedes, and he tried for days to find a solution as to how to measure the amount of gold in the crown, but it was only when he was in the bath and the water overflowed that he realised the answer to his question. The mathematical equation was subsequently adopted in science and became known as Archimedes’ Principle. The neurological point being made here is that certain aspects of information about the weight of gold were stored somewhere in his memory, perhaps inaccessible via the language centres of the left brain. It was only when Archimedes was in the bath that he embodied the scientific principle in a different way. Perhaps the reader might research this story and imagine his dilemma when they are next in the bath!

Conclusion The anatomical knowledge of the brain and its functions is at the forefront of our learning. It is highly likely that neurons in many structures of the brain are active during dramatherapy interventions, with the embodied experience also affecting the psyche. Change and transformation are manifested through behaviour, cognitive function and heightened self-awareness. My ongoing research is twofold, as I endeavour to understand how and where the actions and benefits of dramatherapy stimulate neuronal growth in the human brain. And, as therapy continues, at what point is change evident, and is it sustainable? I believe dramatherapy has been waiting patiently for science to catch up and, to this end, I believe the gap is narrowing. Clinical psychologists have recognized the need for a paradigm shift away from formal classification systems, moving away from formally medicalising behaviours as outlined in the Diagnostic Statistical Manual that psychiatrists traditionally depend on. The clinical psychologist’s tool of formulation involves listening to the client’s story, social context and life history and using those as a basis 178

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for understanding the individual’s current difficulties, thus getting away from the experimental language of clusters and populations. Hurrah! Another Eureka moment! This seems so much closer to the way in which dramatherapists approach their work with people and is perhaps indicative of a move towards a more collaborative approach between professionals with protected titles. As I’ve researched for this chapter, there have been real Eureka moments, discovering that scientists are using their imagination by integrating creative approaches in their experiments. I believe they are also beginning to acknowledge the importance of empathy as being in synchrony with the creative feeling brain, and its value to the health and well-being of patients. It is heartening, as I journey into the latter stages of my working life, to read about innovative employers who are thinking creatively and sensitively around the individual needs of people accessing services. The jobs are being created for dramatherapists in schools, clinics and hospitals throughout the UK. The recently developed Arts for Health committee within our present government acknowledges the benefits of arts for people with dementia, cancer and Alzheimer’s (another Eureka moment), and I am hoping this acknowledgement will translate into policy for properly funded posts. I pause and consider that the work I do as a therapist, in my interaction with people, is most likely represented in the brain via the mirror neuron system, and I welcome further discussion around this topic. My thanks, meanwhile, go to Dr Sue Jennings, a true pioneer in our field, a colleague and friend who has maintained her belief in me during the past decade. Meanwhile, I believe we, as humans, are indebted to the monkey for providing us with compelling evidence that has revolutionized medicine and evolution.

References Abraham, A. (2013) ‘The promises and perils of the neuroscience of creativity’, Frontiers in Human Neuroscience, 7, article 246. Azis-Zadeh, L., Kaplin, J. T. and Iacoboni, M. (2009) ‘“Aha!”: The neural correlates of verbal insight solutions’, Human Brain Mapping, 30, 908–16. England, M. A. and Wakely, J. (1991) A Colour Atlas of the Brain and Spinal Cord. London: Wolfe. Gilbert, P. (2009) ‘Moving beyond cognitive behaviour therapy’, The Psychologist, 22, 400–3. Golding, K. and Hughes, D. A. (2012) Creating Loving Attachments. London: Jessica Kingsley. Hess, M. (2012) ‘Mirror neurons, the development of empathy, and digital story telling’, Religious Education: The Official Journal of the Religious Education Association, 107, 4, 401–4. Hsu, C.-T., Jacobs, A. M. and Conrad, M.(2015) ‘Can Harry Potter still put a spell on us in a second language? An fMRI study on reading emotion-laden literature in late bilinguals’, Cortex, 63, 282–95. Iacoboni, M. (2008) Mirroring People. New York: Farrar, Strauss & Giroux Jennings, S. (2011) Healthy Attachments, and Neuro-Dramatic Play. London: Jessica Kingsley. Kellermann, P. F (1994) ‘Role reversal in psychodrama’, in Holmes, P., Karp, M. and Watson, M. (eds), Psychodrama Since Moreno: Innovations in theory and practice, pp. 263–79. London: Routledge. Kidd, J. (1995) Motor Cortex Influence Over the Hand During Precision Grip in Man. Unpublished MSc thesis UCL, London. Lupien, S. J., Parent, S., Evans, A. C.m Tremblay, R. E., Zelazo, P. D., Corbo, V., Pruessner, J. C. and Séguin, J. R. (2011) ‘Larger amygdala but no change in hippocampal volume in 10-year-old children exposed to maternal depressive symptomatology since birth’, PNAS, 108, 34, 14324–9. McGarry, L. M. and Russo, F. A. (2011) ‘Mirroring in dance/movement therapy: Potential mechanisms behind empathy enhancement’, The Arts in Psychotherapy, 38, 178–84. Pechtel, P., Lyons-Ruth, K., Anderson, C. M. and Teicher, M. H. (2014) ‘Sensitive periods of amygdala development: The role of maltreatment in preadolescence’, Neuroimage, 97, 236–44. Yaniv, D. (2012) ‘Dynamics of creativity and empathy in role reversal: Contributions from neuroscience’, Review of General Psychology, 16, 1, 70–7.

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18 Open Sesame and the Soul Cave Mary Smail

Introduction The chapter will focus on the Jungian-based Sesame approach to drama and movement therapy, which places itself at the indirect or oblique end of the dramatherapy spectrum and is also used as a method within psychotherapy. Since 1964, dream-founded Sesame has held the ‘Ali Baba and the Forty Thieves’ story as a central metaphor, likening drama and movement to password keys that open doors beyond inhibiting defences or learned behaviour into the depths of the personality. This has been well documented by Marian Lindkvist, Jenny Pearson, Mary Smail and Pat Watts (Pearson 1996; Lindkvist 1998; Pearson et al. 2013). More recently, the Sesame Institute (UK and International) has been developing this work by considering the potency of the inner resources of the psychesoul and how these are recognized and conveyed to people in the health and caring professions for work with their patients or clients. How do we name the treasure hidden and forgotten inside that, when permitted, advocates towards personal worth, meaning and a validity of purpose for living life, even in the face of suffering and difficulty? A question about where dramatherapy and spirituality meet will be posed, and the notion of soul as one name for this perspective will be presented. Have soul values been designated only to temple, church or to a religious code, or can therapists who work through the symbol and metaphor language of psyche be seen as custodians of soul healing? A pedagogy of soul within Sesame therapy will be briefly described, as taught on the ‘Psyche and Soma’ course, which is evolving a fresh articulation of the binding connection that exists between the ancient roots of deity and drama.

Divine roots The ancients of Greece used ritual and theatre as a road to the gods. Like dramatherapy, Greek healing was a homogeneous mix of theories drawing on both the body and the soul, believing that illness and healing sprung out of the relationship between mortality and divinity. The original meaning of the Greek word therapeia was a ‘waiting upon’ or a ‘service done’ to the gods, with implications of tending, nurturing, caring and being an attendant; in time, the word was applied to medical care. The original connotation is pertinent to the handling of 180

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acute ‘psychotic’ episodes, as the persons undergoing them are in a state of being overwhelmed by images of gods and other mythic elements. Hence, a therapist does well to ‘be an attendant’ (therapeutes) upon these mythic images so as to foster their work. ‘Treatment’ strives to stop what is happening, whereas ‘therapy’ attempts to move with the underlying process and help achieve the creative aim implicit in it (Perry 1998, p. 4). The ancient healing shrine at Epidaurus in Greece is a fine example of this. Supplicants came to the theatre to attend the rituals of a play, very often a tragedy. They were led into the Abaton, a sacred place where sleep was induced so that Asclepius, god of healing, could manifest in some shape or form to the one seeking guidance. The god would bring a message or prescription, something that must be done as a condition of the invocation being answered. When this happened, a testimony was written on a stone to evidence divine help and give thanks to the god. Some of these tablets were excavated in 1881 and have been documented in the book Asclepius from where this example comes. Ithmonice of Pellene came to the Temple for offspring. When she had fallen asleep she saw a vision. It seemed to her that she asked the god that she might get pregnant with a daughter and that Asclepius said that she would be pregnant and that if she asked for something else he would grant her that too, but that she answered she did not need anything else. When she had become pregnant she carried in her womb for three years, until she approached the god as a suppliant concerning the birth. When she had fallen asleep she had a vision. It seemed to her that the god asked her if she had not obtained all she had asked for and was pregnant; about the birth she had added nothing. . . . But since now she had come for this as a suppliant to him, he said he would accord even it to her. After that, she hastened to leave the Abaton, and when she was outside the sacred precincts she gave birth to a girl. (Edelstein et al. 1998, p. 229) Although it is hard to understand the nature of a 3-year pregnancy, this testimony speaks of an effecting sequence where drama, dream and deity mysteriously produce quantifiable outcome and life change. The Right Honourable Alan Johnson, Secretary of State for Health, said in a speech given at the Arts and Healthcare Event in 16 September 2008: The therapeutic value of the arts has long been acknowledged. The Greek theatre of Epidaurus built in 400 BC, was a place for pilgrims to honour the God of medicine: A commentator at the time said: ‘They came to cleanse their souls with therapeutic waters and with theatre’. This god root in the theatre shrine points to a missing part of our dramatherapy profession. We use similar tools to the Ancients, but have remained silent about the question of the divine in our practice.

Secular spirituality and dramatherapy Spirit, like God, denotes an object of psychic experience that cannot be proved to exist in the external world and cannot be understood rationally. This is its meaning if we use the word ‘spirit’ in its best sense. Once we have freed ourselves from the prejudice that we have about referring to concepts of external experience or to a priori categories of reason, we can turn our attention and curiosity wholly to that strange and unknown thing we call spirit (Jung 1970). 181

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In the midst of my writing this chapter, a colleague and I attended the annual conference of the British Association of Dramatherapists to co-conduct the closing event for 200 dramatherapists. We decided to work with the elements of air, fire, water and earth, using symbols to demark areas in the room that could be visited as a means of recalling the inspiration, illumination, nourishment and grounding of the conference. The ritual was quiet and reflective, as large clusters of people moved individually within a collective. Observing from the edge, I had a sense of the dramatherapy community simultaneously as a whole, and as individuals ‘at prayer’ together, sharing in a form of meditational harvest. Later, I heard that many had valued this time, but there had also been others who were challenged by the quietness. The candles, the water, the essential oil and the rocks, were they some kind of churchy artefact? It felt inner and towards spirituality and so was questionable. The movement and expression were below the surface, honouring internal dramas held contemplatively in the space of silence. There was not the outward exuberance beloved of the dramatherapy community. Dramatherapy has much about it that is full of colour, zest and joy. It works like a folk art, inviting people into their creative legacy through the possibility of imagination revisioning and embodying both the suffering and potential of their life. The distancing protection of story text, role, image and gesture allows meaning to spontaneously emerge so that, for a time, the participant can enter a world that affirms them. It is very simple: self-worth changes when people find a route to the source wisdom that lives and guides beyond what they think they know. Using the tools of theatre and embodied symbol, dramatherapists see people change over and over again through this process. Without a doubt, this is a joyous practice, based on personal creativity leading to health, which is worthy of celebration. The following sample mission statements demonstrate a consistent worldwide maturity about the assertions dramatherapists are now able to make in describing their work: Dramatherapy has as its main focus the intentional use of healing aspects of drama and theatre as the therapeutic process. It is a method of working and playing that uses action methods to facilitate creativity, imagination, learning, insight and growth. (British Association of Dramatherapists 2011) Drama therapy is an active, experiential approach to facilitating change. Through storytelling, projective play, purposeful improvisation, and performance, participants are invited to rehearse desired behaviours, practice being in relationship, expand and find flexibility between life roles, and perform the change they wish to be and see in the world. (North American Dramatherapy Association 2014) Dramatherapy is the use of theatre techniques to facilitate personal growth and promote health. Dramatherapy is an expressive therapy modality used in a wide variety of settings, including hospitals, schools, mental health centres, prisons, and businesses. Dramatherapy exists in many forms and can be applicable to individuals, couples, families, and various groups. (Dramatherapy Centre, Sydney 2014) Taking these three declarations as examples of many, it can be argued that, as dramatherapists, we have found fluent language for what we do. The first job of any new graduate is to learn how to find their individual confidence to communicate the power of their craft to a world that is latent in understanding the value. Within the community, research has been seen as the 182

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way to substantiate dramatherapy further. If we can name our purpose through statements, and on top of that measure our potency scientifically, the fantasy is that the profession will be even more employable, fundable and respected. There is a problem though. Existing evaluation methods include no tick box to mark the very stuff of dramatherapy: those potent moments we encounter viscerally when ‘something else’ makes itself present in a session. A previously unspeakable quality of tenderness, rage, sadness, passion, loss, love suddenly comes sweeping in through a story or role and is released and understood. The artist knows this place, as does the therapist. It stands underneath our practice and breaks through most strongly when we come to the end of ourselves. Dramatherapy does not account for this phenomenon because we do not know what to call it. The profession rightfully longs to prove itself, but, just for a moment, let’s play the what if game. What if we need a different paradigm? What if dramatherapy belongs to another camp alongside the medical one? What if the dramatherapist could be invested with a sense of priest/ess vocation, in the same way that those serving in ancient temples knew their call to healing? What if trainees were prepared and ordained to serve Mystery, name it as you will – the Universe, Higher Power, Ultimate Reality, the Cosmos, Zeus, Buddha, Allah, Christ or God? If we began to differentiate the healing process that is provided through a dramatherapy intervention from the cure of medical empiricism, would we cut more ice? Over the past quarter-century, I have asked dramatherapists what brought them to training. More often than not this question draws out a story about two things. People speak about a personal life dilemma or inhibition shifting when they allowed themselves to play and be creative. Dance, song, acting, storytelling, writing took them to a source part of themselves, and, although outer circumstance remained consistent, they perceived themselves afresh, distinguished apart from their problem, and this in itself was healing and life enhancing. Something called them to this work. It made them want to enable a similar experience for others. A felt sense of this numinous presence is inherent in what dramatherapists do, but we do not have the words or courage to speak of it yet. There is no tick box for the presence of ‘Other’. If we go back to the dramatherapy conference, with its ‘Is this spiritual?’ question, there is a valid apprehension about discussing spirituality within the profession, for fear of being seen as a church or cult. John Casson speaks of this: ‘I think there is necessarily a spiritual dimension: I am cautious because I will focus only on the clients’ spirituality, holding mine to one side and I do not want Dramatherapy to become a religious activity.’1 I agree with this, but would also propose that dramatherapy mission statements are overcautious and sell themselves short when they only list the tools. In so doing, we have managed to dump the divine, so present in our Greek roots, and have lost the inherent interweaving between the arts, spirituality and the gods. Sesame has not got off with such a clean forgetting, because two stories keep us firmly rooted in the territory of the unconscious and god presence, and I would like to look at this now.

The two stories of Sesame During 1964, and in good Ancient Greek tradition, Marian Billy Lindkvist, the founder of the Sesame Approach, had a dream at a time in her life when she faced great difficulty. She writes: It is early January, 1964, 6.30 am. I am floating from dreaming to half-waking. I see a hospital ward, and patients moving together, watching plays, then creating them for themselves. The picture widens into an enormous transformation of the lives of the ill. . . . There is a feeling of new birth and joy. (Lindkvist 1998, p. 16) 183

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The ‘prescription’ of this dream, coming out of Billy’s suffering predicament, led her to the eventual creation of the Sesame Institute charity, which promotes a way of working called the Sesame Approach, an embodied Jungian therapy. Sesame combines the use of movement, mythology, spontaneous play and nonverbal touch and sound, prioritizing symbol and metaphor as the active healing agencies of the unconscious. The dream origin and a sense of experiencing image creator of theory inform the ethos of all Sesame trainings. The second story of Sesame is the story Ali Baba in the Arabian Nights, from which the organization and way of working take their name. This tale tells of a rock face opening to a hero who overhears a magical password used by thieves to pass inside. Ali Baba uses this Open Sesame key, enters in, plunders the riches and takes them from the cave. Dream messages and dark-cave treasure then are the primary symbols on which the Sesame Approach is founded and which continue to inspire students coming on both trainings. This is not passed to them through indoctrination, but rather, as a story lives through the oral tradition, the call of the dream and the image of the treasure hold up a mirror to an archetypal liveliness that students recognize because it already exists inside them. Each of the stories inspires because they both hold a promise of healing coming through the door of wound or limitation against the odds. They are potent metaphors for a healing model describing the promise of what might grow in people’s lives if the purpose and wisdom of the psyche-soul is attended and followed. My sense is that Sesame holds this value for the entire dramatherapy profession, because we have the support and challenge of a dream message and a story metaphor. These keep us allied to archetypal knowing and the practice of working from inner-world health. A close connection formed with the work of Sesame’s patron James Hillman and his archetypal psychology, which gives a place to soul outcomes in therapy manifesting qualitatively. Meaning as a route to prognosis and the living of life is as important as diagnosis and treatment, which only succeed when they bring about quantifiable change and cure.

What’s a soul? In the space of this chapter, it is not possible to offer a literature review on the history of ideas around the human soul, and the phenomenon that I am calling soul would not appreciate being boxed in by a lining up of facts. I am, therefore, going to offer four stories as thin spaces to see through to soul, and will then provide some cite-bites of theory to underpin them.

Before the Beginning First of all, and prior to all else, She was there. First-born, there at the source, brought into being, well before Earth began. Before Great God conceived the waters, She was there. Before Great God sculpted mountains or gave the hills their shape, there She was. Before Great God lowered himself to the details of soil or horizoned the sky, Her wisdom was there. Present and vital, making sure everything held and was underpinned, ensuring all came together. All this, before She was forgotten. But now, She claims her place! She takes her stand in the city square, at the busiest junction. ‘You Fools! I am talking to you. Ready-up to hear! If you fail to notice, you flirt with death, and damage me, your soul.’ She, who was always, has built a house close to her neighbours Sanity, Knowledge and Discretion. She has set a banquet with flowers and silver. She calls in the city, ‘Nothing you could wish for holds a candle to me. I have prepared fresh bread, my wine is poured. I am Insight. Feast with me.’2 184

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Soul into matter The Creator gathered all of creation and said, ‘I want to hide something from humans until they are ready for it. It is the part that makes me real to them and it is precious. Not to be squandered.’ Eagle said, ‘Give it to me, I will take it to the moon.’ The Creator said, ‘No. They will go there and find it.’ Salmon said, ‘I will bury it in the bottom of the ocean.’ The Creator said, ‘No, they will go there too.’ Buffalo said, ‘I will bury it on the Great Plains.’ The Creator said, ‘They will cut the earth skin and find it even there.’ Grandmother Mole, who has no physical eyes but sees with spiritual eyes, said, ‘Put it inside of them.’ And the Creator said, ‘It is done.’3

Soul in the world In days when the everlasting ones still walked in Ireland, there was a deep well of wisdom. People came to it, but stayed only long enough to skim the surface of the water. They took this and turned it into knowledge, inspiring others without being inspired themselves, seeking only power and leaving the deep water unfathomed. Sinann, born of the sea, came wild. Unstoppable, unknowable and ungovernable she came. When the well waters sensed her coming, they rose up to meet her. The land was storm tossed as the well waters rose up to meet her and flowed free, available for all. That is how it is now, for those who will resist stopping at the surface and let the wisdom of Sinann blow through them and on freely to others.4

Purpose and call Er, as a soldier, had fought all his life, but, after his final battle, he journeyed with other souls to a strange meadow where he saw passages leading up and down, and Judges directing souls above or below. They told Er to write everything he saw. Once judged, the souls all camped out together, sharing songs and stories. On the eighth day, they set out for a pillar of rainbow light, in which Necessity was enthroned and beneath her sat Lachesis, who sings of the past, Clotho, who sings of the present, and Atropos, who sings of the future. Each soul was told to select their next life. They must choose wisely, for, once made, the decision could not be revoked. Having chosen, each soul returned to Lachesis, who gave each a daemon, to protect the life. Clotho span the life and the daemon into one single thread, on her spindle. And Atropos plaited the thread, so that it could never be broken. Each soul bowed before Necessity and then travelled until they came to the River of Unmindfulness. Thirsty, they drank, not knowing the water would erase all memory of what had gone before. Much later, a great storm cast them upwards from where they fell back to earth to try to remember the purpose they had chosen. And Er wrote it all down, so that we now know.5 The stories show nuances of soul, which are now restated through a patchwork of citations: It’s the job of a psychological person today to reclaim psychology from theology where it has been trapped. The fact that theology made dogmas about the soul – about its immorality, about its nature, about the catechism . . . doesn’t necessarily mean that the individual today has to continue in that theological fashion. So soul-making . . . is taking the soul out of jail. (Hillman 1983, p. 18) It is impossible to define precisely what the soul is. Definition is an intellectual enterprise anyway; the soul prefers to imagine . . . its instrument is neither the mind nor the body, but imagination. (Moore 1994, p. xiii) 185

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The Soul wants imaginative responses that move it, delight it, deepen it . . . explanatory responses just put us back into positivisms and science – or worse into delusion . . . an ignorance that makes us believe we know. (Hillman 1983, p. 38) The soul needs love as urgently as the body needs air. In the warmth of love the soul can be itself. All the possibilities of your human destiny are asleep in your soul. You are here to realise and honour these possibilities. (O’Donohue 1997, p. 30) What Jung was acknowledging here was that the epiphanies of soul exceed the words that psychology give to them, there is always a gap, and perhaps even an abyss, between what psychology says of soul and what soul wants to be spoken. (Romanyshyn 2007, p. 30) I would like to add a way of responding to the notion of Soul. Soul is the container for all aspects of the human condition that she holds unconditionally, opening them to the presence of the divine, without expecting judgement or demanding transformation or result. Soul does not strive to make better, nor does she have a moralizing function. Soul is in the realm of mystery, rather than knowledge. Her purpose is to draw attention to inner purpose, the lost or hidden story about personal or collective meaning through the likening effect of symbol, through metaphor, imagination and relationship. Soul appreciates story because she feels at home there. Soul likes to move so that what is awkward does not get stuck. Soul does not want to talk too much, because it makes her dizzy. Illness, compulsive patterns, addictions, emptiness, erotic longing, failure, beauty are all ways through which Soul births what needs to be remembered or restored. Soul works to inspire a life that values inner qualities, even when outer circumstance seems without hope.

The Soul Cave and lower education The treasure Ali Baba found was hard to keep. He did not know whether to hide it or use it. It took a long time for him to know how to use the treasure, but eventually he put it to good use, in just the right way. Like Ali Baba, it took me time to consider the treasure at the back of the mythic cave and realize it was calling for attention. Over the years, the Sesame Approach knew all about drama and movement as keys and passwords, but had fallen shy of the inner gold, because it becomes invisible in the world of matter and daylight, even though it glints beautifully when left in darkness. The call to gold manifested to me when I was teaching the mythology module of the Sesame dramatherapy training in London. I had served there for 14 years but was feeling restricted by the curriculum, which appropriately steers students along a prescribed timeline towards a professional end. The part of my teaching that was most valuable to the students was when we slowed down to make space for the pain and import of what was wounded and insecure in their life story, and this could not happen until late on in the programme, when the students and I were sufficiently secure with each other to risk the unconscious, non-linear image fragments that make up soul thinking. I wanted to teach a counter-logical way of speaking spontaneously and in simple words about the experience of archetypal symbol through imagining and enacting a role. I wanted the soul of the person to be heard and not be interrupted by any over-fast interruption of logic to make 186

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sense. I started to note the conditions that people need to risk faltering, half-formed articulations and tolerate the attendant pink-cheeked, sweaty-palmed word fragments that communications from the soul inside prefer. When this happened, when we got there, the quality in the room changed. Students reported hearing themselves or others feel and say new and vital things. There was shift. An outside researcher or observer could not have measured these insights. What was happening was a change in energy and perspective that was qualitative. ‘Who is serving this soul treasure?’ I asked myself. ‘Who is teaching therapy through a pedagogy written inside out? How is time found for this in Sesame work? It was a big question. As with Asclepius of old, the message did not arrive with a how-to manual. The need to sit in with it and let something evolve and change from the inside out is terrifyingly unfamiliar for the ego or outer personality. In time, I realized that I needed to uproot myself from teaching and ponder the conditions of a soul training through the Sesame way of working, sufficiently rigorous to be respectable, but that would be assessed differently and that would make a clear return to world by attending uncompromisingly to the health behind brokenness in its own terms. Thus began ‘Psyche and Soma’, which has been running to a lower-education standard since 2008 and is written about more fully at www.sesame-institute.org/psyche-and-soma

To sum up In this chapter, I have been suggesting that dramatherapy – springing from Greek theatre, where gods and health belonged – might do well to consider how open we are to the modern God root. Based on the dream story and the Ali Baba metaphor, Sesame grapples with this and is beginning to extend the ideas of archetypal psychology through embodying soul, now taught on a Sesame training course for health-care professionals. However, questions must follow. How does it better the world to have a soulful perspective? What is the point of it? Can it make any difference to practice? As yet, these questions can only be posed. The answers, in case-study data, are emergent and still in the making. Some fragments of soul precepts have become clear, however, and, in conclusion, I offer these first findings: A soulful perspective: • • • • • • •

works in an emerging paradigm of consciousness through imaginal intelligence; favours what is damaged and honours what is broken, without cheering it to an over-fast resolution; transforms suffering by giving it a context within the pattern of an ancient story, so that image and meaning emerge; tends to healing more than it prioritizes cure; unseats pathology and shame by instilling love and a connection to spiritual perception, individually and, thus, collectively; adheres to infinite time and is not governed by the limitations of life goal or time running out; comes into its own when death is close.

Carl Jung, who spent his life in the service and study of soul, wrote in a letter to Eugen Rolfe: I had to understand that I was unable to make the people see what I am after. I am practically alone. There are a few who understand this and that, but almost nobody sees the whole. 187

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. . . I have failed in my foremost task, to open people’s eyes to the fact that man has a soul and there is a buried treasure in the field, and that our religion and philosophy are in a lamentable state. (Rolfe 1989, p. 1) If only he had known the way of working we call dramatherapy, or the international crowd of us who ‘serve the treasure’. If our religions and philosophy are tired, dramatherapy is fresh and alive throughout the world. It is time to take hold of our calling and freshen the old systems, with our creative joy most certainly, but also with what yet lies in our practice unnamed. In time, there will be more to say. This work is only at its beginning. All praise to the Mystery, the Universe, Higher Power, Ultimate Reality, the Cosmos, Zeus, Buddha, Mohammed, Allah, Christ or God – name it as you will. Name it as you will.

Notes 1 2 3 4 5

Email to Mary Smail, unpublished correspondence, October 2014. Used with permission. The Bible, Proverbs 8 and 9, paraphrased by Mary Smail. Sioux myth, retold by Mary Smail. Irish myth, retold by Mary Smail. The Myth of Er, retold by Mary Smail.

References British Association of Dramatherapists. (2011) Online. Available at: https://badth.org.uk/ (accessed 7 February 2016). Dramatherapy Centre, Sydney. (2014) Online. Available at: www.dramatherapy.com.au/index.html (accessed 7 February 2016). Edelstein, E., Edelstein, L. and Ferngren, G. (1998) Asclepius: Collection of interpretation of testimonies. Baltimore, MD: Johns Hopkins University Press. Hillman, J. (1983) Inter Views. Dallas, TX: Spring. Jung, C. (1970) The Structure and Dynamics of the Psyche (2nd edn). Princeton, NJ: Princeton University Press. Lindkvist, M. (1998) Bring White Beads When You Call on the Healer. New Orleans, LA: Rivendell House. Moore, T. (1994) Care of the Soul. New York: Harper Perennial. North American Dramatherapy Association. (2014) Online. Available at: www.nadta.org/ (accessed 7 February 2016). O’Donohue, J. (1997) Anam Cara, Spiritual Wisdom from the Celtic World (2nd edn). London: Bantam. Pearson, J. (1996) Discovering the Self through Drama and Movement. London: Jessica Kingsley. Pearson, J., Smail, M. and Watts, P. (2013) Dramatherapy with Myth and Fairytale. London: Jessica Kingsley. Perry, J. (1998) Trials of the Visionary Mind. New York: Suny Press. Rolfe, E. (1989) Encounter with Jung. Boston, MA: Sigo Press. Romanyshyn, R. (2007) The Wounded Researcher: Research with soul in mind. New York: Spring Journal. Webster Online Dictionary (2014) Online. Available at: www.merriam-webster.com/dictionary (accessed 7 February 2016).

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Part III

Internationalism and specific practice

The premise for Part III is the focus on specific practice. We focus on dramatherapists from around the world who work with specific populations of clients, be they children, adults, older people or people in specific situations struggling with particular life-changing illnesses or events. We begin with Alia Safadi Zoabi and Natalie Hayek Damouni (Israel), whose chapter focuses on working with women who have been sexually abused within Arab/Israeli societies. There is an acknowledgement from them that scholarship on creative therapies in the Arab world is scarce. Their chapter adds significantly to this. Penny McFarlane (UK) invites us to consider the plight of children and young people today in Western society. She acknowledges the important contribution that dramatherapy can make to supporting children who have suffered a variety of abuse. We then return to the Arab/Israeli context, and Amani Mussa (Israel) considers the use of dramatherapy approaches with children with special needs in the education system and the challenges this creates within Mussa’s own social context. We remain with children and adolescents when Anna Marie Weber and Craig Haen (US) share their dramatherapy practice, with case examples from an attachment perspective, examining what young people need in order to create happy and healthy relationships. Sarah Mann Shaw (UK) also works with children and young people and examines, through her private practice, the issue of assessment in dramatherapy and the importance of the relationship between therapist and young client. We move to a very different population with Milan Valenta and Ivana Listiakova (Czech Republic), who share with us their research into working with adult clients who have neurotic disorders within a Central European health-care system. They offer some valuable quantitative data suggesting the benefits of dramatherapy to assist this population. In Chapter 25, Dorit Dror Hadar (Israel) shares with us her moving account of working with terminally ill patients and how dramatherapy can be of benefit to people, even within the final weeks and days of their life. In the final chapter of Part III, Joanna Jaaniste (Australia) shares her Antipodean experiences of working with clients struggling with one of the most debilitating conditions – dementia. She too explores the benefit of dramatherapy for people struggling with such huge, life-changing and challenging events.

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19 The contribution of dramatherapy to the reconnection of abused Palestinian females with their bodies and feelings Alia Safadi Zoabi and Natalie Hayek Damouni

Introduction Scholarship on creative therapies in the Arab world is scarce. Dramatherapy is a form of psychological therapy. It is a new, experiential approach that was formally founded in the UK in 1976. In the US, it first began to appear in therapeutic circles in 1979.1 It would take nearly a decade before it arrived in Israel, in 1988. As for the Arab Palestinian minority in Israel, dramatherapy remains alien to this day. Conventionally, the Arab society is conservative and mostly views patients of therapeutic fields such as psychotherapy as suffering from strains of mental diseases. Moreover, the societal framework particularly targets female patients in its ruthless categorisations of people undergoing therapy. There is a general fear that therapy may increase independence and ultimately destabilise a woman’s life and marriage (Alnabulsi and Mansour 2011, p. 93). Dramatherapy enables access to emotional and psychological problems and exploring inner issues, which increase women’s self-awareness by dramatic distance instead of direct talking. The aim of this chapter is to present specific cases of how dramatherapy relates to conceptualisations of the female body in the patriarchal context of Arab societies. First, we intend to discuss specific problems regarding the female body in Arab patriarchy. Then, we want to focus on the role of the body in dramatherapy in general and how it is used in the therapeutic process. Second, the chapter compares and contrasts characteristics of two generational groups of Arab females in dramatherapy sessions: adult women and adolescents. We present two case studies to demonstrate how dramatherapy helps Palestinian women in reconnecting to their bodies and emotions.

Abused Palestinian Arab females: Between body and heritage In this chapter we are going to present the complex structure of oppression used against women and adolescent females and their bodies. 191

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The Israeli–Palestinian social field is informed by several meta-narratives, including modernity, national identity, cultural authenticity, Islamic morality and liberal entitlement. Despite the various epistemological contradictions between these meta-narratives, their institutional forms are alike in that they are all distinctly patriarchal2 (Saar 2007, p. 53). The Arab Palestinian family structure is traditionally patriarchal. Hisham Sharabi claims that patriarchy has survived despite attempts of modernising Arab society. As a result, a ‘neo-patriarchal’ structure has emerged that may appear modern, and at times progressive (Sharabi 1988, p. 4), but it has mainly continued to marginalise and inferiorise women in the roles of serving men (Piltak and Mahameed 1989). Arab mothers, the main caretakers of children, as in most societies, create different relationships with their sons and daughters. Whereas they encourage the boy to leave them to become independent from an early age, they encourage the girl to stay close, even till amalgamation. Females design their identity basically from a lasting relationship to the mother, who treats her daughter as a projection of herself (Chodorow 1999). This development of identity is based on gender ideologies that are related to social patriarchal structures. In many societies, adolescent females go through a multistep identity crisis. The female crisis of identity and moral belief centres on her struggle to disentangle herself from others and to find a language that represents her experience, understanding her status and role as a woman in the society (Gilligan 1995, pp. 156–7). In a suppressive societal framework that discriminates against women, adolescent Arab females do not experience similar identity crises, and they may never establish individual autonomy. They are not expected to act out, become self-centred or engage in nonconformist behaviour. Marwan Dwairy claims that the ‘self’ in Arab society is defined as an addition to the collective. The individual identity is defined exclusively in relation to familial and tribal affiliations, rather than personal features or achievements (Dwairy 2006, p. 61). As part of the collective patriarchy, adolescent Arab females are merely raised to serve others’ needs, rather than their own. Arab society determines female behaviour from early childhood. It ruthlessly criticises social behaviour and physical movement, forcing young females to respect and necessarily stick to strict ethical standards: ‘be shy’, ‘speak in low voice’ and ‘dress humbly’ (Reziq 1983). Society’s formative criticism extends to interpersonal relationships: talking to adolescent males may be viewed as ‘inappropriate’. In some cases, such interaction is even prohibited. One effective mechanism in maintaining this cultural attitude is what is known as ‘honour law’. It is an unwritten law targeting women, thus determining their behaviour in all areas of life. From a patriarchal perspective, non-obedient or law-breaking conduct warrants penalty, at times, even execution (Hawari 2014, p. 2). This patriarchal repression aims to weaken the woman’s self-esteem and pride and reinforces traditional gender roles (Shalhoub 1999). As a result, adult and adolescent females grow up with no authority over their own bodies whatsoever. The oppression of Palestinian women in Israel is threefold. First, they are inferior in the context of cultural patriarchy. Second, the State of Israel discriminates against them, as they are Palestinians. Third, the State of Israel also discriminates against them because they are women.3 This triple oppression shapes every aspect of women’s daily lives – be it in the personal or public sphere – and empowers male hegemony in society. These relations similarly exclude women from decision-making positions by depriving them of economic and social independence. Also, they position women under male custody in all stages of life (Hawari 2014). One of these aspects applies to the female body. As Zeinab Muaddi puts it, the body is one of the main sites for the suppression of women (Muaddi 2004, p. 75). Discrimination against adult and adolescent Palestinian females in Israel determines the construction of the female personality: awareness of herself and her needs, independence in making decisions and controlling her body and life. 192

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Palestinian females in Israel generally face extensive repression in their own society. Abused females suffer the most and are particularly targeted; thus, they need help and support.

Dramatherapy and abused Palestinian females in Israel Dramatherapy is effective for females who have experienced traumatic domestic abuse or violence. Working through the media of drama and movement can encourage them to explore feelings and emotions at a distance from their own experience, and to reconnect with themselves. In this chapter, we will focus on the role of the body in dramatherapy in general and how it is used in the therapeutic process according to Jennings’ (1998) EPR model in particular, and its use with abused women and adolescent females.

Dramatherapy Dramatherapy employs expressive tools and created metaphors to help clients set goals, tell their stories and solve problems. They express feelings and, hopefully, experience catharses. Clients may explore the depth and breadth of inner experiences through drama to enhance interpersonal relationship skills. Moreover, they may expand and further develop life roles. Stories, myths, body movements, voice, play texts, puppetry, masks and improvisation are examples of the range of artistic contexts a dramatherapist may employ. These enable clients to indirectly explore difficult and painful life experiences by affording them some distance from real-life crises. Dramatic distance is an important step in the therapeutic process. It creates a safe medium for clients to explore thoughts and feelings, and those enable them to gain perspective on the immediate reality and actively experiment with alternatives.4 The body is used as a main tool of communication and expression in dramatherapy. It is a medium through which inner material can emerge. The use of the body in a dramatic act trains the individual to be expressive and aware of their own body, which changes the way they relate to their body and their sense of identity (Jones 1996). Body movement can be regarded as a communication of the mores, customs and role relationships found in Arab culture. Dramatherapy sessions usually start with a warm-up exercise to prepare body and mind for activity; this warm-up focuses on the physical being and also opens imagination and creativity.

Embodiment–Projection–Role Embodiment–Projection–Role (EPR) is a dramatherapy theory developed by Sue Jennings. The EPR model charts the ‘dramatic development’ of children from birth to the age of 7, which roughly demarcates the age limit for when children become able to enter the world of imagination and symbolism – that is, the world of dramatic play and drama (Jennings 1998, p. 1). During (EPR) stages, children develop understanding of everyday reality and the imagination, and this enables the body self and other and the role self and other to become established, influenced by the values of the society (Jennings 1998, p. 61). During the first year, children’s early experiences are physical and mainly expressed through bodily movement and the senses, which are essential for the development of the body-self. The transition from the embodiment stage to projection occurs between the ages of 2 and 3. Children begin to relate to their surroundings in ways that are not merely physical. They start to construct stories by means of objects such as the doll’s house, drawings or puppets. These objects are 193

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usually considered to be a child’s first symbol, usually representing the absent mother figure. In the role stage, which occurs between the ages of 6 and 7, children begin to take on roles. They develop the right role for the right scene, and their level of awareness gradually increases (Jennings 1998, pp. 54–6). The role allows clients to explore various dimensions of their inner personality and selectively pull out secrets and different aspects from the inner world, towards gaining wider skills (Landy 1992, p. 101). EPR can be integrated into group dramatherapy sessions with both women and female adolescents. When they are able to make their experience physical and make it larger than life, when they can take on different roles and characters, their EPR becomes extended in movement, voice, objects, space, themes and roles. It enables them to transform their experience and go beyond themselves (Jennings 1998). Domestic abuse and violence can leave women with a poor sense of self and cause serious trauma. Psychosomatic symptoms such as loss of authority or disconnecting from the body are common. Abused women are locked in a cycle of avoidance and are mostly neither ready nor willing to address issues directly. The psychological effects of abusive experiences are often buried deep in the unconscious and, as such, may not be accessible through talking therapies alone.5 This applies to both adult and adolescent Arab Palestinian females: the abused Arab females experience repression and traumatic abuse, not only as individuals, but also as women in a patriarchal society who suffer from triple oppression and mostly live in denial. They rely on ‘inferiorising’ their own body. As a result, there are many Arab females who do not accept their own body and live in isolation from it (Alnabulsi and Mansour 2011, p. 32). Abused Arab Palestinian females need a sort of therapy that can help them to rediscover stability and find their place in the world again. They need to re-establish their identity without feeling the guilt of being the survivor. Thus, it is very important to provide a safe space for them to explore their changing relationship to their self and the other through the body. Ritualising the trauma, either by telling it or creating a symbolic drama, allows forward movement rather than repetition; it is then possible to deal with the after-effects such as loss of belief and confidence (Jennings 1998, p. 43). Dramatherapy helps abused Palestinian females in Israel, first, to deal with forbidden social issues such as non-obedience or rejection of a man’s demands; second, to relate differently to the problem and focus on inner strengths instead of self-blaming or victimising; and third, to create new perspectives towards their personal lives and choices. It also supports them in exploring new roles in their life and reconnecting with their body and will. This process can re-establish EPR development, which contributes to obtaining tools to deal with distressing experiences.

Case studies from past and recent fieldwork As dramatherapists, we meet adult and adolescent females during crises that expose the fragility of their feminine identity. Also, they are detached from themselves, and from their own wills, and are more connected to the external world and others’ needs. We have presented two case studies here. The first focuses on women and was performed in 2004. The second one is based on recent fieldwork and focuses on adolescents. The therapeutic process presented relies primarily on Sue Jennings’ EPR model. Unlike adult females, the adolescent females brought different issues and dilemmas to the sessions. Most of the adolescent females were moving more easily and using their voices, even though they could not understand the emotional, expressive language at the beginning. 194

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Case 1 (2004) This case focuses on a group of ten women, in their thirties and from low socio-economic backgrounds. Some were married and others divorced. They went through a short-term therapeutic process. We met once a week for fifteen sessions. Most of the women suffered from depression and domestic violence, which damaged their personal resilience and self-esteem. The aim of our therapy was to help them become more self-aware and re-establish a healthy relationship to their bodies by enhancing inner strengths. In the early sessions, it was hard for these women to engage in a new expressive framework. Attempts to leave the safe space of their chairs and move authentically in this context mostly failed. They preferred to remain seated. The ‘threat’ of leaving this zone mirrored their deeply flawed relationship to their bodies. Nonetheless, as we advanced, these women became increasingly committed to the process. They found a place where they could share a common language of pain and hope. The projective work and the uses of metaphor with different projective items such as therapeutic cards, storytelling and drawing were effective in helping the group to relax and communicate with their inner worlds. Also, these items challenged them emotionally and encouraged them to express their feelings. They confronted various dimensions of authority, such as in their relationships to their spouses and the extended family, against which they felt helpless. They also confronted other critical issues, such as their inability to influence their surroundings and their nearly absolute dependence on the conventional familial framework. Their testimonies reflected these women’s deep depression as they described their solitary existence and anger towards society. Gradually, as the process progressed, the group gained confidence and succeeded in building a consistent framework in every session. Light stretching and breathing exercises, at the beginning, helped them to begin to leave their chairs and briefly move around. The participants occasionally dared to disengage from their chairs, but only for brief intervals. Then, they shared thoughts and feelings and, at the end, chose a personal experience they could explore further. The safe space associated with sitting on chairs set the main stage for these exchanges and explorations. Shorook One of the participants, Shorook, a woman in her thirties, was mostly shy and silent during sessions. She joined our group therapy after a long journey of mental and physical abuse by her husband. After years of humiliation in front of her children, she was weak and helpless. It was only in the seventh session that Shorook dared to share her personal experience. As her story progressed, she became increasingly tense and unable to complete her sentences. The other participants immediately rushed to offer advice based on similar, personal experiences and to vent their own frustrations. The situation was stressful and overwhelming. At this point, the therapists decided to employ a projective dramatic tool to help Shorook express her feelings and experiences from a safe distance. We began with the ‘empty chair’. Two chairs were posited in the room, and Shorook occupied one of them. She metaphorically invited her husband to sit in the other chair and talk about matters that were important to her. The conversation began to flow, but, at some point, her body started to shake, and she became incoherent, until she fell completely silent. The ‘empty chair’ proved a strong projective tool that brought Shorook to a close, tense, although imaginary, confrontation with her husband. She ultimately froze as she would in a real-life confrontation. 195

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In the following session, the work with Shorook continued. She shared her thoughts on many unjust things that had come to her attention and confused her. The other participants contributed by sharing their inner voices to help Shorook organise and focus her thoughts. Some voiced a fear of change and concerns about confrontation that may lead to further complications in family life. Others shared concerns about their incapability to confront family issues. A common theme in these sharings was the participants’ passionate desire for freedom and independence, regardless of the high price they might pay. Shorook derived strength from the group and dared to sit in front of the empty chair again. She metaphorically invited her husband again and articulated her feelings and demands. She expressed for the first time her frustrations and dissatisfaction with their relationship, her unlimited giving and sacrifices, her love and fear and, in a very strong, confident voice, she expressed her desire for change and demanded a relationship based on mutual respect. Gradually, in later sessions, Shorook became more active in the group. She started to express personal opinions to support other women and encourage them to confront issues in their lives. Towards the end, Shorook shared that she had dared to meet her husband’s eyes and explicitly express her wants and feelings. The expressive tools employed in the dramatherapy sessions helped Shorook change. She connected to her inner voice, which had previously been suppressed, and she was able to reinvent a voice both louder and stronger. As a result, she discovered a new will for freedom and independence, reconnected with a new, confronting role.

Case 2 (2013) This group consisted of ten participants. They were adolescents between the ages of 13 and 15, from low socio-economic backgrounds and with histories of abuse and violence. We met once a week, for fifteen sessions. The meetings took place after school in the Warm Home, a project run by the local municipality for abused adolescent females under 18. The aims of the sessions were to raise awareness of body image and encourage self-expression and the use of feelings in self-expression. Most of the adolescents used their bodies (in a limited way though), but there was one participant who was particularly blocked and did not move easily: Amal Amal joined the Warm Home later than the other participants in the group. Amal was very committed to the sessions. She always arrived on time. At the ‘joining’ stage of the short-term therapeutic process, Amal hesitated a lot before taking any step or saying any word. She did not initiate conversation. Others decided for her. Amal’s self-esteem was low, and she was unable to cope with problems by herself. Instead, she chose to run away by leaving the room. Amal was nearly invisible in the group. In the second session, the group chose her for the role of the ‘elephant’ in the Indian myth.6 She was not connected to her body. The others played the roles of six blind men and one wise man. At a certain point, when they repeatedly started to touch her body (as the elephant) and even stabbed her once, she did not resist. She merely stood still, inactively playing the role imposed upon her. In the following three sessions, the group entered into a personal process to raise awareness of body image. First, the participants of the group were asked to choose another participant that they trusted, for mutual help in this process. Amal hesitated at first, but joined the process after a while and chose a partner. Then, the participants were asked to lie down on a large piece of paper, one of a couple at a time, and the partner was asked to draw the outline of her partner’s body lightly on the paper, and then they changed places. After both participants had finished the outlines, they were asked to go into a personal process. Each participant of the 196

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group was asked to fill the image with shapes, colours and lines, in the way they saw themselves and their body. Amal mostly hesitated and constantly asked me what colours she should use, and how I see her painting. She moved between hesitation and frustration within the process. In the two following sessions, Amal was, respectively, absent for the first time and then late. This suggested the beginning of rebellion. Through encouragement, she continued her painting, asking for help over and over, and she learned gradually to trust herself and do whatever she felt like doing. Amal started with the ‘nails’. Usually, Amal’s clothes were dark and not expressive of her young age, and she wore a hijab.7 In her painting, she used a very shiny orange for the shirt, which was sleeveless and collarless, and green for her trousers. There was a tear larger than the eye, and there was no hijab or additional accessories. After she had finished the painting, she named it ‘the stranger’. When she shared her final work with the group, she expressed her happiness while doing it and said it was different from her choices in general. One of the participants asked her if she wanted to be like ‘the stranger’, without hijab and wearing bold clothes. She did not hesitate and said ‘yes’ loudly. Moments later, she regreted her boldness and retracted. She said the tear is larger than the eye because the ‘stranger’ feels very sad. Dramatherapy helped Amal to reconnect with her body image; she dreamed about being different. Although she found it difficult to connect to her body at the beginning, the projective work allowed her to wear bold colours, express internal fantasies and discover new, daring roles. Also, she began to move freely around during the following sessions. The projective expressive tool showed many contrasts in her work. By choosing different roles, she took advantage of the chance to be in another dimension, a place that she can’t experience in her reality back home or in the neighbourhood/society. The ‘stranger’ allowed her to reveal hidden aspects of her personality and express her desires out loud. This revealed inner conflicts between her own will and social traditions. This is the paradox of drama: I come closer by being more distanced (Jennings 1998, p. 117). Or, as in Amal’s case, she became closer through estrangement. Through dramatic distancing, she was able to express her feelings for the first time in the process and say that the stranger was sad. She was exposed to emotional language and faced this feeling by this expressive tool, not in a threatening way, but by assuming new roles. She allowed herself to feel sad and to express her sadness, and this reconnected her to her own feelings; the group mirrored this to her. This process contributed to her self-awareness. For her, self-expression was possible within the therapeutic process in a society that does not allow her to speak up and express herself.

Conclusion Dramatherapy with adult and adolescent females in the Arab society revealed a significant conflict between therapeutic approaches and social convention. On the one hand, dramatherapy is based on movement and use of the body. On the other hand, society has damaged how these women viewed their bodies (Alnabulsi and Mansour 2011, p. 32). This deeply impacted physical participation during sessions. Dramatherapy with the adolescent females brought different, common issues and dilemmas to the sessions. Unlike the adult females, most of the adolescents moved easily and used their voices, but they could not understand the emotionally expressive language at the beginning. Free movement does not suggest that they easily connected to their bodies. Rather, it may reflect the beginnings of society’s oppression of young personalities that are not fully developed yet. Society may conceive of authoritative attitudes towards the body as a betrayal of ethics and convention. Adult and adolescent females in the Arab Palestinian society connected to the 197

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collective unconscious, which directs them to be humble and shy, to speak in a low voice and neither laugh nor sing loudly (Reziq 1983). More significantly, the collective directs them towards shame of their own body. With both generations, movement seems threatening, as it highlights the conflicts between the woman and her own body. The social oppression and disconnection from body lead abused Arab females through different dramatic developments from those presented by Jennings. These developments impact the last stage of the role, which leads them to take on rigid roles rather than exploring new ones and limits their skills. The therapeutic process based on Jennings’ EPR model, as illustrated in Amal’s and Shorook’s case studies, reflected difficulties in the embodiment stage, in which they were asked to move their bodies or express themselves by body movements. Participants, both women and adolescents, felt safer with the projection stage (e.g. the chair, using therapeutic cards and body drawing). Projection created a distance from their actual, real-life identity; it helped them later, especially the women, to dare to move out of the chair; furthermore, it helped to raise inner conflicts and develop an alternative relationship with them. Self-exploration allowed for the discovery of new dimensions in their personalities and exploration of different roles. The ‘empty chair’, in Shorook’s case, gave her the opportunity to explore new roles, such as the confrontation role, and to widen her skills. The drawing, in Amal’s case, revealed hidden aspects in her personality and created a new role for the stranger in her life. Dramatherapy encouraged both groups to explore feelings and emotions and reconnect to their bodies and feelings through distancing and projection. It helped them to re-establish the EPR development and discover various tools to deal with distressing experiences. The sessions contributed to the construction of an independent self, a personal outlook and a world with significant relationships. For the authors of this article, working with abused adult and adolescent females in a patriarchal Arab society makes dramatherapy challenging. At the end, we ponder how hard it is to make a change in a traditional society. What is the price that these women pay for individuality? In the short-term therapeutic processes, we sensed a beginning of change. Hopefully, abused women such as Shorook and Amal will become more independent so that they can make free choices for a better quality of life in the future.

Notes 1 2 3 4 5 6 7

See www.nadta.org/ A patriarchal society has a powerful hierarchal structure controlled by men and features social division of the gender workforce; the individual is very submissive to the family and norms. See www.mada-research.org/en/gender-studies/ See www.nadta.org/ See www.dramatherapist.net/dramatherapy-for-victims-of-domestic-violence See ‘The blind men and elephant’. Online. Available at: www.constitution.org/col/blind_men.htm (accessed 21 February 2016). Hijab: a scarf that religious Muslim women put on to cover their hair.

References Alnabulsi, R. and Mansour, A. (2011) Women and Their Bodies. The guide to women’s health, bodies, and sexuality. Part 1. Tel-Aviv: Women and Their Bodies Organization. Chodorow, N. (1999) The Reproduction of Mothering: Psychoanalysis and the sociology of gender. Berkeley, CA: University of California Press. Dwairy, M. (2006) Counseling and Psychotherapy with Arabs and Muslims. New York: Columbia University. Gilligan, C. (1995) In a Different Voice: Psychological theory and women’s development. Cambridge, UK: Cambridge University Press. 198

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Hawari, M. (2014) ‘The murder of Palestinian women: Amid patriarchal authority and Israeli authority’, Jadal, 19, 27–31. Jennings, S. (1998) Introduction to Dramatherapy. London: Jessica Kingsley. Jones, P. (1996) Drama as Therapy: Theatre as living. London: Routledge. Landy, R. (1992) ‘One-on-one: The role of the drama therapist working with individuals’, in Jennings, S. (ed.), Dramatherapy: Theory and practice 2, pp. 97–111. London: Routledge. Reziq, I. (1983) ‘Women’s role in contemporary Algeria: Tradition and modernism’, in Utas, B. (ed.), Women in Islamic Society: Social attitudes and historical perspectives, pp. 192–210. London/Malmo: Curzon Press. Saar, A. (2007) ‘Contradictory location: Assessing the position of Palestinian women citizens of Israel’, Journal of Middle East Women Studies, 3, 45–74. Shalhoub, K. N. (1999) ‘Towards a cultural definition of rape: Dilemmas in dealing with rape victims in Palestinian society’, Women’s Studies International Forum, 22, 2, 157–73. Sharabi, H. (1988) Neopatriarchy: A theory of distorted change in Arab society. New York: Oxford University Press.

References in Arabic Muaddi, Z. (2004) Aljasad AlU’nthawy Wa Houloum Al Tanmiya [The Female Body and Development Dream]. Aldar ElBaydaa: Morocco: Dar el Fanak Press.

References in Hebrew Piltak, I. and Mahamed, N. (1989) Ot Shel Piham, Olamam Shel Tzee’rem Aravim Biyisrael [Coal SignalAdolescent Arab World’s in Israel]. Givaa’t Habiba: Arab Studies Institution.

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20 Drowning . . . but waving Children today Penny McFarlane

Vignette 1: Jodie Everyone was highly concerned about Jodie. From the teaching assistant who used every trick in her book to try to engage and sustain her attention, to the headteacher who had held numerous meetings with both parents and support staff, no one could work Jodie out. She did not want to come to school. When asked, she liked school, liked her teacher, didn’t find the work difficult and wasn’t being bullied. She just did not want to be there. Moreover, she was unhappy: palpably, intensely unhappy. She had lost her maternal grandmother during the preceding year, but her distress seemed out of proportion to the natural grief felt by the family. Everyone, including family, seemed mystified.

Vignette 2: Sam Sam spent the majority of his school day hiding under tables. He could be enticed out for break and lunchtimes, but only if someone held his hand all the time. He too had had a family bereavement, this time in the form of his paternal grandfather, but the teaching assistant with whom he spent most time said that Sam did not seem overly close to his grandfather, nor that upset by his death. Clearly, something was bothering Sam, but what? This chapter will endeavour to show how children such as Jodie and Sam were helped by a combination of dramatherapy and family therapy: how dramatherapy is ideally placed to represent the voice of the child, and family therapy is able to put that child’s needs within a recognisable context. It will put forward the supposition that, ‘the joint working of drama and family therapy may be seen as valuable support for children and their families’, and that therapy in education goes a long way towards achieving the aims of recent UK government policy, namely to ‘help children and young people to be healthy and safe, to enjoy and achieve, and to make a positive contribution’ (McFarlane and Harvey 2012a, pp. 154, 17). Moreover, the commonalities in the two disciplines may be shown to make this combined approach, especially within a multi-agency team in education, an effective way of understanding what children are trying to tell us through their behaviour, joining up the pieces of the jigsaw so that further 200

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tragedies may be prevented. In particular, the increasingly concerning issue of children affected by parental mental illness will be discussed and used as a basis for relevant case histories. In the USA, the National Co-morbidity Survey (Nicholson et al. 1998, 1999) showed that 68% of women with mental health disorders are parents, compared with 57% of men. Similar figures are reported in the UK (Richman, 1976, Brown and Harris, 1978, Oates, 1997) and in Australia (McGrath et al. 1999). (Cooklin et al. 2012, p. 13) In essence, both Jodie and Sam had the same problem – one that was not fundamentally of their own making but originated in the difficulties of their parents. ‘Sometimes children’s “bad” behaviour, anger or even violence can mask a parent’s problems, allowing the focus of shame to shift from parent to child in a concealed transaction that neither may be fully conscious of’ (Chown 2013, p. 180). Here, Chown is writing about the effects on children of parental drug and alcohol problems, but I put forward the premise that this statement may equally be true for parents affected by other issues, such as, as seen in this context, abuse and bereavement. The level of escalation of this problem, as observed during my time as a dramatherapist working in education, has led me to choose this particular issue as a basis for demonstrating the value and effectiveness of a combined dramatherapy and family therapy approach. That is to say, during the last 15 years, I have observed a fundamental rise in the number of children whose behaviour has, at first sight, been anomalous with their environment. Even taking into account the fact that, ‘Difficult behaviour in classrooms can indicate emotional difficulties at home; for instance the separation of parents or the death of a grandparent’ (Leigh et al. 2012, p. 5), nothing in these children’s current personal situations or backgrounds has been able to provide sufficient explanation for the degree of anger, misery, fear, hostility, etc. they are portraying. Nevertheless, their distress is real. It is only, in my experience, through prolonged, combined therapeutic interventions that an unexpected discovery has been made: these children are reacting to the distress of their parents. After some weeks, Jodie told me a story and drew pictures, which raised my concerns to the extent that I took both story and illustrations directly to my supervisor. She confirmed my suspicions: there was reason to believe Jodie might be the victim of abuse by a member of her family. Sensitive handling by the family therapist, however, resulted in a disclosure by the mother that it was not Jodie who was being abused but the mother, by her own father. Furthermore, this abuse was taking place while the children were normally at school, thus explaining Jodie’s reluctance to attend classes. The mother was emphatic that Jodie knew nothing of the abuse, but her story and drawings had said otherwise. Her mother’s distress had become her own: her mother’s hidden attempts at suicide had become Jodie’s cries for help. Without the intervention of the family therapist, both the social worker and I might have embarked on a painful and totally erroneous line of enquiry; without the dramatherapeutic input, which enabled Jodie to tell of her distress through the metaphor, the abuse might not have been discovered. These last statements are, of course, hypothetical, but the facts serve to demonstrate the need, as highlighted in the Laming report on the Victoria Climbié case (Lord Laming 2003), for professionals, at least in these complex cases, not to ‘go it alone’ but join forces and compare notes. Sam’s story was similar. Although it was true that he himself did not feel deep grief for the grandfather he hardly knew, his father was inconsolable. On the surface, the father had been telling everyone that the family was ‘coping’, even though traumatic circumstances had surrounded the death. In reality, the father was ‘hiding away’, refusing to leave the house and making excuses as to why he should not have visitors. He had begun to drink heavily but had forbidden his wife to talk about the situation, saying that it was no one’s business but his 201

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own. Moreover, he was not talking to his children, who knew that something was very wrong, but did not fully understand what, and had begun to think it was something they had done. By hiding under tables, Sam was, in the metaphor, mirroring his father’s behaviour. In familytherapy terms, Sam was bringing his family to therapy. As a dramatherapist, I inhabit the land of metaphor, so much more since this is the natural landscape of children, where they feel most at home. It is much easier for (a child) to tell you that the baby tortoise was unhappy because he couldn’t run as fast as his friend the cheetah, than try to explain the complex feelings he has around the fact that he is not as bright or quick as his older brother and is afraid his parents do not love him as much. (McFarlane 2012, p. 28) As a dramatherapist, I am used to listening to, accepting and, if appropriate, encouraging the extension of stories and plays in which the metaphor is, more often than not, an amazingly creative interpretation of his or her situation on the part of the child. However, this realisation that I must add another dimension to my thinking, that I must consider the possible ‘downloading of information from parent to child’ that may be present in the child’s metaphorical presentation has, I will own, pushed at the limits of my experience (and, at times, credulity) as a dramatherapist. The verification of this ‘downloading’ has been made much easier by the intervention of a family therapist, and I would suggest that, as we see a rise in adult mental health issues and consider the effects on children, we should, as dramatherapists, acknowledge the need for a combined therapeutic approach to address this very real and growing problem, which is, at long last, beginning to be recognised and, in some measure, addressed. ‘When artists converge on a particular subject en masse it suggests a degree of cultural significance or urgency. What, then, to make of the number of shows at this year’s (Edinburgh) festival concerned with mental health?’ (Trueman 2014, p. 9). In Sam’s case, after working separately with parent and child, my family-therapist colleague and I were able introduce some combined sessions in which Sam learned that, although very sad, his father was going to survive, and his father learned that, by not sharing his feelings, he had created a situation where his children had imagined a far worse scenario.

Vignette 3: Kevin Kevin was another young lad whose metaphorical presentation of his situation appeared to be at odds with what we knew about him and his family background. The school reported angry, aggressive behaviour at the slightest provocation. His mother, a divorcee, was very concerned about her only child, whom she idolised. Kevin drew picture after picture of violent-looking sharks with extremely sharp teeth, of octopuses strangling smaller fish and little crabs hiding in dark caves. He was obsessed with these drawings and came to session after session not prepared to do anything else. He was an aloof boy at school, but there was no suggestion of his being bullied. Loved and cherished at home by his mother, he saw little of his estranged father, but reported happy, if infrequent, times with him. He had no access to violent DVDs or computer games, so where did all this violence originate? As with Jodie and Sam, Kevin was not trying to paint a picture of his own distress, but that of his mother. Although she was adamant that she had never spoken about her own abusive and neglected childhood, there was no doubt that somehow Kevin had picked up on this and was outwardly portraying his reaction, just as his mother was inwardly hiding hers. I put forward the hypothesis that cases such as Jodie’s, Sam’s and Kevin’s appear to indicate some correlation 202

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between the extent to which a parent hides his or her mental health problems and the extent to which a child exhibits disturbing and thus attention-seeking behaviour. In these cases, it is as if parent and child are enmeshed in a negative downward spiral of behaviour. Whilst a child’s mental health is affected by the parent’s mental health and the relationship s/he has with the parent, the parent’s ability to stay well is in turn affected by how the child is and how the parenting role and the relationship with the child is working out. (Cooklin et al. 2012, p. 19) By working through his anxiety and anger in a series of non-directive dramatherapy sessions, Kevin was able to externalize much of his buried and little understood emotional stress. The work, in Kevin’s case (as often feels most appropriate in these situations), remained entirely in the metaphor. Gradually, the sharks became less violent, and the little crabs, in the company of some other larger fish as protection, began to venture out of their caves. Meanwhile, Mum, with the support of my family-therapist colleague, was able to revisit and, in part, reframe her difficult and abusive childhood. Joint sessions were then held where the emphasis was on a bright and happy future. Continuing the underwater metaphor (interesting, as the sea is often taken to be symbolic of the emotions and/or the unconscious), Kevin and his mum explored ways in which the smaller creatures of the ocean could be protected and nurtured. In my advocacy for a combined therapeutic intervention, I must also recognize that many of my colleagues might make the point that work with the parent could equally well be done by the dramatherapist working with the child. Although I acknowledge that, in certain cases, this is possible, I would also suggest that working with parent and child might sometimes present a conflict of interests and might also breach the contract of confidentiality taken out with the child at the start of the sessions. I would also suggest that the potential ‘enmeshment’, as detailed above, might make separate sessions with parent and child, by the same worker, a difficult undertaking. The approach that worked well and that was found to be effective in the cases of Kevin, Jodie and Sam, as well as in many other cases, was, as detailed above, to conduct a series of separate sessions in which the child received dramatherapy and the parent received family therapy. In this way, both pieces of the jigsaw could be joined to give an enlightening picture, and, once the picture was understood, joint sessions could take place that involved the four participants: the child, the parent, the family therapist and myself as the dramatherapist. That the joint working of dramatherapy and family therapy is not only possible but also effective relies on the fact that, in many ways, both disciplines share basic commonalities. ‘In practice, systemic family therapy, like dramatherapy focuses on the relationships, stories and narratives told and heard and the metaphorical use of language’ (Strevett-Smith 2010, p. 8). It is this common use of the language of metaphor that, to my mind, unites family therapy and dramatherapy in a creative dance of effective intervention. Through metaphor, both therapies employ dramatic distancing to enable their clients to view their situation and problems through an objective rather than a subjective lens, which, as Jennings says, ‘Paradoxically . . . enables us to come closer and to experience at a greater depth’ (Jennings 1991, p. 6). In this way, a therapist may, in collaboration with a family that is struggling, search for a metaphor that describes its situation. Coming up, for example, with the idea that it feels as if it is pushing a very heavy cart up a hill, the family may then be able to explore such ideas as how it can lighten the load, who it might bring in to help push, and whether everyone is pulling (or pushing!) their weight. Both dramatherapy and family therapy rely heavily on building an atmosphere of mutual trust between all parties concerned. Both disciplines have as their core value an acknowledgement 203

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of the need to start where the child or family is. That is to say, neither discipline will enter the therapeutic alliance as the perceived expert. Rather, the family therapist will adopt a stance of curiosity and ‘not knowing’, and the dramatherapist will enter the world of the child and be content to remain there until such time as the child wants to move on. Both therapeutic interventions prefer to adopt the role of explorer rather than jumping to any preconceived notions of how things are or ‘should be’. Neither family nor child will feel that they are ‘done unto’. Rather, the approach is one of playfulness: more in the guise of ‘let’s play around with this for a while and see where it gets us’. Within family therapy, this is encouraged by the use of the ‘reflecting team’, who will discuss and reflect on the family’s concerns in front of the family. An in-depth explanation of family therapy techniques is beyond the scope of this chapter, but suffice it to say that, ‘this open debate and discussion can include disagreements and opposing points of view which can help a family in conflict feel understood’ and can provide ‘an antidote to the “problem saturated” ways of describing family dynamics’ (Strevett-Smith 2010, p. 9). Hand in hand with playfulness, a sense of humour and fun is also a valuable tool, used to help family and child view their problems as surmountable rather than momentous. A dramatherapist may encourage the child to see his or her anger as a naughty demon that sneaks up on the child while he or she is not looking. A family therapist may involve the family in taking a humourous look at their externalized problem, perhaps asking how each member would view the problem in terms of an animal and what mess it might make? Strevett-Smith was writing in 2010, but, by 2001, Bill Radmall had already outlined similarities in approach and structure between dramatherapy and postmodern systemic therapy, saying that, ‘Until recently these two fields of therapy seem to have been like two old relations who sit either side of a fence refusing to engage with or acknowledge the other’s existence’, and concluding, ‘I am struck at how much complementarity there is between the two fields. Both disciplines have great amounts of creativity and liveliness. So how is it they’ve not danced before?’ (Radmall 2001/2002: pp. 16, 18). Fortunately, since 2001, dramatherapy and systemic family therapy have begun to dance together, and, as recent government legislation has emphasized the need to address the requirements of the family (Landmark Children and Families Act 2014), I would propose that it is in everyone’s interests that they continue to do so for the following reasons. Dramatherapy has long been acknowledged in many circles as an ideal medium through which to access, explore and understand the voice of the child. It harnesses the child’s natural instincts to play and to express through play whatever emotions may be around for him or her, exploring in a safe way alternative scenarios, choices and outcomes. ‘In my work I often use the analogy of a garden which may be secret or derelict or overgrown or scary, and together through the playing we can find the safe spaces and face the monsters and the insects’ (Jennings 1999, p. 21). In the hands of a skilled therapist, it can bypass the left hemisphere of the brain, which judges, criticizes and filters out material that it deems inappropriate, unnecessary or even dangerous to divulge. As dramatherapy is ‘a procedure that moves from talking to creative action where the client is encouraged to let go, play in space, integrate action, imagination, feeling, thought’ (Casson 1998, p. 13), it follows that the child does not need to find the words to explain how they are feeling or why they may be reacting in such a way. For a very young child, or a child too deeply traumatised to use words to express emotion, this may be a way forward to understanding what is going on for them. It would seem, then, that dramatherapy or play therapy might well be a welcome solution as a way of addressing the concerns highlighted in the 2010 Ofsted report: that ‘babies and toddlers were unable to express themselves in words’, and that some children felt ‘uncomfortable speaking about their problems in front of other family members or in certain environments’ (NSPCC 2011). 204

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However, it is my experience that accessing the voice of the child in isolation is not always enough. To be able to bring about sustainable change to that child’s situation, I would suggest that, ideally, the child needs to be set within the confines of its family and environment. For many years, I worked as a lone dramatherapist within schools, both primary and secondary. Although I felt the work was usually effective in helping a child build on his or her self-esteem, resilience and confidence, which was useful in dealing with issues of confused role or gender identity and successful in the instances of buried or unresolved trauma, I was often dismayed by the child’s slide back into his or her previous challenging behaviour following a prolonged period back with the family. Additionally, I was aware of the homeostasis of the family: that is to say, by ‘changing’ one family member, in this case the child, I would inevitable bring about further changes to the social and emotional dynamics of the family as a whole. A child who had previously not displayed any disruptive behaviour might, for example, become the next scapegoat and behave accordingly. Tacit and often unconscious bonds, known within family therapy as dyads and triads, might well be affected, not necessarily in a positive way. Conversely, it must also be acknowledged that many therapists have done amazing work with children without recourse to their families. Alison Chown, a play therapist who advocates using ‘the outdoor environment which is a much more natural playroom for the child than a confined indoor space’, takes us through the case of Michael, with whom she worked over a prolonged period of time and who began eventually to be ‘much more resilient . . . with a stronger sense of who he was and able to cope better’, in spite of changing family situations and the relationship with his mother (Chown 2014, pp. 22, 180). In the same way that dramatherapy may be said to access the voice of the child, so family therapy listens to, and is an advocate for, the voice of the family. For some families, who have become fed up with the interventions and (as they often perceive it) intrusions from social and health workers, police and educational welfare officers, friendly faces dropping round for coffee and a ‘chat’, prepared just to listen and understand the situation ‘from the inside out’, can come as a welcome relief. Other agencies may view the family’s situation from their own perspective; the family therapists I know endeavour to put aside any preconceived notions they may have and consider the situation from the family’s point of view. Having listened to the child and to the family, they can then bring a more balanced perspective to bear on the overall situation. Additionally, alarm bells might ring when skilled and experienced family therapists are barred from entering a family home, and, in these cases, it would be more than ever important to use a dramatherapist or play therapist to access the voice of the child: the failure to do just this was one of the major concerns of the 2010 Ofsted report: ‘The child was not seen frequently enough by the professionals involved, or was not asked about their views and feelings’ (Ofsted 2011, p. 4). Another finding of the above Ofsted report was that agencies did not always listen to adults who tried to speak on behalf of the child or who had important information to impart. In Jodie’s case, before I began to work in tandem with my family-therapist colleague, I had, on the advice of my supervisor and the head of the multi-agency support team with whom I was working at the time, taken Jodie’s drawings and story to social services, who were interested but informed me that they could not consider seriously any information put forward in the metaphor. Much later, at a strategy meeting, they admitted that this was an oversight. The point is, not that my information could have been acted upon in isolation, but that it could have been considered along with the perspectives of other professionals to complete the jigsaw of concern. As Camilla Pemberton, in her article on serious case reviews for Birmingham City Council’s Community Care, noted: 205

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Another key issue running through both SCR’s were problems associated with multi-agency working. In both cases professionals often had concerns running in parallel to each other but never seemed able to join them up together, which according to the hindsight of a SCR, would have flagged up serious issues. (Pemberton 2013, no page numbers) Having worked for a number of years on a multi-agency support team within education, I am a huge advocate for this sort of work. I believe it is the way ahead to provide the best and the most comprehensive level of support for the child, meeting his/her needs and the needs of the family, provided that the professionals concerned ‘have the courage to work across boundaries of skills while maintaining professionalism’, so that they can ‘achieve greater multi-agency effectiveness’ (McFarlane and Harvey 2012a, p. 162). That is to say, the professionals concerned have to be prepared to overcome their own preferences and prejudices and talk to each other. I don’t pretend that this is an easy option, especially for therapists working from an intuitive, heart-centred, often-termed ‘touchy-feely’ way in a society that, on the whole, favours the quantitative, cognitive approach. In their article on culture, dialogue and identity in multiprofessional settings, Pete Holloway and Henri Seebohm refer to the difficulties often faced by a dramatherapist working within a multidisciplinary team who may find ‘her/himself one amongst many other professionals, who do not necessarily understand or sympathize with some of the core concepts of dramatherapy’, or who maybe ‘influenced by some of the more powerful professional voices within the team and more easily 6lose sight of her/his core professional identity’ (Holloway and Seebohm 2011, pp. 4–5). Difficulties notwithstanding, since such tragic cases as Victoria Climbié’s, the need to integrate services in the UK has been well and truly identified, alongside, as already discussed, the need to provide a skilled professional who is able to access the voice of the child. Valuable work within settings such as education is already beginning to happen in the UK: ‘the development of arts therapies such as dramatherapy in schools can be seen from an historical point of view as a key element of the move towards interdisciplinarity and the school as a site of multi agency working’ (Jones 2012, p. 25). Other countries, such as Sweden, have already embraced this approach, where there has been more emphasis on ‘addressing children and young people holistically’ with ‘aims to support their all round development’ (Moss 2003, p. 2). Elsewhere, countries such as South Korea are becoming interested in the arts therapies and their place within multi-agency working (McFarlane and Harvey 2012b). As dramatherapy is a relatively young profession, and multi-agency working is a relatively recent approach, it follows that the script for the coming together of these two characters has not yet been fully written. At this stage of the play, there is still much improvisation to be done, so that eventually a more formal set of lines, cues and directions can be set out to which the whole cast may be able to subscribe and adhere. The cultural and social need for this sort of performance has already been established and highlighted by recent tragic events. As one generation with diagnosed or undiagnosed mental-health difficulties grows up and produces another, the situation can only get worse, and so it is up to us, now, before it is too late, to recognise the signals from those children who are ‘too far out’ and who are waving, but who, through their waving, are trying to tell us, not only that they are in serious trouble, but also that they are, in fact, drowning.

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References Casson, J. (1998) ‘Right/left brain and dramatherapy’, Dramatherapy, 20, 1, 14. Chown, A. (2014) Play Therapy in the Outdoors: Taking Play Therapy out of the playroom and into natural environments. London: Jessica Kingsley. Chown, T. (2013) ‘When the child proof cap has been left off the medicine bottle – Dramatherapy with young people affected by parental drug and alcohol problems’, Dramatherapy, 35, 3, 174–85. Cooklin, A., Bishop, P., Francis, D., Fagin, L. and Asen, E. (2012) The Kidstime Workshops Manual: A multi-family intervention for the effects of parental mental illness. Anna Freud Centre. London: CAMHS. Holloway, P. and Seebohm, H. (2011) ‘When worlds elide: Culture, dialogue and identity in multiprofessional settings’, Dramatherapy: The Journal of the British Association of Dramatherapists, 33, 1, 4–5. Jennings, S. (1991) ‘Theatre art. The heart of dramatherapy’, Dramatherapy: The Journal of the British Association of Dramatherapists, 14, 1, 6. Jennings, S. (1999) Introduction to Developmental Playtherapy: Playing and health. London: Jessica Kingsley. Jones, P. (2012) ‘Childhood today and dramatherapy’, in Leigh, L., Gersch, I., Dix, A. and Haythorne, D. (eds), Dramatherapy with Children, Young People and Schools. Hove, UK: Routledge. Landmark Children and Families Act (2014) Department for Education. Online. Available at: www.gov.uk/government/news/landmark-children-and-families-act-2014-gains-royal-assent (accessed 20 August 2014). Leigh, L., Gersch, I., Dix, A. and Haythorne, D. (2012) ‘The role and relevance of dramatherapy in schools today’ in Leigh, L., Gersch, I., Dix, A. and Haythorne, D. (eds), Dramatherapy with Children, Young People and Schools. Hove, UK: Routledge. Lord Laming (2003) The Victoria Climbié Inquiry. Presented to Parliament by the Secretary of State for Health and the Secretary of State for the Home Department by Command of her Majesty. Online. Available at: www.gov.uk/government/uploads/system/uploads/attachment_data/file/273183/5730. pdf (accessed 20 August 2014). McFarlane, P. (2012) Creative Drama for Emotional Support: Activities and exercises for use in the classroom. London: Jessica Kingsley. McFarlane, P. and Harvey, J. (2012a) Dramatherapy and Family Therapy in Education: Essential pieces of the multi agency jigsaw. London: Jessica Kingsley. McFarlane, P. and Harvey, J. (2012b) Dramatherapy and Family Therapy in Education: Essential pieces of the multi agency jigsaw (Korean language edn, 2013, published by Sigma Press by arrangement with Jessica Kingsley). Moss, P. (2003) ‘Re-forming the education and care workforce in England, Scotland and Sweden’, UNESCO Policy Brief on Early Childhood, 13, 1–2. National Society for the Prevention of Cruelty to Children (NSPCC). (2011) A Summary of Ofsted’s ‘The Voice of the Child: learning lessons from serious case reviews’. Online. Available at: www.nspcc.org.uk/ inform/research/briefings/voice_of_the_child_wda81898.html (accessed 23 August 2014). Office for Standards in Education, Children’s Services and Skills (Ofsted). (2011) Learning Lessons From Serious Case Reviews: The voice of the child. Online. Available at: www.ofsted.gov.uk/publications/100224 (accessed on 4 August 2014; now archived). Pemberton, C. (2013) The Lessons to be Learnt From Three Recent High Profile Serious Case Reviews. Birmingham City Council: Community Care. Online. Available at: www.communitycare.co.uk/ 2013/10/09/the-lessons-to-be-learnt-from-three-recent-high-profile-serious-case-reviews/ (accessed 4 September 2014). Radmall, B. (2001/2002) ‘The dance between post-modern systemic therapy and dramatherapy’, Dramatherapy, 23, 3, 16–19. Strevett-Smith, A. (2010) ‘Dramatherapy in the context of systemic family therapy: Towards systemic dramatherapy’, Dramatherapy, 32, 1, 8–13. Trueman, M. (2014) ‘Edinburgh Festival 2014: Mental health takes centre stage’, The Independent, Radar Magazine, 9 August.

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21 ‘I am a black flower’ The use of rituals in dramatherapy work with a special education class in Arab–Israeli society Amani Mussa

All the world’s a stage, and all the men and women merely players. William Shakespeare

Is it true? Are we continuously playing various parts and preventing people from revealing our real personality? When I, the therapist, open the classroom door, the teacher greets me with a large smile: ‘I am so glad you have come to take him, please keep him with you all day.’ I have heard this sentence over and over again from different teachers. The sentence passed through the child towards roaring silence. Many various sayings about pupils playing the same role: ‘violent, disturbing, shouting, obstinate, annoying, dumb . . .’ How is it that the child is playing this role in front of us and not other roles? It is unclear how one child may be consistently hurtful. Doesn’t he want to study or make advancements when, at the same time and in the same space, other pupils are laughing, studying and being happy? Over the years, I have learned that the true vision of the soul is not a matter of good or bad, but of multiple characters and internal personality aspects. Working with dramatherapy enables the patient to view greater complexity, instead of simplistic, black and white vision, decreasing the negative weight of self-accusation. Adolescence is a challenging period. It involves many biological changes, accompanied by social and emotional ones, as well as expectations and roles that are expressed in disquiet. Among the problems plaguing therapists and teachers working with adolescents are the constant motion, restlessness and difficulty children experience sitting down quietly, particularly those suffering from attention and learning disorders. Therefore, adolescent dramatherapy groups require clear boundaries, and therapy rituals turn into the limit of a safe space, providing all those within the defined boundary with flexibility and free personal expression. This article describes a group dramatherapeutic process, expressing the participants’ emotional need to process adolescent passage difficulties and transitions between regular classes and the 208

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special education class in which they are placed. It includes the transition between different characters in the therapy room and outside it, and the influence of therapy rituals that build a safe place. It involves attention to the place of drama therapy and the therapeutic world within Arab society.

Acquaintance with the world of the Arab adolescent with ADHD What is Attention Deficit Hyperactivity Disorder (ADHD)? There is more than one explanation, and I will present two theories; one is biological, and the other is psychological–developmental. The first theory relates to an organic disorder, with a hereditary background and neurological base, whose source is probably in hypo-activity of certain areas of the brain responsible for regulating attention and behaviour. Compared with children free of the disorder, there is a decline in production of the neurotransmitter dopamine, responsible for transmitting electrical stimuli in the brain to areas related to regulation of attention and control of behaviour, as well as a decline in oxygen and sugar consumption during attention (Karin 2002). Along with the biological concept is the psychological–developmental concept relating attention disorder to lack of emotional continuity in mother and child relations and the child’s difficulty in reaching object permanence. According to this approach, in order to reach normal emotional development, a baby requires beneficial interaction with an external parental figure who organizes and regulates things, to protect the baby from infiltration of stimuli and contents the neonatal soul cannot bear or defend itself against (Karin 2002). Lacking an ‘adequate’ parental shell, the attention function designed to coordinate inner needs with external objects and remove disturbing, harmful contents to the edges of consciousness may also be harmed (Karin 2002). Therefore, the child will find it difficult to assimilate, screen and organize the stream of external and internal stimuli, leading to disorganized self-development, with difficulties in self-regulation, coping with complex life situations and functioning in interpersonal situations and comprehending them (Karin 2002).

The difference between a dysfunctional teenager in Arab society and other societies concerns the treatment and expectations he receives from his environment Both parents and teachers in Arab society expect children and teens to obey adults, every adult, even if they are not a part of the inner circle. Following tribal tradition, they teach togetherness and giving up oneself for the sake of one’s group and parents. Islam places great emphasis on respect for one’s elders in general and parents in particular: ‘those who do not obey their parents forfeit Heaven’. Teachers’ and parents’ authority has changed now compared with the past, but it is still relatively present in Arab communities or villages. A parent would bring the pupil to the teacher and tell him, in front of the child: ‘Take the meat and leave me the bones’ – this means, ‘I am giving you the authority to deal however you wish with my child’. In one of my interviews with teachers in an Arab village, one told me that once, if children met their teacher on the street, they would look down out of respect for the teacher or hide so that the teacher would not see them, for fear he may chastise them the following day for roaming the streets instead of doing their homework. This village has relatively preserved its values and teachers’ authority, which includes fear of physical punishment or even a harsh glance. Many parents still back teachers in all situations. However, there is a new trend that has begun to undermine the teachers’ authority, following 209

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the Israeli law that forbids violence towards children and requires respect for children. The law places full responsibility on the teachers. I see a great difference in the quality of education and the educational approach in Arab society compared with Jewish society in Israel. The teachers and the system in Arab society have fewer tools for handling children, particularly behaviour modification tools or attention and communication skills adapted to these children.

Adolescent tasks in Arab society In addition to biological, emotional and social changes related to adolescence, let us take a look at changes that occur within the world of an adolescent – and not simply an adolescent, but one bearing a dysfunction, difficulty, criticism and loneliness, as well as a damaged self-value; an adolescent who has not yet lost his difficulty in transition between classes, roles and identities that constitute another transition into adolescence. Adolescence is a sensitive, significant period in our life, a period of ‘agitation and stress’ in which contradicting tendencies develop, a behavioural chaos based on biologically derived impulses (Hovav et al. 2008). Adolescence is considered an interim period between two ‘welldefined’ periods – childhood on the one hand and adulthood on the other hand (Ziv 1984). Additionally, adolescence is considered one of the most important, significant periods in the development of every person. According to Ericson, adolescence is the fifth critical stage in which the individual strives to develop stability and relationships with significant groups that surround him. The family loses significance when one leaves childhood and attempts to form one’s personality (Hovav et al. 2008). According to Islam and Arab society, when a child reaches adolescence, the age in which he is able to discern between good and bad, he is required to uphold religious duties, including five daily prayers, fasting on Ramadan, respecting Islamic values of honouring parents and adults, not raising his voice at them, and obeying and respecting all adults at any time, including obeying one’s teacher. An Arab proverb says, ‘rise for your teacher and respect him, your teacher is almost a Prophet’. The teacher deserves the respect of the Prophet, and one must honour and obey the teacher’s words.

Emotional treatment using drama in Arab society The idea of psychological therapy is an extremely sensitive subject in Arab society and it is carried out in secret, hidden from society. Until recently, there was no art therapy in Arab society. The boys’ group was the first in this Arab school, and I was the first dramatherapist whom students, parents and educational staff have encountered. I was the school’s first dramatherapist. It was the first time a mental therapist who uses drama had entered the elementary school space. The principal and faculty welcomed me with gracious Arabic hospitality. However, they also expressed many questions and fears: Who am I? What is emotional dramatherapy? Am I a clown? The difference between drama class and emotional dramatherapy was not very clear! Interest, will and fear of a cultural encounter arose. There was an encounter between traditional Arab educational language and concept and the therapeutic–emotional concept I introduced, with many other overt and covert strata. The principal and faculty expressed fears. I was perceived as a teacher, a character who has to act according to the system, work as a substitute teacher and in shifts. One of the first points I agreed upon with the principal was the importance of a long-term group of pupils and that the location and therapy room, as well as day and time, would be regular. I explained that these 210

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points were important to build a stable, safe environment so that the children in therapy could express their emotional world. Another crucial point was the principal’s use of authority to do rounds of the classrooms, entering in a random fashion to observe. It took challenging work on my part to explain to the principal that the therapy room was not freely open to any authority or other figure, as it could influence the pupils’ sense of security. Furthermore, at the beginning of the year, there were many questions regarding the identity of dramatherapy among teachers, and, therefore, it was important to hold workshops with groups of teachers to provide them with hands-on experience of the therapeutic discipline. In addition to the teachers, there were other challenges when I met parents. At the beginning of the year, I sent the boys’ parents a consent form and invitation for therapy. This was done with great caution; the letter was phrased with sensitivity. However, the meeting in which the parents came to get acquainted with therapy was complex. I, as the therapist, had to be creative, attentive and understanding of their fears and hesitation about therapy. Some parents objected to the very idea of emotional therapy, fearing the social reaction to the fact their son would be in therapy. However, there were many who voiced their concerns: ‘My son is not mentally ill, maybe he needs help but what will people say, could it possibly be extremely secret?’ What helped here was the support of faculty members with whom the parents are familiar, as well as the fact therapy used drama and art, serving as a pretty, non-threatening external wrapping. They called it a class, although aware it was actually therapy. Dramatherapy has a relatively short tradition of therapeutic work with patients from cultures that differ from the therapist’s culture. Professor Sue Jennings, dramatherapist and anthropologist, writes that children’s world of play is complex and dependent on the values and boundaries of the culture they live in. Dramatherapeutic intervention must be adapted to this world (Grainger 1990; Jennings 1995). Very little has been studied and written about emotional therapy among Arabs. Professor Alkrinawi, a pioneering researcher in this field, found Bedouins, part of Islamic Arab society, to prefer therapeutic rituals that link them to their own tradition over Western therapeutic methods, including conversations (Alkrinawi 2000). The Arab patient treats his therapist like a teacher or an authoritative figure and expects instructions on how to behave. At this time, he limits his self-importance and does not use his creativity to find solutions. Therefore, the psychodynamic approach is difficult to apply and problematic in Arab society. The patient feels confused if the therapist decides to work in spaces in which the patient is expected to grasp the problem and its solutions on his own (Alkrinawi 1999). Dr Huss studied groups of Bedouin women who underwent art therapy. Her study shows art may serve as an intercultural bridge and channel for self-expression for those whose culture does not allow direct emotional discourse (Gafni 2010). Treatment using dramatic tools adds to the discourse treatment additional elements of intuition, imagination, emotion and power that the patient receives from the dramatic actions (Faust, in Nir gafni 2010).

Dramatherapy What is dramatherapy? Dramatherapy is intentional use of various techniques deriving from drama and theatre, including storytelling, puppets, pantomime, improvisation, role-play, drama play, parts of plays, masks, video, etc., all for therapeutic purposes. Using the projection mechanism, the patient brings his inner world and provides it with aesthetic form (Landy, in Nir gafni, 2010). 211

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Dramatherapy can help patients discover new inner contents they had not known previously, for example, creativity and humour. They can simply discover or find the power channel they have and learn to use it. The patient is like an artist or actor, taking his inner world and shaping it. He becomes active and uses his inner resources and, through imaginary characters, he can project feelings, thoughts and relationships from his inner world in a safe, unthreatening manner. Using dramatherapy methods, we want to achieve the patient’s discovery and self-expression. One can try to solve dilemmas using acting, as the properties of acting enable the child to give up his painful self-awareness. Acting things out makes it easier to build a relationship with the experienced realities that promotes the child’s development (Lahad 2006).

Dramatherapy rituals in general and in Arab society in particular Rituals are an integral part of dramatherapy in the structure and content of sessions. Furthermore, one can say dramatherapeutic work is similar to rituals in its conduct, the profound significance it touches and the changes it strives to attain (Grainger 1990). A ritual is a series of determined, expected and well-known actions composed of symbolic and real elements. ‘Rituals bring together parts of one’s self and tie the individual to his community and history’ (Alkrinawi 2000). An inseparable part of dramatherapy work includes a regular opening and closing ceremony, and the very fact the structure is familiar and expectable enables participants to have a sense of security. The higher the anxiety levels of the group and poorer the ability to handle the unknown, the greater the use of rituals in therapeutic work. These rituals are intended to provide security and create an experience of inclusion, enabling the participants to undergo internal-emotional work and generate change, however small or even minute, in their lives. Dramatherapists use the language of rituals as it is extremely suitable for our requirements: rituals enable unity to be created within the group, strengthening consolidation and trusting relationships, facilitating the sense of belonging and enhancing group presence. The ritual may help make the group’s mission and identity clearer and better comprehended and facilitate passage between dramatic reality and everyday reality. Facilitated passage turns the dramatic space into a familiar, well-known field with marked borders that are able to contain both the familiar and unfamiliar. Thus, dramatherapeutic work extends the participants’ ability to remain within this threatening space (Grainger 1990; Whitlock 1994). Another ritual element of dramatherapy is the concept that acting is self-sufficient, and, therefore, there is no need to explain every detail within it. Similar to details of rituals, activity is symbolic and representative and not always self-sufficient. In rituals, we touch the truth without being disturbed. The things that happen relate to everyday life but are not governed by it. In dramatherapy work as well, there is a connection between profound inner truth and everyday life without the ‘magic’ being disturbed. One can say rituals and therapy alike are ‘transitional times’, an interim time that generates connections and borders between past and future (Grainger 1990). Change occurs in this interim time. Therapeutic rituals and ceremonies are carried out in order to translate the child’s inner events and experiences into a significant life experience and define them. These rituals are related to the metaphorical magic of dramatherapy that enables connection to powers from the world of imagination and fantasy and translates them into tools with actual therapeutic powers. Moslem Arab society has a lot of ceremonies, but not particular ones for adolescence. For example, when a boy is born, he undergoes a ‘purification’ ceremony similar to Jewish 212

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circumcision. A piece of flesh is cut off the boy’s penis, which purifies him. The ceremony includes a feast, where sweetmeats are passed round and the entire family and friends gather. There is another ceremony called Snunia. The ceremony involves a baby whose first tooth has emerged and denotes a passage stage. Candy is placed on boiled wheat, special songs are sung, and family and friends are invited to take part in the ceremony. Furthermore, mourning involves ceremonies in Islam – for example, the Announcement ceremony, in which the name of the deceased, the time of the burial and mourning rituals are announced at the mosque. The external expression of mourning and feelings that emerge are emphasized, as well as expressions such as: men are generally expected to control their feelings, express their pain in a quiet, restrained fashion and hold on, despite the loss they have suffered. Women accept the social role of vocal emotional expression of pain and grief through wailing, crying and yelling, but they are also constrained by time and place (Robin and Ismail 2006, p. 48, in Nir gafni 2010). Another element is the social support and tribal cohesion expressed in the process. Actually, from the moment a death is announced, the community accompanies the family of the deceased for 3 days, in all tasks relating to the death and other moments. Relatives, neighbours, acquaintances and friends assume many roles: the crier who announces the demise, a handful of close, suitable people who accompany the purification of the deceased, relatives and friends who dig the grave, participation in a mass wake that accompanies the body to the cemetery, organizing separate seating for men and women and preparing it for the family and consolers, preparing meals for the family of the deceased, accompanying the family to the grave, etc. (Abu Rabia, in Nir gafni 2010). Values of solidarity, support and friendship are quite prominent at this time. There are further rituals that maintain the sense of solidarity and support for the mourners. This support is also a social arrangement that enables legitimate processing of the loss and mourning among acquaintances and friends who are not part of the close cycle of mourners.

Description of the therapy group The therapy group is composed of five boys, aged 12–13, who underwent a dramatherapy treatment process within a Muslim Arab school. They took part in weekly, 90-minute sessions, at a regular date and time throughout the school year. These students are in special education after being diagnosed with attention and concentration problems and learning disabilities, and they have also been defined as suffering from behavioural problems. These children are usually part of a ‘self-contained class’ within a regular school. Within this class, children with special needs study all the time (or most of the time) in the special education class. Their presence in a regular school and proximity to regular children enable physical integration and, perhaps, social integration and facilitate attempts of gradual integration within the frameworks that are open for integration of children with special needs. In these frameworks, children may be placed in a regular classroom part time, based on their ability, with relative success. If the attempt succeeds, the length of integration may be gradually increased until the child is totally integrated in the regular class. However, along with the opportunity of allowing them to be in a regular school, other students tend not to accept them socially because of their difficulties and dysfunctions, and they suffer a lot of stigma and mockery because they belong to the special education class. These pupils move from the special education class to the regular class, and these transitions involve changes in the educational environment and, of course, influence the children’s sense of security. These children, owing to their problems, become a burden on the educational system, particularly the teachers. Children with adjustment problems based on ADHD must face many failures and hardships. They must struggle to generate a normal sense of self-esteem in view of 213

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the challenges, and quite often their struggles are not comprehended by the environment and do not receive its support. The sense of self-esteem drives development, and, until a person does not feel this esteem, he restlessly searches to satisfy his sense of self-esteem. This is particularly the case with children with attention disorder, owing to the damage to their self-esteem caused by the education systems and social and family experiences.

The relationship between the emotional dramatherapist and ‘voices’ inside and outside the therapy room Therapeutic work with the boys focused on several levels: 1

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Relationship with the dramatherapist: The boy has emotional experiences in transition between classrooms, transitions and changes relating to adolescence, and sometimes the difference felt in transition between the therapy room and classroom. He also experiences division between the personal, containing, empathetic attitude provided by the therapist and the harsh, judgemental attitude displayed by teachers. Therefore, the student begins to view the therapist as a positive, warm figure and views the educational system as a hurtful enemy. He also behaves differently in the room and outside it, receiving different responses to his behaviour. Thus, the therapist’s work and relationship with the boy’s surroundings are no less important than therapeutic work within the room. The major therapeutic objective in the therapy room is to construct a safe space with determined boundaries. Improved self-esteem provides a response to emotional inner hardships and conflicts, helps to make the boy’s fixed or unsuitable attitudes and thoughts about himself and his environment more flexible and provides tools that facilitate self-control and comprehension of interpersonal situations. The dramatherapy process uses rituals as a means of using emotional therapy to enable the boy to express himself creatively and authentically within a safe, nonjudgemental group space. It puts together different parts of the self, sometimes polar, in his emotional world and expresses his powers, abilities and difficulties. The boy gets to know himself and, while doing so, acquires tools for better-controlled organization, conduct and communication in his inner and interpersonal world, along with learning to accept the existence of his attention disorder as an inseparable part of his formulating personal identity. Parental instruction: Parents receive instruction that helps them comprehend and process their emotions and responses with regard to their child and the problems he encounters, and it provides the parents with tools and knowledge that help them set boundaries and adapt rules of conduct in the home and family space in a way that contributes to controlling the child’s behaviour. It is important to note that, in traditional Arab society, emotional language is not very well developed, and, therefore, one should develop this language among parents, listen to them and instruct them on how to approach their child with empathy. Arab society teaches obedience and restraint, particularly towards males. Men should not express feelings, which are perceived as weakness. The emotional aspect is adapted more towards women who cry, get angry, etc. Children learn this rule from an early age – in the group, it was expressed by the fact the boys concealed their tears and refrained from expressing their feelings for fear they would be thought unmanly. Therefore, the opening and closing rituals provided room for expressing emotions in words and motion in order to develop emotional language. Work with the educational staff using a systemic approach: Work with the educational staff was on several levels. One level involved getting acquainted and building trust between staff

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and therapist and teaching the therapeutic language to the educational staff. There were many workshops for teachers about dramatherapy and tools, teaching terms that include listening and containment through their personal experience with the dramatherapy tools. All of this was to help them gain profound understanding of the challenging child’s inner world. In addition, there were systemic work and training for homeroom teachers to adapt classroom rules of conduct. Rituals were presented as tools the teacher could use with these children: a daily opening ritual that opens emotional communicational channels between students and teacher; lessons containing short-term play; reading or writing rituals; a feedback and reinforcement ritual in each lesson; and the collecting of ‘smiley faces’, a symbol of each child’s accumulated acceptable behaviour.

The therapeutic session Each session’s structure usually contains a warm-up, body of work and closure. The warm-up and body of work usually contain exercises, games and different dramatic activities selected according to the objectives of the work and the group’s character and requirements (Gersie 1996). Ritual is included in these parts. Warm-up or the first opening exercise was usually a regular exercise called the opening ritual, which repeated itself throughout the sessions and marked the beginning of every session. An example of an opening ritual was movement and a sentence about the state I arrived in today. This would happen with the entire group seated in a circle listening, and the speaker would sit on the ‘theatrical chair’ from which he would express himself. With time, the boys learned the sequence of the opening ritual and managed it on their own, upholding the rules of attention. A part of the opening ritual was my reminder of the rules we had included in our agreement (arrival on time, non-violence, etc.), and I would tell them what exercise we would do today or on what subject we would be working and which tools we would use, whether we will work in pairs, individually or as a group. This was part of expectation coordination. Another example is the technique provided to teach the children boundaries – a ritual called freeze: after we have constructed the contract, defined rules and boundaries in the room and undertaken to uphold them as a group, each of the boys is responsible for these rules, and, any time one of the group violates a particular rule during an activity, such as interrupting a speaker, using violence in the group or not arriving on time, the first person who notices the violations announces ‘freeze’ and halts all drama and action in the room. The group forms a circle to discuss the problem or continue with the session. When exiting the drama, we carry out de-roling, a ritual that marks crossing the border from dramatic space back into reality. All the pupils discard the roles they played and return to being themselves here and now. For example, one of them says, ‘Hi, I am Amani; I am not the witch of the forest’. Then there is activity that helps assimilate and comprehend personal and group learning, observation and insight. Closure is carried out in a reinforcement closing ritual. I turn to each of them in turn and tell him one thing I liked about him today, and other group members are also encouraged to say something positive. The closing ritual involves one motion or sound with which I leave the session, also a regular feature. The rituals actually become the borders that protect us and the therapeutic space; the way in which the rituals are enacted is less threatening or stressful and, on the contrary, is assimilated and freely grows within. The middle part between the opening and closing rituals contains the heart of the treatment. Within these two boundaries, we can move freely when selecting characters in the story we tell and the colours we choose to paint. There we are protected and can express ourselves freely. During the process, I have noticed that the more familiar the boys were with the structure of 215

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the session and the assimilated rituals, the safer they felt, and they were able to sense pleasure within the dramatic space. According to Gersie, the dramatherapist observes and takes part in the patient’s drama, and his intervention takes into consideration several points, including the patient’s emotional containment boundaries, awareness of the object and the object’s permanence, the patient’s ability to handle emotional proximity and distance and his ability to organize a ‘self-presentation’ using dramatic and non-dramatic means (Gersie 1996). When working in a cultural space that differs from the therapist’s own original culture, another element is added that should be considered, and that is the patient’s cultural world, and the codes, norms and values that arise from it (Alkrinawi 2000).

Thoughts about therapeutic work Metaphorically speaking, in the therapy room, the boys could act out their struggle, adults’ attitudes towards them, their feelings and tradition, based on the sense of security within the group. They also brought their connection to tradition, Islam, God, the village and its culture, as well as the group’s presence together as a family or close community, which provides egosupportive forces in the process. Islamic rituals of mourning and happiness place great emphasis on the values of solidarity and support in the community, and reliving them through drama allowed the boys to express these aspects in the classroom. One student managed to ask a teacher who had chided him for failing an exam to respect him and understand his challenges. Each boy chose a dramatic role through which he was able to emotionally process the transitions he was undergoing. In the course of the dramatic process, the boys were able to change roles, playing a teacher, parent or principal and changing roles to those characters, looking for solutions based on their emotional needs here and now. The rituals in each session may be construed as borders that provide a clear, safe and familiar border, but without limits to the self and contents each boy can bring and without judgement or criticism, but with a lot of reinforcement. Repetition of rituals in a weekly session provided them with the security they needed to display their self without fear. Special education children usually experience themselves as marginal figures in society. The children are low in status at home and in society, unaccepted, and receive a lot of criticism that expresses their parents’, relatives’ and teachers’ frustration. Compared with their ‘normal’ siblings and friends, they feel inferior and unworthy of attention and affection.

Summary When I try to sense and understand the existential experience of each of the boys in the dramatherapy group, beyond the fact that they suffer from attention disorder, I see them encountering with their body and mind strong, continuous winds and confronting them, responding in an authentic manner while being torn by their own internal situations and attempting to march forward towards their destiny. For this kind of boy in Arab society, dramatherapy is a beam of light within a dark room, lighting up the place so he can see more clearly the things happening inside it as well as surrounding reality. Dramatherapy is a window that enables one to express feelings and provides a source of air to breathe. The rituals enclose the space and provide a teaching, cultivating and experiential border in a facilitating group space. 216

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One should note that treatment of children suffering from attention disorder usually involves integrative work by a multidisciplinary staff, requiring the emotional therapist to operate this system and channel it for the benefit of the boy’s therapeutic process. I further believe that teaching and learning are extremely valuable, but it is no less important to bring about change in Arab society and, in particular, the approach and treatment children and adolescents receive from educators and adults; they must view them as equals and partners. It is extremely important that pupils graduate school as human beings with life skills. This is why teachers must be attentive to the children’s emotional and social world as well. I am certain that both teaching and learning will gain from it. I believe we can and should become significant characters for the pupils and help them generate mental fortitude. The image of a teacher, therapist or parent is the child’s ‘model’. The child learns through us and through our attitudes to ourselves and our surroundings. Therefore, I expect that, along with the complexity of our Arab tradition and culture and together with the authoritative figure of the Arab teacher, we must deviate from the traditional role of knowledge providers and give students educational treatment based on personal acquaintance and learn how to generate optimal proximity with them. We must get to know the children based on their entire world: personal, social and familial, in addition to their academic background. I dream of a school with empathy for its pupils. I refer to respectful, attentive, warm and caring treatment of each pupil. This term has become worn, along with the will and intentions inside a complex, multitask and wearying school system.

References Alkrinawi, A. (1999) ‘Culture-sensitive mental therapy in Arab society’, in Rabin, K. (ed.), Being Different in Israel: Ethnic origin and gender in therapy in Israel, pp. 65–81. Tel Aviv, Israel. Alkrinawi, A. (2000) Ethno-Psychology in Bedouin-Arab Society in the Negev. Tel Aviv, Israel: Hakibutz Hameuchad. Gersie, A. (1996) ‘Introduction’, in Gersie, A. (ed.), Dramatic Approaches to Brief Therapy, pp. 1–27. Trowbridge, UK: Cromwell Press. Grainger, R. (1990) Drama and Healing: The roots of dramatherapy. London: Jessica Kingsley. Hovav, M., Mahal, M. and Golan, M. (2008) From Risk to Chance: Therapeutic interventions for juvenile delinquents and young people in need. Jerusalem, Israel: Carme. Jennings, S. (1995) Theatre, Ritual and Transformation: The Senoi Temiars. London: Routledge. Karin, Y. (2002) The diagnosis of ADHD - ADHD, implications of the diagnosis, ADHD diagnostic process and the beginning of a systemic intervention. Hebrew Psychology Website. Online. Available at: www.hebpsy. net/articles.asp?id=7 (accessed 6 April 2016).Lahad, M. (2006) Fantastic Reality: Creative therapeutic instruction. Haifa, Israel: Nord. Gafni, N. (2010) ‘Separating from Pony’: The process of separation using rituals in dramatherapy, working in the Bedouin sector. From a booklet of models in group therapy for pupils with special needs, Ministry of Education. Whitlock, G. (1994) ‘Drama therapy in a psychiatric day clinic’, in Jennings, S. (ed.), Drama Therapy In Practice B, pp. 238–62. Kiryat Bialik, Israel: Ach. Ziv, A. (1984) Adolescence. Tel Aviv, Israel: Massada.

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22 Attachment-informed drama therapy with adolescents Anna Marie Weber and Craig Haen

Attachment theory offers ways of understanding both normative and pathogenic developmental processes rooted in biological and affective transactions between infants and caregivers (Bowlby 1980). These processes shape the developing brain, the homeostatic regulatory structures of the body and internalized expectations about future relationships (Tronick 2009; Schore 2013a, 2013b). As Farnfield and Holmes summarized, ‘Attachment is first and foremost a relational theory . . . a way of describing what we do when we are anxious and how we use past experience to make predictions about what is most likely to keep us safe in the future’ (2014, p. 2). Throughout the last 40 years, researchers have validated and broadened Bowlby’s (1980) original vision of attachment theory. It is only recently, however, that clinicians have begun to clearly apply the attachment framework to psychotherapy (Wallin 2007; Costello 2013; Marrone 2014). Recent models have incorporated an appreciation of the presence of the body and nonverbal communication in the therapy space, and a shifting of attention to the subtle transactions between therapist and patient that constitute ‘the music behind the words’ (Hart 2011, p. 293). In addition, a deepened understanding of the impact of trauma on a child’s future relationships has evolved. In this chapter, we seek to ground the work of drama therapy within the clinical advances of attachment theory. In doing so, we will consider how an attachmentinformed drama therapy can contribute to effective treatment for many adolescents, not just those with severe attachment problems. Before proceeding, there are three important caveats to the application of attachment theory to clinical work. The first is that attachment theory is largely reflective of relationships in Western culture and may not be reliably applied across cultures without adaptation (Quinn and Mageo 2013). Second, the qualities of a good enough caregiving relationship are contextual. As Music (2014) suggested, good parenting in violent neighbourhoods requires an authoritarian style that is unnecessary in more physically safe environments, a point underscored by data on how parenting style correlates with academic achievement. Finally, attachment theory has primarily used the paradigm of the traditional family, so that families composed of two mothers or fathers are largely invisible within attachment research and clinical literature (Corbett 2009).

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Adolescent development Adolescence is a time of change, growth and risk. For every maturational advance or new step taken, there is often a related fear. At the heart of this developmental stage is an alteration of the meaning and importance of relationships. This shift occurs in tandem with an evolving crystallization of a sense of identity and visions of a future self (Gallo-Lopez 2005; Bendicsen 2013). Adolescent development is marked by a decrease in, but not diminishment of, the importance of the parent–child relationship, as teens broaden their attachment network to include peers, romantic partners, mentors, teachers and even celebrities (Scharf and Mayseless 2007). Although there is debate about whether these new relationships represent primary attachments on a par with the parental one, they undoubtedly fulfil various attachment-related functions, including establishing felt security, trust and co-regulation (Allen and Manning 2007). The ideal endpoint of this developmental stage is not independence, but mutual interdependence (Kieffer 2011), a balance of both affiliation with others and autonomy. As Johnson wrote, ‘The more securely connected we are, the more separate and different we can be’ (2009, p. 263). Although adolescents hunger for peer relationships (Siegel 2013), they are often terrified to reach out for connection and frequently have conflicting feelings about stepping away from parents. Many freeze and find themselves isolated and alone, whereas others anxiously attach to whoever is near and act out in order to maintain these alliances. These approach-avoidance tendencies are effectively captured within the metaphor of a dance whose steps are swaying: one foot forward and one foot back (Kline 2009). Undergirding the psychic shifts in adolescence are massive physiological changes accompanied by the reorganization and fine-tuning of the brain (Casey et al. 2011). The multiple brain changes of adolescence, which can be likened to a software upgrade on a computer in which processes are streamlined but which initially leads to misfiring, have both positive and negative effects. Adolescent neuromaturation causes a developmental mismatch: between elevated attraction to novelty, reward and social engagement, and comparatively immature capacities to regulate impulses (Casey et al. 2011; Steinberg 2014). The result is the triggering of potentially destructive behaviours, as well as wonderful creative opportunities (Haen and Weil 2010; Siegel 2013). The developmental shifts of adolescence are mirrored by the teen’s presentation in therapy, which is often characterized by ambivalence about dependency, trust and the question of coming or going (Kline 2009). Therapists who work with adolescents can find themselves partaking in what Beebe and Lachmann (2014) recently described as a sequence of chase and dodge. As such, effective therapists ‘make adjustments for the fact that the adolescent mind is shaped, at times, by a construction zone’ (Siegel 2013, p. 105). As adolescence is beginning earlier and lasting longer than in previous generations (Steinberg 2014), additional patience is needed. Because teens are in transition, the therapist must work to provide scaffolding while skills are acquired. When new organizational structures develop in the brain, the previous structure is broken down. Thus, there are gaps, because teenagers’ old modes of functioning have dissolved, and yet new structures have not fully come online (Hart 2011). These transitional periods are riddled with doubt, confusion and frustration for young people, parents and therapists. During these times, all involved need reminders that change is happening. In Music’s words: Sometimes when something frozen begins to thaw out, what replaces it might be traits that we find abhorrent. In the cases I have seen tolerating this has been a stepping stone in development, rather than the unleashing of psychopathic monsters. (2014, p. 45) 219

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Implications of an attachment-informed drama therapy Cozolino defined psychotherapy as a ‘guided attachment relationship’ (2014, p. 155) in which the central concern is activating and facilitating neuroplastic processes. By neuroplasticity, Cozolino is referring to the potential for experience to both shape the brain and repair insecure attachment schemas. As such, drama therapists can serve as ‘mobile laboratories of social engagement’ (Klin and Jones 2007, p. 16) for their adolescent patients, offering opportunities within and outside dramatic reality to explore, deconstruct and reshape relationships. Attachment theory has important implications for the way therapists conceptualize and respond to patients. Chief among these is seeing difficult patients as operating from a place of fear rather than aggression (Slade 2008). This reframing will likely shift how we formulate treatment and interact with our most off-putting and noxious adolescents. Like Wachtel (2014), we are more interested in the process of attachment than the diagnostic implications of attachment categories. As Holmes (2014) pointed out, insecure attachment may very well be an adaptive response to a lack of relational and environmental safety in childhood. The resulting interpersonal patterns are problematic to the extent that they limit adolescents’ potential to form healthy, sustaining relationships and to regulate stress. In the sections that follow, we highlight several areas in which attachment theory can inform drama therapists in their work with adolescents: attunement, self-regulation, positive emotion, state dependence and narrative. Many of these topic areas also refer to components necessary for building the foundations for secure attachment. Each section includes clinical material from our work that illustrates the principles presented.

Attunement Attunement is the ability of caregivers and children to read each other’s cues accurately, anticipate each other’s needs and respond accordingly. In order to accomplish this, they must tune in to cognitions, emotions, behaviour and physiology (Blaustein and Kinniburgh 2010). Stern (1985) noted that 87 per cent of attunement is cross-modal, in that caregivers may respond to the child’s expression within one modality (e.g. a vocal utterance) and mirror it back using others (e.g. gesture, facial expression, touch). By engaging in precise, frame-by-frame analysis of videos of caregivers interacting with their children, infant researchers have influenced a similarly detailed attention among clinicians to multiple layers of experience. Attachment-informed therapists describe a moment-by-moment tracking of interpersonal process in sessions, which includes attending to fleeting expressions of affect and ‘to what is and what is not communicated about easily’ (Costello 2013, p. 147). This intensive focus suggests a specific kind of therapeutic presence and listening that engages the body, what Tortora called embodied resonance. She defined this form of listening as one in which the therapist ‘stays attuned to the patient, being present by listening through the whole body, by deeply attending to the multilayered sensations, feeling states, and images that arise within him as he observes the patient moment-to-moment’ (2013, p. 147). Beebe and Lachmann concurred: ‘Our ability as therapists to sense and not to inhibit our own bodily arousal, attention patterns, affective reactions, orientation shifts, and touch patterns is key. This is the therapist’s action knowledge of her own bodily communication’ (2014, p. 143). Drama therapists who use their action knowledge gain an attuned understanding of their adolescent patients. Messages about early relational experiences that often cannot be communicated through words, because they have been relegated to the edge of awareness, are often conveyed to the therapist in subsymbolic, somatic forms (Wallin 2007). 220

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For example, Music (2014) noted how young people with dismissive attachment patterns are often difficult for the therapist to hold in mind. Memories of these patients slip away, and it can become challenging to remember what they said or did in sessions. Therapists may find themselves registering adolescent attachment patterns through engaging in unintentional facial mirroring, subtle self-soothing behaviours, or the closing off of the body through crossed arms, gritted teeth or a concave posture. Although meticulous in nature, the quality of therapeutic attunement prescribed here is not an intense hypertracking of the patient, which most adolescents would find intrusive. Instead, the attention exists within the midrange, a level that coordinates with secure attachment (Beebe and Lachmann 2014). Infants need moments of togetherness as well as moments of separation in which to be absorbed in their own rhythms and assimilate the impact of connecting with the caregiver (Hart 2011). Adapting this principle to psychotherapy, Benjamin wrote about the importance of oscillating between states of ‘being together-with and being apart’ (2002, p. 48). When adolescents first appear in session, they need time to assess the situation, check out the space and the therapist, and adjust to setting their usual distractions aside to be present with another person. They need time to be. As they work to develop their own identity and sense of themselves, the drama therapist supports teens by pivoting between joining and separating. This includes distinguishing times when it is important to embody and mirror the affect of distressed adolescents from moments when it is more beneficial not to resonate with their distress fully, instead remaining a stable, grounded presence (Beebe and Lachmann 2014). It also means working actively to repair inevitable moments of misattunement. Doing so creates safety in the relationship and reinforces empathic connection (Hughes 2007). Later in the process, the therapist ideally guides the teen’s reconnection with caregivers, strengthening security in those relationships. In order for attunement to be effective, it must be both contingent (accurate) and marked as pretense (Fonagy et al. 2004). In other words, if the caregiver’s mirroring of an infant’s distress is too literal, the baby will understand this as an expression of the caregiver’s distress rather than a representation of his own. Wallin, reflecting on the role of pretend in attunement, wrote: In the mode of pretense, experience can be what you want it to be – but only as long as the wolves of reality are kept sufficiently distant from the door . . . the ‘play space’ of therapy can quickly become all too frighteningly real, and along with the collapse into embeddedness can come the disruption of affect regulation. For when internal experience seems suddenly no different than external reality, we may well feel overwhelmed, as if confronting alone a dangerous, no-exit situation. (2007, p. 142) For drama therapists, this means assessing the optimal amount of emotional distance required moment to moment, and facilitating the patient toward greater or lesser expression (Weber 2005; Landy 2009; Haen 2015). When role-play becomes too much like reality, the play space collapses, and attuned connection ceases (Hodermarska et al. 2014). Modulating needed distance fosters brain integration, self-regulation and the ability to take in the therapy relationship. In addition to emotional presence, attunement can be promoted by an environment that communicates permission for teenagers to be their full selves in the space (Haen 2011) and ‘invites the client to explore, create, and contribute’ (Blaustein and Kinniburgh 2010, p. 69). This includes environmental attunement to diversity, gender and the various ways that teenagers seek grounding. The last is particularly important, because the therapy relationship, 221

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with its foundation of intimacy and experiencing emotions, can activate the attachment system’s need to self-protect – through avoidance or anxious pursuit of the other (Johnson 2009; Haen 2015). Attuned sensory design for the therapy space might be as simple as bean-bag chairs in safe corners, soft afghans on chairs, lamps for soothing lighting that can be turned to make spot lights, and a speaker system that allows adolescents to connect their MP3 players. Sand trays with a variety of textured objects, props, fabrics, feathers, water toys, music, access to YouTube and bongo drums stimulate brain integration and the attachment process (Weber 2005; Chasen 2011). The first author collaborated with an artist from the organization Splashes of Hope to design a soothing mural in one room of a rape crisis counselling centre. The resulting beach scene took up the full wall, so the viewer got the sense of overlooking the sea, surrounded by palm trees, with sailboats in the distance. The room also happened to have motion-activated lights. As a closure to difficult sessions, clients would be invited over by the therapist saying, ‘Let’s go to Aruba’. As they stepped side by side into the room, the lights would come on, and therapist and client would face the mural. Placing themselves in the scene, they would create imaginary vacation vignettes. Through embodiment, imagination and repetition, this closure ritual became strengthened in the adolescents’ minds, allowing for easy recall during times of stress. This process highlights a key focus of attachment-informed drama therapy: attention to developing selfregulation.

Self-regulation At the core of attachment theory is an understanding of the ways in which infants entrain with their caregiver’s nervous system to stabilize their own physiology (Trevarthen 2009). This process occurs at the level of affect as well. Parents work to attune to the emotional states of their children – while keeping their own internal state regulated – in order to modify feelings so they are manageable and able to be metabolized (Hart 2011). Babies in turn impact the states of their caregivers, thereby gaining a sense of relationship building and intersubjectivity (Hughes 2007; Trevarthen 2009; Ammaniti and Gallese 2014). Through this process of interactive regulation (Schore 2013b) the infant gradually develops the capacity to self-regulate. Allen and Manning proposed that, as children enter adolescence, the attachment system ‘evolves into a broader affect regulation system’ (2007, p. 28), one that increasingly seeks relationships for their regulatory functions. Related abilities to tolerate complexity and to exercise control over one’s thoughts, feelings and behaviours have wide ramifications for young people’s futures. As Steinberg asserted, ‘The capacity for self-regulation is probably the single most important contributor to achievement, mental health, and social success’ (2014, p. 16). Working from an attachment framework means attending actively to the myriad ways of creating safety in the relationship from the very elements that facilitate infant attunement: dialogic exchange at the levels of facial, gestural, tactile, rhythmic, respiratory and prosodic communication (Schore and Schore 2008; Schore 2013b). Drama therapists may be especially adept at using these instruments of expression to create safety, because theatrical training serves to sharpen awareness of, and command over, the voice and body. In particular, the ability to modulate one’s vocal tone, volume, timing and phrasing is a little-discussed clinical skill that can positively impact attunement. Affective states are connected to certain action tendencies (e.g. to approach, avoid, fight or disengage; Costello 2013) and are, therefore, modified through action as well. An adolescent 222

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brain in the alarm state cannot create or experience fun or safety. Drama therapists working with teenagers use warm-up and closure processes and the explicit teaching of self-regulation strategies to up- and down-regulate adolescent systems in order to bring them within, and to expand, the window of tolerance (Mark-Goldstein and Siegel 2013). This metaphoric window represents the amount of affect a patient can tolerate while still remaining present and engaged. It is akin to Landy’s concept of aesthetic distance (2009), a balance of affect and cognition, of both engaging in an experience and reflecting upon it. For a time, the therapist becomes the regulatory agent for the adolescent, until she is able to take command of her own regulation. Somatosensory activity such as walking, drawing, tracing the infinity symbol in sand, balancing side to side, drumming with one’s fingers, throwing a ball from hand to hand, dancing, pushing against a wall, massaging oneself, diaphragmatic breathing and other forms of patterned, repetitive movement contribute to state regulation. The message from neuroscientific research is clear: these bottom–up interventions offer autonomic and limbic attunement, a foundation necessary for effective higher-order verbal and cognitive processing (Hart 2011; Gaskill and Perry 2014). For insecurely attached patients, engaging in interactive regulation promotes the forming of earned secure relationships and right-brain expansion (Jennings 2011; Schore 2013a). In this context, the drama therapist becomes an interactive, multisensory, creative right-brain presence. Early in treatment, teens are often hesitant to follow the drama therapist’s suggestions for grounding and relaxation. They may be afraid of failure or of feeling fragmented if they let go. Adolescent boys, in particular, may find self-regulation strategies threatening to their need to seem cool and in control. For traumatized young people, the suggestion to focus on the breath may be triggering, because many interpersonal traumas are connected to not being able to breathe or choking. Jennings (2011) cautioned that adolescence is already imbued with shame for many young people, and so it is especially important when working with this age group that treatment not become yet another failure. Optimal self-regulation approaches are best chosen through exploration and co-creation with the adolescent, as what is relaxing for one teen may not be so for another. Water toys offer a concrete way to explore self-regulation and mindfulness in a non-threatening manner (Weber 2005). These toys, which are designed for adults and older children, use water and oil to promote relaxation or document the passing of time. Because water toys are frequently found on a professional’s desk, adolescents can often engage with them without feeling infantilized. In the first author’s office there is an assortment of such toys: floating polar bears, droplets that flow through twisting mazes, and swimming dolphins. In an introduction to a mindfulness or mindsight (Siegel 2013) activity, an adolescent is invited to choose one of the toys as part of a closing ritual at the ends of sessions. The patient focuses on the droplets of oil in water while letting go of thoughts, breathing and guiding their focus back to the droplets when distracted. One long-term patient, a 13-year-old witness of severe domestic violence and survivor of physical abuse, was emblematic of the transition from co-regulation to self-regulation. As the drama therapist passed her a blue water toy she’d chosen one session, Sonia stated with exuberance, ‘I bought myself one at the Aquarium’. She had integrated the process and began to incorporate the self-regulation technique in her own life and personal space, as the water toy now resided in her bedroom. For the first time, she hadn’t asked her parent to buy the item, but instead purchased it herself. This was a new step for this client, who primarily shopped at stores selling Goth apparel. As she took ownership of her own regulation, she grew increasingly empowered and interdependent. 223

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Positive emotion It is not just the regulation of distressing affect that is central to attachment relationships. Rather, Stern (1985) noted that the presence of joy and interest are two markers of affective attunement. The ability to attune to and amplify positive emotions of pride, excitement, curiosity, silliness and attraction makes the clinical relationship one suffused with affective resonance (Hughes 2007; Schore and Schore 2008). Similarly, communicating to adolescent patients that you’ve held them in mind between sessions strengthens an attachment bond. Often, they will initially resolve the dilemma of coming or going in treatment by communicating, ‘I don’t like therapy, but I like you’. Drama therapy provides a framework for engaging the joy and interest of adolescents, particularly because it allows a shift from the role of patient to that of artist (Haen 2015) and provides opportunities for relating in role that are, paradoxically, more distanced from reality, yet often more emotionally intimate. Stern (2010) framed the arts as forms of vitality, means through which human beings connect to and animate one another. Recently, Nelson (2012) added laughter to the list of attachment-generating behaviours. Drama therapists would do well to engage in shared humour with their adolescent patients, and to scaffold potential areas of growth with positive emotion. Seventeen-year-old Jeremiah was not at all interested in therapy when he entered the second author’s office for his third session. He had seen two prior therapists who both described him as unreachable. After stonewalling the drama therapist for the bulk of his session by dismissing each attempt made to connect with him, Jeremiah eventually grew bored and wandered over to the shelf to grab the Nerf basketball. As he took shots on the hoop hanging from the closet door, the therapist first quietly watched, then began to comment occasionally: ‘Nice shot. . . . Oh, that was close. . . . Try from the other corner’. Jeremiah visibly relaxed his defended posture, a cue to the therapist that he could try to engage further. The therapist gradually shifted his commentary to that of a sports announcer who was giving the play-by-play for a professional match. Jeremiah rolled his eyes, but his face communicated interest and amusement, while the repetitive movements inherent to basketball contributed to integration. As the therapist grew more animated in his commentary, Jeremiah matched his rhythm with increased energy in his shooting. The play culminated in the announcer conducting a brief post-game interview with the imaginary player. At the session’s end, the therapist walked him to the door. In the previous sessions, Jeremiah had left without a response when the therapist said, ‘See you next week’. However, this time, he met his gaze briefly and responded, ‘You will’.

State dependence Wachtel (2014) advocated that, rather than understanding attachment categories as indicative of how a person relates to others all the time, therapists derive the most benefit from viewing these styles as contextual and relational. As such, attachment patterns emerge when the attachment system is activated by interaction with the therapist and others, often in situations that evoke threat. During these moments, internal working models influence behaviour. This idea is consistent with the relational analytic concept of multiple self-states. Bromberg (2011) is one of many authors who have advanced the notion that the self is composed of numerous parts. These parts, or self-states, can be likened to roles in Landy’s (2009) role theory. This theory has particular relevance for adolescents, who have not yet integrated a coherent role system. As such, they often shift from one state to another during the course of interaction, with little correspondence between the two. 224

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This can mean that asking teenagers to remember how they felt during an emotionally charged moment while in session days later can be an exercise in failure, met with dulled responses of ‘I don’t know’. It is when the affect belonging to that circumstance is felt in the present that the adolescent can often find words to describe it. In this way, memory is thought to be statedependent, so that being in the same state one was in when an event happened facilitates recall. Although it would be remiss to attempt to provoke affect, drama therapy offers safe ways of inviting emotions into the present. When adolescents create scenes that mimic real-life situations, they experience some of the same physiological effects. However, because they are acting, they are more readily able both experience the feeling and reflect on it, as they are both actor and character in these moments (Haen and Weil 2010). Adolescents’ capacities are similarly statedependent. We might witness an otherwise insightful, reflective teenager revert to an earlier developmental stage when his or her attachment system is stimulated in response to perceived threat. This regression is not defensive so much as it is self-protective and contingent upon the self-state that is operating in the moment. Tracking shifts in affect during sessions and noting them with gentle curiosity can promote expanded self-awareness. By asking adolescents to return to feelings that surface but are quickly shifted away from (e.g. a flash of anger across the face, a look of yearning, a grimace of pain), we are gradually expanding their window of tolerance. Costello described it in the following way: The therapist actively and frequently engages the patient’s nonverbal signals and communications by inquiring about what is happening internally when a shift in nonverbal signals takes place. The stance is one not of passive understanding but rather of active companionship, including the lively elicitation of what the patient may be feeling only inchoately and without much awareness. (2013, pp. 180–1) Slowing down the process in order to examine state shifts can be as simple as asking, ‘What happened just then?’, or reflecting, ‘I got the sense there was another feeling under what you were saying’. Within dramatic action, adolescents can be asked to pause a scene and to replay a particular moment. The affect can then be heightened and given fuller expression – such as asking the patient’s fists that are balled up to give a monologue about what they are feeling. In moments outside scenework, the drama therapist might play back what they witnessed during a state shift so that the teen can see it from an outside vantage point. Lilly, a 16-year-old who consistently did not get her needs met as a child, recently withdrew during a session with the second author. They had been discussing her plan for trying out new behaviours in the coming week when she swiftly became blank and unreadable. At the time, she could not reconnect with the therapist and had no words to articulate her withdrawal, only able to say, ‘I don’t want to talk about this anymore’. It was during the next session, when the therapist enquired about her withdrawing, that Lilly was able to verbalize that she thought the therapist’s encouragement to adjust her ambitious goal for the week to one that was more easily accomplishable meant he expected very little of her. Self-protectively, she withdrew, seeing the therapist as yet another adult who viewed her as incapable. In drama-therapy terms, the stimulation of the attachment system within a relational frame can be seen as calling upon role expectancies. As roles are relational (Haen and Weber 2009), they require a corresponding role in order to come alive. In this example, therapist and patient both played out a familiar scene: that of the baby who lacks the ability to hold her mother’s gaze and, therefore, is left with an abiding sense of failure. Correspondingly, the therapist 225

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experienced on a gut level what it must feel like to try to attune to a mother who offers little in response, like listening to the static of a radio station without a clear signal.

Narrative A second wave of attachment research was ushered in when Mary Main and colleagues (George et al. 1985) developed a structured interview protocol for the assessment of attachment in adults. The Adult Attachment Interview (AAI) shifted focus from relational patterns to states of mind with regard to attachment, as indicated by degrees of narrative fluidity and coherence (Levy et al. 2012). In analysing data from interviews in which subjects were asked to speak about their childhood experiences of being parented, Main and colleagues looked for linguistic representations of either deactivating or hyperactivating defences. They located insecure attachment ‘in narrative process, markers of which include change of voice, contradictions, lapses, irrelevancies, and breakdowns in meaning during discussions of family relationships’ (Slade 2008, p. 773). Narratives have particular relevance for adolescents, who define themselves in the telling and retelling of events. As Corbett (2009) noted, children reinforce attachment by asking to hear stories about their birth and infancy. These stories often take on a romantic quality, emphasizing events as dramatic and heroic, and enter the realm of fantastic reality (Lahad 2005). The stories adolescents tell about themselves have a similar quality. Taking cues from the AAI, drama therapists can attend to breaks and gaps in adolescents’ narratives. Noticing these and fleshing them out can help develop a greater sense of self-awareness in patients and indicate potential areas of clinical intervention. In particular, encouraging the finishing of half-formed thoughts and enquiring about shifts in focus can yield fertile material. Furthermore, following adolescents into and out of fantastic reality allows the therapist to experience the teen’s hopes and wishes, and can bring meaning to otherwise confusing life experiences. The distance provided by the narrative allows adolescents to reconsider messages they’ve internalized about how relationships work (Meldrum 2012). Ty was a 16-year-old who was removed from his mother’s care and brought to a crisis shelter following an incident in which they barricaded themselves in their apartment and refused to allow police to enter. Ty’s mother, who was an accomplished university professor, had decompensated over the past several years and become increasingly paranoid and delusional. Ty’s relationship with her was enmeshed, and the two were engaged in a long-standing folie à deux. When the second author began treating Ty, the teen was incredibly distrustful and confused, unable to make sense of how he, an affluent Caucasian, had ended up in a shelter with primarily Black and Latino teenagers. Further, his mother’s ongoing feedback that he was incredibly gifted, with special abilities to influence others, was not proving true in his new circumstances. Trusting his therapist meant having to cope with conflicting loyalties, as the therapist represented the system that had deemed his mother unfit and taken Ty from her. The therapist offered him a metaphor for understanding his experience and asked him to consider its validity. In this narrative, Ty’s life was likened to that of a prince who lived in a protected castle at the top of a hill. Born of royalty and surrounded only by servants, he had no choice but to understand himself, heir to the throne, as nothing short of a god. However, one day the castle was raided, and the royal family fled, becoming separated in the chaos. The prince, who lost everything, was forced to live among the villagers, where he found that his strengths and weaknesses were fairly common, not unlike those of the people around him. Ty and his therapist returned to this narrative throughout treatment, fleshing out different aspects of it as he came to new realizations about his own life. Befitting his attachment style, 226

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Ty became anxiously attached to his therapist, and it was difficult at times to establish interpersonal boundaries. However, gradually, Ty was able to find equilibrium in the relationship. A turning point in treatment happened when he no longer needed the narrative, instead sitting the therapist down and saying, ‘Tell me the truth: my mom’s really sick, isn’t she?’.

Summing up In his recent book on trauma, van der Kolk asserted: If we look beyond the list of specific symptoms that entail formal psychiatric diagnoses, we find that almost all mental suffering involves either trouble in creating workable and satisfying relationships or difficulties in regulating arousal. . . . Usually it’s a combination of both. (2014, p. 78–9) His words emphasize the vast potential for attachment-informed clinical practice to influence a broad range of mental-health issues. As drama therapists, we have found that integrating classic and modern attachment theory into our clinical approach both validates the experiential nature of our work and also challenges us to deepen our process and become more creative in supporting our adolescent patients. The adolescents we treat have been our best guides, though, and continue to inspire us with their fumbling, courageous attempts to grow.

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Gaskill, R. L. and Perry, B. D. (2014) ‘The neurobiological power of play: Using the neurosequential model of therapeutics to guide play in the healing process’, in Malchiodi, C. A. and Crenshaw, D. A. (eds), Creative Arts and Play Therapy for Attachment Problems, pp. 178–94. New York: Guilford. George, C., Kaplan, N. and Main, M. (1985) Adult Attachment Interview Protocol. Unpublished manuscript, University of California at Berkeley. Haen, C. (2011) ‘Boys and therapy: The need for creative reformulation’, in Engaging Boys in Treatment: Creative Approaches to the Therapy Process, pp. 3–40. New York: Routledge. Haen, C. (2015) ‘Expressive therapy groups for adolescents with complex trauma: Fostering change when safety is fleeting’, in Webb, N. B. (ed.), Play and Expressive Therapies with Children and Adolescents in Crisis: Treatments for stress, anxiety, and trauma, pp. 239–56. New York: Guilford. Haen, C. and Weber, A. M. (2009) ‘Beyond retribution: Working through revenge fantasies with traumatized young people’, The Arts in Psychotherapy, 36, 84–93. Haen, C. and Weil, M. (2010) ‘Group therapy on the edge: Adolescence, creativity, and group work’, Group, 34, 37–52. Hart, S. (2011) The Impact of Attachment: Developmental neuroaffective psychology. New York: Norton. Hodermarska, M., Haen, C. and McLellan, L. (2014) ‘Exquisite corpse: On dissociation and intersubjectivity—Implications for trauma-informed drama therapy’, in Sajnani, N. and Johnson, D. R. (eds), Trauma-Informed Drama Therapy: Transforming clinics, classrooms, and communities, pp. 179–205. Springfield, IL: Charles C. Thomas. Holmes, J. (2014) ‘Where the child is the concern: Working psychotherapeutically with parents’, in Holmes, P. and Farnfield, S. (eds), The Routledge Handbook of Attachment: Implications and interventions, pp. 53–64. New York: Routledge. Hughes, D. A. (2007) Attachment-Focused Family Therapy. New York: Norton. Jennings, S. (2011) Healthy Attachments and Neuro-Dramatic-Play. London: Jessica Kingsley. Johnson, S. (2009) ‘Extravagant emotion: Understanding and transforming love relationships in emotionally focused therapy’, in Fosha, D., Siegel, D. J. and Solomon, M. F. (eds), The Healing Power of Emotion: Affective neuroscience, development and clinical practice, pp. 257–79. New York: Norton. Kieffer, C. (2011) ‘Adolescence as a time to play’, in Akhtar, M. C. (ed.), Play and Playfulness: Developmental, cultural, and clinical aspects, pp. 33–47. Lanham, MD: Jason Aronson. Klin, A. and Jones, W. (2007) ‘Embodied psychoanalysis? Or, on the confluence of psychodynamic theory and developmental science’, in Mayes, L., Fonagy, P. and Target, M. (eds), Developmental Science and Psychoanalysis: Integration and innovation, pp. 5–38. London: Karnac. Kline, W. H. (2009) ‘How do adolescents leave psychotherapy?’, Journal of Infant, Child and Adolescent Psychotherapy, 8, 169–80. Lahad, M. (2005) ‘Transcending into fantastic reality: Story making with adolescents in crisis’, in Schaefer, C., McCormick, J. and Ohnogi, A. (eds), International Handbook of Play Therapy: Advances in assessment, theory, research, and practice, pp. 133–58. Lanham, MD: Jason Aronson. Landy, R. J. (2009) ‘Role theory and the role method of drama therapy’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy (2nd edn), pp. 65–88. Springfield, IL: Charles C. Thomas. Levy, K. N, Meehan, K. B., Temes, C. M. and Yeomans, F. E. (2012) ‘Attachment theory and research: Implications for psychodynamic psychotherapy’, in Levy, R. A., Ablon, J. S. and Kächele, H. (eds), Psychodynamic Psychotherapy Research: Evidence-based practice and practice-based evidence, pp. 139–67. New York: Springer. Mark-Goldstein, B. and Siegel, D. J. (2013) ‘The mindful group: Using mind–body–brain interactions in group therapy to foster resilience and integration’, in Siegel, D. J. and Solomon, M. (eds), Healing Moments in Psychotherapy, pp. 217–41. New York: Norton. Marrone, M. (2014) Attachment and Interaction: From Bowlby to current clinical theory and practice (2nd edn). London: Jessica Kingsley. Meldrum, B. (2012) ‘Supporting children in primary school through dramatherapy and the creative therapies’, in Leigh, L., Gersch, I. and Dix, A. (eds), Dramatherapy with Children, Young People and Schools: Enabling creativity, sociability, communication and learning, pp. 39–47. London: Routledge. Music, G. (2014) ‘Attachment theory and its uses in child psychotherapy’, in Holmes, P. and Farnfield, S. (eds), The Routledge Handbook of Attachment: Implications and interventions, pp. 32–52. New York: Routledge. Nelson, J. K. (2012) What Made Freud Laugh: An attachment perspective on laughter. New York: Routledge. Quinn, N. and Mageo, J. M. (eds) (2013) Attachment Reconsidered: Cultural perspectives on a Western theory. New York: Palgrave Macmillan. 228

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Scharf, M. and Mayseless, O. (2007) ‘Putting eggs in more than one basket: A new look at developmental processes of attachment in adolescence’, New Directions in Child & Adolescent Development, 117, 1–22. Schore, A. N. (2013a) ‘Bowlby’s “environment of evolutionary adaptedness”: Recent studies on the interpersonal neurobiology of attachment and emotional development’, in Narvaez, D., Panksepp, J., Schore, A. N. and Gleason, T. R. (eds), Evolution, Early Experience and Human Development: From research to practice and policy, pp. 31–67. New York: Oxford University Press. Schore, A. N. (2013b) ‘Relational trauma, brain development, and dissociation’, in Ford, J. D. and Courtois, C. A. (eds), Treating Complex Traumatic Stress Disorders in Children and Adolescents: Scientific foundations and therapeutic models, pp. 3–23. New York: Guilford. Schore, J. R. and Schore, A. N. (2008) ‘Modern attachment theory: The central role of affect regulation in development and treatment’, Clinical Social Work Journal, 36, 9–20. Siegel, D. J. (2013) Brainstorm: The power and purpose of the teenage brain. New York: Jeremy P. Tarcher/Penguin. Slade, A. (2008) ‘The implications of attachment theory and research for adult psychotherapy: Research and clinical perspectives’, in Cassidy, J. and Shaver, P. R. (eds), Handbook of Attachment: Theory, research, and clinical applications (2nd edn), pp. 762–82. New York: Guilford. Steinberg, L. (2014) Age of Opportunity: Lessons from the new science of adolescence. Boston, MA: Houghton Mifflin Harcourt. Stern, D. N. (1985) The Interpersonal World of the Infant: A view from psychoanalysis and developmental psychology. New York: Basic Books. Stern, D. N. (2010) ‘The issue of vitality’, Nordic Journal of Music Therapy, 19, 88–102. Tortora, S. (2013) ‘The essential role of the body in the parent–infant relationship: Nonverbal analysis of attachment’, in Bettmann, J. E. and Friedman, D. D. (eds), Attachment-Based Clinical Work with Children and Adolescents, pp. 141–64. New York: Springer. Trevarthen, C. (2009) ‘The functions of emotion in infancy: The regulation and communication of rhythm, sympathy, and meaning in human development’, in Fosha, D., Siegel, D. J. and Solomon, M. F. (eds), The Healing Power of Emotion: Affective neuroscience, development and clinical practice, pp. 55–85. New York: Norton. Tronick, E. (2009) ‘Multilevel meaning making and dyadic expansion of consciousness theory: The emotional and the polymorphic polysemic flow of meaning’, in Fosha, D., Siegel, D. J. and Solomon, M. F. (eds), The Healing Power of Emotion: Affective neuroscience, development and clinical practice, pp. 86–111. New York: Norton. van der Kolk, B. (2014) The Body Keeps the Score: Brain, mind, and body in the healing of trauma. New York: Penguin Random House. Wachtel, P. L. (2014) Cyclical Psychodynamics and the Contextual Self. New York: Routledge. Wallin, D. J. (2007) Attachment in Psychotherapy. New York: Guilford. Weber, A. M. (2005) ‘“Don’t hurt my mommy”: Drama therapy for children who have witnessed severe domestic violence’, in Weber, A. M. and Haen, C. (eds), Clinical Applications of Drama Therapy in Child and Adolescent Treatment, pp. 25–44. New York: Routledge.

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23 Stevie and the Little Dinosaur A story of assessment in dramatherapy Sarah Mann Shaw

Assessment is that part of the dramatherapy process concerned with understanding a client’s condition and therapeutic needs. (Bruscia 1980)

My query in this chapter is how does dramatherapy assessment contribute to our understanding of the ‘client’s condition’? How does the insight of a dramatherapy assessment sit alongside other generic outcome measures and the practitioner’s knowledge and experience of the client? Rarely does an assessment function solely as assessment. It is also a treatment intervention relying on the quality of the creative intervention and on the particular quality of the relationship between child and therapist and between therapist and parent. It is this that supports integration and consolidation and that enables the child to move towards a place of recovery and emotional health. This chapter will explore the use of Embodiment–Projection–Role (EPR; Jennings 2012), initially designed as a paradigm to understand child development in relation to dramatic play within dramatherapy, and look at the function of this in an extended assessment process for dramatherapists. Using anonymised case material, this chapter will illustrate the application of theory to practice before reflecting on the usefulness of the dramatherapy assessment to the overall understanding of the client’s narrative.

Introducing Stevie Stevie was 10 years old. He had been adopted at 8 years of age, after numerous placement moves. His birth family had been characterised by high levels of drug use, domestic violence and prostitution. His adopted parents and social worker described him as ‘agitated’ and ‘controlling’, particularly in relation to his adopted mum. The system and parents felt that a dramatherapy assessment might be helpful in exploring what was happening for this little boy in a way that would not overwhelm him and potentially increase his current distress. The social worker felt that dramatherapy might help them understand what was happening for Stevie and how his adoptive parents, in particular, might best respond to him. 230

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Assessment measures Dramatherapy assessment currently considers other generic assessment tools that help evidence the effectiveness of our intervention. This chapter is not designed to explore these generic assessment tools; however, these differing assessments need to sit alongside and complement each other to create a composite picture that can more fully address the need to: 1 2 3 4

make clear and informed intervention in dramatherapy practice; be helpful and appropriate for the referred client; contribute a therapeutic understanding of client need to those involved with the child and his family; continually evaluate the effectiveness of dramatherapy, so contributing to a larger treatment picture.

As a dramatherapist in private practice, I use a combination of Goodman’s Strengths and Difficulties Questionnaire (SDQ; Goodman 1997) and Psychlops for Kids (Haythorne et al. 2012). These both offer a quantitative score pre-, mid- and post-therapeutic intervention, making them an accessible measure for evaluating effectiveness. There are several other assessment tools that I access if I feel they would serve a useful purpose in thinking about interventions in the dramatherapy or if they would support the thinking in the system surrounding the child. These include: 1 2 3 4

Child Dissociative Checklist, version 3 (Putnam 1997); Adolescent Dissociative Experience Scale II (Armstrong et al. 1997); Teenagers Locked in Rage or Hate Checklist (Sunderland 2008); Horowitz’s Revised Child Impact of Events Scale (Horowitz et al. 1979).

I use an assessment tool created by Andersen-Warren (1986 – as yet unpublished). This was initially devised for traumatised adult survivors referred for dramatherapy within the NHS. I have adapted it to include relevant assessment methodology for a younger client group (see Appendix). The first part of the assessment form aims to gather a clear history, the reasons for referral and the presenting difficulties. This information is gathered from the first professional meeting, from case notes and from professional conversations, and it forms the explicit story. By this I mean the story that is known, has a coherent structure, contains words and is autobiographical in nature and, therefore, is verbally accessible. The second section works with a framework of EPR and deals with the implicit story. The implicit story is held by the body; it is held in images, in sensory information, and is not necessarily sequential in nature. As such, the implicit story is connected to the amygdala; it is emotionally driven, hypersensitive to external stimuli connected to trauma and not always easy to regulate. It is in the process of exploring the implicit story that the child is enabled to make coherent sense of what has previously been experienced as a jumble of confusing sensory information. EPR assessment information is gathered continually throughout the assessment process. Both parts contribute to my thinking about the story the child brings with them to dramatherapy. As a dramatherapist, I am interested in the following: • • •

What is the story? Who is telling it? How is it being told? 231

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In putting the two stories together, dramatherapy hopes to support the child to make sense of experience and reduce those behaviours that are stressed responses to the original experience of trauma. EPR is a developmental paradigm charting the progression of dramatic play from infancy to the age of 7 years. In my use of it as an assessment tool, information is gathered from parental observations of the child’s day-to-day experience, for example patterns of sleep, appetite, movement, behaviour, affect, play, dreams, roles played and roles not yet accessed. This material is added to in the dramatherapy assessment through the dramatherapist’s observation of the child’s potential to engage in this paradigm. If development is interrupted by difficult attachment experiences and/or trauma, then this will also be represented in a child’s capacity for dramatic play.

Stevie’s assessment profile Stevie scored 22/40 on the Goodman SDQ completed by his adoptive parents, scoring particularly highly in the area of conduct problems (8/10) and on the ‘borderline’ scale for emotional symptomology (5/10) and hyperactivity (6/10). In his Psychlops pre-therapy form, in response to what he felt was most troubling him, he drew a huge, shadowy mummy figure and ticked the boxes that indicated that this worried him a lot and that it had been worrying him for a long time, but it had not been hard over the last week, and he had felt pretty good. He felt OK about coming to therapy. He scored 4/12 on this self-rated outcome measure. When I asked him if there was anything he would like to add in the final box of his Psychlops form, he drew a huge red ‘mummy’ Tyrannosaurus Rex. This served as a useful image to work with in dramatherapy, becoming an extended narrative that we worked on throughout the assessment process. Although Stevie might not be able to comprehend an explicit solution to his conduct or emotional difficulties as presented though his SDQ score, he might be able to imagine, through an EPR dramatherapy assessment, an implicit metaphorical solution to the problem of the mummy dinosaur as presented in his Psychlops assessment.

Embodiment In dramatherapy, embodiment concerns the way an individual relates to their body at an unconscious as well as a conscious level. The body is the primary way of learning about and processing early experience. If the infant has experienced an interruption to developing a healthy, confident and playful relationship with their body, this will be evident through their explicitly held and observed embodied patterns, i.e. through their pattern of sleep, appetite, conduct, physicality and movement.

Stevie’s embodiment Stevie’s adoptive parents said that Stevie was a ‘hot’ sleeper, and that he had to be surrounded by teddies while he slept, which they felt contributed to his body heat but which he could not do without. He had no interest in food and, when he ate, he did so quickly and without thought for what he was eating. Stevie was a quick and jerky mover. He relaxed only when watching TV, which he managed for short periods of time, when both his mum and dad were in the room. He liked boisterous play, and they noticed that he always had to be in charge of any game played. He contained himself well at school, but they described him as ‘exploding’ on the way home. We know that persistent neglect in infancy can lead to persistent states of extreme emotional distress. As a result, these emotions and bodily feelings can be experienced as indications of 232

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threat. This can mean that the child (or adult) experiences affective states of anxiety, anger, sadness, embodied experiences of pain and discomfort and, as in Stevie’s case, associated deficits in basic self-regulation, i.e. feeding, sleep–wake cycles and self-soothing (Ford 2013).

Projection The beliefs, thoughts and feelings our clients may project can be seen through their dreams, relationships, their religious and spiritual beliefs, their play, their engagement with books, stories, film, TV and computer games. Dramatherapists might use objects supporting a client to construct a story, for example, to symbolically hold projective meaning.

Stevie’s projections Stevie’s parents reported Stevie never cried out in his sleep, nor reported any dreams or nightmares. In his play, they noticed that the conflict between good and bad always presented itself for attention. In play with his adoptive mum, Stevie would try to hit out at her and tell her that she was ‘stupid’ and ‘no good’. Stevie’s play contained themes of power struggles, and his related behaviour contained blame, threats, verbal insults and aggression and were hurtful to his mum. Stevie’s conduct in his projective play was indicative of a fight trauma response (Marks 2012).

Role Using this form of assessment, it is important to ask the question, ‘What are the significant roles the client has learned to play in their life to date, and what roles have been underdeveloped?’. In order to be able to engage in role-play, a client must have a capacity to pretend an action, imagine what a situation might be like for someone else, imagine how someone might respond to something, be able to respond to others’ ideas imaginatively, be able to communicate effectively and be able to use objects as substitutes for other objects with imaginative intention. It is a sophisticated task and one that a child with a secure attachment usually reaches at 4–7 years. Role-play enables a child to explore a developing sense of self and of other; it enables the development of empathy and demonstrates a successful integration of the previous stages of embodiment and projection.

Stevie’s roles Stevie’s adoptive mum reported that she felt uncomfortable with the regressed and demanding roles that Stevie exhibited, and she did not know how to respond. She reported feeling ‘bullied’ by the controlling behaviour and asked her husband to intervene. She did not set boundaries for Stevie’s behaviour, and, perhaps as a result, Stevie continued to inhabit and move between roles of needy infant and insecure toddler in relation to his adoptive mum. Both parents felt that his dominant role was one of ‘top dog’, while also recognising that they had a very scared and vulnerable child. Attachment theory informs us that Stevie would have learned to regulate his behaviour by anticipating his caregivers’ response to him. This interaction would have allowed him to construct an internal working model (Bowlby 2005) on which the basis for later relational interaction would have been formed. When a child has an experience of a secure attachment figure, they learn to trust both what they feel and how they understand the world. Their experience of feeling understood provides them with the confidence that they can manage well, and that they are capable of experiencing good relationships. They understand that, if they do not know how 233

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to deal with a difficult situation, they can find someone to help them. Many parents and carers are able to help distressed children to restore a sense of safety and control by soothing their distress and by modelling emotional regulation. In this way, the child comes to understand their own potential to settle distressing thoughts and experiences. However, when distress has happened while in the care of a vulnerable, relationally absent, rejecting and/or scary caregiver, the child’s response is likely to replicate that of the parent; the more disorganized the parent’s responses to the child, the more disorganized the child is and, thus, unable to create an internally secure and confident sense of self. The child cannot create that which has not been successfully first modelled by the parent. Stevie had been impacted by his early life experience, and the assessment material gathered from the adoptive parents and supporting system suggested that he was operating from a traumatized and distressed internal working model. He was struggling to reorganize experience, even in the presence of two new, loving parents who, in turn, were struggling to understand why their love for Stevie did not seem able to repair his early experience of relationship. Children can learn to moderate the intensity of psychological arousal with repeated interactions with emotionally attuned caregivers. After 2 years, Stevie still struggled to accept and make use of these positive interactions. My hypothesis was that Stevie was operating from an implicit, nonverbal memory system that was informed by traumatic sensory material (Schacter 1996), and this was conditioning a fearful, hyper-aroused response. He could not relinquish the controlling role of top dog because he had no internal representation of a safe and trusting other. He was scared of trusting his new mum and dad, and this fear repeatedly conditioned him to reject their advances. Schore writes that: The growth-inhibiting environment of relational trauma generates dense and prolonged levels of negative affect associated with extremely stressful states of hyper and hypoarousal. In self-defense the child severely restricts overt expression of the attachment need and significantly reduces the output of the emotion-processing, limbic centred, attachment system. (2009, p. 114) Stevie’s brain was still operating from an unprocessed experience of trauma. The aim of the dramatherapy assessment was, therefore, to also provide Stevie with a dramatic language to give ‘form to feeling’ (Langer 1979, p. 64), with enough emotional distance to support him to explore the unimaginable and the inexpressible. I needed to work out in assessment how Stevie might be able to manage this approach. We want a dramatherapy intervention to help repair the interpersonal bridge and so support the young person to begin to be able to explore what it might be like to co-construct meaningful and non-abusive relationships. I wanted dramatherapy to assess how Stevie might be supported to develop a different attachment experience with his adoptive parents, and, in order to do this, dramatherapy had to also address Stevie’s hyper-arousal.

Eight assessment sessions of dramatherapy The eight assessment sessions I offer are generally structured to cover the initial professionals and parent meeting and six dramatherapy sessions: • • 234

Session 1: Safety; Session 2: Creative projection;

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• • • •

Session Session Session Session

3: 4: 5: 6:

Moving into metaphor; Exploring resistance to change; Exploring change through dramatic engagement; Closure and reflection.

There follows the final professional and parent meeting (Sessions 7 and 8).

A vignette from Session 3: Moving into metaphor Forenote: In the second session, Stevie had depicted in the sand tray his adoptive family as a collection of dinosaurs. He had named the qualities of each dinosaur: his dinosaur was described as ‘strong but not too strong’, dad was ‘strong and protective’ and mum was ‘spiky’. He had told me that the world they lived in was full of fighting and was very scary. Stevie had already started to move into metaphor through this extended description. The third session was designed to support Stevie to move fully into metaphorical engagement. Stevie played with the dinosaurs in the sand, and I made gentle enquiries about their world: ‘How long had the dinosaurs been there? What was in the landscape? What was their day like?’ Stevie told me that there was nothing in their land; there wasn’t any food or water, so the dinosaurs were often hungry, and this made them really cross, and they fought each other all the time. He also told me that a big volcano was going to erupt and that all the dinosaurs were going to get hurt by the lava; he said that he didn’t want the little dinosaurs to get hurt, but the big dinosaurs were too busy fighting to help. I asked him if there was anything or anyone else who might help; he struggled to articulate a response. In dramatherapy, a client’s capacity, or lack of it, to engage with a character that is considered helpful is usually a good indication of whether they are able to begin to imagine trusting another. The process of imagining trusting another is an important aspect of therapeutic movement. If we can first imagine an action, then we also have the potential to explore that action and its implication more fully. I was aware from earlier assessment material that Stevie struggled to trust an ‘actual other’; might he be enabled to explore the process of trust as an imaginary and dramatic process? At this point in the session, Stevie wanted to show me his backward flips and began moving round the room with a frenetic energy. Witnessing his ‘great’ flips from a still place in the centre of the room, I wondered how this could help him with thinking about the problem of who or what could help. We first worked on slowing the backward flip down, then on noticing the room while doing slower backward flips. I commented on the fact that, now he was moving more slowly, I could really see how great his backward flips were. Eventually, Stevie was able to come back to task. When Stevie struggled with thinking about something that was difficult, such as a reliable helping character, he engaged with hyper-aroused movement, the purpose of which was to distract him from engaging with that which was difficult. My interventions were designed to slow Stevie down and to encourage him to experience his capacity to tolerate that which was difficult from a position that was neither hyper- or hypo-aroused. His hyper-aroused movement felt driven by traumatic memories in which there had been no trusting other to help him with these overwhelming feelings. Stevie picked a large bird puppet and said that the bird would fly in and rescue the little boy dinosaur and take him to a safe place, but that the little dinosaur might not be able to stay there and might have to come back to the scary dinosaur world. In his sharing this with me, I felt that Stevie had articulated some of his historical and current patterns of survival. Using metaphor, the implicit was becoming explicit and, therefore, accessible to a verbal narrative. 235

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A vignette from Session 4: Exploring resistance to change I was curious to see if, in this session, dramatherapy could offer Stevie a way to solve the problem the little dinosaur experienced by continued metaphorical engagement. The power of metaphor rests upon its levels of meaning and its ability to be flexible, poetic and intuitive, ‘to make verbally concrete such intangibles as emotion’ (Templeton 1974, p. 22). With the use of metaphor, we are able to combine two different realms of experience, opening the way for new and different levels of meaning. Lakoff and Johnson (2003) argue that metaphors act as cultural containers by which we live. They argue that our ordinary conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature. Metaphors seem to function through their connotations of the universal and personal; this makes them a rich resource for dramatherapy assessment. Stevie set up two sand trays next to one another. He set up the ‘bad and scary’ dinosaur world in one tray and, in the other, ‘a happy and good world’. He told me that the little dinosaur was strongest in the ‘bad’ world and demonstrated how well it fought with the other dinosaurs. Placing the figure of the dinosaur in the ‘good’ world, he told me that it liked it there but that it just wanted to fight and did not know how to stop. I shared with Stevie that it did indeed seem a tricky dilemma for the little dinosaur; Stevie informed me that it was even worse because the bad dinosaur world was going to die, and that he did not want the little dinosaur to be there when that happened. I wondered what the ‘dying’ might look like and wondered if the bird puppet he had played with last week might be able to help the little dinosaur in surviving the destruction of the ‘bad’ dinosaur world. I wanted to facilitate through symbolic play and dramatic representation that Stevie could reflect and think about the experience of the little dinosaur, and that this might help some of Stevie’s unconscious ‘acting out’ behaviour to become less driven. In response to thinking about destruction, Stevie and I made a volcano together. Stevie asked what the volcano might look like when it exploded; I described the reaction between vinegar, bicarbonate of soda and paint and noticed that Stevie was clearly nervous. I asked if he would like to see what happened before the volcano erupted in the dinosaur world; looking really worried, he nodded. I asked where he thought might be a safe place in the room to watch from, and how near or far he wanted the demonstration of the volcano to be in relation to him. Stevie sat on the sofa holding the bird puppet, directing me to be some distance away. I described what I was doing and calmly noticed the impact of the volcano as it erupted. I noticed what was changed by the eruption and what remained unaltered. My thinking was that my speaking in a calm and soothing manner might help Stevie tolerate the explosion differently, offering him a capacity to witness and feel a sense of emotional regulation in the therapeutic relationship, rather than responding from a place of stress. It was important that he felt empowered to witness this from a safe place of his own choosing. I felt that it was also important that he witnessed me, as a safe and trusted adult, containing the potential chaos and destruction of the volcano. I would not be ‘infected’ by the volcano; I would not mirror its destruction; I could maintain a capacity to notice and to be curious about it and its impact. Stevie watched the first demonstration and looked relieved. He asked me to put the volcano in the sand tray that held the bad dinosaur world. Getting a little closer this time, he placed the father and son dinosaurs in the path of the volcano’s eruption and asked me to show him again. Stevie told me, after the eruption, that both dinosaurs felt sick; he said that he also felt sick and held on to his tummy. I reflected that feeling sick could feel horrible and rubbed my tummy; Stevie nodded and mimicked rubbing his tummy also. He then asked if we could make a third explosion, and he placed all the dinosaurs around the volcano; they were all covered by lava. Stevie asked the bird if it was ready to be brave and he manipulated the bird to 236

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nod in return. The bird came in to rescue all the dinosaurs, one by one, and ended up getting covered in lava itself. Stevie decided to wash all the creatures clean and was very interested in bringing mum into the session to show her the mess of the volcano and how the little dinosaur had survived it with the help of the bird. Following this session, mum reported that, at home, the session had played on Stevie’s mind. Stevie had wanted to talk about the little dinosaur and the bird and had been upset that the little dinosaur had needed rescuing. Mum had been able to think with Stevie about the story and had imagined that the little dinosaur had been very scared. Children with insecure attachment patterns have trouble relying on others to help them, while also being unable to regulate their emotional hyper-arousal themselves. Consequently, they remain anxious or aggressive, ignoring both what they feel and what they perceive. As a child who had experienced trauma, Stevie had a limited repertoire of feelings. He tended to rely on primitive psychological defences such as splitting, projection and denial (Irwin 2005). He had learned to see relationships and actions as either good or bad, with no room to explore the potential for a middle space. This space offers an integration of this split and thus supports a rich internal life of thought, meaning and feeling. I felt that the process of rehearsal and witness in Session 4 was significant for Stevie. The session had potentially triggered internal material, and this gave mum an opportunity to respond to Stevie in a boundaried and caring way, noticing his hyper-arousal and practising soothing him. It had also enabled Stevie to notice and comment on the world of the little dinosaur. He was able to say how hard it was for the little dinosaur to stay away from the bad world. Stevie and mum thought about this together. Both understood the story to be ‘imaginary’, and this enabled them to connect creatively, thoughtfully and relationally. Stevie had developed a creative language to aid metaphoric self-reflection; because he and his mum were only thinking about the little dinosaur, he could tolerate her closeness in a way that previously had been difficult. Post note: In session 5, Stevie created a world in which the dinosaurs could be fed good food and spent the entire session feeding and soothing each dinosaur in turn.

Stevie’s post-assessment profile In completing a post-dramatherapy SDQ, Stevie’s parents scored him at an overall score of 12. His emotional symptomology had moved down to 4/10, his conduct score down to 2/10, and his hyperactivity down to 2/10. All SDQ scores were within ‘normal’ range. On his Psychlops form, Stevie said he wasn’t worried about a mummy dinosaur and that he couldn’t remember having ever been worried. He scored himself at an overall score of 0/12. Dramatherapists know that the resources we are able to offer such children are rich. Dramatherapy has the capacity to enable children to begin to create a coherent sense of the implicit, traumatically held experience and allows them to find alternative avenues of expression. Dramatherapy supports the early relational trauma that is imprinted and embedded in the core structure of the developing right-hand brain to be processed and known by the left-hand brain, which holds coherence and autobiographical meaning (Schore 2009). We know that life–drama connections do not have to be explicitly made by the client in order to assess whether integration of the traumatic material has happened. This is assessed by the child’s report of their own experience and by the parents’ and therapist’s observation of physical, affective, cognitive, relational and behavioural changes.

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Conclusion: Evaluating the effectiveness of an EPR dramatherapy assessment Effectiveness was measured by ongoing clinical observations of Stevie throughout the dramatherapy process and in follow-up professional and parent meetings. In particular, each aspect of this developmental paradigm was assessed with particular reference to the criteria expressed in the Appendix. Stevie’s dramatherapy assessment had added to the clinical picture and it had enabled Stevie to explore the world of the little dinosaur through metaphoric, dramatic and playful engagement. It had given Stevie and his parents a narrative to think about how difficult it was to move from the old world to the new. They started to name emotions that the dinosaur might be having and were able to recognize that being ‘well fed’ really helped the dinosaur stay in the good world. Children usually develop the capacity for narrative knowledge in the first 2 years of life and, by their third year, a capacity for an autobiographical self (Parvizi and Damasio 2001). This includes the ability to organize knowledge chronologically and to extend this knowledge into the past, present and future and includes ‘reflective awareness’ (Fonagy 2003, p. 227). With his parents’ support, Stevie was beginning to develop the capacity to explore, through metaphorical narrative, a sequential and coherent sense of the little dinosaur’s world. While he was engaging in this process, there was an observed difference in Stevie’s physicality, his controlling behaviours and his affect. Most noticeably, there was a diminished sense of hyper-arousal and an increase in his capacity to tolerate an attachment relationship, with his adoptive mum in particular. The dramatherapy assessment is not just about creating a picture for others to use; it is also about the quality of the relationship created between therapist and child, and how this has been therapeutically experienced. My last image of Stevie is of him, in the final session, sandwiched between his mum and dad; they are listening to me narrate the story of the little dinosaur, as told by Stevie in therapy. In this picture, the metaphorical narrative and the therapeutic relationship are shared and translated into a useful experience for the family. The capacity for holding and sharing experience is empathically mirrored from therapist to family unit and back again. I was able to witness Stevie allowing himself to be held, lovingly, by his new family and to reflect this back to me. Further dramatherapy was recommended in my report to support further integration and consolidation of the work Stevie and the little dinosaur had begun, and this was supported by his family. However, it was unable to be supported by the professional system, although disappointment was voiced and explored. I hope that Stevie’s little dinosaur continues to serve him well.

References Armstrong, J., Putnam, F. W. and Carlson, E. B. (1997) ‘Development and validation of a measure of adolescent dissociation. The Adolescent Dissociative Experiences Scale’, Journal of Nervous & Mental Disease, 185, 8, 491–7. Bowlby, J. (2005) A Secure Base. New York: Routledge Classics. Bruscia, K. (1980) ‘Standards for clinical assessments in the arts therapies’, The Arts in Psychotherapy, 15, 5–10. Fonagy, P. (2003) ‘The development of psychopathology from infancy to adulthood: The mysterious unfolding of disturbance in time’, Infant Mental Health Journal, 24, 212–39. Ford, J. (2013) ‘Neurobiological and developmental research. Clinical implications’, in Courtois, C. and Ford, J. (eds), Treating Complex Traumatic Stress Disorders. An evidence based guide, pp. 31–58. New York: Guilford. 238

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Goodman, R. (1997) ‘The Strengths and Difficulties Questionnaire: A research note’, Journal of Child Psychology & Psychiatry, 38, 581–586. Online. Available at: www.youthinmind.info (accessed 13 October 2011). Haythorne, D., Crockford, S. and Godfrey, E. (2012) ‘Roundabout and the development of Psychlops Kids evaluation’, in Leigh, L. (ed.), Dramatherapy with Children, Young People and Schools: Enabling creativity, sociability, communication and learning, pp. 185–94. London. Routledge. Horowitz, M. J., Wilner, N. and Alvarez, W. (1979) ‘Impact of event scale: A measure of subjective stress’, Psychosomatic Medicine, 41, 209–18. Online. Available at: www.heardalliance.org (accessed 13 October 2011). Irwin, E. C. (2005) ‘Facilitating play with non-players: A developmental perspective’, in Weber, A. M. and Haen, C. (eds), Clinical Applications of Drama Therapy In Child and Adolescent Treatment, pp. 3–25. New York: Brunner-Routledge. Jennings, S. (2012) ‘Embodiment–Projection–Role’, in Johnson, D. R., Pendzik, S. and Snow, S. (eds), Assessment in Drama Therapy, pp. 177–96. Springfield, IL: Charles C. Thomas. Lakoff, G. and Johnson, M. (2003) Metaphors We Live By. Chicago, IL: University of Chicago Press. Langer, S. (1979) Feeling and Form. London: Routledge & Kegan Paul. Marks, R. (2012) ‘Assessment and treatment of traumatized children and adolescents with dissociative symptoms and disorders (course material)’, The Child and Adolescent Course. International Society for the Study of Trauma and Dissociation. Instructor Renée Marks, PhD, Winter 2011–Summer 2012. Huddersfield, UK. Parvizi, J. and Damasio, A. (2001) ‘Consciousness and the brainstem’, Cognition, 79, 135–59. Putnam, F. (1997) Dissociation in Children and Adolescents: A developmental perspective. New York: Guilford. Schacter, D. (1996) Searching for Memory. New York: Basic Books. Schore, A. (2009) ‘Attachment trauma and the developing right brain: Origins of pathological dissociation’, in Dell, P. and O’Neil, J. (eds), Dissociation and the Dissociative Disorders: DSM-V and beyond, pp. 107–41. New York: Routledge. Sunderland, M. (2008) ‘Teenagers locked in rage or hate’, handout at Teenagers Locked in Rage or Hate, Centre for Child Mental Health 1-Day Conference, London. Templeton, D. E. (1974) ‘Analogizing: Its growth and development’, Journal of Aesthetic Education, 7, 3, 21–33.

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24 Evaluation of dramatherapeutical process for clients with neurotic disorder Milan Valenta and Ivana Listiakova

Dramatherapy offers healing through involvement in dramatic reality. The space of pretend play that dramatherapy creates provides an opportunity for experimenting safely with new behaviours and roles. Stepping in and out of the metaphor of a story and playing on the verge of truth and lie provide personal experiences of insight and catharsis. The connections of thought and emotions that happen in dramatherapeutic activities are an important part of treatment of people with neurotic disorders, as they address the need of the psychosomatic nature of the disorders. Dramatherapeutical process is individual and it happens as an inner change, within the person. Therefore, similar to psychotherapy, evaluations of dramatherapeutical processes are usually based on observations of changes in the behaviour of clients. To capture the specific potential for change of engagement in dramatic activities, development of dramatherapeutically specific observation scales is necessary. The team of dramatherapists of Palacky University elaborated and tested a rating scale designed to monitor dramatherapeutical process. The items of this rating scale reflect different effective factors of a group dramatherapeutical programme. It functions as an assessment of characteristics that promote change in dramatherapy. First of all, the validity of this instrument needed to be researched. We applied the rating scale during dramatherapeutic sessions offered to clients in a department of a psychiatric hospital. As well as testing the instrument, we were interested in exploring how the dramatherapeutic work affected the clients in areas of emotionality, expression and interactions. The clients of the chosen psychiatric department were clients with neurotic disorders who needed treatment and support in managing highly stressful life situations. The department where we offered dramatherapeutic sessions was the ‘Legendary Eighteen’, Department 18 of the Kromeriz psychiatric hospital in the Czech Republic, for people with neurotic disorders. This department has been under the leadership of the father of Czech psychotherapy, Professor Stanislav Kratochvíl. It is the only hospital in the country that provides an inpatient unit for clients with neuroses. The capacity is about twenty people, and the programme lasts 6 weeks. In an interview with Jan Zvelebil (2002), Kratochvíl mentioned the most common neurotic issues of his clients. He considered the most prevalent causes of neurotic disorders in male clients 240

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were work related. A portion of his clients did not enjoy their jobs, or they struggled with conflicts in the workplace. Some of them thought their bosses or colleagues were against them. There were also men who were workaholics, with an unbearable work pace. Another group of neurotic male clients were those who lost their jobs and were struggling with unemployment. Women, on the other hand, were more emotionally involved. They suffered from longing for a partner, or unfulfilled expectations in their partnerships. They felt their partners did not have time for them, would not listen to them or considered their struggles insignificant. The issues of female clients were mostly connected with relationships. There were also some overworked women who needed psychiatric help, but the percentage of these women was much lower than that of male clients in this category. Kratochvíl explained this phenomenon by women’s higher flexibility and their capability to manage multiple responsibilities, such as career and household. Difficulties for women, according to him, arrived with an unfulfilled desire to have children or difficulty in letting them go when they grew up. Men handle this better, but for women it is stressful, even though they cannot change the situation. At the department for patients with neurosis, the clients are mostly women. Men tend to start drinking and, therefore, they are more likely to be treated in alcohol and drug addiction treatment departments. As Kratochvíl (2006) mentioned, neurosis is an unpleasant illness. Even though, most of the time, the difficulties might just go away after a while, they can linger, and it is important for the person to learn to live with them. In the beginning of the treatment, clients expect that ‘the doctor will do something about it’. However, overcoming neurotic difficulties can only be achieved by inner work on the client’s part. Dramatherapeutic sessions lead clients towards experiencing changes in their feelings and also towards accepting responsibility for treatment. They offer support, but do not take the action out of the clients’ hands. On the contrary, they encourage self-management through enhancing self-esteem and offering a feeling of success. Neurotic symptoms can be observed in the form of physical pain, heart, stomach-ache, tiredness, depressive mood or other unpleasant body reactions that cannot be explained by a specific somatic cause. The human mind and soul communicate through the body by means of its language. Dramatherapy uses embodiment as one of its core processes, as Jones (2007) described them. It relates to specific needs of clients with neurotic disorders, because the symptoms of their psychiatric issues manifest themselves in various bodily forms. Dramatherapy offers change that grows out of the solutions that clients find in their bodies, in the embodied metaphors and stories. For clients with neurotic disorders, it is especially important to work on achieving aesthetic distance, as described by Landy (1994), as a balance between a rational, cognitive way of approaching thought and actions and more sensitive, emotion-based reactions. As neurotic disorders include many different types of difficulty, we describe the main issues of a few particular disorders, with the focus on needs and dramatherapeutic ways of addressing these needs. Neurotic disorders include phobias and anxiety disorders. The main symptoms range from feelings of fear to panic attacks. From the therapeutic perspective, we focus on the needs of clients, which can be identified as a search for safety, a need for feelings of success and managing, a need to strengthen self-esteem and learning to relax and calm down. These needs are addressed in group and individual psychotherapy, as well as in the dramatherapeutic process. Dramatherapy methods function on the level of metaphor and story and, therefore, they provide safety as well as an opportunity to identify with the portrayed characters. Clients identify with characters that have similar issues and, later on in the dramatherapeutic process, they have a chance to identify with strong characters who overcome their troubles. In role-play, for example, clients can experience superiority over their issues and transfer this supportive feeling into consensual reality. Anxiety and fear can be overcome by successful coping in pretend play situations. 241

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Another group of neurotic difficulties are obsessive-compulsive disorders that are typically accompanied by obsessive thoughts and stereotypical behaviours. Clients gain a feeling of control over the environment and their life by complying with certain rituals. It is important for clients with obsessive-compulsive disorders to learn to accept their inability to influence certain situations. Dramatherapy creates space for experiencing the feared scenarios and surviving, which supports change in everyday challenges. Acute stress reactions and post-traumatic stress disorder require safety and help in orientation, instead of fight, flight or freeze reactions. Strengthening resilience and empowering clients can be achieved through mastery experienced in dramatherapeutic sessions. Adaptation disorders represent another type of neurotic disorder and are caused by life changes, such as enrolment in school, marriage, having a child or retiring. They can bring sadness, anxiety or lower performance levels. In dramatherapy, expression of emotions and experiences of coping help to broaden clients’ role repertoires and, therefore, help them to manage these changes. Dissociative disorders affect the motor system, memory and identity of a person. The needs that can be addressed in dramatherapy include restoring clients’ connection to their bodies, enabling them to rely on signals from the body and trust feelings. Dramatherapy also provides the opportunity to gain awareness of one’s ability to cope. Somatoform disorders such as hypochondria and psychosomatic disorders are accompanied by physical pain, and, therefore, it is important for clients to learn to divert attention from the body, but also to make connections between body and self and between the person and other people. Dramatherapeutic activities are based on group work, supporting interactions and work in pairs and as a group. They include movement in space and contact with oneself and other people. Another neurotic disorder is neurasthenia, characterized by the inability to relax and, therefore, constant tiredness. Autogenic training is often used to help these clients. Dramatherapy also offers imaginative techniques that include relaxation and are very helpful for clients with neurotic disorders. Based on the connection between body and mind, dramatherapy addresses the needs of clients with neurotic disorders. In order to provide evidence-based practice, it is important to monitor and evaluate the realized dramatherapeutical process. Traditionally, research in psychotherapy is oriented towards research on the effect, process or their relation. Research on the effect aims to find out ‘whether it works’: whether the offered therapeutic approach or method is or is not causing change. Research on the process is focused on ‘how it works’. It enquires about the mechanisms of change and their specific functioning. The third type of research maps the relationship between the process and the result of psychotherapy (process-outcome research). The crucial factor in this type of research design is time, and an important tool is catamnesis, which allows retrospective comparisons. Unlike the financially demanding researches focused on verifying the effect and effectiveness of psychotherapy, this research process is methodologically and economically less demanding. The subject content and formal framework of process research in psychotherapeutic intervention can be very wide. Research can be structured (a) according to data provider, that is, whether the information was collected from clients, therapists or independent observers. It can also be structured (b) based on participatory versus non-participatory approaches; (c) according to the way of recording data; or (d) according to the forms of interaction bond and therapeutic relationship, which in group psychotherapy include not only the client–therapist bond but also client–client, client–group, therapist–group and therapist–co-therapist. As Timulak (2005) mentioned, the object of the research is often the interaction of the clients, their expressivity, 242

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affirmation, opposition, strategies, verbal and nonverbal expressions of contents of their statements, hidden expressions or cohesion versus tension in the group. Group therapy has a long tradition at the Kromeriz psychiatry hospital, as well as its research, especially because of the pioneering personality of Stanislav Kratochvíl mentioned above. The following short insight into these researches is a selection from Kratochvíl’s publication Group Psychotherapy in Practice (2009), in which the author demonstrates theoretical constructs in clinical practice at the psychiatry hospital. In research on the psychotherapeutic process, the author focused on the assessment of clients in the sense of assessing the level of neurotic difficulties, quantification of their problems, activity in group therapy, position in group and self-knowledge. Six-point scales were administered every week during a 6-week treatment. Valenta (2014) applied a similar strategy in research on the dramatherapeutic process, using items on a scale in a regular weekly assessment of clients during the whole process of a 6-week treatment. Vankova-Tenglerova (1972) repeatedly focused on catamnestic research, using a method of analysis of informal records. She succeeded in categorizing the following effective factors mentioned by the clients: membership in the group, friendship with other clients, emotional support, self-exploration, self-expression, self-knowledge, gaining self-confidence, insight and training of new behaviour. Important techniques and approaches leading to change were considered: psycho-gymnastics, psychodrama, family therapy, relaxation and writing journals. Based on the analyses of epicrises, the research team of Jedlickova, Kratochvíl and Scudlik (1988) defined these five process types of therapeutic group: (1) the type with good activity from the beginning to the end of therapy – modus category; (2) the type with an overcome crisis; (3) the type with a passive beginning and a gradual increase in activity; (4) the type with a gradual decrease in initially good activity; (5) and the bad type of group, in which building a therapeutic atmosphere was completely unsuccessful. In these groups, researchers Plháková and Kratochvíl (1988) tried to analyse positive and negative variables that could influence this typology. Of the positive ones, it is important to highlight the positive motivation of the majority of the group. Among the negative ones, on the other hand, there were low motivation and low or very high intelligence levels, which led to defensiveness against therapy. Also, a gender-unbalanced group, a higher average age, or a group with a majority of clients with personality disorders had a negative influence. Further researches at this department for clients with neurotic disorders in Kromeriz focused on exploring the impact of group size on cohesion and tension, and the impact of the initial psychogymnastics warm-up on the atmosphere of the sessions. The dramatherapeutic team in this department decided to construct an evaluation tool that would reflect the processes that allow change and are specific to a dramatherapeutic process. The evaluation rating is an assessment scale based on observations of clients during dramatherapeutic sessions. In the first phase of our research, we focused on methodological research for evaluating the validity of this research tool.

Evaluation rating of dramatherapeutical process The heading of the evaluation rating includes items identifying the client, therapist, co-therapist (data collector), place, day and short outline of intervention, in order to describe the proband and the situation of observation properly. The rating consists of fourteen items that are evaluated on a five-point scale by the therapist and co-therapists separately (Table 24.1). The construction of this rating has a certain theoretical–empirical grounding that was fully described by Czereova and M. Valenta (2013) and M. Valenta (2014). It was based on traditions of assessment and evaluation in dramatherapy. In general, the evaluation rating does not 243

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Table 24.1 Evaluation rating I

II

III

IV

V

Position of client in a group (according to Schindler)

Black sheep

Ignored

Middle position

Liked/ favourite

Star

Position of client in a group

Does not cooperate with others

Rarely cooperates with others

Sometimes cooperates with others

Often cooperates with others

Always cooperates with others

Activity of client

Indifferent/ does not care

Mostly passive

Middle, ambivalent

High activity

Leadership activity

Spontaneity

Rigidity

Low spontaneity

Middle, ambivalence

High level of spontaneity

Maximum spontaneity

Concentration/focus

Never focused

Often not focused

Middle

Stable for most of the time

Stable during the whole time of intervention

Emotional expression

None

Low

Appropriate to situation

Overly emotional

Threatening

Emotionality of client

Does not Only show activity superficial and rejects uncovering

Personal uncovering

Uncovering on emotional level in a particular context

Uncovering of emotional and affective nature expressed outside

Nonverbal expression

Without expression or not appropriate to the situation

Low level

Middle

Appropriate in some situations

Appropriate for situations all the time

Interaction

Untouched

Low level of reaction

Ambivalent

Mostly conscious reactions on people

Conscious reactions on the group members

Imagination

Without imagination

Islands of imagination

Middle (develops at least a half of other objects and brings in a half of their own objects)

Ability to hold other objects and bring their own

Permanently brings new objects and develops other objects

Distance

Minimal

Short

Aesthetic

Prolonged

Large

Dramatherapeutic expression on the level of

Movement

Sound

Picture

Character

Verbalization

Entering a role and its level Unable to step into role

Simulation without interaction

Middle, sometimes out of role

Keeping the role with interaction

Interactive characterization

Usage of space

Uses space rather little

Sometimes uses space

Uses space quite a lot

Fully uses space

244

Does not use space

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differentiate between the terms assessment and evaluation, as, in the Czech language, these are used as synonyms, and the authors of the rating perceive them as a continuum. Evaluation of dramatic activities is based on J. Valenta’s (1995) structure. The first part is constituted by the perspective of basic functions of the evaluation, e.g. personal development of the client, content of the play, quality of informative and formative processes or level of transfer. The second perspective positions the evaluation in a timeframe of the whole dramatherapeutic process, and it proposes a question of when the evaluation happens, e.g. after each play session, between sections of play or within the play. The third perspective is focused on the time, e.g. duration of the play, duration of reflection or the retrospective question of the client’s previous experience with similar activities. The fourth perspective consists of the contents of the evaluation, e.g. self-reflection, reflection of other people or reflection of play activities. The fifth perspective depends on how wide or general the topic of the evaluation is, e.g. evaluation of a particular scene in play, or analogical events that lead towards generalization and transfer. The last perspective takes into account the influences of other factors and evaluates the meta-cognitive processes of clients and therapists. Machkova (2004) suggested categories of evaluation that are in accordance with the goals of dramatic activities. She divides the observation categories into the ones focused on individuals and those aimed at group evaluation. The criteria for assessment of individuals include: concentration, attention, interest, activity, verbal and nonverbal communication, expression through movement, rhythm, cooperation, contact, relationships of the individual in group, creativity, imagination, original solutions and flexibility, attitudes towards work, and thought-related criteria, such as recognizing relationships between objects, planning and organization. Criteria for group evaluation consist of: group atmosphere, relationships in the group, relation to common activities, level of problem-solving and cooperation, distribution of roles in group, level of sociometry, tolerance and self-discipline. The authors of the evaluation rating presented here were inspired by Johnson’s test of roleplay (1982) that assessed role repertoire, role type, style of role-play, way of structuralizing scene, tasks and role, interactions and affect. Some rating items were based on generally accepted theoretical constructs, as in the case of the first item of typology of group roles according to Schindler (alpha, beta, gamma, omega, and P-type). Item 11 was based on the theory of aesthetic distance described by Landy (1994). Item 10 used an application of the theory of cognitive development by Piaget in terms of developmental transformations in dramatherapy founded by Johnson (1992). Item 13 is based on structuralizing the levels of entering a role according to J. Valenta (1997), who concentrates on educational drama and scenology. Other items utilize the professional experience of dramatherapists who participated in the evaluation process. These items apply ‘general’ items of the client engagement scale published by Jones (1996). The goal of the research was to find out the correlation of the individual items in the assessment of particular clients by the therapist–co-therapist tandem. The defined goal is based on the premise that the validity of the items is proportional to the correlation of evaluation by the participating therapists in the assessment on a five-point rating scale. The correlation of assessment in particular rating items has then become the object of the research. A complementary goal of the research was to find out if there was progress in individual items in particular clients during treatment at the institution. We conducted this part by comparing and contrasting the initial assessment with one at the end of the intervention. The aim was to find out whether there were any changes in the client that were related to the effect of the therapy treatment during the stay in the institution.

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Sample The sample consisted of sixteen probands and 140 evaluated dramatherapy interventions (Table 24.2). The sample was selected from the population using the form of institutional selection in psychotherapy department 18b, Kromeriz psychiatric hospital. Clients were mostly women of reproductive age, with neurotic disorders, acute reactions to stress and addictions, divided into two therapeutic groups with a total of ten clients (eighty evaluated dramatherapy interventions). The second place of data collection was the children’s department in Sternberk psychiatric hospital. The probands were three children and adolescents with behaviour disorders (thirty evaluated interventions). The third part of the sample contained three probands (thirty evaluated interventions) from Kurim prison facility. They were men of productive age, convicted for illegal activity connected with drug abuse, most often property crime and the production and distribution of narcotic substances. Data collection was conducted during a 3-month dramatherapy intervention consisting of regular 90-minute sessions once a week, provided by a therapist and a co-therapist, who were also collecting data without mutual consultation or comparison of result scales. The dramatherapists followed a similar theoretical concept based on the therapeutic–formative approach described by M. Valenta (2012). The sessions followed a structure of: greeting of the dramatherapist and the group, warm-up, opening of play space, starting play, main topic, closing and reflection. They also included an opening and closing ritual that provided a safe border for beginning and ending of the play space. The research was anonymized by client code. In this way, an evaluation rating was allotted to each client during the whole time of the stay in the institution. In the case of most of the data collection, at the psychiatric hospital in Kromeriz, there were twelve datasets per person, because of the 6-week hospitalization period in the department, and the assessment was done by the therapist and the co-therapist after each of the sessions. The method of data collection was a participatory observation using the evaluation rating record that was identical in all proband groups. The weakest point of the designed instrument is the inability to prove the relationship (statistical dependence) between independent and dependent variables. It is not possible to gain control over all independent variables. An experiment with more groups, using a double-control group, could not be considered, considering the nature of the research. Practically, the variables include factors such as medication and other curatively aimed psychotherapeutic agents, such as

Table 24.2 Sample description Sample description

Setting

No. of clients

Women with neurotic disorders, acute reactions to stress or addictions (in two separate therapeutic groups)

Kromeriz psychiatric hospital

10

80

Children’s department; children and adolescents with behaviour disorders

Sternberk psychiatric hospital

3

30

Men convicted for illegal activity connected with theft and drug production and distribution

Kurim prison

3

30

16

140

Total

246

No. of sessions

Clients with neurotic disorder

spontaneous tendency to healing, current state and mood of clients. Regarding the absence of a control group, we were resigned only to determine the statistical significance of the collected data and verification of the hypothesis – only in the complementary goal, we marginally stated statistical difference between items in the schema of the pre- and post-intervention evaluation. In contrast, the strengths of the evaluation rating lie in its construction simplicity, transferability and the possibility of quantification of qualitative markers. Other benefits of the tool are its comparability in time in particular clients, the possibility to observe development and the possibility to record the main tendencies in observed markers in time (persistence, decrease, increase).

Research results The assessments of clients for particular items of the rating, recorded by the therapist and cotherapist after each dramatherapy intervention, were coded and statistically processed by a singlefactor analysis of variance with correlation transfer, with the results in the scale items shown in Table 24.3. Single-factor analysis of variance (cond. first/last) was also used in defining the statistical significance of the difference in the advancement in the scales towards higher numbers in particular items. Statistically significant shift has been demonstrated only in some items (Table 24.4).

Table 24.3 Results of single-factor analysis of variance with correlation transfer Item

Correlation

Position of client in Group I Position of client in Group II Activity of client Spontaneity Concentration/focus Emotional expression Emotionality of client Nonverbal expression Interaction Imagination Distance Dramatherapeutic expression Entering role and its level Usage of space

0.782 0.938 0.404 0.513 0.546 0.264 0.773 0.867 0.494 0.146 0.644 0.821 0.383 0.150

Table 24.4 Results of statistically significant items Item

Significance

Position of client in Group I Dramatherapeutic expression Entering role and its level Usage of space

.032 .012 .027 .036

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Interpretation of results There is a considerable difference between correlations of particular rating items. The following proved to be highly correlating: items assessing the position of the client in the therapeutic group or community (Items 1 and 2), items quantifying clients’ emotionality and nonverbal expression (Items 7 and 8) and ability for dramatherapeutic expression (Item 12). On the other hand, items focused on assessment of imagination and the ability to use space in dramatherapeutic intervention (Items 10 and 14) proved to be low correlating; relatively low correlation was also reflected in assessment of emotional expression and the level of entering role (Items 6 and 13). Regarding the study as a methodological investigation, we were focused on verifying the validity of the evaluation tool for expressive–therapeutic intervention, with an emphasis on dramatherapy. Considering the validity of the measurement tool, we proceeded from the assumption that, the greater the validity of the items, the greater the validity of the measuring instrument. The validity of the items of the instrument depended on the conformity with which the participating therapists made their evaluations on the five-point scale. For this reason, for further data collection, a rating tool that integrates only items with high or higher correlations will be used. Regarding the study as an investigation of the factual problem, the verified tool showed a statistically significant shift on the scale in observations of particular clients who were evaluated at the beginning and at the end of the intervention. Changes were observed in items focused on evaluation of client in group (Item 1), dramatherapeutic expression (Item 12), level of entering role (Item 13) and usage of space (Item 14). In the case of the majority of the data collection, at Kromeriz psychiatric hospital, it was a comparison of assessments of clients at the beginning and at the end of a 6-week treatment cycle; in other settings, it was a measurement at the beginning and at the end of a 3-month intervention. We can assume that clients gradually got used to the style of work in dramatherapy. The dramatic activities offered were focused on exploring group cohesion and tension, opening up in front of the group, and exploring positions in the group. Therefore, it is valuable for us to see that clients who were originally on the verge of the group found a more solid place within it. Group dynamics are addressed in almost any group therapy, but the next highly correlating items of dramatherapeutic expression, entering role and usage of space, are specific to dramatic activities. Clients discovered the possibilities of expressing emotions in a dramatic form. They became familiar with playing roles and more relaxed, which was observed as freedom of movement and less defensive dropping out of role situations. As already mentioned above, it should be emphasized that, owing to the large number of independent variables influencing the positive changes in clients in the mentioned items in time, and owing to the lack of a control group, we admit only a little predictive value, with minimal generalization. Dramatherapeutical process offered to clients with neurotic disorders brought changes to their behaviour and served as a supplementary treatment to regular psychotherapeutic groups and psycho-gymnastics. Evaluation of the process is a complex task, and, especially for deeper assessment of individual therapeutic changes, monitoring of several variables is necessary. The designed evaluation rating contributes to this task by providing information on items related to dramatic activities in group. The validity of the tool depends on the ability of therapists to assess particular items. It seems that dramatherapists trained in therapeutic–formative dramatherapy in the Czech Republic are reliably able to observe clients’ emotional expressions, their nonverbal communication and group dynamics. We assume the reasons are connected with the nature of dramatherapy, their training and the methods used, and also the goals they set for the dramatherapeutic sessions. 248

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References ˇ Czereova, L. and Valenta, M. (2013) ‘Evaluace dramaterapeutického procesu – I. Cást [Evaluation of ˇ dramatherapeutic process – Part I]’, Speciálny pedagóg [Special Educator], 2, 2, 41–51. Jedlickova, D., Kratochvíl, S. and Scudlik, M. (1988) ‘Pru˚beˇhové typy terapeutickych skupin neurotiku˚ ˇ Psychiatrie [Czechoslovakian Psychiatry], 84, [Processual types of therapeutic groups for neurotics]’, Cs. 313–16. Johnson, D. R. (1982) ‘Developmental approaches to drama therapy’, The Arts in Psychotherapy, 10, 63–79. Johnson, D. R. (1992) ‘The Dramaterapist “in-role”’, in Jennings, S. (ed.), Dramatherapy: Theory and Practice (Volume 2), pp. 112–36. London: Routledge. Jones, P. (1996) Drama as Therapy. London: Routledge. Jones, P. (2007) Drama as Therapy: Theory, practice, and research (2nd edn). London/New York: Routledge. Kratochvíl, S. (2006) Jak zˇít s neurozou: O neurotickych poruchách a jejich zvládání [How to Live With Neurosis: About neurotic disorders and coping with them]. Prague: Triton. Kratochvíl, S. (2009) Skupinová psychoterapie v praxi [Group Psychotherapy in Practice]. Prague: Galen. Landy, R. J. (1994) Drama Therapy: Concepts, theories, and practices (2nd edn). Springfield, IL: Charles C. Thomas. Machkova, E. (2004) Jak se ucˇ í dramatická vychova: Didaktika dramatické vychovy [How to Teach Drama Education: Pedagogy of drama education]. Prague: Akademie múzickych umeˇní [Academy of Performing Arts]. Plháková, A. and Kratochvíl, S. (1988) ‘Vliv slozˇení skupiny na pru˚beˇh skupinové terapie neuróz [Influence ˇ Psychiatrie [Czechoslovakian Psychiatry], 84, of group composition on the process of group therapy]’, Cs. 323–6. Timulak, L. (2005) Soucˇasny vyzkum psychoterapie [Current Research in Psychotherapy]. Prague: Triton. Valenta, J. (1995) Kapitoly z teorie vychovné dramatiky [Chapters on the Theory of Drama Education]. Prague: Strom. Valenta, J. (1997) Metody a techniky dramatické vychovy [Methods and Techniques of Drama Education]. Prague: Strom. Valenta, M. (2012) Dramaterapie [Dramatherapy]. Prague: Grada. ˇ [Evaluation of dramatherapeutic process Valenta, M. (2014) ‘Evaluace dramaterapeutického procesu – II.Cást ˇ – Part 2]’, Speciálny pedagóg [Special Educator], 3, 1, 9–15. Vankova-Tenglerova, P. (1972) Katamnestické hodnocení efektivnosti skupinové psychoterapie [Catamnestic Evaluation of Effectivity of Group Psychotherapy]. MA thesis, Filozofická fakulta Masarykovy univerzity, Brno. Zvelebil, J. (2002) ‘Uzlícˇky nervu˚ [Bundle of Nerves]. An interview with Stanislav Kratochvíl’, Reflex, 10 October.

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25 Sparks of hope Dramatherapy with people with a terminal illness Dorit Dror Hadar

We met only yesterday. We sat on her terrace. Death was already present in the room. Nevertheless, Naomi’s death hit me hard, as though I had not imagined how close it was . . . A few hours after I parted from her, her husband phoned to tell me she had passed away in her sleep. I was the last person she spoke to before she died.

Naomi (false name) was a member of a group of cancer patients and their spouses that I worked with as a dramatherapist. When her condition worsened and she found it difficult to come to group meetings, I had met with her privately. From the moment I heard about her death, I knew that the group’s journey was about to change, that we had reached a turning point. The group members were intimate, friendly, loving. Now Naomi was no more. In this chapter, I will describe the manner of recruiting members for a dramatherapy group, which is critical, especially regarding average adults, who are not aware of the possibilities of therapy and support using drama. I will describe the therapy session with Naomi a few hours before her death and the group processes during the session after her death. Finally, I will analyse the process that took place at these sessions. From a theoretical standpoint, I will employ elements from the discipline of dramatherapy while focusing on the mandala describing the dramatic structure of the mind and the EPR developmental model (Jennings 1998). In addition, I will relate to the topic of rituals (Jennings 1998, 2010). I will integrate theories of processes of death and loss from the field of psychology (Kübler-Ross 1969/1997; Viorst 1988) and will add elements from world literature (Tolstoy 1886) and art (Chagall 1978) that are relevant to the subject.

Introduction The sages say, ‘A man does not know the day of his death’. From the moment of our birth, death accompanies us constantly and permanently. However, human beings deny its existence and live as though they will never die. They ignore the temporary existence that awaits them 250

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on the face of the Earth. When one learns that he or she has cancer, it is as though ‘the ceiling caves in’. The person sees an end to the time allotted him or her. The ‘dream’ of eternal life vanishes, and a new journey begins, in which time is limited. Jennings (1998, p. 124–6, 2010) describes the dramatic structure of the healthy, balanced mind by means of a mandala (meaning ‘whole’ or ‘wholeness’ in Sanskrit; see Figure 25.1). The four equal parts are: • • • •

Internal guide: the moderator, the understanding of the heart and mind that shows the way; the observer. Skills: the skills that a person acquires in life; knowledge. Vulnerability: the wounded parts; anxious feelings. Creative artist: creativity; self-expression.

These functions create a whole person and balance one another. At the centre of the mandala is the belief system, which colours and mediates among the different spheres. The role of the dramatherapist is to help people reconstruct their functioning anew, after a certain disturbance has occurred in their belief system or there is confusion among the different areas as the result of a crisis or a trauma, and return them to a balanced state. ‘And the whole, rather than the fragments are what we are all seeking’ (Jennings 2010). The picture of the complete, balanced dramatic structure of the mind changes the instant that individuals learn that they have cancer. Patients lose the belief in their ‘healthy self’ and the illusion of ‘eternal life’. The feeling of control over the body is taken away from them. Generally, they will turn to an oncologist, who will relate mainly to their physical illness, bring them to cope with the experience of being a ‘passive patient’, who is being treated by somebody else and is in a position of helplessness and lack of control. On the other hand, they experience a world with no tomorrow, no future and no hope, accompanied by a sense of deep anxiety, depression and physical and mental pain. Figure 25.2 shows the mandala depicting the impact of the news of the difficult illness, as I learned from my cancer patients and also in my own personal experience, when my beloved one became ill.

Internal guide

Skills

Beliefs Beliefs Creative

Vulnerability

Artist

Figure 25.1 The dramatic structure of the mind 251

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Vulnerability Beliefs I am going to die There is no future No hope

Figure 25.2 Vulnerability

The picture of the balanced dramatic structure of the mind is disturbed. Belief darkens, the ill, vulnerable part takes over, and the person loses touch with other potential areas. As a therapist, I asked myself questions about the suitable manner of providing therapy in these conditions of the unbalanced mandala. How does one provide therapy for people who cannot visualize a future? How does the image of ‘no future’ influence their belief system, their hopes? What is the meaning of ‘hope’ in such circumstances? These questions preoccupied me constantly and later were what led me to analyse each session and group intervention. I noticed that, during my 3-year involvement with the group, the questions I asked myself were the same ones that the group kept asking at each session. The topic of hope, as opposed to despair and death, was expressed in open dialogue. From this, I understood that the mandala structure could constitute an internal map and anchor and would guide me ‘to restore their internal states to a balanced equilibrium’ (Jennings 1998, p. 125) and also as a tool in the hands of the dramatherapist like a theatre director to see the ‘vision of the whole’ (Landy 1992, p. 98) and to hold the group’s imaginary journey, for their benefit, like a shaman (Johnson 1992). All these provide the structure in which the participants can work creatively in order to discover or confirm the significance of their roles. This is the mandala of the therapist as a resource for the group’s needs, which I will describe in detail in the chapter (see Figure 25.3). I invite readers to read on and imagine the situations described below as though they are playing the role of witnesses or watching a drama unfold on a stage.

How it all began: Recruiting the group The history of the group began when Shoshana, a nurse by profession, decided to create a group in which ‘we don’t only talk’. She understood from her experience that one must do, experience and try things out with a group of peers that could provide support for herself and her husband. She co-opted me, ‘a dramatherapist’, to lead the group, which would consist of couples (a patient and a supporter). A year earlier, my sister had died of cancer, and so I was more than 252

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Internal guides

Skills

My father and sister, of blessed memory Jennings (1987, 1998, 2012) – Mandala

Rituals, individual drama therapy, leading the group.

rituals, EPR model

The choice of appropriate activities

Landy (1992) – Individual dramatherapy

according to the need

Viorst (1988) – Losses

and stage at which

Kübler-Ross – Death & Dying

the participants are Beliefs : The dramatic,

Tolstoy (1886) – Ivan Ilyich Schrader (2012) – Rituals

found.

imaginative process has the power to support people and restore the dramatic structure of the

Creativity

mind to balance.

The connection between

The wounded part The memory of my

various content worlds:

suffering during the

drama and creativity,

process of my sister’s

understanding the process, theoretical

death and afterwards that of

knowledge, the transference processes.

my father; missing dear ones.

Figure 25.3 Mandala of the therapist

prepared to help support cancer sufferers and their families. We were two strangers joined by common losses. The two of us, strongly motivated, set out to recruit group members. We received lists from hospitals and approached cancer patients. At the interviews many of them said: ‘I have my own problems. Why do I need to hear about other people’s cancer?’ Or ‘Drama is for children . . . I don’t know how to act . . . I am a truthful person . . .’ Or ‘What is all this about drama? Do you really believe that it can help me, when I’m so sick?’ Gradually, we became braver and provided potential members with samples from the field of creativity and self-expression. We played the role-playing game of ‘doctor and patient’. We suggested that they draw a picture of their illness, make up a prayer and hum it together. In the end, we gathered together twelve adults aged 35–60 (six couples). They arrived at the first meeting doubtful (Jennings 1998, p. 97) about dramatherapy and the possibility that it would contribute anything to them. It may be assumed that their desperate situation brought them to even give it a try. 253

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Through the process, they learned to use drama, role-play and drawing, and were particularly amazed each time anew when they came into contact with their balanced, healthy selves and with their dreams. They strongly supported one another and eagerly anticipated the meetings, which were lengthened from 2 to 3 hours a session. The sessions took place in a large, empty hall that filled with life and excitement each week, as the members of the group recreated their lives anew. Everywhere else they were identified as ‘cancer sufferers’, but in the group they were simply people! They could remember and experience themselves as whole persons who were also cancer patients. After 8 months of being part of the group, Naomi’s condition worsened, and she occasionally missed the group sessions, although her husband continued to participate. After a while, I learned from her husband that her condition had become serious. I went to visit her. A person does not know the day of his death.

An individual dramatherapy session Naomi received me, sitting in an armchair in the living room of her house. She requested that we go and sit outside on the verandah. I saw how her eloquent speech and firm gaze managed to hide and turn attention away from her difficult physical state. She got up with difficulty and hardly managed to move her legs. Her body refused to obey her commands – it was hard for me to see it. From the first time we had met, about a year earlier, she had reminded me of my sister, Zippi, who had passed away a short time beforehand. Naomi was beautiful like my sister and even resembled her physically. I remembered that my sister had displayed that same gap: the firmness of the voice contrasted with the deterioration of the body. Seeing Naomi had been a shock. Over the phone, I didn’t imagine that her condition was so terrible. While moving outside to the verandah, I realized that Naomi was in the transition stage from this world to the next. On my way to the session, I hadn’t planned what to work on or which direction we should take. However, as a dramatherapist, I had brought my special bag containing objects that provided opportunities for active creative work (Wharam 1992, p. 83). I understood that, first of all, I should hear from her how she understood her situation. Naomi said that she thought the illness was advancing. She felt weakness and a general decline in physical strength. What worried her most was: ‘How will I feel when I begin dying? How much time do I have? How will it happen?’ I asked: ‘How much time do you think you have?’ She answered without hesitation: ‘A year, maybe two . . .’ I was undecided what I should say and what treatment to offer. I remembered long conversations with my sister, who, a few days before her death, was busy planning a trip with me to Romania . . . and her daughter’s upcoming wedding. She displayed total denial of her situation and total unwillingness to discuss the approaching death that was ravaging her physically without pity. I always chose to answer my sister’s needs and follow her wishes. I felt that this situation was similar, but also different in a certain sense. I felt proud of myself that I was managing to separate the voices inside me and those of Naomi, in whom I heard two different voices. On the one hand, she was in denial regarding the time remaining to her. On the other hand, she was relating clearly and decisively to her fears in face of the dying process. I also understood from her words that she was not discussing this with her loved ones, out of a desire not to upset them. Kübler-Ross (1969/1997) encourages us to hold discussions with people who are dying. She describes the tremendous relief of dying patients when it is suggested to them to include someone 254

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in their fears and needs. She claims that such conversations can ease the journey towards death. I also remembered the story, The death of Ivan Ilyich (Tolstoy 1886), in which he demands to be recognized as someone who is dying: ‘Many times he was on the verge of getting up and shouting at them: “Stop lying. Both you and I know that I am going to die, so at least stop lying!”’ Naomi was an art lover, so I thought it appropriate to show her pictures by famous painters that I had brought along in my bag. I thought that we could begin working through distancing, indirect projection, so that I could go according to her pace, in hope of giving her unconscious content to come to expression, listen to her and understand her needs. I took out the pictures, spread them out on the table: Gaugin, Michelangelo, Matisse, Chagall. A whole world of beauty opened up before our eyes. Naomi studied every single painting. ‘I saw this one in a museum in Paris and that one in London.’ I could see that she was enthusiastic – had left her suffering body – and that her mind was roaming through happy memories of grace and love. I asked her to choose a painting that could represent her today or the one that spoke most strongly to her. Without hesitation, she chose Chagall’s famous painting ‘The Stroll’ (1978) – which, like so many of his paintings, made a connection between fantasy and dream – in which we see a masculine figure holding the hand of a woman floating in air. ‘That’s exactly me!’ she declared with decision.1 The man is Leon [false name; her husband] and he is holding onto me with all his might so that I don’t fly even higher or disappear, so that he would have to part from me. I am not on this earth any longer, but I am being held here a bit longer by Leon. I asked her how the floating figure was feeling: She doesn’t want to float anymore. It is hard for her that her hand is being held. She wants to break free and fly far away. It is also difficult for the man – he is busy concentrating on holding her and can’t do anything else. His body is in an uncomfortable position. It is hard for both of them. His hand hurts a lot, and so does hers. We fell silent – it was an impossible situation, almost unbearable. We hovered between life and death. She said that she wanted to depart from this life, to fly, and she remained suffering terribly for the sake of one she loved and who loved her, also afraid of what would happen if she let go of his hand. Naomi told me softly that she was very worried about Leon. He was so attached to her that she didn’t know how he would manage after she was gone. The choice of that painting and our short conversation made it clear to me that it was possible to examine directions of intervention by means of pictures. I asked Naomi if she was willing to create a drama based on the painting. The weakness she had displayed at the beginning of the session gave way to excitement and reorganization. Naomi sat up straight, took a deep breath and said: ‘I agree’. Naomi, who was already used to group work, closed her eyes and repeated: ‘I agree!’ I also took a few breaths. I could feel my heart beating. I was apprehensive and glad at the same time. I was ready and willing to join her in her internal theatre. I took a deep, quiet breath and asked Naomi to see the picture in her mind’s eye and locate herself in it. I was prepared to direct her on her way through imagination, as Landy (1992) suggests in cases of one-on-one therapy for limited or ill patients. Naomi immediately visualized her inner theatre. She was floating in the air, a last handholding, parting from Leon, and up she went. Her adopted parents, who had died many years 255

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before and whom she missed terribly, were holding out their arms to welcome her. They were already waiting for her and preparing the special jam that she loved. Naomi was crying, excited, laughing. I hadn’t seen her like that for a year, so full of enthusiasm. As I repeated what she told me, she added more details. She had already reached their home in the sky, which reminded her of where they had lived in this world. She is inside the house, steady, experiencing scents and voices. Naomi sighed with relief and wiped away her tears, tears of relief, pain, hope, sweet tears that were mixed with the tears that were falling from my eyes. She continued to tell, as if in a trance (Gilligan 1987), while deeply focusing her mind, how she was already tucked up in bed by her parents. I heard her voice and realized that, through my own experience with my sister’s death, I could understand Naomi more deeply. Since my sister and father had died, I felt that, when the time came to pass over into the next world, they would also be waiting for me, and that I would not be alone. When she opened her eyes, I saw that they were different: alive, whole; her body sat upright in the chair. We hugged and felt that we were really together. The clock indicated that an hour and a half had passed, but we had experienced a sense of endless time, of general existence. Naomi was tired. We had gone through an entire world, from physical hardships to the world’s greatest artists, to floating to the world of the dead, memories of love and special relationships, and back to our reality and the special ties that had developed between us during the session. I parted from Naomi with the sense that she had laid down a heavy burden that was weighing her down. I also felt lighter and satisfied with the fruitful session. A few hours later, her husband phoned and said that she had not woken up from her afternoon nap. I was shocked, but at the same time I felt relieved: Naomi was no longer in pain. She had achieved eternal rest. Was it a coincidence? Or had my intervention helped her to prepare for her death by having an ‘out-of-body experience’, as Kübler-Ross (1995) highlights, and there she becomes acquainted with the place and people she is going to meet. According to Pendzik (1993/2004), through our dramatherapy work, it was possible to set out on a journey into the future by means of projection. And what was presented on the symbolic level echoes in real life and opens the door to this dramatic change. Still, questions remained open! It was, however, clear that something important had occurred during our session.

The group session after Naomi’s death The group was grief-stricken. I had convinced Leon, Naomi’s husband, to participate. He arrived and was surrounded by the group. Leon shared with the group the great sorrow, loneliness and anxiety that had come over him. He was gently led to the centre of the circle, while the group approached and hugged him, humming softly what sounded like a heartfelt prayer. It was a well-known Israeli song called, ‘Men cry in the night’, which expresses men’s loneliness and pain. People were saying: ‘Leon, we understand you. We are with you. You took such wonderful care of Naomi. It’s hard for you now, but at least she is at rest and no longer suffering.’ Leon’s arrival helped to soften the charged atmosphere. The group’s ability to support him mitigated their sense of helplessness. The idea of the work with couples in the group was to be with the supporters while they were bearing the burden of illness and the processes involved in the approaching death of their ill partner. It was also meant to help them restore their personal balance after their partner’s death. Then we spoke about Naomi and how she had contributed to the group’s emotional growth, how each group member related to her experience; in so doing, each of them was enabled to 256

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understand their own experiences on a deeper level. All group members also described their individual battle and fears with cancer from their own perspective. The atmosphere was heavy – I could hardly breathe. I was in a quandary about where to go from there. And now that we were face to face with the concrete presence of death, their own reality floated back to the surface: ‘Soon we will be the ones who are dying’. Again, vulnerability took control, darkening belief and the significance of hope. I remembered my father’s words that occasionally echoed in my head. My father was diagnosed with lung cancer at the age of 63, and the doctors gave him a year to live. My father, with his special sense of humour and amazingly strong will, survived another 14 years. He lived in the shadow of death all those years, and death was a constant guest in our family home. It was present in conversations, jokes and future plans, always being taken into consideration. At times, it was important for my father to apprise me of the family finances, just in case . . . I would reply, ‘Stop it, Dad, when the time comes I’ll know what to do’. On one occasion, my father answered me softly and addressed me in a way that I had never heard before: ‘My child, you too will die some day!’ At first, his soft tone and harsh statement shocked me. Afterwards, all at once, I felt that a stone had been lifted from my heart. I am also mortal, I don’t have superhuman powers, and my father’s death was not in my hands, nor in his. We are all flesh and blood, and each of us will die when our time comes. With one sentence, my father released me from the sense of guilt that was weighing me down, as though his approaching death depended on me. My father’s words also added the insight that we all want to feel that our final self is part of something bigger and is not lost with us, so that it is possible to achieve what might be called eternity. The poets have conveyed to us in different voices and emotional registers the parting words of the dying. From these musings, I thought of suggesting to the group that we hold a ritual.2 I thought that it could be containing and soothing and impart a sense of security in a situation of anxiety and fear. I felt that the ritual had the power to teach us how to accept the new situation together (Jennings 1987, 1998, pp. 102–3, 126). By means of the ritual, the group would be able to arrive at a higher stage of emotional development then they had as yet been capable of. Eissler (1969) pointed out that the time before death allowed ‘a last step forward’ that was likely to be the greatest achievement of our lives. I also hoped that the ritual would make it possible to achieve a direct, powerful, transcendent experience (Viorst, 1988). The group accepted the idea immediately, as though I had thrown them a life raft. They suggested that we hold a funeral at which each of them would read an obituary. Writing an obituary makes it possible to stop and consider one’s life from a distant birdseye perspective, or to zoom in on certain significant points that one wishes to touch on. I suggested inviting mythological figures or involving a literary work about the underworld. My suggestion was rejected out of hand. They wanted to write obituaries and present them directly. I considered some ways in which the group would be able to develop greater theatrical distance, as I was a bit worried that the experience would be too confrontational. I suggested a chorus that would allow them, I hoped, to be able to observe the scene from above and not only from within their own personal experience (Jennings 1992). They responded to the idea with enthusiasm. The dialogue made it possible to discover an additional external perspective without relinquishing the direct coping with death that the group was experiencing. It allowed them to sense the ability to choose. Preparations for the funeral began and continued during the next three sessions, in which they created a life map, which included a graphic diagram of their life stories. They wrote their obituaries, created white masks, discussed the role of the chorus: Should it make comments about what was happening? Should it sing or only mime? Where would it stand? They collected 257

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clothing, materials from nature, earth and leaves, as a symbol for the Jewish burial: ‘For dust you are – and to dust you shall return’. The group was now ready for the ritual. They prepared the centre of the ceremonial space, as they felt was appropriate for a burial ritual. The space was marked out, and the group put on the white masks. They each wrapped themselves in material, dragging behind them the cloths laden with the materials they had gathered from nature. They began walking around the central space in a circle, beating drums. After seven rounds, they stood still. They began singing the prayer, ‘God is filled with mercy’ (a well-known Jewish burial prayer). Everyone sat down. The first participant stood up and faced the group, spilled the materials from his cloth in the centre of the circle and read his obituary. At the end of each obituary, the chorus, which was made up of the rest of the group, created a spontaneous song made up of the words they had heard during the obituary and again circled seven times to the beat of the drum. From one obituary to another, I felt the transition from sadness and pain to a sense of mutual empowerment would be enormously healing for all. As Somé (1996) wrote, ‘because on the other side of grief is real joy’. Each member of the group got up on the stage in turn as the chief actor in his own burial ritual, both inside and outside his grave, each in his or her own unique style. A weird, surrealistic world was created. The members of the group remained in this world, while creating a dramatic reality of the next world and reaching transcendence. These were special moments that pushed our dramatic borders further and moved us into a metaphysical experience (Jennings 1998, p. 128). Naomi’s death made it possible to hold a communal ritual in which the members of the group supported one another and did not feel alone. Each of them knew that the others were there for them, ‘holding the space for your grief’ (Schrader 2012, p. 88). Finally, the group members lay down on mats, and I guided them through breathing to return to their physical bodies and the here and now. When they opened their eyes, they seemed shiny, radiant, more complete than I had ever seen them. They had reached a cathartic peak through which their grief could be released (Schrader 2012, p. 84).

The process of expanding the mandala and restoring hope This chapter provides actual examples of how individual and group dramatherapy expands belief and opens the dramatic structure of the mind (the mandala) to reorganization and release, in a situation where the vulnerable part ‘comes to life’ and takes over, as is liable to occur in lifethreatening circumstances.

How does the process take place? I will describe the process by combining the mandala structure and the EPR paradigm.3 In the individual drama therapy session with Naomi, the vulnerable part constituted the starting point. The sick body was dominant, preoccupied with pain, collapsing and contracting, asking questions about death and expressing beliefs connected with fear and a sense of being trapped between this world and the next. Naomi’s sense of embodiment served as the preliminary contact and connection between us. I observed and experienced her weak body, imagining my sister, who served as my guide, as I served as Naomi’s. Naomi’s internal guide awakened and answered my call for her to experience an out-of-body journey towards the creative artist, which began by means of projected works of art. 258

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Here began the turning point for the beginning of a movement to an expanded journey. The choice of the picture by Chagall was the starting-off point for entering a role by means of imagination. The patient played out her story as it was superimposed on Chagall’s painting. The two stories were amalgamated into one narrative framework for her internal drama, in which she dwelled and moved towards the future into a trance-like state. The whole dramatic process led her to a trance and a metaphysical experience that together created the conditions for her to be fully in her dying process (Gilligan 1987; Pendzik 1993/2004; Kübler-Ross 1995; Jennings 1998). Naomi used her skills of imagination, language and expression, demonstrating abilities such as translating experiences, feelings and pictures into words. She summarized the story, in which she discovered another story, and connected them together into one narrative framework. This created access to a creative solution for her (Erickson and Rossi 1979), as was seen actually in her inner drama. Naomi’s internal guide was present, impressive and palpable. It afforded her an accurate version of herself. It heard my call to set out on a journey and continue by choosing the Chagall painting that she related to deeply, transforming it into a subject preoccupying her, which accurately reflected her own current life situation. It was that which drove the creative process exactly according to her needs. By analysing the entire process, it is possible to see a connection of past memories, through the current experiences in the present, moving into the future, which is part of belief – belief that there is a world beyond this one, which we leave and depart, and perhaps we even meet again. Movement was created towards an open place that was a container of space for the future and for hope; death was given a broader basis of belief. The vulnerable part was present, but not dominant. Each part was restored to its proper place, and thus Naomi succeeded in freeing herself from the grip of fear. She became whole and ready to say goodbye, as actually occurred. In the group therapy session, the encounter with Naomi’s death brought the group to realize that they were in a similar situation. Again, there was no tomorrow, no future and no hope. Vulnerability and pain took control and again shadowed belief. The suggestion to hold a ritual was aimed at allowing the group to undergo a process of expanding the mandala on two levels: 1

2

The ritual as a social tool: The ritual makes it possible to connect to something greater; it allows each individual in the group the experience of being part of a great whole that includes the Creator, nature, the community and the group. Part of the ceremonial healing process is related to mutual cooperation and a sense of being together with a group that shares a common fate. There is a rhythm that repeats itself. ‘Even when we are no longer alive, it will continue . . . Naomi died and we held a funeral for her and we continue with our own ritual and those that will be held for us later on.’ The process of actually creating the ritual allowed every member of the group to connect to the creative artist within themselves, activate their skills and listen to their internal guides. Through their roles, they chose how to investigate their own journey towards death, which was connected to the wounded, frightened, vulnerable part.

The ceremonial process opened a space into the future. They participated in their own funeral and even eulogized themselves. They broadened the wounded part into an active drama that gave them a freedom of movement continuing into the future. The passivity of approaching 259

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death in reality was transformed into dramatic activity, which turned the ‘end’ into the ‘future’ – and when there is a future, there is hope. Vulnerability was gathered back to its proper place, and the other parts also returned to their correct position. Belief was rehabilitated, and balance was restored to the system.

Summary By means of peer-group, dramatic, authentic activity and relationship and guidance with a dramatherapist, the key was found for the participants to live the balanced dramatic structure of their minds to the fullest – to reframe the perspective of their own death. Therapeutic work with people who are in an acute, life-threatening situation is often very brief and thus limited in its scope of therapeutic benefit owing to time constraints; nonetheless, it can be hugely transformative and healing as well. In every session, patients are born, live and also say goodbye. Flexibility based on individual sessions is necessary, and use of this therapeutic modality can be modified, depending on each individual circumstance, to enable healing for all those affected by the person who is ill. At every session, the degree of vulnerability and its dominant role are examined anew. The therapeutic intervention deals with developing a perspective that helps enlarge the complete picture of the mandala, based on belief and the ability to connect to hope, not in the sense of ‘I will recover’, but in a different sense: I understand that there is a greater plan, and that I am part of it. Everybody will die, and I am no exception. I am prepared to live life to the fullest in the here and now, and in the here and now I will connect with my whole self. That is the hope. Dedicated to my father and my sister, of blessed memory, who included me in the entire process of their dying To my mother, who spared me all that To the group members To Shoshana who made the group happen

Notes 1 2

3

To see this image online, visit http://curiator.com/art/marc-chagall/the-stroll The ritual in the therapeutic framework: The ritual structure is based on traditions that were formulated by our forefathers. It supplies a space providing protection, security and boundaries for an imaginary, dramatic journey in which the group and its members actively participate as actors and audience and face the transition to new situations related to lack of control and insecurity, confusion, fear and anxiety. The ritual creates an experience of interpersonal unity with nature and the universe and helps create a sense of order, continuity and control in a chaotic, frightening world. Clothes, costumes, games and dance facilitate the transitions. Rituals facilitate communal learning about the new situation (Jennings 1987, 1998; Berger 2010). Participation in the ritual involves deep emotional involvement and connection to the ‘invisible realm of incomparable power’ (Somé 1996, p. 60), and the most powerful effect of the ritual is to know you are never alone: someone is there for you (Schrader 2012, p. 88). The EPR paradigm (Jennings 1998, pp. 54–62) is a developmental paradigm that describes the development of dramatic play by natural stages. The first year of life is characterized by physical, sensory play (embodiment); projected play (projection) then develops at ages 1–3, and after it comes role-play

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(role). At ages 6–7, the developmental process of dramatic play ends. The basic assumption of this paradigm is that any ordinary individual, during adult life, can perform in any of these modes according to circumstance. However, natural development is liable to be delayed by trauma, neglect or other reasons. It provides a parallel progression alongside other developmental processes, such as physical, cognitive, emotional and social.

References Berger, R. (2010) Back to Ritual – The ritual and integration framework as a major axis in arts and creative therapy, pp. 1–13 (Hebrew). Tel Aviv University. Chagall, M. (1978) My life (Hebrew). Tel Aviv: Library Workers Publication. Eissler, K. E. (1969) The Psychiatrist and the Dying Patient. Madison, CT: International Universities Press. Erickson, M. H. and Rossi, E. L. (1979) Hypnotherapy: An exploratory casebook. New York: Irvington. In Megged, A. (2001) Fairs and Witches (Hebrew). Nord Publication. Gilligan, S. G. (1987) Theraputic Trance: The cooperation principle in Ericksonian hypnotherapy. New York: Brunner/Mazel. Jennings, S.(1987) ‘Dramatherapy and groups’, in Jennings, S. (ed.), Dramatherapy: Theory and practice for teachers and clinicians (vol. 1), pp. 1–18. London: Routledge. Jennings, S. (1992) ‘Therapeutic journeys through King Lear’, in Jennings, S. (ed.), Dramatherapy: Theory and practice (vol. 2), pp. 5–18. London: Routledge. Jennings, S. (1998) Introduction to Dramatherapy: Theatre and healing: Ariadne’s ball of thread. London: Jessica Kingsley. Jennings, S. (2010) Healthy Attachments and Neuro-Dramatic-Play. London: Jessica Kingsley. Johnson, D. R. (1992) ‘The drama therapist “in-role”’, in Jennings, S. (ed.) Dramatherapy: Theory and practice (vol. 2), pp. 112–36. London: Routledge. Kübler-Ross, E. (1995) Death Is of Vital Importance: On life, death, and life after death. Barrytown, NY: Station Hill Press. Kübler-Ross, E. (1969/1997) On Death and Dying. New York: Scribner. Landy, R. (1992) ‘One-on-one: The role of the dramatherapist working with individuals’, in Jennings, S. (ed.), Dramatherapy: Theory and practice (vol. 2), pp. 97–111. London: Routledge. Pendzik, S. (1993/2004) ‘Reflections on shamanism and dramatherapy practices (German)’, in Krey, R. and Merz, V. (eds), Feministic Reflections, pp. 142–61. St Gallen, Switzerland: BoD, Nordersted & IffForum. Schrader, C. (2012) ‘“We don’t need therapy, we have ritual”: An overview of the work of Malidoma Somé and a personal experience of a Dagara grief ritual’, in Schrader, C. (ed.), Ritual theatre: The power of dramatic ritual in personal development groups and clinical practice, pp. 79–92 (foreword by James RooseEvans). London: Jessica Kingsley. Somé, M. P. (1996) ‘Ritual: Power healing and community’, in Schrader, C. (ed.), Ritual theatre: The power of dramatic ritual in personal development groups and clinical practice, p. 126 (foreword by James RooseEvans). London: Jessica Kingsley. Tolstoy, L. N. (1886) The Death of Ivan Ilyich (trans. Kriksunov, P., 1999). Tel Aviv, Israel: Hakibbutz Hameuchad Publishing House – New Library. Viorst, J. (1988) Necessary Losses: The loves, illusions, dependencies, and impossible expectations that all of us have to give up in order to grow (Hebrew). Tel Aviv, Israel: Machbarot Lesifrut-Zmora Publications. Wharam, T. (1992) ‘The building blocks of dramatherapy’, in Jennings, S. (ed.), Dramatherapy: Theory and practice (vol. 2), pp. 82–96. London: Routledge.

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26 Life stage and human development in dramatherapy with people who have dementia Joanna Jaaniste

Introduction In Australia, as in other Western countries, respect for elders is being lost in the economic and political discourse over dementia and its perceived social and fiscal consequences. Because of ‘gerontologists’ value-dependent assumptions’ (Tornstam 2005, p. 29), little is written about life-stage development for the elderly, even in dementia. This chapter advocates for sensitive use of developmental models, thereby avoiding the chance of ‘othering’ older people (Taussig 1980). The critique of the notion of autonomous existence through theories of intersubjectivity and embodiment (Merleau-Ponty 1945/1962) lends weight to Taussig’s warning, emphasising the value of the selfhood of people with dementia. Merleau-Ponty’s interpretation of embodiment and intersubjectivity seems to be missing from Kitwood’s (1997) otherwise enlightened views of how personhood may be maintained in dementia in an interpersonal dimension (Kontos 2004, 2005). Developmental dramatherapy, undertaken as part of a mixed-method research project to discover whether dramatherapy can improve the quality of life (QoL) of people with dementia, is discussed. One of the models used in the project to help older people with dementia to improve their QoL is considered – Embodiment–Projection–Role (EPR; Jennings 1973, 1993, 1999, pp. 51–3) – and examples of the model’s reversal (RPE) are presented. Developmental theory is applied here; however, critiques of this and how it positions development at later stages of life are introduced. The approach taken in this chapter is, therefore, a critical developmental one. Much of the mainstream literature on ageing describes the older person as ‘distant’ or ‘remote’ (Twigg 2004, p. 71). Discourse emphasizing unmitigated decline has become enmeshed with a generalized ‘coding’ of old age into stereotypes that have nothing in common with people with shared cultural or professional interests in later mid-life and beyond (Krekula 2009). In the interests of such people’s well-being, Malone and Camp (2007) believe that, ‘the single greatest barrier to the provision of high quality care for persons with dementia is not a lack of resources, but a belief . . . that they are incapable of learning new things, incapable of showing anything but decline’ (p. 151). The authors expose a nihilistic approach to the care of the elderly, 262

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where learned helplessness stems from ‘an over-emphasis on the deficits associated with dementia’ (p. 151) and a lack of acknowledgement of people’s resilience in the face of it.

Dementia Dementia appears in many forms, Alzheimer’s disease (AD) being the most common, where the person with dementia loses neurones and, therefore, synaptic connection. Brain atrophy and symptoms of cell degeneration can be detected microscopically (Kitwood 1997), signs of degeneration being revealed in plaque deposits and neurofibrillary tangles found through tomography or autopsy (Kitwood 1997). Power (2011) describes a traditional view of dementia as one that emphasizes loss (of executive brain function and memory, for example). Referring to the regrettable assessment of people with dementia by their inabilities, rather than their strengths, he cites the widely used Mini-Mental Status Examination (Folstein et al. 1975), where there is ‘a litany of discrete tasks to be performed: Can you spell “world” backwards? Can you remember three objects after five minutes? Can you copy a figure of two intersecting pentagrams?’ (Power 2011, p. x). Power goes on to describe how the ‘biomedical approach to dementia’ (2011, p. x) encourages us to set up environments (and, I would add, form attitudes) that are more appropriate to the needs of the care force or family carers than to individuals living with the diagnosis. If we can alter our focus from a disease-related model to a wholistic one, we are more likely to understand the world-view of the person with dementia (Power 2011). In the light of the above authors’ open-minded approaches to development at the end of life, how far do we apply these stages, and how do they help a participant understand the meaning of their existence up to this point? The following overview of such developmental theories is intended to present questions for the dramatherapist working with people with dementia.

Developmental theories and later life Early last century, there was little appreciation of the nature or significance of later life stages. Freud (1905), at 49 years old, dismissed the over-50s as incapable of being educated. Jung, on the other hand, recognized how life’s later stages could be lived so as to bring out its meaning and purpose (Prétat, 1994). Jung put forward various ways of ageing consciously, so that ageing did not need to be a negative experience, although stating that it could be in some sense a return to childhood (Jung 1969). Erikson later advocated for robustness and potentiality in a human being who could overcome early and later crises throughout the lifespan. He defined the final stage of life as ‘ego integrity versus despair’, emphasizing acceptance of one’s life cycle (1963, p. 268), positioning the elderly person’s acceptance of life stages as inevitable and supporting his ability to ‘defend the dignity of his own life style against all physical and economic threats’ (p. 268). If this did not occur, despair would be the result – a somewhat unsatisfactory claim, perhaps, when considering cultural understandings of lifespan development in non-Western cultures, and also with particular reference to current healthy longevity in many parts of the world. With regard to Erikson’s eighth stage, his erstwhile collaborator Joan Erikson notes, in a posthumous, edited version of his final work, The Life Cycle Completed (1998), that it was not until later life that she and her husband ‘really confronted their ageing selves’ and believed in late development beyond his final stage (quoted in Brown and Lowis 2003, p. 417). She bases her argument on her experience of their years beyond 80, and on Tornstam’s research. Tornstam suggests that ‘a shift in meta-perspective from a materialistic and rational view to a more cosmic 263

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and transcendent one’ (2005, p. 41) is brought about through actually experiencing the challenges of old age. In normal circumstances, he says, life satisfaction occurs at the same time and as a result of overcoming these challenges. Piaget’s theory, unlike Erikson’s, has been seen as purely cognitive and free of the development that arises from conflict (Anthony 1956). At first, Piaget’s cognitive stages of preand post-operational developmental levels were thought to have little to do with adult development. Later in the twentieth century, research comparing adults in mid life and older with teenagers and young adults on Piagetian activities encouraged a belief that ageing produced regression to more concrete forms of thinking.

Exploring selfhood in the embodied experience Theories of cognition and of cognitive decline may not take sufficient account of how latent knowledge remains accessible to people with dementia. Merleau-Ponty’s work presents the dramatherapist with significant information about embodiment. His thinking reveals the importance of bodily gesture, where expression is not restricted to language (1945/1962). In dementia, it is interesting to reflect on the laborious mental efforts involved in finding the ‘right’ language, a circumstance often necessary for people living with the condition in order to build their existential future. It is, then, useful to look at alternatives to this cognitive and speechbased struggle through the prism of embodiment. Merleau-Ponty argues that intentionality ‘does not come into being through the transparency of any (mental) consciousness, but takes for granted all the latent knowledge of itself that (our) body possesses’ (1945/1962, p. 233). This latent knowledge is a field of possible actions and movements the body ‘knows’ how to perform (p. 233), just as an itch needs to be scratched, and the scratcher bypasses the cognitive conscious process in the action, relying on body memory to find the location of the itch (1945/1962). An understanding of the importance of this ‘body wisdom’ gives the creative arts therapist a much better understanding of the significance of embodied practices for people with dementia. Significant advances in theories of dementia and embodiment reframe and deconstruct the linking of cognition with selfhood (Kontos 2012; Kontos and Martin 2013) and call into question the notion that self-awareness is linked only to pre-dementia cognition (Klein et al. 2003). Kontos and Martin (2014) argue that, ‘gesture emphasises more than the natural expression of the body; it discloses social and cultural movements and physical cues that derive from the internalisation of a sociocultural environment through one’s primary socialisation’ (2014, p. 91). Kontos (2004) writes of physical positioning that shows manifestations of class distinction. She argues (2006) that various instances of embodied selfhood have been found in religious rituals, which is particularly suggestive of dramatherapists’ practice with this population. Kontos and Martin (2014) believe these cases demonstrate that the investigation of body movement and embodiment–environment relations gives significant indications for a better understanding of therapeutic relationships for people with dementia.

Neuroscientific evidence Kitwood (1997) accepts neuroscientific evidence that nerve architecture develops through environmental and life experiential learning, varying in the individual’s strength of resistance to dementia. Further psychosocial research has been conducted in the arts therapies of brain plasticity (Kennard 2007; Hans-Cohn and Carr 2008; Jennings 2010); however, its neglect in biomedical research, noted by Kitwood (1997, pp. 18–19) and Little (2002, p. 41), may still be with us. 264

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A research project with elderly people who have dementia A mixed-method two-arm research project (Jaaniste et al. 2015) investigates the hypothesis that dramatherapy may improve the QoL of people with dementia; QoL-related data from neuropsychological scales are explored in the thesis. The dramatherapy arm (N = 5)1 and diversional film-watching arm (N = 9) comprised two groups of participants with dementia living in the community, engaged for sixteen sessions. Qualitative methods applied to dramatherapy are phenomenological, narrative, ethnographic and metaphoric; investigation was also through video and transcripts. Mixed-method research findings suggest that dramatherapy is a promising activity for people with dementia, associated with significant attributes of positive QoL. Three art-therapy students and staff from Alzheimer’s Australia (NSW) assisted with the setting up of the groups and were involved in the sessions. Participants and their carers gave informed written consent; names were changed, and the research was approved by the University of Western Sydney Ethics Committee. The aim here of referring solely to qualitative investigation and results, instead of mixedmethod outcomes of the research into dramatherapy and dementia, is twofold. First, the overall aim of this chapter is more readily supported by describing the adaptation of a non-quantitative developmental model that engendered dramatherapy fieldwork explored in the project. Second, the complexities of the quantitative enquiry, although mixed-method findings were promising, would obviate the necessary space for description of results achieved through application of this model.

Dementia, dramatherapy and development The dramatherapist, as facilitator and witness of the client’s life script, is almost always involved in the struggle of transition and rites of passage. Johnson (1982) believes development is linked to transformation in dramatherapy, encouraging the therapist to ‘monitor the ongoing (transformational) flow while remaining aware of disruptions in that flow, especially during transitional phases’ (p. 188). With elderly people, he uses a stepwise structure of play space, encounter, embodiment and transformation, where the therapist can be aware of progression and regression in the developmental sequence (Johnson et al. 2003, p. 80). Cattanach (1994) understands the developmental model as assisting clients to creatively explore their life, ‘restoring life through art’ (p. 28) and engaging with life stages through returning to more vulnerable times. For this to happen, the dramatherapist must offer a safe enough environment for early vulnerability to be expressed through the dramatic engagement. Knocker (2001) makes a robust case for play being a powerful model of such engagement for the elderly. Embodiment in play does indeed have significant relevance for the later stages of dementia, as it does for early human development. Lev-Aladgem (1999) describes her work with dramatic play with elders, some of whom had dementia, noting that their play went beyond its developmental function to achieve wholistic maturity. She quotes Rapp (1982, p. 73), who says that these elders bring a form of play to the drama that is less a reflection of reality than ‘a reflecting upon a reality’. In fact, as suggested above, the late life stages of such people are filled with reflective activity: a contemporary Jungian perspective (see also Prétat 1994, pp. 86–7, for embodied reflection) a significant quality of their life stage. Andersen-Warren (1996) believes that time needs to be dedicated to participants at the end of group dramatherapy, thereby allowing any uncomfortable feelings to be reflected upon. She considers that the dramatherapist working with older people ‘first needs to understand and challenge one’s perception of older people, old age and death’ (quoted in Morris 2011, p. 149). These are aspects of the clients’ developmental stages that may need to be addressed. 265

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Hensman (2005) refers to the reintegration process that brings safety and containment after improvisation with elders: ‘The boundaries between play, dramatic play, drama and dramatherapy themselves seem less rigid if one considers that they are in a sense developmental stages of a process’ (p. 20). She gives as an example Sue Jennings’ (1999) EPR method. Here, activities of embodying an emotion or feeling, projecting it on to an object or taking on a role synchronize with early developmental processes of the human being. Awareness of sequencing interventions within this process is a primary tool for dramatherapists and can engage clients gradually and naturally in a trustful group experience.

Embodiment–Projection–Role Jennings’ developmental theory of EPR has informed this project with elderly people and presented the opportunity to find ways to help them fulfil the requirements of their later life stages (see also Jaaniste 2011). It has been valuable to employ this paradigm, which she created while working with prenatal mothers and observing children’s play.

Embodiment Infants’ earliest experiences of their environment are predominantly expressed physically, through the senses and bodily stimulus. Infants move and play along with the outer world physically, using facial muscles and limbs in order to experience it. This helps them with later identity development.

Projection Toddlers relate more to the environment beyond their bodies, focusing on familiar objects and playthings as they explore the world through their relationships to toys and objects; stories can also be dramatized through concrete articles. It can be easier for them to speak through their soft toy or favourite doll – for example, ‘Dolly’s hungry’.

Role A significant change occurs at about 3 years old, when the child identifies him/herself as ‘I’. A new way of playing is born as he or she recognizes the ‘as if’ and the difference between everyday and imaginary reality. The impulse to imitate is strong, and situations involving parents and others are played out. The child borrows the caregivers’ clothes and role-plays. Applied in reverse, the model becomes Role, Projection and Embodiment (RPE). For people whose dementia level is mild, taking a role is easier, projection works best for moderate dementia, and embodiment is useful with the person whose diagnosis is severe. It might appear to the reader that this reversal could be interpreted as infantilization; I believe, however, that this is very far from the truth. Knocker refers to Kitwood’s phrase ‘malignant social psychology’ (Kitwood 1997, p. 45) when referring to any infantilization that might take place in the care and support of people with dementia. ‘The real problem arises’, Knocker writes, ‘with the automatic association of play as being the domain of children alone, and that “being treated like a child” necessarily equates with a lack of respect or looking down on someone’ (2001, p. 5). (It is vital to note here that treatment of elders as children is disrespectful and clearly to be avoided at all costs. This is indeed a destructive and ‘malignant social psychology’ (Kitwood 266

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1997, p. 45). Such treatment of people with dementia is in no way to be confused with the reversal of this paradigm. The EPR-reversed model of RPE is a safe structure for clients to validate their inner life when approached phenomenologically. In so doing, the ‘true nature’ of human agency is not reliant on empiricism and reductionist measures in order to do so; corporeality and spatiality can also be included in the methodology, factors that are particularly significant for the concept of embodied selfhood.

Qualitative research related to RPE The following descriptions of sessional engagement serve to illustrate developmental dramatherapy work with people with mild and moderate dementia and are useful for the person with a severe level of dementia. They are presented here to illustrate the adaptability of RPE to the status and advancement of the dementia.

Role Neil (62), with mild dementia, was the youngest member of the group and was often able, during the 16 weeks, to take on role. Before receiving the diagnosis, he worked as a priest and counsellor. By the fourth meeting, he wanted to take a new national flag he had designed earlier in the session to ‘parliament house’. He gave himself an archetypal, average Aussie name, ‘Bruce’ (‘so that ASIO2 won’t be able to track me down’). Neil raised support from other clients to accompany him and requested ‘funding’ from the dramatherapist, supporting staff and arttherapy students, protesting that ‘we need a change of national flag’. He helped volunteers to march in unison, shouting, ‘We want to change the flag’. The group accosted a ‘politician’ (he chose a staff member), who replied, in the manner of politicians, ‘I’ll take this back to my party’. At this, Neil remarked on the fact that politicians never listen. When reflecting upon this encounter, Neil liked the fact that Bruce ‘spoke out’ and ‘a lot of Australians don’t do that’. He also believed Bruce would ‘turn a lot of people off – he needs calming down’. Another participant, David, said we should be more Australian and ‘serve ourselves’. The metaphorical sense of protest about their own dementia lasted until the end of the session, when Paul (85) initiated and led us in singing, in French, ‘La Marseillaise’ (Rouget de Lisle 1972). The English translation of the first lines is as follows: ‘Let’s go, children of the fatherland, the day of glory has arrived! Against us tyranny’s bloody flag is raised!’ The social justice nature of the dementia cause was apparent throughout the session and affirmed by this song (see also Jaaniste 2014). Neil’s enthusiastic leadership role enabled him to guide the group in noisy expressions of protest that needed to be addressed. The fact that he had mild dementia allowed him to make sense of his role on his own and others’ behalf, recreating ‘internal aspects of (his) psyche in the interpersonal milieu’ (Little 2002, p. 42).

Projection Tanya (89), a German woman with moderate dementia, once lived in Vienna and escaped from Nazi Austria, fleeing with her family, via Holland, to Australia. She often told us she didn’t know who had accompanied her to the group or who would take her home, saying that she had lost her brain. Occasionally, we would help her look for it, and, in the playful search, she would often forget about her memory problems. Tanya was highly intelligent and 267

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had been a nurse and a political activist. Because of her moderate rather than mild dementia, it was important for her creativity to be expressed without going into role. As long as she could be part of the group, without specific role identification, she could manage to engage in the sessions. In the third session, she burst into tears at the memory of the fear she had experienced during the train journey with her socialist father, from Austria to Holland, to escape the Nazis in 1938. Wearing my dramatherapist’s hat (as opposed to the researcher’s), and anticipating that the group at this stage was going on a fairly scary metaphorical journey into the unknown,3 I suggested we all get into the ‘train’ together, in order to support her in the relived youthful experience. As the participants embodied the train’s lumbering motion, some making the engine’s sound, Paul (85), who had moderate dementia, said: ‘And we’re not going to get out, might be the . . .?’ (His intonation clearly identified the statement as a question.) When the train finally arrived in ‘Holland’, and we did all get out, Neil encouraged us, saying ‘breathe!’ and ‘relief!’. This playful, albeit scary, intervention’s closure enabled Tanya to breathe normally and appear more relaxed. Other participants’ comments were, ‘Happy!’ and ‘Relief!’. Gradually, Tanya’s mood improved as the group played games with the ball, joined in Group Mood (Emunah 1994) and finally chose a babushka from a large assortment of toys and objects. It offered memories and returned her to a pleasanter early life stage for a little while. Even so, she suddenly asked, ‘Where is my brain?’. Ben (73), whose moderate dementia was deteriorating to severe, pointed to the doll and said, ‘Isn’t that it, in your hands?’. The metaphor appeared to wake Tanya up, and she told us her father had brought her a babushka from Turkestan when she was small. Appearing comforted by it, and instead of asking the identity of her accompanying caregivers, she said confidently, ‘I expect someone is coming to take me home’ (see also Jaaniste et al. 2015). The preparatory make-believe and subsequent engagement with the projective object of choice had awakened healing memories of Tanya’s father, who had helped her escape from Nazi terror all those years before. Although her distressing memories would return, the toy had lightened her mood and brought her gratitude for the brave father who had saved and protected her, as well as her own courage in their flight.

Embodiment Ben’s first words at the initial group session were, ‘Join the crowd’. This is fundamentally how this man liked to be: talking about talking, rather than connecting with his own feeling life. His dementia was becoming severe at a frightening and disorienting rate, and, in early sessions, he would often stand ramrod straight, while others used the space to move around and interact. He initially used conversation about football to reply to questions about how he was feeling. Oliver Sacks (1985) writes about the loss of Mr Thompson’s biography, where it is easier to join the crowd, healing the breaches in memory through ceaseless chatter: ‘Is he in a torment all the while – the torment of a man lost in unreality, struggling to rescue himself but sinking himself, by ceaseless inventions, illusions, themselves quite unreal?’ (p. 107). As sessions progressed, however, it became obvious that Ben was able to connect with people through interpersonal touch and movement. Using silk cloths for gesturing and action gave him the opportunity for touch, and he would unbend, showing through movement and gesture that he had more interest in others. He also asked, poignantly, ‘If you could get hold of some certain material . . .’ and quickly the silk cloths were introduced. Ben became a bullfighter, and I took the role of a frightened little bull. He battled with me for a while and then told me (himself, perhaps) not to be frightened and that everything was going to be okay. 268

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From that point on, the embodied interpersonal dimensions of Ben’s work preceded or suggested his insights, as his speech became less intelligible. He was able to admit that, as an adolescent, it was hard to come home to an empty house where people left notes for each other, and that war was ‘difficult to come to terms with’ (he had been in the army as a young man). He told us, after a trust movement exercise, that he would take away ‘some certain touches and tastes of music in this room’. The session had not included music, and yet Ben seemed to have picked up an ambience of group harmony. He spoke about sadness being ‘a huge thing to have around the house’, which may have been a comment about being locked in at home, in case he absconded. He gradually lost his sense of isolation as language skills diminished and, through body gestures and movement, began to unlock his feeling life.

Conclusion The limitations of this research include the small numbers of volunteers, the lack of spontaneity that can sometimes occur through clients’ physical impediments and the brief therapy requirements of aged care facilities that are short of funding. Further research needs to be carried out on embodied selfhood and EPR. Through phenomenological epistemology, however, it became evident that significant developmental areas of participants’ lives were ‘woken up’ during the fieldwork, providing them with a rich interpersonal journey. Through application of RPE, the QoL of these elders with dementia was shown to have improved, reminding them of past life experiences that they could share with others. By taking on a role, Neil was able to bring to bear the leadership qualities he had called upon in his working life, encouraging others to join him in his call for national independence. Through communal embodiment and projection of her story, Tanya could leave aside her short-term memory anxieties and celebrate her father’s courage and her own escape from the Third Reich. Ben was enabled to use touch and embodiment to express selfhood and engage with others in play. The dramatherapy interventions at the centre of this research, applied from a critical development perspective, helped to lift the veil from what was formerly invisible: their capacity for ongoing growth and development in later life.

Notes 1 2 3

The quantitative research had only four dramatherapy participants who were assessed at Time 2 as well as at baseline. Australian Security Intelligence Organisation. This scene is pivotal in the story of the dramatherapy group and sits in the ‘storming’ stage of group practice (Tuckman 1965). It is also a metaphor for the dementia and the unknown journey the group is taking.

References Andersen-Warren, M. (1996) Creative Groupwork With Elderly People: Drama. Milton Keynes, UK: Speechmark. Anthony, E. J. (1956) ‘The significance of Jean Piaget for child psychiatry’, British Journal of Medical Psychology, 29, 20–34. Brown, C. and Lowis, M. J. (2003) ‘Psychosocial development in the elderly: An investigation into Erikson’s ninth stage’, Journal of Aging Studies, 17, 4, 415–26. Cattanach, A. (1994) ‘The developmental model of dramatherapy’, in Jennings, S., Cattanach, A., Mitchell, S. and Meldrum, B. (eds), The Handbook of Dramatherapy, pp. 28–40. London/New York: Routledge. Emunah, R. (1994) Acting for Real. New York: Brunner Mazel. 269

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Erikson, E. H. (1963) Childhood and Society. New York/London: W. W. Norton. Erikson, E. H. (1998) The Life Cycle Completed (2nd edn). New York: Norton. Folstein, M., Folstein, S. and McHugh, P. (1975) ‘“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician’, Journal of Psychiatric Resources, 12, 189–98. Freud, S. (1905) On Psychotherapy. Reprinted (1953–1974) in Standard Edition of the Complete Works of Sigmund Freud (trans. and ed. J. Strachey; vol. 7). London: Hogarth Press. Hans-Cohn, N. and Carr, R. (eds) (2008) Art Therapy and Clinical Neuroscience. London/Philadelphia, PA: Jessica Kingsley. Hensman, J. (2005) ‘Some differences between drama and dramatherapy working with old people’, Dramatherapy, 27, 2, 18–22. Jaaniste, J. (2011) ‘Dramatherapy and spirituality in dementia care’, Dramatherapy, 33, 1, 16–27. Jaaniste, J. (2014 ) ‘Missing the point: Dementia, biomedicine and dramatherapy’, in Veljanova, I., Mills, I. C. and Emmanuel, G. (eds), Health, Agency and Wellbeing, pp. 3–16. Oxford, UK: Inter-Disciplinary Press. Jaaniste, J., Linnell, S., Ollerton, R. and Slewa-Younan, S. (2015) ‘Drama therapy with older people with dementia: Does it improve quality of life?’, The Arts in Psychotherapy, 43, April, 40–48. Jennings, S. (1973) Remedial Drama. London: Pitman & A. C. Black. Jennings, S. (1993) Playtherapy with Children: A practitioner’s guide. Oxford, UK: Blackwell Scientific. Jennings, S. (1999) Introduction to Developmental Playtherapy. London/Philadelphia, PA: Jessica Kingsley. Jennings, S. (2010) Healthy Attachments and Neuro-Dramatic-Play. London/Philadelphia, PA: Jessica Kingsley. Johnson, D. R. (1982) ‘Developmental approaches in drama’, Arts in Psychotherapy, 9, 183–90. Johnson, D., Smith, A. and James, M. (2003) ‘Developmental transformations in group therapy with the elderly’, in Schaefer, C. (ed.), Play Therapy with Adults, pp. 78–106. New York: Wiley. Jung, C. J. (1969) The Structure and Dynamics of the Psyche (2nd edn). Princeton, NJ: Princeton University Press. Kennard, G. (2007) ‘Art and science: Can neuroscience help an artist develop his/her theory of art and the brain?’, Nepal Journal of Neuroscience, 3, 1, 1–10. Kitwood T. (1997) Dementia Reconsidered: The person comes first. Buckingham, UK: Open University Press. Klein, S. B., Cosmides, L. and Costabile, K. A. (2003) ‘Preserved knowledge of self in a case of Alzheimer’s dementia’, Social Cognition, 21, 2, 157–65. Knocker, S. (2001) ‘A meeting of worlds: Play and metaphor in dementia care and dramatherapy’, Dramatherapy, 23, 2, 4–9. Kontos, P. (2004) ‘Ethnographic reflections on selfhood, embodiment and Alzheimer’s disease’, Ageing & Society, 24, 829–49. Kontos, P. (2005) ‘Embodied selfhood in Alzheimer’s disease: Rethinking person-centred care’, Dementia, 4, 4, 553–70. Kontos, P. (2006) ‘Embodied selfhood: An ethnographic exploration of Alzheimer’s disease’, in Leibing, A. and Cohen, L. (eds), Thinking About Dementia: Culture, loss, and the anthropology of senility, pp. 195–217. New Brunswick, NJ: Rutgers University Press. Kontos, P. (2012) ‘Rethinking sociability in long-term care: An embodied dimension of selfhood’, Dementia, 11, 3, 329–46. Kontos, P. and Martin, W. (2013) ‘Embodiment and dementia: Exploring critical narratives of selfhood, surveillance and dementia care’, Dementia, 12, 3, 288–302. Krekula, C. (2009) ‘Age coding: On aged-based practices of distinction’, International Journal of Aging, 4, 2, 7–31. Lev-Aladgem, S. (1999) ‘Dramatic play amongst the aged’, Dramatherapy, 21, 3, 3–10. Little, D’A. (2002) ‘Dementia: A developmental approach’, Geriatrics & Aging, 5, 9, 41–4. Malone, M. L. and Camp, C. J. (2007) ‘Montessori-based dementia programming®: Providing tools for engagement’, Dementia, 6, 1, 150–7. Merleau-Ponty, M. (1962) Phenomenology of Perception (trans. C. Smith). London: Routledge. (Original work published 1945). Morris, N. (2011) ‘Unspoken depths: Dramatherapy and dementia’, Dramatherapy, 33, 3, 144–57. Power, G. A. (2011) ‘Foreword’, in Lee, H. and Adams, T. (eds), Creative Approaches in Dementia Care, pp. x–xiv. Basingstoke, UK/New York: Palgrave MacMillan. Prétat, J. (1994) Coming to Age: The croning years and late-life transformation. Toronto, Canada: Inner City Books. 270

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Rapp, U. (1982) ‘Simulation and imagination: Mimesis as play’, Maske & Kothurn, 28, 68–86. Rouget de Lisle, C.-J.(1792) ‘La Marseillaise’. Online. Available at: http://cantorion.org/music/3814/ La-Marseillaise-Voice-Piano (accessed 31 October 2013). Sacks, O. (1985) The Man who Mistook his Wife for a Hat. New York: Harper. Taussig, M. (1980) ‘Reification and the consciousness of the patient’, Social Science & Medicine, 14B, 3–13. Tornstam, L. (2005) Gerotranscendence: A developmental theory of positive aging. New York: Springer. Tuckman, B. W. (1965) ‘Developmental sequence in small groups’, Psychological Bulletin, 63, 5, 384–99. Twigg, J. (2004) ‘The body, gender, and age: Feminist insights in social gerontology’, Journal of Aging Studies, 18, 59–73.

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Part IV

Internationalism and new and innovative approaches

In this final section of the book, we begin to look at new, alternative and innovative practice from an international dramatherapy perspective. Whereas Part II focused on theory, this section very much focuses on method. We look at how dramatherapists have developed and extended their practice, creating new processes and ideas that complement their initial training and work, and how this assists the individuals and groups with whom they work. Salvo Pitruzzella (Italy) begins this final part of the Internatonal Handbook as he examines the ancient theatrical tradition of commedia and its connection to dramatherapy. He focuses on the improvisational nature of the comedic tradition and shows us how this is a natural partner to dramatherapy. In a similar vein, Demys Kyriacou (Greece) introduces us to Spagyric dramatherapy, from a spiritual and transcendental perspective. He suggests that dramatherapy is as much a spiritual quest as it is a psychotherapeutic one. Claire Schrader (UK) introduces us, through her private practice, to her unique approach to adults who struggle with shyness, using dramatherapy approaches. Though shyness may not appear to be particularly debilitating, it can have a huge impact on the lives of many ordinary people who are outside a health-care system that would acknowledge it. Susana Pendzik (Israel) introduces us to the notion that the feminist therapy perspective is similar to that of dramatherapy, owing to their potentially subversive natures. Her chapter explores connections between feminist philosophy and dramatherapy. Jenelle Mazaris (Romania/USA) introduces us to the idea of yogadrama, which is a synthesis of two dynamic practices, hatha yoga and dramatherapy. Using examples from practice, she shows us how these two dynamic practices complement each other. Steve Mitchell (UK) introduces us to a ritual dramatherapy process that he has used in shortterm dramatherapy work. He introduces us to a specific approach and technique in which he focuses on transitional events and how these events are animated in practice. In our only contribution from South America, Grace Schuchner (Argentina) introduces us to a contemplative meditative approach to dramatherapy, in a similar vein to that of Jenelle Mazaris. Schuchner introduces us to a nine-point method she uses that emphasizes both a spiritual and meditational mantra used in her practice. In our final chapter, Warren Nebe, from South Africa, has developed his ‘Drama for Life’ dramatherapy training and praxis. Although, in some ways, this chapter could fit into Part II’s

theoretical approaches, it is fitting that it is placed here. This unique, innovative approach to South African training has been born out of a post-apartheid landscape. Nebe concludes, ‘Drama therapy offers a light for our comprehension of, and our agency over, the world that we live in, no matter how dark it sometimes appears’, a fitting line on which to finish. In these four parts, we have travelled the world, from the Far East to South America, in a truly global journey that encompasses present-day international practice; long may it continue, in all of its diversity.

27 The dramatherapy commedia Improvisation, creativity and person-making Salvo Pitruzzella

It is evident that these actors penetrate to the very core of their subjects, establishing their scenes on different bases with so many varieties of dialogue that, with each performance, the interpretation seems quite new, yet inevitable and permanent. [. . .] Such is the system of our improvised comedy, to which our nation can only lay claim. (Carlo Gozzi)1

Introduction Dante called his major work Commedia, according to the mediaeval aesthetics that defined it, in contrast to tragedy, as a narrative that goes from unhappiness to joy, written in a ‘humble’ language, meaning people’s everyday speech. It does not necessarily imply humour, and yet it does not exclude it. However, in a way that is different from tragedy, Dante’s Commedia is focused mainly on transformation: from getting lost in the ‘dark forest’ to seeing the stars first, then becoming able to reach them, and finally perceiving ‘Love which moves the sun and the other stars’. Dramatherapy aims to help people transform themselves, removing the blocks and entanglements that hinder their potentiality of being fully human. The dramatic model of person-making, implicit in dramatherapy, urges us to leave aside the traditional concept of self-identity as something immune to life’s continuous changes, and take a step forward, seeing the person as a more dynamic and complex system, immersed in an everchanging world of relationships. The interconnected clusters of such a system, which interface with the world, may be loosened and rearranged through the experience within the dramatic reality, where they are put into play, explored and compared with other people’s. The aim of this movement is to make the whole system more flexible, suited to easing life’s strikes, and, eventually, to finding some inner sources of joy, to share with others. This process can be done gently, preserving the precious bond-making quality of humour and letting people enjoy being creative together. Improvisation gives us a good example of a dramatic creative process, dealing with freedom and boundaries, with self-perception coupled with awareness of the others, and with role making and role-playing. In a nutshell: dealing with the universal machinery of relationships. 275

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The commedia dell’arte is another way of being commedia, using the grotesque and excess, but at the same time presenting clear characters, embodying primary human needs, which can be taken either as masks or as mirrors. In this sense, it can be used as training for improvisation (seeing the stars), as a tool to improve individual and group creativity (reaching for the stars), and as a jolly way to foster group relationships, hopefully catching, in the experience of togetherness, a glimpse of love that moves the stars. In this short chapter, I will touch upon these three arguments: the dramatic model of personhood, and how dramatherapy can help people to put it in motion, in order to momentarily get loose from identity’s constraints and open a space for a creative rearrangement; the nature and value of dramatic improvisation; and a brief introduction to the commedia dell’arte and a reflection upon some of its features, which can be useful as tools in approaching the improvisation process in dramatherapy. I would like to thank my friend and colleague Anna Seymour, who first made me discover how valuable for dramatherapy this old Italian theatre tradition can be, and Matyas Fazakas, with whom I shared an exciting workshop on the Commedia at the summer school of the Romanian dramatherapy association, in Sue Jennings’ magical place in Zarnesti. Many thanks also to Andrea Graf, former student and now colleague, who carefully checked the use of language.

Identity, flow and drama René Descartes paved the way to his core belief with a forest of doubts. How can I be sure that something really exists? And if something really exists, how can I be sure that I am able to know it? A modern philosopher would say: what if we are nothing more than a bunch of brains in a vat, connected to a computer simulating reality? A modern cinema goer would say: what if we are all inside the Matrix? Descartes solved the riddle in a smart and elegant way: I can doubt everything, except the fact that I doubt. With hindsight, we may now look at it in a rather critical way, as we see the damage done. The idea of a core subject that, although disembodied, masters not only our mental operations, but also our body itself had the side effect of considering the body no more than a machine, with the disastrous consequences we all know (and it is at the root of the brains-in-a-vat and Matrix nightmares). On the other hand, as the neuroscientist Antonio Damasio remarks, Descartes’ error was that of not understanding that nature built our reasoning apparatus, not over our biological regulation system, but inside it (1995). The sceptic David Hume mocked Descartes’ notion of subject, stating that: The mind is a kind of theatre, where several perceptions successively make their appearance; pass, re-pass, glide away, and mingle in an infinite variety of postures and situations. There is properly no simplicity in it at one time, nor identity in different (times); whatever natural propension we may have to imagine that simplicity and identity. (Hume 1739, Book I, Part IV, Sect. VI) These are the horns of identity’s dilemma. On one side, we see a core self, in charge of our life. This is a disembodied principle, which has been called in turn mind, reason, Self or Ego, that owns the body and governs it. On the other side, we see the continuous sea of change, within which we anxiously try to imagine a solid ground, or even a lifeboat. A similar tension animates the discussion of identity at a social level. As the Nobel Prize economist Amartya Sen has demonstrated, so many massacres have been perpetrated in the name 276

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of self-ordained national, cultural, ethnic or tribal identities (2006). And the Italian anthropologist F. Remotti maintains that, ‘identity’ is a poisonous word (1996). The fact is, he suggests, that social identities are construed by opposing ‘we’ to ‘the others’. However, at the base of ‘we’ there is a request for recognition of needs, characteristics, roles, rights, projects, objectives, even of our very existence, but not necessarily of identity. Strong identities grow where there is conflict, and often they contribute to keeping conflict alive, in a vicious circle that inevitably leads towards violence. However, identity and otherness are not two separate fields, but the ideal, extreme poles of a continuum, a range of possibilities within which every subject, individual or collective, finds their place. Around the identity pole we find the values of coherence, stability and unity; around the otherness pole, we find the values of openness, communication, exchange and creativity. The radical solution Remotti proposes is to give up the concept of identity and try to find new balances between ‘we’ and ‘the others’. Going back to individual identity, we see how its meanings have changed so quickly in recent times. In the 1960s, the American psychologist Erik Erikson watched the revolt of the youth against the old politics and ways of life and focused on the identity crisis that marks the passage from adolescence to adult life (1974). Every step of our life, from childhood to old age, he maintained, knows its own crisis, from which, if we are lucky, we re-emerge with new values and a stronger sense of the Ego. Only some 20 years later, another American psychologist, Kenneth Gergen, explored a completely different territory (1991). The great narrations of modernity are obfuscated, and social identities are atomized; individuals are immersed in flows of information and knowledge never seen before, including myriads of contradictory aspects, with no clues as to how to choose properly. Models of identification and belonging multiply, and each individual is constantly exposed to alternative possibilities of being. This saturation provokes a sense of overpopulation of the Self, leading to ‘multiphrenia’, ‘the splitting of the individual into a multiplicity of selfinvestments’, none of which plays the role of identity’s spokesperson. According to Gergen, the unceasing identity crisis that went through the twentieth century has crossed a border, beyond which there is nothing corresponding to such a concept, and, after everything that has passed, it is not even worth searching for it. Giving up identity can be felt as a liberation; it does not imply an annihilation of the person, but rather its refoundation, not as a monument of the Self, but as a dynamic hub at the centre of a nearly endless swarm of possibilities. If we can live such a change, overcoming the sense of bewilderment that may push us to grasp any reassuring identity, we can accept just being in the flow. It may be a precarious and uncertain condition, but also rich with wonder and surprise; we can appreciate the Buddhist precept that releasing our grip on the Ego handhold does not make us fall, but ascend. However, at a more radical level, the collapse of the identity fortress can open up to the acknowledgement of the others within us. The notion of the radically intersubjective nature of human beings is nowadays coming to be more and more universally accepted, as increasing multidisciplinary research has focused on the web of relationships that makes up individuals, rather than on the individuals themselves. Stain Bråten and his circle have focused on the notion of an intersubjective matrix as the upcoming paradigm of human nature (2007). They showed that, contrary to what has been surmised from Piaget’s line of enquiry and psychoanalytic thinking, namely the idea that infants are asocial and egocentric, there is a new understanding that a baby is born with a lively talent for interpersonal communion. A newborn baby can engage in complex and subtle proto-conversations with his or her caretaker, which Bråten defines as ‘dance-like’, and the ability of intersubjective attunement grows as the child grows. The discovery of mirror neurons has demonstrated that 277

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our brain is programmed to create embodied simulations of the others, so we can feel what the others feel before thinking. Leaving the Ego aside for a while may help us resume this dimension. This implies that, for a moment, we put aside our identity, the collection of roles, narrations and knowledge that we are used to considering as ourselves, including social labels, such as ‘average’ or ‘diverse’. This implies that we live in the present moment. Drama can be the right place for this. In drama, people meet each other in a special time and place, no matter who they are or how clever they are, to begin a new journey, where everything can be re-invented and renewed. We can let ourselves freely follow the flow and, as Grotowski maintained, cross the border between ‘me’ and ‘you’. We can reopen the channels of empathy and compassion, the ‘pity’ that Aristotle mentioned as being at the core of theatrical catharsis, Eleos, which has many names: from Christian mercy, to Buddhist Karuna, from Gandhi’s Ahimsa to Desmond Tutu’s Ubuntu. On this basis, we can put into play and share our roles, narratives and knowledge and let the others help us to rearrange and refresh our sense of self, as provisional as it can be. Dramatic improvisation is, at the same time, free play with the personal and intersubjective materials of which we are made, and a form of communication that can be, using the precious definition by Danilo Dolci, a continuous, mutually creative adjustment (2011).

Playing with the unexpected In spite of the variety of styles and approaches that characterize dramatherapy, we can identify some important methodological similarities concerning the use of specific structures of the artistic process, which we may define by the following terms: training, improvisation and composition. Training is the first contact with the specific features of the dramatic language. It is not aimed at learning already established codes or the ‘right’ communication techniques, but rather at encouraging people to experiment with the language itself, looking for their own particular forms of expression. In groups, it is often presented in the form of a series of games and exercises, helping to work, at the same time, on interpersonal relationships and collaboration. Improvisation is the free and immediate application of the language explored. There can be individual or group improvisations; they can be totally free or partly planned (for example, they may or may not have a planned topic or plot). They are the space in which people reveal themselves, through the mediating metaphor of the dramatic language, and where they actively search for new patterns and new meanings, through interaction with the others and with the therapist. Composition is the deliberate expressive plan, made by individuals or groups. It includes gathering ideas, refining them and actively looking for a way to express them properly. In composition, spontaneity is interwoven with knowledge, and the need to communicate plays a key role. We will look closely at the improvisation mode, in order to explore further the concept of mutually creative adjustment. In improvisation, the expressive tools that have been experimented with in training are now used to create dramatic forms in the immediacy of here and now, individually or in a group. Whereas exercise is set upon a rule, in improvisation, rules are created from the process itself and can be transformed within its course. The musician Stephen Nachmanovitch reminds us that, ‘we improvise when we move with the flow of time and with our own evolving consciousness, rather than with a preordained script or recipe’ (Nachmanovitch 1990, p. 17). In improvisation, any gesture, sign, word or sound may lead to countless developments, some of which are absolutely unexpected. This is even more evident in group improvisation, where 278

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the presence of others is both a constraint and a resource. At the same time, we learn to cohabit with chaos: improvisations may not be coherent or congruent; they may not follow a logical development or reach a proper end; it might even happen that an improvisation collapses or gets stuck. The amount of anxiety generated by such vicissitudes is, however, shared and contained by the group and the therapist, and it does not overflow or compromise the process; on the contrary, it may become an energy helping it to continue. In dramatherapy, it quite often happens that the initial embarrassment of showing oneself later becomes self-irony and the ability to laugh at oneself. When children’s play is at its best, in its ‘state of grace’, their improvisations are pure art forms. I recall some long play sessions with animal puppets, between my daughter Viola and a friend of hers, when she was 5 years old. Every gesture, every move of the game was in the right place, where it had to be, with no hesitations or regrets, as if the two children were following a detailed script, including adventures, relationships and feelings played by the puppets. Nor did they take time to prepare it: a simple agreement between two characters (‘I am the rabbit and I call on you . . .’) was enough, and the rest flowed without any effort, leaving the daddy–observer with a sensation of freshness and vigour. The explanation my daughter gave of the inexhaustibility of that play was that ‘animals are alive’. The visible aspects of this way of improvising, which can be found in dramatherapy when the process works right, are: immediacy, appropriateness and naturalness.

Immediacy The spontaneous action appears as a motion from inside to outside, which is not planned, denoting an ability to act without a predefined project and even without the mediation of thought. The actors improvising have no time consciously to consider all the possibilities: they act relying upon the impulse of the moment, letting the imaginative schemes, either born under the threshold of consciousness or learned by training, guide the action. They must learn to trust them and to take the risk.

Appropriateness Even when freedom and spontaneity are at their peak, the result is not a formless hotchpotch, a juxtaposition of loose sounds or gestures; it appears instead as an organized chaos, a meaningful event. This is because, in improvisation, every expressive micro-event (gesture, word, action or sound) is always intersubjectively connected. Such connection may manifest itself in different nuances, according to the internal rules of the groups of improvisers: they may be either equal or governed by a leader; they may place stress either on challenge or on support; in any case, they move along a dialogical principle, rooted in a continuous sharing: give and take; accept the other’s proposals and offer yours. In group improvisation, such connection implies a particular sensitivity to grasp even the smallest hints from the others, including involuntary body signals, which are shown in posture, muscle tension and facial expressions. It also implies the ability to rework them at once to calibrate the action. The improvisers must be focused on themselves and on their own action, but, at the same time, they must be aware of everything happening around them. From the subject’s point of view, ‘appropriateness is the feeling that our own actions and reactions are not false notes, but they belong to a harmony of the relationship; they are fitting to the context and, meanwhile, they contribute to its construction and definition’ (Pitruzzella 2004, p. 95). Jonathan Fox2 suggests that the idea of appropriateness may ‘include a difficult279

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to-attain notion of “right action”, not unlike the Zen master’s injunction to “eat while eating; sleep while sleeping”’ (Fox 1994, p. 80).

Naturalness What is the meaning of the last phrase? At first sight, it just looks like an invitation to follow our natural body needs: eat when you are hungry, sleep when you are sleepy. In fact, this invitation goes much further, asking us to live our actions, even the most trivial, with the awareness of the present moment. The musician Keith Jarrett, author of many performances of total improvisation, some of which are considered absolute masterpieces, maintains that ‘creativity is the awareness of the potential of the moment’ (Toms 1997. p. 91). In his well-known report of a Western thinker’s encounter with the world of Zen Buddhism, Eugen Herrigel has outlined the fascinating paradox lying underneath the practice of archery (Kyudo). On the one hand, the aspiring archers submit to an intense and laborious training; on the other hand, they can succeed in hitting the target only when all this is forgotten, and the archers become one with their bows, their arrows and their targets. Then, the archer’s task is just to let the arrow go, and it will reach the target by itself (perhaps the arrow is also alive, like Viola’s puppets?).

Italian comedy Although improvised drama became widespread in the second half of the last century, it had a notable ancestor, which we must take into consideration, as it may give us some interesting suggestions for dramatherapy. I am speaking of the commedia dell’arte, which suddenly sprung up halfway through the sixteenth century and flourished for about 200 years, eventually disappearing as quickly as it was born. Certainly, it has left many traces: characters such as Arlecchino were kept alive in other theatre forms, and many of them have become regional masks, used in carnivals. Yet it never reappeared as it was in its time, when it became one of the most important form of Italian theatre, and surely the one that was best known abroad, all around Europe. Its reputation in Italy had been heavily biased by the negative view argued by the idealistic philosopher Benedetto Croce, who made a strict distinction between ‘Art’ and ‘art’. In his essay on the topic (1930), Croce refutes the attribution of ‘poetry’ to this kind of theatre. He reasonably claims that, ‘the name itself states it clearly: comedy of art, that is comedy treated by people who made it a profession, a job. This is actually the meaning of the word “art” in ancient Italian’. In a certain sense, he was right: the oldest legal act that constituted a professional theatre company, stating rights and duties and, most of all, claiming its independency and commitment, dates back to 1545 and was held by a group of comedians. And they were certainly proud and protective of their dramatic skills, which were many and very elaborate (one of the most relevant companies called itself Gelosi, jealous, meaning that it was watchful of its own art). But Croce went farther, saying that, notwithstanding their prodigious technical skills, they never reached the ideal and spiritual dimension of real poetry, and what they did was mere ‘buffoonery’. In a previous text, he had been even sterner, questioning the very core of the commedia, that of improvisation3: ‘under the apparent improvisation [. . .] there was preparation and mechanism; under the apparent richness, poverty’ (Croce 1914, p. 13). He did not understand that the two levels (preparation and improvisation) can coexist, as we said above, and that the specific poetry of that form of art has to be sought, not in its contents, but in its intrinsic freedom and playfulness. 280

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Croce’s bias influenced most of the twentieth century’s studies on the subject: even eminent scholars such as Vito Pandolfi (1957, 1964) and Mario Apollonio (2003), who studied all the documents relating to the commedia dell’arte in depth, were quite shy of confuting Croce’s main statements. We owe the recent rediscovery and diffusion of the commedia dell’arte in Italy mostly to the actor, director, playwright and Nobel Prize winner Dario Fo, who enthusiastically grasped the revolutionary spirit of the commedia, claiming that its originality: is not determined by the specific use of masks, or by casting the character into fixed types, but by a revolutionary conception of making theatre and by the unique role actors played in it. [. . .] The whole theatrical game lies on their shoulder: histrionic actors are authors, stage managers, storytellers, and directors; they can shift indifferently from the role of protagonist to that of stooge, all of a sudden, surprising, with continuous trips and hops, not only the audience, but also their fellow players. (Fo 1987, p. 14) Fo emphasizes the great vitality of the improvised commedia, dealing with characters and situations that have precise similarities in real life. And the actors called themselves ‘professors of living art’, considering the commedia like a ‘living picture’, a mirror to nature, in which ‘lively images unveil themselves’ (Domenico Bruni, Prologhi (parte II), quoted in Marotti and Romei 1991, pp. 385, 413–15). We can find some prototypes of the structure of the commedia in early documents, namely the ‘Dialogo de un Magnifico con Zani bergamasco’, dating back to the beginning of the sixtennth century, which embodies the everlasting master–servant dynamics. In it, two characters, who eventually became protagonists of the commedia, are portrayed: the old lecher, wealthy and miserly, who will later turn into Pantalone, and the silly servant, apparently obtuse, but actually cunning, who will have many variations, including Arlecchino and Brighella. The dialogue includes a series of lazzi: the typical gags, mostly slapstick, but also sometimes using lines, of which the performances were pointed. The etymology of the word is uncertain: it might refer to lacci (strings, knots), suggesting the fact that they were fixed parts of a repertoire, to be used in different occasions. Yet it could also derive from l’azione (the action); in this case, the meaning would be slightly different, pointing to any action improvised on the spur of the moment. However, the turning point in the evolution of the commedia was the challenge of setting up a whole story, not just single situations or extemporary gags, without the support of a written text. The scenario pinned up in the theatre wings was just an outline to follow, a base on which the actors had to invent and improvise. Gherardi, a famous Arlecchino, wrote: The Italian comedians learn nothing by heart; they need but to glance at the subject of a play a moment or two before going upon the stage. It is this very ability to play at a moment’s notice which makes a good Italian actor so difficult to replace. Anyone can learn a part and recite it on the stage, but something else is required for Italian comedy. For a good Italian actor is a man of infinite resources and resourcefulness, a man who plays more from imagination than from memory; he matches his words and action so perfectly with those of his colleague on the stage that he enters instantly into whatever acting and movements are required of him in such a manner as to give the impression that all that they do has been prearranged. (quoted in Duchartre 1966) 281

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It seems evident that they were well aware of the value of their art, and they valued highly the qualities of immediacy, appropriateness and naturalness, of which we talked above.

Instructions for use Given these premises, in which we could have noticed some relevant analogies between the commedia and improvisation in dramatherapy, we must be aware that the commedia cannot be used in dramatherapy ‘as it is’; in addition, we do not know much about the actual training of the comedians, and even all the recent experiences of restoring it (including Dario Fo’s), as valuable as they are at an artistic level, are nothing but interpretations, based on spare remnants. However, I think that we can distil some ideas and principles from what we know of the practice of the commedia, which can be used creatively, both as training exercises for improvisation and as broad improvisational structures. I have summarized them in three categories: the play with fixed roles, the challenge/cooperation dynamics in improvisation and the liberating energy of humour. Playing with fixed roles might appear paradoxical, as one of dramatherapy’s major purposes is helping people to make their role repertoire larger and more flexible. Nonetheless, in my personal experience, I have found it very useful, for two main reasons. In training, playing with fixed roles eases the difficult task of showing oneself to the others and being seen. I can present myself within a clear, visible container. It protects me, and at the same time provides me with hints for action, and also the relationships between the characters obey their implicit dynamics. This helps people enter easily into play, especially those who are fearful about showing themselves. For example, I have been working with a group of inmates of a therapeutic community, where people had grown so used to the presence of the others in their everyday routine that they ended up becoming invisible to each other. I asked them to try out some commedia roles (namely, the Zanni, the Lover and the Captain), working in groups, and then to introduce themselves in front of the others using one of the three roles of their choice, saying their real name. It had the sudden effect of awakening the curiosity concerning the others that seemed extinguished: people started looking at each other with a mixture of solidarity (after all, everybody, including the therapist, was doing something absolutely ridiculous) and surprise (‘I would never expect that my dull community mate could be so jolly and funny’). The second reason is that the basic characters of the commedia display, in a clear and direct way, the connection between body and role. Playing the Zanni means to be comically overwhelmed by the weight of the world: his body is subjected to gravity, which pulls it down, and he gets very tired and miserable4; he is always hungry and always complaining. For some people I have worked with, feeling crushed by a weight they cannot bear is quite an effective metaphor for their ordinary existence. The amusing exaggeration of such a condition helps people to look at it from a different point of view, with a little distance, which makes it look less appalling. The basic figure of the Zanni, which is rather primitive in its features, as we said before, quickly evolved into more complex characters, the most relevant of which is Arlecchino.5 Arlecchino is the creative Zanni; he is witty and intelligent, charming and amiable, sometimes malicious, and even wicked, but always full of bright ideas and sharp jokes. Whereas the Zanni is a predestined victim, Arlecchino is a survivor. The transition from Zanni to Arlecchino, as clearly shown by Dario Fo in his lesson–performances, is mainly a bodily change. Arlecchino’s body is far from being as overwhelmed as Zanni’s: he shifts his body weight from one foot to another, constantly remaining in an unbalanced state, which suggests alertness and readiness for action. Experimenting with such a transition, people begin to realize that mastering their 282

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expressive bodies means creating differences in characters, and this experience points to the radical flexibility of roles. The second aspect, which is hinted at in Dario Fo’s words quoted above, is related to the basic machinery of improvisation.6 At the beginning, people are encouraged be kind, supporting and favouring each other and establishing a climate of collaboration. As the experience progresses, and skills grow, each person can try to challenge him/herself and their playmates, with swift turns, soft provocations and unexpected reactions, always keeping the friendly, supportive frame. This is its great value for improvisation: it cannot be either too bland or too demanding; a reasonable compromise between boredom and anxiety is required, which is, according to Mihaly Csikszentmihalyi, the necessary requirement to attain the ‘flow’ condition, which is the experience of those moments when: instead of being buffeted by anonymous forces, we do feel in control of our actions, masters of our own fate. On the rare occasions that it happens, we feel a sense of exhilaration, a deep sense of enjoyment that is long cherished and that becomes a landmark in memory for what life should be like. (Csikszentmihalyi 1990, p. 3) Finally, a few words have to be spent on the humour issue. Playing with the commedia means dealing with elementary comic structures. It is a gentle and safe way to make a fool of oneself and create together a cheerful and playful environment. Humour, when well managed, can be a powerful therapeutic tool: we can learn to look at our troubles from a different perspective, establishing the right distance that may release their grip on our life.

Conclusions Improvisation is one of dramatherapy’s core methods. It can help people learn to live in the moment, making continuous, joyful exchanges with the others, fostering relationships and mutual listening. It is a good metaphor for life, as we acknowledge that life is not just following predetermined scripts, but can be revived and refreshed moment by moment, with the support of the others. Our identity’s features can be put in motion, rearranged and renewed, reflecting back the existential truth that we can let ourselves go with the flow, with no risk of drowning. Playing with the commedia dell’arte can be a precious tool to learn and practise improvisation, through the exploration of structures and functions that, although tied to an old and noble tradition, are universal and accessible and can be creatively re-invented day by day.

Notes 1 2 3

4 5

6

Quoted in Duchartre (1966). Inventor of Playback Theatre, a form of psychosocial drama based on improvisation. We now know for certain that the name commedia dell’arte is quite late (attributed to Carlo Goldoni); they probably preferred to call it commedia all’improvviso, and their theatre was known worldwide as Italian comedy. Originally, the Zanni was a facchino (porter) from Bergamo and, therefore, used to carrying heavy bags. Arlecchino is a very intriguing, complex figure: on the one hand, he is the evolution of the Zanni, transferred from the rough Bergamo countryside to refined and civilized Venice. On the other hand, his origins can also be traced back to ancient folklore: he has both some ‘devilish’ features and some aspects that recall the ‘wild man’ of old, seasonal traditions. This is also recovered in Keith Johnstone’s method (1979). 283

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References Apollonio, M. (2003) Storia del teatro italiano. Milano: Rizzoli. (Original work published 1940) Bråten, S. (ed.) (2007) On Being Moved. From mirror neurons to empathy. Amsterdam/Philadelphia: John Benjamins. Croce, B. (1914) ‘Prefazione’, in Del Cerro, E., Nel regno delle maschere. Napoli: Perrella. Croce, B. (1930) ‘Intorno alla “Commedia dell’Arte”’, in Poesia popolare e poesia d’arte. Studi sulla poesia italiana dal Tre al Cinquecento. Bari, Italy: Laterza. Csikszentmihalyi, M. (1990) Flow. The psychology of optimal experience. New York: Harper & Row. Damasio, A.R. (1995) L’errore di Cartesio. Milan, Italy: Adelphi. (Published in English (1994) Descartes’ Error. New York: Penguin Putnam) Dolci, D. (2011) Dal trasmettere al comunicare. Casale Monferrato, Italy: Sonda. Duchartre, P. L. (1966) The Italian Comedy. New York: Dover. (Original work published 1929). Erikson, E. H. (1974) Gioventù e crisi d’identità. Rome: Armando. (Published in English (1971) Identity: Youth and crisis. London: Faber & Faber) Fo, D. (1987) Manuale minimo dell’attore. Turin, Italy: Einaudi. (Published in English (1992) The Tricks of the Trade. London, Methuen Drama) Fox, J. (1994) Acts of Service. New Paltz, NY: Tusitala. (Original work published 1986) Gergen, K. (1991) The Saturated Self. New York: Basic Books. Hume, D. (1739) A Treatise on Human Nature, Book I, Part IV, Sect. VI. Johnstone, K. (1979) Impro. New York: Routledge. Nachmanovitch, S. (1990) Free Play. Improvisation in life and art. New York: Tarcher/Putnam. Marotti, F. and Romei, G. (1991) La Commedia dell’Arte e la società barocca. La professione del teatro. Rome: Bulzoni. Pandolfi, V. (1957) La Commedia dell’arte, storia e testo. Florence, Italy: Sansoni. Pandolfi, V. (1964) Storia universale del teatro drammatico. Turin, Italy: UTET. Pitruzzella, S. (2004) Introduction to Dramatherapy. Person and threshold. London: Routledge. Remotti, F. (1996) Contro l’identità. Bari, Italy: Laterza. Sen, A. K. (2006) Identità e violenza. Bari, Italy: Laterza. (Published in English (2006) Identity and Violence: The illusion of destiny. London: Penguin) Toms M. (ed.) (1997) The Well of Creativity. Carlsbad, CA: Hay House.

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28 Spagyric dramatherapy A transcendental perspective Demys Kyriacou

Introduction The notion that we are not awake, that we are not at a level of consciousness where we can understand anything rightly, and where it is impossible to know or have anything real, and where we cannot be in control of ourselves because we are not conscious at the point where control would be possible – is found throughout Platonic, Christian and many other teachings. But consider how difficult – how impossible – it is for us to admit that we are asleep in life. (Dr Maurice Nicoll 1976, p. 68)

A spiritual teacher once said that there are two ways of experiencing the world and our existence: the being and the doing – both acting in a complementary manner to each other. However, in our Western societies, much stress has been laid on the doing aspect of existence – ‘How to do this or that’, ‘What to do now’, etc. – instead of asking ‘How to be’ or ‘How am I or how do I feel?’. We have gradually transformed ourselves from human beings into human doings. We are being rewarded for our doingness and not for our beingness. The whole education system is based on that; I have such and such a diploma, title, specialization. All these form a large part of our identity. Therapists are not an exception in this matrix of doingness. The paradox is that we try to help our fellow humans find their beingness! Too much stress laid upon doingness has cut us off from the mystery and poetry of life, from the excitement of exploring the unknown. It has cut us off from beauty, and from that inner incubating silence that is one of the hallmarks of beingness. Doingness reinforced by scientific thought has robbed psychotherapy of its arts aspect – being an arts therapist does not guarantee that I am free of its grip though! It has caused words and concepts such as ‘soul’ or ‘spirit’ to vanish from the textbooks of psychotherapy. The search for the spiritual path, the torment of existential anguish and deep-seated, unanswered questions about ‘being’ were, for many decades, not the concern of psychotherapy, except perhaps when interpreted and categorized as the defence mechanism of sublimation! Thomas Moore (1992), best-selling author, philosopher and psychotherapist, grieves that the great malady of the twentieth century was the loss of soul. Moore maintains that, when the 285

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soul is neglected, it demonstrates its woundedness symptomatically in addictions, fears, nightmares, obsessions, loss of meaning and violence. Most therapists attempt to isolate or eradicate these symptoms, failing to understand that their roots often lie in our lost wisdom about the soul. Moore distinguishes between cure and care by pointing out that cure implies the end of trouble, whereas care offers a sense of ongoing attention, of decoding and understanding the inner language and containing the mystery. He believes that psychotherapists’ approach would change dramatically if they thought about their work as offering ongoing care, rather than pursuit of a cure. He reminds us that problems, symptoms and obstacles can offer us opportunities for deep reflection and discovery that might otherwise be overlooked. Another eminent psychotherapist, James Hillman, in his book The Soul’s Code: In search of character and calling (1997), outlines what he calls the acorn theory of the soul. This theory states that each individual holds the potential for their unique possibilities inside themselves already, just like an acorn holds the pattern for the oak, invisible within itself. It argues against the parental fallacy whereby our parents are seen as crucial in determining who we are, and also against other external and environmental factors as being the main determinants of individual growth. Instead, the book makes the argument for a reconnection with what is invisible within us, our daemon or soul or acorn, and its calling to a wider world. It argues against theories that attempt to map life into phases, suggesting that this is counter-productive and makes people feel like they are failing to live up to what is normal. As a consequence, this produces a truncated, normalized society of soulless mediocrity, where evil is not allowed, but injustice is everywhere – a society that cannot tolerate eccentricity or distinctiveness, but sees them as illnesses to be medicated out of existence. In my opinion, psychotherapy and, consequently, dramatherapy must aim simultaneously at the two levels of human existence, i.e. the horizontal one, which is everyday life, with all its problems and joys, all its ups and downs, and the vertical one, which is the spiritual quest each one of us is called upon. This vertical level is quite often omitted by many psychotherapeutic schools of thought, and yet I consider it of the utmost importance, as humans are beings participating, whether they consciously acknowledge this or not, on both of these planes of existence.

What is Spagyria? Therefore learn Alchemy, which is otherwise called Spagyria. This teaches you to discern between the true and the false. Such a Light of Nature is it that it is a mode of proof in all things, and walks in light. (Paracelsus, Paramirum, Lib. I., c. 3)

Spagyria is an old, compound alchemical term of Greek origin signifying a double process necessary for inner transformation. It comprises the Greek verbs spao (σπ άω), meaning to break down, to extract, and ageiro (αγείρω), meaning to collect, to reconstruct anew, to reunite. Some personality forms and patterns can impede the unfolding of spiritual potential. The Spagyria concept implies that these must break down and then be restructured and transformed, giving place for soul-stuff to rise and manifest. To put it in esoteric terms, to clear up lower centres of consciousness from egotistic elements and, in so doing, give higher centres and levels of consciousness the chance to manifest in one’s life. The result is a psychologically balanced individual – not an egocentric one – who at the same time is in touch with his/her inner spiritual core, the real I. A careful study of the Great Alchemical Work will clearly show one what the Spagyric process is all about. Actually, the whole process is not about learning new things but 286

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rather about unlearning; metaphorically speaking, not acquiring new luggage, but leaving things that burden us behind, clearing the channel for energies from super-conscious realms to pass through (Assagioli 1976). It’s about re-membering what has been dis-membered long ago: as it were, having no recollection of inner unity in our daily life!

What is Spagyric dramatherapy? Accounts of religious experiences often speak of a ‘call’ from God, or a ‘pull’ from some Higher Power; this sometimes starts a ‘dialogue’ between the man [or woman] and this ‘higher Source’. (Assagioli 1976, p. 114)

What follows has evolved from my 40 years of study and practice of esoteric and spiritual teachings and from the last 25 years of practice as a dramatherapist, psychotherapist and psychiatrist. Starting out as my own need to find the common ground between these two lines of work in oneself, I’ve realized that many people involved in the esoteric practices, as in various forms of meditation, shamanism and spiritual disciplines, lacked some basic psychological knowledge and experience; this made it difficult for them to fully understand and delve into the innermost recesses of their psyche. On the other hand, people well versed in psychology and psychotherapy had a tendency to disregard the esoteric as a kind of ‘metaphysical escapism’ from the everyday ‘real life’, thus excluding mystery, destiny, higher levels of consciousness, alternative realities and many other concepts from their scientific vocabulary. Thanks to psychotherapists such as Carl Jung, James Hillman, Thomas Moore, Roberto Assagioli and a few others, the esoteric and psychological areas are not that far apart anymore. The unconscious is no longer viewed only as a dark, chaotic space full of uncontrolled and repressed emotions, but is also seen as a space or reality entertaining luminous aspects of one’s being, the kingdom of soul and spirit. As a dramatherapist who has conducted many personal development workshops and ongoing closed groups, I have developed, over time, my own way of working, which, because of its distinctiveness, I have named Spagyric dramatherapy. Spagyric dramatherapy is a form or model of dramatherapy that attempts to build a bridge beween the world of psychological/psychotherapeutic theory and practice and that of spirituality and esoteric teachings and methods. It addresses the needs of those adult men and women who want to make a further step regarding their self-development; a step beyond symptom alleviation, psychological problem-solving or the working through of issues and symptoms related to everyday life. Men and women who yearn for a deeper understanding and meaning in their lives; who are tormented by existential questions and seek to penetrate the veil of illusion and mechanical way of living and who have not found answers on the everyday personality level. Thus, the centre of gravity of Spagyric dramatherapy’s methodology is shifted towards the golden mean of the axis spreading between spirit/soul and ego/personality. Using dramatherapy tools on the one hand – body, movement, ritual, metaphor, symbol, storytelling, role-playing, drawing, etc. – and spiritual methods promoting awareness and awakening from the sleep of everyday life on the other, this model hearkens to the deeper whispers of the soul, or daemon, as James Hillman (1997) calls it. It attempts to open up the rainbow channel or bridge between the everyday personality and the core of one’s being, offering the soul a chance to manifest and fulfil its destiny. It also maintains that the spiritual dimension is a particular state of being, an alternative reality, and not just a figment of the imagination. 287

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The daemon Each person bears a uniqueness that asks to be lived and that is already present before it can be lived. (Hillman 1997, p. 6)

It has been made clear to me, from my experience and observations, and agreeing with James Hillman, that we are not born tabula rasas upon which our parents, educators and society delineate our subsequent histories. Something deep in our psyche is already there, in the form of a daemon, a goal or agenda that environmental and parental influences can either collaborate with or interfere with. Talents, predispositions and a very specific potential are already there in a kind of ‘zipped’, coded form when we arrive on this Earth. Thus, by way of example, my father’s dominant, business-oriented view of life may obstruct the agenda of my daemon, which would lead me in the direction of philosophy, introspection, astrology and the search for a deeper meaning in life, whereas my mother’s artistic nature and her inclination towards the abstract would enhance the manifestation of my inner potential. The word ‘daemon’ has been greatly misunderstood. In Western, Christian cultures it is identified with ‘evil spirit’, which is not the case where it first originated, i.e. ancient Greece. It is a Greek word to begin with, δαίμων, which means godlike power, fate or god. In Plato’s Symposium (1993), daemons are referred to as deities or spirit guides, benevolent or benign nature spirits. A daemon or spirit guide was mentioned by Socrates himself, the voice of which guided him throughout his life and played a crucial role at his trial. Every decision Socrates took was always after consulting his daemon, residing in the deepest recesses of his psyche. In Hesiod’s Theogony (1983), Phaethon becomes an incorporeal daemon or a divine spirit, and Homer uses the words theoi (‘gods’ – θεοί) and daimones (δαίμονες), suggesting that, although distinct, they are similar in kind. Plato, in Cratylus, speculates that the word daimo¯n (δαίμων – ‘deity’) is synonymous with dae¯mo¯n (δαήμων – ‘knowing or wise’); however, it is more probably daio¯ (δαίω – ‘to divide, to distribute destinies, to allot’). In Plato’s Symposium, the priestess Diotima teaches Socrates that love is not a deity, but rather a great daemon. The great Heraclitus also states that character is for man his daemon. Daemon is the veiled countenance of divine activity; every deity can thus act as daemon. A special knowledge of daemones is also claimed by Pythagoreans, and, for Plato, a daemon is a spiritual being who watches over each individual and is synonymous with a higher self or an angel. Even today, in Greece, when we want to describe someone as being ingenious or shrewd, we say that he is daemonios (δαιμόνιος), a description used in ancient times for Aristotle. In his acorn theory, Hillman (1997) proposes that the daemon has the particular agenda of the acorn becoming an oak. Though external circumstances can slow down, inhibit, distort or foster the eventual development of that oak tree, they cannot prevent it, nor are they responsible for the acorn’s inevitable destiny to become an oak eventually. Hillman also suggests that, although, in most cases, the daemon is a benign and benevolent influence, in a small percentage of cases, it seems to be a bad one, leading its charge into antisocial, criminal and self-destructive behaviour.

The holistic approach of Spagyric dramatherapy The focus of Spagyric dramatherapy is the soul, that spiritual plane of existence that our everyday personality is mostly oblivious to, and about which thousands of years of esoteric tradition and practice have taught us. As a process, it aims beyond the mere reorganization of psychological 288

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defence mechanisms and a general ‘feeling better’ or a ‘healthier ego’ state and looks for the transformative and spiritual elements usually ignored by most of the current psychotherapeutic schools. It is oriented towards, on the one hand, the inherent soul-potential (Hillman’s daemon) and, on the other, clearing the ground for the ego to cooperate, understand and contain the soul’s purpose, messages and treasures. Thus, it addresses the totality of one’s nature, attempting to build an energy line connecting the superconscious (spirit/soul), the ego (personality) and the unconscious. Ultimately, it sensitizes someone to the call of his/her daemon, helping the manifestation of the inner potential and, thus, enhancing and nourishing the ‘acorn’ to fulfil its destiny, to become a strong oak tree. In practice, in Spagyric dramatherapy, we use all the dramatherapy tools, such as body, movement, music, role-playing, sculpting, drawing, narration and working on myths and stories, enactments, etc. However, the focus and aim are as described above: a process in which ‘space’ is being created for the manifestation of the authentic, true Self in us all.

Pairs of Opposites and the Transcendent function Out of [the] collision of opposites the unconscious psyche always creates a third thing of an irrational nature, which the conscious mind neither expects nor understands. It presents itself in a form that is neither a straight ‘yes’ nor a straight ‘no’. ( Jung 1968, para. 285)

What exactly do we mean by the terms ‘pair of opposites’ and ‘transcendent function’? And what is the relationship of Spagyric dramatherapy to these terms? Dualism is considered by many spiritual traditions to be the source of a great deal of emotional pain and other problems experienced by human beings. Even our social values show up as opposites: failure/success, merciful/cruel, strong/weak, aggressive/tolerant, generous/miserly, advancing/retreating, joy/sorrow, conscious/unconscious, and the list goes on and on. Almost every aspect of our life stands on dualism; in fact, we consider it as natural, normal and healthy. But is it so? Dualism is like a double-ended stick. We fail to understand and accept the fact that, whenever we choose the positive end of the stick, we immediately and unavoidably invite in the negative end! We begin, for example, a new project or a relationship with joyous expectations, and yet sorrow is lurking in the shadows. Is there a way out of this duality? What is life like when not trapped in dualism? Spiritual traditions from all over the world assert that true life and a much higher state of consciousness begin with the appearance of the third thing of irrational nature mentioned by Jung. He refers to the transcendent function as the mediating force between oppositions within the psyche. The transcendent function emerges out of intense, concentrated conflicts within the individual. Like Zen koans or the ‘shocks’ in Gurdjieff teaching, extreme and painful paradoxes can lead us to a place where we must transcend the ego, so that our perception of reality is no longer split into two opposing forces. Jung says that holding the tension of the opposites is consequential to bridging the gap between the egoconsciousness and the unconscious. If the tension between the opposites can be held long enough without one succumbing to the urge to identify with one side or the other, the third, completely unexpected image or state of consciousness, one that unites the two in a creative new way, comes into being. Spagyric dramatherapy creates the inner space and invokes this third force, the transcendent function (Jung 1969), in the individual, acknowledging the various opposites in one’s psyche, attempting to help one shift one’s psychic centre of gravity beyond them, a shift beyond their battlefield and subjectivity, reaching out for that special inner sanctum where the so-called Hieros Gamos 289

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– sacred marriage (Eleusinian Mysteries) – or the alchemical Coniunctio can take place. In practice, the dramatherapist promotes friction of the yes and no through individual tasks and roles that lie outside the comfort zone of the group members, thus helping them to hold the tension between opposites. In this way, a variety of aims are being achieved: first, the realisation that the opposites always go together; second, members are helped to get in touch with the illusory nature of the pairs of opposites; and third, conditions are being created for the transcendent function to come into view.

Dramatic ritual in Spagyric dramatherapy Anthropologists, sociologists, psychotherapists and above all dramatherapists are pretty much confident of the healing power of dramatic ritual. Dramatic ritual, to put it simply, is the enactment of a myth or archetypal story with the intention of bringing about healing. Usually, this involves resolving an issue, dealing with a difficult life experience, restoring drained energies or easing a transition of some sort. However, ‘healing’, in the broader and more holistic sense of the word, is a gradual and multilevel process, very close to what Jung named the individuation process, or else, the process of becoming whole. The focus of dramatic ritual in Spagyric dramatherapy is not so much on ‘resolving an issue’ but, instead, on addressing and perhaps resolving the issue, i.e. the fragmentation of personality, ‘ego’ and persona predominance and alienation from the soul (Self or daemon). It therefore becomes more than ‘dealing with a difficult life experience’; instead, it deals with the obliteration of the vertical level of spirituality by a horizontal, ‘mechanical’ and ‘stimulus-response’ life. Dramatic ritual in Spagyric dramatherapy also involves working with one’s subpersonalities, or what I choose to call ‘inner cast’, patiently collecting parts of the mosaic for the soul to create the final image, the mandala of one’s being.

The inner cast Man has no individual I. But there are, instead, hundreds and thousands of separate small ‘I’s, very often entirely unknown to one another, never coming into contact, or, on the contrary, hostile to each other, mutually exclusive and incompatible. Each minute, each moment, man is saying or thinking, ‘I’. And each time his I is different. Just now it was a thought, now it is a desire, now a sensation, now another thought, and so on, endlessly. Man is a plurality. Man’s name is legion. (Ouspensky 1977, p. 59)

Subpersonality is a term used in transpersonal psychology and it refers to a personality mode that makes its presence felt in order to allow a person to cope with certain types of psychological and social situation. It includes specific sets of thoughts, feelings, physiology, actions and other elements of human behaviour. In Jungian terms, it is synonymous with a ‘complex’, along with its relevant archetypal images and figures. Over the history of psychotherapy, many approaches have worked with subpersonalities, including Jungian analysis, psychosynthesis, Gestalt therapy and transactional analysis. The average person has a great number of subpersonalities: each of us is a crowd, and this of course must not be confused with dissociative identity disorder (formerly known as multiple personality disorder). I prefer the term ‘inner cast’, with its more theatrical connotation, the subpersonalities being inner actors in one’s life drama. Here are some examples. First, a very common subpersonality for most people is the inner judge, which makes its presence felt through judgemental thoughts, critical words, punitive 290

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action, anger, harsh criticism, superior feelings and body tension when confronted with one’s own/or others’ fallibility. The inner judge, just like the Freudian super-ego, promotes guilt and remorse, thus suppressing one’s spontaneity and creativity. Second, there is the inner wounded child, who sometimes, with the help of the inner victim, kicks in with naivety, playfulness, helplessness and a manipulative attitude when one is trying to cope with a difficult situation involving an authority figure. At other times, the inner trickster pops up, sabotaging a project, internal or external, or creating an atmosphere of lightness and fun, belittling a situation when it is experienced as too threatening and serious. Further examples include the inquisitor and the martyr, the lover and the monk, the rebel and the intellectual, the whore and the priest, the seducer and the housewife, the saboteur and the aesthete, the organizer and the bon vivant. Each bears its own unique characteristics and mythology, and each resides more or less comfortably, yet crowdedly, in one single person. Roberto Assagioli wrote (quoted by Piero Ferrucci): We are not unified; we often feel that we are, because we do not have many bodies and many limbs, and because one hand doesn’t usually hit the other. But, metaphorically, that is exactly what does happen within us. Several subpersonalities are continually scuffling: impulses, desires, principles, aspirations are engaged in an unceasing struggle. (Ferrucci 1982, p. 48) Vernon Howard, the eminent American spiritual teacher and writer, commenting on Gurdjieff’s teaching, wrote: The many I’s within a man explains many mysteries about human nature. For example, a man decides to give up an undesirable habit, but the next day he repeats it again. Why? Because another I has taken over, one that likes the habit and has no intention of giving it up. Or perhaps a woman decides to quit fooling around with her life: she determines to find her real self. She reads a book or two and goes to a few lectures. Then, suddenly, she loses all interest and goes back to her self-defeating behavior. What happened? An entirely different I, one that doesn’t want her to wake up, took charge. Gurdjieff provides a simple solution to this contradictory condition: Become aware of the many I’s. Watch how one takes over and then another. Also, see that they do not represent the true you, but consist of borrowed opinions and imitated viewpoints. Such Self-Observation weakens their grip; you eventually find your Real I. That is the New Birth proclaimed by esoteric Christianity. (Howard 2004, p. 31) The list of the inner cast can go on and on, and, when one fully acknowledges the fact of its existence, one realizes how illusory is the belief that we are an indivisible, immutable and totally consistent being. The characters of the inner cast are often far from being at peace with one another, and this is the root of much of our dysfunction as personalities in our everyday life. This happens because some of the inner characters have very different motives, needs and ideas about how one’s life should be run! This can cause internal conflict, making life very difficult, especially if one gets identified with a particular member of the inner cast. Quite a few psychotherapies have encouraged the dialogue between the various subpersonalities, with the aim of gaining some insight into what is going on in our inner world. In dramatherapy, the powerful tool of enactment, the use of voice, movement, sculpting and ritual, gives us the chance to encounter our subpersonalities in a fine, colourful and vivid manner. 291

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Thus, subpersonalities stop being vague voices, thoughts and feelings and become dramatic characters with which we can work, thus increasing the level of our understanding and consciousness. In Spagyric dramatherapy, we attempt a step further. Apart from acknowledging the existence of, and working through, our subpersonalities, we look for and encourage the manifestation of the authentic Self (the inner daemon) that lies at the core of our being, beyond the noisy voices of the inner cast. It is not an easy task to hear the whispers of the real I, as they are not easily recognisable beneath the innumerable layers of masks, belief systems and set of values in our life.

The parable of the horse, carriage and driver: A vignette The parable of the horse, carriage and driver is a very ancient tale of unknown origin, brought to the West by G. I.Gurdjieff, although variations of it are found in the Upanishads, the Mahabharata and Plato’s Phaedrus. The equipage presents a picture of Man. In it, the horse, harnessed to the carriage and drawing it, represents the function and manifestation of feelings and emotions. The carriage stands for the body, with all its motor reflexes and functions, and the coachman, sitting on the box and directing the horse, corresponds to what, in a man, we usually call consciousness or thought. Finally, the passenger, seated in the carriage and commanding the coachman, is what is called ‘I’ or ‘Self’. However, the above illustration is an ideal picture of Man. In his ordinary state, things are not so well balanced. Thus, the state of the average person is as follows: the carriage is in terrible disrepair, with no proper maintenance. The horses are either semi-wild or not well fed and cared for. The driver is unfocused or drunk, and the passenger, the Master of the carriage, is fast asleep or absent. The carriage is being used mostly as a cab, and a multitude of characters (passengers, not the passenger), some quite strange or even unknown to each other, use the carriage for their own purpose, thus giving a clear image of our fragmented selves (inner cast), who enter the carriage one after another and order it this way or that. The arrival of the master, or what might be called a unified ‘I’, can only be the result of many years of exacting, patient and arduous inner work. During a 5-day, intensive dramatherapy residential, group members were introduced to and worked with the above parable, using various dramatherapy techniques. On one occasion, they were asked to explore the various elements of the parable (carriage, horses, coachman, etc.) through body sculpts, initially on an individual basis and subsequently within subgroups. One of the peak, shockingly insightful moments came when, as subgroups, they created successive sculpts of the ordinary state of man (where all is chaos) and the ideal state of man (where all is in harmony). The aim of this exercise was to attain a deeper understanding of the different inner levels of man and, in particular, the levels of ego and Self/daemon and how they relate and differ. The experience of embodying these two images facilitated the opening of a space of greater understanding and insight. It was the juxtaposition of the two opposing sculpts that allowed some of the members, some for the first time, to see more clearly their inner state of disorder and chaos caused by the predominance of the ‘ego’ state and the absence of the real I (Self or daemon) in their lives. Some of them had blissful moments of a deeper Presence within themselves (the Master of the carriage), of an inner place beyond the conflict and warfare of opposite forces within – a place where stillness abides. This shift of consciousness was also clearly shown in their bodies: breathing shifted from shallow to deep, muscles, limbs and torso from being tense to being relaxed, in a graceful and harmonious manner. These observations were further evinced by verbal reflection by the group.

Epilogue Your innermost sense of self, of who you are, is inseparable from stillness. This is the I Am that is deeper than name and form. (Tolle 2003, 3) 292

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It is true that drama and dramatherapy are about action. But what is action without stillness? Experience has shown that, in stillness, right action is born; but, then again, what is right action? It is of the utmost importance to emphasise that, although, on a horizontal level of existence, stillness is considered the opposite of action, on a vertical, soul level, stillness and action are mysteriously interwoven. We may consider stillness as the pause between inhalation and exhalation, the silence between two words, the actual canvas where words and actions are being drawn. Stillness is both a form of action and the source of action. We’ve all had experiences of making impulsive decisions or decisions made by the book and acting in a way that we have later regretted. However, the regret does not come from the unexpected outcomes of our actions. It comes from an inner recognition that we did not listen to the one guide, the soul, our daemon, which was giving us wise and compassionate counsel all along. Leonard Bernstein, the wellknown composer, once said that, ‘Stillness is our most intense mode of action. It is in our moments of deep quiet that is born every idea, emotion, and drive which we eventually honor with the name of action’ ( Jordan 2002, p. 108). Although the term right action implies its opposite, wrong action, it is here abusively used to denote the form of action that is in alignment with one’s inner daemon, i.e. an action that does not originate from thoughts, feelings or application of techniques alone. Spagyric dramatherapy aims at connecting one with that inner core where stillness abides and all truly therapeutic and transformative action originates.

References Assagioli, R. (1976) Psychosynthesis. Harmondsworth, UK: Penguin. Ferrucci, P. (1982) What We May Be. Winnipeg, Canada: Turnstone Press. Hesiod (1983) Theogony Introduction, Translation, and Notes, Athanassakis Apostolos. Baltimore, MD: Johns Hopkins University Press. Hillman, J. (1997) The Soul’s Code: In search of character and calling. New York: Warner Books. Howard, V. (2004) Mystic Path to Cosmic Power. Pine, AZ: New Life Foundation. Jordan, J. (2002) The Musician’s Spirit: Connecting to others through story/G5866. Chicago, IL: G I A. Jung, C. G. (1968) Collected Works of C. G. Jung (vol. 9, part 1; 2nd edn). Princeton, NJ: Princeton University Press. Jung, C. G. (1969) Archetypes and the Collective Unconscious (vol.9, part 1). London: Routledge & Kegan Paul. Moore, T. (1992) Care of the Soul. London: Piatkus Books. Nicoll, M. (1984) Psychological Commentaries on the Teachings of Gurdjieff and Ouspensky. Boulder, CO/London: Shambhala. Nicoll, M. (1976) Living Time and the Integration of the Life. Boulder, CO/London: Shambhala. Ouspensky, P. D. (1977) In Search of the Miraculous. New York: Harcourt Brace Jovanovich. Plato (1993) The Symposium (trans. with commentary by R. E. Allen). New Haven, CT: Yale University Press. Tolle, E. (2003) Stillness Speaks. Novato, CA: New World Library.

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29 Breaking through the walls of shyness Overcoming shyness, self-consciousness and social anxiety through dramatherapy Claire Schrader

Acting is the shy person’s revenge on the world. (Sinead Cusack)

We live in a communications age, and, in spite of the proliferation of electronic communication, face-to-face verbal communication remains one of the most important ways in which we gain social acceptance. Life too, it seems, has a way of singling out and rewarding those who communicate well, leaving those who cannot feeling hopelessly excluded. For many people with shyness this is excruciatingly painful and means they remain forever locked away inside their ‘shell’, fearing they will face ridicule, criticism and, at worst, ostracism, and so they choose to stay in the shadows, rather than make their situation worse. This can lead to depression, social isolation and long-standing unhappiness. In some cases, it may develop into more serious conditions: social phobia, agoraphobia, clinical depression and a wide range of anxiety disorders. In this chapter, I will describe an application of dramatherapy that I have developed for normal adults who are experiencing shyness,1 based on my own experiences of combating shyness through drama. My clients are working people who are challenged by shyness in either their professional or personal lives. Many have been struggling to overcome this issue through cognitive behavioural therapy (CBT), psychotherapy, hypnotherapy or neuro-linguistic programming (NLP), but still feel seriously hampered by their shyness. After participating in the 12-week Breakthrough Group, these same individuals report significant improvements in their shyness and, over time, banishing shyness for good.2

The pathologisation of shyness In recent years, shyness has become progressively medicalised and pathologised. According to sociologist Susie Scott, the diagnostic label of social phobia (also known as social anxiety disorder) ‘has been applied to an increasing number of people who would once have been seen as “just 294

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shy”’ (Scott 2006, p. 133). In Shyness: How normal behavior became a sickness, Christopher Lane tells us that the pathologisation of shyness started when ‘psychiatrists in the 1880s, known at the time as “alienists”, began viewing shyness as a morbid condition that bordered on pathology’ (Lane 2008, p. 14). Then, in the 1970s: A small group of leading psychiatrists met behind closed doors and literally rewrote the book on their profession. Revising and greatly expanding ‘The Diagnostic and Statistical Manual of Mental Disorders’ (DSM for short) in which social phobia appeared for the first time in the classification of mental health disorders. (Lane 2008, abstract) This led to rising diagnosis rates over time in which many shy people were acquiring the stigma of a mental-health condition, with the possibility also that many may have been misdiagnosed (Scott 2006).3 Psychologists Crozier, Henderson and Zimbardo go further and name shyness a ‘social disease’ and ‘societal pathology’. The rising rates of shyness, they see ‘as a warning signal of a public health danger that appears to be heading toward epidemic proportions’ (Henderson and Zimbardo 1998, p. 10), and they point to the factors that are perpetrating shyness: Where once shyness could be considered a form of individual pathology, now it may well be better construed as an index of societal pathology, a signal that forces are at work in our society fuelling this sudden rise in the experience of shyness. Some of those forces may come from the growing addiction to technologies that entertain and inform us at the cost of isolating us and making us socially passive, as well as from socially deficient family structures, and socially defunct neighbourhood structures that foster anomie rather than amity. These are some of the vectors in a public health model of shyness as a social disease currently spreading its web across our society. (Crozier 2002, p. 38) With the growing popularity of electronic devices (particularly among young people), it seems all the more important to address the problem of shyness before it becomes a societal phenomenon.

Shyness and its causes Shyness classically develops in response to a perceived trauma, including: emotional abuse, a highly critical working or family environment, or a shameful incident that has left deep psychological scars (Buss 1986). Some people have endured a lifetime of exclusion as a result of merely having a quieter personality; often, they are also introverts (Cain 2012), and this exclusion keeps them feeling perpetually alienated from other people.4 For many, shyness starts in childhood, and 15 per cent of infants are born with a tendency toward shyness (Rubin and Coplan 2010). Although many grow out of their childhood shyness, often this leaves the individual with a habitual reserve or self-consciousness. Alternatively, shyness may be a personality trait or develop through the lack of social skills (Kelly 1982; Glass and Shea 1986; Phillips and Bruch 1988), and, more rarely, there may be neurological causes due to damage to the right hemisphere of the brain (Weintraub and Mesulam 1983). For a certain proportion of people, there is a puzzling shyness that develops in adulthood, where, in spite of a happy, well-adjusted childhood, suddenly these individuals experience 295

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uncharacteristic shyness. Typically, this is owing to a traumatic event (bullying/ridicule) that has undermined confidence, but, for some, there is no real explanation, or not one that can be accessed consciously. Over 18 years of working with shy clients, I have come to the conclusion that ‘shyness is not a syndrome. It is not a disorder or condition but an aspect of normal psychological health. Almost everybody is shy in some area of their lives’ (Schrader 2004). There are even certain situations where shyness can be a distinct advantage.5 Although shyness is not a syndrome, it can be a serious limitation. Shy people have learned at an early stage in life that it is safer to live in their internal haven than in the real world. Most experience shame that they are not ‘braver’ and more able to face situations that seem to come more naturally to others. Shyness is fuelled by the adrenaline ‘flight/freeze’ response causing the individual to withdraw into their shell every time they feel under ‘attack’. For the acutely shy, the flight/freeze response is frequently being triggered, which means they are habitually living in fear and in adrenaline overload, resulting in high levels of the toxic hormone cortisol, which, according to biochemist Candice Pert, drains immunity and is potentially damaging to health and well-being (Pert 1997).

Why dramatherapy is effective at overcoming shyness Shyness, in most cases, is learned or adapted behaviour and, for that reason, can be unlearned. Like learning anything, this takes time and application to achieve, and then practice to truly make the new behaviour one’s own. Drama is generally the last thing a shy person wants to do, and yet it is well known that drama builds confidence: Julia Roberts, Tom Hanks, Audrey Hepburn, Paul Schofield and Emma Watson were all previously quiet, shy or introverted people who have acquired confidence through drama. One of the reasons that dramatherapy is so effective at overcoming shyness is that, like most phobias, being exposed to the stimulus of fear in a safe environment gradually reduces its power over the individual. Facing their deepest fear of being in the spotlight, witnessed by others, looking foolish and potentially being judged by others puts the shy client so far out of their comfort zone that their self-concept has to shift. Most treatments for shyness focus on the cognitive and behavioural aspects of shyness, which enables the client to manage their shyness more effectively. CBT, the commonest shyness treatment, addresses the cognitive aspects (the thought patterns that fuel the fear), along with the behaviour that perpetuates it. Most shyness treatments are technique-based, which requires clients not only to practise the technique but also to use it in extremis – and most do not have the confidence to call on these techniques when stressed (Schrader 2014). The kind of practice that shy people receive in CBT, and even assertiveness and social-skills training, is not sufficient to build up a solid confidence, because it does not feel like ‘real life’. This is where dramatherapy differs. Dramatherapy enables the client to connect with their true, and often lost, authentic self and, by this means, bypass their adaptive response (shyness). Dramatherapy calls on a very basic human skill, the capacity to imagine yourself as another, drawing on development skills that are innate in every human being6 (Jennings 2011). Playing the character in a dramatic situation gives permission to express emotions and behaviour that are not normally in the client’s range of expression. This, ironically, feels more ‘real’ than practising a technique, as it enables the embodiment of the characteristics and behaviour that the client is seeking to emulate. This is expressed naturally by the client in the dramatic situation and is, therefore, sourced within and by the client. Shy clients, too, have the uncanny ability to be in two psychological places at once without any sense of paradox. They are intensely fixated on their inner experience, to the point of it 296

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being debilitating, and intensely and erroneously aware of what they believe to be the critical response of others (Crozier 2002). Yet within this, there is the concealed, deeper desire for the attention in which they receive the love and approval of others: attention that they also flee from, because of their self-fulfilling, negative expectations. Thus, they are both inside and outside themselves, on the sidelines and in the spotlight. This is why dramatherapy is so effective, because it enables the client to play out these internal paradoxes through actually being in two places at once: the place of being the character (the ‘not me’) and also the place of being the ‘me that is playing the character’. In the fluctuating gap between the two, there is an opportunity for an internal shift to take place. Dramatherapy uses a group solution to resolve a group problem. Most shy treatments are one to one and, therefore, do not challenge the client to address their anxiety in groups. A dramatherapy group provides the context in which the shy client can play out their longing for attention that they avoid so intensely, in a safe and judgement-free setting.

The Breakthrough Group I developed the Breakthrough Group as a solution to shyness, using the theatre model of dramatherapy (Jennings 1991, 1992) and drawing extensively on Jungian psychology, Keith Johnstone’s improvisational theatre, Joseph Campbell’s teachings, and many personal development approaches and philosophies that made a significant impact on my experience of overcoming shyness (Schrader 2012). The Breakthrough Group provides a balance of challenges in a very safe environment, working through dramatic distance (Jennings 1991), so that clients can emerge from their shell at their own pace and in their own way. Each 12-week group provides structures to unlearn that behaviour and put new behaviour in its place. When this happens in a context where all members of the group are committed to supporting each other to move through their fears, then there is the potential to make a significant shift. A key aspect of my approach is to destigmatise shyness. Thus, I deliberately use transformational language to describe the process, emphasising the self-improvement aspects of the group, which helps to normalise the experience, removing the stigma of ‘needing therapy for a problem’. I invite participants to refrain from identifying themselves as a shy person, but rather as a person who ‘at times feels shy’. This helps to reduce their own stigmatisation of themselves in seeing themselves as a victim or a lesser person. The design and delivery of the group are focused on empowering participants to break down the walls of shyness and to believe that they can create the life they want. An important part of the group is the integration of the group experience with normal life. The weekly, 2-hour sessions give participants opportunities to stretch and move through their resistances and then return to everyday life.

Commitment Because many shy people have developed complex, avoidant strategies and have experienced many setbacks, clients need to be highly motivated to overcome their own internal oppressors. Making the commitment7 to attend the group each week enables the client to move through resistance and the blocking strategies of their defence mechanisms, so that a new habit of selfconfidence can become second nature. Setting a powerful intention assists the client to start creating a new mindset, the cornerstone of building a more resilient confidence. In the first session, I set up a dramatic structure in 297

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which participants create a symbolic collective breakthrough seeding in much bigger possibilities for themselves, by entering into ritual space (Schrader 2012). This serves as a simple ‘rite of separation’ (Van Gennep 1960/2010), enabling participants to enter into an altered psychological state of liminality, outside normal social time and rules, through which they can begin to separate themselves from the experience of shyness and which will be played out more fully in the remaining 12 weeks of the group. A typical enactment classically involves the group forming a tight circle of chairs within which they are trapped, to represent their experience of shyness. They may wear masks to represent their habit of hiding behind a mask of conforming to the expectations of others. As they break out of the circle in unison, sending chairs clattering to the ground, they symbolically leap into new possibilities for themselves. Some may tear off their masks, or very consciously and slowly remove their masks, to represent their intention to stop hiding themselves away behind a false self-image. This enactment creates a physical memory of their release from shyness, sending powerful physical, visual and auditory messages to their shared unconscious and preparing themselves for the possibilities that lie ahead.8

The Medusa Effect To be petrified is to be turned into stone, to become hardened, fossilised, fixated in fear. This is what the Gorgon, Medusa, from Greek myth does to men who see her (the sight of her is so horrific that they are turned into stone). For many shy clients, this is an only-toofamiliar experience, in which certain situations cause their fear to intensify to such a degree that they become frozen (an adrenaline response). I call this ‘the Medusa Effect’ (Schrader 2004, p. 5), in which there is often a need for the client to remain physically still so as not to attract attention to themselves; some clients may also have developed a rigid body type.9 The freeze is ‘the stage’ for an internal battleground, where an increasingly strong motive to ‘do something’ is being blocked by increasingly strong fears, to ‘avoid doing something wrong’. There is often so much psychic energy going into this escalating, futile internal conflict that the person has no spare energy to act autonomously. They become literally petrified. What make the Medusa Effect in shyness so painful are the social pressures of the group. Watching others actively participate increases their shame and their inability to conform to social rules. Their frozen state puts out unconscious messages to others to stay away, creating social isolation. The fact they have created the problem for themselves does not help, for, even though they hold the key to releasing themselves from it, the Medusa Effect has got such a pernicious hold that their self-judgement increases along with their panic, and the ‘freeze’ only gets deeper. Working with the myth of Medusa gives clients a means to move through the layers of fear and resistance that have kept them frozen. The hero of the myth, Perseus, represents the part of the client that wants to bring about change to their shyness, and Medusa represents the part that immobilises them (turns them into stone). By drawing attention to their own internal mechanisms, through enacting these different aspects of themselves, they raise awareness and the power within them to release their internal tension and to claim their lost power. Exploring the story of Perseus and Medusa dramatically ‘frames’ each weekly session as an episode in the Hero’s Journey (Campbell 1949), in which they play out their own internal heroes, demons, sabotoeurs and divine helpers that will gradually loosen the grip of the Medusa Effect. The experience of collaborating creatively together to create a short ‘performance’ that is witnessed by other members of the group (a key component in the theatre model of dramatherapy) is in itself a liberation and a huge confidence builder. 298

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Accessing support to overcome obstacles Support is a crucial aspect of the group process and the means by which clients make such significant progress. Shy people are classically unaware of the qualities and strengths they possess, for which they receive acknowledgement through the group process. Receiving validation for who they are, from a compassionate and supportive group who understand their pain, enables them to challenge and reframe some of their erroneous ideas, by direct experience, and so build a natural and authentic way of relating to others. Most shy clients are fiercely independent and believe they need to do everything themselves. They often find themselves locked in a pattern of giving without receiving. Asking for and receiving support is an important aspect of the group, which we address in an early session, opening them up to ‘interdependence’10 and new behavioural possibilities. Receiving help too is intrinsic to the Hero’s Journey (Campbell 1949)11: Perseus could not achieve his task without the assistance of the gods, and neither can the shy client. However, Athena does not simply give Perseus the help he needs: she directs him on an empowerment pathway that is going to call him to build on his inner resources. He must ask for the help of the Graeae, three old women who share one eye. The Graeae refuse to help him, representing the obstacles that clients are inevitably going to meet in their journey out of shyness. Groups commonly play out this scene comically, taking relish in the Graeae’s stubborness.12 They may experience the pleasure of bonding with other group members through sharing the single eye (group connectedness), or they may welcome the opportunity to say ‘no’ to the powerful figure of Perseus (as many shy people are reluctant to challenge authority figures). Perseus breaks the rules: he ‘steals’ the Graeae’s single eye, or tooth, and bargains with them for his success. He does this humorously and teasingly, inviting lightness into the situation. This offers shy clients an opportunity to look at options they may have considered unacceptable, because of their tendency to think rigidly, opening them up to the possibility to break rules in small ways, to ‘think outside the box’ or to use humour to overcome obstacles in their path. Clients learn in Breakthrough that, with support, they can overcome their deepest challenges. As well as the support they receive in sessions, I encourage the group to stay in touch between sessions. Many go on to form strong friendships with each other and stay in touch long after the group has finished. This, in turn, empowers their resolve to keep practising what they have learned.

Overcoming the inner critic/observer Perhaps the most debilitating aspect of the Medusa Effect is the presence of the powerful inner critic, a destructive observer of behaviour. This takes the form of being so acutely aware of themselves that it is as if a part of the self has become detached and is now watching from the outside. Henderson and Zimbardo draw attention to the ‘egocentric preoccupation of shyness’ (Henderson and Zimbardo 2002, p. xiii), which is paradoxical, as one of the last qualities that the shy person believes of themselves is that they have any ego strength at all, judging themselves as weak, foolish and/or inept. It is vital to address the cognitive aspects that perpetuate shyness; otherwise, the client will persist in tearing down their greatest victories. Improvisation (in particular Keith Johnstone’s method) is one of the most effective ways to move participants out of habitual, critical selffocus. I induct the group gradually into improvisational flow, starting with mirror exercises where they are encouraged to stay focused on the solar plexus. This is a simple trick to bypass the analytic mind and connect with their intuitive right brain, and this is the first step to breaking 299

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down the deep habits of self-criticism. Participants learn by degrees to deeply trust their instinctive capabilities, so that they reach a point where they can surrender control of the mind and, in this, for the first time, they discover true spontaneity: spontaneity that comes from a deeply, intuitive place that does not involve analytic thinking (Johnstone 1979/2007). Working with the myth of Medusa is a powerful metaphor for releasing the supremacy of the head. As Medusa is decapitated, it is a violent image, and yet, when Perseus beheads Medusa, he liberates her from her torment.13 The shy client needs to take the sword of Perseus, along with the winged sandals of Hermes/Mercury, the helmet of Hades, god of the underworld, and the assistance of Athena, the warrior goddess,14 to liberate themselves from the tyranny of their own head. When Medusa is decapitated and liberated, Pegasus, the winged horse of poetic inspiration, and the giant Chrysoar are born – representing the possibilities for the shy client of claiming the ‘giant within’ and the winged horse of free expression. The enactment of the myth also invites the client to claim their own warrior nature, which might include owning and expressing their anger and drawing on the different parts of themselves that live in the underworld.15

Getting stuck Even with all these tools, clients still get stuck. Cheryl, a fragile young woman, upbraided herself because she felt unable to speak when playing the part of the Medusa, and, for her, ‘speaking’ was the key aspect of her shyness that she found so intolerable. If others were speaking in the dramatic enactment when she was silent, then Cheryl felt she had failed, in her own mind. ‘Perhaps Medusa didn’t want to speak,’ I suggest, ‘perhaps her silence is important.’ Shy people are unaware that, in dramatic terms, silence can be powerful. A few weeks later, Cheryl was happily speaking in enactments and, around this time, she also realised that her job was one of the keys to her unhappiness and she resolved to seek another. I encourage clients to embrace their stuckness: ‘It is fine to be stuck, but play it out, express how stuck you feel’, as this is generally unacceptable in their everyday lives. I have seen countless clients frozen in a role, unable to act out the behaviour of the character they’ve chosen – however, this is often an important ‘breaking point’ in their progress. Fatma, a Turkish woman, was playing a dominant character in a scene – but Fatma was silent, frozen to the spot and unable to express any aspect of the character’s power. Yet she was highly visible, having wrapped herself in a bright red piece of fabric and was standing prominently in the middle of the ‘stage’. Fatma was unable to attend for a few weeks afterwards, and I was concerned that she would drop out. However, when she returned to the group, she reported that, much to her surprise, she had delivered a presentation with ease, which previously had been beyond her capability – her key motivation for attending the group. This is the power of the archetype to bring about a significant shift. When a shy client steps into a powerful archetype, this is often enough in itself. Embodying the archetype is waking up the dormant potential within them, and it only takes time before that potential naturally surfaces in more confident behaviour in their everyday life.

The Breakthrough Process Although the dramatic exploration of the myth is an important aspect of the group, it is the transformational aspect of the Breakthrough Process that enables them to make lasting behavioural change. The process uses an adaptation of a playback structure,16 in which the client becomes hero in a collective journey into their deepest psyche, where traumatic experiences, which cannot be expressed in words, are dramatised and transformed. 300

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The process offers a window into vulnerability and gives acceptance of shared experiences, particularly shame. As clients are working in metaphor, vulnerable feelings can be acknowledged, without the need to enter into the traumatic memory. This is the part of the Breakthrough experience that makes sense to clients, because it relates more to their real-life experiences and satisfies their anxiety to translate their achievements in the group into more assertive behaviour in the outside world. The Breakthrough Process starts with image-making in which each client draws a symbolic representation of their ‘breakthrough’ in two parts: (1) the core issue that they believe is keeping them locked away in their shell and (2) the ‘breakthrough’ that they are seeking. (The image in itself can be a powerful representation of how shyness has impacted their life and, as a result, can be deeply healing in itself.) The focus client will explain their breakthrough and the important aspects of it to them, and other group members may offer their perceptions, which may give the client a window into their unconscious processes. In Figure 29.1, you will see 28-year-old teacher Rebecca’s depiction of her shyness (1) as a thin, ghostly girl, hardly visible at all, who is squeezed into a narrow space on the paper and separated from the rest of life by a dividing ‘wall’, as if she is ‘waiting in the wings’. This epitomizes how many shy clients feel: that they are ‘ghosts’, hardly having human form, unnoticed and unseen behind a wall that keeps them in the shadows. They are ‘waiting in the wings’, unable to participate in life as a whole. The metaphor of the ghost is powerful, because a ghost is an unhappy soul who haunts the site of their deepest pain, unable to find a way out and, like the shy client, is trapped into a mode of behaviour they can see no way of escaping.

Figure 29.1 Rebecca's Breakthrough image. To the left is the ghostly girl - the core issue of her shyness (1). To the right is the vibrant explosion of colour behind which she has drawn a peaceful face - the Breakthrough that will move her out of her shyness (2) 301

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In the second stage of the process, the image (Figure 29.1) is explored in dramatic form by the group, in the same way as they have played out characters in the Perseus myth. The group plays this back17 to the client on their behalf, who is witness to their own story. This is classically the battleground with their personal demons. Often, specific members of the group will strongly identify with the focus client’s experience and elect to play their role. This can be liberating, as they play out their own story on behalf of another. Both clients are doing their own work and work for each other. This, too, is witnessed by the whole group, who are also active participants, often playing out the focus client’s internal oppressors while also playing out their own oppressors, thus awakening the power that lies dormant within them. (For many shy people, ‘being bad’ is unacceptable, representing increased reasons for social exclusion, and so to play bad or powerful characters, in the service of others through shared dramatic enactment, is deeply empowering.) As a result of the trust that has built up between them in previous weeks, group members will instinctively pick up many unconscious elements in the focus client’s experience. Without any discussion or planning, whole groups will ‘play back’ a quality or experience that they could not possibly have known about and that is highly significant for the focus client. In essence, they are playing out experiences that are held in the collective unconscious and that are shared by them all. When this pain is so accurately portrayed, it no longer remains locked away inside, but is shared with others, and this is deeply healing, dissolving shame and painful memories for the focus client (and for other group members too).18 The final part of the process is the actual breakthrough: the key action that is needed to bring about transformation of the issue. This is where the focus person steps out of role as witness into being an active participant in their breakthrough and, in so doing, becomes the source of their own empowerment. Often, the focus client knows instinctively what they need to do. In witnessing the playback, they have discovered their own internal, outraged rescuer: the hero, heroine, superman, superwoman, whose sole purpose is to bring about resolution to a perceived wrong/injustice on their personal quest to claim their fully authentic self. Rebecca’s breakthrough image (Figure 29.1) is bold and daring: a vivid explosion of colour that dominates the page, expressing the life force and desire for change that lives in potenta within her. Interestingly, the vibrant colour takes the form of a cross, which may indicate that there is a part of Rebecca that wants to say ‘No’ (especially as she is a teacher). The image has a double meaning in simultaneously and powerfully saying ‘yes’ and ‘no’, expressing the paradox that is within many shy clients. However, behind the large cross, Rebecca had drawn a peaceful face: her deeper breakthrough was to feel more peaceful within. Thus, Rebecca took powerful action to enable the ghostly girl to break through the wall into the wild exuberance of being fully alive. Dancing and joyous celebration is common at this stage in the process. For Rebecca, once this had been fully expressed, her breakthrough transitioned into the group creating a Haven of Peace in which she could rest: the ‘boon’ or blessing (Campbell 1949) at the end of the journey. I have seen many walls and dividers being broken through in the Breakthrough Process: it is very satisfying to see a delicate, timid, shy client taking energetic action to smash down their walls, after which they are glowing with the sheer exhilaration of their action. The Breakthrough Process provides an ‘out of time’ experience in which the client, as playwright, brings about a profound shift in the transformational climax of their drama/story/ history. The playback of the client’s experience in dramatic form raises it above the everyday world into artistic expression. It is hard for most shy clients to express the battle with their internal oppressors in normal, rational thoughts or words; however, when it is expressed through a theatrical form that is both personal and archetypal, the aesthetic aspects of the shared experience 302

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liberates everyone (Jennings 2001).19 One client turned her breakthrough into a film that was professionally produced and viewed at film festivals – enabling her to give her breakthrough public expression, moving audiences with the potent images explored in the film and healing layers of shame and invisibility (Phillips 2006).

Conclusion In conclusion, shyness is not a syndrome or a pathology; it is, in most cases, a normal psychological response to challenging life events. Addressing shyness in childhood is obviously important, as it can seriously hamper a child’s ability to use and develop their talents in later life, and, if not dealt with, shyness can develop into more serious conditions in adulthood. We live in a world where extraverted skills are increasingly valued, leaving shy, introverted and quiet people on the sidelines, in spite of their considerable talents and skills. I have seen an increasing trend in which employers are demanding that their staff should be competent in public speaking and networking and be active team players (all extroverted skills) or promotion paths may be blocked, and, in some cases, they may be in danger of losing their jobs. Having watched countless shy, and often also introverted, clients walk into the Breakthrough Group with high levels of inhibition and seen them walk out with natural self-assurance, I know this means they are then able to meet these challenges with growing confidence. Shyness is not a life sentence, and many shy people from all walks of life have gone on to lead highly successful lives. Sinead Cusack said, ‘Acting is the shy person’s revenge on the world’ (Rutter et al. 1988, p. xii), and this is precisely why dramatherapy is such a powerful solution. The Breakthrough Group frees clients from the supremacy of their heads and the root of their limiting self-consciousness, so that they can access an instinctive way of relating to others. Perhaps most importantly, it is a fun and enjoyable process; as many shy clients have a tendency to overseriousness, this enables them to connect with the joy of expressing themselves. Working through myth, improvisation, dramatic distance and the Breakthrough Process enables them to address the multifaceted issues of shyness, working on many levels to liberate themselves from the internal blockages, habits and trauma that have kept them in perpetual adrenaline flight/freeze mode. For me, breaking down the walls of shyness through the transformational power of drama, over time, has enabled me to live a life that would not have been possible otherwise. It is my greatest pleasure to pass this on to other shy people and see them stretch their wings too, like Pegasus, breaking free of the contraction that keeps them under Medusa’s spell, and over time to take flight into their deepest and fullest potential.

Notes 1 I distinguish here between what is commonly labelled shyness or social anxiety (the experience of feeling anxious or inhibited in social situations) and social phobia, also known as social anxiety disorder, which is a mental-health condition. 2 The results that clients achieve depend on the degree to which they are hampered by shyness, and some achieve a remarkable shift after a relatively short engagement with the process, i.e. a 1-day workshop. Others may need to participate in a series of groups before they reach this level. 3 ‘Meanwhile in the USA, the National Institute for Mental Health (2005) estimates that around 3.7 per cent of the population aged 18–54 (or 10.1 million Americans) have received a diagnosis of the disorder in the past year. This incidence rate of one in 27 is higher than the prevalence rate of one in 51 (or 1.95 per cent of the population), which suggests that there may have been a sudden increase in the rates of diagnosis in recent years. These statistics are based on the rates of officially recorded diagnoses of SP as it is defined in the DSM-IV’ (Scott 2006, p. 133). 303

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4 Shyness and introversion are not the same thing: although introverts are internally oriented, they do not fear social interaction as shy people do. However, in my view, many introverts become shy as a result of being perceived as not conforming to the extravert expectation that is becoming more and more prevalent in our society. 5 Shyness can be perceived as charming and appealing, making the individual more approachable/ attractive to others. In previous eras, shyness was considered a ‘virtue’ and a quality that was held in high esteem. 6 The Embodiment–Projection–Role developmental stage of childhood means that all humans have the ability to imagine themselves as another, even if they never role-played as children. It is an ability that is innate in every human being (Jennings 1990). 7 Often, clients discover that they have set themselves such low expectations that, previously, they have not dared to commit themselves to anything. 8 The physicalisation of such a metaphor carries extra-powerful messages to the unconscious, particularly auditory and sensory messages. The loud clatter and physical disarray of chairs create a physical memory of the group’s release from shyness, bringing a shock factor to their shared unconscious. This provides positive triggers to dissolve old memories of shame, ridicule, exposure, etc. and replaces them with new memories – the memory of their experiences in the Breakthrough Group. 9 Many shy clients present with a rigid body type, which draws additional attention to their physical awkwardness. This may be owing to prolonged anxiety states or, according to bioenergetics, damage in utero or in early life that has created a rigid movement style. Many are so self-conscious of their physical awkwardness that they are reluctant to move. This is why dramatherapy and movement work is so important, enabling them to release the tension they hold in their bodies, and often I will recommend bodywork to support the work. Hellerwork, deep tissue massage, is my preferred form, leading to lasting change in posture and movement style. 10 Interdependence is a state that American popular psychologist Chuck Spezzano emphasises in his workshops, programmes and books. He asserts that interdependence, together with the recognition that we are interconnected with everyone and everything, opens up to true receiving and what he calls ‘partnership’ in our personal and professional lives (Spezzano 1996). 11 The hero encounters and receives help from other forces that enables them to achieve their quest – these could be gods, goddesses, magical beings, old men and crones encountered on the roadside, fellow humans, animals or birds or the discovery of an ‘instrument of power’ that enables them to achieve superhuman tasks. 12 This may represent expressing their own obstinacy or resistance to change or limited vision of what is possible for them. When shy people are focused on their issue, they are unable to see other options and choices. 13 According to Ovid (Metamorphoses 4.770), once a beautiful woman, Medusa was violated by Poseidon in the temple and was punished by Athena: her beautiful hair became snakes, and she was destined to turn all her suitors into stone. 14 In the myth, Perseus is guided to find the winged sandals of Hermes, so he can fly up above Medusa, and the helmet of Hades, which will render him invisible so that he can escape. Armed with a sword given to him by Hermes and accompanied by Athena, who holds up her shield so he can see Medusa’s reflection, Perseus decapitates Medusa. 15 I suggest to clients that it is often the darker aspects of their experience, which in symbolic language live in the underworld (their pain, shame and rage), that are the keys to their release from shyness. By embodying these (playing darker characters), they are able to claim these hidden aspects and bring them into the light. 16 This structure was taught to me by Anna Chesner as part of the theatre model of dramatherapy. 17 The core premise of playback theatre is to play back the teller’s story in a theatrical form, usually by playback actors. In witnessing their own story, the teller releases and transforms the traumatic memory (Salas 1993). 18 Often, other group members make deeper shifts when they are playing roles in another’s breakthrough. As the focus is not on themself, and they are serving another group member, they can go deeper into a role, often playing it to the hilt in ways they have not been able to do in other sessions. 19 Many shy people see their experiences as weak and shameful, and so to bring these experiences out into the open and to share them with so much compassion and feeling bring about a deep shift in their self-image. 304

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References Buss, A. H. (1986) ‘A theory of shyness’, in Jones, W. H., Cheek, J. M. and Briggs, S. R. (eds), Shyness, pp. 39–46. New York: Springer. Cain, S. (2012) Quiet: The power of introverts in a world that can’t stop talking. London: Penguin. Campbell, J. (2008) The Hero with a Thousand Faces (3rd edn). Novato, CA: New World Library. (Original work published 1949) Crozier, W. R. (ed.) (2002) Shyness: Development, consolidation and change. London: Routledge. Glass, C. R. and Shea, C. A. (1986) ‘Cognitive therapy for shyness and social anxiety’, in Jones, W. H., Cheek, J. M. and Briggs, S. R. (eds), Shyness, pp. 315–27. New York: Springer. Henderson, L. and Zimbardo, P. (1998) Trouble in river city: shame and anger in chronic shyness. Paper presented at the American Psychological Association, 106th National Conference, San Francisco, CA. Henderson, L. and Zimbardo, P. G. (2002) ‘Shyness: An overview of shyness, what is known and how it is treated’, in Friedman, H., Schwarzer, R., Cohen Silver, R., Spiegel, D., Adler, N. E., Parker, R. D. and Peterson, C. (eds), The Encyclopedia of Mental Health (p. 10). San Diego, CA: Academic Press. Jennings S. (1990) Dramatherapy with Families, Groups and Individuals: Waiting in the wings. London: Jessica Kingsley. Jennings, S. (1991) ‘Theatre art: The heart of dramatherapy’, British Association of Dramatherapy Journal, 14, 1, 4–7. Jennings, S. (1992) ‘The nature and scope of dramatherapy: Theatre of healing’, in Cox, M. (ed.), Shakespeare Comes to Broadmoor: The actors are come hither: The performance of tragedy in a secure psychiatric hospital, pp. 229–50. London: Jessica Kingsley. Jennings, S. (2001) Shakespeare’s Theatre of Healing. London: Jessica Kingsley. Jennings, S. (2011) Healthy Attachments and Neuro-Dramatic Play. London: Jessica Kingsley. Johnstone, K. (2007) Impro: Improvisation and the theatre. London: Methuen Drama. (Original work published 1979) Kelly, L. (1982) ‘A rose by any other name is still a rose: A comparative analysis of reticence, communication apprehension, unwillingness to communicate, and shyness’, in Courtright, J. A. (ed.), Human Communication Research, 8, 2, 99–113. Lane, C. (2008) Shyness: How normal behavior became a sickness. New Haven, CT: Yale University Press. Pert, C. (1997) Molecules of Emotion: Why you feel the way you feel. London: Pocket Books (Simon & Shuster). (Pocket edition 1999) Phillips, C. (2006) ‘Taking the plunge’, in Schrader, C. (ed.), Making Moves Newsletter, Spring. London: Making Moves. Online. Available at: www.makingmoves.net/inspiring-stories/building-confidence/ (accessed 7 November 2014). Phillips, S. D. and Bruch, M. A. (1988) ‘Shyness and dysfunction in career development’, in Tracey, T. (ed.), Journal of Counseling Psychology, 35, 2, 159. Washington, DC: American Psychological Association. Rubin, K. H. and Coplan, R. J. (2010) Social Withdrawal and Shyness in Childhood: The development of shyness and social withdrawal, pp. 3–20. New York: Guilford. Rutter, C. C., Cusack, S., Dionisotti, P., Shaw, F., Stevenson, J., Walter, H. and Evans, F. (ed.) (1988) Clamorous Voices: Shakespeare’s women today. New York: Routledge. Salas, J. (1993) Improvising Real Life. Dubuque, IA: Kendall/Hunt Publishing. Schrader, C. (2004) Shyness: The way out (unpublished e-book). London: Making Moves. Schrader, C. (2012) ‘Myth-a-drama: Ritual theatre in personal development’, in Schrader, C. (ed.), Ritual Theatre: The power of dramatic ritual in personal development groups and clinical practice, pp. 94–128. London: Jessica Kingsley. Schrader, C. (2014) The Self-Confidence Myth. London: Making Moves. Online. Available at: www.making moves.net/self-confidence-ebook/ (accessed 7 November 2014). Scott, S. (2006) ‘The medicalisation of shyness: From social misfits to social fitness’, in Williams, G. (ed.), Sociology of Health & Illness, 28, 2, 133–53. Hoboken, NJ: Wiley. Spezzano, C. (1996) The Enlightenment Book. London: Rider. Van Gennep, A. (2010) Rites of Passage. London: Routledge. (Original work published 1960) Weintraub, S. and Mesulam, M. (1983) ‘Developmental learning disabilities of the right hemisphere: Emotional, interpersonal, and cognitive components’, in Rosenberg, R. (ed.), Jama Neurology, 40, 8, 463. Chicago: JAMA. (Formerly Archives of Neurology.)

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30 Dramatherapy and the feminist tradition Susana Pendzik

Introduction: Dramatherapy and the question of origins The way in which a field or school of thought comes into being has a definite impact upon its nature, both by influencing the process of its forging an identity and as a representation of the political and ideological context from which it springs. Ideas do not arise in a vacuum: they originate in a specific context, from a particular ideology. For example, Richard Schechner (1977/2005) challenged the Western notion that claimed that ancient Greek theatre derives from ritual on the grounds that it was a hypothesis (not a proven fact), inspired by the theories of evolution that were popular in the positivistic paradigm of the nineteenth century. Instead, he proposed a horizontal explanation (supported by the egalitarian spirit of the second half of the twentieth century), by which the development of theatre is an occurrence that happens naturally in all cultures, along with six other activities (play, games, sport, ritual, music and dance), which together ‘comprise the public performance activities of humans’ (1977/2005, p. 7). Dramatherapy poses questions regarding its origins: When did it start? How did it come into being? Does it have a founder who represents its inception? Although the field has prehistoric roots in the shamanic tradition (Casson in this volume; Snow 2009; Pendzik and Raviv 2011), in its modern version as a profession, dramatherapy was born out of the social and political milieux of the last decades of the twentieth century and thus carries the philosophical concerns and reflects the aesthetic explorations that occurred at that time. As opposed to David Johnson’s (2009a) statement that, ‘in the beginning there was Moreno’ (p. 5), this chapter maintains that dramatherapy does not have a ‘guru’ or single founder who can claim ‘paternity’ of it. The field’s conception is grounded in quests that proceeded along parallel paths, all of which were connected to the innovative use of theatre, drama, play and the arts, with therapeutic purposes. Like Schechner’s (2005) theory on the development of theatre, the onset of dramatherapy may too be conceived as happening in horizontal fashion. Numerous early pioneers could be mentioned – including Jacob L. Moreno, Vladimir Iljine, Peter Slade, Viola Spolin, Gertrude Schattner and others (Bailey 2006; Jones 2007; Johnson 2009a). However, it is typical of the beginning stages of the professional development of dramatherapy to find several people who suddenly realized that they had been working in analogous ways, each of them ‘inventing the wheel’ so to speak, by combining elements of 306

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theatre and drama with therapeutic purposes. These experiments were often given names akin to dramatherapy – such as theatertherapie or psicoteatro. Speaking of the creative arts therapies, a ‘larger umbrella’ for the development of dramatherapy, Renée Emunah states that they were mainly composed of artists who ‘were intrigued by the personal transformation, clarification, enrichment, or soothing that they experienced while engaged in their art or that they noted in students or clients with whom they were working’ (1997, p. 109). This was probably the case in the UK, most European countries and the USA, and, as far as I know, a similar pattern may be found in parts of Latin America. The diversity and eclecticism that characterized the beginning stages of the field generated intense debates around core dichotomies – such as drama-based versus psychotherapy-based positions, or dramatherapy versus psychodrama (Meldrum 1994). All of these are still playing out to some extent, in what John Casson (1996) calls ‘the archetypal splits’ of our field. To illustrate using the UK as a case in point, he claims that the development of dramatherapy in the UK was not considerably influenced by Moreno, and that this was not only because Peter Slade (one of its early pioneers) had favoured a gentler, less confrontational style; he also maintained that the field evolved ‘due to a whole group of people, most of whom were women: Dorothy Heathcote, Marian Lindkvist, Veronica Sherbourne, Sue Jennings’ (1996, p. 308). I’d like to follow Casson’s (1996) wise advice not to incur in the split of labelling psychodrama the ‘masculine’ and dramatherapy the ‘feminine’ aspects of the practice. Considering dramatherapy as psychodrama’s ‘younger sister’ or its ‘feminine side’ is another way of perpetuating a stereotypical gender split – something that, at best, would be a sterile definition. As feminist writer and philosopher Hélène Cixous argues, ‘the classic opposition, dualist and hierarchical . . . Man/Woman automatically means great/small, superior/inferior . . . means high or low, means Nature/History, means transformation/inertia’ (1981, p. 44). She further claims that this kind of patriarchal binary thinking always leaves the woman in the position of the oppressed. Certainly, one way in which dramatherapy differs from psychodrama is in its development. Psychodrama progressed under the leadership of Moreno: its practice, training, research and writings were mostly centralized around his influential work. Although other people collaborated closely with him (Blatner 2000), Moreno is considered the creator of psychodrama, and those who worked with him are regarded as his disciples more than his colleagues. This is a different route from the one taken by dramatherapy. I suggest we look at dramatherapy in connection with the sociopolitical climate of the 1960s and 1970s. Speaking about the post-war context in Europe and North America, Phil Jones points out that, ‘the evolution of new attitudes towards therapy and theatre . . . created an environment which made it possible for dramatherapy to exist’ (2007, p. 23), and that, ‘the increasing awareness of, and contact between, other cultures and different models of health and drama added to this “new attitude”’ (2007, p. 23). Brenda Meldrum supports this view by maintaining that the inspiration for the establishment of dramatherapy came from the optimism of the times, ‘when it seemed that new ideas and radical approaches . . . would really change society’ (1994, p. 12). Rather than being propelled by the impulse of a single leader, dramatherapy seems to have developed as a movement, concomitant with the political and social effervescence of the time, which included civil rights and anti-war movements, mobilizations for the rights of women, gays and lesbians, ethnic minorities, etc., advocating values such as equality, collective action and self-determination, and calling for a revision of the power structure in all levels of life – including the academia and the prevailing scientific paradigms (Edelman 2001). Much like feminist therapy, which grew without a ‘founding parent’, as a confluence of many people’s experiences (Brown 2008), incorporating persons from different academic backgrounds and populated by 307

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conflicting concepts (Enns 2004), dramatherapy did not evolve as a monolithic discipline, but was established as an encounter between fields, between people, between ideas, in the tradition of pluralism and dialogue, in a way that can be defined a feminist mode.

Dramatherapy and gender In spite of the sociopolitical context of its inception, most dramatherapists did not align naturally with feminist therapy; for that matter (for all its good intentions!), the field did not even take up ‘gender’ as one of its theoretical concerns. As Curtis (2013a) points out, this has been the case with all the creative-arts therapies: ‘While earlier inroads have been made in such disciplines as psychology and social work . . . in the various creative arts therapies . . . an examination of gender is greatly needed’ (Curtis 2013b, p. 371). Several reasons may have contributed to this fact, among others, ‘a concern for the negative connotations associated with the term “feminism”’ and the belief that therapeutic work is not political (Curtis 2013b, p. 371). Furthermore, as Hadley and Edwards (2004) suggest in connection with music therapy, even the presence of a majority of women in the profession may account for the attitude of gender blindness. Although these theoretical gaps are gradually being filled, it certainly took until 2013 for The Arts in Psychotherapy to devote a special issue to ‘gender and the creative arts therapies’ (Curtis 2013a). Paradigmatically of the feminist fashion, I’d like to contradict what I said in the previous paragraph by also pointing out that, throughout the years, some scholars have noted the womenoriented nature of dramatherapy and emphasized its connection with the feminist tradition, notably, Sue Jennings (1987, 1994, 1996, 1998, 2009), Ditty Dokter (1994a, 1994b, 1998a, 1998b), Nisha Sajnani (2012a, 2012b, 2013) and myself (Pendzik 1988, 1997, 1999; Pendzik and Sotomayor 1991). Jennings was among the first editors to devote an entire section in one of her books to ‘gender issues in supervision and practice’ (1997); Dokter highlighted the gender and cultural contexts of her approach to eating disorders, claiming ‘that this disease is seen as a modern social dis-ease of society, especially of the female half’ (1994a, p. 7); she also provided ample space for the consideration of race and gender in dramatherapy practice (1998a, 1998b). I have written extensively on violence against women (Pendzik 1997, 1999), emphasizing that the use of dramatherapy and action techniques may be an antidote to the ‘learned helplessness’ that women are trained to play out. More recently, Sajnani (2012a, 2013) has focused on the conceptualization of the connections between feminist theory and dramatherapy, arguing that these have not been discussed properly and, furthermore, calling for a ‘critical race feminist paradigm’ (2012a, p. 187). A fine example of a feminist attitude in dramatherapy can be observed in Jennings’ brilliant critique of long-term psychoanalytically oriented psychotherapy, where she argues that, in this approach, ‘an artificial “theatre of therapy” is created between two people whose unequal roles are therapist and patient, in ritualized time and space’ (1996, p. 202). Speaking about her work in a fertility clinic, Jennings states: I am struck by the similarities in this psychoanalytic dynamics with the relationships that are created between members of the medical profession and people who unfortunately have to seek assistance with problems of infertility. Again an artificial, intense relationship is created between a woman (almost always) and a doctor (usually male) which frequently makes major demands on finance, and puts great stress on family and couple relationships. This relationship is also highly dependent, with the ‘patient’ often regressing into being ‘the good child’ in order for the doctor/father or clinical spouse . . . to overcome the lack of fertility or potential for impregnation. Since the waiting time for fertility treatment is 308

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protracted, unless one is in the private sector, people can often be living under stress for two to three years after preliminary outpatient investigation. (1996, p. 203) This paragraph illustrates Jennings’ position regarding some of the main topics championed by feminist theory and therapy: (a) readiness to engage with gender issues – in this case, pregnancy and infertility; (b) giving attention to context, by referring to the treatment’s impact on the family and discussing its financial aspects; (c) keeping an eye on the power structure of the therapeutic relationship; and (d) flexibilizing the personal and the public. Sajnani summarizes the basic tenets of feminist therapy using similar parameters. She speaks about encouraging response/ability in our practice as ‘the ability to respond amidst suffering and against oppression’ (2012a, p. 189). In her view, the necessary ingredients for engaging in this process exist in dramatherapy. I would argue that, although the ‘ability’ exists, the ‘response’ remains to be cultivated: Dramatherapy possesses indeed the fundamental ability to realize the feminist vision, and, as Sajnani (2012a) rightly suggests, to an extent, some practitioners are precisely doing this. She credits Johnson’s (2009b) Developmental Transformations (DvTs) with subverting ‘rigid expressions of identity’ and allowing relational play; she recognizes Christine Mayor’s (2012) critical extension of DvTs that permits one to ‘play with race’, and Fred Landers’ (2011) use of public play as a form of social activism that challenges the constraints of neoliberalism. She acknowledges Armand Volkas’s (2009) attempts ‘to deconstruct national identities’ and Renée Emunah and Emilie Burkes-Nossiter’s Theatre for Change, a project that explores the ways in which the social and political context shapes lived experiences (Sajnani 2012a, p. 190). To these acknowledgements, I would also add two of the main related techniques currently in use by dramatherapists: Playback Theatre (PT) and Theatre of the Oppressed (TO). Although each works in its own way, both of them stretch the usual boundaries of theatrical performance, flexibilize the roles of performers and audiences, address and challenge oppression (TO) or play with the margins between the public and the private (PT). In short, all of these can be seen as paradigmatic of feminist thinking. Like Molière’s Mr Jourdain, who did not realize he was ‘speaking in prose’, is it possible that many dramatherapists are doing feminist work without knowing it?

Signs of feminist practice: The role of the dramatherapist and the place of the body Besides its origins, the theoretical diversity and the eclectic qualities that characterize the field, there are at least two distinct ways in which dramatherapy successfully effectuates feminist core ideas and values. These are connected to the therapist’s role and the place of the body. Feminist therapy calls for psychotherapists to engage in power-sharing practices, in which power differentials between therapist and client are minimized, control is shared and knowledge is not used in an oppressive way (Worell and Remer 2003; Rader and Gilbert 2005; Brown 2008). According to Sajnani, ‘feminist critiques of psychotherapy have questioned and called for a re-articulation of the roles of the therapist and the client towards an increasingly relational ethic based on values such as cultural responsiveness, transparency, mutuality, and accountability’ (2012b). In this regard, Laura Brown stresses that feminist therapists do not subscribe to specific intervention strategies: ‘A therapist may sit quietly with one client and be very active and coaching with another’ (2008, p. 291). Strategies are tailor-made to fit the client’s needs, and they may include the use of self-disclosure by the therapist – which has been embraced by the feminist paradigm as a valuable aspect of the therapeutic relationship since its onset (Brown and Walker, 1990). 309

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The therapist’s role in psychotherapy has been the subject of much questioning and criticism in recent decades. The classical model of the ‘blank screen neutrality’, in which the psychoanalyst is supposed to be ‘positioned outside the patient’s subjectivity and the therapeutic relationship’ (Larner 2000, p. 66), has been challenged by numerous schools, such as the narrative, the humanistic and even contemporary psychoanalysis. Practitioners have called for the establishment of ‘a relationship of openness, presence, directness, immediacy, and mutuality’ (Friedman 2001, p. 344), thus shifting the boundaries of the therapeutic alliance, and re/constructing it as more collaborative and dialogical. In spite of these changes, and as highly involved in the relationship and in the process as s/he may be, the psychotherapist is generally seen in the role of an empathic witness who is skilled in verbal mirroring, a non-judgemental companion/guide/container of the client’s process, and the maintainer of the therapeutic setting. Although the multiplicity of symbolic roles embodied by the therapist are acknowledged (and often encouraged) via the transference phenomenon, as pointed out above, because the client is not necessarily aware of it, the role-play aspect of transference is not effectively based on mutuality – which raises questions of transparency and power. Furthermore, for the most part, the therapist’s participation in the session does not include active interactions such physical play or scene improvisation, and thus the roles embodied in transference are not fully embodied. In short, the amount and the quality of participation and self-disclosing by the therapist are – at best – very limited in most psychotherapy approaches. This is true even in psychodrama, where the therapist is defined as the ‘director’ of the session – albeit one who must be ‘able to model the spontaneity she wishes to elicit and to find ways of showing the group what can be done’ (Leveton 2001, p. 2), but is clearly maintaining the position of directing the action rather than taking part in it. In contrast, dramatherapists may position themselves along a variety of roles that can be openly and honestly played out: Therapeutic interventions can be made from any of them, allowing them to shape their participation in dramatic reality in accordance with the person or group they are working with and their needs (Pendzik 2008; Emunah 2009). Dramatherapists can take on the role of audience, directors and actors – both by playing co-actors (as in DvT) and in the sense of acting for their client (as in Playback Theatre or dramatic resonances); in addition to these, any other roles involved in theatre production – backstage crew, assistant director, etc. – are also available to them. Johnson mentions some of the possible roles that the dramatherapist can take, including witness or mirror, director, sidecoach, leader, guide and shaman, emphasizing that, ‘in fact, learning to be a dramatherapist involves practice in moving smoothly along this continuum, depending upon the clinical need’ (1992, p. 113). Although transferential roles may also appear (and they do) in the dramatherapeutic context, they may be genuinely ‘downloaded’ into dramatic reality, which provides a concrete arena where these can be expressed and fully experienced. Feminist discourse considers the human body a site where political struggle is expressed (Sajnani 2013). Although a ubiquitous presence, part and parcel of human experience, the re/pression of the body in Western tradition or its transformation into an object of study has produced as a result a disembodied lineage of therapeutic approaches, where bodies are, at best, ignored and, at worst, oppressed. In their critiques of psychoanalysis, Cixous reminds us that, ‘silence is the mark of hysteria’, and that hysterical symptoms are a ‘body that talks’ (1981, p. 49), and Luce Irigaray (1985) calls our attention to the fact that female sexuality in psychoanalysis has been construed using masculine parameters. Julia Kristeva (1992) further illuminates the centrality of the body in her distinction between the ‘semiotic’ and the ‘symbolic’. She maintains that the semiotic (associated with the preverbal, pre-Oedipal, maternal and material body) is the site of movement, rhythms and tones – and is the order of maternal regulation experienced by all human beings during pregnancy and early infancy. Drawing on Plato’s notion of the chora (both 310

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receptacle and nurse of creation), Kristeva describes the semiotic chora as a psychic space, the ‘wetnurse of becoming’ that is able to ‘generate the energy that fuels the signifying process’ (McAfee 2004, p. 19). The symbolic order, on the other hand, is the order of verbal signification, is acquired along with language and its grammatical laws, and is governed by paternal law. According to Kristeva, in spite of the privileged place that the symbolic order has been given in Western culture and patriarchal thought, all signification is composed of these two elements. The semiotic is a precondition of the symbolic; it constitutes the basis of all subjectivity and is always at work: In spoken discourse, it is perceived as a disruption of the thetic enunciation of language, which usually appears in the form of babbling, repetition or utterance of unintelligible sounds; in artistic practices, it is often experienced as an irruption (or a revelation) of a subjacent layer of signification. In her own critique of feminism, Kristeva vindicates the maternal body, asserting that, ‘real female innovation (in whatever field) will only come about when maternity, female creation and the link between them are better understood’ (1992, p. 298). In spite of their genuine attempts to bring the body to the centre stage by focusing on gender as a core parameter, contextualizing it as political and giving it a space in their discourse, with the exception of some forms of somatic/body-oriented approaches, the presence of the body in the feminist therapy room is, for the most, part still bound to the verbal realm. The task falls to dramatherapy (as also to psychodrama, dance-movement therapy and, to some extent, other arts therapies) of literally ‘putting the body’ in the centre stage (Moreno, 1987; Dokter 1994a; Jennings 1995, 2011; Casson 2004; Jones 2007; Allegranti 2013; Hogan 2013). Dramatherapy is practically inconceivable without the body. Briefly stated, here are two examples: In a special issue of The Prompt celebrating Sue Jennings’ contribution to dramatherapy, Dokter (2012) emphasizes the immense relevance of the body in Jennings’ work; among other areas, she mentions the concept of ‘embodiment’ as the basis of dramatic play development, its role in early attachment, the psychosomatic aspects of dramatherapeutic work for both client and therapist, and the place of the body in cultural context. Johnson (2009b) also speaks about Body as energetic presence and body (uncapitalized) as the physical body, highlighting it as a cardinal notion in DvTs, where the physical presence of both therapist and client is paramount.

Dramatic Resonances Dramatic Resonances is a dramatherapy approach that uses the transformative power of dramatic reality to further interpersonal communication through art mediation, cultivate synchronized co-creation, foster self-reflection and mindfulness, and nurture our ability for collective thinking. Mostly used in group settings, the method focuses on the creative responses that participants offer from within dramatic reality to an input posed by one of the members or by the dramatherapist. The input may be a personal experience (memory, dream, etc.) or a non-personal narrative (play, story, text); the resonances are a succession of images evoked by the input that attempt to deconstruct it by offering multiple possibilities of meaning. Shaped by aesthetic pulses, the approach has a ritual style that integrates elements from various sources – including the shamanic tradition, Playback Theatre, meditative practices, feminist spirituality and deconstruction theory. As a full-scale technique, it can be used in performance – which requires an ensemble of trained participants (Pendzik 2008). However, as an approach, its basic principles can be applied both in individual and in work group (here, I will focus on the latter). My purpose in presenting Dramatic Resonances in this chapter is that they ‘resonate’ with feminist dramatherapy. Dramatic Resonances can be best illustrated with an image: The input is a stone thrown in a calm lake; the resonances are the ripples created by this act. In order for this to happen, the group has to be receptive and alert – like the lake. This is aided by the practice of inner focusing, 311

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mindfulness and active-listening techniques. The responses that comprise the next stage need to be distinguished from spontaneous impulses or free associations: Contrary to the instant quality of Playback Theatre, the associative flow of play in DvT or the massive ‘production of subjectivity’ of ‘dramatic multiplication (Kesselman and Pavlovsky 2006), Dramatic Resonances take the input inside, as it were, to the artists’ laboratory – a womb of sorts – where the creative responses can germinate and develop. Depending on the context, this can take several minutes or a few weeks. As a first response, I encourage a close mirroring of the input (for instance, a playback short form or an image theatre technique). The mirror resonance attempts to grasp the message put forth by the input-giver by staying close to the text – a theatrical way of saying ‘this is what we’ve heard you say’. This reflection is crucial, for it provides the input-giver with a sense of recognition and empathy. After a short verbal processing with the input-giver, the input is ‘handed over to the collective’: The group divides into smaller groups – each weaving a different resonance. Participants choose their working group according to the resonance that ‘vibrates’ more with them; people may also choose to work on a resonance individually. The input-giver may join one of the groups, or a creative task may be suggested to her/him (such as reflective writing, drawing, etc.). Figure 30.1 shows a list of ‘ripples’ with some of the most common resonances, and Table 30.1 provides the readers with explanations of the basic traits of each resonance. Just like the ripples in a lake, the resonances tend to spread out at some ‘aesthetic distance’ from the original input – usually, not as symmetrically as it appears on the diagram.

Universalizing

Personalizing Expanding

Colouring

Mirroring

INPUT

Point of view

Framing Quoting

Figure 30.1 Dramatic Resonances 312

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Table 30.1 Dramatic Resonances summary Mirroring: Close to the text; a relatively faithful representation of the input Colouring: Highlighting the emotional tone of the input Point of view: Playing with focus; illuminating non-dominant or unusual perspectives Expanding: Extending the narrative (before or after): scenes that could have taken place Framing: Enclosing the input within a larger Gestalt (zoom-out, story within a story) Personalizing: Presenting analogous personal experiences in an aesthetic form Quoting: Intertextuality, parallel creations (songs, poems) that allude to similar themes Universalizing: Connecting with the archetypal (mythology, Big Story, natural phenomena)

The next phase is the performance. After an accorded time frame, the working groups join the circle, and a ‘stage is open’ to present the resonances. These are usually performed in a ritual fashion, ‘keeping the atmosphere of a sacred time and space, and with an eye on the aesthetics’ (Pendzik 2008, p. 218). The resonances are conceived as aesthetic pulses of a single creative effort: they are performed sequentially, the group’s collective intuition deciding which resonances are suitable to begin, follow and end the piece. If the group is familiar with the form, spontaneous resonances may be added, if members feel inspired to do so. When the pulses finish, ‘the stage is closed’. The session ends with some verbal processing and closure. The Dramatic Resonances approach shares some of the coincidences found between dramatherapy and feminist practices: It embraces the idea that dramatic reality can be a transformative vessel that holds the key to the processes of healing, growth and change. Like Kristeva’s chora, dramatic reality is perceived as embodying both a space and a transformative energy. Though the input may be verbal, the interventions always take place in dramatic reality, which means that the approach relies on ‘putting the body’ at centre stage. The dramatherapist’s role is flexible: on one hand, s/he keeps the setting and is the master of ceremonies; on the other, s/he may jump on to the stage to offer a resonance, whenever appropriate. The approach establishes a respectful dialogue between the personal and the public. The ‘handing over of the input to the collective’ helps to deconstruct it by offering multiple angles of interpretation, while exposing, at the same time, the meaning-making mechanism of interpretation. Multiplicity has a strong hold both in feminist tradition and in dramatherapy development. Dramatic resonances allow for the emergence of an eclectic, intersubjective narrative, in which ambiguity, repetition and other emanations of the semiotic order become manifest. However deconstructed, the input is not abandoned at the level of interpretation, but is regenerated as an art form, interweaved by the manifold hands of the group.

Concluding remarks Like feminist therapy, dramatherapy has something intrinsically subversive: It challenges (and sometimes even threatens) the established customs of traditional psychotherapy. Perhaps, as Jennings pointed out many years ago, this has to do with the projections that the field draws upon itself owing to the Dionysian aspects associated with it: I would suggest that anthropologists and psychoanalysts generally have been guilty of what I term ‘the Dionysian error’. They perceive the emotional aspects of dramatic ritual and early theatre, the arousal of archetypal images and the stimulation of uncontrollable feelings 313

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through powerful representations associated with destructive femaleness. It then follows that such expression need to be interpreted and verbally controlled by the power of reason and logic within the classical intellectual framework. (1987, p. 10) I think that Sue Jennings’ resonances from the Bacchae, which bring together rebellious women, madness and drama, are a good note on which to end this chapter.

References Allegranti, B. (2013) ‘The politics of becoming bodies: Sex, gender and intersubjectivity in motion’, The Arts in Psychotherapy, 40, 394–403. Bailey, S. (2006) ‘Ancient and modern roots of drama therapy’, in Brooke, S. L. (ed.), Creative Arts Therapies Manual, pp. 214–22. Springfield, IL: Charles C. Thomas. Blatner, A. (2000) Foundations of Psychodrama: History, theory and practice (4th edn). New York: Springer. Brown, L. (2008) ‘Feminist therapy’, in Lebow, J. (ed.), Twenty-first Century Psychotherapies: Contemporary approaches to theory and practice, pp. 277–306. Hoboken, NJ: John Wiley. Brown, L. and Walker, L. (1990) ‘Feminist therapy perspectives on self-disclosure’, in Stricker, G. and Fisher, M. (ed.), Self-disclosure in the Therapeutic Relationship, pp. 135–54. New York: Springer Science + Business Media. Casson, J. (1996) ‘Archetypal splitting: Drama therapy and psychodrama’, The Arts in Psychotherapy, 23, 4, 307–9. Casson, J. (2004) Drama, Psychotherapy and Psychosis: Dramatherapy and psychodrama with people who hear voices. Hove/New York: Brunner-Routledge. Cixous, H. (1981) ‘Castration or decapitation?’ (trans. A. Kuhn), Signs, 7, 1, 44–55. Online. Available at: http://links.jstor.org/sici?sici=00979740%28198123%297%3Al%3C41%3ACOD%3E2.0.CO%3B2-N (accessed 12 February 2016). Curtis, S. (2013a) ‘Sorry it has taken so long: Continuing feminist dialogues in music therapy’, Voices: A World Forum for Music Therapy, 13,1. Online. Available at: https://normt.uib.no/index.php/voices/ article/view/688/572 (accessed 12 February 2016). Curtis, S. (ed.) (2013b) ‘Special issue on gender and the creative arts therapies’, The Arts in Psychotherapy, 40, 4, 371–448. Dokter, D. (ed.) (1994a) Arts Therapies and Clients With Eating Disorders. London: Jessica Kingsley. Dokter, D. (1994b) ‘Fragile board – Arts therapies and clients with eating disorders’, in Dokter, D. (ed.), Arts Therapies and Clients With Eating Disorders, pp. 7–22. London: Jessica Kingsley. Dokter, D. (ed.) (1998a) Arts Therapists, Refugees and Migrants: Reaching across borders. London: Jessica Kingsley. Dokter, D. (1998b) ‘Being a migrant, working with migrants: Issues of identity and embodiment’, In Dokter, D. (ed.), Arts Therapists, Refugees and Migrants: Reaching across borders, pp. 145–54. London: Jessica Kingsley. Dokter, D. (2012) ‘The dramatic body or stay with the chaos and the meaning may emerge’, The Prompt: Festschrift – Celebrating Dr Sue Jennings, 32–35. Edelman, M. (2001) ‘Social movements: Changing paradigms and forms of politics’, Annual Review of Anthropology, 30, 285–317. Online. Available at: www.jstor.org/stable/3069218 (accessed 12 February 2016). Emunah, R. (1997) ‘Drama therapy and psychodrama: An integrated model’, International Journal of Action Methods, 50, 3, 108–34. Emunah, R. (2009) ‘The integrative five phase model of drama therapy’, in Johnson, D. and Emunah, R. (eds), Current Approaches in Drama Therapy, pp. 37–64. Springfield, IL: Charles C. Thomas. Enns, Z. E. (2004) Feminist Theories and Feminist Psychotherapies: Origins, themes, and diversity (2nd edn). Binghamton, NY: Hawthorne Press. Friedman, M. (2001) ‘Expanding the boundaries of theory’, in Schneider, K., Bugental, J. and Fraser Pierson, J. (eds), The Handbook of Humanistic Psychology: Leading edges in theory, research and practice, pp. 343–8. Thousand Oaks, CA: Sage. Hadley, S. and Edwards, J. (2004) ‘Sorry for the silence: A contribution from feminist theory to the discourse(s) within music therapy’, Voices: A World Forum for Music Therapy, 4, 2. Online. Available at: https://normt.uib.no/index.php/voices/article/view/177/136 (accessed 12 February 2016). 314

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Hogan, S. (2013) ‘Your body is a battleground: Art therapy with women’, The Arts in Psychotherapy, 40, 415–19. Irigaray, L. (1985) This Sex Which Is Not One. New York: Cornell University Press. Jennings, S. (1987) ‘Dramatherapy and groups’, in Jennings, S. (ed.), Dramatherapy: Theory and practice for teachers and clinicians, pp. 1–18. London: Routledge. Jennings, S. (1994) ‘A dramatherapy case history: An anorectic response to an incomplete “rite-of-passage”’, in Dokter, D. (ed.), Arts Therapies and Clients With Eating Disorders, pp. 91–104. London: Jessica Kingsley. Jennings, S. (1995) ‘Dramatherapy for survival’, in Jennings, S. (ed.), Dramatherapy With Children and Adolescents, pp. 90–106. London/New York: Routledge. Jennings, S. (1996) ‘Brief dramatherapy: The healing power of the dramatized here and now’, in Gersie, A. (ed.), Dramatic Approaches to Brief Therapy, pp. 201–15. London: Jessica Kingsley. Jennings, S. (ed.) (1997) Dramatherapy: Theory and practice (vol. 3). London/New York: Routledge. Jennings, S. (1998) Introduction to Dramatherapy: Theatre and healing – Ariadne’s ball of thread. London: Jessica Kingsley. Jennings, S. (ed.) (2009) ‘Prologue – “Escape unto myself: Personal experience and public performance”’, in Dramatherapy and Social Theatre: Necessary dialogues, pp. 1–11. London: Routledge. Jennings, S. (2011) Healthy Attachments and Neuro-Dramatic Play. London/Philadelphia, PA: Jessica Kingsley. Johnson, D. (1992) ‘The dramatherapist “in role”’, in Jennings, S. (ed.), Dramatherapy Theory and Practice (vol. 2), pp. 112–36. London: Routledge. Johnson, D. (2009a) ‘The history and development of the field of drama therapy in North America’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy, pp. 5–15. Springfield, IL: Charles C. Thomas. Johnson, D. (2009b) ‘Developmental transformations: Towards the body as presence’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy, pp. 89–116. Springfield, IL: Charles C Thomas. Jones, P. (2007) Drama as Therapy: Theory, practice and research. London: Routledge. Kesselman, H. and Pavlovsky, E. (2006). La multiplicación dramática (rev. edn). Buenos Aires: Atuel. Kristeva, J. (1992) The Kristeva Reader (ed. T. Moi). Oxford, UK: Blackwell. Landers, F. (2011) ‘Urban play: Imaginatively responsible behavior as an alternative to neoliberalism’, The Arts in Psychotherapy, 29, 3, 201–5. Larner, G. (2000) ‘Towards a common ground in psychoanalysis and family therapy: On knowing not to know’, Journal of Family Therapy, 22, 61–82. Leveton, E. (2001) A Clinician’s Guide to Psychodrama (3rd edn). New York: Springer. McAfee, N. (2004) Julia Kristeva. New York/London: Routledge. Mayor, C. (2012) ‘Playing with race: A framework and approach for creative arts therapists’, The Arts in Psychotherapy, 39, 214–19. Meldrum, B. (1994) ‘Historical background and overview of dramatherapy’, in Jennings, S., Cattannack, A., Mitchell, S., Chesner, A. and Meldrum, B. (eds), The Handbook of Dramatherapy, pp. 12–27. London: Routledge. Moreno, J. L. (1987) The Essential Moreno: Writings on psychodrama, group method, and spontaneity (ed. J. Fox). New York: Springer. Pendzik, S. (1988) ‘Dramatherapy on abuse: A descent into the underworld’, Dramatherapy, 11, 2, 21–8. Pendzik, S. (1997) ‘Dramatherapy and violence against women’, in Jennings, S. (ed.), Dramatherapy: Theory and practice (vol. 3), pp. 221–33. London: Routledge. Pendzik, S. (1999) Gruppenarbeit mit mißhandelten Frauen. Munich: SPAK Bücher. Pendzik, S. (2008) ‘Dramatic Resonances: A technique of intervention in drama therapy, supervision, and training’, The Arts in Psychotherapy, 35, 217–23. Pendzik, S. and Raviv, A. (2011) ‘Therapeutic clowning and drama therapy: A family resemblance’, The Arts in Psychotherapy, 38, 267–75. Pendzik, S. and Sotomayor, L. (1991) ‘Training battered women’s counsellors: A dramatherapy lab’, Dramatherapy, 13, 2, 15–19. Rader, J. and Gilbert, L. A. (2005) ‘The egalitarian relationship in feminist therapy’, Psychology of Women Quarterly, 29, 4, 427–35. Sajnani, N. (2012a) ‘Response/ability: Imagining a critical race feminist paradigm for the creative arts therapies’, The Arts in Psychotherapy, 39, 3, 186–91. Online. Available at: www.academia.edu/1118473/ Response_Ability_Imagining_a_Critical_Race_Feminist_Paradigm_for_the_Creative_Arts_Therapies (accessed 12 February 2016). 315

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Sajnani, N. (2012b) ‘The implicated witness: Towards a relational aesthetic in dramatherapy’, Dramatherapy, 34, 1, 6–21. Sajnani, N. (2013) ‘The Body Politic: The relevance of an intersectional framework for therapeutic performance research in drama therapy’, The Arts in Psychotherapy, 40, 382–5. Schechner, R. (2005) Performance Theory. London: Routledge. (Original work published 1977) Snow, S. (2009) ‘Ritual/theatre/therapy’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy (2nd edn), pp. 117–44. Springfield, IL: Charles C. Thomas. Volkas, A. (2009) ‘Healing the wounds of history: Drama therapy in collective trauma and intercultural conflict resolution’, in Johnson, D. R. and Emunah, R. (eds), Current Approaches in Drama Therapy, pp. 145–71. Springfield, IL: Charles C. Thomas. Worell, J. and Remer, P. (2003) Feminist Perspectives in Therapy: Empowering diverse women (2nd edn). Hoboken, NJ: John Wiley.

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31 Yogadrama – ‘As if I were a mountain’ Jenelle Mazaris

Introduction Yogadrama is a synthesis of two dynamic practices, hatha yoga and drama therapy. It comprises basic hatha yoga postures and breath exercises combined with drama-therapy theory and practice. Hatha yoga practice is used in adjunct with drama-therapy methods to help people increase their self-awareness, maximize their overall potential and maintain a state of optimum health and well-being. The focus of yogadrama is on increasing the health and awareness of the physical body by practising hatha yoga postures and taking that one step further by exploring the metaphor of the postures themselves dramatically. It is a holistic approach that is practised as a therapeutic intervention in various settings and contexts, such as in personal development classes and workshops, in institutions with groups and individuals, and in trainings with drama therapists and yoga teachers.

Hatha yoga In the West, yoga focuses mostly on hatha yoga, which emphasizes a holistic system of mind–body practices for mental and physical health and includes various techniques, such as meditation, breathing exercises, sustained concentration and physical postures that develop strength and flexibility (Khalsa et al. 2009). The daily practice of hatha yoga has many researched physical and mental benefits and has been found effective in the treatment of anxiety and depression (Harner et al. 2010). Researched physical benefits include a significant increase in muscle strength and endurance, flexibility and cardiorespiratory endurance (Tran et al. 2001). Hatha yoga can be a practical aid or philosophy; it does not need to be practised as a religion or belief system. There are many forms of hatha yoga that vary in sequences of postures and breathing exercises, and classes are mostly taught by way of verbal instruction and modelling, and do not require any hands-on manipulation by the instructor. In the US, yoga instructors are usually certified in a particular hatha yoga method. The discipline of regular hatha yoga practice requires one to learn and identify the physical postures, gain an understanding of how to control breathing and foster an increased sense of physical awareness. Theoretically, and if possible, the yoga postures are practised with an acceptance and mindfulness of what is being felt and experienced in the present moment, physically, emotionally and mentally. 317

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Yoga therapy Yoga therapy is the practice of designing particular yoga exercises to treat a client’s specific psychological and physical health concerns. It has recently become more popular in its use and more accepted (Khalsa et al. 2009). Yoga therapy has many healing benefits, and, according to yoga therapist Lee: After a series of sessions clients often will report finding greater clarity around significant life issues; greater freedom of movement; less tension in their bodies; more finely tuned awareness of their physical, emotional, and mental states; and better connection with their inner spirit for guidance. (1999, p. 208)

Yogadrama A yogadrama therapist, similar to a yoga therapist, understands the benefits of yoga and each posture and how they can be applied therapeutically. In addition, a yogadrama therapist is a trained drama therapist and knows how to apply the therapeutic tools of drama therapy. Each yoga posture holds an array of universal themes and dramatic metaphors that are developed by using drama therapy methods for increased therapeutic benefits. During a yogadrama session, the yoga poses are built into the practice as an integral part of the dramatherapeutic process. Yogadrama’s aim is to support the health of the whole body, mind and spirit, by developing the creativity, spontaneity and physical well-being of the client.

Creative expression and physical expression A traditional hatha yoga class addresses both sides of the body. If you practise a posture using the left leg, you will most likely then move to the right side and practise the same posture. Exploring both sides and mentally observing the differences and similarities of sensation and mobility increase body awareness. It is this exploration of the duality in the body and mind that is highlighted and explored within a session of yogadrama. For example, if a person is rigid in their movements and shy about expressing their creativity, practising the yoga postures and developing physical flexibility may open them up to more creative expression with the support of drama therapy. A Jungian analyst and yoga instructor, Harris, claims that, in her experience, ‘the simultaneous transformation of the body and the psyche is only possible if both sides (of the body) are worked on at the same time’ (2001, p. 19). Similarly, in a yogadrama session, the body and mind are given the space to simultaneously move between physical expression and creative expression. A short example illustrates this point: during an individual session using yogadrama, a woman expressed her struggle with perfectionism and how she felt it was blocking her creative expression. She was able to fully embody the yoga postures physically, but struggled with her attachment to having the perfect alignment and wasn’t able to express herself freely within them. As an intervention, I felt it was important to take her off of her yoga mat, where she had developed such precision and perfectionism, and provide her with a safe and open space with no boundaries or form. She flourished in this space, as she expressed her creativity through spontaneous dance and improvisation exercises. She then returned to the mat to integrate this new awareness within her yoga practice.

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Working thematically Another positive aspect of yogadrama is that it allows for multiple points of observation. Practising the yoga postures lays the groundwork for physical development as a person follows their progression and increased mastery of the yoga postures over time. Additionally, as drama-therapy methods are integrated and applied within the yoga practice, emotional, cognitive and social domains are also developed. Working thematically with postures that are based on ancient archetypal images is an important part of my work and how I use metaphor in working with clients. For example, I have used themes related to physical traits that are needed to perform the yoga postures, such as balance and flexibility, which are then integrated into the drama therapy and applied to the postures. I use these universal themes as self-reflective tools and guidelines for practitioners to determine their own areas of strength and areas that need improvement. During an intensive postgraduate summer training programme for drama therapists in Romania, yogadrama practice was integrated into the curriculum. The participants had no formal theatre training or yoga training and had minimal experience in action-oriented therapies. Therefore, I found it important for the students to increase their overall body awareness. An intervention I used to accomplish this was to start each morning with a different theme and to apply this particular theme to the yoga postures. For example, one morning, the theme was breath, and the participants were taught a traditional yoga breathing exercise. After they had learned the exercise, they were encouraged to choose a scarf and together create an improvised theatre enactment of the ocean, using the breathing exercise as the core of the piece. The students learned how to apply their breathing creatively as actors, as well as experience the benefits of calm and rhythmic breathing. This increased awareness of their breathing also engaged them to think about how they used their breathing in their daily lives, especially as therapists. One Romanian drama-therapy student who had not done yogadrama before commented, ‘I learned that balance, breathing, flexibility, concentration and strength interconnect with each other and that they are not really possible without the others’.

The dramatic mat The practice of hatha yoga itself could be thought of as a dramatic act, starting the moment a person steps on to the yoga mat and begins to practise the postures. The yogadrama client steps on to the stage. The mat provides a designated and safe arena to be actor and witness to oneself and to the others in the room. Once on the mat, in the role of yoga practitioner, the story unfolds. The practitioner is taken on a journey, following the guidance of the yoga instructor acting as director, in either a ritualized sequence of postures or a more improvised flow. The ancient postures and breathing exercises handed down through the ages were mainly modelled on observable elements in nature. Many of the postures take on the shapes of animals, such as eagle, locust, camel, rabbit, cat, cow, and elements such as ocean breath and half-moon, to name a few. In drama therapy, these metaphors become very useful, and the yogadrama therapist can use these to develop and explore these archetypal images. The practice of hatha yoga introduces a person, perhaps unknowingly, to dramatic reality, as one’s body acts as the instrument carrying the metaphor. Jennings refers to dramatic reality: ‘Dramatic reality has that quality of “forgetting” that we experience in dreams, trance or day-to-day absorption, which allows our “other selves” to become manifest’ (1995, p. xxviii). It is this engagement with the yoga postures and daily practice of holding and maintaining them that I believe corresponds to taking on a role in dramatic reality. It is the beginning of manifesting and embodying the qualities of 319

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the postures themselves and a gateway for the practitioner to imagine themselves in role, ‘as if’ I were a mountain, ‘as if’ I were a lion, ‘as if’ I were a tree. Pendzik (2006) defines dramatic reality: It is an as if made real, an island of imagination that becomes apparent in the midst of actual life. Dramatic reality involves a departure from ordinary life into a world that is both actual and hypothetical: it is the establishment of a world within a world. (p. 272) When people practise the yoga postures and breathing exercises, they are transported on their yoga mats into a world of various roles. Yogadrama provides a space for one to step off the mat in a role such as the yoga posture ‘warrior’ and explore those qualities more deeply, creatively and dramatically. During a 10-week yogadrama series that I conducted in Michigan with middle-school children, it was important for them to identify and explore the yoga postures that most impacted them. As we prepared for the culminating performance developed by the group, each child wrote and acted out a story that corresponded to the posture that had meaning for them. The posture served as a catalyst for understanding and development of a deeper need. The children functioned as writers, actors and directors, and this empowerment helped them boost their selfconfidence and be witnessed as valued creators by their parents and community.

Yogadrama and drama-therapy theory Yogadrama uses an eclectic mix of drama-therapy methods, in particular Sue Jennings’ developmental paradigm Embodiment–Projection–Role (EPR), improvisation techniques and theatre performance. As the theory of EPR is a holistic developmental paradigm, it complements the practice of yogadrama’s aims. During a yogadrama session, the embodiment stage is applied, not only as a warm-up, but also as an integral part of the practice. The embodied practice of the postures themselves, coupled with the rhythm of the breathing practised within the safe boundaries of the yoga mat, encapsulates the primary stage of creative development. The projective stage is practised each session through drawing and writing about a particular yoga posture and or theme related to it. The role stage is practised each session, as the yoga posture acts as a metaphorical container for a role to be explored and developed and then performed. Improvisation techniques and theatre performance enrich the practice further. The creative improvisations and short dramatizations each week allow for the participants to explore and be open in their self-expression, whereas, within the practice of yoga postures, there can be a more rigid frame emphasizing form and alignment. Similar to the practice of the yoga postures, improvisation techniques are also skills to be nurtured and developed. The theatre processes of creating, writing, acting in and directing a show are also an integral part of the yogadrama process if the participants choose to have a culminating show. A yogadrama group therapy session usually begins with a general check-in and then a brainstorming activity based on the week’s theme. A theme in yogadrama is an archetypal image or universal truth that emerges or can be extrapolated from the posture. The week’s theme acts as a frame for the session and is woven into every activity. For example, if balance is the week’s theme, the participants may think of words such as balance beam, scales, time, etc. The words and images elicited from the brainstorming activity are usually followed by a short-form playback theatre technique, such as fluid sculptures (Fox 2007, p. 7). The playback exercises 320

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are the first introduction to the embodiment phase of EPR. For example, during a fluid sculpt for the theme balance, the word ‘scales’ would be called out by the facilitator, and the participants would create a sculpt embodying the word ‘scales’, using various sounds and movements. This is usually followed by more drama exercises that pertain to balance, such as balancing a peacock feather on your finger, walking blindfolded through a small space with obstacles or improvising scenes about balance. After this initial warm-up and creative exploration, the session then moves into a regularly practised series of yoga postures, such as sun-salutations I and II. In addition, we focus on particular postures for that session depending on the theme, such as the tree posture for balance. After practising the tree posture, we would then move into the more projective phase of EPR and create poetry, write monologues, draw, paint and/or create masks or puppets about the tree posture or the universal theme of balance. Each session usually culminates with the participants entering into the role phase of EPR and creating short dramatizations incorporating the yoga posture, such as the tree posture, and their newfound knowledge or insight gained from the projective exercises about balance and/or the tree. Each session closes with a relaxation and breathing exercise, such as the traditional yoga posture corpse pose, or with participants sitting back to back listening to a guided imagery. This closure gives the participants time to integrate the experience.

10-week yogadrama group for personal development This section describes a 10-week yogadrama programme that was applied to a group of preadolescent girls with the overall goal of personal development. The girls met twice a week for an hour and a half each session. Six girls participated, all between the ages of 11 and 12. The yogadrama programme culminated in a theatre performance based on what the girls created during improvisations, projective exercises, role-plays and yoga postures they learned during the sessions. The fundamental goal of the programme was to teach an introduction to the practice of hatha yoga postures and breathing exercises and to actively explore a universal theme each week using drama-therapy methods. Other goals were to create a space where the girls felt comfortable to express themselves freely and safe enough to take risks physically and emotionally, with the hopes of therefore increasing overall self-confidence, body awareness and relationships within a group context.

Space We converted an empty, 250-square-foot studio into our yogadrama space. It was decorated with the participants’ various works of art as the sessions progressed. The space was divided into three areas: the theatre area, yoga practice area and art area. For the final theatre performance, we fixed theatre lights and hung curtains from the ceiling to create a stage.

Music In the first meeting, the girls were asked to write a list of their favourite songs, and, based on their requests, playlists were created with the music they each chose to listen to while they practised the yoga postures. The aim was for them to choose the music they liked to listen to and for this to be another gateway for them to express themselves. This also was a way for me to step into and get a glimpse of what was popular and socially acceptable for them. Sharing the music that interested them was a useful way for them to get to know each other. They 321

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submitted an eclectic mix of pop music, country music and hip-hop. It is not necessary to practise yoga with music, but, for this age group, I thought of it as an opportunity to help them feel more comfortable by offering something familiar.

Theme Each week, a universal theme was introduced, and the drama-therapy methods and yoga postures were based on this particular idea. The aim of the theme each week was to bring a more universal awareness to a particular aspect of body and psyche and how they related. In this particular series, I chose themes related to physical states, such as balance, strength and flexibility. I chose these particular themes to be used as learning tools. None of the participants had taken a yoga class prior to the group, but some of them had previous drama training and had performed in plays. A few of them had previous gymnastics training or dance training and were more bodyoriented. The nature of yogadrama, with the integration of drama and yoga, allowed each participant to showcase an area of personal strength. It was important to emphasize during the sessions that, generally, people differ in their flexibility and balance, and that these are all areas that can be improved with continued practice. The postures acted as a mirror for them to look at their lives and identify areas that needed development. For example, it may take flexibility to hold a yoga posture such as half-moon, but what else in your life requires that kind of flexibility?

Warm-up We started each class with a warm-up and an introduction to the week’s theme in the theatre area. The girls were each given a piece of paper and asked to brainstorm whatever initial images or words came up about the week’s theme and write or draw them on the paper. Afterwards, they each shared their ideas with the group and moved into dramatizing the themes with the playback theatre technique of fluid sculptures (Fox 2007, p. 7). After this initial warm-up, a series of drama games that had some relationship with the week’s theme were performed. For example, if the week’s theme were flexibility, a candle would be passed around as an object, and the group would have to transform it into something else, such as a phone, a microphone, a showerhead, etc. Another useful exercise would be to play the improvisation game – yes . . . let’s . . . – and practise being flexible with everyone’s offers. For example, during one session, the theme was concentration, and the girls performed an improvisation exercise called ‘rant’, which requires concentration to perform. They lined up and, as part of the exercise, interrupted each other as they shared moments of when they had difficulty concentrating: ‘when I am interrupted by my younger brother, by my cat sitting on my keyboard, by the annoying tapping of my friend’s pencil in class, or from my father yelling to my mother from another room’. This exercise gave them the opportunity to bring alive the theme and relate it to the context of their lives.

Hatha yoga postures After these initial warm-ups to the theme, the girls would change the space and meet on the other side of the room for the yoga warm-ups. The girls either brought their own yoga mat from home or chose one from the mat pile. A variety of mats with different colours, textures and images on them were available. They placed their mats side by side in a line and were instructed verbally and by my modelling in a basic yoga sequence of sun-salutations. We did this at least five times, and eventually they reached a point where they were able to practise the 322

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sequence alone and sometimes with the help of one of the girls leading the verbal instructions. This constant sequence of postures allowed them to physically experience their own progress throughout the weeks. For example, one of the girls was not able to do a push-up at the beginning but, a few weeks later, had built up enough overall strength to be able to do one. After practising the initial sequence of yoga postures, a new yoga posture complementing the week’s theme was introduced. After they had been taught the posture, they were invited to practise the posture and verbalize aspects of the theme while practising. For example, if the theme was concentration, they would practise the posture eagle, which requires a great deal of concentration, and, while in the posture, share what it takes for them to concentrate in that moment: looking at one spot, clearing their mind of distracting thoughts, slowing their breathing, etc.

Writing and drawing about the theme or posture After learning and practising the new posture, the participants moved to the art space. This transition gave them an opportunity to physically rest and to move into more creative and artistic projective exercises. For example, for the theme of balance, they created casts of their hands out of plaster and decorated them. These casts were transformed into puppets and later incorporated into their final theatre performance. The hands, especially in hatha yoga, symbolize an important tool for balancing. Another week’s theme was strength, and the girls created shields that symbolized their personal strengths. These shields were also incorporated into the final performance as props for their role of the yoga posture warrior.

The posture as a role Either during the same session or the following session, the girls would return to their yoga mats and, after a short warm-up sequence, revisit the posture related to the week’s theme. During this phase of the practice, the girls began to explore the posture as a role and, for example, while practising the yoga posture half-moon, create or recite a monologue that they had created in the previous projective phase of the session. This is an illustration of a monologue written by one of the participants about the posture moon: I am the moon. I see different people with different stories. I hear owls, whoo whoo whoo! I smell heavy smoke from campfires down below. I taste mores from the people down below. I feel calm with the wind blowing against my face and clouds going through me. As a group or in pairs, they created a short dramatization combining their interpretations of the week’s theme and roles of the postures.

Theatre performance The sessions culminated in a final performance created by the participants. They designed the music, lighting and scenery. The material was a combination of scripted scenes and improvised scenes created during the sessions. Each scene shared with the audience what the participants had physically accomplished with their new yoga skills and their personal reflections on the week’s universal themes. They invited their family and friends to witness them in this unique performance. A couple weeks after the performance, the participants were invited to write a personal description of their experience. 323

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These were some of the comments: In yoga I loved how you challenged me to do harder things and now I feel I am much more flexible, balanced, and stronger. In drama I loved how you let us use our imagination and now I’m more creative and prepared before a big audition or show. Things like acting as a character or speaking out ideas gave me more confidence. Another comment: Not only did I gain life long friends but, I also grew as a person. In this class, which I attended weekly, I was taught how to be me, and not care what others think. I was taught how to focus on the good things in life, and imagine doing the impossible. Being part of this class will always be one of my favorite memories. And everything I learned, I will use in the future to help myself grow as a person.

Conclusion Yogadrama was created out of my experience as a hatha yoga teacher and drama therapist. In my opinion, if the body, mind, emotions and creativity are connected and act as an integral whole, it makes sense that, when the body is exercised, these other domains of development also need exercising. I came to this hypothesis after witnessing yoga students transform their physical bodies and discove a new sense of vitality. I began to wonder, if they were able to achieve this physical transformation with attention and daily practice, what would happen if they gave this same attention to their development of creativity and other psychological domains? Yogadrama strives to achieve this aim by supporting, not only the body’s development, but also the creative, social and cognitive development of a person. In order to practise yogadrama, I think it is important for the facilitator to have some basic training in yoga and, ideally, a regular yoga practice themselves. Yogadrama can be practised as a preventative method or therapeutically.

References Fox, H. (2007) ‘Playback theatre’, in Blatner, A. (ed.), Interactive and Improvisational Drama, pp. 3–12. Lincoln, NE: iUniverse. Harner, H., Hanlon, A. L. and Garfinkle, M. (2010) ‘Effect of Iyengar yoga on mental health of incarcerated women: A feasibility study’, Nursing Research, 59, 389–99. Harris, J. (2001) Jung and Yoga: The psyche–body connection. Toronto, Canada: Inner City Books. Jennings, S. (1995) Theatre, Ritual and Transformation: The Senoi Temiars. London: Routledge. Khalsa, S. B. S., Shorter, M., Cope, S., Wyshak, G. and Sklar, E. (2009) ‘Yoga ameliorates performance anxiety and mood disturbance in young professional musicians’, Applied Psychophysiology & Biofeedback, 34, 279–89. Lee, M. (1999) ‘Phoenix rising yoga therapy’, in Wiener, D. J. (ed.), Beyond Talk Therapy: Using movement and expressive techniques in clinical practice, pp. 205–21. Washington, DC: American Psychological Association. Pendzik, S. (2006) ‘On dramatic reality and its therapeutic function in drama therapy’, The Arts in Psychotherapy, 33, 271–80. Tran, M. D., Holly, R. G., Lashbrook, J. and Amsterdam, E. A. (2001) ‘Effects of Hatha Yoga practice on the health-related aspects of physical fitness’, Preventive Cardiology, 4, 165–70.

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32 Ritual theatre in short-term group dramatherapy Steve Mitchell

(There) is a fundamental psychological transformation that everyone has to undergo. We are in childhood in a condition of dependency . . . and supervision for some fourteen to twentyone years . . . in no way a self-responsible . . . free-agent but an obedient dependent, expecting punishments and receiving rewards. To evolve out of this position . . . to . . . selfresponsibility . . . requires a death and resurrection. (Campbell with Moyers 1989, p. 124)

I have argued that no theory of human functioning can be restricted to only a description of psychological process; it must also be consonant with what we know of the biological structure of brain development. (Schore 2012, p. 1)

I will present a methodology that belongs to the ritual theatre form of dramatherapy, the Theatre of Self Expression (see Mitchell 2012a, 2012b), to advocate how Campbell’s ‘death and resurrection’ can be achieved in a short-term dramatherapy group of up to twenty-five sessions, with adult outpatients. I make a distinction between ‘short-term’ and ‘brief’ dramatherapy, the latter being a handful of sessions, whereas the former is a more substantial intervention. In both cases, the dramatherapist needs to address the challenge of structuring tasks that will be enduringly psychologically safe, both during and after sessions; often, an error neophytes can make is not taking into account how their interventions continue to incubate and impact on a client long after the close of sessions. I will also outline a radical ‘evolving hypothesis’, a theory of biological change that I believe underpins psychological healing through dramatherapy. The ideas outlining short-term dramatherapy presented here are an update of initial work, previously published, on a process that emphasized working physically (see Mitchell 1992). I have since found that, for many clients, such an emphasis is too overwhelming, and have replaced this with reaching for archetypal and personifying mythic figures, both more potent and within the compass of clients within adult psychiatry.

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Aims In the present health-care climate, dramatherapists are encouraged to embrace short-term work. The all-important question is how to employ dramatherapy in a realistic, time-limited manner. The answer, in my view, is to pursue an aim that focuses on a biological objective rather than just psychological. The research emerging from neuropsychology offers an alternative paradigm for understanding how the brain functions, which has implications for how biological change occurs. This is a vast field, with conflicting points of view, and for more detailed knowledge I recommend Lewis et al. (2000), Cozolino (2010) and Schore (1994, 2012). I am inclined towards those who advocate that the ‘limbic brain’ (separate from the reptilian or neocortical brain) holds early templates that can become repetitive inclinations later in life (see Lewis et al. 2001). I believe that specific processes in dramatherapy galvanize neurological change, which I call the ‘Gears of Physis’. It involves activating a dynamic physiological/psychological sequence through a series of calibrated challenges in a safe manner. This begins with a client risking joining a dramatherapy group and participating in activities designed to teach the action methods that, in future sessions, will explore personal issues, as well as, importantly, building group cohesion. This factor then enables a further challenge, the risk of what in ritual has been called an ordeal. It is engaging with this task that catalyses what I define as ‘numinosity’ – an invisible force, triggering what philosophers have conceptualized as ‘physis’: a state that I believe can alter brain chemistry. Subsequently, this impacts upon on the neocortical brain through the action of ‘poiesis’; new constructs and abstract configurations become possible and evolve. This process is neither metaphysical nor transpersonal, nor the function of catharsis, but a dynamic that impacts on the totality of the human organism, facilitating durable change. (For a more detailed discussion of this biological/psychological operation and how the dynamics of dramatherapy particularly enhance its function, see Mitchell 2012a, 2013/2014, 2016; Rossi 2005.)

Sequence of the group I will now outline how this ‘death and resurrection’ is implemented in short-term dramatherapy. The format follows para-theatrical operations that view each session as an ‘organic improvisation’, with a thematic structure, but crucially also incorporating flexibility to enable solo rituals to take place (see Mitchell 1992). Each session lasts two and a half hours.

Drum circles This cover ceremony opens and closes each session. Initially, the dramatherapist guides the group through each figure of action. The dramatherapist also sets the room with a circle of large floor cushions, one for each member of the group, the dramatherapist (and assistant). In front of each cushion is an upside-down plastic garden bin – employed as a drum. At the centre of the circle is a round patterned cloth, and, at its centre, a small, decorated drum is placed. When the group members enter the room, this is the scene they perceive.

Opening drum circle In the opening drum circle, the dramatherapist will provide a ‘motif’, a simple beat everyone follows, unless, like in jazz, a different rhythm emerges, and the group wish to follow this new development. Even while this improvisation takes place, the motif continues underneath, so that what Grotowski called the ‘string’ in para-theatrical work continues, to be returned to 326

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once the cadenza is finished or so that those who do not want to follow the spontaneous evolution can stay with the motif. In this manner, the drum circle proceeds, with the group beating out the motif or giving drumming animation to what ignites them in the present moment. The opening drumming lasts about 10 minutes and is brought to an end by the dramatherapist creating a succession of single rapid beats, reaching a climax, to denote the close of the drumming. In the silence that follows, each client places their drum–bin behind them, outside the circle. We wait for someone to rise and take the small drum from the centre. When a member of the group does decide to take the drum, they choose whether to hand it round the circle to the left or right. The first round is always silent. The second round of the drum is to check in, giving a statement of feelings in the ‘here and now’. When the drum has been replaced in the centre, the dramatherapist asks the group if there are any business items, practical concerns that need to be dealt with, before the group continues. The drum circle closes with the individual who initially took the drum placing it outside the circle, somewhere safe in the room.

Closing drum circle The drum and circular cloth are placed back in the centre of the circle of large floor cushions, and the group sits facing the centre with their drum–bins. The ceremony begins with drumming to the motif, and the group members are encouraged to use this as a way of externalizing any energy that they wish to vent. Following the drumming, the ‘small drum’ will go round the group twice. On both occasions, when a client is holding the drum, if they wish to make an exit statement, support someone in the group or remain silent, this takes place. The end of the group is signified by the person who started the go-round replacing the small drum in the centre.

Threshold time If a member of the group has what Klein termed ‘a point of urgency’ (1932, pp. 58–9), that is, an immediate, hot, affective issue, this takes precedence over thematic work in what I call ‘threshold time’. On the other hand, if no one is unusually in a place of disquiet, the next task of the group takes place. A client engaging in psychological change can move through a process of confusion, alarm and anxiety. If through assessment a person is deemed to have stable ego boundaries, this disorientation of the status quo usually can be held within the individual and group process. This containment may be enhanced by offering someone threshold time. Threshold time acknowledges both group and individual disquiet and is a space where either personal or group processes are given attention. Anyone in the group can propose a wish to instigate threshold time, including the dramatherapist. At all times, the dramatherapist is vigilant to the individual and group energies and whether to offer an individual or the group threshold time. What takes place in threshold time? This depends on the moment and the individual concerned. It can simply be an acknowledgement of someone’s presenting emotional state and, on occasion, other group members too offering support. Alternatively, it may develop into animating a brief ‘transitional event’, where a client explores their mood; this may simply be being allowed to weep, to have the right to be angry, to physically express an anxiety or impulse that does not have cognitive definition, or to share verbally a disclosure not communicated before. If, at any time, group tensions arise, I then may propose a threshold time to clear group issues: a situation that may involve resolving conflict between two group members or uneasiness in the whole group. I have described the structure for this clearing in Mitchell (2012c); it involves 327

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expressing ‘resentments’ and noting ‘appreciations’ felt and inspired by members in the group, in a contained and structured manner. The deployment of threshold time enables the dramatherapist to avoid falling into the trap of presenting a workshop to the group. It respectfully offers group members a meaningful thematic framework, but importantly responds to the dynamic experience in the moment, which is also at the heart of para-theatre. On certain occasions, threshold time will become what I have previously defined as a ‘threshold ritual’ (Mitchell 1996). This means that, if a client’s experience cannot be contained in a brief piece of solo work and requires the entire time of the session to explore a personal issue, rather than pursuing the thematic work of the whole group, the decision to continue is decided by the group. I have never known a group to object to genuine psychological distress that an individual is experiencing and veto such a client’s need. Once this decision is made, the structure employed in the ‘transitional events’ takes place.

The three tasks After the warm-ups to build group cohesion through learning a variety of action methods (these structures will be evolved later in the group, to animate collective or personal exploration), there are three tasks of thematic development: the group’s preparation and work on the monomyth, which lays the foundation for shared group work; animation of individual transitional events; closure of the group, saying goodbye to each other and planning how to take into their life what has been prepared in the group.

The monomyth The Gears of Physis are manifest by work that has both a ritual and an archetypal propensity. This gives potency to the process of transformation. A significant archetype is Campbell’s concept of the heroic monomyth: The usual hero adventure begins with someone from whom something has been taken, or who feels something is lacking in the normal experiences available or permitted to the members of his society. This person then takes off on a series of adventures beyond the ordinary, either to recover what has been lost or to discover some life giving elixir. (Campbell with Moyers 1989, p. 123) Paul Rebillot, a renowned group leader (see my chapter concerning his unique experiential work in Mitchell 2012c) who had worked with Campbell, also believed that something had to die, but translated this into the psychological need to say ‘goodbye’ to a belief, a symbol or injunction. Campbell called these injunctions ‘thou shalts’ (1989, p. 154), as, like the biblical commandment, these can rule the psyche. Work with the pattern of the monomyth means structuring its plot and personifying the principal figures, as well as incorporating the ‘thou shalts’ that either consciously or unconsciously sabotage change.

The plot At this stage, the group is asked to create mythological characters, employing dramatic distance rather than making a direct connection to their own personal world. It begins with the group lying on the floor with their eyes closed and accompanying the telling of the story by using 328

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their hands to represent, as puppets, the action of the characters, creating a solo hand-dance while the dramatherapist tells the story of the monomyth. The story begins with a protagonist in their daily life, living, working, and in a discontented state. This disaffection may arise from a certain specific loss or be an accumulation of undifferentiated malaise about their quality of life. Using one of your hands create this imaginary character and like a dance drama create movements which depict the nature of their first contentment and then ‘fall’ to a dissatisfied state with their life. One day this character ‘hears a deep call within to change’. They respond with motivation. A shift psychologically takes place and this individual shifts into the role of a Seeker. Searching after their truth, this often takes them to many different experiences, but often to no avail in meeting their goal for contentment. The realisation emerges that what they seek cannot be found on their own. The Seeker now looks for someone who can be their Guide: a person who has the gift of ‘sight’ and can prepare them for their quest. Envision this Guide; animate this figure’s energy with your hand. The Guide initiates a form of training which enables the Seeker to become a powerful Warrior: a figure that has the ability to face the tests which will need to be overcome, if they are to complete their mission successfully. The Guide will also give the Warrior gifts such as an Instrument of Power, which has supernatural properties to help them overcome future challenges. The Warrior is directed by the Guide to the path and sets out on their quest. Soon the Warrior reaches the first threshold, where stands The Monster of Obstacles: this figure is the personification of the psychological saboteur and will employ the potency of their ‘Thou Shalts’ to stop the Warrior in their tracks. Create and animate this figure’s energy with your hand. Sometimes the Monster evokes the archetype of the Orphan: another figure that constitutes the younger damaged self, who experiences the anguish of hopelessness, despair and aloneness. The task of the Warrior is to draw on all of their resources, match the power of the Monster of Obstacles, stand their ground and negotiate a new relationship. If this can take place, a transformation occurs and the Warrior and Monster integrate into a formidable HeroicSelf. The Heroic Self can now enter a special zone. Here other ordeals take place. The Hero, with the help of their gifts, faces their trials, asserting their power and employing all of their affirmative resources to overcome these challenges. If these tests are overcome the Hero will come to the ‘Temple of the Reward’ and receive their boon, to take back into the world. The Hero now returns, but at the threshold is required to leave all magic behind and return to their earthly existence, with the symbol of their boon to share with their community and the new found presence, their journey has created within. The activity closes with the clients drawing a personal picture of the mythic figures and sharing their impressions in pairs.

Personifying composite characters The group members create composite characters of the figures in the monomyth. Each of these personas is given immediacy by being connected jointly to the psychological dispositions of the group’s experience and how their psychological saboteurs, warriors and guides operate in their worlds. Monster of obstacles To establish this figure, the group members are given the task of writing a personal list of ten people in their lives, past or present, they have disliked or have had difficulties with and, next 329

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to each person’s name, three attributes that are experienced negatively. These traits are pooled, and, by consensus, four negative qualities are chosen for the composite monster of obstacles. The group members now pool various injunctions they have received in the terms of a ‘should’, ‘ought’ or what was ‘forbidden’ (in the eyes of a significant person). Three of these sanctions are selected to be this character’s script. Finally, to inhabit this persona, the members individually make a full-face mask depicting the monster of obstacles. Using the mask, the group engage in a movement exploration personifying this figure, ending with making a sculpt of the essential psychological gesture of the monster of obstacles. Warrior The group members begin individually, creating another list of ten people they admire and, this time, noting three affirmative personality qualities. These qualities are shared to see if there are any similarities, and, again through consensus, bearing in mind that their warrior will need to have the resources to stand up to the monster of obstacles, four decisive qualities are chosen. The group members also explore how this figure might respond to their adversary in the form of rebuttal statements. The members now make individual half-masks, representing the qualities of this character. There follows a movement improvisation in which the group members, wearing their half-masks, individually explore each of the four affirmative qualities and physically define the goal of their quest. Finally, creating another sculpt, they depict their warrior ‘reaching’ towards their heroic goal. Guide In pairs, the group members identify significant people in their lives who have the attributes of a good teacher or mentor, or have been inspirational or wise role models. A list of six people and their particular qualities is written down, and the personality qualities are shared in the whole group. Once again, by consensus, these are whittled down to four specific qualities. To build this character, the group members use clay to show its posture. Having each created their miniature representation of the guide, working in pairs, each person takes turn in first directing their partner into the posture of this figure, before changing places and experiencing the dynamics of this figure from within.

First threshold This takes place in four phases: collective storytelling, composition, animating the threshold drama and, finally, personalizing the monomyth.

Collective storytelling The group members sit on floor cushions in a large circle and tell the story of the threshold drama between the warrior, the monster of obstacles and the guide. The dramatherapist leads this activity by asking the group to invent answers to questions asked about how the different mythic characters progress. The dramatherapist evokes the scene, but what actually takes place and what is said are jointly decided by the group. The questions asked might include: imagine you are watching this on a film: where will their meeting be located? Who will speak first? What are the opening statements of each character? How does one character answer another character’s statement? In what manner, physically or vocally, are their points of view expressed? This is their opportunity to really vent their feelings to each other. What is it they feel? What do they secretly want to tell the other figure? If this 330

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were a dream, what actions might take place between them? In what way can the guide influence these proceedings? Can they listen to one another? Is there any possibility of a new arrangement taking place between them?

Composition The group now uses this story to build a piece of ritual theatre. The interpretation employs the skills and abilities within the group, with the dramatherapist working as a resource person. The group is given the following guidelines: • • • • •

•

Devise a way clients can work in pairs (as a way of making it safe for more sensitive group members). Include a way that characters can be personified, using alternate pairs (so that the principal characters are shared). Consider the overall theatrical style as ceremonial, enabling movements and gestures to have a repetitious frame interspersing each episode of the story. Consider what modes of dramatic representation might be employed in the different episodes (realism, expressionism, symbolism, melodrama, dance, mime, musical theatre, etc.). Include a clear framework marking each episode: beginning: opening statements, responses by the principals; middle: how the argument’s complication is revealed, generating the core dramatic conflict; ending: resulting in an impasse, or moving towards a discovery, a resolution and the ‘obligatory scene’ revealing the denouement. Include the use of their masks and consider what other costumes may be included. What technical devices such as props, lighting, sound effects or scenery are required.

Animation What has been prepared is now animated as a piece of ritual theatre.

Personalising the monomyth Debriefing the ritual theatre takes a number of forms: first, sharing their experience in pairs; second, with a triad, exploring how their personal warrior, saboteur and guide operate in their own lives; and finally, sharing in the whole group the impact of the work.

Second threshold The hero now enters what Campbell defines a special ‘zone’ and encounters ‘the road of trials’. Rebillot, in his adaptation of the monomyth, drew upon Campbell and his understanding of how ancient societies employed ritual as a means of meeting these challenges and processing them. When we turn now . . . to consider the numerous strange rituals that have been reported from the primitive tribes and great civilizations of the past, it becomes apparent that the purpose and actual effect of these was to conduct people across those difficult thresholds of transformation that demand a change in the patterns not only of conscious but also unconscious life. (Campbell 1988, p. 10) 331

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Rebillot adapted this in many of his workshops, most notably, in my view, in Rituals of Transformation (1993), where he provided a form where participants could process developmental impairments by employing the structure of ritual. Rebillot importantly did not believe that the animation of a ritual was the change itself, but a form of preparation that needed to be consolidated in concentrated efforts in the everyday world. A ritual only writes into the psyche a new possibility through the actions I have identified as the Gears of Physis. The final act of this process is to make concrete changes in life. This takes awareness, risk and courage, which are the reasons this form of ritual theatre focuses on nurturing the resilience of a client, rather than emphasizing reducing symptoms or their underlying psychopathology (see also Jennings 2012; Mitchell 2012a). However there are two important cautionary notes: first, in short-term clinical dramatherapy, there is not time, and it is not safe, to work through complex archaic wounds. Therefore, my own adaptation of this ritual process is to offer what I call a ‘transitional event’. This structure is a development of Cieslak’s more open ‘experiences’ (see Mitchell 1992). Each person in the group is offered time to explore an issue of their choice within a defined structure. For some, taking the space will be risk enough; for others, there may be a wish to explore a more personalised threshold drama, an incident from their past or anticipated future to focus upon. For some clients, work involving a solo piece is not appropriate, and participating in this structure is not obligatory. Second, in the formal discipline of the caring professions, the term ritual can have a diverse range of meanings. Dramatherapists are aware of the significance of language when facilitating work, but this also applies, not only with clients, but also with managers representing institutional values. I try to avoid any language that could be misinterpreted and instead employ the term transitional event. This is a distinct structure based on ritual, a scaffold for the client to have facilitated space to process anything that has arisen during the group or, in some unique way, prepare their psyche for some identified challenge in the future – see procedure below. A transitional event is a structure that is secular, devoid of any religious accruements – unless it is the wish of a particular client to include such transpersonal forces. In making this adaptation, I do not view it as a concession, but as a way of being respectful to group members and the discipline of psychiatry, an institution that operates within a scientific discipline. I too have doubts about the transpersonal, and this too influences my decision to offer a transitional event rather than an emotive concept of ritual that can be misconstrued and misunderstood.

Transitional event The facilitation procedure begins with an orientation clarifying its focus: • • • •

• •

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Where are the feelings in the moment? Encourage expression of this energy, animating it in motion, vocalising it in sound or speaking verbally about their experience – what is the best form for them in this moment? Separating out the task: what images emerge that may need attention? How does the animateur want to approach this task? What level of distance through dramatic metaphor or more explicit representation of a figure, situation or belief is required to animate their state of being? The animateur creates a Passage (marking it out on the floor with tape, paper, cushions, chairs or objects) to focus the path of transition. An imaginary threshold is designated at the start, followed by different locations where the symbols representing what is to be addressed are located (this may be with objects, materials or group members acting as substitutes who are given specific statements to speak). The

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•

dramatherapist sometimes needs to help the animateur to select what is a priority to attend to in the overall time frame of the session. A final concrete threshold is constructed at the end of their ‘passage’ to mark the change of psychological status.

Animating the event (a) Does the animateur wish to call in a divine power or make a dedication to someone or something in nature (this is an offer that is sometimes significant to the animateur)? (b) The group: the animateur takes their place at the start of their passage and, in a manner previously agreed, is facilitated across their imaginary threshold by the dramatherapist. (c) The animateur moves to his/her symbolic representations, addressing each in turn, expressing what needs to be said to what is behind the symbols or hearing what needs to heard from a particular figure. (d) The animateur moves to his/her concrete threshold and, before crossing, turns to face their symbols and says their ‘goodbye’. (e) The animateur crosses their concrete threshold into a space designated the ‘future’. Here, the animateur may wish to stand, sit silently, make motions, play an instrument or sing a song, whatever enables the animateur to contemplate their new potential. (f) The animateur returns to the group and makes an existential statement summarizing the experience, thus giving cognitive definition to his/her new status. (g) Those who have participated as substitutes de-role. (h) Feedback from the group: The animateur listens to and receives each person’s comments without responding; this is not a time to enter into a discussion or analysis. I have outlined my internal map, adapted through clinical work from Rebillot’s (1993) and Cieslak’s (Mitchell 1992) inspirations. However, it is also possible that a client might wish to do something completely different. If this is the case, I go with the client’s ‘proposition’, as long as it does not violate any ethical codes of practice of dramatherapy.

Closure This is an important group activity that I have written about in my chapter in Ritual Theatre (Mitchell 2012b), and the structures of debriefing the group, explicitly clearing any group issues and saying goodbyes all need to be addressed before the termination of the dramatherapy group.

Conclusion In this chapter, I have set out my aims as a dramatherapist and the practical manner I use in triggering the Gears of Physis, employing the ritual theatre form of dramatherapy, the Theatre of Self Expression, for short-term group work. I based this on the philosophy of Campbell’s notion of the need for a ‘death and resurrection’ and adapted Rebillot’s work with the monomyth and ritual into safe ‘transitional events’, within a clinical context, for outpatients in adult psychiatry.

References Campbell, J. (1988) The Hero with a Thousand Faces. London: Paladin Grafton (originally work published 1949 by Bollingen). 333

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Campbell, J. with Moyers, B. (1989) The Power of Myth. Canada: Doubleday. Cozolino, L. (2010) The Neuroscience of Psychotherapy (2nd edn). London: W. W. Norton. Jennings, S. (2012) ‘Theatre of Resilience – Ritual and attachment with marginalised groups’, in Schrader C. (ed.), Ritual Theatre: The power of dramatic ritual in personal development groups and clinical practice, pp. 200–16. London: Jessica Kingsley. Klein, M. (1932) The Psychoanalysis of Children. London: Hogarth. Lewis, T., Amini, F. and Lannon, R. (2001) A General Theory of Love. New York: Vintage Books. Mitchell, S. (1992) ‘Therapeutic Theatre: A para-theatrical model of dramatherapy’, in Jennings, S. (ed.), Dramatherapy Theory and Practice (vol. 2), pp. 51–67. London: Routledge. Mitchell, S. (1996) ‘The ritual of individual dramatherapy’, in Mitchell, S. (ed.), Dramatherapy Clinical Studies, pp. 71–90. London: Jessica Kingsley. Mitchell, S. (2012a) ‘The significance of ritual theatre in healing and (drama) therapy: The essential functions of numinosity, physis and poiesis’, paper presented at the University of Aberystwyth’s International Conference on Ritual/Action/Performance, Aberystwyth, UK. Mitchell, S. (2012b) ‘The THEATRE OF SELF EXPRESSION: A brief introduction to the theory and practice of this ritual theatre form in clinical dramatherapy’, in Schrader, C. (ed.), Ritual Theatre: The power of dramatic ritual in personal development groups and clinical practice, pp. 240–4. London: Jessica Kingsley. Mitchell, S. (2012c) ‘Paul Rebillot’s modern day rites of passage’, in Schrader, C. (ed.), Ritual Theatre: The power of dramatic ritual in personal development groups and clinical practice, pp. 129–52. London: Jessica Kingsley. Mitchell, S. (2013/2014) ‘What if our knowledge of healing is a myth and other forces are at work?’, The Prompt: Newsletter for the British Association of Dramatherapy, December 2013, 22–6, February 2014, 36–41. Mitchell, S. (2016) Short-term Individual Dramatherapy employing ‘The Theatre of Self Expression’ working with different unconscious archetypes and conscious aspects of the psyche. In The Prompt: Newsletter of The British Association of Dramatherapy. Rebillot, P. (1993) Workshop: Rituals of Transformation. London: Roehampton Institute. Rossi, E. (2005) ‘Creativity and the nature of the numinosum: The psychological genomics of Jung’s transcendent function in art, science, spirit, and psychotherapy’, Spring, a Journal of Archetype and Culture, 72, 313–37. Schore, A. N. (1994) Affect Regulation and the Origin of the Self: The neurobiology of emotional development. London: Psychology Press. Schore, A. N. (2012) The Science of the Art of Psychotherapy. New York: W. W. Norton.

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33 Meditation and dramatherapy Grace Schuchner

Brief personal history ‘Fits like a glove’

On Earth Regarding the words from the writing ‘a ladder leaned on earth whose peak touched the skies’, Rabbi Aaron from Karlin stated the following: ‘if the man from Israel has firm control of himself and steps firmly on earth, his head reaches the sky’ (Buber 1978, p. 42). The two pillars of my life have been my artistic path and my spiritual path. When I was 15 years old, my mother took my brother and me to a course of Silva Mind Control.1 When I was 18, she and I did a course on Transcendental Meditation,2 where I was introduced to the practice of meditation with the repetition of a mantra. My spiritual search continued with the reading of books, varied workshops, a study on metaphysics, guided meditations and visualizations. Today, my search of knowledge and spiritual support comes from the millenarian wisdom of the Kabbalah. Once a week, I have meetings with a Kabbalah teacher, Rabbi Jaim Baruj. These meetings serve as therapeutic help, guidance and fuel for my soul and intellect. Simultaneously with entering the spiritual world, I began my artistic path. At the age of 15, the teacher with whom I attended corporal expression lessons made up a group of theatre dance, of which I was invited to be part. I continued attending drama lessons and finally made the decision to leave my safe place, Buenos Aires, and move to Paris to study drama with Philippe Gaulier and Monika Pagneaux. To know the work of Roy Hart Theatre, located in Malérargues in the Cévennes hills of southern France, awakened my desire to be part of a group of drama with these characteristics. My dream came true when I arrived in Israel and a ‘messenger of life’, today a great friend of mine, introduced me to the director, at that time, of the Acco Theatre Centre, David Maayan. 335

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During the years I lived in Israel, which were 17, I belonged to the theatre company of Acco, but, most importantly, there I met my artistic and spiritual family. One day, a friend from the Acco Theatre visited me in my house and told me that she was going to study dramatherapy at Tel Hai College. Immediately, I felt deep inside that dramatherapy fitted me like a glove, and it was going to make the union of my two pillars possible. After 21 years living far from my hometown and my family, at the age of 42, I decided to come back to ‘My beloved Buenos Aires’,3 the title of a tango song written by Carlos Gardel, which begins as follows: My beloved Buenos Aires, when I see you again, There will be no more sorrow or forgetfulness. When I arrived in Buenos Aires, I started attending a postgraduate course on systemic family therapy. Before completing the second year, I got pregnant. I gave birth to Shira at the age of 44. My return to my origins had a clear purpose: ‘to heal the bond with my family’; I am not sure whether I managed to dispel all the sorrow, but surely I firmly stepped on Earth. And, after becoming a mother, I could finally touch the sky.

Ritual structure Dramatherapy sessions are ritualistic in their form and structure and usually start and end with familiar ritualized expression; this acts as a container for the exploration and risk taking within the session in which participants encounter material that is less familiar or unknown. (Jennings 1998)

The great symbolic importance given to the number three in philosophy, science and religions is quite acknowledged. In fact, in many ancient cultures, this number was considered the most sacred one. According to the Jewish tradition, the number three represents continuity and stability. Similarly, for the Kabbalah, three is the number of peace and harmony. Additionally, association in triad has a very significant value. I will illustrate this with some examples, and I encourage you to enlarge the list: The polygon with three sides is called a triangle. Time has three dimensions: past, present and future. Likewise, the body is divided in three parts: head, trunk and limbs. The triad: Father, Mother and Son. Phil Jones writes about ‘the triangle in dramatherapy practice’ and states that, ‘One way of looking at this triangle is to see it as concerning the ways the therapist, the client and the art form create the dramatherapy space together’ (Jones 2010, p. 10). Sue Jennings also divides the drama developmental paradigm into three, Embodiment– Projection–Role (EPR; see Jennings 1998, p. 121), and it is the base structure I use in my therapeutic work. I could simplify the structure of the meditation and dramatherapy sessions with two triangles (as illustrated in Figure 33.1; I have used this musical instrument, intentionally, since my beginnings as a dramatherapist, for the opening and closing of sessions). 336

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Figure 33.1 Day-to-day reality

A triangle would be: • • •

meditation meditation – de-roling song – integration.

The second triangle is the development of the dramatherapy session: EPR. I will not delve into the subject of triangles, as the two interwined triangles are one of the most well-known symbols of Judaism, known as the Star of David, and its symbolic study and mystical value are very deep. I only wish to emphasise that my choice to place one upwards and the other downwards is not arbitrary. The first represents the sky, and the second the Earth. One of the meanings of the two triangles interwined is the union between the sky and the Earth. This union, according to the Kabbalah, is made when the Earth approaches the sky. That is to say, it is the man who shall approach God so that union between them is attained. 337

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With reference to this belief, within the therapeutic framework, the individual is responsible for making the necessary actions in order to produce changes and heal him/herself. He/she shall also approach his or her spiritual self. Going back to triads, in my ritual structure, there is a third triangle, which is made up of: • • •

the coming in of the participants to the sessions, from day-to-day reality; crossing to the reality of the imagination; closure, back to day-to-day reality.

Description of the nine stages Stage 1: Entrance to the room: day-to-day reality Just as preparations by actors, production teams and spectators take place before a show, I also make preparations before I receive a participant in a dramatherapy session. They come into a space where there is pleasant fragrance and a lit candle. The materials for the projective work (sheets of paper, pencils, paintings, associative cards, Kesem, newspapers, magazines, dough, etc.), musical instruments and clothes are organized and set out for use during the session. It is the moment to greet, explain the rules, set individual and group goals, if it is a first session; otherwise, it is the time to do the follow-up of the previous session, which will allow us to focus on the next course to take.

Stage 2: Crossing the space A journey of a thousand miles begins with a single step. (Lao Tzu)

It is the moment to transition from the place where we are seated, which represents our dayto-day reality, to the place where each participant will choose to meditate. That simple action aims at consciously crossing from the day-to-day reality to the reality of the dramatic imagination (see Jennings 1998, p. 117).

Stage 3: Meditation The vessel There are a wide variety of meditation techniques and teachings. For the time being, I will choose a movement meditation and a seated meditation. I consider this stage the groundwork for the development of the dramatherapy sessions I am describing in this chapter. The movement meditation consists of making a circle standing up, with all the participants holding hands, closing eyes, focusing the consciousness on the feet resting on the floor (preferably barefoot), and starting a subtle swinging where the movement goes forwards on to the toes and then backwards on to the heels, and so on and so forth. Music can be used, or else it can be done in silence. At this point, rhythmic breathing helps create a unified rhythm. This meditation came up in a Congress of Reformist Rabbis, held in Buenos Aires in 2012. The organisers asked me to offer a closure activity for all the participants. Owing to the section 338

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Figure 33.2 Meditation

of the Bible that was being studied during that week, called ‘Ekev’, which has its root in the Hebrew word ‘Akev’, meaning ‘heel’, I decided to work with the soles of Esther Buk, and, because of her, I know that the sole of our feet can be divided into the four elements: air, fire, water and earth (2007). The toes represent the air, and the heel the earth; the metatarsus fire, and the arch water. While swinging, when we transfer our body weight towards the toes, we can activate and connect with the air, the sky. Each of our toes represents the senses, and all of them together allow us to connect ourselves with the divine. When we transfer our body weight towards the heels, inevitably we go through the metatarsus, which contains the sentiment of here and know, the sentiment of our present time. Then we pass through the arch of the foot, where emotions are contained and, finally, we reach the heel, which represents the concrete core of everything that manifests on Earth: people, places and objects. Metaphorically, with this movement meditation, I suggest that we can awaken the consciousness and intention of bringing the sky to the Earth and taking anything we desire from Earth to the sky. When I explained the activity I was going to offer to the rabbis in charge of the organization of the Congress, for them the explanation of the sole of the foot and the metaphor of the sky and the Earth was a great revelation, as rabbis, when praying, naturally swing, something that in Yiddish is called schucklen.4 I use this meditation basically when the aim is to create a feeling of union within the group. The seated meditation consists of remaining in silence for 10 minutes. The metaphor I use is taken from a book by Pema Chödrön: The meditative space is like the big sky – spacious, vast enough to accommodate anything that arises. In meditation, thoughts and emotions can become like clouds and pass away. Good and comfortable, pleasing and difficult and painful – all of this comes and goes. (2013, p. 4) 339

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In this meditation, the aim is simply to remain seated, do nothing and find a pause in the noises (external and internal). The intention is to ‘Be in the Self’. I practise both meditations with the participants in individual and group sessions. Lynne McTaggart wrote: Between the smallest particles of our self, between our body and our environment, between each of us and those with which we interact, and the members of each group of society there is a bond, such a comprehensive and deep connection that it is not possible to exactly define where one thing ends and where the other begins. (2011, p. 27) For me, the feeling that, at this moment, together we are creating the space for creative work is a very profound experience. Additionally, according to the Kabbalah, we are creating ‘The vessel for the creative Light to come in’, ‘both men and women are Vessels for the Light of the Creator’ (Berg 2008, p. 65). Lastly, I associate this moment with some of the qualities of female energy: the peace and receptivity of the inner world and the creation of space for that which has to gestate and grow.5

Stage 4: Embodiment The curtain opens. On this stage, my intervention begins; it is fundamentally based on Gerda Alexander’s Eutonia method, the work of Body Expression created by Patricia Stokoe and some principles of authentic movement created by Mary Starks Whitehouse. It is when the body begins to move that the curtain opens and I start to observe the dramatic reality in which the participant is situated. The world of imagination becomes visible to the eyes, one movement brings another, and the creation becomes real. ‘Behind the visible movement there is another movement, one which cannot be seen, which is very strong, on which the outer movement depends. If this inner movement were not so strong, the outer one would not have any action’ (Mme de Salzmann 1889–1990).6

Stage 5: Projection The projection stage is dynamic, with regard to the order in which I use it during the sessions. Sometimes I may use it before embodiment or after the role stage; it depends on the needs of the participant or group. Shaun McNiff, an international pioneer in expressive arts therapy said, ‘As we begin to move in the most elemental ways with art forms, expression emanates’ (Rappaport 2014, p. 18). The use of projective tools is very helpful and clarifying, both for the participant and therapist.

Stage 6: Role Just like in the embodiment stage, my work is based on what I have learned since the beginning of my artistic career, through physical practice, and its later development through different physical techniques. It is in this stage that my experience of more than 30 years performing and meeting great drama teachers and directors enhances my ‘artistic–therapeutic eye’. For me, this stage is the heart of dramatherapy. 340

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Here, dramatisation and play begin, as Peter Brook says: ‘The Theatre of the Invisible-MadeVisible: the notion that the stage is a place where the invisible can appear has a deep hold on our thoughts’ (Brook 1996, p. 49). And, according to Sue Jennings: Dramatherapy is about creating this ‘fiction’ in order for people to understand themselves in new ways through dramatic interaction on a therapeutic stage. Through the creation of fiction and the entering of fictive characters we not only understand ourselves better, but are able to communicate things that otherwise we could not. (Jennings 1990, p. 12)

Stage 7: Meditation – de-roling The curtain closes. It is very tempting, after all that has been gone through, to feel like going directly to the closure. Additionally, we are generally used to living in this way: we pass from one thing to another, without ‘taking a pause’.7 I totally agree with what Shaun McNiff says about his refrain of ‘taking a pause’: ‘It slows everything down so that important things can emerge and be experienced’ (Rappaport 2014, p. 22). Whether in group movement meditation or seated meditation (I suggest between 5 and 10 minutes of this), both the participants and the therapist can return to their equilibrium, go back home after a trip; also, the image of Turkish coffee comes to my mind as a metaphor: ‘We have to wait until the coffee dregs are settled so that coffee can be drunk’. I invite you to include and experience this in your dramatherapy sessions.

Stage 8: Song – integration To close the session, listening to some music that inspires inner peace and harmony awakens feelings of ‘self-acceptance’ of the process experienced and of openness to what has become visible. I could certainly say that the feeling, for both the participants and the therapist, is one of integrity and connection with the spiritual world, which leaves them in peace. I share with you two songs that have inspired me for this moment: • •

Music for the movement meditation: Deva Premal: ‘Om Namo Bhagavate’. Music to end the meditation in a seated position: Miten with Deva Premal: ‘So much magnificence’.

There are surely other songs you may wish to choose, and I may well eventually replace them with others.

Stage 9: Closure Back to day-to-day reality. Owing to the fact that, together, participants and therapist have taken ‘a pause’ for the experience to settle, they go back to sit where they started the session, which represents their day-to-day reality, without the need to verbalise much; maybe a few closing words are enough. Here, the ritual formally ends, and it’s time to be grateful for the encounter and for what has arisen. 341

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Other approaches integrating meditation and dramatherapy Joel Gluck, in Cambridge, Massachusetts, has created a system of dramatherapy based on the principles of insight meditation, also known as vipassana – the fundamental practice of Theravadan Buddhism. Gluck’s method, known as Insight Improvisation (2013), is based on three core concepts: mindfulness, choicelessness and loving-kindness. He has developed a unique practice, called psolodrama, that combines authentic movement and psychodrama. It invites the client to go on a meditative journey into the psyche, connecting with bodily sensations, emotions and inner imagery; embodying and speaking as the emerging roles; and playing out the resultant drama in the presence of a supportive witness.

Ritual and repetition ‘Rituals create an order.’ There are various books written about rituals: the ritual and the theatre, the ritual theatre, the ritual and dramatherapy. Personally, I am keen on rituals, either because they are related to tradition and religious festivities or to shamanic cultures or simply family and daily rituals, and I wish to give some input regarding this topic. Through my research, I have come across a book called Rituals for Children, written by Petra Kunza and Catharina Salamander (2004), which explains the importance of rituals in the education and development of children. After reading this book, I felt enthused to make an analogy of some of the concepts the authors bring up between the importance that rituals have in children and the importance of rituals in dramatherapy sessions – see Table 33.1. Table 33.1 Rituals for children Rituals for children

Dramatherapy sessions

Diversity

Owing to the diversity of rituals, it is important to create or choose one that is accurate for individual sessions and one that is in accordance with a group’s characteristics

Children need fixed structures

A fixed structure enables a predictable space for exploration

Facilitate setting limits and rules

In every therapeutic process, agreement on the limits, rules and goals of the sessions is made

Convey confidence

While experiencing confidence, the participant can move more freely in unknown areas

Reinforce self-identity

The group or participant develops characteristics of belonging that are special and unique

Eliminate fears

Rituals are helpful when resistance and fear arise

Create special and distinctive bonds that will evolve over the time

Rituals reinforce the relationship among the participants and with the therapist and develop trust

For rituals to be helpful, they must be flexible and must evolve permanently

A ritual is stable but not immutable. It is dynamic

Benefit family harmony

Rituals contribute to the group’s harmony and enrich the work

Note: The choice of ritual will vary according to the characteristics and goals of the group or individual. For example, my ritual choice when working with chronic schizophrenic patients in the psychiatric hospital of Mazra, located in the north of Israel, is totally different from the one I choose when working with students of the Technical Certificate of Dramatherapy in Chile, or in individual or group sessions.

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Positive aspects of repetition ‘The true power of rituals lies in their repetition’ (Kunza and Salamander 2004). In 2008, I gave a theoretical–experiential presentation together with a music therapist, at the Congress of Music Therapy held in Buenos Aires. The name of the presentation was, ‘The encounter between Music Therapy and Dramatherapy in the treatment of psychiatric patients’. The theoretical presentation consisted of a case study of a chronic schizophrenic patient with whom I worked in Mazra psychiatric hospital, Israel, for more than a year. The aim was to share the experience and importance of ‘repetition’ in the therapeutic process. The work done with this patient consisted of listening to the album The Wall, by Pink Floyd, in every session. It is not my intention, in this chapter, to present my work with psychiatric patients, but to encourage not being afraid of ‘repetition’ and to share some of the conclusions I reached. I remember Professor Mooli Lahad, in one of his lessons when I was studying dramatherapy at Tel Hai College, telling us that it is more important to develop an attitude of ‘being interested in our patients than of being interesting in our interventions’. Many times, as therapists, we become demanding, because we feel that we have to include new and different ideas and activities for each session, whereas creating a framework that repeats its form reveals very positive characteristics. I will illustrate some of them: •

•

•

•

• • •

In French, the rehearsal of a play is called répétition. Both the process of rehearsals and the performances of a play can be very creative and enriching for the actors when accompanied by the game of creativity, which adds something different to the repetition. These are creative repetitions that, as well as being similar, are at the same time different. Repetition is the best way to reinforce a new neuronal pathway in the brain, and so it will be particularly helpful in supporting the new, more accurate beliefs that we’ll be putting in place to supplant the old (Berg 2013). Early stimulation is based on the repetition of what scientists call units of information, or bits. The intention is to reinforce the neuronal areas of interest through the systemic repetition of simple exercises and games with the baby. In her book Healthy Attachment and Neuro-Dramatic-Play, referring to the relationship between mother and baby, Sue Jennings writes: ‘The repetition of “ritualized” actions that can include singing games and stories with sounds becomes a secure base from which creativity and improvisation can grow’ (Jennings 2011; italics in original). It is natural to see the pleasure children find in repetition, either from a game, a movie or a song. One of the benefits of the repetition of a mantra, word or sentence is the relaxation produced in the body and the ability to remove blocks and tap into a higher state of consciousness.8 And going back to arts, in 1992, the work of twelve artists was exhibited at the National Museum of Queen Sofia Arts Centre in Madrid. The proposal was about repetition as a way of transformation, and the name of the exhibition was ‘Repetition/Transformation’. In literature, repetition provides rhythm and melody. Carolyn Van Dort and Denise Grocke write that, in music, ‘Repetition is a key feature of music that enhances mindfulness, so that the mindful brain is not stimulated by new sounds and patterns that require processing’ (Rappaport 2014, p. 96).

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Shira: Dramatherapy brings children into the world By day the Lord will command his loving kindness, and in the night his song [Shirah] shall be with me, a prayer to the God of my life (Psalms 42:8)

Sue Jennings asked me to include in this chapter my own pregnancy process and the work done with women who have difficulty in getting pregnant. In one of the workshops led by Sue Jennings, while I was a student at Tel Hai College, I remember she told us that dramatherapy ‘brings children into the world’. Her belief echoed in me, and, softly and pleasingly, there was an inner voice every now and then that reminded me of that and made me wonder, secretly and without anyone noticing it, how could it be that, if I feel that dramatherapy fits me like a glove, I was not yet a mother. It did not become a persistent thought, but every so often a bell rang. And it happened – naturally and lovingly – the father of Shira lives in Israel, while I live in Buenos Aires, and I am a single mother. Although Professor Mooli Lahad’s Integrative Model of Coping and Resiliency, BASIC PH (Lahad 2013), is a deeper and more complex therapeutic model in the way I am going to address it, I want to apply it to describe the way I chose to cope with my pregnancy as a single mother. • • • • • •

B (Beliefs and values): My belief was total trust and certainty that ‘everything is ok and will be ok’. A (Affect): Only positive thoughts, stories and images were permitted. I exuded happiness. S (Social mode): I had the unconditional support of my family and friends. I (Imaginative way): I practised my daily meditations and attended a music therapy group for pregnant women once a week. C (Cognitive): I was in the second year of the postgraduate course on systemic family therapy. PH (Physical): I went swimming every day, until the day I gave birth, and I also attended lessons on body rolling for pregnant women.

I kept a diary where I wrote about my daily activities, thoughts and emotions related to my pregnancy. I gave birth naturally and I was accompanied by my mother. It was the clearest experience I had had of divine connection. I was completely surrendered to the Light of the Creator. Sue Jennings writes, ‘What is important is not the stimulation but the development of the relationship and the more we can focus on the prebirth attachment, the more the transition to mother and babyhood will be both beneficial and pleasurable’ (2011, p. 89). I must confess that, during the 9 months of pregnancy, I felt in a state of grace and union with my baby. In my last month of pregnancy, I made a promise to help, through dramatherapy, women who have difficulty in getting pregnant, as a way of expressing my gratitude for having received the gift of motherhood. In that sense, my work is just beginning to develop. One of the ways I address this topic is through a short performance created in the form of therapeutic theatre, where, after the performance, I hold a workshop. The main character is Hanna, included in the book of Samuel 1.1. Hanna, like the matriarchs of the Bible – Sarah, Rachel and Rivka – cries in anguish over her difficulty and longing to become a mother. Her story ends with her request being granted: she gives birth to Samuel. 344

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Figure 33.3 Hanna

In the Bible, there exists this paradox, ‘from infertility to matriarchy’, which in itself is very interesting to study. Another way is through individual or group sessions, where I apply the work of meditation and dramatherapy. My belief why dramatherapy may help is because contact is made with the realm of creativity and creation. The inclusion of meditation allows, in the first place, ‘the pause’ and connection with the female energy where the space, the vessel, is created. Then, after putting into action the thoughts and intention using dramatherapy tools, the male energy is activated. The union between the male and female allows the conception of a child, and, if it is not of a child specifically, of a new understanding or change in the healing process. ‘Art heals by transforming difficulties into creative expressions if we can open ourselves to these processes’ (Rappaport 2014, p. 17).

End of ritual ‘What the mouth wants’: Baal Shem Tov9 said, ‘when I connect my spirit to Hashem10 I let my mouth speak what it wants, since then my words are tied to his roots in the sky’ (Buber 1979, p. 108). My closure is made with a drawing that Shira made while I was writing. She did not know the subject of my writing. Thank you. 345

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Figure 33.4 Shira’s image

Acknowledgement I would like to thank Sue Jennings for inviting me to be part of this book. I am delighted to feel that my heart beats together with other dramatherapists from all parts of the world and, from Buenos Aires, Argentina, to have the chance to pave the way so that the seed of dramatherapy may be spread here as well. I hope this seed flourishes. Grace

Notes 1 The Silva Method is the name given to a self-help programme developed by José Silva, which claims to increase an individual’s IQ and sense of personal well-being through relaxation and development of their higher brain functions. 2 Transcendental Meditation was created by Maharishi Mahesh Yogi in India in the middle of the 1950s. 3 ‘Mi Buenos Aires querido’ (My beloved Buenos Aires) is one of the most popular tangos by Carlos Gardel and Alfredo Le Pera. It was composed in 1934. It was part of the homonymous film from 1936, written and directed by Julio Irigoyen. 4 Rabbi Samuel Hanaguid from Granada (died 1056) is the first who mentions the swinging during the study of the Torah in his poetry: 346

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And we arrive angry at the House of God and I wish we had confused the way, since, you see, the rabbi and his students were swinging their heads like a tamarind in the dessert.

5 6 7 8 9 10

There is vast literature about shucklen. In English, see The Jewish Encyclopedia (vol. 11). New York, 1905, p. 607. The swinging of the body forward and backward is a natural instinct and it can be related to the prenatal state when the foetus is located in the mother’s womb. That is why it is said that swinging is one of the universal calming movements, and the rocking of a baby when holding it in the arms is common in most cultures. I refer to the female and male energy that both men and women have. Jeanne Matignon de Salzmann, born Jeanne Allemand, often addressed as Madame de Salzmann, was a close pupil of G. I. Gurdjieff. Taking a pause: I use the image of Shaun McNiff, ‘take a pause’ (Rappaport 2014, p. 21). ‘Mantra meditation is a fairly safe method for most people, but it can be dangerous for someone with a history of mental illness’ (Kaplan 1985, p. 58). Israel Ben Eliezer, as known as Baal Shem Tov or Besht, was a Jewish rabbi considered the founder of Hasidic Judaism. Hashem is a Hebrew word that literally means ‘The name’. It is used to avoid using the name of God YHWH.

References Berg, Y. (2008) The Spiritual Rules of Engagement: How Kabbalah can help your soul mate find you. Los Angeles, CA: Kabbalah. Berg, Y. (2013) If You Don’t Like Your Life, Change It! Los Angeles, CA: Kabbalah. Brook, P. (1996) The Empty Space. New York: Touchstone. Buber, M. (1978) Cuentos Jasídicos de los Primeros Maestros II. Buenos Aires: Editorial Paidos. Buber, M. (1979) Cuentos Jasídicos de los Primeros Maestros. Buenos Aires: Editorial Paidos. Buk, E. (2007) Holistic Reflexology: Wisdom from top to bottom (Spanish edn). Buenos Aires: Editorial Kier. Chödrön, P. (2013) How to Meditate: A practical guide to making friends with your mind. Boulder, CO: Sounds True. Gluck, J. (2013) ‘Mindfulness and drama therapy’, in Rappaport, L. (ed.), Mindfulness and the Arts Therapies, pp. 107–16. London: Jessica Kingsley. Jennings, S. (1990) Dramatherapy with Families, Groups and Individuals: Waiting in the wings. London/ Philadelphia, PA: Jessica Kingsley. Jennings, S. (1998) Introduction to Dramatherapy. London: Jessica Kingsley. Jennings, S. (2011) Healthy Attachments and Neuro-Dramatic-Play. London: Jessica Kingsley. Jones, P. (2010) Drama as Therapy, Volume 2: Clinical work and research into practice. London: Routledge. Kaplan, A. (1985) Jewish Meditation: A practical guide. New York: Schoken Books. Kunza, P. and Salamander, C. (2004). Rituales para niños / Rituals for children (Spanish edn). Barcelona, Spain: Hispano Europea Editorial. Lahad, M. (2013) The ‘BASIC PH’ Model of Coping and Resiliency: Theory, research and cross-cultural application. London: Jessica Kingsley. McTaggart, L. (2011) The Bond: Connecting through the space between us. New York: Baror International. Rappaport, L. (2014) Mindfulness and the Arts Therapies: Theory and practice. London: Jessica Kingsley.

Websites www.crianzanatural.com/art/art11.html (accessed 5 August 2014). www.museoreinasofia.es/publicaciones/repeticiontransformacion (accessed 26 August 2014). http://en.wikipedia.org/wiki/Silva_Method (accessed 4 August 2014). http://en.wikipedia.org/wiki/Transcendental_Meditation (accessed 4 August 2014).

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34 Redefinition, restoration, resilience1 Drama therapy for healing and social transformation Warren Nebe

Annie Dillard, with her deft ability to describe everyday reality tells, in An American Childhood (1987), a story about a moth. Her teacher had placed a cocoon in a glass mason jar. The mason jar sat on the teacher’s desk where the big moth emerged. ‘The moth had clawed a hole in its hot cocoon’, supported by the jar as in a womb, ‘and crawled out’, ready to take its place in the world (1987, p. 160). Dillard says: A smaller moth could have spread its wings to their utmost in that mason jar, but the Polyphemus moth was big. Its gold furred body was almost as big as a mouse. Its brown, yellow, pink and blue wings would have extended six inches from tip to tip, but the jar was simply too small. The moth could not open its wings. (1987, p. 161) It needed to. The wings needed to open to take shape, to form, to be able to be used. A hatched moth must spread its wings quickly, and fill them with blood slowly, before it can fly. Instead, the jar constricted the early life of the moth. Days passed. Dillard was transfixed by the moth’s struggle in the jar; its wings now dry, big and unusable. On a particular sun-drenched day, the teacher and the class took the jar outside into the yard, freeing the large moth to walk unsteadily down the asphalt driveway on its six tiny legs to meet its inevitable fate in the road, its useless, broad wing-clumps heaving as it went, unable to open. The teacher and her class of children watched the moth crawl its way to its fate, triumphant in their belief that they had done well to have played midwife to a moth’s freedom. I referred to this story at a now defunct South African Association of Drama and Youth Theatre conference towards the end of 1993, months away from our democratic dawn. I was calling for an educational system that would ensure the freedom of the child. It is no coincidence that I was gripped by the symbolism of the moth at a time when we were all literally walking towards our freedom. The harsh rigidity of the apartheid system was beginning to crumble. 348

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We were a country at war with itself, but we were also a country willing to take a huge leap of faith in the healing promised (Tutu 1999). Twenty-one years later, I am still gripped by the power of this story. It reverberates, resonating ever more to our current condition in South Africa. Twenty-one years ago we crawled out of the confines of oppression, black and white, hoping our wings would open miraculously. Twentyone years later, we still have glass jars that injure our children, suffocate our adolescents and damage our adult relationships to a point of disrepair. Our education system, like a series of glass jars, not dissimilar from apartheid’s structure, damages the inherent potential of our young through a profound lack of imagination and an impoverishment that cultivates a culture of neglect. At the same time, we find a system of jars that literally cocoons our select young in crystal glass towers, leaving them detached, socially and politically inept and removed from a reality that could speak back to their economic privilege. Our mental health care system, similarly, is broken. It is no surprise, then, that in the same week in 2014, the Sunday Times, one of South Africa’s biggest newspapers, published a front-page story with the trauma-inscribed headline ‘SA’s sick state of mental health’ (6 July), and the reputable Mail and Guardian (4 July) carried a comprehensive set of stories about the insidious, diseased inscription of alcohol and substance abuse etched upon every community in our country, with its inevitable impact on crime and violence. An average of forty-seven murders a day speaks of a country still at war with itself, a war that Alex Boraine believes has brought South Africa close to a failed state (2014). Our social revolution, encapsulated by Nelson Mandela’s significant legacy, has literally fallen ill. The Sunday Times investigation reported that, although one-third of South Africans suffer from mental illnesses, 75 per cent of them will never receive any form of treatment. More than 17 million people in South Africa are dealing with depression, substance abuse, anxiety, bipolar disorder and schizophrenia – illnesses that round out the top five mental health diagnoses, according to the Mental Health Federation of South Africa. Despite the high number, the Department of Health annually spends only 4% . . . of its budget to address the crisis. (Tromp et al. 2014, p. 1) We are literally offering the majority of South Africans glass jars that are too small. With underresourced places of healing, we are re-wounding our mentally ill through gross negligence. What has gone so horribly wrong? Our psychosocial culture, a socially constructed reality, is one of dislocation that, regardless of race or class, betrays the human spirit. Apartheid was a profound betrayal of the human spirit, a silent genocide of souls, witnessed by an indifferent world for several decades (Ramphele 2008; Gobodo-Madikizela 2014). Apartheid, together with the inaction of a powerful international community over decades, left its scars. The birth of our democratic constitution promised healing and social transformation, but we were betrayed again by the Truth and Reconciliation Commission, with its untimely closure and overt negation by Thabo Mbeki’s government, ironically, of the necessity for healing, restitution and restoration (Nebe 2013; GobodoMadikizela 2014). We are indeed the polyphemus moth, wings all clumped up, covering the hard ground in search of a chance to fly. Our internationally celebrated constitution could be seen as the new glass jar that was meant to contain, nurture and midwife our freedom. There are some remarkable features about South Africa’s constitutional democracy, beautifully elucidated by Justice Edwin Cameron (2014). But something went horribly wrong: we failed to break the old jars that needed breaking. We did not address the needs of people who were broken in one way or another by the apartheid 349

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system. Economics has taken precedence over a concern for our humanity. Neo-liberalism’s triumphant anthem to individual narcissism is winning the day (Ramphele 2012). A culture of Whiteness born of a history of slavery, colonialism and apartheid, as opposed to a culture of freedom, pervades our mental health care profession, our deeply flawed and divided education system and society as a whole. In South Africa, healing is necessary (Tutu 1999; Ramphele 2008; Gobodo-Madikizela 2014). In order for us to effect genuine healing, we have to reimagine our mental health care professions (Vetten 2005). In order for healing spaces and processes to become transformative, our social and cultural relationships and, by implication, systems and structures have to change. We can no longer focus solely on the marginalized, or safeguard healing for the privileged few who have access to private health care, because the polyphemus moth in all of us needs to spread its wings at birth, letting the blood give life to each and every vein. How we nurture such life is dependent on how we construct the world we live in. Understanding that we can play a part in the construction of social reality is partly dependent on the education we choose to engage with. Given this predicament, Drama for Life is a radical attempt to address our current social reality by recruiting drama, theatre and performance leaders in higher education as a means to achieving social transformation in Africa, and South Africa specifically (Sichel 2008). At the same time, it endeavours to catalyse creativity in education in order to address our multiple challenges. A qualification in drama therapy is officially offered by the University of the Witwatersrand, Johannesburg, through Drama for Life, a division of postgraduate studies in applied drama and theatre, drama education and drama therapy. It is the only professional qualification in drama therapy offered in Africa. The qualification leads to full registration and recognition by the Health Professions Council of South Africa (HPCSA; www.dramaforlife.co.za/dramatherapy). In this chapter, I refer to the recent experience of the drama therapy profession in Africa as a means to make apparent the need for counter-hegemonic action and thought in our discipline. In order to counter prevailing practices, which all too often turn a blind eye to the divisions that exist in our country, we have had to rethink the education of the drama therapist. Dominant trends in professional training within the international arena fall within the liberal humanist tradition – encapsulated in the Renaissance dictum, which characterizes the individual as the measure of all things. Such a pedagogic orientation is symbolized by the traditional psychic journey of ‘travelling within’. Before engaging in healing practices, one is expected to heal oneself by undertaking an inward psychological journey. Drama for Life, however, offers a counter to this tradition – a tradition that implicitly negates sociopolitical responsibilities and leaves ethical questions unanswered. Rather, we endorse the proposition that education, in its deepest form, is ‘the art of enticing the soul to emerge from its cocoon, from its coil of potentiality and its cave of hiding’ (Moore 1996, p. 3). How we work towards this goal is what is developed in the argument below. The Drama for Life postgraduate centre is unique in the academic dialogue it supports between the drama therapy, drama education and applied drama and theatre courses. All three courses have features and principles that address the psychosocial trauma, community health and institutional fragmentation in Southern Africa. Central to the professional education of the drama therapist, I argue, is a critical reflexive praxis within these three different, but related, fields. This integrated, reflective orientation fosters a collaborative curriculum model combining developmental, educational and psychological strands and disturbing health-care practices of professional isolation and dislocation. The latter practices are unfortunately perpetuated in psychological, social and professional roles within informal and formal health and education in urban and rural communities, among rich and poor of all races and cultures alike. Drama for 350

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Life aims to bring down the imagined walls that separate the personal, the political, the psychological and the social in daily lived experience. Critical reflexive praxis is at the heart of an engaged pedagogy, which, according to bell hooks, emphasizes that learning is enhanced through an interactive, meaningful relationship between teacher and student. Such dialogic education, embracing a critical reflexive praxis, foregrounds the political nature of the psychosocial and aims to redress the biases that have informed knowledge production and the teaching methods used to interrogate, or not, knowledge systems (hooks 1994, pp. 13–22). The praxis, also posited by Freire (1998, 2001, 2012), is towards ‘social action that is critically informed and premised on experiential knowledge of the world, dialogue, and critical reflection and is ultimately guided by the values of social transformation’ (Stevens et al. 2013, p. 6). Drama for Life’s assertion, in line with Darder et al. (2009), is that a critical pedagogy, built on dialogue, is valuable and necessary, but is limited without a conscious, mindful inclusion of embodied reflexivity. In this context, drama offers a powerful symbolic opportunity for reflexivity, which, if integrated with critical reflexive praxis, requires vulnerability and a willingness to engage with what it means to be human in Africa. This includes having to embrace the spiritual ethic embedded in the centuries-old cultural practice of Ubuntu. This is what impels me to contend that what we are attempting, through our pedagogy, is to create a learning journey, a rite of passage, for the becoming drama therapist that is both inward looking and outward looking; a journey that encapsulates, through doing, the inherent meaning of Ubuntu, namely ‘I am who I am because of you’. Our discourse is framed by theories of critical pedagogy, cultural studies and social psychology; our professional development is underpinned by a reflective, progressive humanism; our praxis is determined by the extent to which we can integrate theory and practice through embodied, conceptual, performance-based research, and teaching that honours the vulnerable and rejects shame-based teaching methods (Boal 1979; Freire 2001; Bial 2007; Ackroyd and O’Toole 2010; Brown 2012). Our praxis, rooted in a research orientation that recognizes and respects conscious and unconscious processes, creates the means by which we are able to interrogate social transformation in education, development and mental health, specifically in Africa. Through critical reflexive praxis, Drama for Life engages its community of participants and students in participatory dialogue about the interrelationship, intersections and integration of applied drama, drama education and drama therapy within a human rights and social justice discourse. Our goal in research and practice is to foster sustainable, collaborative, ethical and context-sensitive social change interventions throughout Africa. This kind of education, in part, is what Carl Rogers refers to as the ‘freedom to learn’: It has a quality of personal involvement – the whole person in both his feeling and cognitive aspects being in the learning event. It is self-initiated. Even when the impetus or stimulus comes from the outside, the sense of discovery, of reaching out, of grasping and comprehending, comes from within. It is pervasive. It makes a difference in the behavior, the attitudes, perhaps even the personality of the learner. . . . He knows whether it is meeting his need, whether it leads toward what he wants to know . . . whether it illuminates the dark area of ignorance he is experiencing. The locus of evaluation, we might say, resides definitely in the learner. Its essence is meaning. (1979: 5) Learning centrally involves an act of meaning-making for the learner. For the becoming drama therapist, the feeling and cognitive aspects of learning have to be integrated with social learning aspects too. In order for a learner to begin to grasp their own agency and its 351

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consequences in this process, they have to engage with the tension between the intra-psychic relationship and the interpersonal relationship. It is about learning that we are not alone. ‘To be educated’, Thomas Moore elucidates, ‘ a person doesn’t have to know much or be informed, but he or she does have to have been exposed vulnerably to the transformative events of an engaged life’ (1996, p. 3). We are social beings, citizens with agency, in relationship with one another. We are not only the moths, but we are also the glass-jar makers and the teachers and children who have agency over the glass jars and the birthing conditions of the moths. Drama for Life’s objective is to educate professional artists, therapists, facilitators and educators in drama for social transformation. This means that Drama for Life is committed to the education of professionals who are research active; professionals who understand what it means to be resilient care-givers, creators and leaders; professionals who embody and execute ethical practice; and professionals who understand, harness and implement collaborative, systemic arts interventions in education, development and/or mental health – interventions that can be effective, affective and sustainable. It is critical that our students begin to grasp that social relationships, systems and structures are not irrelevant to their personal experience, but rather that their personal and interpersonal politics is what determines social relationships, systems and structures. Given these intentions, our ethos is driven by two key questions: What does it mean to be human in the twenty-first century? And, as we engage with the enormous challenges of change that we all face, how can we learn to be resilient without compromising our humanity? The question of humanness is addressed through three key principles that underpin relationships between therapist and client, educator and learner, theatre-maker–facilitator and community member and that were originally articulated by Carl Rogers (1979). First, questions of humanity must be asked with genuineness, empathy and unconditional positive regard for the parties involved. This is a strategic way of attending to and healing our social fragmentation and is essential to destabilizing the traditional academy, built on an ideology of Whiteness, in Africa. Rogers saw genuineness, empathy and unconditional positive regard as crucial for the enhancement of relationships embedded in integrity and freedom. He ‘believed the art of becoming a therapist consisted entirely in developing one’s capacity to move farther and farther along each of (these) three continua’ (Kahn 1997, p. 48). In Between Therapist and Client: The new relationship, Khan notes that the implication of this approach is ‘extraordinarily radical’: Studying theories and techniques, however interesting they may be, is of no value to the therapist. Training could be helpful, in fact very helpful, but that training would not consist of the acquisition of knowledge. It would be experiential training, the sort of training that would help therapists increase their self-awareness so that they might become more genuine in all aspects of their lives; sensitive to all the people they deal with, so that they might be more empathic with clients. And it would be a training that would enable them to come to terms with their buried prejudices and resentments so that they might be free to prize their clients. (1997, p. 48) Drama for Life’s immersion in a human rights and social justice discourse that examines diversity, not as a theme, but as a way power is structurally and systemically organized and performed, implies that our students have to confront their own prejudices, social power and racial, sexual, cultural and national identity politics. The notion that drama is value-free because 352

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of its expressive and so-called ‘natural’ playful nature is debunked here. Drama is not valuefree, and, by implication, neither is the drama therapist (Nebe 1991). Furthermore, another implication that emerges from the self-reflexive approach advocated by Rogers and implemented by Drama for Life is that, although a drama therapist should be an all-rounder professional in drama therapy education, particularly in the understanding of mental illness and diagnosis, like Rogers, we also contend that, ultimately, ‘there is no therapeutic value in diagnosis’. That is, says Kahn: finding a category into which the client may be fitted adds nothing to the therapist’s effectiveness. It doesn’t make any difference whether you think your client is borderline or narcissistic or schizophrenic or mildly depressed. If you can be genuine, if you can communicate that you are managing to grasp your client’s experiences, and if you can let them know of your unshakable regard for their worth as human beings – if you can do all that to a significant degree, then your clients will grow and change, whatever label might be applied to them. (1997, p. 49) With regard to training drama therapists in Africa, there is another context-specific reason why we need to be acutely aware of the dangers of diagnosis. Illness in Africa, as a social construct, doesn’t embody the same Western, scientific interpretations that are entrenched in our postcolonial, mainstream mental-health system. Rather, we understand illness within a holistic, body–mind–spirit continuum (Patel 1995; Manda 2008; Makanya 2014). For instance, vocabulary doesn’t exist for what the Western psychologies so readily term ‘stress’, because, in our context, ‘stress’ is constructed through culture in ways unfamiliar to a Western mindset. Given this context, the Drama for Life postgraduate degree in drama therapy is structured to include the indigenous education of a new generation of resilient, HPCSA-registered drama therapists enabled to work in a wide range of clinical, special needs, educational and communitybased settings. Such settings are often in need of facilitation for critical, psychosocial trauma that stems from historical and contemporary economic deprivation, political and social violence, a poverty of education and imagination and serious health challenges. It is not our intention to contribute to the fragmentation of drama therapy, a worrying trend in the field, by further developing a ‘new method’ of drama therapy (Johnson and Emunah 2009). Rather, I would suggest that it is our intention to develop an integrated approach to drama therapy, driven by a human rights and social justice discourse, through our critical reflexive praxis. Learners engage with a range of established theories and approaches, inclusive of drama therapy theory, such as Jennings (1992), Jones (1996, 2010), the Integrative Model (Emunah 1994), the role method (Landy 1994), the Sesame method (Pearson 1996), Playback Theatre (Fox 1994) and psychodrama and sociometry (Dayton 2005). Such models are included in an integrated approach, infused with indigenous cultural, performance and healing practices found across Africa. These many approaches are taught as a way to further encourage dialogue with extant applied drama and theatre and drama education approaches, particularly those rooted in Africa and other developing-world contexts, such as the work of Zakes Mda (1993) and Augusto Boal (1979). Drama for Life’s explicit intention, with this paradigm, is to train drama therapists who will be flexible professionals and resilient clinicians, able to adapt to a diverse range of settings, frequently in unstable, oppressive, depressive and ethically challenging circumstances, and who will know how to deal innovatively and creatively with rapidly changing circumstances. Critical reflexive praxis, within a community-based health model, enables our students to engage with 353

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a multicultural and multilingual society in deep transition. The intersection between drama therapy, applied drama and theatre and drama education ensures that our students are grounded in effective group, community and systemically oriented strategies appropriate to deal with challenges arising from diversity and psychosocial trauma. The urgent questions that inform our curriculum, for which we do not necessarily have all the answers, are therefore complex in nature. What are the qualities and skills most needed in order for a drama therapist to engage in healing, and to function as a socially responsible change agent? How can genuineness, empathy and unconditional positive regard be translated into a socially responsive approach based on principles of restorative justice, so that the therapist doesn’t only operate within private, interpersonal relationships? How can the drama therapist best function as a collaborator with allied professionals and colleagues in ways that build cohesion, as opposed to ways that individualize and separate, thereby reinforcing neo-liberal tendencies that seriously reduce any sense of psychosocial and political responsibility on the part of the health-care professionals? The drama therapy student undertakes a 2-year postgraduate academic and practical training, inclusive of clinical and community-based placements, followed by a year-long internship, before full registration as a clinician. The training includes the study of applied drama and theatre, and drama education studies. It is this intersection that enables the student drama therapist to begin to find ways to address some of the questions raised above. Drama for Life’s conceptual basis for applied drama is rooted in the history of Theatre for Development in Africa. Our study of this discipline, through the lenses of power, pedagogy and praxis, is a critical enquiry into the theories and practice of social development and change within the context of economic and educational impoverishment and global climate, cultural and religious change (Moore and Mitchell 2008). Theatre for Development, as developed by David Kerr, Ross Kidd and Zakes Mda, among many others, draws upon the stories of people, seeking to locate the personal story within the public event, working from the particular to the universal. Theatre for Development, often associated with the theory and practice of the Theatre of the Oppressed (Boal 1979), is a combination of processes that are used to address a problem that has social and developmental consequences within a specific community. This form of theatre involves a group of experts, activists and sometimes performers, often from outside the target community, who research a problem such as water conservation or alcoholism with the community, through a range of processes such as interviews, community meetings, role-play and traditional forms of performance. These processes are used to understand the social, political and developmental nature of the problem presented. The team withdraws from the community to reflect on the problem and how best to mirror this problem back to the community in all its complexity, as a means to begin problem-solving. Any intervention, it would be fiercely argued, should be rooted in principles of sustainable development. A range of theatre processes may be used: forum theatre, image theatre, storytelling, masked rituals, role-play, song and dance, and other forms of interactive theatre. The team proceeds to reunite with the community, with the blessing of the elders and/or authorities, and presents the problem through performance to the community. However, the work never stays at a presentational level, but rather engages the audience in discussion, participation and ultimately, hopefully, in resolution of the problem. Ideal Theatre for Development processes will ensure that the problem is processed in depth, taking a considerable amount of time, patience and negotiation, finding ways to empower the community through skills-sharing and training, and by giving them a voice in the problem that is essentially theirs to live with, or change. The primary goal of Theatre for Development, one would argue, is to empower communities to solve their own problems. It is not about the imposition of ideas, methods and foreign solutions on people (Mda 1993; Odhiambo 2008; Barnes 2013a). 354

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Drama for Life’s critical reflexive praxis also poses questions about traditional concepts and methods of Theatre for Development through the exploration of related contemporary, community-based drama, theatre in education, documentary and therapeutic performance methods and aesthetic forms. Through the dialogue between liberation pedagogy theories (hooks 1994; Freire 2001) and a learner-centred humanism (Kahn 1997; Rogers 1979), this interdisciplinary space draws attention to sociological and anthropological approaches to performance as social-change intervention (Nebe 2012; Shmukler 2014). These questions, which continually surface in Drama for Life public discourse, draw attention to the lack of research; ‘outsider’ and ‘insider’ facilitation; race, gender, religious, national and sexual identities; ethical practice; cultural frames of expression; cultural literacy and efficacy; linguistic abilities and challenges; process drama, dramatic media and drama methodologies; and supervision, monitoring and evaluation, and sustainability. These issues are cogently raised, implicitly and explicitly, in the work of many authors captured in the Drama for Life conference publications edited by Hazel Barnes (Barnes 2013a; Barnes and Coetzee 2014). Our applied drama, on urban streets and in rural villages, prisons, schools, shelters for the homeless, homes for the elderly, rehabilitation centres, non-governmental organizations devoted to marginalized groups, universities and colleges, is recorded, reflected upon and theorized through arts-based research that integrates ethnographic, narrative and participatory-action research methodologies, as and when appropriate. Our global research questions include those raised by Nicholson, namely, in what ways could interventionist theatre continue to radicalise human rights through creativity in an international context. And how can theatre-making allow us all the ability to explore ethical participation (Nicholson 2005). Since its inception in 2008, the annual Drama for Life Africa Research Conference has become a significant event in Africa that explores these and other questions in considerable depth, opening new conversations and understandings about the work. Recent publications are testimony to the scope of this academic project (Barnes 2013a, 2013b; Barnes and Coetzee 2014; Sinding and Barnes 2015; South African Theatre Journal, 2015, 28, 1). Drama for Life, given this context for applied drama and, by implication, drama therapy, rejects functional interpretations of the art form. A technical reduction of drama as ‘applied’ is an instrument to maintain the legacy of colonial art forms. International trends in applied drama incorporate an eclectic combination of theatre for social change methods, but what they don’t have in common is an interdisciplinary research commitment to the continuum of drama, theatre and performance as a means to speak truth to power within a social justice context. Again, I would argue that there is an assumption that all applied drama and theatre interventions are progressive – meaning human rights embedded – in orientation. This is simply untrue. Drama for Life attempts to embrace a human rights discourse through the interrogation of the methods and theories that underpin prison theatre, theatre in education, Theatre of the Oppressed, participatory community-based theatre, political theatre, guerilla theatre, museum theatre, Playback Theatre, popular theatre and many other forms. It is our intention to consciously frame the different theoretical and methodological approaches within the context of Drama for Life’s mission and vision, to question the efficacy and relevance of the work and to explore ways that enhance the voices of our partner communities. Critical questions within this field, developed by Drama for Life staff, speak of our ongoing continental concerns and provide the framework for our self-evaluation, namely: How can/do the arts address/challenge the political mechanisms that perpetuate silences/recurring systems of silencing of the oppressed? How can/do the arts articulate democracy as action/as an act of civil education? And, how can the arts support/ empower individuals and communities to cope in the continuous flux of our current socioeconomic and political environment? 355

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These questions are just as relevant to the drama therapist as they are to the applied drama and theatre facilitator. A collaborative model would resonate with diverse professionals concerned with a variety of aspects of the same questions. It is this process that ensures that no binaries are maintained in the work, and it is this process that begins to allow us to address the larger, more pressing concern that surely can only be addressed through an integrated drama therapy approach, one that is situated in effective professional collaboration. In this way, I believe we can begin to answer the question: in what ways can drama effectively help us remember our heritage, restore our sense of belonging, reimagine who we can become as responsible, relational social change agents committed to the well-being of ‘self’ and ‘other’? By so doing we will contribute towards the reconstruction and restoration of cohesive communities. We all need to be the glass-jar makers; the drama therapist cannot do this alone, and neither can the applied drama and theatre facilitator. Enter drama education, the means to better understanding of the aesthetic of drama as the medium through which meaning can be learned and negotiated. Drama for Life’s inclusion of drama education is a deliberate acknowledgement of the role of the drama practitioner who uses drama as an educational methodology, the drama practitioner who facilitates theatre-making as an educational strategy, and the drama practitioner who teaches drama as a subject. The relationship between those who work in the broader community for development and those who work in formal and informal settings for the purposes of education differ, to some extent, in purpose, content and context. The opportunities for synergies between applied drama, drama therapy and drama education are considerable, however. Convergence occurs in what is referred to as process drama, which conceptualizes drama as a process of enquiry that is embodied as method, a way of learning, and as subject and as art form (Nebe 1991; O’Neill 1995; Landy and Montgomery 2012). Drama for Life sees this as the key to what prepares applied drama facilitators, drama educators and drama therapists to become sound, effective professionals who understand the symbolic, psychological, anthropological and sociological research aspects of the dramatic medium that is never value neutral. Process drama is interpreted as a pedagogical approach to education that places the individual learner at the centre of a social learning experience where meaning is not absolute but rather negotiated collectively (Wagner 1976; Bolton 1979; Heathcote, in Johnson and O’Neill 1984; Nebe 1991; O’Neill 1995). Through learning in process drama, imaginary contexts are created as metaphors of the real world. These metaphors function as bridges for learners to engage with the real world. Through role-play and story, among many other strategies and drama structures, they help people engage with personal, professional, social and cultural roles and attitudes that affect economic, social and political relationships. Process drama affords the opportunity to participants to practise attitudinal and behavioural change, and to comprehend their own role and relationship to society. The metaphors are the means to teach how meaning is negotiated, how other people live and why they live the way they do, and to come to an embodied understanding of how both personal and political power determines the extent to which people have agency over meaning-making. The drama educator and all the learners engage in the drama and reflect upon the drama, together. There are never outsider audience members. The emphasis is on the process: how the drama is created; how the learners and the drama educator explore symbolic worlds together; how the learners and the drama educator use different roles and other dramatic media to talk about things that matter; how the story unfolds; and what lessons are learned from the story construction. It is this ability to collectively negotiate the creation of imaginary contexts through the dramatic make-believe that serves as a bridge between the imagined learning space and the real world (Wagner 1976). 356

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This nuanced method of negotiating contexts of meaning, rendering them symbolic objects for consideration and reflecting upon their meanings and consequent possible avenues for action requires considerable insight and skill to conceptualize, improvise, critically question and move from existing contexts to enacting imagined contexts. I believe it is a fundamental aspect of training for the drama therapist. It not only provides a grounded and embodied understanding of play, role and role-play as learning processes, but it also provides an opportunity to understand the inherent interconnections between narrative drama and social construction (Burr 2006). It is, thus, a crucial part of the critical reflexive praxis of the Drama for Life curriculum. Process drama, we argue, teaches our learner drama therapists that they cannot accept glass-jar conditions without questioning their existence, their aesthetic form, their contents and their makers and modes of production. It also teaches drama therapists that they may not be the sole authority on the nature or conditions of glass jars. If glass jars are to be effective incubators for healing, then glass jars need to be collectively, aesthetically created through a time-considerate and contextsensitive process of making that will foster a significant, negotiated process in which power is distributed to all, irrespective of status or sex or race, and where activism is valued and respected as the creative psychology necessary for the challenges of the twenty-first century (Csikszentmihalyi 1996). Our dream for drama therapists, in partnership with applied drama and theatre facilitators and drama educators, is that they will create imaginary glass jars collectively, big enough for the wings of all, transient enough to melt away when no longer needed, and strong enough to hold and to be held and to be respected by all those who dream into the imaginary. ‘Without imagination there is no vision; without vision there is no hope; and without hope there is no life’ (Mueller-Glodde and Nebe 2006, p. 3). Imagination, vision and hope, I believe, are largely dependent on our collective humanity. ‘All of our humanity’, says Archbishop Desmond Tutu, ‘is dependent on recognizing the humanity in others’. When we begin to recognize the humanity of another, we have effectively begun to imagine outwards; we have started to imagine ourselves into the lives of others, and we have started to understand ourselves in relation to others, and, by so doing, we have effectively begun to comprehend what it means to be human. For being human is dependent on memory, and ‘memory does not exist in a vacuum’ (Dorfman 2011, p. 7). What I comprehend of the world that I live in is largely dependent on the extent to which I am willing to imagine into the past, present and future with you. Drama therapy offers a light for our comprehension of, and our agency over, the world that we live in, no matter how dark it sometimes appears.

Note 1

Content from this chapter was presented as part of a keynote address at the inaugural Healing and Social Transformation in Mental Healthcare in South Africa Conference, presented by the South African Association of Drama Therapy, Drama for Life – University of the Witwatersrand, Division of Occupational Therapy – University of Cape Town, and the South African Network of Arts Therapy Organisations, 14–15 July 2014, at the University of Cape Town, South Africa.

References Ackroyd, J. and O’Toole, J. (2010) Performing Research. Stoke-on-Trent, UK: Trentham Books. Barnes, H. (ed.) (2013a) Arts Activism, Education and Therapies: Transforming communities across Africa. Amsterdam: Rodopi. Barnes, H. (ed.) (2013b) Applied Drama and Theatre as an Interdisciplinary Field in the Context of HIV/AIDS in Africa. Amsterdam: Rodopi. 357

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Barnes, H. and Coetzee, M.-H. (eds) (2014) Applied Drama/Theatre as Social Intervention in Conflict and Post-Conflict Contexts. Newcastle upon Tyne, UK: Cambridge Scholars Publishing. Bial, H. (ed.) (2007) The Performance Studies Reader. London: Routledge. Brown, B. (2012) Daring Greatly. London: Penguin. Boal, A. (1979) Theatre of the Oppressed. London: Pluto. Bolton, G. (1979) Towards a Theory of Drama in Education. London: Longman. Boraine, A. (2014) What’s Gone Wrong? On the brink of a failed state. Johannesburg, SA: Jonathan Ball. Burr, V. (2006) An Introduction to Social Constructionism. London: Routledge. Cameron, E. (2014) Justice: A personal account. Cape Town, SA: Tafelberg. Csikszentmihalyi, M. (1996) Creativity: The psychology of discovery and invention. New York: HarperCollins. Darder, A., Baltodano, P. and Torres, R. D. (eds) (2009) The Critical Pedagogy Reader. London: Routledge. Dayton, T. (2005) The Living Stage. Deerfield Beach, FL: Health Communications. Dillard, A. (1987) An American Childhood. New York: Harper & Row. Dorfman, A. (2011) Writing the Deep South. Johannesburg, SA: Picador. Emunah, R. (1994) Acting for Real: Drama therapy process, technique and performance. New York: Brunner/ Mazel. Fox, J. (1994) Acts of Service: Spontaneity, commitment, tradition in the nonscripted theatre. New Paltz, NY: Tusitala. Freire, P. (1998) Pedagogy of Hope. London: Bloomsbury. Freire, P. (2001) Pedagogy of Freedom. New York: Rowman & Littlefield. Freire, P. (2012) Pedagogy of the Oppressed. New York: Bloomsbury. Gobodo-Madikizela, P. (2014) Dare We Hope? Facing our past to find a new future. Cape Town, SA: Tafelberg. hooks, b. (1994) Teaching to Transgress: Education as the practice of freedom. New York: Routledge. Jennings, S. (ed.) (1992) Dramatherapy: Theory and Practice 2. London: Tavistock/Routledge. Johnson, D. R. and Emunah, R. (eds) (2009) Current Approaches in Drama Therapy. Springfield, IL: Charles C. Thomas. Johnson, L. and O’Neill, C. (1984) Dorothy Heathcote: Collected writings on education and drama. London: Hutchinson. Jones, P. (ed.) (1996) Drama as Therapy: Theory, practice and research. London: Routledge Jones, P. (ed.) (2010) Drama as Therapy: Clinical work and research into practice (vol. 2). London: Routledge. Kahn, M. (1997) Between Therapist and Client: The new relationship. New York: W.H. Freeman. Landy, R. J. (1994) Drama Therapy: Concepts, theories and practices. Springfield, IL: Charles C. Thomas. Landy, R. J. and Montgomery, D. T. (2012) Theatre for Social Change: Education, social action and therapy. New York: Palgrave Macmillan. Mail and Guardian. (4 July 2014) Drug edition. Johannesburg, SA. Online. Available at: www.mg.co.za/ tag/drug-edition-2014 (accessed 13 February 2016). Makanya, S. (2014) ‘The missing links: A South African perspective of the theories of health in drama therapy’, The Arts in Psychotherapy, 41, 302–6. Manda, L. D. (2008) ‘Africa’s healing wisdom: Spiritual and ethical values of traditional African healthcare practices’, in Nicholson, R. (ed.), Persons in Community: African Ethics in Global Culture, pp. 125–43. Scottsville, SA: University of KwaZulu Natal Press. Mda, Z. (1993) When People Play People: Development communication through theatre. London: Zed Books. Moore, S. A. and Mitchell, R. C. (eds) (2008) Power, Pedagogy and Praxis: Social justice in the globalized classroom. Rotterdam, Netherlands: Sense. Moore, T. (ed.) (1996) The Education of the Heart. New York: HarperCollins. Mueller-Glodde, U. and Nebe, W. (2006) ‘SADC capacity development in HIV and AIDS education through applied drama’, Appraisal Mission Report (‘STOP’) and Programme Proposal, ‘Drama for Life’, Commissioned by GTZ-SADC, Gaborone, Botswana (SADC–GTZ Report). Nebe, W. (1991) A Critical Analysis of the Teaching Technique Role Play, With Particular Reference to Educational Drama. Submitted in partial fulfilment of MA requirements, University of Cape Town, SA. Nebe, W. (2012) ‘What’s in a name?’, in Heidenreich-Seleme, L. and O’Toole, S. (eds), Uber(W)unden: Art in troubled times, pp. 152–63. Johannesburg, SA: Jacana Media. Nebe, W. (2013) ‘Rites of passage: Re-imagining our stories through creative reflexive contexts’, keynote address as part of 6th Annual Drama for Life Africa Research Conference: The Unfinished Business of Truth and Reconciliation: Arts, trauma and healing, Johannesburg, SA. Nicholson, H. (2005) Applied Drama: The gift of theatre. Basingstoke, UK: Palgrave Macmillan. 358

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Odhiambo, C. J. (2008) Theatre for Development in Kenya: In search of appropriate procedure and methodology. Bayreuth, Germany: Bayreuth African Studies. O’Neill, C. (1995) Drama Worlds: A framework for process drama. Portsmouth, UK: Heinemann. Patel, V. (1995) ‘Explanatory models of mental illness in Sub-Saharan Africa’, Social Science & Medicine, 40, 9, 1291–8. Pearson, J. (1996) Discovering the Self Through Drama and Movement. London: Jessica Kingsley. Ramphele, M. (2008) Laying Ghosts to Rest: Dilemmas of the transformation in South Africa. Cape Town, SA: Tafelberg. Ramphele, M. (2012) Conversations with My Sons and Daughters. Johannesburg, SA: Penguin. Rogers, C. (1979) Freedom to Learn. London: Charles E. Merrill. Shmukler, G. (2014) ‘Trauma and theatre making with reference to The Line’, in Barnes, H. and Coetzee, M.-H. (eds), Applied Drama/Theatre as Social Intervention in Conflict and Post-Conflict Contexts, pp. 103–54. Newcastle upon Tyne, UK: Cambridge Scholars Publishing. Sichel, A. (2008) ‘Levelling the African playing grounds . . .’, The Star, 12 November. Online. Available at: www.highbeam.com/doc/1G1-188839289.html (accessed 24 February 2016). Sinding, C. and Barnes, H. (eds) (2015) Social Work Artfully: Beyond borders and boundaries. Waterloo, Canada: Wilfred Laurier University Press. Stevens, G., Duncan, N. and Hook, D. (eds) (2013) Race, Memory and The Apartheid Archive: Towards a psychosocial praxis. Johannesburg, SA: Wits University Press. Tromp, B., Dolley, C., Laganparsad, M. and Govender, S. (2014) ‘South Africa’s sick state of mental health’, Sunday Times, Johannesburg, SA. Online. Available at: http://crm.bhfglobal.com/sas-sick-state-mentalhealth (accessed 13 February 2016). Tutu, D. (1999) No Future Without Forgiveness. Parktown, SA: Random House. Vetten, L. (2005) ‘Show me the money: A review of budgets allocated towards the implementation of South Africa’s Domestic Violence Act’, Politikon: The South African Journal of Political Studies, 32, 2, 277–95. Wagner, B. J. (1976) Dorothy Heathcote: Drama as a learning medium. London: Hutchinson.

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Afterword Clive Holmwood

When the first Handbook of Dramatherapy came out in 1994 (Jennings et al. 1994), I would not have believed that a little over 21 years later, I would be co-editing the first International Handbook of Dramatherapy. The original book has sat on my bookshelf for many years and has become an essential book to refer to, as I hope the current volume will be for the next generation of readers. These dates are both significant and poignant, on a personal and professional level. In 1994, I began my dramatherapy training at the University of Hertfordshire, a course originally set up by Sue Jennings. Twenty-one, in Western cultures at least, is considered significant in that a young adult is considered to have reached maturity. I am not sure that I have necessarily reached maturity as a therapist, but maybe, just maybe, dramatherapy is beginning to leave the uncertainty of its adolescent growing pains and is beginning to enter into its adult maturity. Of course maturity is, to an extent, semantic and contextual. In differing societies, the age of maturity can be anything from 12 through to 21. Neuroscience suggests brain maturity is not achieved until our mid twenties, or beyond. None the less, it seems appropriate that the first International Handbook of Dramatherapy should be published at this time. One of the great advantages to editing a book is that, as editor, I am the first person in the world to read it – which I just have! It is quite remarkable, and the breadth and depth of empirical and theoretical experiences that this book covers give some credence to its current development. As Sue Jennings has pointed out in the Foreword, dramatherapy appears to avoid an imperialistic approach. It is an unhelpful misnomer to say that dramatherapy has matured in the West, but less so in other countries. The roots of dramatherapy lie in each individual, cultural and societal acknowledgement that drama, which exists in all cultures and all societies, is present in a myriad of approaches. Therefore, dramatherapy is something that, in essence, goes back millennia in all societies. However, as a recognized force for good, within a medical-dominated world, we may just be able to raise our heads above the parapet and acknowledge that we are beginning to develop processes that are culturally and socially specific, dependent upon our individual practice and location. In her Foreword, Sue Jennings also acknowledged a key importance for the profession’s future. Although I see Sue as Grandmother to the profession and Peter Slade as Great-grandfather, Sue herself points out that it is all of us who are practising today who are the currency and future of the profession, regardless of where we are and how we practise. Research will certainly play 360

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an integral role in the more medicalised Western world, where we will need to prove scientifically that dramatherapy is both an appropriate and effective practice. In finishing, we can also rest assured that drama and the arts have been used therapeutically for millennia and have been both effective in and relevant to our individual societies and cultures. This book, if nothing more, reminds us of this. Clive Holmwood PhD Staffordshire, England

Reference Jennings, S., Cattanach, A., Mitchell, S., Chesner, A, and Meldrum, B. (1994) The Handbook of Dramatherapy. London: Routledge.

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Appendix

Dramatherapy assessment Therapist Name of client Date of first visit Names or parents/carers Address Contact numbers Date of birth of client Professional network Social worker: School: Clinical psychology: Reason for referral Previous therapy GP Address Contact Number Medication:

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Presenting Difficulties: 1 2 3 4 5 6 7 8 9 10 Presentation of self: Living circumstances History: Genogram: Medical history: Projection: Dreams: Metaphors/images: Play: Religious spiritual beliefs: Cultural beliefs: Other: Presentation in therapy: – Observed behavioural changes: – Observed changes in themes of play: – Observed changes in metaphorical engagement: Role: Overdeveloped roles (historically and in current family system): Underdeveloped roles: Presentation in therapy: – Observed relational changes: – Observed shifts in over developed roles: – Observed shifts in under developed roles: Therapist’s clinical comments:

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Index

Please note ‘n’ denotes chapter endnotes. AAI (Adult Attachment Interview) 226 ABT (arts-based therapy) 19–25 abuse 127–128, 191–199, 201–202; see also sexual abuse academic conferences 11–12 academic trend, Korea 5 acorn theory 286, 288 ‘acting out’ 212, 236 action: aesthetic paradigm 145–159; group psychotherapy 112; knowledge 220; measurement 170–171; Spagyric dramatherapy 293 action-oriented processes 96 action research 55 active witnessing 79, 80, 88–89 activism 152 Actor Network Theory 150 AD (Alzheimer’s disease) 263 adaptation disorders 242 addiction 29, 30, 32, 141 ADHD see Attention Deficit Hyperactivity Disorder adolescence: abused Palestinian females 194–197; Arab–Israeli society 208–210, 212; attachment-informed therapy 218–229; deafness 48; development 219; see also teenagers Adult Attachment Interview (AAI) 226 aesthetic paradigm 145–159 affective states, adolescence 222, 225 Africa 350–351, 353–355; see also individual countries agency, learning 352 ‘alienation effect’ 163 ALIVE (Animating Learning by Integrating and Validating Experience) 151–152 alliances 61 altered states of consciousness 126 Alzheimer’s disease (AD) 263 Amal case study 196–197

amygdala 173 ancient roots, drama/deity 180–181 Anderson, Hans Christian 146 animal imagery 133 Animating Learning by Integrating and Validating Experience (ALIVE) 151–152 animation 331, 333 anomalous profession, dramatherapy 74 anxiety disorders 241, 294–304 apartheid system 349–350 applied drama 355–356 appropriateness, improvisation 279–280 Arab female abuse 191–193 Arab–Israeli society 208–217 Aristotle 161–162 art forms: crossing boundaries 22; Italian comedy 280–281; reinstalling 24 artists: dramatherapists as 67–76; origins of word 72 arts aspects, psychotherapy 285 arts-based therapy (ABT), India 19–25 art therapy: BADTh 70–71; critical theory 148; embodiment in 115–116; human science 3–18 assessments: eight sessions 234–235; EPR/NDP 47; form for 362–363; Korean dramatherapy 4, 5; measures 231–232; profiles 232, 237; rating scales 240; Stevie case 230–239 attachment: neurobiology 173–174; Stevie’s case 233–234, 237 attachment-informed therapy 218–229 Attention Deficit Hyperactivity Disorder (ADHD) 209, 213–214 attunement 220–222 audience: performers relationship 37, 41; reaction to TfC 95 Austin, Stephen F. 54 autistic spectrum 84 autobiographical elements: Boalian techniques 151; TfC 94 365

Index

autobiographical self 238 Ayodhya kingdom 27–30 babies: ADHD development 209; sensory experience 139, 141–142; see also children BAC (British Association for Counselling) 73 BADTh (British Association of Dramatherapy) 67–76 Bedouins 211 behavioural problems 213 behavioural therapy 170; see also cognitivebehavioural therapy beingness 285 belief system, mandala 251, 259–260 ‘believe’ statement, BADTh 70–72, 74 Beti medicine 41 Bharat character 28 biological concept: ADHD 209; short-term group therapy 326 ‘blank screen neutrality’ 310 Boal, Augusto 150–152, 164, 168n bodily control, older people 138–139 body/bodies: abused Palestinian females 191–199; brains and 143–144; critical aesthetic paradigm 154; dramatizing 79; as metaphor 135; place of 309–311; preoccupation with 136; Ramayana 27, 31, 33; relationships and 121–122; role connection 282; see also embodiment body learning, children 46 brain science 168 brains: bodies and 143–144; as collaborators 170–179; limbic 326; preoccupation with 135–136 brainstorming sessions 320 Breakthrough Group 297 Breakthrough Process 300–303 breath/breathing 27, 31, 33–34, 319 Brecht, Bertholt 149–151, 161, 162–163 ‘brief’ dramatherapy 325 Britain, 1977 events 73–74 British Association for Counselling (BAC) 73 British Association of Dramatherapy (BADTh) 67–76 Buddhism 280 ‘Buddhist mind-training’ 22–23 budgetary restrictions, learner’s place 137–138 call/purpose, soul 185–186 Cameroon 36–44 Canada 56–57, 60 cancer patients 250–254, 257 Casson, John 53–54, 155, 174, 183, 307 catamnesis 242–243 catharsis debate 161–162 CBT see cognitive-behavioural therapy 366

ceremony, texts 40 chakra system 31–32, 34 change: opportunities 77–91; resistance to 236–237 chemical transmission, brain 173 children: Arab–Israeli society 208–209; attachment process 173; body learning 136; bringing into the world 344–345; core processes 80–81, 83; deaf children 47–51; development 107, 116–117; EPR model 46, 193–194; improvisation 277–278, 279; Korea 4; neurotic disorders 246; rituals for 342; social identity 75; South Africa 349; Taiwan 15, 17; today’s 200–207; yogadrama 320; see also wounded child; young people China 13 classroom diversity 95–103 clearing process 327–328 client change, understanding 77–91 clinical practice: field of 109–112; recording/evaluating 82–83 clinical psychologists 178–179 closing ritual: drum circles 327; meditation 341, 345; short-term group therapy 333; therapeutic sessions 215 clowning 131 cochlear implants 47–48, 50–51 cognitive-behavioural therapy (CBT) 100, 136, 170–171, 296 collaboration: applied drama 356; brain 170–179 collective humanity 357 ‘collective psychiatry’ 41 collective storytelling 330–331 college courses, Taiwan 8–9 colonialism, India 21 commedia 275–284 commedia dell’arte 276, 280–282, 283n commitment, shyness and 297–298 communication: deaf children 49; Taiwan 12–13 Communicube 131–133, 174 Communism, Romania 45 community-based approach: Cameroon 36–44; critical reflexive praxis 353–355; experiential experimentation 114 community drama, North American 54 community involvement, Taiwan 15–16 comparative approach, embodiment 115 compassion 278 competency: cultural 92–104; dramatherapy studies 59 composite characters 329–330 composition 278, 331 Concordia, Canada 56–57 concretization, metaphors 110 conferences, Taiwan 11–12

Index

conflict 96–103 connections, improvisation 279 consciousness 287; altered states 126; chakra system 31–32 content: critical theory 147; cultural competence 97 contextual relevances, core processes 78 core processes 77–91 correlations, neurotic disorders study 248 courses: Indian therapy 23; Taiwanese dramatherapy 8, 9–10; see also training courses creative-arts therapy 60, 75, 93, 307 creative expression, yogadrama 318 creative integration 106–114 creative supervisors 112–113 creative trainers 113 creativity: brain collaboration 178; commedia 275–284; mandala 251, 253, 259; measuring 174 critical aesthetic paradigm 145–159 critical perspectives 149–154 critical reflexive praxis 350–351, 353–355, 357 critical theory 146–149 critics, inner critic 299–300 Croce, Benedetto 280–281 cultural competence 92–104 cultural democracy 148 culture: Arab society 211, 216; democratization 148; embodiment 120; mental health and 36–44; South Africa 349–350 Czech Republic 240–249 ‘daemons’ 288 dance 34, 115–116, 120, 122 Dante’s Commedia 275 Dasa-ratha, King 27–28 data collection, neurotic disorders 246, 248 day-to-day reality 337–338 deaf children 47–51 death see terminal patients deity roots 180–181 dementia 139, 262–271 democracy, cultural 148 democratization of culture 148 de-roling 215, 341 Descartes, René 276 desire 29 developmental drama 56 developmental models, dementia 262–271 developmental play 116–118 Developmental Transformations (DvTs) 151–152 developments in dramatherapy 1; India 19–25; Korea 3–18; Taiwan 8–18 diagnostic assessments 4 dialogic reflection 111

Dionysian aspects, feminism 313–314 disabilities: Indian therapy 21; Taiwanese dramatherapy 15 disconnection 27, 29, 32 discourse analysis 155, 211 disease 126–127; see also illness construct dissociative disorders 242 distancing 79, 81–82, 86, 88; aesthetic paradigm 145–159; attunement 221; catharsis and 162–164; Palestinian females 193, 197 distress 201, 234 diversity 95–103, 145–159 divided self 29–30 divine activity 288 Dodo conjecture 75 doingness 285 doubling technique 163 Down’s syndrome 118 drama: ancient roots 180–181; emotional treatment 210–211; identity/flow and 276–278; in schools 136 drama education 356 Drama for Life studies 350–357 dramatherapeutic empathy/distancing 79, 86 dramatherapists, role of 309–311 dramatherapy: definition 211–212; descriptions 161; origins 306–308; redefinition 348–357; theory 320–321 dramatic mat 319–320 dramatic projection 78, 85 dramatic reality 319 Dramatic Resonances 311–313 dramatic rituals see rituals dramatic structure, mind 251 drawing experience, yogadrama 323 dream messages 184 drums/drum circles 129, 326–327 dual identity, dramatherapists 72, 75 dualism 289 dualities, Ramayana 29 duty 29 DvTs (Developmental Transformations) 151–152 dyads 205 dysfunctional teenagers 209–210 Earth, meditation on 335–336 Earth–Deity character 27, 30 Eastern–Western world bridge 7 eating disorders 116, 118, 122 education: Arab–Israeli society 208–217; Drama for Life studies 351, 356; goals of 138; multiagency working 206; sensory 140; shrinking of 135; Soul Cave 186–187; TfC elements 94–95; see also schools education programmes, North America 59 367

Index

educational staff 214–215; see also teachers’ authority effectiveness measures, EPR model 238 effect research 242 ego: identity and 277–278; Ramayana 27, 31; Spagyric dramatherapy 289 egocentricity, North American 53 elderly people 15, 265; see also dementia; older people embodied relationships 121–122 embodied resonance 220 embodiment 115–124, 232; in arts therapies 115–116; Ayodhya kingdom 29–30; deaf children’s activities 50; dementia patients 264–265, 268–269; developmental play 116–118; dramatizing body 79; evaluation 86, 88; Hanuman character 33–35; interpretation 120–121; meditation 340; moments of 109–110; neurotic disorders 241; in practice 79–80; Ramayana 26–35; Sita character 34–35; sociocultural aspects 118–120; Stevie’s case 232–233; terminal patients 258; transference 310; see also body Embodiment–Projection–Role (EPR) model 4, 46–47, 49, 116–117, 175, 193–194, 198, 230, 232, 238, 260–261n, 262, 266–267, 320–321 emotional aspects: Arab society 210–211, 214–215; attachment 224; catharsis 162–164; deaf children 48–49; regulation 236 emotional model, Korea 5–6 empathy 79, 81–82, 86, 88, 122, 162–163, 177, 278 empirical truth 71 ‘empty chair’ technique 195–196 Emunah, Renée 12, 56 ending ritual see closing ritual entrance, meditation 338 EPR model see Embodiment–Projection–Role (EPR) model Erikson, E.H. and J. 263 Esie performance, Cameroon 36–44, 43n evaluation ratings, dramatherapy 243–245 evaluative frame, clinical practice 83–90 everyday life, sleep of 287 examinations 60 expectations, Arab teenagers 209–210 experiential experimentation field 113–114 experimentation 113–114 exploration 174–178, 236–237 eye contact 174 facilitated passages 212 facts, critical theory 147 family therapy 200–205 feelings, abused females 191–199 368

females, Palestine 191–199; see also women feminist tradition 306–316 fertility ceremonies 129 fieldwork, abused females 194–197 fifth point, BADTh 67–76 fight trauma response 233 fixed roles, playing with 282 flow, commedia 276–278 ‘fluid sculpture’ technique 96 Fo, Dario 281, 283 folk forms, India 19, 20 form, critical theory 147 Freedom Bus 151 freedom from suffering 20 freeze ritual 215 Freud, S. 263 frontal lobe 175–176 games workshops 171–173 gender 192, 308–309; see also females, Palestine; male clients; women genealogy, contentious 53–54 Gersie, Alida 161, 216 Gestalt therapy 55, 178 gesticulations 176 gods: ancient roots 180–181; Ramayana 27–28, 30 golden mean 287 Goodman’s SDQ questionnaire 231 goodness 30 Greek culture 180–181 grounded theory 149, 221–222 group analytic psychotherapy 108, 111–112 Group Mirror technique 99 group work: Arab–Israeli society 208; description of 213–214; Dramatic Resonances 312–313; improvisation 278–279; neurotic disorders 243, 248; Ramayana 29; short-term 325–334; shyness 297; terminal patients 252–259 guide character 330 Hanna character 344–345 Hanuman character 26, 31, 33–35 ‘happiness’ 5–6, 50 hatha yoga 317, 319, 322–323 healing practices: Cameroon 36–42; critical perspectives 150; dramatherapy for 348–357; India 23; Spagyric dramatherapy 290 hearing aids 48–49 heritage, Palestinian females 191–193 hermeneutics 146 heterodox foundations, dramatherapy 71 Hillman, James 288 Hinduism 26–35 hippocampus 173

Index

historical background, fifth point, BADTh 68–69 historical performances 40 holistic approaches 288–289 Holmwood, C. 39, 54, 65, 360–361 homunculus 175 Hong Kong 13 hope, mandala 252, 258–260 horizontal development, dramatherapy 306 horizontal level, existence 286 horse, carriage and driver vignette 292 hospitals 4, 11–12 human beings/doings 285 human development, dementia 262–271 human growth 140–141 human science, art therapy 3–18 humanity 352, 357 humour 204, 224, 283 hyper-aroused movement 235

intersubjective matrix 277 interventions, children 48 Islam 213, 216 isolationism 53 Israel 191, 193–194, 208–217 Italian comedy 280–282

identity, commedia 276–278 identity crises 53, 192, 277 illness construct 21, 127–128, 353; see also disease illusions 30, 32 imagination 167, 175, 357 immediacy 279 implicit story assessment 231 improvisation 106–109, 111–112; commedia 275–284; creative integration 113; dramatherapy 320; Korean dramatherapy 4–5; machinery of 283; yogadrama 322 impure emotion 6 incommensurability 53 India 19–25, 26–35 individualism 58 individual work, terminal patients 254–256 individuation process 290 infantilization 266 inner cast 290–292 inner critic, overcoming 299–300 inner space, Spagyric dramatherapy 289–290 innovative approaches 273–274 insight strategy 178 integral dramatherapy modality 37–42 integrated arts, India 19–20 integration: creative 106–114; critical reflexive praxis 353; song 341; trainers’ role 113 interactive participation 42 interactive regulation 222–223 interdisciplinary discourses 160–169 internal guide, mandala 251, 258–259 international communication, Taiwan 12–13 international developments 1 internationalism: innovative approaches 273–274; specific practice 189; theoretical approaches 65

Kevin vignette 202–206 kinaesthetic empathy 122 Korean dramatherapy 3–18; academic trend 5; current trend of practice 3–5; overview 3; prospects 6–7 Kristeva, J. 311 Kübler–Ross, E. 254–255

James, William 74 Jennings, Sue 13, 45, 47, 67, 70–71, 128–129, 179, 308–309, 313–314, 344, 360 Ji-gon Asked for Rehabilitation work 11, 12–14 Jodie vignette 200–201, 205 Jones, Phil 4, 37, 53, 54, 65, 115–117, 121, 146–147, 149, 153–155, 162–163, 206, 241, 245, 307, 336 judgement 146, 291 juggler, improvising 111–112 Jung, Carl 180, 187–188, 263, 289 justice, meaning making in 145–159

lack 29 Lakshman character 26–28, 30, 32 Landy, Robert 11, 12, 13–14, 53, 55 language: exploration 176; hermeneutics 146; ritual theatre 332; theatre 108; training 278 laughter 131 laws, Taiwanese dramatherapy 14 lazzi concept 281 leadership, Esie performance 40–42 learning 136, 351–352 legal challenges, professional licensure 59–60 LGBTQ acronym 148, 155n licences: professional licensure 59–60; therapists 14–15, 17n life–drama connection 79, 86, 89, 119, 237 life stage, dementia patients 262–271 limbic system 173, 175, 326 loss 29, 31–32, 34 lower education, Soul Cave 186–187 MA programmes see Master’s (MA) programmes MacKay, Barbara 56 Mahasohon demon 130 male clients, neurotic disorders 241, 246 mandala 131–133, 251–253, 258–260 manifestations, Esie performance 38–39 marriage 28 369

Index

mask work: breaking silence 45–51; composite characters 330; Ramayana 26; shamanism 129; Taiwanese dramatherapy 16; terminal patients 257–258 Master’s (MA) programmes 8, 10, 15, 56, 59–60, 160 matter, soul into 185 maturity 360 meaning-making 145–159, 356 measurement: action 170–171; creativity 174 mechanical way of living 287 medicalised world 360–361 meditation 335–346 Medusa effect 298 memory 163, 234, 287, 357 mental health: attachment-informed therapy 227; critical reflexive praxis 351; critical theory 148; culture and 36–44; Indian therapy 21; North America 55, 60; parents 202–203; South Africa 349–350 Merleau-Ponty, M. 264 metaphors 202–203, 235–236; Ayodhya kingdom 29; body as 135; concretization 110; process drama 356; psychodrama 108; Sesame approach 180 meta-roles 110 method, innovative approaches 273 Mexico 57 micro-aggression 97 migration 118–119, 121–122 mind: dramatic structure of 251; Ramayana 27 mindfulness 223 mirror neurons 176–177, 277–278 mirror neuron system (MNS) 177 mirror resonance 312 Mirror technique 99 MNS (mirror neuron system) 177 monomyth 328, 331 monster of obstacles 329–330 Moore, Thomas 285–286 Moreno, Jacob L. 307 Moreno, Z. 54–55 mother–child attachment process 173 mourning ceremonies 213 movement: abused females 197; assessments 235; embodiment 117, 120, 122; meditation 338–339; mirror neurons 177; theatre 167 multi-agency working 206 multicultural awareness 92 ‘multiphrenia’ 277 music/music therapy 22, 50, 70–71, 321–322, 341 ‘must be’ statement, BADTh 71–72 myths 328–329 370

NADT see North American Drama Therapy NADTA see North American Drama Therapy Association ‘naming’ 96 narrative 84–85, 226–227, 238; see also stories/storytelling naturalness, improvisation 280 nature 137–138, 141 NDP see Neuro–Dramatic–Play nervous systems 171, 173 neural games workshops 171–173 neurasthenia 242 neurobiology: attachment process 173–174; of dramatherapy 174 Neuro–Dramatic–Play (NDP) 47, 140–141, 144, 173 neurons 171, 176–177 neuroscience paradigm 167 neuroscientific evidence, dementia 264 neurotic disorders 240–249 non-hearing children see deaf children nonsense/sense 139–140 North America: current state of field 57–60; future 52–63; history 52–63; trends 52–63 North American Drama Therapy (NADT) 55–57, 59–60 North American Drama Therapy Association (NADTA) 155 Northern Ireland Troubles 73 obituaries 257–258 objects of attention, space 37 observation categories, evaluation ratings 245 observer, overcoming 299–300 obsessive-compulsive disorders 242 obstacles 329–330 older people 135–144; see also elderly people one-on-one therapy 255 opening rituals 215, 326–327 opposite pairs 289–290 oppression 102 oral texts 40 othering 152, 155 otherness, identity 277 outdoor space 137, 141 ‘out-of-body experiences’ 256 pairs of opposites, transcendent function 289–290 Palestine, abused females 191–199 parable vignette 292 paradigms: critical aesthetic 145–159; neuroscience paradigm 167 parental instruction, emotional therapy 214

Index

parents: Arab society 209; attachment-informed therapy 219; mental health 202; problems 201–202 participants, social dramas 41–42 ‘passing’ 155–156n pathologization, shyness 294–295 patriarchy 192 peer relationships 219 Pehchaan 34 performance phase: Dramatic Resonances 313; yogadrama 323–324 performance praxis 154 performance space, Cameroon 39 performer–audience relationship 37, 41 performing arts, Taiwan 9, 11 personal development, yogadrama 321–324 personality mode, Spagyric dramatherapy 290 personalizing monomyth 331 personifying composite characters 329–330 person-making 275–284 phobias 241 physical expression, yogadrama 318 Piaget’s theory 264 Pitruzzella, Salvo 155, 273 place of body 309–311 playback theatre 57, 107, 109, 309 play/playfulness 78, 82, 85, 87; assessments 233; babies 139–140; commedia 282; definition 106; dementia patients 265; embodiment in 116–118, 121; family therapy 204; gender and 309; human growth/well-being 140–141; in practice 106–108, 112; teenagers 142–143; with the unexpected 278–280 play therapy 45–51 poetry 280–281 Point 5 see fifth point, BADTh politics, Ramayana 28 ‘pool’ activity 98–99 positive emotions 224 post-assessment profiles 237 postures, hatha yoga 322–323 power: abuse and 128; critical theory 146, 147, 154–155; Ramayana 30 Power, G.A. 263 power-sharing practices 309 practice analysis 60 preoccupations, very young/very old 135–144 private institution courses 9–10 problem-solving 354 process, cultural competence 97 process drama 356–357 process–outcome research 242 professional identity 58 professional licensure 59–60 projection 233; abused females 195, 197; dementia patients 267–268; dramatic 78, 85;

meditation 340; Stevie’s case 233; terminal patients 256, 258; see also Embodiment– Projection–Role (EPR) model proto-play 139 ‘Psyche and Soma’ course 180, 187 psychiatric interventions 42–43 Psychlops for Kids assessment 231, 232, 237 psychodrama 52, 54–55, 57, 107–112, 307, 310 psychological–developmental concept, ADHD 209 psychological modalities 112 psychology 45, 178–179, 287 psychosis 127 psychotherapy: arts aspects 285; group analytic psychotherapy 108; North America 60–61; psychodrama 107, 111–112; psychology bridge 287; research in 242–243; theatre and 166; therapists role 310 public participation, Korea 5 public performances 13–14, 51 publications, Taiwan 10–11 puppets/puppet shows 14, 125 pure emotion 6 ‘purification’ ceremonies 212–213 purpose/call, soul 185–186 QoL (quality of life) 262 qualitative methods, dementia 265, 267–269 quality of life (QoL), dementia 262 Quebec, Canada 60 race 94, 152 racism 147–148 Rama character 26–28, 30, 31–32 Ramayana 26–35 rating scales, assessments 240 rational cognition 162 Ravan character 26–27, 30–32 RDTs (registered drama therapists) 61 Rebillot, P. 331–332 reception process, participants 41–42 reciprocal psychiatry 42 reconnection, Palestinian females 191–199 recording clinical practice 82–83 recovery 27, 29, 31–32, 34 reflection, creative integration 109–111 reflexive practice 350–351, 353–355, 357 refugees 119 registered drama therapists (RDTs) 61 regulation system 222, 233, 236 regulations, professional licensure 59 relational roles 225, 233–234 relationship-building process 174 relationship play 117 371

Index

relationships: adolescence 219; commedia 275; embodied 121–122; emotional therapy 214–215 religious dogmas 47 repetition, rituals 342–343 research studies: dementia patients 265; neurotic disorders 247; psychotherapy 242–243; Taiwanese dramatherapy 10 resilience 348–357 resistance to change 236–237 resonances 311–313 restoration, dramatherapy 348–357 rites 38, 40–41 ritual theatre 325–334 rituals: abused Palestinian females 194; Arab–Israeli society 208–217; Cameroon 40; India 20, 27–28, 30; meditation 336–338, 341–343; shamanism 128–129; Spagyric dramatherapy 290; terminal patients 257–259, 260n Role, Projection and Embodiment (RPE) 266–269; see also Embodiment–Projection– Role (EPR) model role reversal 108, 177–178 role/role play 81–82, 233; body connection 282; commedia 282; critical perspectives 153; dementia patients 267; evaluation 85–86, 87–88, 245; meditation 340–341; North American 53; psychodrama 107, 112; self-states 224–225; Stevie’s case 233–234; Taiwanese dramatherapy 12, 14, 16; terminal patients 259; vignettes 110–112; yogadrama postures 323; see also Embodiment– Projection–Role (EPR) model Romania 45–51 RPE see Role, Projection and Embodiment safety, self-regulation 222 Sajnani, N. 309 Sam vignette 200–202 sample group, neurotic disorders 246–247 Schechner, Richard 306 schools 136; see also education ‘scientification’ of dramatherapy 168 sculpture technique 96, 100–102 SDQ see strengths and difficulties questionnaire seated meditation 339–340 secular spirituality 181–183 self, divided self 29–30 self-attunement 122 self-consciousness, overcoming 294–304 self-esteem 214 self-exploration, abused females 198 self-harming 29, 32, 117, 142–143 selfhood, dementia 264 372

self-mutilation see self-harming self-psychology characteristics 6 self-reflexive approach 353 self-regulation 222–223, 233 self-revelatory performance 92, 94 self-states 224–225 self-sufficiency 212 semiotics 37, 39, 310–311 sensory development, young children 141–142 sensory system 136, 139–141 separation 31 Sesame approach 73, 180–188 sexual abuse 127; see also abuse shadow puppets 14 Shakespeare, William 136, 143–144 shamanism 125–134; aims 125; environment 125; methods 125 shame dynamics 60–61 Shira character 344–346 Shiva, God 27–28 Shorook case study 195–196 short-term group therapy: aims 326; first threshold 330–331; plot 328–329; ritual theatre 325–334; second threshold 331–332; sequence of group 326–328; three tasks 328–330 Shuttleworth, Roy 69–70 shyness: breaking through walls 294–304; causes 295–296; getting stuck 300; overcoming 294–304; pathologization 294–295 signs 39, 309–311 silence-breaking mask work 45–51 Sita character 26–28, 30–31, 32, 34–35 skills, mandala 251, 259 Slade, Peter 17n, 54 sleep, everyday life 287 Smail, Mary 65 Smyth, G. 82–83 Snow, Stephen 56 Snunia ceremony 213 social anxiety 294–304 social conventions, Palestinian females 197 social dramas 41 social environment, Arab teenagers 209–210 social identity, children 75 social justice 145–159 social level, identity 276–277 social services 205 social transformation 348–357 society, rites 40 sociocultural aspects, embodiment 118–120 sociodrama 52, 54 solar plexus 33 solidarity, Arab society 213 somatoform disorders 242 somatosensory activities 223

Index

songs, meditation 341; see also music/music therapy soul: definition 184–186; Ramayana 27; Spagyric dramatherapy 285–286, 288–289 Soul Cave 180–188 South Africa 153, 348–350 space: bodies and 135; healing performances 37–40; meditation 338; outdoors 137, 141; Spagyric dramatherapy 289–290; yogadrama 321 Spagyria definition 286–287 Spagyric dramatherapy 285–293 spatial settings, healing performances 37–40 special education classes 208–217 specialists, cochlear implants 48 specific practice 189, 194–197 spirituality 180, 181–183 splitting 237, 277 spontaneity, play 106–107 Stanislavski, C. 161, 162–163 state dependence 224–226 ‘statement of obvious fact’, BADTh 69–72, 74 ‘Stevie and the Little Dinosaur’ 230–239 stories/storytelling: assessment 231; Cameroon 51; EPR model 46; Korean dramatherapy 6; Ramayana 34; short-term group therapy 330–331; terminal patients 259; see also narrative strengths and difficulties questionnaire (SDQ) 231, 232, 237 ‘stress’ 353 strikes 73–74 structural evaluation, clinical practice 83–90 subpersonality 290–292 suffering, freedom from 20 supervision field 112–113 support, shyness and 299 surplus reality 108 surveys 164–167 symbolism: body 310–311; embodiment and 115–116, 121; Esie performance 39; meditation 337; Ramayana 28–35; shamanism and 126 synaptic cleft 171 systemic therapy 204, 214–215 Taiwanese dramatherapy 8–18 teachers’ authority 209–210; see also educational staff teenagers: Arab society 209–210; cochlear implants 50; embodiment 80; playfulness 142–143; see also adolescence terminal patients 250–261 texts, Esie performance 40–41 TfC see Theatre for Change

theatre artists 72 Theatre for Change (TfC) 92, 93–95 Theatre for Development 354–355 theatre discourses 160–169 theatre language 108 Theatre of the Oppressed (TO) 309 theatre performance, yogadrama 323–324 theatrical techniques: community-based approach 36–37, 42–43; cultural competence 92–95; North America 55, 57; shamanism 125–134 thematic work, yogadrama 319, 322 theoretical approaches 65 therapeutic public performances 13–14 therapeutic sessions, rituals 215–216 therapeutic theatre model 42–43 therapeutic triad 113–114 therapists: dramatherapists as 67–76; legitimate practice 167; mandala of 252–253; origins of word 73; role in psychotherapy 310; Taiwan 14–15, 18n therapy, Greek meaning 180–181 therapy group 213–214; see also group work therapy paradigm 22, 149 theses, Taiwanese dramatherapy 10 thoughts, focusing on 34 three-dimensional response, texts 40 threshold drama 330–331 threshold time, group therapy 327–328 time frame, processes 87–90 TO (Theatre of the Oppressed) 309 Tornstam’s research 263–264 traditional healing 37–42 traditional performance space, Cameroon 39 training courses: cultural competence 103; Dodo conjecture 75; establishment 69, 73; India 23; North America 59 training field 112–113 training language 278 trance 126, 128–129, 259 transcendental function, pairs of opposites 289–290 transcendental perspectives 285–293 transference 122, 310 transformation 79–82, 86, 89–90, 275, 348–357 transitional events 328, 332–333 transitional objects 116 transitions: adolescence 219; commedia 282–283; EPR model 46 trauma assessments 237 triads 205 triangles, meditation 336–337 triangular relationships 86, 90 trickster character 143 Troubles, Northern Ireland 73 trust 117, 234–235 373

Index

truth 71, 147, 212 Twelve Steps Programme 29–30 Ubuntu practice 351 uncertainty, ‘believe’ statement 71–72 unconsciousness 287 undergraduate courses 160 unexpected, play with 278–280 unification, individualism and 58 university programmes see Master’s programmes; undergraduate courses value of drama 352–353 variables, neurotic disorders study 246 Vedic system 31, 33, 35 vertical level, existence 286 vessels, meditation 338–340 Vishnu, God 27, 30 ‘voices’ inside/outside 214–215 volunteers 49–50 voucher system, Korea 4 vulnerability 251–252, 257–258, 260 warm-up session, yogadrama 322 warrior character 330

374

water toys 223 ‘we’ identity 277 welfare centres, Korea 4 well-being 140–141 Western world: colonialism 21; Communist segregation 45; dramatherapy approaches 360–361; Eastern bridge 7; mental health approach 36 witnessing 79, 80, 86, 88–89, 237 women: eating disorders 118–119; neurotic disorders 241, 246; Palestine 191–199; Pehchaan 34; shamanism and 127; workshops for 10; see also gender workshops 8, 9–10, 171–173 world-view: India 20; soul 185 World War II 68 wounded child 291 writing experience, yogadrama 323 yoga therapy 318 yogadrama 317–324 yogis 22 young people: preoccupations 135–144; sensory development 141–142; see also children