Psychodrama and Systemic Therapy

Chris Farmer

• Publisher: Routledge
• Year: 2018
• Topic: Psychology
• eBook ISBN:
  9780429918131
• Subtopic: History & Theory in Psychology
• Index: Psychology

It is now increasingly recognized that psychodrama provides a valid and useful tool in many different contexts; equally, practitioners in a wide variety of fields are acknowledging the benefits that a systems thinking approach can bring to their work. This book unites the two by describing the author's work over a number of years. The author provides a lucid exposition of his own systemic approach to psychodrama, both theoretically and in practical clinical terms. The final section, which discusses systemic approaches to psychiatric care in general, puts the book in a wider context, and will make it of interest to a wide range of mental health professionals.

Chapter One
Psychiatry systems and drama

Systemic Family Therapy

Family therapy looks at the system as it appears to the therapist and to the family members as they interact in a session. I say "it appears" because "it" does not exist, except in the minds of the individual members. Each member and therapist would regard the system from a different viewpoint; if it were a psychodrama and not a family therapy session, each would present his own distinct individual representation of the family. There is no "correct" portrayal. The "family system" is an abstraction that is derived from each individual's perceptions and formulations as these evolve together in the minds of the family members and the therapists while they participate together in dialogue (Anderson et al., 1987).

Systemic family therapy seeks to enable the family to define itself in such a way as is congruent for the individual members. The feedback gained from such techniques as circular and reflexive questioning helps each person to see himself more clearly in relation to other family members. Together they utilize the knowledge of differences that feedback provides to construct a redefinition of the family system that encompasses the descriptions of each individual member. Thus, at the end of a period of systemic family therapy, one would in theory expect that if each individual member were to enact a psychodrama, it would portray a family picture that is more akin to that of other family members than it would have been before family therapy began.

This, of course, is the ideal—that family members would have recognized shared meanings about how their family should operate and would then have interpreted the attitudes and behaviour of each other in accordance with their beliefs. Such belief systems, however, are not static; when recognized and expressed in dialogue, the shared configurations of belief evolve as the family members seek to incorporate their different ideas into a more all-embracing pattern of meaning. Like a "figure" in gestalt psychology, beliefs never stay the same; as they are apprehended, they merge into the "ground" from which they had arisen and are replaced in the perception of the subject by different images.

For a family system to survive and develop, it needs to have access to, and to utilize information from, the wider social system of which it is a part and which itself is subject to flux.

The family boundary is permeable to a varying degree, but entry, growth, and separation or death is inevitable. As a family evolves through time, beliefs change to accommodate to transitions in its life cycle and to the vicissitudes of society outside the family. Furthermore, individual members become more differentiated from their original family beliefs as they adapt themselves to life outside. Were people to view themselves the same way in their relationships outside the family as they do inside, it is likely that neither they nor their family could develop appropriately. If family members share and accept each other's individual development, they can evolve together with relatively congruent ideas; if they can accept differences and yet stay connected, they do not have to split off their individuality from their family life, and the other family members also can develop their own autonomy.

What is important is a unity (but not a uniformity) that allows for differences. The ideal family model for systemic therapists includes a shared belief about allowing for or encouraging individuality within a framework of members belonging together but respecting differences. This I will term a meta-belief of systemic therapists: the notion that family members can be different and have different beliefs but still be connected, be attached, or "belong" to one another in some way.

If systemic family therapy seeks to avoid the limitations of treating one member rather than the family as a whole, then it might appear that psychodramas by individuals about family problems would be a contradiction to family therapy. Both media, however, promote differentiation of self. Thus, while psychodrama has everything to do with individuality, it is also a group activity and is grounded in communality. In fact, it is the very structure and rules of a psychodrama group that enable a person to find his individuality.* Whether we are in family groups or in stranger groups, our selves evolve in relationship; it is through the process of interacting that we develop and become aware of ourselves as individuals. Moreover, we can only comprehend differences if there are also similarities from which the differences can be distinguished (Agazarian, 1993). We grow as families and as individuals through both identification and differentiation.

Psychodrama

In addition to presenting dramatic action on the stage, psychodrama exemplifies the dramatic quality of human interaction in general in the way that people relate to one another and then reflect upon their exchanges. [Throughout the book, I refer to psychodrama in a clinical context and in relation to its direct use in elucidating and resolving problems that relate to present or past family situations.] In life we are constantly engaging dramatically with one another when we encounter each other in defined situations. Our personal narratives are of news and not of routines. Stories require the interruption of routines (Johnstone, 1979). What becomes meaningful and interesting is the way connections are made between otherwise commonplace or predictable events. Our life stories are about the interaction of the expected with the unexpected—the stuff of comedy and tragedy. Hopes become dashed, or they are fulfilled despite obstacles. We are all dramatic insofar as we think of ourselves in dramatic terms; we are aware of being observed or experienced by those with whom we interact (Brittan, 1973). Together we each conspire to create in life our own roles of victim and tyrant, loser and winner, and so on. This is also the language of staged drama.

Analytic psychotherapy is a dialogue. For some people, it is sufficient in itself to gain access to feelings and to link them with thoughts to find meaning. Others also require action; they express themselves non-verbally to "show" as well as to "tell". Everyday gestures indicate how we express ourselves in movement—in space as well as in time. As an amateur pianist, I am very much aware that music I "remember" is not "in my head" in a form in which it can be written on manuscript paper; it is recalled as I use my hands. Without the movement of my hands on the keyboard, I would not even "know" that I remembered the details of the music. Thus from action I learn from myself as well as about myself.

Moreover, with action I can put a narrative into a frame of reference without having to contextualize my conversation with additional language. Action can put words into a framework without the use of yet more words as meta-dialogue. Conversely, words can be the index of action: if the content of a communication is words, then action is the process, and vice versa. In drama, the index of context and the context itself occur simultaneously with an immediacy that establishes an impact upon both actors and observers.

Movement also changes the circumstances of the actor as observer of himself. As a pianist hears his music while his fingers are operating, so the self-reflective actor experiences himself roused as he acts. Insofar as he sees the same scene differently as he changes position, he experiences the others on the stage in a novel aspect.

There are important differences between the contexts of psychodrama and family therapy. Psychodrama is usually a stranger-group activity, even though it is very often about families, whereas family therapy involves people who already belong to a well-organized and long-established human group. The implications of this distinction are considerable. A protagonist would never express himself in a family group in the way he does on the psychodrama stage, where he has the freedom to present himself without the external constraints of the other family members; he does not have to consider their feelings or to be accountable to them afterwards—he can return to his family without them knowing what took place.

However, even without family members being present, he is still subject to substantial constraints pertaining to the influence of his family; they appear to be experienced largely as coming from within himself if, indeed, he is even aware of them. Psychodrama can help him look at the limitations he imposes upon himself. It explores the family system that he has internalized (Holmes, 1992; Laing, 1967).

Psychodrama is a medium par excellence for both identification and for differentiation. The first phase is termed the "warm-up" and consists of simple group procedures that enable the members to make contact with one another. They share their sense of being together as they become aware of their similarities and differences. Sub-grouping may be encouraged to highlight areas of similarities of interest, energy, or feeling (Fig. 1.1). Differences between subgroups may then be compared with differences within sub-groups (Agazarian, 1993). Eventually there emerges a group concern that becomes centred upon the topic of the psychodrama and the selection of the protagonist for the action phase.

Drama elicits identification, whether it is in "life" or upon the stage. The actor needs to recognize his rapport with the audience, and the members of the audience in turn put themselves in the shoes of the actor. Staged drama allows for maximum identification between actors and audience in both directions. The spectators sympathize with the victim, hate the persecutor, and become excited as combatants fight. The actors, in turn, are aware of the spectators' emotional involvement with them. The "stage" need not be in the theatre—it can be a sporting event, a chess contest, or even a scenario in front of a real kitchen sink. Wherever the actual drama takes place, however, the process follows certain universal patterns, such as, for example, contests in which there are winners and losers. The distinctive difference with the theatre is that the outcome has been arranged in advance of the action.

FIGURE 1.1

A psychodrama is usually a story, and so it has a beginning, a middle, and an end. It is not a routine, and, unlike a play in the theatre, the end is not known to anyone until it has been reached. The middle is the breaking-up of set patterns. The story is that of the protagonist. It evolves as it happens on the stage. Nothing is pre-ordained. It is not planned in advance. The protagonist usually has a general idea of what he wants to do, but neither the protagonist nor anyone else will know how scenes will be experienced and how people will respond until the actual episodes come to pass.

This is not to say that there is no structure. There is a psychodramatic process, which the director follows to enable the protagonist to find his way to tell his story. The director has rules and techniques to allow the protagonist to attain the required roles and then, in portraying them, to feel, to act, and to think. Insight and understanding come through integration of experience shared with other group members.

Psychodrama as a Systems Therapy

The first function of the director is to set boundaries in space and in time (Fig. 1.2). There is a stage, a place for the action. There is a group. There is an overall context—an expectation of dramatic action in the group. There is a time sequence: the warm-up, the action, and the closure with sharing.

With regard to the overall spatial structure, the director attends to a permeable boundary between those on the stage and the other members of the group. He draws upon the members for participation in the scenes, and he scans the group for its response during the action; the audience is an essential participant whose contributions the director taps. Without an audience—either real or implied—as witness to the action, there is no drama.

FIGURE 1.2

During the action, the director helps the protagonist to manipulate time and space in the choice of settings and in the starting and finishing of individual scenes. He organizes scenes to take place in the present, even though they may represent the past, a hypothetical future, a "pretend" situation, or an impossible scene (termed "surplus reality"). Scenes initially may portray what "really" happened; later, however, the director is more interested in what did not happen but might or should have taken place.

The director has people from the group act as the "auxiliaries" and take on the roles that represent aspects of the protagonist's life—inside or outside of the boundary of his individual self. Although mainly chosen by the protagonist, they are regarded as tools of the director to help the protagonist to demonstrate himself in his life situation. These auxiliaries typically represent the significant other people in the protagonist's life with whom he enacts his drama. As an example, the action may start in the present day with people at work and then be followed by a family scene in which there is found to be a fundamental and unresolvable conflict of the same pattern. The similarities are explained, and the protagonist has the opportunity to work through the original drama to a more satisfying conclusion. From the experience of achieving this and the process of struggling with the forces within himself that have hitherto been out of contact or awareness, he gains insight and a sense of power. He is able to accomplish this by externalizing what is inside and thus "seeing" and therefore confronting what he has been trying unsuccessfully to grapple with internally. Typically, these patterns of conflict have been internalized during early family life.

The auxiliaries are thus also manifestations of the protagonist's inner life. The drama usually begins with an outside representation of an underlying repetitive and unresolved struggle within the protagonist; once it is externalized, he can encounter it directly and change it. In altering what is outside, the protagonist is also modified internally as he confronts the struggle by engaging himself in it.

The director makes the task possible by helping the protagonist to invoke the characters of his story and then allowing him to encounter them in a manner that had not appeared possible or desirable before. The director is a magician who creates possibilities. The protagonist is constantly given choices. On a psychodrama stage, everything and anything is possible. Time can pass in any direction and at any speed. It can be compressed or interrupted at any moment. Space can be contracted or expanded, and it can be filled with anything—from the protagonist's own inner imagination to his perceived outer world. Through the director's exploitation of metaphor, anything can represent anything else, and, by a process termed "concretization", ideas or images may be put into spatial dimensions in the form of objects or of people on the stage.

The protagonist must apprehend and acknowledge new possibilities, and he must also learn to accept the impossibilities. He must make the choices. The director shows what is conceivable. The protagonist must explore and understand before he can choose, and then he has to choose for himself. To accomplish something hitherto regarded as impossible or undesirable, he must see things in a new way. This is accomplished through action. Instead of passively accepting what is presented to him, he acts, and he invents as he actively creates his own drama. With spontaneity, he wills as he moves, and he discovers as he explores. Finally, in dramatic action, as he experiences, so he becomes. Mental and bodily action become one.

For the protagonist to see new possibilities, the director employs (apart from a multitude of secondary procedures) certain basic techniques that involve the use of other group members in the roles of "auxiliary egos"—tools of the director, used to represent other people in the drama or parts of the patient's self (real or invented). The protagonist, in addition to presenting himself (as he is, was, should have been, wishes to...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• ACKNOWLEDGEMENTS
• Contents
• EDITORS' FOREWORD
• FOREWORD
• PREFACE
• Introduction
• CHAPTER ONE Psychiatry systems and drama
• CHAPTER TWO A psychodrama in action
• CHAPTER THREE The psychodramatic exploration of transgenerational psychiatry: "sins of the fathers"
• CHAPTER FOUR Strategic psychodrama: helping an abusive mother to converse with her children's social worker
• CHAPTER FIVE Psychodrama as a source of information
• CHAPTER SIX Summary: the effect of one therapy role upon another in a public mental health service
• REFERENCES AND BIBLIOGRAPHY
• INDEX