Authors:
Leni M. F. Verhofstadt-Denève, Let Dillen, Denis Helskens & Mariska Siongers (Ghent University)

This chapter describes the construction of a semi-structured protocol of the action sociogram for 6- to 12-year-old children. The first section outlines the basic characteristics of a development-oriented theory, the Phenomenological-Dialectic Personality Model (Phe-Di PModel). The second section demonstrates how – within this theoretical framework – the psychodramatic “Social Atom” can be applied to school-aged children. The Social Atom enables the children to devise a spatial scene in which they use puppets to represent themselves in relation to significant others. This action method makes it possible to externalize the child’s multiple self-constructions and the internal self-dialogues. Moreover, we think that the action sociogram can be understood as an intense situational-affective experience of dialectic oppositions, in which emotions, actions, cognitions, language and effective learning can be integrated.

 

1. A development-oriented therapeutic theory

 

The Phenomenological-Dialectic Personality Model

The Phe-Di PModel– as constructed by Verhofstadt-Denève (2000, 2003) on the basis of practical work – aims to describe, explain and stimulate developments occurring in the course of a lifetime. The core idea is that personal oppositions can effect qualitative changes via inherently dialectic processes and that the content of these processes is characterized by existential themes.

The phenomenological aspect refers to the content which individuals design about themselves, significant others and their surroundings (Verhofstadt-Denève, 2000, 2003). The model describes the person as a dynamically developing relation between I and ME, the I as the subject pole (see James’s ‘self-as-knower’) being able to reflect on the ME, the object pole (see James’s ‘self-as-known’).

The reflection of I on ME generates six fundamental questions, leading to six phenomenological self-constructions or dimensions of the self:

• Who was I, am I and will I be with my shortcomings and my potential in this world? Answers reflect the Self-Image.
• This Self-Image is continuously compared with the perception that we have of other people. The answer to ‘Who are the others in their world at this moment, in the past or in the future?’ constitutes the Alter-Image.
• If one tries to form an idea of how one’s own person is viewed by the others (‘What perception and/or expectations do the others have of me and my world at the different time dimensions?’) one is constructing the Meta-Self.
• These three dimensions are counterbalanced by their corresponding ideal-images:
  • Who would I like to be in a world I would like to live in?: the Ideal-Self
  • What should the others be like in a world they should like to live in?: Ideal-Alter
  • How should the others perceive me and my ideal world?: Ideal-Meta-Self

The I-ME reflection encompasses more than the conventional self-reflection, since the object pole comprises not only subjective interpretations of the self but also of the social and object world. The ME can be seen as the objectified result of a ‘multivoiced’ self with six parts that can interact or conflict with each other.

The same basic structure applies to each of the six constructions: 1) differentiation between personality characteristics and conditions, 2) a time dimension with past, present as well as future situations, 3) a distinction between internal aspects (what we feel and think) and external aspects (how we act towards to the outside world), 4) different levels of awareness, ranging from unaware to fully aware.

While the dimensions of the self constitute the content of the personality model, the moving force of the development process is dialectics. It is the very nature of dialectic processes that a higher synthesis is achieved through double negation (for concrete examples: see protocol). The synthesis – or ‘Aufhebung’ – comprises at once the preservation, the annihilation and the raising to a higher level of conflicting but complementary poles (Verhofstadt-Denève, 2000). This view has a significant effect on the positive interpretation of oppositions[1], as a conflict is seen as a potential for change. The Phe-Di PModel assumes that the six constructions can be dialectically opposed so that development becomes possible.

The dialogue between the multiple selves connected to the different phenomenological dimensions is the basis for stimulating personality development into the greatest possible actualization of the self, all the while maintaining a harmonious relationship with significant others. The interrelational activity between the self and others[2] is the primary requirement for this kind of personality development[3]. Action and drama techniques can stimulate these self-dialogues in a secure atmosphere through concrete-spatial action.

 Origin and development of I-ME dynamics

In the view of the adaptation of the protocol, the question is raised to what extent the primary-school children (6-12 years[4]) can use their cognitive and social-emotional skills to integrate self- reflection and self-knowledge (Self-Image), reflection on and empathy with the other (Alter-Image and Meta-Self) and reflection on the world, including possible divergences between subjective constructions and ‘objective’ reality. At the core is the general problem of the development of children’s understanding of mind.

      According to Piaget’s early writings this development runs parallel to general cognitive development; mental phenomena are highly confusing to young children because of their non-substantial nature. This difficulty in understanding mental states is extended into middle childhood. Although the child learns to organize experienced reality systematically and is capable of taking several dimensions into account within a given situation, (social) cognitive understanding remains largely dependent on the tangible representation of reality. It is for instance assumed that the child does not develop role-taking skills[5] until the age of 7-8 and that profound hypothetical thinking is impossible until adolescence. Within this frame of reference, the incipient reflection on and differentiation of the self (Self-Image) and others (Alter-Image) is situated at the age of 7-8, when the transition from egocentrism to decentration takes place. Indeed, the dialectics of assimilation and accommodation create a transition from external to internal I-ME dynamics, which makes an incipient form of self-reflection possible.

Recent studies within the ‘theory of mind’ tradition have qualified Piaget’s claims. For instance, children are assumed to acquire an understanding of the relations between their own mental states, the world and action even during the first years of their lives (Scholl & Leslie, 2001). The possession of a ‘theory of mind’ implies the use of someone’s convictions and desires in order to understand, explain and predict his/her behaviour. Such a reasoning carries the possibility for the simultaneous comparison of representations of mental states of themselves and others, as well as representations of the world and an understanding of the relation between these mental representations of the world and the resulting convictions (Templeton & Wilcox, 2000). In contrast with Piaget’s views, the early competence theory proposed by Leslie and colleagues states that theory-of-mind acquisition takes place universally, rapidly and at a very early stage (Scholl & Leslie, 2001). Even at the age of two, children are believed to acquire our mental terminology and use it appropriately in daily life (Perner, Frith, Leslie, & Leekman, 1989). The age between 3 and 5 is assumed to be characterised by a developing power of reflection on others’ minds and a rapidly changing understanding of the psychic basis of human actions (Dunn, Brown, Slomkowski, Tesla & Youngblade, 1991). Studies suggest a shift from an understanding of desire and emotions to an understanding of beliefs, thoughts and knowledge (Wellman, 2002). The initial explanation of human action on the basis of the actor’s wishes, desires, hopes and intentions is complemented at the age of 4-5 by a contemplation of human action in terms of representational mental states, such as thoughts, representations and knowledge. At this age, children start comprehending something of the subjectivity and consequently the diversity of thoughts. This suggests that they can differentiate between the perspective of themselves on the one hand and the perspective of someone else on the other. It also indicates that the young school-age child is capable of contemplating more than one representation simultaneously (Templeton & Wilcox, 2000). At around the age of six, children are assumed to have representational skills that are similar to those of adults and they start developing the capacity for second-order belief attributions (‘Mary thinks that John thinks that…’) (Perner et al., 1989). These meta-representational skills, together with the understanding of interpretative diversity, will be developed fully around the age of eight (Taylor, Cartwright & Bowden, 1991).

Results within this research tradition enable us to situate the different reflection capacities at an early stage in childhood. This early psychological conceptualisation is largely confined to emotional and situational attributions and the still developing capacity for contemplating different representations simultaneously. In other words, the Self- and Alter-Images will be construed mainly by means of emotions, desires and concrete information. From the age of 6 or 7 onwards, the child will learn to fully appreciate the interpretative nature of representations[6]. In other words, there is an enrichment of the phenomenological images. The internal aspect of the Self-Image and the Alter-Image can now be supplemented with representational information. In addition, children acquire the capacity for attributing second-order beliefs, which makes the construction of the Meta-Self possible.

Ideal Images are formed on the basis of early comparisons of Self-Image, Alter-Image and Meta-Self. During childhood the different – possibly contradictory – features of the self-constructions are joined together[7]. According to Harter (1998), the capacity for bi-directional thinking installs the incipient possibility of coexisting positive and negative self-evaluations, which creates a more accurate Self-Image and more general self-evaluations.

Although the building blocks of the Phenomenological-Dialectic Personality Model are present at the end of primary school age, the organisation[8] of the whole still has to be achieved (mainly during adolescence).

 

2. Dialectic Action:
Psychodrama and the social Atom

Development of psychodrama and the social atom

In 1920 Moreno created psychodrama – “the science to explore the truth by dramatic methods” (Moreno, 1946). The concept is intrinsically linked with Moreno’s basic philosophy, which regards man as a social interacting being (Marineau, 1989). Our social matrix influences and guides our actions and self-perceptions and underlies our personal identity (Davies, 1987).

As social relations were seen to be so important, a central theoretical and procedural psychodrama construct was developed, viz. the social atom theory (Taylor, 1984), a theory of relations constituting a psychological, social and cultural framework in order to describe and explain how people build up and maintain long-term relationships (Remer, 2001).

The social atom is [the diagram of] “the smallest nucleus of all individuals with whom a person is related in a most significant manner constituting negative and positive emotional bonds” (Moreno, 1934). The therapeutic impact of the social atom is enhanced by means of the spatial activation of the social atom in the action sociogram (Anderson-Klontz, Dayton, & Anderson-Klontz, 1999). The action sociogram is a psychodramatic method which allows the protagonists to portray their significant others (via group members or objects) spatially in a rational-affective distance to themselves and to each other. The protagonists are thus able to enter upon a dialogue between the self and his significant antagonists. The I constructs a ‘multivoiced’ world in which the individual can not only talk about a variety of imaginary others (antagonists), but also with them as a relatively independent parts of a wider self (Hermans, 2003). The action sociogram is distinctive in that the dialectic makes for an intense integration of emotions, cognitions, language, action and effective learning.

In view of the current interest in accountability and evidence-based proceeding, psychodramatists need to concentrate on weaknesses, unambiguous conceptualizations, protocols and reporting on techniques (Kane, 1992) and on a more solid personality theory (Kellermann, 1987, a,b; Kipper, 1978, 1997, 1998). The present chapter is part of the attempts to update psychodrama. It tries to found the action sociogram on a development-oriented theory of psychotherapy (part 1), to make this technique adapted for the work with children, and to facilitate the evaluation of effects by means of clearer descriptions in the protocol (part 2).

Construction of a semi-structured protocol for children

The scenario of the action sociogram for adults (Verhofstadt-Denève, 2003) served as the basis for the present study, the same multistage structure being used to find out what adaptations were necessary to suit the primary school children. In a first stage, phenomenological reality is exteriorized via the puppets (Stage A). The second stage offers the opportunity to explore the ideal images (Stage B). Further stages (C and D), though relevant, are not considered in this chapter. The practical work showed that the following adaptations had to be made:

• Individual sessions

Although the original scenario called for a group setting, preference was given to individual one-hour sessions, because of the children’s attention span and motivation.

• Addition of pet animals and fantasy figures

Practice showed that the introduction of pet animals and fantasy figures was essential. They are part and parcel of the child’s phenomenological reality.

• From chairs to puppets

Initially we used chairs to represent him- or herself in relation to significant others. Puppets were substituted for chairs for the following reasons: 1) children found the chairs dull and boring; 2) speaking through the puppets acts as a buffer against reality, which the child may find threatening. The director and the co-director also used puppets as symbols for themselves through which they addressed the I-puppet and other puppets directly. When chairs were used, the children seemed to have difficulties with the transition from the Self-Images to Alter-Images and Meta-Self. We noticed that using puppets instead of chairs facilitated this transition; 3) the puppets constitute projection screens since (a) they create distance (“they are not my family, they are merely puppets”) and (b) their connotations are not threatening, they have a human shape and they can be manipulated by putting clothes on them; 4) the puppets introduce curiosity, playfulness and unpredictability.

The children create their phenomenological reality on the stage; they choose which puppet is going to play, cloth the puppets and represent the concrete image they have of themselves and the others.

• Avoidance of lengthy proceedings

Children’s limited attention span requires some further changes in the scenario: 1) rigidity and standardized questions need to be avoided. If children are to remain motivated, it is important to deal with each situation creatively; 2) a change in the order of role-taking turned out to be necessary. Initially, the first step was to have all the puppets take a role, after which each puppet’s Meta-Self was investigated. This procedure was laborious; the children’s attention quickly waned and information on the Meta-Self was scarce. We therefore questioned the Alter-Image and the Meta-Self at the same time; 3) thirdly, the sessions were reduced to 1 hour instead of 4 hours; 4) finally, it is recommended to deal with stages A and B in separate sessions in order to avoid confusion.

• Transition from the concrete to the abstract

The construction of ideal-images requires abstract thinking, the ability to make simultaneous comparisons of self-images and an effective capacity for mutual role-taking. These are skills which, although they are potentially present in the latency child, are not fully developed until adolescence. This difficulty became apparent in stage B. Although the children were well able to stage an ideal reality with the aid of the puppets, the transfer to everyday reality proved to be laborious. This could be rectified by phrasing the questions in such a way that reality was strongly emphasized: “The way things are at home, what would you like to change?”. Likewise, the question of how to stage ideal reality needed to be tackled in a different way, for the children’s answers did not go beyond the concrete level (e.g. “move the chairs closer”). This can be solved by means of doubling by the co-director. In doubling, the co-director verbalizes what he/she thinks the person is thinking or feeling or what information is possibly lacking. Such doublings enable the co-director to make third-person information more explicit.

• Probing the Self-Image through questions in specific areas

Children younger than eight find it difficult to achieve overall self-evaluations and instead focus on specific areas. Therefore questions about overall self-evaluation (“What do you think of yourself?”) are replaced with questions about specific areas. In the next part all these recommendations will be illustrated.

Illustration of the semi-structured protocol for children

We will now describe and comment on a few episodes from our clinical work with John, an 11-year-old boy.  John was referred to a psychiatric centre because of oppositional and aggressive behaviour. After an assessment period the following diagnosis was proposed:

Axis I: Disorganized attachment disorder and post-traumatic stress disorder as result of a history of multiple abuses. John has been sexually abused by his maternal grandparents, uncle and granduncle. His mother forced John to make sexual advances on his sister and his stepfather beat him several times.

Axis II: Light mental retardation (mental age estimated at 6/7 years)

Axis III: Epilepsy and nocturnal enuresis

Axis IV: Problems within primary support group: neglect, maltreatment, sexual abuse.

This co-morbid diagnosis legitimated a long-term residential therapeutic program in which the social atom method was introduced because of its potentials in the field of self-appreciation, relationships with significant others and self-insight.

SESSIONS COMMENTS

Chast of characters:

 

After an initial warming-up exercise the social atom is introduced. The child dresses every puppet and gives a mouth and a wig. The protagonist starts with a puppet for himself; next, he dresses his mother, brother and sister. The director and co-director also make a puppet for themselves. From now on, the puppets are addressed directly. The director and co-director also sit down on the edge of the carpet each with their puppet.

DR: Wonderful! Who else is there in your family?
P: The bad one.
DR: The bad one?
P: My dad is too weak, you know!
DR: What does your dad look like?
P: I’m going to dress him in the filthiest clothes I can find. (…)

Selecting and dressing a puppet is a first action-oriented exploration of the external aspects (and projections of internal aspects) of the Self-Image and Alter-Image. The filthy clothes refer to an external aspect of the Alter-Image and are coloured by the negative feelings towards the father puppet. This Alter-Image is explored through questions.

P constructs his father as a bad person (internal Alter-Image). His mother – in contrast – will get an absolutistic all-good meaning for John (see further). Because of intense emotions and conflict traumatized children fail partially to integrate different modes of relating internal experiences to the external situation (Fonagy & Target, 1997). Disorganization of attachment leads to multiple, conflicting representations (Nicolai, 2001a, b). Familial abuse is seen as interacting with the domain- and situation-specific restrictions upon reflective function. John possesses the beginning ability to be reflective in general, but shows minimal reflectiveness in the familial context or relationships which activate the same schemata.

A blanket is spread on the ground and serves as the stage[9] on which John is going to present his family. First John introduces a puppet for himself, which he enacts (Self-Image):

DR: Hi John! You can stand or sit anywhere you like.
P (as John): Ah! (Places his puppet on the left side of the room)
DR: Is this where you want to be? Do you feel comfortable there?
P (as John) nods.
DR: OK. Now John.[…] if your friends were asked “what is John like…”, what would they say?
P (as John): I don’t know.
DR: What do you like?
P (as John): I like playing with my teddy bears; I’ll show them to you. (smiles, takes the dogs and places them on the blanket in front of him)                      

The question concerning the Meta-Self (‘What would your friends think of you?’) appears too difficult because of insufficient role-taking capacities, insufficient meta-representational skills and an insufficient capacity for hypothetical thought. And yet, John’s doubt can be construed as a first step towards reflection on the Meta-Self.

Next, aspects of the Self-Image (thesis) are probed. ‘Who are you?’ is replaced by ‘What do you like?’ (cf. difficulty of overall self-evaluation with 7-year-olds). The protagonist installs the dogs at the metaphorical level in his internal Self-Image (i.e. interests) and gives them a protective and aggressive function (John will indicate later during the session that he needs these dogs for his protection). During the session John often ‘growls’.

            After introducing himself (Self-Image), John also stages the other family members. And that’s when the puppets can start talking. Before a new puppet is brought into the room, we always return to the Self-Image (I-puppet).

DR: Fine, John. I suggest that we ask someone else of your family to come in. Who would you like to come in?
P (as John): My dearest, dearest mum!
DR: Ah, there’s mum! Hi mum, do come in. Tell us: who are you, mum?
P (as mother): I am a mother of 3 children.
DR: Is there something you don’t like?
P (as mother): I like almost everything, except when my darling is having a row.
DR: And John, what do you think of him?
P (as mother): He’s a great boy. If a bad guy threatens me, John defends me, he is strong.
DR: Well, in that case John must like you very much.
P (as mother): Oh yes, he loves me. But his father? I don’t know, we’ll find out later.
DR: John, did you hear what your mum said?
P (as John): Yes, that’s nice.
DR: Does this make you feel good?
P (as John): Yes, because my mother always likes me.

 This passage illustrates the concrete probing of characteristics and conditions of the Alter-Image. Starting from the introduction of the Self-Image (thesis), the protagonist negates this Self-Image in moving to his internal Alter-Image (‘my dearest, dearest mum’). This role-taking in the mother puppet comprises the dialectical antithesis stage, since the protagonist – by becoming his mother (Alter-Image) – ignores himself (Self-Image).

At the same time we see the internal (nice) and external (defence) Meta-Self: what mother thinks of John, according to the protagonist. In contrast with the first attempt to grasp the Meta-Self, the questioning and role-taking make the articulation of the Meta-Self possible.

Before the introduction of another puppet, there is a short reflection from the I-puppet – as a synthesis of the dialectic process. From the I-puppet, it is examined what John thinks of what mother has said. In doing so, John ignores the Alter-Image (i.e., his role-taking of his mother) and becomes himself again (Self-Image).

Now John is asked to give his mother a place on the stage. The emotional-affective distance is important here: someone who is important is placed nearby the I-puppet; someone who is less important or whom the protagonist has a conflictual relationship with, is kept at a greater distance. John places his mother close beside his I-puppet. Next, his brother and sister are introduced and are placed nearby the I-puppet as well.

The determination of the affective-emotional distance emphasizes the spatial dimension proper to the dynamic within a dialogical self. Mother is placed nearby, indicating that she is an important figure to John (social condition of the Self-Image).

The significant others and accessory self-constructs underscore the ‘multifacetedness’ of the self, the action and enacting the ‘multivoicedness’ of the self. The different selves or I-positions are given an affective-situational concreteness by means of the puppets, which makes it possible to exteriorize internal dialogues into action.

DR: OK, John. Who can come in now?
P growls, barks and takes the dogs.
DR: Who are you, little dogs?
P: (as dog): We are John’s friends!

 

John places the dogs in a semicircle around himself, his mother, brother and sister.

DR: What are you doing, why are you standing there?
P: (as dog): We are protecting John and the others […]
DR: Who else have we forgotten?
P growls softly.
P (as John): The father.
DR: How do you call father?
P (as dad): The bad one.
DR: John, I’m now going to ask your dad.
P (as John): That’s what he himself says, doesn’t he?
DR: You think you’re bad. Why?
P (as dad): Mum doesn’t want me any more.
DR: And do you get on with your son John?
P (as dad): He is mean to me.
DR: What do you think John?
P (as John): Bad.

 This enactment represents the internal Alter-Image (the bad one). At the same time, the fragment illustrates how difficult it is for John to enact the aggressor (when there is no mediation by the dogs). He initially doesn’t speak from the father role but from himself; that is why the director repeats the question. The Alter-Image and the Meta-Self (“John is mean to me”) imply an antithesis vis-à-vis the Self-Image.

The return to the Self-Image comprises the synthesis in which an ‘Aufhebung’ is reached via a double negation. Given John’s serious traumatic anamnesis, the ‘Aufhebung’ process is only achieved partially. The difficulty of reconstructing meaning may be part of: a) black-and-white thinking in which contrasts can only sporadically be offset and integrated (cf. mental age 6/7 years), b) the insufficient capacity for real role-taking behaviour, and c) the partially problematic reflective function caused by the disorganized attachment style. Given this background, the process as launched in the social atom, can only be a first realization for a further reconstruction of meaning within a longer therapeutic process.

At the end of this psychodrama session, the social atom is checked from above and John is given the opportunity to say something to every member of his family.

 DR: Do you have something in mind? Are you going to say it loud or silently?
P (as John): I’m going to whisper.
P whispers something to the ‘I-puppet’, to his mother, brother and sister.
DR: You can also say something to your father.
P (as John): FUCK YOU!!!

The protagonist not only talks about but also to and with significant others (externalization of self-dialogues). After desymbolizing the puppets (“This is no longer John, it’s just a puppet”), a short scene concludes the psychodrama. The protagonist has the final say. Then the session is closed explicitly (“And this ends our puppet play”). Finally, it is checked whether the protagonist is in the here-and-now again by asking concrete questions, so that he doesn’t remain fixed to the object projections.

SESSION 2: Stage B: CONCRETIZING OF THE IDEAL PHENOMENOLOGICAL IMAGE

A connection is made with the previous session by reinstalling the actual phenomenological situation (stage A). John makes no major changes. Next, it is checked again from above whether this is the “real” situation. This is followed by the move to the desired situation:

DR: This is the situation at home as it is now. Supposing you had magic power, what would you change at home?
P (as John): Remove Roger.
DR: Who is Roger? Dad?
P (as John): Yes.
DR: OK, you can now do with the puppets whatever you like.
P (as John): I can do whatever I like?
DR: You can do whatever you like.
P (as John): Roger: throw away!
DR: That’s OK. Do you want to throw him away?
P growls and barks.
P (as John): I can undress the puppet as well, can’t I?
DR: You can do whatever you like. You can undress it.
P growls, barks, shouts. The dogs tear the clothes off the Dad-puppet and the puppet is thrown into a box which serves as jail.
P (as dad): Help!!!
DR: OK. Now we’ll listen first. I’m first going to ask John what he thinks…, John?
P (as John): Yes?
DR: Did you see what happened?
P (as John): Yes.
DR: And what do you think?
P (as John): Better.
DR: If this were to be the case, would you feel better?
P (as John): Well, the father is gone, isn’t he?
DR: How does that make you feel?
P (as John): Me? He did mean things. He hit my mother and had a fight with her. Don’t you understand?! Can’t you get this into your head? Can’t get this into your head, stupid?
CO (doubles John’s puppet): I think that my father should be punished for all the bad things he’s done. That’s why I’m very angry with him.
P (as John): Right.
DR: Right. So Mariska is right?
P (as John): Yes.
DR: Could you say this in your own words?
P (as John): I’m saying that he should be sent to jail.

This passage illustrates the search for ideal constructions and ‘possible selves’ as components of the ‘multivoiced’ self (Hermans, 1996). Everything is checked from above again to see whether this new situation is better for the protagonist. After this general reflection, John and the other members of the family are asked how they feel about this new situation. The I-puppet (Self-Image) is constantly returned to in order to probe his thoughts and feelings.

 CO (doubles John’s puppet): I’m wondering whether dad is missing us, now that he’s gone.
DR: Could John think this?
P laughs.
DR: Could John think that dad misses them. Do you think dad misses you?
P (as John): No… I don’t know… He was mean; he hit my mother

 After every doubling, the protagonist should be asked whether the ‘doubled’ statement is correct. The protagonist should then reformulate it in his own words – the protagonist thus becomes co-investigator of his own phenomenological truth. The above doubling illustrates that story-telling is a co-construction between the storyteller and the listener (Hermans, 1996). Doublings may include slight provocations/contradictions to stimulate the reconstruction of meaning. With John as well, we see that after an initial “no”, the doubling stimulates doubt (“I don’t know”) or a rudimentary type of integrative reflection process.

Finally, John is allowed to say or whisper something to everyone, after which the puppets are desymbolized and there’s a short closing scene. Stages C and D of the experimental version of the protocol are currently being elaborated and are not illustrated in the present case.

3. Discussion

Our clinical work with John illustrates the first steps of a reflection process in which meanings are reconstructed. This case study shows how the action sociogram, if duly adjusted, can support and intensify the dialogical self-processes even in children. The children are given the chance of actually moving from one I-position to other positions (Hermans, 2003), becoming and meeting the antagonists in a concrete space and time (Verhofstadt-Denève, 2003). Moreover, the emotional-cognitive exploration of the problem, via affective-situational actions, intensifies the learning process (Verhofstadt-Denève, 2003).  Nevertheless, it proved difficult to launch an explicitly dialectic process of reconstruction of meanings in just a few sessions. This may be explained as follows.

First, the age of 7 is a major milestone in cognitive development. The egocentric features gradually weaken, so that reflection on the (more objective) knowledge of the self, the others and the world grows. Before that age, the child is limited to unidimensional or black-and-white thinking; before the age of six or seven, children find it hard to cope with multirepresentationality or the simultaneous contemplation of several conflictual representations (Templeton & Wilcox, 2000). In addition, children around this age develop an incipient, clear understanding of interpretative diversity that needs to be consolidated (Taylor et al., 1991). Now although John’s biological age is eleven, his mental age of six to seven years can partly explain the momentaneous breakthroughs of unidimensional and egocentric self-constructions and the difficulties he shows with the second-order belief attributions.

Secondly, John has to cope with severe psychic problems, which affect his potential for reflection. Bowlby (1969) postulated a clear link between attachment disorders and psychic problems in later life. Attachment is a mental state or representation which organizes information about emotions and cognitions regarding the self and others, integrates affects and cognitions and makes memories accessible. Recent research has specified this link to Self-Image disorders and the processes which trigger the integration of Self-functions. Children with a disorganized attachment style are thought to have problems developing the reflective function, which comprises the ability to react to the behaviour of others and to conceive an idea of their beliefs, wishes, pretensions, plans and feelings. Evaluation and appreciation of significant others is a major determiner in the growth of a positive feeling of self-esteem (Harter, 1998); the internalization of standards and evaluations of significant others co-determines the content of self-constructions. As a result, children growing up in dysfunctional families are more liable to develop negative perceptions, with all the accessory feelings of worthlessness, impotence and badness. This means that damage could occur in the ME (inter alia, greater discrepancies between the real and ideal selves, lower self-esteem, self-accusation) as well as in the I (inter alia, damaged self-coherence, diminished agency). This could be why traumatized children find it so much harder to achieve the integration of positive and negative self-evaluations (cf. all-or-nothing thinking or lack of reflexive function). We recognize all these limitations in John, as illustrated, for instance, in his inability to immerse himself in his father without the help of mediators.

These theoretical considerations lead to a number of issues to be examined. The first question that is raised is if the laborious explicit ‘Aufhebung’ of oppositions, as witnessed in John, is a major consequence of his insufficient cognitive development, a major consequence of his psychopathology, or an interaction of the two.

Secondly, the case study proves the practicability of the action sociogram in working with school-aged children. Stages A and B (i.e. the construction of phenomenological reality and the ideal situation, respectively) can be worked through, on condition that proceedings are based on concrete questions and direct spatial action and backed up by doubling.

If you want to read more: When puppets speak (2009) Leni Verhofstadt e.a.

[1] Yet, not all oppositions have a constructive effect (Verhofstadt-Denève, 2000).
[2] This importance of the interrelational activity between the self and others is also emphasized by Bakhtin. Indeed, it is in the actual interaction of a dialogue with others that we can know the third person’s view of who we are. Without this perspective, our view of ourselves would remain incomplete. In addition, the inherent interpretation differences between two speakers of the same action makes that self and other are essentially in dialogue with each other (both at the interpersonal and intrapersonal level) (Barresi, 2002).
[3] The phenomenological constructions and internal dialogues constitute the basis for therapeutic work, and this goes for psychodrama too: “The subject must act out “his truth”… Enactment comes first, retraining comes later” (Moreno, 1975/1959, p. 234).
[4] This age limit serves as a guideline only and should not be taken too strictly.
[5] In Selman’s social perspective-taking model, we see that children acquire a rudimentary form of perspective-taking capacity at an early age. However, Selman suggests that in the period between ages 7 and 12, there is no self-reflective role-taking. A five-year-old already recognizes the subjective singularity of preferences and feelings and also realizes that others may have different feelings. However, only between ages 7 and 12 does the child begin to recognize that others make inferences about his/her thoughts and feelings. However, these stages have been criticized on the grounds that the research method has led to an underestimation of children’s capacities.
[6] Before this age, children do have the capacity for thinking about diversity through emotional responses but not through interpretative representations.
[7] Up to middle adolescence, the multiple, situational selves remain compartmentalized; they co-exist alongside each other (Kunnen & Bosma, 2000).
[8] Research into the development of the dialogical self also suggests that – in spite of the fact that multiple selves occur in early childhood (Fogel, de Koeyer, Bellagamba, & Bell, 2002) – reflections on and dialogues between the different voices are not fully possible until late adolescence. The compartmentalization of the multiple selves then shifts to a higher level of integration.
[9] The stage is the place where the psychodrama is enacted. Cuvelier (1993) clarifies that – irrespective of the use of a real stage – the creation of a symbolic space by the protagonist is the essence. The blanket concretizes a symbolic spatial delimitation.

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Information about the author

Leni Verhofstadt-Denève (PhD) is emeritus professor in Theoretical and Clinical Developmental Psychology at Ghent University, Belgium. Trained in clinical psychodrama by, amongst others, Dean and Doreen Elefthery; Trainer Educator and Psychodrama Practitioner (TEP) (Netherlands-Belgium Board). Member of the Royal Flemish Academy of Belgium for Science and the Arts. Author of many books and (international) articles on psychodrama from an Existential-Dialectical framework and Developmental Psychology. Founder and Director of the School of Experiential-Dialectical Psychodrama (recognised FEPTO training institute).

If you want to read more: When puppets speak (2009) Leni Verhofstadt e.a.