Practicing psychodrama online in times of pandemic: some theoretical considerations

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Nikos Takis, Ph.D.
Clinical Psychologist, Psychodramatist, Group Analyst

 Abstract.

The Covid-19 pandemic has affected significantly group psychotherapy and psychodrama practice. In the present paper, the major changes of the transition from face-to-face to online settings are reviewed. The question that arises is whether psychodrama can be delivered in the absence of the physical bodies of the participants, via the use of online platforms. To answer this question some major theoretical concepts of psychodrama, like the surplus reality and tele, are discussed. It is also suggested that the three basic psychodrama techniques, double, mirroring, and role reversal can be used effectively in online psychodrama as well. The main position is that J.L. and Zerka T. Moreno had founded psychodrama in a way that is not bound by the limitations of the external reality and equipped with the necessary theoretical tools that enabled its adaptation to the requirements of the virtual reality of the online practice.

Introduction

The unprecedented crisis of the Covid-19 pandemic has brought on immense changes in the practice of group therapy and psychodrama. The restrictions in transportation and the fear of contamination have halted or postponed the sessions of many groups. In the majority of cases, nonetheless, the group process continued through online communication platforms. Undoubtedly, these new conditions significantly alter the meaning of group work and psychodrama, as we have come to know it. The situation in which the members are meeting through a computer screen, tablet or mobile phone is the new reality that has inevitably changed the way of conducting sessions. This article is an attempt to “track” these shifts and explore the main features of this new unfamiliar situation where members and group coordinators have found themselves functioning during these last months.

Online therapy key aspects what’s different

The predominant characteristic of the group process during the pandemic is surely the physical absence of the body from the sessions. Is it really an absence, though? First off, the protection of the body itself is the reason why its absence, its elimination, is paramount. The discussions regarding how the coronavirus manifests, the bodily symptoms, the self-observation of bodily functions, the undergoing of tests, the long explanations about how each vaccine works, the constant announcements of new cases, deaths, intubated patients in ICUs are in the agenda of many internet sessions. In other words, the body is emphatically present, although physically absent. Our ongoing preoccupation with it is connected to the agony of death and preservation of life within the spectrum of an invisible threat, from which group members feel they cannot protect themselves.

Another basic parameter is that important sensory data and stimuli within the group are significantly diminished. Touch and sense of smell are excluded from online sessions. Sight and sound, with slight variations, however, are the only channels of communication as opposed to being physically present in sessions.

Regarding sight, only part of the body is visible on camera; it is usually the face, the arms, and the upper torso. The rest of the body is missing. Each participant can choose what part of his/her self he/she will expose. The overall viewing of the body, its movements, and reactions are no longer available. Inescapably, a large part of information attained from body posture, non-visible gestures of the group members, and the whole sense of the bodily situation, are excluded from the sessions. Therefore, the whole display of the body in the eyes of the other participants fades completely. This contrast could create a sense of control and safety for some members but takes away a vital parameter from the whole procedure. Meanwhile, the participants cannot discern who watches them or where each one’s gaze is directed since they all appear in a “window”, as per the TV term, on the screen.

Yet another new feature is that each participant can see his/her reflection along with the other members on the screen. There is a double representation of self, created by each member of the session: The self as someone feeling, thinking, mentally reverberating, and at the same time another self appearing on-screen visible to oneself. Frequently, due to connectivity problems, the image is altogether removed for a large part of the session.

Crucial differences can also be observed with audio communication. Frequent connectivity issues can strain conversation among members. Things said are not understood and need to be repeated. It is a constant worry whether what a member says can be heard online or is lost. Questions like “can you hear me?” or “are you there?” are common during online sessions. There seems to be a concern as to the mental connection among the affiliates, and ultimately the existence of the others, which must be verified either by sight or sound. This concern can be experienced during the moments of silence too, which also work differently with internet sessions.

Furthermore, the microphones of the non-speakers must remain switched off to avoid interference and various sound problems. This also results in the loss of a significant amount of information and reactions while conversing with the group. Chuckles, sighs, exclamations, and other sounds as impulsive reactions to something being said are no longer perceptible. The therapists and members must rely on the fact that each member will choose to speak when it is their turn. Through this procedure, much data is in effect silenced.

One more important change has to do with the space the meeting takes place. The members do not congregate in a room of a mental institution or a private office. They do not travel somewhere else but participate from their own private space or a place of their choice. The other participants have access to this real space through their cameras. Thus, they all share something very private with the rest of the group. They take part in the session in body but also within their own “private place”, with personal belongings showing on camera, such as paintings, posters on the wall, etc. The place where the group meets now is somewhere new, consisting of the sum of spaces where each member is during the session.

The space-time dimension of this group experience is significantly altered. A new “here” is presented, more abstract and transcendental. The “now” has changed, without the “here” that the members have grown to know. The time of transportation to the group’s meeting place and back, is also canceled, along with the real and symbolic meaning this might have for each participant. For many members, this portion of time helps them prepare to enter the reality of the group and process what happened in session afterwards. In online groups, the participants usually make the transition without taking the time to think about the group.

Psychodrama groupwork online

With regards to psychodrama practice, there are even more repercussions. As our work entails a lot of movement, which is necessary for the warm-up and the expression of spontaneity and creativity of the protagonist, the auxiliaries, and the whole group, the group leaders have to invent other ways to attain their goals. In the online environment, group members are usually static, fixed in front of their screens, with limited ability to move, walk and use their body. Thankfully, many of our colleagues in FEPTO have been very resourceful in this task.

The external reality, the meta-frame according to Kaës (1988), is the main configuration factor of this circumstance. Online group psychotherapy is not something new. It has been going on for almost two decades (Weinberg, 2014). The difference, in this case, is that due to the pandemic, it is the only available choice. Members meet via the internet, under curfew, and with the threat of contamination from the virus hanging like the “Sword of Damocles” over their heads. Shops are shut, gatherings are prohibited, the financial status of society is all but paralyzed. At the same time, we are informed daily of dozens or even hundreds of new deaths and admittances in ICUs. Everyone’s everyday life is veiled over by the threat of death that pushes us into unusual withdrawal and self-isolation. The term lockdown, which is used to describe the current situation, most certainly refers to confinement, imprisonment. It reignites old memories, when authoritarian regimes or invaders, inflicted similar restrictions in the past. It can be hypothesized that the pandemic is bringing to the surface of consciousness facts of a traumatic past from the collective unconscious.

During any limited contact with other people, avoidance of physical touch is encouraged, and wearing a face mask is mandatory. We can no longer see other people’s faces except through monitors. The government suggests we stay at home to remain safe. To many, this message takes them back to their childhood, as they listened to their parents saying that the only truly safe place is at home with family. This is a “return at home” without an abundance of exits or ways out. The spike detected in domestic violence incidents during this pandemic is probably one of the effects of this return. We have all entered an unfamiliar reality that establishes a new frame of reference for the groups.

So far, only the main changes of the transition to online sessions have been mentioned. These are just a few and they have not been analyzed in detail. They do, however, signify that a new circumstance is created, which calls us to reflect on the basic meanings and functions of group psychotherapy and psychodrama. Moreover, how can a psychodrama group be established within an internet environment? How can it accomplish its goals, as it is a method that relies heavily upon the participation of the body of the participants?

Having limited experience when it comes to online group work, as it was forced upon all group therapists and psychodramatists due to the unprecedented reality of the pandemic, there can be no definitive answer at this point. In any case, the common findings from the past months of online psychodrama practice yield that, that despite the changes, the groups perform successfully. Some members even comment that this new circumstance feels more productive than physically appearing at sessions. Many of them report that the online group sessions helped them significantly in sensing that they remain connected with other people, in times of quarantine and social isolation. However, it must be noted that this does not pertain to groups of patients with severe psychopathological disorders, like bipolar disorder, borderline personality disorder, etc.

In his book “The Paradox of Internet Groups: Alone in the Presence of Virtual Others” Weinberg (2014), mentions that the members of these groups feel they can get involved and withdraw from the group at the same time. They maintain their individuality, set their personal boundaries, and decide up to what point they want their virtual reality to be known to others. Equally, they feel part of an expansive network, entering a wider womb/grid (a matrix, according to Moreno and Foulkes) of connections and becoming units of this enveloping environment. It seems that internet groups can provide the opportunity, even if it is a delusion, for members to decide to what degree they will be in or out of the group, how close or how far, at any time. Physical absence pushes members to invest further in the main representatives of the frame, the group leaders. Besides, the frame is primarily the therapist’s psyche, according to Bleger (1967).

Undoubtedly, internet group therapies create a new reality, a new “here and now” within the group. According to the philosopher Immanuel Kant, we cannot in any case perceive reality itself. To approach it we rely on thought, which in turn is based on the sense of stability of space and time. The sense of reality is subjective and is always mediated by other parameters, like comprehension, thought and experience.

There are similar reports in group psychotherapy. Bion (1984) discriminates between the ultimate Truth (calling it O) and surmises that it cannot be known, and intellectual knowledge (calling it K) where it can be learned. Jacques Lacan (1977) theorizes that the real cannot be uttered with words. What we think as reality is in effect something symbolic that constitutes a signifier for the real. As per Derrida (1974), the belief that words represent reality is an illusion, as they are mere symbols of a personal code that has nothing to do with the subject. The interpretation of reality seems to be a subjective process of creating images of the self and others.

When it comes to psychodrama, what theoretical and tools do we possess to be able to adjust to the new online reality, as it is shaped after the pandemic? Although J.L. Moreno had not experienced the virtual reality of the internet, he had suggested some important considerations that seem very applicable nowadays. Back in 1966, in his paper: “Psychiatry of the 20th Century; Function of the Universalia: Time, Space, Reality and the Cosmos”, he points out that “the objective of psychodrama is to construct a new therapeutic setting that will use life as a model, beginning by integrating the universals: time, space, reality and cosmos”. He emphasizes the need to take into account these elements and explore all their nuances and details. By using the principle of concretization, the participants of both psychodrama and sociodrama can create their own subjective experience, in which all four elements are entailed.

Regarding time, he points out that, in opposition to other methods, psychodrama bypasses its limitations. The participants can travel in the past, the present, and the future. They can go back in time, revisit the significant experiences of their childhood, reconstruct them, and having them resulting in a different effect to their present self. For example, a traumatic experience can, through the use of action methods, be registered differently and less painfully. He also underlines the importance of investigating the phantasies and desires about the future and not focusing only on the past, as it is happening usually in other forms of psychotherapy.

As far as space is concerned, the place where the action happens needs to be clearly described and recreated within the stage of psychodrama. By distinguishing between the internal and external reality, psychodrama enables the protagonist to travel in space and time, when and where the roles firstly appeared, in “situ et locu nascendi”. Through this process, the origins of the existing roles are examined and their effectiveness in face of the actual challenges and needs of the member’s life is assessed. The individuals can create new roles, more proactive with regards to the present, and more suitable for the future. It seems that Moreno had already predicted the importance of taking into account all the dimensions that have now been significantly altered with the transition to the online practice of group psychotherapy and especially psychodrama. This is an indication of his genius.

In terms of reality, he is even more innovative. He claims that in traditional psychotherapy, only a reduced part of reality is depicted. On the contrary, the therapeutic situation should simulate the patients’ lives as much as possible. He suggests the concept of surplus reality, which refers to the “intangible, invisible dimensions of intra- and extra-psychic life. It means that there are dimensions not fully experienced or expressed, and that is why we have to use surplus operations and instruments to bring them out in our therapeutic settings”. One of the most popular techniques that operate in surplus reality is role reversal.

According to Moreno, surplus reality constitutes the transcendental level, on which the transforming and healing effect of psychodrama is delivered, released from the limitations of the objective external reality. This is a fundamental reason that permits psychodrama practice to transition in online settings. Its stage, represented by Moreno as the higher of three same centered cycles, is only departing from the external reality (1st level), passes through the reality of the group (2nd level), and culminates on the third layer, where the psychodramatic action takes place. The online platforms can serve as a psychodrama stage, as the protagonist and auxiliaries are taking part in the action in a virtual, symbolical form. The absence of the body might even allow for more spontaneity for some members, as it deliberates them from inhibitions, hesitations, and the influence of external reality (Weinberg, 2020).

The dimension of the cosmos pertains to the universality of psychodrama. Human relations happen in a special universe, created by the beings that participate in it. Moreno believed from early on that there is a “larger world beyond the psychodynamics and sociodynamics of human society, cosmodynamics. Therefore, man is a “cosmic man”, not only a social man or an individual man, a cosmic being”. In this sense, a new cosmic universe can be created also in the virtual environment of an online platform, if individuals are willing to communicate. In Morenian terms, a new “cosmic reality” is emerging, in which psychodrama practice can be delivered, with some necessary modifications. The internet can be seen as a new infinite “matrix”, without limits and borders, which can potentially include the entire mankind, as J.L. Moreno always aspired. As many of us have experienced the last year, spontaneity and creativity, the two primary generating forces of psychodrama, can develop in online groups without being impeded by the physical absence.

But what enables the magic of psychodrama to be happening online, in the absence of the physical body? Back in 1943, in “Sociometry and the Cultural Order” Moreno postulated that it may be a mistake to believe that the psyche is placed inside the soma. He proposed that the psyche might be located outside the body, the physical corps being engulfed by the soul. That would send the core of our existence “out there”, in the infinity of cosmos, including the virtual universe of the internet, where our online practice is taking place. We quote from this paper:

..Resistance against any attempt to break the sacred union between the individual has one of its roots to idea the feelings, emotions, ideas, must reside in some structure in which it can emerge, and within which it can function or disappear… These feelings, emotions, and ideas “leave” the organism. Where can then they reside? Group research shows that they find their expression between people, in interpersonal and intergroup relations, traveling throughout the network, sometimes visibly, sometimes not, but often without predictable effects. The energy involved in these streams of feelings and moods that feeds them, we assume to be “tele”.

We assume that the networks in which the groups and relations’ energy travels, both visibly and invisibly, are the ones of the internet, the new field of human, interpersonal and social interaction. Zerka Moreno (2000) believes that placing the psyche outside the body is what allows for people to meet authentically and have meaningful exchanges, encounters, in psychodramatic language. She describes beautifully: “That is how and where the human encounter takes place and it requires a two-way corridor to an open field along which to travel”. In our view, the online platforms might be considered as “two-way corridors” to the “open field” of the new virtual world. Internet is a new universe, a new cosmic reality in which encounters, relations, and interactions happen, fueled by the energy of “tele”.

We will now examine the alterations in the use of the main psychodrama techniques. Regarding the double, the experience of the double reenacts a dynamic from early childhood, where the “young child looks into a mirror and seed another child, someone else who is exactly like himself” (Remer et al., 2007). In terms of technique, the double, which is an auxiliary assigned a specialized role, duplicates the protagonist and “attempts to become his or her psychological twin, to serve as the protagonist’s inner voice and conscience, to reflect his or her feelings, to uncover concealed thoughts and concerns” (Kipper, 1986). Blatner (1996) believes that the double is the most significant psychodramatic technique, as it enables the protagonist to understand and articulate deeper emotions and pre-conscious thoughts and fantasies. According to Zerka T. Moreno, doubling originates on the “second universe” of differentiated all identity, in which other individuals are experienced as separate beings, but the child maintains the illusory belief that he or she can control them (Kellerman, 2007).

The online platforms possess an important advantage with regards to the double: the participants are doubling themselves, by looking throughout the sessions their reflection on the screen. The twofold presence of members allows for the creation of a symbolic space between the two different representations of the self: a part of them participates in the group and another part observes what is happening. The second part can become the “inner voice” of the first. By doing so, members are entering into a new, unfamiliar condition, and may have various reactions in the beginning. This innovation offers new possibilities and options for the use of the technique. For example, the group leader can ask the members to express what their reflections on the screen think and feel, and maybe do not reveal in the group.

The technique of mirroring, or the outside reflection according to Kellerman (2007), derives also from the second universe of differentiated all-identity, like doubling, but relates more with the later stage in which the differentiation between the self and other people is attained. This is the phase of separation-individuation according to Mahler (1972). Technically, mirroring provides immediate feedback to the protagonist, presenting him or her a reflection of the self from outside: the auxiliary assigned the role of the protagonist reenacts a scene that the latter has just completed. By watching the scene as a spectator, the protagonist takes a psychological and physical distance from the issue that concerns him or her. This process allows for the adoption of a more rational, sober point of view, less influenced by personal engagement and biases.

The physical distance between members in the case of online enables mirroring to function effectively and provide a fair amount of insight to the participants. In the case of an emotionally charged psychodramatic act, the protagonist might be able to draw significant inferences and gain more awareness of his/her behavior and reactions compared to what would happen in a face-to-face session. Furthermore, members could more easily imagine the type of behaviors and roles they would want to develop in the future, being more distanced and less overwhelmed from the action that takes on the psychodramatic stage.

Regarding the technique of “role reversal”, maybe the most famous and powerful tool of the psychodramatic method, there do not seem to be impediments to its usage in online settings. According to Blatner and Cukier (2007), role reversal is both a technique and a principle, that promotes the development of empathy and moving beyond egocentricity. By taking the role of the other person, members become able to understand his or her view on a situation. Moreno (1950) considered role reversal to be a major technique of socialization and self-integration. It is the surplus reality of psychodrama, which “brings into the manifest form through enactment situations that cannot happen in ordinary reality”, that allows the utilization of role reversal. As the online environment of the internet functions as an alternative abstract reality, in which people meet virtually, without using their physical bodies, it may be even easier to enter in the “other person’s shoes”, become him or her, in the role exchange process. Besides, according to Moreno (1966), in psychodrama “there is no age, there is no gender, there is no time”. The limitations of the objective reality can be overcome on the psychodrama stage. In this sense, the participants can become someone else in an online role reversal, with the appropriate instructions and warm-up from the group leaders. For example, they might be asked to wear a cloth, a hat, to hold an accessory that will facilitate the process of acting the desired role.

Conclusion

Conclusively, as the recent experience of online practice also yields, the main techniques of psychodrama can be effectively implemented remotely, via the use of online platforms. However, there may be a need for some necessary modifications or alterations. Nonetheless, J.L. and Zerka T. Moreno invented a method of exploration and improvement of human relations and social interactions that exceeds the boundaries and the traits of any specific cultural, national and social reality. They elevated the human soul, the psyche, to a higher level, above the human body, in which they believed that encounter takes place. In our view, this is exactly what the online platforms are offering: a symbolic, transcendental field in which we can meet each other truthfully, authentically, and spontaneously. If practiced correctly, the method of psychodrama is more than appropriate to be utilized in this field.

References

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Information about the author

Nikolaos Takis, Ph.D. is a clinical psychologist, individual and group psychotherapist, and psychodrama trainer. He is the former president of FEPTO (Federation of European Psychodrama Training Organizations). He is also an associate professor and director of the counselling center of the American College of Greece. He is a full member of the French and Hellenic Association of Psychoanalytical Group Psychotherapy and the Hellenic Psychoanalytical Society.