Psychotherapeutic functions activated in psychodrama

19

Proposal for an analytical model of change process
by Paola De Leonardis

 

Abstract

The article proposes to associate to the parameters that are generally adopted for analyzing a psychodrama session – that is, the type of activities carried out, the objectives for each individual in the group and the objectives for the group itself – a fourth parameter which regards the mental functions that support change and are specifically activated in the different stages of the session itself, with particular reference to the psychotherapeutic field. First of all, the author describes each of the mental functions identified as psychotherapeutic from the general psychological point of view and with regard to psychodrama in particular. She then tries to identify the psychodramatic activators that are specific to such functions and, finally, she proposes an interpretation framework for a typical psychodrama session specifically for each of its classical stages according to the four parameters mentioned above.


Introduction

In order to understand what happens in a psychodrama session, both from an interpersonal and an intrapsychic point of view, it is important to assume precise parameters of analysis. In this article I propose to assume four fundamental parameters: 1) the type of activities carried out in the session, 2) the objectives with respect to the individual member of the group, 3) the aims with respect to the group, and finally 4) the mental (psychotherapeutic) functions activated.

Many theoretical-methodological reflections and most of the analyses of psychodramatic sessions, including those published in the past in this same journal, focus on the first three of these parameters. However, I do not think that the fourth of the mentioned parameters – the mental (psychotherapeutic) functions activated in the psychodramatic process – has received specific consideration except, rather briefly, by Giovanni Boria in his Psychodramatic Psychotherapy, in the chapter entitled “The elective mental mechanisms”, in which the functions of double and mirror, perceptual decentring and catharsis are considered in sequence (Boria, 2005, pp. 98-100).

I think that a clearer idea of which mental functions, and therefore which intrapsychic dynamics psychodrama promotes in its various applications, can give us, as psychodrama leaders, a greater awareness and guide our actions in different contexts, particularly in the psychotherapeutic field, with regard to both containing (holding) and stimulating actions. The first objective of this article is therefore to identify the psychological functions, among those generally considered favourable to change, that psychodrama activates most frequently in group interventions. I will then describe these functions one by one, so as to place the roots of my reflection on a common conceptual ground. I will then continue my reflection by considering the psychodramatic activators that seem to me specific to the different psychotherapeutic functions, and finally I propose a reading frame of a typical psychodramatic session, specific to each of its classic ‘phases’, according to the four parameters listed above.

Due to reasons of space, it is not possible to offer an example here of such an analysis applied to a psychodramatic session actually conducted and videotaped. Is is even less possible to present, according to these four parameters, the analysis of a series of psychodramatic sessions in a 2 psychotherapy group, focusing on a single member or on the group as a whole. I hope this work can be done elsewhere in the future. However, I hope that the interpretation framework proposed here can facilitate and enrich the analysis of a psychodramatic session, allowing a better understanding of it from the point of view of intrapsychic dynamics and describing its process in a more structured way. The same interpretation key can also be useful in the sequential analysis of several sessions, in order to recognise and distinguish the behavioural and verbal signals of change of individual group members. Finally, the use of such criteria may help to better identify group relationships and read the specific group dynamics.

What kind of intervention is psychodrama?

Psychodrama, in line with the theory that informs it, applying a methodology that can, with great flexibility, pursue different aims: formative, educational, cognitive, or psychotherapeutic. Psychodramatic interventions in the educational field and in the psychotherapeutic field have different intentions and objectives. The activation of precise ‘mental functions’ is the instrument through which the different psychological approaches propose paths of personal development and change.

That does not mean that the psychological functions activated for psychotherapeutic purposes are not also activated in training or educational contexts. What changes is precisely the intentionality of exploring or not exploring the unconscious territories in a systematic way. In this article I will try to identify the mental functions specifically activated by psychodrama referring to the psychotherapeutic setting, because it is in this setting that the intentionality of change is fully expressed.

What kind of psychotherapy is psychodrama?

Usually psychotherapies are distinguished into different categories and subcategories. The three basic categories usually mentioned are supportive, re-educational and reconstructive (Gabbard, 2009). The category of re-educational psychotherapies includes the subcategories of expressive and experiential psychotherapies, among which psychodrama is most often categorised. With regard to these psychotherapies, the emphasis is often placed on the client’s ability to readjust to the demands of life, while at the same time providing a satisfactory or acceptable response to his/her own needs, also through the identification and processing of unconscious conflicts.

Reconstructive or restructuring psychotherapies, in which all psychoanalytical therapies are usually placed, aim at a reorganisation of the individual’s personality, not only through the recognition of needs and unconscious drives and the dissolution of the consequent internal conflicts but, above all, through the emotional and cognitive development resulting from a clearer knowledge of one’s own psychological functioning (Ogden, 2009).

If the above distinction between psychotherapeutic categories makes sense, many years of experience lead me to recognise in psychodrama a psychotherapy that is not only expressive and experiential, but also properly reconstructive. In psychodrama too, the therapist orients his work towards the whole personality of the individual, in its relational and unconscious aspects, and it would seem incongruent to me to say that psychodrama does not aim at significant emotional and cognitive development. Yet the extent to which psychodrama intends to explore unconscious territories – intrapsychic and intergroup – is worth reflecting upon.

Which unconscious in psychodrama?

The unconscious realms have always belonged to psychoanalysis as a discipline specifically oriented to explore them and – according to Freud’s declared goal – to transform them into consciousness. This assumption – according to which, for a true transformational psychotherapy, what is in the Id (unconscious) must be brought into the Ego (consciousness) – is not transferable as such to current psychoanalysis and its interpersonal and intersubjective branches. These orientations consider the unconscious a mental condition not only to be explored, and therefore to be made knowable, but to be re-constructed through the therapist-patient relationship, in the awareness that in this work it is more correct to think of continuously evolving mental processes than of more or less accessible or inaccessible mental states.

In Moreno’s texts the concept of the unconscious has an extemporaneous presence, used mostly when he talks about spontaneity and to differentiate psychodrama from psychoanalysis. To my knowledge, the only articulated reflection on the unconscious appears in the book The spaces of Psychodrama, published in 1950 (Moreno and Toeman Moreno, 1995), consisting of “theoretical cards” on various topics sent to well-known psychologists of other orientations, from whom Moreno requested “reasoned comments”.

In fact, Moreno believed that, for the purposes of changing the individual and treating his mental disorders, the psychodramatic method made it unnecessary to systematically explore the archaic or primary affective experiences, which are closely related to the shaping of the unconscious and its conditioning power on people’s adult behaviour. Moreno maintained (Moreno, 1985, pp.13-218) that his method is aimed at developing a state of mind (or mental condition), that of spontaneity, which activates the healthy parts of the person and makes his/her inner resources productive and creative in a relational context that is both supportive and stimulating.

According to Moreno, the development of spontaneity-creativity – which he came to indicate as the main instrument of a ‘third psychiatric revolution’ – is able to activate, in the here and now of the group context, the psychological functions and relational skills that had been inhibited or distorted there and then. The individual, as a unitary dynamic system, benefits in its entirety from the development of spontaneity-creativity, and tends towards increasingly articulated and complex levels of evolution.

This, in extreme brevity, is the rationale of Morenian psychotherapy. But where has the unconscious gone? What happened to that deep knowledge of oneself and one’s psychological functioning that, according to the current classification, make the difference between reconstructive and re-educative therapies? This way of framing the question of psychotherapy seems to me to be somewhat limiting. I sincerely think that if Moreno had taken the Freudian unconscious seriously at that time, he would have been seriously caught up in it, and he probably would not have been able to give his theoretical and methodological approach the coherence that today has been brought to light by much practice of psychodrama and much reflection on it. But I also believe that, if he were here with us today, he would return to that theme and incorporate it into his theory.

As mentioned above, Moreno deals with the question of the unconscious and the psychodynamic therapies that have made it the centre of their interest in a much more articulate and in-depth manner in the chapter of The spaces of psychodrama entitled “Interpersonal therapy, group psychotherapy and the function of the unconscious” (Moreno and Toeman Moreno, 1995, pp. 59-110). However, he turns very quickly to the concept of the co-unconscious, since the heart of his examination is interpersonal psychotherapy, or rather the psychotherapy of interpersonal relationships, of which group psychotherapy was then the newest expression.

In fact, for Moreno the personal unconscious is part of what he calls “the Inc. system”, which includes the Freudian unconscious and preconscious, the Jungian collective unconscious and what he calls the co-unconscious, supporting the thesis that in group psychotherapy the latter is the natural field of exploration.

The concept of co-unconscious, proposed by Moreno in his Psychodrama vol. I (Moreno, 1985, p.194; and 1987, p. 236), is extraordinarily innovative and achieves a real “breakthrough” with respect to the evolutionary history of the Freudian unconscious and to a large extent also from the Jungian unconscious. In fact, Moreno focuses on the co-constructed aspect of the unconscious, essentially what modern relational psychoanalysis considers to be central to the formation of the unconscious, both archaic and current.

Psychoanalytic theory and psychodramatic theory are today much closer in this respect than when Moreno introduced that concept (De Leonardis, 2006). Their therapeutic processes are also closer, because Moreno’s psychodramatic here and now has recently been joined by the here and now of the psychoanalytic process, when the latter conceives the co-exploration of the patient’s inner world as a narrative re-construction made together with the therapist and co-created in respect of the person’s existential project. In spite of many clichés that still circulate in the psychodramatic environment, it seems to me fully justified and coherent to consider the unconscious territories of a person’s inner world and the unconscious dynamics of the psychodramatic group as privileged spaces to co-explore, co-live, conarrate (co-perform) and therefore co-construct in the here and now of the group or be-personal psychodramatic setting.

A thought on psychotherapeutic theories and practices

All psychological theories, including the more pragmatic ones, have their own development theory which constitutes one of their foundations. Every psychotherapeutic action hinges on a specific evolutionary theory, yet even this does not seem to be fundamental for the effectiveness of the psychotherapeutic intervention, since it has been demonstrated that different psychotherapeutic orientations, which refer to different evolutionary theories, can have comparable effectiveness (Cristini, 2012).

For example, in the psychodynamic field – without wishing to go back to old references – the so called theory of drive conflict and the theory of the adaptation deficit in the child-caregiver relationship have long been opposed. Today, this issue is simply outdated, since it is reasonable to think that both the negative influence of primary deficiencies and the configuration of unconscious intrapsychic conflicts play important roles in psychopathology. However, although both perspectives are present in every therapist’s consideration, personal beliefs and modes of intervention may influence him/her to lean more frequently towards one or the other theory.

With this somewhat simplistic statement I would like to support the idea that in psychology there are really no alternative theories. In behaviourism, drive conflict theory occupies an important part, and cognitivist psychology includes a significant theory of cognitive dissonance. This is also the case in psychodrama, both in terms of the therapist’s attention to reading the patient’s various modes of functioning in different contexts and conditions, and from a methodological point of view, for example in the choice of different stimuli to provide to the protagonist to help him explore a theme, a problem, an aspect of his internal world and the ways in which it functions.

In general, it is clear that the ‘therapeutic guidelines’ for a certain type of psychotherapy as opposed to another type have reasons that I will not go into here. However, the specificity of psychotherapeutic orientations has lost some of its importance as a result of the fact that a great deal of research on psychotherapeutic outcome in recent years has emphasised common psychotherapeutic factors, in particular the ‘patient-therapist relationship’ factor (Roth and Fonagy, 1997). This phenomenon is more understandable if, as mentioned above, we look at psychotherapy as a co-exploration, co-experience, co-reading and co-construction of meaning: concepts, all of which refer directly to psychological functions that can be activated in the psychotherapeutic context. I shall call these functions psychotherapeutic functions.

Psychotherapeutic factors and psychotherapeutic functions

In psychotherapy we usually speak more frequently of psychotherapeutic factors than of psychotherapeutic functions. There is a considerable difference between the two concepts. It is well known that psychotherapeutic factors are divided into two categories: a) factors common to all psychotherapies and b) factors specific to each psychotherapeutic orientation (Dazzi, Lingardi, Colli, 2006).

Among the factors common to all forms of psychotherapy often listed are: 1) the positive affective experience that a good psychotherapeutic relationship provides; 2) a cognitive reorganisation; 3) a regulation of emotions and behaviour; 4) a coherent psychological theory and methodology of reference.

The specific factors of psychoanalysis include: 1) the systematic exploration of unconscious instances (transference, conflict, etc.) that condition behaviour and relationships; 2) the strengthening of the ego and its functions; 3) the activation of the capacity for symbolic processing; 4) the widening of reflexivity and consciousness.

Among the main specific factors in psychodramatic psychotherapy the following are usually mentioned: 1) the development of spontaneity-creativity and the breaking of behavioural scripts; 2) the exploration of emotions and intrapsychic conflicts; 3) the positive group experience; 4) the active experimenting of new roles through theatre play; 5) the transference-free telic relationship (intersubjective encounter). For a detailed exposition of these factors I refer to Giovanni Boria’s above-mentioned book Psychodramatic Psychotherapy (Boria, 2005).

In short, the specific psychotherapeutic factors of any approach refer to specific objectives and to specific methods or techniques of intervention, in relation to which the clinical indications are defined. On the other hand, the psychotherapeutic functions, which I shall examine in this paper, are placed in a conceptual category further upstream from the psychotherapeutic factors. They refer to the mental processes, or mental mechanisms, which are presumed to be activated by both common and specific psychotherapeutic factors relating to the various approaches.

What is meant by psychotherapeutic function?

By “psychotherapeutic function” I mean a particular mental process activated in the patient within the framework of a given intervention methodology, in which the therapist is a co-participant.

I refer to the concept of function as it is framed in the area of systemic therapy (Beebe and Lachmann, 2002), or of the general theory of systems (Bertalanffy, 1968) and complexity (Bocchi and Ceruti, 1985). Thus I am inclined to believe that the body participates not only in the expression of all mental processes, or functions, but also in their activation and feedback. Sensation, for example, is closely related to emotivity, but also to the manner of knowing and consciousness, both in the sense that it influences these functions and that it is influenced by them.

The main psychotherapeutic functions activated in psychodrama

The main psychotherapeutic functions involved in the psychotherapeutic processes of co-exploration, co-experience, co-reading and co-construction of meaning that I will consider are:

  • the sense-motor function
  • the expressive-cathartic function
  • the symbolic function
  • the experiential function
  • the analytical function
  • the reflexive-empathetic function
  • the cognitive-conscious function

The mental functions that can be engaged in a psychotherapeutic process are more numerous than those listed above. This is particularly true in psychodrama where multiple relational levels are involved (gestural, verbal, sensorial etc.), also because of its holistic nature. However, I have limited my analysis to the functions mentioned because they are the most significant in the psychodramatic process.

A few preliminary remarks are necessary. The function called “reflexive-empathic” is not understood here as the therapist’s ability to emotionally tune in to the patient, which is of course of central importance in psychotherapy. It is instead understood as the activation in the patient of the faculty to perceive his own and others’ feelings, beliefs, emotions, intentions, i.e., the ability to read one’s own mind and the minds of others. In addition, I have included the functions of double, mirror and role reversal – to which the corresponding techniques relate – in the discussion of the reflexive-empathic function as these are the main relational functions involved in the development of mentalisation in young children (Fonagy and Target, 2001; 2002)

The sense-motor function

Although the sense-motor function is transversal to the expressive function and the conscious function, I consider it be a psychotherapeutic function in its own right because it is the one that marks the difference between verbal psychotherapies and action psychotherapies, among which psychodrama is the most complex representative. It is true that the bodily element has been re-evaluated in many psychotherapeutic approaches for at least 20 years. But it is also true that physical and sensorial activation is intrinsic to theatre and to the psychodramatic method. Acting, and at the same time seeing, hearing, touching, and through imagination tasting and smelling are an integral part of the magic of theatre. And conversely, giving physical expression to sensations and emotions is a theatrical art that psychodrama cultivates.

Physicality, movement and action

By “physicality” I refer to the body together with its movement and its expressiveness, but also to the “physical self” or “sense of self as physical agent” (illustrated in Fonagy et. al., 2001, pp. 156-181), in which both corporeity and action are included. In the clinical field, a number of disciplines developed since the middle of the last century have overcome the old mind-body dualism claiming their inseparable functional unity, and have developed methods for studying the personality and modifying psychic activity through posture, movement and bodily relations, whether or not combined with mental practices. Those disciplines include psychomotricity, bioenergetics, autogenic training, and, in some respects, psychodrama.

Freudian psychoanalysis assigned to drives, first and foremost the sexual drive, a guiding role in bodily expressions, and ascribed to their inhibition or conflictual dynamics their conversion into psychosomatic symptoms. To-day the mind-body relationship occupies a prominent place in many psychological branches, especially in psychopathology.

Disturbances in body image can affect individual organs or functions, which are invested with symbolic meanings, just as stress and mental disturbances can manifest themselves in organic dysfunctions. Similarly, states of organic disease, as well as traumatic events or difficult life conditions, can have a profound psychic influence, triggering serious psychopathological processes.

In psychodrama the mind-body system is regarded as a two-way system, that can be activated either by the body or by the mind. The mind-body system reacts to stimuli of any kind – environmental, proprioceptive or visceral. What distinguishes the concept of mind-body in psychodrama is the importance given to the movement, thus to the act as a ‘psychological organiser’, i.e., an organiser of roles.

In Morenian theory the generalised drive (Freud’s “free energy”) is called “hunger for action”. Through action, that impulse takes the form of role and accesses relationship. During a child’s development the primitive hunger for action undergoes a series of transformations: from simple 7 expressive-motor expression, it becomes a “hunger for relationships”, then a “hunger for being there” (Heidegger Dasein), until it becomes that profound need for Other and for New that drives the individual to research and exploration (De Leonardis, 1994; 1999; 2011). Therefore, in psychodrama action becomes a powerful tool for psychological intervention.

Sensoriality

Sensoriality is closely linked to body movement. According to recent research (reported in Fonagy et. al., 2001, pp.159-160) the new-born has an innate program to connect his sensory stimuli and motor responses, which initially works under conditions of perfect ‘congruence’ but then quickly becomes more flexible and broader. By 6 months of age, the child is thus able to represent its bodily self as a spatially differentiated object, and by 8-9 months to differentiate the goals and means to achieve these goals.

Sensory activation in psychodrama follows the laws of theatre and is directly linked to imagination on one hand and to symbolic potential on the other. One might say that sensoriality makes the body penetrate the realms of the unconscious, using imagination and symbols as bridges. Imagination and symbols not only connect the unconscious with consciousness and reality, but are the organisers of the ‘unconscious discourse’ in reality (art is the paradigm). On the psychodramatic stage, sensory activation fulfils this function precisely.

Many psychodrama settings nowadays try to enrich, when possible, sensory activation through the use of lights, special subdivision of spaces, symbolic objects, etc. These aids are facilitating but not at all indispensable. Imagination travels on conventional tracks: a chair can remain a chair, or it can become a car or a horse if the rule of the game is that an object can become what a person decides it is.

In play, sensoriality has few requirements, it needs very few elements of verisimilitude, but it is demanding with regard to consistency in the relationships between the sizes, shapes and colours of the objects used, that is, with regard to symbolic consistency between objects. Seeing the results of a road accident can have much more consciential effect than many lectures on road safety. Hearing about the traumatic experience of his sea voyage from an emigrant activates many more mental connections and produces an inside knowledge very different to listening to a treatise on the subject. This is because the senses are involved in the experience, and senses activate emotions. It is an ‘understanding from within’, because it involves processes of identification and empathy that are important components of knowledge and self-awareness.

Sensations and emotions are closely connected (Damasio, 2003). Their functional link is mental representations, which can be conscious and unconscious. Emotional activation usually goes through sensoriality. In verbal psychotherapy it is mediated by the narration, which in communication with the therapist becomes testimony and therefore possibility of recognition of oneself and one’s affective contents. In psychodrama sensoriality is not mediated, it is direct. Sensorial afferences are real, like the emotions that generate them or are generated by them. This is also true for the verbalisation phases of the psychodramatic session, including sharing.

Scenic concretisation involves the five senses but also the sense of movement, the perception of distance and proximity, and the sense of time, which – when extended into hours, days and years – is translated into space. It involves the activation of the whole range of proprioceptive (musculoskeletal) and visceral (neurovegetative) sensations related to particular situations.

As I mentioned above, sensory activation has a direct effect on emotions and emotional expression, as well as on consciousness function. However, it has its own place among psychotherapeutic functions. It is situated on the mind-body boundary (which is also, but not only, the ego-skin of Anzieu, 1985). Its place among the psychotherapeutic functions is based on the assumption that the quantity and quality of sensory activation in psychodrama have their own effect in promoting change.

The expressive-cathartic function

The expression of emotions is considered by many psychotherapeutic approaches not only as a function of the psychotherapeutic process but often as the starter of the process itself. The healing effect of emotional expression, noted by ancient traditional medicines, was the basis of Freud’s ‘word therapy’ in the early days of his work. Freud called it ‘cathartic effect’, but soon stopped pursuing it because he thought it slowed down the process of awareness and the recognition of unconscious conflicts. What was especially lacking in his therapy was probably the ‘emotional corrective experience’ that Alexander later came to focus on (Alexander, 1946).

All expressive therapies pursue the highest expression of the emotions around which intrapsychic conflicts crystallize, conditioning thoughts, feelings, cognitions and intentions. Modern Emotional Focused Therapy places the reactivation and exploration of emotions at the centre of the change process, since, according to Leslie Greenberg, re-experiencing ‘critical’ emotions allows their positive integration into the patient’s autobiographical memory (Greenberg, L.S., Rice L.N., Elliott R., 2004). Psychodrama also pursues the full expression of emotion, up to cathartic abreaction, that is, the washing out of emotional tension with the effect of emptying and inner cleansing. This wash out promotes the state of spontaneity-creativity necessary for processing difficult and conflicting emotions.

From this moment on, the real exploration of the emotions at stake begins, up to their integration into the protagonist’s inner world through a possible distancing from them and a reflexive accommodation of his/her inner needs. In psychodrama, emotions are often personified on stage and as persons they relate to each other, to the protagonist and/or to the auxiliaries on stage. This technique, and others such as amplification, are used not only to facilitate abreaction, but to help the protagonist recognise ambivalent emotions, name them and confront them from a position of strength.

The symbolic function

In psychology, one cannot speak of symbols and symbolic function without referring to Carl Gustav Jung, who made it the focus of his work from 1912, the date that marks the beginning of his separation from Freud (Jung, 1970 and 1977). Freud considered the process of symbolisation only from the point of view of the removal of affective contents not acceptable to consciousness, starting with the analysis of his own dreams (Freud, 2014). The analysis of the symbols produced by the patient then constituted the direct route of his practice. For Jung the symbol is much more. It is the meeting point between individual experience and the collective universe, it expresses the universal meaning of a particular experience.

Taking into account that for Jung the unconscious is not only the repository of removed data of experience but the container of hereditary archetypal forms common to all men (that is why it is called collective unconscious), we understand how the symbol is considered the link between unconscious and consciousness. Its function is to organise individual experiences with reference to the archetypal mental contents and to preside over the process of individuation, that is, the realisation of the existential project proper to each individual. Therefore, the symbol also becomes the meeting point between the individual unconscious and the collective unconscious.

For Jung the unconscious is revealed through symbols and metaphors, and through dreams, whose significance is given by the emotions that accompany them and their intensity. But above all, the symbol creates new connections between data of consciousness, giving rise to new mental dynamics. It thus enables the evolutionary transformation of some psychic functions. Jung’s elaboration on the symbol and archetypes is very interestingly intertwined with the work carried out on the symbol and metaphor since the beginning of the last century in the linguistic field, with wide extension in the philosophical and anthropological field.

In the field of language the symbol (from the Greek syn-ballo: collecting together) is understood as a form that, through a signifier (expressive form, image: e.g. the flame), brings together many possible 9 meanings (contents or “nuclei of understanding”: e.g. the domestic hearth or the fire of passion). The symbol embodies these meanings. The symbol thus concentrates many concepts in a single image and gives a particular word a universal value. It allows the transposition of meanings from one content to another, bringing out different sets of emotions. This also occurs through complex forms such as metaphor, allegory, myth, fairy tale, parable and all forms of artistic representation. To exercise its functions as dispenser of meanings and activator of emotions, the symbol must be contextualised. It is the context in which the symbol is placed that activates specific emotions and produces meaning.

Psychodrama offers the symbol, and its more complex forms (metaphors, myths, rites, dreams), the possibility of a precise and concrete contextualisation on the stage. And vice versa, it allows to translate, or represent, in symbolic form the internal contents, the tensions, the emotional states, the intrapsychic conflicts. For this reason in psychodrama the symbolic function is a psychotherapeutic function not in a generic sense but in a methodological way. Psychodrama is symbolic representation and it is symbolic realisation (see the following paragraph on the experiential function).

In psychodrama, the symbolic function is for the most part fulfilled in an iconic form, as a concretisation on stage: a form of mental representation that is more archaic than the verbal one. The reflexive verbalisations (including soliloquies) which continually intersperse the process of psychodramatic representation fulfil the symbolic function in verbal terms, just as happens in other verbal forms of psychotherapy.

The iconic representation offers a wide range of tools for exploring internal contents, states of mind and conflictual relational situations. The concretisation on stage of significant persons, as well as of abstract elements (emotions, feelings, ideas, cognitions…) through the choice of symbolic objects, leads to clearly distinguish the different parts that make up specific internal contents. Psychodramatic action then allows these parts or roles to be put in relation to each other, transforming the static iconic description into a symbolically significant dynamic process.

In psychodrama, as in theatre, the symbolic representation takes meaning through two reference contexts: the intrapsychic one, brought on stage by the protagonist, and the relational one, of which the group is the referent. The sharing of meanings produced by contextualising the symbolic function creates connections of meaning co-constructed within the group and/or between therapist and client. Sharing is witnessed by the coherent cooperation of the auxiliaries and by the participatory attention of the audience, and is topped off by the verbal participation that always concludes the psychodramatic process.

The experiential function

I think that three aspects of the experiential function are particularly relevant in psychodrama: the corrective emotional experience, the symbolic realisation, and the encounter as a relational model. Among these, I consider the last one the least connected to techniques but not the least important.

The corrective emotional experience

The corrective emotional experience – which I have already referred to in the section on the expressive-cathartic function – was introduced as a major psychotherapeutic tool by Alexander in his essay of 1946 (Alexander, 1946). It was then disavowed by official psychonalysis but its basic theses have been taken up by Ferenczi, Balint, Fairbairn and Kohut. Today it is living a new season of favour through relational psychoanalysis. The corrective emotional experience consists in the activation of a corrective or reparative function of archaic relational experiences which were defective or distorted.

In psychoanalysis, this function is activated by building a psychotherapeutic relationship characterised by affective communication, mutual trust and confidence; a relationship in which the patient accepts the asymmetrical position with the psychotherapist in order to identify his/her authentic needs and find his/her potentials and limits, while discovering the potentials and limits of the therapist himself, and so living that relationship as a possible existential model.

The experiential function is also activated in psychodrama, through the expression and elaboration of the inner world of the patient/s in a welcoming and safe context, but the relationship between the group members and the therapist does not pass through a dependency; from the beginning it is based on equality and inter-subjectivity.

The inter-subjective relationship (De Leonardis, 1994 and 2012; Greco, 2009) offers an interpersonal model of mutual recognition, respect and understanding; it is a relationship in which each subject maintains their own specificity, but also becomes a nourishing element of knowledge and awareness for the others. The intersubjective relationship is fully realised in the Encounter, where, as Moreno said, people are able to exchange eyes and see each other in their uniqueness and complexity.

The symbolic realisation

The experiential function is activated in another important psychodramatic activity: that of symbolic realisation. The symbolic realisation I am talking about is the psychotherapeutic method documented successfully for the first time by the Swiss psychologist and psychoanalist Marguerite A. Sechehaye in the treatment of a schizophrenic patient who had been in her care for more than three years and was followed up for a long time (Sechehaye 1956; 2006). The symbolic realisation has a special place in the psychodramatic process.

Psychodrama does not only aim at re-living significant situations, it aims to resolve them (from solvo: I dissolve) through experiences imagined ex novo and realised on stage in a way that is compatible with the reality of the protagonist. The psychodramatic “scene of desire or in plusreality” is never far-fetched or illusory; it may use a symbolic transposition if necessary.

For example, let us suppose that the protagonist, after a scene of conflict with his mother, has expressed the wish to receive an expression of love from her instead of the usual complaints and protests. The director can proceed with a scene of symbolic realisation by suggesting to the protagonist reversing the mother to choose objects representing the lamentations to hold in one hand, and to choose an object for the other hand representing her love for her son.

After the child/mother has chosen the symbolic objects to hold, the director will ask her if on that special occasion she can put down the objects/lamentations and offer her love object to the child, explaining what it is and why it is important to her. The symbolic realization will be concluded by a dialogue of love which, if conducted with suitable words, can also include conflict without affecting the relationship.

The encounter

The encounter is another of Moreno’s key concepts referred to a moment in the here and now, indicating the experience of ‘a positive reciprocal tele’, i.e., a deep mutual perception and acceptance (Moreno and Moreno Toeman, 1995, pp.11-23). In our daily life the experience of positive mutual tele can be a rather frequent event in certain conditions, for example between two lovers; but it can also occur as an impromptu event between people who do not know each other, as it is described by Daniel Stern in his book The present moment. Stern identifies three main neural correlates of intersubjectivity that produce encounter: mirror neurons, adaptive oscillators (responsible for a kind of motor tuning) and affective tuning. With regard to the latter, it is “…a selective transmodal imitation based on the reciprocal perception of affective states and intentions…One of the implications is the idea of a mind intrinsically open to intersubjectivity and constructed in part by interaction with the minds of others.”. (Stern, 2004, p.80).

The psychodrama methodology promotes the experience of encounter at different phases of the process: during the work with the protagonist, and often during the warming-up or the sharing. What is most important in this respect is the relationship model that the director proposes to the group members: a warm, facilitating, restraining, and stimulating relationship, never openly protective or directive. With his relationship model, the director transmits equality and mutual respect, awareness of role differences, and everyone’s sharing of co-responsibility and co-creativity towards the world and its becoming.

The analytical function

Moreno had the chance to protest against psychoanalysis’ exclusive avocation of the analytical function to itself. He said that in psychodrama, analysis, free association, indirect interpretation are commonly used, but not without first exploring with the patient his/her conflictual core and his/her emotions through representation and action (Moreno and Toeman Moreno, 1995, p.263 ff.).

The exploration of unconscious factors

The analytical function refers to the exploration of the unconscious factors that make up states of mind and condition behaviour. Dreams, missed acts, free associations constitute the psychoanalytical route for such exploration. The direct or indirect interpretation of the psychoanalyst is a fundamental tool. How and to what extent is the analytical function activated in psychodrama? Dreams, missed acts, free associations are brought into play in psychodrama. The extent to which this happens depends on the analytical disposition of the director, who can target its enquiries to a greater or lesser extent to explore these “middle lands” or “free territories” of the intrapsychic. These emerging contents are connected to life events, previous experiences, internalisations and projections of the patient through the re-actualisation of real or imagined scenes. The tool of interpretation is used with great caution in psychodrama.

The interpretative tool

Even in modern psychoanalysis interpretation is often a two-way instrument rather than a reflexive proposal of the analyst to promote insight. In psychodrama, direct interpretation is always avoided; indirect interpretation is reduced to a very minimum, or rather it comes almost exclusively through action. The director lets the insight with unconscious or preconscious contents emerge from the dialogue concretised on stage between the I-actor and the I-observer of the protagonist.

Some psychodramatists take on the function of double in the first person in order to help the protagonist to focus conflicting emotions or intentions that would otherwise remain in the shadows. Others prefer to propose changes of scene or personifications of feelings that lead to enlighten those shadowy areas. For this purpose, the flexibility of psychodramatic techniques is very valuable. The term “to propose” is central in psychodrama, if combined with a sincere intention to find together with the patient what is best for him at that moment for a properly analytical purpose. The metaphor used by Giovanni Boria (Boria, 1987), of “pulling the red thread from the patient’s mouth”, gives a clear idea of the roles of therapist and patient in exploring the unconscious.

The inner dialogue between the actor-Ego and the observer-Ego

A way for activating the analytical function in a non-interpretive way is keeping the internal dialogue between the actor-Ego and the observer-Ego of the protagonist constantly active throughout the psychodramatic work. The degree of fluency and richness of the internal dialogue between actor-Ego and the observerEgo on stage can be considered a sign of good psychological functioning. Of course, by ‘actor-Ego’ and ‘observer-Ego’ are meant here two distinct internal positions, one engaged in action and the other in reflection.

In situations of crisis, strong emotions, or trauma, the observer-Ego’s function can be discontinued, or on the contrary can impose its tyranny through obsessive thoughts or by forcing sensoriality and emotionality into restricted boundaries (mental anaesthesia). An observer-Ego monopolised by a super-Ego that is severely judging, and/or by a frustrating and unattainable ideal-Ego, reduces internal dialogue to the point of crystallisation.

On the other hand, a fugitive observer-Ego, that tends to turn his face away from the experiences of his own actor-Ego – or gives him very inadequate mirrors – drastically inhibits internal dialogue. This is often replaced, in the psychodramatic scene, by a strange actor-Ego ‘ballet’ that mimics the observer-Ego role in a rationalising and echolalic way.

When the observer-Ego is made up of open-minded and constructive internalisations, it establishes a cooperative relationship with his actor-Ego giving him sincere mirrors but also helps and supports him. The internal dialogue becomes fluid and rich, and the Self feels whole and safe. The internal dialogue concretised on stage activates the analytical function in the most direct way. The soliloquy technique, usually used when strong emotions emerge on stage, creates a bridge between the internal positions of the protagonist’s actor-Ego and observer-Ego. But the analytical function is activated the most by the decentralisation technique, when the observer-Ego of the protagonist is put off-stage, in the balcony or to the side of the playing space.

Where the psychotherapeutic situation allows it, the decentralised position facilitates the exploration of the observer-Ego traits by asking him to give voice to his different ‘parts’, or characteristic aspects, in the specific situation on stage: parts that in turn are concretised so as to allow a dialogue between them and of course while the actor-Ego is still on stage. The well-ordered dialogue between these many voices helps to identify hidden internalisations, give them a name, thus facilitating inner integration, which is precisely the main purpose of the analytical function.

The reflexive-empathetic function

As mentioned above, I include in the reflexive-empathetic function both the two primary relational functions of the double and the mirror, as well as the function of role reversal, which comes later in the child’s development. The reflexive function develops mainly through the first two of the functions mentioned: those of the double and the mirror, while the empathic function develops mainly through the role reversal function.

The reflexive function

According to Fonagy and Target (2000; 2002, p. 372), the reflexive function is ‘the ability to be aware of one’s own and others’ mental states’. Through this capacity the child not only develops a sense of ‘being an agent’, but also a certain degree of emotional awareness and an ability to regulate his/her emotional states. The reflexive or mentalisation function is recognised by these authors as the main result of the dyadic relationship from which the self – or the sense of self – of the young child is generated.

The process of mentalisation has its phases. The language used by the mother is initially the language of ‘we’ (‘we are hungry today’, ‘we are very sleepy’, etc.), which is the language of the double; after about the first year of age, the language of ‘you’ is also introduced, which is the language of the mirror (‘don’t go on the ladder, it’s dangerous’); and after the third year of age, the child himself accedes to the role of the other by adopting his language.

Mirroring as a communicative mode, and role reversal become dominant the more the bond of interpersonal dependency is loosened. In turn, the communicative mode also persists throughout life in specific situations of greater or lesser intimacy. As far as I know, Fonagy and Target do not focus on the characteristics of mother-child language, and thus on the main tool for developing mentalisation. Nor have I found any discussion on this theme in attachment theory or in the contributions of Winnicott and Stern. However, I think that the forms of caregiver-child language can help in understanding the developmental process and in transfering this knowledge to the psychotherapeutic setting.

Of course, the reflexive function is not simply given once and for all after childhood development, but continues to develop throughout life, being activated in different ways at different stages of existence.

The empathetic function

The empathetic function develops mainly through role reversal. Role reversal does not only consist of perceiving the other’s emotions and intentions: the functions of double and mirror are already very important for this. It consists rather of ‘putting oneself in the shoes of the other’, of taking on his or her point of view, and if the game becomes theatrical, as in 13 psychodrama, of making his or her character traits one’s own. The mirror neuron system is in charge of this whole process (Rizzolatti and Sinigaglia, 2006; Gallese, Fadiga et al. 2006).

An interesting question might be how much of the development of the mirror neuron system is due to double and mirror functions? The answer to this question could have important implications for psychotherapy. For the time being, we can only say that the empathic function develops on an emotional and cognitive basis, as well as on a reflexive basis: shifting one’s point of view is only possible on a reflexive basis after perceiving the other’s emotions and identifying his or her intentions.

Another question is: how the empathetic function modifies, enriches or diversifies the reflexive function? Identification and internalisation (and their psychoanalytical variants, as introjection, projection, embodyment, etc.) are mental processes that can influence the empathetic function positively or negatively. Their influence depends on the extent to which they are unconscious or conscious processes. Both are involved in the relational functions of double, mirror, and role reversal.

The cognitive-conscious function

In the following reflections I refer to the neurophysiological studies reported by Daniel Siegel in The Relational Mind (Siegel, 1999), and by Antonio Damasio in Emotion and Consciousness (Damasio, 2000). But I want to preface this theme with a stimulating definition of consciousness that I found in a work by Bernard J. Baar (a neurophysiologist and cognitivist psychologist of Dutch origin and American adoption): “Consciousness: the result of a highly integrated activity of multiple unconscious brain processes. The prefrontal areas involved in the regulation of selective attention constitute the brain module that plays the decisive role of ‘internal observer’ in the so-called ‘theatre of consciousness’.” (Baar, 1997; Baar and Gage, 2010).

Some useful neurophysiological concepts

Siegel is known to take a strictly neurophysiological approach to the functioning of the mind. For example, he distinguishes three types of neurons – perceptual, categorical and linguistic – that are activated simultaneously in the initial formation of consciousness. This in turn activates the central prefrontal areas through feedback mechanisms and reciprocal neuronal excitation, giving rise to integrative processes, such as social cognition, response flexibility and working memory. These give rise to autonoetic consciousness, i.e., awareness of oneself and one’s perceptual processes. In such cognitive-conscious processes, emotions regulate activation flows and determine the meaning of representations/information.

Siegel is precise in delimiting consciousness:

“…the conscious self actually constitutes only a small part of the mind’s activities. Perception, memory, emotions, social interactions are all processes that take place mostly outside consciousness. In general, we can say that the self does not consist of a conscious and an unconscious part, separated by a clear line of demarcation; rather, the self is generated by unconscious processes, and by the selective association of these processes into an entity we call ‘consciousness’. (…) Consciousness allows us to modify automatic and reflex reactions and to introduce elements of ‘choice’ into our behaviour, especially when sharing information with other people.”

The question is, how is this transformed into knowledge? “Consciousness’, says Siegel, is linked to attentional mechanisms and working memory, which is the ‘blackboard of the mind’ on which associations between information are made. These mechanisms produce new information, which can also change emotional states.” (Siegel, 1999, pp. 256-257). Damasio distinguishes between nuclear consciousness, or nuclear sense of self, and extended consciousness, and correlates both these forms of consciousness to knowledge and cognitive function, defining the latter as the ability to translate (Damasio says “the impossibility of not translating”- p.225) consciousness data with sequences of images (as in a film) or with words and sentences, therefore verbally. According to Damasio the cognitive function is closely related to the conscious function, and is made up of elements of consciousness united in the form of a ‘narrative’ or a ‘tale’, i.e., connected by sequences of words or images.

The term “translate”, which Damasio uses insistently in this context, is significant in that it indicates a changing of something into something else: in short, a transposition of the datum of consciousness into a symbol. In this regard the author states the current lack of neurophysiological research capable of describing or explaining this process: the formation of mental representation, the symbolic process.

For this reason Damasio deduces from various studies the iconic or verbal nature of the representation of the elements of consciousness, but does not go so far as to hypothesise how these elements are processed. He limits himself to noting “…the enormous amount of processes and content that remain unconscious…” in the course of a lifetime (Damasio, ibid., p. 276), and refrains from postulating a differentiation between types of storage of autobiographical memories, although he assumes their existence.

Psychodynamic hypotheses

The categories of conscious, preconscious and unconscious have no place in neurophysiology, they belong to psychoanalysis, and those of implicit and explicit consciousness to cognitive-behavioural approaches (Carli and Rodini, 2008). Psychoanalysis, intersubjective psychoanalysis in particular, argue that to some extent exploration of the unconscious is possible through the symbolic function, and that to some extent the unconscious can be transformed into the conscious through the analytic function. In this view the analytic function is central, and to it the developmental change is attributed.

In psychodrama

In psychodrama the cognitive-conscious function has never had much scope. The tendency in psychodrama to privilege the expression of emotions and their dynamic exploration on stage has obscured the cognitive-conscious function, leading to consider it, if not unimportant, almost a by-product of emotional expression. Yet cognition is an essential part of mental activity and of positive relational behaviour. Consciousness cannot be considered merely the container of the rational. Neurophysiology points to it as the necessary basis for access to creative mental processes (Damasio, ibid., pp. 362 et seq.).

In the psychodrama process, the director helps the protagonist to activate the analytical function and, through the concretization of the internal dialogue, to translate the emotional contents explored on stage into cognitions. This knowledge is strengthened by the witnessing of the auxiliaries and the group during the sharing.

The group witnessing has an important cognitive effect, which in my opinion should be more widely reinforced especially in ongoing psychodrama therapy groups. The administration of tests such as Core-OM, Change Interview, and HAMPCAS can help in this respect. For that purpose special consideration should be given to the methodology of analytical psychodrama, which foresees the presence of a co-therapist in the psychodrama session, whose role is to give back to the group a narrative of the dynamic process in which they have just participated. Perhaps this restitution entails the risk of putting group members in a passive position with regard to their own internal dynamics. In any case, we have to remember that the main therapeutic goal is to help the patient to access his unconscious conflicts, or his dissociated states of the Self (Bromberg, 2007). To this end it is necessary to create the conditions for their symbolic representation in full emotional valence, so as they can become “thinkable”, be recognised and therefore to make them communicable in the patient/therapist dyad or in the therapy group.

Specific psychodramatic activators of psychotherapeutic functions

What are the mental functions, which we can call psychotherapeutic, specifically activated in psychodrama? I will try to identify them by referring to the main steps of the psychodramatic process.

Psychodramatic activators of the sense-motor function

  • The theatrical concretisation that is both iconic and dynamic.
  • Activation of the five senses, proprioceptive sensitivity, and perception of one’s inner feelings and moods.

Psychodramatic activators of expressive function

  • Activation of the mind-body unit, experiencing connections from one to the other and vice versa.
  • Psychosomatic and relational play to foster the mental state of spontaneity.
  • Enhancement of the bodily expression of emotions, ways of being, relationships.
  • Experiencing internal dialogue in a concrete way.
  • Experiencing active and verbal self-expression in the relationship with the group.

Psychodramatic activators of the cathartic function

  • Perceptual activation: choice of symbolic objects on the basis of significant shapes, dimensions, colours and eventually sound; symbolic organisation of space and time, expressed through distances.
  • Emotional activation: concretisation, personification, and differentiation of emotions, making it possible to relate them to each other.
  • Amplification of emotions, identification of ambivalences, highlighting of intrapsychic conflicts and bringing them into play.
  • Abreative catharsis: emotional discharge in a welcoming and safe environment, making room for spontaneity and new emotions.

Psychodramatic activators of the experiential function

  • Role-playing, experiencing and exploring unusual roles.
  • Activation of unusual relationships in the as-if dimension.
  • Learning of relational skills.
  • Experience of a ‘good group’, characterised by inter-subjective relationship.
  • Identification of deep desires and their symbolic realisation in a reality dimension.

Psychodramatic activators of the symbolic function

  • Time is transformed into space, divisible into coherent intervals.
  • Objects of various shapes and characteristics become emotions, personality traits, events.
  • Objects are personified, people are represented by other people.
  • Places and environments are represented by essential symbolic elements.
  • Emotions are personified.
  • Use of different means of expression: drawing, masks, puppets.
  • Concretization of metaphors, dreams, fears, desires.

Psychodramatic activators of the analytic function

  • Identification of internal contents/conflicts and differentiation of their components.
  • Dynamic representation of the internal contents/conflicts.
  • Activation of free association with other internal contents or relational situations.
  • During the exploration of internal contents, continuous change of the ego’s position, from the position of action to that of observation.

Psychodramatic activators of the reflexive-empathetic function

  • Doubling and mirroring techniques directly used by the director or auxiliaries.
  • Role reversal techniques.
  • Facilitating awareness of identification and internalisation processes.

Psychodramatic activators of the cognitive-conscious function

  • Use of soliloquy and reflective verbalizations after emotionally significant activities.
  • Concretization of the internal dialogue.
  • Emotional and cognitive references in the narrative restitution by group members during the sharing.
  • Introduction of a final reflection phase after sharing with possible completion of short questionnaires.

What happens in the psychodrama session?

In this paragraph I shall try to identify the psychotherapeutic functions activated in a typical psychodrama session. The phases of the session considered are:

  • Psychosomatic warm-up;
  • Psychodramatic warm-up;
  • Circle communication;
  • Emergence of images or scenes;
  • Choice of the protagonist as group emergent;
  • Work with the protagonist in 2-3 sequential scenes;
  • Group sharing.

For each phase I mention three components: 1) The type of activity the director chooses according to the characteristics of the group and the therapeutic agreement; 2) The goals pursued; 3) The psychotherapeutic functions mainly activated.

The psychodrama rules

In a new group, I think it is appropriate, before starting the session, to inform the participants of the “rules of psychodrama”:

  1. Taking care not to hurt themselves or others;
  2. Suspend judgment towards oneself and others;
  3. Respect the circularity of communication by avoiding interpersonal dialectics;
  4. Undertake not to divulge anything concerning the group.

Psychosomatic warm-up

Type of activities: interactive games, with greater or lesser relational commitment.
Individual goals: integration into the group; access to the game dimension, activation of the mindbody system; perception of one’s own and others’ inner world; activation of spontaneity.
Group goals: activation of the group network through reciprocity and circularity of communication; drawing the individual-group boundaries.
Main psychotherapeutic functions: sensory and expressive functions.

Psychodramatic warm-up

Type of activities: theme-oriented role-play in pairs, subgroups or with the whole group; expressive games with a high relational impact; sociometric activities for intra-group knowledge.
Individual goals: experimenting unusual roles and unconventional interpersonal relationships; perception of personal boundaries in the group and of the group’s emotional potential; intrapsychic activation on “hot” topics;
Group goals: building-strengthening of group identity and sense of belonging.
Main psychotherapeutic functions: sensory, expressive, symbolic, and experiential function.

Circle communication

Type of activities: verbal expression of emotions, memories, fantasies, fears, desires, emerged during previous activities. Individual goals: recognition of one’s own feelings and related life experiences.
Group goals: emotional and cognitive nourishment resulting from the exchange of experiences.
Main psychotherapeutic functions: expressive, analytical, reflective-empathetic, and conscious functions.

Emergence of images or scenes and choice of the protagonist

Types of activities: self-exploration of inner contents; circle communication of images, life situations, desires and fears; choice of the protagonist by sociometric technique.
Individual goals: recognition of significant inner contents contextualised in specific experiences;
Group goals: recognition of the most resonant theme in the group; strengthening the sense of equality in individual differences. Main psychotherapeutic functions: analytical, conscious functions.

Taking charge of the protagonist

Types of activities: welcoming the protagonist in the role of group emergent; redefinition with the protagonist of his/her internal content to be explored.
Individual goals: reassuring and stimulating the protagonist; warming him/her up to spontaneity.
Group goals: recognition of personal inner contents; role of witness and mirror to the protagonist.
Main psychotherapeutic functions: analytical, conscious functions.

Working with the protagonist – 1st exploratory scene

Type of activities: dynamic representation of the internal content/conflict proposed, created by the protagonist with the help of auxiliaries, tending towards emotional acme (catharsis); verbal expression by the protagonist (soliloquy) and communication of his/her remarks (answering the director’s questions); activation of emotional associations and suggestion for a second scene that would deepen the theme or, alternatively, move on to the emotional integration phase (see below).
Goal for the protagonist: exploration in a dynamic form of his/her internal content/conflict by concretising its main components and relating them to each other; recognition and naming of the significant emotions/feelings emerged in the performance; verbalisation of emotional associations.
Group goals: activation of empathy, internalisation and identification; participation in the scene in the role of auxiliaries; witnessing the emotional experiences of the protagonist; choral participation in the drama and in its possible cathartic fulfilment; direct or not direct experience of new roles, which may be egosyntonic or egodistonic.
Main psychotherapeutic functions: expressive-cathartic, symbolic, experiential, analytical, and reflective-empathetic functions.

Working with the protagonist – 2nd exploratory scene (not always realised)

Type of activities: dynamic representation of a new scene deeping the theme, followed by emotional verbal expression by the protagonist (soliloquy) and communication of his/her remarks (with the help of the director); director’s proposal of a further integrative scene or a final reflective situation.
Goal for the protagonist: analytical exploration in dynamic form of the conflict that emerged from the first scene; recognition and naming of the main emotions/feelings emerged in the new scene (soliloquy); verbalization of emotional associations.
Group goals: activation of identification and interiorization processes; connection between the transference projections and the reflexive consciousness; witnessing to the emotional experiences of the protagonist, choral participation in the drama and cathartic process; direct or not direct experience of new roles, which may be egosyntonic or egodistonic.
Main psychotherapeutic functions: expressive-cathartic, symbolic, analytical, experiential, reflectiveempathetic.

Working with the protagonist- 3rd integrative scene and/or conclusive integration through Ego-decentralization

Types of activities:
a) Integrative scene: dynamic representation of a virtual (or so-called desire) scene proposed by the protagonist or the director, followed by protagonist’s emotional verbalization (soliloquy and answering to the director’s questions);
b) Ego-decentralization: placement of the protagonist outside the scene (balcony); dynamic representation of the intrapsychic dialogue; moving to the reality dimension both of the protagonist and of the auxiliaries.
Goals for the protagonist:
a) Integrative scene: de-activation of internalised negative roles, creation of appropriate roles providing a positive symbolic experience (realisation of the desire within the relational Gestalt); verbalisation of the significant emotions/feelings emerged (soliloquy and answering the director’s questions);
b) Ego-decentralization: full engagement of the protagonist in the reflexive position, while activating his/her empathic capacities toward him/herself; development of the intrapsychic dialogue; distancing oneself from one’s own problems and conflicts.
Group goals:
a) Integrative scene: activation of identification and internalisation processes; emotional participation in the symbolic realising experience; witnessing the emotional experience of the protagonist; activation of co-conscious and co-unconscious states in the changing process; for the auxiliaries: development of new roles in a helping position.
b) Ego-decentralization: same aims pursued in the protagonist.
Main psychotherapeutic functions:
a) Integrative scene: expressive-cathartic, symbolic, experiential, reflective-empathetic functions.
b) Ego-decentralization: analytic function; experiential function; reflexive/empathic, and cognitive-conscious functions.

Sharing

Types of activities: group members in a circular arrangement share their emotions and personal internal content/conflicts that have emerged in association with the content/conflict explored by the protagonist.
Goals for the protagonist: placement of its intrapsychic subjectivity in the context of an interpersonal exchange of emotional experiences.
Group goals: strengthening of the group as locus, medium, and agent of reciprocal therapy; returning individual-group communication to the reality dimension.
Main psychotherapeutic functions: analytical, reflective/empathetic, cognitive-conscious functions.

Some concluding reflections

The analysis of a videotaped psychodrama session according to the parameters of activated psychotherapeutic functions would take up too much space. In any case, the linearity of the psychodrama session and the precision of the psychodramatic process make it relatively easy to read them with reference to the parameters indicated. The main psychotherapeutic factors involved are:

  1. The mentioned rules of psychodrama group;
  2. The involvement of the mind-body system;
  3. The director’s roles of holding and stimulating;
  4. The “as if” condition of psychodramatic performance;
  5. The continuous shifting of the protagonist from the position of actor to the position of observer and vice versa;
  6. The progression in the process from sensory stimulation to emotional activation to reflexivity;
  7. The experiential value of the psychodramatic process;
  8. The active presence of the group;
  9. The witness role of the group;
  10. Openness to meeting others;
  11. The strengthening of a co-conscious and co-inconscious state of mind.
  12. Bringing psychotherapy and personal growth closer together and make experiences in psychotherapeutic and training-educational settings comparable.

This last point may sound provocative but it is not insignificant in our society where, on one hand, professions and intervention settings are highly specialised and, on the other, personal and group development needs are often overlooked or ignored altogether.


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Information about the author:
Paola De Leonardis Independent Individual & Family Services Professional. Psychodrama Trainer.