The Embodied Student

The following was presented at Spotlight K-State on March 24, 2015 in Forum Hall in the Kansas State University Student Union.

Image result for hamlet and skull scene

Alas, Poor Yorick.  I knew him, Horatio.

A student of infinite curiosity, of most excellent imagination.  Beheaded in his quest for knowledge by educators who promised he did not need his body in order to learn – only his head!

OK, that soliloquy may be a little exaggerated, but I find that many teachers from first grade onward seem bound and determined to leave their students’ bodies out of the classroom or at least tied to their chairs behind their desks.

I wonder if this push to move from embodied learning to bodiless, abstract learning began with a misunderstanding of Jean Piaget’s theory of cognitive development.

Piaget’s Model of Cognitive Development 

If you remember, in Child Psychology we learned that there are four stages of cognitive development.  The first stage is Sensorimotor Learning which we organically begin to use as soon as we are born to find out about the world: we look, listen, touch, taste, smell, and manipulate things to learn.

Next is Pre-Operational Learning  — my personal favorite – because we begin using dramatic play and our imaginations to understand the social and cultural world around us.  We begin to think symbolically, and we learn how to take on different roles and play them out physically – to see the world from different people’s points of view.

Then we move onto Concrete Operational Learning.  During this stage we learn to follow rules and develop a complete theory of mind.  We can concretely look at different aspects and levels of a problem, but we are not yet able to think abstractly and hypothetically until we reach the fourth and final stage – Formal Operations.  Formal Operations is considered mature thinking – the best kind of thinking – and in secondary and post-secondary school, the best way to use your brain – forget about those lower stages – they are more primitive and therefore, not as good.

When Piaget’s theory is usually graphed, it is not conceptualized as a pyramid, but I  am conceptualizing it this way because from years of teaching drama, I know that we don’t move through these stages and leave them behind – we continue using ALL of them.  We don’t move through them and jettison them like the stages of a rocket on its way into space; we bring all the stages with us as we age. We never lose that baseline of understanding the world through our body and our senses.  We never stop needing to explore the social and emotional content of the world through experimentation and embodied dramatic play.  In fact, the ability to ask “What if…?” grows out of dramatic play and is crucial to keep alive in order to remain, open, curious, and engaged in our studies.  Each stage remains in our repertoire of learning skills.  And look – the ones involving the body are the biggest and the others balance upon them!

Scultping Monarchy - This picture is from below looking up - the peasants' view of society
Sculpting Monarchy — from below looking up – the Peasants’ View

When students are only allowed to learn by passively sitting and listening to a lecture or passively sitting and watching a video, they are being limited to only part of the learning tools at their disposal.  Even involvement in discussions skims the surface of embodiment.

Sculpting Monarchy -- Point of View of society from the Top
Sculpting Monarchy — The View from the Top Down

I believe in the embodied student – and in embodied learning!  Students must use their whole selves to experience, test, and totally understand new information – whether it is through an experiment done in a lab or an intellectual concept embodied in a student sculpture!

How can one teach abstract concepts in an embodied way – well, I could explain the steps from an exclusive society to an inclusive, diverse one by lecturing like I am doing right now OR I could share this chart which provides a visual

OR I could get students up out of their seats to explore the concepts with their bodies.

Sculpture of Marginalization - from the Four Phases of Inclusion - two people are refusing to look at third person who is begging them to see him.
Sculpture of Marginalization – from the Four Phases of Inclusion
Sculpture of "Tolerance" in the Phases of Inclusion of Stigmatized Individuals - persons on the right and left are being very condescending to the middle person
Sculpture of “Tolerance” in the Phases of Inclusion of Stigmatized Individuals
Human Sculpture of "Reform" - in the Four Phases of Inclusion - Persons on left and right are trying to change the person in the middle
Sculpture of “Reform” – in the Four Phases of Inclusion

 

 

 

 

 

 

Human Sculpture of the Concept of Valuing, the fourth and preferred sculpt in the Four Phases of Inclusion - three people have joined hands in a circle and are sharing their weight among each other.
Sculpture of Valuing, the fourth sculpt in the Four Phases of Inclusion

And in each case students would have to problem-solve how to physicalize the concept, they would experience it, evaluate it. and then reflect upon it personally and abstractly, individually and in groups, calling up all levels of learning on my Piagetian Pyramid.

This doesn’t mean I think lectures and discussion and reading and writing are not important educational tools –they are! I absolutely give them their due…but it means that I don’t think they are enough.

Our students deserve to access all of themselves when they are in school, not just proportionally 13%, which is the proportion of the size of the head to the rest of the body.  I challenge all educators to include embodied learning in their teaching methods.  You are able to do it  – unless you have amputated your head from your body – and I can see that you haven’t – because you have access to all of the learning tools that you have gathered from the Piagetian Pyramid, too!

Addressing Bullying in Schools Through Drama Therapy

Introduction

Bullying is an age-old and international problem. Surveys have identified bullying in schools across the globe. Dan Olewus first systematically researched bullying in Sweden in the 1970’s and created the first official definition and the first major intervention program (Olewus, 1993). UNESCO’s definition of bullying in schools is based on Olewus’s:

A learner is bullied when s/he is exposed repeatedly over time to aggressive behaviour that intentionally inflicts injury or discomfort through physical contact, verbal attacks, fighting or psychological manipulation. Bullying involves an imbalance of power and can include teasing, taunting, use of hurtful nicknames, physical violence or social exclusion. A bully can operate alone or within a group of peers. Bullying may be direct, such as one child demanding money or possessions from another, or indirect, such as a group of students spreading rumours about another. Cyber bullying is harassment through e-mail, cell phones, text messages and defamatory websites.  (UNESCO)

The key component in bullying is imbalance of power, which can be addressed best through education and action interventions using drama therapy.

Negotiation author and expert William Ury, in his book Getting to Peace (retitled The Third Side in a revised edition) explains that there are three sides to any conflict, not two sides. In the case of bullying the three sides are the bully, the victim, and the community. The community has a vested interest resolving the conflict, because it disrupts cooperation and peace. In recent books on bullying, such as Barbara Coloroso’s 2003 book The Bully, the Bullied, and the Bystander, those three sides are reiterated. Most bystanders function as passive community witnesses to the bullying, because they do not know positive action steps to take to stop it. Without appropriate intervention skills they fear they will be pulled into the conflict and possibly become victims, too.

In case you believe that bullying is a normal rite of passage that children and teens need to experience as part of growing up, think again. Research reveals that children who have been bullied have more symptoms of depression, anxiety, and other psychiatric disorders than children who have not. These disorders continue into adulthood. Victims of bullies are 4.3 times more likely to have an anxiety disorder as an adult, and bullies who were also victims are 14.5 times more likely to develop panic disorder, 4.8 times more likely to be diagnosed with depression, and 18.5 times more likely to have suicidal thoughts as adults (Saint Louis, 2013).

Different parts of the brain have sensitive growth periods; exposure to trauma in those periods can interfere with brain development. Martin Teicher and his associates scanned the brains of young adults who had been bullied as children and had no history of other traumatic abuse. Scans showed abnormalities in the corpus callosum that links the left brain with the right resembling abnormalities found in children who had experienced multiple forms of childhood trauma. His model of how peer verbal abuse psychologically effects children at different ages indicates peer verbal abuse in elementary school can lead to somatization (psychosomatic symptoms), in middle school to anxiety, drug use, depression, and dissociation, and in high school to anger and hostility (Anthes, 2010; Teicher et al, 2010).

In a study conducted by psychologist Tracy Vaillancourt, boys who were bullied showed higher levels of cortisol, a stress hormone, than boys who were not. These higher levels weaken the immune system and can damage the hippocampus, the part of the brain involved in creating memories. Vaillancourt speculates that that this may be one reason why bullied students have more difficulty learning and earn lower grades once bullying starts (Anthes, 2010). Neuroscientist Daniel A. Peterson found that in rats who were victims of bullying by other rats, after just one bullying experience, neuron cells in a bullied rat’s hippocampus (the memory making area) started to die (Anthes, 2010).

Bullies are affected as much as their victims. As adults they are 4.1 times more likely to develop anti-social personality disorder, which often leads them into a life of crime (Saint Louis, 2013). These scientific studies explain why dealing with bullying behavior effectively is important to the health, wellbeing, and education of all students.

Unfortunately, most bullying curricula, including the one developed by Olewus, which is considered to be the “gold standard,” provide education about bullying and guidelines for student behavior, but after implementation in schools, the bullying remains. The problem is these programs are lecture-based and follow a standardized, one-size-fits-all protocol with fixed objectives that do not take the ambiguous nature of the world into consideration (Boggs, et al., 2007). Bullying is a complex problem and cannot be solved without a flexible, context specific approach. Solutions work best when they come from the students; then students feel empowered to take action (McGrath, 2013).

Drama Therapy Interventions

Enter drama therapy! Drama therapy matches active interventions to specific behaviors and situational problems. Participants are engaged mentally, physically, and emotionally in the learning, whether they are acting or watching. Because it is embodied and action-oriented, drama therapy offers a powerful and safe experiential alternative to passive education. By its very nature drama therapy develops students’ perspective taking and empathy, self-expression, flexible problem-solving, internal locus of control, and abilities to share and collaborate with others. Students’ participation is valued and needed in drama therapy, and the opportunity to practice newly learned knowledge and skills in fictional situations that function realistically help students integrate and remember how to respond appropriately.

In addition to educational pluses, research indicates that artistic activities enhance moods, emotions, and psychological states, contribute toward the reduction of stress and depression, and alleviate physiological states associated with stress (Nobel & Stuckey, 2010). Through drama therapy students can deal with the intense emotional issues of bullying without feeling the need to tune out or risk becoming re-traumatized. Finally, when an activity is viewed as more personally meaningful, students become motivated participants who are more apt to apply the information they have learned to real-life situations (Dawes & Larson, 2010).

A variety of action methods used by drama therapists can prevent and end bullying in a non-violent, effective manner. Exactly which interventions will work best depends on the age of the students and the specifics of the problem, as well as the schedule, timeframe, and resources available in the school.

Forum Theatre

Forum Theatre, created in the 60’s by Brazilian theatre director Augusto Boal, is an interactive theatre form that allows participants to explore an imbalance of power through the lens of social justice (Gourd & Gourd, 2011; Sajnani, 2009). Since imbalance of power is the key element in bullying, Forum Theatre addresses the root problem. In a Forum Theatre performance actors improvise a previously created scenario that depicts a situation of oppression. Then the scene is replayed, and the Joker, or emcee, asks the audience to stop the action at a pivotal moment and suggest changes an actor could take to improve the situation. The scene is replayed to see if the suggestion works. Audience members (called spect-actors, because they are actively participating as well as watching) are also encouraged to enter the scene and show the actors their idea. As the scene is re-worked, many suggestions can be tried out for the same moment to see which work and which do not. The Joker facilitates dialogue about ways to equalize the relationships among the characters (Boggs et al., 2007; Gourd & Gourd, 2011; Sajnani, 2009). A key to creating deep and pertinent educational discussions is to embed learning objectives into the scenario and to have the Joker provide background knowledge, frame thought provoking questions, and instill the spec-actors with the confidence to challenge the status quo and dig deeper (Boggs et al., 2007; Gourd & Gourd, 2011). This engages students in ethical discussions and decision making, allowing them to improve not only their moral and ethical reasoning, but also their perspective taking and empathy skills.

A professional Forum Theatre company could be brought into a school to perform, but an even more effective use of Forum Theatre is to have a drama therapist work with small groups of students to create fictional scenarios based on current school issues. These students would present the scenes to small classes with the drama therapist as Joker, optimizing chances to involve as many students in the exploration as possible.

 Middle school (ages 10 to 14) is not too early to engage students in Forum Theatre. Young adolescents can be self-centered and rebellious, because they are testing boundaries and experimenting with their identity as they move from childhood to adulthood, but they also need structure and yearn for mentorship from the trusted adults in their lives (Reagan, 2015). Early adolescents are usually in Stage Three (the Morality of Interpersonal Cooperation) of Kohlberg’s moral development continuum where the focus on peer relationships. However, they can also relate strongly to issues of social justice and bringing these concerns into education at this time increases their moral maturity and sense of responsibility.

James DeBastiani, a Registered Drama Therapist and drama teacher in Delaware, USA, turned detention at his middle school into a laboratory for exploring new ways to solve conflict through Forum Theatre and other Theatre of the Oppressed techniques. Detention is a form of punishment for students who get into trouble that requires the offenders to stay after school. Jim turned detention from a time of punishment into an opportunity for learning. Students were able to express themselves and investigate new ways to solve problems through drama. Some began thinking about the points of view of the other students and teachers for the first time. Jim served as the Joker who pushed them to take emotional risks that helped them understand themselves and others better (personal communication, 2004).

Playback Theater

Another theatre form used by drama therapists that can transform bullying behavior is Playback Theatre. Created in the 1970’s by Jonathan Fox and his wife Jo Salas, Playback Theatre elicits personal feelings and stories from audience members who watch them acted out (played back) by a trained team of improvisational actors. A Playback Theatre performance is facilitated by an emcee called the Conductor, who welcomes the audience and elicits stories (Salas, 2005, 2011). While the Conductor in Playback is analogous to the Joker in Forum Theatre, his/her function is a little different; the Conductor is less provocateur, more supportive dramaturg, helping the Teller to articulate his/her story.

Jo Salas, a Registered Music Therapist, has been involved for over a decade in using Playback Theatre to address bullying in schools from elementary through high school through a program she calls “No More Bullying!” (NMB) Playback. A NMB Playback performance starts with the professional actors briefly sharing their bullying experiences, followed by involving the audience in creating a group definition of bullying. Then students are invited to invent a fictional scenario in which an imaginary character, played by a troupe member, is bullied. They are asked for suggestions about how the witnesses in the scene could help. This fictional scene is a technique borrowed from Theatre Forum for the purposes of modeling constructive bullying solutions. (Scenes of retribution are not acted out.) Finally, students are invited to tell about an experience as a victim, witness, or bully and watch it come to life. Because the adults are modeling respect and because the ritual form of Playback creates an environment of acceptance and safety, students are able to sit in the spotlight, speak up and shift the power. If disrespect rears its ugly head during a performance, Jo intervenes immediately to stop it (Salas, 2011).

Jo says when the audience sees a scene enacted: They understand it viscerally – it’s not just about the words, it’s about the physical expression. When you see a feeling embodied by an actor, you have a kinesthetic response: you feel it in your own body. You understand it in a non-cognitive way…if you are the “teller,” seeing your feeling expressed in the bodies, faces, and voices of the actors allows you to know beyond doubt that you’ve been heard and understood (Salas, 2011, 107).

When possible, six weeks previous to a school performance, Jo trains a group of diverse students weekly in Playback techniques and teaches them about bullying. As they practice Playback, telling their stories of bullying experiences to each other during the training, their skills at empathy grow just as their acting skills do. Then during the performances teams of four students and three adult actors work together to play back bullying stories to audiences of 25 to 50 (Salas, 2011). When their peers are onstage, students sit up and take notice, or as one student actor told Jo, “If a child hears it from a child, they listen.” (Salas, 2011, 107).  These children then become anti-bullying leaders in their schools (Salas, 2011).

Playback Theatre has also been used as a tool for conflict resolution with middle and high school students by Timothy Reagan, Registered Drama Therapist and drama teacher, at Sidwell Friends School in Washington, DC. He is a graduate of the Playback Theatre School in New York and an accredited Playback trainer. Tim began integrating Playback Theatre into the Sidwell curriculum as a way for students to reflect on their individual stories in a class taken by all 7th grade students. He leads an 8th grade Playback troupe called Vertical Voices and a high school troupe called Friendly Rewinders (Reagan, 2015). While Forum Theatre helps students connect outward to the world and social justice principles through their life experiences, Tim feels that Playback Theatre helps adolescents “learn to turn inward; to access, share, and listen to personal stories. Playback provides a significant experience for adolescents to make personal connections between creative expression and the healing power of the arts” (Reagan, 2015, 26). Empathic listening skills are developed through storytelling and story listening (Reagan, 2015). Students begin to treat each other with more respect and consideration.

Eclectic Mixes of Drama Therapy Interventions

Other drama therapists, like Becca Greene van Horne, incorporate many drama therapy techniques, including Playback, to inoculate students against bullying and teach empathy and constructive behavior. Her adolescent ActSmart Improv Theatre in Amherst, Massachusetts, USA, was created in response to the suicide of Phoebe Prince, a bullied girl from a neighboring town. They rehearse weekly and then perform at local schools to pass along their message through improv, rehearsed skits, and Playback (Diehl, 2012). Becca says, “I’m committed to teaching everyone emotional and social intelligence through play and drama” (Diehl, 2012, 2). She feels that drama therapy is how to implement bullying education “in a constructive and appropriate way [because] we can act out what we wished would have happened, and we can act out different alternatives for choices that were made” (Diehl, 2012, 2-3). Becca also offers anti-bullying workshops, social/emotional intelligence training, and conflict resolution training with student, parent, and teacher/administrator groups to get participants dramatically involved in learning pro-social behavior.

In Kansas City, Missouri, USA, Registered Drama Therapy Monica Phinney directs a troupe of teen actors in The Outrage, an ever-evolving script (to keep it up to date) about dating violence and sexual assault, another form of bullying that adolescents face. The show tours to middle and high schools. After performances the drama therapist and the actors hold a question and answer session with the students, and follow-up drama therapy workshops are held at the schools in the following weeks. In addition, Monica runs an 8-10 week Healthy Relationships curriculum in schools, delivering information through role play, theatre games, and other drama therapy methods.

Excellent plays for young audiences have been written on bullying. These can be can be performed to explore the subject in a safe public forum. During rehearsals, student actors should be educated about bullying facts and myths, and time should be set aside for discussion and sharing among cast members, so they can process not just the material in the play, but also the experiences they have had in their own lives. Actors need to be de-roled[i] after each rehearsal and performance, so that they do not take the roles of bully, victim, or bystander home with them. Talkbacks on the subject should be held after every performance so audience members can ask questions, get information, and de-role themselves. Talkbacks can include a panel of experts to speak to the issue, including educators, therapists, and witnesses or victims who feel strong enough to share their stories. If there are printed bullying resources in the school or community, those should be included in the program or available to be picked up in the lobby.

Cyber-bullying

In the age of Facebook and social media, bullying has moved from the classroom, the playground, and school hallways, to cyberspace where some of the cruelest bullying happens. Some cyber-bullying happens anonymously, but even when posts publically identify bullies, they often acts as if they is anonymous and all-powerful. Once something is up on the internet, it can be taken down from public view, but before that happens it could be copied, pasted, forwarded, uploaded, and downloaded by unknown amount of known and unknown others. Even if a post is “deleted,” it still remains forever somewhere on a server in cyberspace. The act of posting a bullying message or insult is a faceless, non-embodied way to strike out at and humiliate someone without fear of physical, embodied reprisal in the moment (James, 2014; Wong-Lo et al, 2012.)

In her book Disconnected: Youth, New Media, and the Ethics Gap, Carrie James introduces the concept of conscientious connectivity. It is not enough to think about your perspective (self-focused thinking) and your family and friends’ perspectives (moral thinking). To use the internet ethically one must be able to engage in complex perspective taking: becoming aware of everyone who could be affected by an online action – self, known others, and unknown others – committing to care about the consequences of your online actions and developing the motivation to deeply explore the ethical blind spots and disconnects that are hidden from our view by technology and the newness of the media. Finally, one must be willing to take action beyond that of not being an online bully by appropriately confronting cyber-bullies and engaging in thoughtful online conversations about issues instead of thoughtless rants. In short, ethical online thinking is community thinking, representing the Third Side.

Any of the drama therapy methods shared previously would work to help educate students of the consequences of cyber-bullying. One important suggestion, however, is to have an adult actor (not the drama therapist who must facilitate the session) enrolled as the recipient of cyber-bully in scenes, as these taunts can be so hurtful and outrageous that having a student on the receiving end could be traumatizing or re-traumatizing whether they have been cyber-bullied in the past or not.

One drama therapist in Lawrence, Kansas, USA, who is also a filmmaker, was able to offer her community a very creative twist on bully and cyber-bully education. As the Outreach Coordinator for the GaDuGi SafeCenter (now the Sexual Trauma and Abuse Center), she focused on violence prevention and sexual assault awareness in local elementary, middle and high schools, as well as two universities, University of Kansas and Haskell Indian Nations University. In partnership with the Lawrence Arts Center she developed theatre and film-based programs to explore social issues and produce projects by, for and about youth and the issues important to them.

She worked closely with local law enforcement and the District Attorney’s office on The InSight Project for youth on pre-file diversion for sex crimes. Juvenile attorneys referred adolescents in danger of receiving felony charges for sexting[ii] or harassment to her for drama therapy sessions to educate, enlighten and empower them to fully understand the impact of their actions. Then they created a Public Service Announcement (PSA) that expressed what they had learned. One of the PSAs they created on sexting can be accessed at: https://www.youtube.com/watch?v=EFxd2I9LPR4

She also worked with middle school students in tandem with the national tour of It Gets Better, a suicide prevention movement. After conducting 8 weekly sessions of drama activities, including role play, scenes, personal monologues, introspective writing, team building, and messaging, the students wrote, composed, and directed a PSA on rejecting bullying labels, which can be seen at: https://vimeo.com/60225788

Why a Drama Therapist and not a Drama Teacher?

If drama therapy works so well to educate students and change behavior, why not hire a drama teacher or an applied theatre professional experienced in improvisation, Playback Theatre, or Theatre of the Oppressed to implement an anti-bullying program? Because drama therapists are specifically trained to do this kind of self-exploration and socio-emotional training safely.

Holmwood and Stavrou (2012) wisely point out that

…teacher training and dramatherapy training are different in approach and

intention. Dramatherapy students are expected to develop an understanding of the self through personal therapy….Drama teachers are not. Drama therapists are equipped to allow the client to work with their internal emotional and psychological world. [Note from author: very pertinent when working on an issue like bullying] The teacher will use a curriculum to teach students to teach students to develop personal, social, and most importantly educational skills (35).

Educated in drama therapy techniques, psychology, and ethics, drama therapists understand how to keep dramatic explorations honest and effective on one hand and emotionally safe for the participants on the other. Holmwood and Stavrou (2012) add, “a good teacher will possess some therapeutic skills just as a good therapist has to be able to teach. However…being therapeutic does not make you a therapist” (34-35).

One of the big ways drama therapists create safety is through the use of emotional distance in dramatizations. For instance, to protect a student’s personal problems from becoming the subject of a scene, a bullying situation would be fictionalized, and the drama therapist would make sure that a real bully and victim were never cast against each other to work out their differences in real life in front of an audience. A scene that was too close to a real bullying incident could end up re-traumatizing the victim and reinforcing the power imbalance. The distance that fiction provides to a dramatic exploration allows students to open their minds to different solutions and even engage in meta-cognition, analysis, and ethical decision-making skills that can transfer to real-life dilemmas (Boggs, et al, 2007).

Distance can also be created through the use of a distancing technique within a method.  For instance, while a student might volunteer to tell her story in Playback Theatre, others act out the story, and many aspects of it are replayed through metaphor, so that it reflects her reality, but does not reproduce it. The teller safely watches her story from a distance and when those others show they understand her story and her feelings, the teller feels heard and validated.

As mentioned earlier, drama therapists are trained to de-role clients after a dramatic enactment and have a variety of methods that accomplish this. When intense emotions are evoked – even if they are from fictional situations – actors need to return to a neutral emotional state and re-connect with themselves. Not doing so could leave them in an emotional state that would preclude discussing the scene and learning from it. In addition, leaving a session still emotionally in the role of a fictional character could create confusion, acting out, and what might be called an “emotional hangover” in a later situation (Bailey & Dickinson, 2016).

Conclusion

Bullying can only be stopped if community witnesses stop being passive and begin to actively intervene. This might be done through a verbal recognition of the bullying act: I see what you are doing! It might be through reporting the bully to a person in authority who will step in and stop it. It might be through distracting the bully, supporting the victim, or through directly intervening in the situation. All of these choices and more can be learned and practiced through drama therapy, turning students into dynamic citizens who speak up for themselves and others.

Bibliography

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Bailey, S., & Dickinson, P. (2016). The Importance of Safely De-Roling. Methods: A Journal of Acting Pedagogy.

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Wong-Lo, M., Bullock, L.M., & Gable, R.A. (2012). Cyber bullying: Practices to face digital aggression. Emotional and Behavioral Difficulties, 16(3) 317-325. DOI: 10.1080/13632752.2011.595098.

[i] De-roling is the process of taking off a role that an actor has been enrolled in. Actors and drama therapy participants should de-role after each role-play or scene, as well as at the end of a rehearsal so that they can leave the character they embodied behind and return to their own persona and mind-set. De-roling is one of the ethical techniques that drama therapists incorporate into their work that make it different from the work of other theatre educators (although drama therapists would love if all theatre educators and professionals began de-roling as a regular practice themselves!)

[ii] Sexting is when a person takes a nude photo of him or herself and sends it to another via the internet. It is illegal in Kansas for nude or pornographic photos of young people under 18 to be sent or received.

Drama: A Powerful Tool for Social Skill Development

Disability Solutions Vol. 2 (1), May/June 1997, pp 1, 3-5.

available online at www.disabilitysolutions.org/pdf/2.1.pdf

Cindy, an attractive young woman with developmental disabilities, is gardening in her front yard, enjoying the afternoon sun, when a dashing young man in a black leather jacket drives up on a motorcycle and stops beside her.  He gives her the once-over and says, “Hey, I’m a biker dude!  I just came to town about an hour or two ago, and I’m looking for a cute girl!”

“Really?” she says, “Do you want to go to the mall?

“Yes!  Do you?”

Without thinking twice, Cindy starts to climb onto his bike.  “Sure!”

“OK, I’m going to freeze the action in this scene, just for a second,” I say, and turn to the group of drama students with disabilities.  “I want to ask the class a question about this situation.  This ‘Biker Dude’ guy has just driven into town.  He’s a complete stranger.  Cindy’s never set eyes on him before and she just said she would go to the mall with him.  Is that safe?”

“NO!!!” shout the students watching.

“Why is that not a safe choice?”

“Because she doesn’t know him that well yet.”

“She doesn’t know him at all!”

“She doesn’t even know his name!”

“It’s not safe to go somewhere with a total stranger,” I agree.  “So maybe we should start this scene again and let Cindy talk to this guy and find out something about him.”

This time Cindy asks the “Biker Dude” lots of questions and discovers that he’s come to town to look for a job as a mechanic.  She doesn’t know of any job openings, but wishes him luck, says goodbye, and goes inside.

That, of course, is not the only way this situation could safely unfold.  In subsequent role-plays, the students try out possible situations involving this dangerous, but definitely fascinating stranger.  For the duration of the class, students are involved, paying attention, and having a wonderful time learning about how to handle a situation which is every parent’s worst nightmare.

Understanding social situations and how to safely and appropriately interact with other people is important for everyone, but young people who have disabilities often have a more difficult time learning safe and appropriate behaviors.  Safety in the community is only one issue.  Job transition literature emphasizes that more jobs are lost through inappropriate social behavior than from lack of job skills.  Individuals who don’t know how to develop friendships and reach out to others become isolated, depressed, passive, or angry.  Successful inclusion in the community is difficult if social skills are lacking; non-disabled community members aren’t welcoming or understanding to an individual who is withdrawn, rude, provocative, or hostile.

The quandary lies not in knowing what skills young people need, but in how best to teach them.  I believe drama is the best vehicle for social skills development because drama involves students in concrete, hands-on practice of behavior.  Skills are physically and verbally acted out instead of just being talked about, so appropriate behavior becomes very real to the participants.  The abstract becomes bodily concrete.

In drama, as in real life, consequences result from actions taken and can’t be ignored.  They must, in turn, be dealt with through more action.  The reasons for this connection between action and consequence can be discussed, re-played, and, finally, understood by participants and observers alike.

If scenes are re-played with students making different choices and experiencing different consequences, flexibility develops as well as an understanding of cause and effect.  Add discussion of scenes to dramatic role-playing sessions and students begin to develop critical thinking, problem-solving, and decision-making skills.

As a drama therapist, I use drama to teach social skills to children, adolescents, and adults who have disabilities.  I know from personal experience that dramatic role-playing generates energy, involvement, laughter, connection, excitement, and understanding.  Role playing real-life situations and watching others do so allows students to rehearse a skill until it becomes part of their skill repertory.

Can anyone learn through drama?  I believe so.  Can anyone use drama as a teaching tool?  I believe so, too.  Developmental psychologists say that all children learn about the world and how to behave in it through deferred imitation, symbolic play, and dramatic play.  These informal methods of learning usually begin to develop when children are as young as three and continue into the early elementary school years.  In a sense, we are all natural-born actors!

Unfortunately, our educational system has yet to harness this powerful, innate method.  The majority of teachers, in both regular and special education, rely on lecture, workbooks, and rote learning.  Abstract learning is valued over concrete learning.  Eventually, children discontinue their use of drama as an informal learning tool because it is labeled by the adults in their lives as “play” or “make-believe,” grown-up codes words for “unimportant,” “childish,” and “useless.”

Many teachers shy away from using drama as a teaching tool because it seems as if it will take too much energy or effort.  Or they think it is a method they couldn’t begin to master without lengthy training.  While training in drama does enhance one’s skills as a group leader, using drama is similar to riding a bike: once you’ve learned how to do it, you never forget – and you’ve known how to do it since you were three!

Drama is not only a useful tool for teachers, it’s useful for parents as well.  Skill rehearsal can become an enjoyable family game instead of a chore.  Rather than lecturing your child about a skill you want her to perform around the house, act it out together.  For example, if you want to teach your child appropriate phone manners, bring two phones into the room and pretend to call her from one of them.  Let her answer the other and engage her in conversation.  Then let her pretend to call you.  With practice, she will learn correct phone etiquette.

The most successful approach to dramatic role-playing is one which is open, playful, and non-judgmental.  This creates an atmosphere where actors can take chances and try out different behaviors.  It can be OK to make a mistake because you can replay the situation and find a way to make it better.

In life, there are many different choices you might make in a given situation.  Some choices are better than others.  Some choices are safer than others.  Some choices are more effective than others.  Through drama many choices, both positive and negative, can be explored – without real-life consequences harming the participants.

The decision-making process can be explored step by step during the role play by freezing the action and questioning the actors or having them share what “thoughts are going on in your head right now.”  Or the process can be explored afterwards through group discussion.

The other advantage of dramatic role-play is that through role reversal, a child can take on the role of a parent, a student can take on the role of teacher, or a client can take on the role of therapist and see the situation from a different perspective.  Dramatically wearing the shoes of the “responsible adults” in their lives helps students begin to understand the need for rules.  Role reversal can provide the group leader with a way to evaluate if the message of the lesson has gotten through.  An actor, taking on the role of authority, will often wax eloquent as he explains to the actor playing the role of the student the reasons why things are done in a certain way – even though he may never have followed those rules or demonstrated an understanding of them in real life.

Actual authority figures (parents, teachers, job coaches, etc.) can learn a lot about being a child, student, or client from role reversals, too.  You might just re-evaluate some of your communication methods after being on the receiving end of a lecture and seeing how you are perceived.

“But,” you ask, “is my child really capable of coming up with sound behavior choices to use in role playing?  Will this method really work with him or her?”  For the answer to than, let’s look at the choices students made for relating to the “Biker Dude.”  On their own, without any prompting from me, the students in my drama class created the following four additional scenarios:

– One girl refused to talk to the “Biker Dude” and went inside her house to get her father to make him go away.

– Another traded phone numbers with him so she could talk with him further before deciding if she wanted to go out with him.

– Another made him give her his phone number, but wouldn’t give our any personal information herself.  Then she told him it was time for him to leave; she wasn’t ready to make a decision about whether or not to call him.

– Yet another invited him to come to her house for dinner so he could meet her family and get to know her in a safe environment.

All were viable choices and all were choices that fell into the range of safe and appropriate ways to handle the situation.

Accommodations for Autism Spectrum Disorder

ASD Behavior/Symptom General Accommodation Drama Accommodation
Easily over-stimulated by too much sensory input.

Result: can shut down, self-stimulate, or melt-down/ tantrum.

Keep clutter in room to a minimum.

Do not design a “busy” environment with lots of colors, movement, etc.

Provide information through one sensory learning channel at a time (verbal or visual or kinesthetic).

Provide a quiet spot in the room with few visual and auditory distractions for student to go to for a break, when necessary.

Keep games simple at first, building complexity as you get to know your students.

Avoid games with lots of simultaneous
movement from all group members.

Avoid games with lots of simultaneous
vocalizations from all group members.

To refocus, try hand pattern games with one other partner.

Aversive to loud, sudden noises. Find a quiet location for your classroom. Avoid games with balloons.

Avoid games with sudden loud sounds.

May have difficulties with boundaries, such as where his physical body ends or where the socio-emotional and physical boundaries are between self and others. Provide clearly designated spaces for sitting
(i.e., chairs, carpet squares, X’s on rug). 

Create clear classroom rules, particularly regarding hands and legs to self, and post rules in a place where all can see them.

Play movement games which teach boundaries
(for example, hula-hoop space walk; play with stretchy bands, cooperabands,
parachutes). 

Delineate acting and audience areas clearly and keep them the same each class.

Tactile Defensiveness (Does not like light touch). Use deep touch.

Give high-fives for praise.

Provide heavy/weighted blanket, mat, bean-bag chair, or heavy pillows
for student to wrap self in or burrow under.

Do not play games that involve touching or tagging.

Use isometric exercises in warm-ups (student presses against self, wall, object, or another person).

Typically does not easily handle changes in routine. Stay in the same space from week to week.

Follow the same order of activities in each lesson plan.

Post lesson plan where it is easy to see.

Try to stick to the scheduled lesson plan.

When playing a game, remind students several rounds before the end of a game so they are prepared to stop.

Keep arrangement of the room the same from week to week: audience area and stage always in the same place, circles always in the same place, etc.

Open and close class with the same ritual drama activity.

Typically are concrete, literal, and visual thinkers versus abstract thinkers. Avoid using figures of speech:  “It’s raining cats and dogs.”

Be concise and concrete with instructions.

Say what you want students to do instead of what not to do: instead of saying, “Stop fooling around!” say “Come over here and sit down.”)

Use lots of props and costumes.

At first, play games that involve concrete objects and later move to abstract, “invisible,” pantomimed objects.

Remind students that drama class is where we use our imaginations and anything can happen: we are not bound by the laws of physics when we pretend.

Might have sensitivity to certain smells. Do not wear perfume, after-shave lotion, scented lotion when teaching.

Ask if janitor can use scent-free cleaning materials.

Avoid room deodorizers and incense.

Avoid using fog machines in productions.
Difficulty making eye contact. Do not force eye contact, but do encourage students to turn towards each other while communicating. Avoid playing games where eye contact is necessary, such as mirroring.

If two actors must look at each other in a scene, suggest they look at the other’s nose or another part of the other’s face instead of directly in the eyes.

Can obsess about certain topics and not want to talk about or work on others. Set clear guidelines about what is OK and not OK to talk about.

Set limits (perhaps use a timer) for the amount of time to discuss any one subject.

Insist that everyone must have the opportunity to share their own ideas and listen to/respect others’ ideas.

When sharing in a circle, use an object like a feather or fake microphone to designate the “official speaker.”

Try to incorporate your students’ interests
into improvs and stories, while encouraging them to branch out to new areas.Add small changes into repetitive routines or stories to create variety and encourage flexibility.

Stress the need for an actor to “be in the moment” and respond to all offers with “Yes, and….” Practice this.

Has a tendency to be rigidly honest and, therefore, may say inappropriate or impolite things to other people. Discuss the importance of demonstrating
respect to others.Define constructive criticism and why it is important.
Role play “constructive” and “destructive” criticism before anyone needs to be critiqued.

Role play “appropriate” and “inappropriate” topics of conversation or comments to others.

Ancient and Modern Roots of Drama Therapy

INTRODUCTION

The word drama comes from ancient Greek and means quite literally “things done” (Harrison, 1913). Drama therapy is, in simplest terms, the use of action techniques, particularly role play, drama games, improvisation, puppetry, masks, and theatrical performance, in the service of behavior change and personal growth. It has its roots in religion, theatre, education, social action, and mental health/therapy. The North American Drama Therapy Association, created for promoting the field of drama therapy in the United States, was organized  in 1979, but drama therapy has been around much longer than that!

ANCIENT ROOTS: RELIGION AND THEATRE

Evidence in archeological records suggests that early humans began to make art – paintings, sculpture, music, dance, and drama – during the Upper Paleolithic period about 45,000-35,000 years ago. Experts marvel at the suddenness with which the arts burst onto the human scene and tie it to the beginnings of symbolic, metaphoric thought (Pfeiffer, 1982; Mithen, 1996; Lewis-Williams, 2002). Simultaneous with this creative explosion, shamans and priests began utilizing the arts in their healing and religious practices. The origins of the arts and religion seem to be intertwined because the arts naturally provided effective symbolic ways to express abstract religious ideas. Dance and drama, in particular, were extremely useful in rites to create sympathetic and contagious magic as well as to embody myths and rituals. Details about these ancient origins are sketchy, but many scholars have hypothesized about those origins, based on surviving cave paintings, artifacts, myths, and even on extrapolating from contemporary shamanistic practices (Pfeiffer, 1982; Lewis-Williams, 2002).

Greek scholar and cultural anthropologist Jane Ellen Harrison, for instance, theorizes that early art developed directly out of ritual from mimesis or imitation of an experience and became an abstract representation or metaphor which was then available for magical use (Harrison, 1913). However, without a written record providing direct testimony, we cannot know exactly what those ancient practices entailed and how those ancient humans understood their ceremonies.

Eventually, the art form of theatre developed out of religious rites and rituals. Western theatre history usually begins its formal accounts with ancient Greek theatre. Religious festivals dedicated to Dionysus, god of fertility and revelry, featured theatrical competitions in which plays brought mythology to life for the community. The Great Dionysia, held in Athens in early spring, featured tragedies, comedies, and satyr plays written by citizen-poets and performed by citizen-actors for the entire populace. During a choral presentation at one of these festivals around 560 B.C. Thespis, the first actor, stepped away from the chorus to take on an individual character for the first time and theatre, as we know it, was born (Brockett, 1968).

The first written theoretical account of drama therapy can be found in connection with Greek theatre. In Poetics, Aristotle says the function of tragedy is to induce catharsis – a release of deep feelings (specifically pity and fear) to purge the senses and the souls of the spectators (Aristotle, trans. 1954). These cathartic feelings are experienced empathically for the characters in the play by the individuals watching the performance and they share that theatrical/cathartic experience with others in the audience magnifying the release and allowing for an adjustment in the community’s attitude as a whole. According to Aristotle, drama’s purpose is not primarily for education or entertainment, but to release harmful emotions which will lead to harmony and healing in the community (Boal, 1985).

In his analysis of Aristotle’s work, Brazilian director Augusto Boal (1985) suggests that this cathartic release helped preserve the status quo in Greek society, for a populace that is content and at peace will not rebel against the rulers in power. Aristotle’s ideas about catharsis have influenced many psychotherapy models from Freudian psychoanalysis onward by focusing psychotherapeutic work on the idea that insight into troubling emotional issues and healing occurs only after the patient has achieved catharsis. This process is disputed as unrealistic and unnecessary by cognitive-behavioral therapists, rational-emotive therapists, and others who feel that catharsis and insight are not enough to induce healing or change, that new thoughts and behaviors must be learned to replace the old, and that change doesn’t automatically follow emotional release and understanding.

MENTAL HEALTH ROOTS

Ancient physicians recognized the value of drama as a therapeutic tool. Soranus, a second century Roman, believed that the way to cure mentally ill patients was to put them into peaceful surroundings and have them read, discuss, and participate in the production of plays in order to create order in their thinking and offset their depression (Cockerham, 1991). In the fifth century, another Roman Caelius Aurelius took this a step farther. He states in his treatise On Acute Diseases and on Chronic Diseases that in order to achieve emotional balance, patients should go to the theatre and watch a performance that expresses the emotion opposite to their condition. For depression, see a comedy; for mania or hysteria, see a tragedy (Jones, 1996).

For the most part, however, people with mental illness were not treated by taking trips to the theatre or by reading and performing plays; they were locked away in horrible prisons and asylums where they were either forgotten or attempts were made to cure them through exorcisms and treatments which could only be described as torture. Not until the late18th century, with the beginning of the “Moral Treatment” movement, did some mental institutions provide occupational, horticultural, and artistic activities as part of their treatment regimen (Cockerham, 1991; Whitaker, 2001). This approach to treatment continued in enlightened institutions in Europe and America into the 20th century and opened the door to the practice of drama therapy.

The groundwork for inclusion of the art therapies into psychiatric hospitals in the U.S. was laid after World War I. Talk therapy and medical interventions did not help veterans recover from what at the time was called “shell-shock” (now called Post-Traumatic Stress Disorder), the emotional response to traumatic combat experience. However, the arts did help. In the early 20’s and 30’s, inclusion of the arts in hospital programming was expanded. Occupational therapists at many psychiatric hospitals began involving patients in the rehearsal and performance of plays, pageants, and puppet shows. Interestingly, the genre of plays performed was limited to comedy, so as not to upset the patients (Phillips, 1994).

T. D. Noble, a psychiatrist at Sheppard-Pratt Hospital in the Baltimore, MD area, noticed that patients in his psychotherapy sessions who had acted in the hospital plays were able to understand and identify emotions better than other patients, could link their present emotional state and behavior to their earlier trauma more easily, and were able to experiment with alternative modes of behavior with more flexibility (Phillips, 1994). He wrote in a 1933 issue of Occupational Therapy and Rehabilitation that he found drama was a vehicle for the discovery and expression of conscious and unconscious conflicts. Playing other characters in the plays, he noted, helped patients release repressed emotions so that they could later deal with them directly in therapy. He also observed that drama was a useful diversion and encouraged socialization among patients (Phillips, 1994).

SOCIAL ROOTS OF DRAMA THERAPY

The social action root of drama therapy can be traced to Hull House and other sites of the settlement movement. Jane Addams opened Hull House in 1889 to serve as a socializing, civilizing, connective, and reforming force for the immigrant, working-class neighborhood of the Nineteenth Ward of Chicago’s West Side (Jackson, 2001). She set up a series of what she termed “Lines of Activity:” courses, lectures, and group experiences which would bring culture, education, social connection, and change to the community living in proximity to the settlement house. The most popular activities were the drama clubs which provided socialization, a creative outlet, and an exciting group experience which led to a product shared with others (Jackson, 2001). Young people would join drama clubs at the age of seven or eight and found so much meaning in their work together that they would remain in them until they were in their 30’s and 40’s. The Little Theatre or community theatre movement grew, in part, out of the enthusiasm for amateur performance that the Hull House drama clubs created (Hecht, 1991).

Movement and recreational groups were run for children at Hull House by Neva Boyd (Jackson, 2001). She used games and improvisation to teach language skills, problem-solving, self-confidence and social skills. Boyd became a sociology and theatre professor at the University of Chicago and is one of the founders of the Recreational Therapy and Educational Drama movements in the U.S. Her student Viola Spolin, learned Boyd’s techniques and developed them further, writing the widely-studied Improvisation for the Theatre, from which many theatre games and improvisation techniques used in American theatre training and in drama therapy originate (Spolin, 1963).

AMERICAN FORE-RUNNERS IN THE FIELD OF DRAMA THERAPY

The surge in the growth of educational theatre in the U.S. can be traced to this source and to the educational theatre program at Northwestern University in Chicago which was helmed by Winifred Ward. Many founders of the National Association for Drama Therapy began as creative drama teachers. Drama therapists like Eleanor Irwin, Rosilyn Wilder, Naida Weisberg, Rose Pavlow, Jan Goodrich, and Patricia Sternberg discovered the therapeutic benefits of process drama through their work with young children and extended it to other populations in an intentional manner.

Lewis Barbato is credited with first using the term drama therapy in print in an article he wrote in 1945 for the Journal of Psychodrama and Group Psychotherapy, and Florsheim published a book in which she discussed utilizing the enactment of scripted plays as therapy in 1945 (Casson, 2004). However, Gertrud Schattner, a Viennese actress, is credited with popularizing the term drama therapy and providing the impetus to create a national organization in the U.S (Reiter, 1996). In order to avoid Hitler’s invasion of Austria, Gertrud fled to Switzerland for safety during the Second World War on a temporary visa. When it expired, she used her acting skills to have herself admitted to a mental hospital as a patient, convincing the doctors that she was suicidal. She learned a great deal about mental illness from “hiding out” in the hospital (Reiter, 1996).

Gertrud ended up marrying Edward Schattner, a psychiatrist working with refugees and survivors of Nazi concentration camps in a Swiss tuberculosis sanitarium. While he was able to make his patients’ bodies healthier, he had little success healing their utter desperation, depression, and despair. Edward asked Gertrud to come in to the sanitarium to do drama, storytelling, and poetry with the patients in a recreational vein. Through their participation in drama, they began to come back to life. Gertrud recognized what she was doing was something special and out of the ordinary – she called it drama therapy (Schattner, 1981; Reiter, 1996).

After the war the Schattners moved to the U.S. and Gertrud practiced drama therapy in a number of social service organizations and psychiatric hospitals in the New York City area. She taught the first drama therapy courses at Turtle Bay Music Center on Long Island (Reiter, 1996). In the early 1970’s, she and drama educator Richard Courtney began approaching other people who were doing similar work to collaborate on a publication which became Drama In Therapy, Volume One: Children and Volume Two: Adults, the first books in print about drama therapy (Schattner & Courtney, 1981). She and a number of those other pioneers, including David Read Johnson, Eleanor Irwin, Marilyn Richman, Rosilyn Wilder, Naida Weisberg, Ramon Gordon, Jan Goodrich, Barbara Sandberg, and others formed the National Association for Drama Therapy (now the North American Drama Therapy Association) in 1979 in order to promote the training and education of drama therapists, to establish standards for registry, and to promote the field (Finneran, 1999).

EUROPEAN ROOTS OF DRAMA THERAPY

At the same time as drama therapy was developing in Great Britain. The British put the two words together: dramatherapy. Sue Jennings reports that because psychotherapy is one word, British dramatherapists felt their modality should also be expressed in one word. Peter Slade, who as early as 1939 addressed the British Medical Association on the new modality, said he felt it had more force that way. (Jones, 1996).

British origins can be connected to the educational drama work of Peter Slade in the 1930’s in an arts center in Worchester. He wrote Child Drama in 1954, the first book to connect drama with helping children develop emotional and physical control, confidence, observation skills, and abilities to be tolerant and considerate of others. In 1959, Slade began calling what he and others were doing dramatherapy in a pamphlet entitled “Dramatherapy as an Aid to Becoming a Person.” (Jones, 1996).

Brian Way developed similar ideas about the essential growth drama offers participants in his classic book  Development through Drama, which collected ideas and methods from his work in educational drama from the 40’s through the mid-60’s (Way, 1967). Dorothy Heathcote used drama in education for teaching purposes, but also as a way for children to develop insight, understanding, and empathy. In 1964 Marian Lindkvist created the first dramatherapy training program, the Sesame Institute, which focused on drama and movement as forms of learning and expression, particularly in work with children with special needs. Peter Slade worked with her to deepen their method through psychological training.

Another early pioneer was Sue Jennings who began doing drama at a psychiatric hospital when she was a young drama student and called the work she was doing “remedial drama” (Jones, 1996). In the 1970’s, she completed a Ph.D. in anthropology which focused on ritual and started referring to her work as “dramatherapy.” (Jones, 1996). The British Association for Dramatherapists (BADth) was created in 1976 to promote the education and credentialing of dramatherapists in the UK (Jones, 1996). It is interesting to note that this is just three years before the NADT was formed in the U.S. While the British and the American forms of drama therapy developed separately and have different theoretical emphases, they truly did develop along parallel lines and in a similar pattern.

Drama therapy also has a history in Russia and the Netherlands. Phil Jones, in Drama as Therapy: Theatre as Living talks about two Russian drama therapists who were influenced strongly by the work of Stanislavky (Jones, 1996). Nicholai Evreinov, a Russian director, created a method he called Theatrotherapy which focused on the internal and psychological processes involved in acting to create healing and well-being in participants and help them re-frame or re-imagine their difficulties into a new way of life. Vladimir Iljine also created a Therapeutic Theatre in the years before the Russian Revolution (1908-1917) using theatre games and improvisational training to encourage flexibility, spontaneity, expressiveness, and communication abilities. He used his methods with individuals and groups in many situations and locations: psychiatric patients, people with emotional problems, and actors in the theatre (Jones, 1996).

After the Revolution there were others who carried on this work. One, Nikolai Sergevich Govorov, developed a theatrical storytelling technique, which he used to help psychiatric patients and others develop social connections, self-confidence, and socially appropriate behavior (A. Martin, personal communication, June 2, 2004). He felt that much of mental health depended on people having the ability to socialize and support each other morally and humanly. Govorov was very aware of Evreinov’s work and consciously built on it and other Western therapeutic theatre work (A. Martin, personal communication, June 2, 2004). His work developed between the 1950’s and the 1970’s.

One other country in which drama therapy currently thrives is The Netherlands. In the late 40’s, Activity Leaders involved with social welfare and youth care in community and residential care centers began using the arts and play for self-expression and social interaction (Jones, 1996). This gave rise to The Netherlands Society for Creative Expressive Therapy in the 1960s; a branch for dramatherapists was formed in 1981. There are, perhaps, more drama therapists per capita in the Netherlands than anywhere else in the world!

OTHER INFLUENCES

Two other individuals should be mentioned as important influences on drama therapy. The first is Constantin Stanislavky. Before Stanislavsky, theatre was not considered a psychological art. His work at the Moscow Art Theatre (1900-1938) set the stage, not just for actor training in the 20th century, but also for the use of his methods as tools for connecting with the emotional mind by other educators and psychotherapy professionals (Blair, 2002). His intuitive utilization of the imagination (the brain’s natural ability to create imagery and metaphor), the unconscious (as a gateway to connecting with true emotion), and given circumstances (embodying the actor in the physical and psychological details of the moment in which the character is) mesh with research that has been done on neurology and brain processes in the past fifteen years. The body-mind is essentially one, as Antonio Damasio explains in Descartes’ Error and The Feeling of What Happens, and as Stanislavsky’s methods demonstrate (Blair, 2002). Stanislavsky’s methods deeply influenced not just the Russian drama therapists, but also theatre artists from the West, most notably in our case, Viola Spolin and the American theatre educators who developed into the first drama therapists.

The other critical individual who must be mentioned is Jacob Levy Moreno, the father of sociometry, sociodrama, and psychodrama (Johnson in Lewis & Johnson, 2000). Moreno, born in Bucharest in 1889, grew up and studied medicine in Vienna. There, as an attending physician at a refugee camp at Mitterndorf at the end of World War I, he developed sociometry, a method of assessing of the social choices made within a group by its members and then intervening in a systemic way to create social change (Garcia & Buchanan in Johnson & Lewis, 2000). He applied these new measurements and intervention tools to create order and improve living conditions in the displaced residents’ lives. It worked! Later he started what amounted to a support group for Viennese prostitutes, using role play and improvisation to help them find solutions to social problems with which they were faced.

From 1920-24 Moreno led The Theatre of Spontaneity, an improvisational theatre in which professional actors created spontaneous drama based on current events. This work developed into sociodrama and later psychodrama as the focus changed from the community and social issues to personal and psychological issues of individuals. Moreno emigrated to the U.S. in 1925 where he continued developing his methods with the general public through the Impromptu Theatre at Carnegie Hall and by consulting at prisons, psychiatric hospitals, and residential treatment centers. In these latter institutions, he helped individuals who had serious personal, emotional or social problems learn how to function better (Blatner, 2000). The American Society for Group Psychotherapy and Psychodrama (ASGPP) was founded in 1942. Many of the pioneers of creative arts therapy movements, experiential therapy, and traditional talk therapy came to his sessions and were influenced by his work, including Marion Chase, Eric Berne, Arthur Janov, and Fritz Perls (Blatner, 2000; Johnson in Lewis & Johnson, 2000).

Psychodrama and drama therapy purists would argue that Moreno’s work is not a subset of drama therapy, but there is some truth to the idea that Moreno was the “first drama therapist,” as he identified role and social relationships as important therapeutic issues through his writing and work with clients long before American or British drama therapists became organized or began publishing (Johnson in Lewis & Johnson, 2000). My view of psychodrama is that it is part of the drama therapy toolbox, and, therefore, its story rightfully belongs as part of drama therapy history.

CURRENT AND FUTURE DIRECTIONS

Currently, there are four Master degree programs in the U.S. and one in Canada approved by NADTA for training drama therapists: New York University in New York City, California Institute for Integral Studies in San Francisco, Lesley University in Cambridge, MA, Antioch University in Seattle, WA, and Concordia University in Montreal, Quebec. NADTA has also developed an alternative training program that allows students to work with a Board Certified Trainer/Mentor to create an individualized program of study in drama therapy in conjunction with a Masters degree in theatre, social work, counseling, special education, or another related discipline. Kansas State University functions as the only university with a drama therapy program under Alternative Training.

Being an interdisciplinary field, training in drama therapy requires courses in psychology/therapy, drama therapy, and other creative arts therapy as well as internships in which students practice their skills and receive supervision from experienced professional drama therapists and other credentialed mental health professionals.

The professional credential for drama therapists in the U.S. and Canada is the R.D.T. (Registered Drama Therapist) which can be applied for after one has finished an appropriate Masters degree, the approved drama therapy and psychology coursework, an 800 hour drama therapy internship, a minimum of 500 hours of theatre experience and a minimum of 1,500 hours of professional hours working as a drama therapist. Most registered drama therapists have much more than a minimum of 500 hours of

Most registered drama therapists have much more than a minimum of 500 hours of theatre when they discover drama therapy since most begin as theatre artists or educators who discover the healing aspects of drama through their theatre training and work. However, more and more social workers, counselors, and special educators are discovering that talk therapy is not enough; that there is a need for “things done” in therapy for insight and change to be effective for clients. As this happens, drama therapists with theatre origins are being joined by drama therapists with clinical mental health backgrounds who have discovered the magic and intrinsic healing value of drama. Among the ranks of drama therapy students, there are also ministers, priests, and rabbis who have discovered the healing power of drama therapy. Perhaps this is an indication that we are rounding the bend to complete the circle to the place where our drama therapy roots began.

DRAMA THERAPY TIMELINE

 43,000 BC – 33,000 BC Homo sapiens sapiens begin thinking symbolically and creating arts (painting, sculpting, dance, drama).

 

TIME

EUROPE RUSSIA

NORTH AMERICA

400-500 BCE     GreeceOrigins of Greek Theatre    
534 BCE             GreecePrize for Best Tragedy established at City Dionysia Festival.    
c. 560 BCE Greece:  Thespus steps out of Greek Chorus to become first actor.    
c. 335-323 BCE Greece:  Aristotle writes Poetics.
     
c. 100-200 ACE  Rome Soranus has mentally ill patients reading and performing plays.    
c. 500 ACE     Rome:  Caelius Aurelius writes On Acute Diseases and on Chronic Diseases.    
 1789 Paris: Moral Therapy reforms begun by Phillippe Pinel and continued by others in Europe.   Moral Therapy continued by others in America.
1889-1900     Hull House, ChicagoTheatre and theatre games with immigrants by Edith de Nancrede and Neva Boyd.
1900-1930 Moscow: Constantin Stanislavski develops his psychological acting method at the Moscow Art Theatre. Hull House, ChicagoTheatre and theatre games with immigrants by Edith de Nancrede and Neva Boyd.
1908-1917  Vienna:  Jacob Moreno develops sociometry. (1917) Kiev: Vladimir Iljine develops Therapeutic Theatre.  
1920-24 Vienna:  Moreno creates the Theatre of Spontaneity. St. Petersburg: Nicholai Evreinov develops   Theatrotheatre.  
1925     Chicago:  Winifred Ward begins educational drama movement; Neva Boyd begins therapeutic recreation movement.
1926-40        New York:  Jacob Moreno developing psychodrama in prisons/hospitals.
1930’s UK:  Peter Slade begins working with children. Occupational therapists using drama with residents in psychiatric hospitals.

Chicago: Viola Spolin is developing her improvisation methods.

1940– 47               Switzerland:  Gertrud Schattner works with refugees in Swiss sanitarium.    
1942     New York:  Moreno founds American Society for Group Psychotherapy & Psychodrama                                                (ASGPP).
1947     New York:  Schattner and Moreno work in schools and hospitals.
1950-70 UK:  Peter Slade writes Child Drama (1954).

UK:  Peter Slade writes Dramatherapy as an Aid to becoming a Person (1959).

UK:  Sue Jennings begins doing “remedial drama” (1960).

The Netherlands: The Netherlands Society for Expressive Therapy formed (1960).

St. Petersburg: Nikolai Govorov develops his drama therapy techniques. New York:  Schattner and Moreno work in schools and hospitals.

 

 

                                                  

1964 UK:  Marian Lindkvist opens The Sesame Institute (1964).   New York: Schattner teaches 1st DT training program at Turtle Bay Music Institute.
1975     Chicago: Marilyn “Toddy” Richman founds The Institute for Therapy Through the Arts.
1976 UK: British Association for Dramatherapy (BADth) founded.    
1979     National Association for Drama Therapy  (NADT) founded.

National Coalition for Creative Arts Therapies (NCCATA) founded.

1981 The NetherlandsDrama Therapy Branch formed in The Netherlands Society for Creative Expressive Therapy   Drama In Therapy, Vols. I and II, published, edited by Gertrud Schattner and Richard Courtney.
1982     Pittsburgh, PA: First Registered Drama Therapist: Eleanor Irwin.

New York: 1st DT MA Program approved at  NYU.

1983     California: 2nd DT MA Program approved at Antioch-Sacremento, later moved to California Institute of Integral Studies in San Francisco.
1999     Montreal: 3rd DT MA Program approved at Concordia University.
2012     NADT changes its name to North American Drama Therapy Association (NADTA) to better represent membership, which includes many Canadian members,
2014     Cambridge, MA: 4th DT MA Program approved at Lesley University.
2015     Seattle, WA: 5th DT MA Program approved at Antioch University.

Drama Therapy Review: First issue of the first journal devoted solely to drama therapy. DTR documents and disseminates research on the relationship between drama, theatre, and wellness.

 

Bibliography

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Blair, R. (2002). Reconsidering Stanislavsky: Feeling, feminism, and the actor. Theatre Topics. (12), 2, 177-190.

Blatner, A. (2000). Foundations of psychodrama. NY: Springer Publishing Company.

Brockett, O. (1968). History of the theatre. Boston: Allyn and Bacon, Inc.

Boal, A. (1985). Theatre of the oppressed. NY: Theatre Communications Group.

Casson, J. (June 30, 2004). “Tribute to Peter Slade,” read at Peter Slade’s funeral.

Cockerham, W. C. (2000). Sociology of mental disorder. Englewood Cliffs, NJ: Prentice Hall.

Damasio, A. (1994). Descartes’ error: Emotion, reason, and the human brain. New York: Avon Books.

Damasio, A. (1999). The feeling of what happens: Body and emotion in the making of consciousness. San Diego: Harcourt, Inc.

Finneran, L. (1999). Beginnings: Letters to and from Gert. (Dramascope. (19) 2, 1, 18-20.

Gordon, R. (1999). Beginnings: Cell Block Theatre. Dramascope. (19) 1, 1, 13, 26.

Harrison, J. E. (1913). Ancient art and ritual. Bath, England: Moonraker Press.

Hecht, S. J. (1991). Edith de Nancrede at Hull House: Theatre programs for youth.Youth Theatre Journal. (6)1, 3-10.

Jackson, S. (2001). Lines of activity: Performance, historiography, Hull-House domesticity. Ann Arbor, MI: University of Michigan.

Jones, P. (1996). Drama as therapy: Theatre as living. London: Routledge.

Landy, R. (1997). Drama therapy – The state of the art. The Arts in Psychotherapy. (24)1, 5-15.

Lewis P. & Johnson D. R. (Eds.). (2000). Current approaches in drama therapy. Springfield, IL: Charles C. Thomas Publisher.

Lewis-Williams, D. (2002). The mind in the cave: Consciousness and the origins of art. London: Thames & Hudson.

Mithen, S. (1996). The prehistory of the mind: The cognitive origins of art, religion and science. London: Thames and Hudson, Ltd.

Pfeiffer, J.E. (1982). The creative explosion: An inquiry into the origins of art and religion. New York: Harper & Row.

Philips, M. E. (1996). The use of drama and puppetry in occupational therapy during the 1920’s and 1930’s. The American Journal of Occupational Therapy (50)3, 229- 233.

Reiter, S. (1996). Honoring Gert Schattner. Dramascope (14)1, 1, 3.

Schattner, G. & Courtney, R. (1981). Drama in therapy, Volume One: Children, NY: Drama Book Specialists.

Slade, P. (1954). Child drama. London: Hodder and Stoughton.

Slade, P. (1959). Dramatherapy as an aid to becoming a person. Pamphlet, Guild of Pastoral Psychology.

Spolin, V. (1963). Improvisation for the theatre. Evanston, IL: Northwestern University.

Stanislavsky, C. (1936). An actor prepares. New York: Theatre Arts Books.

Way, B. (1967). Development through drama. Atlantic Highlands, NJ: Humanities Press.

Whitaker, R. (2001). Mad in America: Bad science, bad medicine, and the enduring mistreatment of the mentally ill. Cambridge, MA: Perseus Publishing.

Art as an Initial Approach to the Treatment of Sexual Trauma for Creative Therapies for Sexual Abuse Survivors

SEXUAL TRAUMA AND THE BRAIN

I am a drama therapist who could not function properly without art, music, movement, and poetry. All of the other art modalities intersect with drama, prepare for it, enhance it, empower it, develop it, and release it. I have found this to be particularly true when working with clients who are recovering from sexual trauma.

Because sexual trauma runs so deep and creates so much overwhelming shame and confusion within the survivor, addressing the emotional wounds caused by the manifestations of sexual abuse requires the choice of therapeutic methods which can create emotional distance and a safe container. Survivors of sexual trauma are not just “resisting” when they avoid dealing with their issues or when say they can’t access their emotions because they feel numb. They are not just “overreacting” when they lash out in anger, experience flashbacks, or display other emotional outbursts in or outside of the therapy session. Their behavior is a direct result of the biological changes that have occurred in their brains in response to their traumatic experience.

Studies reveal that trauma material is not encoded in the brain’s long-term memory system in meaningful narrative form as non-traumatic experiences are, but is dissociated into somatic sensations, undifferentiated, free floating affective states, and visual images that can break through to consciousness in nightmares and flashbacks (van der Kolk et al, 1996; van der Kolk, 2002). This is experienced as threatening and overwhelming as if the trauma were happening all over again in the present moment, not as a past event (van der Kolk et al, 1996; van der Kolk, 2002). An immediate lack of emotional distance is created the minute the survivor starts accessing the past trauma, whether triggered by chance in everyday life or on purpose in therapy.

Words are inaccessible when the brain is in a traumatized state. Brain scans reveal that while remembering trauma, survivors’ right hemispheres, where negative emotions are processed, become active and Broca’s area in the left hemisphere, where words are processed, shuts down (van der Kolk, 2002). This literally leaves trauma survivors in a speechless condition. Bessel van der Kolk, one of the world’s foremost authorities on traumatic stress reactions, says, “When people get close to reexperiencing their trauma, they get so upset that they can no longer speak….Fundamentally, words can’t integrate the disorganized sensations and action patterns that form the core imprint of the trauma.” (Wylie, 2004, 34-35). As a result, he currently advocates nonverbal therapeutic approaches to trauma material (Wylie, 2004; van der Kolk, 2002).

VISUAL IMAGES TO ART TO WORDS

If clients do not have access to words, it makes sense that the subject of the trauma is best broached through images. Likewise, if clients feel mentally, physically, and emotionally overwhelmed when approaching traumatic memories, it makes sense that a less embodied, more distanced therapeutic modality be used. Art therapy is often a better initial approach to identify and express an experience that was horrific beyond words and somatic in origin. The visual images have been preserved in unconscious, nonverbal memory and can serve as the tools to bring the unconscious to light. The resulting art work acts as a safe, distanced container that can hold the feeling and the memory of the experience for the client.

Putting the trauma into words so it can be understood, translating those words into metaphors, and integrating the meaning that is created back into one’s life history is necessary for healing. Humans are narrative-making creatures and we cannot integrate an experience into our mental schema and emotional make-up until we can make sense of it for ourselves within a worded story of our life (Dayton, 1994, 1997, 2000; Herman, 1992; van der Kolk et al, 1997). The art work, because it physically exists, can capture the essence of the image and feeling in a way that does not feel overwhelming. It can then be returned to in future therapy sessions as a resource for putting the experience into words and creating metaphors. The therapist can say, “Tell me about this,” or “Tell me more.” What often begins as a description of the object turns into an explanation of what it means at a symbolic level or a narrative of the traumatic experience itself. Therapeutic work can move into the other distancing containers of movement, music, drama, or poetry later when the client has been able to get past the hurdle of acknowledging the traumatic experience to the self and to witnesses (therapist alone or therapist and group) and has moved a little further into the healing process. At all points the client can feel in control because she made the image herself, she is able to step back from it to observe it, and she uses her own words to describe what it means to her.

SEXUAL TRAUMA AND ADDICTION

While I was working with recovering drug addicts at Second Genesis in Washington, DC, a long-term residential substance abuse treatment center, I found that the vast majority of my clients, both male and female, had experienced multiple sexual traumas. Van der Kolk states that about one-third of traumatized people eventually turn to alcohol or drugs to relieve themselves from the emotional symptoms caused by their trauma (van der Kolk, 2002, 38). I discovered as I listened to my clients’ stories that many were survivors of childhood/adolescent incest or rape and almost all of them had prostituted themselves during their addiction in order to procure drugs. If you needed to get high and you didn’t have any money, sooner or later you ended up prostituting yourself formally for money or informally as a barter for drugs. It was hardest for the men to admit to this, since most of them identified as heterosexuals but had engaged in homosexual acts. The vast majority of potential customers interested in buying sex on the street were men who were looking for either heterosexual encounters or homosexual encounters. While everyone felt shame about their street behavior after they got sober, the heterosexual men had real difficulty coming to terms with their prostitution experiences, as it was cognitively dissonant with their life-long internalized beliefs about their sexual preference. African-American males had the most problem as their community is traditionally macho and homophobic.

Additionally, addicts who ended up imprisoned had often endured rape while incarcerated, sometimes gang rapes by other inmates or sexual alliances forged with one particular inmate to gain protection from gang rapes and abuse at the hands of prison staff. This set up existed in male and female prisons. Although protection through sexual alliances was a practical matter of survival behind bars, it was still experienced as extremely shameful and traumatizing, particularly for males. The Bureau of Justice Statistics did its first survey of sexual violence in prisons in 2004. The statistics reveal that proportionally more male prisoners than female experienced and reported nonconsensual sex acts and that 42 percent involved staff-on-prisoner violence. Actual figures identified only 2,090 incidents in the six-month period of the survey, but as the survey was completed by prison officials in relation to reported sexual violence and not gathered directly or anonymously from inmates, the true figures of all cases of rape, sodomy, and harassment are undoubtedly higher (BJS, 2006).

On one hand, if residents did not admit to their past sexual traumas, especially those incurred while they were active addicts, treatment staff did not feel they were fully addressing the goal of Phase 1 of the program (Accepting the Need to Change) or Steps 4 and 5 of the 12 Steps of AA/NA (Narcotics Anonymous, 1988):

Step 4: We made a searching and fearless moral inventory of ourselves.

Step 5: We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

On the other hand, residents were not supposed to focus on healing from their sexual traumas while in drug treatment because the philosophy of the therapeutic model required that they focus on recovery from their drug addictions first. The idea behind this focus makes sense at first glance. Residents were in treatment primarily for their addiction, so that was what the therapeutic contract identified and prioritized. Overseeing government agencies and managed care organizations that pay for treatment like to see very specifically identified goals and objectives on treatment plans that refer directly back to the identified treatment issue they are funding. Many staff members were recovering addicts themselves who had earned their certification in addictions counseling, but were not trained in dealing with sexual trauma. Many of them were still young in their own recovery from substance abuse and had not yet addressed their own sexual trauma issues. When I brought up the need to deal with abuse issues in our treatment team meetings, I was told focusing on them would take away from addiction issues and we hardly had enough time to work through them. The official word from above was that healing from sexual traumas or any other traumatic experiences prior to or concurrent with addiction were supposed to wait until the recovering addicts had been clean and sober for a minimum of a year, otherwise their sobriety was at risk.

However, this caused a very big Catch-22. One of the major reasons these clients had become addicts in the first place was to numb the emotional pain caused by their sexual (and other) traumas. Stopping the drugs meant not just struggling with the symptoms of withdrawal and the cravings created by their physical and psychological addiction; it also meant that with sobriety the old feelings from the trauma that had been numbed away for so long started to come back.

Many residents were not able to handle learning to live without drugs, developing the social and emotional skills they had not practiced for years while “on the street,” holding at bay all the feelings of guilt and shame for their addictive behavior (cheating, lying, stealing, neglecting children and spouses, betraying friends and family) while doing drugs, and handling the feelings generated by their unresolved traumas. It was too overwhelming. Second Genesis had a very high success rate as far as drug treatment programs went (33%), but many people absconded and relapsed before they ever finished the program, and I have always believed that some of them left in order to medicate their trauma symptoms, not because they couldn’t resist drug cravings.

CASE EXAMPLE: THE BOX SELF-PORTRAIT WITH CAMILLE

For the first eight years I worked at Second Genesis, I was the itinerant drama therapist who traveled between the six residential facilities running a weekly drama therapy group in each. Later I worked full time as a primary therapist and drama therapist at Melwood House, the facility for women addicts and their children. Throughout these years other primary therapists came to me to share that they had difficulty getting their clients to deal with essential issues in individual sessions. Some clients resisted talking in group sessions about anything beyond the obvious (“I had a drug problem.”). I didn’t have difficulty getting drama group members to open up about issues or to talk in my drama group because through basic games and improvisations they began to feel very safe with each other and with me. Usually about the fifth or sixth session, I would bring in an art exercise which we used to facilitate NA Steps 4 and 5, the “searching and fearless moral inventory.” I called this the Box Self-Portrait. This exercise creates a literal and metaphorical container for clients’ issues in concrete three-dimensions. It illuminates for them the emotional dichotomy that exists for them as addicts and survivors: projecting a false identity to the world on the outside while hiding their real thoughts and feelings inside. Denial is a big issue in addiction and must be addressed before addicts can begin to “get honest” and “deal openly” with their issues. Dissociation is a big issue in trauma and must be broken through before the trauma can be consciously accessed and addressed. Exploring their feelings through the Box Self-Portrait helped reveal what was happening on the inside while also validating the existence of their outside defenses. In a sense, they could have their cake and eat it, too, because they were able to acknowledge their defenses and what those defenses were protecting.

I bought three different sizes/shapes of boxes from a local bakery supply store and brought in an array of art supplies: Magic Markers, crayons, construction paper, tissue paper, pipe cleaners, colored cellophane, scissors, tape, and glue. Each person picked a box that best represented them (a big rectangular box, a flat pie box, or a medium square box). They were to decorate the outside with colors, shapes, pictures, and symbols (no words unless they were involved in a symbol – like a STOP sign) to express all the qualities, emotions, behaviors, and personality traits – good and bad – that they show to others. They decorated the inside with colors, shapes, pictures, and symbols to express all the qualities, emotions, behaviors, and personality traits – good and bad – that they experience on the inside, but which they may or may not show to others. I always had to say “good and bad” or I would only get one or the other, depending on how the person was feeling about himself that day. A talent for drawing was not necessary in order to make the box very effective and striking because there were the options of cutting out paper, coloring designs, making three-dimensional objects to put inside or outside, or even cutting the box itself.

Drama group was two hours long. After a check in and a physical warm-up, the group members typically spent an hour creating their Box Self-Portraits. Then we went around the circle and shared them. Each person got to describe what the symbols on the box and inside the box meant.

What was inside the box was hidden from view as long as the box was closed, but when the box was opened, it became visible for the whole group to see. This often caused some anxiety for people who were willing to express what was happening on the inside as long as nobody ever saw it. My response to their questions about this while they were working was, “The rule for this exercise is you have to show us whatever you put in the box, but then you can close the box back up after you show us. If you don’t want to show us something, don’t put it in the box.” This was enough of a reassurance of safety for group members to move forward. I never had anyone refuse to open their box and share it with the group, partly because there was a great deal of pride generated in making this kind of self-portrait and partly because of the level of trust we had generated by that time in the series of sessions. While I’m sure there were plenty of unhappy experiences and ugly feelings that did not get put in boxes, no one avoided including at least some of their uncomfortable inside parts. If nothing else, I could always count on getting a depiction of the person’s drug of choice!

The sharing time was often the first time many had ever expressed either their abuse or the emotions they felt about it. One of the most dramatic examples of this was Camille, whose earliest memory at the age of 3 was of her older brother sexually abusing her, a practice he kept up the entire time they were growing up. When, as a teenager, Camille finally disclosed the abuse to her mother, she was not believed. Camille had to wait until her brother graduated high school and went out on his own for the daily abuse to stop. By that time she had such a low self-concept and lack of physical and emotional boundaries that she continued to allow herself to be used sexually by every man who came her way. In groups and individual sessions at the beginning of her treatment, she insisted that she wasn’t angry about anything, that she was, on the contrary, very happy and optimistic. Her rationale for this happy state of mind was that she had made it into treatment and was in the process of turning her life around.

It wasn’t until she made her Box Self-Portrait that she felt safe enough to express the truth. The outside of her box had a bright happy sun on it with flowers growing and birds flying in the air, but the inside of the box she had filled with a three dimensional sculpture of red, orange, and black tissue paper in the form of an erupting volcano. And underneath the volcano, drawn very small in faint crayon was a little girl, hidden, helpless, and trapped beneath it all.

Color is an important element in art therapy as it symbolizes emotions. Some color symbolism is culturally derived. For example, in Western countries white symbolizes purity which is why brides wear white, but in many Asian countries, white symbolizes death and is the color worn by mourners. Some use of color is based on nature: fire is red, grass is green. Other uses are very personal emotional symbols, such as a client associating lavender with love because her loving mother always wore that color. Due to different associative experiences, one person may associate a color with one quality or emotion, while another associates the same color with something very contrasting. For example, someone who loves being near and in water might associate blue with relaxation and happiness while another might associate it with sadness, and another might connect it with fear. Some art therapists subscribe to the belief that certain colors always represent certain emotions, but I was trained in the psychocybernetic model of art therapy (Nucho, 1987), so I believe in asking clients to interpret their work to me, rather than putting my own symbolism on their images. This, I think, works well with trauma survivors because a large part of their therapeutic task in recovery is to make meaning of their own experience (Dayton, 1997, 2000; Herman, 1992; van der Kolk et al, 1997).

Camille reported that the red, orange, and black symbolized a volcano, its molten lava, and fire which, in turn, symbolized her rage. She was relieved to finally be able to express what she was feeling in (what she considered) an indirect way. In her mind she hadn’t actually said, “I’m angry,” but she was able to acknowledge the unacceptable emotion. Anger had not been an emotion that was allowed expression in her home at any time in her past or present.

Anger, like all emotions, is a survival signal that tells us when we are in potential danger and we need take action to protect ourselves from being violated (Bilodeau, 1992; Tavris, 1982.) However, anger is usually not expressed openly by survivors to their abusers or to their families, sometimes not even to themselves. Expression of it during or after the trauma could have put them in danger at the hands of their abuser. In case of incest, where there are family bonds and emotional connection at stake, expressing anger could put the survivor at risk of losing the love of the abuser to whom she still feels a loving connection. Instead survivor anger tends to be turned inward against the self, leading to depression, self-harm, or suicide attempts (Dayton, 1997, 2000; Herman, 1992). If trauma occurs repeatedly over a long period of time, the survivor can develop learned helplessness, a belief that action is useless and the only choice is to accept the abuse passively (Dayton, 2000).

Whenever Camille had expressed her anger in the years after she revealed her brother’s abuse, her mother and father had accused her of trying to hurt them and rejected her. After Camille made the volcano, she began to be able to talk about her family dynamics and to understand how her parents had been implicitly involved in the abuse by turning a blind eye to her situation. She began to acknowledge all the emotions – positive and negative – that she was experiencing on a daily basis. She went back to working through The Courage to Heal (Bass & Davis, 1988), a self-help book for survivors of sexual trauma, which she had tried unsuccessfully to work on during her addiction. Later in treatment, I had her write a fairy tale about the little girl under the volcano and explore how she got there and how she finally got out. Camille also began attending a weekly sexual survivors’ support group outside of the facility.

I was called on the carpet for allowing Camille to work on her sexual abuse issues so directly. The facility director said, “Residents aren’t ready to deal with sexual trauma while they are in treatment.” But I knew that if I didn’t help her deal with it while she was in a residential facility where there was lots of support – staff members and other residents to whom she could go to 24 hours a day – that once she moved out and the old feelings of guilt and shame returned, she would start smoking crack again in order to deal with the feelings.

Other residents also used the Box Self-Portrait to symbolize traumatic experiences in acceptable and safe ways. Using images instead of words, they felt as if they were being extremely honest and direct, while also being covert and indirect. They enjoyed being able to feel proud and sneaky at the same time. As addicts they put a great deal of energy into rationalizing, hiding behind words, and manipulating meaning for others and themselves through language. Graphic images bypassed their practiced verbal abilities and gave them an “out” for being honest since it was a wordless medium. It was simultaneously less real and more real, in part because it was an unfamiliar way of communicating, but also because it created a safe distance and communicated viscerally, as opposed to intellectually, through color, shape, and image. Great pride was taken in sharing images and then revealing their meaning through words. For many, it was their first truly honest attempt at a moral inventory they had undertaken.

CASE EXAMPLE TWO: DRAWING AND MASK MAKING WITH GENA

At the time I was working at Melwood House, the entire residential treatment program lasted six months, and each drama therapy group was about three months long. Phase 1: Accepting the Need to Change was 1 month. Phase 2: Working on Recovery and Relapse Prevention was three months. Residents were usually assigned to drama therapy group in this second phase. Phase 3: Re-entry was two months. Then the women returned for after-care meetings one evening a week for several months.

Gena, one client on my caseload, waited until she was in her sixth month before she revealed that she had been incested as a teenager. Throughout her time in treatment, she had been compliant, but evasive. I knew there was something going on inside, but she wouldn’t let anyone in. She was what Second Genesis staff called a “people pleaser,” willing to work hard and do anything asked of her, to the point of denying her own needs in hopes that others would like her. She had difficulty disciplining her children because that meant confronting them and saying, “No!” She agreed with whatever others said and never put forth her own opinion to avoid confrontation and controversy. In essence, she compromised her own needs, wants, and desires in order to fulfil those of others; however, what happened instead was that she was used by them and then abandoned. She would not set limits on the negative behaviors that others performed in her presence and would “go along” in order not to make waves. This had the potential of jeopardizing her recovery, because if she got involved with the wrong crowd once she was out on her own, she could end up relapsing because she couldn’t say no. “People pleasing” is a survival behavior that develops in chemically dependent and abusive families. It works but at great cost to the self-efficacy of the “people pleaser.”

In the early months, Gena would do anything to avoid individual sessions with me, because – as it turned out – she was afraid she would reveal her traumatic secret and I would not like her anymore. She would always say, “I’m OK. I don’t want to bother you,” and would go on an errand or work down in the child care center. I would have to seek her out and tell her again and again that she was not bothering me; she deserved her individual session; furthermore, she was required to have one. Finally, the week before she was ready to move out, in her individual session she was talking about how even though she was getting ready to leave, she did not feel ready because she still felt uncomfortable. She said she could not describe it in words, but she felt it in her body. I asked her where this uncomfortable feeling was and she pointed to her chest. Then, I asked if she could maybe draw for me what it felt like. She quickly drew a little round ball with many spikes sticking out of it. It looked to me like an explosive mine. I asked her to tell me about it and suddenly she was telling me the story about how her mother and father had died when she was about eleven and she had to go live with her grandmother and grandfather. A year or so later her grandmother died. Her grandfather started “using her for his sexual needs.” And her uncle who lived with them found out. Instead of rescuing her, he demanded that his father share her with him. She seriously considered running away, but she did not know how she would survive on her own, so she stayed. And began hating herself. And doing drugs to numb the pain. None of this history was in her intake interview, nor had she breathed a word of it in any groups she had participated in the last six months.

When I asked, “Why didn’t you tell me about this before?” her response was, “I have never told anyone before, and I thought if I told you, you would think badly of me.” I immediately reassured her that it was not her fault, that she did nothing to deserve this treatment, and, of course, I did not think badly of her! She was immensely relieved.

I knew that having just revealed this horrible secret, leaving treatment would be experienced by her as a rejection. In truth, her revelation was quite literally a cry for help. I told her I thought we needed to bring this information to the attention of the director and the rest of the therapeutic team because maybe now was not the right time for her to move out, maybe she needed some more time in the facility to work on this important issue. She agreed. I requested that she be demoted to Phase 1 so she could start treatment over. My reasoning to staff was that she was only now finally able to be honest and could begin addressing her addiction issues. The rest of the staff agreed with me and she was able to stay for another six months.

Never a verbal person, art remained the best way for Gena to express how she felt, how she thought, and how she could change. One of the most powerful pieces she made during that time was a plaster of Paris life mask that expressed exactly how her history of abuse fueled her people-pleasing behavior. Again, the outside/inside metaphor helped her express the conflict between her feelings and her behavior. The outside of the mask was painted with images of love – a large heart covering her mouth showed she only said loving and pleasant words to others and another heart on her forehead showed how she only thought positive thoughts about others. But on the inside of the mask, the heart over her forehead was broken and the whole bottom of her face was covered with prison bars which held back the words she really wanted to say: No! No! No! No! No!

When asked what the two faces would say if the mask could come alive, she wrote:

Outside Mask depicting "The People Pleaser"
Outside Mask of “The People Pleaser”


FRONT
I’m looked on as
The one who’s always happy,
Smiling,
Always caring,
Always sharing,
Always willing to do whatever
For whoever.

Inside Mask, “No!”

BACK
But what I’m really feeling is
Frustration,
Angry,  Guilty,
Because what I really want to say is
“NO, NO, NO,
PLEASE NOT NOW!”
But I’m afraid I might hurt your feelings.


Six months later Gena was truly ready to move out with her children and begin to try to live life on life’s terms. She had matured a great deal, and while she still struggled with “people pleasing,” she had begun to be able to hold herself and others accountable for their actions.

Conclusion
My experience suggests that traversing the bridge of healing involves careful movement from unspeakable wound to image to languaged story in order to unlock and release the trauma trapped in the heart and mind of a survivor. A journey that happens too quickly or which covers too much distance at once can cause re-traumatization or can scare the client into being unwilling to make the journey at all. Art, as a more primal expression than language, but a less embodied one than movement, can be a valuable tool, particularly in allowing the client an initial way of expressing what seems to be inexpressible.

WORKS CITED

Bass, E. & Davis, L. (1988). The courage to heal. New York: HarperCollins Publisher, Inc.

Beck, A.J. & Hughes, T.A. (July 2005). “Sexual violence reported by correctional authorities, 2004.” U.S. Department of Justice, Bureau of Justice Statistics Special Report. Retrieved January 30, 2006, from http://www.ojp.usdoj.gov/bjs/pub/pdf/svrcao4.pdf

Bilodeau, L. (1992). The anger workbook. Minneapolis, MN: CompCare Publishers.

Dayton, T. (1994). The drama within: Psychodrama and experiential therapy. Deerfield Beach, FL: Health Communications, Inc.

Dayton, T. (1997). Heartwounds: The impact of unresolved trauma and grief on relationships. Deerfield Beach, FL: Health Communications, Inc.

Dayton, T. (2000). Trauma and addiction: Ending the cycle of pain through emotional literacy. Deerfield Beach, FL: Health Communications, Inc.

Herman, J. (1992). Trauma and recovery. NY: Basic Books.

Narcotics Anonymous (5th ed.). (1988). Van Nuys, CA: World Service Office, Inc.

Nucho, A. (1987). The psychocybernetic model of art therapy. Springfield, IL: Charles C. Thomas Publisher.

Rizzo, T. (January 23, 2006). “New study sheds light on prisons’ sexual predators.” Kansas City Star, A1, A4.

Tavris, C. (1982). Anger: The misunderstood emotion. New York: Simon & Schuster.

van der Kolk, B. (2002). “In terror’s grip: Healing the ravages of trauma.” Cerebrum, 4(1), 34-50.

van der Kolk, B., McFarlane, A.C., & Weisaeth, L., eds. (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: Guilford Press.

Wylie, M.S. (2004). “The limits of talk.” Psychotherapy Networker. 6(1), 30-41, 67.


APPENDIX
Sample of Therapy Plans for Drama Therapy Group at Melwood House

Session One: Introduction
Physical Warm-up
Name Game
Individual introductions to group and pantomime something you like to do
Mirrors

Session Two: Games
Check in (Identify an emotion)
Physical Warm-up
The Winds are Blowing
Partner Pantomimes
What Are You Doing?

Session Three: Nonverbal Communication
Mind-Reading
Physical Warm-up
Come-Go-Stay
Identify Personal Space
Making an Entrance
Tone of voice/Open Scenes

Session Four: Personal Inventory
Check in (What color are you?)
Stretch and write your names in the air
Make Self-Portrait boxes and share

Session Five: Setting Goals
Check in (What animal do you feel like?)
Pass the imaginary object and change it
Emotion statues (drama game)
Past-Present-Future Self Portrait Statues (drama game)

Session Six: Mask Making
Check in
Physical Warm-up
Make plaster of Paris Life Masks

Session Seven: Mask Making
Check in
Physical Warm-up
Design and begin painting masks

Session Eight: Mask Making and Exploration
Check in
Physical Warm-up
Finish painting masks
Writing: Imagine what the inside and the outside of the mask would say to you if it came alive. Write it down.

Session Nine: Performance and Closure
Check in
Physical Warm-up
Practice performing mask pieces
Perform mask pieces for invited audience
Graduation from Drama Group

Ideas for Inclusive Playwriting

Think in terms of the strengths and talents of your actors – what do they do best?

INCORPORATE THEIR STRENGTHS AND INTERESTS INTO THE SCRIPT.

Think of ways to SIDE-STEP the WEAKNESSES of your actors.

  • You can do this by not giving actors action or lines that you know would be difficult for them.
  • Incorporate other actors into the scene who can help them (see ideas below).

    CAST the play before you begin to write so you can pair up people who can help each other in different ways during the course of the play.

    INCORPORATE SPECIAL TALENTS:
  • Playing an instrument,
  • Dancing,
  • Singing,
  • Pantomime,
  • Juggling,
  • Magic Tricks,
  • Telling jokes,
  • Howling like a werewolf,
  • Puppetry,
  • Pratfalls, etc.

    INCORPORATE wheelchairs and other devices into the play so there is a reason for the devices to be onstage:
  • Thrones,
  • Carriages,
  • Royal litters,
  • Haywagons,
  • Ambulances,
  • Trucks,
  • Cabs, etc.

    • On the other hand, you don’t HAVE to have a rationale or excuse for a character to be in a wheelchair or to have another obvious disability – you can have that just be part of that character that is not even remarked upon in the play.

• Don’t let a device or a disability stop a character from doing what he or she needs to do in the play. Where there’s a will, there’s a way.

IF A LINE IS DIFFICULT TO SAY, rewrite it:

  • Use different words
  • Change the order of the phrases
  • Shorten the line


USING MEMORIZATION STRENGTHS:

• Use the natural speaking rhythms, phrasing, and vocabulary of your actors, especially if the script is based on their improvisations. If the lines are already in their words, speech, and thought patterns, they will be easier for actors to speak and remember.

• If you have an actor who is a good memorizer, have him or her ask questions in a scene to an actor who is not as good at memorization. It is easier to remember the answer to a question (especially since you know the answer from the script) than it is to remember a question.

• However, don’t have characters answer just “yes” or “no,” as they may become confused about which answer to say. Have answers be with specific Who, What, Where, and When information that relates clearly to the story and which can be more easily remembered.

• An actor who is a good memorizer can also handle the part of someone in authority, who gives orders.

• If an actor has a joke – make sure he/she understands the humor/meaning behind it, or he won’t be able to remember it.

• Incorporate reminders for actions and lines into the dialogue of actors who can memorize – make sure those reminders are phrased in positive terms. An actor with a cognitive disability will do what he or she is told to do, but can become confused if the hint is phrased in a negative way (For example, if you want an actor to go into a cave, a hint from another actor like, “Don’t go in there!” probably will be taken as a direction to not go in!).

If a line is phrased indirectly (“I wonder where we should go next?”) the actor being cued won’t be helped…because there is no hint in the line.

• Use a live or recorded narrator to structure the scene.

• Use music and/or sound effects to remind characters about entrances or exits or cue changes in the action within a scene.

• Incorporate video or film into your play. These scenes won’t have to be memorized. And they can be filmed as many times as you need in rehearsal until they are just right.


SIDESTEPPING problems with MEMORIZATION:

• A character like a TV interviewer, talk show host, doctor, or detective can have a clipboard of notes that can be referred to for the questions they might have to ask other characters. It looks realistic to incorporate the lines written on those props.

• Create groups of characters who work together onstage with at least one actor involved who has a good sense of direction and memorization. Everyone else can follow along and do their appropriate lines and actions if they have someone reliable to follow.

• In rehearsals encourage actors to improvise if they forget a line and to help fellow actors remember lines through asking them appropriate questions in character. Let them practice so they will be ready if it happens in performance.


SIDESTEPPING problems with actors who are NOT CLEAR SPEAKERS:

• Have another character repeat the line incredulously, pretending they understood what was said.
“I didn’t do it!”
“You didn’t do it? How do you expect me to believe that?”


or…more subtly…


“You expect me to believe that you didn’t do it?”
“I went to the store”
“Yes, I know you went to the store, but what did you buy there?”

• Have the actor who does not speak clearly play a foreign character who nobody in the play understands or play someone who always mutters under their breath. (Example: Swen Swenson, the Swedish cinematographer, has been hired because of his movie making talents, but he speaks no English. That’s ok because all he needs to understand to do his job is “Action” and “Cut.”)

There could be a legitimate reason why a character can’t speak. For instance:

  • She is a professional mime,
  • He has laryngitis because he yelled too loudly at the football game,
  • She’s taken a vow of silence for religious reasons,
  • He is refusing to speak because he is angry,
  • Her voice was stolen by an evil wizard.

SIDESTEPPING problems with actors who CAN’T REMEMBER BLOCKING:

• Have the character teamed with a duo or trio of others who can remember blocking.

• Cast the actor a character who is a ruler or rich person who needs a personal assistant to be at his beck and call. (The personal assistant can be an actor who knows what to do and where to go and will be the one who is really in control, but will not look like it).

Behavior Change Through Drama Therapy with Students with Special Needs

A number of years ago I was hired as a drama consultant to conduct ten sessions in a special education classroom at Diamond Elementary School in Gaithersburg, MD, north of Washington, DC. The children were between the ages of 9 and 12. A number had severe learning disabilities and several had various forms of mental retardation. Besides basic reading and math skills, students focused on learning life skills like how to shop, how to make change, how to travel on the bus and subway systems, and other essentials to survival in a large urban area.

When I asked the teacher if there were any educational or social issues I could help with, she immediately said she’d been having trouble with students getting along in the classroom. Certain students would tease others and tears would result. Pencils and other small items got “borrowed” from desks without permission and angry accusations of stealing ensued, along with pushing, shoving, insults, and the inevitable hurt feelings.

I decided to start with identifying emotions and move on to practicing problem-solving social skills through role-playing. We started out simply. We had fun drawing faces and making faces and talking about feelings. Then we started identifying emotions in others by looking at pictures of faces to figure out what these people were feeling. We moved on to show how we felt with our whole bodies and by the way we moved. Then we began to tackle situations of conflict in the classroom.

I wasn’t sure how quickly these children would catch on to that fact that we were just pretending these situations. They’d never had drama before, either in their classroom or as an extracurricular activity. I didn’t want confusion between fantasy and reality to create more bad feelings than already existed. The “worst possible scenario player” in my head created visions of children crying and yelling, “I hate you, I hate you, I hate you,” at each other while the teacher and the principal kicked me out the front door of the school with the admonition never to set foot in Gaithersburg again!

Needless to say, my worst fears were not played out. In fact, each time I set up a dramatic situation in which one student was supposed to create a conflict with another and demonstrate their worst behavior, they insisted on doing the “right thing” and resolving their conflicts peacefully. I started to feel frustrated because I couldn’t get a fight going! Even with direct permission from me to enact an example of “the bad way” or “the wrong way,” they insisted on listening to each other with sensitivity and offering generous win-win solutions.

At the end of class, I shrugged my shoulders and half-seriously said to the teacher, “I’m sorry. I tried. I couldn’t get them to misbehave.” She nodded sagely and said, “Actually, I learned a lot today. Probably more than they did. I learned how much they actually do understand about appropriate behavior. I’m going to have much higher expectations of them now.”

Behavior change. I wish it were simple. I wish, when a student didn’t know how to behave, I could tell him what to do and he’d just do it! Or when a client is not behaving the way I want her to, I could tell her how to change…and she would!

But we all know it’s not that easy. It takes motivation to learn; it takes rehearsal over a period of time; and most of all, it takes patience on the part of the learner and the teacher until the old behavior has been extinguished and the new behavior has come to be second nature.

This is without addressing the issue of learning styles; the fact that each person has a different profile of preferences, both sensory and neurological, for taking in information. Some people are haptic and have to actually kinesthetically experience a new skill, others need to see someone else do it;  others grasp the information best through hearing and reflecting back, and most of us need to do a combination of all three.

Mel Levine, M.D., a pediatrician and expert in the learning and behavior of children, has identified specific neurodevelopmental systems or constructs that each different kind of learning task requires in his book A Mind at a Time (2002). The components within these constructs don’t work alone; they are interconnected and dependent on each other, but the construct framework provide a handy metaphor through which to look at the skills that certain learning tasks require. A block or weakness in a particular system — Levine calls them “breakdown points” – requires pinpointing the exact breakdown through carefully observing the child’s behavior while involved in the learning task, then ascertaining whether this particular individual can heal/improve that breakdown or if it would be more efficient to substitute some other strength from a different process to bypass the “glitch.” To educators and parents who ask, “How can you expect me to invest so much time and expertise in each individual I’m responsible to teach?” and Dr. Levine responds, “Because it’s your job!”

Dr. Levine is one of my ultimate heroes, along with Howard Gardner, Ph.D., who posits that intelligence is multiple and can be accessed, measured, and expressed through the arts, and Daniel Goleman, Ph.D., who speaks eloquently about the necessity of Emotional Intelligence for our social survival. What my three heroes haven’t yet discovered, however, is that the best tool available for implementing their wonderful ideas is drama therapy.

Drama therapy is quite simply the intentional use of drama or (to use the Greek translation of the word) doing to achieve new understanding of oneself and others. Depending on the requirements of the situation and the needs of the students/clients involved, drama therapy can focus purely on discovery through process drama (role-play, creative drama, improvisation, etc.) or can lead to rehearsal and the creation of a formal product (performance). Either way, our most basic human developmental learning strategies are harnessed: imitation and dramatic play which begin universally at about age 3 in most children as well as the use of metaphor for framing and understanding concepts which begins a little later. As drama – watched or participated in – is an embodied, three dimensional, sensory experience, all possible learning styles are encompassed with students listening, speaking, seeing, moving, thinking, feeling, inventing, and replaying by turns or simultaneously. In addition, all the intelligences are accessed at some point in the process. As can be seen in the chart below, all of Aristotle’s elements of drama are reflected in Gardner’s multiple intelligences:

 VERBAL-LINGUISTIC

PLOT, LANGUAGE

Words spoken or signed

LOGICAL-MATHEMATICAL

PLOT,
THOUGHT

Sequence, logical reasoning

VISUAL-SPATIAL

SPECTACLE

Costumes, Sets,
Props, Stage pictures

BODILY-KINESTHETIC

DANCE/CHARACTER

Blocking, Gesture, Dance, Posture, Pose


The connection between drama and multiple intelligences was first identified by the Southeast Institute for Education in Theatre at the University of Tennessee at Chattanooga in their Data Based Theatre Education model (DBTE). What it ultimately means for parents and educators is that when dramatic forms are used to express an idea, the multiple intelligences are naturally all stimulated simultaneously.

What’s most exciting is that while most of us are not pediatricians or neurologists or educational psychologists, we all are expert dramatists. You may not have ever acted in a play, but you have acted out imaginary stories in your backyard or basement while you were growing up, you’ve rehearsed and performed job interviews and presentations, you’ve even occasionally “created dramatic scenes” for good or ill with the other people in your life.

Drama is like riding a bicycle. Once you learn how to do it, you might not “do it” for years, but you always remember how – that inner balance and relationship between your body and mind never leaves you. It comes back naturally, the minute you put it back into practice.

Of course, you can always develop those dramatic skills further – hone them so that they can be used seamlessly in the classroom, at meetings, demonstrations and workshops, and on the job as methods of communication, training, and clarity. The best part is that whether it’s through a formal class, a workshop, or a community play, dramatic skills are not only useful, they’re fun to develop. And the next best part is that the students who you’ll be teaching are also expert dramatists, with perhaps more recent hands-on practice that you!

I discovered in my years of teaching children, adolescents, and adults with and without disabilities that if you, as the leader, are willing to initiate dramatic play, your students will join in. Maybe not with perfect behavior, but gladly! Enthusiastically! Even students with no previous dramatic training in the special education room at Diamond Elementary knew how to role play!

Bibliography:

Bailey, S. (1993). Wings to fly: Bringing theatre arts to students with special needs, Bethesda: Woodbine House.

Bailey, S. & Agogliati, L. (2002) Dreams to sign, Bethesda: Imagination Stage.

Gardner, H. (1993).  Multiple intelligences: The theory in practice, NY: Bantam Books.

Gardner, H. (1999).  Intelligence reframed: Multiple intelligences for the 21st century, NY: Basic Books.

Goleman, D. (1995).  Emotional intelligence: Why it matters more than IQ, NY: Bantam Books.

Levine, S. (2002). A Mind At A Time, NY: Simon & Schuster.

1 Drama comes from the Greek dran, “to do,” hypothetically derived from dra-, “to work” or “deed” and has developed into our modern concept of drama as action through which something of value is accomplished. Webster’s New World Dictionary of the American Language, 2nd ed., 1970.

Bridging the Past and Present for Adults with Alzheimer’s Disease through Drama

Drama Therapy has been used in nursing homes and assisted living facilities for years as a way of enlivening residents and building community. This is true whether the drama group participants have normal cognition or if they have begun to develop dementia. In fact, because drama therapy engages the imagination and stimulates the senses through embodied, concrete activities, it can bring adults struggling with Alzheimer’s Disease lucidly into the present moment and connect them clearly with memories of their past for the duration of the group.

Drama involves the whole person in an active manner. As a result, individuals who have been out of touch with themselves or with their surroundings will often become very alert, energized, and cognizant during a drama group. Acting out a memory makes it more real because an abstract thought is given form and movement in an improvised scene. Drama can be done with dialogue or in silence (as pantomime), making it adaptable to the verbal abilities of the group. Even without using words, participants become aware of the others around them and start to connect and create social relationships. And best of all, drama is fun!

Drama therapy incorporates all the other arts. A session may move from brainstorming an idea to acting out a scene to singing a song to playing a game to drawing a picture all on the same theme. Whatever strengths the group members bring will be accessed by several of the activities incorporated into the session, even if they aren’t engaged by everything in the lesson plan.

Typically a group begins with a warm-up activity which introduces a dramatic theme to be explored. The group might sing a song or look at a picture or touch an object that brings up memories and begins to connect them to themselves and to the group around them. Then group members take the memories into action, replaying parts of their past or trying out new adventures they have just imagined.

Most participants, even those who may be confused generally, understand when they are pretending in a drama group and when they aren’t. As far as I know there has been no research to explain how or why this phenomenon happens; however, I suspect that since the ability to use the imagination and to pretend begins early in development – between ages 2 and 3 when children begin to imitate others and use dramatic play to learn about the world around them – that we retain this ability even when certain parts of the brain that developed later in life begin to malfunction.

But enough talk. In theatre we say, “Show me, don’t tell me!” What follows is a partial record that Hailey Gillespie, a graduate student in drama therapy at Kansas State University, kept of a series of drama therapy sessions held in fall 2005 for a group of adults with early stage Alzheimer’s Disease. These sessions were led jointly by Hailey, Karen Johnson, and Stacey Pierce, all drama therapy students, who ran a forty-five minute drama group once a week at Tinklin Point neighborhood at Meadowlark Hills Retirement Community, Manhattan, Kansas.  All names of participants have been changed to provide anonymity.

As you read through these descriptions of sessions you will note that the activities are planned ahead of time, but the leaders follow the interests of the participants. Sometimes the “plan” gets off track. That’s OK.  What is important is keeping everyone focused on the logic of the moment. As the group improvises together, no one gets lost or confused or distracted; everyone communicates clearly and understands what is going on in the shared imaginary world.

Pirates: Aarrggh! – September 14

Pick a Pirate name.

Treasure Hunt.

Magic Box – we can take anything we want out of the treasure box.

This theme was a lot of fun. The residents had a good time coming up with various pirate names, and they laughed when we leaders would describe the story of how we got our pirate names. The transition into the pretend realm was aided by our use of costumes: hat, scarves, and eye patches. I used a pirate’s voice that they found entertaining. We discussed going on a treasure hunt, which became very exciting when they described the jewels they’d find. Lew was particularly animated about digging up his “booty.” We had to do some encouraging and offered suggestions when developing our scene of the treasure hunt, but I whipped out a map, and they were very interested in its contents. They told me they saw a forest we’d have to go through, and we’d have to swim across a river because we left our ship at the shore. Molly got frightened in the forest of deadly animals. To ease her anxiety, we tamed the wild beast together (the Meadowlark black cat), and it became her mascot. I had to leave early, and Karen told them I had gone looking for firewood; they quickly forgot about me.

Creating Stories from Pictures – September 21

Create a story from selected pictures.

Enact the story or write them down (whichever the group is more interested in doing).

Create a poem about what happened today.

Karen provided various pictures to elicit memories; however, the conversation seemed to focus on the weather, so we decided to talk about fall. Most of the group seemed distant and didn’t participate as actively as usual, but we were able to engage in a lot of conversation about harvest, dances, school, and the cool weather. We did not enact any memories, but during the conversation Karen wrote down key words on a large white sheet of paper. Afterwards, she showed the group all of the words they had come up with: colors, leaves, chill, falling, and more. She read the words aloud rhythmically and it turned out the group had created a poem about fall. Lew mentioned in a good-natured way that it didn’t rhyme, but no one else was bothered by that.

Creating Stories from Props – September 28

Create stories from selected props.

Enact story.

My intention for this session was to get people to talk about different memories as they held a prop in their hand (e.g., a doll, phone, old time egg beater). However, when I provided an example of a memory about school, they all decided to share school memories. This turned out to be a great theme as many of the residents had shared similar experiences of one-room schoolhouses, spelling bees, and playgrounds.

Each of them remembered the words to a song about school. The other leaders and I didn’t know the words, so the residents sang it several times for us until we had learned it. Another way we connected was by playing a game that was very popular during recess for them. Again, they all knew how to play and had to teach us! We spent a while playing an adapted form of catch with a chair in the middle of the room to represent the schoolhouse that we threw the ball over.

We divided the group in two and talked about other games and activities we did at school, then we acted them out for the other group. My group was very focused on recess, so we acted out hopscotch. The other group enacted the scene where the teacher rings the bell and everyone runs to the schoolhouse from the playground.

We helped create bonds and group cohesion by finding memories the residents shared. I think they also enjoyed teaching the leaders a thing or two for a change.

On the Farm – October 12

Discuss the farms everyone grew up on.

Farm Animal Charades

Plastic Egg Toss

Since almost everyone grew up in rural Kansas, the residents easily remembered something about being on a farm. Vicky and I wore pig noses and everyone got quite a kick out of that. Others decided to wear sun hats or cowboy hats.

We talked about barn dances, barn raising, milking cows, chores, and chickens. The residents were clear about their reminiscences. The charade game was quite a hit. We placed all the ideas into a cowboy hat and passed it around. Each person picked a piece of paper and acted out what it said. They were encouraged to use props, hats, and costumes.

The egg toss was wonderful. We lost track of time because the residents were having so much fun. We placed four buckets in the center of the room, gave each participant a mixing spoon and a pile of eggs. Taking turns going around the room, each resident got three tries to hit the target. Helen started getting impatient for her turn and just started chucking eggs into baskets at random. We accommodated and made it a race: who could get the most eggs in their baskets the fastest? Our job was to refill the spoons and keep the egg piles full.

Halloween – October 26

Acting out Halloween creatures

Making masks

TPing the house

Monster Mash

I drew on the knowledge that the residents really enjoy physical activities, and we brainstormed various things associated with Halloween to act out. We used costumes: white scarves draped over the face for a ghost, a monster hat for a zombie, etc. One of the Meadowlark pets was a black cat which was a nice addition.

We then created masks for ourselves out of paper plates and markers. We had to assist the residents quite a bit, but most of them had an idea of what they wanted to become. Helen and Gert wanted to make pumpkin masks, Molly was a Princess, Katherine was a black cat, and Lew was a vampire. We each held our masks to our faces when we finished and had the others guess what we were.

Then we played a game based on what happens when you don’t get a treat on Halloween: we TPed the Tinklin living room – playing catch with toilet paper rolls and wrapping up appendages when the TP roll dropped. They really liked this and it was safe since the roll was so soft.

The closing was The Monster Mash. I played the song on my CD player and we thought up actions for each character. A witch stirred a cauldron; zombies staggered around; bats flew. We were all tired at the end of this session!

Harvest Time – November 2

Corn Maze

Mystery box – identify item with your sense of touch

Scarf Dancing

The residents seemed off in their own world today, but I had some tactile stuff that got them interested. When they first arrived, I had created a “corn maze” on the floor of the room with masking tape. I assisted them in finding a seat by navigating the maze and avoiding obstacles (the dog decided to take a nap right in the middle). They thought this was pretty neat.

We first reminisced about harvest time. I brought a box of vegetables and they took turns reaching into the box and guessing what was inside. Vicky touched an ear of corn first, which she guessed after I had her smell it. I asked if she’d ever shucked corn before and her eyes got very large. “Why, no!” she said. So we went ahead and made a mess shucking the ear of corn. The other things in the box included a squash, tomato, little pumpkin, and a sheaf of wheat.

The last thing we did was a scarf dance. Vicky and Lew didn’t want to stand, so Stacey and I adapted the activity and pretended the scarves were leaves, which we threw everywhere. It turned into a leaf fight! They had a good time with this!

Trip to Hawaii – November 9

Take an airplane to Hawaii

Luau with feast and hula dancing

Group photo

Cruise back home

This session was one of the best we had. The theme provided for much creativity and imagination. We had many props to assist in our pretend play, which helped everyone get into it more. Karen, Stacey, and I greeted each resident as they arrived at “Meadowlark International Airport” and handed each a ticket. I wore a pilot’s hat and name badge. As they came in the doorway, they were instructed to check their baggage, walk through the metal detector, and were escorted to a window or aisle seat in the plane. They all got a kick out of this and played along immediately without getting confused at all.

All of the chairs were in rows facing me and Karen (my flight attendant) and I enacted pre-flight instructions. Before take off we talked about where they would like to go. Katharine wanted to visit her daughter in New Jersey. Molly wanted to go to China. Vicky mentioned Hawaii where she grew up and at that I told them they’d guessed our plane’s destination. We talked about what we needed to bring on the trip, enacted the take-off, and dealt with the turbulence. We even had a pretend in-flight beverage service complete with cart, napkins and cups.

After landing in Hawaii we put on grass skirts, went fishing, cooked our fish, and had a great feast at the luau. Hawaiian music was playing. I asked Vicky (who grew up in Hawaii) if she would teach us the Hula, which she did. Even Helen, who was in a wheelchair, got into the arm movements and had a great time. We took a [pretend] group picture before we left to come back home – one “nice” one and one “silly” one. Then we took a cruise ship home which gave us time to reflect on the favorite parts of our trip.

The residents really enjoyed this session. They were all in character the whole time and played along. They thanked us as we were packing up. I don’t think they wanted us to leave. I told Vicky I was glad she came along to guide us around her home state. She beamed and told me that we should go again soon.

The Olympics – November 16

Create flags

Play several Olympic Games

Medal Ceremony

We started the session around the table so they could decorate flags while we discussed the Olympics and our favorite sports. Stacey, Karen, and I helped draw pictures and add stickers. When we finished, everyone displayed and explained their flag. Vicky created a Hawaiian State flag while Helen did a Kansas State University flag. They were all very proud of their creations and enjoyed the compliments they received.

We had a fanfare into the next room where we sat in a large circle for our Olympic games. First, we did the Shot Put: everyone threw a bean bag underhand to see how far they could make it go. Next was the Javelin: where they tried to throw a bean bag into a hula hoop on the floor. Third, was Archery: tossing bean bags through the hula hoops while Stacey held them up in the air. Finally, we played Volley Bean Bag: counting how many times they could catch the bean bag before it dropped. Everyone received a gold medal in one event. They were all very proud of their accomplishments. From their reactions, I think this was one of the most therapeutic sessions we did.

Reflections on the whole process:

I really enjoyed working with every one of the residents. They each had their own interests and backgrounds to create a rich atmosphere for acting and playing. Vicky, for instance, was from Hawaii and taught us to Hula. Lew was never without comical and good-natured wit, often keeping us on our toes. He once told me with a wink to bring more of my young friends with me next time. Helen challenged us to keep her attention and when we succeeded in doing so, we felt rewarded. She was very direct and honest with us. Whenever she would comment that she had had fun, I would chalk that up to a great success because she never said anything just to be polite. Katherine would glow when she spoke about her memories. Her only reservation was allowing herself to be silly and play, but she came around and toward the end and wore silly hats with the rest of us. Molly was a creative actress who got totally into her roles.

The two biggest things I learned from working at Meadowlark were:

  1. Be flexible and accommodating. Don’t try to force a session in any direction. You must be willing to go along with where the residents want to go.
  2. Keep your attitude upbeat. The residents are very tuned into your body language, tone of voice, and facial expression. The way you present yourself will have an effect on the group. If I was tired and was metaphorically “watching the clock,” the residents became anxious and difficult to work with. If I decided to genuinely have a good time no matter what, the residents would, too.

Recommended books on drama with older adults who have dementia:

Basting, A. D. & Killick, J. (2003). The arts and dementia care: A resource guide, Brooklyn, NY: National Center for Creative Aging.

Clements, C. B. (1994). The arts/fitness quality of life activities program, Baltimore: Health Professions Press.

King, K. (2014). Engage! 28 enrichment experiences for older adults, Portland, OR: ArtAge Publications.

Sandel, S. & Johnson, D. R. (1987). Waiting at the gate: Creativity and hope in the nursing home, New York: Haworth Press.

Thurman, A. H. & Piggins, C. A. (1982). Drama activities with older adults: A handbook for leaders, NY: Haworth Press.

Weisberg, N. & Wilder, R. (2001). Expressive arts with elders: A resource, 2nd ed., London: Jessica Kingsley.

Many thanks to Hailey Gillespie, M.A., who provided the session descriptions!