There is a distinction to be made between psycho-drama, a method of investigating psychic processes by dramatizing improvised scenes staged and acted by a group of participants, and "analytic psychodrama," a form of analytic psychotherapy that uses a play and its dramatization as a means of elucidating unconscious phenomena. In analytic psychodrama the emphasis is on the interpretative function of the play: a play leader analyzes transference and resistances. The drama presented in the play is an invitation to engage in symbolizing, which is often fragile in the kind of patient for whom this therapy is intended.
Psychoanalysis is indebted primarily to Jacob Levy Moreno (1889-1974) for the remarkable insight of deploying theatrical improvisation and its dramatization in plays in the service of psychoanalysis. He continually combined his psychiatric training with his training as an actor to open up new modes of expression that used lively dialogue and developed a rediscovered spontaneity. He anticipated that such a catharsis would lead to an emotional release, facilitated by body language. Later he moved on to a more specific study of interpersonal group relations, which subsequently formed the basis for his theory of roles and interaction (sociometry).
After the Second World War, interest in theories about groups and group methods developed rapidly and found a particularly favorable reception in France. In the wake of the work of Georges Heuyer in child psychoanalysis and Mireille Monod in psychodrama, Serge Lebovici undertook the first analytic psychodramas with children. He based his practice on psychoanalytic findings and thereby instigated the gradual process by which psychodrama, founded on Moreno's theories, became established. Informed by a wealth of observations, the field of psychodrama then grew and was extended to adult psychotherapy.
In Great Britain, the Tavistock Clinic was the source of group therapies, which benefited from Wilfred R. Bion's remarkable contribution. In the United States, group therapy and psychodrama became particularly fashionable, with the American Society for Group Psychotherapy and Psychodrama in New York as its starting base. In Argentina, following the years of repression under the military dictatorship, psychodrama underwent a new expansion. In particular, an association for psychodrama and group psychotherapy was founded there in 1963. Psychodrama also began to emerge in Russia, Czechoslovakia, and Vietnam, where it remains strongly characterized by Moreno's influence.
In practice, an analytic psychodrama is centered around a theme suggested by a patient, which is acted out by him and the other participants. Instead of the free associations used in classical treatment, the patient is invited to act out and stage everything that comes to mind with the help of the other actors. Anything can be acted out, though it has to remain in the realm of the play. Through the reaction that it produces, the play resuscitates what is often a deficient psychic dynamic. The drama enacts and accomplishes the following:
- The dramatization of conflicts. Affect is connected with words and gestures, which allows the drives to be based in the body.
- Access to representability. The drama enacted by the actors and the interpretation provided by the play leader facilitate the formulation of otherwise inexpressible anxieties and thereby suggest representations often containing affects that are painful to the patient's ego.
- Mediation through the play. By reducing the influence of censorship, the fiction created by the play lifts certain inhibitions and facilitates access to unconscious conflicts. The enjoyment of the play reinforces the subject's narcissism and his confidence.
There are many varieties of psychodrama, which bears witness that the practice is evolving, creative, and receptive. There is the form of group psychodrama in which the theme is one shared by the whole group and is interpreted accordingly. There are also two main varieties of psychodrama with individual themes: individual psychodrama and group psychodrama. In these latter two types of psychodrama, a patient or group of patients meets with a team of therapists. In either case, the theme is always individual, as is the resulting interpretation. There are three types of participant in psychodrama: the patient, who chooses the scene, a character to play, and the roles to be assigned to the other actors; the other actors, who act out the suggested scene (their acting has a primarily interpretative purpose, being closest to the unconscious impulses expressed by the patient); and the play leader, who does not act but interprets and makes connections between the meaning of the different scenes. The play leader also assists in the staging and reinforces the setting. To the play leader falls the task of interpreting the transference.
Whether the use of analytic psychodrama is indicated depends more on the patient's mode of functioning than on nosographic categories. Psychodrama is more often recommended for patients who suffer from sensory deprivation or rigid defensive procedures, who are deficient in their ability to fantasize, or who harbor dominant psychotic fears. Furthermore, since psychodrama was first used in treating child and adolescent pathologies, it continues to be the treatment of choice for young patients.
See also: Idea/representation; Moreno, Jacob Levy; Psychotherapy; Symbolization, process of; Technique with adults, psychoanalytic; Technique with children, psychoanalytic.
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