The Road to MFT

Introduction

            Who am I?  What do I want?  How am I going to get it?  In my professional career, I have found these questions to be the starting point for most actors studying the art of drama and theatrical performance.  These questions enable an individual to live in a parallel universe, the world of the play.  A glorious world it is, until the actor realizes he cannot live in it alone.  Relationships within this world give life to the fantasy, and so an actor must explore his relationship with everyone involved in this created world, or else he will be considered a fraud.  Being a great actor requires one necessary trait: the ability to tell the truth.  The truth may be discovered within an individual’s relationships, a realization that sparks further exploration.  It is this examination that fills the questions aforementioned with subtext and meaning.  Once the role of the individual has been established, the creative work can finally begin.

            A drama therapist approaches therapy much like how an actor chooses to act: it is a constant exploration of relationship patterns between individuals.  In this paper, I will discuss drama as a creative arts practice known as drama therapy.  Following a brief overview of intimacy, I will then present research that supports Developmental Transformations (DvT) in the drama therapy group.  Finally, I will attempt to reveal how DvT in drama therapy establishes and maintains intimacy in relationships amongst group participants.

What is Drama Therapy?

            “Creativity is the source of life” (Jennings, Cattanach, Mitchell, Chesner, & Meldrum, 1993, p. 180).  The creative individual engages in play, humor, colors, and stories (Jennings et al, 1993).  Once creativity is accessed, healing can begin to take place.

            Drama therapy is creative healing.  Jennings et al (1993) quote a 12-year-old boy who defines the alternative therapy simply and elegantly: “Drama therapy is about touching and playing with objects, drawing and telling stories, and making up plays about them.  This lets you collect up and get out the frightening feelings from inside you, and doing all this helps you to be calm.  I can’t explain it, but it’s got something to do with here,” as he pats the area around his heart (p. 184).  As the boy alludes, drama therapy stirs deep emotional awareness.  Furthermore, this dramatic approach to therapy is suitable for all ages, as it does not require insight to facilitate change (Butler, 2012, p. 88).  It does, however, require a level of commitment to the work: active, embodied exploration of an individual’s relationships to others. 

Group drama therapy gives individuals an opportunity to share with each other and work together, “as opposed to being individualistic, competitive, and closing off oneself” (Jennings et al, 1993, p. 169).  Together, participants explore “their creativity, their energy, their problems, their aims, and their joys” (Jennings, 1992, p. 77).  Since everything is shared on the drama therapy playground, relationships are inevitably formed.  Because relationships are built in the context of the drama, exploration of these relationships becomes the world.  This exploration gives birth to a rather profound level of intimacy, which will be discussed shortly.  During a role-play, participants are said to share a “collective communal experience” (Jennings et al, 1993), one experience shared by all.  This means that together, participants enter and exit the world they have created in therapy.  This is a safe world that allows them an uninhibited opportunity to explore what may be vulnerable outside the therapy circle.  Within dramatic reenactments, the group is aware of their subconscious: they know that the characters they have created are mere representations of their own wishes, “but the dramatic paradox enables them to say and experience far more” (Jennings, 1992, p. 77).  This concept, known exclusively to drama therapy, is called distancing.

            Distancing allows an individual’s psychological material to be examined “with an underlying safety net that it is only a story,” (Butler, 2012, p. 88).  Distancing actually separates the individual from having a direct interaction with his/her conflict.  In a group, dramatizations that use puppets, masks, or living sculptures (for example) create a layer of distance between individuals and also between the individual and his/her concern.  Through the drama created by the group, participants explore the depths of this safety net with freedom to move to their intended point of vulnerability.   “The person feels less threatened and more in control, with choices rather than ultimatums” (Butler, 2012, p. 88).  Distancing in drama therapy gives individuals room to reflect (Jennings et al, 1993, p. 173) and space to heal without identifying the thing (Jennings et al, 1993, p. 180).  By identifying roles and events and replaying them, distancing provides a variety of outlets for individuals to enter (Jennings et al, 1993, p. 180).

            Drama therapy, like theatre, explores the role and the story of the individual.  “Without role and story, theatre cannot occur” (Jennings et al, 1993, p. 176).  Role and story, in the context of a drama, helps to define relationships amongst group members.  When one knows his role (Who am I?)and his story (What do I want?), it is now a necessity to engage in an intimate relationship (From who am I going to get it?).  In other words, it is the relationship to a fellow group member that provides an individual with his story (his desires).  Drama therapy uniquely gives an individual the opportunity to explore the many roles he/she may play by providing time to reflect upon and modify these roles in some way (Jennings et al, 1993, p. 177).

            Now that I have succinctly described a few key concepts of drama therapy, I would like to provide a brief overview of intimacy and how it is relevant in drama therapy groups.  

An Overview of Intimacy

            Yalom (2005) believes, “The chief concern of the group is with intimacy and closeness” (p. 319).  He describes group therapy as a formative process, one that requires individuals to collectively progress along a series of stages.  The third stage of group therapy is Development of Cohesiveness, a time where intimacy is established and trust is formed amongst the group (Yalom, 2005, p. 319).  “Although there may be greater freedom of self-disclosure in this phase, there may also be communicational restrictions of another sort: often the group suppresses all expression of negative affect in the service of cohesion” (Yalom, 2005, p. 319).  Because group work in drama therapy requires a considerable level of cohesion from the very beginning (Butler, 2012, p. 88), participants may bypass this desire-to-please effect as described by Yalom.  Also, individuals participating in drama therapy communicate indirectly through the use of dramatizations.  This ambiguous mode of communication makes emotional restrictions less likely to occur.  Thus, drama therapy may enhance the closeness and intimacy of relationships both organically and creatively.        

            Yalom (2005) found in an experiential study that those individuals with “constricted emotionality may be threatened by the expression of feelings by others” (p. 245).  They may have “difficulty experiencing and expressing their own emotional reactions” (Yalom, 2005, p. 245).  Ironically, it is these individuals who gain the most and change most often as a result of their group experience, “even though they are significantly more uncomfortable in the group (Yalom, 2005, p. 246).  Here it is relevant to recall the importance of distancing in drama therapy: through distancing, individuals can explore their own level of emotionality within the group context.  Within the safety of the drama, they can explore their relationship to the expression of feelings by others.  The active drama provides an opportunity to rehearse and explore both experiencing and expressing their emotional reactions.  Drama therapy becomes yet another playground amongst many for individuals to discover and define intimacy.

            Intimacy amongst group members develops with time and trust.  Distancing allows exploration to occur, and it is the exploration that encourages intimacy.  Actors would say that it is the journey that makes the destination worthwhile; in drama therapy, the journey is the exploration of relationships, and the destination is a greater knowledge of self, both individually and interpersonally.  Robert Landy, an American drama therapy leader, describes the exploration of roles to relationships: “It is the in-between space where the greatest possibilities could grow and occur” (Jennings et al, 1993, p. 175).  It could be argued that the in-between space is the process of exploration.  I envision the process as a deep well that contains intimacy at its very core.  A group who gathers one bucket and lowers it into the well together emerges a stronger, more unified group, because the heart of intimacy has been revealed.  At this time, participants must make way for a new therapeutic goal: maintaining intimacy so as to deepen the bond of relationship.

            Drama therapy explores the “looking-glass self,” (Jennings et al, 1993, p. 173), a philosophy that understands the self as an extension of self in relationships.  In other words, you look at another person and see much of yourself in them.  “I am self, I know who I am by virtue of looking in the mirror: that is, all other people in my social world and what they look like back, is a sense of what I am” (Jennings et al, 1993, p. 173).  Drama therapists embody the looking-glass experience by dramatizing the relationships between group members as a way to further explore personal issues.  Once group members connect on this creative, physical level, the bond of intimacy is even furthermore established, because a level of vulnerability has been achieved.

            I have briefly discussed intimacy and its relevance to drama therapy. After giving a brief description of Developmental Transformations (DvT), an embodied approach to drama therapy, I will then attempt to explore the depths of intimacy further within this particular technique.

Developmental Transformations (DvT) in Drama Therapy

            Although Developmental Transformations (DvT) is best understood when experienced, I will describe it in accordance with the experts.  Most simply put, DvT operates on three basic principles: embodiment, encounter, and transformation.  Individuals physically engage one another in the playspace – “an interpersonal field in an imaginative realm where the imagination infuses the ordinary” (Johnson, 1991, p. 289).  The therapist draws attention to the body (Butler, 2012, p. 89), encouraging individuals to participate in group play, including “brushing up against [each other] in an encounter that gives all involved a chance to examine, explore, and release some of those ‘stuck’ patterns” (Reynolds, 2011, p. 297).  A client must find ways to cope with the ensuing anxiety from experiencing the encounter (Butler, 2012, p. 89).  “Transformation occurs as the action continually shifts and changes” (Butler, 2012, p. 89).  Butler (2012) reports that transformations allow the group to confront and change defenses (p. 90) and rigidity, the lack of motivation to change (p. 90).  The father of DvT, David Read Johnson (1991) wrote that transformations are essential to the psychotherapeutic process, evoking profound images, scenes, and characters that are often “very primitive and personal” (p. 290) in nature. 

            DvT operates under dramatic improvisations that “emphasize the use of developmental sequences of dramatic forms to facilitate a spontaneous flow of images within the client (Johnson, 1991, p. 289).  Like Freudian free association, DvT looks beyond words, deeply examining movement, sound, gesture, and dramatic character (Johnson, 1991, p. 287).  Through role-play, symbolic enactment, verbalization, and silent imaging (Johnson, 1991, p. 288), individuals “confront the choices made in the past and possibilities for choice in the present” (Johnson, 1991, p. 288).  Yalom (2005) advises mental health professionals, “As long as you persistently direct the group from the non-relevant, from the then-and-there, to the here-and-now, you are operationally correct” (p. 162).  Individuals participating in DvT have no choice but explore the here-and-now, albeit in an “unconventional” way compared to industry standards.  Johnson (1991) poignantly describes the challenge of living in the present moment in DvT, “The process of being existentially real is to live with the acknowledgement of one’s state of becoming, to be in role and out of role at the same time, to be both player and audience” (p. 286).  A DvT group explores this duality actively, freely, and most importantly, in relation to its fellow members.

DvT and Intimacy

            DvT explores intimacy by way of conflict within the encounter of individuals.  Yalom (2005) says, “If overt conflict is denied or suppressed, invariably it will manifest itself in oblique, corrosive, and often ugly ways.”  An impasse is what DvT calls “a major interruption in the flow of therapy characterized by conflict” (Johnson, 1991, p. 289).  Yalom (2005) argues that there are both negative and positive attributes of conflict; “its absence suggests some impairment of the developmental sequence,” (p. 364); finally, the perfect dose of conflict can be especially worthwhile in therapy (p. 364).  Conflicts often reveal an individual’s more deeply laden anxieties and fears.  In the course of DvT, group members are allowed “to flee the conflict by transforming the scene while remaining in the playspace” (Johnson, 1991, p. 290).  They do not ignore the conflict.  Quite the contrary, DvT participants challenge the conflict in real-time.  Group members sense the intruder (conflict), and together explore the possibilities of progression.  Unity and understanding are ever so important in this phase of DvT.  At each moment of conflict, intimacy is reinforced by the unity of the encounter.

            DvT elicits intimacy amongst group members most notably in the encounter itself.  Therapists emphasize “the process of noticing, feeling, animating, and expressing” (Butler, 2012, p. 90).  DvT seeks to slow down the communication process by encouraging group members to truly notice a difference in a partner, feel an emotional response to the difference, experience a physical, lively response, and then express a verbal response back to the partner (Butler, 2012, p. 90).  Group members feel safe in the playspace, because proper communication patterns have been established, and thus intimacy grows and fosters.  “The playspace in DvT also gives clients the opportunity to play out roles that might not otherwise be attributed to them,” (Butler, 2012, p. 91).  Individuals explore these roles with group members in the encounter, strengthening relationships, enhancing intimacy, and providing a more meaningful understanding of self. 

            The encounter in DvT is live, constant, and indirect feedback, and has the potential to enrich intimacy with the flow of the improvisation.  The encounter is safe enough for group members to explore their relationships in the playspace “without immediately challenging or agreeing with the expressed viewpoint” (Reynolds, 2011, p. 307).  Group members discover playful and safe ways to explore negative emotions like anger and aggression, without having to act out in reality, (Reynolds, 2011, p. 299).  Perhaps members also find “the group leader neither abandons nor rejects them for [negative] feelings” (Reynolds, 2011, p. 299), deeply enhancing the satisfying bond of intimacy between client and drama therapist.

Conclusion

            This paper began by describing the drama therapy approach in detail.  I attempted to give insight toward distancing, a unique drama therapy intervention that requires skill and intuition.  I briefly overviewed the potential drama therapy for developing intimate relationships.  Finally, I examined how Developmental Transformations (DvT) is utilized in drama therapy as a tool to explore, deepen, and thus maintain intimate relationships between individuals in a drama therapy group.  In doing so, I reviewed the importance of conflict within the encounter.  I have learned that the goal of all therapy, and especially drama therapy, “is neither to succumb nor pretend, but to accept and transcend” (Johnson, 1991, p. 286).  It is within this transfiguration that the learning takes place.  It is the creative exploration of the soul that ensues when words simply cannot speak.

References

Butler, J.D. (2012). Playing with madness: developmental transformations and the treatment of    schizophrenia. The Arts in Psychotherapy, 39, 87-94.

Jennings, S., Cattanach, A., Mitchell, S., Chesner, A., & Meldrum, B. (1993). The handbook of    dramatherapy. London: Taylor & Francis, LTD.

Jennings, S. (1992). Dramatherapy with families, groups, and individuals: waiting in the wings.    London: Taylor & Francis, LTD.

Johnson, D.R., (1991). The theory and technique of transformations in drama therapy. The Arts   in Psychotherapy, 18, 285-300.

Reynolds, A. (2011). Developmental transformations: improvisational drama therapy with           children in acute inpatient psychiatry. Social Work with Groups, 34:3-4, 296-309.

Yalom, I.D., & Leszcz, M. (2005). The theory and practice of group psychotherapy. New York:   Basic Books.

The New York Times wrote an article of a “new study” today, entitled, “New Definition of Autism May Exclude Many, Study Suggests.”  You can read the article here: http://nyti.ms/NYTimesAutism

The article itself is premature, and is causing such an uproar amongst people who do not work in the mental health community, particularly parents and other primary caregivers.  Parents of children with Autism are some of the hardest working people I know.  They devote their lives to their children.  Unfortunately, I fear people aren’t understanding the need to guide the diagnosis properly.  When I was a kid, everyone had ADHD.  Nobody wanted to address their social communication issues; why do that?  It’s easier to drug them.  In the 80s, everyone who was anyone had Multiple Personality Disorder. My point is, clinical diagnoses do become sensationalized, whether we want to believe it or not.  Yes, Autism is a real disorder; it is also a disorder with a broad spectrum of possibilities.  The reason behind the APA’s Revised DSM is to address this very problem.  Currently, the DSM is categorical: black and white.  You either fit it or you don’t. With the revisions, clinicians hope to have a more dimensional approach to diagnosis, so children who lack social skills don’t mistakenly get diagnosed with Aspergers.  In order for the mental health community to continue to grow, it is essential to address these issues of concern NOW so that a cause of Autism can be identified.  

For all of you against this process, I hope that you realize that with all mental health disorders, this has been the process of understanding since Freud imagined his theory of development in the early 1900s.  The DSM is not the end-all to the be-all, hence the need to revise.  Please consider how social psychology has affected the previous DSM in the 70’s, which claimed homosexuality was a mental disorder.  We may view this as absurd today, but this was how researchers explained what seemed to become a phenomenon.  Homosexuality didn’t just pop up - it was always a part of humanity.  People simply became aware of its existence and were unafraid to talk about it.  Same thing with Autism.  It has been here all along.  We’ve named it.  Now we need to trace it’s cause.

Here was my inspiration to write this post.  A comment made by an average person on the NYTimes Article:

I am confused why doctors of mental health are charged with formulating a diagnosis of autism. I though austism concerned a number of developmental delays of people caused by physical abnormalities in the brain, which is a medical not mental condition. 

Ignorance will not serve us well.  Generalizations do not serve us well.  Friend in Austin, TX, if it were as easy as you are stating, don’t you think we would have found a cause by now?  No two cases of Autism are alike.  The “common symptoms” do not occur in every diagnosed case.  How do you explain that?  How confident would you feel going to your doctor to receive a diagnosis of the flu when you have a stomach ache, and your friend getting the same diagnosis when she had a headache?  The treatment available for your stomach ache is the same treatment for your friend’s headache.  Does this make any sense?  No, it doesn’t make sense - a stomach ache and a headache may be components of the flu, but if not accompanied by a fever, you would demand different treatment for your stomach ache to your friend’s headache.  In the same sense, refining the DSM is essential for refining treatment, so our children can actually get the treatment they need.  

I will always be an advocate for children with special needs.  They are my loves, and my world would be nothing without their sweet hearts.

(Source: http)

I can’t believe it - I accepted a job offer today as a Behavior Therapist!  Thank you for all of your prayers and support throughout this process!  I start training on December 1st.  Then I head home for the holidays, including a little stop in San Francisco to spend time with none other than my best friend ever, Larry/Charlie/Mike/Baby/whichever is befitting to the moment.  But come January 4th, I’m back with my first full-time case in January!  I am beyond excited.  I’m so excited that I’m baking cupcakes and going out dancing in Hollywood tonight.  That’s a ton of excitement!

This also means that I now have to have that awkward conversation with the family I’ve been with for almost a year… How am I supposed to tell them I have this amazing new opportunity, and I can’t stay with them any longer?  How do I explain what an incredible step up in terms of my career this is?  How am I supposed to do this without stressing them out or hurting a perfectly awesome relationship?  I am in love with this family, and I love their children like I will someday love my own… that’s a LOT of love people!!  What’s a girl supposed to do?  My heart breaks to think I will have to say goodbye to people who mean so much to me.

Like I stated before, you must lose a little to gain a little.

Today I cry tears of joy…  I am putting behind me a phase in my life that was less guided.  This is a major accomplishment for me, as I tend to be the type to hold on to something, even if it’s not working.  

Thank God I listened to the beat of my heart… My favorite man Jesus lives in there, and He’s the captain of this ship!

Sail away!

So I was offered a job as a Behavior Therapist working for a medium-sized, private agency here in Los Angeles!  I’m super excited about the opportunity, and praying for guidance as I make my decision.  The position starts full-time, which is rare for a beginning Behavior Therapist, and the company is absolutely wonderful!  

Joni Mitchell says this line, Something’s lost and something’s gained in living every day.

Joni’s words are filled with such wisdom and grace.  I’ve never once before had to leave a job that I love for another job that I will love equally, if not more.  This is very new for me, but I trust Joni’s phrase is stated from experience.  Even my incredibly profound mother says, “When one door closes, another window opens.”  This and similar phrases seem to be expressing the same sentiment,

You must give a little to get a little.  You must lose a little to gain a little.  You must close a little to open a little.  

You may even have to step back a little to move further ahead…a little.

Saying prayers of wisdom and guidance today for each of you!

On my quest to becoming an MFT, I should probably get a feel for (or a healthy reminder of) what it’s like to be on “the other side.”  As the client, I think my therapist, Dr. DiPaolo of Santa Monica, CA, was exactly what I needed: an empathetic, unbiased, non-judgmental person who can shed perspective on a situation that has clouded my perception.

In today’s session, I learned that I have been engaging in similar patterns of behavior that clearly have not been working for me.  These issues must be resolved completely before I can go on with life.  One of these things is my inefficiency with “letting go.”  You know the saying, “Let go and let God?”  I’d probably be the first to preach it, but the last to actually walk it.  Maybe I should practice more what I preach, huh?

Often times, the only reason why I let go of painful circumstances are for the obvious “out of sight, out of mind” reasons.  I’m a runner.  I literally run away from problems that cause me pain.  I hated New Castle.  So I moved to New York.  After a while, New York wash’t helping me grow in any positive directions.  So I moved to Cali.  In between, there have been friendships, relationships, and opportunities I have simply run away from, because avoiding the pain is so much easier than facing it.  

But today, the therapist made me realize: I can’t keep running all my life.  These emotions I feel are real, and they are strong.  I need to face them, understand them, and not allow them to control my life.  My emotions are in my control, and I can choose more constructive behaviors so that I can reach my goals, not run from my goals!  

I’ve always felt like my highs are super high, and my lows are frighteningly low.  Finding the middle ground is what I am aiming to do.

In Adlerian theory, the Neurotic Symptom says,

These are your “Yes-but” types of people.  For example,

Therapist: “Why don’t you clean your house if the dirt causes you anxiety.”

Client: “Yes, and I try, but you see, there’s never enough time, because I work so much.  So, you know, it’s always on my mind, but I never get to it.”

They know what they should do or feel, but they “can’t.”  

Where exactly does this tendency live?

In discouragement, of course.  These types of people will avoid or postpone, maybe even take circuitous routes to solutions, so that they can “save face.”  How many times have you become anxious studying for an exam and physically became too overwhelmed to study?  This is a form of Neurosis, or what I like to call self-sabotage.  You know that studying will help you get a good grade, but because the pressure of studying is too much to handle, you shove it aside until the night before the exam.  This way, if you do poorly on the exam, you have the excuse of, “I hardly studied anyway.  In no way does it doesn’t reflect how smart I am.”  You can hold on to your laziness or neglect, as this masks your fear of failing.  Even when you arrange to fail, you still try to salvage some self-esteem.

Is this you?

Since only 1% of the entire human population is self-actualizing, then YES, this is you.  We all have a little neurotic hiding inside of us.  Here’s me getting all neurotic on you… BUT (…get it… Yes - but) we can manage this little voice by replacing statements beginning with:

“I can’t…”

or

“I won’t…”

with

“I can…”

and

“I will…”