Beyond Moreno’s methods and modified psychodrama approaches are multiple other methods that developed with considerable overlap to psychodrama. Some explicitly trace their history back to Moreno while others use methods Moreno developed without much or any reference to him.
15.5.1 Drama Therapy
While the term drama therapy is sometimes used interchangeably with psychodrama in the literature, it is its own unique field and approach separate from psychodrama with its own professional society, journal, degree programs, and credentialing board. Nevertheless, many drama therapists consider Jacob Moreno to be the first drama therapist (Bailey, 2006). There may be far more similarities than differences when it comes to psychodrama and drama therapy. Both are used as approaches in psychotherapy, education, and community work integrating role theory, drama, improv games, role playing
, symbolism, spontaneity
, creativity, and a biopsychosocial perspective.
In terms of differences, psychodrama focuses on enacting one individual’s story or topic while drama therapy enacts stories or topics related to the group-as-a-whole (similar to sociodrama). Psychodrama is more structured while drama therapy is more fluid. While psychodrama uses imagination and reality, drama therapy is more focused on symbolic or surplus reality. Psychodrama can be traced back solely to Moreno’s theoretical and philosophical foundation in the early 1900. On the other hand, drama therapy emerged with multiple different theoretical and practical approaches developed by different pioneers several decades after Moreno (Johnson & Emunah, 2009; Landy, 2017). Kadem-Tahar and Kellermann (1996) offer an eloquently stated differentiation below:
we have found that there is a fundamental difference between psychodrama and drama therapy. It seems that whereas in psychodrama the “soul” (psyche) is the aim and the “action” (drama) is the means, the opposite is true for drama therapy in which drama itself (as pure art) is the aim and the psyche is the means (of expression) (Kedem-Tahar & Kellermann, 1996, p. 29).
Drama therapy is more connected to theater and sometimes moves from a therapeutic process to a focus on creating a theater production (Landy, 2017). While some psychodramatists are also theater professionals, most are not. Interestingly, the field of drama therapy seems to have professionalized and integrated within academia, research, and higher education in the USA far more than psychodrama has. Multiple graduate degrees are offered in drama therapy in the USA while there is not a single graduate program in psychodrama.
Learning psychodrama is a required part of drama therapy education, as such, psychodrama interventions become a part of every drama therapist’s toolbox in an explicit way. Alternatively, psychodramatists do not all learn drama therapy interventions, though many psychodramatists are also drama therapists and some drama therapy techniques, especially warm-up games, have become integrated into the psychodrama culture.
Playback Theater emerged in the early 1970, developed by Jonathan Fox who was experienced in psychodrama (Blatner, 2000; Fox, Fox, Salas, & Sparrow, 2000). Fox explicitly credits psychodrama for the foundation of Playback Theater and even notes how Playback Theater was largely developed on the original Moreno psychodrama stage in New Paltz, NY (2018). Playback Theater utilizes a small group of trained actors to spontaneously enact personal stories from the audience (Fox, 1994). Jonathan Fox writes that he sees Playback Theater as more connected to Moreno’s Theater of Spontaneity than it is connected to psychodrama (Fox, 2004). Playback Theater seems to be more closely related to sociodrama and drama therapy than psychodrama in that it uses metaphor and symbolism with a focus on the drama more so than the individual’s story. Playback Theater is more concerned with the process of putting stories into action than using drama or theater as a means to uncovering solutions for personal or collective problems (Fox, 2004). In Playback Theater, the storyteller remains an audience member while in psychodrama or drama therapy they become an active role player. It is important to note that Playback Theater is not a psychotherapy, though sometimes used within therapy and often providing a therapeutic experience for audiences.
Playback Theater is often integrated into psychodrama work and often is used in major events at the national psychodrama conferences. Playback Theater and Theater of the Oppressed are sometimes confused with each other though they also have fundamental differences. Playback emerged from Fox’s experience in theater and psychodrama while Theater of the Oppressed developed from Augusto Boal’s socio-political experience in Latin America.
15.5.3 Theater of the Oppressed
While Playback Theater is focused on personal changes or revolution, Theater of the Oppressed uses the individual’s story as a catalyst for social revolution and collective change (Weinblatt, 2015). Theater of the Oppressed focuses on developing solutions to social issues while Playback Theater is less solution focused (Fox, 2004). Theater of the Oppressed and Playback Theater are similar in their use of an individual’s story as the script for the enactment, which differs from sociodrama’s spontaneously emerging storyline. Augusto Boal developed Theater of the Oppressed in the 1970 in South America which evolved to include multiple theater modalities including forum theater, image theater, invisible theater, and the rainbow of desire (Boal, 2000, 2013; Feldhendler, 1993; Oliveira & Araujo, 2012). Perhaps one of the simplest ways of differentiating Moreno and Boal is to remember the paradigms from which they developed their ideas. Moreno was an existential psychiatrist while Boal was a Marxist playwright (Oliveira & Araujo, 2012). Feldhendler (1993) notes that Boal’s Newspaper Theater and Moreno’s Living Newspaper are nearly identical. Boal participated psychodrama groups in the 1960 but denies that psychodrama or Moreno had influence on his developing of Theater of the Oppressed. Later in 1994, Boal dedicates his Rainbow of Desire book focused on using theater in therapy to Zerka Moreno (Boal, 2013). Similar to Moreno’s trajectory, Boal’s work was initially based on social justice issues in society but later he developed an approach for psychotherapy (Boal, 2013; Feldhendler, 1993).
In Theater of the Oppressed, a scene is played out for the storyteller until the point of the central conflict, at which point audience members are invited to step onto the stage and offer experiential demonstrations of solutions or responses to the situation. This method is quite similar to psychodramatic doubling. As the name suggests, Theater of the Oppressed concerns itself primarily with issues of social justice and oppression. Later, when living in France, Boal developed methods for working with European bourgeoisie by conceptualizing mild neurosis as internal forms of oppression (Blatner, 2000). The experience of a Theater of Oppressed session provides audience members with new ways of confronting moments of oppression and injustice through the co-created process. Theater of the Oppressed, Playback Theater
, drama therapy
, and Moreno’s methods have much in common and are often integrated together by psychodrama practitioners.
Gestalt therapy is an existential therapy focusing on the whole person while incorporating here-and-now awareness, relational emphasis, and experiential techniques (Perls, 1969a). Fritz and Laura Perls created gestalt therapy in the 1940 and put it forth in their 1951 book Gestalt Therapy (Perls, Hefferline, & Goodman, 1951). Similarly, to psychodrama, gestalt emerged from the rejection of aspects of psychoanalysis, with emphasis on relationships, and use of the empty chair with role playing
. Gestalt therapy seems to have outdone psychodrama in terms of popularity in the USA and offers a modality framed as both an individual and a group approach. Gestalt therapy’s focus on individual therapy, while psychodrama is much more group focused, may be one of the reasons it has achieved and maintained popularity. At the same time, some group workers critique gestalt therapists for simply doing individual therapy in a group setting and being unable to engage the group-as-a-whole. From a psychodrama perspective, gestalt therapy is considered a monodrama where the client works one-on-one with the therapist without auxiliary egos—even in group settings (Yablonsky, 1976). The audience in gestalt therapy has very little involvement compared to psychodrama. Psychodrama seems to be much more action-based using an open stage while gestalt puts the client into the hot seat and uses more introspection.
Who created the empty chair technique? Gestalt therapists often claim it for their founder, Fritz Perls while psychodramatists insist that Moreno created it. There is much misunderstanding about this, and it seems Perls is frequently credited with the development of the empty chair because he made it popular and brought it into mainstream culture with his public demonstrations at Esalen Institute. Nevertheless, historical analysis reveals that Perls was a frequent attendee of psychodrama sessions in New York and later writes in his memoir, In and Out of the Garbage Pail, that Moreno and psychodrama had considerable influence on him (Berne, 1970; Blatner, 1996, 2000; Moreno, 2019b; Perls, 1969b; Yablonsky, 1976). Walter Truett Anderson, journalist and encounter group leader, recalls an encounter between Moreno and Fritz Perls in 1969 at a psychology convention where they presented on the same panel—Moreno publicly confronts Perls, “I don’t mind you stealing my stuff, but you should have stolen all of it”. Perls responded, “Ah, Jacob, Jacob, when will you just accept your greatness?” (Moreno, 2014, p. 218).
15.5.5 Internal Family Systems
Internal Family Systems Therapy (IFS) conceptualizes the psyche as having multiple parts with a centralized self—the core essence of an individual (Schwartz, 1994). This perspective is quite similar to Moreno’s role theory, with the self having parallels to the Morenean concept of the autonomous healing center within (Longer & Giacomucci, 2020). Like gestalt and psychodrama, IFS uses a non-pathologizing person-centered approach with a primary goal of promoting further integration within the self and in the external environment. In IFS, parts are categorized as either exiled parts or protective parts. Furthermore, there are two types of protective parts—proactive managers or reactive firefighters. IFS places considerable emphasis on defense mechanisms and asking permission from parts before engaging with interventions.
Internal Family Systems Therapy (IFS) was developed by Richard Schwartz in the 1980–1990 integrating a mix of family therapy, systems theory, and parts work. In the development of IFS, Schwartz was influenced by Fritz Perls empty chair work and by his work with Virginia Satir, who had integrated Moreno’s methods into the family therapy field (Schwartz & Sweezy, 2019). IFS seems to be utilized primarily in individual work, but also adapted to group work. IFS and gestalt are similar in this way, and in that they both emphasize parts of self while exploring inner parts with mindfulness and interoception. IFS group work is much more similar to psychodrama than IFS individual work as parts are externalized in the group with role players, but in individual therapy parts are interfaced within the individual. Very little has been published about the connection between IFS and psychodrama, albeit many practitioners and trainers integrate both into their work. Rachel Longer and I published a recent short article outlining their similarities and how both IFS practitioners and psychodramatists could benefit from adapting aspects of the other’s approaches (2020).
System Psychomotor Therapy
The Pesso Boyden System Psychomotor (PBSP) Therapy, sometimes called psychomotor therapy for short, was created by dance teachers Albert Pesso and Diane Boyden-Pesso in the 1960 in New York. PBSP is focused on providing experiential corrective experiences with idealized roles to reverse the impact of unmet needs from childhood (Winnette & Baylin, 2017). A PBSP session or structure appears to be quite similar to a psychodrama enactment as they both use role playing
within a group to recreate scenes from the past and wished for scenes (Blatner, 2000). Similar to the psychodrama process, the PBSP approach follows the lead of the protagonist, constructs a dramatic scene, facilitates de-roling of role players, and finishes by sharing from participants in the group. PBSP’s witness role has many similarities to the mirror position in psychodrama or the observing ego role in the Therapeutic Spiral Model.
Psychomotor therapy has a similar process as psychodrama but also has its own terminology, theory, and training process (Pesso, 1969; Pesso & Crandall, 1991). It also is more explicitly trauma-focused and body-oriented than classical psychodrama. A psychomotor therapist uses microtracking to follow the subtle non-verbal communication from the protagonist (van der Kolk, 2014). The facilitation of psychomotor structures is more contained, scripted, and intentional than a spontaneous psychodrama enactment. Although the Pesso Boyden therapeutic approach seems to have limited research and publications, it has received an increased spotlight due to Bessel van der Kolk’s 2014 chapter on it in his best-selling book The Body Keeps the Score and his newly offered experiential psychodramatic workshops based on his training with Albert Pesso.
15.5.7 Family Constellations and Systemic Constellations
Family constellations and systemic constellations therapy were developed by Bert Hellinger in the 1970s with a focus on the family ancestral system or other system such as an organization (Hellinger, 2003). The constellations therapy process revolves around one client, usually in a group setting, who chooses group members to hold the places of different family members, ancestors, or members of the system (Carnabucci & Anderson, 2012). Instead of being referred to as roles or auxiliary egos like in psychodrama, they are referred to as representatives. The place where the experience emerges is called the field, akin to the psychodrama stage. The client physically places representatives in the field and returns to their seat to observe. A constellations session is much less action-based or dramatic as psychodrama and focuses on information that emerges for the client or representatives through intuition, thoughts, impulses, body sensations, or energy. Rather than acting, doubling, or role reversal, the representatives are instructed to attune themselves to the field. The facilitator checks in with the representatives asking them to report what they are experiencing in the field and encouraging brief movements or statements. The process involves very subtle movement, periods of silence, and significant time spent with each representative attuned to their inner experience. Once an issue is concretized in the field between members of the system, the facilitator will instruct them to make simple gestures or statements to each other in attempts to move toward resolution while the client observes (Carnabucci, 2018). Constellations work can get to systemic issues in a streamlined manner but misses nuances of experience due to minimal verbal involvement (von Ameln & Becker-Ebel, 2020).
Family constellation sessions are based on three orders of love outlined by Hellinger—(1) every member has the right to belong to the family, (2) wrongs in previous generations will be redressed in future generations, and (3) people have rank according to who entered the system first (Hellinger, Weber, & Beaumont, 1998). Carnabucci (2018) comments on Hellinger’s work as being related to Moreno’s concept of tele and making it the central mechanism of change in an explicit way. Carnabucci and Anderson (2012) write four major differences between the two approaches: (1) psychodrama focuses on conscious reality while constellations work focuses on the unconscious and ancestral; (2) psychodrama auxiliaries are role trained by information from the protagonist while constellation representatives learn information about their character from their inner experience; (3) in constellation work, resonating statements are used in a way similar to doubling statements in psychodrama but much less frequent and usually provided by the facilitator; (4) the psychodrama enactment places the protagonist within the drama which explores elements of their life while the family constellation session is takes places within the field of one’s ancestry. Psychodrama enactments generally have a clearly defined scene while constellation work takes places without concrete context (Carnabucci, 2018). While clear differences exist between the two approaches, they also have much in common, including being experiential group methods focused on the person within their social environment and larger systems. Both approaches are based in comprehensive existential philosophical systems with emphasis on spirituality that include applications in psychotherapy and beyond (Carnabucci & Anderson, 2012).