Keywords

I have had the good fortune to develop three ideas. The first idea, a study of the godhead ,’ has remained cryptic and misapprehended. The second, a study of man called psychodrama, has aroused some hope that man can train his spontaneity to overcome many of his shortcomings. My third idea, the study of society called sociometry, has given the greatest promise that a measure can be developed for a deeper understanding of society and a key to the treatment of its ills. Many of my friends consider these three ideas one apart from the other. In my own mind, however, all the three ideas are of one piece. One has developed out of the other. The first idea initiates a cannon of the universe, the second a cannon of the individual, the third a cannon of human society. (Moreno, 1943, p. 299)

1 Philosophical Underpinnings of Moreno’s Work

While some modern psychotherapists are aware of the contributions of technique from J. L. Moreno (see Fig. 4.1), most are unaware that psychodrama is a comprehensive system of theory, philosophy, and technique.

Fig. 4.1
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Jacob Moreno in the early 1960s. Reprinted with permission from Figusch (2014)

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My philosophy has been misunderstood. It has been disregarded in many religious and scientific circles. This has not hindered me from continuing to develop techniques whereby my vision of what the world could be might be established in fact. It is curious that these techniques—sociometry, psychodrama, group therapy - created to implement an underlying philosophy of life have been almost universally accepted while the underlying philosophy has been relegated to the dark corners of library shelves or entirely pushed aside. (Moreno , 2019, p. 175)

Some suggest psychodrama is one of the most complex psychotherapy systems (von Ameln & Becker-Ebel, 2020). Psychodrama is built upon multiple theories including action theory , role theory , and spontaneity–creativity theory . While psychodrama does come equipped with its own theoretical basis, because it is highly process-driven involving numerous clinical techniques, it can be adapted to contain the theoretical content of any other theoretical system.

Psychodramatists have integrated psychodrama with many other modalities or theoretical systems including: cognitive behavioral therapy (Hammond, 2007; Treadwell, Dartnell, Travaglini, Staats, & Devinney, 2016; Treadwell, 2020), Freudian psychoanalysis (Brown, 2007; Cortes, 2016), Jungian psychology (Gasseau & Scategni, 2007), object relations theory (Holmes, 2015), positive psychology (Tomasulo, 2011), 12-step and addiction frameworks (Dayton, 2005; Giacomucci, 2017, 2020a; Giacomucci, Gera, Briggs, & Bass, 2018; Miller, 2007), trauma therapy (Dayton, 2005, 2015; Giacomucci & Marquit, 2020; Hudgins, 2017; Hudgins & Toscani, 2013; Kellermann & Hudgins, 2000), attachment theory (Baim, 2007), drama therapy (Casson, 2007; Landy, 2017), family systems therapy (Anderson & Carnabucci, 2011; Chimera, 2007; Gershoni, 2003), EMDR therapy (Bradshaw-Tauvon, 2007), music therapy (Moreno, 1999), and art therapy (Peterson, 2003). In the same way, foundational social work theories can be integrated with psychodrama practice. Bitel (2000) writes, “Social group work is an arena for boundless creativity . In viewing the group work setting as a stage for the creation of countless stories, dramas, struggles, and resolutions, the social group worker becomes an artist in her own medium” (p. 79).

This section outlines the core of Morenean philosophy which is essential understanding prior to engaging with his methods of sociometry and psychodrama. Moreno had mixed feelings about his methods being adapted into the mainstream culture , while his philosophy was neglected. Zerka Moreno writes in 1969:

Substitute theories are false and misleading as they abrogate or abort the complete execution of the methods. Moreno’s position was therefore “take my ideas, my concepts, but do not separate them from their parent, the philosophy; do not split my children in half, like a Solomonic judgment, love them in toto, support and respect the entire structure upon which they rest.” (p. 5)

2 Human Nature, Cosmic Man, and the Godhead

Moreno’s philosophy is essentially an existentialist understanding of human nature and human’s place within the cosmos. Moreno was strongly influenced by Einstein’s inclusion of God consciousness into his mathematical and scientific understandings of the world. Morenean philosophy argues that humans are not only biological, psychological, and social creatures, but also cosmic creatures. Moreno’s conceptualizations of forces that influence humans go beyond psychodynamics and sociodynamics to include cosmodynamics (von Ameln & Becker-Ebel, 2020). He declared “every man is a genius ”—there are only geniuses (Moreno, 2019, p. 12). Moreno’s newly published Autobiography of a Genius title may sound egotistic and grandiose; however, his intent is to elevate everyone to experiencing themselves and everyone around them as a geniuses.

In declaring the essential nature of the genius , Jacob Levy Moreno declares that you are a genius – that all humans are genius. He calls upon all human beings to recognize their creative genius and co-create a better world. This call to action comes at a pivotal time in the history of our world: will we survive? (Schreiber, Kelley, & Giacomucci, 2019, pp. 9–10)

Moreno’s attempts to empower human’s sense of self did not start with the exclamation that everyone is a genius . He began with the even bolder statement the Godhead is within each person.

His early work prior to immigrating to the United States was essentially spiritually and existentially oriented. He was deeply influenced by world religions, saints, Jesus, the Buddha, his family’s Jewish heritage, and his mother’s spirituality. His idea of a healer was closely related to Jesus, a traveling mystic who goes to meet the people where they are, rather than a doctor psychoanalyzing a patient on a couch. In Who Shall Survive? he writes:

I did not think that a great healer and therapist would look and act the way Wagner or Freud did. I visualized the healer as a spontaneous-creative protagonist in the midst of the group. My concept of the physician as a healer, and that of theirs were very far apart. To my mind, persons like Jesus, Buddha, Socrates, and Ghandi were doctors and healers; for Freud they were probably patients. (1953, p. xxvii)

In studying the evolution of the concept of God, he provided a new evolution of understanding the Godhead . He highlights that the Old Testament concept of God was a distant and invisible deity (“He-God”), and that the New Testament God was human, loving and present (“Thou-God”). He declared the only natural evolution of the God idea to be an understanding of humans as God (“I-God”) (Moreno, 1921, 2019). His early work culminated with a 1921 publication titled The Words of the Father , which outlined his spiritual views. Moreno attempted to put these views into action by treating everyone as if they were God and possessed the same divinity and capacity for creativity . While some may be deterred by his spiritual views, essentially, he elevated the dignity and worth of each human being to the forefront of his philosophical system and approach to societal problems.

In addition to seeing every human as God, Moreno also wrote of a Godhead , the ultimate creator. He writes that his fascination with God began in his childhood—leading to what he described as his first psychodrama at age 4 when he and his friends began to enact a heavenly scene with Moreno in the role of God. Later as a young adult, Moreno could be found encouraging other children in the parks of Vienna to role-play as God through impromptu play and drama. Moreno repeatedly suggests to his readers that his sociometric and psychodramatic systems cannot be fully understood without first understanding his spiritual views. “I had envisioned the Godhead as the Protagonist of the Universe and made the first sociogram , the sociogram of the Godhead.” (Moreno, 2019, p. 174).

I tried the sociometric system first on the cosmos. God was a super sociometrist. The genesis of sociometry was the metric universe of God's creation, the science of “theometry”. What I know of sociometry I learned first from my speculations and experiments on a religious and axiological plane. (Moreno, 2019, p. 28)

In these quotes from his autobiography, we can see the influence of his spirituality on the development of his thinking about sociometry and society. He goes on to say that in addition to sociometry, “the genesis of psychodrama was closely related to the genesis of the Godhead ” (Moreno, 2019, p. 25). The impact of his philosophy of human nature and the universe is inseparable from the methods of sociometry and psychodrama. Zerka Moreno, in her memoir To Dream Again, echoes J. L.’s philosophical view when stating, “our instruments are basically spiritual and existential, pointing to and supporting the value of the human spirit” (2012, p. 515). She goes on to indicate that “we are more than biological, economical, sociological, or psychological creatures, that we are first of all cosmic beings” (2012, p. 40). And, “instead of looking at mankind as a fallen being, everyone is a potential genius and like the Supreme Being, co-responsible for all of mankind” (Moreno, 2012, p. 295).

The conceptualization of all people as Gods or geniuses requires a stance that all people are co-responsible and capable of contributing to the enhancement of the world. Moreno thought of humans as auxiliary egos for God and his work in the cosmos—“there is so much misery and suffering in the world, even God seems unable to heal it all alone, so we must share responsibility.” (Moreno, 1989, p. 6) Moreno, in the final section of his autobiography describes the cosmic man as:

A man who is warmed up to himself - to act in accordance with his own moods or designs, unwilling to act by any other law beside his inner voice. He is an individual who is close to all beings, not really apart from them but with them and within them, involved with all men, animals and plants. He believes himself to be a part of the universe and not a member of a family or clan. Everyone is a brother or partner to him, - he does not make any distinction between rich or poor, black or white, man or woman. Everyone is his friend and he wants to help everybody. (2019, p. 339)

Many parallels can be drawn between this description of the cosmic man and a description of a social worker who inherently is motivated to speak difficult truths, to treat all as equals, to prevent injustice and discrimination based on difference, and to help as many people as possible.

3 The Encounter Symbol and Autonomous Healing Center

Moreno described the presence of a first universe “which contains all beings and in which all events are sacred” (Moreno, 2019, p. 27) as opposed to the second universe of form, space, and time. It is at the encounter of these two universes that the human being exists (see Fig. 4.2). His philosophy suggests that there is “primordial nature which is immortal and returns afresh with every generation,” (Moreno, 2019, p. 27) that the spirit or soul of an infant emerges from the first universe into the second universe through the birth experience. He describes the first few years of an infant’s life as existing within the matrix of identity where no sense of self is realized and the infant is one with all (Moreno, 1953). Through the course of socialization and psychosocial development, humans become more integrated within the second universe while experiencing glimpses of the first universe or cosmic reality. Moreno envisioned the surplus reality of psychodrama as an avenue for accessing and living within the first universe and that upon death one returns to this first universe (Moreno, 2012).

Fig. 4.2
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The encounter model

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In Morenean philosophy , this component of human nature is called the autonomous healing center . The Morenos described the activation of one’s autonomous healing center as a process that happens quietly within the body, deep within the self, and that it is initiated through action not mere words (Moreno, 2012). Zerka later states explicitly that the intention of all forms of therapy should be to help the client tap into their autonomous healing center and find their own path (2012).

Just as each individual is seen as containing an autonomous healing center , the Godhead within, Moreno also believed every group, community, and even society itself to have an autonomous healing center within and the capacity to heal itself if accessed. All of Moreno’s group methods and instruments are mutual aid processes focused on cultivating the power of group members healing and helping each other—or in other words, the group accessing its autonomous healing center which exists within the interpersonal sociometry and collective consciousness of the group (Giacomucci, 2019).

How would our work look if we treated each human as God with the capacity to heal themselves and each group as already possessing everything it needs to self-heal?

The role demand and expectation that this belief puts on others empower them to access their spontaneity and creativity to heal themselves and resolve their own problems. This is essentially the role of the social worker and the role of the psychodramatist.

4 Spontaneity–Creativity Theory

J. L. Moreno ’s spontaneity –creativity theory is the theory of change within Morenean philosophy and psychodrama as a therapeutic approach. Prior to his medical training, Moreno studied theology and philosophy with the intent of developing a religion (see the Religion of Encounter in Nolte, 2014) and was described by many as a mystic. In defining his concept of the Godhead , he described its most defining quality as the function as creator—its creativity. Thus, he believed that the ability to create something new—art, music, an idea, a new response, a child—was inherently godlike (Moreno, 1921, 2019). At the same time, Moreno suggested that as a culture we overemphasized the products of creation without giving attention to the process of the creative act itself. He believed both spontaneity and creativity to be foremost spiritual qualities and emphasized the ‘godlikeness’ of all humans (Moreno, 2019). He writes that “spontaneity is the constant companion of creativity. It is the existential factor ‘intervening’ for creative processes to be released” (1956, p. 103). For Moreno, the twin principles of spontaneity–creativity are the ultimate force underpinning all human progress and all human activity (Nolte, 2014). He defined spontaneity as the ability to “respond with some degree of adequacy to a new situation or with some degree of novelty to an old situation” (Moreno, 1964, p xii).

He also identified “forms of pathological spontaneity that distort perceptions, dissociate the enactment of roles, and interfere with their integration on the various levels of living” (Moreno, 1964, p. xii); one might think of pathological spontaneity as a novel response without adequacy (Dayton, 2005). He believed that emotional or psychological problems were either related to a lack of healthy spontaneity or some type of pathological spontaneity. Furthermore, he observed that anxiety and spontaneity are inversely proportional in that as one increases, the other decreases—“Anxiety sets in because there is spontaneity missing, not because ‘there is anxiety’, and spontaneity dwindles because anxiety rises” (1953, p. 337). This observation was later confirmed through quantitative research on panic disorder and spontaneity (Tarashoeva, Marinova-Djambazova, & Kojuharov, 2017).

Interestingly, Daniel Siegel ’s definition of health and wellness seems to reflect Moreno’s spontaneity theory decades later. Siegel suggests that all mental illness and social dysfunction are a result of too much chaos or too much rigidity—and that a state of health exists at the balance between these two extremes (Siegel, 2010). In Morenean philosophy , chaos is a function of pathological spontaneity , and rigidity is a function of the lack of spontaneity. Moreno argues that spontaneity is essentially an indicator of health and the ability to respond with competence.

J. L. Moreno described the warming up process as essential for the generation of spontaneity —“spontaneity is generated in action whenever an organism is found in the process of warming-up” (1956, p. 110). While spontaneity is associated with the readiness of the creative act, creativity is associated with the act itself. The created product, after the moment it is produced, is no longer spontaneous; this is referred to as a cultural conserve . J. L. Moreno developed a visual chart, the Canon of Creativity (1953) to visualize the creative process and depict his theory of spontaneity–creativity (see Fig. 4.3). It is through this process that all intrapsychic, interpersonal, and social change takes place.

Fig. 4.3
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Canon of creativity, depicting the warming up process and the relationship between spontaneity, creativity, and the cultural conserve

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5 The Moment, the Situation, and the Here-and-Now

Moreno emphasized the here-and-now and the sacredness of the moment. Action, spontaneity , and creativity are only accessible in the here-and-now. The present moment has a different type of quality and is the bridge between the past and the future. Moreno’s philosophy considers the past as “memory-in-the-moment of past experiences” and the future as “here and now anticipation-in-the-moment of what might be eventually experienced” (Nolte, 2020, p. 131). The present is a transition between past and future. When spontaneity and creativity are accessed in the present, new dynamic meaning is created which transforms the present into a moment (Moreno & Moreno, 1969). In psychodrama, the protagonist puts a scene into action in the here-and-now as if it was currently happening. The protagonist’s subjective truth is honored and enacted on the psychodrama stage. Zerka Moreno notes that the concretization of an old event in the here-and-now of psychodrama allows one to find a new truth from an old event (1994).

Moreno’s existential philosophy positions each moment and each situation as an opportunity for change through spontaneity and creative action. In this way, each human is an initiator, a creator, and an active agent in the world rather than a victim of predeterminism. Psychodrama provides one with the opportunity to revisit moments of the past and enact another possibility; or to fast forward time in the here-and-now to experience a moment yet to come. Psychodrama allows one to become unchained from their reality and experience the freedom of creating a new drama through surplus reality (Moreno, 1946).

At first sight it looks as if the psychodramatic function and the reality function would exclude one another. This is in fact only an outward appearance, the stage is not a stage in a theatrical sense, it is a social platform, the actors are not actors but actual people and they do not “act” but present their own selves. (Moreno, 1943, p. 333)

Human beings are fundamentally meaning makers—psychodrama is used to explore, deconstruct, and construct meaning through the creative process in action (Oudijk, 2007). Moreno operated from a postmodern framework as evidenced by psychodrama’s emphasis on the perspective of the protagonist (Blatner, 2000). In enacting a psychodrama scene, the protagonist portrays the scene, the roles, and the action from their perspective—Moreno even held to this principle when working with psychotic and schizophrenic patients providing them with a space to literally act out their fantasies and realities. He emphasized the importance of meeting the client where they were at and in the here-and-now .

6 Action Theory

J.L. Moreno believed that we were all improvising actors in the play of life that each human was an auxiliary ego for one another (Moreno, 2013). He integrated aspects of theater to create psychodrama, believing that “what was learned in action, must be unlearned in action” (Dayton, 2005, p. xxvii). The very term psychodrama means “Psyche in action” (Carnabucci, 2014). He believed in the power of action to create change and challenged Freud ’s “talking cure”. In encountering Freud at the University of Vienna, J. L. Moreno exclaimed:

Dr. Freud , I start where you leave off. You meet people in the artificial setting of your office. I meet them on the street and in their homes, in their natural surroundings. You analyzed their dreams; I try to give them courage to dream again. (J. L. Moreno, Z. T. Moreno, & J. D. Moreno, 1964, pp. 16–17).

Psychodrama is one of the first body-oriented forms of psychotherapy, moving beyond just words and narrative (Carnabucci & Ciotola, 2013). J. L. Moreno ’s action theory rests on the idea that talking alone severely limits the client–therapists’ ability to explore an issue or produce change. “However important verbal behavior is, the act is prior to the word and ‘includes’ it” (Moreno, 1955, p. 17). Zerka Moreno later states that “even when interpretation is given, action is primary. There can be no interpretation without previous action” (1965, p. 77).

Neuroscience research has demonstrated that we are “beings of action and the stories of our lives are literally written on our neural systems” (Dayton, 2005, p. 55). It has been declared by the neuroscientists thast experience changes the brain and has the corrective potential to reverse the impact of previous adverse experiences (Cozolino, 2014; Siegel, 2012). The surplus reality of psychodrama offers possibilities for corrective emotional experiences that would have been otherwise impossible (Giacomucci, 2018c; Giacomucci & Stone, 2019).

Action theory is complimentary with experiential learning theories which have become embedded within social work education . Experiential education proposes an embodied learning experience where the teaching content is interfaced with in action rather than simply talked about. Moreno was inspired by John Dewey , the father of experiential education , and even proposed his own Spontaneity Theory of Learning (1949) which emphasized spontaneity training in education rather than memorizing facts or information. Moreno’s action-based education ideas reflect those of Freire (2013), as well as Kolb & Kolb who describe the approach as “an integrative approach to learning that balances feeling, thinking, acting and reflecting” (Kolb & Kolb, 2005, p. 200). Social work education describes its signature pedagogy as the field placement experience which is essentially an experiential learning structure emphasizing role training (Giacomucci, 2019).

7 Role Theory

Moreno’s theory of personality is based on role theory (Telias, 2018). The term role does not originate from sociology , psychology , or psychiatry , but instead comes from the theater . In ancient Greek and Roman drama productions, an actor’s character or lines would often be written on “rolls” and memorized. J. L. Moreno claims that role theory transcended the limitations of psychoanalysis and behaviorism with a systematic exploration of social phenomenon, thus serving as a major bridge between psychiatry and the social sciences (1961). The concept of the role integrates cognitive, affective, and behavioral states for simple categorization (Buchanan, 1984) while demystifying psychiatric labels and connecting them with the client’s experience of self (Hudgins, 2002).

J. L. Moreno viewed each human being as a role-player (Fox, 1987). He states that the self, or the personality, is composed of all the roles that one plays in their life—“roles do not emerge from the self, but the self emerges from roles” (1953, p. 76). He outlines three categories of roles—somatic, psychodramatic, and social roles . Somatic roles develop first, in the preverbal stages of life, and represent physical or bodily aspects of the self—including eater, breather, sleeper, crawler, etc. Later, psychodramatic and social roles develop—but all three types of roles are intimately connected. Psychodramatic roles , or roles played out in the psyche, represent the internal dimensions of the self—the thinker, feeler, fantasizer, dreamer, etc. And, finally social roles , which are embedded within a cultural context, are the roles that we hold in relationship to others and society, such as father, sister, teacher, and student. (Moreno, 1934). Moreno writes that the collection of all of one’s somatic or physiological roles equals their somatic or physiological self. Similarly, the cluster of all of one’s psychodramatic roles and social roles represent their psychodramatic self and social self. These three clusters of roles allow an individual to fully experience their body, psyche, and society (Moreno, 1972).

Operational and contact links must gradually develop between the social, the psychological, the physiological role clusters in order that we can identify and experience after their unification, that which we call the “me” or the “I”… Body, psyche, and society are then the intermediary parts of the entire self. (Moreno, 1972, p. III–IV)

In this way, Moreno’s role theory is inherently a biopsychosocial-spiritual conceptualization of self which fits nicely within the social work philosophy framing an individual within a larger social context.

Furthermore, he outlines three stages of role-development , beginning with role-taking or role training . In this phase, an individual is learning a new role and the process of stepping into the role including working through any ambivalence about the role and connecting with role models. Once a culturally conserved role is learned, it is role-played. During the role-playing stage of development, an individual starts to naturally bring parts of themselves to the role. The final stage of development is that of role creation , which describes the process of transforming the once learned role into a new, unique role (Dayton, 2005). This process of role creation or role transformation often bring one back to the role-taking stage as they learn to hold the newly created role.

Role theory proposes that an individual with a wide role repertoire, or the ability to adequately transition to diverse roles based on the situational context (spontaneity ) will demonstrate healthy personality and social functioning (Fox, 1987). Role theory provides a non-pathologizing alternative to traditional theories of personality and psychopathology. For example, J. L. Moreno conceptualized regression as a type of role-playing :

In a paranoiac behavior, the repertory of roles is reduced to distorted acting in a single role. The deviate is unable to carry out a role in situ. He either overplays or underplays the part; inadequate perception is combined with distorted enactment. Histrionic neurosis of actors is due to the intervention of role fragments “alien” to the role personality of the actor. (1961, p. 521)

This passage points to his understanding of roles as being in ascendance or descendance based on how much, or how little, one has developed the role and how accessible the role is to the ego. “The ego must have roles in which to operate” (Hale, 1981, p. 8).

As role-players, we do not exist in social isolation—instead, each of our roles develops and exists in relationship with others. Roles are linked to counter-roles demonstrating the phenomenon of role reciprocity . “There are no parents without children, no teachers without students, no therapists without clients, no slaves without masters, etc. In other words, we are all inter-actors with one another” (Moreno, 2013, p. 38). Role reciprocity emphasizes the person-in-environment perspective by conceptualizing roles, or aspects of self, as inherently in relation to others. In a future Sect. (5.4), the cultural atom will be presented as a diagram of role relationships between an individual and their social circle.

8 Developmental Theory

Moreno’s philosophy includes its own unique developmental theory and stages of development which reflect and guide the interventions used in a psychodrama enactment. The developmental theory is intricately linked to Morenean philosophy of human nature and the cosmic man—this link is explicit in article 27 of the Quintessential Zerka titled The Eight Stages of Cosmic Being in Terms of Capacity and Need to Double and Role Reverse (2006). As noted previously, Moreno suggested that an infant is given birth into this world from the first universe and exists in a state of undifferentiated identity. In the first few weeks after birth, infants live within the matrix of identity during which they experience themselves as one with not only their mothers, but all objects and their surroundings (1952). Through appropriate doubling , mirroring , and role reversal , the child develops a sense of self and a sense of others.

Doubling is the first stage of J. L. Moreno ’s psychodramatic development theory . Zerka Moreno (2006) indicates that doubling is essential to healthy attachment in that the caregivers put words to what is unspoken and unlabeled for the non-verbal infant (as cited in Hudgins & Toscani, 2013). In this developmental stage, doubling creates a holding environment for the infant (or client) to feel seen and understood from the inside out (Dayton, 2005). This stage of development is characterized by the significance of attachment between infant and caregiver(s) and sets the framework for the infant’s ability to self-regulate in the future (Cozolino, 2014). Dayton outlines the importance of attachment from J. L. Moreno ’s developmental theory in the following passage:

If the parent is an attuned ‘double’ for the child’s experience, the child feels a sense of place and belonging. If, on the other hand, she leaves the infant to a world without doubling , the child may feel that he is incomprehensible to others and a sort of fissure may occur within the self due to feeling misunderstood or out of sync with his external representations of self since, from a child’s point of view, parents and some siblings are part of his own self. (2005, p. 161)

In this first developmental stage, doubling is essential for the healthy formation of identity. If the mother’s attempts to double and meet the needs of the infant are inaccurate, the infant will surely let her know through non-verbal communication. In a similar way, the protagonist will correct inaccurate doubling statements from other group members—thus strengthening their ego identity. The double intervention, or role, in a psychodrama helps with the exploration of the inner reality of the protagonist and serves as a bridge between the director and protagonist (Hudgins & Toscani, 2013; Moreno, 2006).

Developmentally speaking, the mirror stage is when the child begins to recognize himself as a separate individual (Moreno, 1952). This stage, which starts around nine months of age, includes the infant’s capacity for “joint attention” and “secondary intersubjectivity” (Dayton, 2005). The infant is now able to shift attention between person and object by aligning their visual attention with their caregiver’s, thus beginning to develop awareness of a shared, but separate experience (Hobson, 1989; Trevarthen, 1998). This is, as Dayton states: “the dawning of an awareness of self as differentiated from the world outside the self” (2005, p. 163).

Moreno’s developmental theory outlines role reversal as the third phase. One does not have the ability to reverse roles until they have first established a basic sense of self. An infant in a previous stage of development, before about the age of two or three, will not have this capacity, though most adults do (Moreno, et al., 1955). J. L., Zerka , and Jonathan Moreno published an article about the use of role reversal to aid in raising a child and emphasizing its therapeutic potential. Role reversal resembles the process of separation and individualization outlined by Mahler, Pine, and Bergman (1975). This stage of development represents a true sense of separateness and the ability to empathize with others. It is a state of intersubjectivity, being in relationship with dual awareness of one’s self and the other within a dynamic relationship (Dayton, 2005). “In role reversal the sense of self is intact enough so that we can temporarily leave it, stand in the shoes of another, and return safely home” (Dayton, 2005, p. 439). Through psychologically role reversing with others, the child develops a greater responsibility for their actions, for their self, and enhances their capacity for empathy with others in the social world.

As the child progresses into adulthood, the parent continues to double and role reverse with them to achieve separation and independence. The adult child then becomes an auxiliary for the aging parent who is declining in health and preparing to reenter the cosmos (Moreno, 2006). Now, the caregiver roles have reversed, and the adult child is doubling and role reversing the parent as they live out their final years in the second universe and fully transition back into the first universe.

9 Biopsychosocial-Spiritual Existence

Most credit the development of the biopsychosocial approach to George Engel in the late 1970s. Nevertheless, Moreno had written of the biopsychosocial contexts of individual experience, relationships, and society decades prior in Who Shall Survive? (1953). In discussing his sociometric system and the distribution of choice, preference, and connection within groups, he writes: “these attractions and repulsions must be related to an index of biological, social, and psychological facts” (1953, p. 611). While traditional conceptualizations of human nature place the psyche within the body, Moreno argues that the psyche exists outside of the body.

The biological picture of an individual places the psyche within the body (as an epi phenomenon). In the sociometric picture of the individual (person), the psyche appears as outside the body, the body is surrounded by the psyche and the psyche is surrounded by and interwoven into the social and cultural atoms. (Moreno, 1943, p. 319)

He argues that the traditional perspective is that feelings emerge within the individual organism and are projected toward others in the social environment. His conceptualization of human beings challenges this idea and instead suggests that the psyche largely emerges and is influenced by social relationships and social forces. Figure 4.4 depicts the interconnectedness of body, psyche, social, and cultural in Moreno’s philosophy. The direction of influence travels from the larger culture and social forces to the interpersonal relations which impact the development of the psyche and the body. The same image depicts the direction of influence for cultural change beginning within the body moving to the psyche and relational to impact the larger social and cultural structure. This framework (see Fig. 4.4), outlining the relationships between the body, psyche, social, and cultural, makes clear the necessity of involving the body in the therapeutic process.

Fig. 4.4
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Sociometric concept depicting the body within the psyche, social atom, and cultural atom

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Modern neuroscience offers us further insight into the potential of understanding the body as engulfed within the psyche. The work of Bessel van der Kolk (2014), Levine (2010), Perry (2006), and Cozolino (2014) point to the significant impact of psychological and relational trauma upon the body and the nervous system. We now know that psychological trauma and relational adversity, especially in childhood, creates lasting imprints in non-verbal and primal parts of the body and brain. The trauma healing process in most contemporary trauma therapies involves the body within the intervention as an essential vehicle for creating psychological and relational change. The field of interpersonal neurobiology highlights the interdependence of brain, psyche, and social relationships especially as it relates to the developing brain. Moreno’s role theory even explicitly articulates the presence of a physiological self, psychodramatic self, and social self (1972). Previously accepted psychotherapy approaches focused solely on healing the psyche and isolating the mind from the body, the social, and the cultural—most would accept this way of working as faulty today. It is fitting to credit the social work profession for promoting an understanding of the psyche–social–cultural influence as it relates to the core values of social justice and the centrality of relationships.

There is more unknown than known when it comes to the brain–mind relationship and thus the body–psyche relationship. New neuroscience findings give us an enhanced, but still incomplete, understanding of the entire picture. In future decades, our knowledge of the position of the body and the psyche will become more evident and clearer. Most recently, Wang and Liu (2020) published an article in a Chinese social work journal emphasizing the complimentary nature between social work with Moreno’s emphasis on (1) the goodness of each person, (2) the importance of relationships , and (3) the structure of society.

10 Social Work Values Relationship to Moreno’s Work

Social work philosophy and Morenean philosophy have many shared values and elements. The field of social work upholds six distinct core values—importance of relationships , dignity and worth of each human being, social justice , service, competence, and integrity (see Fig. 4.5). These six social work values are echoed throughout the body of Moreno’s work, his philosophy, and his 1957 Code of Ethics of Group Psychotherapists.

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Social work core values

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11 The Importance and Centrality of Relationships

This is a shared core value that makes both social work and Moreno’s work unique. This core value was key for social work’s differentiation process in relation to the field of psychology . While the psychologists were more focused on the individual and the internal drives, feelings, and thoughts of the individual, social work positioned itself emphasizing the relationships of the individual within their social environment. Similarly, Morenean philosophy developed with emphasis on the sociodynamics of interpersonal relationships, in opposition to psychoanalysis which was oriented on the individual’s psychodynamics. Truedley (1944) goes as far as writing that psychodrama “often does succeed in treating the relationship rather than the individual” (p. 171).

While the traditional psychologist conducts Rorschach tests and diagnostic assessments, the social worker assists the client in drawing genograms and ecomaps, and the psychodramatist facilitates the production of social atoms , sociograms , and role diagrams. The differences in assessment tools utilized between from the start of treatment demonstrate the philosophical variations between fields. The social worker and psychodramatist are assessing the person in their environment because of the fields’ philosophical emphasis and value of relationships. The fact that the development of the social atom assessment (Moreno, 1934) preceded the emergence of the genogram and ecomap in the 1970s-80s (Hartman, 1978; McGoldrick, Gerson, & Petry, 2008) has caused some to argue that Moreno’s work had a larger influence than he is given credit for. Schwinger (2016) highlights the social atom as a useful tool for the field of social work. While the psychologist and analyst exclusively met with clients in their offices, social workers and psychodramatists emphasized the importance of meeting clients within their communities and neighborhoods.

The therapeutic relationship occupies a central component in social work philosophy , while psychology and psychoanalysis place less emphasis on use of self and the here-and-now relationship in the office. Psychoanalysis and psychology seem to emphasize the therapeutic relationship as it relates to transference and projection much less than the here-and-now relational experience. Psychodrama and sociometry are inherently here-and-now approaches in that even when the past is being explored, it is often done so through enactments where everyone acts as if it were happening in the here-and-now. The social worker and the psychodramatist seem much more likely to utilize self-disclosure and use of self than a traditional psychoanalyst or psychologist. Moreno advocates for the importance of the therapeutic relationship in the following quote, “I believe that the doctor's warmth and caring, the touch of his hand, his compassion for his patients are the most decisive elements in a doctor's success or failure in treating people” (2019, p. 238).

The importance of relationships is also considered from a macro and mezzoapproach in social work and Morenean philosophy in that both also concern themselves with a larger picture of social groupings, social networks , and society (Giacomucci, 2018a, b). Social work often uses the language of micro, mezzo, and macro to describe its attentions to clinical work (micro), group work (mezzo), and community work (macro). Similarly, Moreno’s triadic and sociatric system attends to each level in that psychodrama enacts an individual’s experience (micro), group psychotherapy is group work (mezzo), and sociometry and sociatry offer approaches to community work and society (macro). The attention given to each of these three domains is unique to social work and Moreno’s methods. The psychology and counseling fields have integrated more focus on relationships in contemporary times; however, they remain almost entirely micro/mezzoapproaches in that they are only concerned with the impact of society and social forces upon their clients. Other macrophilosophies exist in sociology , anthropology, and philosophy; however, they remain overly focused on society at the macrolevel without intervention at the micro or mezzospheres. Both social work and Morenean philosophies integrate micro, mezzo, and macroperspectives as they take into consideration the impact of society on the individual clients they treat while also concerning themselves with intervening and creating change on a larger societal level. Blatner (2000) writes that Moreno saw individual and social psychology as inseparable and that healing had to be oriented not only at “those in the ‘sick role’ but equally to the cultural matrix which often revealed its own pathological features” (p. 77). Few other fields are driven by philosophies as encompassing and integrative as social work and Morenean philosophy.

In addition to the macro and microconnections, social work and Morenean philosophies place much more emphasis on the mezzoaspect of group work than other fields. As noted previously (see Sect. 2.2), mainstream group work essentially aligned itself with the social work profession (Andrews, 2001; Trecker, 1944). Although social work’s emphasis on group work has declined tremendously, some graduate social work degree programs offer concentrations in group work, unlike master’s degrees of psychology , counseling , or marriage and family therapy . Moreno’s philosophy embedded within his triadic system of sociometry, psychodrama, and group psychotherapy which explicitly aligns itself with group work.

Moreno’s philosophy of group work perceives each group member to possess therapeutic power and agency—the ability to contribute to the healing of other group members. Social workers refer to this as mutual aid (Northen & Kurland, 2001; Steinberg, 2010). Moreno’s Code of Ethics for Group Psychotherapists (1957) suggests that because not only the physician has therapeutic agency, but that it resides with each group member—that the Hippocratic Oath extends to each group participant. He writes specifically in terms of each participant upholding the ethical principles of confidentiality, do no harm , and contributing to the welfare of the group. This principle within his code of ethics formalizes and concretizes commitments to the centrality of mutual aid relationships, dismantling the power dynamic within the therapist–patient relationship, and honoring the dignity and worth of each human being.

11.1 Dignity and Worth of Each Human Being

Unique to both social work with groups and psychodrama is the emphasis on mutual aid (Giacomucci, 2019, 2020b). For both social group workers and psychodramatists, the goal of the facilitator is to help participants to support, heal, and educate each other. Other fields implicitly emphasize the therapeutic power of the professional, while social workers and psychodramatists explicitly emphasize the therapeutic potential within each group member. The mutual aid approach cannot operate without placing considerable value in each individual’s strengths, dignity, and worth.

Both fields began with a focus entirely on working with the most oppressed, stigmatized, and vulnerable populations; in doing so, they demonstrated their value of acknowledging and enhancing the recognized worth and dignity of each person regardless of their race, ethnicity, culture, country of origin, religion, gender, sexuality, social status, physical ability, finances, and other histories. Social workers advocate for society’s outcasts and underserved, believing in their inherent worth. Moreno went as far as elevating the dignity and worth of each person to that of a potential genius with the Godhead within (2019). Psychodrama’s emphasis on helping a client access their autonomous healing center is based on the belief that each individual has the power and capacity to solve their own problems and heal themselves. Moreno’s (1957) code of ethics states that group psychotherapists are expected “to render service to groups of patients with full respect for the dignity of every patient” (p. 143).

Empowerment is an unspoken value that social workers and psychodramatists demonstrate through their work based on their faith in the worth of others. Both fields, though forced to work within the medicalized mental health industry, attempt to avoid and even challenge pathologizing norms and practices. The valued dignity and worth of each person is strongly related to social work’s commitment to social justice .

11.2 Social Justice

Some argue that this is the value that significantly differentiates social workers from other mental health practitioners, including psychologists, counselors, and marriage and family therapists. Social workers attempt to avoid falling into the trap of only helping their clients adjust to social injustice and instead work to change unjust policies and systems that are causing many of the interpersonal and psychological problems that clients present with. The NASW Code of Ethics states that “Social workers are cognizant of their dual responsibility to clients and to the broader society” (2017, p. 6). Jacob Moreno , originally trained as a psychiatrist, developed a socially just vision of Sociatry —or “healing for society” (Moreno, 2019). He wrote that “a truly therapeutic procedure must have no less objective than the whole of mankind” (Moreno, 1953, p. 1)—suggesting that seeing clients in an individual or group setting was not enough. Moreno envisioned a therapeutic society and worked to create tools that had the potential for societal change including using the theater , radio, film, and music.

J. L. Moreno ’s own experiences as a Jewish man, a refugee in Europe, and an immigrant to the United States likely impacted his sense of social justice . He writes in his autobiography about how the discrimination he experienced as a Jew influenced him to create his own professional society. Moreno, along with his colleagues, developed Ethnodrama as an approach to resolving ethnic problems. Moreno’s methods are inherently aligned with social constructionism and postmodern theory in that they consider the client and the group to be the experts of their experience. Rather than attempt to convince others of an objective reality or truth, the psychodramatist puts into action the subjective truth of the protagonist or the collective truth of the group. Heinonen, Halonen, and Krahn (2018) note that, “As social workers (or representatives of any other professional discipline), expressive artforms such as psychodrama can also support us in deconstructing our own cultural location and its historical legacies, which may be unconsciously influencing our relationships with others” (p. 14). Through the integration of anti-oppressive frameworks and psychodrama, Nieto (2010) proposes a new approach to practice in an anti-oppressive and culturally-informed way.

Moreno’s methods have been absorbed into community work , community organizing , social activism, and cultural diversity work (see Chaps. 18 and 19). Many community organizers and activists use sociometry processes such as the spectrogram, step-in sociometry , and locograms, as well as role-playing techniques or simulations to empower the communities that they work with or promote social change. Some of this integration may have been influenced by Boal’s Theater of the Oppressed (1985) or Playback Theater (Salas, 1993) both of which emphasize a social justice approach and share considerable philosophical and practical overlap with z’s work (Landy, 2008) (see Sects. 15.5.2 and 15.5.3). Interestingly, it seems that psychodramatists in the United States are, as a whole, more focused on therapeutic applications while psychodramatists of other countries are also oriented on social justice and community applications.

Social group workers are expected to use a social justice framework to contextualize their group work experience and create a fair and just group experience for each participant. Similarly, Moreno writes in his code of ethics for group psychotherapists that “therapeutic groups should be so organized that they represent a model of democratic behavior. Regardless of the economic, racial, and religious differences of the patients they should be given “equality of status” inside the therapeutic group” (1957, p. 143). Without this objective, our groups will simply reenact the systems of oppression, discrimination, privilege, and social injustice that exist within the larger society because of the sociodynamic effect. From a Morenean perspective, group workers are expected to prioritize the active reversal of the sociodynamic effect within the groups they facilitate. Both social workers and psychodramatists emphasize their role as being of service to individuals, groups, communities, and society (Niepenberg, 2017).

11.3 Service

The NASW Code of Ethics describes the core value of service stating “social workers’ primary goal is to help people in need and to address social problems” (2017, p. 5). Many social workers provide psychotherapy and operate as therapists—a word that has ancient Greek etymological roots meaning “service” (Wronka, 2016). Being in service to individuals and to society is an explicit mission of all social workers. Social workers provide services in a variety of contexts including psychotherapy services, child and family services, government services, military services, prison services, medical services, case management services, organizational services, educational services, research services, social services, and policy services. The social worker is one who is in service to individuals, groups, families, organizations, communities, and society. Similarly, Moreno writes that.

“the world at large needed a doctor more urgently than the sickest individual… I began to think in earnest that I had a special mission, that there was an important service to be rendered to the world, and that there was no reason why I shouldn't undertake that mission. (2019, p. 233)

Moreno challenges psychodramatists to be of service not only to their clients or groups, but also to the society as a whole—to be world therapists. Of all the professions, the field of social work is most closely related to the praxis of serving the world and operating as world therapists.

11.4 Competence

This core value dictates that social workers practice within their area of competence and training. The NASW Code of Ethics states “social workers practice within their areas of competence and develop and enhance their professional expertise” (2017, p. 7). In order to practice competently, one must be aware of their strengths and limitations, as well as personal issues that may impact professional competence.

Licensure and certification are designed to be stamps of competence for practitioners who have completed extensive training, supervision, and practice requirements. In the United States, the process of becoming a licensed clinical social worker takes several years between degree programs and post-graduate practice under supervision. Similarly, the American Board of Examiners in sociometry, psychodrama, and group psychotherapy offers certification after rigorous training, supervision, and practice. The entry level psychodrama certification requires a graduate degree, 780 training hours, a year of supervised practice, a written exam, and an on-site examination. These requirements generally take many years to fulfill which helps to ensure the competency of the practitioner.

Most social workers are expected to facilitate groups in their careers with little or no education in group work through their degree programs. The lack of group work training for social workers makes social workers’ level of competence in facilitating groups questionable. Pursuing training in sociometry, psychodrama, and group psychotherapy fills the gaps in group work competencies for social workers. In the past decade, it seems that the Council on Social Work Education has given more attention to the core value of competency by adopting a new “competency-based framework” for Education Policy and Accreditation Standards (EPAS) (CSWE , 2015). The new EPAS standards outline the nine social work competencies (see Fig. 4.6).

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Coucil on social work education’s (CSWE) nine competencies outlined in the educational policy and accreditation standards (EPAS)

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Competencies 6–9 focus on social workers’ relationships to “individuals, families, groups, organizations, and communities” through engagement (competency 6), assessment (competency 7), intervention (competency 8), and evaluation (competency 9). Unfortunately, there is little to no differentiation offered by the CSWE when it comes to each of these competencies and the differences between engaging (assessing, intervening, or evaluating) with individuals, families, groups, organizations, and communities. The knowledge, skills, and approaches to engaging individuals are quite different than those needed to engage groups or communities. It seems that the lack of differentiation between approaches to individual work and work with groups is perpetuated by the new CSWE EPAS. If we are to increase the group work competence level of social workers, we must differentiate individual work (psychodynamics) from group work (sociodynamics ). The practices of group-as-a-whole engagement, assessment, intervention, and evaluation simply require different knowledge, understanding, and competencies than working with individuals. Moreno’s (1957) code of ethics explicitly states that the designation group psychotherapist should not be used by anyone unless they have obtained specialized formal training in group therapy .

The ability to uphold social work’s value of competence requires one to demonstrate humility and an awareness of their scope of practice and the areas outside their scope of practice. Attempting to work outside the scope of one’s knowledge and skill set is a violation of this value and potentially harmful for clients. The value of competence is also closely related to social work’s final core value of integrity.

11.5 Integrity

Social workers are expected to uphold the core value of integrity in all that they do including working in a trustworthy manner. Interestingly, in Aristotle ’s philosophical system, integrity is presented as the glue that holds together all the other virtues or values (Banks, 2012). NASW Code of Ethics state that “social workers are continually aware of the profession's mission, values, ethical principles, and ethical standards and practice in a manner consistent with them” (2017, p. 6). Maintaining professional integrity requires a social worker to uphold the values and mission of the field.

Banks (2004) writes that “‘Integrity’ is literally about ‘wholeness’” and has multiple layers including moral integrity, professional integrity, personal integrity, and intellectual integrity (p. 22). Banks touch upon the idea of integrity for the social worker as being related to integrating a personal identity and professional identity with congruent values. For many, social work is a vocation or a calling which allows for unity between personal and professional life. In a similar way, Moreno hoped his methods would be experienced as a way of life rather than just a therapy practice (Moreno, 2012). The experiential learning process one undertakes to become certified as a psychodramatist requires extensive experience and participation in psychodramas. In order to become a psychodramatist, one is expected to engage in their own personal work through the experiential training process. For both the social worker and the psychodramatist, the personal and the professional are married.

11.6 Conclusion

Morenean philosophy and social work philosophy exist with considerable overlap. The emergence of both fields took place around the same historical time and in similar sociocultural contexts. Both philosophical systems are rooted in and influenced by postmodernism, social constructionism, and existentialism. The underlying philosophical framework of social work and Moreno’s methods provide a basis for understanding individuals, groups, and society. Moreno’s philosophy of human nature , mental illness, relationships, groups, and society have much in common with core social work philosophy . In both systems, the individual is conceptualized within their environment while considering biological, psychological, social, and cultural influences. Both systems are truly interdisciplinary or transdisciplinary in that their philosophies encompass psychology , sociology , anthropology, theology, and medicine. While Morenean and social work philosophies offer a framing of the nature of human problems, their theories offer strategies for action and intervention—which will be outlined in the following chapters.