Psychodrama and Social Work Theory

Abstract

This chapter includes an overview of foundational psychodrama theories—action theory, catharsis, and surplus reality. The three phases of a psychodrama group (warm-up, enactment, and sharing) and the five elements of a psychodrama (stage, protagonist, director, auxiliary egos, and audience/group) are described. Morenean philosophy and sociometric theory are revisited as they relate to psychodrama. The similar elements of psychodrama theory and social work are underlined including the importance of mutual aid, spontaneity, creativity, empowerment, self-determination, interpersonal skills, relationships, group stages, and roles.

Keywords

Many definitions of psychodrama have been proposed since its inception. Moreno offers a simple, though ambiguous, definition of psychodrama—“science which explores the ‘truth’ by dramatic methods” (1972, p. a). Moreno also has defined psychodrama as a theology (1921), a dramatic art form (1924), a socio-political system (1953), a method of psychotherapy (1946), and a philosophy of life (1955) (see Fig. 6.1). It seems that the experiential nature of psychodrama makes it difficult to describe adequately with words. Kellermann (1992) offers us a comprehensive definition of psychodrama:

Fig. 6.1

Jacob Moreno seated on the psychodrama stage. Reprinted with permission from Figusch, 2014

Psychodrama is a form of psychotherapy in which clients are encouraged to continue and complete their actions through dramatization, role-playing, and dramatic self-presentation. Both verbal and nonverbal communications are utilized. A number of scenes are enacted, depicted, for example, memories of specific happenings in the past, unfinished situations, inner dramas, fantasies, dreams, preparations for future risk-taking situations, or unrehearsed expressions of mental states in the here and now. These scenes either approximate real-life situations or are eternalizations of inner mental processes. If required, other roles may be taken by group members or by inanimate objects. Many techniques are employed, such the role reversal, the double, the mirror, concretization, maximizing and soliloquy. Usually the phases of warm up, action, working through, closure and sharing can be identified. (p. 20).

Psychodrama is a comprehensive approach that integrates elements of psychology, sociology, religion, and the theater. In the USA, psychodrama seems to be primarily classified as a psychotherapy—internationally, psychodrama seems to be employed more often in a variety of settings beyond psychotherapy including in communities, religion, politics, business, education, training, theater, and research (Nolte, 2020). Though the objectives of psychodrama enactments may vary from setting to setting, most psychodrama sessions consistently include three phases, five elements, and at least a few core psychodrama techniques.

6.1 Healing in Action

The etymology of the word psychodrama carries the meaning of “psyche in action” (Moreno, 1946). J.L. Moreno believed that because we are wounded in relationship and in action, healing must also take place in relationship and in action. Moreno suggested that we have various conscious and unconscious drives and urges that move us into action and movement. And that “the hidden dynamics of behavior are better brought to view in action than in words because acting is closer to the deeper levels of that which is unconscious than is language” (Nolte, 2020, pp. 132–133). Prior to verbal language, gesturing is our first mode of communication and serves as “the mind–body connection upon which all subsequent language is built” (Dayton, 2005, p. xvii). Psychodrama’s reliance on action helps participants access non-verbal (or preverbal) emotional content in a holistic way. This becomes especially important when working with trauma because of how the body is impacted by adverse experiences and holds implicit memory (Levine, 2010; van der Kolk, 2014). Psychodrama was the first body-oriented therapy and is operated as a comprehensive biopsychosocial-spiritual approach (Giacomucci, 2019a).

In psychodrama, we are working with roles, which have a physical, psychological, social, and sometimes a spiritual component to them. Moreno argued that the concept of the role provides a bridge between psychology and the social sciences while offering a simplified understanding of the complexities of clustered emotion, cognition, and behavior for clients (Buchanan, 1984; Moreno, 1961). Psychodrama is meant to reflect real life and mirrors the actual behavior of participants in life situations (Nolte, 2020). Psychodrama allows a protagonist to act out situations or events that would have been impossible otherwise. In psychodrama, everything is based on the principle of “as-if.” The imagination is used to act as if the imaginary aspects of the drama are real and happening in the here-and-now. Moreno writes that “as-if” is the foundation of accessing spontaneity in the moment:

it is the quality which gives newness and vivacity to feelings, acting, and verbal utterances which are nothing but repetitions of what an individual has experienced a thousand times before…This form of spontaneity has apparently a great practical importance in energizing and unifying the self. It makes dissociated automaton like acts be felt and look like true self-expression and acts like a ‘cosmetic’ for the psyche (Moreno, 1972, pp. 89–90, as cited in Kellermann, 1992).

In psychodrama, spontaneity is understood as the curative factor of the therapeutic process. Moreno defined it as the capacity 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). Spontaneity allows one to respond in a new way to old behaviors, thoughts, emotions, obsessions, repetitions, re-enactments, and relational experiences. A spontaneous action is characterized by competence, adequacy, and novelty based on the situation at hand—whether it is a social situation or an intrapsychic experience. A psychodramatic scene, infused with spontaneity of its role players acting “as-if”, offers unlimited potentials for new experience. This has multiple clinical implications including providing role training for future situations, offering moments developmental repair or corrective emotional experiences, providing the body with the chance to complete survival responses to traumatic events that were interrupted leaving one frozen, and simply establishing an avenue to satisfy various act hungers.

Act hunger is a term that describes one’s drive to get into action in order to achieve some sort of completion (Dayton, 2005). Act hungers may originate from unrealized roles, dreams, hopes, or goals, from unexpressed thoughts or emotions, from unresolved business, or from unjust circumstances which create oppressive conditions. Psychodrama allows one to embody experiences that have been otherwise absent from their life and experience an act-completion, or the satisfaction of resolving the act hunger (Kellermann, 1992). Moreno argued against psychoanalysis’s restriction of the client to laying on a couch for interpretation, instead he encouraged them to act out their inner conflicts and joys. While Freud considered “acting out” as a resistance to psychotherapy, Moreno practiced in a way that acting out was the therapy (Nolte, 2014). He believed that acting out through a psychodrama reduced the impulse for acting out inappropriately in real life (Nolte, 2020). A social worker, Treudley, writes of the advantages of psychodrama to case work interviewing:

Psychodrama offers many advantages in fulfilling the functions that case work sets for itself. It makes possible a much clearer understanding of personality patterning than an interview can possibly do…The acting brings back memories that no verbalization would recall. The client is much more in control of an interview than of a play and unconsciously reveals much in acting than he would block from expression in talking.” (Treudley, 1944, p. 170).

Moreno believed that through role-playing and action, a participant accesses previously unconscious or suppressed emotions, thoughts, and memories. Acting out issues through psychodrama allows for a deeper, holistic expression, the fulfillment of act hungers, experiences of act completions, and the integration of new action insights.

Action insight is defined as experiential learning, or “the integration of emotional, cognitive, imaginary, behavioral, and interpersonal learning experiences” (Kellermann, 1992, p. 86). Action insights are different from intellectual insights or self-awareness in that they are more fully embodied and integrated throughout the self because they are achieved through multidimensional action rather than simply talking or reflecting. Action insights are a function of spontaneity and are most often preceded by an emotional catharsis. Interestingly, some psychologists have highlighted the connections between action and emotion (Nolte, 2020). Even the etymology of the word “emotion” derives the meaning “to stir up” or “to move out.” Our emotions prime us for social action through varying experiences of emotion in the body (DeRivera and Dahl, 1977; Pally, 2000). Psychodrama is often associated with emotions because of its power to create intense emotional experiences or catharses for participants. The interconnectedness between mind, body, and relationship is highlighted by the following quote by Pally (2000), “emotion connects not only the mind and body of one individual but minds and bodies between individuals” (p. 74, emphasis in original). In psychodrama, the group-as-a-whole emotional experience is palpable as the emotionally charged action of the drama connects the minds and bodies of group members in shared catharsis.

6.2 Catharsis

Breuer and Freud were the first to introduce the concept of catharsis to psychiatry in Studies on Hysteria (1895/1957), though the idea was previously used in the medical and theatrical fields. Freud described catharsis as an instinctive and involuntary release of affect associated with a past event (1893). Similarly, catharsis is defined by an influential psychodramatist as an experience of release that takes place when an inner mobilization finds its outlet through action (Kellermann, 1984, p. 1). Psychodrama theory highlights catharsis as a function related to both explicit narrative memory, but also implicit somatic memory. Due to psychodrama’s action-based approach, catharsis is quite common because the entire self, physical and mental, is put into action (Nolte, 2014). J. L. Moreno offered significant contributions to the understanding of catharsis in psychotherapy and society (Moreno, 1971).

J.L. Moreno’s conceptualization of catharsis was influenced by Aristotle who believed that audience members enjoyed watching Greek tragedies because of the experienced Katharsis of fear and pity (1951). Adding to Aristotle’s discussion, Moreno noted that “the cathartic effect relies on novelty and surprise” (Nolte, 2014, p. 220). This cathartic effect is most potent on the first viewing, and it gradually diminishes with each viewing—thus catharsis is related to spontaneity (Moreno, 1940). In the traditional theater, actors role-play the same roles with the same scripts lacking spontaneity; the play is a cultural conserve. Psychodrama, on the other hand, is alive with spontaneity. There is no script, everything happens for the first time, and no psychodrama is repeated identically. While Aristotle was focused on spectator catharsis, Moreno was also curious about catharsis of the actors. Psychodrama involves both. He writes “The greater a spectator’s social and psychodramatic roles correspond to the symbolic roles portrayed on the stage, the greater is the catharsis produced by the drama” (1940, p. 226).

Moreno also noted the difference between audience catharsis and action catharsis, positing that the former could never be entirely adequate by itself (1946). “The greater catharsis achieved through action is undeniable. The patient is able to express kinesthetically many feelings for which he has no words” (Moreno & Enneis, 1950, p. 13). Moreno also considered the relational context of catharsis. In psychodrama and group psychotherapy, catharsis is not taking place in a vacuum; there are other humans in the room. In Psychodrama Volume 1, he writes that the catharsis of one group member is dependent upon the catharsis of other group members—“the catharsis has to be interpersonal” (1972, p. 180).

The psychodramatic theory of catharsis includes two primary types of catharsis—catharsis of abreaction and catharsis of integration. Historically, psychodrama seems to have gained a reputation for its ability to produce catharsis of abreaction – but the goal of psychodrama is actually a catharsis of integration (Hollander, 1969; Hug, 2013; Nolte, 2014). While the catharsis of abreaction could be conceptualized as overcoming or loosening resistance through release, expression, or discharge, the catharsis of integration helps to re-order or transform intrapsychic structure after the release (Kellermann, 1984). Abreaction provides a sense of completion and a release of tension related to the issue; integrative catharsis provides a renewed sense of harmony and equilibrium through a meaningful shift in perception (Nolte, 2014). Kellermann articulately outlines J.L. Moreno’s (1924, 1940, 1946, 1953) contribution and enlargement of the original meaning of the term catharsis:

To include not only release and relief of emotions, but also integration and ordering; not only intense reliving of the past, but also intense living in the here-and-now; not only a passive, verbal reflection, but also an active, nonverbal enactment; not only a private ritual, but also a communal, shared rite of healing; not only an intrapsychic tension reduction, but also an interpersonal conflict resolution; not only a medical purification, but also a religious and aesthetic experience. (1984, pp. 10–11).

While psychodrama may have developed a reputation for being overly focused on catharsis of abreaction, which can be re-traumatizing for trauma survivors, over the past two decades, there has been a deeper sensitivity in considering psychodrama’s clinical use with trauma survivors (Dayton, 2015; Giacomucci & Marquit, 2020; Giacomucci & Stone, 2019; Hudgins & Toscani, 2013).

6.3 Surplus Reality and Concretization

A psychodrama enactment almost always takes place through surplus reality. Jacob Moreno defines surplus reality as a mode of subjective experience that is beyond reality and is enhanced through the imagination (1965, pp. 212–213). Surplus reality describes the element of psychodrama during which the subjective reality of the client is put into action using role-playing techniques. “It allows the protagonist to experience physically what has been experienced psychologically” (Watersong, 2011, p. 21). Surplus reality can also be used to describe the inner imaginal space of an individual or the subjective experience of different mental health symptoms that are a distortion of reality—flashbacks, delusions, hallucinations, etc. (Giacomucci, 2018c).

Psychodrama provides a bridge between the intrapsychic reality of the client and the outer objective reality through the technique of concretization (Watersong, 2011). This technique makes the client’s inner world tangible by using other group members or objects to represent or symbolize them. The technique of concretization utilizes the vehicle of projection through symbolic representation. A client may choose a group member to play the role of their mother, or a scarf to represent their courage. In these examples, the client is projecting an internalized object relation or intrapsychic quality into another human or object. In an interview, Blatner (2010, as cited in Konopik & Cheung, 2013) emphasized the significance of concretization, stating “it gets past tendencies to distance oneself through narration.” The psychodrama stage is seen “as-if” it is a creative and spontaneity space where anything could take place—especially the impossible (Kellermann, 1992). Watersong (2011) states: “Surplus reality in psychodrama addresses our deep hunger to explore creative potential by experiencing and expressing all that we are and expanding into the abundance of life” (p. 26). The use of surplus reality encourages an element of play. Winnicott (1971) writes of the importance of play in that the individual expresses their spontaneity and creativity, engages their whole self, and discovers the new aspects of personality.

Moreno (1939) highlighted the existence of unseen dimensions of life that are not fully explored, processed, expressed, or experienced and that surplus reality of psychodrama was needed to work through these aspects of life. Through the surplus reality of a psychodrama, an experience in the future or a scene from the past could be put into action. A historical moment could be brought into the classroom for students to engage with. In trauma therapy, psychodramatists often create surplus reality moments of developmental repair during which the client is provided with an embodied experience of having their previously unmet needs fulfilled today on the psychodrama stage (Giacomucci & Stone, 2019). Psychodrama techniques permit one to have dialogues with the dead, offering an efficient method for renegotiating unresolved grief and losses (Darrow & Childs, 2020; Giacomucci, 2020a). A protagonist has the capacity in psychodrama’s surplus reality to dialogue with ancestors or even an unborn child!

Psychodrama is a way to change the world in the HERE AND NOW using the fundamental rules of imagination without falling into the abyss of illusion, hallucination or delusion. The human brain is the vehicle of imagination. Psychodrama, in training the imagination, overcomes the differences which hinder communication between the sexes, between the races, the generations, the sick and the healthy, between people and animals, between people and objects, between the living and the dead. The simple methods of psychodrama give us courage, return to us our lost unity with the universe, and re-establish the continuity of life. (Moreno, 1972, p. 131)

Concretization and surplus reality provide the psychodramatist with tools for enactment and assisting the protagonist toward achieving their goal. Zerka Moreno (2000) observed that the most healing catharses emerge from psychodrama scenes that could not, did not, or are unlikely to play out in reality.

6.4 Three Phases of a Psychodrama

A standard psychodrama group includes three essential stages—warm-up, enactment, and sharing (see Fig. 6.2). In many ways, these three stages mirror J.L. Moreno’s triadic system of sociometry, psychodrama, and group psychotherapy. Furthermore, these three group phases also reflect the beginning, middle, and ending phases depicted in social work with groups theory (Shulman, 2015).

Fig. 6.2

Three phases of a psychodrama session (Shulman, 2015)

6.4.1 The Warm-Up

The warm-up stage often includes an action-based sociometric exploration of the group which serves to both warm-up participants to physical action and internally to warm up to a psychodrama. The warm-up phase of a group may include introductions, group norms, discussion, check-ins, and/or sociometry explorations. In the warm-up stage, a protagonist is selected—often by sociometric process of the group. Moreno strongly emphasizes the importance of warming-up in his writing—“the chief point of the technique was to get the patient started, to get him warmed up so that he might throw his psyche into operation and unfold the psychodrama” (1972, p. 182). The warm-up is an essential phase of the group; further phases are incomplete without adequate warm-up. Many role-plays attempted by social workers in therapeutic, educational, or community settings fail due to a lack of attention to warm-up.

6.4.2 The Enactment

The enactment phase involves bringing the protagonist’s intrapsychic or interpersonal life onto the stage through role-playing and other psychodramatic techniques. Dayton (2005) describes it as externalizing and concretizing the protagonist’s inner world of object relations. She states that “the psychodramatic stage becomes a path into another world, where it allows a protagonist to time-travel out of the narrow dimensions of her everyday life” (2005, p. 24). This is the phase during which the group moves onto the stage and into surplus reality. The enactment may be a psychodrama, sociodrama, or other action-based process.

6.4.3 Sharing

After the enactment, group members de-role and the sharing phase begins. During this phase, group members share about their own experience of playing a role or observing the psychodrama with the intent of identifying with and connecting to the protagonist. This serves as an integration period for group members as they apply the theme and experience to their own lives, but also for the protagonist who is re-integrating himself intrapsychically and interpersonally after the enactment. Sharing in psychodrama generally does not include feedback or giving advice; instead, it emphasizes the sharing of personal insight and identification based on the psychodrama enactment. Participants may also provide broader perspectives from the experience in their role (role feedback) (von Ameln & Becker-Ebel, 2020). The psychodrama director often will also participate in the sharing process of a psychodrama with clients while taking into consideration professional boundaries.

6.5 The Five Elements of a Psychodrama

There are five ingredients to any psychodrama; they are the stage, a director, a protagonist, at least one auxiliary ego, and the audience (see Fig. 6.3).

Fig. 6.3

The five elements of a psychodrama enactment

6.5.1 Stage

The stage provides a place for the action to be held and contained within space. Moreno (1953, p. 81) states that “the stage space is an extension of life beyond the reality test of life itself. Reality and fantasy are not in conflict, but both are functions within a wider sphere—the psychodramatic world of objects, persons, and events.” On the psychodrama stage, anything is possible. Moreno describes it as a multidimensional living space in contrast to the restraints of reality (Nolte, 2020). Moreno designed his own unique stage in the 1920s for the Theater of Spontaneity in Vienna, which he later built in New York at his sanitarium in Beacon. His stage design was circular with three levels and a balcony which was recreated multiple times at psychodrama institutes or hospitals around the world (see Fig. 6.4).

Fig. 6.4

Psychodrama stage with its three levels and balcony. Reprinted with permission from Figusch (2014)

6.5.2 Protagonist

The second ingredient is a protagonist who is a member of the group chosen to provide the content of the psychodrama based on his or her goals. The protagonist emerges from the group and becomes the center of attention for the psychodrama enactment. The protagonist may be selected by the group, self-selected, scheduled, or chosen by the therapist/director. Dayton (2005) says that offering a protagonist the stage is offering them an opportunity to meet themselves on an inward journey. Simultaneously, the protagonist is embarking on a “hero’s journey” for themself, the group, and the larger community (Mosher, 2009). The scene of the psychodrama is primarily based on the experience, perception, and action of the protagonist. They are externalizing their inner reality through the psychodrama process. The protagonist, together with the director, co-creates the psychodramatic enactment on the stage with the support of the group. Moreno notes that the goal is “not to turn the patients into actors, but rather to stir them up to be on the stage what they are, more deeply and explicitly than they appear to be in life reality” (Moreno, 1946, p. 251).

6.5.3 Director

The director is the person facilitating the session and guiding the protagonist toward the completion of their goal in the psychodrama. The director uses a variety of techniques which will be discussed further in the next section. In classical psychodrama, the protagonist leads the way as the director helps to concretize and produce the psychodramatic scene. The director’s responsibilities also include keeping the enactment physically and emotionally safe. The psychodrama director is an integration of four roles—therapist, sociometrist/group leader, analyst, and producer (Kellermann, 1992). Though psychodrama directing may seem like a straight-forward and simple task, a skilled psychodrama director is incorporating a wealth of philosophy, theory, and interventions within the directing process. The director is faced with countless choices within each moment of the enactment and carefully discerns which intervention might best facilitate movement toward the overall goals of the protagonist, the psychodrama, and the group-as-a-whole. It is not suggested that any professional attempt to direct a full psychodrama until they have completed at least 100 h of psychodrama training—though the process of becoming certified as a practitioner in psychodrama includes a total of 780 training hours.

6.5.4 Auxiliary Egos

The fourth element is that of one or more auxiliary egos. These auxiliary roles are most often held by other group members but could also be staff members or students. Moreno writes that the auxiliary ego has three functions: (a) as an actor, (b) as a therapeutic agent, and (c) as an active social investigator, rather than a passive audience member (1972). Utilizing auxiliaries is a tool of the director, but once enrolled, they are an extension of the protagonist (Moreno, 1947). Most often the protagonist selects the auxiliaries who will hold the roles necessary for the enactment to take place. At times, the director may make clinical role assignments based on his knowledge of group members’ needs. The auxiliary plays a role based on role training from the protagonist and in service of the needs of the psychodrama scene. At the same time, the auxiliaries may experience a dormant role within their own self-system awaken as they bring themselves to the role (Dayton, 2005; Hudgins & Toscani, 2013).

Auxiliary egos initially play their role in the scene through the role training of the protagonist and director. Often, they are initially role reversed into the protagonist role so they can observe the protagonist demonstrate their role for them. A skillful director will have auxiliaries bring their own emotional content into their roles, so they are playing roles not just for the protagonist, but also for themselves. In most psychodramas, it seems that the protagonist chooses group members for auxiliary roles based on their telic connection which results in the role player having a meaningful connection to the role they are playing. Tele may also active when a group member spontaneously doubles for the protagonist in the scene. The role of the double can be taken by the director, an audience member, an auxiliary ego, or sometimes multiple auxiliary egos.

6.5.5 The Audience or the Group

The audience (the group) is the final element in psychodrama and provides the protagonist with an important function by bearing witness to their story. The action of a psychodrama has a catching force that stirs up powerful emotions in audience members, just as observing an emotional movie scene. “The audience sees itself, that is, one of its collective syndromes portrayed on the stage” (Moreno, 1946, p. 251). Group members in the audience have the opportunity to identify with the protagonist’s story while watching it from a distance. Most frequently, audience members experience both catharsis of abreaction and integration through their observer role in the drama, which Hug (2007) attributes to the mechanisms of mirror neurons (Sect. 8.4.4 for a more complete description of mirror neurons).

Moreno writes that the audience (or group) has two functions: (a) observing the psychodrama and protagonist on stage, and (b) serving as the patient or a learner (1972). In Moreno’s group psychotherapy system, the group is the patient (1947). When the group is the patient, the work becomes “with the group, by the group, and for the group” (von Ameln & Becker-Ebel, 2020, p. 7). The protagonist, auxiliary egos, and the topic of the psychodrama emerge from the group and return to the group through de-roling. In the sharing process of the psychodrama, group members share about how they relate to the protagonist’s psychodrama and the roles or themes within it. A skillful psychodrama director facilitates the selection of a psychodrama topic and protagonist that represents the group-as-a-whole. This ensures that audience members are also benefiting from the psychodrama enactment. When a psychodrama is enacted that does not represent the group-as-a-whole, the group session becomes an individual session in a group setting—which Moreno and others have cautioned against (Moreno, 1947; Nolte, 2020).

6.6 Morenean Philosophy and Sociometric Theory Within Psychodrama

Although many have segregated psychodrama from Moreno’s philosophy and his sociometric system, they are part of the same whole. So, although this chapter is devoted to psychodrama theory, it is incomplete without also outlining the intersection and integration of Morenean philosophy and sociometry within psychodrama.

6.6.1 Sociometry

Moreno’s approach to group psychotherapy begins with assessing the sociodynamics within the group. He used to say that “psychodrama without sociometry is blind.” Sociometry is often used as a warm-up to the psychodrama enactment. In some cases, an individual group member’s social atom or role atom may be enacted through psychodrama. The sociometric assessment and exploration of the group allows the psychodramatist to help the group uncover a central concern and open tensions systems within the group with a topic that most represents the group-as-a-whole. The topic and protagonist of a psychodrama are often chosen through sociometric selection by the other group members. This ensures that the topic is relatable to the rest of the group and that the psychodrama does not become individual therapy in a group setting. Innumerable sociograms could be created from infinite criteria within one group. While the social atom and cultural atom depict the individual’s social life, the sociogram depicts the sociodynamics within the group. Just as a pattern of role relations exists within each social atom, so too does a pattern of role relations exist within each sociogram and within each psychodrama group. An exploration of the complexities of these social and role relationships is further explored in Chap. 14.

Tele is the glue that keeps the group together and cohesive allowing for helpful relationships. Acting as a socio-gravitational force within the group, tele enhances the warm-up process and brings participants together upon a core issue. Tele often expresses itself through the protagonist’s choice for role players. Through the intimate experience of psychodrama, transference and projection dissolve and are often replaced by stronger telic connections between group members. “The telic relationships between protagonist, therapist, auxiliary egos, and the significant dramatis personae of the world which they portray are crucial for the therapeutic progress.” (Moreno, 1972, p. XI).

The sharing portion of a psychodrama group functions to re-integrate the protagonist back from the surplus reality of the psychodrama stage into the sociometry of the group itself. In the sharing, group members often give voice to previously undiscovered sociometric connections between themselves and the protagonist. At this time, the protagonist takes a less active role while others have a chance to share. This provides the protagonist with a chance to internally integrate and digest their experience while being held by the group. This is when the newfound tele is labeled and relationships between group members further strengthened. In these ways, sociometry is consistently present throughout each of the three phases of a psychodrama group—warm-up, enactment, and sharing.

6.6.2 Role Theory, Role Relations, and Role-Playing

Psychodrama uses drama to express the psyche or the self. The vehicle from which the self is expressed both in life and in psychodrama is through roles. Every psychodrama uses roles and role-playing techniques. The psychodramatic enactment may include intrapsychic roles, interpersonal roles, social roles, psychodramatic or fantasy roles, spiritual roles, or a mix of various types of roles. The protagonist chooses other group members to play the roles needed for the scene. The relationships between the protagonist and the roles on the stage are enacted and often transformed through the psychodrama process. In addition to the role dynamics between the psychodrama roles, each role player also has role relationships to the protagonist, the other group members, the director, the actual role that they are playing, and the roles within their social atom which are symbolically represented through the protagonist’s psychodrama. There are layers upon layers of role dynamics actively engaged, some more explicitly than others, within a psychodrama experience. A skillful psychodrama director can bring to consciousness these multiple layers of role relations for each participant and weave them through the psychodrama process—effectively making each participant a protagonist.

While traditional role-plays are often scripted or hypothetical, psychodrama role-plays are spontaneous real-life simulations (von Falko & Becker-Ebel, 2020). Many psychodramas are entirely focused on helping a protagonist adopt a new role, let go of an old role, role train for future situations, feel more competent or spontaneous in their current roles and role relationships (role-playing), or transform an old role into something new (role creation). Many psychodramas even have different scenes that can be connected to the three different phases of role development. At the end of each psychodrama enactment, participants are asked to de-role as they return to the role of themselves for sharing. The essentiality of roles to psychodrama is clearly depicted in that four of the five core elements of a psychodrama are roles (director, protagonist, auxiliary egos, and audience members).

6.6.3 Theories of Change

Psychodrama’s theories of change include action theory and spontaneity-creativity theory which are core to every psychodrama enactment. Every psychodrama is spontaneously put into action without a script. Moreno’s Canon of Creativity provides the psychodrama director with a map for change at the intrapsychic, interpersonal, and social levels. The group begins in the warming-up phase—circling the outside of the canon. A spark of spontaneity emerges from the group process and is met with creativity, giving birth to a new cultural conserve within the group process. This Canon of Creativity is activated multiple times by each group member throughout a psychodrama while also serving as the overarching clinical map for the psychodrama itself.

In psychodrama, the healing does not come from the therapist to the protagonist, but instead from relationships between the protagonist and the enacted roles and other group members. Zerka Moreno states that the purpose of psychodrama is to help the protagonist remove barriers to healing themselves by accessing their autonomous healing center within (Moreno, 2012). Psychodrama leverages the mutual aid between group members, effectively helping the group-as-a-whole to access its autonomous healing center (Giacomucci, 2019b).

6.6.4 Developmental Theory

As noted in a previous chapter (see Sect. 4.8), Moreno’s developmental theory reflects core psychodrama interventions—the double, the mirror, and role reversal (Moreno, 1952). Although it is not often considered, these three phases of Moreno’s developmental theory can be used as a clinical map to inform which psychodramatic interventions are clinically appropriate for the group and the protagonist in any given moment. Doubling explores the subjective experience of the protagonist, the mirror attempts to increase objectivity in approaching the situation, and role reversal aims to provide insight into the intersubjectivity of the experience. Developmentally speaking, doubling from parents provides a labeling of the infant’s experience, stabilization in this universe, and a beginning of differentiation of the self. These developmental goals are also clinical goals that the intervention of doubling can be used to achieve.

Doubling from the director or other group members not only creates connection but also helps to articulate something unspoken for the protagonist. The double provides a stabilizing force for the protagonist within their role in surplus reality of the psychodrama. When a protagonist is unable to fully see themselves and their behavior within relationships in the psychodrama, the mirror intervention may be clinically necessary to assist with the developmental task of accurately seeing one’s self in the world. This could be used for helping a protagonist identify problematic behavior or positive aspects of self that they have not fully owned. Role reversal is the third developmental stage during which the individual has the capacity to step into the shoes of another and see the world through their eyes. Once the therapeutic and developmental tasks of doubling and mirroring have been given attention, role reversal can be employed as a clinical intervention for new action insights and catharsis of integration.

In psychodrama work with trauma, it is especially important to consider the role of developmental trauma and how the developmental theory might offer both diagnostic information and direction for corrective experiences (Giacomucci, 2018c). Many survivors of childhood trauma were not adequately doubled or mirrored by their caregivers; thus, they struggle with a sense of self, codependency, individualization, and tasks related to these phases of development. It has been this writer’s experience that a client’s here-and-now presentation is often indicative of which of the three developmental stages they experienced neglect or trauma and thus which corresponding psychodrama intervention needs to be focused on (see Table 6.1 for more info). A client with a destabilized or lacking sense of self may have experienced a lack of attuned doubling in childhood which would have promoted self-expression and self-understanding. A client with a distorted or undifferentiated sense of self is likely to have suffered from the absence of mirroring or misattunement in the mirror phase of development. And a client presenting with a distorted sense of others or lack of awareness of others is likely to have suffered adversity or neglect in the role reversal phase. In this way, Morenean developmental theory provides both a diagnostic framework and a prescriptive guide for intervention. This is a new idea and still needs to be further researched and tested.

Table 6.1 Psychodrama developmental phases and interventions—double, mirror, and role reversal

When working with trauma-based roles (especially the victim and perpetrator roles) in a psychodrama scene with a trauma survivor, it is important that the double and mirror interventions be used prior to the role reversal. This allows the protagonist to stabilize, express (doubling), and accurately see themself and the situation (mirror) prior to being role reversed into a trauma-based role. If role reversal with a trauma-based role is attempted prematurely, it may result in re-traumatization, dissociation, uncontained catharsis, or further role training the protagonist in trauma-based roles. Hudgins & Toscani (2013) suggest that it is unsafe to role reverse a protagonist into a victim or perpetrator role (regardless if it is an intrapsychic or interpersonal role) until they have demonstrated the ability to spontaneously interact with the trauma-based role as themselves. For the victim role, this would mean rescuing, nurturing, and validating the victim role from their adult ego state; for the perpetrator roles, this would mean tolerating, standing up to, and setting boundaries with the perpetrator role from their adult ego state. Using the three phases of developmental theory as a map of clinical interventions within a psychodrama provides a guide to the director.

Furthermore, the three phases of a psychodrama group seem to also reflect the three phases of development. In the warm-up phase, group members are actively doubling each other through sociometry while giving voice to the central concerns of the group-as-a-whole. In the warm-up peer identification, connection, cohesion, and the stability of the group within the session take place. When a protagonist is chosen sociometrically by the group based on identification with a shared topic, the psychodrama enactment becomes relatable to everyone. The scene is essentially a double and a mirror for each group member to see themselves through the protagonist’s psychodrama. The role relationships on stage shine light on the similarities in dynamics for each participant in their own lives. Each audience member is in the mirror position, seeing themselves in the protagonist. Each participant intuitively and intrapsychically role reverses with the protagonist through seeing themselves mirrored in the psychodrama process. They are imagining they are on the stage as protagonist, imagining what they would say or do next. The completion of the final phase of the group, sharing, is the completion of this inner role reversal for participants; they de-role from being an auxiliary role or audience member and step into the role of themselves again. The sharing provides the participants with the opportunity to return to the role of self while labeling what they integrated through experiencing the psychodramatic reality of the protagonist. One could argue that even a seemingly uninvolved audience or group member is being implicitly doubled, mirrored, and role reversed throughout the process of a psychodrama group. Though there are some parallels between doubling, mirroring, and role reversals with the three phases of a group, it is important to note that these interventions are primarily, and often exclusively, employed in the enactment group phase. The idea of using Moreno’s developmental theory as a clinical map to guide the interventions of the director is still a new idea and needs more research and exploration—nevertheless, it can be helpful for directors to consider the various elements of the double, mirror, and role reversal (see Table 6.1). A future chapter (see Sect. 13.1) will dive further into the actual implementation of the aforementioned psychodrama interventions.

6.7 Psychodrama and Social Work Theory

Social work and psychodrama exist with considerable overlap (Zwilling, 2004). Both share emphasis on the significance of mutual aid, non-judgmental acceptance, spontaneity, creativity, meeting the client where they are, roles, group phases, interpersonal skills, communication, empowerment, and human relationships (Gershoni, 2013; Giacomucci, 2018a, b; 2019b; Giacomucci & Stone, 2019; Konopik & Cheung, 2013; Skolnik, 2018; Wang & Liu, 2020). Skolnik’s 2018 publication exclaims that social work and psychodrama form “a synergistic union.” Social work and psychodrama are both employed in a variety of settings with different group types, including educational groups, training groups, supervision groups, support groups, treatment groups, self-help groups, therapeutic communities, community groups, social activism, policy work, and organizational groups.

Social work and psychodrama hold many core values in common and emphasizes the significance of human relationships and mutual aid. Moreno believed that change was a result of the interaction between the group members playing roles in a psychodrama, not from the therapist (Moreno, Blomkvist, & Rutzel, 2000). He argued that each participant in the group had therapeutic potential and that group members could collectively act as therapists for each other.

Both psychodrama and social work emphasize the importance of role theory. The IASWG group standards explicitly state that “role theory and its application to members’ relationships with one another and the worker” is “required knowledge” for the social worker (IASWG, 2015, p. 14). Similarly, psychodrama is based on Moreno’s role theory. The role of the psychodrama facilitator reflects the role of the social group worker as a guide, ally, or facilitator of the group with the intent to cultivate mutual aid (Carey, 2016; Drumm, 2006; Giacomucci, 2017; Skolnik, 2018). The social worker, within the group, operates as another human being, often sharing personal ideas, perceptions, beliefs, and emotions. The use of self is highlighted as an essential tool for social work practice with groups (Bitel, 2000; Northen & Kurland, 2001). Similarly, the psychodrama director often discloses from self in the sharing and processing stage of the psychodrama. This more active use of self is more common in the social work field and the psychodrama fields than in other fields.

Social work with groups and psychodrama each operates from a phasic model of group development and process (Skolnik, 2018). Social group work’s phases of group development describe the tasks of the group over the course of its existence—from the preliminary stage, to a beginning stage, middle stage, and ending stage (Northen & Kurland, 2001; Shulman, 2015). On the other hand, psychodrama theory offers a three-phase conceptualization of each group session—beginning with the warm-up stage, then the action stage, followed by the sharing and integration stage (Wysong, 2017). Shulman (2015) suggests that the social group work stages are also applicable as a framework for each individual session. While these models of group process and development describe different aspects of group experience, they are often integrated and used concurrently by social group workers and psychodramatists.

Both social workers and psychodramatists conceptualize the individual within their social environment and look to increase clients’ interpersonal skills. As Bendel’s (2017) systematic review indicates, psychodrama research consistently points to its efficacy in improving interpersonal skills (Dogan, 2010, 2018; Karabilgin et al., 2012; Karatas & Gokcakan, 2009; Li et al., 2015; McVea & Gow, 2006; McVea et al., 2011; Smokowski & Bacallao, 2009) and that “psychodrama applications for social work may find aptitude in client development of interpersonal skills” (Bendel, 2017, p. 47). Nolte (2020) compares organism in an environment perspective of psychology as slightly different than the being in a situation of psychodrama. He writes that the behaviorist psychology perspective, at its extreme, portrays human behavior as predetermined and controlled by its environment. Nolte writes that psychodrama’s position is opposite to predetermined behaviorism in that it considers the individual within the environment as a holistic being, actor, and initiator within a situation. He states that “the conventional psychological model is a deterministic, mechanical model of human behavior. The existential psychodramatic one is a non-deterministic (spontaneous), dynamic one.” (Nolte, 2020, p. 124) At the same time, one’s ability to access spontaneity may be limited due to oppression related to marginalized social group assignments (or identity) within society or within the group itself (Nieto, 2010; Nieto, Boyer, Goodwin, Johnson, & Smith, 2010). Privilege and oppression certainly play a role in the warming up process to spontaneity.

Interpersonal skills and social interaction are based on the foundation and essence of communication (Shaw, 1981). While ideas are primarily expressed through verbal communication, emotional content is conveyed through non-verbal gestures such as facial expression, posture, and subtle body movements (Northen & Kurland, 2001). Though many social group work modalities seem to solely focus on verbal processing, the non-verbal is emphasized in Lang’s non-deliberative social work model (2010, 2016) as well as the psychodramatic approach. J.L. Moreno is quick to highlight how action precedes words in human development and often convey messages that words could not (1955). Psychodramatists even use action, body posture, and movement without words as a form of communication or sharing about an experience. Role training effective communication is the objective of some psychodrama groups, during which group members offer various spontaneous demonstrations of communication styles for a given situation. The protagonist is then provided with an opportunity to try these different communication approaches and/or experience them from the role-reversed position. Psychodrama as a process is used in a variety of fields to teach communication skills to clients (Corsini, 2017; Dayton, 2005), students (Joyner & Young, 2009), social workers (Konopik & Cheung, 2013), lawyers (Cole, 2001), medical professionals (Baile & Blatner, 2014; Walters & Baile, 2014), and others.

Just as social workers utilize a systems approach to group and individual treatment, psychodrama uses the social atom to examine the social system in which the client operates, while utilizing the sociogram to see the group as its own sociodynamic system. Sociometry-based warm-up exercises are most commonly used leading up to a psychodrama with the intent of developing group cohesion (Dayton, 2005; Haworth & Vasiljevic, 2012). The International Association of Social Work with Groups Standards of Practice highlights group cohesion as a beginning task of the social worker who “aids the group members in establishing relationships with one another so as to promote group cohesion” (IASWG, 2015, p. 11). In social work research with groups, it has been shown that the greater the group cohesion, the stronger the influence of the group upon its members (Northen & Kurland, 2001). Yalom & Lesczc (2005) reference the importance of group cohesion in group work to that of the therapeutic relationship in individual work.

Social work with groups and psychodrama each place significance on tension and conflict within the group process. Social workers conceptualize both tension and conflict as essential components of human development and group development while offering multiple strategies for working through them (Northen & Kurland, 2001). Similarly, psychodramatists assess tension and conflict in the group with sociometric tools and use a variety of psychodramatic interventions to resolve the conflict—including the encounter (Hale, 1981). The psychodramatic encounter provides participants with an opportunity to explore, label, and concretize transference/countertransference in the conflict and experientially remove projections from the group member. In the psychodramatic encounter, conflicting group members have an opportunity to role reverse with each other to fully see things from the other’s perspective which often relieves the conflict. Psychodramatists also pay considerable attention to tension in the group and are trained to assess open tension systems within group members and the group-as-a-whole. Dayton (2005, p. 453) defines open tension systems as “unresolved situations that live inside the psyche in an unfinished state and produce internal tension.”

In group treatment, psychodrama and social work approaches complement each other by treating the group-as-a-whole, while also being aware of each individual that make up the group itself (Carey, 2016; Giacomucci, 2020b; Giacomucci & Stone, 2019; Indagator & Chung, 2014). Frequently in a psychodrama group, the topic of the psychodrama is chosen democratically by group members which promotes the group-as-a-whole experience. J.L. Moreno compared the psychodynamics of the individual with the sociodynamics of the group and their interplay in the psychodrama process. The locus of social work has been described by Viglante et al. (1981) as the “psychosocial interface” which seems to capture Moreno’s thinking. Both social work and psychodrama focus their work on marginalized populations and work to empower individuals, groups, and communities (Skolnik, 2018).

Skolnik (2018) highlights the overlap between social work and psychodrama in the emphasis on spontaneity and creativity with the group process as a collective and creative endeavor. Both the social worker and the psychodramatist are artists who “integrate knowledge, intuition, experience, and theory in the moment to act spontaneously and creatively to produce an intervention” (Skolnik, 2018, pp. 62–63). The social group work environment of mutual aid cultivates spontaneous and creative action in the group experience (Steinberg, 2010). As outlined in a Sect. 4.4, psychodrama practice developed from, and depends on, Moreno’s spontaneity–creativity theory.

6.8 Conclusion

Theoretically, almost all of psychodrama’s core theories are reflected in social work theory. Figure 6.5 provides a depiction of the multiple overlapping theories and philosophies between Moreno’s system and social work (see Fig. 6.5). As Skolnik noted, psychodrama and social group work form a synergistic union (2018). The social worker’s role in their relationship with individuals, groups, and communities can be enhanced through the integration of psychodrama. Konopik and Cheung’s research (2013) outline three major areas of social work that could be enhanced by the integration of psychodrama—clinical social work or psychotherapy, the training of social workers or training of others, and the use of psychoeducation.

Fig. 6.5

Similarities between social work with groups and Moreno's triadic system. Reprinted with permission from Giacomucci (2019a, b).