The evolution of neuroscience research in the past two decades has provided psychodrama and experiential trauma therapies with a richer foundation for an evidence base. These neuroscience findings have led many to even claim that experiential therapies are the treatment of choice for specific mental health and trauma-related clinical issues (Dayton, 2015; Giacomucci, 2018; Hudgins, 2017; van der Kolk, 1996, 2014). Over 100 years ago, Moreno was actively developing the foundational philosophy for his sociometric and psychodramatic methods. His active attempts to associate his ideas with science are demonstrated in his choice of words for his new ideas, such as: social atom, cultural atom, role atom, sociometry, sociostasis, sociogram, sociogenetic law, the law of social gravity, and social microscopy among others. Yaniv writes that “his eagerness to relate sociometry to other traditional scientific domains, such as biology, physics, or mathematics, led him to some outstanding hypotheses and predictions that turned out to be empirically valid a century later” (2014, p. 108).
The brain is an action-oriented organ, so it should not be surprising that its integrative potential is realized through action. Where words are inadequate or blocked from access to primary material, the brain is open to other avenues of expression. The psychological dynamics explored by psychodrama reflect fundamental operations within the brain/body in which emotional dynamics favor more subcortical layers and rational modes favor more neocortical layers of the brain (Hug, 2007, p. 227). J.L. Moreno’s action theory and approach to psychotherapy is supported nearly 100 years later by the growing body of neuroscience research. As noted previously, psychodrama is one of the first body-oriented models of psychotherapy. Many treatment approaches focus entirely on thoughts, narrative, emotion, and talking, which are neglecting a major element of human experience. It is imperative that treatment include the whole individual—their cognitions, emotions, their body, their social context, and in many cases a spiritual component.
The field of “interpersonal neurobiology assumes that the brain is a social organ built via experience” (Cozolino, 2014, p. xvii). The brain develops in relationships with others through experience, which is facilitated, in part, by experience-dependent neuroplasticity. This phenomenon describes the interplay of nature and nurture whereby “our brains are structured and restructured by interactions with our social and natural environments” (Cozolino, 2014, pp. 77–78). In the early stages of a child’s life, all communication is in action—gesturing, motioning, facial expression, and body language. It is not until later that one develops the capacity to communicate through words and language, and even then, a large portion of communication remains nonverbal. Psychodrama’s emphasis on action, interaction, and enactment speaks to this facet of our nature as human beings of action.
8.4.2 Healing Trauma with Psychodrama
Many treatments for trauma focus heavily on the cognitive, emotional, social, and spiritual impacts of trauma but do not include intervention and sensitivity to the ways in which trauma effects an individual’s central nervous system. Psychodrama includes the body and the central nervous system in its interventions which may be a large component of their efficacy. Neurobiology research suggests that experiential and body-centered treatments may be better suited for trauma treatment (Dayton, 2015; Levine, 2010; van der Kolk, 2014).
Prone to action, and deficient in words, these patients (trauma survivors) can often express their internal states more articulately in physical movements or in pictures than in words. Utilizing drawings and psychodrama may help them develop a language that is essential for effective communication and for the symbolic transformation that can occur in psychotherapy. (van der Kolk, 1996, p. 195)
These findings have been used to suggest that experiential therapy and trauma-focused psychodrama is a treatment of choice when working with PTSD (Dayton, 2015; Giacomucci, 2018; Hudgins, 2017; Kellermann & Hudgins, 2000; Hug, 2013).
The brain changes through experience (Siegel, 2012). A psychodramatic experience has the power to change psychological and somatic imprints of trauma by activating traumatic neural networks while safely renegotiating the traumatic content and providing completion of the previously incomplete survival response of the nervous system (Giacomucci & Stone, 2019; Levine, 2010; Porges, 2017). While other trauma therapies seem to focus on desensitization or symptom control, psychodrama may offer an path for renegotiation, integration, and resolution of PTSD (Dayton, 2015; Giacomucci, 2018; Giacomucci & Marquit, 2020; Giacomucci & Stone, 2019; Hudgins, 2017; Hudgins & Toscani, 2013).
8.4.3 Integration as the Key to Wellness
The purpose of all types of psychotherapy, Cozolino (2010) writes, is to enhance the integration of neural networks. He suggests that bilateral hemispheric integration and vertical neural integration are most relevant to neuroscience and psychotherapy. Vertical integration refers to the “unification of body, emotion, and conscious awareness” and includes “the ability of the cortex to process, inhibit, and organize the reflexes, impulses, and emotions generated by the brainstem and limbic system (Alexander, DeLong, & Strick, 1986; Cummings, 1993; as cited in Cozolino, 2010, p. 27). At the same time, bilateral integration is necessary to put language to our inner experience. The right hemisphere is more connected with body sensations and emotions–the limbic system and brain stem. The left hemisphere is more identified with cortical functioning and language (Shapiro, 2018). Hug (2007) and Robbins (2018) posit that the action of psychodrama, which stimulates the body and levels of functioning beyond cortical, provides an opportunity for information from the limbic system to emerge and be integrated—including implicit memory such as attachment schemas, traumatic experiences, and affect regulation processes. He maintains that psychodrama has a unique potential to renegotiate not just explicit memory (hippocampus), but also affective memory (centered with the amygdala). “Psychodrama has to do with connective body and language through enactment and action…the body remembers what the conscious mind may confabulate or may not remember at all” (Hug, 2007, pp. 230–231).
The term interpersonal neurobiology was coined by Siegel, who defines integration as the key to mental health. He offers eight different domains of integration—consciousness, bilateral, vertical, memory, narrative, state, interpersonal, and temporal (2012). He states that “our task is to find the impediments to the eight domains of integration and liberate the mind’s natural drive to heal—to integrate mind, brain, and relationships” (2010, p. 76). Strikingly, Siegel’s statement mirrors the following statement by Zerka Moreno—“protagonists themselves do the healing. My task is to find and touch that autonomous healing center within, to assist and direct the protagonist to do the same” (2012, p. 504). Furthermore, Moreno’s (1953) emphasis on catharsis of integration finds neuroscientific merit through the research of interpersonal neurobiology (Giacomucci, 2018). “Integration is the goal, not catharsis” (Hug, 2013, p. 129). Or, to express it in classical psychodrama terms, a catharsis of integration must follow a catharsis of abreaction (Hollander, 1969; Moreno, 1953). Beyond neurobiological and psychological integration, psychodrama group work also offers opportunities for social and spiritual integration.
8.4.4 Mirror Neurons—The Double, The Mirror, and Audience Catharsis
Returning to the psychodramatic technique of doubling, Hug (2007) offers a neurobiological basis at the core of doubling—mirror neurons. Mirror neurons describe the phenomenon within the frontal lobes, or the “seat of empathy,” during which one’s brain activity will mirror the brain activity of another whom they are watching in action (Keysers & Gazzola, 2010). It is likely that mirror neurons are at the foundation of one’s ability to double the protagonist. Mirror neurons were originally discovered by accident when researchers had connected electrodes to a monkey’s brain to measure their premotor area as the monkey picked up a food object. At one point, as the monkey sat still and watched, the researcher picked up a food pellet—to everyone’s surprise, the monkey’s brain cells fired in the same exact way as if he himself had picked up the food (van der Kolk, 2014). In the same way, as group participants observe a psychodrama protagonist in action, it is likely that their brain is activated as if they were participating in the action too. This may provide a neurobiological understanding to clients’ experience of psychodrama as having a “catching force” that emotionally engages even the audience members. Operationally, this may mean that each group member receives similar therapeutic effects as the protagonist of the psychodrama.
Schermer (2013) suggests that mirror neurons and their related systems “serve as a biological substrate for systemic group-as-a-whole relations” (p. 31). The two primary poles of functioning of mirror neurons are action and recognition, which together lead to the development of human connection and larger social units (Schermer, 2013). Klein writes that the observer or mirror position in psychodrama is mostly associated with neocortex activation while role-playing activates the brainstem and limbic system (2015). Considering this neurobiological understanding, the mirror position can be used by the psychodrama director to facilitate affect regulation and cognitive processing for the protagonist (Klein, 2015; von Ameln & Becker-Ebel, 2020). The mirror position helps a protagonist accurately see themselves in action from a place of safety and distance which may also promote multiple types of integration including vertical and bilateral.
8.4.5 Role-Playing and Role Reversal
When a protagonist volunteers, offers a trauma-related topic to the group, and states a goal for the work, they are tapping into both the memory of the trauma and the associated neural network. Beginning the drama with strengths-based roles helps to renegotiate the emotional context of the traumatic memory by activating different affective systems and providing a felt sense of safety after the memory has been stimulated. These strengths-based roles are most likely to initiate the PLAY, CARE, and SEEKING social–emotional systems, as described by Panksepp and Biven (2012), which in effect provide a renegotiation and recontextualization of the traumatic memory (Levine, 2015).
In role reversals with positive roles, a psychodramatist utilizes the role reciprocity between the protagonist and role to activate both the protagonist’s creativity spontaneity and CARE system as they role train compassion and care for self (Giacomucci, 2018). Panksepp and Biven (2012) write that experiencing feelings of PANIC/GRIEF in others (even through a role-player!) is one of the most powerful triggers of the CARE system—thus highlighting one of the neurobiological mechanisms of role reciprocity in psychodrama. Furthermore, activating the protagonist’s CARE system (in the role reversal) will inhibit their GRIEF system (p. 285), effectively strengthening the renegotiation of the memory’s emotional context.
The fact that another human plays the role of these roles is neurobiologically significant. The interaction with a role (and thus the group member playing the role) activates the protagonist’s ventral vagal nerve (“Smart Vagus”) and social engagement system providing emotional regulation (Porges, 2017). On the other hand, the auxiliary roles’ interactions with the protagonist throughout the drama provide an experience of consistent attunement which is also associated with emotional regulation and feelings of security, safety, self-esteem, confidence, and connection (Fishbane, 2007). Furthermore, because “the ‘self’ is largely a construction of the prefrontal cortex or the thinking mind” (Dayton, 2015, p. 111), which is often frozen when trauma becomes activated, the experience of role reversing into any other role allows the protagonist to concretize and physically see one’s self―helping to keep the prefrontal cortex of the brain actively stimulated. The role reversal requires the protagonist to utilize internal representations of the other along with their spontaneity and creativity as they continue to engage in the psychodrama (Yaniv, 2011, 2012).
8.4.6 Neurospirituality of Spontaneity
Jacob Moreno’s definition of spontaneity is an adequate response to novelty and a new response to an old situation (1953). Furthermore, Moreno believed spontaneity to be cosmic in nature and directly related to spirituality and the Godhead (Moreno, 2019). Martin and colleagues (1997) conducted research measuring neural activation when participants performed novel tasks, as compared to routine tasks. In novel situation, medial temporal structures of the right brain were particularly active along with left-brain structures, while routine tasks showed only left-brain activation. This research sheds light on psychodrama’s ability, through the activation of spontaneity to awaken a bilateral integration within the brain (Goldberg, 2001; Hug, 2007, 2013). Interestingly, the right medial temporal lobe which was especially active in Martin’s (1997) research is also involved in out-of-body experiences and religious experiences—thus neuroscience seems to support Moreno’s (1921) notion that “God is spontaneity.”