Interpersonal Neurobiology, Social Work, Sociometry, and Psychodrama

Abstract

The rapidly emerging neuroscience research continues to validate the practice of social work, group therapy, and psychodrama. The centrality of human relationships is being supported by the field of interpersonal neurobiology. New technologies allow us to learn more about the brain and the ways it is impacted by adversity, healing, and action. The importance of safety, connection, integration, and a strength-s-based approach is supported in the neuroscience literature. The neurobiological mechanisms which promote change in psychodrama are becoming clearer. Furthermore, the words of contemporary neuroscientists appear to echo Moreno’s writings of sociometry and psychodrama nearly a decade earlier.

Keywords

8.1 Trauma and Neuroscience

The evolution of technology has stimulated an advancement in research in the field of neurobiology in the past few decades. Many refer to the 1990s as The Decade of the Brain, due to the significant findings that emerged in the field of neuroscience (Gabbard, 1992). The field of trauma and post-traumatic stress has been revolutionized in the past few decades with an influx of new information about how trauma impacts the body and the brain. Some core neurobiological processes to understand when it comes to trauma include the structure of the brain, attachment and affect regulation, poly-vagal theory, and trauma responses, HPA axis, memory and learning, and healing from trauma.

8.1.1 Brain Structure and Brain Systems

The brain is an incredibly complex organ, most of which we still do not fully understand due to its many complexities. Some foundational understandings of the structure of the brain include the conceptualization of the brain as a part of multiple larger systems including the nervous system, the body, the family system, and larger social systems. Neurons, or brain cells, develop neural networks through connections with each other. Neural connections are strengthened by repetition, resulting in the famous neuroscience rhymes “neurons that fire together, wire together,” and “use it or lose it” (Hebb, 1949). The brain is most malleable and develops at its quickest rate in the early years of life. Following its evolutionary history, brain structures develop hierarchically from oldest to newest; beginning with the brain stem (sometimes called the reptilian brain) which regulates basic bodily functions such as heart rate, breathing, and temperature. Next, the limbic system (sometimes called the mammalian brain) develops which includes the thalamus, amygdala, hippocampus, and hypothalamus responsible for the facilitation of sensory information, emotions, relationships, and memory. The final part of the brain to develop is the cortex, which is responsible for more sophisticated aspects of human life including language, meaning making, ideas, processing information, and fine motor movement. The cortex is broken into two hemispheres, connected by the corpus collosum. Generally speaking, the right hemisphere specializes in emotions and sensory information while the left hemisphere specializes in detail related to language, meaning making, and fine motor movements (Shapiro & Applegate, 2018; Siegel, 2012).

8.1.2 Attachment and Brain Development

The brain develops along this trajectory in relationship to close attachment figures of the individual. Cozolino (2014) suggests that instead of the Darwin’s idea of survival of the fittest, the neuroscience research suggests survival of the nurtured is more accurate. He writes that “there are no single human brains—brains only exist within networks of other brains” (2014, p. xvi). The infant’s caregivers, through attuned presence and nurturing, contribute to optimal conditions for healthy brain development and the child’s capacity for emotional self-regulation as an adult (Schore, 2015). The human child is dependent on others for their survival for a longer time than any other species—“they survive based on the abilities of their caretakers to detect the needs and intentions of those around them” (Cozolino, 2014, p. 6). Emotional and physical neglect or abuse have the potential to disrupt the brain’s development and cause psychosocial problems throughout the lifespan (van der Kolk, 2014). Our need for connection and relationships is wired into us as humans and continues long after maturation. Even in adulthood, we continue to regulate our emotions through relationships and social engagement with others (Porges, 2017).

8.1.3 Polyvagal Theory and Danger Responses

Stephen Porges’ Polyvagal Theory suggests that “in humans, three basic neural energy subsystems underpin the overall state of the nervous system and correlative behaviors and emotions” (Levine, 2010, p. 97). These three subsystems developed evolutionarily to facilitate our responses to external threats and to maintain homeostasis or a sense of safety (Porges, 2017). The most primitive of these systems is the unmyelinated dorsal vagal complex—the immobilization system (freeze response) that we have in common with almost all vertebrates. The next system to develop phylogenetically is the mammalian sympathetic nervous system that supports mobilization of fight and flight responses. And finally, the most recently developed stage of the hierarchy is the myelinated ventral vagal complex, a major component of the social engagement system. The more refined ventral vagal system, or “smart vagus,” is linked to facial expression, orienting, listening, and vocalization which facilitate (verbal and non-verbal) social communication, relationships, and attachment (Porges, 2017). These three subsystems compose a map of human response strategies employed as physiological reactions to external threats—beginning with the social engagement system as a first utilized adaptive response, preceding the mobilization responses, and finally calling upon the immobilization response as a last effort to survive.

Both the immobilization and mobilization responses are necessary for healthy functioning and human survival. The responses to danger are meant to be short and quick responses; however, some traumatized individuals can experience chronic hyperarousal (fight/flight) or immobilization (freeze) because the nervous system does not discriminate between a perceived, current threat and a distress about an experience in the past (Levine, 2010).

8.1.4 Stress Regulation and the HPA Axis

The hypothalamic–pituitary–adrenal (HPA) axis regulates and controls the release of hormones to the body which produce stress and prepare the body for responses to threat or danger. The immediacy of this process is essential for short-term survival while the quick return to normalcy is essential for long-term survival (Cozolino, 2014). Chronic or prolonged stress from repeated trauma responses disrupts various processes in the body and can result in the breakdown of different systems including the musculoskeletal, cardiovascular, endocrine, respiratory, gastrointestinal, immune, reproductive, and nervous systems (Cozolino, 2014; Maté, 2011; McFarlane, 2010; van der Kolk, 2014).

8.1.5 Experience and Memory

The neurobiological underpinnings of experience, learning, and memory are highly relevant in the approach to trauma and PTSD. The finding that the brain maintains its neuroplasticity means that the brain, and thus the person, continues to be impacted and shaped by experiences throughout their lifespan (Cozolino, 2010; Siegel, 2012). Experiences, especially relational experiences, result in meaningful learning due to the social nature of our brain circuitry (Cozolino, 2014). Trauma, adversity, and chronic stress have the potential to disrupt the brain’s capacity for normal learning due to the resulting hyperarousal, overwhelming emotions, negative thoughts and beliefs, intrusive images, avoidance, and dissociation (Levine, 2010; Shapiro & Applegate, 2018).

There are various types of memory including explicit and implicit memory, both of which play a role in traumatic stress. Explicit memories are consciously remembered experiences while implicit memories are not conscious but affect our feelings, sensations, and actions in the here-and-now (Levine, 2010). Until the hippocampus is formed around 18 months old, the infant is operating without explicit memory and their learning is based entirely on experiences that result in implicit memories. Traumatic experiences result in both implicit and explicit memory—while the individual may or may not recall the traumatic event, the body continues to keep the score and responds to stimuli related to the trauma (van der Kolk, 2014).

Research by Rauch and colleagues (1996) indicates that when a traumatic memory is activated it appears to significantly impact the functioning of the speech and language centers of the brain (van der Kolk, 2014), which theoretically challenges the effectiveness of talk therapy. These findings also highlight a neurobiological understanding as to why trauma survivors may have difficulty talking about their experiences. Bessel van der Kolk explains that the “imprint of trauma doesn’t sit in the verbal, understanding part of the brain…but in much deeper regions—amygdala, hippocampus, hypothalamus, brain stem—which are only marginally affected by thinking and cognition” (as cited in Wylie, 2004, pp. 30–41).

8.1.6 Dissociation, Fragmentation, and Integration

Trauma experts seem to agree that when someone experiences something as traumatic, it is because their capacity to process and integrate the experience was overwhelmed—often resulting in fragmentation, dissociation, avoidance, and/or re-experiencing of the traumatic material (Fisher, 2017; Herman, 1992; Levine, 2010; Shapiro, 2018; Siegel, 2012; van der Kolk, 2014). Trauma creates fragmentation and dissociation interpersonally, intrapsychically, and neurobiologically (Giacomucci, 2019). Neurobiologically, a trauma survivor’s vertical and hemispherical integration is disrupted. Psychologically, their sense of self, narrative, cognition, and memories become fragmented. And interpersonally, their relationships are often characterized by reenactment, insecure attachment, and discord. In order to diminish these PTSD symptoms, the traumatic experience must be processed and integrated by the individual at the mind, body, and relational levels.

8.2 Social Work and Neuroscience

Social workers frequently are working with individuals, groups, or communities that have experienced trauma, neglect, or adversity. The influx of new neurobiology research has provided social workers with another layer of information and evidence on which to base our profession and our practice. Farmer (2009) even declares that neuroscience is a missing link for social workers. Neuroscience research has challenged previously held beliefs of the separateness of mind and body in favor of an integrated mind–body perspective (Johnson, 2008). Furthermore, interpersonal neurobiology endorses an integrated biopsychosocial viewpoint demonstrating the interconnectedness of mind, body, and relationships. In addition to suggesting new ways of practicing for clinical social workers, “findings from neurobiology help them appreciate the biopsychosocial substrate of relational dynamics that serve as a context for effectively applying techniques they already use” (Shapiro & Applegate, 2018, p. xxi).

Interpersonal neurobiology research supports many of the core theories that have become integrated within the foundation of the field of clinical social work. In Neurobiology for Clinical Social Work, Shapiro and Applegate (2018), highlight multiple facets of neurobiology which are relevant and important for social work practice including how neuroscience relates to memory, learning, stress, trauma, narrative, affect regulation, emotion, human behavior, attachment, human development, adult relationships, and psychotherapy. Neuroscience provides an increased understanding of the complexities of most personal and societal problems encounter on a regular basis by social workers (Farmer, 2009).

8.2.1 Foundation of Relationships

Social work philosophy emphasizes the value of relationships and specifically the importance of the therapeutic relationship between client and social worker. Research in the field of psychotherapy has validated social work philosophy by demonstrated the therapeutic relationship to be the most important aspect related to psychotherapy outcomes (Ardito & Rabellino, 2011; Horvath & Symonds, 1991). The field of interpersonal neurobiology uncovers the biopsychosocial factors that resulting in the significance of human relationships in psychotherapy and “why the humanity we share with our patients can be as powerful as any drug” (Cozolino, 2018, p. xii). Findings in epigenetics demonstrate how experiences impact the expression or inhibition of genetic potential. An individual’s environment and their life experiences influence their genetic expression which supports social work’s person-in-environment perspective (Shapiro & Applegate, 2018).

Many neuroscience experts agree that one of the most important neuroscience implications for psychotherapy is an understanding and movement toward neural integration. Siegel (2012) points to integration as the key to mental health, while Cozolino (2010) emphasizes neural integration as the key to optimal outcomes in psychotherapy. He outlines key areas to include: (1) the safe and trusting holding environment of the therapeutic relationship; (2) new corrective experiences that lead to learning across neural networks; (3) integration of neural networks, especially those that have been fragmented or disconnected; and (4) practicing affect regulation and stress tolerance within the safety of the therapeutic alliance. These considerations for psychotherapy provide social workers with a neurobiology-informed approach to clinical work.

Through the framework of interpersonal neurobiology, relationships can be conceptualized as biological interventions (Cozolino, 2018). It seems that interpersonal neurobiology has fulfilled J. L. Moreno’s vision a half-century earlier of a scientifically based interpersonal therapy. The increased value placement in relationships and their importance in human life seems to have emerged concurrently with the increased practice of group psychotherapy in the past few decades.

8.3 Group Psychotherapy and Neuroscience

Similar to social work practice, the practice of group psychotherapy is validated by new neuroscience findings (Flores, 2013). While much has been written about neuroscience as it relates to mental health and individual psychotherapy, the literature on group therapy and neuroscience is lacking. Considering relationships as one of the most important aspects of psychotherapy, it would make sense that a group setting may offer exponentially more opportunities for relational healing than individual work. Because of this, Gantt and Badenoch suggest that from a brain-based perspective, group therapy may be “a more powerful and logical choice” than individual therapy (2013, p. xx).

Badenoch and Cox (2013), in Integrating Interpersonal Neurobiology with Group Psychotherapy, suggest three primary focus points for group therapists to incorporate neuroscience into their work: (1) early brain development and memories (explicit, implicit, and autobiographical); (2) the group as an regulating holding environment for both group members’ emotions and nervous systems; and (3) attention to the four domains of neural integration—consciousness, interpersonal, vertical, and bilateral integration.

8.3.1 Group Holding Environment

The aforementioned clinical recommendations for the integration of interpersonal neurobiology into group work echo the same suggestions provided by Cozolino (2010) for individual psychotherapy. The primary difference in the suggested areas is that in individual therapy the relationship between client and therapist is emphasized for its safety, regulation, and capacity for corrective experiences—while in group psychotherapy the group-as-a-whole is emphasized as possessing these same capacities. The holding environment shifts from being the relationship between client and therapist, to the matrix of relationships between all group members. Gantt and Agazarian (2013) articulate this in suggesting that:

Maximising neuroplasticity requires that we create an experiential group environment that provides a secure relational context, with neural and emotional regulation within and between brains, where moderate levels of emotion can be experienced with the right-brain resonance and responsiveness that enables modulation, development, and greater implicit integration. (p. 82)

The brain’s capacity for change throughout the lifespan is leveraged as a mechanism for therapeutic effect in group psychotherapy whereby individual participants come together creating a collective and are healed by the group-as-a-whole. One might argue that the value of group psychotherapy becomes especially realized when working with individuals who have experienced adverse or traumatic relationships in their life. The social nature of group psychotherapy activates the social engagement system in a way that “the group-as-a-whole can be supported in gradually becoming havens of safety and regulation for all members” (Badenoch & Cox, 2013, p. 10).

8.3.2 Early Childhood Experiences

Early childhood experiences become encoded in the brain and nervous system as implicit memories and attachment styles which impact our lives going forward (Cozolino, 2014; Siegel, 2012). In the first 12–18 months of an infant’s life, these are the only type of memory created—“embodied, wordless, yet rich and foundational to our view of the world” (Badenoch & Cox, 2013, p. 4). The right-brain to right-brain communication and resonance between individuals of an attuned group provides a holding environment to regulate the activation of these implicit memory systems and offer an avenue toward neural integration (Siegel, 2013). Early childhood experiences, often encoded as implicit memories are difficult to work with in traditional psychotherapy settings however, the “group is a unique context that can trigger, amplify, contain, and provide resonance for a broad range of human experiences, creating robust conditions for changing the brain” (Gantt & Badenoch, 2013, p. xix).

8.3.3 Neural Integration Through Group Psychotherapy

The integration of consciousness is defined as the mind’s ability to compassionately observe itself (Siegel, 2007). This capacity becomes enhanced through group psychotherapy’s process of story-telling and compassionate witnessing between group members. When safety and cohesion is established within the group, interpersonal integration emerges and contributes to integration of consciousness for each individual group member. “Energy and information constantly flow not only within brains, but between brains” (Badenoch & Cox, 2013, p. 14). Coincidentally, both interpersonal integration and integration of consciousness work together to enhance vertical and bilateral integration. On the other hand, bilateral integration refers to the bridge between right hemisphere sensations and emotions with left hemisphere words and insight to develop a coherent narrative of an experience. Siegel, the developer of interpersonal neurobiology, writes that integration is at the heart of health and that humans who come together with a common history, identity, and purpose have an innate drive toward integration and wholeness (2013).

8.4 Sociometry, Psychodrama, and Neuroscience

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).

8.4.1 Action

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.”

8.5 Sociometry and Interpersonal Neurobiology

J. L. Moreno’s understanding of individuals existing within social networks and social atoms, as well as his statement that “an individual is tied to his social atom as closely as to his body” (1953, p. 703), seem to be echoed in Cozolino’s description of the social synapse, “there are no single human brains – brains only exist within networks of other brains” (2014, p. xvi). An exploration of the social atom and tele, as they related to neuroscience was published by Yaniv (2014) in which he compares tele to neurophysiological experience of emotional valence. Moreno even wrote in 1953 that “it seems to us a valuable working hypothesis to assume that back of all social and psychological interactions between individuals there must once have been and still are two or more reciprocating physiological organs which interact with each other” (Moreno, 1953, p. 313, italics in origin).

Moreno even offered hypotheses on the evolution of mankind’s social nature which reflect modern evolutionary neuropsychology findings (Yaniv, 2014). He writes of the evolution of society and the evolution of groups, from undifferentiated to more complex and highly differentiated parts which integrated together make up the larger whole (Moreno, 1953). This idea parallels the development of the individual brain, mind, and social atom which rapidly develop from less differentiated to highly differentiated parts and systems which support the wholeness of the brain, mind, and social atom. Moreno’s Who Shall Survive? text indicates that:

For this “affinity” we could not avoid considering the possibility of a “social” physiology… At a certain point man emancipated from the animal not only as a species but also as a society. And it is within this society that the most important “social” organs of man developed. The degree of attraction and repulsion of one person towards others suggests a point of view by means of which an interpretation of the evolution of the social organs can be given. (1953, p. 313)

Nearly a half-century before the emergence of Interpersonal Neurobiology and “The Social Brain” hypothesis, Moreno was writing of a “social physiology.” Cozolino underlines a similar parallel process, that the communicative space between connected neurons, called a synapse, reflects the same relational space between humans–the social synapse (2014).

Moreno’s role theory of personality also seems to reflect Cozolino’s (2014) theory of self which is based on the social brain. Interpersonal neurobiology describes the self as developing from the infant’s early relationships which reflects Moreno’s theory of development in that Moreno highlights the developing self as a function of new roles emerging through role reciprocity and accurate doubling from caregivers. Cozolino writes:

How does the self come to develop within the social brain? It is safe to assume that the self consists of many layers of neural processing that develop from the bottom up as we grow. The first systems of internal bodily sensations are joined by sensory-motor systems, added to by emotional and cognitive processing, and later topped off with abstract ideas and beliefs. All these systems are woven together in the context of our relationships. (2014, p. 422)

This description of the layers of self, from body and action, to emotions and cognitions, along with abstract ideas, all within a relational context seems to reflect Moreno’s role theory and role categories of somatic roles, psychodramatic roles, and social roles (Moreno, 1972). Cozolino goes on to articulate that the self does not exist in one part of the brain but is an emergent function of multiple systems. Again, this reflects Moreno’s statement that the self emerges from all the roles in one’s life and expresses itself through roles. The complex web of role relationships between an individual and their social atom is called the cultural atom–which provides a depiction of the co-constructed self within its web of role relationships and role reciprocity.

Moreno introduced the term sociostasis, describing that “the emotional economy of the social atom is operating in accord with an unconscious postulate-to keep the social atoms in equilibrium” (1947, p. 81). Interestingly, Cozolino used the same term, sociostasis, as a chapter title in The Neuroscience of Human Relationships (2014) to describe how our brains are regulated through the matrix of our relationships. He concludes the chapter by stating that “sociostatic processes … reflect the basic interconnectedness of our brains, minds, and bodies and point to the sometimes unseen reality that we are far more interdependent than our individualistic philosophies would lead us to believe” (p. 257). The interconnectedness between sociometry, the social atom, and interpersonal neurobiology has yet to be fully explored by psychodramatists and sociometrists.

8.6 Conclusion

Moreno’s 1934 title, Who Shall Survive? was influenced by Darwin’s theory of natural selection which indicates that the most adapted organisms survive and reproduce—survival of the fittest. Moreno writes that Darwin asked the question of who shall survive from the role of a biologist while Moreno reintroduces the question from the perspective of a sociologist or sociometrist—the “microscopic social laws which we have discovered may correlate with the gross evolutionary laws of the biologist” (Moreno, 1978, p. 7). He raised the question of how social forces and relationships impact the survival of individuals, groups, and society itself. What is the natural process of social selection? Why do some get large numbers of choices, selections, and social wealth while others are unselected, isolated, and deprived of connection or love? The interpersonal neurobiologists offer another answer to the question of who shall survive—the survival of the nurtured. As human beings, we survive because of our relationships—because of our sociometry.

The importance of relationships is central to the fields of interpersonal neurobiology, social work, and Moreno’s methods. One might take the stance that the greatest overlap between social work, sociometry, and psychodrama is also the emphasis on the social. It is only paradoxical then that the continued study of the human brain, mind, and biology repeatedly brings us back to the importance of relationships and the social nature of man. Interpersonal neurobiology offers further scientific validation to the practices of social work, sociometry, psychodrama, and group psychotherapy.