Healing World Trauma with the Therapeutic Spiral Model. Группа авторов

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      Again, this is a simple psychodrama technique borrowed from the theater where the protagonist is asked to turn his or her head aside and to talk out loud as though no one in the theater can hear them. It is different from soliloquy in that with an aside a person has a “point” to make to him or herself; it is not just free association. It is also used in TSM as it is classically described, without change.

      The Empty Chair

      This technique actually has a long history of controversy between psychodramatists and Gestalt therapists (Perls, Hefferline, and Goodman 1951) about who created it. As the seminal experiential psychotherapy (Moreno and Moreno 1969), psychodrama does lay claim to all action techniques and that is true for the empty chair as well, while Gestalt was a “wholistic” theory, not a therapy, at the time Moreno was establishing his work (Wertheimer 1924). The empty chair technique has actually shown up in many other methodologies, including cognitive behavioral therapy, role training, and others that use psychodrama or action methods but do not give credit.

      TSM, which often uses the empty chair, does in fact give credit and gratitude to classical psychodrama for creating this very valuable tool that can be used in individual as well as group psychotherapy. TSM actually incorporates the intrapsychic structure of Perls with Moreno’s interpersonal focus through this empty chair technique. For example, the empty chair is used for a dialogue between parts of self in order to resolve an interpersonal situation.

      Doubling

      Doubling in classical psychodrama serves the purpose of becoming the inner voice for the protagonist of what is not said. The double speaks subjectively, I – I, as in, “I am upset. I need… I want…” It is often described as echoing the first stage of childhood development, when the baby does not have words and the mother, or other caretaker, begins to put words to what is unspoken (Z.T. Moreno 2006). For example, if you imagine a baby’s face scrunched up, eyes closed, and s/he is making angry sounds with fists balled up, an attentive mommy will say, “Oh baby is angry. Baby is so angry!” With that intuitive action she has just helped her baby learn to identify and verbalize angry feelings.

      A double in classical psychodrama will stand beside the protagonist, notice that his or her hand is clenched in a fist and knocking slighting against the thigh, and say, “Oh, I am angry. See my fist. I am so angry! I want to hit someone!” In this way, the classical double notes and expands what is out of conscious awareness for the protagonist or individual client, and often helps them to move into an expressive catharsis.

      Since the classical double is designed to expand unconscious awareness and increase emotions, it has limited use in TSM where the goals are for a contained and conscious expression of emotion. And yet, because of its central importance of bringing unconscious elements to light, TSM integrated this powerful technique into its primary repertoire. And it is here that TSM has made some major advances to classical psychodrama, doing what was clinically prescribed even before neurobiology taught about not overwhelming the brain with too much intense emotion. We have created two clinically modified doubles: the Containing Double (CD) and the Body Double (BD).

      THE CONTAINING DOUBLE

      The Containing Double, differentiated from classical psychodrama’s early cognitive double (Buchanan 2011, personal communication), is the first clinical advance on the classical psychodramatic double (Toscani and Hudgins 1993; Hudgins 2002). It is by far the most frequently used TSM intervention that has been imported into other practices around the world in individual, couples, family and group therapy, workshops, community organizing, and corporate situations. It is an intervention that focuses on balancing the right-brain of sensation, images, and emotions with the left-brain of language and meaning-making. This provides a truly balanced and integrated neurobiological experience of experiential therapy for the purpose of full developmental trauma repair. It has been successfully researched in a number of settings (Hudgins, Culbertson, and Hug 2009; Forst 2001; Hudgins, Drucker, and Metcalf 2000; Hudgins and Drucker 1998).

      The CD helps the protagonist notice unconscious feelings held in the body, while at the same time helping to put words to express those feelings. You will notice the difference in the following example as compared with the previous one from classical psychodrama. When the CD notices the closed fist of anger, the inner dialogue of the protagonist is far different, with the CD saying, “Hmmmm…I notice my fist is closed. I can open it up, back and forth. Slowly open; slowly close. Open and close. I wonder what I am feeling there. Is it anger? Or something else? I wonder what I want to express here and how I want to express it—but I don’t have to express it yet. I can sit with these feelings and just notice them and then make the choice when I’m ready to express myself.” The CD does not make the emotion bigger; it contains it with sensitive observation, curiosity, and with calming words while leading into future action.

      Another example of its effective use is when the protagonist is dissociating from the present and/or getting caught in a past trauma. In that instance, the CD might say, “Right now I’m feeling very scared of the situation I’m in, but if I look around I can see that I’m really in a safe place with my friends around me. I can see Bob, and Jean, and others that I really feel safe with. I’m really here—not back there. Life is changing.” Grounding in the moment and establishing a foothold for the protagonist, the CD eventually leads into meaning-making.

      THE BODY DOUBLE

      While the CD is busy holding and making meaning concerning the emotional state, the Body Double’s use evolved to concentrate specifically on calming and soothing the body if feelings start to become overwhelming, and the cognitive and emotional container of the CD is not enough. As a TSM intervention, it focuses initially on grounding the protagonist in an awareness of healthy and appropriate body sensations in the here-and-now through breathing (Burden and Ciotola 2001; Carnabucci and Anderson 2012). The BD helps the person to stay in the present to control unwanted body memories or triggers that jettison them into unprocessed trauma memories without conscious choice.

      Following on the previous example, the BD can pick up on the body cues, saying something to the effect of “When I look around at my friends, I can feel my body starting to relax. I can breathe and don’t have to be tense and constricted here. This is a safe place. I can breathe and let my body feel the safety. I am not afraid to lift my eyes and look at my friends. I can breathe calmly and make my body my friend, too.”

      A major component of the BD is audible breathing. In and of itself, breathing slowly, calmly, and out loud begins immediately to quiet the protagonist and other group members when intense emotion gets triggered. It is interesting to see how quickly the entire group can begin to use this calming breath of the BD for self-soothing, once it is introduced into a drama. In Chapter 8, Colleen Baratka, who had been using this technique for years before it was named, gives an exquisite demonstration of the BD with eating disorders where it is used as a crucial TSM intervention.

      In most dramas, the CD and BD are intertwined and are held by one auxiliary. In severe cases of body dysfunction, the BD is a separate role. Neurobiologically, it could be said that, from clinical experience, the BD was devised to calm and soothe the amygdala, while the CD acts as a corpus callosum connecting the right and left hemispheres of the brain, thereby also calming the amygdala by giving a narrative where one did not previously exist. The workings of these two roles bring the trauma picture into the safety of the here-and-now, thereby enabling the protagonist to deal with it appropriately.

      Role Reversal

      Another major classical psychodrama technique that TSM embraces is that of role reversal, described as person “A” taking the place of person “B,” at the same time as person “B” becomes person “A.” It is a complete exchange of roles, identity, body movements, and voice tone, as much as possible. Role reversal is СКАЧАТЬ