What is it that makes us human and how can we bring the maximum of our humanness to the therapeutic moment? We are not talking heads; our lives occur in real time, real action. We have a felt and sentient encounter with each and every moment. Why shouldn’t therapy allow and even train us to deepen our experience with the here and now?
Role-play allows for the body to move in a fashion that is natural to the human being rather than to ask them to sit still, disengage from the body, and talk exclusively from the head about their trauma. The intense and often split off emotions and body sensations that are stored in the limbic system become naturally stimulated through role-play; after which words can be added to the direct experience.
Celia began her psychodrama in the usual way by setting the scene—this one was in France. Celia choose someone to play her mom, her sister, and her half-brother who became her sister’s lover. He wasn’t her half-brother after all . . . or was he? There were so many family secrets. Celia then chose someone to play her confusion and someone to play her overwhelming fear, disorientation, and shame. Celia reversed roles with each part of herself along with the other characters she wanted to experience “as if from within their skin.” She stood in the shoes of her mother and felt the world as her mother might have. She did the same for her half-brother and her sister. As she did this she gained not only a degree of empathy for how they experienced the world, but also a degree of separation. Having had the courage to stand in their shoes for a moment, she found herself more easily able to step out of them. She gained a sense of where they left off and she began.
So often we take those around us inside of ourselves almost unconsciously—there they live, seeing out through our words, thinking our thoughts, and driving our actions without our awareness. By actually stepping into and momentarily inhabiting these important figures in our lives, we find the door through which we can again step out and back into ourselves. Celia also reversed roles with aspects of herself; she gave form and voice to silent complexes that were pressing on her from within. She became her shame, her confusion, and her general overwhelm. She talked back to herself from each “place” inside that represented a place inside of her, each emotional state. Slowly and bit by bit she let herself collapse; first the rage, then the sadness, then the collapse she’d held onto for so many years, the one she had warded off with drugs and alcohol. She felt that if she ever fully entered the collapse, she might not come out the other end.
However, it was just this collapsing—that she had so assiduously avoided before—that let her to shed the buried tears and allow something that had felt dead to come alive. It seems like one of those paradoxes again.
Traumatized people live, not in our stories, but as if the threat of being shocked, of having the rug pulled out from under us, of having our world turned upside and handed back to us all messed up, were happening again and again and again. It’s not so much that we reenact and recreate; it’s that we never really leave home.
Psychodrama allows the mind and body to tell that story, which makes it an ideal modality for doing trauma resolution. Psychodrama is largely intrapersonal as it deals with the issues in the inner world of the client or “protagonist” (the person whose story is being enacted). It is also interpersonal or relational, meaning that the issues can be dealt with through role-play and through repeated exposure and limbic bonding.
The Effect of Trauma on Relationships
Our neural networks can become oversensitized to stress if we’ve been traumatized. Distorted thinking, hyperreactivity, mistrust, and ambivalence can be some of the issues that become part of being in close relationships. Dysfunctional patterns of relating that are the direct result of relationship trauma literally wrap around our emotional and psychological development and imprint themselves on our neural networks. If our pain occurred in the context of our primary close childhood relationships, the most likely place our posttraumatic stress reactions will surface is in our primary close relationships in adulthood. In partnership, the very closeness we feel—along with feelings of dependency and vulnerability that are part of intimacy—can bring up our previous experiences around early primary relationships.
This is why recovery from relationship trauma that has imprinted itself onto our self system takes time. We are changing the body as well as the mind. When trauma occurs within the context of our early relationships, it not only affects our relational patterns but also impacts our mind-body system through the phenomenon of neural patterning. These patterns set the foundations from which we operate in our relationships throughout life. Additionally, the more we play patterns out in our relationships, the more engraved and ingrained the patterns become.
It is our thinking mind that makes sense out of the emotional and sensory input from our limbic mind. This is how we make meaning out of experience. However, trauma is all about not experiencing what we are experiencing. It is about splitting off or numbing out what we’re feeling because what we’re experiencing is frightening us. When our environment is chaotic or fear inducing we may have a hard time tolerating what we’re feeling or have a hard time staying in our bodies. When we cannot remove ourselves from what is frightening us nor fight it off, we may go numb or shut down.
Why do we freeze? We freeze because we’re scared, because something is overwhelming us. And what happens when we freeze? When we freeze we don’t process what’s going on the way we do normally. We experience an altered state of consciousness during which our normal sense of a situation can become altered. Time may even be slowed down or feel fragmented. Our senses go on high alert while the thinking part of our brain shuts down.
The limbic system is responsible for such wide ranging functions as appetite and sleep cycles, mood and emotional tone. Problems in the limbic system can cause long-term effects in our ability to self-regulate and maintain emotional and psychological balance. The key to resolving trauma is getting the prefrontal cortex—which shuts down in times of high stress, shock or terror—to wake up and reengage so that it can make sense of the limbic material that comes pouring forth in a psychodrama. The following exercise, The Symptom Floor Check, is a psychoeducational group process that allows clients to wrap their minds around the nature of the symptoms that are the fallout of relational trauma. The exercise is part of Relational Trauma Repair (RTR) and a model of treatment that offers moments of incremental, interpersonal healing, allowing the body as well as the mind to engage in a healing process while attempting new relational behaviors. It is the magic of group process that there is always someone in the group who can hear and understand; someone who can identify and act as an agent of healing for another person.
Symptom Floor Check Exercise: Learning about and Assessing PTSD Issues and Emotions
This is a cornerstone exercise. It will help to educate clients about the pathological characteristics that are a part of the PTSD syndrome so that they can develop a language through which to understand and work with them. The idea here is to normalize symptoms by making them conscious, translating them into words, and sharing them with others. Participants can bring symptoms out into the open, hear others share, and accept identification and support. This process helps to breakdown isolation and makes feeling intense, split off, or repressed emotions less threatening. What we don’t know can hurt us. While these symptoms remain unconscious they can exert significant power over the lives and relationships of clients.
- To educate clients as to the range of symptoms that can accompany relationship trauma
- To provide a format through which clients can decide for themselves which symptoms they feel they identify as experiencing in their own lives and relationships
- To create opportunities to hear about how symptoms manifest for other people and in other people’s lives and relationships
- To encourage connection, sharing, and support around facing difficult personal issues
- To educate clients as to how to trade a pathological symptom for a healthy trait
1. On large pieces of paper, write these symptoms or characteristics of relationship trauma:
- Cultivation of a false self
- Problems with self-regulation
- Hyperreactivity/easily triggered
- Learned helplessness/collapse
- Emotional constriction
- Relationship issues
- Somatic disturbances such as body aches and pains
- Learning issues
- Loss of trust and faith such as in relationships or an orderly world
- Traumatic bonding
- Unresolved grief
- Depression with feelings of despair
- Distorted reasoning
- Loss of ability to take in caring and support from others
- Tendency to isolate or withdraw
- Cycles of reenactment such as repeating painful relationship patterns
- High-risk behaviors such as speeding, sex or spending/debting
- Survival guilt/shame
- Development of rigid psychological defenses such as denial, dissociation, splitting, minimization or intellectualization
- Desire to self-medicate with drugs, alcohol, food, sex, money or work
2. Place the papers with symptoms on them a couple of feet apart scattered around the floor.
3. Ask participants to stand on or near a characteristic that they identify as being a problem for them in their lives.
4. Once group members are standing on the characteristic that they identify with, invite them to share a sentence or two about why they are standing where they are standing.
5. Next invite group members to stand on or near a trait or symptom that they feel was present either in someone in their family of origin or in their family of origin as a whole that created problems.
6. Once group members are standing back on the characteristic that they identify with, invite them to share another sentence or two about why they are standing where they are standing. A resilience-building question might be, “Which characteristic do you feel used to be a problem for you, but you have worked your way through?”
7. After group members have shared about one, two or three characteristics say, “Walk over to someone who shared something that you identified with or that moved you, place a hand on their shoulder and share with them what moved you.” (Note: the sharing will be taking place in dyads and subgroups that will naturally and spontaneously form as a result of this question.)
8. At this point the group may be ready to (a) sit down and share about the experience so far, (b) do “Letting the Child Speak” under Symptom Locogram in The Personal Journal, or (c) move into psychodramas of “Letting the Child Speak” by talking to the child self (in an empty chair or a role-player representing the child self) while in the throes of one of these characteristics, reversing roles and talking as the child and doubling for the child.
Group members can share so that the entire group can hear them or, if the group is large, they can share with those who are standing on the same characteristic that they chose. When they share “around their characteristic or symptom” they will be sociometrically aligned by symptom (i.e., all those experiencing a particular symptom will be sharing with others experiencing that symptom). This subgrouping can make sharing feel safer and can allow clients to feel seen, supported, and more open. The symptom choosing can go on as long as it is useful, depending on the needs of the group. Generally, the group is saturated by the third choice and needs to move into sharing, journaling or psychodrama.
The therapist may vary questions. For example, “Which symptom do you have the toughest time dealing with in other people?” or “Which symptom seemed to be the most present in your family or origin?” or “Which symptom do you feel you recreate the most on your present day life?” A resilience-building question might be, “Walk over to someone from whom you feel you could learn something and ask them for help.” The therapist might invite group members to share what qualities they feel they developed through adversity or what the silver linings are for them in having gone through a particular circumstance. The therapist may also invite group members to “upgrade” their symptoms, that is, to trade in one for a trait they would like their symptom to morph into. For example, “I would like to trade learned helplessness for a chosen position of surrender” or “I would like to trade hypervigilance for awareness” or “I would like to trade a loss of trust and faith with renewed faith in Higher Power” and so on. As they do this, let them write their new “upgrade” on a sheet of paper and place it next to or on top of the symptom. Allow them to do this for any symptoms with which they identify.
- Letting the Child Speak: Mentally reverse roles with yourself while in the throes of any one of the trauma characteristics and journal from that place. For example, “I feel helpless” or “I get this way whenever” or “I am feeling so emotionally constricted I just want to . . .” and so on.
- A Moment of Repair: Journal about a time when repair occurred and write about how you felt during or after a moment of repair—apology, reconnection, repair of some sort—within the relationship. Write what positive lessons you learned about relationship repair from it that you might still be living.