What Is Psychodrama Therapy? 10 Techniques for Your Sessions

What Is Psychodrama Therapy? 10 Techniques for Your Sessions – Psychodrama has been described as individual therapy in a group format, with action taking place around the protagonist’s multiple roles in life, such as a parent, partner, sibling, and employee.

Perhaps surprisingly, psychodrama as psychotherapy is deeply connected with psychology, sociology, and even theater, with the potential to bridge divides between individuals, groups, and communities (Cruz et al., 2018; Giacomucci, 2021).

This fascinating approach has broad applications, including treating depression, phobias, alcohol and drug use, relationships, and family issues (Nicholls, 2017).

In this article, we explore some of the psychodramatic techniques and activities that practitioners can integrate alongside their existing approaches when treating clients.

What Is Psychodrama in Therapy?

Psychodrama began with J. L. Moreno in the 1920s and remains popular, having evolved and been reinterpreted many times since. It is a “therapeutic model widely used in Europe in private and public health settings, including hospitals, […] and mental health services, […] in the treatment of various pathologies such as schizophrenia […] and substance abuse” (Cruz et al., 2018, p. 2).

This form of psychotherapy – while preferably performed in a group setting – is focused on the individual at the center of multiple relational roles (such as being a spouse, sibling, or parent) and their difficulties and potential challenges, such as a fear of rejection or flying, or doubts regarding abilities at work (Cruz et al., 2018).

Psychodrama is often described as an individual therapy performed in a group format, homing in on the various roles or identities clients take on throughout their lives.

The approach offers clients the opportunity to explore how past experiences may have influenced their thinking, feeling, and behavior in the present and how it will shape the future by drawing “on the group’s energy and spontaneity to explore the protagonist’s situation” (Nicholls, 2017, para. 2).

Typically, psychodramatic sessions are made up of social, group, and dramatic contexts, using five instruments, including (Cruz et al., 2018):

• Protagonist
  The member of the group who provides the content for the psychodrama
• Stage
  Where the actions take place and are contained
• Auxiliary-ego(s)
  Other group members or staff
• Director
  The person facilitating the session, usually the therapist
• Audience
  The remaining members of the group who bear witness to the protagonist’s story

Each session involves three distinct phases (Cruz et al., 2018; Giacomucci, 2021):

1. Warm-up – Get the participants ready for physical action and the psychodrama.
2. Action (enactment) – Bring the protagonist’s intrapsychic or interpersonal life onto the stage.
3. Sharing – Once enactment is complete, group members de-role and share their experiences.

Psychodramatic tools provide a warm-up for the action phase or combine to “assist the protagonist in the dramatization of the conflict that needs to be solved” (Cruz et al., 2018, p. 2).

3 Examples of Psychodramatic Techniques

A recent systematic review of the literature identified 11 core psychodramatic techniques.

We include three below and others in subsequent sections (Cruz et al., 2018; Giacomucci, 2021).

Doubling

The double aims to give voice to the protagonist’s inner world by digging deeper than the visible “I” and revealing how they talk to themselves in the safety of their private world.

Doubling can be achieved by another person (the therapist or anyone in the group acting as the double) physically standing close by the protagonist, mimicking their posture, and talking as if they were them. The protagonist corrects them if the doubling is inaccurate but owns and repeats what they say when correct.

Such a technique can be particularly helpful in supporting the protagonist in integrating emotions and thinking that have previously been “split out of consciousness due to the overwhelming nature of the traumatic experience” (Giacomucci, 2021, p. 255).

Mirroring

This technique provides the protagonist with the opportunity to see themselves as others do by looking at themselves in a ‘mirror.’ The therapist asks them to take a seat and observe another group member reenact a scene while mirroring their behavior. The technique is particularly valuable when the protagonist is stuck in a role or unaware of how their behavior impacts others.

By swapping places with a member of the audience, they can gain perspective, see maladaptive relational patterns, and identify changes they have created as a result of treatment.

Role reversal

Stepping out of one’s own identity and trading places with another is considered a crucial technique in psychodrama. Seeing another’s perspective (such as the other partner in a relationship, a role model, a historical figure, or even God) can be a powerful experience.

As an approach, it can expand the protagonist’s perception and help them become unstuck from negative feelings such as guilt and shame.

3 Best Psychodrama Interventions

The following three interventions are integral to and powerful supporting tools for psychodrama as a treatment and can be used alone or in conjunction with other techniques (Cruz et al., 2018; Giacomucci, 2021).

Initial interview

Having selected a protagonist, the next step is the initial interview with the director. While usually kept short and often performed while walking together in a circle to create physical movement, it has multiple purposes, including (Giacomucci, 2021):

• Continuing to warm up the protagonist
• Warming up the group and the director for enacting the psychodrama
• Developing trust, understanding, and connection
• Creating a contract around the goal of the enactment
• Gathering additional information regarding the presenting topic

Scene setting

Immediately after the initial interview, it is vital to choose a setting for the psychodrama and start using objects that help make it real. This marks the move into what therapists refer to as “surplus reality,” where the protagonist moves into action, warming up their body, emotions, and imagination.

The protagonist may be left to set the scene up on their own, showing how it should look while potentially accessing and sharing deep memories.

Self-presentation

At this point, the protagonist begins to show the director, auxiliary-egos, and the audience how they typically act in a given situation. This intervention establishes a starting point and the opportunity to enter the surplus reality, increasing spontaneity while reducing anxiety.

Perhaps most importantly, self-presentation is an opportunity to “externalize their own subjective reality, perspective, and experience” (Giacomucci, 2021, p. 260). The protagonist can then proceed with enactment of their past, present, or future-based psychodrama.

2 Effective Activities and Exercises

Psychodrama is as much about action as talking.

For that reason, it is essential to warm up the group and create a scene that has many of the qualities of the situation being enacted.

The following activities and exercises can help create and maintain the energy required (Giacomucci, 2021).

Spontaneous improvisation

Unlike self-presentation, the protagonist is asked to take on the role of a fictitious character. The director typically places strong demands on them, creating distance from their original psychodramatic topic.

For example, someone struggling with addiction may be asked to act out being a father protecting his family. Spontaneous improvisation can be valuable for a warm-up or as a grounding intervention after a particularly intense personal psychodrama.

Resistance interpolation

While the protagonist sets the physical scene, the director may choose to make modifications that place new role demands. The exercise may be changed in some previously unforeseen way for the protagonist, increasing spontaneity and potentially uncovering new behavioral responses and aspects of the personality.

A Look at Psychodrama in Group Therapy

Psychodrama uses a group format and tools from theater, psychology, and sociology to perform psychotherapy (Cruz et al., 2018).

While a session focuses on one individual as a protagonist, others in the group take on roles as needed. The therapist works directly with the protagonist, but the group provides supporting energies and creativity by acting out roles within their psychodrama (Nicholls, 2017).

Interestingly, once safety and cohesion within the group have been achieved, it becomes its own organism, increasing its effect on its members, and can be treated as the identified client. Research over recent years has shown group therapy to be at least as effective as individual therapy and remains a fundamental aspect of psychodrama (Giacomucci, 2021).

2 Psychodrama group activities

The following two activities, in particular, engage multiple members of the group in the enactment (Cruz et al., 2018; Giacomucci, 2021).

Sculpting

Rather than other members of the group remaining static or disengaged, they are involved in completing the scene.

The protagonist directs where they are and what they are doing. Along with doubling and role reversal, psychodramatic techniques sculpt and make concrete the perceived relationships with their family, environment, and even internal parts of the self.

Empty chair(s)

Rather than solely talking to the empty chair – as is the case with some other therapeutic approaches – this activity is used to facilitate role reversal and doubling in psychodrama.

The approach reduces the load on the protagonist, particularly useful when having a single person acting the role could be too stressful. The chair (or chairs) can remain empty or alternated between multiple group members. For example, multiple group members may take turns sitting at a chair and verbalizing positive or negative messages associated with the protagonist’s life.