Creative Conversations in Somatic Psychotherapy

Interview for the US Bodypsychotherapy Assn .

June 2007: Linda Ciotola

Linda Ciotola, M.Ed., CHES, (ret.), CP/TEP is a Certified Clinical Psychodramatist, health educator, fitness and yoga instructor.

The following is a transcript of the original audio, which is part of the Creative Conversations on the USABP website (www.USABP.org). Please note that this conversation was meant to be a spontaneous ex-change, not an edited piece. For better or worse, the transcript retains the unedited quality of the conversation.

Serge Prengel: I’m having this conversation with Linda Ciotola who is a certified clinical psychodramatist. She is also a member of USABP, and she has other certifications in the area of fitness and Yoga. One question I can ask you to start is: in what way is psychodrama related to what’s called action methods?

Linda Ciotola: Psychodrama was actually developed by Dr. J.L. Moreno back in the early part of the last century. He was actually just a bit younger than Freud and most action methods are derived from psychodrama. So for example, a lot of Gestalt work, empty chair work, enactments, a lot of the work that Virginia Satir did, all derived from psychodrama. And while they may not have the whole structure of psychodrama, they’re sort of derived and excerpted, if you will, from psychodrama. And we refer to the general field as action methods, but the specific structure of psychodrama was created by Dr. Moreno..and further developed by Zerka Moreno and others.

S P: And you know, the psychodrama-this action in many people’s mind-is related to something that involves a lot of people and is a group process. So is psychodrama always a group process?

L C: Psychodrama is generally a group process. Moreno believed that we’re all auxiliaries that help heal one another and certainly the newer research on limbic resonance and empathic attunement will bear that out. However, I also do what are called private psychodramas where an individual client may contract with me to do what’s called a private drama and sometimes it may just be the two of us and empty chairs and some of what I call furry auxiliaries, which are puppets and stuffed animals, sometimes there may be one of my trainee students doing auxiliary work. If it’s just two people, the director and the protagonist, it’s called psychodrama a deux (just for two). So it can be a very individualized process in that regard. But it’s generally used with groups, but it has a lot of applications for individual practice as well.

A L: And anot S P: another question that probably a lot of people who
listen to this would have is: in what way is this related to body psychotherapy; what’s body-related about it?

L C: That’s a great question. Actually one of the things that appealed to me about psychodrama, being a body-oriented person myself, was that Moreno knew very early on the importance of incorporating the body in any therapeutic work. In fact, one of his great quotations is, “The body remembers what the mind forgets.” So psychodrama itself, as a method, is a very embodied practice. So the body is involved. The direction for psychodrama is, “show me” it’s not, “tell me,” so the person has to use the body to put into action their story. So it’s about showing us their story, not just telling us their story.

S P: So I think there are several stages in a psychodrama . . .
L C: That’s right. There’s the warm up, the action, and the sharing; and those are the three essential elements. The warm up is basically the preparation stage; it’s getting the protagonist, who is the person whose story is going to be enacted, and the group, warmed up, safe, active, ready, accessing the material. The action stage is the actual enactment; the action piece, the story that will be shown. And sharing is a very essential part of psychodrama and it takes place after the action has finished; and it is when the group comes together and shares with the protagonist how his or her story directly related to or touched them in a personal way. In other words, it’s not about advice giving or commenting on the process, but rather about saying, “Your story really touched me in particular because I related to something in particular that happened in my life and here’s what it was . . . ” And so the protagonist has shared his or her story with the group as a way for the group to heal through the protagonist. In the sharing the group gives back to the protagonist how they were helped by the enactment that occurred.

S P: If we go through these 3 stages, one by one, could you give me some concrete sense of how you use the body related information to deal with them?

L C: I’d be happy to. I can give you a very concrete example from a warm-up that I just did at the Psychodrama Conference-I did a workshop there for the attendees and it was a training workshop, but still we used warm-up, action, and sharing-and for the warm-up I asked the participants to think of a body-based activity that they really derived pleasure from, that they really enjoyed, and to say their name, to say what it was, and to show us with their body what that was. So of course we had a number of things; people showed us how they loved to walk their dog or pet the cat or smell soup that’s cooking, feel the breeze on their face, enjoy swimming, and to show all of these body based activities with their body. And then I had the group mirror each one back. And so involving the body in that way really warmed people up to the body based focus of the work that we were doing, which was a actually an action based structure called the body dialogue in which the purpose is to help people develop an empathic relationship with the body.

S P: So if I understand correctly, then, in that warm-up phase, you help people connect with the body by going into the body and demonstrating something pleasurable and the other part, empathy, for the other participants to create empathy by also reenacting what they see the protagonist doing.
S P: Exactly L C: Exactly, and of course in the warm-up, everybody gets to do it, the whole group is doing it, and that’s part of building the safety and developing the relationships in the group that will allow the safety to develop so that the work can take place. Because a little later on, I know that is really anchoring them in the strength that they have in their body and the pleasure that they have in their body. And a bit later on, I did some work with them to help them get in touch with anything about their relationship with the body that was distressing to them. And I did that using the body in a non-verbal way. I paired up folks into dyads and had them communicate in a non-verbal way what their bodies were needing from them, what their bodies wanted to say about how they were feeling and what they needed. So that was a way to move them into what we call the warm-up to prepare them for the action to take place. So we anchored the strength in the body first, and then we got in touch with what body based issues were up for people that they really wanted to resolve and work on.

S P: So from the beginning, from the warm-up stage, you didn’t create safety by having people relate to each other’s situations in terms of describing them; but the safety came form going into the body and connecting at that body level.

L C: Actually I did both: I did the one that I described to you and I also did something called “Circle Sociometry” which uses the body but in a much less specific way. It’s where each person in the group gets to say something that’s true for them. We’d like to know if it’s true for other members in the group and so someone might say, for example, “Anyone who has ever struggled with body image, please step into the circle.” And anyone who has had that struggle and who was willing to step into the circle then steps in. And so people begin to see that they’re not alone. And that other people in the group share the same struggles and concerns that they have. But again they’re not just saying it, they’re actually stepping into the circle with their body.

S P: Ok. So from the very beginning there is that connection with the body that’s part of the work. So that is the first stage, the warm-up, so what happens at the second stage?

L C: The second stage is the action and that’s the enactment of the story. And that can be a full psychodrama or it can be a short piece of action, which is actually what happened at the recent conference, where there was a protagonist chosen and she wanted to have a conversation with her body to try to help and repair the relationship with the body. So I used role reversal and included some sensory-motor processing into the work and when it was finished we had some sharing. Now, it might be, in another situation, we may have a full psychodrama, which means that we may need more time, of course.

S P: So what kind of time frame are you talking about for short or long?

L C: Very interesting-I like to have a minimum of two hours for psychodramatic work, but I often book four hours for a full psychodrama. And of course when I do workshops, particularly if I’m co-leading workshops with colleagues of mine, then we may actually have a group coming and we may do what’s called a retreat weekend-I have one actually coming up the first weekend in June with one or two of my colleague-and we may work Friday night, all day Saturday, and say half a day Sunday. So it really varies; anything from two hours to a whole weekend.

S P: So the whole psychodrama unfolds over the course of a weekend in that case . . .

L C: Well a single psychodrama normally would not be more than two and a half hours. So we might, in the course of a workshop, incorporate warm-ups, we might use music, movement, art; other expressive arts modalities as well as psychodrama.

S P: So back to stage two: the action part. So how does body information or body action, body movement, get to be part of it?

L C: That’s a great question. I’ll give you an example: a protagonist within my work at one point in time said that what she wanted to get out of the drama was she wanted to feel less heaviness in her body when it came to a relationship that she had with a particular person in her life. And so I asked specifically where in her body did she feel it and to describe it and ask some sensory-motor processing questions and ask her on a scale of 1 to 10, what was the level of heaviness that she felt and so at the end of the psychodrama I was able to ask, “What is the level of heaviness that you feel now?” It of course was an assessment question, but I also used that information in my directing to inform some of my directorial choices. Another example of how I use body in my work is I often will use my work as a Yoga instructor and sometimes I will ask people to assume a certain Yoga position in a role, in a drama, because taking that body position will help them to assume the role in a way that will be beneficial to them. So for example let’s say that someone is in a role and they are trying to develop the role of being able to be assertive and speak their truth and they have difficulty doing it. That would show up in the body collapsing. So I might actually ask them to take, let’s say, the warrior 2 position, which is the pose of confidence in Yoga and I may ask them to take that position when they speak their truth in the drama as a way of helping them to feel more empowered as they speak their truth.

S P: So, in other words, there is an interplay that you pay attention to: what role they’re playing in everyday life, what role they’d like to have. There is a sense of how the role they play is associated with, say, a collapse in the body. There is a sense of how the role they would like to have corresponds to a physical body language or body position. And you play with that in the psychodrama.

L C: Exactly, and I also pay very close attention to the breath. I do a lot of work with trauma survivors and, certainly as we know, breath patterns are very deeply impacted by trauma, and so I will be actually using my own body to tune in to the protagonist’s body and I will be listening for shallow breathing or rapid breathing; just monitoring the client’s breathing, and also asking them to check in with their own breathing and to see where that is because that gives me information as a director about how are they doing in terms of being able to stay present and grounded. So I use my work as a Yoga practitioner and my knowledge of the body and the breath to tune in to the protagonist to help them stay safe and grounded and to look for signs of dissociation so that I can keep the protagonist present, safe, and grounded throughout the drama.

S P: So what you’re talking about is that your work, while one way to describe it is being a director, certainly another way to describe it is a very strong sense of tuning in to what the protagonist is doing.

L C: Yes, in fact, that’s really part of the director’s role, to be empathically tuned in to the protagonist and to be tracking how the protagonist is doing throughout the drama. That’s a very important directorial task, if you will.

S P: So what helps you do that? Actually, is your Yoga background helpful?

L C: That’s a great question. There are several things that help me do that, I would say, especially my background in Yoga helps me to do that; it helps me, myself, to stay present and grounded, and in the present moment and able to be in the moment with the protagonist so that I can access my own creativity.

S P: Is that the breathing? I mean what specifically helps you
. . .
L C: Well, it’s breathing, it’s keeping, as I say, all four corners of the feet grounded on the floor; you know, noticing within myself my breath and using my own awareness, as I said earlier, of the client. Now there’s also something else that’s helpful that I learned when I did my training with the Therapeutic Spiral Modeltm of psychodrama-that’s a very specific adaptation of psychodrama that’s used with trauma survivors. It was developed by Dr. Kate Hudgins and I’m a certified team leader in that model, and there’s something that we learned called the body doubleTM: there’s something called the double in regular classical psychodrama which is a role in which the auxiliary, or, sometimes, the director, but it’s usually an auxiliary person, stands next to the protagonist and just slightly behind, and really tunes in, verbally and non-verbally, to what the protagonist is saying and tries, then, to articulate what is just under the surface, but not being expressed and if the double speaks what is accurate, the protagonist repeats it. If it’s not accurate the protagonist corrects it. So it’s a lovely way for the protagonist to really get in touch with what is inside and maybe not just at the surface, but also to feel really heard and validated. Now, a body doubleTM is an adaptation of that classical double in which the focus of the doubling is really at the body level. So the focus is on the posture of the protagonist, the breathing, picking up on any movements that the body may be having that could be very subtle, and verbalizing those, bringing those to the attention of the protagonist, and then leading the protagonist from what might be the beginning of, let’s say, a dissociative episode, into the ability to be safe and grounded in the body by shifting the position of the body, the breath, and so forth.

S P: So you would give feedback by telling the protagonist something about the way their body is?

L C: Well, actually, the double takes the role of the inner voice of the protagonist so the double, or body doubleTM, would speak from the “I,” as if he were the protagonist or the protagonist’s inner voice. So let’s say I was acting as a body doubleTM for a protagonist and I noticed, let’s say, one foot was off the floor and they were picking at the thumbnail, I might say, “I can notice that my right foot is off the floor and resting behind my calf and I can slowly allow that foot to come down to the floor. And I can notice that my thumb can release from the other finger and my other hand can gently stroke my thumb rather than picking it.” So it’s noticing where the protagonist is and then leading them into a healthier, safer place.

S P: So you do that and what’s your body position; are you sitting are you standing, are you . . . ?

L C: Well whatever the protagonist is doing, the double is doing.
S P: So as the double you’re mirroring, on a physical level, what the protagonist is doing, but in addition to mirroring it physically, you’re also stating it as an “I” statement so that if the protagonist is not able to notice it physically, there is also that inner voice track.

S P: Exactly L C: Exactly, so it is both verbal and non-verbal. So it’s bringing them into awareness and then helping to lead them into a place of safety in the body. Because, honestly, if someone is dissociated during a drama, then the drama will either be ineffective at the very least, or re-traumatizing. And so safety is always my primary concern as a director, and so I’m paying attention to the pacing of the drama, and really tuning in and noticing, “How is my protagonist doing?”

S P: So you mentioned a lot of things about dissociation and trauma, so maybe, what are the kinds of people that you work with in psychodrama?

L C: Well, as I say, I work with people who have been traumatized, maybe have suffered physical, sexual, emotional abuse; have been through disasters, medical traumas, wars, any type of trauma; and often times they are also suffering with depression and other mood disorders, anxiety disorders, substance abuse disorders, eating disorders, so very complex. But I want to make clear that the action methods in psychodrama are very useful for role training in non-trauma related situations. It’s very useful to use in school settings, educational programs, businesses; any place where people need to have role training in their lives. And also there is group work, that is called sociodrama that is focused on issues that are particular to a group, that people have in common and want to explore. So it has a lot of applications, this just happens to be my particular area of interest and expertise.

S P: And if I understand correctly, it’s not something that you do exclusively with one client-
something that you can do on a one time basis in collaboration with somebody’s therapist, or. . .

L C: Yes. For example, I work very closely with a colleague of mine who is a licensed clinical social worker and she sees her clients, of course, on a very regular basis and often times brings me in as an adjunctive therapist specifically to do action methods with her client or clients on a particular issue. And I might do that with the therapist and the client and myself in, let’s say, a two hour time block in her office, or we might schedule time for a private psychodrama so we would go for a longer period of time and I may bring in one or two auxiliaries. So that’s one of the more frequent ways in which I work.

S P: And I wanted to just maybe still stay there for a moment about how you measure-is there any kind of benchmark-or how do you evaluate progress or goals?

L C: That’s a great question. I said earlier that we always ask in the very beginning what does the client want to have to be different as a result of the drama? And so, for example let’s say the client mentioned letting go of the feeling of heaviness, and I might say, “On a scale of 1 to 10, where is that heaviness now?” Well if the person says that the heaviness is 9 at the beginning of the drama, and I ask at the end of the drama, “What level is the heaviness now” and they say, “two,” then that’s a measure that we met the contract for the drama, that there was a significant decrease in the feeling of heaviness. It’s not always that specific, it might be that the protagonist could say, “I want to really work on my ability to speak the truth for myself without collapsing, without feeling guilty, or whatever the issue is, we state the contract for the work at the beginning and then we evaluate at the end, “Was the contract for the work met?” And that’s a question that the protagonist can answer.

S P: And so that gives us a transition, and we spent quite some time, for the second phase, but that maybe gives us a transition for the third phase of the drama . . .

L C: Exactly, and the third phase, as I said earlier, is about sharing; it’s when the group shares with the protagonist how his or her work touched them, helped them relate it to experiences that they had in their own life. And so it’s also a way of what we call “de-roleing,” so if any group members played a role in the drama, they can speak from what they experienced in-role in the drama, and then speak from their own personal lives. And that helps the process of de-roleing as well as helps the protagonist to really hear how his or her work was useful for other members of the group. And, of course, it also helps to enhance group solidarity and the group cohesiveness if, let’s say, we have an ongoing psychodrama group in particular and it may meet weekly or once a month or twice a month, and as the group continues to meet, the cohesiveness from the sharing continues to build and so the work of the drama can go deeper and deeper over time because the safety that’s felt. But there can be safety felt in a single session. I’ve seen it done, and know that a lot of the work that we do in warm-up and then that we finish in the sharing really provides that container of safety.

S P: So thanks, Linda, that was really a very nice, very great introduction to psychodrama and how it interacts with body psychotherapy . . .

L C : Well, my pleasure, I really love using these two fields together and I also love working with other colleagues and interweaving music and art and having what I consider a lovely tapestry of healing.

This is part of USABP’s monthly Creative Conversations, hosted by Serge Prengel.
Transcribed by Calin Cheznoiu

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