CLINICIAN HEAL THYSELF! (featuring guest blogger Lucy McLellan)

 As former Program/Training Director/Blog Editor at CANY, I was honored to be invited to contribute this month’s post. Although I live 1,000 miles away from NYC these days, situated in Madison, WI, I continue to follow SYNTHESIS on a monthly basis. It keeps me connected to the ideas and practice swirling around the CANY and wider drama therapy community, something that keeps my clinical heart beating as one of only three Registered Drama Therapists in the state of Wisconsin. What I offer below speaks to this experience directly. It is an invitation to you, reader, to consider the ways in which we remain connected to our knowledge, skills and passion on the job.


 

CLINICIAN, HEAL THYSELF!

I am high energy person. Even in middle age, I barrel through daily life with intensity. It is, to draw from Tich Nach Hahn, a habit energy; not as much an innate state as an energetic drive that I have adopted over the years, pushing me on.

As a drama therapist, however, my high energy serves me well. I enter the therapeutic space comfortable with emotional intensity. I do not fear the stories or the roles conjured up in the playspace of the trauma-affected clients I work with. I am drawn to the vigor of enactment.

All that said, I am as prone to compassion fatigue as the next clinician, arguably more so. My high energetic out-put requires conscious replenishment, a lesson I have learned the hard way. Staying clinically engaged and countering the secondary hurts of posttraumatic stress has become a necessary labor of (self) love for me. Over the last year, I have repeatedly found myself drawing from Mary Jo Barrett’s concept of ethical attunement as a way of managing my energy as a therapist.

Understanding Ethical Attunement

“Ethical Attunement is a non-reactive therapeutic stance in which practitioners are open and responsive to their own internal processes and to those of their clients.” (p.60)

Ethical attunement demands that we as therapists monitor our own energetic resources and as necessary. Compassion fatigue becomes a clinical certainty when we energetically give in the treatment of others and neglect to restock our own energy stores. Mary Jo nails it – “We cannot stay ethically attuned if we are energy-depleted.”(p.59)

In the office space I share at work here in Madison, WI, I have created a large chalk copy of Barrett’s infographic “Manage Your Energy for Optimal Ethical Performance“. For me it provides a simple and applicable blueprint for remaining plugged into my energetic needs so that I can recognize and meet those of my clients.

Of course there’s more than just high energy. One of my favorite aspects of Mary Jo’s energy management action plan is her attention to both low positive (drinking warm tea) and high positive (running, dancing) energy replenishers. A brief survey reveals a broad spectrum of ways in which my current co-workers like to energetically restock, ranging from “yoga” and “solitude” to “smashing playdoh”. Whatever floats your energetic boat!

 

Lucy CANY

As a drama therapist, I wonder also about creative replenishment. Mary Jo identifies five domains of ethical awareness, each a player in overall well-being:

  • Emotional
  • Physical
  • Intellectual
  • Spiritual
  • Sexual

I would argue that there is a sixth; creativity being that missing piece.

In my work with CANY over a ten year period, I experienced both the energetic highs and lows of group leadership. For every exquisite metaphor enacted, there was a drama that spluttered into life, sometimes refusing to spark altogether. Regardless of what happened in the playspace, my role as a drama therapist was (and is) to hold the energy of possibility. It’s the “yes” of improv; creativity at its essence.

Let me give you a concrete example. I used to facilitate a weekly group with Heidi Landis, CANY’s Associate Executive Director. Together, we would drive to Westchester to co-lead a group with teenage girls who shared a history of commercial sexual exploitation, more commonly known as sex trafficking. Before even entering the room, our knowledge of the girls’ traumatic history arguably impacted our energetic potential. A therapist can sometimes feel crushed by psychosocial knowledge of a client in a way that counters the zesty, fierce (albeit traumatized) individual that walks into treatment.

The group experience itself was textbook chaos, characterized by unscheduled interruptions and dysregulated expressions of anger and distrust. Unsurprisingly the clients seemed avoidant and disconnected. Planning sessions that prefaced weekly groups left me feeling clueless. No activity or intervention seemed safe from rejection. Post-group processing was equally gruesome as we dissected the blood and guts of what happened, searching for something that we might call therapeutic progress.

How could Heidi and I remain ethically attuned to the emotional, physical, intellectual, spiritual and sexual experience of our clients in our stuckness? How could we honor their creative potential too when we were felt so artistically deflated?

Simple. We reminded ourselves of our therapeutic potential by returning to our creative roots. We played, we laughed; from the sublime to the ridiculous. We listened to 1980’s rock ballads we drove north on the Henry Hudson Parkway. We bought reviving coffee in Dobbs Ferry. We talked about our lives and about the lives of our clients. We remembered our times as actors, shared comic tales of touring our respective nations. We talked about our values, our beliefs. We tied them into group plans and the hopes we had for these remarkable, though life-battered girls. There was an investment in each domain of ethical awareness, including our creativity. And thus, when we arrived at and left our group each week, we were ready to engage. Our doubts, our stuff on hold so that we could be present and attuned to the stuff of our clients. This was how we managed our energy for optimal ethical performance.

I realize in concluding this blog post that I have written a letter of gratitude to my co-therapist, Heidi. Indeed to all my co-leaders at CANY. The very model that CANY offers its employees essentially allows for the management of energy and thus ethical attunement through relationship, which in my opinion is the very best medicine of all. So, thank you, Heidi (and CANY) for helping me to reconnect with my creative heartbeat before and after each group. We didn’t get to smash playdoh together but we replenished in a whole host of other high and low energy ways.

 

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Lucy McLellan, MA, RDT-BCT, LCAT

 

TO BE OR NOT TO BE: An Invitation to a Process of Becoming

Welcome 2016!

Reflecting on the year gone by, I am filled with gratitude, a burgeoning desire for growth and an array of questions. As is customary at the beginning of the year, there is much talk about being better or healthier people or not being so impatient and so on. However, I am humbled by the complexity of the existential question, “What does it even mean to be?” What does it mean to truly be in this world? The beginning of the year also brings with it much change. In my own life, this new year ushers in a major and unexpected change that requires my relocation to my beautiful home country, Trinidad and Tobago. As I begin my transition, leaving my time at CANY behind, I reflect on the person I have been at this organization and the many beings I encountered along the journey.

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Photograph by Gjon Mili

In the sacred spaces at CANY, I have been therapist, colleague, trainee, friend, exotic person/one, immigrant, black person, invisible one, betrayer, misunderstood one and more. Yet who I am, or who I experience myself to be, was never fully accounted for by these roles. Like the discomfort of mismatched socks to the obsessively compulsive, there was a burdening discrepancy between who I experience myself to be and the personas others choose to see in me. I engaged in this disparity even further as I witnessed its performance in many of my adolescent clients.

Working with adolescents for the past year has immersed me in a reflective parallel process. I viscerally experienced the very mercurial, ever changing, on stage-off stage enactment that is adolescence. “Nina” was one such individual who would repeatedly perform this incongruence with the person she experienced herself to be and that which others saw in her. She would enter the room happily and dramatically and then express how exhausted, pissed off and hungry she was. This way of being pervaded the group process. Fittingly, nearing the end of our time together, this group organically invited each other to share their first impressions of each other versus what they now know to be true through the group process. Nina was initially viewed by her peers as being “stuck up, annoying and judgmental”. Now, they have come to appreciate her as a “loving and cool”. Nina confirmed these observations, having heard them several times before, while highlighting the tendency for others to see her differently from who she really is. Like the connective tissue that is the red thread in their performances of adolescence, each individual acknowledged and gave voice this observed discrepancy; their ways of being.

More literally, I think of the verb ‘to be’. I think of the old man of the sea in Greek mythology, Proteus. Like the sea, he was ever-shifting and able to take different forms of being. He was all-knowing but reluctant to share his knowledge. As such, one would have to grab him quickly and hold on tightly even as he attempts to escape by taking on these different forms: lion, snake, tree etc. He would then eventually share his knowledge and plunge into the sea. The verb ‘to be’ is known as the most protean in the English language: constantly changing, without discernible patterns, most irregular and often used. Similarly, ‘being’ in this world alludes to a continuous process of change, transition and even shape-shifting.

The first noted definition of the verb “to be” is to exist or to be present. I have come to value presence, especially within the framework of CANY’s trauma-informed model, as the grounded manifestation of one’s being in the moment. A client’s presence in the room ought not be limited to or defined by what he or she is actively doing but rather experienced as psychic energy consisting of thoughts, feelings, roles, history, dreams, spirit, passions and the like that are experienced in relationship. Therefore, “to be” in this world conjures an image of an ever-moving sea that carries within its waves the dignity of human realities.

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Photograph by Gjon Mili

Which brings me to other questions: What does it mean to “be” in Western culture, which attributes “doing” to one’s being? What does it mean to be in a community that assigns privilege to categories of actions, potentially negating the essence of one’s presence? Here we encounter an ablest framework of existence which devalues the ever-shifting seas that are not accounted for by socially valued actions that denote being. Through this lens, to be is to do and to not do is to be absent. I think of the number of New Yorkers spending their years chasing the capitalist ideals of self-actualization and productivity, living to work rather than working to live. I think of the physically disabled immediately being perceived as weak-minded or incompetent. I think of the criminalizing and decimating of black and brown bodies walking with hoodies gathered on the street corners. I think of students that learn differently than the valued norm being lost in our education system.

Imprinted by a very different cultural and socio-economic reality in New York, I take with me a host of new roles to the shores of my island. As my role system continues to shift and be shaped by the people, places, ideas and systems around me, I relinquish the idea of being anything. Instead, I posit a process of becoming that aims to capture the inevitable process of change that pervades human existence. A process of ‘becoming’ seems to liberate one from the value systems and expectations of the powerful and privileged. Herein, one possesses inherent potential for growth, movement and error. As such the roles we play are not the end-all. Rather, they are in service of the process that is life.

To be or to become? That is my question.


 

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Karline Brathwaite, MA, RDT, LCAT-Permit; CANY Staff Member

 

GOODBYE TO ALL THAT: termination in the drama therapy process

“I don’t want to talk about goodbyes,” a CANY group member recently said to me, “Can’t we talk about something fun instead?” The client’s words sum up what many group members express during termination, regardless of their age or population, the sentiment of “It’s not really goodbye, it’s see you later. ‘Cause I’ll see you later, right?” While others, knowing that a final session is approaching, won’t show up for the group at all.

As many of our groups terminate with the end of the academic year, CANY finds itself in the midst of our annual goodbye season. This year, the season feels especially significant, as we prepare to say goodbye next month to our Executive Director of 10 years, Jonathan Hilton. This period of transition and leadership change marks an opportunity for a deeper parallel process with our clients. CANY’s group leaders as well as clinicians who engage in training with us often share their clients sentiments; we don’t necessarily enjoy the business of saying goodbye either.

During a CANY training session, staff at Community Mental Health Affiliates (CMHA), CT explore the theme of goodbye

The opportunity to create a process around termination can be both unfamiliar and uncomfortable for all involved. For those for whom goodbyes have been abrupt, non-reciprocal, unpredictable or unacknowledged, there is a drive not to dwell in the domain of termination and the unsavory feelings that arise around it. Alternatively, there are those for whom termination has become a frequent occurrence and in this case, goodbye isn’t a special event, but as commonplace as the sunrise. “Goodbye is no big deal,” said one CANY client last week. “Happens all the time. You just move on.”

And yet, in CANY’s trauma-informed model, the process of marking a goodbye is crucial. A mentor of mine and professor of Drama Therapy at NYU, Maria Hodermarska, tells her students, “You prepare for goodbye at hello.” When it comes to ethical practice, goodbye is not a singular event or one stand-alone session. Instead, it is the mindful process of moving toward closure, marking the end of the therapeutic relationship. In group practice, goodbye means the end of the cohort’s collective relationship and the unique bonds that have formed between members. At CANY, our clients have traumatic histories around goodbyes that include sudden ruptures in the family system, imprisonment, fleeing one’s homeland, war/military service, foster home/residential placement (and displacement) and we hold these experiences in mind as we carefully prepare for and explore termination with our groups.

Refugee clients embody their experience of goodbye during a CANY group *

So how do we incorporate goodbyes into our groups? Often, we ask our clients about the meaning that goodbyes hold for them, inviting reflection on the sundry emotional experiences that accompany termination. Feelings of sadness, anger, excitement, pride, anxiety, fear, joy and ambivalence are frequently named. We may ask for occasions when people say goodbye: moving home, graduation, death, break-ups, and deployment were included in a recent list compiled in an adolescent group, a session that marked the CANY intern’s final day. Participants were then invited to choose one of the goodbyes listed to create a drama, thereby allowing the clients to consciously or unconsciously titrate the amount of distance they needed to explore saying goodbye. Sometimes, members require considerable emotional distance to explore the turmoil and loss invoked by termination. Sometimes this is manifest in the use of humor, exemplified below.  

The drama the teens created told the story of a Person saying goodbye to her Mop. The Mop, feeling taken advantage of and filthy, was enraged to find that her owner was discarding her for a fancy new Swiffer. Feeling betrayed, Mop plotted revenge with her friend Bucket, aiming to make Person feel as hurt and heartbroken as Mop herself had felt. In this way, our group was able to express anger at being cast aside by the intern’s departure and imminent end of program, and enact revenge fantasies against the therapists, one of whom was enrolled as Person. 

A teen client puts passion into the act of goodbye during a CANY group

Swiffer, Bucket and Mop collaborated to teach Person a lesson and ultimately ran off together to the Bahamas. This fantasy of escape bears significance for a group whose members had historically presented as dissociated and fractured. By enacting this story, the teen clients were able to transform their dissociative tendencies into collaborative action, taking leave of Person who had initiated the goodbye. Concurrently, they had fun doing it. “This is hilarious,” said one group member. It was only after the drama’s conclusion that participants were able to say goodbye to our intern, in the process acknowledging and validating their own contributions to the group and impact on each other.

Some goodbyes may be fun to play out; others may be painful. The good news for the client who asked to do something “fun” instead of saying goodbye, is that drama therapy allows us to do both. Being trauma-informed means that CANY therapists create a playspace that is safe enough to tolerate a goodbye that we might rather not say (or one we may be ready to be over and done with) recognizing that many, if not all of our clients have had traumatic experiences rooted in the rupture of goodbye. CANY’s model of drama therapy provides not only a chance to share in a reparative termination experience, based on the creativity, imagination and needs of each unique group, but also the invitation to play with goodbye, perhaps even creating a good enough one in the process.

Meredith Dean, RDT, LCAT, CSAC, 

CANY Program Director

  

 

*MANY THANKS to Cathryn Lynne Photography for her images of CANY groups.

Don’t forget to leave us your thoughts & reflections below. We love to hear your comments!

STAYING ALIVE: how drama helps us survive

“What’s the big deal about trauma?”, Dr Sandra Bloom asked at the final event in CANY’s inaugural seminar series on trauma, featured below. In answering her own question, Sandra cited a recent Department of Justice study, “Defending Childhood”, which found that every year 2 out of 3 American children are exposed to acts of violence, abuse and neglect. Traumatic stress is a modern epidemic, Sandra concluded. 

As a drama therapist, the part of Sandra’s lecture that captivated me most was her focus on the evolutionary significance of the arts. Artistic performance, she argued, is central to individual and collective survival. Now, while many of us could speak to the “feel good” or therapeutic value of painting a picture or throwing a pot, survival is a weightier claim. How, then, do the arts help us survive?

Trauma is a rock thrown through a window. We shatter, we fragment; struggling to piece our lives back together. The arts, Sandra suggests, allow us to integrate and gradually make meaning out of these adverse experiences through performance; ritual acts of expression that allow for “collectively held distress” (Bloom, 2010, p.22) to be explored in a structured and communal form. From Ancient Greece to contemporary performance art, we can identify ways in which theatrical performance serves to honor, contain and transform the splintered experience that characterizes individual and community trauma, from the Greek tragedies of Ajax and Antigone to the Culture Project’s, The Exonerated or the rock musical, Next to Normal. 

So how does this concept of artistic performance as an evolutionary drive for survival pertain to drama therapy and how do CANY programs serve as a primary integrating mechanism, to use Sandra’s words, with the trauma-affected clients we serve?  While CANY’s drama therapy is not delivered through performance, per se, dramas are created and enacted in each group, giving fictional form to the real life experience, as explored in the examples below: 

  • Becoming butterflies: In a group at a safe shelter, women survivors of domestic violence transported themselves into a magical forrest, enacting the story of a caterpillar who transforms into a butterfly, allowing for an integration of past victimization with the possibility of healing, healthy connections and freedom. 
  • The end is nigh: In a group at an alternative high school, teen participants created a melodrama of familial revenge, allowing them to give voice to the peer pressure, vulnerability and shame dynamics that underlie the interpersonal violence they experience daily.  
  • Perfectly imperfect: In a group with adult refugees, participants created the drama of a utopian society, one that while seemingly perfect was not a place where its inhabitants could learn or grow. The drama served as a vehicle for clients to transform their refugee experience into a collective narrative of new opportunities, relationships and life roles. 

For Sandra, recovery from trauma lies beyond “[…] a simple project of the re-knitting of bones and muscles, but instead requires a re-working of the soul – of time, of space, of identity, of meaning” (Bloom, 2005, p.xv). This re-working of the soul occurs through the co-creation and enactment of dramatic narratives in CANY groups and the period of reflection that follows wherein clients are guided to make connections between and ultimately integrate discoveries made in the fictional realm into their real life experience. In this moment, new possibilities emerge through the meaning-making process that occurs when processing the dramatic work.     

I’ll leave you as I began with a video, more specifically with Ramona Gordon, a former CANY group member and survivor of intimate partner violence.  

Speaking with typical passion and insight, Ramona shares how the CANY program she participated in at a domestic violence shelter fuelled her recovery. “That was my solace”, Ramona explains. For Ramona and her peers at the shelter, the CANY group allowed for their “collectively held distress” to be witnessed, honored and transformed. Without the integration that artistic performance provides, there is surviving but no thriving, as explored in an earlier post – I Am More Than My Suffering. Ramona’s voice and spirit is a testament to thriving, to a re-working of the soul, identity and meaning. We wish her well.

Lucy McLellan, LCAT, RDT-BCT

_____________________________________________________________________________________ 

SPECIAL THANKS TO:

Dr Sandra Bloom for her time, support and ongoing inspiration. 

Ragnar Freidank & Reelworks Teen Filmaking for capturing our programs in video form!

REFERENCES:

Bloom, S. L. (2005). Foreword. In A. M. Weber & C. Haen (Eds.), Clinical applications of drama therapy in child and adolescent treatment (pp. xv–xviii). New York: Brunner-Routledge.

Bloom, S. L. (2010). Bridging the black hole of trauma: The evolutionary significance of the arts. Psychotherapy and Politics International, 8(3):198–212.

 

THE ART OF RESILIENCE: creative approaches to military wellness

For this month’s post, Creative Alternatives of New York invited Aynisa Leonardo, LCAT, ATR-BC, Co-Founder and Director of Clinical Development of the Military Resilience Project to share her experience of CANY drama therapy programs. As former Clinical Coordinator of the Military Wellness Program and Director of the Family Reintegration Program at Holliswood Hospital, Aynisa collaborated with CANY group leaders last year before Holliswood closed its doors in August 2013. Aynisa holds a Master’s degree in Creative Arts Therapy from Hofstra University and below speaks about the use of effective and integrated models of treatment for service members and the ways in which the CANY model added value to the program offerings at Holliswood.  

Aynisa Leonardo, LCAT, ATR-BC

CANY: Aynisa, thanks so much for joining us. Although CANY was sad to see the end of our initial collaboration with the close of Holliswood Hospital, we know that you continue to focus on veterans through the Military Resilience Project and Bridge Back to Life Center, Inc. Tell us about your work with this community? 
 
Aynisa: I have been working with the military community for the past 6 years, including my Director and Coordinator roles at Holliswood Hospital. I have consulted with River Hospital in Alexandria Bay, supporting the 10th Mountain Division at Fort Drum through their Partial Hospitalization Program. In Fall of 2013, I began working with an outpatient treatment network, Bridge Back to Life Center, Inc., as Clinical Coordinator of Military and Integrated Services, providing direct clinical treatment to uniformed service personnel (Military, FDNY, NYPD). I also work as a clinical consultant for a NYC non-profit, Intersections International, informing their Veteran Civilian Dialogue. In addition, I co-founded the Military Resilience Project, LLC, in Fall 2013 where our mission is to incorporate preventive and comprehensive services into the community by way of Education, Advocacy, and Wellness Events. In each of these programs, I have been instrumental in developing and coordinating effective treatment models, applying expressive, humanistic, existential and evidence based therapeutic modalities. I specialize in substance and alcohol abuse counseling, along with trauma-focused therapies for individuals, groups, couples and families. My overarching focus is on advanced program development, care coordination, community reintegration events, and transitional services, to best treat and support our nations’ military members and their families. 
 

IMAGES OF WAR: “Gassed” – John Singer Sargent

CANY: In your experience, what are the primary challenges and/or concerns that veterans bring into treatment and what are the core goals that you typically focus on during treatment?
 
Aynisa: Veterans present with a complex array of needs, often coming from complex environments and situations. Commonly, a military client will be working through transitional challenges due to a recent deployment, retirement, separation, medical board, or unit re-assignment. Underlying typical issues that surround employment, education, relationships and finances is the common thread of existential questioning. Clinical symptoms generally center around Posttraumatic Stress, anxiety, depression, and/or substance and alcohol misuse. Because military clients present with wide-ranging issues, therapeutic goals need to be comprehensive, supporting the spectrum of concurrent needs. I implement a “bio-psycho-social-spiritual” model, with goals focusing on education, emotional awareness, mood stabilization, relational healing, and ultimately self discovery and purpose building. As a therapist, the greatest challenge in working with this population is priority management. Goals are sequential, but not linear. As the military environment evolves, the therapist must as well. It’s important to remain progressive and connected to a network of resources that will keep you educated, accountable, and open minded.

CANY: What are the ways in which the creative arts therapies represent a unique approach to working with the military experience?
 
Aynisa: Expressive therapies enable us to tap into multi-levels of processing, experiencing, and healing. While trauma is typically stored in the right brain, therapy is traditionally a left-brain function, involving speaking, problem solving, logical thinking and reasoning; each a function required for someone to develop context and attach meaning to their experiences, create proactive goals, and move forward. Without the use of expressive therapies, this process would be extended, and the resolution may not be as deeply manifested. Symptomatically, expressive therapies can de-activate a hyper aroused physiological response, while simultaneously gaining access to underlying cognitive material. Traumatic memories are stored as disjointed imprints, encoded as charged visual images and body sensations. Expressive therapies allow for a safe and efficient reverse conditioning that mirrors this visual and sensory process. The client is then able to pair and integrate what may feel like opposing mechanisms: Mind and Body, Creativity and Logic, Trauma and Survival, Anxiety and Safety, Vulnerability and Strength. Expressive therapies allow for left brain-right brain engagement, which leads to symptom reduction, trauma processing, and problem solving to occur in unison.
 

IMAGES OF WAR: “The Bright Side” – Winslow Homer 

CANY: Tell us about your history and experience of working with CANY.

Aynisa: I first came into contact with CANY at Holliswood Hospital. Group leaders worked closely with high acuity military members in treatment, diverse in age, era of service, branch of service, discharge status (if separated), clinical diagnoses, and geographic origin. Feedback from clients was exceedingly positive. Many stated that the drama therapy process took them outside of their comfort zone in a way that helped them grow. CANY group leaders were able to connect with clients and engage them in a relational process that allowed them to reconnect with themselves and the world around them, on a first micro, and ultimately macro level. CANY drama therapy groups enabled our veteran clients to transform their experiences of tragedy into experiences of togetherness, understanding, and insight. Two specific results that our treatment team noticed each day after drama therapy was that the clients were: 1- full of positive energy with a fresh perpsective and 2- ready and eager to work on relevant treatment goals. 

CANY: What are some of the unique strengths and challenges that veterans might experience when participating in a CANY group?

Aynisa:  Military members experience a sense of collectiveness during participation in CANY programs, working together towards shared and also independent goals. Group members are given channels to work through interpersonal dynamics and find new ways to communicate and problem solve. Military clients often feel misunderstood, so creating an avenue for them to be seen and heard is extremely validating. Clients also have an opportunity to safely access traumatic or emotionally charged material through the use of metaphor. Military members in treatment are often trained to be relationally and emotionally shut down. Expressive therapies create a back door focal point that is triangulated away from the intimate therapeutic relationship and process. The creative avenue feels safer, and allows for more substantial processing, ultimately producing significant gains.
 
That said, many military members feel a resistance to this form of treatment. Drama, and the arts in general, can become stigmatized due to an association with vulnerability, femininity, or immaturity. This barrier often quickly dissipates once participants realize the value of the intervention. Another challenge is the tendency for military members to want immediate and tangible results. Because drama therapy is process oriented, it can be frustrating to some who are more task and material oriented. In those situations, the process can be a great tool for learning that all rewards are not material, and that results are sometimes internally measurable. Finally, a challenge that needs to be considered is the potential for re-triggering a memory or event, due to the intensity of many service members’ experiences. However, this is true to any therapeutic modality, and is the responsibility of the trained therapists to create a safe and contained avenue for healing.
 

IMAGES OF WAR: “A Ride for Liberty – The Fugitive Slaves” – Eastman Johnson

CANY: What do you perceive as the core value of CANY programs and other creative approaches being integrated into mainstream systems of care? 
 
Aynisa: I believe that mainstream systems of care provide valuable and effective treatment. I have implemented traditional and evidence based methodologies into every treatment setting I’ve worked in. I believe there is an “all or nothing” misconception that we as providers must adhere to one or the other, traditional or progressive methods. The irony is that all methods (traditional, holistic, progressive, expressive) work best when used in unison with each other. The most effective therapeutic recipe is one that consists of a diverse and comprehensive array of services. The bottom line is that these expressive therapy programs are effective and do enrich the treatment outcomes for individual clients and for systems of care overall. It is absolutely essential to have them incorporated into any and all models of treatment, and it is my hope that if we keep doing the work and effecting positive outcomes, then these programs will gain efficacy, become billable services and thereby receive greater recognition and support overall.
 
CANY: Let’s finish up with a creative challenge! If you could sum up the CANY veteran experience in three simple words, what would say?
 
Aynisa: Perspective, Insight, Growth  
 

If you’d like to reach Aynisa directly and hear more about the Military Resilience Project, or Bridge Back to Life Center, you can email her: ALeonardo@MilResilience.com 
                       ______________________________________________________________________

COMING IN APRIL! 

STAYING ALIVE: how drama helps us survive

 

 





 




 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 

POSTSCRIPT: I AM MY SUFFERING AND MORE

Our February post, “I am more than my suffering”, explored typical roles that are played out by trauma survivors in life and in therapy and how the roles of Victim and Survivor might, over time, be transformed into the role of Thriver, allowing for everyday acts of living as well as creative and spiritual endeavors that allow the individual to overcome their suffering.

The responses we received came in written and verbal form, all of which enriched my initial understanding of trauma informed roles, as its author. One response, in particular, challenged my concept of the Victim role and is an important addition to the dialogue I sought to begin. Written to me in confidence, the drama therapist in question, a friend and esteemed colleague, has agreed to let me share her sentiments here on the Synthesis blog.

The premise of my post, quite simply, was that we are and should be more than our suffering. Not always, my friend replied. Sometimes, for some people, she wrote, there are moments in the healing process when an individual cannot move past their suffering. She went on to challenge a more generalized value judgement that she perceives in the world around her pertaining to the Victim role. Acknowledging that trauma survivors can get stuck in patterns of helplessness, addiction, or even manipulation to get their needs met, she reminded me that people who endure traumatic events are indeed victims. They feel “vulnerable and helpless” and have to “succumb and give up control”.

My friend nailed it, I thought, when she said, “Being able to feel suffering in a contained way, and be witnessed and accepted in that pain is an important part of the healing process”, echoing Judith Herman’s “mourning” phase, she reminded me. It made me wonder about my own desire to move the client, perhaps prematurely, through their sense of pain and helplessness, because of the countertransferential suffering invoked in me, because of the pain that empathy can bring. Without validating the suffering and victimhood experienced in the aftermath of trauma, might the therapist exacerbate the client’s sense of shame and lacking, giving rise to roles surrounding addiction, self-harm and even enduring abuse? Did I need to allow the Victim into the playspace and give it space to live and breathe without scratching my itch to transform it ASAP?

My friend closed by inviting me and other therapists to hold the possibility of, “I am more than my suffering” AND “I am my suffering”, otherwise we run the risk of communicating that the client in their embodied state of pain is lacking and therefore failing in the recovery process. That’s when trust withers and with it the potential to mend and grow.

My friend generously thanked me, as she wrapped up, for holding space for suffering in my work and here in this blog. I, in return, thank her for enriching my sense of victimhood, for highlighting its importance in the recovery process.

We are Victim, Survivor and Thriver and a whole lot more.

 

Lucy McLellan, RDT-BCT, LCAT

CANY Training Consultant 

 

I AM MORE THAN MY SUFFERING: trauma & role in drama therapy

Drama therapists are guided by the concept of role. If story is the body, role represents the internal organs, the pumping heart of the work. 

Our work at Creative Alternatives of New York (CANY) focuses on the implementation of a trauma-informed model of drama therapy. Facilitating weekly groups in a variety of treatment settings, CANY group leaders spend a good deal of time exploring the ways in which trauma is performed through role.  

  • What roles are available and/or unavailable to trauma-affected individuals and communities? 
  • How might the drama therapist facilitate a transformation of traumatic experience through addressing role in therapeutic play? 
  • What might lie beyond the role of survivor? Can our clients transcend their suffering through an exploration of alternative roles? 

Twenty years ago, Dr. Robert Landy (1993), director of the NYU Drama Therapy Program, published a taxonomy of roles that consisted of 84 role types derived from over 600 dramatic texts within Western literature, each broken down into quality, function and style. 

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Roles that CANY clients bring into treatment are explored through therapeutic action *

For Landy (1993), mental health is evident in a contrasting yet balanced repertoire of roles, one that the individual is able to access and play out in their daily life and interactions. Roles that may be experienced by the client as imbalanced or undesirable, initially leading the individual into treatment, are not banished in therapy but worked through and ultimately integrated into a larger system of roles so that the role of addict, for example, can co-exist with that of mother and worker, perhaps, bringing the client into a state of balance and improved mental wellbeing.

How might Landy’s concepts surrounding role as well as his system of classification guide the trauma-informed drama therapist? Are there roles within his extensive taxonomy that reflect the experience of those exposed to chronic and acute trauma? While this line of inquiry deserves more extensive study than this post can provide, Landy’s taxonomy does afford us some immediate answers in the form of role, some more obvious than others. 

We begin with the role of Victim, defined by Landy (1993) as “vulnerable, trapped, defenseless” whose function it is to “succumb, to give up control” (p.194), echoing notions of a post traumatic learned helplessness. The role of Suicide also has resonance within a trauma frame, characterized by Landy as a “self-killer” who is “passive, fearful, trapped, despondent and hopeless” (p.228). The dramatic examples that Landy provides, namely Ophelia and Miss Julie, serve as compelling personifications of the dissociative processes that can accompany profound suffering and loss. Meanwhile, the Survivor, a persona that Landy gifts with the qualities of being “morally courageous, tough, and resilient” (p.200), clearly speaks to the sense of endurance required in the recovery period that follows traumatic events. 

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A CANY group member explores the role of Survivor

But is survival enough? Must we settle on the role of Survivor as our therapeutic endpoint? Dr. Clarissa Pinkola Estes (1996) suggests that surviving must give way to thriving for true healing to occur. 

Being able to say that one is a survivor is an accomplishment.[…]And yet there comes a time in the individuation process when the threat or trauma is significantly past. Then is the time to go to the next stage after survivorship, to healing and thriving.[…]Once the threat is past, there is a potential trap in calling ourselves by names taken on during the most terrible time of our lives. It creates a mind-set that is potentially limiting. It is not good to base the soul identity solely on the feats and losses and victories of the bad times. (p.210)

The role of Thriver does not appear in Landy’s taxonomy. Perhaps, instead, we can consider the act of thriving was as a composition of roles. What might they be? Perhaps the resourceful Artist, the pleasure-seeking Lover, or the Dreamer who imagines a future of their own making. Might this construct of Thriver also include seemingly mundane roles such as the Adult or the Average One, signaling the importance of normality in the aftermath of an extraordinary event or experience?

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A CANY group member puts thriving into action!

Trauma invites rigidity. The client can become role-locked, perpetually playing out the role of Victim or Addict, perhaps, as well as deceptively idealized roles, such as Innocent or Survivor. Through structured dramatic enactments, CANY group leaders facilitate an exploration of role that challenge the client’s “stuckness”. The goal is not to eradicate trauma-defined roles from the individual’s repertoire but to introduce new possibilities, such as Friend, Lover and Wise One, moving towards the act of thriving.

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CANY clients explore thriving as a group

Clearly Landy’s role taxonomy is just one theoretical stance on addressing role with trauma-affected clients. We welcome your comments and experience surrounding this and other perspectives/forms of practice. Before closing, it is worth reflecting on the cultural framework that has shaped this inquiry. Because Landy’s taxonomy focuses on play texts rooted in a Western theatre tradition, it behooves us to recognize the ways in which these classified roles might reaffirm established and privileged norms. Are there roles available to trauma survivors that lie at the margins of a heteronormative, white, Eurocentric tradition and an experience of privilege that need exploration here? Of course. What roles might become pertinent and/or available to the post traumatic experience if we were to widen the lens?

Share your thoughts below!

Lucy McLellan, RDT-BCT, LCAT, CANY Training Consultant 

* MANY THANKS to Cathryn Lynne Photography for her images of CANY groups. 

References

Landy, R. J. (1993). Persona and Performance: The meaning of Drama, Therapy, and Everyday Life. New York, NY: The Guilford Press.

Pinkola Estes, C. (1996). Women Who Run With the Wolves: myths and stories of the wild woman archetype. New York, NY: Ballantine Books.