10: Using Drama and Puppets in Play Therapy
Note: Play Therapy Across the Lifespan is created to be heard. If you are able, we strongly encourage you to listen to the audio so that you are able to appreciate the emotion and emphasis that cannot be captured by text alone. Transcripts may contain errors and differ slightly from the audio. Please check the corresponding audio before quoting it in print.
Resources and Links
Creative Counseling Techniques can be found on Amazon by clicking this link:
https://www.amazon.com/gp/product/0911907068/ref=dbs_a_def_rwt_bibl_vppi_i2
The Body Keeps the Score can be found on Amazon by clicking on this link:
https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/0143127748
Prologue
I have always had a fondness for Gestalt theory, and I think the reason is that one of its strengths is an attunement to what the body is expressing nonverbally. Perhaps this stems from my years in a drama group in college. I loved being in character, especially when I was in the villainous roles. I found such freedom in expressing typically unexpressed sides of myself but under the guise of being someone else. I just might have a flair for the dramatic! That is what we are going to talk about in today’s episode, incorporating drama and puppets into therapy.
Disclaimer – Drama Therapy vs. Drama in Therapy
Drama therapy is a specialty area of therapeutic work and requires a specific degree and in-depth training, along with the appropriate credentials to call yourself a Drama Therapist. I emphasize this because a string of techniques does not mean that you are a specialist in your work, and your clients deserve to have a clear understanding of your training and experience. Misrepresenting yourself by calling yourself something that you lack the credentials for hurts our profession… and potentially hurts clients. So, I like to clearly differentiate between drama therapy and drama IN therapy or using drama techniques.
However, you can, with your generalist training in therapy, incorporate drama techniques in your work. I encourage it if this is an expressive art form that you enjoy. If you are interested in learning more about becoming a registered drama therapist, check out the website for the North American Drama Therapy Association. We’ll have the link in the show notes.
At nadta.org, the website describes it this way, “Drama therapy is an embodied practice that is active and experiential. This approach can provide the context for participants to tell their stories, set goals and solve problems, express feelings, or achieve catharsis. Through drama, the depth and breadth of inner experience can be actively explored and interpersonal relationship skills can be enhanced.”
What Is Drama in Therapy?
Using techniques in story-telling, role-playing, feeling expression, and so on may be something that is helpful to your clients, but what fits in this category? Think of any theatrical production, but this includes movies, musicals, improv, comedy, one man (or woman) shows, film shorts, puppetry, marionettes, or even audio theatre. All these forms have several characteristics in common. They have characters, a setting, and a story. Usually, there is conflict and struggle, but also some sort of resolution.
They may have a full cast or a cast of one, which means that in therapy you can use drama techniques in groups or with individuals. The props may be real or imaginary, and they may be scripted or unscripted, so you can do a lot in your office, even if you don’t have specific props and a script. This is why the famous Gestalt technique of empty chair works so well. That empty chair can be anyone or anything, and the client can both interact with the empty chair and then be in it. Oh the possibilities, but don’t worry if you don’t call yourself "Gestalt." You can use drama techniques, regardless of your theoretical orientation. This just gives me a great opportunity to talk about Gestalt Play Therapy, which is underrepresented.
If you have puppets in your office, clients can use drama in therapy. If you’ve ever asked a client to role-play an interaction, you are using drama in therapy. If you ask clients to close their eyes and describe emotions to you, you are probably using drama in therapy, especially if they describe that emotion in the first person. Okay, that’s a brief description of what it is, now what materials are needed?
What Materials Are Needed?
This is where it gets fun! If this expressive art is for you, then you’ll probably want to invest in some physical props and costumes. But remember that more can be too much and too overwhelming, so just a few key things will be enough to start. You can add more later.
Consider what you most need in the work you do for five categories: cast, props, costumes, sets, and scripts. Again, you don’t always need real versions of these.
Let’s start with cast. You need the key characters in some form. They can be other people, but they can also be small figures, family sets, stuffed animals, or puppets. The ages of your clients will influence which kinds of representative characters are most appropriate.
Next, think about the props. Ed Jacobs has a great book called Creative Counseling Techniques that I found for about five bucks on Amazon. It has lots of suggestions for using basic things like chairs, rubber bands, Styrofoam cups, and other props for visual ways to explore specific topics, like self-esteem, boundaries, and emotions. One of my favorite ideas from his book is having different sized chairs, so if, for example, an adult client is going home for the holidays, they can sit in a child-sized chair and share what it is like to feel like a child again. Without trying to direct a full production (which could also be cool therapy) you can add a drama technique to help the client externalize the experience in a very concrete way. If you do a lot of boundary work, have props that represent clear boundaries. If you have clients that avoid conflict, have props that offer a way to hide or ignore. You might want props that represent the tools needed for change.
Costumes are the next category. You can imagine costumes, but your clients might get into the technique more if they get to wear a cape, hat, medal, shield, or sparkly wings. It will feel more real, and drama is about externalizing what is internal. If you use figures or small toys to represent others, having them in various costumes works, too, so including pirates, soldiers, doctors, and heroes can represent themes of conflict, battle, help, and rescue.
Sets really add some realism, too. Sure, you can imagine being on a battlefield, but having sand can give it a setting. Backdrops are great if you have space, but maybe you can use a whiteboard or a chalkboard wall to draw a few key elements or find an online image and project it on a wall for a quick and detailed background. Part of sets is the lighting, so you might consider the intimacy of low lights or what might be important to spotlight. “Setting the stage” is part of the work for your client.
Scripts are the last category. Personally, I like the flexibility and openness of not using scripts, but I am pretty non-directive, so that makes sense. The beauty of a script is that it can be pre-planned, thought out, and prepared. It can save time with groups and intentionally educate. But, who is the author? Maybe you have prepared scripts or loosely scripted ad-libbing options. Maybe you want the client to write the script. That’s another expressive art, but it could be beneficial with drama, too.
To Prompt or Not To Prompt?
What about prompting? In my opinion, this expressive art is often prompted. The therapist often takes on the role of director, and that means giving direction about how the production should be done. Yet, as I mentioned earlier, if you have a puppet stage available, the client initiates a role play, or you have sand and miniatures available, even the most non-directive therapist is providing the option of drama techniques in the playroom. So, drama in therapy can be used with a variety of theoretical approaches and different preferences.
Drama Across the Lifespan
As I’ve been talking about drama, I have lots of ideas for applying it with children, adolescents, and adults.
Children
In my own experience, things that I now call drama techniques often happen naturally with children. I don’t usually prompt a child to show me what her teacher is like. She’ll show me by the kind of puppet she picks and how the teacher talks in what is natural play. This kind of play is so important for child development as children try on roles and test out actions. So, my encouragement with children is to have the toys available for the cast, props, costumes, sets, and scripts that invite big, imaginative play. Whether you or the child is the director will largely be determined by how you do play therapy.
Adolescents
Adolescents are doing a lot of trying on roles, too, but they will waver back and forth between enjoying younger things and turning their noses up at them. In front of peers, anything that is too juvenile may be embarrassing and awkward, even if they secretly enjoy it. Plastic and primary colors are probably not the best choices. Props that are better quality, such as a furry-lined cape instead of a plastic one may work better. A taped paper crown may work for kids, but a heavier, metallic-looking one would probably be better with adolescents. Even though imaginative play is fun, it will feel juvenile, so some adolescents may resist drama techniques without physical props. You know your adolescent clients and what works and doesn’t… or you will soon because they will let you know.
Emerging Adults
We call the college student population emerging adults because they have what can be a cushioned four-or-five-year experience where they aren’t fully responsible for themselves yet, even though they are legally considered adults. In this category today, I am including trade schools if the student isn’t financially independent, but I am not including those 18-year-old high school graduates who are self-sufficient. Emerging adults often revert to more child-like things, and they may be really open to imaginative role-playing and anything that rings of drama. Of course, this doesn’t describe everyone in this category, but you may have more liberty for big, imaginative play during this time than any post-childhood time.
Professional Adults
Some adults have lost their playfulness. This could mean that drama techniques are a refreshing way to work their adult pain, but it may mean that they need clearer prompts and a gentle easing into using the technique. If you sense some resistance or awkwardness, pause the technique and process what happening with the client in the now. You might say something like, “It seems like this is hard for you. Let’s pause on the technique for a minute, and tell me what you are thinking right now.” Adults usually find it easier to talk about cognitions than emotions, so if you are creating safety, ask what the client is thinking first.
Groups and Individuals
Before I wrap up this segment and introduce you to this week’s guest, I do want to talk about group therapy. Most of the time on this podcast, I talk about individual therapy. My background and training is mostly centered on the individual, the client. But some of you are trained and experienced in systems thinking, group therapy, or family counseling and your work includes others or a collective client. Drama in therapy offers some fun group options and more opportunities with the “cast.” You can certainly use drama with individuals, too, but its strengths shine with groups. So maybe this has you considering some creative ways you can use therapy to benefit more than one person at a time.
Interview with Jamie Langley
[The interview portion of this episode was not transcribed. To listen to the interview click the episode link at the top of the page.]
Research Summary
Hello and welcome back to the research segment! Today, I am going to summarize a book chapter from a book that has completely shifted my perspective on trauma. It is called The Body Keeps the Score by Dr. Bessel van der Kolk. I truly believe this is one of those "must-reads" for all therapists, and maybe even all helping professionals. The way Dr. van der Kolk reports on and discusses research is digestible, and his findings have vast implications for our field. It has totally shifted my paradigm and the way that I conceptualize treating trauma.
One of the most tragic impacts of trauma is that it fundamentally disconnects us from our bodies. As Bessel describes in the book, “Almost every brain-imaging study of trauma patients finds abnormal activation of the insula, the part of the brain that integrates and interprets the input from our internal organs—including our muscles, joints, and balance systems—to generate the sense of being embodied.”
This “abnormal activation of the insula” basically means that the part of your brain that’s supposed to say, "HEY, HERE’S WHAT GOING ON IN YOU," isn’t working correctly. So, it causes the amygdala to trigger the fight/flight system, which then results in us being more disconnected from our bodies.
I believe that this is why the expressive arts brings some serious magic to the therapy room. Because it is EMBODIED! Not only does it promote cross-hemispheric connections, as we discussed last week, but it can involve the WHOLE SELF. In The Body Keeps the Score, Bessel goes on to discuss certain embodied interventions like EMDR, yoga, neurofeedback, and drama! And I wanted to share with you a little bit about what he has to say about using drama/theater to treat trauma.
Bessel talks about how over the past decade he has observed and studied 3 different programs for treating trauma through theater in the Northeast and abroad, and he shares some of his observations from those programs.
He says, “Despite their differences, all these programs share a common foundation: confrontation of the painful realities of life and symbolic transformation through communal action. Love and hate, aggression and surrender, loyalty and betrayal are the stuff of theater and the stuff of trauma.”
Bessel goes on to talk about how these programs allow trauma survivors to confront two things that are often painfully difficult to confront—emotions and conflict. Trauma makes people afraid to feel, and as we talked about last week, that means typically fleeing to the left side of our brain. Trauma leads to a loss of control, yet the theater and acting is all about embodying emotions and giving them a voice. Trauma makes people fear conflict, yet conflict is central to theater. Bessel says, “Trauma is about trying to forget, hiding how scared, enraged or helpless you are. Theater is about finding ways of telling the truth and conveying deep truths to your audience.” Perhaps this is why the theater has a unique way of moving us. Thanks to our mirror neurons, just being part of an audience and watching either tragedy or romance or joy, has the ability to activate parts of our brains from which perhaps we’ve been disconnected.
In this chapter, Bessel describes amazing programs all around the world that are bringing kids/teens and adults together, into safe communities with social support where healing happens in the context of drama, theater, and improv. This embodied and expressive art is giving trauma survivors around the globe a chance to, quite literally, use their voice and to reclaim what trauma took from them. If you’re interested in learning more, I highly encourage you to go grab a copy of The Body Keeps the Score.
Conclusion
That’s all for today’s show. I’m feeling a little more dramatic now, not that I needed help with that. You can’t see me, but I’ve struck a dynamic pose with my hand on my forehead. I love the creative options we have to use play therapy with all clients. I’ll be back in two weeks with a different expressive art. Try this today: Consider a client who might benefit from using drama to pull out what is internal and express it in a concrete way. What could that client use for a cast, props, costumes, a set, and a script? Check out the North American Drama Therapy Association and the Ed Jacobs book on Creative Counseling Techniques.
Thank you to our Expressive Arts Technique guest, Jamie Langley.
