Avanthika*, an 11-year-old girl, was anxious all the time. She felt that someone was always following her. When she consulted a therapist, she was made to undergo psychodrama sessions. It is a form of psychotherapy in which patients act out events from their past.
And, as a part of the sessions, Avanthika enacted the anxiety, that she assumed to be a black flowy form, and what she felt each time she thought someone was following her. At one point, she turned back and asked the anxiety ‘why are you following me?’ She also reversed the role and played the fear itself, as she explained why she followed Avanthika.
Similarly, Geethika*, a teenager with socio-phobia enacted the positive and negative sides of her condition. On the positive side she wanted sympathy and the on the negative front, she wanted to change the fact that she didn’t have friends. Over time, with the help of the sessions, she trounced her complexes with herself that restricted her from making friends.
Psychodrama, which dates to the early 20th Century, is one of the popular tools used by therapists and counsellors for their clients who have a range of psychological conditions. Magdalene Jeyarathnam, founder-director, Indian Institute of Psychodrama, who has been applying it on a wide age group for a number of conditions including anxiety and hallucinations. Magdalene spoke to DT Next about a case of a woman with visual hallucination and the frightening experiences she had because of it. Through psychodrama she was made to explore the purpose of the hallucination. She said, “The key word is encounter and meeting the person where they are, i.e. in their reality. Psychodrama also has a role reversal, when, in the case of someone who is enacting how they experience fear, also dons the role of the fear itself, talking about its purpose in the person’s life. But it takes a while to get there.”
Finding the better person
There is always a better person in an individual and many don’t realise it, added Dr R Sathianathan, former director Institute of Mental Health. Dr Sathianathan said that expressive or art-based therapy can be broadly applied in even cases of obsessive-compulsive disorder (OCD), adding that some patients in the IMH have benefitted from the therapies. He explained, “Once they develop a mental illness they feel low and diffident and have a negative outlook. In the case of a psychodrama, the inner person is brought out and the person is surprised to know he or she is dominant and assertive and not meek. A series of such sessions enhances their self-esteem and helps them to handle the situation better.”
In art therapy or when a person is made to bring out the dormant side, the inner emotions are translated in the pictures. “The expressions also include the way they project themselves or explain the emotions they have been bottling,” he said.
Muscles have memories
Certain incidents are stored in our muscle has muscle memories, said Victoria Niveditha, art and creative movement psychotherapist, who in the past few years has been exploring movement and expression to look at trauma, abusive behaviour and conflict in her clients. She said, “Body movement helps the person to move and express to ventilate the depression or any emotion without having to verbalise it. There is no need for an audience and it could be between the therapist and a group of people or an individual and a therapist.” Victoria has been having sessions in playback theatre forms with inmates of juvenile homes in Tamil Nadu. They are made to express their story and are trained to enact their own friends’ stories to understand themselves and help team bonding.
Eric Miller, director of World Storytelling Institute, who has been training psychological counsellors to apply it, said that the medium can be powerful when it is used to explore emotions like grief and confusion, or even happiness. “Especially when they are made to draw a parallel with epics or with movie plots, they realise they are not alone,” he said. Miller focuses on internalising and externalising stories. “These are about narrate own life experiences from an outsider’s view and taking up first person accounts for another person’s stories. When you make someone talk about their life’s story in only 10 minutes, it helps them take stock of the major decisions they have had to make, identify the frustrations or anything that needs to be resolved,” he said.
The therapists also apply a mutual storytelling technique, when the client in case of a child starts with a story, and a therapist picks the same story with more events or characters. Dr Lakshmi Ravikanth, the deputy dean of The Banyan Academy of Leadership in Mental Health (BALM), said, “The stories can be explicit, experiential or introspective, depending on the age and level.”
Dr Ravikanth shared the case details of a child who was made to express his grief about losing his grandmother through clay therapy. “Just about seven to eight years, he did not know how to ask or explain the bereavement.”
She added that the therapies look at redeeming the individual from what they may or may not be able to articulate and offer catharsis. “It doesn’t happen in a day or two and has to be done only at the client’s comfort level. Take the case of a person, who is highly anxious and has spoken about it to me. I can use a technique called doodling, after I have asked her to suspend talk. You can combine music with drawing, painting with singing and slowly when they feel drawn inward, gradually they come to a feeling that there is calmness inside. With music therapy, you can attune to certain types of music and notes and feel rested,” she said.
In Ramana Sunritya Aalaya (RASA) run by multi-faceted Ambika Kameshwar, the five tools of theatre such as namely dance, drama, music, storytelling and arts and crafts are structured to address specific needs. She said, “Session plans are made based on the needs and goals to be addressed after a ‘diagnosis’ or assessment is done.” RASA has worked with the patients at Kilpauk institute of mental health as well as the Schizophrenia Research foundation (SCARF)
The key, however, in all of these forms is not to judge or make quick conclusions, added Dr Ravikanth. Expressive therapy can be tough in the case of children below five and with those with any kind of impairment. “These therapies are a challenge with those who are blind, though they can take up music or drumming. In such cases, we can resort to kinesthetics,” she said.
Popular Art-Based Therapies
- In South India, if a person dies suddenly without saying goodbye, someone usually dresses up as the person and visits the family, so that they can be given a send-off. Though a traditional ritual, it is also related to psychodrama
- Dance and movement therapy is based on muscle memories—be it those invoking negative or positive emotions
- While storytelling is seen as an activity related to children as it evolved in the form of folklore in ancient India, is about human beings and emotions in different situations
- Music is unbelievably calming as is painting and craft work
- Drama allows for catharsis and fosters a deeper understanding of oneself