STOP! This is the crucial point with role reversal in TSM. When working with a trauma survivor in Prescriptive Roles, it is important to keep the protagonist in role reversal until they have reached a full state of spontaneity as that role of courage or other strength. That is, the protagonist must be able to stay in a strength, or other Prescriptive Role, long enough to experience an adequate response to a new situation or a novel response to a repetitive situation. This initial staging takes time, and the director must be patient with establishing these Prescriptive Roles and wait until the protagonist has fully embodied each and every role.
To fully integrate the Prescriptive Role it may be important to have the protagonist, in that role, interact with other roles on stage and with the group members in the audience, all the while having a trained auxiliary walk with them making doubling comments, thereby cementing the role even further. The director must keep them active in a nonverbal and verbal state of that strength, as long as needed before role-reversing them back into the protagonist role. Most importantly, the role reversal is to help them fully experience the highest state of spontaneity that they will need, in these Prescriptive Roles, in order to face the trauma that will soon appear in the drama.
By contrast, generally in TSM, role reversal is very limited when the protagonist has introduced the Trauma-based Roles of Victim or Perpetrator onto the stage. Since these roles are already well known in their internalized personality structure, the protagonist does not need to experience them further. In fact, experiencing them can be dangerous since they can trigger dissociation, intense feelings, or uncontrolled regression. The director, again, must be very aware of what level the protagonist can handle before being overwhelmed by the role. As a safeguard in TSM, a trained auxiliary ego (TAE) usually takes these roles—especially the beginning stages. (Chapter 3 addresses clinical considerations when role-reversing into the Trauma-based Roles.)
There is No Audience in TSM Dramas
An obvious difference between TSM and classical psychodrama is one that has been alluded to throughout this chapter, especially in speaking about projections, spontaneity, and creativity: there is no audience in TSM dramas. In classical psychodrama, there is a protagonist, director, and auxiliary egos; the rest of the group remains in the audience position. Because TSM is a model of intrapsychic psychodrama, what happens in a TSM drama belongs to all group members who identify with the protagonist and/or elements of the enactment. The reason for this is reciprocal: the protagonist projects onto other group members whatever s/he cannot contain and, because trauma survivors have an innate sensitivity to the emotions of others and have these feelings themselves, they will identify with these unconscious projections and often become triggered by them—projective identification.
With the TSM Action Healing Team, group members can be supported to experience their own feelings and add another dimension to the drama, but all in a contained fashion. For instance, when a protagonist is expressing sadness or anger on the stage, many group members will also feel these emotions deeply. Rather than leaving them alone in their experience as audience members, which can add to guilt and shame, TSM Team members sensitively note how are they feeling and ask what needs to be done. Even if the group member can’t answer the questions, TAEs will gently integrate them into the drama as strengths, wounded children, good-enough mothers, etc., or even as the “Greek Chorus” speaking anger or other emotion when appropriate on the sidelines. By the time the trauma scene is fully enacted, the entire group is on the stage in one of (or doubling) the Prescriptive, Trauma-based, or Transformative Roles in the drama.
This is not a scene for the faint-hearted, yet when the Team members are clinically astute and trained to work well together, these are dramas of deep healing for all.
TSM Action Healing Teams
TSM’s Action Healing Team was born in 1992 as a spontaneous co-creation in the midst of a drama with a protagonist diagnosed with multiple personality disorder (MPD) (dissociative identity disorder [DID]) (Toscani 1995a). As a Containing Double, Francesca was “directing” a drama with a client who was abreacting in an auxiliary role while Kate directed the main drama. The role of Assistant Leader, unique in the field of psychodrama, then evolved when they worked together to bring these disparate dramas into one. It became clear that utilizing a team approach was necessary for safety and allowed for a depth of co-creation not possible with a single director.
Recognizing the intensity of this work with trauma survivors, the Action Healing Team is a necessary component and picks up the trail of classical psychodrama’s first footsteps. During the first several decades of work at Beacon Theatre in New York, all psychodramas were conducted with a team of trained auxiliary egos. This was possible because students did internships for months or more at a time at the Moreno Institute to learn psychodrama. One example is when a patient claimed to be Jesus and a group of auxiliaries were his 12 apostles for days at a time, fulfilling his psychotic reality until he himself began to see that this was not the truth (Z.T. Moreno 2010, personal communication).
Unfortunately today, due to insurance and private pay concerns, it is most unlikely that you will encounter many psychodrama groups with a team of trained auxiliaries. In most cases it is considered fortunate to have two co-leaders share the directing of a psychodrama group. TSM is the notable exception to this rule and follows the training structures of having student interns and practica to enable a team approach. While providing for the best treatment possible in our personal growth weekends for people with PTSD, this modality also allows students to have hands-on, live supervision in TSM.
In classical psychodrama the director’s role is most important and actually comprises several components that are necessary for dramas to have full therapeutic effect. Peter Felix Kellermann described the director’s role as composed of four highly complex parts: therapist, analyst, group leader, and producer (Kellermann 1992). That there are four roles or segments gives a stabilizing effect (think of a four-legged table) and wholeness to the director’s role and responsibilities.
TSM adapted and teaches Kellermann’s roles of director when creating the Action Healing Team that is integrated to work as a whole entity, of which the director or Team Leader (TL) is a part. The other members of the Team are the Assistant Leader (AL) and Trained Auxiliary Ego(s) (TAE) and when the Team functions as a well-put-together entity, it becomes the director. With this concept, the individual director of a particular drama does not have full responsibility for all of the director’s roles because all Team members are constantly vigilant about what is happening with the protagonist, the group, each other, and the drama itself.
For our purposes the director roles are redefined and shared among Team members who embody separate parts but who are also keenly aware to pick up whatever is missing and share responsibilities. Essentially, the Team is a holistic and holographic entity and, like any well-put-together entity including the brain, the actions of all these roles are in ascendance and descendance at any moment in the drama. Briefly stated, the skills associated with each director role, and of which the Team members are to have knowledge, are as follows.
•Therapist: Has unconditional positive regard and develops a supportive relationship with the protagonist. Assesses protagonist’s needs and uses clinical interventions appropriately. Facilitates positive emotional release and cognitive insight through action and roles. In TSM dramas it is not unusual for the director to stop an action and explain to the protagonist what is going on intrapsychically, giving them an intellectual framework. This can be done, as well, by TAEs in CD and/or Observing Ego roles.
•Analyst: Has full awareness of the protagonist’s condition, including an understanding of intrapsychic and interpersonal phenomena. Has a theoretical and clinical perspective that guides the overall plan, but adopts a “Socratic ignorance.” Identifies emotionally with the protagonist’s work, yet maintains objectivity and separate identity. This is especially important for TAEs playing roles and for the director who is leading the drama into various scenes and dimensions.
•Group Leader (Sociometrist):