In Chapter 2, Kate Hudgins and Francesca Toscani discuss the similarities and differences between TSM and classical psychodrama. They detail the parts of the model that have been retained even as practitioners and trainers alike have used TSM in new settings, with different populations, and in varied cultures. They include the original use of spontaneity and creativity theory and they expand the use of role theory by modifying classical psychodrama interventions. Chapter 2 also introduces the Action Healing Team and the Six Safety Action Structures of the Therapeutic Spiral Model.
In Chapter 3, Francesca and Kate detail a full and updated Trauma Survivor’s Intrapsychic Role Atom (TSIRA). This is the clinical structure of TSM dramas when working with trauma survivors, including persons diagnosed with PTSD, other psychiatric diagnoses, and long-standing problems resulting from trauma. It includes the latest roles and the most recent clarification of existing roles, and other features never before published.
Both chapters are replete with clinical examples to bring the work to life and are tangible for psychotherapists, educators, and community organizers who work with trauma.
Part 2 anchors the Therapeutic Spiral Model into its theoretical foundations and research that goes beyond classical psychodrama into neurobiology, experiential psychotherapy, and clinical psychology.
Ed Hug, MSW, CP, is the best-known psychodramatist writing on the subject of neurobiology and its relationship to trauma. In Chapter 4 he details what is widely known now—how the brain operates and why experiential psychotherapy is the treatment of choice for PTSD. Simply put, trauma experiences change the neurobiology of the brain, which stores un-worked-through trauma in its nonverbal centers, making those very traumatic memories inaccessible to language, words, and talk therapy. Ed discusses the specifics of TSM and how it improves upon classical psychodrama when working with PTSD, since its basic features are to provide safety and to contain intense emotions, thereby preventing re-traumatization during re-enactment of scenes.
Les Greenberg, Ph.D., is a clinical psychologist from the University of Toronto and the best-known researcher in the world on experiential methods of psychotherapy. In Chapter 5, he anchors TSM into the rich foundation of research in experiential psychotherapy and clinical psychology. In 1996, Les wrote a chapter in The Handbook of Psychotherapy and Behavior Change demonstrating that experiential psychotherapy is equally as effective as cognitive behavioral therapy (CBT) or psychodynamic therapy to treat general psychological problems. Today, we know it is the most effective treatment for PTSD and other trauma-related difficulties.
In Chapter 6, Wen Chun Cho, Ph.D., a psychologist from Taiwan, introduces you to the Action Healing Team. Having gone through her own TSM training to become a Team Leader, Dr. Cho writes clearly on a small research project exploring the training process of students in TSM—the pros and cons. As Wen Chun probes the research, she brings to light many nuances of roles specific to TSM and the Team, for example, Containing Double (CD), Trained Auxiliary Ego (TAE), and especially the role of Assistant Leader (AL). She makes clear recommendations to help to improve the training, especially in cross-cultural situations, such as practica in individual, couples, family, and organization. Today, many of these suggestions are implemented into our International Certification Training Program to Treat Trauma using the Therapeutic Spiral Model.
Chapter 7, the final chapter in Part 2, is written by Charmaine McVea, a psychologist, psychodramatist, and TSM trainer from Australia. This chapter is part of a larger research study she completed for her Ph.D. at University of Queensland in Brisbane, Australia. Here, Charmaine describes significant moments of clinical change as she implements her own mixture of TSM therapy and classical psychodrama. Focusing on a unique aspect of psychodrama—the use of trained and spontaneous auxiliaries as part of the healing process—she defines the therapeutic alliance between protagonist and auxiliaries. That Charmaine is a gifted clinician and director is seen in the heart-touching stories of healing that she shares about workshop participants.
Part 3, the original clinical applications of the Therapeutic Spiral Model, spotlights work by authors who are from the original TSM training group. Their stories show clearly how they’ve incorporated the model into their work from the beginning and expanded it in a variety of settings with eating disorders, addictions, and in individual therapy.
In Chapter 8, Colleen Baratka, M.A., RDT, TEP, shares her stories of bringing TSM to treat eating disorders at the Renfrew Center in Philadelphia, PA. While Director of Training there, she developed an inpatient trauma track program based on TSM to provide relief for men and women suffering from eating disorders. Today, she conducts client and training workshops in the Philadelphia area using TSM. Colleen’s chapter teaches the power of the Body Double (BD), a TSM intervention for people with distorted body images and who often have flashbacks from abuse. The power of her work with clients is palpable, as is her love of walking the healing path with them, and in this chapter we are privy to her moving experiences.
In Chapter 9, Mary Anne (Mimi) Hughes Cox, LSCW, TEP, one of the first TSM team members and trainers, describes the many ways she uses TSM in the treatment of addiction work with her clients. She clearly explains the similarities between the principles of TSM and the 12-step recovery programs, making this a good match for people seeking change from their addictive behaviors. Mimi presents a powerful integration of a well-known relapse prevention tool with the Containing Double that increases alcoholics’ chances of success in early recovery.
In Chapter 10, Karen Drucker, Psy.D., TEP, a psychologist, psychodrama trainer, and TSM trainer in private practice, teaches us about the use of TSM in individual therapy. As with most of the authors, she relates the success and usefulness of both the Containing Double and the Restorative Roles of Strengths, bringing the “compassionate witness” to her work. Karen presents a moving example of TSM in individual therapy that can benefit all practitioners of experiential methods to treat trauma.
Part 4 focuses on the new clinical applications of the Therapeutic Spiral Model. In this section, you hear from authors who have expanded the use of TSM to combine other modalities and theories through their own practice in clinical settings, including group and family therapy, and weekend workshops. Without exception, they are highly specialized clinicians with bright minds, a love of the model, and dedication to help to heal more people around the world. Examples are given from Taiwan, England, and South Africa. These chapters reach deeply into the human condition and touch the hearts of all who are attuned to the pain of suffering and the joy of true healing.
In Chapter 11, Dr. Nien-Hwa Lai, Ph.D., TEP, presents information about an ongoing research project she conducts in Taiwan with women and children who suffer from domestic violence. She is the first Certified Therapeutic Spiral Model Trainer in Asia and