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The late arrival of group psychiatry and group psychotherapy has a plausible explanation when we consider the development of modern psychiatry out of somatic medicine. In a particular group a subject may be used as an instrument to diagnose and as a therapeutic agent to treat the other subjects. The doctor as the final source of mental therapeusis has failed. Sociometric methods have demonstrated that therapeutic values are scattered throughout the membership of the group. One patient can treat the other. The role of the healer has changed from the owner and actor of therapy to its assigner and trustee. But as long as the agent of psychotherapy was a particular, special individual, a doctor or a priest, the consequence was that he was also the medium of therapy as well as the catalyzer of healing power.
This chapter discusses psychodrama to sociometry. The psychodramatic method uses mainly five instruments the stage, the subject or actor, the director, the staff of therapeutic aides or auxiliary egos, and the audience. Reality and fantasy are not in conflict, but both are functions within a wider sphere the psychodramatic world of objects, persons, and events. Delusions and hallucinations are given flesh and an equality of status with normal sensory perceptions. The architectural design of the stage is made in accord with operational requirements. The locus of a psychodrama, if necessary, may be designated anywhere, wherever the subjects are, the field of battle, the classroom, or the private home, but the ultimate resolution of deep mental conflicts requires an objective setting, the psychodramatic theatre. The psychodramatic approach deals with personal problems principally and aims at personal catharsis; the sociodramatic approach deals with social problems and aims at social catharsis.
As long as the nature of eugenic affinities is not established by biogenetic research, we shall assume two practical rules: that psychological nearness or distance is indicative of eugenic nearness or distance and that clinical studies of crossings lead to a preliminary classification of eugenic affinity. We may have to consider not only changes in the genes but changes between the genes whatever mutation may have taken place in a gene and for whatever reason, mechanical and chemical. If this mutation should be favorable the genes must be attractive to one another, that is, must correspond to changes in some other genes. In other words, the genes must be able to produce a functional relation; morphological affinities and disaffinities between them may exist. A definite relation may exist between gene effect, the reflection of one gene upon another and upon the individual characters, and tele effect.
This chapter discusses autobiographical fragments. It also presents examples from Moreno’s own cases containing verbatim transcripts that illustrate the give-and-take between Moreno, his patients, and the audience observers. The chapter reviews Moreno’s life and ideas in the context of his time and in the field of psychotherapy. When he was very young the idea of death, his own death, never entered his mind. He was in direct communication with God. If love or comradeship should arise, it should be fulfilled and retained in the moment without calculating the possible returns and without expecting any compensation. It was in his work with the children that his theories of spontaneity and creativity crystallized. The two factors, spontaneity and creativity, went together. Also he found that whenever a child repeated himself in the playing out of an idea of a dramatic sketch, his portrayals became more and more rigid.
The new era is one of multiple innovations which have set the pace for the developments in psychiatry. The theories of interpersonal relations, micrasociology, and sociometry and the theories of the encounter, spontaneity, and creativity have opened up vast areas of research in psychiatry, social psychology, and social anthropology. New methods of therapy group psychotherapy, psychodrarna, sociodrama, psychosomatic medicine, and psychopharmacology have been introduced. The ideas of the therapeutic society, therapeutic community, and the “open door” of prisons and mental hospitals are beginning to replace the older coercive methods of the management of prisoners and mental patients. A new body of theory has developed in the last thirty years which aims to establish a bridge between psychiatry and the social sciences; it tries to transcend the limitations of psychoanalysis and behaviorism by a systematic investigation of social phenomena. One of the most significant concepts in this new theoretical framework is the role concept.
One of the greatest of the methodological difficulties which the social sciences have had to face has been the discrepancy between verbalized behavior and behavior in life situations. The more fundamental and central a situation or relationship may be in family and marriage relationships for the individuals concerned, the greater is the social tension if such discrepancy arises. Psychodramatic procedure establishes a number of typical situations which are standardized for use in the various relationships which come under observation. These situations, of course, are based upon actual psychodramatic experience with many married couples. Psychodramatic treatment of marriage problems has emphasized the importance of the part played by hidden roles in the personalities of the two partners. Many cases of failure have been noted in which the cause could be traced to the emergence of the role, at a time which may be even years after the wedding.
This chapter illustrates how the psychodramatist uses action techniques for diagnosis. It also discusses three techniques which are used today in psychodramatic work: the double technique, the mirror technique, and the reversal technique. These techniques in psychodrama can be significantly compared to three stages in the development of the infant: the stage of identity; the stage of the recognition of the self; stage of the recognition of the other. The double is a trained person, trained to produce the same patterns of activity, the same patterns of feeling, the same patterns of thought, the same patterns of verbal communication which the patient produces. Identification presupposes that there is an established self trying to find identity with another established self. Now, identification cannot take place until long after the child is grown and has developed an ability to separate itself, to set itself apart from another person.
Psychoses can be treated by means of the psychodraina, but questions have been raised as to just how this treatment can be accomplished and what effect the psychodramatic treatment has upon the psychotic and his disorder. Freud distinguished between those mental disorders in which a transference from the patient to the physician can take place and those of such narcissistic character that no transference is possible. He declared persistently that psychoanalytic treatment can be applied only to patients who can produce a transference to the analyst. Consequently, as soon as he discovered that a patient was suffering from a schizophrenia or similar narcissistic disorder, he declined to treat the patient further stating that psychoanalytic treatment would do no good. The psychodrama actually functions as a milieu which will reflect that patient’s psychosis in such a way and on such a level that he can see his psychotic experiences objectified.