Experiential Therapy – Possible Treatment for Addiction and Trauma

Experiential therapy — a broadly based description of therapeutic modalities that employ here-and-now experiences — can be greatly effective when working with people in recovery.

Within recent years, many treatment centers and other programs are re-inventing and re-informing their programs to show recognition of the particular needs to women as well as introducing a number of holistic treatment components. Many of the same professionals also are re-evaluating the need for experiential learning and broadening experiential programs with metaphor, ritual and ceremony, the creative arts and work with animals defined by distinct clinical objectives.

Because addicts of all kinds habitually use compulsive behavior to avoid experience of self, experiential therapy offers opportunities to have direct experience of self and feelings in a safe and structured setting. In addition, experiential therapy offers multi-modal opportunities for learning, so that people who have difficulty thinking, writing or speaking can learn and express themselves in a variety of ways.

Experiential therapy is based on psychodrama, a holistic method developed in the 1920s and 1930s by Dr. J.L. Moreno, a physician who was a younger contemporary of Dr. Sigmund Freud. He adapted theatrical principles for working with people so that people could begin to experiment with solving problems differently, moving away from the victim role into cooperative, flexible and creative behaviors. Moreno also understood the healing value of the group as early as 1913 — long before 12-step support groups got their start — and coined the phrase “group psychotherapy.”

Although most people look at experiential therapy as role playing, it is far more complex. Psychodrama is a holistic method that uses action to explore a person’s public and private worlds in a multi-dimensional way.In psychodrama, we identify a very specific three-part process for maximum involvement with both the enactment and the group experience. In psychodrama, participants explore concerns in a safe environment with action rather than simply talking about them. This involves not only exploring the history but also the psychological dimensions that are not normally addressed in conventional dramatic process: unspoken thoughts, encounters with those not present, portrayals of fantasies of what others might be thinking and feeling; night dreams and envisioning possibilities.

Beyond psychotherapy, Jonathan Fox used psychodramatic philosophy to develop Playback Theatre, which combines improvised theater and community building and is now recognized as a method of its own (Read “Improvising Real Life” by Jo Salas to learn how Playback originated). Peter Pitzele has employed psychodramatic ideas in creating Bibliodrama to enliven stories of scripture; he details the method in his books, “Our Fathers’ Wells” and “Scripture Windows.” Others adapted psychodramatic techniques as well as Moreno’s sociodrama, a related method, to explore societal issues, for use in business and organizational settings.

Unfortunately, psychodrama has received bad reputation in some circles in the 1960s when the method was used incorrectly and haphazardly by many people – some of them not even psychotherapists – with little or no training.

Counselors who hear groans when they suggest a role-taking exercise in sessions may be neglecting the very important “warming up” part of the process, the activities that warm people to genuine, rather than compliant, action.

And action is not just limited to role play, but may include art work, choice-making, movement, therapeutic sculpture, anger reduction exercises, simple ritual, writing, work with animals, map making and guided imagery. Finally, a specific non-judgmental sharing process in the therapeutic setting helps people discover meaning in the experience as well as positive connection with others.

In group therapy, it is also important to observe the group’s sociometry, which is the measure of social relationships within the group. People tend to say involved and motivated in group because of the high level of sociometry that is present and may leave group — we often call this “against medical advice” — when they are not sufficiently connected.

Knowledge of sociometric theory and judicious use of sociometric exercises will improve connections in group and serve as great warm-up exercises.

In the individual session, action methods increase the richness, depth and understanding of a recovery issue. The method is adaptable to diverse clinical specialties, and philosophy and techniques can be easily integrated into traditional talk modalities.

Action therapy has the potential to help people quickly address hidden issues, feelings and patterns that would take months or even years to address in conventional talk therapy.

Moreno’s method is not just a set of techniques but a highly complex way of thinking about working with people and groups. It is important that counselors and other clinical staff, including supervisors and auxiliary staff members, understand the basics of the theory of this method, both in educating the clients of its use and in the actual safe practice of the method in groups and individual settings for most effective treatment.

For many survivors of trauma, talking provides opportunities to remember and report experiences of trauma. With the sorting of thoughts and feelings directed to a compassionate and skilled listener, survivors are often able to use talk therapy to make meaning out of extremely painful experiences.

But many survivors — as well as clinicians —know that talk therapy has limitations. It provides symptom management but does not completely address the continuing post-traumautic realities of emotional flooding, intrusive images and dissociative episodes.

Experiential therapies, including psychodrama, have regained interest in recent years as helping professionals continue to seek ways to address the complexity of trauma recovery. In fact, experiential treatment has just been recognized as the treatment of choice for trauma survivors by the “bible” of psychologists, “The Handbook of Psychotherapy and Behavior Change.”

When raw emotions are not appropriately resolved for the client and the remainder of the group, we can expect confusion and lack of truly effective treatment at the least; at worst, retraumatization of the individual or group.

Counselors should never push or shame people into a particular mode of action work but instead work to respond creatively and spontaneously when a client appears either compliant or resistant.

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