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Drama for Trauma: A Seriously Unique Approach to Therapy

June 7, 2016Posted by Helaina Hovitz

Let’s make one thing clear: there’s a big difference between theater for the sake of performance, and theater as therapy.

The latter is actually a Master’s level program offered at the New York State level, on par with the certifications psychologists and therapists receive. Becoming certified as a drama therapist requires specific, national credentialing.

Having therapists such as these on staff has allowed Creative Alternatives of New York (CANY) to help 260,000 trauma survivors—many of them, children—use dramatic fiction to help provide a safe space for processing difficult feelings and thoughts.

“Trauma takes away our ability to play, and imagine, and have hope. We help children and adults figure out how to play again and have spontaneity,” said Heidi Landis, CANY’s Associate Executive Director of Clinical and Training Programs. who has worked within the program for the past 10 years.

With active contracts out to over a dozen institutions like hospitals, community centers, residential treatment centers, schools, and shelters during any given year, CANY staff operates from the belief that creativity is health.

“Creativity and anxiety are in direct correlation with each other, so as anxiety goes up, creativity and spontaneity goes down,” said Landis. “When we’re anxious, fight, flight, or freeze response goes into play, the trauma response gets triggered, and we can’t react in a new way.”

But, as CANY staff has seen time and time again over the past 40 years, if clients can imagine a new possibility, it can happen, not only for children who have survived abuse, sex trafficking, and neglect, but for adult survivors of domestic abuse, veterans and active duty service members, refugees, and others.

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In small groups, therapists will start with warm ups, helping the group to imagine a scene, which always reflects a variation of the trauma they personally have lived through. A few years ago, a group of 12-17 year old girls rescued from sex trafficking (rescued) right here in Queens, New York, insisted on recreating the same scene over and over, for six months.

A mother and daughter get into a fight, and the mother beats her.

“Could we imagine a possibility where there’s a different outcome other than the mother beating her?” Landis asked.

The girls were adamant: there could be no other outcome.

Landis felt it was important to allow the girls to play out the story lines, “because they needed to know we could tolerate them and their stories.”

Then, one day, after half of their yearly contract was up, the girls decided to create a scene where the mother and daughter were baking cookies.

“What happens next?” asked Landis after letting it play out for a while.

“Nothing,” the girls answered. “They’re just baking cookies.”

There was no conflict, no mother-beating-daughter, just a scene where a mother and daughter were creating something together, which the girls found “riveting.”

“They likely won’t have this kind of relationship with their own mothers, but many are already parents themselves, ” Landis said. “This tells us that they discover there’s a possibility for a different kind of relationship, with their own daughters or with their friends.”

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According to Dr. Deidre Hanbury of the JCCA, an organization dedicated to helping meet the child welfare and mental health needs of young people in the New York area, many adolescents struggle with traditional, one-on-one psychotherapy because it relies so heavily on the ability to verbalize one’s feelings.

“Trauma erodes the ability to trust, and so the intimacy of this approach can often feel intrusive and too intense for youth who are in the beginning stages of recovery,” said Dr. Hanbury. “Creative expression offers individuals to express themselves through powerful, alternative means.”

As a result of participating in the program, 72% of teens demonstrated a reduced negative self-image and improved sense of identity, and 63% of young adults showed improved peer relationships.

The program helps clients develop empathy and social bonding skills, increase their emotional awareness, regulate destructive and impulsive behaviors, build a positive sense of self, and imagine new life possibilities.

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In countless individuals, the therapists at CANY have found that the more roles a person has access to in their lives, the healthier they are.

“Most of our clients feel stuck in a role, whether it’s the victim, the bad kid, the bully, but theater gives us the chance to try new roles without consequences. But if I’m playing a leader, I can access leadership qualities in myself, and we can internalize those qualities,” Landis said.

“Research is starting to show that when we enact those things, it changes our brains and rewires the pathways that have been damaged for these kids who have experienced complex trauma.”

Trauma is defined as a deeply distressing or disturbing experience, whether a single event or recurring, often, when they perceive their own life to be in danger. As a result of living through trauma, individuals often develop post traumatic stress disorder (PTSD) with symptoms ranging from insomnia to impulse control and a tendency to isolate from others. Individuals with PTSD lack a solid sense of self, have a hard time tolerating their own feelings and triggers from the world around them, and experience difficulty trusting others and developing healthy relationships with them. When left untreated and unresolved, PTSD can later spiral into addiction, depression, and worse.

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As Alissa Desmarais, Executive Director of CANY, will tell you, kids who experience trauma often act out and struggle with behavioral regulation, so they will often become misdiagnosed, like with Attention Deficit Disorder (ADD).

“What we know about complex trauma is that it causes an inability to regulate your own behavior,” she said. “Being in character lets us work on that, because when you come back to yourself, you can reflect on it: what was it like to be that character, did you learn anything about yourself, what pieces of that character do you want to keep with you, what don’t you ever want to experience again?”

When teenager Roberta first joined the group, she felt depressed and hopeless. She had been shuffled from foster home to foster home her whole life, and was not making any progress in talk therapy. The group at CANY encouraged her to get on her feet, participate, interact with other people, and create new stories for herself. She began to see the world in a new light, and even decided to pursue a career in theater. Recently, she was cast in a play written by teens about their experiences with mental illness.

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Initially founded under the name The Imagination Workshop in 1969, Janet Levy used this innovative and therapeutically-oriented theatre workshop model with patients in the psychiatric units at The Mount Sinai Hospital. Since then, it has grown and evolved.

But perhaps, not at the rate we need it to: there are a total of six licensed creative arts therapists on staff at CANY, and about 600 registered drama therapists in all of North America. To Landis’s knowledge, CANY is the only program of its kind in America.

More and more frequently, Landis is being asked to work with teachers in local schools, who are seeing more incidences of trauma among their students and feel they are not equipped to deal with it.

“This is really important work in the world. We’re a small but mighty organization, and healing from trauma takes time. Trauma work is slow work,” she said. “It’s not done in 12 weeks, although that is our shortest contract. That’s when we begin to see a shift. It’s a lifelong process, and we hope that the seeds we plant stay with them through the years.”

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