Healing World Trauma with the Therapeutic Spiral Model. Группа авторов

      Chapter 2

      The Similarities and

      Differences Between Classical

      Psychodrama and the

      Therapeutic Spiral Model

      Kate Hudgins, Ph.D., TEP, and

      Francesca Toscani, M.Ed., TEP

      Introduction

      It has been a long journey, sometimes circuitous, but this chapter details the unfailing and unflagging allegiance of Therapeutic Spiral Model (TSM) to the foundations of classical psychodrama. It also describes the clinical reasons for the changes of TSM from an interpersonal to an intrapsychic model of experiential psychotherapy. We show the clinical modifications to the core interventions of classical psychodrama as described in Chapter 1, all the while respecting its original forms and methods. A description of the Six Safety Action Structures (Cox 2001) and the TSM Action Healing Team (Toscani 1995a) are included here since they are adaptations of classical psychodrama’s techniques and earliest methodology.

      Like Chapter 3, this chapter includes much detailed clinical information and suggestions for action intervention. Please feel free to read and digest it at your own pace and, we hope, you will soon integrate the knowledge and structures into your role repertoire.

      The Therapeutic Spiral Model

      TSM has its base in classical psychodrama theory and methodology, especially those of spontaneity, creativity, and role theories (Hudgins 2008, 2007a, b, 2002, 2000, 1998, 1989; Hudgins, Culbertson, and Hug 2009; Toscani and Hudgins 1993; Toscani 1996; Lai et al., In Press). Using basic psychodrama techniques clinically modified for safety and containment, TSM adds to classical psychodrama the latest knowledge and research in clinical psychology and neurobiology about the treatment of Post-Traumatic Stress Disorder (PTSD). TSM places an unusual emphasis on safety and containment both for the protagonist working on trauma repair and for group members who are fully involved during the dramatic process at all times. An important teaching from neurobiology, as well as clinical observation, is not to overwhelm the brain with intense emotions or uncontrolled regression and all of the TSM clinical action structures have been dedicated to this goal from the very beginning.

      Neurobiology and PTSD

      Learning about the latest research on the neurobiology of the brains of persons with PTSD was an affirmation of the clinical therapeutic interventions we had been making for years with TSM. Here we give a simple review of three changes in the brain that result from the experience of trauma and violence, regardless of the stressor—childhood abuse, domestic violence, natural catastrophe, war trauma, accidents, or illness. (Please see Ed Hug’s Chapter 4 for more detailed information.)

      Right-Brain–Left-Brain Split

      PTSD, as defined in the DSM-IV-R (APA 2000), is caused by experiencing a single episode or continuing episodes of stress that overwhelm normal coping abilities, leaving the person helpless and terrified. What neurobiology shows is that overwhelming emotional stress shuts down the left-brain cognitive functions. The trauma remains unprocessed in the right-brain and stays there as sensory data without words—body sensations, feelings, smells, fragments of images. Research has shown that experiential treatment is more effective than cognitive behavioral therapy to treat PTSD because these right-brain symptoms are not accessible to talk therapy (Elliott, Davis, and Slatick 1998; Rausch et al. 1996).

      The