Healing World Trauma with the Therapeutic Spiral Model. Группа авторов
thinking and feeling. It is an operationalized state of spontaneity, meaning that it allows an appropriate response to whatever appears.
Experiencing: all aspects of the protagonist’s internal and external awareness are presented safely in the here-and-now so that s/he can make spontaneous and creatively healthy decisions to change old situations with new actions.
Meaning-Making: develops a new cohesive, personal narrative that organizes the past in a good way and provides guidance to the future.
The First Spark of TSM: Kate Hudgins’ Story
In 1941, J.L. Moreno, the co-founder of psychodrama, began a training program at St. Elizabeths Hospital in Washington, D.C., in psychodrama and group psychotherapy. Decades later, on a year-long internship funded by the National Institute of Mental Health, Kate had the good fortune to receive clinical training in this modality from Dale Richard Buchanan, Ph.D., TEP, among other well-known and respected clinicians. Below, Kate tells the story of how it was here at St. Elizabeths Hospital that the first creative spark of the Therapeutic Spiral Model emerged accidentally or synchronistically, if you will, in the early 1980s.
Intern Directing: An Action Learning Experience
The structure of the training at St. Elizabeths required that the interns direct one another in personal psychodramas for one training session a week during Intern Directing. It was our only chance to practice on “normal folks” since all of our other directing was with actual inpatients or day-treatment patients at this major psychiatric hospital.
We were near the end of our training year together and, as often happens with intense relationships, the group was struggling with each other interpersonally and in danger of falling apart during the termination phase. For several weeks, our intern group of 12 had been focused on a major interpersonal conflict among three people in the group, the very ones who had become the group’s leaders over time. This conflict was causing considerable disruption, with members having strong feelings and aligning with different sides of a divisive issue that concerned us all.
As Intern Director of the week, I had decided ahead of time that I would lead a metaphorical psychodrama permitting people to express their feelings to get beyond the conflict. This drama would be a type of sociodrama, allowing more of an emotional distance than any one person’s psychodrama. So as my peers entered the psychodrama theatre, I handed them each imaginary guns telling them to “Take their sides and build their forts.” Everyone got into the action structure, laughing in camaraderie, play acting like kids shooting “their enemies” on the other side.
Suddenly, one of our fellow interns rushed to the center of the stage, clearly confused and distressed. He was shouting, “Stop killing the women and children. Stop, stop, stop!” and collapsed in agony on the stage. I was stunned, shocked, and at a complete loss as to what was happening. What we were all witnessing was a psychotic break before our eyes, and I felt I had caused it. This person was a friend of mine, a peer, a private practice therapist who was studying to be a psychodramatist…and he was now lying on the floor writhing in agony. Screaming about killing women and children, he was no longer on the psychodrama stage but was absolutely, totally back in the jungles of Vietnam. His consciousness had slipped into the morass, the jungles, of un-worked-through trauma from his past, and we were there with him.
Taken aback, I turned to my supervisor sitting in the room and asked, “What do I do now?” She replied tautly, “Direct the drama.” I looked around the room at the stunned faces, at the scene lying at my feet, and thought, “What can be done to heal this man?” Not having an answer, I said a silent prayer.
Classical Psychodramatic Healing
The prayer was answered when, spontaneously, another intern threw himself on the stage floor and began to take the role of a psychodramatic Double for the Veteran (Toeman 1948). As Double, he took on the protagonist’s pain and agony, physically, mentally, emotionally, and, yes, spiritually. As Double, he totally immersed himself into the task of reaching into another’s reality and, as he merged himself, the protagonist was no longer alone.
It was at that moment that the healing began to happen before our eyes. I will never forget the look on the Double’s face as he fully gave himself over to experiencing the intense pain of another human. As the Double held his pain, the Veteran was able to come back to the present and into contact with his mind. He was able to reorient to time and space rather than spiraling deeper into the chaos, terror, and the violence of war.
But as he shifted from one state to another, he also looked around and felt ashamed and embarrassed. It was then that I took the Director’s role, holding out my hand and asking him to stand beside me. While his Double stayed on the floor holding the pain, I asked the Veteran to reach out and comfort his self (the Double) in agony, his self from the war. Gradually, he was able to reach out to his self, to hold him tightly in his arms, weeping and grieving together. His Double asked, “Can you forgive me? Can you?”
Another psychodrama intern was a pastoral counselor and I turned to him asking if he knew a “forgiveness ceremony.” He spontaneously created a healing ceremony for this Vietnam Veteran, actually for all of us present. In the immediacy of the psychodrama, we had all witnessed the horror of killing others. We, too, needed healing. In the “forgiveness ceremony” the minister asked us all to name what we were ashamed of, what behaviors we had done that we now regretted, what we needed forgiveness for in order to let go of our past shames.
First, as a group we held hands around the scene taking place in front of us. Together we were able to truly see, to witness, and, most importantly, to have compassion for the scene on the stage. We saw our peer, today’s man, comforting and grieving with his 19-year-old self, a bewildered young man who had killed men, women, and children during a war that went out of control. Witnessing such depths enabled each of us to now name our own sorrows and shame: beating up on sisters and brothers; hating our parents; bullying others; lying, stealing, cheating; adultery; abortion; drug abuse; domestic violence; violence toward our children; suicide attempts—all the acting-out behaviors of anger and rage perpetrated on ourselves and others. Loneliness, abandonment, our dysfunctional backgrounds shared, the minister prayed with and for us all.
A profound sense of forgiveness, of holiness, of God/Spirit’s presence in our lives filled the room. We looked around at each other with love and compassion. There were many “waterfalls of tears” flowing and we honored the courage it took to walk together psychodramatically for a year of learning, growth, and of healing ourselves and others. We had traveled to the depths of human despair and ugliness together and we had returned to a place of healing and love. We were thankful for it all and to be alive in the present.
Post-Traumatic Stress Disorder
Later, I was to learn that I had actually witnessed a flashback, not a psychotic break, caused by a present stressor for someone who had PTSD. And years after that I recognized that the exquisite doubling experience I had witnessed in this drama was akin to the shamanic work I was to study. While I did not know it then, the drama at St. Elizabeths was the beginning seed of the Therapeutic Spiral Model, the beginning of my own lifelong commitment to the belief that we all can be healed in a group of like-minded and spirited people.
TSM Takes Root: Francesca’s Seeds
The year was 1990 and another war—Desert Storm—was approaching. Kate Hudgins and Milton Hawkins, TEP, were beginning a psychodrama training group in Richmond, Virginia. It was during this group that Francesca Toscani and other members of the eventual “Action Healing Teams” (including Mimi Hughes Cox, author of Chapter 9) were first introduced to Kate, each other, and intensive psychodrama training. But Francesca recalls a much different and more reticent path to psychodrama and working with trauma survivors than Kate’s story of immediate immersion. She writes:
Coming from a broad background of business, the arts, and an in-depth study and experience of Jungian Analytical Psychology, I became a therapist in 1982. The clients I worked with were not trauma survivors per se, yet were searching for deeper meaning—a spiritual connection that would breathe life into their daily existence.
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