Fairytales, Psychodrama and Action Methods: ways of helping traumatized children to heal

by Rebecca Walters 

 

Abstract: This article describes the experiences of using psychodrama and its associated methods: sociodrama, bibliodrama, playback theater etc., with young children who are inpatients in a hospital. The ways in which these methods help young people to heal are by creating emotional distance for them to process their traumatic life experinces, develop new roles and resilience through the psychotherapeutic process.  The therapist’s balancing act of closeness and distance when entering their lives is explored; all the while bearing in mind the age and development of the young person. The article moves from the general to the specific of using fairy tales to enable young children to experience role expansion and develop social skills.

Introduction 

While working as psychodramatist on the adolescent units at Four Winds Psychiatric Hospital an inpatient unit for five to twelve year olds was opened. A great number of children were admitted who had been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). The nursing director of the unit told me that 75% of the children were coming in diagnosed ADHD but that “most of these children are actually suffering from post-traumatic stress disorder”. Trauma was the cause of their hyper-vigilance and dysregulation which looked like ADHD. As a consequence, I was asked to start a psychodrama group on two of the children’s units: one for five to seven year olds and one for seven to eleven year olds. The clinical directors of the units believed that psychodrama and sociodrama could be a real asset in helping these children tell their stories, express strong feelings in a safe way, and learn new ways of coping with overwhelming feelings; this would increase their ability to self-regulate and develop better social skills.

So we began. I had not worked with young children in over twenty years and, at that time, I was a student teacher, I did mostly creative drama in the classroom. Starting with what I knew, we acted out the story of the Billy Goats Gruff to see how it went. The children seemed to enjoy it a great deal. The following week I went in and asked two of the oldest children to stand on chairs and take the roles of big trolls. I asked who wanted to sit on the floor and be the little trolls: everyone did. I invited the big trolls to start to argue in gibberish. The little trolls were asked how they felt. They stated the obvious: “Scared”, “Angry”, “Sad” and then seven year old Keith said in his loud squeaky voice: “That’s just like my Mommy and Daddy”. Moving into a sociodrama, many little trolls had a lot to say to the big trolls. But Keith wanted to say some things to his own parents (we made use of empty chairs for the parents). We moved smoothly from bibliodrama, or the acting out stories from literature, to sociodrama and on to psychodrama. The children were focused and engaged. The staff described the children as “looking like normal kids”, something I heard repeatedly throughout the years of working on the children’s units; in psychodrama groups the children looked less disturbed and more like regular kids.

The importance of play in psychodrama with traumantized young people

Dramatic and symbolic play is built upon a child’s lived experiences. Children whose experiences have been dominated by trauma or who have lived in an environment devoid of sufficient social experiences have a need to be immersed in positive social environments. Dramatic and symbolic play offers that opportunity. At first, these children may need an adult to demonstrate and practice pro-social behaviors. This then becomes a springboard for children to enter into play. The play itself allows children to try on new roles and to experiment with them in a social setting. Lev Vygotsky psychologist and educator of the Soviet era, remarked: In play a child is always above his average age, above his daily behavior; in play it is as though he were a head taller than himself. As in the focus of a magnifying glass, play contains all developmental tendencies in a condensed form; in play it is as though the child were trying to jump above the level of his normal behavior (Vygotsky 1967).

Learning to double others in the group and playing roles in other children’s dramas as auxiliary egos give participants the chance to feel useful and helpful and to have a positive impact in other people’s dramas. This sense of efficacy can assist in changing the child’s view of themselves as the problem. A new and different mirror is held up to them as they see themselves as a functional and useful member of the group rather than as the source of family problems: a troublemaker or the identified patient. Children who are diagnosed with ADHD, which is a common presentation in a child with PTSD, can easily see themselves as the problem child in the family, classroom and in the group. They have undoubtedly been told so often enough. In a psychodrama group their impulsivity can be harnessed and guided into spontaneity in the service of the protagonist.

Psychodramatists, who work with adults, sometimes see a protagonist becoming overwhelmed and have the chance to change who they are, when or where the scene takes place, or who we bring in for support. We can physically distance the protagonist from the stage, where the action is taking place, or move the auxiliary ego in the abusing role across the room. We can even pull the protagonist entirely out of the scene. Any and all of these allow the protagonist to get the physical and emotional distance they need in order to regulate themselves emotionally. This brings them back into what is described as the Window of Tolerance, which is the space where the trauma survivor can tolerate emotion and be able to integrate information rather than have their amygdala hijacked into fight, flight or freeze (Ogden 2006).

Illustration 1. Window of Tolerance (Ogden, Minton and Pain 2006) p.2

With children, under the age of thirteen, we move slowly and cautiously, from distance to being more direct; because of social, emotional and/or cognitive developmental issues they often have not developed the ability to regulate their feelings and, as a consequence, their behaviors. The variety of therapeutic action methods provides a range of techniques and structures that can be graded from very distant (about made up characters) to the very close (personal stories). We can choose story-centered bibliodrama and sociodrama in which the children play characters other than themselves.  We can invite “tellers” to stay outside the action using playback theater processes. And, of course, we can work with personal stories enacted in psychodramatic scenes, vignette encounters and full protagonist-centered psychodramas. The younger the children, the more intense the trauma, the earlier developmentally and the more recent the trauma the more we work sociodramatically or bibliodramatically. These modalities offer a helpful distance. They allow the child to approach the material in the role of another, and are more likely to keep them in the window of tolerance than working directly with their own story, as in psychodrama. If the story is too close, the child will often decompensate into dysregulation, acting out, refusing to participate and even leaving the session.

Working with old and new stories and fairytales 

The use of fairy and folk tales provides us with an entrance into trauma work without overwhelming the individual. In general, fairy tales (e.g. Jack and the Giant Beanstalk or Cinderella), have magic in them while folktales (e.g. the Billy Goats Gruff or Goldilocks) often are about talking animals. Fairytales and folktales are part of the cultural conserve that can be used to address children’s fears, help them tell their story and give them some role training in an approach that honors the children window of tolerance. Bruno Bettelheim (1975) is only one of a number of psychologists and anthropologists who have written about these old stories having deep psychological truths to them that reflect psychosocial development and common human struggles.  These stories are the very ones that have been handed down through the oral tradition over the centuries. Stories collected by the Brothers Grimm (German), Charles Perrault (French) and Joseph Jacobs (English) are useful resources. So are the nursery stories most of us were told as children. It is also useful to consider the background of the children with whom we work and find stories from their own diverse cultures.

Traditional tales have proven themselves to have significant meaning across many generations.  These stories from the oral tradition, even though they are now written down in books, are the ones that I have primarily chosen to work with. I also use made up stories that are not necessarily from the oral tradition but follow traditional motifs and structures.
Stories in popular culture are challenging to work with. Once a traditional story has been turned into a movie, the creation of the characters is in the hands of the movie studios rather than the child’s own imagination. The Lion King is a familiar story that follows the traditional motif of an innocent going on the hero’s journey, overcoming adversity and finding resolution. It would seem to be a perfect story for children preparing for an out of home placement. When put into action, however, it caused great distress because as the kids would say that’s not the way it is in the movie. I actually was eventually able to use the story, but I had to change the animal and the name to Liger the Tiger so as to avoid creating a script that the children would feel compelled to follow.

For our purposes, there is great value in telling the story rather than reading it aloud. First of all, there is no fighting over who gets to see the pictures. Pictures in a book are both a help and a hindrance.  Clearly they provide a scaffold for children learning to read. However, when hearing a story, free of external images, the children are forming their own mental image which allows them to be part of the creative process. As a listener, the child is actively co-creating the experience as opposed to passively receiving it. In addition, telling a story well keeps children in a group engaged in a way that differs from being read to. The teller maintains eye contact, and watches the children rather than the book. The teller will notice if a child becomes frightened, bored or dissociated and adjust the story to meet the need of the individuals in the group. The oral story gives the teller the flexibility to amplify parts of the story that might not be in the book. One can add the five senses to engage distracted children more fully. Or the storyteller can use her voice to re-engage distracted children by calling them by name as if it were part of the story as in. And then, Mary, Cinderella ran down the steps and left her glass slipper on the stairs. If it looks as if the child may not understand the concept, the teller can add some description. If the child becomes frightened the teller can pull them close or soften the voice of the wicked villain. The teller can notice all this because they are looking at the group of children rather than at the book. This ability to shift the story a bit to a variety of listeners’ tell it with more or less verbal emphasis based on immediate feedback from the children’s behaviors is especially helpful in a therapeutic environment.

Billy Goats Gruff and the Big Mean Troll

One story that adapts easily is the Billy Goats Gruff: the three Billy Goats cross the bridge, first the little one, then the middle size one, then the big one to get to the grass that is green and sweet, only to be threatened by the Big Mean Troll who threatens to come up on the bridge and “eat you up”. In telling the story aloud, we can encourage the children sitting in a circle on the floor to slap their hands on the floor to go “trip trap trip” representing the sound of the Billy Goats crossing the bridge. If we use repetitive phrases: “the goat was crossing the bridge to get to the grass that was green and sweet” or “I’m gonna come up there and eat you up” we only need to encourage a little to get the entire group chiming in as we tell the tale. For children who are frequently told they are bad, get in trouble, are the identified patient, doing something that is both fun and helpful to the group is a welcome relief from being told “no!”, “stop!” and “sit down!” all the time.
Before we start moving into action we need to practice making troll faces and troll sounds. This is especially useful for children who are very reserved or are too frightened of their own internal anger to express it. It is also useful to those children who have been harshly punished for expression of righteous anger.  Often we choose one of the well behaved children to play a troll. It is role expansion for them. One can have three goats and one troll, three goats and three trolls. Some shyer children may want to have a troll buddy with them when they act out this scary role. We can encourage some of the smaller children in the group to be the Big Billy Goat with his big round horns who will get to knock the troll off the bridge to protect his little brothers. (done as in pantomime with no actually touching). If we have time, we may ask another six children to get a turn and/or ask the three goats and three trolls to reverse roles and act out the story one more time.
Children playing the younger goats get to experience being protected by the big Billy Goat. Playing the trolls or the Big Billy Goat encourages role expansion for those children who need to develop a strong and assertive role. Sometimes the more powerful, assertive children need to give “troll lessons” to the quieter, more passive group members.  And let’s not forget that this is just plain fun for most of these children. The structure of it provides predictability and safety in their play.
In the end, I invite the Billy Goats to talk among themselves. Often the smaller goats spontaneously thank the Big Billy Goat for being such a good protective brother. Sharing can be anything from:  “how did it feel to work together to put on the play?” to “who in your life protects you and from what?” The choice will depend on where the window of tolerance is situated. With a group of about eight, five and six year olds I made the mistake of asking who protects you. It was the last five minutes of a group that had gone quite well. In those last five minutes children started acting out, lying down on the floor instead of sitting up, hitting one another, crying. I had clearly moved out of their window. Another time the Billy Goats (who were all girls in this case) decided they would try to find the Troll and ask him why he was so mean to them. The Troll said he wanted to be their friend and these three little girls, with some role training, set some very firm limits to his behavior if he wanted to play with them. In addition, the following week the girls decided they wanted to be ponies, rather than goats. We can leave the psychosocial implications of this for another day. Suffice it to say they took that “game” out to the playground with them and continued to use the characters of ponies and trolls to further develop social skills and problem solving skills.

Jack and the Beanstalk and the Giant

In telling the story of Jack and the Beanstalk the group as a whole can climb the beanstalks (pantomime climbing), run as fast as one can (hands on knees or feet on floor), wipe the sweat from their brow (wiping their forehead). This experience is played out first as Jack climbs the beanstalk and runs to the Giant’s Castle where he is protected from the Giant by Mrs. Giant. It is reversed as Jack runs away from the castle and climbs back down the beanstalk. These movements keep all the children actively involved. It is irresistible even to the least warmed up child who will likely eventually choose to join in. Once we tell the whole story it is time to invite the children to act it out. Sometime we do Jack and the Beanstalk, other times Jill and the Beanstalk, sometimes Jack and James and the Beanstalk. Casting the giant is an opportunity to encourage role expansion by casting one of the smallest children in the group. Six year old George, the youngest in his foster family, got to play the giant. He spent the better part of a week after the group gleefully telling everyone who came onto the unit “I was the Giant”. Getting to play with what might be called his shadow side, an angry scary self, was deeply satisfying for him. He appeared less timid in his interactions with other children and in addition, he found a stronger voice to use when needed with other children. Giants can come in twos as can Mrs. Giant so that more timid children can have a play buddy take the role with them.

Cinderella and her horrid family

By enacting the story of Cinderella one can choose to highlight relevant issues such as dealing with abusive parents, abandoning parents and sibling rivalry. Time may be left at the end to share how children personally relate to the story. Some of them may have something they want to say to their own abusive or abandoning parent.  Some children are not ready to speak to their own parents directly and need to stay within the safe container of the story. They want to address Cinderella’s abandoning father, evil stepmother or mean sisters. As one ten year old boy whose father had left the family told me as he expressed anger to Cinderella’s father “I’m not talking to my Dad here, but to Cinderella’s” even though his own father had disappeared from the family.

Using fairy tales can act as a warm up to more personal work for those children ready for it. After acting out the story of Jill and the Beanstalk I asked the group what they wanted to say to the Giant, and then, if they had Mrs. Giant by their side, who is it in their life to whom they have something to say?  Seven year old Morgan, a quiet and timid child, decided that if Mrs. Giant would stand by her side, she had some things to say to her ex-foster mother. Morgan asked her primary therapist to play Mrs. Giant. She stood on a solid wooden chair with Mrs. Giant physically steadying her, and an empty chair took the role of the stepmother. Morgan had some very big, angry feelings to express. She leaned over a bit, shaking her finger at the step mother and told her, in an angry voice, she had no right to lock her in the dark basement to punish her, that she was just a little girl and had been very, very frightened by being locked in the dark. That nothing she did or could have done would have made her deserve that.

Learning from children and practice

Over the course of my career there has been a marked increase in the identification of trauma as well as research into its impact on cognitive and emotional development in children. It is critical that we find ways to sensitively and effectively approach treatment of these children. Psychodramatists working with these children need to come to their work with sensitivity to the varied developmental needs of the children within each group as well as an acute awareness the window of tolerance exhibited by the individual children and the group as a whole. The use of familiar and unfamiliar fairy tales and folk tales creates a safe container in which children can create a new narrative and address their own personal story, find new and empowered roles, uncover their own spontaneity and develop a sense of commonality with other children depending upon the need of the child. Our own spontaneity, as trained psychodramatists, offers both the skills to meet the children where they are as well as the flexibility to adapt what one is doing in the moment.

 

References

Arber, C. (2016). Therapeutic Window of Tolerance. https://worthit2bme.com/fightflightimmoboliztherapeutic-window-of-tolerance/. Accessed November 5, 2016.

Bettelheim, B. (1975). The uses of enchantment: The meaning and importance of fairy tales. New York: Vintage Books.

Blatner, A. (1996). Acting-In: Practical Applications of Psychodramatic Methods, Third Edition.  New York: Springer.

Blatner, A.  (1988).  Foundations of psychodrama: History, theory, and practice.  New York: Springer.

Moreno, J.L. (1946).  Psychodrama, Volume 1. New York: Beacon House.

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to  psychotherapy. New York, NY: Guilford Press.

Vygotsky, L. S. (1967). Play and its role in the mental development of the child. Soviet Psychology, 5,6,18.

Rebecca Walters, MS, LMHC, LCAT, TEP is the founder (1989) and co-director of the Hudson Valley Psychodrama Institute in Highland, NY. She has utilize action methods with individuals and groups of children, adolescence and adults for over 40 years. She was the director of psychodrama services at Four Winds Hospital in Katona NY where she worked for 25 years. In addition to HVPI, Rebecca has trained throughout United States. She is also an internationaly respected trainer at confereces and institutes in the UK, Europe, Asia and Central America.

 

The final publication is available at Springer via http://dx.doi.org/10.1007/s11620-017-0381-1