A Productive Role

IMG_2385What is dramatherapy? According to Mary Booker MEd, it’s “the use of all the creative processes involved in the making of drama, used to heal and develop a person.”

The British Association of Dramatherapists adds that it’s “a method of working and playing that uses action methods to facilitate creativity, imagination, learning, insight and growth.”

With some 25 years’ experience working with a wide variety of client groups—including 12 years teaching at a school for children and young people with visual impairment and complex needs—Booker knows first hand how dramatherapy can make a real difference. “The number of times carers have said to me: ‘Oh, I’ve never seen him do that before! I didn’t know he could do that’,” she says.

Unfortunately, she believes that dramatherapy is neither used nor funded sufficiently in the UK. In part, that’s why she wrote her book, Developmental Drama (published in 2011), to “show how dramatherapy can enable people living with severe or profound multiple disabilities (PMLD) to develop their communication skills, learn to deal with emotions more effectively and gain a greater understanding of their physical and social environment.”

“A lot of the work I was doing [at the school] was very much focused on the development of emotional intelligence and emotional literacy,” Booker says. “If you have sensory difficulties, then you cannot see all the non-verbal communications in a person’s face and body, and that can actually become a big barrier to understanding what is happening. A lot of the ways in which we communicate what’s going on for us is non-verbal. And that’s an area that can be overlooked in traditional therapies. People with visual impairments can actually be quite isolated, or seem very self-focused, self-absorbed.

“So, first of all, dramatherapy is about helping them access emotions—not only their own but other people’s—and then finding a label for them, understanding them, and developing some more resilience with the more difficult emotions like fear and anger—and how to be able to tolerate those emotions in themselves and others. It’s about understanding their emotions and being more embodied and present with them, and more resilient in how they deal with emotions.”

This undoubtedly helps with social interaction. “Human beings are social animals, we need to feel connected to others,” she points out. “But misunderstanding of emotions—of what other people mean, are feeling and need, or of their own needs being misunderstood or not being heard or met by others—can get in the way of good communications.” This can be true as much for people with mental health issues or children with social problems.

So what does dramatherapy entail? “It’s starts very simply because, with all the art forms—and drama is no exception—you need to access your senses,” she explains. “Of course, when you’re dealing with people with severe difficulties, this sensory work is very important; it’s part of being able to access their creativity, to awaken their senses so they can take in more information through them, be more creative in a sensory way.

“And then you move into things like play. Play is very important to drama, and there’s a whole level of play in children that is dramatic play. We don’t call that drama, but it is dramatic in form. Then, as you move up into more formal types of drama, that play then becomes improvisation, role-play, and so on, developing rituals.

“You have to bring your clients with you; they have to know what to expect, what’s expected of them, and that can take some time to build up,” Booker adds. “So you start in a very small way, doing simple things that you know they will enjoy and find pleasurable. You repeat those things until they get a sense of ability to participate in them, they learn to know what to expect, and what kind of responses are acceptable and possible.

“It has to be made fun, it has to be motivating,” she accepts; if nothing else, dramatherapy is always client-led, and will usually take place in a location the client considers familiar and safe—and it’s always voluntary. “Getting their attention in the first place, so that they’re really listening to you, and they’re really open to what’s happening, is the number one thing to do—and then making that thing motivating so they want to do it again. Repetition is very important.

“Then you build the challenges in, so they have to push the envelope a bit each time,” she adds. “There’s a whole term in learning theory called ‘scaffolding’; by supporting somebody, not only may they be able to do more than they could on their own, but the the resulting confidence means they may eventually be able to do it on their own.”

This is particularly important when working with people with severe or profound multiple disabilities, whose abilities may well be seen as “limited” by their carers and support staff. “Often what happens in dramatherapy isn’t so much that the clients take a new leap in development, it’s that they suddenly show what they can do, which nobody knew they could do,” she says. “They’ve been given space to express themselves that they’re not been given in other situations.

“That can happen when carers do things for them or tell them what they should do and feel, or how they should respond. That can even go to the extent of people taking their hand and putting it on things, which is really disempowering. Yes, sometimes its necessary—with people who are deaf-blind, for instance. But it depends on how it is done.”

“It’s about empowering people,” she insists. “I’ve always talked about the children and young people in my groups as ‘actors’, and I insisted that the carers be ‘support actors’—their job, in the sessions, is to support their young person to be a better actor. It meant they could let go of some of their other role and focus on the drama; and it worked, to a certain extent!”

Booker is the first to point out that it’s vital, especially when working with people with severe or profound disabilities, to have their carers on-side—not least so the ‘scaffolding’ doesn’t simply vanish at the end of each session. But, obviously, this can be itself worrying for people who are not trained dramatherapists.

“That’s why I wrote the book, so that people feel that it’s not something they don’t know how to do, or where to begin,” Booker says. “In the book I explained that it’s not that difficult, here are ways in which you can do it, and here’s why you’re doing it; this is the bit you can do to support the work in the setting. I’ve a whole chapter on working with the support staff; it’s absolutely crucial to have them with you.

Further Information
More details about dramatherapy, and how to find a dramatherapist near you, can be found at the British Association of Dramatherapists.

Article first published in Access magazine #20 (December 2014)