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Psychodrama in Couple Therapy

by Stefan Neszpor, FRCPC, director of the Adelaide Couples Clinic and PACT Level II practitioner, Adelaide, Australia
Email: couples@kern.com.au

Most couples have a story about what is taking place in their relationship. However, the story often doesn’t match the reality of how they experience one another. I was reminded of this recently when I met a couple in their mid 30s, with two small children. With respect to PACT attachment styles of relating, he was an island and she was a wave. In simple terms, that meant he tended to distance himself, while she was more the clinging type.

They came to therapy because she had become infatuated with a man living next door who seemed more approachable to her. Indirectly, it seemed she was trying to signal to her partner that she wanted him to be more attentive.

In the initial therapy sessions, they were able to identify one of her early patterns whereby she had a deep desire for affection. This showed itself as anxiety. Her way out was to gain attention as a form of approval for her sense of self.

Several sessions later, I asked them to do a simple exercise called the lovers’ pose as a way enabling themselves to have greater access to one another. They liked it and I could see that it was helpful, so I asked them to experiment with aspects of their experience at home.

When I saw them at the next session, I asked them how it went. The husband reported that they had been “too busy” to do the exercise on their own.

Ordinarily if I were using a psychodynamic therapeutic frame, I would have gotten caught up in asking them to define busy. I would have tried to understand the various dimensions of “busy” to find out how that undercut their attempts at connection. However, I decided instead to use my PACT skills of psychodrama. I asked them to “show me what busy looked like.”

The first step was setting the scene. They proceeded to set up the therapy office as though she were in the kitchen preparing some food, and he had just arrived home from a busy day’s work. He gave her the shortest of greetings and started to play with one of the children. He virtually ignored his partner.

All this was videotaped, so they were able to review it afterwards. I began by asking how satisfying it was to have this distance between one another, and whether this was actually meeting their needs.

As they reviewed the video, they saw their overall lack of contact, lack of eye contact, and distancing behaviours. They recognized the impact on their relationship and were able to articulate a different story about what they had called “busyness.” It was a story of sadness, of fear and apprehension about making contact. He expressed the overwhelming shame he felt at his inability to know how to initiate contact with her in an affectionate way.

I asked them if they could think of any particular things they could add to their interaction to make it more pleasant. Both of them found this difficult to identify. So I coached them in how to make greater eye contact and use physical contact as a way of signalling to one another what actions felt safe. I modelled the behaviours and encouraged them to give it a try—much as a director might do with actors in a play.

I then gave them the option of re-enacting “busyness in a way that their needs could be expressed. With the support of my coaching, they were able to do this. They found it to be much more enjoyable and engaging. They seemed empowered to go further with their ability to seek each other out. The psychodrama had made it safe for them to make the contact for which they both seemed to yearn.

I set new homework assignment for further exploration, which they were able to do. The end result of this process was that they were able to dissipate some of their fear and avoidance behaviours, and begin to make true, meaningful contact with one another.

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3 Comments

  1. Thank you for this clear post : it´s a common scenario and a very nice “way out” . kind regards, Annette

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  2. admin says:

    I was listening to your interview: https://youtu.be/u83_LQF01n8 and you mentioned theory of mind deficits which got me thinking. If I understand that my partner has a theory of mind deficit, I can give him more information about my state and what I need him to do for me rather than assume that he is choosing to ignore my distress. This helps overcome this deficit (assuming he can trust my words when I share my mind) and I can assume that he does not realise the effect of his words that may appear hurtful to me by asking can you explain what he meant. Do you have any further recommendations in terms of reading of books or advice ?

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    • Tarnya,

      I cannot confirm the theory of mind issue in your partner. There is no way to “overcome” a deficit such as this, at least not to my knowledge. It would be better if you drop this notion including the idea that your partner has a theory of mind problem. Using this idea of deficit will not help your relationship in any manner.

      Stan

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