Psychodrama Therapy for Cancer Patients

Life of a modern man is very busy and stressful. This affects health and leads to mental disorders. The main health disorders that affect a major population of people are cardiovascular diseases, stroke and cancer; while mental disorders include drug addiction, trauma, and depression and other mental illness. Despite use of modern treatment modalities the outcome is not always satisfactory due to which the individual turns to other therapeutic methods. These could be alternative or complimentary therapies. There are different complimentary therapies present such as reiki, regression therapy, yoga, crystal therapy, psychodrama and others. All these therapies have been reported to be successful in healing patients of these disorders either directly or indirectly.

Cancer is a disease characterized by the uncontrolled proliferation of the cells. When a patient gets cancer, it is a slow growing mass of cells which many a times remain dormant. However, later on, it may or may not proliferate aggressively. For a proliferating cancer, as a standard treatment regimen, cancer patients have to undergo surgery, radiation and chemotherapy along with counselling. In many cases this does not yield good results and often cancer patient succumbs to death. In order to overcome this tragedy, it has been suggested that along with the routine treatment, there is a need to use psychodrama technique too. In many cancer patients there is despair, disguise, distress and deeper suffering which need to be healed. It has been observed that experimental intervention by a psycho-oncologically well-trained therapist has the best chance to slow the cancer growth and increase survival chances.

Psychodrama is a creative therapeutic approach that uses guided dramatic action to examine problems. It is a form of psychotherapy developed by Dr. Jacob Levy Moreno, M.D in 1921. It is so called since the individual or a group enacts the life situations in the form of a drama. This is done under the able guidance of a therapist or psychodrama director.

In each session, the participant re-enacts specific scenes from the past situations (or inner mental processes) in present time. This enables the individuals to express what they had experienced in the past, which they could not express then. The aim being that the patient suffering from any pain while re-enacting and going through it again is able to gain a psychological/mental healing that ultimately removes the suffering. While in group settings, the participants play role of the audience to make them realize the issues and how to deal with them. Thus, psychodrama allows one to practise new roles safely, see oneself from outside, gain insight and change. This further improves and enhances personal and professional life of the participant. However, a psychodrama therapist with lot of understanding and patience towards participant is required to make this a success.

Psychodrama has been practiced on cancer patients since deep inner work and outside training can help them cope with the problems of cancer. Most cancers start proliferating aggressively due to psychological disturbance caused to the patient by some unfortunate incident in life. Hence, it is necessary that the patient becomes aware of such incidents and of the repressed feelings which lead to disturbance in the mind and the body. Through monodrama or group therapy sessions, psychodrama therapist resurfaces these supressed feelings of a cancer patient. This enables the patient to get better insight and understanding of the difficult situation and emotional issues which are hard to cope with and at times the reasons for having cancer (like lung cancer due to excessive smoking). This awareness often leads to the experience of ‘cry of happiness’ by the patients. There are reports from research studies that use of psychodrama leads to positive results in terms of slow progression or complete regression of cancer. Thus, this creative technique helps in healing of cancer patients due to which they re-experience joy, life and become expressive.

There are two main methods used in psychodrama:

• Monodrama: It involves psychodrama done by a cancer patient and a therapist. Both therapist (director) and patient sit and shortly talk about the disease, diagnosis, and stage of treatment. Different chairs are present and named accordingly and used during psychodrama. The second session involves the act by patient and the last session consists of technical discourse.
• Group Therapy Sessions of Psychodrama: It includes only cancer patients. Although all are strangers to one another yet they get bonded, since they all suffer from cancer. This further leads to creation of mutual double bond of comfort and safety among participants. Group therapy sessions gives patients a chance to explore, express and identify feelings by sharing, due to which they feel less lonely or isolated. The process includes one of the cancer patients becoming the protagonist and focuses and enacts a specific, personal emotional problem. The scenes are similar to the real-life situations or are externalizations of inner mental processes. Other group members become the support system or auxiliaries who support the protagonist by playing other important roles in the scene.

While interacting, the cancer patient is made to use certain specific techniques including mirroring, doubling, and soliloquy and role reversal. Each session is divided into three phases as –warm-up, the action and post discussion (sharing). Warm-up session activates the participants and makes them aware of the present moment. While in action section the actual scenes take place and finally in the post discussion, different actors comment on the action of the cancer patient.

Being part of psychodrama group within the oncological care pathway is an intense experience to express emotions and relational pains due to cancer as noted from various participants. They get a space to openly self-disclose themselves.

The following are core psychodrama techniques used either in a monodrama or group session:

• Mirroring: The patient first enacts the experience. Then steps out and observe as the other actor plays the same role.
• Doubling: When the protagonist is unable to express any thoughts and feelings properly because of shyness, guilt, and fear, the patient is allowed to make double attempts to give form to these thoughts and make them more conscious.
• Role Playing: The protagonist portrays the person or object that is problematic to him/her.
• Soliloquy: The patient expresses thoughts loudly.
• Role Reversal: The protagonist is made to portray another person while the second actor portrays the patient in a particular scene.

Both individual and group session therapy have been reported in mitigating and decreasing the psychological effects which contribute towards the emotional trauma and issues faced during cancer and also to cater to the daily life difficulties experienced by the patient to enable a holistic living.

Some studies have conducted group sessions of psychodrama with 8 members. Generally there is no definite number of group members in of psychodrama, since groups are hampered due to irregular attendance of cancer participants due to treatments or other consequences of treatment or diseases. However, smaller groups are preferred over larger groups in of psychodrama as the therapist can easily pay attention to smaller groups of people.

A psychodrama session typically lasts for 90 minutes to 2 hours and focuses on a single participant or a group of patient.

Psychodrama is a powerful therapeutic technique. The small number of reported studies for treatment of cancer patients by psychodrama has shown to heal them of cancer and enable them to live a satisfactory lifestyle. Thus, psychodrama should be encouraged to be used along with standard treatment for cancer patients to prolong their survival and achieve a holistic healing.

Also Read:

• Understanding Drama Therapy, Its Aim, Techniques and Benefits!