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“Don't tell us—show us”: the use of role play in the teaching of psychoanalytic theory
Journal ¢~f.Adolescertce t988, 11, 6S-TX
" D o n ' t tell u in the t e a c h t"
us": of role of p S y c h o a n a l y t t"c the PAUL H O L
ated with na ~ imes and ~ t h d~-tur~d a cents, D ions I m ~ i~t h~b.|ight their usefuln~s in diniea! sit~tiom. This p a ~ - de~ the use of ~tiw es in a staff ~gr~ed to teach about the AdoleseenC features of "transfer~ce '~and ~'counter-t~n~erencC' were b ht Mi groups, and se~=al other theo ~ntribu of ern were dem te~ within of s training on. T-hese groups were not intended to train but to rt and i existing s t y ~ of work with adolescents. II'~TRODUCTION
Psychoanalytic theory as ofi~nally developed by Freud in the early d~ades of the t-xentieth century was designed to describe the internal dymtmics and psychopathology of the individual. However, as 'the theory and practice of psychoanalysis developed it became clear that the imeraetions between the individuaI and the other (either the therapist or other m e m b e r s of the individual:s social network) also required detailed study and description.
Through these developments the concepts of transference and, subsequently, counter.transference became fundamental features of both t h e o ~ and practice. F u r t h e r d e v e l o p m e n ~ have led to the apph~Catton of psychoanalysis to institutions and groups. Isabel Menzies (i 97 o) used analytic theory to investigate and describe the difficulties experienced within the complex structure, o£ a medical w a ~ arming, through her ms g~',~, to assist the professions in .this system.~ T h u s t es of F r e u d and his were found to be applicable, indeed useful, as a means of u n d n d m g the comp|ex M t between indivMuals within a p and the ways in which they indlviduMly and ~ group cope with and anxiety. tydc th~eofies been fo u ~ f u l in the u ing of s with their own ly g ~ u p , lting in a of iiy Reprint to D r ~ u l H Child G u l d s n ~ ~- Unit, 6 ot4o-~97~$tolo<~6s + ~
~3.~o
t R~d,
kant in Child and S W z ~,
~ ~S T~
f~r ~he P~iattdc
,B Qf
P. H O L M E S
in which the "containment of anxiety", by the therapist, is central, and in which tranderenee can be explored between' hmily members and the i therapist (Box, Copley, M ~ a ~ a , and Moustak, x~I). The people, however, who have broadened out the appli~tions of classics! psychoanalytic theory have on the te come from within the ranks of those indivduals experienced and tram ' e d in individual psychoanalytic or psychotherapeutic practice. MaRy of them will initially have entered treatment as a consequence of their own pemonal needs, only subsequently going on to tra in as therapists in an attempt to help other mdlvtdua s or groups. Professionals working ~ t h disturbed adolescents either in the community * (through S~cial Services a r ~ offices, Intermed!ate Treatmen $ U n i t s or other " e ntta| " " i hospitals, profe~iona l roles) or in r~std setting~ (nurs~ in psychiatric residenti~ care worke~ in children~ homes) ~ y be pre~nted ~ t h a range of highly distuft~ed clients. These staff often seek advice through consukations from other professionals whom they feel might he able m help ruth their case loads and to perhaps help relieve their personal distress resulting from work with certain young people, I have found that the use of psychoanalytic theory has been very potent as a way of understanding the personalttes and * C an be the behaviour of the clients and thep h a l When t h e e theortes described "Ina use~uI and unde~tandable way to the prof~sionaI, often much relief is rienced and, ho~fully, an improvement in the way with which ' t s. However,: itl s my experience that the mere they attempt to help their then description of analytic concepts when applied to particular clients is often difficult for the professional with no theoretical or personal grounding in psychoanalysis to understand. In an attempt to work with this problem, I started a weekly ~ o u p for social worke~, residential care workers and intermediate treatment staff all "k . . . . . a I adolescents. Each ~ o u p member was asked to working wtt,~ mdtwdu present a p r ~ e s s recording (a detailed v~batim account of the verbal i n t ~ c t i o n b e t w e ~ prof~sional and client) of one of their meett gs with their ado eat. i found that the m rs of this group found this task very " C e of writing down details of segsions difficult. They had no regular expenen from memory and in the groups often changed into a discussion of the management of a particular adolescent rather than an attempt to look in detail at the interaction in one meeting b e t w ~ n client and professional. We thus developed a group method (b~ed on psychodrama t~hniques; s~ee Biatner, I973 and Leveton, 1977) in which the social worker role-played their client who was then inte~iewed by one or more other bers of this t ~ rang group. This p all us to on s e r i a l e~parate l ~ t t ~ : (t) V¢'ewere able to observe the actual inte~iew style of group members an d throug h this we were able to commem on their skills and techniques.
ROLE PLAY AND TEACHING PSYCHOANALYTIC THEORY 67 What became very apparent was a tendency for some of the group merP:oers to avoid challenging the client, or rats " i ng their arLxiety t h r o u # focussing on significant" fnterpemonal or social difficulties. There was a tendency to talk about the weather, what they warned t o d o in the future, or other relatively non-anxiety provoking topics and to avoid, real issues relating to psychic pain. Within the group setting the interviewers got immediate feed-back from the person role-playing the adolescent about how dist~ssing it was for important issues to be thus avoided. Other group m e m b e ~ clearly became angered by the "adolescent ') they were talking tqj some tnteraetto s get m g quite heated. This also seemed to be unproductive to the interview. (z) It became clear to the group that lyoth the inte~iewer and othergroup members were often actively oveP~heImed by feelings such as a , despmr, depression or ~ n f u ~ o n . Through the proems of the group a~tivity we were abie to explore these as phen~merla of Counter-transference. It was possible to separate neurotic counter-transference (Racker, I968 ) in which the feelings related to the Intervtewer s own neurotic difficulties (stirred up by the adolescent) f ~ m those fegli in the interviewer that relate to feelings .in the adolescent (counter-transference as used as a ~ n , 195o ), therapeutic tool, " se e Herman These issues are well understood and described in the literature of individual psychotherapy or psychoanalysis, however, we discovered in this ' t ~t was being group that similar phenomena also occurred when the cite role-played. T h e social worker to!e-playing a client who they knew professionally very well has become, I th i nk, identified with the client in a healthy way and was able to be in touch with the others persona]ity in such a way that real feelings were engendered in the tnterv ew and thus within the group, These could be sepa~'-ated through group discussions from feelings of " t.Be workers in the role-play s ituatton. It thus became possible to demonstrate to the group in a very active way the processes of transference, countertransference (both neurotic and non-neurotic). I s s u ~ of project on and splitting could be equally clearly ~ternalized, demonstrated and dlscu S sed.
RTING A GROUP The members of the ~ o u p de~zri in this er were, understandably, initially somewhat angoras and t e n ~ . It had been made clear in the literature advertizing the Course that role play and perhaps ocher actiqn techniques
68 P. HOLMES volunteer from the group to play an ~ r y individual thereby avoiding some of the diseu~ions feeh tha t might he generated shouh~ a ~ a t adoI at have been ueed. T h e group leader's task is to exe~ise auth as a director, rama) as ped by no and his foilowe~, has demon ve D, dearly that for the process m be e ire the director of any session must be firmly in charge. Through this, at times, somewhat dictatorial position they are able to contain anxiety by setdfig boundaries within which the individuals participating can be free to express and feel a wide range of thoughts and affects (see Holmes, x984). The group leaders' (director) task is to each meeting moving fo smoothty and with some vitality, thus, at times it wilt k~ n ry to stop a role-play should one or of|mr partici ~ inn. It may be d ~ i , ld it another member of the group take over. It is be the " " mtervtewer " , to ~ug also Me to suggest that the interviewer and role-#ayed adolescent should swop roles (in psychodrama terms "role reversal"). This techniqjae can be very pt)werful allowing both individuals to experience immediately some of the feelings a~ociated with the other role. Occasiortally I have u~ed the technique of "doubhng" " i n these training ~ o u p s ; in this a third member of the group sits behind the shoulder of one of the main protag'anists and acts as a double adding words and phrases that they feel may facilitate the i w. Thi~ technique, h r, has limitations and I fee| should be used with caution ~ there is a tendency for it to confuse the two i prota~nists in the role-play. The latter part of the first meeting !d be used to demonstrate andther psychodramatic concept---sharing. In this the group members are a|| encouraged to add their thoughts and feelin~ about the role-play interview that has just occurred. It is very important to help those who have been role-playing the "adolescent" or the "interAewer" to establish clearly the difference bevween the rote and their own reality. Rituals oY techniques of "de-~ting" can be used, however I have d ere~:l that a group discussion in which the m a n pr ists talk their ~ n feeli and while M role helps the ~ o u p member sort out the fe and s dunng the an. It is the leader's ~o make sure that no participant up feeling unduly eritieised or attacked by their peers and to encourage a free discussion on the issues of technique av.~ psychopathology that had been demonstrated. It is also possible at this phase during a session to discuss issues in a more theoretical way and indeed, on occasions, to give group members photocop ~ of pertineat papers from the psychoanalytic literature. At the end of this it is ntial that a rots be prepared so that each group me it Ls ~neir turn to present an t. can be to bring w material to session /or instarme, a chronology of the adol nt's life m~ents or fa i. It '
R O L E PLAY A N D T E A C H I N G P S Y C H O A N A L Y T I C T H E O R Y
69
is often helpful to have such mate~al distributed to group membe~ at the b ~ n n l g of the se~iolI in order to facilitate hhe brief and necessa~¢ case presema~on that precedes role-play+ RfJTH AND JOHN Today was P~ath's turn to presen~ and she began to talk at some length about John, a disaffected ~5+ye~-old k~|ack youth who was in day care m her !ntertnediate T r ~ t m e n t Centre. JG~mhad a ser~s of convictions for offenc~ ..... |l including burglary and robbery. Ado lttona y, his home situation w ~ very tense and attttcu . His mother, a single parent, was undergoing psychiatric + e s in which she was violent and dlfficu + + 1t treatment herself and there were ttm towards her son. The group, some o~ whom knew about John already, began to become highly e n ~ g e d m a di~uss osn about the management l~Jue r a t e d by John's difficult circumstances. Was Intermediate Treatment the r i # t place for him or did he need a more th +rapeuttc placement? Should he be fostered in the teenage fostering scheme (undoubtedly the care at home was very inadequate) ? Who should ~ with him to court, his field social worker or the worker from the I.'F, centre? The group, ~+shtngto support Ruth with some of t h e ~ ve~" difficult de~sions~ b e ~ n to tMk in a matter of-fact way about some of these issues. Rapidly a case conference was developing within the room. This was stopped, however, very f i ~ l y by ~sking Ruth to role-play + + r m ' John. There was no need for her to give any further tnlo atton about the boy and one of the other members of the group volunteered to conduct the interview, not attempting to play Ruth but undertaking another task which they them~Ives had defined. Today Rosemary took the role of John's P~bation Officer, taking a ~ i a | history for one of the forthcoming Cou~ appearances, lnitiaily this role-played interview Eocussed on relatively easy external issues, John's ambitions for the future, some aeounts of the offences and what he thought about the i +T+ centre. The interview progressed slowly and painfuIly. John was reluctant to give very much information (as role-played by Ruth) and the Probation Officer :,as finding difficulty in ehct* t mg m~.tch information or indeed many feelings. ~ At this poim I halted Cne role+play and we had a brief discu~ion and feed-back from the active participants. Ruth (speaking still f ~ m the role of John) said she found the interview difficult and rather pointless. ~Important emotional issues were being avo Ided, the rows at home, the Ioss of his father + r and his mother's periodic psychotic episodes. The Probation Offme (Rosemary) felt that John w ~ in a prickly, anxious state and that issues which might have rMevance to t~e offences cou!d not be touched for fear of upsetting John. Other members of the group were able t o talk about their
70
p.
MgS
~n
sense of de ion wht e w a t c h ~ this role-p|ay, it felt hopeless and . feeli , e:v@ d, were ~pidly n up by Ruth (J that ~ s the way she (he) felt and that she (he) felt fhat the"P n Officer" was more hopele~ arid u~less, ly as this in Ruth's (John's) |an was ~ n g to be un e and would be disappearing after one or two in . T~ausj in psychoanalytic terms, phenomena exhibited. It is pro un andable that Rmh's Oohn~s) feelings about the "Probation eer", aIthough in part on reality, can Mso be unde od in the light of John's inadequate f:athering and periodically p otie mother (i,e. issue of tran nee). Rosemary's e " fe l~gs, as the interviewer, can be unde~tood in part as a countertransference to Joh n ~s own terror of the power of his feelings and his emotional fragility and depression. The feelings ot John were also very keenly experienced by the other members of the group who experienced the sense of gloom and depression (group counter-transference). Both the interviewed and the interviewer felt ill .~ e , . ease and rather frightened and anxiety levels were high. Following this discussion, it w ~ decided that the "Probation Officer" in the next part of the role.play should be much more active in asking Ruth (John) about the hmily situation and the ~ y ' s own emotional state. T h a s in the second part of the role-#ay the inter¢ie-,ver was encouraged to use their own counter-transference (an understanding o[ John's ennotional state and preoccupations) and be more direct in the nature of the question. Issues around-John's pelion wAh his mother and her mental state and the migsing father were taken up th h'~g John ahotat his po ial rn that none of the ale in his Iife would wait enough to rea|ly help him and to tolerate his behaviour and m difficulties. T h e inte~iew p sed r a ~ l y and ly, eventual/y being s t o p p ~ as the end of the ~ u F . A final d i ~ revealed that Ruth (Jok~) had felt infinitely ~ s i e r and anxioLls once the of ng were d app ed. Ro a~ ( 0 r) felt quite su . . . in a. potentially . . that she had been able t o mtervtew intrust V e and intense style, different from bier al w~y of working with young pempte, and, alth she was not sure she would wish m use this technique herseIf in her day to day work, .there was e l y a direct exp e that an individual's anxiety could be directly contained and d through the nature and the style of the questioning relationship deve~ped with them by another individual. CONCLUSIONS
Feedback from the group of professionals involved in this training suggests
ROLE PLAY A N D T E A C H I N G P S Y C H O A N A L Y T I C T H E O R Y
71
that they found this very active technique ful and rewarding, in members of the up, who initially had been very wary of psychoanalytic concepts seeing ° t he m as irrelevant and father"precious", found that through their riene~ could develop s respect and, in , enthusi for die anal model in its pts to explain individual and group o . This group made no attempt to train these workers as therapists, the only aim be ing to help them understand the consequences of their interaction on the client and to understand the results of the client's ' psycho 1oglcal funet i onlng (and psychopathology) on the social worker and other people within their social network. It was made clear that should any of these professionals wish to develop their psyehotherapemic skills (as opposed to their inMividuaI working skills) they would require further specialist training, onaI es rsised during the course result~ in one group member deciding to go into personal therapy, an expertenCe which may lead on to (in due course) r u s h e r training in ot . However, I have no doubt that this experience of analytic theory nted in this very active and obvious way was of benefit to the workers involved who could go back to their profess1'o hal duties with an ao-i'i! ty to keep some psychic distance between themselves and their clients~ reducing the risk of getting utterly immersed, confused, despairing or angry through interactions with deeply dist , difficu!t and unhappy young p e. The author wishes to thank the c o d e ~ e r s (at diffe~nt times) of ~bose t~ching
groups Ke ith Htpwoo " d and Sandra Egleton and to acknowkdge the support and active encouragement of the other mernbe~ of the group.
REFERENCES Blather, H. A. (z973).
In, Practical
New York: Springer Pnbtizhing~
tions of Psych
a
Box, 8 , Copley, B., Maga~a, J., and s ~ i , E. (I98 x). otherapy u,z~ An Ana London: R ~ t &K Paul. Heimann, P, (~ , On . Interns ffoUmat~¢
d ses.
31) 8~-8,
Holmes, P. . Boundaries or chaos: an outpatient d group for addescents..,7ounzal of Adolescence 7, 387-400. Leveton, E. (~977). Psychodrama Jot" the Tbnid Clinician. New York: Springer Menzies, L E. P. (t 970). A Cast Study in the Fu nctioning of Social Systems ~ a Defense agamsl Anx~ ~¢ Laando~: Tavistoek Institute of Human Relations. Racker, H, (I968). Tramj~rence ~ d Counter tra ce. ~ n d o n : Mares|ield
" D o n ' t tell u in the t e a c h t"
us": of role of p S y c h o a n a l y t t"c the PAUL H O L
ated with na ~ imes and ~ t h d~-tur~d a cents, D ions I m ~ i~t h~b.|ight their usefuln~s in diniea! sit~tiom. This p a ~ - de~ the use of ~tiw es in a staff ~gr~ed to teach about the AdoleseenC features of "transfer~ce '~and ~'counter-t~n~erencC' were b ht Mi groups, and se~=al other theo ~ntribu of ern were dem te~ within of s training on. T-hese groups were not intended to train but to rt and i existing s t y ~ of work with adolescents. II'~TRODUCTION
Psychoanalytic theory as ofi~nally developed by Freud in the early d~ades of the t-xentieth century was designed to describe the internal dymtmics and psychopathology of the individual. However, as 'the theory and practice of psychoanalysis developed it became clear that the imeraetions between the individuaI and the other (either the therapist or other m e m b e r s of the individual:s social network) also required detailed study and description.
Through these developments the concepts of transference and, subsequently, counter.transference became fundamental features of both t h e o ~ and practice. F u r t h e r d e v e l o p m e n ~ have led to the apph~Catton of psychoanalysis to institutions and groups. Isabel Menzies (i 97 o) used analytic theory to investigate and describe the difficulties experienced within the complex structure, o£ a medical w a ~ arming, through her ms g~',~, to assist the professions in .this system.~ T h u s t es of F r e u d and his were found to be applicable, indeed useful, as a means of u n d n d m g the comp|ex M t between indivMuals within a p and the ways in which they indlviduMly and ~ group cope with and anxiety. tydc th~eofies been fo u ~ f u l in the u ing of s with their own ly g ~ u p , lting in a of iiy Reprint to D r ~ u l H Child G u l d s n ~ ~- Unit, 6 ot4o-~97~$tolo<~6s + ~
~3.~o
t R~d,
kant in Child and S W z ~,
~ ~S T~
f~r ~he P~iattdc
,B Qf
P. H O L M E S
in which the "containment of anxiety", by the therapist, is central, and in which tranderenee can be explored between' hmily members and the i therapist (Box, Copley, M ~ a ~ a , and Moustak, x~I). The people, however, who have broadened out the appli~tions of classics! psychoanalytic theory have on the te come from within the ranks of those indivduals experienced and tram ' e d in individual psychoanalytic or psychotherapeutic practice. MaRy of them will initially have entered treatment as a consequence of their own pemonal needs, only subsequently going on to tra in as therapists in an attempt to help other mdlvtdua s or groups. Professionals working ~ t h disturbed adolescents either in the community * (through S~cial Services a r ~ offices, Intermed!ate Treatmen $ U n i t s or other " e ntta| " " i hospitals, profe~iona l roles) or in r~std setting~ (nurs~ in psychiatric residenti~ care worke~ in children~ homes) ~ y be pre~nted ~ t h a range of highly distuft~ed clients. These staff often seek advice through consukations from other professionals whom they feel might he able m help ruth their case loads and to perhaps help relieve their personal distress resulting from work with certain young people, I have found that the use of psychoanalytic theory has been very potent as a way of understanding the personalttes and * C an be the behaviour of the clients and thep h a l When t h e e theortes described "Ina use~uI and unde~tandable way to the prof~sionaI, often much relief is rienced and, ho~fully, an improvement in the way with which ' t s. However,: itl s my experience that the mere they attempt to help their then description of analytic concepts when applied to particular clients is often difficult for the professional with no theoretical or personal grounding in psychoanalysis to understand. In an attempt to work with this problem, I started a weekly ~ o u p for social worke~, residential care workers and intermediate treatment staff all "k . . . . . a I adolescents. Each ~ o u p member was asked to working wtt,~ mdtwdu present a p r ~ e s s recording (a detailed v~batim account of the verbal i n t ~ c t i o n b e t w e ~ prof~sional and client) of one of their meett gs with their ado eat. i found that the m rs of this group found this task very " C e of writing down details of segsions difficult. They had no regular expenen from memory and in the groups often changed into a discussion of the management of a particular adolescent rather than an attempt to look in detail at the interaction in one meeting b e t w ~ n client and professional. We thus developed a group method (b~ed on psychodrama t~hniques; s~ee Biatner, I973 and Leveton, 1977) in which the social worker role-played their client who was then inte~iewed by one or more other bers of this t ~ rang group. This p all us to on s e r i a l e~parate l ~ t t ~ : (t) V¢'ewere able to observe the actual inte~iew style of group members an d throug h this we were able to commem on their skills and techniques.
ROLE PLAY AND TEACHING PSYCHOANALYTIC THEORY 67 What became very apparent was a tendency for some of the group merP:oers to avoid challenging the client, or rats " i ng their arLxiety t h r o u # focussing on significant" fnterpemonal or social difficulties. There was a tendency to talk about the weather, what they warned t o d o in the future, or other relatively non-anxiety provoking topics and to avoid, real issues relating to psychic pain. Within the group setting the interviewers got immediate feed-back from the person role-playing the adolescent about how dist~ssing it was for important issues to be thus avoided. Other group m e m b e ~ clearly became angered by the "adolescent ') they were talking tqj some tnteraetto s get m g quite heated. This also seemed to be unproductive to the interview. (z) It became clear to the group that lyoth the inte~iewer and othergroup members were often actively oveP~heImed by feelings such as a , despmr, depression or ~ n f u ~ o n . Through the proems of the group a~tivity we were abie to explore these as phen~merla of Counter-transference. It was possible to separate neurotic counter-transference (Racker, I968 ) in which the feelings related to the Intervtewer s own neurotic difficulties (stirred up by the adolescent) f ~ m those fegli in the interviewer that relate to feelings .in the adolescent (counter-transference as used as a ~ n , 195o ), therapeutic tool, " se e Herman These issues are well understood and described in the literature of individual psychotherapy or psychoanalysis, however, we discovered in this ' t ~t was being group that similar phenomena also occurred when the cite role-played. T h e social worker to!e-playing a client who they knew professionally very well has become, I th i nk, identified with the client in a healthy way and was able to be in touch with the others persona]ity in such a way that real feelings were engendered in the tnterv ew and thus within the group, These could be sepa~'-ated through group discussions from feelings of " t.Be workers in the role-play s ituatton. It thus became possible to demonstrate to the group in a very active way the processes of transference, countertransference (both neurotic and non-neurotic). I s s u ~ of project on and splitting could be equally clearly ~ternalized, demonstrated and dlscu S sed.
RTING A GROUP The members of the ~ o u p de~zri in this er were, understandably, initially somewhat angoras and t e n ~ . It had been made clear in the literature advertizing the Course that role play and perhaps ocher actiqn techniques
68 P. HOLMES volunteer from the group to play an ~ r y individual thereby avoiding some of the diseu~ions feeh tha t might he generated shouh~ a ~ a t adoI at have been ueed. T h e group leader's task is to exe~ise auth as a director, rama) as ped by no and his foilowe~, has demon ve D, dearly that for the process m be e ire the director of any session must be firmly in charge. Through this, at times, somewhat dictatorial position they are able to contain anxiety by setdfig boundaries within which the individuals participating can be free to express and feel a wide range of thoughts and affects (see Holmes, x984). The group leaders' (director) task is to each meeting moving fo smoothty and with some vitality, thus, at times it wilt k~ n ry to stop a role-play should one or of|mr partici ~ inn. It may be d ~ i , ld it another member of the group take over. It is be the " " mtervtewer " , to ~ug also Me to suggest that the interviewer and role-#ayed adolescent should swop roles (in psychodrama terms "role reversal"). This techniqjae can be very pt)werful allowing both individuals to experience immediately some of the feelings a~ociated with the other role. Occasiortally I have u~ed the technique of "doubhng" " i n these training ~ o u p s ; in this a third member of the group sits behind the shoulder of one of the main protag'anists and acts as a double adding words and phrases that they feel may facilitate the i w. Thi~ technique, h r, has limitations and I fee| should be used with caution ~ there is a tendency for it to confuse the two i prota~nists in the role-play. The latter part of the first meeting !d be used to demonstrate andther psychodramatic concept---sharing. In this the group members are a|| encouraged to add their thoughts and feelin~ about the role-play interview that has just occurred. It is very important to help those who have been role-playing the "adolescent" or the "interAewer" to establish clearly the difference bevween the rote and their own reality. Rituals oY techniques of "de-~ting" can be used, however I have d ere~:l that a group discussion in which the m a n pr ists talk their ~ n feeli and while M role helps the ~ o u p member sort out the fe and s dunng the an. It is the leader's ~o make sure that no participant up feeling unduly eritieised or attacked by their peers and to encourage a free discussion on the issues of technique av.~ psychopathology that had been demonstrated. It is also possible at this phase during a session to discuss issues in a more theoretical way and indeed, on occasions, to give group members photocop ~ of pertineat papers from the psychoanalytic literature. At the end of this it is ntial that a rots be prepared so that each group me it Ls ~neir turn to present an t. can be to bring w material to session /or instarme, a chronology of the adol nt's life m~ents or fa i. It '
R O L E PLAY A N D T E A C H I N G P S Y C H O A N A L Y T I C T H E O R Y
69
is often helpful to have such mate~al distributed to group membe~ at the b ~ n n l g of the se~iolI in order to facilitate hhe brief and necessa~¢ case presema~on that precedes role-play+ RfJTH AND JOHN Today was P~ath's turn to presen~ and she began to talk at some length about John, a disaffected ~5+ye~-old k~|ack youth who was in day care m her !ntertnediate T r ~ t m e n t Centre. JG~mhad a ser~s of convictions for offenc~ ..... |l including burglary and robbery. Ado lttona y, his home situation w ~ very tense and attttcu . His mother, a single parent, was undergoing psychiatric + e s in which she was violent and dlfficu + + 1t treatment herself and there were ttm towards her son. The group, some o~ whom knew about John already, began to become highly e n ~ g e d m a di~uss osn about the management l~Jue r a t e d by John's difficult circumstances. Was Intermediate Treatment the r i # t place for him or did he need a more th +rapeuttc placement? Should he be fostered in the teenage fostering scheme (undoubtedly the care at home was very inadequate) ? Who should ~ with him to court, his field social worker or the worker from the I.'F, centre? The group, ~+shtngto support Ruth with some of t h e ~ ve~" difficult de~sions~ b e ~ n to tMk in a matter of-fact way about some of these issues. Rapidly a case conference was developing within the room. This was stopped, however, very f i ~ l y by ~sking Ruth to role-play + + r m ' John. There was no need for her to give any further tnlo atton about the boy and one of the other members of the group volunteered to conduct the interview, not attempting to play Ruth but undertaking another task which they them~Ives had defined. Today Rosemary took the role of John's P~bation Officer, taking a ~ i a | history for one of the forthcoming Cou~ appearances, lnitiaily this role-played interview Eocussed on relatively easy external issues, John's ambitions for the future, some aeounts of the offences and what he thought about the i +T+ centre. The interview progressed slowly and painfuIly. John was reluctant to give very much information (as role-played by Ruth) and the Probation Officer :,as finding difficulty in ehct* t mg m~.tch information or indeed many feelings. ~ At this poim I halted Cne role+play and we had a brief discu~ion and feed-back from the active participants. Ruth (speaking still f ~ m the role of John) said she found the interview difficult and rather pointless. ~Important emotional issues were being avo Ided, the rows at home, the Ioss of his father + r and his mother's periodic psychotic episodes. The Probation Offme (Rosemary) felt that John w ~ in a prickly, anxious state and that issues which might have rMevance to t~e offences cou!d not be touched for fear of upsetting John. Other members of the group were able t o talk about their
70
p.
MgS
~n
sense of de ion wht e w a t c h ~ this role-p|ay, it felt hopeless and . feeli , e:v@ d, were ~pidly n up by Ruth (J that ~ s the way she (he) felt and that she (he) felt fhat the"P n Officer" was more hopele~ arid u~less, ly as this in Ruth's (John's) |an was ~ n g to be un e and would be disappearing after one or two in . T~ausj in psychoanalytic terms, phenomena exhibited. It is pro un andable that Rmh's Oohn~s) feelings about the "Probation eer", aIthough in part on reality, can Mso be unde od in the light of John's inadequate f:athering and periodically p otie mother (i,e. issue of tran nee). Rosemary's e " fe l~gs, as the interviewer, can be unde~tood in part as a countertransference to Joh n ~s own terror of the power of his feelings and his emotional fragility and depression. The feelings ot John were also very keenly experienced by the other members of the group who experienced the sense of gloom and depression (group counter-transference). Both the interviewed and the interviewer felt ill .~ e , . ease and rather frightened and anxiety levels were high. Following this discussion, it w ~ decided that the "Probation Officer" in the next part of the role.play should be much more active in asking Ruth (John) about the hmily situation and the ~ y ' s own emotional state. T h a s in the second part of the role-#ay the inter¢ie-,ver was encouraged to use their own counter-transference (an understanding o[ John's ennotional state and preoccupations) and be more direct in the nature of the question. Issues around-John's pelion wAh his mother and her mental state and the migsing father were taken up th h'~g John ahotat his po ial rn that none of the ale in his Iife would wait enough to rea|ly help him and to tolerate his behaviour and m difficulties. T h e inte~iew p sed r a ~ l y and ly, eventual/y being s t o p p ~ as the end of the ~ u F . A final d i ~ revealed that Ruth (Jok~) had felt infinitely ~ s i e r and anxioLls once the of ng were d app ed. Ro a~ ( 0 r) felt quite su . . . in a. potentially . . that she had been able t o mtervtew intrust V e and intense style, different from bier al w~y of working with young pempte, and, alth she was not sure she would wish m use this technique herseIf in her day to day work, .there was e l y a direct exp e that an individual's anxiety could be directly contained and d through the nature and the style of the questioning relationship deve~ped with them by another individual. CONCLUSIONS
Feedback from the group of professionals involved in this training suggests
ROLE PLAY A N D T E A C H I N G P S Y C H O A N A L Y T I C T H E O R Y
71
that they found this very active technique ful and rewarding, in members of the up, who initially had been very wary of psychoanalytic concepts seeing ° t he m as irrelevant and father"precious", found that through their riene~ could develop s respect and, in , enthusi for die anal model in its pts to explain individual and group o . This group made no attempt to train these workers as therapists, the only aim be ing to help them understand the consequences of their interaction on the client and to understand the results of the client's ' psycho 1oglcal funet i onlng (and psychopathology) on the social worker and other people within their social network. It was made clear that should any of these professionals wish to develop their psyehotherapemic skills (as opposed to their inMividuaI working skills) they would require further specialist training, onaI es rsised during the course result~ in one group member deciding to go into personal therapy, an expertenCe which may lead on to (in due course) r u s h e r training in ot . However, I have no doubt that this experience of analytic theory nted in this very active and obvious way was of benefit to the workers involved who could go back to their profess1'o hal duties with an ao-i'i! ty to keep some psychic distance between themselves and their clients~ reducing the risk of getting utterly immersed, confused, despairing or angry through interactions with deeply dist , difficu!t and unhappy young p e. The author wishes to thank the c o d e ~ e r s (at diffe~nt times) of ~bose t~ching
groups Ke ith Htpwoo " d and Sandra Egleton and to acknowkdge the support and active encouragement of the other mernbe~ of the group.
REFERENCES Blather, H. A. (z973).
In, Practical
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Box, 8 , Copley, B., Maga~a, J., and s ~ i , E. (I98 x). otherapy u,z~ An Ana London: R ~ t &K Paul. Heimann, P, (~ , On . Interns ffoUmat~¢
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Holmes, P. . Boundaries or chaos: an outpatient d group for addescents..,7ounzal of Adolescence 7, 387-400. Leveton, E. (~977). Psychodrama Jot" the Tbnid Clinician. New York: Springer Menzies, L E. P. (t 970). A Cast Study in the Fu nctioning of Social Systems ~ a Defense agamsl Anx~ ~¢ Laando~: Tavistoek Institute of Human Relations. Racker, H, (I968). Tramj~rence ~ d Counter tra ce. ~ n d o n : Mares|ield