THEATER THERAPY - A MILIEU THERAPEUTIC EXTENSION OF OUTPATIENT PSYCHOTHERAPY

Theatre, as a mean of expression like dancing, music and art, is as ol d as mankind and has already been used in the early medicine. Theatre developed out of the ritualistic orientated part of mankind's history, in which it was an experience of the whole group, with no separation between actors and audience. That separation first appeared in the 5th century before Christ, when the greek theatre created fixed parts and a complete story. This creation has been conserved until now. Theatre in the old Greece was made to give people a chance of political discu ssion, and it was Aristoteles' credit to expess theatre's cathartic ef fect for the audience. In psychiatry performing a play as a therapeuti c method was first used by Reil (1805) and Marquis de Sade (1815). In psychotherapy performing theatre had already been grasped and fullfill ed at the beginning of psychoanalysis as a therapeutic possibility, ab ove all Moreno and Iljine are to be named. Depending on Gunter Ammon's Dynamic Psychiatry the author sees theatre therapy as a milieu therap eutic instrument, which can be used for and integrated in analytical t reating in the attention group- and single-person-psychotherapy (see A mmon 1959). After a short historical overview about the development of theatre therapy in Dynamic Psychiatry the author introduces theatre t herapy with out-patients. It is a half-open group with which she is wo rking since ten years ago. This corresponds to a longlasting milieu th erapy, where the members have the possibility to analyze and treat the ir experiences in a parallel running verbal therapy.The theatre-group chooses the plays on its own, creates set and costumes, directs and ta kes on all duties appearing until the day of performance. In the follo wing example the group chose >>Ein Engel kommt nach Babylon<< by Fried rich Durrenmatt. To get acquainted with the play, the group took ten d ays for milieu therapeutic work, where it applied itself to the mental background of the play. It considered the author, the content, the me ssage and the historical time of the play. In the paper the special at tention is directed on the process of finding a role, which is especia lly important, because the role will be a part of the patient's identi ty. She describes, using two examples, how the role makes problems bec ome apparent in a nonverbal way, problems, which were not seen and the refore not treated in the analytic-therapy-group. After having found a role the patient starts identifying with it, he is at one with it. At this point the therapeutical work in the attending verbal therapy has to start. The patient becomes aware of the unconscious parts of his r ole and might either refuse them as anotherone's or use them and integ rate them as new possibility to develop his personality. Also the auth or cares about the therapeutical meaning of the so-called >>free play< <. The patients choose issues on their own, which they perform in impr ovized scenes. In an unconscious way there often creative abilities an d also deficiencies and destructive trends become visible, which the p atient did not dare to verbalize yet because of worrying about meeting with disapproval in group-therapy. Theatre work and working with drea ms is handed in a similar therapeutic way. The stage is the screen on which the play develops as a dream. And like a dream the play of patie nts is either taken as a gift, as it is often by very ill patients, or analyzed by patients with a more stable personality. An essential par t of theatre work is dealing with acting on the group-dynamic level. I n regular a situation appears in which the play is acted on-the group- dynamic level. The author describes that the group has identified itse lf with the destructive aggression in >>Ein Engel kommt nach Babylon<< by Durrenmatt, and that therefore the group almost fell apart. Only b y intense work with transference, countertrancference and resistance, not only in the theatre-group but also in the attending verbal therape utic groups, it was possible to solve difficulties and to continue wit h the stagnating group-process. The end of the group-process is always the public performance which is a special experience not only for the actor but also for the spectator. When both are touched, the catharti c effect of theatre can exhibit to both of them.