Role Playing in Psychotherapy

Raymond Corsini

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351307185
• Edition: 1
• Topic: Psicología
• Subtopic: Historia y teoría en psicología

Role playing is the most naturalistic form of psychotherapy. In the safety and privacy of an office, psychiatrists and psychologists guide patients in more competent ways of living, and help patients see how they behave. Role playing, which is also used for diagnostic purposes by therapists, is an unparalleled procedure for letting patients see themselves in action, and helps them establish and assimilate in concrete fashion the insights achieved in the interview.

From the point of view of the patient, psychotherapy has two main aspects; the personality of the therapist, which includes the attitude towards the patient and their understanding; and the procedures used by the therapist, such as how he conducts therapy. The therapist sees psychotherapy as a process which helps the patient to understand themselves, to modify their attitudes and levels of aspiration, and generate new ways of behaving. It is a process of change in the sense of abandoning old concepts, coming to new generalizations, and learning new behavior patterns for a current generation.

Role playing as a psychotherapeutic technique is not as well understood as it merits. The beliefs that role playing is an exotic method which commits the user to a special school of thought, that it is used only in group therapy, or that it is difficult to learn, are common erroneous notions. This book gives a clear picture of therapeutic role playing, and explains how it is used and for what purposes. A rationale for its value and examples of its use are provided by the author.

CHAPTER ONE

An Overview

PSYCHOTHERAPY IS A learning process which can occur autonomously as in self-therapy, in a dyadic relationship between patient and therapist, or in a group situation with a therapist and six to twelve patients.

What is to be learned varies from patient to patient. Each person may present myriad interacting problems, symptoms, and complaints, but for the purpose of classification all problems can be separated into two major categories: (1) subjective states of discomfort such as feelings of inferiority, shyness, anxieties, guilts, tensions, and (2) behavioral insufficiencies or maladjustments, such as social ineptitude, withdrawals, rage states, inadequate functioning in school, on the job, in the family, etc. The patient expects that through psychotherapy he will learn to adjust better to himself, reduce his various internal, private conflicts and tensions, and thus arrive at a state of comfort and serenity; and also that he will become more competent in his overt life functioning.

From the point of view of the patient, psychotherapy has two main facets: the personality of the therapist—the kind of person he seems (to the patient) to be, the degree of interest he shows, his attitude toward the patient, his understanding and his wisdom; and the procedures used by the therapist—how he conducts the therapy, his systematic approach to solving problems.

The therapist sees psychotherapy as a process which helps the patient to understand himself, to come to peace with himself, to realign his thinking, to modify his attitudes and levels of aspiration, to accept himself, to learn new values, and new ways of behaving. It is a process of change in the sense of abandoning old concepts, coming to new generalizations, and learning new behavior patterns.

While therapists generally accept the same general aims of treatment, namely, improving subjective comfort and objective functioning, they differ in a variety of ways. First, each therapist has some sort of map of the patient, a prior conception of how he developed, how he learns, how he unlearns, what is the most desired state. This map is known as personality theory. Therapists belong to any of a variety of “schools” of personality theory, of which there are currently some two dozen major systems, each formulated to various degrees of completeness.¹ Other therapists, labeled eclectics, have no official connection with nor do they give a blanket acceptance of any single school of thought, but have developed their own systems, sometimes taking parts from two or more schools.

Whatever the map of the unknown that a therapist has, he operates in some manner consistent with his frame of reference but responsive to the nature of the person he deals with and to the nature of this person’s problem. His method of operating may be called his technique. There are probably a dozen or so major techniques used in individual therapy, and twice as many in group psychotherapy. The purpose of this book is to discuss one class of techniques known as roleplaying.

STRATEGY

Strategy refers to the way the therapist approaches the patient. Speaking very generally, therapists may take a supportive position or they may take an uncovering or analytic position. In the first case, they want to comfort and reassure the patient; in the second case they tend to dig deeply into history and motivations. Another important distinction depends on the role that psychotherapists tend to assume in the relationship.

Some therapists see themselves as teachers. Why, they ask, would anyone want to come to us unless to take advantage of our training and experience? It is our function to diagnose the patient’s personality and life situation, to explain his thinking, his feelings and his behavior, and to advise, counsel, and direct him. Therapists who assume this systematic posture are known generally as directive.

Other therapists see themselves as facilitators. They view the therapy process as essentially autochthonous, the therapist serving as a catalyst. Therapy, they say, is the exclusive function of the patient, a unique, personal, ineffable process which must be learned by the patient on his own. Therapists who assume this systematic posture are generally called non-directive.

Another important distinguishing characteristic is the road that therapists take to their goals. We can identify three major approaches: (1) Some therapists assume that the most appropriate medium is the intellect. Therapy is seen as a cognitive process, and so one listens and understands and then one advises, counsels, questions, interprets. The battleground is reason. The weapon is logic. (2) Other therapists believe the major approach should be made through the feelings. A person cannot be reasoned with, cannot unfreeze his attitudes and viewpoints unless he achieves an emotional state of relaxation and self-acceptance. Consequently, the therapist must encourage the patient through showing him acceptance. (3) Still other therapists approach therapy through action methods. They believe that the patient’s thinking and feelings are relatively inaccessible but that behavior can be modified easily and, if modified, internal benefits will accrue.

The reader must not assume that with respect to supportive and analytic therapies, with respect to directive or non-directive approaches, or with respect to intellectual, emotional, or behavioral methods that any therapist can be precisely classified, or that he will always work consistently. Therapy is generally too fluid and too changeable a situation to permit rigidity, even though some therapists do tend to remain fairly consistent from session to session or from patient to patient.

TECHNIQUES OF PSYCHOTHERAPY

What do therapists actually do in relation to their patients and in terms of their various aims? What do they either suggest or permit their patients to do?

Questioning. Some psychotherapists concentrate on asking questions which can be subdivided into three groups: (1) Questions intended to elicit historical material, such as: “Tell me about your children.” “What were your parents like?” VWhat are your earliest memories?” “What did you say then?” (2) Question intended to probe for thinking or feeling, such as “Why do you think so?” “Why did you feel this way?” “How do you usually interpret such behavior?” (3) Questions intended to challenge the person, such as “Do you think another person would react in the same manner?” “Suppose you do fail, what then?” “Would it be so bad if he does not care for you?”

Interpreting. A second common tactic is for the therapist to do the thinking for the patient and to explain to him the meaning of his thoughts, feelings, or behavior. Thus a therapist may say, “It seems to me that your earliest recollection indicates that you expect people to give you service.” Or he may say, “Most likely your dream means that you feel alone in the world,” or “Your behavior quite possibly may be seen by most people as selfish.”

Advising. Therapists may assume the role of a wise man and, on an intervention continuum suggest ways of thinking, feeling, or acting. These may range from gentle suggestions such as “Don’t you feel that this attitude—that unless you are the best you are no good—is really quite foolish?” through warnings such as “Unless you stop this behavior immediately you will get into serious trouble,” to direct orders, “I want you to go into a restaurant and force yourself to order a meal, and I don’t care about your feelings.”

Narrating. Other therapists encourage the patient to talk a great deal. Both the technique of free association which Freud emphasized and Rogers’s technique of reflection are likely to get the patient to do a great deal of talking.

There are many other techniques: confrontation, hypnosis, finger painting, music production, etc., used by therapists, but those discussed above are the major ones.

ROLEPLAYING

Roleplaying can be viewed as a technique which can be associated with every one of the procedures discussed above. It can be employed by therapists in the individual or group situation, and can even be used in self-therapy. Roleplaying, since it is only a technique, can be used by any therapist regardless of his theoretical orientation, and it has been employed by psychoanalysts (10, 115, 121*), by Adlerians (88, 109, 111), by Rogerians (36, 43), as well as by eclectics (3, 5, 22, 59).

Roleplaying can be used as a major technique or it can be used as an auxiliary procedure, supplementing other methods. It can be employed in a directive or in a non-directive manner. The therapist can use roleplaying for three primary purposes:

1. As a means of diagnosis. As the patient roleplays, the therapist may learn more about the nature and extent of the problem, how the patient actually operates, how he thinks and feels.

2. As a means of instruction. As the patient watches others roleplay, he learns how others operate in various situations.

3. As a means of training. Through engaging in roleplay, the patient may obtain insight into himself, may be able to learn to control his feelings or to develop new life skills.

DEFINITION OF ROLEPLAYING

Essentially, roleplaying is a “make believe” process. In therapy, the patient (and if it is to be an interactional situation, the others involved) will act for a limited time “as if” the acted-out situation were real. Some examples should help to clarify this definition.

Autonomous, subjective roleplaying. Let us consider a patient who is thinking as follows:

Now this is what will happen. I will go into my boss’s office and I’ll say: “Mr. Smith, I have something to say to you,” and he will say, “What is it?” I’ll say “I have been with the firm two years.” Then he’ll reply, “Why do you tell me this?” and I’ll answer, “Do you know how many pay raises I’ve gotten in that time?” and he’ll say ... .

Autonomous, behavioral roleplaying. Let us consider a person who is anticipating making a speech. In the privacy of his room he stands up and says:

And now I wish to present our distinguished speaker of the evening, Dr. Charlen. (He sits down, gets on his feet again, bows to the “audience” and says) Thank you, Mr. Chairman, and thank you ladies and gentlemen for your kind reception. As I face you I am reminded of a little story which may be new to some of you . . . (And so he rehearses his speech.)

Dyadic, therapeutic role playing. A patient is with his therapist and is talking.

P: I just can’t get along with my wife. She is so unreasonable. She will argue about everything, and I’m just fed up with her. This morning, for example, she started a quarrel at breakfast.

T: What happened ?

P: She wanted to know when I’d come home and when I told her I didn’t know she got angry. For no reason at all.

T: Let’s roleplay the breakfast scene.

P: What’s that? Roleplay? I don’t understand.

T: It’s simple. I’ll take the role of your wife. You play your own role. Let’s repeat what happened. You try to act just as you did and I’ll try to act as she does.

P: But you don’t know my wife.

T: If I don’t act her role properly, let me know and I’ll try to imitate her.

P: O.K.

T: Let’s make out my desk is the breakfast table. What’s the set up?

P: She sits in front of me. We usually have juice, eggs, coffee, and toast.

T: She has prepared breakfast?

P: Yes.

T: What happens?

P: I get called to breakfast and I go out and get the newspaper, come to the table, and I read and eat.

T: She talks to you while you’re reading?

P: Yes.

T: Fine. Here I am. I’m your wife and there’s a paper. I’ll call you, you pick up the paper and then you come to the table and make believe you’re eating while you read. Do everything just as you did this morning.

T(W)*: Breakfast is ready.

P(P): Let me get the paper. (He picks up the paper, comes to the table, lays the paper out, and begins to read it while going through the motions of eating.)

T(W): What time will you be home tonight?

P(P): Huh?

T(W): I said, what time will you be home tonight?

P(P): I heard you. I don’t know.

T(W): I only want to know when to have supper ready.

P(P): I told you I don’t know. Stop nagging me. You’re always on my back!

T: Well, that wasn’t too bad. Did I portray your wife accurately?

P: Pretty good. She nags me.

T: How about your behavior?

P: Normal.

T: Do you think that the way you responded was normal?

P: Well, maybe. She doesn’t like me to read at breakfast, but I don’t have much time otherwise. Maybe I ought to stop it. I can read my paper at the office. Maybe I did jump on her too fast.

This short excerpt demonstrates how roleplaying was used to supplement the interview which preceded and followed the roleplaying. The therapist suggested this situation to enable him to understand the patient better, and to permit the patient to understand himself better. The scene afforded a more realistic picture of what actually happened, evinced the ...

Table of contents

• Cover Page
• Title Page
• Copyright
• Contents
• A NOTE ON TERMINOLOGY
• CHAPTER 1 An Overview
• CHAPTER 2 Roleplaying Theory
• CHAPTER 3 The Process of Therapeutic Roleplaying
• CHAPTER 4 Roleplaying Procedures
• CHAPTER 5 Roleplaying in Diagnosis
• CHAPTER 6 Roleplaying for Instruction
• CHAPTER 7 Roleplaying for Training
• CHAPTER 8 Roleplaying Centered Group Therapy
• CHAPTER 9 A Case Example of Psychodramatic Group Therapy
• CHAPTER 10 A Case Example of Roleplaying in Individual Psychotherapy
• CHAPTER 11 Summary and Conclusions
• ANNOTATED BIBLIOGRAPHY
• GLOSSARY
• INDEX