Patients in psychotherapy often have issues regarding their basic sense of worth, the locus of authority for their guidance, the source of their solace, and/or the foundations for their values and beliefs. Such problems have been called "existential," but for most people they are spiritual in nature. "Spirituality" refers to that dimension of being that seems transcendent, possibly containing a source of greater wisdom, and serving as the ground of reality and meaning in life.
As children grow they develop a sense of relationship not only with the major people in their lives, but also to "them," what the social philosopher George Herbert Mead called "the generalized other." This "them" actually can refer to a variety of roles, not only the "other kids at school" or "the family," but also "the country" and, especially for the purposes to be addressed here, the invisible beings who populate the cultural mythos. And just as children construct distortions of their roles with significant others, because of problems in relationship as well as the child's inability to make more mature discriminations, so do they distort their relationships with the spiritual dimension of life.
Most commonly, they carry forward unrealistic and simplistic expectations of rescue and relief from responsibility from their early childhood lessons about religion, and yet, in balance, these lessons also carry complex and sometimes "double-binding" injunctions and stories of deeply frightening consequences for those unwilling (or unable) to adhere to the stated rules. In adolescence and adulthood these earlier beliefs often are compounded by new confusions and complexities, yet there are rarely opportunities to bring them all out into the open and re-evaluate these attitudes and beliefs in the light of present awareness.
Unfortunately, the field of psychotherapy has traditionally left this task of re-evaluation to the clergy, but these themes do come up in the course of therapy and it behooves us to meet the challenge. However, therapists need a way to maintain their neutrality and avoid imposing their own value systems onto their patients while yet facilitating the patients' need to explore and clarify spiritual or philosophical issues in their lives.
The technique of enacted dialogue offers a powerful vehicle for helping patients access their own deeper wisdom in constructing answers to their existential problems. Enacted dialogue is a form of role playing or psychodrama which has been modified so it may be applied by therapists in one-to-one situations. It involves the patient imagining an encounter with some spiritual being, and then engaging in a dialogue in which the patient poses questions or makes statements, then changes parts (reverses roles) and from the perspective of that spiritual figure, responds. This interaction is sustained for at least several minutes, the therapist functioning primarily in the role only of a facilitator.
In the following description of the technique of enacted dialogue, in order to simplify the pronouns used, the therapist will be a woman and the patient a man. The therapist positions an empty chair directly facing the patient's seat, and proceeds to warm up the patient: "You've raised some issues about the way the universe works, and it may be helpful to discover what subconscious attitudes you have about that. This will be a way to clarify and work out some of those problems.
Let's imagine that you could really talk to someone who could give you answers. Who might that be?" The patient is then invited to explore some of the relevant spiritual figures in his life.
Of course there will be a number of possible resistances. If the spiritual entity who is chosen is Jesus, God, or some other sacred being, at least in our culture there may be sense of dangerous presumption in seeking to question, express resentment. Reminding the patient that this relationship is going on anyway as a mini-drama in the subconscious and this process is simply aimed at making it conscious may help, as the dialogue is recognized as not being a statement about the "real" God but rather the immature or past beliefs about that God.
It should be noted that many other spiritual figures may be chosen as the focus of an enacted dialogue, such as the Virgin Mary, the Devil, Saint Peter, various angels, saints, sages, gurus, spiritual teachers, or even mythic beings from various religious traditions. In our increasingly multicultural society, other figures may also be chosen, such as the Goddess, other kinds of gods, ancestors, nature spirits, etc.
Another important category of "beings" who can be encountered in an enacted dialogue represent the spiritual aspects of one's own psyche, who may be called "soul," "daimon," "higher self," "higher power," "Self," or "Inner Wisdom." These representatives of the creative unconscious are experienced as "other" or "not-I," and in this quasi-dissociated sense, they may be interacted with as if they were someone else. These "entities" also function as bridges to the more archetypal images associated with people's mythic or religious cultural backgrounds.
The next step in establishing an enacted dialogue is that of daring to embody the spiritual entity. The patient is told that he will have a dialogue with whomever is identified, and that means that he will need to move into and out of the role of that being. Of course it's acknowledged that he can't "really" be that entity but rather he is to attempt to bring to that role as much awareness that he can.
This establishing of a dramatic context which entails some of the tentativeness and flexibility of play also offers some role distance (Blatner & Blatner, 1997). Role distance means that the actors recognize themselves as not being the roles they play. Thus, in an encounter with a higher power it is not breaking a taboo to seek to discover more truth about that being. The therapist reminds the patient that it's important to develop insight into one's transferences and projections, and that people confuse their own beliefs based on past experiences and more immature patterns of thinking with what they are afraid the "highest authority" might require of them. In this way some justification is given so that it becomes okay to play out those roles. The idea of a sustained dialogue with one of a person's spiritual entities goes beyond the ordinary concepts of either prayer or meditation. In a sense, prayer entails the person speaking to the transcendental other; meditation represents a state of receptivity, listening to or visualizing what is revealed by that other. In dialogue, though, the interaction is sustained. Each statement invites an answer, and each answer is in turn replied to. There may be confrontations, accusations, apologies, defiance, pleadings, protests, explanations, confrontations, questions, appreciations, reassurances, complaints, justifications, negotiations and reconciliations.
In addition to the therapist inviting her patient to engage in a direct encounter with his significant other spiritual being, she also encourages him to disclose to that being his deepest feelings. Then the therapist directs the patient to change parts, reverse roles, actually get out of his own chair and sit in the other being's chair. He is invited to play the role of the other, the higher self, God, or other source of power and wisdom. In that role, he is to consider how to reply to what was said to him by the patient in his own role. In other words, he objectifies and forces an explicit interaction between his ordinary or habitual ego and his "higher self."
For many people this higher power may be played at first in a somewhat judgmental or rigid way, stereotyping the character as it may have been learned as a child or seems to be implied in the most pervasive cultural interpretation in the patient's experience. This portrayal often reflects the projected fears rather than an active contemplation of what a truly sublime being might embody. In psychological terms, the superego is often the first to be represented, "clothed" in sacred form.
The dialogue continues, with levels of disclosure going deeper. The goal is to bring out the unspoken assumptions and, in the heat of the interaction and the spontaneity of the interchange, admit feelings and reactions which would ordinarily be inhibited by the habitual modes of the ego's defensiveness.
At this point, the therapist has the patient change parts, become himself, and then in a sense step out of the scene and join the observing role of the therapist. "Do you think this is really what God is about?" In this dramatic time out of time, the therapist can allow the patient to consider his own highest aspirations. "What if God is as loving as you are at your best, and a thousand times more?" This is the mental stretching which begins to develop and integrate the ego ideal functions.
"Ask that question again and let's see what a loving God would answer." The patient re-encounters his projected other and again is directed to role reverse. Usually from this re-considered role a more holistically and constructive response is made. Indeed, once people warm up to the role of the higher power as a source of guidance and wisdom, what they say spontaneously in that role is often more to the point, more insightful, and more effectively targeted to the patient's own understanding and receptivity than anything the therapist could say.
The therapist encourages the patient to continue the dialogue, posing ever more pointed questions, pursuing the repartee with some vigor. Through the give-and-take there is a movement from generalities to more specific concerns, issues related to the particularities of the patient's individual situation. In turn, the patient in the role of his own higher power is allowed to individualize the advice, to make allowances, address strengths, acknowledge weaknesses, and in sum function as a firm yet caring internal ideal parent, friend, teacher, older sibling, offering comfort and yet an en-courage-ment (to be filled with courage) to move towards more responsibility, openness, faith, discrimination, humility, and other spiritual virtues.
Just as in ordinary interpersonal discourse the more authentic issues may lay dormant unless some conscious intent and specific method brings them to the surface, so is this true even in the intrapsychic realm. The subconscious mind may best be characterized as a swirling soup, and only in the distillation processes of conscious analysis can higher wisdom be separated from petty desires and unfounded fears distinguished from realistic probabilities. Also, patients' cognitions often are obscured by overgeneralized and reified words, but in the course of dialogue, Socratic-like, these can be challenged: "What do you mean by success?" "How hard do I need to try?" "But what do you mean by the word `love'?" This is a less academic and more down to earth way to make the kinds of discriminating semantic analyses and deconstructions which neutralize the immature mind's tendencies to become paralyzed by the connotations of certain emotionally loaded words.
During the dialogue patients commonly tend to slip out of their role playing and re-engage the therapist in narrative, explanation, questioning, or commentary. Sometimes this is necessary in order to keep the patient oriented to the process, but it's more often a form of subtle resistance, a retreat into a more familiar role relationship which accommodates habitual patterns of defensiveness. The therapist should be alert to this possibility and if it seems to be operating, simply direct the patient back into the role: "Say that to (name of the spiritual figure)," or "What do you have to say to His answer?" In other words, the therapist should attempt to remain in the role of facilitator, as if she were not even in the scene, and indeed, some therapists even get up out of their chair and stand aside out of the immediate view of the patient so the patients can interact more vividly with whom they "see" (project) in the other chair.
Enacted dialogue is in some ways a dramatic way to help patients engage in what Carl Jung called "active imagination." That technique involved going beyond the mere analysis of dream and fantasy images and instead allowing them to "dream the dream onward" (as James Hillman put it). Instead of simply associating to the figures of a wise old man or a fearsome dragon or an ineffably beautiful woman, the patient is invited to ask it questions and listen to its "answers." Moreno's psychodrama complements this process, giving it concrete form and thereby rendering the interaction far more vivid and psychologically powerful (Blatner, 1988). In the physicalized dialogue various ancillary techniques can be utilized, and the patient's consciously changing parts and verbalizing the imagined answers of the spiritual entity also serves to reinforce at a subtle level the fact that this "other being" is also the self, which thus sustains the sense of responsibility and maintains the locus of control in the functioning (though expanded) ego.
The activity of role playing a spiritual being further fosters the integration of the ego ideal. The ego ideal represents all the patient's aspirations, values, and noblest beliefs. Yet in most patients these haven't been coordinated, and many patients haven't even developed a conscious system of values. Of course everyone lives by values, even infants, but in most cases these represent unconscious gradients of preferences or fragmented beliefs. Also, it's common that certain values related to one role, such as that of a churchgoing parishioner, may not be correlated with the values in another role, such as that of parent or business executive. In enacting the role of the "higher self" or some other wise and benevolent spiritual entity, patients find themselves embodying their own ego ideals, and as a result, the statements made in the course of role playing then become affirmations which become consciously associated with the emerging sense of self.
Enacted dialogue is improvisational, as is all forms of role playing, and in the course of this improvisation the spontaneity of the interactions brings forth subconscious material more freely, circumventing habitual patterns of defensiveness. (This is another reason psychodrama is a powerful addition to the therapist's repertoire of treatment methods.) Just as the ego ideal is strengthened by playing noble roles, so does the patient develop an increasing receptivity to the creative unconscious.
The unconscious must be recognized as functioning in many ways which remain mysterious. Certainly its role as Freud suggested as that of being a repository for disowned and repressed emotions and ideas is only one aspect of the richness of the unconscious. Artists, poets and scientists are only the more obvious examples of people who utilize their "muse" in being creative in their lives, but in fact everyone has a great and mostly untapped reserve of creativity in their psyches.
When the spiritual other is embodied as either the person's own subconscious "higher power," or as the "still, small, voice" which is the link to an externally represented spiritual authority, the creative unconscious is thus identified as a source of wisdom, warning, comfort and guidance. Enacted dialogue thus synthesizes the functions of the ego ideal and the creative unconscious. In the heat of the interactive role playing patients often find themselves saying things they wouldn't ordinarily think or say from the perspective of their ordinary or familiar ego-centric positions. In other words, this process intensifies the idea that at some deeper level patients often know what they need and believe, and it is healing to put their superficial identities in touch with that deeper knowing.
Two currently fashionable variations of psychoanalytic thinking have provided some useful theoretical constructs which further illuminate the therapeutic dynamics of enacted dialogue: object relations theory and self psychology. The former school of thought emphasizes the centrality of the way people psychologically function in terms of their relationships with each other. This represents a core need even more than sexuality, but more importantly, the essential dynamic of this psychoanalytic approach is that people's emotional lives consist of what I call "mini-dramas" of their fantasized interactions with the imagined representations of the key people in their social networks. And of course these representations overlap, so that, for example, the wife takes on elements of the mother, the employer elements of the father, etc.
The term "object" should be understood in the sense of being the object of desire, fear, hope, love or hate rather than in the sense of being an inanimate object. (It's a slightly misleading term because of this ambiguity.) Everyone creates an inner cast of characters who receive the projections and transferences as well as realistic memories that occur in the course of people's history--there's nothing intrinsically pathological or even problematical about having object relationships.
The point, then, is to recognize that people also develop internalized object relationships with the spiritual beings in their lives. And just as object relationships as "mini-dramas" include the attitudes of individuals towards the significant others in their lives, so do they also project on the figures of God or Jesus or other spiritual entities the expectations and fantasies of feelings, desires and reaction patterns. Thus, God comes to be experienced as close or distant, loving and/or judging, and children engage in a wide range of psychological maneuvers in relation to the omniscient and powerful yet invisible beings whom they've heard about from elders and peers.
Spiritual object relationships are rich complexes which continue to be elaborated throughout life. Associated with them are all kinds of experiences which involve aspirations and conscience, the sense of personal significance and the sense of basic faith. Yet for the most part people have had little opportunities to carefully examine these relationships, and they, no less than the set of personal object relationships, tend to become contaminated with residuals of childish misunderstandings and traumas.
Enacted dialogue brings these mini-dramas into objective form, subjects them to the process of reflection in the sphere of consensual reality. The attitudes, goals, and modes of thinking can be re-evaluated in light of the patient's consciousness in the present. The faculties of hindsight, foresight, and a broadened perspective become available when the "observing ego" is empowered, and from the resulting insights new decisions can be made.
The psychoanalytic school of self psychology offers another important insight, that a core dynamic of development is the construction and maintenance of a coherent sense of self. As part of this, and in a way similar to the concepts of object relations, the personality requires others to confirm the essential beliefs and experiences of that sense of self, those others then functioning as a "self-object."
The problem is that the mind and life in general is so complex that no real other human can successfully play this role. A sensitive and empathic therapist may seek to offer an what Franz Alexander termed an "emotionally re-educative experience" by at least trying to and partially succeeding in fulfilling that role, but eventually this requires a process of emotional weaning also.
Enacted dialogue facilitates this process because the role playing of a spiritual being constructs an implicit self-object relationship with the aforementioned synthesis of the ego ideal and the creative unconscious. This complex is embodied as the "God within" or "Jesus' voice in my soul" or some other imaginal form that is consistent with the patient's beliefs and cultural matrix. I call this process "self-objecting the soul," and it represents the most effective approach to (1) countering the common problem of an inner sense of emptiness and to (2) providing a dynamic source of comfort and guidance even in the absence of a supportive person in the external world.
In other words, aside from the contents or information that comes out of the dialogue, which may involve great insights or not, the important thing is that the patient begins to develop a relationship with that aspect of their creative unconscious that is formed as the "higher power" or "soul" or "Self." As this relationship grows, patients begin to feel a source of psychic vitality and solace which is more individualized, more accurately empathic, more subtle and clever, and in short, more capable of effective self-objecting functions than any merely human other person.
This "self-objecting the soul" dynamic is transpersonal, it draws upon aspects of being that go beyond the persona-oriented manipulations and illusions of pathological narcissism. Working from the unconditionality of an ego-ideal whose implicit role it is to be wise rather than clever, loving rather than selfish, and giving rather than getting, patients are helped to move towards healthier goals.
Patients who develop this relationship with the source of wisdom within find that the relationship is always somewhat surprising. Partaking of the same source as dreams, it will at times warn, confront, disturb, and in other ways invite the individual to seek more deeply into a situation, face it more squarely, consider where there might be imbalances, and in other ways serve to strengthen the psyche. In this sense, the relationship partakes of the purer dynamics of what the Jewish theologian Martin Buber called an "I-Thou" relationship. In contrast to an I-It relationship, in which people treat the other as a thing to be manipulated, the I-Thou relationship is a genuine encounter, open to newness and resisting any preconceptions. An authentic dialogue generates this kind of more existentially meaningful interpersonal process, and in its white heat transferences are transformed into more realistic recognitions.
A final dynamic of healing involves the integration of spiritual issues themselves. Addressing spirituality in the course of psychotherapy suggests to patients that there is a valid place for the construction of a relevant and functionally uplifting overall frame of reference or philosophy of life. Dealing with psychospiritual themes establishes a mythic framework for a more vital utilization of values, and these in turn keep the patient's therapeutic work aimed towards achievable and maturely realistic goals. (This is also consistent with Alfred Adler's theory of social interest as an organizing theme for therapy.) Enacted dialogue thus makes it easier for patients to re-connect with any religious tradition or community of their choice with a revitalized sense of their own spiritual path.
Carl Jung (1971) wrote that in adult life most neuroses have at their roots a religious problem, though at the time of his writing that term referred not to organized religion but the broader idea of spirituality, referring to the kinds of beliefs and images which form the mythos or basic assumptions of existence. Addressing the existential and spiritual issues in psychotherapy often is necessary in order to develop a stronger internalized source of strength and comfort. This deepening of the psyche transcends mere ego-strengthening as it draws on the symbolizing, emotionally evocative complexes of the creative unconscious and synthesizes them with the sublimated ego ideal as a transformed superego derivative.
Even more important is the sheer vitality of this process, as it draws on an unending fountain of imagery and is experienced through the magic of spontaneity. Through enacted dialogue patients become conscious of the truth that they are more than who they thought they were, they are full of wonder (wonder-ful) in the presence of deeper, wiser, and more loving parts of themselves that they hadn't known before. It is a reconciliation, an at-one-ment, an integrative process of great healing.
The technique of enacted dialogue is useful not only in psychotherapy, but also as a method for helping healthy people in the course of their spiritual journeys in life. Inevitably they discover that they must clear up their emotional baggage in order to make progress, and the kinds of work described in this paper have equal applicability to the process of personal transformation.
Blatner, A. & Blatner, A. (1997). The spirit of play (Chapter 15), in The Art of Play: Helping adults reclaim imagination and spontaneity. Philadelphia: Brunner/Mazel-Taylor & Francis.
Blatner, A. (1988). Foundations of psychodrama: History, theory & practice. New York: Springer.
Jung, C.G. (1973). Foreword to Erich Neumann, Depth Psychology and a new ethic. New York: Harper Torchbooks/Harper & Row. (pp. 11-18).
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Adam Blatner, M.D., is a Fellow of the American Psychiatric Association, Board Certified in both Child & Adolescent and Adult Psychiatry, a Certified Trainer of Psychodrama, and the author of some of the major books about psychodrama. He lives just north of Austin, the capital city of Texas, where he writes, teaches, and participates in the challenge of building a soulful community of senior citizens.
His address: 103 Crystal Springs Drive Georgetown, TX 78628-4502 USA
Tel: (512) 864-0516 Email: ablatner@aol.com or adam@blatner.com