Headway Nottingham's Dramatherapist in training, Morgan Koronis, takes us through the important role Dramatherapy can play in rehabilitation and rebuilding skills after brain injury.
Puppetry and Play Post Brain Injury: What is dramatherapy and how can dramatherapy be utilised in Brain injury rehabilitation?

Dramatherapy is a significant and innovative addition to what Headway Nottingham has to offer.  I am a final year trainee Dramatherapist, studying at Derby University and have recently taken over the delivery of this creative expressive therapy. 

The emphasis at Headway Nottingham has been to utilise dramatherapy techniques to build self-confidence, increase resilience, group connections and relationships.  Dramatherapy most importantly gives space for individuals to explore self-identity and social identity.  This space facilitates a sesne of empowerment for individuals which may lead to greater autonomy and self-advocacy post injury.  

However, the question remains. What is dramatherapy?  How does it work, and can dramatherapy be utilised with individuals after brain injury?

What is dramatherapy?

Dramatherapy is a creative psychological therapy which uses the therapeutic and expressive modes of drama as a medium to stimulate imagination, insight into self-identity, lead to personal growth and healing.  Dramatherapy can facilitate a space that does not solely rely on verbal or cognitive ability however advocates emotional expression using multi-sensory aspects.  The dramatherapy tool kit as per se employs Dramatherapist Sue Jennings' ‘embodiment-projection-role’ paradigm through dramatic techniques such as storytelling, puppetry, role-play, improvisation and creative arts as mediums to explore the self in addition to the world around them.  

Using creativity, voice, body and movement, dramatherapy provides the space where individuals can build trusting relationships in a safe environment.  The therapeutic power of dramatherapy may allow individuals to develop expression of thoughts and feelings while building group connections through the universality of common themes.  

Individuals are provided with expressive means to tell their story in a space where everyone has a voice, allowing individuals at Headway to feel understood and valued in an individual or group dramatherapy setting.

Dramatherapy has the ability to work powerfully through metaphor.  Through experiencing and observing our inner states from a metaphorical distance, we can be witness to our own thoughts and feelings whilst experiencing them.  From the standpoint of current neurological research, the concept or mirror neurons reveal a large part of the work to uncovering aspects of self.  Mirrroring properties can help explain the mechanisms of social and emotional cognition and understanding.

Dramatherapy and brain injury?

Dramatherapy sessions are entirely client-centred.  However, Dramatherapy can provide structure, offering containment and providing foundations for feelings of safely and control.  In hope of progressing learning and information retention, this can be enhanced through repetition in opening and closing of the sessions.  However, the direction of the session entirely person-centred, supporting exploration and individual and group expression.

Dramatherapy like much artistic expression occurs in a frame, like that of an actor on stage.  Therefore, the frame in some dramatherapy sessions may invite individuals to move away from the reality of every day life and together create a fictional or symbolic world or language.  This language is no stranger to pantomime humour, to joyful memories, inquisitive places, and the rainbow of emotions.  

Dramatherapy is both a right hemisphere and left hemisphere process as it may use the unconscious emotional content along with in some cases verbal or non-verbal vocalisations.  Through metaphor this may indirectly bring into consciousness content and meaning while maintaining a safe distance.  This can forge mind-body connections, building up a stronger sense of self post-injury.  

Through fiction individuals may have a way to understand the connection between what they have discovered in the imaginative world and connect this to everyday life which may provide ease moving forward in their own lives.

Dramatherapy has the ability to influence both the physical, cognitive, emotional, and social effects of the brain injury. 

Client work may be to explore but is not limited to associations between identity change, grief, low mood, changes in physicality, relationships, self-esteem and self-awareness.  Dramatherapy provides a flexible space which may help with adjustment to a long-term neurological condition which may lead to psychosocial adjustment and alternations to cognition and positive mood.  The importance of dramatherapy provides the engagement within the therapeutic relationship and brings ourselves back to a state of play and curiosity to provide a space like no other.