The aesthetics of language,body and distancing in dramatherapeutic trauma work

Introduction

Through the aesthetic use of their respective media, the arts therapies offer unique perspectives on body-based trauma work. While dramatherapy shares with dance therapy the potential for movement work, with art therapy the use of symbol and imagery and with music therapy the use of sound and the voice, what is unique to dramatherapy is the use of role (Landy, 1991), story (Johnson, 1993) and the potential for embodied language in the ‘as if’ space of dramatic reality (Pendzik, 2003, 2013). Despite this, there has been little written about the aesthetic use of verbal language in dramatherapy as a healing factor (Buckley, 2020). This article addresses this gap in the literature with a theoretical study of language in dramatherapy trauma work.

Various approaches to the healing of trauma emphasize both the importance and the difficulty of reconciling (often implicit) traumatic body memory with verbal narrative (Cozolino, 2002; Busch and McNamara, 2020; Van der Kolk, 2014). Trauma is by definition overwhelming; it resists containment and description. Yet a healthy sense of self relies on the integration of physical self-awareness and the narrative/autobiographical self (Van der Kolk, 2014). On this account, trauma healing consists of repairing or creating new connections between physical, affective and narrative experience, and thus offers heightened potential for exploring the aesthetic impact of language for therapeutic change in dramatherapy.

Dramatherapy offers a richness of ways to work with narrative. Traumatic content can be directly addressed, as in any verbal therapy; it can also be worked through physically and non-verbally. Dramatherapy offers an additional layer with the potential to work through theatrical language, fiction, and enactment, with aesthetic distancing as the key to identifying a level of language and communication that is accessible to the client.

Freeman (2021) argues for language itself as dramatherapy’s aesthetic medium, yet his literature review paper looks to disciplines outside of the field of dramatherapy. While elements of language such as voice (Abdul-Rahim, 2006; Houseman, 1994; Newham, 1994; Partridge, 1994; Passalacqua, 1995), text (Jenkyns, 1996) and metaphor (Milioni, 2007; Swanepoel, 2011) had been explored as vital elements of dramatherapy practice, Buckley (2020) was not able to locate a holistic discussion of the aesthetic uses of language in the dramatherapy literature. Dramatherapy is essentially an action therapy providing the possibility of embodying thought, meaning and form, in addition to accessing reason and reflection. This article seeks to unite voice and text, language and embodiment, as a means of better understanding how the crucial elements of dramatherapy come together in actual practice, aiming to produce a preliminary model of dramatherapeutic language use and its application in trauma treatment.

The article is structured through a review of relevant literature, followed by the theoretical arguments concerning the nature of language use in dramatherapy trauma work. The theory will be illustrated with examples drawn from existing literature and the author’s arts-based research (Buckley, 2020). Implications for further research and clinical application will be explored.

Foundational assumptions

This article rests on a number of fundamental assumptions, including that therapy is conducted in the context of a unique relationship mediated by social and cultural structures. I assume that dramatherapists use their entire, embodied experience as information in making clinical decisions, and that while it is difficult to accurately verbalize such information, it is useful to do so in the literature to more fully reflect the nature of dramatherapy practice. I assume that finding ways to bring embodied experience back into relationship with thought, language and narrative mirrors the process of trauma healing. Embodiment is considered to be part of all human experience (including thinking and language) and therefore is relevant in all elements of a dramatherapy session, not only those involving physical movement or ‘acting’.

My perspective on these issues is formed and informed by my identity as a white, cis, queer, anglophone, middle-class, educated, settler North American woman with an invisible disability, as well as by my professional training as a dancer, visual artist, theoretical linguist and dramatherapist.

Language and trauma

How does language represent or fail to represent traumatic experience? In a special issue of the journal Applied Linguistics, Busch and McNamara (2020) outline complex relationships between language, emotion and bodily experience, arguing that even as language itself can cause trauma, with or without physical violence, trauma may have significant impacts on survivors’ use (or avoidance) of language. While language and narrative are shared and social, Van der Kolk (2014) characterizes traumatic memory as essentially solitary, in which ‘the imprints of traumatic experiences are organized not as coherent logical narrative but as fragmented sensory and emotional traces’ (p. 176), rendering it difficult for the individual to come to a sense of self-understanding, let alone share the experience with others.

Applied linguistics research has been unable to identify particular linguistic features that characterize a trauma narrative, instead finding:

a continuum between fully contextualized, structured narratives and fragmented accounts characterized by gaps, hesitations, and disruptions, between an obvious strong personal and emotional involvement and stance-taking, on the one hand, and a seemingly detached narrative that abstracts from the narrative self as an experiencing instance, on the other (Busch and McNamara, 2020: 330).

Busch and McNamara (2020) argue for the language of trauma hovering ‘at the limit of what is sayable and hearable, sometimes involving turning to performance, poetic, or artistic means’ (p. 330). Busch and McNamara (2020) identify particular challenges of traumatic language, including that ‘meaning can lie equally in the said and in the unsaid or in specific words (or sounds) that function as “place holders for the unsayable”’ (p. 331); they argue that when ordinary language becomes insufficient, meaning may be more easily conveyed through other forms (i.e. through artistic media).

Van der Kolk (2014) and Garza (2020) both refer to the speechlessness of horror. Garza (2020) contrasts horror with suffering, which she argues is how victims become re-voiced and able to share their experiences, identifying the social responsibility of the language of pain. To reach for language, to express, is to feel the pain and thus to become unfrozen, to enter into relationship.

While silence, speechlessness and immobility may be the legacy of trauma, somehow finding a means into movement and words is one pathway towards reconnection and healing, one where both verbal and non-verbal communication are integral to the process of therapy and trauma work.

Body and language in therapy

Language is central to ‘talk therapy’, so interwoven that it is difficult to isolate as a factor. Cozolino (2002) identifies the following levels of language use in therapy: ‘reflexive social language, an internal dialogue, and a language of self-reflection’ (p. 36); the latter blending cognition and affect to make therapeutic change possible.

Westland (2015) claims that 85% of communication in therapy is non-verbal, including the manner of speaking, posture, gesture and perceptible shifts in body physiology; whether or not these shifts (or the awareness of these shifts) are made explicit, they constitute a majority of the information that is communicated between therapist and client. Hodermarska et al. (2014) emphasize that these interactions often occur below the level of verbal awareness such that ‘therapist and client are therefore both vulnerable to the traction of one another’s relational patterns’ (p. 181). Stern (2004) likewise highlights the centrality of embodied experience, claiming that the physically experienced present moment is ‘the lived material from which verbalizations, interpretations, representations, generalizations, and metapsychology are all derived abstractions’ (pp. 135–136). In the dramatherapy context, Jones (2007) states that verbal and non-verbal communication are ‘not two distinct categories, but naturally combine and interrelate [. . .] all the time’ (p. 228). This article seeks to acknowledge a totality of communication and expression that contains sensation, affect, image, symbol and word, while focussing on the verbal to better understand how the different elements of language contribute to the making of meaning and to dramatherapeutic change.

Cozolino’s (2002) identification of therapeutic change with the blending of cognition and affect relates to the dramatherapeutic concept of aesthetic distancing (Landy, 1996; Scheff, 1979), the means by which the dramatherapist assesses the client’s availability for the work of therapy and appropriateness of a given intervention in the present moment. Crucial in any dramatherapy context, distancing’s significance is heightened in trauma work, where slight variations in stimulation can mean the difference between fruitful work and dissociation or retraumatization.

Trauma and the aesthetics of distancing in dramatherapy

Johnson and Sajnani (2014) identify aesthetic distancing as one of the elements constituting dramatherapy’s unique contribution to trauma work, yielding a more expansive range for clinical work as well as a greater flexibility of intervention. Glass (2006) defines aesthetic distancing as ‘the point at which the client can have access to his feelings and also maintain an observer stance’ (p. 58), naming distance as the ‘touchstone for assessment of the effectiveness of treatment’ (p. 58). For Glass (2006) as well as Haen (2022), using a combination of over- and underdistancing techniques allows the dramatherapist to titrate exposure to traumatic content through the dramatic medium itself.

Johnson and Sajnani (2014) note that dramatherapy trauma work can be aligned with numerous value systems and treatment methods, offering a unique approach more through its methods than its ideology. Distancing, one of Jones’ (2007) core processes of dramatherapy, is applicable in any dramatherapy approach and in this article provides a focus for understanding body and language in dramatherapy for trauma healing.

Frydman et al.’s (2022) study of the core processes from a North American perspective offers this tripartite definition of distancing:

[What it is:] A process of titrating emotion and cognition through engagement with dramatic media.

[What it does:] Allows the participant(s) to move between feeling and thinking, helping participant(s) to fully feel, express, and tolerate emotions and/or expand perspective, awareness, and capacity for self-regulation.

[What is observed:] There is a noticeable shift from a place of emotional flooding or intellectualizing; the participant(s) move(s) or is/are guided along a continuum of emotional and cognitive expression. (p. 8)

Absent from this definition is the word ‘aesthetic’, which was present in Landy’s (1996) and Scheff’s (1979) writing based in theatrical traditions of catharsis. Pendzik (2013) names as a core assumption of the field that ‘most of the therapeutic force lies precisely in the aesthetic experience’ (p. 94); Pendzik (2003) notes that a shift in aesthetic distance may cause a shift in the quality of dramatic reality, highlighting the intimate link between the aesthetic element and the capacity to find a balance of thinking and feeling in dramatherapy work. I use the term aesthetic distancing to emphasize the essential connection between the drama of dramatherapy and the use of distancing as a therapeutic process.

What is language in dramatherapy?

What is verbal language? Of interest to this article are both the written and spoken word; language includes content and meaning as well as the manner of production, the qualities of how the language is uttered, and the social and cultural contexts in which language, speaker/writer and audience/reader are embedded. The form and meaning of language are also expressed through embodiment: the qualities of the voice, the identities that are claimed by (or forced upon) the body that utters language, and the contributions of gesture and posture to the meaning that is uttered. Language in therapy includes both the therapist’s use of language and the client’s. Language is embodied both in its productive and its receptive aspects: speech involves breath and the movement of the articulatory structures, while sound waves vibrate the receiving body; the hand moves to write and the eye to read; there are also more subtle physical responses, as when emotionally affected by words we are ‘moved’ – a shift that can have significant physiological impacts such as changes in heart rate, temperature, and tears. Language, like art, is simultaneously both form and content. The topic encompasses many facets of the dramatherapist’s work.

Here I will provide an overview of the levels of language that seem to me to be relevant and useful to the dramatherapist in their implementation of aesthetic distancing and trauma work. Following from the discussion of aesthetics in dramatherapy, I do not offer a means to evaluate aesthetic quality against a rubric or metric, but rather provide a list of questions bringing awareness to the elements of language, functioning to increase the therapist’s sensitivity to emergent meaning. It is essential to recognize that these aesthetic judgements are only valid in relation to the given client, their unique use of language and means of expression, cultural identities, and desired outcomes for treatment, all of which require knowledge of and relationship with the client.

Language, body and aesthetic distancing in dramatherapeutic trauma work

Based on this schema, how does the dramatherapist use language as part of titrating the work of trauma therapy?

The process of distancing as described in the literature (i.e. Landy, 1996) often focusses on particular interventions tending to provoke more or less distancing; there is less discussion, however, of the dramatherapist’s felt intuition of how to intervene to sustain a balance of distancing (Buckley, 2020). This parallels other areas of the field, which in the necessary process of operationalizing key dramatherapy terms have tended to define from the perspective of a visual observer, rather than the multisensorial co-presence of the dramatherapeutic relationship (i.e. Armstrong et al., 2016; Frydman et al., 2022). Dramatherapists do not rely on a single source of information, but rather respond to both embodied and linguistic data in responding to their client’s needs. Cassidy et al. (2017) found that dramatherapists understand it to be their responsibility to achieve safe distance for their clients in order for dramatherapy work to be possible, often beginning with projection and being cautious with embodied role-play; they found that client choices also determine the level of distancing particularly as clients become more familiar with the medium and means of working. Yet as a field, we lack a definition of how the dramatherapist knows that the appropriate level of distancing is attained.

I assume that there is no single, predictable impact of a dramatherapy intervention, but rather that dramatherapy is conducted in the context of a unique relationship which informs all intervention choices. It seems highly relevant to expand our collective understanding of the dramatherapist’s process of decision-making in the clinical moment – not because it would ever be possible to manualize and standardize dramatherapy – but because expanding a verbal common ground between practitioners allows us to better share knowledge, verbal and embodied, about our common practices. The crucial question becomes, how does a dramatherapist know that a client is tending towards over- or underdistance? How does the therapist intervene to restore a balance? I argue that this knowledge is first experienced as a felt sense, which the dramatherapist draws upon and brings into awareness to respond intentionally through the dramatherapy techniques available. Where the dramatherapist is not connected with their own embodied response, there is the risk of missing necessary communication, especially in the traumatic context where the details are often absent from the discourse or simply unsayable (Busch and McNamara, 2020).

How does the dramatherapist recognize trauma? Haen (2022) provides the following description of some aesthetic hallmarks of trauma:

Trauma performs in rigid roles and narratives that cycle but do not resolve. It plays in staccato and discontinuous rhythms and oppressive, deadened silence. It shows itself in whitewashed and hazy or visceral and jarring images that lack continuity of form. It moves in concave and guarded postures or aggressive body armor. Understanding these aesthetic markers can help not only to identify the presence of trauma, but also to pinpoint stuck points or ‘hot spots’ for intervention. (p. 289)

Here the aesthetic acts as identifier not only of a trauma pattern but also of the location(s) for the initiation or expansion of the therapeutic work. Available as data here are the client’s performance but also the therapist’s embodied response, including the replication of one’s own relational and trauma patterns, initialized by the client’s material.

In an exploration of the varied arts modalities in trauma therapy, Haen (2022: 291) provides the following schema in which to understand how different aesthetic media respond to distancing needs in trauma work, while acknowledging that each art form has its inherent qualities, strengths and limitations:

(1) the concrete versus ephemeral nature of the form (2) the amount of sensory stimulation (3) the use of metaphor and imagination (4) the degree of embodiment (5) the level of intimacy

While a text is concrete, a performance is ephemeral; written and spoken texts carry different levels of sensory stimulation. Exploring polarities and continua of the aesthetic elements of language enrich the potential ways to work with embodied language in trauma work, providing a subtle diversity of levels of stimulation assisting the needed movement towards aesthetic distance. Importantly, these factors need to be considered in the context of the client and their specific experiences rather than having an essentialized, predictable effect. Haen (2022) points to the significance of complexity, as in the distancing effects of a metaphor, as a means of de-rigidifying a trauma story and opening up the possibility of transformation and healing. In this way, language facilitates healing when it supports a movement towards subtlety, detail, variation, playfulness and the growing potential to remain present with intense yet tolerable experience.

Dramatherapeutic trauma work must address varied challenges to attaining or maintaining aesthetic distance when verbalizing experience. There is the problem of expression: the traumatic content is known yet expressing it is overwhelming, such that the client disconnects from feeling, moving into overdistance, or becomes overwhelmed by feeling, moving into underdistance. Bleuer and Harnden (2018) describe the therapist’s action to embody an overdistanced client’s words; the client softens into tears as the therapist makes a sculpt representing the client’s utterance, facilitating the connection with feeling in a non-overwhelming way. Haen (2022) describes a process of carefully titrated work across multiple arts modalities with an easily underdistanced actor-client, where drawing, metaphor, a gradual progression towards embodied action, and the performance of existing monologues were used to prepare for the possibility of the client creating his own monologue and being able to perform it, in full embodiment, remaining at aesthetic distance. Attending to the quality of linguistic expression and to the body’s responses allows for multiple means of reconnecting a verbal narrative with its associated sensations and feelings, allowing the needed story to be both told and felt.

There is also the problem of access: the traumatic content is not available to awareness. How can language work in dramatherapy assist in the finding of words for that which is not only unsayable but unthinkable? Here I rely on my own experience of discovering the existence of a prenatal trauma through the emergence, in adulthood, of kinaesthetic traumatic memories from a time long before I had words. How to reconcile the telling of what had happened and the cellular experience of the foetus that somehow survived dormant inside my adult, languaged body? I somehow had to find a process to fill in the space between opposing poles of factual language and incomprehensible physical sensation. This became the work of my culminating research article for my dramatherapy degree (Buckley, 2020), an exploration that led me to acknowledge that it is not always possible to work at aesthetic distance; instead, I worked to make connections between over- and under-, pure thinking and pure sensation, to make a relationship with the overwhelming affect that linked them. I worked to find words for fragmentary sounds, shapes, sensations, feelings, voices, that eventually became characters who could begin to tell their own stories. I assembled a mass of fragments, then from a safely overdistanced analytical perspective, categorized and grouped them, identifying themes and beginning to compose a narrative that could contain and structure the fragments. Physical and textual images and metaphors helped hold incomprehensibility long enough to feel something about it. I was eventually able to create a play with four characters that expressed different aspects of the experience and found ways of representing what was known and what inherently remained unknown. Finding forms to represent absence was an essential part of the work. In this process, moving between the roles of performer and director/writer and concentrating on the work as an aesthetic object was crucial in interrupting traumatic tendencies towards rigidity, recognizing that while there might be no essential truth of the experience, that there were multiple ways to navigate through the terrain, and to share it.

Further research

In this article I have proposed a schema for understanding language as an aesthetic element of dramatherapy, as well as its relationship with aesthetic distancing in dramatherapy trauma work. It would be useful to explore how this schema relates to the work of dramatherapy through empirical investigation. Much work remains to be done in understanding the concept of distancing in dramatherapy, including the argument made here that the dramatherapist’s embodied process of decision-making is an important site for understanding distancing in practice. Dramatherapy processes for working with early and preverbal trauma are another area for future research.

Conclusion

This article has explored the aesthetic use of language in dramatherapy trauma work, including the particularities of linguistic expression in the context of trauma, the unique facets of language in dramatherapy and the contribution of aesthetic distancing as a guide for intervention. I have argued for a greater attentiveness and explicitness in the ways that dramatherapists think and write about and use language in their work, in attending to their clients’ expressions, in choosing their interventions, and in exploring the relationships between felt sensation and what is thought, uttered, and written. Language contains complexity that requires conscious attention and sensitivity, yet should not be over-privileged at the expense of other forms of knowing. The focus on language in this article has precisely been to bring further into awareness the linguistic data offered in session, as well as to highlight the impact of therapists’ (often unconscious) linguistic choices. Language is one part of our work, the sound in relation with silence, the verbal in relation with all other forms of expression and meaning. To attend to language is to restore and return it to the blended whole of the shared, relational, aesthetic experience that is the work of dramatherapy.