In small theater spaces people fighting psychiatric illness are learning that acting can be a powerful form of therapy, while the shows they put on help educate audiences through deeply personal accounts of mental health issues.
"Theater arts can really give patients a very valuable additional opportunity to piece their lives back together," said David A. Faigin, department of psychology, Bowling Green State University, Bowling Green, Ohio. He believes the approach works by "focusing on the same things that standard interventions focus on: community reintegration and social reintegration."
Faigin, along with Bowling Green professor of clinical psychology Catherine Stein, co-authored a review of theater as mental health therapy in a recent issue of of Psychiatric Services.
More and more, mental health professionals are viewing the arts - visual arts, dance, writing - as key tools in patients' recovery, and theater is no exception.
Faigin has tracked the efficacy of the technique through the Stars of Light group, a community theater linked to the Janet Wattles Centre, a mental health agency serving adults in the Rockford, Ill. area.
Stars of Light has had a 15-year partnership with the Wattles Centre, putting on productions using amateur actors diagnosed with a wide range of mental health problems. Faigin described the effort as "an exciting exemplar of a grass-roots, community-based theater setting devoted to involving and helping people with psychiatric disabilities."
He estimates there are about 20 similar groups scattered across the country in places like Chicago, Memphis and Connecticut. In these programs, artistic directors work with mental health staff to help bring structure to an environment where patients are free to generate the artistic content necessary to stage theatrical productions. That means everything from script development (often involving autobiographical content) to final performances at churches and community centers.
These kinds of theaters are not large, typically involving between six and 12 volunteer actors. Sometimes they are closely connected and managed by a psychiatric facility, and sometimes they are entirely independent.
The idea of meshing therapy with the dramatic arts isn't new. As Faigin pointed out, psychotherapy has long employed role-playing techniques to help patients tackle past traumas, depression or personality disorders, and to foster awareness and self-esteem.
How acting helps
"Research has shown that chronic mental illness is so incredibly disruptive of so many aspects on one's life - family dynamics, relationships, employment - that there's sort of a broken self there in terms of meaning and purpose," Faigin noted.
But for many patients, performance "sparks a real process of identity development by being forced to get up on stage and be themselves - quite literally - [and] by sharing their own personal stories in recovery."
At the same time, acting by its very nature can also give the patient "a break from everyday life, by being somebody else for a half-hour," Faigin said.
"They have a creative voice and express themselves as someone who has something to say," he explained. "It's a very in-your-face opportunity that forces the patients to 'own it,' because they're accountable when they're up on stage in a live performance in ways that they are not in the privacy of their home."
Other experts agreed that theater can play a role in mental health care.
Therapists learn from acting too
"Mostly my experience has been with patients who have found it very useful to enroll in acting courses," said Marvin Aronson, a private practitioner in individual, group, and couples therapy, as well as former director of the group therapy department at the Postgraduate Centre for Mental Health in New York City.
"It's not putting on a play or a long-term consuming involvement, but the principle is probably not so different. The setting gives them a license to learn how people spontaneously express feelings, and be exposed to people who are not inhibited."
People who often benefit most from the approach are those who have had past experiences that have taught them to shut down their emotional responses, he added.
"Acting gives them an excuse, in essence, to learn how to express themselves," Aronson said.
Robin F. Goodman, a clinical psychologist, art therapist and past president of the American Art Therapy Association, agreed.
"Lots of times there are experiences that have happened to you that are housed in non-verbal ways, and the arts are a way to access some of this stuff in terms of a feeling, an emotion, a movement, a song," she noted. "The experience of theater can be a terrific way to get out some of these things."
And it's not only the acting that's important. Mounting any kind of theatrical production involves a long timeline and teamwork from start to finish.
"That's a good challenge for patients, to have them accept a level of responsibility to and from themselves and their peers," Faigin said. "They get support and they give it. So at an emotional level there's a sense of feeling safe in a group, and part of a group, and feeling that people understand them."
Audiences can benefit, too, often getting an inside look into the world of those with mental illness. By letting people with bipolar disorder and other conditions step out of the shadows, the plays help overturn the stigma long attached to such ills.
"When these patients publicly share their own stories and their own voices they inevitably raise awareness about mental health issues, so it also offers a very important public health benefit," Faigin explained.
He said he's often seen theater help move patients to a better place, no matter what their diagnosis. "It gives them a real sense of purpose, a real creative spirit and a real creative voice. It can be a very powerful thing." - (July 2010)
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