Dispositif thérapeutique et de recherche en psychodrame

Abstract

ObjectivesThis article is part of a general reflection on psychoanalytical psychodrama, and of a dynamic evaluation of its effects and psychotherapeutic processes, and builds upon what has already been written on the subject. The angle of approach adopted here concerns the contents and the articulation between, on the one hand, the sessions themselves and, on the other hand, the team's reflection on the clinical material outside of the sessions themselves. MethodThe methodology adopted is based on a contemporary and global description of the major stakes of the technique, differentiating its analytical framework from its different variations in terms of setting (according to the institution or the patients received), in order to facilitate the understanding and the grasp of its effects for the reader. Based on an updated literature review and taking into account current research on evaluation and practices, we rely on several key concepts, such as the work of co-construction, group elaboration of transferential issues, the deployment of symbolization processes, and transitional play itself. ResultsIt appears that the work of co-construction during the session, between the therapists and the patient(s), and the work undertaken in intervision and supervision outside of the sessions, are part of an interactive dialectic, functioning in a loop, reciprocally interlocking, and producing effects of potentially therapeutic changes for our patients. These effects are visible and observable both in the content of the psychodrama and the exchanges with the patients, and in the exchanges with the patients and their families, both in and out of the sessions. DiscussionThe investment of the setting by the therapists solicits them during and outside the session, individually and as a group, leading them to engage in a complex, multidimensional work, taking various but complementary forms. Analyzing what is played out, consciously and unconsciously, during these different times and spaces, allows us to promote the understanding of their links, and, moreover, to support these processes of co-construction of psychic life and symbolization processes. Thus, by putting the co-therapists to work – psychoanalytically speaking – regarding their positioning, experiences and elaborations, the practice of psychodrama also has a didactic and formative aim. ConclusionsThe proposals put forward in the article allow for a better understanding of the therapeutic processes that psychoanalytic psychodrama supports, by showing how the group work engaged in by the therapists is indeed carried out on several levels and in several spaces, making the usual understanding of these issues more complex. They invite us to pursue research concerning this type of therapy, highlighting both the group issues and the place afforded to play. We promote the use of psychodrama in our psychiatric and medico-social institutions that serve complex patients, for whom the more classic treatments are not always indicated nor efficient in treating difficult symptomatology, and who often refuse elaboration, or even exchange.