Louise Montello, DA, CMT, NCPsyA
New York University, New York, NY
(Published in Music Therapy Perspectives, Vol. 18)
One of the challenges in practicing music therapy with groups of higher-functioning verbal individuals is finding an elegant and effective way to combine music and words to facilitate therapeutic change. In his book, Acting Your Inner Music: Music Therapy and Psychodrama, music therapist Joseph Moreno has developed an integrative treatment approach that creatively addresses the issue. Moreno, the nephew of the originator of psychodrama, J. L. (Jacob) Moreno, combines his unique training in this modality with depth-oriented music therapy techniques to create "Musical Psychodrama" which he defines as "the integration of music improvisation, imagery, and other music therapy techniques with traditional actional psychodrama in order to realize an expanded approach that transcends the possibilities of either method used separately."
Although psychodrama is a powerful treatment approach in itself that requires years of training, therapy and supervision before one can be certified to practice, Joseph Moreno has attempted to present the basic psychodramatic concepts and techniques that can be integrated into music therapy practice. He describes the roots of his approach as stemming from J. L. Moreno's early experimentation with music in psychodrama (1930-40s) that he called "psychomusic," which involved improvised vocal music and/or rhythmic expression, along with instrumental improvisation. Music was generally used by J. L. Moreno to warm up the group, leading to the selection of a protagonist for the actual psychodramatic work.
J. L. Moreno was also fascinated by the dynamic qualities of those playing the roles of what he called psychodramatic "doubles." The task of the double was to become an extension of the protagonist, and through his entrainment with the protagonist's feelings, help him to better express himself. Joseph Moreno notes that the doubles often used additional sound reinforcement to add energy and power to their words, which led to his idea to use live music in psychodrama—and so musical psychodrama was born. In Moreno's approach, music often serves to support and mirror the verbal expression in psychodramatic enactments.
Chapters Four through Eight of Moreno's book focus on the integration of specific music therapy techniques into the psychodramatic framework. He describes the use of music improvisation as an effective projective tool when used as a psychodramatic warm up. He then differentiates the practice of individual music improvisations from group music improvisations. In a case vignette, he describes how during a group music improvisation, the music allowed a protagonist who was confronting painful premature losses, to work into a role and how the sustained musical mood of sadness created by the group during his soliloquy gave him the emotional support he needed to begin to express and explore his deeper conflicts. With respect to therapeutic gain in general, Moreno suggests that at times musical behavioral change may be easier and less threatening than trying to practice and learn new social behavior.
I found Moreno's chapter on music and imagery in psychodrama particularly insightful. He offers several good ideas for selecting music to induce imagery. He also suggests using improvised music to evoke imagery and describes in detail the use of music and imagery as a psychodramatic warm up.
In Chapter Eight, Moreno provides a detailed description of specific musical psychodrama techniques that can be applied to music therapy practice. These techniques include musical role reversal, which encourages a more focused and less intellectualized kind of role exchange through music; musical dialogue, bringing closure to relationships using improvised music; and music and divided self. Here Moreno notes that music is the most effective device for dramatizing inner polarities. Two other useful techniques are musical modeling, which enables auxiliaries to demonstrate new behaviors and interactive approaches through improvisational statements, and musical doubling. The musical double can musically exaggerate a feeling to help liberate the protagonist towards a freer verbal expression or integrate music and words as a combined stimulus. With each technique, Moreno suggests that people may feel less inhibited in expressing different feelings in symbolic musical language rather than through the explicit language of words.
The case examples from Moreno's ongoing Musical psychodrama groups in Chapter Nine were interesting and point to the depth of change that is possible with the integration of the two modalities (music therapy and psychodrama). Moreno suggests that the most profound function of psychodrama itself is to serve as a warm up to life. He stresses that the deeper goal is for participants to take any newfound confidence gained from the therapeutic sessions and apply it in real-life relationships.
In Chapter Ten, Moreno describes 15 scenarios that can be used to initiate group work in music and psychodrama, some of which include opportunities to integrate art and movement expressions. Many of the scenarios are standard creative art therapy exercises such as re-enacting dream material with musical improvisation, exploring relational conflicts through drum dialogue, musical rebirth, realizing one's inner song through songwriting, and expressing one's feelings about a particular painting through musical improvisation. All of the techniques described here can be used as warm ups to musical psychodramatic enactments.
In Chapter Eleven, Moreno draws from his wealth of personal experience in working with the shamanic traditions in his description of the similarities between musical psychodrama and traditional shamanic ritual. It was fascinating for me to see the connection between psychodramatic role-playing and the practice of spirit possession in traditional cultures. He also describes the possibility of creating death-rebirth rituals with Musical psychodrama and the implications for divining the future with the psychodramatic future projection technique.
In the final chapter, Moreno concludes with his views on the importance of integrating all arts in therapy, which seems to be a growing trend in the field of creative arts therapy today. Certainly the therapeutic effects emerging out of the combination of music therapy and psychodrama as practiced by a therapist skilled in both modalities is greater than the sum of their parts. Moreno's book points to the importance of clients being able to process musical experiences verbally and vice versa. My one caveat for this book is that readers who have no familiarity with psychodrama may be at a loss and may want to read an introductory text before delving into Moreno's well-written, organized, and intriguing tome. In his creative capacity as a synthesizer and orchestrator of two diverse, yet complementary modalities, he makes an important contribution to our field.
OTHER REVIEWER COMMENTS
"A remarkable synthesis of music therapy and psychodrama."
- Adam Blatner, MD
author of The Art of Play® and Acting In
"A thorough investigation of the use of music in psychodrama....Makes an excellent case for integration of all the creative art therapies into a comprehensive therapeutic approach...."
- Barbara J. Crowe, MMT, MT-BC
Director of Music Therapy
Arizona State University
"I've been waiting for this book for a long time. In his new work, Moreno weds two great therapeutic traditions...[with] a strong emphasis on concepts from both....Moreno has the expertise, the vision, and the scholarship to help us negotiate this difﬁcult territory....It is truly a sound bridge builder between many ﬁelds."
- Carolyn Bereznak Kenny, RMT, MTA, MA
Simon Fraser University, Burnaby, BC
author of The Field of Play, The Mythic Artery; and Listening, Playing, Creating
"Of all the innovations on psychodrama...this book must stand atop the list....An elegant and creative, serious piece of work. Both music therapists and psychodramatists can beneﬁt.
- Zerka T. Moreno, TEP
clinician/author in group psychotherapy and psychodrama
"...an excellent and inspirational resource."
- Liz Mofﬁtt, CMT
music therapy faculty, Capilano College Vancouver, British Columbia