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Couples Therapy: Communication Strategies that work!
Couples Communication continuing education psychology CEUs

Section 23
Action Methods Used in Couples/Family Therapy

CEU Question 23 | CEU Answer Booklet | Table of Contents
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Action Methods Derived From Psychodrama
In this section, we include Action Methods that are distinct from psychodramatic work. The methods, however, make use of psychodramatic techniques or recognizable modifications.

For several Action Methods, Satir adapted role play and action sociometric techniques that Moreno originated (Satir, Banmen, Gerber, and Gomori, 1991). One wellknown example of action sociometry, popularized by Satir and often used by experiential therapists, is family sculpting*, which Duhl, Kantor, and Duhl (1973) developed. In family sculpting, Satir supervised the positioning of all family members in turn, according to each individual member’s perception of his or her experience of the family. Such a sculpture—a static, spatial representation of the felt experience of one member—was then adjusted by changing all members’ positions in the tableau to conform to every other member’s perception, so that all family members present could experience nonverbally the similarities and differences across their experiences of the family system. Other sculpting variants include kinetic family sculpture to represent change processes over time (McKelvie, 1987); using stand-ins so that family members can be replaced in the sculpt, permitting them to walk around the tableau and experience it from an “outside” perspective (Constantine, 1978); and sculpting in which members, starting from a silent, static tableau, then added brief, repetitive phrases or movements (Jefferson, 1978).

Satir was also well known for her creation of family reconstruction*, a technique in which clients are able first to recreate and then alter troubling scenes in their family. In this method, the client, named the “Explorer,” reenacts scenes from his or her childhood past, reexperiencing relationships in ways that may affirm or alter his or her present perspective. Unlike family sculpting but akin to psychodrama’s use of auxiliaries, nonfamily group members (called “players”) represent actual family members in the Explorer’s scenes (Nerin, 1986).

Although based on one individual’s perspective, a family reconstruction witnessed by other family members profoundly shifts the family’s present process. Teachworth (2002), a Gestalt therapist, uses two three-chair enactments* to help clients to re-experience their own relationships with their partners and their parents’ union. In one, clients first role-play themselves as children witnessing their parents’ interactions from one chair and then reverse roles to embody each parent interacting with the other in the third empty chair. In the other enactment, the client takes the role of a counselor engaged in a couples therapy session scene, working to resolve a core conflict between his or her parents in the other two empty chairs.

For action modality psychotherapy (Hayden-Seman, 1998), when applied to couples therapy, the therapist uses guided dramatic action within the psychodramatic structure of warm up, enactment, and closure. Moving from the warm-up phase to enactment, one client, as protagonist, recreates his or her experience of the relationship, alternately directing and enacting a realistic scene relevant to a central issue. The client’s partner assists by taking other roles in the scene. From this goal-directed scene, the couple moves on to enacting a painful scene set in the partner’s childhood that is connected to the first enactment. In this painful scene, the therapist plays any roles that are seen as hurtful or negative to avoid a conflicting transference. Next, a reconstructed scene* is enacted as healing or positive, with the protagonist’s mate playing a healthy, nurturing role in the place of the previous negative one. During closure, the therapist models the sharing that is expected from each partner, emphasizing process feedback.

In another approach, similar to Hayden-Seman’s, of orchestrating “reformed past” scenes* (Chasin, Roth, & Bograd, 1989), clients experience their pasts as mutable constructions, rather than unchangeable givens. After inviting each partner to name his or her own strengths in the presence of the other, the therapist asks each partner for a verbal description of future wishes for their relationship. Then, both clients enact a first scene incorporating both partner’s future vision, concretizing their future wishes together. The partners now enact a second, painful scene from one of their pasts (usually from childhood) in which their desired wishes were thwarted. Then they stage a third, culminating “reformed past” enactment as a revision of the second scene in which the partner plays a healing figure that transforms the remembered
defeat into fulfillment.

Action Methods Used for Concretization and Representation
Action metaphors are a class of Action Methods that serve to concretize interactional processes in therapy. One example is boundary sculpture* (Duhl, 1999) with couples, which begins with each partner visualizing his or her ideal personal space. One partner paces off personal space in the room, describing it and adding details in response to the therapist’s questions that focus on the nature of boundaries and entrances to the space. Then the other partner approaches the space and seeks to enter. The reactions of both partners to the enactment are processed immediately afterward.

Satir employed many Action Methods to externalize psychological processes and functions and staged formatted enactments for family discovery and learning, such as her parts party* and the four interpersonal styles* (Satir et al., 1991). Her followers (McLendon, 1999) went further in using physical props charged with symbolic or metaphorical meanings (e.g., a piece of rope to represent a boundary or a bond between family members, or a self-esteem tool kit* that included plush hearts, stuffed toy animals, and a detective hat).

Wiener (1998b) uses the feeding exercise to concretize struggles over autonomy and nurturance in couples therapy. Partners in this Action Methods take turns feeding one another small pieces of hand-held food (e.g., grapes or small cubes of cheese); the eater remains physically passive, moving only his or her mouth. There are three variations to the exercise: Both may speak during the enactment; only the feeder may speak; and neither may speak. In the variations in which the eater may not speak, the feeder is instructed nonspecifically to attend to the eater’s nonverbal cues. This enactment frequently produces vivid associations; the eater may feel helplessly dependent while the feeder may experience intense responsibility for the eater.

In staged metaphors* (Papp, 1982), the therapist first has both partners create a visual fantasy about self and their partner in which both take on a symbolic animal form. The therapist then instructs them to imagine what kind of interaction occurs between these animals in the fantasy. Once the fantasies are visualized completely, each spouse in turn enacts his or her choreographed fantasy with the other spouse. The therapist asks questions to supply a plot for the action of the scene and helps the couple bring postural and gestural details into the scene.

Therapeutic rituals* constitute a class of Action Methods that are useful in addressing a variety of situations arising in therapy practice. These scripted Action Methods use recognized symbols for processes, events, places, people, and objects and are typically devised to lift constraints on the family system arising from the absence of adequate cultural rituals, such as religious ceremonies, celebrations, or rites of passage. They function in a number of ways: to signify and celebrate healing and completion; to acknowledge changes of membership, status or identity; to affirm a change in expression of belief. Through family rituals, members are able to integrate multiple meanings of behavior and safely express strong emotions through the manipulation of symbolic objects and by taking symbolic action. (Imber-Black, Roberts, & Whiting, 1988; Winek & Craven, 2003).

Social ceremonies are rituals used to conform and normalize changes made to established relationships within the social order. Therapeutic ceremonies* are intentionally designed to enhance the self-esteem of the participants and thus provide occasions for processing distressing emotions and spontaneous actions. Lubin and Johnson (2003) have devised a number of therapeutic ceremonies for multiple family groups dealing with such shared traumata as foster families struggling to integrate foster children or families of military veterans dealing with PTSD. The ceremonies reduce such families’ marginalized social status, internalized shame, denial, and distress.

Family constellations (Hellinger, Weber, & Beaumont, 1998) is a unique approach used to repair intergenerational damages to love in families. Family constellations are tools for discovery that make use of nonfamily members (called “representatives”) who stand in for other family members, living and dead, and are selected by the client from a larger group.

The first phase of constellations work is a personal, subjective, spatial representation of the ways that the family system influences the client’s feelings and actions, in which the representatives’ reactions supplement the client’s reports. A crucial difference between family constellations and family sculpting or family reconstruction is that the representatives are not in role; that is, they report what they experience as themselves, not as what the client’s family member whom they represent might or would experience. The second phase involves a trial-and-error search for an image of systemic balance and loving resolution, obtained by the therapist moving representatives and using feedback from changes reported in their experience. The third, final phase is the creation of a constellation embodying an image of what the family can be, in which every represented family member has an appropriate place and function.

- Wiener, Daniel J., & Laurie Pels-Roulier. Action methods in marriage and family therapy: a review. Journal of Group Psychotherapy, Psychodrama, & Sociometry, Summer 2005, Vol. 58, Issue 2..
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #9
The preceding section contained information about action methods used in couples/family therapy.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 23
For action modality psychotherapy, the therapist uses guided dramatic action within what type of psychodramatic structure? Record the letter of the correct answer the CEU Answer Booklet.

 
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