Can Art Save Lives? Questions for Nisha Sajnani on How Drama Therapy Heals
藝術能拯救生命嗎？Nisha Sajnani對於戲劇治療如何療癒訪談錄
Nisha Sajnani (at right).Nisha右邊那一位
Nisha Sajnani, PhD, RDT-BCT, is an associate professor at NYU Steinhardt and the director of the Department of Music and Performing Arts Professions’ Drama Therapy Program. She serves as the research director of the As Performance: Theatre and Health Lab and editor of the Drama Therapy Review. We interviewed her about the healing power of drama therapy.
Nisha Sajnani，博士、註冊戲劇治療師/督導，是一位紐約大學史坦福學院的助理教授，任教於音樂與表演藝術學院的戲劇治療所。她擔任「如同表演：劇場與健康實驗室」的主任和《戲劇治療評論》的編輯。我們針對戲劇治療的療癒能力與她進行了訪談。
以下為訪談內容：
Q：I’m interested in the fact that drama therapy combines both theater and mental health principles; art and psychology. Can you speak to the history of that combination?
我對於戲劇治療聯結了劇場以及心理健康的原則、藝術和心理學很有興趣。你可以說說看這些聯結產生的歷史嗎？
A：Drama therapy combines ideas and practices from psychology and theatre as both involve the study of human emotion, cognition, and behavior. It is a form of therapy for those recuperating from psychological and interpersonal injuries that encourages personal and social change through projective play, dramatic improvisation, role-play, storytelling, fiction, playwriting, and performance.
戲劇治療結合了心理學和劇場的理念與實踐，這兩者皆來自於對人類情緒、認知和行為的研究。戲劇治療是一種治療型態，針對受過心理與人際間傷害、正在恢復中的人們，(戲劇治療)可以透過投射遊戲、戲劇即興、角色扮演、說故事、虛構、編劇和表演來鼓勵個人及社會性的改變。
The use of drama and theatre to heal has a very long history dating back to ritualistic healing performances done by specially authorized persons who were seen as healers in their communities. Ancient performance manuals such as Aristotle’s Poetics and Bharata Muni’s Natyashastra refer to the psychological properties of acting, witnessing, and otherwise participating in theatre. Aristotle, for example, proposed that feelings of fear and pity could be actively aroused and released in audiences to tragic plays resulting in feelings of clarity and renewal. We experience the truth of this insight today every time we find ourselves identifying with the characters of a play, film, or tv serial.
Psychologists Green and Brock referred to this phenomenon as ‘narrative transportation.’
戲劇和劇場用於治療有悠久的歷史，可追溯至社群中的治療者被授權演出儀式性的療癒表演。古代的表演守則，如亞里斯多德的《詩學》和婆羅多牟尼的《舞論》*(或作《劇論》)也論及表演、觀看和劇場參與的心理學特質。舉例來說，亞里斯多德主張觀看悲劇的觀眾會被激起恐懼與悲憫，這些感覺也被釋放；最終被淨化與更新。在現今我們每次觀看表演時認同了戲劇、電影或電視連戲劇中的角色都會經驗到亞里斯多德論點中的真實。心理學家格林和布洛克將這樣的現象稱作「敘事移轉**」。
*註一：《舞論》。印度最偉大的一部戲劇、音樂和舞蹈百科全書，為數世紀以來最完整的梵文作品，被稱為第五部吠陀。Natya Shastra以近代術語可以譯為舞蹈的科學（The Science of Dancing），也可譯作《劇論》。此書是一部古老經典，是印度現存最早的戲劇學著作。相傳為婆羅多牟尼（Bharata Muni）集前人大成的經典鉅作，是一劃時代的著作，其成書年代已無可追溯，另有一說認為該書約完成於西元前二世紀至西元後三世紀之間，其內容主要談及舞蹈、戲劇和音樂，是流傳下來梵文著作中最完整的一本。
**註二：「敘事移轉」。The experience of being transported to the world of a story is called narrative transportation.被傳送到故事的世界中，這樣的經驗即稱為「敘事移轉」。
Around the fifth century, Caelius Aurelianus translated the ideas of Soranus of Ephesus in On Acute Diseases and On Chronic Diseases in which Soranus prescribes plays best suited to his patients’ needs. Imagine, for example, prescribing a play like Come from Away to help people to grieve 9/11, Sarah Kane’s 4:48 Psychosis to grapple with themes of depression and suicidality, or Richard III for veterans returning from war.
西元五世紀左右，塞利烏斯‧奧雷利安努斯翻譯了希臘以弗所醫生─索蘭納斯的《關於急性疾病》和《關於慢性疾病》，在這兩本著作中索蘭納斯描述了戲劇最能切中他的病患的需求。想像一下，舉例來說，像是《來自遠方》***這樣的戲劇幫助人們來悼念911事件，莎拉‧肯恩的《4.48 精神崩潰》****與憂鬱症和自殺議題搏鬥，或是理查三世獻給從戰場回來的老兵。
***註三：《來自遠方》故事講的是9.11期間，38架客機被迫降落在加拿大紐芬蘭的一個偏僻小鎮甘德。當地的居民向機上的6579名來自世界各地的陌生 人敞開家門，展現出在非常時期裡的人性光輝。
****註四：《4.48 精神崩潰》。凌晨四時四十八分，據說是人一天之中精神最錯亂、最容易自殺的時刻。《4.48 精神崩潰》是英國傳奇編劇莎拉．肯恩（Sarah Kane）的遺作。她完成此劇本不久，首演還未上映之前，就上吊自殺，令此劇像極了死前的告白。莎拉．肯恩在極度抑鬱的痛苦中，寫下了這個劇本，內容呈現作者錯亂的精神世界、心靈自我矛盾的對話，從求生不得，轉而求死的掙扎過程。
Several developments happen over the 16th-18th centuries that reflect a shift in mental health practice including observations by Sir Francis Bacon about the benefits of ‘stage-playing’ to memory and confidence. William Shakespeare refers to the healing properties of dramatic enactments in King Lear and, later, in The Two Noble Kinsmen. Biagio Miraglia, the first Italian psychiatrist, was amongst the first to formally organize the use of theatre in mental health facilities around the mid-1800s noting that acting gave patients an outlet to express repressed feelings.
在十六到十八世紀之間出現了一些發展顯示了心理衛生的轉變，包括培根關於舞台表演對於記憶力和自信心產生的益處的觀察；莎士比亞在《李爾王》和其後的《兩位貴族親戚》中提及戲劇演出的療癒元素。比亞‧米拉利亞，第一位義大利心理學家，是第一批在十八世紀中葉左右正式使用劇場於心理健康機構的先驅之一，他指出表演給予病患一個表達壓抑感受的出口。
Acting “as-if” something is true, as children naturally do in pretend play, was popularized by pioneering psychologist William James and theatre director Konstantin Stanislavski in the late 19th and early 20th century. Being able to make-believe gives people a chance to try out different possibilities and to create new storylines about their lives in a less risky environment. We can, infact, rehearse the change we wish to be and see.
如同兒童自然而然地在扮演遊戲中所作的，「表演”假如”某些東西是真實的」在十九世紀晚期和二十世紀初期被心理學家的先驅威廉‧詹姆士和劇場導演史坦尼斯拉夫斯基推廣。有能力去「假裝」給予人們一個機會去嘗試不同的可能性，並在一個較沒有風險的環境中創造新的生命故事情節。事實上，我們能夠排演那些我們期待看到的改變。
Residents from the Hebrew Home for the Aged at Riverdale prepare for their performance of “The Birds” in the green room of the Black Box Theatre in Steinhardt, NYU. Directed by NYU Drama Therapy Alum Barbara Kaynan and presented as part of the As Performance series.
河谷地，紐約大學史坦福學院的黑箱劇場，綠色房間；希伯來長者之家的居民在預備他們的演出”鳥”，由紐約大學戲劇治療所的校友芭芭拉‧卡南所導，為如同表演系列作品之一。
Perhaps the greatest influence on drama therapy in the U.S was Jacob L. Moreno, a Viennese psychiatrist who, between the 1920s-60s, founded group psychotherapy and two approaches to exploring psychological processes through dramatic action: psychodrama and sociodrama. Both approaches use similar methods and techniques of role-playing based on his relational role-theory of personality and his ideas about the health benefits of spontaneity and creativity.
或許對於美國戲劇治療影響最大的是雅各‧莫雷諾，一位維也納的心理學家，他在一九二零到一九六零年代之間創立了團體心理治療和兩種運用戲劇行動探索心理歷程的取向：心理劇和社會劇。這兩種取向使用了相似的方法和角色扮演的技巧─皆根基於他的關係性的人格角色理論和他對於創意與自發性所帶來的健康益處的想法。
“Drama therapy” was first used as a term in 1917 but was only formalized as a profession in the U.S. in 1979 through the founding of the North American Drama Therapy Association. I had the pleasure of co-founding the World Alliance of Drama Therapy with member associations representing 22 countries, just last year – 100 years after the first documented use of the term.
戲劇治療一詞初次出現在1917年，但於1979年在美國經由北美戲劇治療協會的成立正式成為一種專業。我很榮幸共同成立了世界戲劇治療聯盟，共有22個會員代表國─就在去年，戲劇治療一詞首次被記錄在文獻中後的一百年。
The practice of the drama therapy continues to evolve — drawing from new discoveries about the psychology of theatre, trauma, and the role of the body, improvisation, play, social roles and narratives, amongst other factors, in facilitating change. The Couch and the Stage, written by Dr. Robert Landy, the founder of the NYU Program in Drama Therapy and director of the film Three Approaches to Drama Therapy offers a detailed account of the history of this marriage between psychology and theatre together with examples of innovative techniques and models of practice. I am the Principal Editor of Drama Therapy Review, the primary journal for research in our field where readers can discover how drama therapists promote positive health outcomes with diverse groups and concerns in a variety of contexts.
戲劇治療的實踐持續演化，從許多領域與心理學的連結中借鏡，如劇場、創傷、身體的角色、即興、遊戲、社會性角色和敘事，並其他的元素來促進改變。羅伯特、藍迪教授─紐約大學戲劇治療所的創辦人以及《戲劇治療的三種流派》的電影導演─他的著作《躺椅和舞台》裡面詳細地描述了心理學與劇場的聯姻，並提及了許多創新的技術與實踐的模式的例子。我是《戲劇治療評論》的總編，這是一本我們這個領域裡的重要期刊，在這裡面讀者可以發現戲劇治療師如何在與多元的團體工作時，促進正向的健康結果，還有在各式各樣的脈絡裡如何去考量評估。
Q：You are the co-editor of Trauma-Informed Drama Therapy: Transforming Clinics, Classrooms, and Communities, which looks at how drama therapists respond to trauma in communities burdened by historical and current wounds. Can you tell me how drama therapy can heal trauma?
你是《創傷知情戲劇治療：轉化臨床工作、教室與社區》*****的共同編者，此書關注戲劇治療師如何對應在社群中的歷史創傷與當下的創傷，你可以跟我談談戲劇治療如何治療創傷嗎？
*****註五：Trauma-Informed:「創傷知情」，就是我們擁有關於創傷的知識，以及這些知識所帶來的力量。換句話說，「創傷知情」就是我們能夠辨認創傷壓力， 能夠了解創傷壓力對個人與系統帶來的影響，甚至，對於創傷的知識，帶給個人與系統能夠進一步預防與療癒創傷的力量。(來自：goo.gl/ne1NNg)
When we go through highly stressful experiences such as chronic poverty, domestic violence, neglect, racism, or singular events like sexual assault or an unexpected loss, we may experience a disruption in our sense of identity, safety, and connection to others. These ruptures can contribute to anxiety, depression, and emotional dysregulation which may, in turn, prompt helpful or harmful coping strategies such as avoidance and social isolation.
當我們經歷了高壓的經驗如長期的貧窮、家暴、被忽略、種族歧視，或是單一事件如性騷擾、意外的損失；我們可能會經驗到自我認同、安全感或是與他人連結的斷裂。這樣的破裂會導致焦慮、憂鬱或是情緒失調，而進一步地促使人們產生有效的或是有害的對應策略，例如迴避或是社會孤立。
Drama therapy can offer survivors of trauma opportunities to use skills related to acting, such as breath and movement, enrolling and de-rolling, to practice regulating emotional experience and returning to present experience. Through the use of projective techniques such as puppets, texts, and masks, participants can find a language to organize the story of their experience and communicate this to others without becoming too detached or emotionally overwhelmed. The use of relational play can facilitate differentiation and progressive desensitization with children who have experienced trauma. Through theatre games and exercises, participants are able to take creative risks in a less threatening environment and rehearse challenging social situations.
戲劇治療可以提供創傷倖存者機會去使用與演戲相關的技巧，例如呼吸與運動、滾動與靜止，去練習規律的情緒經驗、回歸現實感。從投射技巧的使用，例如操偶、文本、面具等，參與者可以找到語言來組織他們的生命經驗成為故事，並以之與他人溝通而不會覺得太過疏離或是情緒上以承受。運用融入關係的遊戲可以促使經歷過創傷的兒童能進漸漸地分別和減低敏感度。透過劇場遊戲和練習，參與者能夠有創意地、在一個較不具威脅性的環境中去承受風險並排演具挑戰性的社會情境。
When conducted in a group, drama therapy can offer children, adolescents, and adults opportunities to experience joy, validation, and connection with others again while making meaning of difficult events. For example, this drama therapist writes about a session held with children who survived the Tsunami in Sri Lanka:
當帶領一個團體時，戲劇治療可以提供遭遇困難事件的兒童、青少年和成人、在尋求意義的同時，也經驗到歡樂、自我效能、與他人連結的經驗。例如，有位戲劇治療師記錄了她和斯里蘭卡海嘯事件中倖存的兒童工作的一個片段：
I placed a blue cloth in the center and waited to see what would emerge. The children began to move their arms up and down and we all began to sway. The energy began to build and a section of the circle lunged towards the center and then another section. There was a lot of laughter, and the lunging became more intense. I requested that the translator ask “what is the sound that goes with this movement?” Then it came: “Whoosh!” Others joined in. We were running in and out of the circle, hands linked: “Whoosh!” The energy and the noise built further, bouncing off the temple walls, a sort of contained chaos. “What’s happening?” I shouted above the din. They told my translator. “A Tsunami! Tsunami is coming!” (Jones, 2007)
我擺放了一塊藍色的布在中央並等待著看會有甚麼浮現。孩子們開始擺動他們的雙臂，接著我們全部開始搖擺。團體的能量開始升高，一部分的圓圈中的人們衝向中央，接著另一部分的圓圈接續。團體中有許多笑聲，而這樣的衝撞變得更強烈。我請翻譯問團體成員：「這個動作會有甚麼聲音？」，有人發出了：「呼咻」的聲音，其他的人跟進。我們不停地跑進、跑出圓圈，手仍牽著。「呼咻」，團體的能量和聲響更加凝聚、升高，在廟宇中的牆垣四壁迴盪，一種被包容接納的混亂。「發生甚麼事了？」我在喧囂聲中大聲地問道。孩子們跟我的翻譯者說：「是海嘯、海嘯來了！」
Nisha Sajnani meets with Drama Therapy students Veronica Filson and Lynn Hodeib at the NYU Launch of the Oxford Handbook of Dance and Wellbeing.
Nisha與戲劇治療所的學生在紐約大學的《牛津出版社‧舞蹈與健康指南》新書發表會
In ALIVE, an exemplary program that I co-founded in New Haven, CT, drama therapists created and use a myth called The Legend of Miss Kendra to help students, teachers, parents, community leaders speak about the impact of adverse childhood experiences. ALIVE has now spread to four different cities and is featured in the award-winning film Resilience by James Redford.
在〈活著〉─我在康乃狄克州的紐芬蘭共創的一個示範性計畫─戲劇治療師創造且運用了一個神話《卡德拉小姐傳奇》來幫助學生、老師、家長和社區中的領袖談論童年時期的不幸經歷帶來的影響。〈活著〉現在擴展到其他的城市，並以詹姆士‧瑞福的得獎電影《復原力》為計畫特色。
In yet another example of the potential of theatre in the treatment of trauma, past U.S Army medic and infantry officer turned actor Stephan Wolfert founded DE-CRUIT to support veterans returning to civilian life. Through “Shakespeare and science” their team, which includes NYU Associate Professor of Applied Psychology Alisha Ali, has been able to demonstrate “significantly improved PTSD, depression and heart rate coherence.” A randomized controlled trial is underway.
在另一個治療創傷的的例子中也可以看到劇場的潛力。前美軍步兵軍醫斯蒂芬‧沃爾特成立了〈退役」這個組織來支持退伍軍人回歸社會。透過「莎士比亞和科學」，整個團隊─包含了紐約大學應用心理學助理教授艾莉莎‧阿里─證實他們的方法有效改善了創傷症候群、憂鬱和心律不整。一個隨機的控制實驗也正在進行中。
Q：You are the recipient of the Corann Okorodudu Global Women’s Advocacy Award and this year you went to the UN with your students to advocate for drama therapy as a mental health treatment modality. Can you talk about your advocacy for drama therapy and tell us why it is an important tool for resolving conflict?
你是本年度Corann Okorodudu全球女性倡議獎得獎人，並且在今年你帶領學生至聯合國為戲劇治療是一項心理健康治療的形式來倡議。你可以談談你為戲劇治療做的倡議，並告訴我們為什麼戲劇治療對於解決衝突是一項重要的工具嗎？
Creating a theatre ensemble is not unlike creating any group in which members seek to co-exist. There has to be a base of respect, a capacity for listening, an acknowledgment of perspectives other than our own, and a willingness to take personal and creative risks together towards a common goal. This is not possible when one side wishes harm to the other. However, where these elements are in place, drama therapy can make a contribution.
建立一個劇團就像建立任何一個成員彼此依存的團體。需要有尊重、傾聽的能力、承認他人的觀點做基礎還有願意付上個人的或創意的風險以完成一個共同的目標。當一方想傷害另一方時是不可能完成的。戲劇治療對於將這些要素放到正確位置有不可磨滅的貢獻。
Exercises, where two or more people improvise and mimic each other’s movements or role-play scenarios from another’s point of view, engage the psychological processes that contribute to empathy such as mirroring and mentalization. For example, in the Montreal Life Stories Project, I directed the Living Histories Ensemble, a theatre company that used Playback Theatre to gather and transmit the stories of survivors of war who had resettled in Montreal. Listening to these stories and watching them brought to life through theatre for mixed audiences encouraged empathy, understanding, and a deeper sense of our responsibilities to each other especially as we struggle with the realities of mass displacement.
在戲劇治療的練習中，兩人或多人一起即興、模仿彼此的動作，或是從彼此的觀點出發來共同角色扮演情境；這些都讓人投入到心理層面的發展，並能培養出同理能力如鏡射或是心智化******。舉例來說，在〈蒙特婁生命故事計畫〉中，我帶領了〈活歷史團隊〉─一個使用一人一故事劇場的劇團，蒐集和傳遞從戰場上倖存並重回蒙特婁定居的老兵的故事。在聆聽這些故事、看到它們如實地被搬上舞台、台下有各式各樣的觀眾，會鼓勵人們產生同理、了解；尤其是當我們掙扎著面對大規模的變動，這使人們燃起更深一層的對彼此的負擔。
******註六：Mentalization：「心智化」，意指一個人具有包含非意識的、自動化的、意識的思慮，可用來瞭解自己與他人認知與情緒狀態的能力（Choi-Kain和Gunderson 2008）。而心智化是透過父母或照顧者對於嬰幼兒的照護，使自體（Self）得以發展所形成（Bateman 和Fonagy，2004）。
We continue to create spaces for individuals and communities to use theatre to share their personal stories through our As Performance: Therapeutic Theatre Lab here at NYU. Theatre is the act of seeing through the eyes of someone different than yourself and this is an integral part of working through conflict.
透過在紐約大學的「如同表演：劇場與健康實驗室」，我們持續為個人或社群創造他們可以分享個人生命故事的空間。劇場使你能透過他者、而非你自己的角度來看事情，而這正是走過衝突的完整的一部分。
Q：And here’s your wildcard question: Can art save lives?
最後是這個大哉問：藝術能拯救生命嗎？
Yes, when words fail us, art gives us a vital way to express and communicate inner experience which can make us feel less alone. This is important given that social support is a critical factor in how we manage life’s stressors. Art can also bring visibility to people and concerns that we have neglected as a society. With its ability to engage, connect, and sustain us, art and the arts therapies show great promise in reducing isolation and helping people to recover their creativity, imagine a better future, put ideas into action, and feel alive again.
是的，當語言無法表達時，藝術給了我們一個重要的管道來表達與溝通內在經驗，讓我們感到較不孤單。有鑑於社會支持在人們處理生活壓力是一關鍵因素，這點十分重要。藝術也能讓那些在社會上被我們忽視的人與想法被看見。因著藝術有能力讓人投入、連結、並支持著我們；藝術和表達性藝術治療師讓人們看見指望─減少人們的孤立，幫助人們重新恢復他們的創意；想像一個更好的未來，將想法付諸行動，並重新感受到自己的生命力。
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