At the beginning of the 21st century, after the advent of several second generation antipsychotics and the establishment of several psychosocial programs, I am still left with the question: How do we truly heal schizophrenia?  After the positive symptoms have mostly abated, and a person is passively participating in community programs, many who work in mental health are satisfied.  However, I am not. Perhaps this is because I have lived through schizophrenia, and I have come to intimately understand what the process of healing was like for me.  The modest gains made by medication and clubhouse participation were undoubtedly key components in my recovery process, but it wasn’t until I started truly engaging, through challenging myself to actively create: to develop friendships, partnerships, mentorships, poetry, visual art and drama, did I actually tune in to my most basic life force, and begin to reconnect with the self temporarily lost in the frightening disease process of schizophrenia.

The Schizophrenia Society of Nova Scotia, where I have been employed, has been running a peer support group called From Recovery to Discovery.  It is an organic offshoot of the Your Recovery Journey group developed by the Schizophrenia Society of Canada.  We have worked with a very interactive model, and we have featured speakers who don’t simply discuss how to exist with a mental illness, but who expect our members to thrive and to become powerful, helpful agents of positivity in our community.  We have asked group members what kinds of speakers they would like to hear, and we have tried our best to fulfill their requests.  We have featured topics such as medication, meditation, mindfulness, spirituality, maîtri (Buddhist psychology), Qi Gong, Orthomolecular medicine, recreation, new research in psychosis, family relationships, relationships and mental health, music therapy, and more.  What is so special about our group is the unspoken belief that all members can recover, and that they are basically good, regardless of their mental health histories.  Communicating to someone that they are a good person with endless potential is a very simple, subtle transaction, but it is of paramount importance.  Without this, a person can easily give in to the conservative, pessimistic view sometimes present in the medical model, and to the stigma and lack of hope sometimes exhibited by those around them.  Creating a container that is free of judgment, brimming with hope and patience, and embedded with faith in transformation and recovery, is the crucial first step. After this is established, choosing hopeful speakers and modeling respect and encouragement within the group simply allows the positive trajectory of the group to fall into place.  Beyond this, the other organizer and I have been lucky to welcome such positive role models into our group.  I suppose that all this allows for a great start for a peer support group to get off the ground and even thrive.

I mentioned before that creativity saved me.  This is no exaggeration.  When I was in my last semester of my Theatre Performance degree at Concordia University, I was struck by the frightening hallucinations, and the disabling negative symptoms of schizophrenia.  After medication was in place, and the positive symptoms abated, I was left with no more ability to act, read, or write, or express thoughts or emotions.  After reading much information online about the chronic course of this disease, I thought that this impoverished state would be with me for the rest of my life.  However, there was a part of me that remained skeptical – the part which would ultimately carry me down the road of recovery.   I somehow knew that creativity would save me.  I also knew through my study of psychology that the brain is plastic, that there are parts of the brain which can compensate for others damaged by illness or injury.  I just needed the courage to try to act, to write, to paint, and to risk failure.  So, after a year and a half of suicidal despair, I began to reach out.  I formed friendships with others living with mental illness through Connections Clubhouse in Halifax.  I started writing, even though I knew that the product of my efforts wasn’t yet readable.  I acted in a Playback Theatre troupe, though my reaction time was delayed and my emotions were blunted.  I could feel just enough joy to keep going, and after working to let go of my ego and the desire to be good at the things I had once mastered, I was finally able to start to heal.  And, once I saw a drama therapist, something lit up in me.  Through an array of creative exercises, I saw bits of life force begin to emerge.  And I wished deep down that this was just the beginning.  And it was.  Never at the time had I thought that I would ever be well enough to return to school at a Masters level to become a drama therapist myself, but now, here I am.  Accepted, with a fellowship, and most of the way through my degree.  This year, my practicum involved working with other youth who have lived through psychosis, as a Drama Therapy Intern at the Douglas Hospital in Montreal.  I know in my heart that creativity saves people.  That it has saved me.  Through creating regularly, and fostering intellectually, emotionally stimulating friendships, my brain has found ways to compensate for the illness which almost took my life.

In my interview in Montreal for the Masters in Drama Therapy program, I was asked what area of research I would like to investigate, were I accepted.  I immediately responded by saying that though there was little research in the area so far, I would like to look into how drama therapy can treat the negative symptoms of schizophrenia.  The professor responded by saying that indeed, it was the only thing he had found that did truly work on this stubborn subset of symptoms.  He had just finished doing research at NYU on this very topic.

So, I wanted to talk a bit further about drama therapy and its incredible potential for treating schizophrenia.  I am fortunate to have been given permission by Professor Jason Butler of Concordia University to use some of his research in this discussion.  I will also reference John Casson from his book, Drama, Psychotherapy and Psychosis.

I want to repeat that medication and all psychosocial interventions are helpful, and often necessary, but drama therapy, though it is a newer intervention, also has it’s role.

Drama therapy, from its roots, comes from shamanism, ritual and storytelling.  Theatre has always been a healing art, and the process of catharsis often involved is a journey which transforms fixed ideas and stasis into fluid and adaptive realizations.  Drama therapy, as it is described today, is an application of theatre structures and processes of dramatic play with the intention of providing psychotherapy.  Its stories, metaphors and objects used create a safe distance from experiences too difficult or overwhelming to confront directly.  It involves reading and improvising roles, reading or writing poetry, play, building scenarios, drawing, telling stories with objects or dolls or metaphors.  The use of drama therapy for the treatment of psychosis is special because it allows one’s disintegrating ego to expand, to further define the boundaries between reality and unreality, and to recover a lost or fragmented sense of self.  It can help one to identify with themselves, and within a group, as practice for the real world.  The play space is a container in which therapy can happen – not real, but it can be a representation of reality.  One learns to get comfortable with the instability of life and to learn to remain whole in the face of it.

Drama therapy gives one a chance to play, to fulfill roles that one may have lost during the illness process, to play out roles that are adaptive, where one can truly engage.  Through the self-motivated nature of the creative process, one develops a sense of personal and social agency to address the problems in one’s life.

Also, drama therapy is useful for self-esteem building.  Who’s self-esteem is more damaged than a person suffering from schizophrenia?  It can heal depression, amotivation, lack of energy, apathy, and the negative symptoms of communicative blunting and delay perhaps better than anything else, according to a researcher in the field.  Drama therapy works on the disconnect between the body and mind, and the sensation of awareness or pleasure.  It breaks through rigidity and despair.  Playing out an emotion in the sanctity and safety of a drama therapy session gives one an opportunity to take what is discovered here and to use these lessons in real life.

Being abandoned by the system, as so many are, creates a rigidity and a loss of hope.  When one is given the opportunity to play out roles that were stigmatized out of one’s concept of what is possible, one is reconnected with a deeper, more adaptive and integrated sense of self.

Basically, to me it makes sense.  Piquing creativity and curiosity harnesses a sense of agency and autonomy, and engages our healing capacity, which is a creative and not a destructive power.  I have seen individuals I have worked with expand upon their temporarily limited communicative abilities through this creative process.

Discovery refers to the active role we all have in the search for meaning.  We have been searching for meaning since the beginning of time, which is why so many people turn to religion or science.  Learning to be active leaders and co-operators helps heal vulnerability and self-doubt through working with and even helping others.  Through evolution or divine right, we have found that discovering ourselves and our new, integrated identities, our omnipresent potential, and our fascinating wide open world, is what saves us from despair.  Creativity works against the destructive tendencies of suicide and indeed provides a helpful buffer against heartache.  It is the antithetical gesture to self-harm and self-destruction.  Through creativity and discovery, we move beyond the role of consumer, or passive recipient of services, and become an active explorer, one who heals the world, from the inside out.