TSM Six Safety Action Structures American Society for Psychodrama, Sociometry and Group Psychotherapy

The TSM Six Safety Action Structures have been developed and used to concretize spontaneity and provide containment and group cohesion for all Therapeutic Spiral Model (TSM) groups for several decades now (Hudgins & Toscani, 2013).  The original paper on these safety structures (Cox, 2001) is available on my website at www.drkatehudgins.com.  This handout is an expansion on the original use of the structures with examples of how they can be used in individual, couples, group and family therapy, as well as in communities and organizations.  At the workshop, they are presented in action just as they would be used to start a TSM group in any of the above settings.

 

The Observing Ego Role

The Observing Ego Role (OE) is the first role that is concretized to establish a cognitive container and a place for protagonists to role reverse in case they get overwhelmed with too much intense affect during experiential work, thus preventing re-traumatization of the brain for trauma survivors. It is described as a role that watches your self with neutrality and without judgment—just collecting the facts without shame or blame so that change is possible. It is a role that helps keep people in the here and now so they can be spontaneous and begin to see what is a possible new response to an old trauma pattern or an adequate response to a new situation (Moreno & Moreno, 1969).

Often called the Observing Eagle from many First Nation’s peoples we have worked with in Canada, this is the first role anyone must develop in adult life if they are to learn to stay in a state of spontaneous learning. Like the eagle, it can be imagined as flying above your life, taking in all that is happening with razor sharp eyes, and knowing when there is safety and when there is a need to dive out of the sky for protection or to scare off a predator or eat a prey animal.

The OE role is established by putting out a set of inspirational cards on the stage and asking group members to pick one or more that they feel can help them to see themselves without judgment.  They are then asked to share why they picked them in pairs to build group cohesion and move gently from words to action. The Director can ask additional questions and continue building the sociometry in different pairs or form pairs into small groups of 4 or 6.  After the sharing, they put the cards on the wall somewhere so this role is available at all times during the workshop in case someone gets confused or overwhelmed.  If not used during a drama or a workshop, the person can be role reversed into it at the end of a session to see what the OE card has witnessed about his or her change to anchor it back into words.

The choice of what type of inspirational cards depends on whether you want to appeal to the creative right brain through visual images or the left brain through cards that primarily have words on them.  As you can see from today’s TSM Animal Cards, we use pictures and simple words to begin a new group hoping to activate both sides of the brain for full spontaneity.

Demonstration of Mario Cossa’s Teaching Structure on the OE helps people who have suffered trauma and are easily triggered during action work clearly see the difference between the OE and being triggered. This is now demonstrated in action.

 

Circle of Safety

When people enter the room for a TSM workshop, they are greeted by a pile of richly textured and colored scarves in the center of the room with the OE cards around them showing pretty and inspirational pictures and words.

After picking a card for the OE and taping it up on the wall somewhere, the 2nd Safety Action Structure, the Circle of Safety is put into action.  Here people are asked to identify their own and others strengths—intrapsychic, interpersonal, and transpersonal so that they can move closer to the state of spontaneous learning with strengths in place. Putting the scarves in a circle immediately creates a stage area, as well as room for people to be in the more observing audience role.  It also serves as a visual container showing that the symptoms of PTSD such as body memories, flashbacks, and dissociated affect can be contained.

In small groups people can be asked to pick up their own strengths (Western way), recognize strengths in others (Asian way) or do small Playback scenes of folk stories, myths or positive family scenes in larger groups.  However, it is done, the group ends up with a Circle that clearly defines a stage area and reminds everyone of the multitude of strengths available to deal with trauma as it surfaces slowly in the group.

A good example of using the Circle of Safety in individual practice is to help a client contain a flashback.  As someone starts to warm up to a flashback and is losing spontaneity, the Director can ask the client to stand up and find 3-6 scarves of strengths that can create a circle out in front of his or her chair, somewhere in the room that shows a place to put the flashback in this Circle of Safety and not have to repeatedly re-experience it again.  The Director also adds scarves to help solidify the circle by bringing his or her own strengths to the session.  Then with the flashback projected into the circle, the client can take some deep breaths, soothe the body, and then begin to examine the flashback for information about the past, by bringing it into the containment of the present moment surrounded by strengths.

Another use for couples of families is to have each person define their own Circle of Safety and strengths they bring to the session. They can then place them solely around themselves, overlapping with others, or co-create a separate circle that is for the relationship.  It is always interesting how this simple exercise can show all sorts of enmeshment, codependency, defenses, and also healthy connections of tele.

 

Spectragrams

Spectragrams are a sociometric tool for assessing behaviors in the present moment on an imaginary line with two points ranging from one to 10.  As the Third Safety Action Structure in TSM it allows the group to take the next step toward action and group cohesion that provides the safety needed for full spontaneity.  Questions are asked following the format of strengths, defenses, trauma and feelings, and finally transformation so there is a predictable path to spontaneity.

There are several creative ways to use a spectrogram. We always start out with having two Action Healing Team auxiliaries show the imaginary line by miming unrolling a ball of string and then stretching it between the two of them and playing with in like jumping rope, a tug of war and other nonverbal cues.  This helps the right brain to again begin to visually see the line in terms of color, energy, and spontaneous play helping them to engage in the activity as fun.  You can then have people on the line talk one by one, talk in dyads or talk in clusters with someone reporting the theme of each cluster.  To increase the spontaneity, the Director can add sound and movement to show where people are on the line without words.  My favorite way to bring people to spontaneity is to create a sound wave when people are pretty evenly spaced out on a criterion.

When I was working in China with the first responders of doctors, nurses, psychologists, social workers, and teachers during the 2008 Earthquake, I asked people to place themselves on the imaginary line on the criterion:

0—-I have no hope of helping people who have lost so much from the earthquake to 10—-I have high hopes I can help people heal from this awful trauma. People were fairly even spaced from 1-10.  So, I asked the first third who had little hope to make a sound, which as you can imagine was sad, mournful, and whimpering.  The middle group made a sound that had some oomph to it but was also filled with wavering and movement back and forth.  Finally, the group that was standing between 8-10 made their sounds and yelled loudly of hope, strength, helping, and holding each other’s pain.  After they had all done the sound once in each group, I then created a Sound Wave by having them do, 1, 2, 3 from the mournful fears to the high expectations of hope.  Then back again from 10 to 1 and finally, a third time back up to end on the end of high expectations.  Together this gave people a chance to spontaneous express their feelings without having to go into a lot of details about why they felt hopeless or hopeful and brought people together by showing the people who were currently is a state of strength and spontaneity, not overwhelmed by the horror of the earthquake.

 

Hands on Shoulders

The 4th Safety Action Structure is another sociometric tool that helps people become more spontaneous and builds group cohesion.  By asking people to make sociometric choices for others, it helps in a number of ways. First, it teaches people how to make choices for others to play roles in a drama, which is a good warm up for when they are protagonists.  Second, it allows people to have the sense of being chosen as the star on criteria, a dyad, or an isolate or unchosen member.  This also allows the Director or Team to assess what roles people are chosen for and which they are not and to help maximize group choosing by picking different criteria.  As with spectragrams, hands on shoulders, also follows the classic TSM structure of strengths, trauma-based roles, and transformative roles as needed.  Finally, this exercise can be used to find where there is tele, projections, and transference in the group making it overt rather than covert, and thus much safer.

When I was working with a small business where there was a lot of group conflict among the 20 people working there, I used hands on shoulders with the following questions.

• Who would you pick to play the role of your courage in this group?
• Who would you pick to play the role of someone in your life outside of the group that you can tell them how you struggle sometimes at work?
• Who would you pick to tell something to that you have been meaning to say? (Can be positive or problematic)
• Who would you pick to tell something difficult to them about how they are affecting you at work?
• Who would you pick to be a person you can count on at work?

While these are simple, yet possibly loaded questions, the structure of hands on shoulders kept people connected to their strengths, both personal and interpersonal outside the group as a start, helping them to stay in the present and be spontaneous for the next few real here and now questions.  Further the structure of placing their hand on someone with whom they were having difficulty allowed them to look at the person and with the support of a Containing Double (Hudgins & Toscani, 2013) if needed, to say what they had been too scared to talk about without structure to stay spontaneous and creativity.  

 

Circle Similarities or Step in Sociometry

What was originally the Fifth Safety Structure is most often moved to the next day of a TSM Trauma workshop so to end the initial evening with an emphasis on strengths rather than trauma, but can in many situations still be used to build group cohesion and naming both strengths and difficulties that people have come to deal with in the session, workshop, or training.  Like the other two sociometric interventions, Circle Similarities starts with questions about stepping in on strength-based criteria, then the sharing of traumas, and finally spiraling back up to transformation.  This allows the group to put into words with the traumas or difficulties are that they share so they feel connected to others in the group, counteracting feeling of being alone with traumatic experience.  It also allows the Director or Action Healing Team to assess people’s needs to not go into dissociation or uncontrolled regression before they actually move into action related to trauma.

In a typical TSM Trauma workshop (of various names), the team begins each set of questions and then asks group members to spontaneously call out things they want to know about the group “popcorn style”as taught to us by Connie Lawrence at the workshop for Female Veterans of the Iraq war during a research project this past August, 2013.

A few examples from each set of questions that shows the way to start with strengths, gently move into traumas, and come back up to transformation follows.

 

Strength Questions

• Step in if you are the oldest (middle, youngest only) child.
• Step in if you have a pet.Move how your pet moves.
• Step in if you feel some excitement about the workshop even if you are scared.

 

Defenses Questions

• Step in if your favorite defense is rationalization and minimization.
• Step in if your frequent default is dissociation even when you are safe in the here and now.
• Step in it you find yourself projecting anger and blame toward others to keep yourself safe.
• Step in if you have had or still have an addiction or eating disorder.

 

Trauma Questions

• Step in if you have experienced difficulties with your parents as a child.
• Step in if you have been verbally abused or criticized to the point of it hurting your self esteem.
• Step in if you have been sexually abused.
• Step in if you don’t believe your trauma is as serious as others.

 

Transformation Questions

• Step in if you have told at least one person in your life most of your full story of trauma.
• Step in if you have received support from a friend you told about your experiences.
• Step in if you have a belief in a higher power that has helped or you believe can help you in your healing.

During each one of these criteria, the Director decides whether to have people share verbally, show in sound or movement, or simply step in and out.  As mentioned after the team would do several of these criteria, always ones that they can self-disclose about to decrease shame for others, then it is opened to the group to see if they have questions they want to know about others.

 

Art Project

The sixth and final TSM Safety Action Structure was developed by Francesca Toscani in the early days of the development of the model to help people have an external container for their strengths, traumas, and transformation.  She says it is also a way to show the unconscious as a thread throughout the weekend and most people seem to really find it a fun and relaxing way to end the day each day of a TSM workshop.

We have done sand trays, collages, dream catchers, containers, face masks, and soul maps to name a few, but you can really choose any art project that people can make individually or as a group.  Just remember to follow the TSM structure of first putting strengths on the project, then putting defenses and trauma and finally seeing the transformation that has happened by the end of the workshop as new objects complete the project.  Then, they are presented to the group either through simple sharing or by role reversing and giving a message to the individual or group.

 

Conclusion

While this is just a short article about the TSM Six Safety Action Structures there are many more examples that could be given, or that you can create on your own.  Knowing what the clinical reason is for each structure helps you know how to adapt it to your own use in individual, couples, family, group, education, or community and organizational settings.

In the end, when completed as the beginning of a group or a workshop, these structures concretize spontaneity through the here and now of the OE, the strengths of the Circle of Safety, and the sociometric exercises to build group cohesion and name trauma before moving them into further action, thus always guaranteeing safety and containment.

 

References 

Hudgins, M.K. & Toscani, F. (eds) (2013.  Healing World Trauma with the       Therapeutic Spiral Model:  Stories from the Frontlines.  London:    Jessica Kingsley Publications.

Moreno, J.L. & Moreno, Z.T. (1969)  Volume Two of Psychodrama.  New York:  Beacon House.