Psychotherapy

Mappsterview No. 8: Please stand up for Dan Tomasulo

Dan TomasuloPlease introduce yourself briefly

I’m Dan Tomasulo, MAPP 7. Since graduation in 2012 I’ve worked as an assistant instructor for Marty Seligman and James Pawelski. I’m also core faculty for the “Spirituality Mind Body Institute” at Teachers College, Columbia University in NYC where I’ve designed and teach the Optimal Well-Being concentration. I also direct the Open Center’s New York Certificate in Applied Positive Psychology (NYCAPP).

What did you do before joining the MAPP program at Penn?

Hmmm. Depends on how far back we are willing to look. 🙂 I’m a licensed psychologist and psychodrama trainer and work in private practice and consulting. I also have an MFA in writing and a few books under my belt. I have a daily blog called Ask the therapist at Psychcentral.com and write for Psychology Today as well.

What got you interested in Positive Psychology in the first place?

I went through a personal crisis and got depressed. There is nothing worse than a depressed psychologist. People would tell me what was bothering them – and I thought, Huh – you think THAT’S bad…wait until I tell you what happened to me. (I never actually said that out loud.) My best friend took me to the first International Positive Psychology Conference and I was hooked. I started doing things that made me feel better and despite all my years of training nothing seemed to be so directly helpful. That was when I decided to go to MAPP.

While googling you, I found a NYT article from 1983(!) stating you used to be a stand-up comedian. Can you tell us more about that?

Damn, I told you not to tell! 🙂 Yep, for a couple of years I was on the circuit. If you are a fan – this was back in the time of Andy Kaufman. I was mostly at the Improv in Hells Kitchen. But it was the same time I was finishing my Ph.D. I had to choose between comedy and psychology and that’s when psychodrama came along. I realized I could blend the two into a therapeutic form. Ultimately, I became a trauma expert using psychodrama to help people unlock the part of their soul that had shut down. Being able to use humor in the right amounts at the right time was part of the gift that stand-up gave me. It helps the healing when people have to touch some dark feelings.

(There is a wonderful story I will write about one day about the night Andy Kaufman told us of how “foreign man’s” “Thank you berry much.” Came about—but that’s a tale for another time.)

As stated above, among other many things, you facilitate and teach Psychodrama. What is that all about?

It is an action-oriented for of psychotherapy where we use role-playing to understand a situation, activate emotions, and correct them. In a group we will use auxiliaries to play the different roles the protagonist is talking about. If you are angry at your mother you would choose a person to play your mother and we would enact the scenes related to the issue. We use a variety of techniques to amplify and explore the emotions. We have people take on the role of someone’s feelings, their ambivalence, their compassion, or anger. It is more than simple role-playing however. The training is long (my post-doctoral training program was 13 years!) and you learn to manage dramas at an individual level, group level, and the community level. At one point I was hired by FEMA (Federal Emergency Management Agency) to use a special type of psychodrama to heal unrest in a community. It was amazing to see large groups of people respond to large-scale group dynamics with a healing result.

And how does Psychodrama tie in with Positive Psychology? Are there any parallels?

Just as psychology focused on the negative aspects and developed tools to alleviate suffering, psychodrama followed suit. Most of the training and the work was targeted at relieving pain. But the tools are so powerful that it seems the methods of psychodrama could be used to activate positive emotions in a way that strengthens and integrates.

This past summer at the IPPA conference in Montreal I was given the Avant-Garde Clinical Intervention award for the development of the Virtual Gratitude Visit (VGV). This technique builds on the original gratitude letter Marty researched. He asked students to deliver a letter of gratitude to someone they felt they needed to thank. This was one of the first pieces of research to show that the use of a positive intervention could improve well-being while stablizing depression for a period of time. In the virtual gratitude visit we use an empty chair to have the protagonist deliver a feeling of gratitude. They then reverse roles, become the person and answer, then reverse back. This is typically a very powerful and moving experience. People can do this with those that have passed on – as well as those they are no longer in touch with. Technically, with negative emotions you get a catharsis that acts like a purging. But with positive emotions you get a catharsis of integration. The expression of the positive emotions pulls together a miriad of feelings and integrates them. This creates a feeling of wholness.

I’ve developed several other experiential methods for use in exploring character strengths, forgiveness, resilience, best possible self, self compassion, etc. Each does a similar thing in using the psychodramatic methods to integrate emotions.

It seems like being a story-teller is an overarching theme in your life. Over the upcoming weeks, your memoir called American Snake Pit will be published. Here´s your space for some unbridled adulation.

American Snakepit - Dan TomasuloI am very excited that in April George Mason’s Stillhouse press will release my memoir, “American Snake Pit: Hope Grit, and Resilience in the Wake of Willowbrook.” This will be my second memoir and it tells the story of moving a group of very challenging people into the community. It gives a voice to those who could not advocate for themselves.

My memoir is in the spirit of “One Flew Over the CooKoo’s Nest”, “Awakenings”, and “Girl Interrupted”. It challenges the perception of mental illness and is the first memoir of its kind concerning the treatment of intellectually disabled and mentally ill patients coming from the infamous Willowbrook, a hell on earth Bobby Kennedy called a “snake pit.” But it is much more than a depiction of the horrors of the institution. It is the story of patients not just surviving, but flourishing for the first time in their lives, proving the resilience and hope of the human spirit. Their story is about what happens when intentional well-being replaces indifference.

American Snake Pit is the story of the disregarded souls who ended up in my care; of the eccentric, resilient staff who helped make such a momentous success possible; and about a blind spot in American history. Because of the success and the progress made by the inmates in group homes like these, mental health became a civil right in the United States. The Civil Rights of Institutionalized Persons Act (CRIPA) of 1980, affects all Americans. It is particularly important now as the right to quality healthcare treatment, and access is so politically charged. This is the story of how it all began.

Why it´s good to have Tea with your dead Aunt once in a while

In my late twenties and early thirties, I was really into Zen Buddhism. I took zazen meditation lessons (stopped it, I think it´s just not for me…), practiced martial arts, and read almost anything related I could get my hands on. I remember a story that was about conquering our fears, where a monk would lay his head inside a dragon´s open jaw – in order to rid himself of the fear of…well…dragons.

I deeply sympathize with this approach of “accepting what´s there” – it´s one of those crucial points where the more helpful spiritual and therapeutic traditions of East and West regularly meet and become friends (e.g., see Kristin Neff´s outline on self-compassion to get an idea for a more Western take on the concept).

I’ve got 99 problems and 93 of them are completely made up scenarios in my head that I’m stressing about for absolutely no reason. (multiple attributions)

John_CageWhile writing this, I remember another sage basically taught me the same lesson almost a decade before my deep-dive into Buddhism. One of my all-time favorites on TV is Ally McBeal. Every other year or so, I start another binge-watching weekend. I still love the affectionately exaggerated characters, the idea of visually externalizing the protagonists´ feelings, and the fabulous blending of music with plot and personal development. Here´s the dialogue that came to my mind:

John: I used to have a hallucination where my dead aunt kept wanting to have tea with me. It went for two years before I finally stopped her.
Ally: How did you stop her?
John: I had tea with her.

Here´s to our dead aunts!

Bibliophilia: How Reading and Writing can Save our Soul

MAPP is a fulltime program – but combines onsite classes with long-distance learning periods. Part of the distance learning comprises a lot of reading (…who would have thought of that…) and writing essays about a wide array of positive psychology topics. I´ve decided to post some of those essays here on Mappalicious. Surely, they´re not the be-all and end-all of academic writing. But then again, it would also be a pity to bury them in the depths of my laptop…

Library - Mind - Hospital

I´ve visited the center of the earth. I´ve travelled 20.000 leagues under the sea. And I´ve toured around the world in 80 days. Three times, actually. And most of that journeying happened while sitting in the bathtub of my parent´s home. When I was a kid, I used to be a semi-professional tennis player. Upon returning home after long weekends of tournaments, I would head straight to my parent´s bathroom and into the bathtub – to stay there for hours and hours, until my skin would be all shriveled. Most of the times, my companion (and therefore, first literary love) would be Jules Verne, or rather, those heavy editions with linen covers of Verne´s most famous novels that my grandpa gave to my father – and my father to me. Ever since that time, I have been an enthusiastic reader. My taste in books changed, obviously. In came Stephen King, Jostein Gaarder, Nick Hornby, Douglas Adams, and even Joanne K. Rowlings Harry Potter, among others. And out they went again. For several years now, I have been reading non-fiction for the most part. But the pleasure of reading remains. For me, it is an act of uttermost hedonic value. But that is not what this essay is all about. Instead, I will try to convey how literature informs our understanding of (psychological) well-being, and how reading and writing can have a therapeutic effect and build psychological acumen and resiliency.

In the Beginning was the Word

There are many descriptions and analogies for the unique quality of the human race. Common wisdom from biology holds that we are “homo sapiens (sapiens)”, the knowing (or discerning) man (Semino, Passarino, Oefner, Lin, Arbuzova, Beckman, …, & Underhill, 2000). But that is by far not the only description for the “pride of creation”. There are researchers who argue the most important feature that distinguishes man from his mammalian ancestors is our ability to create, remember, and narrate stories – that we are “homo narrans”: the story-telling men (Niles, 1999). Through the narration of stories, man used to recollect and still does recollect his own history, interprets it, and transfers it to the future generation(s), thereby shaping Hegel´s “world spirit” that strives to recognize itself (Hegel, 1822).

But storytelling is almost never done for sheer fun of it, or for objectively reporting was has been before. Telling stories, be it in traditional oral style, in print, or some audio-visual presentation mode, almost always has some instructive, some prescriptive quality to it. Whoever creates or narrates the story oftentimes wants to instill a change in the recipient, wants him to know or even be something else when the story is over. This educational facet of storytelling can be traced all the way through the literary history, from Homer´s “Iliad” and “Odyssey” and Aesop´s fables, to early religious accounts such as the “Upanishads” and the Bible, to medieval works such as Dante´s “Divine Comedy”, Shakespeare´s works of drama (e.g., “Hamlet”), to the early (e.g. Goethe´s “Wilhelm Meister´s Apprenticeship”) and later (e.g. Dickens´s “Great Expectations”) “Bildungsroman” – all the way up to 20th century masterpieces such as de Saint-Exupéry “Little Prince” and New Age classics along the lines of Bach´s “Jonathan Livingston Seagull” or Coelho´s “Alchemist”.

Oftentimes, this educational element is conveyed by carefully depicting the protagonists´ lifestyles – in order to then confront the recipient with the outcomes of these modes of existence. By way of example, both Leo Tolstoy´s “The Death of Ivan Ilych” (1886/2010) and Willa Cather´s “Neighbour Rosicky” (1932/2010) try to educate the reader (among other things) on the value of and human need for close relationships. While Cather portrays the distinctly positive outcomes of understanding that “no man is an island”, Tolstoy´s narrative describes Ivan Ilyich as a human being that literally dies of social and emotional isolation. So, while both stories do not contain any “how-to advice” such as modern self-help books, it remains unequivocal that they try to convey some underlying and implicit understanding of human well-being, that they represent a prescription for “a life well-lived”.

It´s never too late to have a good Childhood*

A special and utmost important kind of story is the story that we tell about ourselves – to ourselves and other people. On that note, psychotherapy has long since discovered the importance of stories and story-telling. It´s not for nothing Freud´s Psychoanalysis is frequently referred to as a “talking cure”. More and more evidence emerges for the notion that being able to convey a coherent and meaningful account of one´s life is a fundamental building block of psychological well-being (Baerger & McAdams 1999). This idea is not only part of the academic literature, but also an important element of pop culture such as the “connecting the dots” element in Steve Jobs´ hugely popular Stanford Commencement Address (2005).

By now, there exists a multitude of ways that stories and storytelling are consciously imbedded into the psychotherapeutic process. By way of example, the branch of “Narrative Therapy” (Monk, Winslade, Crockett, & Epston, 1997) distinctly focuses on those (life) stories that a client brings into the therapeutic setting. Taking on another angle, Cinematherapy (Sharp, Smith, & Cole, 2002) and Bibliotherapy (Cuijpers, 1997) use the potential healing power of existing works of literature, poetry, and film to sow the seed for desirable changes in clients´ mental models and, subsequently, behavioral patterns. Taking on a more active approach, Writing Therapy (Pizarro, 2004) offers relief for patients suffering from severe stress and psychological trauma through the act of writing one´s own account of those stressful events. While the raw facts, the objective events that happened in the past, cannot be altered any more, it is very much possible to change once rational and emotional perception of that same past. It is absolutely possible to “come to terms” with one´s life history, e.g., by consciously creating mental distance to it, by altering its emotional valence, or retroactively finding a deeper meaning in what happened to us earlier (Pennebaker, 1997). Especially the act of discovering a heightened sense of meaning and purpose in life – which is a sign of post-traumatic growth (Tedeschi & Calhoun, 2004) – seems to have very beneficial on our psychological well-being (Singer, 2004).

But the favorable outcomes of writing are not limited to the stories of our past. Some psychologists, especially in the emerging field of Positive Psychology (Seligman & Csikszentmihalyi, 2000), stress the importance of (possible) future events for our well-being. Seligman, Railton, Baumeister, and Sripada (2013) describe the human species as beings that are drawn by the future rather than being driven by the past. As such, actively engaging in the creation of a desirable future is a sign of optimal psychological functioning. On that note, positive psychologists have tried to create interventions that help to consciously facilitate the process of optimistic prospection. One of these interventions is based on visualizing and writing about one´s “best possible self” – where subjects are instructed to “imagine yourself in the future, after everything has gone as well as it possibly could” (Sheldon & Lyubomirsky, 2006, p. 77). Doing this regularly has shown to boost satisfaction with life and an optimistic mindset, among other things – even beyond the time of actively carrying out the exercise.

To draw to a close, I´d like to cite Joseph Campbell, the famous mythologist who discovered that most well-known stories follow a very similar pattern, the so-called “Monomyth” (“The Hero´s Journey” in the pop culture). Campbell once said in an interview: “We must let go of the life we have planned, so as to accept the one that is waiting for us.” Campbell´s monomyth theory posits that compelling stories can typically be structured into twelve different stages (Lang & Trimble, 1988). In stage eight, the hero is supposed to find a magic elixir that will help him to overcome his enemies and bring long-desired changes to the world from which he originally came. Personally, I hope that Positive Psychology will be mine…

References

Andrews, D. H., Hull, T. D., & Donahue, J. A. (2009). Storytelling as an instructional method: Definitions and research questions. Interdisciplinary Journal of Problem-based Learning, 3(2), 6-23.

Sharp, C., Smith, J. V., & Cole, A. (2002). Cinematherapy: Metaphorically promoting therapeutic change. Counselling Psychology Quarterly, 15(3), 269-276.

Baerger, D. R., & McAdams, D. P. (1999). Life story coherence and its relation to psychological well-being. Narrative Inquiry, 9(1), 69-96.

Cather, W. (2010). Neighbor Rosicky. In Obscure destinies (pp. 1-38). Oxford, UK: Oxford City Press. (Original work published in 1932).

Cuijpers, P. (1997). Bibliotherapy in unipolar depression: A meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 28(2), 139-147.

Hegel, G. W. F. (1822). The philosophy of history. New York: Dover Publications.

Jobs, S. (2005). Stanford Commencement Address, retrieved from: http://www.youtube.com/watch?v=UF8uR6Z6KLc

Lang, J. S., & Trimble, P. (1988). Whatever happened to the Man of Tomorrow? An examination of the American monomyth and the comic book superhero. Journal of Popular Culture, 22(3), 157-173.

Monk, G.,Winslade, J., Crockett, K., & Epston, D. (Eds.). (1997). Narrative therapy in practice: The archaeology of hope. San Francisco: Jossey-Bass.

Niles, J. D. (1999). Homo narrans. The poetics and anthropology of oral literature. Philadelphia: University of Pennsylvania Press.

Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8(3), 162-166.

Pizarro, J. (2004). The efficacy of art and writing therapy: Increasing positive mental health outcomes and participant retention after exposure to traumatic experience. Art Therapy, 21(1), 5-12.

Seligman, M. E., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5-14.

Seligman, M. E., Railton, P., Baumeister, R. F., & Sripada, C. (2013). Navigating into the future or driven by the past. Perspectives on Psychological Science, 8(2), 119-141.

Semino, O., Passarino, G., Oefner, P. J., Lin, A. A., Arbuzova, S., Beckman, L. E., … & Underhill, P. A. (2000). The genetic legacy of paleolithic homo sapiens sapiens in extant Europeans: AY chromosome perspective. Science, 290(5494), 1155-1159.

Sheldon, K. M., & Lyubomirsky, S. (2006). How to increase and sustain positive emotion: The effects of expressing gratitude and visualizing best possible selves. Journal of Positive Psychology, 1(2), 73-82.

Singer, J. A. (2004). Narrative identity and meaning making across the adult lifespan: An introduction. Journal of Personality, 72(3), 437-460.

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic Growth: Conceptual Foundations and Empirical Evidence. Psychological Inquiry, 15(1), 1-18.

Tolstoy, L. (2010). The death of Ivan Ilych. New York: SoHo Books. (Original work published in 1886).

Vaughan, S. C. (1997). The talking cure: the science behind psychotherapy. New York: Putnam and Sons.

*That phrase is most commonly attributed to Novelist Tom Robbins.

Header picture taken from the Facebook fan page of Random House, Inc.