Under stressfull circumstances at work, a middle aged man had three migraine attacks. In a psychodrama session we decided to roleplay with the migraine. A female group member was chosen to play the migraine. Exhibiting the disease, she sat there, dressed in black, strong, rigid and, as she said, ready to attack any moment. A role-exchange was performed: the lady took place on the man's seat, while he took place on hers, the migraine seat. There, he experienced what this was like: strong, autonomous, not afraid for anyone at all and a little 'mephisto-like'. At this point, the man remembered that his mother used to say, that, sometimes, he could be like that: somewhat smart-looking, amused, feeling rather superior and not sensitive to pressure whatsoever: ruling the world.
The man then realised that he had lost these 'qualities' over the years. Actually, in the circumstances of his work, one now and then needed qualities like this to stay upright and withstand individual jerks or unreasonable expectations. He had become 'too nice' for the circumstances and as the saying goes: 'You pay a price for being nice'.
On the other hand -but this insight followed some months later- the coolness and solitary isolation of the migraine in the psychodrama, like a cartoon, depicted some of the ill-characteristics of his sphinx like freezing under the stressed circumstances. Actually, we may recognise the last version of three different way of reacting to stress: fight, flight or 'freeze'.
Psychodrama with physical disease may show two sides of the coin: it may show potentials one needs, to cope with situations that may have contributed to getting ill; and it may show what is wrong in the way one was coping so far.
When stressed again, this man reminded and relived the psychodrama and the experiences on the migraine-chair. After becoming more expressive and communicative, the migraine did not return.
This way of working reminds of Alvin Mahrer. As a therapist in working with cancer patients, he identified with the patient's cancer and 'spoke from thereof'. In rather rough lines, very straight, he would tell the patient how the patient, f.e. had given in to other people and had wasted his strength, autonomy and decesiveness. In Mahrer's view, he identified with 'the cancer related potential': qualities and power that actually belonged to the patient himself, but that had got 'split off' or dissociated. When more appropriate psychodrama is done -and it works out well in monodrama, too- the patient easily feels what it is like to be this autonomous, self-aware, expressive and not frightened at all. This experiential shift seems more strong than cognitive-instructive appoaches.
