Psychotic Disorders

The disorder-specific psychodrama therapy of psychoses was the first step toward the development of psychodrama as a psychotherapy method. In the as-if mode of play, the patient directly develops his rudimentary metacognitive processes that produce his dysfunctional delusional thought content with the help of the therapist as a doppelganger. He tries to develop his delusion production into a coping story. In doing this, the patient gains ego control over his delusional production as well as an insight into his illness. This stops the disintegration of his self. Over time, he learns to stop his production of delusional content in a self-determined manner. The method requires the therapist to be willing to give up his own natural defense against the absurdity of delusion and, as a doppelganger, to courageously engage transmodally with the patient’s symptom production. The author has adapted and expanded the methodological approach developed by Moreno to suit the conditions and necessities of the present time. The described disorder-specific psychodramatic action methods complement depth-psychological, behavioral, and systemic psychotherapy approaches to psychoses with a disorder-specific essential quality.