Unique Interactive Style of Learning Can Reduce Social Anxiety
Ten years ago, I was asked by the Asperger Autism Network of New England (A.A.N.E.) to run a group for young adults who wanted to learn the basics of dating and romance. At that point in my life, I had been an attorney, a divorce mediator, a life coach, and was beginning my training as a psycho dramatist.
Throughout all of these transitions, I continued to perform as a professional improvisational actress and comic. My response to the request was to say, “Yes, and can I run it as an action-based group as opposed to a support group?” This “Yes, and…” is the foundation of improvisation. Its true purpose is the progression of social interaction. In my work with this group, and others, I have come to discover that this “rule” forms an essential part of working with any group where the goal is learning to be spontaneous and expanding social capabilities.
During the dating group’s two year run, the members learned from one another how to take risks, to be spontaneous, how to listen to the “other,” how to read and appreciate the other person’s perspective, and how to “share the limelight.” The group taught me that a central problem for individuals on the autism spectrum is that they struggle with the process of starting a social interaction and then keeping it moving.
This group was an exploration to determine whether employing elements of improvisation, psychodrama, theater games, and a dash of spontaneity” could be useful in helping individuals on the autism spectrum to acquire social skills that might be generalized from my office to the real world.
“Paul” was a charming, sensitive 16-year-old boy who participated in one of my teen groups working on enhancing social skills. He had been diagnosed with autism spectrum disorder (ASD), had marked anxiety, and severe Attention Deficit Hyperactivity Disorder (ADHD). One of the things that I came to learn about Paul is that he managed his ADHD symptoms through athletic activities such as competitive and non-competitive sports. Sitting left Paul feeling as if he would “jump out of his skin.”
One morning, Paul told the group he wanted to work on his competitive behaviors as he had some thoughts that this might be getting in his way socially but he was unclear as to why. I asked him to share an example drawn from his personal experience. Paul described playing games of Ultimate Frisbee. It was a favorite activity, permitting him to burn off excessive energy helping him to deal more effectively with his ADHD and anxiety.
It was also one of his strategies for making social connections. The problem was that Paul took the game quite seriously. The other peers with whom he played were in the game solely for fun. “Ben” was one such team member. Not particularly physically adept, he often dropped passes and could not keep up with the game. With each dropped pass, Paul became increasingly frustrated and his shouts of Ben louder and louder. Ultimately, he would have to leave the game to “take a run” as a means of managing his feelings. Often, after he had regained control, he would return to an empty field.
Paul had joined my group because he wanted to make “real” friends. He thought these Ultimate Frisbee pick-up games would be the perfect vehicle. He was aware of his competitive nature but had no idea how any of these feelings or behaviors were experienced by the others. His intensity was off-putting and, while the other kids agreed to play, it did not translate into meaningful friendships. Paul told the group that he knew that Ben was a nice person and that there was no reason to be angry as there was nothing at stake in losing. In fact, he always thought of Ben as a possible friend.
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To help Paul, I asked him to set the scene. We created a space in the room to be the “field” and Paul picked one of the other group members to be Ben. A Koosh ball replaced the Frisbee and Paul and the other boy recreated the moment where the Frisbee was dropped. Paul yelled, “Ben!” with the same volume and tone as expressed in the story.
Standing behind Paul I “doubled” him. Doubling is a psycho dramatic technique. Using my experience of Paul’s words, actions, and emotions, as presented in the presented scene, I verbalized what I believed he was experiencing but was unable or was unwilling to say. Speaking as if I was Paul’s inner self, I said, “Damn it, Ben! You’re a terrible player. Why do you always have to drop it? Why aren’t you any good? You shouldn’t be in this game.”
I took Paul’s internal and unsaid emotional experience and made it external and available for Paul and the group to hear. Following the double, one always checks the accuracy of the statement. If the double is accurate, the individual feels heard, understood, and validated. If the double is inaccurate, the teen is given the opportunity to correct the statement which helps him/her share what they are truly feeling thus creating a stronger bond with both the group and me. I asked Paul if my statement felt correct. Shocked, he said, “How did you know what I was thinking?”
I then asked Paul to “reverse roles” with Ben and replay the scene. Now Paul was the one who dropped the ball and the other child, who was now in Paul’s role angrily yelled, “Oh Ben!!” When Paul heard how angry he sounded, he was appalled.
I looked at Paul and said, “Speaking as Ben, tell me what Ben is thinking and feeling as he gets yelled at by Paul. What is his inner monologue?”
As Ben, Paul responded, “Holy shit. Paul is really angry at me and I don’t know why. It’s supposed to be a fun game. Maybe I shouldn’t play.”
“Is that true that you don’t want to play even though you’re not perfect?” I asked.
Speaking as himself Paul replied, “I guess that’s not really true. I think he would still want to play even though he’s mad at me. He would just avoid me.”
Paul began to appreciate that his demeanor was experienced by others as being very aggressive. I asked the group, “When Paul yells, what do you think Ben is feeling or thinking?” One boy started to speak about how anger can push people away.
“Okay,” I said. “Double the role of Ben. Say out loud what you think he or anyone might be thinking and feeling when Paul sounds that angry.” It is very important for the group to be the main source of the doubling. It pushes them to think about how actions, tone of voice, and body language can affect any relationship. It also permits the group members to be empathic towards one another. It is very hard for anyone to double, to try to understand and express the feelings and thoughts of another, that is, to take “the other person’s perspective.” This is an essential problem for individuals with autism.
We replayed the scene over and over, the toss, the drop, the “BEN!!” Following each “BEN!!” each young man said aloud what he thought Ben might be feeling. Some of the doubles were, “Why is Paul so mad?” “I thought this was supposed to be fun?” “Why is Paul taking this so seriously?” “I’m not coming back next week,” and “Paul is a jerk.”
As he took it all in, Paul’s eyes filled with tears. He felt bad for Ben since it was never his intention to hurt anyone. The “problem” was clear and now the question was how to fix it. The thing Paul wanted was for Ben to try a little harder in the game and, hopefully, to become friends. Unfortunately, he had no idea as to how to accomplish this. We returned to the scene and began the process of “role training,” the process of learning how to develop new role behaviors.
Paul, realized that his “usual response” did not get him what he wanted. He had to learn what the role of “understanding friend” meant and how to embody it. This had never been his norm. We did this in action with the entire group playing a collective Ben. Paul threw the ball, Ben dropped it, and instead of yelling his usual “Ben!!” I asked the group, “What are some different ways Paul could address Ben?”
Members of the group tried alternative approaches such as, “Hey Ben, don’t worry it’s only a game;” “Hey Ben, maybe you should be on the other team;” and “HeyBen, why don’t you just watch?” After each new response I asked everyone, “From the perspective of Ben, would that work?” Ultimately the response that felt the most comfortable and achievable was some version of “Don’t worry,” and “Would you ever want to get together and practice?,” This response achieved, for Paul, the ultimate goal (a better player and a social connection) while still feeling true to himself. He left the session promising to try it out during the next game and report back to the group.
Though the story focused on one individual, each boy saw a part of himself and his struggle in Paul and his actions and feelings.
This was an emotional piece of work for the entire group. It is my practice that, following such intense work, that I engage the group in an activity that is playful and fun but also reinforces the skill that we have practiced. Typically, this is an improv game which creates laughter that releases the tension.
The game I chose for everyone to play that day was “Yes and…” This is a game of progression based on the improv rule to always say, “Yes and” that initially lead to my interest in this mode of work. The goal of the game is to keep the scene going forward by using “Yes and…” Accepting an offer and then throwing out the next one, moving the scene forward. The game ultimately becomes an absurd but enjoyable one-upmanship. The skill that it stresses is how to accept a situation (“I’m competitive”) but not get stuck in it (“Want to practice together?”).
Paul and the group left that day with a new understanding of how to take the other’s perspective. The following session, Paul reported to the group that he tried the new approach and felt less angry and actually enjoyed practicing with Ben, “but he still dropped the Frisbee.”
This article was featured in Issue 75 – Helping Your Child with Autism Thrive