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Working between cultures: The drama therapy internship experience of an American-born Chinese Gradua
Photo credit: Jonas Verstuyft
The NYU Program in Drama Therapy has, for many years, maintained a clinical internship site at Hamilton Madison House, a community-based multi-service organization in Manhattan’s Chinatown. Hamilton Madison House offers a broad range of clinical and community services, from mental health care to substance abuse treatment to services for the aging and for the very young. Often graduate students in drama therapy, whose primary language is Mandarin or Cantonese or whose cultural identity as American-born Chinese (ABC), have a strong interest in developing their clinical skills within their duplex or multi-plex cultural identity parameters. These students may seek out this internship as a place to develop and explore their burgeoning clinical (within their cultural) experience.
As educators and students applying a critical lens to our work in the creative arts therapies, we want to be able to translate the Anglo-Western theories and methodologies of praxis in which we are trained (or that dominate training programs in the US) to culturally relevant and meaningful practice. We also want our graduate students to create from within their identities new and better approaches to theory, praxis and practice.
There are currently no drama therapists to supervise drama therapy interns at Hamilton Madison House.So, students are dually supervised by the Clinical Director, a clinical mental health counselor on site (who is a Chinese-American) and by their drama therapist internship coordinator (who is a white, cis-female, European American) to ensure that the students are afforded a breadth of clinical support across theories, experience and culture.
Lantie Tom (LT) who identifies as ABC, is a current student in the NYU Program in Drama Therapy. This conversation between Lantie and her drama therapy internship coordinator, Maria Hodermarska (MH), is intended to explore the challenges and the benefits of conscious work across culture for student interns as part of a larger effort towards critical pedagogies in the creative arts therapies.
MH: Can you describe for the readers how we have structured your clinical supervision process?
LT: As a student, I receive both individual supervision and group supervision (in class) within the Drama Therapy program. Your feedback and that of my peers, serves as guidance for ethical practices and general approaches to integrating drama therapy in individual counseling and group therapy.I receive individual supervision and group supervision from the clinical director at Hamilton Madison House. He is a licensed mental health counselor. Combined, input from both supervisors offers me complementary guidance that in my opinion, satisfies the clinical-creative needs of the client as well as University and government regulations.
MH: As I do not have the culturally relevant experience to fully understand the cultural, linguistic and immigration issues faced by the people in your care at Hamilton-Madison House, can you describe the needs presented by the people who you support there?
LT: Many of the adolescents we serve suffer dysfunctions resulting from severe cultural parenting, experienced dissonance between American and Chinese cultures, and tension between pride and shame endemic to acculturation. Some of the middle-aged and elderly clients I work with are in recovery from severe illnesses and trauma that occurred in the motherland and as immigrants in the United States. Some do not speak English at all, many are eager to learn English, and many of them speak more than one dialect. I have noticed that within Mandarin Chinese, the words used for “mental illness” are highly stigmatized (more so than in English), which at times, makes addressing recovery a delicate task, and one that is better served through metaphor and nonverbal communication.
MH: How would you characterize this hybrid supervision process? Does it meet your needs?
LT: While the clinical supervisor at my site is familiar with the presenting problems and histories of my clients, he also understands the significant challenges and stressors of immigration, English language learning and cultural taboos around mental illness that are experienced by people of Chinese heritage. As his approach is primarily psychodynamic, he has guided my conceptualization of cases in which disruptions in attachment are central to the issues presented. He has for instance, provided valuable insight into the transference of a client who struggles with depression and issues of identity, and the correlation to the client’s lack of stable attachments as she grew up.
My clinical supervisor responds similarly to our cultural norms, around a more limited set of responses to embodiment and playful dramatic enactment. I see myself as a shy person and perhaps a little recessive when I’m at school. But at the site, I am the dramatic one, the spontaneous one, the clown, the expressive embodied therapist with initiative.
On site, I recall your (MH) guidance and try to mirror your model of aesthetics and adaptability to my clients. At school, I mirror my clinical supervisor’s model of planning treatment for measurable outcomes. The breadth of space between you two (physically and stylistically) has provided me ample space to mirror and internalize both of you when I need to, and to fashion the tools in my own style. What I have found is that your complex and sometimes contrasting interpretations of the people that I see, adds to the picture I have of them. Your cultural distance and knowledge has, therefore, challenged me, broadened my perspective, and offered space for a wider scope of possible interpretations, inspiring hope and stimulating creativity in the process.
MH: Can you discuss the people that you support at the site and how their diagnoses and cultural experience present in the treatment space?
LT: On site, my peers and I have discussed the passivity and rejection of help that is common to our aging population, and identified the roots of this resistance as cultural. When encountering these impasses with clients, instead of driving around in circles or feeling like I am at a dead end, I have been able to understand and circumvent resistance through the theory and techniques of Drama Therapy, and with the guidance of both supervisors. Landy’s (1993) role taxonomy, for example, (both the English and Mandarin versions (Yang,2016)) has been very useful for assessment and intervention, as have Developmental Transformations (Johnson, 2009) and the use of projective techniques.
There are times during on-site group supervision, that the best intervention or approach I can offer my peers, who are counseling and social work students, is a drama therapy technique. Although all therapy requires work and courage, the embodied exploration of archetypes and metaphors yields profound insights and catharsis, and therefore, can sometimes feel magical. Magic is what many clients hope for when they come for therapy, and it is the magic that inspires hope in the client as well as this clinician.
MH: Can you speak to where there have been gaps or challenges remain for you?
LT: My challenge remains to integrate theoretical approaches outside of drama therapy with culturally appropriate levels of embodiment, and revise my concept of therapy for a population of Chinese immigrants in recovery from severe mental illness.
MH: Can you give an example of when the opposite held true, when through distance of my perspective you discovered useful information?
LT: Yes! There was an instance, when I was challenged in one group. I had been baffled over why people from a so-called collectivist culture would consistently obviate all my attempts at fostering group cohesiveness. You reminded me that Western drama therapeutic theories are constructed on individualistic notions of performance, a person enters the circle to perform a sculpt or is passed an object to transform, the spotlight is on the individual. Once I began to reexamine and deconstruct therapeutic interventions from Western, individualist concepts, my own cultural compass was set in motion, resulting in an unusual level of collective responsiveness from this population. Another example, is an approach to facilitating sociometry, check-ins and warm-ups (which was modeled for us by Dr. Craig Haen, our professor of Projectives Techniques). Instead of waiting for individuals to volunteer any verbal participation or self-disclosure, I have been asking them, “Who would you like to hear from?” or “Who do you think we should hear from next (Haen, C. personal communication, October, 2018)?” This has been effective for empowering individuals to activate personal agency to serve the collective good. It reduces the pressure on each individual to volunteer information, and encourages social connections when shame and social isolation are prevalent. It also serves as a sociometric indicator of how the group’s individuals relate to each other on that given day. After several weeks of employing this method, the group has successfully reached a place where they are working well together.
MH: So, what is the or an answer for students, like yourself, who are working at the intersections of culture and identities about how to address cultural discrepancies in their supervision process? How can students and supervisors work together, with and through difference, meaningfully, in order to expand cultural awareness in theory and practice?
LT: I have been blessed to have two very different, very supportive supervisors. Receiving their humble curiosity and enthusiasm from both directions has structured my development as a clinician. My recommendation for other students is: first, use your own therapy to develop attunement to your own cultural narratives and generational traumas. Second, expect and notice them (whether similar or different) in our clients. And finally, bring that awareness to the supervision dialogue, especially when there is a cultural discrepancy. Appreciate discrepancies as opportunities to deepen your knowledge through the help of a distanced perspective. The things we have in common with our supervisors is useful for validation and reality testing, but the spaces between what we have in common are rich in potential for new understanding.
References
Haen, C. personal communication, October, 2018.
Johnson, D.R. (2009). Developmental Transformations. In, Johnson, D.R. & Emunah, R. (Eds) Current Approaches in Drama Therapy. Springfield, Ill: Charles C. Thomas Publishers.
Landy, R.J. (1993). Persona and performance: The meaning of role in drama, therapy, and everyday life. New York, NY: Guilford Press.
Yang, Y. (2016). Landy’s Taxonomy of Roles Mandarin Translation. In Role Theory and Method [Powerpoint slides]. Hodermarska, Jenn & Yang Presentation for the Applied Drama Research Centre of China Second Annual Conference on Education and Drama. Beijing, China.
Lantie Tom is a second-year graduate student of the M.A. Program in Drama Therapy at NYU, following an M.A. in Educational Theatre at NYU and a B.A. in Linguistics at the University of Massachusetts. She has been an actor, choreographer, and designer for Physical Theatre, and has begun exploring embodied language in clinical contexts.
Maria Hodermarska, MA, RDT-BCT, CASAC, LCAT is a clinical assistant professor of drama therapy at NYU Steinhardt. She is supervisor of creative arts therapies for Project Common Bond, an international symposium for young people who have lost a family member to an act of terror, armed or inter-religious conflict.