Addiction Medicine Made Easy | Fighting back against addiction

Meet Your Inner Mentor (Your Inner Critic Already Knows You) - Anonymous Drama Therapy

• Casey Grover, MD, FACEP, FASAM

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Mark MacNichol, a playwright and charity director, shares how his therapeutic approach called Anonymous Drama helps people in recovery and the justice system process trauma and develop emotional wellbeing by viewing their inner thoughts as characters in a play.

• Anonymous Drama is not traditional theater but uses dramatic techniques for therapeutic purposes
• The program helps participants identify characters in their life story, such as the protagonist, the inner critic, and the inner mentor
• Anonymity protocol allows people to explore trauma through fictional characters without revealing personal experiences
• Participants learn to recognize the difference between their negative inner critic and their positive inner mentor
• Over 5,000 people have participated in Anonymous Drama programs, primarily in justice and recovery settings
• The method works by helping people "rewrite their scripts" and develop healthier relationships with themselves
• Mark developed this approach after his own experiences with family addiction and losing his brother to heroin overdose
• Programs are available through an app for individuals or through group sessions
• Financial assistance is available for those who cannot afford the subscription fee

To learn more about Mark's work: https://www.markmacnicol.com/

To contact Dr. Grover: ammadeeasy@fastmail.com


Speaker 1:

Welcome to the Addiction Medicine Made Easy Podcast. Hey there, I'm Dr Casey Grover, an addiction medicine doctor based on California's Central Coast. For 14 years I worked in the emergency department seeing countless patients struggling with addiction. Now I'm on the other side of the fight, helping people rebuild their lives when drugs and alcohol take control. Thanks for tuning in. Let's get started.

Speaker 1:

Today's episode is a little out of my comfort zone. As an addiction medicine doctor, I am familiar with medications, therapy and group meetings. I am used to hearing about different types of therapy, such as cognitive behavioral therapy. Today's episode is on a therapeutic modality called anonymous drama. I interviewed Mark McNichol, who is a playwright who has found that a particular way to approach therapy, which is taking people's lives and viewing them as scripts in a play, is extremely therapeutic for processing trauma and negative emotions related to addiction. He's the man behind this modality. Mark has been doing great work helping people in jail and prison process their negative experiences.

Speaker 1:

I had zero knowledge or experience about this topic before our interview and by the end of the interview I was ready to start referring patients to his program. I will include links to his work and programs in the show notes. A few heads up before we get started. There is some use of adult language in this episode and Mark's audio cuts out a few times during the interview, but otherwise it was amazing. I learned a ton and I'm grateful to share it with you. Here we go, all right, well, greetings from England. I am so glad to have you on my podcast. Why don't you start by telling me who you are and what you do?

Speaker 2:

My name is Mark McNichol. I run a couple of charities in the UK that deliver what I would describe as emotional well-being programs for individuals and also for groups.

Speaker 1:

How did you get in that line of work this?

Speaker 2:

became my focus, this type of work About 10 years ago, 2016. Prior to that, I was a writer, director, written and directed bit of film Mostly theatre, also produced some theatre. So my day job at that point was writing, directing and producing Bit of film mostly theatre and I was invited by a charity in Scotland into a maximum security prison to deliver what would be described as a kind of traditional drama group, a traditional applied theatre group, and that was my introduction to the idea of using the arts and creativity specifically with therapeutic intent. Rather than the usual way that you go into these types of settings with drama programs. It's about introducing the participants to creative writing or performing, etc. I became more interested in focusing on the therapeutic intent, so I started to study things like drama therapy, psychodrama, well-established fields that focus on utilising dramatic techniques in order to provide therapeutic support to the individuals or groups that are being worked with 2016,.

Speaker 2:

But then that very first project Maximum Security Prison, working with 10 inmates all serving life sentences on an applied theatre drama type group, and I just became obsessed, really obsessed, with the notion of the arts and creativity being used to try and have a positive impact on individuals in the justice system or in recovery and over the last 10 years over 5,000 participants have been through our group programme. I can have a big mix of groups, but probably they would be split. Maybe 50% of them go in the justice space and 50% of them in the recovery space. I mean, really the group work can be applied to any group. So we've had domestic violence groups, learning disability groups, but the vast majority of those 5,000 individuals have been either in the justice system, at risk of entering the justice system, or in recovery.

Speaker 1:

So I recommend art and music and poetry to my patients all the time. In fact, I just bought one of my patients a PTSD art book. She's got a history of alcohol addiction and so the book has exercises paint this and work on these feelings while you paint. But acting in theater is a little different. I have to say I'm not an artistic person. This stage is not what I like to do, unless I'm speaking publicly. What's it actually like, like boots on the ground? What's it feel like to be in one of these theater groups?

Speaker 2:

first thing we always say is it's not a drama group the way that I usually describe it to someone who's never encountered the program before maybe considering taking part in a session. In fact, on our posters and it actually says that it's like drama therapy for people who usually don't have any interest in drama. So over 75% of our participants have no interest in creative writing, they've got no interest in performing, but they're in a situation where they might be up for trying something a bit different. Obviously, everybody's motivation for taking part in a programme is different. So, for example, being honest, some of our participants in the justice space might take part in the programme because they're bored, because they're sitting in their cell for 23 hours a day. Or they might do it because they want the parole boards to look upon them favourably and they want to be seen to be taking part in these types of activities. So you know lots of different motivations for taking part in the group, but the vast majority of individuals have got no interest in creative writing or performing. But we've got a very structured programme that we go through and, at the kind of core, the essence of what we explore is there's a conversation going on inside all of our heads 24-7. And 99% of the population think of it as their thoughts. But we explore an alternative view and through the program we actually start to give those voices inside our heads specific character roles.

Speaker 2:

So every group builds three recurring characters from scratch. The first one is the protagonist, the main character, and that character represents everybody in the room, everybody in the group. And then the second character is the inner critic, who has a constant source of negativity, disruption, all the bad stuff. And then the third character is the inner mentor. The inner mentor is the opposite Constant source of love, compassion, positivity, encouragement, all the good stuff. So, in essence, in the group sessions, participants are creating those three recurring characters from scratch and over the weeks they are putting layers on those characters and at the same time they're also developing a script. So there is character development, there is script development and the work is not subtle in the sense that what we're trying to do is we're trying to give you, as a participant, a mirror to hold up to yourself. So it's an opportunity to look in the mirror in a very unique and quite unusual setting.

Speaker 2:

Ultimately, go on a journey of self-awareness, where, by putting these conversations under the microscope, where by putting these conversations under the microscope, we start to learn more about ourselves and develop a better relationship with self. So, for example, if we take alcohol, the nature of what we do is it's not specifically the alcohol that we are interested in, or the drugs, it's the conversation that goes along with it. Because if me and you are sitting at a table and you put a bottle of wine or a bottle of whiskey on the table, our relationship it will be completely different to that alcohol, but the alcohol is the same. It's the same alcohol, two different conversations.

Speaker 2:

So we deconstruct for our participants, or give them the opportunity to deconstruct, the conversation that's going on inside their heads relating to alcohol or drugs. It could be anything sex, status, money, you know anything. Basically every piece of content in our lives 24 7 that we encounter, there's a conversation that goes along with it. How do we feel about this person or this theme or this setting or whatever it is? Everything in our lives is accompanied by a conversation and once people start to understand that, they might not always be able to control the conversation, but as a bare minimum, they can definitely be aware of the conversation taking place and, like I say, 99 of the population are unaware of the conversation taking place and, like I say, 99% of the population are unaware of the conversation and just think it's their thoughts.

Speaker 1:

So let me just ask, mark. So my first job before I was an addiction doctor is I was a doctor in the emergency department and I like to simplify everything to just what I need to know. So let me see if I can simplify this so I understand it. So I had come into this conversation thinking this was about acting, but instead what you're saying is that it's more about therapy, with the framework being that your life is a story, there's a script and the individual thought patterns are the characters, and it gives the participants a framework to understand how their brain sees and lives in the world. Is that right?

Speaker 1:

yes okay, and why is it done in a group setting as opposed to individual?

Speaker 2:

well, I suppose the original program came from that first project. Ah, obviously I was delivering a drama group in a prison and it's interesting because I had a conversation with the prison psychologist and he told me basically that he wasn't keen on drama groups. And you know, obviously, as someone who was delivering a drama group, at that point I did my best to not take it personally and find out why. And his answer was fascinating because what he said was that drama group was being delivered by myself as a playwright and by a friend of mine who's an actor. And what he said was that over the years that he's worked in prisons he's seen so many drama groups coming in and as part of the work that they do especially if you're writing a script from scratch and you're developing characters part of that might involve you tapping into your own history, your own lived experience, and he reckoned that it was quite common in that setting for participants to start to negotiate areas that could be described as emotionally charged, in some cases even triggering, and the exploration of unresolved trauma, for example, as part of the character and script development. And understandably he was concerned by the fact that these drama groups were doing that when you've got a playwright and an actor, neither of whom are mental health professionals. It's potentially problematic, but it's also problematic for me as a playwright to be put in a position where people serving life sentences are potentially unpacking unresolved trauma.

Speaker 2:

So I had the idea that I would introduce anonymity into the program, which was something that I started to experiment with quite early on, and I discovered very quickly that it was effective. So what I basically did was I introduced an anonymity protocol, which basically meant that in every session, if Casey's a participant and Casey wants to talk about mum's alcoholism and the impact that it had on him as a child, then our facilitators are trained to basically deflect that onto fictional characters. So you will be stopped and the conversation will be. Let's not do that. Instead, let's look at this fictional character's mom's alcoholism and the impact that it had on this fictional character as a child. So all of the personal history and lived experience is done in such a way that basically nobody in a session knows the difference between what's fiction and what's lived experience.

Speaker 1:

So it's almost like a safe place to let the stories out, because it's fiction.

Speaker 2:

Nobody knows. This is the thing. It's interesting because if you think about what fiction is, fiction isn't fiction in the sense that the person who is writing it if it's a novel or if it's a stage play or if it's a screenplay probably the person who is writing that script is using their lived experience. So, for example, I wrote a novel many years ago Now.

Speaker 2:

If you read the novel and then me and you sit down we could go through the novel and I could explain to you which characters and scenes in the novel are completely made up and which ones actually happened and which ones are maybe a mixture of the two. But the irony of good fiction is that in order for it to be good fiction, it has to be real. So when we're in these group settings and participants are developing fictional characters in an anonymous context, an anonymous setting where nobody knows the difference between what's lived experience and what's fiction, as the characters are developed and as the script is developed, who can say what is fiction and what is lived experience? Just like if you read my novel, you can't say which bits are fictional and which bits are lived experience, because you don't have the insight into me as the source. Creator of the novel.

Speaker 1:

So once again let me put on my simple ER doc brain. So what I'm hearing is that drama therapy again is looking at your life as a story and you're trying to understand the script by naming different thoughts and even people in your life as characters. It would seem like this would be a useful one-on-one technique where a person could work on their inner critic and their inner mentor, but in a group setting. It's more just allowing people to get their stories out in a safe place. And my understanding about trauma is just you've got to process it in some way. And my understanding about trauma is just you've got to process it in some way. And if this works, that sounds great to me.

Speaker 2:

Yeah, to give you an example, we do have a program for individuals. That was an adaptation of the group program. We started with the group program but we wanted to give exactly like you said. We wanted to give individuals the opportunity to do this type of work on their own, in their own time, at their own pace. So we created a programme called Find your Mentor and that programme is very successful, also In a group setting. The idea is, for example, we always do exit interviews. Every participant gets an exit interview. It gives us the opportunity to evaluate and get a sense of what's working, what's not working.

Speaker 2:

And I remember one chap who said that something happened to him in high school which was so traumatic that he had never been able to share it with anyone. He'd never shared it with friends, family. He went to fellowship meetings. He'd never shared a fellowship meeting. He had one-to-one psychotherapy and group psychotherapy. He had never shared a fellowship meeting. He had one-to-one psychotherapy and group psychotherapy. He had never shared it anywhere because it was too traumatic for him. However, in our group sessions, because nobody knew the difference between what was real and what was fictional, he said that he was able to do some work with a fictional character in the group that ultimately represented him at high school going through this difficult experience. But because nobody knew that it was real, he felt more relaxed, confident to be given the opportunity to do some exploration work that was my next question is how do you tell if it works?

Speaker 2:

Well, unfortunately, in a recovery and a justice context that is very easy to do, because if the participant returns to jail, then it didn't work. There you go. And if in a recovery context, if the participant dies, then it didn't work. Recovery context if the participant dies, then it didn't work. So you know the stakes couldn't be any higher. On the work that we do. We're trying to keep people out of prison, we're trying to stop people from offending or re-offending and we're trying to keep people in recovery. My lived experience and probably one of the reasons why I'm so passionate about the work when I grew up, my mum and dad were both alcoholics and we can have this conversation because we're not in a session, so the anonymity protocol doesn't apply. My parents were both alcoholics and my brother, who was in and out of the justice system, unfortunately died of a heroin overdose. So, as a family member affected by addiction and the justice system, I have a fair amount of lived experience and, in terms of how we know if we are making a difference or not, we're not naive and we know that it's not a silver bullet.

Speaker 2:

A result of this program, a decent number of people have been kept out of the justice system and a decent number of people have been kept in recovery. Now, obviously it's not just because of this program, because if you are staying out of the justice system or if you're staying in recovery, then the reality is you're going to be doing the work, and the work involves doing many different things. It's not one thing that's going to fix you, so to speak. The work is going to be different for everybody. To stay on that path that we all know is the path that we want to stay on, then you might be doing things like exercise, eating, clean meditation, sauna, cold water, supplements, whatever. You know, everybody's different. But the people who are being kept out of the justice system and being kept in recovery it's not just because of this program, but certainly this program could be considered to contribute so I'm just looking online while we're talking it seems like there's a couple of permutations of drama therapy, so I'm seeing some drama therapy that's much more like acting.

Speaker 1:

Are there different approaches?

Speaker 2:

Well, the first thing I would say is drama therapy is its own thing and anonymous drama is its own thing.

Speaker 2:

If I say to someone it's like drama therapy but it's not drama therapy, at least that gives them kind of half an idea of the direction that I'm going in.

Speaker 2:

But my understanding of, for example, drama therapy and psychodrama now, drama therapy and psychodrama are two well-established fields. They are both in the mental health space. My understanding is that this is just my personal experience. Most of the drama therapy practitioners that I meet come from a creative arts background, so they are perhaps trained as actors or writers etc. And moved into the drama therapy field, whereas psychodrama practitioners, in my experience, come from the mental health arena and tend to be psychotherapists etc. So psychodrama and drama therapy are two well-established fields, but, like I say, anonymous drama. Basically what I did back in 2016 I introduced the anonymity to keep the prison psychologist happy and by doing so, it gave me the opportunity to experiment and explore what the anonymity, what's it like in that type of environment where you're developing characters and you're developing monologues and sketchings and spoken words what's it like to actually do it in this unusual, anonymous setting? So the program is called Anonymous Drama.

Speaker 1:

Anonymous Drama.

Speaker 2:

Yeah, because we wanted to give people a sense of the anonymity and we also wanted to give people a sense of the fact that, whilst it's not a drama group, if you come to one of the sessions, you are going to be getting involved in things like improvisations and hot seats and things that typically you would expect to see in a rehearsal room.

Speaker 1:

Wow. So it seems like there's an established field of drama therapy and psychodrama, but your program, specifically the anonymous drama, is more focused on people who are justice involved and with addiction. Is that right?

Speaker 2:

Well, technically, the anonymous drama group could be applied to any group. Okay, so you know the nature of the facilitators who go through the induction and training in order to deliver one of the groups. They don't need to have a drama background, they don't need to have a therapy background. They don't need to have a drama therapy background. Many of our facilitators actually start off as participants and come back as volunteers, go through the induction and training, so they would be classed as lived experience facilitators with no drama or therapy type backgrounds. But, like I say, technically any group could be brought into the session plan. You know, each session is two hours. We start off with some icebreakers and group games and then we do some character development and then we do some meditation and breath work and then we do some script development and then we do some kind of exit guided imagery. So that session plan can be applied to any group.

Speaker 2:

Now, why, for the last 10 years, have the charities who deliver the programme focused in particular on people in the justice space or people in the recovery space? If I'm being honest, it's probably for two reasons. Number one, my personal lived experience and my desire to have a positive impact on people in the justice space of people in recovery. And number two most of the work that we do and have done is funded. In the UK we call it third sector. In the US you probably call it not-for-profit. The vast majority of funding comes from grant funders and if you are going to apply for some grant funding, usually the grant funders want you to sit in a box. So if you're submitting an application for funding, then it's a justice group or it's a recovery group or you know. Those are probably the two reasons why the focus has been justice or recovery. But, like I say, it could be applied to any group.

Speaker 1:

I'm curious, so pick on me. I tend to be a pretty open book when I'm podcasting. Can you actually show me, with me, what it would look like to develop some of my own characters?

Speaker 2:

So are you talking about the group program or the program for individuals?

Speaker 1:

Just kind of how it works, like, let's imagine we're in a group and there's more people and you're specifically focusing on me, helping me to understand my characters.

Speaker 2:

Well, I suppose it's probably going to be easier because there's just two of us. It's going to be easier because there's just two of us. It's going to be easier for us to do it in the context of the program for individuals. Okay, rather than a group, because we don't have a group, it's just you.

Speaker 2:

But the program for individuals is on an app, and so you would log into the app and, by the way, the links to both programs are on the front page of all my socials, so what we are talking about can be accessed on any of my socials, which is mark m-a-r-k-m-a-c-n-i-c-o-l, mark mcnichol. So if you download the app, the first thing you're going to do is you can either read the intro or you can watch a video or listen to the audio of the intro, and then step one is going to be after you've been introduced to the concept of the conversation that's going on inside your head, the idea of the majority of it being negative and critical, and the idea that you can actually develop a relationship with a mentor who gives you constant love, compassion, positivity. Your biggest fan that's always in your corner, that's the inner mentor. Yeah, so when I talk about the inner critic, would it be fair to say that you've got a good understanding of who I'm talking about inside your own head.

Speaker 1:

I know it's there, I've never worked with it. I have a therapist, but we go a totally different direction. Do I name it?

Speaker 2:

I would say no, because the idea is that what we are trying to do is we are trying to be conscious of the fact that the inner critic exists, but keep to a minimum the amount of interaction we have with the inner critic, because the inner critic's job is to fuck you up. It's so true. Yeah, so basically, a good day at the office for the inner critic is you committing suicide? That's fair. And this is 24-7. This is while you're asleep.

Speaker 2:

Also, you are constantly being bombarded with messages of all of the ways in which you are not good enough, inadequate, a completely useless, worthless piece of shit, and it's just constant. And if you give the inner critique the opportunity, it will just do it 24-7. And it's very subtle and it's very clever because it knows your specific karmic buttons. It knows the things that it can get you on, so it might be able to get you on things that it's not going to try to get me on, because it knows you arguably better than you know yourself so it's my job to write the inner critic out of my script.

Speaker 2:

So after you start to accept the existence of the inner critique and after you start to become aware of them, it becomes a bit like muscle memory, where the more you do the work and the program you start to, every now and then you'll be walking down the street and you'll hear it. You'll hear a voice and you'll be like that's it. That's the voice. I heard that Now. Previously you probably weren't even aware of the voice because you just thought it was your thoughts. So you're going to be aware of the voice but you're going to meet. In some cases for the first time. You're going to meet the inner mentor and you're going to meet the opposite of the inner critic that's got lots of different names and lots of different cultures to be in our program. You don't have to be religious or spiritual. It works if you're atheist or agnostic. Some people would call the inner mentor god, some people would call it buddha, some people would call it reauthentic self, the universe, whatever, but the idea that you've got access to something which is going to put an arm around you and basically just remind you of your inherent value. It's that authentic self, that part of you that most of us either don't know it exists or, if we do, we don't spend as much time with it as we should. For example, one of the first things that you're going to do in the program is you're going to pick a specific piece of content, so it might might be alcohol, it might be drugs, it might be sugar, it might be a specific person or relationship, it could be anything. But in the programme we're going to work with that particular piece of content and we're going to work with listening to what the inner critic says about that content and engaging with the inner mentor.

Speaker 2:

One exercise that participants are asked to do which is very popular is the idea of writing a love letter from your inner mentor. So, for example, you know Casey giving Casey's inner mentor the opportunity to write a one-page love letter telling you all of the reasons why you're a good guy and why you're doing your best, and all of the things that you're a good guy and why you're doing your best and all of the things that you've got to be grateful for, etc. That is something that very few people that come through our programme have ever even considered doing. It can be a very powerful exercise when participants write their love letter to themselves from their inner mentor, because we're all being bombarded 24-7 by the inner critic and every now and then it's very powerful to engage with and develop a relationship with the inner critic's nemesis. Who is the inner mentor?

Speaker 1:

The battle of good and evil in the brain mark. This is fascinating. I've got plenty of patients that would really benefit from this. If someone's listening and they think I either want this sort of therapy or I want to get in a group like this, or my brother or my loved one would benefit from this, how can they get started? Get?

Speaker 2:

on the mark, but nickel socials and have a look at the links. Any individual who wants to go through the program, there's a monthly subscription. But if somebody can't afford that monthly subscription although it is quite low I mean, it's only a couple of coffees but if, for whatever reason, somebody was not able to afford that subscription, if they message the email address on the link then they will get a free access, because the people who can pay pay for the people who can't pay. And then, when it comes to the group sessions, there is a link to a subscription for individuals to go through the induction and training so that they can deliver their own groups, because the reality is that you probably won't have a group local. So if you don't have a group local, then we would encourage you to set up your own group and again, if the subscription fee was a barrier to you doing that, then you will get a free subscription because the people who can pay for it pay for the people who can't.

Speaker 1:

You know, Mark, I can tell you've had some lived experience with addiction in your life. Because you care, I'm the Mark. I can tell you've had some lived experience with addiction in your life. Because you care, I'm the same way Like if you can't pay, we'll make it work. Well, I got to say, Mark, as I came into this not knowing what to expect, and you have totally given me lots to think about. And research reminds me of a podcast episode I did a few weeks ago with a woman Actually, I bought her book where she finally got sober when she learned to identify her inner critic and identify positive self-talk. And it's just a different way to think of the inner critic and the inner mentor. So I have to say thank you so much for coming on my podcast. I'll put some of the links to your work in the show notes and thank you for what you do.

Speaker 2:

Thank you for having me along, because if it wasn't for people like you, Casey people like me couldn't get the word out. So thank you for what you do. Thank you for having me along, because if it wasn't for people like you, Casey people like me couldn't get the word out. So thank you for your work.

Speaker 1:

Before we wrap up, a huge thank you to the Montage Health Foundation for backing my mission to create fun, engaging education on addiction, and a shout out to the non-profit Central Coast Overdose Prevention for teaming up with me on this podcast. Our partnership helps me get the word out about how to treat addiction and prevent overdoses To those healthcare providers out there treating patients with addiction. You're doing life-saving work and thank you for what you do For everyone else tuning in. Thank you for taking the time to learn about addiction. It's a fight we cannot win without awareness and action. There's still so much we can do to improve how addiction is treated. Together we can make it happen. Thanks for listening and remember treating addiction saves lives you.