Breaking the silence: using testimony and theatre to improve the practice of care

New techniques developed from research into verbatim theatre have (1) helped families affected by child sexual abuse by a) giving them new ways of ‘working through’ the trauma of their experiences and b) improving communication and dialogue with the relevant agencies of care; (2) developed in social work professionals, through new training methods, a greater understanding of a) sexual abuse and its impact on families and b) how to train social workers in this field; (3) been extended and adapted for student nurses, to facilitate new approaches to training, empathic engagement and reflective approaches to practice.

A specialist in applied theatre at Central, Amanda Stuart Fisher’s current research began in 2004 by looking at the theatrical enactment of stories of actual lived events. From this emerged the challenge of dealing theatrically with trauma, a condition which is seemingly ‘unspeakable’: resisting articulation, unable to be assimilated to cognition and functioning as a postponed or ‘belated experience’ (Lacan 1994, Caruth 1996). A series of ensuing research inquiries explored whether theatre can enable individuals to ‘work through’ traumatic events of the past. These insights were tested in the production of a verbatim theatre play about child sexual abuse, which in turn became a vehicle for impact.

The first phase of the research (2004-2010) explored the methodological problems inherent in theatrical attempts to bear witness to lived experience and trauma. Stuart Fisher’s applied-theatre work with Camden Young People’s and Clean Break Theatres proposed a modelling of the playwright as ‘community storyteller’. An analysis of Yael Farber’s South African testimonial theatre methodology confirmed that while story-telling might facilitate social cohesion, some events of historico-political trauma resist direct narration. The role of empathy and the relationship between testifier and listener/playwright led to an exploration of the dangers of identification and possible appropriation. Practically, the research sought to shape a theatrical mode of ‘empathic unsettlement’ (LaCapra 2001). This research was argued both philosophically and aesthetically, as seen in outputs from this phase that engage with Badiou’s ethics of the event, the theatremaker as a form of community witness, and the limits of verbatim theatre. These publications have been cited widely (Kuppers, P. (2007), Community Performance; Neelands, J. (2007) ‘Taming the political’ RiDE 12:3; Bharucha, R. (2011) ‘Problematising applied theatre’ RiDE16.3; and Prendergast, M. & Saxton, J. (2013), Applied Drama: A Facilitator’s Handbook for Working in a Community).

Building on these insights, the second phase (2010-2013) modelled a practice to remedy the problems Stuart Fisher had explored. Her method was to write a verbatim play challenging the taboos around the issue of familial child sexual abuse. To test her process and its viability she worked with a partner closely engaged with trauma management in families: Mosac, the leading support organisation for non-abusing parents and carers of sexually abused children. Mosac’s particular problem related closely to Stuart Fisher’s research inquiry, in that it needed to resolve the difficulty of discussing sexual abuse of one’s own children and/or where the perpetrator is known to the victim and/or is a family member. As a model of potential practice, the play, From the Mouths of Mothers, used witnessing techniques to negotiate the relationship between taboo and ownership in encountering childhood sexual abuse. Performed initially for Mosac’s clientele and stakeholders, the project’s challenges, its therapeutic value and the questions it poses to dominant understandings of verbatim theatre are analysed in Stuart Fisher’s 2011 article in Studies in Theatre and Performance. The quality and significance of this research have been recognised in the invitation to Stuart Fisher to co-edit (with Alison Forsyth, Aberystwyth) a special issue of the journal Performing Ethos: ‘Acting Out Trauma’ (2013).

Mothers offered an exemplary model for focusing on the family and thereby enabling both families and carers to gain greater understanding of sexual abuse trauma. This then produced new ways of training carers.

A. New understanding

The problem faced by Mosac was that the silence and taboo around familial child sexual abuse hinder therapeutic support of families, delaying appropriate social, health and legal interventions. Mothers established the first step towards impact by enabling the voice of the families to be heard by social and health workers, teachers and policy makers. Victims and carers learnt how to break the silence. As one of the participating mothers said:

Doing the play, seeing it, it was like a funny way of counseling to me.... It’s made me look at things in a different way. Whereas before I’d have avoided looking at these issues, now I’d find a way of addressing them. It was a good way of dealing with it. Seeing it acted out like that.

Breaking the silence was a definable impact of Mothers, as Denise Hubble, Mosac’s clinical services manager, explains:

The idea of addressing that which seems to ‘lie beyond words’ is something that is often discussed by my clients, and Mothers is a direct aid in doing that. We do not have another means of addressing the ‘lies beyond words’ as effective and sensitive as the play. In that, it is the most useful tool for communication we have …. This play has helped professionals and facilities gain a deeper insight into how sexual abusers operate in our society …. Most children do not disclose … that makes the need of finding a way to narrate the experience all the more acute for social workers, caring professionals, and policymakers as well. We have found Mothers to be a helpful tool with all these groups.

Piloted at Central with a Mosac audience (July 2007), Mothers was performed in September 2007 at the Mosac AGM, a training forum for social workers:

It gave me good insight into the experiences of these women, and other women and children who are in similar circumstances….I think this play would benefit anyone working with non abusing parents of sexually abused children.

In May 2013 Mothers was the centrepiece (at the Pleasance, Islington) of Mosac’s awareness-raising week. 79% of the 491 who saw it said it altered their thinking about the families affected. A health care worker said it ‘informed [her] further in [her] understanding of the mother’s point of view’. Another said: ‘A valuable…. play/life story – I believe that this is essential in being able to increase belief and awareness of abuse’. A teacher said ‘[It] makes you more aware of a child's needs and signs. It will make me work with caution and compassion if I come across a family/child who has been affected by sexual abuse’. Published for this event, the script remains in use by Mosac.

B. New training

Following specialist recognition of the efficacy of witness-based drama, the research insights were next used to develop training regimes for nurses and social workers. When Stuart Fisher discovered that carers neglected their own experience she initiated collaboration with the Florence Nightingale School of Nursing (KCL) to develop and test (May 2011) a new form of nurse training, involving both trainees and their tutors. A subsequent workshop (January 2012) assembled specialists from Barnardos, Camden Carers, Mosac, RHUL, UEL, Queen Mary, and the Nightingale School. For over 60% this training changed their thinking about and approach to the practice of care (source B6). Ian Noonan, Programme Leader in Mental Health Nursing, said: ‘[the KCL workshop] gave the students the opportunity to see their practice ... in a new way. They were quite simply bowled over by the process. One student wrote ... I realised for the first time that I was struggling with competing feelings of compassion and apprehension”.’

Building on the work with nurses, Stuart Fisher collaborated with the Department of Social Work, RHUL, to create a new training programme (delivered May 2012 and 2013). Social workers who participated said it changed their approach to child sexual abuse issues, with the effect that they ‘think more about the persecutory nature in which we question or work with non-abusing parents’, ‘try to do more of what I know is important – open mind – empathy’. Anna Gupta, Head of Social Work, RHUL, said: ‘The workshop has encouraged us to think differently about the way we train social workers to support families affected by child sexual abuse and the evaluations from students ... [suggest] that they too have changed their perception towards support in child sexual abuse situations.….a highly useful learning tool ... and one we could not get from any other source’.