The power of psychodrama should be demonstrated by different neuroimaging techniques that have been studied for different views on psychotherapy

The functioning of the brain, the ability to maintain its development by making new connections is like the representation of group dynamics in psychodrama. The brain and the psychodrama system are both so similar that they are the product of Moreno's genius, inspired by the system of existence. 

The fact that neurons need other neurons to process signals, create the energetic synapses and structures, while the main force is in a single neuron that will initiate the ignition of the stimulus, is like the representation of the relationship between individual and group, individual and society, individual and macroplan.

Recovery is only possible when individuals restore a healthy relationship of trust with life and people. Every moment means a new opportunity for a choice. Making new choices means reorganizing neurons within oneself at the cellular level. 

The psychodramatic view of the soul and the body as a whole moves in a cycle, each interacting with the other. The emotional expansions of the individual and the increase in consciousness have the potential to change the whole structure.

The purpose of psychodrama is to remind individuals, as part of the macro-plan, that they have creative power. In addition to this recovery, the individual also achieves the integrity of existence by attaining the transcendent role.

The power of psychodrama should be demonstrated by various neuro-imaging techniques that have been studied for different conceptions of psychotherapy.

Esra BİLİK, MSc. Psychologist (Clinical Neuroscience) / Psychodrama Trainer Coordinator of Child Psychodrama Department of IPI İstanbul Psychodrama Institute / Istanbul International Zerka Moreno Institute ‘Neurons and humans are social entities, cannot exist in isolation, and can only be understood in relationships with others’ (Siegel).

In my opinion, the most important invention of our age is the formation of new neurons in the brain, which has been proved by science in recent years. This means there is a chance of recovery and improvement for everyone and every moment. We know that the brain's innate potential and the environmental factors are critical for its evolution. Especially the relationships established in the early years with caregivers are the most important determinants of healthy brain-soul development. Recent studies have shown that apsychotherapy process changes brain chemistry, and new pathways have been developed in place of the old ones (2). I am of the opinion that the similarities between the ways of working and learning of the brain, and the philosophy and techniques of psychodrama will place Psychodrama into a much more privileged position among these methods.

NEUROSCIENTIFIC STAGES OF A PSYCHODRAMA SESSION:

“Every true second time is the release from the first.” JL Moreno 1923
Warm-Up: A psychodrama session allows the deepest activities to be conducted with the presence of multiple therapeutic elements in the warm-up, enactment and sharing stages. The first stage, warm-up, consist of physical, emotional, intellectual, social and transcendental warm-ups in psychodrama. The warm-up process being the beginning of a protagonist study covers more than one of these categories and this initiates activation from subcortical areas to the cortex, including emotion, cognition and memory.In this way, both the right and left hemispheres, which are also directed to different functions, begin to activate.

It is important that physical warm-up begins with action, our first repertoire in life. The warm-up walking activates the kinesic memoryof the body (9), preparing the body for its deepest record. At this stage, the psychodrama therapist maintains physical contact with the protagonist, ‘being together’, ‘feeling together’ and ‘doing/making together’. This first contact represents the first trust relationship between the mother and the baby. In this way, the protagonist is enclosed in the secure network necessary for self- disclosure. This means that they will warm up to the new networks to be formed with the memory and emotions activated during the psychodramatic warm-up. Together with the process of warming-up and the process of remembering the second part of psychodrama start (enactment).

Enactment:
The aim of the psychotherapy is to provide integration; is the integration of neural networks devoted to emotion, cognition, sensation and behavior. Normally interrupted neural networks are activated and become available for conscious processing (2).
Even though psychodrama includes many therapeutic elements in each stage, the action phase is the most important phase where more than one region of the brain is activated at the same time, and the path leading to new synapses is opened and new structures begin to take place. One of the secrets lies in the concept of “surplus reality”. Surplus reality, where people discover that they know more than they think they know, leads to significant expansions and catharsis in the mind. D. Eagleman uses the concept of "traveling in time" for the decision-making mechanism of the human brain taking advantage of experiences and life accumulations (3).Meanwhile, especially the orbitofrontal cortexis active. Journeys to the memories in psychodrama scenes sometimes take the form of recalling known memories (Retrieval and Recall) from the narrative memoryin which memories are recorded at the consciousness level, in the hindbrain regionsand association cortexes. However, most of the time we observe protagonists remembering the memories they suppressed and seeing the connections they never made. These are rather memories recalled from the power of action and the memory of the body.

As the most powerful recordings are recorded with stimuli such as smell and sound accompanying the strong emotions, the psychodrama enables the senses to be regressed and catharsis in a way that activates the senses with the help of establishing the memories with all the details. That is why Moreno describes scenes as semi-hypnotic place. Recalling the trauma and bringing it to the stage enables the re-activation of the noradrenergic system, the hypothalamus-pituitary-adrenalgland neurohormone systemsand many regions of brain. These include the prefrontal cortexassociated with personality and higher cognitive functions, the amygdalaassociated with memory and emotions, the hippocampus, the dorsal raphe nucleusand the locus coeruleus. In addition, high levels of adrenaline and cortisol hormonessecreted in the anterior cingulate gyrusand upper right temporal gyrus were found to be high in the case of stress (6). These important encounters in the scenes also provide a certain level of anxiety and stress, which is found to be necessary for permanent recovery. Moreno's phrase “Every true second time is the release from the first(1923)" summarizes the therapeutic power of these encounters. However, confronting the truth can diminish its power and it turns out to be an opportunity to fill its place with more appropriate behavior. Meanwhile, the protagonist's reactivated neurons, which have reached a higher level of reality, also move towards new synapses. Not only the protagonists are healed in a protagonist activity. There are some other members making many discoveries in their selected roles or watching the activity, thus warming to their own themes, sometimes experiencing intense affect and catharsis. In other words, it would not be wrong to say that most of all the brain activations stated happen in all group members.

Symbolic Realizationscenes, which are mostly established towards the end of the enactment, complete the transition to the new one. It promotes the learning of new live’s truths and the formation of new synapses between neurons in the brain of the protagonist, whose nodes are untied during the game. This is a complete change. As the power of the old synapses’ changes, information begins to move through the network in different ways. A sufficiently weak connection will eventually fade away; new connections that are getting stronger will grow by sprouting. A part of this restructuring process is driven

by reward systems and allows the neurotransmitter dopamine to spread throughout the network. Symbolic realization scenes mean the active use of the central brain (ventral tegmental area and substantia nigra), which are the re-update and decision-making centers of the brain (3).

In psychodrama sessions, not only the protagonist but also the memories of the older generations are on the stage. In cases where the subject goes to intergenerationalextensions, this goes back to much older ancestors. We know that important experiences become permanent and form our genes (3). The main issue here is that the incomplete tasks remain strong. The Russian psychologist Zeigarnikcalled as the effectbecause the organism tends to complete unfinished tasks (9). Anniversary syndromes, farewells, and all incomplete tasks do not go away until they are complete and continue their intergenerational transmission. And individuals can only move to a new one after completing the old one. It is only possible to solve these difficulties at the cellular level in psychodrama, to be able to work at the level of reality achieved by attachments, tele, role concept and role change, and to be able to enter and modify the memory of the body with operational techniques.

Sharing:
The sharing phase is where the digestion starts after receiving the nutrients during the action phase. Since the integrity of meaning is the stage for the protagonist, it could be stated that the prefrontal cortex, wernice and brocaregions related to expression and meaning, and limbic regionsare active in the brain. It is the stage in which the support for the protagonist is completed with group support and warming and learning for the group members. CREATIVE-SPONTANEOUS-ACTIVE NEURONES:

“...It would be a must to look at; because there is no inertial perception. Without look one does not see.” O.Sacks
The first experiences of the infant also shape the neural networks. The brain organizes various defense strategies for the anxiety that will arise if there are problems with the baby's initial bonds with the mother or caregiver (2,5). This distortion occurs especially in unconscious memory circuits that control anxiety and fear administered by the amygdala, hippocampus, cortico-striatal-

thalamo-corticalcircuit. The anxiety experienced in the early years paves the way for various pathologies that may occur in later periods.
However, the human baby has adaptive skills that make it distinctive from other species. Humans come to the world fully equipped so that they can adapt to almost any condition. "Experience and learning" occupy a great place in the emotional and neurobiological development of human beings. The brain continues to develop by becoming a permanent structure of the neural networks formed by connecting each new knowledge and acquisition learned. The adaptation process allows to maintain and protect the individual, whereas it may cause a virtual sense of security. The environmental factors that Moreno calls ‘cultural conserves’ can turn people into creatures compatible with their environment and remove them from their creative essences. This causes individuals to be trapped in both the brain regions (especially the limbic system) that give "get-away-from-anxiety" alarms, as well as the inability to have all their roles in life in a healthy way.

Being at the moment is getting closer to one's own reality, and sometimes it arouses anxiety. Psychodrama members boldly meet their own truths with ‘here and now’. Instead of old and dysfunctional behavioral patterns, new creative and spontaneous responses of the members lead to the emergence of neuronal nodes formed by anxiety and fear. This is the release of great energy. The neurons of individuals who are reunited with their creativity and spontaneity are activated. The neurons of the present are neurons that are open to possibilities to establish new synapses. The development of creativity also supports the development of the right hemisphere. While left hemisphere predominantly exhibits more cautious, non-innovative, resilient features based on established thought patterns, the right hemisphere is the wider, analytical, intuitive side. Creativity and the development of spontaneity increase activation in the right brain. Providing a holistic working system by establishing the right and left balance supports the mental health of individuals in a positive way. Action, in which creativity and spontaneity are being aroused, is the most important complementary part of all decisions. Action is not

the end but the first step that makes sense. As in the definition of the famous neurologist O. Sacks, there is “no perception without action, nothing is seen without looking”(7). Action, our first language in life, is also a powerful tool in psychodrama to break the resistances and reach the body's records. In psychodrama sessions, every moment passes through an action including warp- up walking, touching/holding, sculptures and the animation of scenes. The fact that action is an indispensable part and need of human nature is also the most permanent means of reorganization for the brain system developing through learning.

THE MEMORY OF THE BODY
“Don’t tell it, but show it”
The first role that the baby establishes a relationship with life is the somatic role. The somaticrole covers everything about the body. In this pre-language period, the first language of the baby is action (1). The mother's response to the baby's calls is very important. It is the first record of body memory that the baby has experienced in the somatic role it has taken since the birth. Schore stated that the development of amygdalabeing two important memory section- related regions was completed before the hippocampus, and that the traumatic events in the first relationships with caregivers were recorded with the amygdala as on the other hand, the memories was not recorded as hippocampal. The suppression of memories in later ages can also be achieved by suppressing hippocampus functions due to increased stress hormones. The “Don’t tell, but show it” principle of psychodrama causes people to regress and use their body memory by using action they used in the first period without words. Unlocking the physical locks with operational techniques enables a quick progress especially in the body-related difficulties and psychosomatic disorders where the suppression mechanism is the most powerful.
The fact that members bring out the deepest memories and confront important facts leads to emotional catharsis. Anger catharsis which is the strongest feeling, provides great relief and purification (action catharsis). At this stage of the action, it can be said that it functions as ejection and discharge of toxins. In the meantime, if neuroimaging techniques can be utilized, it is expected that changes in serotonin, norepinephrine and dopamine releases

may be observed, especially in sensory limbic systems(especially amygdala), imaging of increased activations in the ventral prefrontal cortex,cingulate cortex.
DOUBLING-ROLE REVERSAL-MIRROR

EMPATHY AND BEYOND
The mother is the first double of the baby's life; It is also likely to be the first antagonist at the time of individualization.With the first role change in the baby's development process, what he sees from the eyes of his mother is the determinant of self-development, relationship with life and brain development. Moreno adapted the three basic techniques of psychodrama from the first relationship patterns. In this way, the protagonist navigating through 3 different levels of reality (objective-subjective-surplus reality) by means of doubling, role reversal and mirror, allows him to retrieve information he forgot or never knew.
Doubling is where the protagonist feels the greatest support of the leader and the group and makes discoveries. During the doubling, it could be noted that the orbitofrontal cortex, mirror neurons, and the language relatedbroca field in the left hemisphere, being associated with empathy of the leader orthe group members are active. In the meantime, especially the prefrontal cortexand limbic systemof the protagonist who makes many connections, internalizes, judges, invokes memories, experiences and maybe restructures, will be activeted.
Recent studies have found that especially "mirror neurons" are autonomous structures related to empathy. Mirror neurons help us to empathize and understand the emotional worlds of others (10). Researches have shown that the emotions are achieved by mimicking the facial expressions of another individual in order to understand the working principle of mirror neurons (mirroring). Strikingly, it was shown that people with botox who lost flexibility in facial muscles began to have difficulty in understanding emotions from the facial expressions shown. The fact that we imitated the other person's emotions to fully understand them made us think of how active the mirror neurons were during the role reversal. On the other hand, the knowledge that the data received during the mirroring of each other was synthesized according to each person's own experience and showed that role change was one step further.

During role reversal, members no longer carry any information from themselves when they move from subjective reality to surplus reality. In the meantime, it could be said that it is the information coming from our invisible bonds extending from the mirror neurons to the macrosystem through the intuitive brain rather than the mirror neurons. This information is obtained in groups by the help of the group's co-unconscious. The intuitive brain is a set of networks rather than an independent region and will be discussed in the next section (see Intuitive Brain).

Mirror, the last basic technique, is the technique that brings the members together with objective reality. When protagonists look at themselves or their reflections in the mirror, they become an eye that deters from their own reality and evaluates them from the outside. Here, the prefrontal cortex, which evaluates, criticizes, and mentions the reality, is active rather than limbic structures. INTUITIVE BRAIN, TELE ANDATTACHMENTS

"It seems that normal brain function depends upon the social network around us. Our neurons require other people’s neurons to survive. We are social creatures and an enormous amount of brain circuitry has to do with other brains." D.Eagleman

D.Eagleman has stated that the roots of our social skills go deep into the neural circuits. The brain is a structure in intricate networks following others, feel their pain, evaluate their intentions and read their emotions. In order to survive even in the most primitive level (subcortical brain structures) and to understand who a friend or an enemy is, one has to look after others based on the subtle clues presented by the sensory data. Neural networks are formed through intuitive networks that we bring from birth to feel others with experiences. The most illuminated place in the neurobiology of intuition is called precenium. It is a small part of the superior parietal lobe, located in the middle of two hemispheres. Precenium is also concerned with episodic memory, audiovisual processing and conscience. Based on previous experiences, the ventromedial prefrontal cortex and caudate nucleus, which provide a rapid analysis and alarm, may also be linked to the intuitive mechanism (11).

Moreno has stated that the intuitive brain uses the teleto describe the part of the relationship. However, its development depends on

the trust relationship established by the caregiver when the baby pass through from the organic placenta to the social placenta.According to Fonseca, the experience of spontaneity between the infant and the caregiver also creates a series of flows between neurons, and the orbitofrontal cortex, which is sensitive to the meaning of facial expressions and especially face-to-face communication, plays an important role in the development oftelic sensitivityor futureempathy capacity(4).

Moreno, in suggesting the concept of group psychotherapy, similar to the working principle of the brain, stated that an individual without social relations is a social fiction. He completed his psychodrama theory with sociometryand sociodramaand went beyond a psychotherapy system and provided us with a deep knowledge of life that both disease and healing come from others, and that important learning in life can only be gained through relationships.As Heidegger has pointed out "you need others to exist, what makes you yourself is largely the world around you. The self cannot exist in the void” (3). The secret of discovering the meaning of life. In other words, the healthy development of the transcendet role is by discovering the bonds we are in from micro to macro. This approach dealing with all aspects of human beings has also made it possible to focus on individuals' pathologies and to take a holistic view without ignoring their healthy sides.

GROUP:
“If God came to the earth again, he'd come as a group”

J.L.Moreno
Moreno's discovery that the system of existence is based on bonds formed the basis for establishing the group system for healing and learning. The group, as defined by Moreno, forms the social placenta, the protective network of the individual at the same time; it meets the need of closeness and support which is its most basic need. Experiments have shown that mice prefer robots with feathered arms to wrap them instead of mannequins providing milk. It has been shown that touched mice have dramatically higher survival rates and more advanced brains than others. Similarly, social and brain development was found to be incomplete in infants left alone by their caregivers in nursing homes. In addition to being an important source of discovery, the group also provides members

with the emotional support and closeness they need, together with the leader. Touching having an important place in psychodrama gives individuals a sense of security with their primary basic needs and provides therapeutic intervention by increasing oxytocinknown to provide bonding in the brain. In studies on the effects of touching, it was observed that the danger threat of limbic systems of patients receiving touching support have decreased. Moreover, it has been shown that touching induces stimulations in the basal ganglia region related to motor-sensory systemsand learning. Physical touching is also an element bringing together and deepens the members and the leader as a representation of touching many themes emotionally and mentally.

As Siegel has argued; cells can only exist in the network of relationships as human beings. Each cell has a meaning only when it is a part of the group. Although there are autonomous regions in the brain such as speech, memory, problem solving, etc., these regions can only work through connections in unity. When there are cells that are damaged in the brain, the surrounding regions, like a cohesive group of solidarity, begin to compensate with new organizations. The life story of Cameron, whose half of her brain was removed since she had a neurological disorder, is a striking example for a life. All functions of the brain are almost the same as that of other children. The healthy hemisphere of Cameron has been dynamically rearranged to take over the missing functions, so that all operations are compressed to half the normal brain volume (3). While Moreno is interested in sociodrama and sociometry, he emphasizes the transformative power of individuals in societies, contrary to many theories that advocate the opposite. Being together with others is a part and necessity of an individual's nature. It is observed that social pain that occurs in the exclusion state activates the same brain regions in the brain as physical pain (3). We, like our neurons, owe both our existence and the meaning we carry to others.

CONCLUSION:
The functioning of the brain, the ability to maintain its development by establishing new connections is like the representation of group dynamics in the psychodrama. The Brain and Psychodrama System are both so similar that they are the product of Moreno's genius,

inspired by the system of existence. The fact that neurons need other neurons to make sense, that the energy-releasing synapses and structures are created whereas that the main force is in a single neuron that will initiate beginning of ignition, is like the representation of the relationship between individual and group, individual and society, individual and macroplan.

Recovery is only possible when individuals reestablish a healthy trust relationship with life and people. Every moment means a new opportunity for a choice. Making new choices means the reorganization of neurons within themselves at the cellular level. The psychodramatic view of the soul and body as a whole moves in a cycle, each of which affecting one another. The individual's emotional expansions and consciousness raising have the potential to change the entire structure. The purpose of the psychodrama is to remind individuals as part of the macro plan that they have creative power. Beyond this recovery, the individual also achieves the integrity of existence by attaining the transcendent role. The power of psychodrama should be demonstrated by various neuroimaging techniques that have been studied for different views of psychotherapy.

REFRENCES:

1. 1.Altınay, D. Handbook of Psychodrama-Psikodrama El Kitabı,
   Epsilon Yayınları, 2001.
2. 2.Cozolina, L. Psikoterapinin Nörobilimi, Psikoterapi Enstitüsü
   Eğitim Yayınları, 2017.
3. 3.Eagleman, D. Beyin, Domingo Yayınları, 2015
4. 4.Fonseca, J. Contemporary Pychodrama, Brunner-Routledge,
   2004.
5. 5.Henckens MJ, Hermans EJ, Pu Z, Joëls M, Fernández G.
   Stressed memories: how acute stress affects memory
   formation in humans. J Neurosci 2009; 29:10111-10119.
6. 6.Öktem, Ö. Sinirbilim Bakış Açısıyla Bellek, İşbankası Kültür
   Yayınları, 2013.
7. 7.Sacks, O. Aklın Gözü, Yapı Kredi Yayınları, 2010.
8. 8.Schore AN. Effects of a secure attachment relationship on right
   brain development, affect regulation, and infant mental health. Infant Ment Health J 2001; 22: 7-66.

9. 9.Schützenberger, Psikosoybilim, A.A. Türkiye İş Bankası Yayınları, 2012.
10. 10.Morgan, M. Neurosciences and Psychotherapy, 2006.
11. 11.Damasio, A. In work on Intuition, Gut Feelings Are Tracked to
    Sourse: The Brain