Cedar’s English-language Israeli book on using psychodrama helps many

Science and Health

Tzippi Cedar doesn’t know how to draw, paint or embroider but she does know how to make and teach others to make sculptures with different-colored scarves to express their feelings. And over the decades and with advanced degrees and courses, she became an expert in using psychodrama to help the elderly, the young, the lonely and even the demented.

Psychodrama, which is becoming very widespread in Israel, is a type of experiential action-based therapy in which people explore issues and conflicts by acting out events and situations. By doing and interacting in a group setting, the participants learn about themselves through role-playing and role-reversals, mirroring, sociometric exercises, empathic doubles and sharing how they feel. The participants gain greater understanding and insight into their lives and experiences, resolve issues and practice new life skills and behaviors, said Cedar in an extensive interview with The Jerusalem Post.

Now an active octogenarian, she was born in the Crown Heights neighborhood in Brooklyn, New York to very-religious parents, in 1942. She traveled from Queens to study in the Yeshiva of Flatbush because a drama teacher said he would put her on the stage. The school presented shows like South Pacific, the 1949 Broadway musical whose lyrics were written by Oscar Hammerstein II and whose music was composed by Richard Rodgers, after the book was written by James Michener. She was captivated by it. “That was the beginning of my love of theater. We sold tickets and even bought an ambulance for Israel,” she recalled.

“I went to Brooklyn College, with a major in speech and theater. I had no role models except to be a nice Jewish housewife like my mother, who had been born to a Hassidic family in Mea Shearim in Jerusalem. My father, a wrestler and boxer (to make a living) and then a butcher and a businessman had been born in Poland.”

She is the wife of Prof. Howard Cedar, whom she calls Howie, to whom she has been very happily married for almost 60 years. Prof Cedar, who continues to bike from their German Colony home to the Hebrew University-Hadassah Medical School in Ein Kerem and then homewards up the steep hill, is a world-renowned expert in developmental biology and cancer research who received his bachelor’s degree from the Massachusetts Institute of Technology and then his medical degree and a doctorate from New York University. They have six children – all of them Israelis – the oldest of whom is Joseph Cedar, the famous film writer and director, followed by Dahlia, Noa, Yoav, Yonatan and Daniel and 24 grandchildren (by the latest count).

A SCULPTURE of resilience with scarves. (credit: TZIPPI CEDAR)

Made aliyah in the 70s

The Cedars made aliya in 1973. Howard has received many distinguished awards, including the Israel Prize, the Wolf Prize in Medicine (shared), the EMET Prize for his work in cancer research, the Rothschild Prize in Biology and membership in the Israel Academy of Sciences and Humanities.

SHE MET Howie serendipitously. “I have a first cousin who moved to Morristown, New Jersey, when he got married. Howie was his neighbor. I was 23 when my cousin invited me to come for Shabbat. Both Howie and I had already been to Israel, so that’s what we talked about. Then, meeting someone committed to Israel was rare. If he had not been, he would have thought I was a nut,” Tzippi recalled.

Their eldest, Joseph, the father of three, “got his brain from his father and his creativity from me. Our first daughter is a psychodramatist, the next is a physician in public health specializing in infectious-disease epidemiology; the next son is a sex therapist (mostly with people with disabilities), followed by a musician and a tour guide who is also a photographer.”

She is an impressive professional in her own right. She earned a master’s degree in expressive arts (theater therapy, arts, dance and psychodrama) at Lesley College in Boston. “There was no way to be an actress and religious and have six kids. My career found me. I was a creative drama teacher at the Israel Museum and taught teachers how to use drama in the classroom to teach a subject. I was always taking part in Hebrew plays and performing as a ventriloquist for the soldiers the months following the Yom Kippur War. I directed big shows as well as small ones in my kids’ schools. Every year, I did plays at the Youth Wing of the Israel Museum to help children develop a healthy self–image. I continue to do play readings.”

In 1995, then-MK Shulamit Aloni initiated a law that to pursue her professional work, she had to earn a master’s degree, so she studied psychodrama and drama in education at New York University. “It changed my life. It gave me the opportunity to help cancer patients, mothers who are experiencing post–trauma from terror attacks, second-generation Holocaust survivors and, of course, children of all ages.”

Psychodrama, she explained, “lets us shout the words we dared not speak. Through role reversing, enactments, through showing instead of telling, we get insight. Scarves have been my language since I started. I can’t draw but scarves help express things. I have about 50 different ones that I bought in the haredi quarter of Geula. I use them in education, to sculpt everything from the Book of Ruth or Psalms to “a what do I need now?” immediately after a terrorist attack while working with classrooms of seventh graders on issues connected to the Holocaust in workshops for children which she helped develop at Yad Vashem.

The color represents a concept, a need an emotion. When you draw something, you can’t move it. Scarves are flexible. Adults and children love scarf sculpting. I ask: “What do you need from a good friend? Pick colors that symbolize these traits.” They stand around the sculpture and I ask: “What do you have in common with this good friend?” With the senior population, no subject was untouchable – relationships with children, frustrations, grandchildren not being religious.

After a member died, Tzippi asked. “After you die, what would you want to be said about you?” “If you could convince a potential new participant to join our group, what would you say? How would you explain what we do here?”

PSYCHODRAMA, ALMOST a century old, was founded by Romanian-born psychiatrist J. L. Moreno (born as Jacob Levy). He said, “Don’t tell me, show me.” Through doing, the people internalize deep action insight. This soul work results in heartwarming moving drama. In drama therapy, which is newer, through fiction stories and metaphors we reach the soul. You can adapt these experiential methods it to any population.” Her son, the sex therapist, adapts it for all kinds of clients and makes good use of her scarves, emotion cards and amazing puppets.

Her students urged her to write a serious book based on her experience helping people of all kinds with psychodrama. She worked on it for over two years. “I was afraid to send the book to a publisher but a friend urged me to send it to the prestigious British publisher, Routledge. Very soon I was told they were interested in it. I’m still in shock. I’m not an academic researcher; I’m a doer.”

 Her 199-page book entitled Group Psychodrama for Dementia, Old Age and Loneliness: Trusting the Process (https://www.amazon.com/Group-Psychodrama-Dementia-Old-Loneliness/dp/1032343583) finally resulted from six months of getting feedback from family, friends and editors and upgrading it. “The volume offers a fresh approach for professionals working with older individuals by employing new and exciting custom methodologies in psychodrama, particularly for clients with Alzheimer’s disease or other forms of dementia.

Eight years ago, the leader of an English-language Melabev group said people need to get into their inner world and express their feelings. Another counselor knew about me and recommended me. I was 72 but I hadn’t had experience with the elderly. I told myself: “You are old. You should try.” I had total empathy with people suffering from dementia. Some were in the group only because they were lonely.”

In her psychodrama groups for those with Alzheimer’s disease, Tzippi found that “their memory is locked up; they couldn’t retrieve it. After the sessions, they say ‘Oh my God, I do remember.’ Their long-term memory is better and their short-term memory is less. But they loved the interaction through psychodrama. I wrote the book because when the consulting physician who does research on dementia sat in on sessions, she said this is the best medicine for them; please write this up for doctors, students and families.”

The responses of the participants in this group were pearls of wisdom and Tzippi asked the volunteers to write everything they said in a special notebook. Hence her new volume is a handbook and a narrative.

The book offers a general explanation of the use of psychodrama by giving an overview of the therapeutic use of drama in all its forms, clearly explaining the concepts and methods and describing the rationale of every intervention while also following a group over six years with precious documentation of the group process. It addresses the main concerns of those who suffer from dementia: adjusting to a new and changing level of functioning, fostering a sense of belonging, preserving their innate dignity and redefining relatioships and roles.

The English-language hardcover and softcover volumes have already received rave reviews. “Cedar’s book humanizes the work with older adults beyond imagination. It not only inspired and encouraged me to do creative work with every living being but I also found myself laughing and crying while reading it, as if I was watching a movie or a theatre piece,” wrote Prof. Susana Pendzik, a Ph.D. and registered drama therapist at Tel Hai Academic College and the Hebrew University of Jerusalem, “The book is written with enthusiasm and clarity. It describes the challenges and achievements of doing creative group work with people suffering from dementia, old age and loneliness with utmost sincerity, enlightening depth and a passionate desire to touch the reader’s heart.”

“IN THE field of dementia care, we’re always looking for additional ways to stimulate our groups. Once upon a time, there was only music therapy and exercises,” commented Leah Abramowitz, who has a master’s degree in social work and was the co-founder of Melabev (a non-profit Israeli organization that provides a range of high-quality services in the community for individuals who are living with dementia) and received the Jerusalem Prize and the Builders of Zion Prize. “This book is fascinating, an easy read but also scientific, well-versed in theoretical data and examples from life, while encouraging a new generation to get on the wagon and join in doing psychodrama. It not only adds a whole new field to our toolbox but in line with the Melabev philosophy, it accents what they can do, not what is lost; relates to them with dignity and uses the interaction within the group to build a safe, loving, support system.”

“This inspiring book authored by a true expert shows convincingly how a group of older adults suffering cognitive decline, Alzheimer’s disease and other dementias responded individually and in group settings to a series of exercises clearly described in each chapter. It is amazing to find out how seniors with various cognitive impairments responded to a wide range of psychodrama techniques wonderfully explained in the book,” added emeritus psychology Prof. Soledad Ballesteros of the Universidad Nacional de Educacion a Distancia in Madrid.

“I’m waiting for an Israeli company to publish it in Hebrew. My daughter-in-law is a very good translator,” confided Tzippi. “Whatever happens, I will see to it that it appears in Hebrew because there is a need for it here.” If she writes a second book, she would write it on psychodrama at home and in the classroom. “Boys and girls both have reacted to my workshops, which I ran with religious themes and social themes. I stressed discovering your best self through creativity,” she said.

She noted that psychodrama and all expressive arts therapies are especially popular in the ultra-Orthodox world because it doesn’t endanger the shidduch (matchmaking of adult children). It doesn’t present a negative connection to psychiatric treatment.”

She recently ran a grief group for women who lost children to cancer or terror. “One woman was divorced from an abusive husband after the terror attack. She said she’s now ready to meet another man. But in psychodrama exercises, I asked her to choose another woman to represent her and for her to act the part of the potential mate. She (acting as he) took a chair at the opposite end of the circle. I asked why. She (as he) said “she won’t let me near her.” She finally understood through this enactment that she still wasn’t ready because of the trauma from her abusive ex-husband. The goal of the therapy is a change in attitude, situation, self-image, functioning or understanding. People are uplifted and feel hope through validation, identification and social cohesion,” Tzippi concluded.