The Arts in Psychotherapy 57 (2018) 88–94

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The Arts in Psychotherapy

Research article

Clown therapy: A drama therapy approach to addiction and beyond

Jeff Gordon a , Yoram Shenar b , Susana Pendzik c,∗
a
Community Theatre Practitioner and Independent Drama/Clown Therapist, Israel
b
Theatre Practitioner and Independent Drama/Clown Therapist, Israel
c
Tel Hai Academic College, Upper Galilee, Israel

a r t i c l e i n f o a b s t r a c t

Article history: A drama therapy approach to working with addiction using clown therapy was developed via a process
Received 9 October 2017 through which clients were led to discover their inner clown. Using drama therapy techniques, each
Received in revised form 2 December 2017 client’s key/dominant and oppositional personality roles were recognized and brought together through
Accepted 7 December 2017
embodiment, leading to the emergence of the clown. The theoretical and practical foundation of the
Available online 11 December 2017
approach are presented here, with reference to the drama therapy literature, to the Jungian concept of
the transcendent function, and to Winnicott’s transitional phenomenon. The stages of the process are
Keywords:
described, illustrated with techniques and short case studies. Viewed as the archetypal embodiment
Clown therapy
Drama therapy
of paradox, it is suggested that the clown can serve as a container of ambivalence, thereby acting as a
Addiction strategy for normalizing paradox in the process of recovery and rehabilitation. Symbolizing the bridge
Clown role between antagonistic sides of the self, the encounter with the inner clown allows individuals to tolerate
Clowning and health and live with paradox, resolving the feeling of being stuck in a state of inner and outer conflict.
Paradox © 2017 Elsevier Ltd. All rights reserved.
Substance abuse rehabilitation
Transcendent function
Transitional phenomena
Embodiment

“The Patient should be instructed not just to accept his fear, but
also to laugh at it. This requires the courage to be ridiculous”
(Viktor Frankl)
Introduction
Throughout history and across cultures, clowns have helped us
to safely confront our human foibles and vulnerability while gen-
erating a cathartic laughter. As we watch them fail, fall, and get
ridiculed, we internally transform personal experiences of feel-
ing embarrassed or disempowered into humorous incidents, thus
reasserting our sense of control. As we laugh at them, we are essen-
tially laughing at ourselves, and releasing tension around issues of
power and powerlessness, competence and incompetence.
The clown emerges from the trickster, jester, and the fool aspects
of the human psyche, appearing in different settings across the
ages, from the courts of kings to the circuses, theatres, and silent
cinema screens –and not infrequently connected to healing prac-
tices or fulfilling supportive roles. In Native American cultures the
∗ Corresponding author at: Drama Therapy Graduate Program, Tel. Hai Academic
College, Upper Galilee, Israel.
E-mail address: pend@netvision.net.il (S. Pendzik).
Sacred Clown, is often considered a shamanic figure, supporting
community rituals of healing (Wright, 2004). In western medicine,
medical clowns have entered hospital wards providing emotional
support to patients and staff, distracting patients from unpleasant
and intrusive medical procedures, and reducing the fear and anxi-
ety involved in hospitalization (Vagnoli, Caprilli, & Messeri, 2010;
Raviv, 2012). The importance of bringing joy and laughter to the
situation of illness reduces stress and is recognized as promot-
ing healing (Adams & Mylander, 1998; Simonds & Warren, 2004).
Clowns are experts in discovering order within disorder, finding
joy in the face of loss and sorrow, pulling the truth from a nest of
lies, laughing at our human foolishness, and tolerating a margin of
mess (Babcock-Abrahams, 1975); therefore, they are well equipped
to provide relief and counsel in a hospital situation.
Most healthcare studies have focussed on the clown’s therapeu-
tic potential; from its ability to invoke humor, or to symbolically
play the role of a significant other (Koller & Gryski, 2008; Ofir, Tener,
Lev-Weisel, On & Lang-Franco, 2016). However, an understanding
of the therapeutic implications and effects of medical clowning has
been explored in recent years through the prism of drama therapy
(Grinberg, Pendzik, Kowalsky, & Goshen, 2012). Medical clowning
has been found to bear a family resemblance to drama therapy. Fur-
thermore, a drama therapy body of knowledge has been used to
explain the clown’s function in assisting clients to reconnect with

https://doi.org/10.1016/j.aip.2017.12.001
0197-4556/© 2017 Elsevier Ltd. All rights reserved.
 J. Gordon et al. / The Arts in Psychotherapy 57 (2018) 88–94
coping mechanisms that were currently unavailable. Perceived as
belonging to the realm of imagination, clowns are immediately
identified as an archetypal figure; therefore, they can relatively
quickly take on the role of guide in a child’s journey through hospi-
talization processes (Pendzik & Raviv, 2011).
The pioneering paper of Cheryl Carp (1998) presented a con-
ceptualization of the clown’s therapeutic potential – termed Clown
Therapy – which differed from medical clowning, being more
attuned to drama therapy and psychotherapy processes. This
approach claimed that developing the clown’s role with a client
– that is, helping clients to find their inner clown – may constitute
a therapeutic goal in itself. Clown therapy is firmly based on drama
therapy techniques, concepts, and theory, particularly rooted in the
notion of dramatic reality (Pendzik, 2006) and role theory (Landy,
2009). It involves the process of recognizing key/dominant and
oppositional personality roles, and bringing them together, lead-
ing to the emergence of the clown. The premise for this paper is
that benefits can be achieved and expanded through the client’s
encounter with their own inner clown.
Besides drama therapy, understanding of the psychological
impact of clown therapy is informed by the notions of the tran-
scendent function and transitional phenomena. As articulated by Jung
(1971), the transcendent function can be defined as the mediatory
space where opposites are suspended or united, where conscious
and unconscious contents converge. This function serves as a facili-
tator for other processes of the self (Miller, 2004). The transcendent
function corresponds with transitional phenomena in the Winni-
cottian sense (2005) – the intermediate area of human experience
between inner reality and the outside world. Transitional phenom-
ena are paradigmatic of the transcendent function, as they evidence
an in-between zone in which rationally irreconcilable opposites
meet and coexist. Both Winnicott’s transitional phenomena and
Jung’s concept of the transcendent function bridge between onto-
logical antagonisms such as self/other, subject/object, inner/outer
through a liminal experience that allows the opposites to be held
side by side.
These ideas resonate with the notion of dramatic reality in drama
therapy, defined as the materialization of the imaginary realm in
the here and now – the concrete form that the transitional space
takes (Pendzik, 2006). The figure of the clown not only illustrates
dramatic reality, but constitutes in itself a concrete incarnation of
the concept: Wherever the clown goes, dramatic reality is made
present and alive (Pendzik & Raviv, 2011). The clown’s presence
imposes upon reality the freedom of liminality, the boundlessness
of imagination, the containment of the potential space, and the
flexibility of paradox. As an archetype, the clown is a carrier of oppo-
sites: it embodies paradox and symbolizes liminality (Citron, 2011;
Van Blerkom,1995; Nichols, 1988). In the clown, we see the mind of
a child in the being of the adult, the coward in the courageous, the
vulnerable in the confident, the out of control in control. It serves
“as a bridge uniting neglected, shadowed, and unconscious ele-
ments with prevailing conscious attitudes through the vehicle of his
antics, his dress, and his personality” (Bala, 2010, p. 53). Hence, our
research has centered around the therapeutic benefits and insights
that a client –in this case, an addict – may gain from experiencing
the clown’s unique perspective and embodying paradox.
While substance use addiction appears to result from complex
interactions of biological, psychological and social-environmental
structures and processes (Arif & Westermeyer, 1988), it is primarily
the psychological aspects that we are concerned with, and within
that, with how the clown role can make a positive impact on the
recovering addict. We have been particularly interested in the work
of Maté: “Those whom we dismiss as ‘junkies’ are not creatures
from a different world, only men and women mired at the extreme
end of a continuum on which, here or there, all of us might well
locate ourselves” (2008, p.2). Maté was inspired by psychologist
89
Alexander, who regarded addiction as our adaptation to isolation
and purposelessness—what he called a poverty of spirit. Alexander
thought that people who are addicted have a void to fill. When they
can’t fill it with love, community, and a sense of meaning, they fill
it with whatever substitutes—or substances—are available.
Research on the use of creative arts therapies to treat substance
abuse suggests many benefits, including promoting motivation
(Holt & Kaiser, 2009) and willingness to participate in the treat-
ment (Dingle, Gleadhill, & Baker, 2008), helping clients move from
reflection into action, and encouraging creativity (Matto, Corcoran,
& Fassler, 2003; Brooke, 2009). Fernandez (2009) evaluated comic-
cartoon drawings within an inpatient treatment facility, claiming
that this technique serves as a vehicle for laughter and joy as well
as a means for containing ambivalence – a major aspect connected
to recovery. In addition, Zografou (2011) reported “the beneficial
effect of dramatization and dramatic play in improving addicts’
spontaneity and ability to self-disclose and self-regulate” (p.118).
A similar conclusion was reached by Bailey (2009), who posed that
addicts tend to be rebels, therefore, fun theatre games might cap-
ture their interest in a way that bypasses psychological resistances.
In addition, drama therapy helps them to connect to, and begin to
trust, their bodies.
Describing treatment of addiction in the creative arts therapies,
Horay (2006) pointed to the contrasting positions between the gen-
eral alignment with the 12-step model, which takes a confrontative
approach in order to break the client’s defense-mechanisms of
denial and shame (Step 1), and the British psychodynamic line of
work, aimed “at strengthening psychological defense-mechanisms,
promoting client strengths, and supporting emergent ambiva-
lence towards recovery” (p.15). Newer approaches have evolved,
such as Motivational Interviewing (MI), which combines a Roge-
rian approach with art making. “Motivational counselors ironically
accept addicted clients as they are providing an empathic atmo-
sphere, listening reflectively, and normalizing stated ambivalence
when possible” (Horay, 2006, p. 16). The dilemma between the
12-step and supporting the expression of ambivalence has accom-
panied the creative arts therapies for a long time (Johnson, 1990),
and is also found in the drama therapy literature on addiction treat-
ment. Bailey (2009) favored the development of drama therapy
groups in combination with the 12-steps, pointing out that drama
therapy brings into the 12-step method a creative resource that
is missing from it (Bailey, 2007). In contrast, Zografou (2011) and
Newman (2017) questioned the compatibility of these approaches.
According to Newman, participants shared their confusion between
the directness of the 12-step method and the use of metaphor and
distancing in drama therapy.
The project
For over ten years, we have been applying Clown Therapy work-
shops in the field of addictions. The project has been carried out in
day-treatment/rehabilitation centers with positive results, and has
gained recognition by the Ministry of Social Welfare in Israel. The
treatment is group-oriented, while the material emerging from the
process can be used in the participant’s individual therapy.
The groups consist of 8–12 participants, including mixed gen-
der groups (often majority male), as well as single gender groups.
The age range has been between early twenties to late fifties. The
groups reflect a cultural mixture of Israeli-born Jews, immigrant
Jews, as well as Muslim and Christian Arabs, Druze and Bedouins.
All have undergone physical withdrawal from substance abuse, and
are monitored by the center to ensure there has been no relapse.
In addition to a range of personality disorders, there is often a
criminal history of behaviours developed to maintain the addic-
tive habits. Some have voluntarily chosen to enter therapy, others
90 J. Gordon et al. / The Arts in Psychotherapy 57 (2018) 88–94
have been ordered by the courts to undergo treatment to avoid jail
sentences. While initially there is a gap between these two popu-
lations (often reflected in a greater resistance to therapy by those
who have been compulsorily enlisted), this gap becomes less appar-
ent, and ultimately, inconsequential, as clown therapy progresses.
In the day-center program, creative arts therapies and animal-
assisted therapy are included, in addition to more conventional
dynamic and cognitive-behavioral approaches. All clients partici-
pate in clown therapy, which is regarded as an integral part of their
rehabilitation process. Groups meet once a week, for 14–16 ses-
sions of three hours each, including a break. A social worker from
the rehabilitation center attends throughout the session and doc-
uments the process as part of the setting. Although initially this
may have an inhibiting impact on the participants, as the process
unfolds, their presence is acknowledged as being positive and sup-
portive.
The purpose of the group is to bring all members to experience,
witness, and accompany each other through a journey of discov-
ery of their own individual clown. Participants play active roles
as protagonists, antagonists, audience, and other supporting roles
and functions. The therapists work in and out of their Clown role,
facilitating a playful yet safe environment for participants. Unlike
medical clowns, therapists wear no costumes or red noses; yet it is
clear through their actions that they play a role that is recognizable
by the clients as a clown – with all it’s playful, foolish, provocative,
paradoxical and humorous elements.
The treatment can be divided into three stages: 1 – Setting the
process in motion; 2 – Giving birth to the clown; and 3- Integrating
the clown’s role in everyday life.
First stage: setting the process in motion (8–10 sessions)
During this stage, there are warm ups and theatre games based
on creative drama, movement, and theatre exercises. These sup-
port the participants to be present, attentive and focused, use their
bodies to express themselves, and become more familiar with non-
verbal communication, which is invaluable in the later work on the
clown. They also encourage participants to be playful and develop
a greater trust in each other, learning to forego judgement and
criticism. In addition, these games provide the therapists with ini-
tial information about individual and group levels of energy and
readiness for work. Warm ups are followed by the main body of
work, which is based on established drama therapy structures and
models, bringing to the surface unconscious material played out
through the different roles that emerge. For the successful “birth of
the clown” in the following sessions, it is important to support the
individual to invoke their widest possible range of roles.
The resistances that arise are often more prevalent in the early
stages of the process, where the emphasis on embodiment can
be experienced sometimes as threatening. Participants may feel
exposed, less in control, and confronted with their body image, par-
ticularly in regard of how others perceive them. The game-playing
may also be initially interpreted as non-serious − leading either
to alienation or to acting out. The cultural differences can also be
challenging. For example, the Bedouin culture emphasizes taking
life seriously, and laughter can be regarded as threatening.
The therapists may have to employ large doses of therapeu-
tic humor and laughter to cope with the resistances that arise in
the work and defuse tensions within the group dynamics. It is not
uncommon that the trickster and the fool aspects of the clown role
take the process in unpredictable directions, instigating provoca-
tive responses and negative behaviors. It is clearly stated from the
outset of the therapy – and reinforced throughout – that laughter
is always encouraged with another person and not at another per-
son. When generated through the individual’s own ability to laugh
at situations which had previously been painful to them, laugh-
ter is usually most liberating. This was the case, for instance, of a
group of women who played out themselves working the streets
in a highly stereotypical and grotesque way. Upon processing this
session, they acknowledged that their laughter reflected the ther-
apeutic progress they had made.
The therapists’ movement in and out of their clown role pro-
vides an encompassing role-model of what is normative. This also
help to bridge the gap between the sense of alienation that many
addicts experience (often having a narrow view of what is normal
behavior), and their perspective on authority figures (usually per-
ceived as hostile and threatening). While the therapists’ blurring
and even crossing of boundaries in their clown role may result in
their loss of a certain amount of authority, they gain a deeper sense
of intimacy and greater trust from the participants. Clown therapy
is in consonance with Reisman’s (2016) claims regarding the appli-
cation of developmental transformations with people diagnosed
with schizophrenia, where the mutuality created between ther-
apist and client through playing with different statuses can help
to “nudge the patient out of the ‘outcast’ role and into stronger,
more capable and empowered roles” (p.93). As such, the role of the
social worker, who remains throughout the therapy as co-partner is
important in maintaining the ground rules and holding the setting
where necessary.
The following exercises were found to be particularly effective in
establishing the repertoire of roles (both inner and outer) that indi-
viduals play out in their lives. It is open for the therapist to choose
whichever drama/theatre exercises would best suit the intended
objective.
Animal
Participants chose an animal that they identify with in terms
of personality traits or that they feel most connected to. They are
instructed to move around embodying this animal, getting inside its
skin, seeing the world around through its eyes. The point of focus
is to play with basic instincts and survival strategies. This work
emphasizes physical expression, preparing the groundwork for the
birth of the clown.
Characterization through physicality
Participants are instructed to lead their movements with differ-
ent body parts: nose, chin, chest, stomach, pelvis, and knees. They
physically create and develop a character that is suggested by each
body part, recognizing how personality is held and expressed with
the body. They are asked to play with shifting the gravitational pull
of the body, identifying how this impacts their emotional state,
how each role holds itself, etc. They are asked to pay attention to
behavioral patterns that can be recognized in the person’s walk,
and how they shift if the rhythm of the walk is changed. Nonverbal
dialogues are practiced between participants, working with exag-
gerated physical gestures. This work begins to deconstruct fixed
mindsets and behaviors, aiming at developing emotional flexibil-
ity; it provides a good basis for giving birth to the clown through
the body.
Playing with oppositional roles (role and counterrole)
A hat or any item of clothing suggests a character that can be
acted out and familiarized with. Having explored it for some time,
another character is chosen that is opposite in nature. Participants
reflect on these opposing characters, and discuss how they relate
to both, looking at the tension between them, and how their differ-
ences can be reconciled.
A story in six parts
Using Lahad’s structure (Lahad & Dent-Brown, 2012), partici-
pants are invited to draw a story, and share it with the group.
 J. Gordon et al. / The Arts in Psychotherapy 57 (2018) 88–94
Following this, they help to enact the story, with the author func-
tioning as director. Akin to Boal’s (1995) Forum theatre, this is done
with the purpose of encouraging the individual to take control of
their material, understanding its complexity and seeing where it
takes them.
Mask-disclosure
A set of basic, full faced theatre masks is laid out on a table in
front of the group. Each participant in turn approaches the table
with their back to the group, and chooses a mask that they are
drawn to. They are asked to choose from an instinctual level, with-
out considering the significance of their choice, and dismissing any
preconceived notions as to how they will act upon putting on the
mask. The work is performed in complete silence, often taking on
a trance-like effect, drawing deeply upon the individual’s uncon-
scious mind. Turning to the group, they are given the opportunity
to “occupy the stage.” The therapist, followed by group members,
ask them various questions pertaining to their character’s life. They
answer only through physical gestures. These answers draw out the
personality that the mask has evoked. The mask is then removed
and returned to the table with one’s back turned. The participant
is asked to verbally process the experience, with the therapist sup-
porting them to connect the unconscious material that emerged
with its expression in their lives. This “unmasking” is an important
stage in approaching the work on the clown.
Stage 2: birth of the clown (3 sessions)
During this phase, the personal clowns are born. To conceptu-
alize this process, we turn to Pendzik’s (2012) distinction between
role and character: While roles represent an archetypal stratum
(clown) or point to functional aspects (performer, director), char-
acters are more personalized, incarnated versions of the role – thus
possessing individualized traits. In this phase of the work, the indi-
vidual clown of each participant is “downloaded” from the clown
archetype, so that each person ends up finding his or her own ver-
sion of it.
For this purpose, all the character types that were explored
in prior sessions are reviewed, and individual as well as shared
personality patterns or behaviors are identified. These dominant
aspects help to configure a map in which personality traits or roles
that the client plays in real life are recognized. In dialogue with each
person, the clown therapists identify two dominant roles, which
may present themselves as Role and Counterrole (Landy, 2009),
conscious and unconscious, revealed and hidden – one role sitting
on, and exerting its influence on the other. While the games played
in the group serve as a basis for establishing the dominant roles
of each participant, a clear grasp of drama therapy language by the
therapists, paired with many conversations with the clients around
their role-play (as in Landy’s (2009) 5th step), are required to reach
an accurate diagnosis of the main paradox at work, and to deter-
mine which are the key elements supporting clown’s emergence.
It is also important to note that failure to establish the dominant
roles did not permit the clown to come into fruition, pointing to
the need to re-examine the dominant roles and find the ones that
were more precise and relevant for the individual.
Once the oppositional dominant roles are established, the per-
son is asked to physically get into the role, and instructed to walk
around (often in an exaggerated way), embodying first one aspect,
then the other. Finally, people are coached to incorporate them
both through their bodies, as they walk. This is a natural process,
and the mind can seldom grasp the paradoxes expressed by the
body. Sometimes people experience resistance at this stage, which
often comes from their difficulty to understand the way in which
the roles merge, or from their fear of allowing it to happen. This
resistance may be comprehensible because the process involves
91
giving physical shape to a symbol! In his seminal work on Jung’s
transcendent function, Miller (2004) states that “symbols are the
quintessential example of something that is neither rational nor
irrational, neither conscious nor unconscious, neither purely rea-
son nor instinct: A symbol is a liminal entity standing with one
foot in opposite camps; it carries pieces of both the opposites and
becomes a mediating force between them” (p.50). Seen in this way,
one might say that the invocation of the clown is essentially about
embodying the transcendent function.
Each clown has a unique physical expression that takes form in
the body. For example, in a happy/sad person, we often see the hap-
piness expressed in the upper part of the body (including the face),
through open and fluid movements, while the sad aspect is voiced
as slow, heavily weighted movements in the lower body, with the
point of gravity in the bending of the knees. In a confident/shy per-
son we see the lower body pushed back while the chest is pushed
forward, or maybe reversed – so that the clown emerges confident
in his/her lack of confidence.
In turn, group members are individually coached to give full
bodily shape to their inner clown, holding the oppositional roles
together and allowing a fun interplay between them, without let-
ting one part dominate the other. It is important to point out that if
the person remains stuck, insisting on asserting one dominant role
over the other, the clown does not emerge. However, when the
invoked clown is born, this is absolutely clear, both to the individ-
ual and to the group: There is a natural sense of peak, (akin to what
Austin (2007) calls a performative), a kind of magic moment, which
is marked by other participants organically standing up and clap-
ping in recognition. In moving into the clown role, the transcendent
function clearly emerges, as the opposites unite by a neutral or an
ambivalent bridge, a symbol expressing either side in such a way
that they can function together (Jung, 1954) – which in this case is
the clown.
At this point we give the individual the red nose. This act anchors
their clown role in a ritual, so that each time they put it on, the
body remembers and moves into the role. Lecoq (2006) writes that
“the red nose is the smallest mask in the world” (p.116), and when
one “enters ‘concealment’ behind the mask, there is a paradoxical
freeing of behavior. . . ultimately the transformation is revealing
rather than concealing” (Larsen,1990 p. 236). One client described
the experience saying: “I feel as if a cork was released in my chest
and now I have so much more energy. . .!” Indeed, it is liberating to
embrace one’s ridiculous side; for in doing so, the clown exposes
absurdities, encourages shifts in perspective, and sparks processes
of change for both performer and audience (Lecoq, 2001; Schechter,
2003; Schutzman, 2008).
Stage 3: integrating the clown into one’s life (3 sessions)
Once all the clients discover their clown, various exercises are
offered to give them the opportunity to explore the role more in
depth – trying out Landy’s (2009) 3rd, 4th, and 5th phases of the role
method (working through the role, exploring alternative qualities
in sub-roles, reflecting upon the role-play). Simple exercises, such
as meeting at a bus stop and waiting for the bus to arrive, painting
the house, dealing with a broken-down car, and so on, are played by
the clowns, revealing the humorous and absurd sides of everyday
life, the pleasure of being totally present, and the possibility for
having fun in the most banal situations.
The interactions of the clowns allow for new patterns of com-
munication to emerge between group members, breaking rigid
power struggles, cynicism, overt criticism and judgmental pat-
terns, and opening up participants to experience a more accepting,
loving and compassionate approach to both themselves and oth-
ers in the group. Experiencing these emotions is a catalyst for
therapeutic growth, as positive emotions broaden an individual’s
92 J. Gordon et al. / The Arts in Psychotherapy 57 (2018) 88–94
momentary mindset, and help to build enduring personal resources
(Fredrickson, 2001).
One of the techniques we normally use at this stage runs parallel
to Landy’s (2009) 6th step: relating the fictional role to everyday
life: Having explored the clown role in depth, the group divides into
pairs. One tells the other about an issue that challenges them, with
which they have difficulties in actual life. The other listens atten-
tively, knowing they will need to feed all this back. The individual
who has told their story, then puts on a red nose, enrolling in their
clown; with the listener repeating the issues, they react by playing
with the material and transforming it from the unique perspective
of their clown. Handed over to the wisdom of the clown, the same
issue that may has been previously threatening or stress provok-
ing, can become approachable, and in many cases, even brought to
a satisfactory closure.
In this way, a fruitful inner dialogue is established between
the person and his/her inner clown. The clown may be invoked to
answer personal needs, and thus become a trusted guide, whom the
person can approach for help and advice. In fact, as Landy (2009)
claimed, “the Guide is a transitional figure that stands between role
and CR and is used by either one as a bridge to the other” (p. 68). If
the person becomes too serious, the clown will remind her/him to
lighten up; if too irreverent, to find respect; if feeling the effects
of depression, to dance the freedom of happiness. Furthermore,
embodying the transcendent function gives individuals the advan-
tage of trusting their inner voice, thus defying the tendency to be
totally dependent on the therapist for life’s ongoing challenges.
The whole process of discovering the clown is then presented as
an autobiographical piece. Putting the narrative in a theatrical form
allows group members to have a perspective on where they started
and where they are now, as well as to explore the various phases
of their journey. Usually, playing this in front of the group per-
mits them to fully grasp the meaning of the clown in their personal
growth and wellbeing. “Jung’s transcendent function is essentially
teleological: it unites opposites as part of a grander plan of indi-
viduation guided by the self.” (Miller, 2004, p. 89). A glimpse of
this grander plan is sometimes attained through autobiographical
performance – a drama therapy format that has been compared to
initiation rituals (Pendzik, 2013; Volkas, 2017).
In tune with Landy’s (2009) final step of the role method (social
modelling), one option for closure that has proved to have a pos-
itive impact on participants, is volunteering for one morning as a
group of clowns in a hostel for children with special needs. For the
recovering addicts, who have spent so much time stuck in victim
role, to experience that they can give something, strongly sup-
ports the changes they have made. Being valued and reciprocating
is an additional motivator for remaining clean and continuing to
contribute to society. In many respects the whole area of social
clowning (clowning in the service of the community, such as in
elderly homes, special education schools, hostels, orphanages, etc.)
can provide a wonderful context for maintaining a deep connection
to the clown role.
Case studies
These are a few illustrations of our work. (All names have been
changed and features have been blurred to protect the client’s iden-
tities).
Moshe
A 50-year-old man, who immigrated to Israel from Eastern
Europe at the age of 11. His integration into the new culture was
problematic, and in this period, his mother took her own life and his
father returned to their home country. Being raised by his aunt who
was diagnosed with a bipolar illness, his first encounter with drugs
was in his early teens, and his heroin addiction began in his early
twenties. He was married and divorced, and he has a child with
special educational needs with whom he has a good and protective
relationship. After three years in jail after a conviction for theft and
drug abuse Moshe entered therapy out of free choice, while under
house arrest. Although at first clown therapy was difficult for him,
by the end of the process he was convinced that it was the most
powerful therapy that he had ever undergone.
The dominant roles that emerged in his process were that of a
very controlling, highly rational and ordered individual, opposite
to an emotionally volatile and chaotic one. Moshe referred many
times to the threatening nature of his emotions and the need to
take control of them without spiraling into a world of anarchy –
clearly represented by his drug-abuse.
When enrolling physically into the clown role, the controlling
side was expressed by his upper body through restricted, stiff,
almost robotic movement, while his emotional chaos was apparent
through a lightness of step with darting movements that were also
expressed in his face. The clown allowed him to bridge the two
conflicting states, and in doing so, he could be both rational and
emotional, in control of his emotions and able to generate a greater
flow within himself.
He stated that it was the first time in his life that he had found a
structure that could hold and maintain both sides of his personality
and benefit from doing so, without feeling one side was threatening
to sabotage him. The experience of being in clown role and bring-
ing joy to people with special needs as he had done, completely
transformed the poor image he held about himself.
David
Born in Israel David was 44 years old, married with four children.
Addicted to drugs for over 30 years, David had been in and out of
prison several times for drug related offences. His mother and sister
died when he was 12, at which point he dropped out of school and
raised himself. Having to provide money for his family, he made
a living by stealing and selling oranges. David described a strong
connection to the sea in his hometown.
The dominant roles that emerged were that of a survivor with
all the strengths for adapting to difficult and challenging situa-
tions, as opposed to an emotionally vulnerable and overwhelmed
individual.
In entering the clown role, his shoulders were bent, his upper
body leaning forward with a certain stiffness in the pelvis area,
representing the depressed, defeated side of himself, opposite to
very energetic lower body movements and a highly animated facial
expression, representing possibilities and energy to keep moving
forward. In combining these two states the clown produced a fre-
netic and heavy figure, with a very humorous approach to the
exercises he was presented with.
He reflected that it was the first time that he realized the deep
level of depression he had fallen into, resulting from the unbearable
pain of his heavy loss and his attempts to ease it with drug use. His
clown was a natural way of reminding him of happier possibilities
and to restore his inner and outer balance, enabling him to function
better.
Joseph
A 54-year-old man, Joseph was of Moroccan background and
had left Israel in his twenties to America where he lived the Ameri-
can dream as a successful filmmaker in the commercial/advertising
market. Joseph lost his financial security and got divorced because
of his drug-abuse. After unsuccessful therapy interventions, he
returned to Israel in his late forties, feeling a total failure.
 J. Gordon et al. / The Arts in Psychotherapy 57 (2018) 88–94
The dominant roles that emerged were that of a passive, accept-
ing and giving person, opposite to a restless and destructive one –
both to himself and to others.
In the clown role, his upper body and chest pushed out, reflecting
a great openness; his pelvis thrust forward in an aggressive way,
arms spread out in an inviting manner, with short restricted leg
movements, reflecting a tightness in his bottom and a resistance to
moving forward. Combining these opposites, the clown emerged
as open to the world around, looking for creative possibilities, yet
without putting himself out there in an exposed and vulnerable
way.
He said that his clown experience reminded him of how the
arts, creativity, and spiritual undertakings are viable structures to
fill the big void that he felt inside his soul, which was threaten-
ing constantly to overwhelm and suffocate him. Since the clown
experience, Joseph returned to writing, scripting feature films and
became involved with supporting rehabilitated addicts.
Dafna
Dafna was an Israeli Jew of Yemenite ascent, in her late thirties,
and a survivor of sexual abuse. She engaged in sex work to pay
for her drug habit. A single mother, her child was taken into child
custody because of her drug abuse.
The dominant roles that emerged were that of an outwardly
powerful, proud and self- confident individual, opposite to an
inwardly vulnerable, exposed and emotionally stunted one. She
described herself as a “bird who wants to fly, but her wings are of
iron and lead.” She dealt throughout the process with the question
of freedom and the possibilities to be free from exploitation.
In her clown role Dafna had the movement of a marionette pup-
pet that had its strings cut. There were both a sense of stiffness and
of flow in her body, reflecting a certain restrictiveness, while her
physical movements were expansive, occupying the space around
her. Her clown reflected the possibilities of freedom, while main-
taining the necessary boundaries and sense of security.
Dafna’s experience with her clown, guided her to a further pow-
erful image, that of ‘Pinocchio’, the wooden puppet that has had his
strings cut off and is slowly becoming a real fully functioning child.
Daphna saw this as a personal rebirth, learning how to cope with
her newly found freedom.
Discussion and conclusion
In a report surveying the responses of 70 clients from nine treat-
ment centers published by the Ministry of Social Welfare, clients
attested to the following positive results of their exposure to Clown
Therapy: a. improved relationships with their families (particularly
with their children); b. an enhanced sense of balance in their lives,
reflected in a capacity to move beyond a constant conflict with
themselves, those around them, and authority figures; c. greater
emotional flexibility, which allows them to be freer in their move-
ments without the need for drugs to release emotions, as one of
the participants expressed, “being able to dance at friend’s wed-
ding without having to drink first;” d. greater ability cope with life
changes; e. an increased level of creativity, which can be applied
to finding solutions to various life-challenges; f. a newly found
sense of achievement, including the discovery of strengths that they
weren’t aware of before; g. an increased self-awareness paired with
the ability to laugh at themselves and their former afflictions; h. the
strengthening of self-esteem and an openness to others in a less
critical and judgmental way (Barnett, 2010).
The clown reveals the human ability to play, which is natu-
rally present in children − and usually lost in adulthood. While
children process life through dramatic play, exploring their place
93
in the world, moving in and out of different roles and narratives,
adults require a theatrical, social or drama therapy context to do so.
The clown role gives adults permission to be playful and express
their full range of emotions. As stated by Winnicott (2005), “it is
in playing and only in playing the individual child or adult is able
to be creative and to use their whole personality, and it is only
in being creative that the individual discovers the self” (p. 72–73).
This is echoed by Corbett (1993) who claims that “the transcendent
function describes the capacity of the psyche to change and grow
toward individuation when consciousness and the unconscious
join, revealing the essential person” (p.395). It is our understanding
that clown therapy supports these processes.
Furthermore, the clown role is a tool for working with paradox
and ambivalence – which is an important aspect of the therapeu-
tic process with recovering addicts. In the clown role, we not only
accept the fundamental paradox of ourselves, but embody it and
learn to play with it as well. We don’t claim that the approach
can “cure” people from addiction, and certainly the possibility of
relapse is always present; yet we have found in the clown a help-
ful strategy for normalizing paradox and tolerating contradiction −
which can be a therapeutic intervention in the treatment of addic-
tion (Horay, 2006; Fernandez, 2009). In Landy’s (2009) words, “the
healthy person, from the point of view of role theory, is noted by
an ability to live with ambivalence, contradictory tendencies and
paradox” (p.73). Internal contradiction causes the clown to be in
a state of perpetual movement between opposites, which makes
inner paradox become a form of logic: the logic of flexibility and
incessant process. As a role that does not seek resolution of paradox,
the clown establishes a dynamic equilibrium that supports self-
regulation, allowing individuals to free themselves from deviant
behavioral patterns, and to hold the future possibility of individ-
uation, “the transformational process of integrating the conscious
with the personal and collective unconscious” (Jung, 1962 p. 301).
In the clown, the individual lives harmoniously with their con-
tradictions, allowing for a fuller and more enriched experience of
life.
An important feature of our approach involves learning, devel-
oping and performing a new role. Role enactment involves the use
of basic cognitive functions that include a relational dimension
(Frydman, 2016), as well as “the engagement of the physical body”
(Armstrong et al., 2016 Armstrong et al., 2016, p.29). The embodied
aspect is crucial in our approach, as clown therapy not only holds
paradoxes in a philosophical realm but also roots them in the per-
son’s body. We found this aspect of the work to have the greatest
impact on our clients. Applying it with addicts, for whom their body
is not to be trusted, this kind of work was extremely healing.
We have debated whether Clown Therapy should be consid-
ered an emerging form in the creative arts therapies, or if it can be
regarded as a specialized branch within drama therapy. As pointed
out throughout the paper, Landy’s role method and theory serve as a
guideline in the therapeutic process. Furthermore, Clown Therapy
clearly shares the nine core processes theorized by Jones (2007)
as constituting the essence of drama therapy practice: Dramatic
projection, playing, embodiment, role playing and personification,
drama therapeutic empathy and distancing, interactive audience
and witnessing, the life-drama connection, therapeutic perfor-
mance, and transformation.
While we have developed Clown Therapy primarily in the con-
text of substance abuse and addiction, it is possible to assume that
it may have potential for people suffering from a wide range of dis-
orders. Participating in the art of clowning has proved effective for
improving the quality of life of people with disabilities, youth at
risk, and other marginalized groups. Perhaps this is so because the
liminality of the clown may offer a voice to those who find them-
selves in marginalized positions. Ultimately, since under certain
circumstances every one of us can be an “outsider” in need of self-
94 J. Gordon et al. / The Arts in Psychotherapy 57 (2018) 88–94
acceptance and social inclusion, clown therapy can be an aid for all
of us.
Acknowledgments
The authors wish to thank Joy of Heart Organisation under the
directorship of Zvi Meir; Ministry of Social Welfare, Gila Barnett
(Former Chief and National Inspector for Substance Abuse at The
Israeli Ministry of Social Welfare); Yachdav Organisation Beer-
sheva; Rashi Foundation, Israel; drama therapist Galila Oren, for
her invaluable comments to the article.
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