Psychodrama therapists need to explain better what they do in therapy when they do what they do (Marineau 2011, p. 43). The role theories are not sufficient to justify the specific therapeutic effects of psychodrama therapy. The cross-analytical concept of mentalizing gives a new scientific basis to the profound emotional experiences in classical psychodrama: Psychodrama is inner mentalizing through external play in the as-if mode.1. The therapist intuitively uses the patient’s metacognitive tools of inner mentalizing as external action modes. Doing this, inner representing, interacting, rehearsing mentally, and integrating become external scene construction, role play, role reversal, and scene change. This knowledge helps to treat the patient's disturbed metacognitive processes directly in a disorder-specific manner with a lot of time in the right place.2. The psychodramatic external action in the as-if mode completes the associated neuronal resonance circuits between the various memory centers with new elements. According to Moreno (1970, p. 77), this gives rise to the “true second time, which liberates from the first”.
The concept of mentalizing explains why psychodrama therapy is not only used in groups, but also in individual settings. Behavioral therapy, systemic therapy, and depth psychological therapy are increasingly integrating the disorder-specific psychodramatic action methods into their own therapeutic work.