It was 1996 when Senior Research Scientist Ramiro Salas, PhD, attended his first Playback Theatre show at The Jung Center of Houston. Salas wasn’t sure what to expect as he walked into the sparse performance space. A few chairs were lined up neatly in rows and a simple curtain backdrop hung on one wall.
 
Had it been any other night, Salas would have been hard at work in his graduate school program, but an old friend who was part of the theatre troupe had urged him to attend. So, he went — mostly as a favor to his friend.
 
Playback Theatre is an interactive form of improvisational theatre. Audience members share real stories from their lives and then watch as actors recreate these moments on the spot with a few basic props. It first emerged in the 1970s in New York but later grew to include hundreds of amateur companies performing around the world.
 

A Powerful Experience

What unfolded during the performance was a revelation for Salas. He had anticipated being a silent observer from the back row, but only 10 minutes into the show, he felt compelled to share his own deeply personal story to be re-enacted in front of him and the audience.
 
“It was something I’d never seen before,” he says. “This is how art should be in a sense; creating something together that is directly coming from my experience.”
 
Soon, Salas was no longer just an audience member but had joined the Houston Playback Theatre company as an actor. He says what makes Playback Theatre so powerful is not the professionalism of the acting, but rather the actors’ ability to listen and find the essence of audience members’ stories. “We’re here because we want to honor people’s stories,” he says. “Why is this person telling this story today?”
 

Therapy through Theatre?

Over the past 25 years, Salas has recreated numerous moments from people’s lives, some poignant, some hilarious, some tragic. He’s also found Playback to be personally therapeutic, helping him to gain a greater appreciation of the human condition and be more forgiving of others.
 
After Hurricane Harvey struck Houston in 2017, leaving thousands of people traumatized by devastating floods, Salas wondered — could Playback Theatre help them better cope like it had helped him? Salas, who is an expert in human brain imaging and an associate professor at Menninger’s affiliate Baylor College of Medicine, decided to conduct a small pilot study to find out.
 

Putting Playback to the Test

In 2018, as part of Salas’s research, Houston Playback Theatre performed a series of four weekly shows centered on the topic of Hurricane Harvey for 13 people who had flooded during the storm.
 
During the performances, participants shared a range of Harvey experiences that arose in a loosely chronological order, like believing that news reports of the potential flooding were overblown, futilely attempting to stop floodwaters from coming inside using towels and duct tape, feeling shame for seeking shelter at a wealthy neighbor’s elevated house, and being grateful for unexpected help from strangers to rebuild. The actors “played back” each story to audience members, weaving a spontaneous narrative of denial and preparation, rescues and immediate aftermath, and rebuilding and coming back.
 
In the week prior to and following the performances, Salas scanned the brains of audience members using functional magnetic resonance imaging (fMRI), which provides a map of brain activity, including regions that are tied to certain thoughts and feelings. Participants also completed questionnaires measuring symptoms of anxiety, depression and post-traumatic stress disorder.
 

A Clinically Significant Change

The pilot study affirmed what Salas himself had experienced. By the end of the performances, the audience members reported improved mental health, with a clinically significant change in symptoms of anxiety, a finding backed up by the fMRI scans. “Their brains actually changed in a way that showed their anxiety was lower,” he says.
 
Results of the study were published in the academic journal Chronic Stress in November 2020. As natural disasters have become more frequent, Salas hopes to secure research funding to pursue a larger study of Playback Theatre as a low-resource intervention for people who experience these types of traumatic events.
 
He believes Playback may help people reconstruct and make sense of natural disasters together, since traumatic memories are often fragmented and disorganized. By empathizing with someone else’s story, we can create a clearer picture of our own experience — and better cope with it. “Every story is relatable in some way,” says Salas.