The curtain rises and the houselights dim. A shy and anxious young woman sits bathed in a spotlight as she wails her confession: “I’ve got problems! I’ve got problems!” Other actors appear around her and gleefully shout out their reply: “We’ve got them too! Welcome to the group!”

Welcome, also, to the opening number of the musical created by American Counseling Association member Aaron Toronto, who first conceived of the idea for Group … For Your Mental Health in 2005 while leading a mock group therapy session during a graduate counseling class at South Dakota State University. “I thought that an anxiety therapy group would be rich fodder for a play. That’s where the inspiration came from,” he says. “I chose anxiety because it’s the most common reason people seek counseling and, I think, seen in the right light, anxiety offers a lot of opportunity for comedy.”

With the creative juices flowing, it didn’t take Toronto long to create a rough draft of the play, which he presented to his adviser, SDSU counselor educator and ACA member Chris Briddick. “I didn’t start writing the play with school in mind,” Toronto says, “but after talking to Chris, he suggested that we should do this as an independent study. I thought, ‘That’s a great idea. Get extra credit for writing a play!’ So we met every week or so about it, and he gave me some great ideas and direction.”

Taking time off to pursue independent study can be risky for a student, but Briddick was confident that Toronto was up to the challenge. “It’s one of those things that, as a professor, you hope that when students step in to do independent studies, that they have the motivation to follow them through and do a good job,” Briddick says. “From day one, I was never concerned that Aaron wouldn’t be able to do this. You could just hear his determination and passion when he spoke about it. And it has turned out to be the most fun I’ve had in my teaching career.”

Toronto collaborated with friend Heidi Grimsley, a composer, to craft the songs for the quirky musical and cast local theater students from SDSU for the production. After several rewrites and rehearsals, the play premiered on campus earlier this year.

In Group, the audience gets to observe group therapy sessions, led by pop psychologist Dr. Bloom, and watch the journey of six panic-riddled clients as they attempt to manage their various anxieties and issues. “Everyone in the group has suffered a number of panic attacks,” Toronto explains. “During the session, they allow time to ‘unpack’ — ‘pack’ being short for panic attack — and share their stories about their anxieties. Although the group members are all connected by anxiety, we do see glimpses of other disorders and issues such as depression, OCD, social phobias, sexual abuse and obesity. However, I wanted anxiety to be the thread that held the quilt together, so to speak.”

In guiding the group members through their anxiety-filled struggles, the egocentric Dr. Bloom, author of the renowned self-help manual, Titanic Panic: Don’t Let Anxiety Sink You, eventually is compelled to face his own demons, which threaten to destroy his career and the fragile world of his clients.

Toronto, who graduated from the master’s counseling program last year and currently works in private practice as well as part time at the SDSU counseling center, says real-life clients inspired several of the characters in his musical production. “I’m a big believer in life imitates art and art imitates life,” he says. “Some of the characters are based on clients that I’ve seen, but one in particular was actually a client of my mother’s. My mom is a psychiatrist, and she saw a client who owns hundreds of pairs of panties because she has a compulsion to change her underwear. I took that idea and exaggerated it a bit for theatrics and to make it funny. The character I created is a woman who must change her panties seven times a day. She does this to get rid of the cooties because her ex-husband cheated on her with seven different women.”

The cast of Group ... For Your Mental Health
The cast of Group … For Your Mental Health.
Aaron Toronto collaborated with songwriter Heidi Grimsley
to create Group.

With taglines such as “Putting the fun back in dysfunctional” and “When you’re one step away from crazy, sometimes all you can do is sing,” audiences understand ahead of time that humor will play a major role in the production. But Toronto notes that the play features some realistic and intense scenes as well. In particular, he points to the play’s climax, when Dr. Bloom collapses in his first panic attack during a group session. His attack is brought on by suppressed emotions surrounding his teenage son’s suicide years earlier. “He’s struggling with his own issues,” Toronto explains. “I wanted to show that this world-famous, well-known author and therapist who has helped many people, in the end, he couldn’t help his own son.”

Briddick adds that one of Dr. Bloom’s biggest flaws is that he is determined to help his clients by the book — his book. “But he also has some things that are haunting him as well, so in a way, it’s about how therapists need to stay in check with their own feelings, issues and well-being,” Briddick says. “It speaks to the importance of therapists making sure that we aren’t impaired by our own issues.”

In addition to weaving the true-life message about self-care into the play, Toronto says he tried to keep the dialogue portions of the musical realistic, reflecting what might be said during a typical counseling session. Ultimately, he says, he wanted the characters to be entertaining yet relatable and universal.

“I really wanted to try to get across the point that everyone struggles,” he says. “The characters are everyday people. Some have had events in their lives that led to their anxiety, and some are just anxious because they are anxious. I wanted to show that everyone has issues and everyone has things they are working on, but it’s better to get through these things together than to go at it alone.”

Some audience members may consider parts of the play shocking, but Toronto insists the scenes weren’t included for their shock value alone. One of the most extreme scenes involves the therapy group’s reenactment of a group member’s sexual assault after Dr. Bloom instructs the group to role-play the incident. Toronto received some negative comments about the scene, and he admits the scenario is far-fetched for any true counseling group, but he believes the scene communicates an important point while also provoking thought. “I wrote it to show that the therapist had become so arrogant that he felt like he could do that and it would be OK,” Toronto explains. “It does get out of hand, and it causes a very intense moment in the play. That scene has bothered some people, but I haven’t changed it because I wanted to push the envelope a bit and also show that therapists make mistakes. They are just people too.”

What the (counselor) critics are saying

Of the nine performances of Group held on the SDSU campus, eight played to sold-out crowds, with many people waiting in standby lines in hopes of scoring an open seat.

Briddick labels Toronto’s musical a “dramedy” — part drama and part comedy. “There are parts where you don’t know if you are supposed to laugh or cry,” the counselor educator says. “But what I enjoyed the most was seeing these quirky and humorous characters display incredible resiliency. The first time I watched the performance, I was literally amazed. Each character feels that they are losing control or that they aren’t in control of their lives. But they all are resilient, and they have a true desire to help themselves and others. It’s one of those therapeutic constants that we hope for — that people have the potential to solve their own problems, and maybe they are strong enough to help those around them.”

Howard B. Smith, interim dean of the counseling department at SDSU, admits that he was concerned about how the mental health profession would be portrayed when he first heard about the play. But after watching a performance, he found that the play represented the profession in a positive — yet still human — light.

“Generally speaking, the fact that counseling as a profession is seen more and more in entertainment in society today is healthy and good for the profession in many ways, as it de-mystifies the profession and makes it more real,” Smith says. “Counselors are usually seen as being the caring and helping professionals that they are, which humanizes them and removes some of the stigma or anxiety that getting help can often create. We, as counselors, must be seen as approachable, well-educated and highly skilled professionals, capable of assisting people as they struggle in their lives. In my humble opinion, Toronto’s Group does just that.”

“As a member of the general audience,” Smith adds, “the story line was easy to grasp and follow. It was entertaining, and the lyrics to the music kept my attention. The cast members seemed to fit their roles both physically and in terms of personality, but I would not call it typecasting. As a mental health professional, the maladies of the group members were presented appropriately, without condescension and with good taste and just a hint of humor at the right time to keep the tone of the play entertaining rather than slipping into becoming maudlin. To be sure, there were moments of intensity, as in any group session, but the overacting of the characters, which is often characteristic of dramatizations dealing with mental health issues, was minimal or nonexistent.”

Ruth Harper, a counselor educator at SDSU and the editor of the Resource Reviews column in Counseling Today, says she was captivated by the play’s music and lyrics and left the theater singing “I’ve got problems, I’ve got problems,” the chorus of the opening number stuck in her head. Additionally, she thought the cast did a phenomenal job of bringing Toronto’s characters to life. She did question some of the writer’s decisions, however.

“From the perspective of a counselor, I am always a bit troubled when the therapist is revealed to have as many or more problems than the clients,” she says. “I’m well aware, and happy, that counselors are fully human and that they are not perfect, not ‘above’ others. Yet, it seems that most dramatic depictions of counselors take some pleasure in bringing the mental health professional down to size, to say, in effect, ‘Look who really has issues.’ For instance, the hilarious and flirtatious dance between Freud and the therapist’s mother while the therapist is out cold after a major panic attack can be seen as another over-the-top rendering of a messed-up group leader.”

Although Harper found that moment of comic relief entertaining, she is concerned about depictions of counselors in the media and arts. “Counselors are often portrayed as (a) too flawed, (b) having no boundaries, (c) displaying limited knowledge of the code of ethics and (d) overemphasizing the value of cathartic breakthrough. I would love to see more realistic portrayals of mental health professionals and their work.”

Briddick, one of Toronto’s biggest fans, sees the flawed characters as human and relatable to the general public. “Aaron took the subject of group counseling and made it known to a much larger audience,” Briddick contends. “One of my fears was, as many people do when they write about counseling, that it might not paint counselors in a positive light. But everyone I’ve talked to said that it was funny, yet at the same time, very respectful of the characters’ issues and the profession. It’s Aaron at his very best as an artist and, in my eyes, as a student. I think it’s going to go places. It’s just that good.”

Group’s future

With the overwhelming success of the play on campus, Toronto has been shopping Group to area production houses and performance art festivals. “We are submitting it to the New York Fringe Festival — it’s like the Sundance of the theater — and I think we have a good shot at being at that,” says Toronto. The play was also selected for a short run this month at the Washington Pavilion, a major playhouse in Sioux Falls.

But Toronto hasn’t completely forsaken his counseling roots for a shot at fame on a larger stage. He recently presented a workshop at the South Dakota Counseling Association Conference on the use of themes and scriptwriting in therapy. He encourages all counselors to tap into their creative sides and incorporate their “outside” talents into their practice. Toronto hopes to present his story and the process of creating Group at next year’s ACA Conference in Charlotte, N.C.

Synopsis of Group … For Your Mental Health

Act I opens with Mel, the newest character of the group, introducing herself by singing “I Got Problems.” Marta and Trent, veterans of the group, then confront each other’s unwillingness to share. Sensing the tension, Dr. Bloom suggests an “emotional devotional,” a therapeutic technique he created to help the group sort through complex emotions. “Emotional Devotional” is a rap spoken over a hip-hop beat. Once the emotional air has cleared, the audience turns to Marta. She reveals that her anxiety this particular week is due to seeing her ex-boyfriend — whom she still loves — at a restaurant with another woman. She searches for a way to overcome her intense fear of her own beauty in the song “Being Beautiful.”

Next is the character Alex, who struggles with obsessive-compulsive disorder and belts out “I Change My Panties,” which details her need to switch undies seven times a day. In her mind, her compulsion helps her “wash away the cooties” brought on by a cheating husband.

The widower Harry is up next in the group. After losing his wife in a car accident, he is reluctant to approach or even speak to women. His goal last week was to just say “hello” to a coworker. He tells of his backward success in “She Said Hello to Me First.”

Afterward, the group gives the “pack” — short for panic attack — report. Alex then suggests that Mel “unpack” or talk about her most recent panic attack. Mel refuses at first, but does so after a tension-filled moment in which Trent questions Dr. Bloom’s ability to help the group. Mel compares a panic attack to love at first sight in her song “I Wish It Was Your Charms.”

The next song takes on a more serious note, as Trent shares his experience in a mental hospital in “Count Thirteen.”

Alex, who’s been trying to tell her very conservative parents that she’s divorced, confronts her emotional roadblocks in the song “Mom and Dad, I’m A Democrat.” Harry and Ben comically role-play her parents. As Act I comes to a close, Ben shares some shocking news with the group. Because of his obesity and diabetes, he is dying. His doctor urged him to lose weight or tempt fate. The group rallies around Ben in the song “One Step Away.”

Act II opens with several group members encouraging Ben to join Belly Busters, a weight loss club. They are all standing outside the door to Belly Busters, but Ben is reluctant to enter the building and sings “You Can Leave Me Here on the Sidewalk.” Eventually, with support and a bit of tough love, Ben walks inside and his life is transformed. The humor doesn’t last too long as the group reconvenes the following week and Marta confronts her past rape through a role-playing song, “Seeing Red.” This highly charged moment leads to Dr. Bloom’s first panic attack. While unconscious in the hospital, Dr. Bloom dreams that his mother and Sigmund Freud dance a psychedelic tango in the song “To Much Id.” Once recovered, the group members talk Dr. Bloom into joining his own therapy group. He does and shares the root of his anxiety — the suicide of his teenage son. The group members embrace the doctor, and the play ends with the song that also began the play, “I Got Problems.” This time, however, the famous Dr. Bloom sings along too.

— Synopsis courtesy of Aaron Toronto