Dialogue. This is another tool for fostering creativity. There is an immediacy about it, using the oft-encouraged "I messages" in speaking directly to the other person, even if that other person is only imagined, as if they were present in, say, an empty chair. (This technique, commonly used in Gestalt therapy, was adapted from psycho-drama.) In contrast, talking "about" a situation, narrating it to a therapist, tends to be contaminated with explanations and other defensive maneuvers. In the directness of an encounter, though, feelings and intuitions--as well as insights--about what might be the actual issues in a problematic relationship occur. In couples and family therapy, one application of this is the therapist's direction, "say that directly to your daughter," or "look right at your husband and say that to him."

These two elements--dialogue and imagination--can also be combined to explore scenes that deal not just with what happens, but with the deeper inner situations, those interactions that never happened and perhaps never could happen. (Moreno called these explorations surplus reality, and noted that it was because of the potential of psychodrama to offer opportunities for this kind of artistic creation, it should be considered a "Theatre of Truth." It was the psychological truth--not the factual-historical truth--that mattered from this existential-phenomenological viewpoint.) Patients can bring to the surface a host of insights by directly encountering a parent who has died, or a child who was never born or perhaps never even conceived. Yet these figures live in the drama of the subconscious or, in terms of the object-relations school of psychoanalysis, as "inner representations."

Skill-building. This describes the activity of shifting between levels of concreteness and abstraction, and among roles and different frames of reference, that develops a host of ancillary techniques which may be applied in everyday life. For example, patients will learn to recognize different levels of self-disclosure, and just knowing that they exist can lead to an inclination to explore them and share them with selected others. The more people learn such skills, they more they develop an infrastructure for creativity in their own minds and in interpersonal and group relations.

Narrative. The idea that people's predicaments can be better appreciated when viewed as if they were stories in process also promotes a more creative attitude. Instead of thinking about problems as quasi-mechanical dysfunctions to be "fixed," the fractal nature of memory and life is recognized: It is impossible to trace most psychological disorders down to the single trauma, or to determine the "truth." The truth is too complex and requires an ever-extending horizon of effort--an asymptotic limit or "analysis interminable." Instead, the trend within psychotherapy, arising from innovative approaches in family therapy, has been to help clients frame their experience as a kind of story, and to participate actively in re-thinking the themes, as a biographer crafts a subject's life, into an artistic and coherent whole. The way the story is framed needs to lead the patient toward a more adaptive present and future response.

Inspiration. Related to the theme of narrative, another current trend in therapy has been to integrate the patient's spiritual beliefs, and often this process, too, requires a creative synthesis. Many patients have either lost their faith or have ongoing conflicts with their religious background so that it doesn't offer the sustenance needed to promote optimal resilience. Working with this transpersonal dimension in therapy also invites patients to creatively engage in finding some satisfactory creative synthesis that will support a sense of meaning and purpose in life--the existential challenge.

Creativity is needed, and often talking about creativity itself as a spiritual theme aids in promoting the existential process of deepening a sense of meaning, belongingness and purpose in life. While I find that few patients include such issues in their presenting complaints, they emerge as secondary and compounding factors in most people with significant emotional problems. The theme of creativity is a most effective tool for addressing this predicament; it reframes life, as Otto Rank suggested, as a work of art, and the patient as an artist. This is even more valid in a world characterized by nothing so much as change itself, and that happening at an accelerating rate (Blatner, 1997).

Integration. One of the most important aspects of the theme of creativity in therapy is for the therapist: All of the aforementioned principles, as well as a wide range of psychodramatic methods, can be creatively synthesized and integrated within almost any approach to psychotherapy--psychodynamic, interpersonal, cognitive-behavioral and so forth. These are principles that operate at the meta-level in therapy, informing most of the underlying processes.

Summary

Creativity is itself a powerful metaphor and adds a dimension of vitality and positivity to what can be an otherwise somewhat painful and almost tedious process, inviting the participants to entertain their aesthetic intuition as an aid in the life-enhancing engaging of re-creating a meaningful and productive life.
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