Those who are experienced in the art of psychotherapy know that a good measure of creativity is needed to adapt whatever methods one uses to each patient's individual needs and abilities. However, the idea of promoting the patient's own creative potential has not been much addressed in the professional literature. Otto Rank, Ph.D., indirectly alluded to it as one of the themes in his writing, in part associated with his own background as an artist and his use of the metaphor of neurosis as a form of failure in the challenge of making one's life a work of art. Carl Jung, M.D., hinted at it in his conception of the unconscious not only as a repository of ego-dystonic, repressed ideas and feelings, but also as a source of potentially creative inspirations and images.
Perhaps the one who was most directly an advocate of the idea that therapy should promote patients' creativity was Jacob L. Moreno, M.D. (1889-1974). Moreno was the innovator who developed psychodrama and sociometry (a method of applied social psychology), was one of the pioneers of role theory, and was one of the earliest and most persistent promoters of all forms of group psychotherapy (Blatner, 1995a; Moreno, 1987). Moreno thought that a major source of psychopathology was habitual thinking--an idea that anticipated the later insights of rational emotional behavior therapy of Albert Ellis, Ph.D., and cognitive-behavioral therapy by Aaron Beck, M.D.--the latter becoming more recognized in recent years. For Moreno, however, the antidote to habitual or automatic thinking was not simply noting and correcting such patterns, but generating a more flexible capacity for creative thinking in general.
It was Moreno's unique insight that creativity is best promoted not through contemplative planning, but rather in the interactive process of improvisation, becoming physically active as a way to warm up to becoming mentally more involved (Blatner, 1996; Moreno, 1947, 1964). He called this gradual process of opening up to the delicate sources of intuition and imagination spontaneity. For Moreno, spontaneity was a key not only to creativity, but also to vitality, a source of deep enjoyment and a reminder of the most authentic aspects of the self. Spontaneity was, in some ways, related to what has also been called flow (Csikszentmihalyi, 1997). Spontaneity is also the opposite of the tendency to rely on what has already been created. Moreno recognized the need to continuously revise the subtle role definitions that pervade our lives, anticipating also those who have observed the psychosocial predicament of the individual in the "postmodern" world (Blatner, 2000).
Other therapies have also shifted in this direction, especially those utilizing the arts media. They were originally applied to help structure time and build useful capacities, and later as vehicles for producing symbolic material that could, like dreams, then be analyzed. Beginning in the 1960s or so, the "creative arts therapies" have emerged as their own fields--art, dance and movement, poetry, music, drama--all of which now give increasing emphasis to the experience of improvising itself and the benefits that accrue thereto (Blatner, 1992; Leveton, 2001).
In family therapy, a powerful strategy is that of reframing the task away from the more mechanistic issue of solving a problem, the often not-so-unconscious desire to have the therapist act as a "judge" in hearing, blaming and counter-blaming, and shift the focus toward the challenge of everyone becoming more creative, and experimenting with novel approaches. Talking about how everyone may be more creative to this end also counters their shame at being in the sick role, at having "a problem" (Blatner, 1995b).
Becoming creative and improvising have certain dynamics that can foster a more healing process.
Playfulness. Playfulness allows for the creation of fail-safe contexts. Scenarios may be explored actively, using role-playing, or even just imagined. There is great power in applying the magic of "if" in language, as patients are helped to consider alternative situations, out of which can also come new insights about their actual predicament as well as discoveries of alternative ways of breaking away from habitual reaction patterns. The conditional nature of play, in which responses are not taken "seriously," and therefore "don't count" the way mundane discourse seems to, allows people to try out saying things they would not ordinarily say (Blatner, 2002).
Playfulness thus functions as a buffer against the anxiety of making a mistake, or saying something and worrying about how it might be "taken" by the other person. Spontaneity cannot emerge when the patient is feeling anxious. A corollary is that this receptivity to intuition cannot be forced or willed. Generating a bit of humor, a tone of looseness, an openness to a measure of the outrageous or unexpected, all help to promote this avenue to creativity (Blatner and Blatner, 1997).
Imagination. Imagination and more pointedly, entertaining imagery also promote creativity. In contrast to abstractness, imagery demands more concreteness. One cannot picture the specific behaviors being talked about when a patient says that a child is loving, aggressive, acting-out or kind. The behaviors being described are thus filtered through the interpretation and preferences of the person speaking. What a parent thinks of as aggressive might be fairly normal self-assertion; what is perceived as loving might be grossly placating. So one of the ways to cut through the subtle defensive function of abstract talk is to encourage patients to describe the scenes in great detail--or, better, to physically get out of their chair and imagine setting up a scene, showing where the door or couch was in the scene being described, and playing the role of the other person, showing how they behave, what words were used, and, most important, adding the nonverbal communication, the way in which the statements were expressed.
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