As a psychotherapist, I meet people at their lowest and through the therapeutic act,
we explore trauma, deep unhappiness and sometimes unthinkable horrors. It seems like play and creativity are at the other end of this spectrum.
One of the most active advocates promoting the idea that therapy should encourage the client’s creativity was Jacob L. Moreno, M.D. (1889-1974). He supported the idea that a major source of psychopathology was habitual thinking - an idea that anticipated the later insights of Rational Emotional Behaviour Therapy of Albert Ellis, Ph.D., and Cognitive-Behavioural Therapy by Aaron Beck, M.D. However, Moreno did not try to correct thinking patterns but to invite creativity and spontaneity into the therapeutic sessions by actively involving the client to express thoughts and feelings through body.
Today creative therapy includes a wide range of techniques which can help find a way of expressing beyond words or traditional talking therapies. It can include Visual Arts Therapy, Writing, Sand-Play, Dance Movement Therapy, Dramatherapy and Music Therapy. Different methods will be used according to the client’s needs.
From an evolutionary point of view through play and creativity, children learn skills, explore roles, rules and feelings, push boundaries and understand limits. This sounds very similar to what happens in psychotherapy. Using creativity in the therapeutic process, helps the client expand the window for emotional tolerance, growth and flexible adaptation to the everchanging environment.
Both psychotherapy and creativity exist as conversations in a relationship. Whether it is the therapeutic alliance between the therapist and the client where certain themes are explored and reflected upon or the relationship between the artist and its painting, where ideas and feelings are expressed. Intra- and interpersonal conversations happen at the same time and the role of the therapist is to create space and facilitate these dialogues.
When working creatively I am always aware of the delicate balance between control and freedom to explore. I am allowing clients, the freedom to take us where they wish, through movement or art using props or just their bodies but I am always aware of what we are exploring and why. It’s very easy to become lost in the client’s creative expressions and sometimes even become part of them. Creativity is such a powerful tool and requires flexibility from the therapist as things will often not go the way we planned or hypothesised. I just trust the process.
Creativity can aid and inform the psychotherapeutic approach. It often yields surprising effects by circumventing defence mechanisms, uncover thoughts and feelings that we forgot we had or in fact thoughts and feeling that surprise us.
Within therapy, especially in the first sessions, clients find it difficult to freely express themselves, they might find it embarrassing or label their experiences uninteresting and unimportant. At the beginning of therapy, I prefer to use the Mandala to answer questions like:
What is my life's motto?
Who inspires me?
What are my weaknesses?
What are my strengths?
How am I creative?
or The House of Change exercise, with questions like:
What are the things that I am happy with?
What are the things that I wish I could do better?
What are the things that I blame myself for?
What are the things that I don’t understand about myself?
The answers can be written text, drawings, paintings or body expressions.
These are only two examples of using creativity within the assessment process. The great thing is that they can be used at the end of therapy too and then compare the answers. Using the two exercises helps the client verbalise the issue that brought them in therapy but also find positive elements in their life. It helps me find the “positum” (Positive Psychotherapy after Peseschian 1977) for their symptoms.
The way we exist in the 4 areas of life (Positive Psychotherapy after Peseschian 1977), the same way creativity and play can be experienced in therapy.
Body: I usually encourage the client to: Show me where the feeling is in your body? Use your body to express the thought or feeling? Create a static or moving sculpture of what we discussed, etc.
Achievement /Work: The creative process is as important as the final product. I find that exploring how it was to express through art/body/ dance/ music, etc. brings to light a wealth of unconscious material that can be explored and acknowledged.
Relationship: As mentioned before therapy and creativity happens in a relationship. Talking about a situation brings with it a sum of explanations and defensive manoeuvres. Encouraging the client to use “I statements” and express feelings and thoughts to the other person, even if that other person is only imagined as if they were present in, say, an empty chair, uncovers a wealth of new information for the client and also for the therapist. (“Say it to your colleague”, “Talk directly to your partner”)
Future/Fantasy/Spirituality: This is probably my favourite area to use in creative exploration with my clients. The use of fables, stories, metaphors, quotes, is incredibly powerful in helping the clients name their strengths and weakness. It allows the clients to identify with either the story or one of the characters in it and it offers a different perspective to the issues discussed in therapy. What I really like about it is that it truly embodies the way I see the therapeutic process. The story “takes” the problem from the client and “lays it” in the middle of the therapeutic room so now both of us can sit side by side and look, reflect and understand what is happening or has happened.
Creativity in psychotherapy allows us to explore and gain a greater sense of ourselves and instinctively understand what we are going through.
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