Creativity as Co-Therapist

The Practitioner's Guide to the Art of Psychotherapy

Lisa Mitchell

• Publisher: Routledge
• Year: 2016
• eBook ISBN: 9781317527619
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

In Creativity as Co-Therapist, experienced psychotherapist and creativity expert, Lisa Mitchell, bridges the gap between theoretical knowledge and therapeutic application by teaching psychotherapists of all backgrounds to see therapy as their art form. Readers are guided through the five stages of the creative process to help them understand the complexities of approaching their work creatively and to effectively identify areas in which they tend to get stuck when working with clients. Along the way workbook assignments, case studies, personal stories, and hands-on art directives will inspire the reader to think outside the box and build the creative muscles that hold the key to enlivening their work.

Part 1 The Art of Therapy

1 The Therapeutic Process is a Creative Process

DOI: 10.4324/9781315723327-1

The Role of Mistakes

As an intern with a dual degree in art therapy and counseling, I worked hard to learn to do things the “right” way. Early on, I started filling a recipe box that matched specific art therapy techniques with their corresponding treatment goals. I rehearsed how to word brief therapy questions and practiced guided visualization scripts. My emphasis on finding the right tool or technique was my yardstick. If I used the right one, I was doing well. If I couldn’t figure out what kind of art activity to ask the client to do or what specific concept to teach, I felt overwhelmed and uncomfortable. I agonized over mistakes and couldn’t wait for the day when I felt experienced enough to feel like I knew what I was doing. The message that I had taken away from my graduate program was decidedly weighted with the need for certainty. I coveted therapeutic moments of comfort and proficiency, where I didn’t waver, falter, or dabble with not-knowing. And as a result, I strived to know my theories inside and out, to apply them with perfection, and to avoid errors at all cost.

I took this same approach with me into my oral exam, the second test on the road to Marriage, Family, and Child Counselor (MFCC) licensure in California. It had a widely criticized and mysterious reputation, but every intern who wanted to be licensed had to train to answer 12 questions about a clinical vignette for a panel of three licensed therapists. Knowing that the pass rate hovered below 40 percent, I had trained for months and created a complex grid system to make sure that I covered all of the criteria for any possible vignette I was given.

On the day of my test, I held my nerves in check while sitting in the “holding room.” I tried to breathe as I stood in the elevator going up to the exam room (a hotel room with the bed removed). I read the vignette, took my notes, and started to answer questions. I was doing fine until a stone-faced examiner asked me question six. I realized in that moment that I had already answered this question and had mixed it up for question four. I knew that if I didn’t go back and talk about the answer for question four, I would fail. All of the content was necessary to pass. I had made a mistake, and I didn’t know how to get out of it. So I just told them, red-faced. “I’ve made a mistake. I think I answered this question already. I must have mixed the questions up and misheard what you asked for number four. I’m sorry. Would it be okay if I went back and talked about question four instead?” I was sure I had failed right then.

One examiner smiled, or maybe smirked. The examiner next to him said, “You can say whatever you want.” I couldn’t read his tone. It was neutral, matter-of-fact, and perhaps a bit impatient.

So I launched into my answer for question four. I covered the content well enough and was able to get through the rest of the exam without crying. My mistake was evidence that I was a terrible listener. I hadn’t been careful enough. They would think I didn’t have the skills it took to be a therapist. During the six weeks I waited to receive my test results, I had decided that I couldn’t go through the exam a second time. I started to make backup plans and imagined myself becoming a preschool teacher or a receptionist in a hair salon.

The day that I received my letter saying I had passed and was officially a licensed MFCC, I was stunned. How could they pass me after that mistake? I was grateful and relieved, but didn’t understand. I called a colleague of mine who had sat on oral exam panels to ask him what he thought. Why had they passed someone who messed up like that? He told me a profound truth. “It’s not about answering the questions perfectly,” he said. “The content is important, but the real test is in how you are able to hold yourself in that level of stress and how well you recover from the mistakes. It is a good thing that you made a mistake and that you recovered from it. That showed them a vital part of what will make you a successful therapist.”

I was grateful for my colleague’s comments, but I didn’t fully take his message to heart. I thought he was being nice and reframing my mistake just to make me feel better. So it is no surprise that I continued to strive for certainty in knowing what I was doing. I wanted the security of knowing that I could deliver my services without making a mistake.

I remember a particularly painful period in 2002, during which I got my Eye Movement Desensitization and Reprocessing (EMDR) certificate and was training with Bruce Ecker to master his Depth-Oriented Brief Therapy (now Coherence Therapy) model. I had the idea that this excellent set of skills was going to eliminate my self-doubt and that my work with clients was going to become easier. I thought knowledge would give me a formula that would take away the uncertainty and finally make me feel secure in my role as therapist. I worked very hard at applying the protocols. I perfected the wording. I consulted and refined. But during a gathering of therapist friends, I found myself in tears because I realized I was not feeling more proficient; instead, I was feeling robotic and inauthentic, trapped at an assembly line of client issues. While I believed I was doing adequate work, I wasn’t being artful. In my endeavor to eliminate uncertainty, I had killed my creativity. I had sold out and, in the process, lost a part of myself that had brought me to the work in the first place.

Scott Miller reintroduced me to this quandary in a 2007 meeting for chapter leaders of the California Association of Marriage and Family Therapists. In his talk, Miller passionately discouraged his colleagues from allowing a state of proficiency to lull us into mediocrity. He called our therapist culture error-phobic and pointed out that this effort to avoid mistakes had fueled a standardization of our practices. He shot down our profession’s assumption that we get better the longer we practice our craft, and instead informed us that we had successfully achieved automaticity and an inflated sense of confidence rather than actual excellence in the field.

“Our profession is the only one that gives you five or six chances to feel like a failure every day,” he told us. I was relieved and amused. Here I’d been, struggling to achieve proficiency in order to be more effective, only to be swept under by the assembly-line approach Miller was describing.

He offered another approach at this meeting. The most successful therapists, he said, were actually the ones who took an error-centric approach, who focused on what wasn’t going right, who treated mistakes as opportunities, and who admitted that they didn’t always have the answer. They were the ones who were in fact better than average.

Scott Miller’s talk was the beginning of my realization that the therapeutic process was actually a creative process. I began to reflect on my lifelong experience as an artist and how I had learned firsthand the importance of mistakes in the creative process. I have been a dabbling artist ever since I can remember; I’ve logged a lot of studio time, both before and after I became a therapist. I realized that the joy and spontaneity that my art making had given me were precisely due to the fact that I had never tried to become proficient. I had always rejected evaluation of the end product and instead emphasized the degree of creative expression and experimentation during the process. Many of the paintings and sculptures I had created over the years relied on the new ideas I had discovered in the course of making a “mistake.” I much preferred trying something totally new, something about which I had no way of predicting the outcome, over and above a paint-by-numbers kit. So I started to take Scott Miller’s invitation seriously, to bring my error-centric artist’s culture into my work as a therapist, and aimed to abandon my error-phobic ways.

Think of the training that you have received. In supervision, did your supervisor give you the latitude to make mistakes? Have you ever had the privilege of watching a training video where a master therapist modeled what it looked like when things were not going right? Were you taught to open yourself to a collaborative stance with your client and invite feedback that might make you feel vulnerable?

The result of an informal poll of therapists from my online classes shows how they react when things aren’t going right. Eighty percent of them stated that they had doubts as to whether they were the right therapists for their clients. Instead of looking at the situation as an opportunity to try something new, they assumed that there was another therapist—probably more experienced—who would do better at the job than they could. Because we are taught to be error-phobic, we miss out on the error-centric creative process that could improve our resilience and ability to stay engaged and alive in our work.

Our creative process depends on us to make mistakes. Norcross’s (2010) research confirms that a therapist’s admitting to error actually enhances the therapeutic alliance. For both artists and therapists, what we do with mistakes is much more important than whether we make mistakes at all. When I began to see the therapeutic process as a creative process, I adopted this potent antidote against collapsing into self-doubt. I could see how considering myself an artist not only in sculpture and painting, but also in therapy, allowed me to be more present and build more engaging connections with my clients because I didn’t have to be so careful about getting it “right.”

Maslow (1959) helped me understand the relationship between creativity, errors, and the ability to create strong therapeutic relationships in his essay, “Creativity in Self-Actualizing People.” He wrote:

When you are creative, you are more self-accepting than the average, less afraid of your own thoughts, and less afraid of being laughed at or disapproved of. You can let yourself be flooded by emotion and you waste less time and energy protecting yourself against yourself.

(Maslow, 1959: p. 88)

As Maslow’s quote suggests, when we are creative and embrace an error-centric approach to therapy, we are more likely to step out of the comfort zone of proficiency and try new ideas because we are not afraid to make mistakes. We know that mistakes are opportunities that lead us to new discoveries for ourselves and our clients. In the end, this leads to us become more creative, more self-actualized, more innovative, and, most importantly, better at doing our work.

The Role of a Collaborative Relationship

In The Heart and Soul of Change: Delivering What Works in Therapy, Duncan, Miller, Wampold, and Hubble (2010) report groundbreaking findings in their meta-analysis of evidence-based psychotherapy research. Their results subvert the idea that there exists a set of specific techniques and approaches for successful treatment of specific disorders, and instead concludes that there is one primary factor that predicts the success of therapy: the therapeutic relationship. This may be old news, but it is worth reiterating here. When encountering a difficult situation with a client, it is easy and tempting to soothe self-doubt with a ready-made protocol. I remember a particularly ridiculous cascade of professional despair when I decided I absolutely had to learn Acceptance and Commitment Therapy in one weekend. I was sure that if I watched all ten DVDs and mastered at least some of the language, I would have a way out of the stuck place in which I had found myself with my client. Learning new modalities and protocols is important, but depending on them to give us the answer is neither effective nor creative. In fact, as Norcross (2010) reports, “The small body of research indicates that the frequency and severity of ruptures are increased by rigid adherence to a treatment manual and an excessive number of transference interpretations.” If we look to the relationship instead of to techniques, we immediately return to a collaborative stance with our clients. And when we collaborate, we do so not just with our clients but with our techniques and protocols as well.

This view that we are active collaborators in the creation of our art is not unfamiliar to art students. Ever since it opened in 1793, the Louvre has allowed, and even encouraged, artists to hone their skills by copying the masterpieces in its collections (Harriss, 2001). Cezanne, who came to the Louvre to copy Michelangelo, Rubens, and classical Greek and Roman statues, noted: “The Louvre is the book where we learn to read.”

But why do artists flock to copy masters’ paintings? It is not to be able to paint like the masters. Instead, they want to learn how the masters solved their artistic problems. They follow the footprints left in the form of the painting in order to learn how the master painter navigated the painting process. In this act of replication, the copier gleans a deeper experience with her own creative process. The master is not there telling the copier what to do each step of the way. The paintings invite the copier into a valuable experience of being an active participant in the process. The master supplies the guide and starting point; the real discovery comes from the collaboration between the copier and her own canvas.

Think of it. If you can imagine yourself trying to copy a master painting at the Louvre, it might be tempting to imagine that in order to copy well, you must figure out how the master applied the paint or used color or rendered a gesture. But this kind of effortful focus on the technical side blinds us from seeing ourselves as active participants in the painting process. We are so busy concentrating on the master painting that our contributions become much less important. But now I’d like you to imagine that you are there in the Louvre, and you discover that you absolutely adore what happens when you layer a veil of Titanium White over Phthalo Blue. While this may or may not be the exact combination that your master used in his painting, your adoration of your discovery causes you to become an active participant in your painting process. In this sense, there is true collaboration between you and your very own painting. A few more of these discoveries, and you are no longer concentrating on how the master painted his painting. Your emphasis becomes about you, your discovery process, and the relationship you establish with your emerging painting.

Around the same time that I heard Scott Miller spe...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Prologue
• Acknowledgments
• Introduction
• Part I The Art of Therapy
• Part II The Five Stages of the Creative Process
• Conclusion
• Appendix: Art in Groups
• Resources
• References
• Index