Therapy at its best is about expanding the edges if what we see as possible, from our therapy and from our lives. In a sense, my concern when I encounter a new therapy patient in my NYC office is less with what they're asking for and more with what they aren't asking for--what they refrain from wanting from their therapy (and their lives) by virtue of having given up (or failed to ever consider) that a whole host of things could possibly come to be other than what it is. And so they don't ask, choosing instead to moderate expectations or stick to the traditional therapy script, with an an emphasis on diagnostic categories, seeking therapy for anxiety, or therapy for depression, anger and stress. Prospective therapy patients have learned to present themselves to a therapist with the question of what brings them to therapy already packaged in the language of symptoms and diagnostics. They expect that's how the therapist prefers to engage. In a sense, they make use of the language they've come to associate with psychotherapy from past experiences in therapy themselves or from psychotherapy's presentation in the broader culture. We confront even a consideration of whether to engage in therapy with an already limited picture of what that work could entail.
If this sounds like a critique of psychotherapy and the ways it's presented itself in the world, it is. In an effort to clarify (brand itself, one might say) and through the alluring mystique of psychotherapists' fashioning themselves as pseudo-physicians, they've claimed a defined domain as their own, roughly mirroring the practice of domain-claiming that takes place in medical specialties (dermatologists handle skin; orthopedists, bones; etc.). Psychotherapists want to be seen as experts in mental illness or mental distress, or even within the subspecialties of depression therapists or anxiety specialists.
There's also a sort of "tyranny of low expectations" that presents itself as pared down wishes for how these experiences might change. Nearly everyday I hear, "I'd like to feel a bit less anxious" or even "everything in my life is fine but I could use some therapy to help with my depression." When discussing stress or anger in an early therapy session they may say "I know everyone gets angry, but I'd like to manage it a bit better." Implicit off the bat is the sense that the best that can be hoped for from therapy is trimming off the rough edges.
These domain-claiming, diagnosis-bolstering and expectation-managing histories can predetermine the scope of the work before a prospective patient even walks in the door (and no doubt prevents many patients from considering entering such a door to begin with). The problematic produced is a serious constraint in creativity.
In therapy, creativity is the cure
My tiny elementary school had a revolving door of part-time art teachers. Some were great, some not so much. One of the least inspired did a tour when I was in second grade and I have a particularly vivid memory of her having us work with water paints. At some point I was curious to see what would happen if I "painted" with the back end of the paint brush so I gingerly scratched at the wet surface of the paint and began to experimenter with my scratching. Noticing, the teacher quickly barked, "You can't erase paint!"
Creativity... squashed!
Had she been a more creative teacher (or an art therapist!) she would have celebrated the exploration and brought curiosity.
In a lot of ways, the process of diagnosis itself, or the broader activity of packaging our feelings and experiences to fit with some idea of how we've been told topics need be packaged for therapy, has the same effect. There's one end of the paint brush we're meant to paint with, we're told. Using the brush in some other way yields an invalid input. (Like asking Siri about the meaning of life or some other question it isn't programmed to make sense of. Try it.)
We say a lot around here that creativity is not just process but cure. When we work in ways that are inspired by great psychologists or established research, we are making use of those creative offers in just the same way that we might make use of offers from another discipline: poetry, art, or music in our therapy work. Rather than understanding these as scientific maxims, we see them as creative inspirations. Might they be useful additions to our collective project? Perhaps. And if not? Throw them out, as an artist or writer might choose to edit her composition.
The philosopher Charles Pierce wrote that the first maxim of science is "Do not block the path to inquiry." While this is true for any creative endeavor it is certainly crucial in therapy. Diagnostic categories are limiting not in-and-of-themselves but by virtue of how we come to relate to them (as The. Truth). Holding them up as a higher class of offering--as a sort of magic media--is what blocks the path to inquiry. To do so in therapy, to insist that we stay within the categorical constraints of established psychology--to color only within the lines--is to block the path to possibilities. It is a creative (and therapeutic) sin.
Changing your vantage point: The therapy of perspective
One of my favorite places in the world is the Dia Foundation Art Museum in Beacon, NY. I first went about a decade ago with a former art-major ex-girlfriend and I confess I had little of the love of contemporary art I have now. Still, the space was convincing. It's an old mill transformed in to a museum, with massive rooms lit by the natural light from the expansive sky-lights left over from the building's original purpose. There were plenty of paintings on the walls, of course, but the space lends itself particularly well to sculpture. You might say my art-museum posture at the time was one of browsing and I was having a well enough time browsing on this visit until I browsed by a particular piece of sculpture. It was formed from a series of flat, silver mirrors, with some pieces joined at right angles and others seemingly shattered and dispersed beneath the piece on the floor. As was my habit I noticed the piece, decided it "interesting" and began to move on. Only my girlfriend wasn't having that. Refusing to dismiss the piece as merely "interesting" she insisted I slow down. "No, no, wait," she said, "You haven't really seen it." We argued a bit, my insisting I'd seen enough until, finally relenting, I consented to bending over to take in the view she was enjoying, having cocked her head and crouched just a few inches above the ground. Reluctant as I was to admit it, she was dead on. It was a completely different experience. The interplay of the straight edges with the shattered pieces reflecting off one another ad infinitum was indeed a truly different, delightful experience. I thought I "knew" how such a composition would look--and that I'd seen enough from the sensible height my head usually idled above the ground. My "knowing" and my stubborn reluctance to get uncomfortable kept me stuck. I needed help to see things different (literally).
The most intractable of beliefs/ habits/ ways of seeing/ ways of living are those that we take as given--not so much beliefs but facts of the universe. These ways of approaching the world are as taken for granted as the sun revolving around the earth was for millennia. Such as was the problem of heliocentrism (the archaic belief that the sun revolves around the earth, debunked with no small amount of drama). The particular structure of the universe, it's laws and our place in it that we come to take as given is see only from the vantage point from which we observe and encounter the world. It's limited by the constraints of particular patch of real estate on which our two feet are planted. The challenge for Copernicus and Galileo (and every science teacher since) was to convince folks to contort themselves (their minds) into an uncomfortable and unfamiliar position, but before that to see that the structure of the universe, the very "rising" and "setting" of the sun could be other than they took it for granted to be.
That it could be other
Before the fancy work of therapy can begin--the deep explorations, the reforming of habits--we have to first engage the question of whether or not the changes might seek are possible. How do we do that? Convincing and pleading, perhaps. Respecting the resistance, to be sure. It's a problem that likely has as many solutions as there are people who set out to try. A safe, caring partner helps.
