Spontaneity and Creativity in Collaborative Therapy Towards More Preferred Therapeutic Outcomes

Oppdatert: 21. nov.


Westerhof, J Addict Behav Ther Rehabil 2018, 7:2

Received: April 20, 2018 Accepted: May 05, 2018 Published: May 10, 2018 DOI: 10.4172/2324-9005.1000180a SciTechnol journal ResearchArticle Journal of Addictive Behaviors, Therapy & Rehabilitation




Abstract

The article focuses on spontaneity and creativity as important parts of collaborate respectful-togetherness and, as a way towards more preferred therapeutic outcomes. At its very core, the flow of conversational collaborative respectful-togetherness should be spontaneous, forever pursuing obtainable possibilities. Being together in conversation in therapy, has in many ways become polluted and disturbed. By “wrapping-inn” the therapy process into rigid protocols and formulas as to how therapy should be done is robbing the conversational collaborative togetherness from spontaneity and its powerful creative potential as a prerequisite for creative collaboration. The collaborative therapist should aim at setting up a relationship with the client characterized by positive unrestricted and unconditional regard, for spontaneity as a prerequisite for creative conversational collaborative togetherness.


Keywords

Spontaneity; Collaborative; Creativity; Therapy


Introduction - How can we Understand Spontaneity?

Spontaneity is one of the most important features in creative collaborative processes. In large degree, spontaneity is a prerequisite in communication, love, decision-making, and creativity. Coping, for instance, often becomes a complicated issue due to a lack of spontaneity: the lack of making spontaneous decisions in correspondence to instant challenges in real-time can undermine coping. Without spontaneity, seeing alternatives and being able to act on them can become a problematic difficult endeavor. Too, survival can become compromised when lacking spontaneity since it often requires instant spontaneous action in correspondence to abrupt unannounced situations. The absence of spontaneity curtails instant response towards unforeseen challenges. This may seem trivial, yet it is important since spontaneity is a vital part of emotional well-being and adaptation.


Spontaneity can be appreciated as a novel response to a new situation, or a response to an old situation [1]. Spontaneity is thus related to a person’s ability to meet new and sudden situations with adequacy. The root of the word “spontaneous” is sponte, the Latin for “free will.” Spontaneity is thus an expression of a person’s experience of autonomy and free-will that is exempted from external influence and force, and from any external influence that he cannot control [1]. Spontaneity is thus a significant factor in helping a person to move beyond himself, a condition for free action [1]. Spontaneity moves in the here-and-now and functions only “in” the moment of its emergence – just like a light turned on in a room and all parts of it become distinct [1]. Spontaneity is thus the opposite of apathy and passivity and is simple being active. According to the Webster’s Dictionary, spontaneity suggests “unplanned”, something that occurs suddenly. To be spontaneous, unplanned, together, talking together promotes collaborative creative processes towards more preferred therapeutic outcomes [2]. A spontaneous event happens because of processes within something rather than being caused by things outside it. Diane Gehart refers to therapeutic spontaneity as the ability to flow naturally and authentically in a variety of contexts and situations [3]. She goes on to say that spontaneity is cultivated and shaped through training which increases a therapist’s repertoire for “being natural” in wide range of clinical situations. Salvador Minuchin says that family therapy requires the use of self. A family therapist cannot observe and probe from without [4]. He must be a part of a system of interdependent people. This means that to be of use as a member of this system, he must respond to circumstances according to the systems rules, while maintaining the widest use of self. According to Minuchin this is what is meant by therapeutic spontaneity. Spontaneity is proceeding from natural feelings without external constraint related to culture. In western culture, people are used to think of human beings as individuals independent of the constraints of contexts. Spontaneity can take on rich meaning when it is understood in relation to human beings moving around in constant interplay between person and context, coming thus closer to its root-definition: of its own motion – like a river flowing its course. From this perspective, a spontaneous collaborative therapist uses various aspects of self in response to different social contexts.


Originality and spontaneity-prerequisites for creative conversations

Originality and spontaneity are associated concepts in creative conversation. They are intertwined, interdependent, and interrelated. Originality and spontaneity reveal themselves in the fluidity of images, ideas, and actions. Spontaneity as an expression of the fluid self is thus continually constructing new truths, selves, and realities within the relational matrices [5]. Collaborative creative conversations stimulate new and useful narratives where healing is promoted [6,7].


All articles published in Journal of Addictive Behaviors, Therapy & Rehabilitation are the property of SciTechnol, and is protected by copyright laws. Copyright © 2018, SciTechnol, All Rights Reserved. International Publisher of Science, Technology and Medicine The spontaneous free-association of words that Sigmund Freud used in treating his patients is based on the notion that spontaneous expression allows unconscious aspects to appear, decreasing their repressive control. Therefore, originality and spontaneity are an important part of the creative process. Psychotherapist Irvin Yalom reminds us of the fact that a therapist must establish a sustainable relationship with the client characterized by genuineness, positive unconditional regard, and spontaneity [8]. I am fervently convinced that these characteristics must be in place as pivotal prerequisites in collaborative conversations where one hopes to create more preferred therapeutic outcomes. I explicitly use the words “more preferred” rather than “better” for the sole reason that the former acknowledges a client attempts to master and change his situation, while the latter doesn’t show any regard at all for a client attempts [9]. When we use phrases like better, instead of, we than are saying that what was prior is not worth regarding. Such statements can undermine a client’s feelings of agency and capability [9]. It is for example more expedient to say; “in addition to what you have tried, are there any other possible options to explore?” This approach shows respect for a client’s prior attempts to cope and master his life in the way suitable to him. My clinical experience is that a client’s responsiveness increases proportioned to him feeling included in collaborative explorative process as an equal. People that feel acknowledged and validated for their prior coping attempts are often more prone to listen and respond to other ideas and suggestions. Yvonne Agazarian writes; “Successful socializations contains the spontaneous expression of energy so that it can be harnessed in the service of both the individual and society” [10]. This means that, at its very core, the flow of collaborative creative togetherness should be spontaneous, forever following unanticipated riverbeds. Joseph Zinker suggests developing creative processes as a counterforce to self-control as this inhibits and limits spontaneity and originality [11]. Thus, creative collaborative togetherness contains aspects like process, development, transformation, growth, and learning. The collaborative therapist can thus be compared with an artist, using his own creativity in collaborative creative processes to help his client.


What Can Obstruct and Promote Spontaneity ?

Obstacles to spontaneity in conversation can occur due to the fear of failing, the insatiable need for control, being tight-up in tradition, fear for the unknown, an extreme need for balance and reluctance to assume responsibility. Too, there are clients that neither are impulsive nor spontaneous; they do not respond either way. Often this goes together with painstakingly rumination over almost every choice, every decision. Such clients may appear obsessive in their demeanor and life-orientation, fearing the loss of control, for example, in conversation, more than anything else. Often these clients can strive with the fear for failure or rejection, and the accompanying feelings of guilt, humiliation, shame, obstructing spontaneity. Clients restricted in their ability to be spontaneous due to emotions of fear, shame and humiliation, can often be concerned about what others might think of them, for example, that they might be perceived as being selfish, childish, that they are not keen on showing interpersonal initiative. Spontaneity in collaborative process often becomes absent when the client feels the need to play it safe, delaying a response, or not responding at all in instances where there is a call for immediate response or action:

“If you wait to do everything until you are sure it is right, you’ll probably never do much of anything” - Win Borden


Whenever the client is afraid of making a mistake, or places exaggerated significance to making one, will undermine and rob the collaborative process from creativity since it obstructs the ability to act in the moment. It is of pivotal importance for the therapist not to assume one thing or the other as to why the client is lacking spontaneity in the collaborative therapeutic process: remember, this opinion is after all subjective. When a client has trouble with contributing spontaneously to the therapeutic process, exploring together how to proceed the process is required. The postmodern approach entails collaborative processes inviting client and therapist to share their multiple personal meanings. This can contribute to, and aid processes of fostering spontaneity. Asking questions like ‘What’ does the client want more off, less off; what the client wants differently are more in coherence with the nature of collaborative therapy. Are there topics that are ‘too unusual appropriately’ for the client to talk about? Postmodern collaborative therapy is based on a mutual composed agenda and context [12]. This implies that the therapist must trust the client’s ability to know what is best for him. Too, it means that the therapist must use and apply a client’s views and opinions as the cornerstone in the collaborative process (ibid).


Composing together is important in collaborative therapy since it prevents hierarchical tendencies and promotes equality. Whenever there is hierarchy in interpersonal communication the danger of inequality is always present, something that is contractionary in collaborative therapy. Clients feeling unequally joked with their therapist feel easily compromised in their ability to cooperate. All interpersonal communication between therapist and client, with the intent to create more preferred therapeutic outcomes requires equality to prevent client detachment. Often a client becomes detached from the therapeutic process because he feels not invited to be an active equal collaborator in the process.When a therapist assumes the role of an expert compromises a client’s experience of being an equal peer collaborator in therapeutic process: it is my experience as a clinician, that experts don’t easily invite clients to vent their thoughts, ideas, feelings and so on. Yet, it is when the therapist admonishes and invite the client to be an active peer co-creator in his own collaborative therapeutic processes towards more preferred outcomes, that he can feel and develop ownership of this generative endeavor. For example, the therapist can ask the client; “in addition to what we already have spoken about is there anything else we might have overlooked?” A question like this extends an invitation to active participation in creative generative processes [9].


Do not force the client to talk about the “appropriately unusual”

Tom Andersen warns the therapist not to assume that all clients are ready to talk about their issues. If there is a client who may seem resistant to change, this client should be consulted from time to time, to see if his status has shifted [13]. Personally, I have a hard time believing that there is such a thing as client resistant to change. Resistance is always related to something and -or someone. When a client doesn’t seem to respond adequately in therapy, it might be that he can’t relate to the therapist as opposed to thinking that he is resistant to treatment and change: a client may be in the gutter but that is far better than to be in an endless sea of infinity. Resistance between therapist and client must be explored, together. For example, the therapist can ask generative epistemological open questions like: What makes you feel the way you feel concerning us talking together? Is there anything you feel that you don’t want to feel or think? Are there things that are appropriate to talk about and thing that are too unusual appropriate to talk about?

Andersen preferred to ask, “How would you like to use this meeting?” at the beginning of each session [9]. In collaborative therapy it is crucial to avoid a format that is unsettling for the client. Conversations should flow in a way where the client feels comfortable, or at least not uncomfortable.


It is thus useful to find out how therapist and client should talk with one another. This is important to discuss because it will add to the comfort level of the client. There are many aspects covered during collaborative conversation. Furthermore, the client can specify ifcertain topics can only be discussed at certain times or not during someone’s presence. All these topics are covered to ensure the client feels at ease during collaborative therapy. Andersen emphasizes the importance of finding the usual pattern of the client [13]. This can be very useful to the collaborative process in that it helps to distinguish what types of questions might be helpful to the client. Tom Andersen always sought to be “appropriately unusual” when deciding what to talk about with clients and how they should talk about it [9,13]. If the context or the style of talking strays too far from the client’s daily life, the conversations tend to stop, and the clients become less engaged or intrigued [14]. A therapist and client must therefore explore together what they can pursue as common goals. Collaboration than becomes a mutual venture where each person’s contribution is validated and used in the creation and construction of new possibilities and more preferred outcomes in therapy [15].


In collaborative therapy, the client and therapist are talking and working together as two equally significant partners. Within a collaborative context the idea of working is with the client, as opposed to being the expert [15]. Collaborative therapy is a generative process. The therapist and client develop consecutively themes to talk about. It is the client that chooses the themes that he feels are appropriate to talk about. Talking about unusual appropriate issues requires a sustainable relationship between client and therapist.

It is imperative for the therapist to not interrupt the client while he is expressing himself [15]. When you interrupt you condone interruption something that can easily make a client feel “not” worth enough to be heard. Clients feeling not worth to be heard easily detach from the therapeutic process. Clients must be allowed to express their thoughts at their own pace. A collaborative process exists of people that listen respectfully to another [15]. The lack of sufficient trust in the therapist will undermine a client’s ability to accept the therapist as a competent collaborative partner.

The therapist must realize that it is up to the client to select what he feels comfortable talking about. Hopefully, these selections might trigger a slight change in the client’s situation or in his understanding of the situation. The absence of a client’s acceptance for the therapist prohibits change since talking about too unusual appropriate issues will be avoided.


Trusting internal constraints as a prerequisite for spontaneity


A client that act spontaneous in the collaborative creative process can do so because he trusts his internal constraints to keep him from doing or saying anything foolish, harmful, damaging, or out-of-order. A client who delight in his own spontaneity is likely to be more able to sustain himself and his relationships with others when meeting painful or challenging events in his live. A wide range of roles and an adaptive ability to move freely between these roles will enable the client to respond spontaneously and creatively when faced with serious challenges in life. Fewer roles and less knowledge and experience of spontaneity will most likely limit a client’s ability to respond. This is likely to result in the client becoming more inclined to withdraw or escape into a fantasy world, to react in a violent or hostile way, or to put his own desires aside to accommodate others when a painful crisis or severe difficulty arises for them.


Moreno advocated training the imagination to increase spontaneity in order to bring vitality into relationships and life [1]. The main emphasis is on how spontaneity may be developed so that creativity is expanded by ‘acting out’, as in outside the individual. Action is involved as well as the thinking and feeling capacities. Increasing the creative ability opens the door to an increase in spontaneity needed for obtaining more preferred therapeutic outcomes.


Socrates once said; “Our conversation is not about something casual, but about the way of life.” My desire with this article is that it will contribute to that conversation. Human beings are tellers of stories in their endeavor to find a sense of completion. It can stimulate creativity when we ask ourselves questions like; “what do stories do for us? What do stories do to us?” When we are together, talking together, sharing stories spontaneously together, we must hope that people will feel enlivened, valued, and appreciated.


Dichotomous worldview obstructs spontaneity

Collaborative creative conversation will be obstructed when the client or therapist adheres to a dichotomous worldview: there are just two alternatives, two roads, two choices etc. Spontaneous collaborative processes and creative conversation cannot take place in a dichotomous environment for the sole reason that it is void of collaborative motion based on equality and the lack of alternatives: almost always one alternative, road, choice i.e., will turn out to be common while the other is celebrated as superior; one will be praised while the other one will be doomed. Spontaneous creativity leaves the conversation as soon as “the talk” becomes saturated with and motivated by, the nature of dichotomous ideology; the offering of a single choice, path, and so on, insinuating that if you do not make the “right” choice and “take” the path that is commended, that it will wretch your life. In collaborative processes we must allow spontaneity to be fluid, permeating our conversations so that creativity can sprout; it is not that dangerous to dwell on believes, imaginations, stories, regardless of evidence if they can contribute to the formation of creative and more therapeutic preferred outcomes.


Acceptance and a non-top-down-approach – indispensable prerequisites in collaborative processes

A client’s acceptance for the therapist is a significant and indispensable factor in therapeutic processes. A therapist that lacks acceptance from his client will be of little use in the therapeutic process. Acceptance is relational conditioned and an important and indispensable prerequisite in processes of change. When a therapist lacks the ability to establishing a sustainable relationship with his client based on equality and acceptance has direct limiting implications on the therapeutic process and its outcomes. A therapist’s ability to connect precedes client-acceptance. The therapist’s capability to connect with the client from a bottom-up position has direct clinical implications on the therapeutic process: a client needs to feel himself as a peer collaborator in the therapeutic process as a prerequisite for more preferred outcomes in therapy. A top-down approach can easily jeopardize the therapeutic process: a top-down-approach is indicative with assuming expert status something that is common within the pathogenic oriented disease-model (the modern paradigm) where the therapist is esteemed to be the expert on the live of a client. When a therapist approaches a client from a top-down position, the client normally shuts down and at its worse, detaches from the therapeutic process [16-20].


A top-down expert approach will obstruct collaborative processes since it is saturated with instructive communication. After my clinical experience, client’s mostly, oppose instructive communication [21]. Instructive communication easily disrupts the power-balance in a therapeutic relationship since it compromises equality between therapist and client. A client can easily become detached from the therapeutic process when the power-balance between him and the therapist is disrupted. A top-down approach will undermine spontaneity as a prerequisite for sustainable creative processes since it reinforces feelings of powerlessness, suppresses spontaneity, curtails creativity, and compromises agency.


Acceptance is thus not some sort of mechanic feature occurring automatically in a client and therapist relationship.

It a fruit of client and therapist collaboration [22]. At a rehab where I used to work, a colleague vented her frustrations in the middle of a staff meeting concerning her non-responsive client’s. She was frustrated because she regularly felt that clients had difficulty in relating to her. She said; “clients must give us their trust because we are the experts on what is best for them.” Her clients came regularly to my office complaining about her haughty attitude, and frequently asked if they could swap to another therapist. Trust is not given, it is earned!


A client’s difficulty to act spontaneous in therapy is thus relational conditioned. Of course, people have contrasting character traits and mental conditions causing one to be more spontaneous than others. But overall, how the client can relate to the therapist is one of the most key features and prerequisites in collaborative therapy. How the client feels he can relate to the therapist determines his ability to talk about the appropriately unusual!

My experience as a clinician is, that when a client can relate to you as a therapist, feels like an equal, heard and taken seriously, he will develop and evolve successively in areas like conversing spontaneously and trust. A therapist must never forget that he cocreates truths, realities, knowledge, and so on, through collaborative processes. Truth, reality and knowledge are not discovered but fruits of creative collaborative interactional processes [22-24]. New realities, truth, and knowledge emerge proportioned to how the client experiences the therapeutic relationship subjectively to be.


Relationship and Consensus in Therapy

There are no universal truths in collaborative therapy as to how and what things are. Whatever we reach resolution on, has its origin in collaborative processes, and consensus created between therapist and client [12,15,25,26]. This means that what the client and therapist consent on as truth and real might not be that way for other people who are not a part of the process wherein consensus is created. Creating consensus, spontaneously, is a relational collaborative interpersonal action between therapist and client and requires the participation and exercises of a man’s free will. Too, consensus reflects the quality of the collaborative relationship between client and therapist.


Why Should we Care?

Creative collaborative togetherness in therapy is a philosophical endeavor that rejects the assumption that there is one truth, self, and way towards change - a view that has defined western culture for centuries [12]. In creative collaborative processes we don’t invent expedient roads to change, but, we create them, collaboratively [24]. There is no such thing as absolute truth within interpersonal transactions, nor is there any perfect recipe for how to be, and when to be spontaneous: all there is to know concerning truth and spontaneity relevant to the collaborative process is created between therapist and client. The creation of new and more preferred outcomes in therapy can emerge in contexts where spontaneity and collaborative talks can be fostered and appear as an important proponent for creative collaborative processes.


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Author Affiliations Top

Clinical specialist in family therapy, Scientific Institute Diakonhjemmet, Norway

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