How to replace pathology with creativity
By Lisa Mitchell
As both an art therapist and a marriage and family therapist, I believe that vulnerability, doubt, fear, and uncertainty—feelings most people try to avoid—are essential to getting unstuck in life and engaging in creative problem solving. I try to guide clients to find new approaches to old problems by teaching them how to move beyond “artist’s block,” a state of being joylessly trapped in repetitive patterns and rigid expectations, and how to welcome the type of anxiety around the unknown that creativity invites.
I used this approach with Pam, a 30-something associate director of a nonprofit organization, who came to my art studio after hearing from a colleague about a training on creativity I’d facilitated. Frustrated by her previous inability to get out of her head in therapy, she was intrigued by my alternative, more experiential approach. On the phone, she told me she was seeking therapy because she felt her “inner slave driver,” which had once helped her succeed in managing her career and three children under the age of 12, had begun to dominate her life. “There are endless lists that structure my every waking minute,” she said. “I feel like I’m being worked to death, and there’s no joy in it.” She went on to say that her anxiety and feelings of emptiness had become even more intense since her best friend had died, six months before.
To start our first session, I asked Pam where she thought her inner slave driver came from. She described being 7 years old and having to care for the household and her younger brother after her mother abandoned the family and her father had immersed himself in work. She’d learned how to manage her life with great order and precision, dedicated to the belief that no one could do anything for her that she couldn’t do for herself. But recently she’d begun to question this stance and note the problems it was causing for her, particularly after a confrontation at dinner with her 6-year-old daughter, Gena. That night, after a long standoff in which Gena had refused to eat her broccoli, Pam had finally gotten her to take three rule-abiding bites.
“I thought I was doing the right thing by enforcing the rule,” Pam said. “So when Gena threw up her dinner, I thought she was just being impossible, and I marched her off to bed. But during the night, Gena woke up with a stomach flu. I spent the whole night nursing her and feeling guilty.”
Instead of offering parenting strategies, I told Pam that I wanted to spend our time looking at new ways to behave when her inner slave driver was keeping her stuck in old, rigid patterns, blocking her from other creative possibilities for responding.
Identifying a Creativity Goal
Early in therapy, I try to introduce the idea of flow as a reference point for clients, like Pam, who complain of feeling stuck and blocked. Trying something new and a bit risky, like singing karaoke or canoeing under a full moon, might be a flow experience for some; others might feel flow when expressing deep love or being vulnerable with a partner. In other words, flow happens in moments when time feels unimportant, connection to self and others feels meaningful, or life feels vibrant with newness. For Pam, I suspected that caring for her lifelong friend, Sandy, through the late stages of breast cancer had forced her to let go of her usual rigid mode of being, and thus had been a flow experience.
“When we first talked on the phone and you told me about Sandy,” I said. “I noticed softness in your voice that was different from when you talked about your daughter. I wonder if you see that difference, too.”
Pam replied thoughtfully, “Yes, I was totally different with Sandy. With her treatment, I couldn’t predict how the next day or week was going to go. I had to let go and be vulnerable. Sometimes I wasn’t a pretty picture. I cried a lot and couldn’t find the right words to say to Sandy. But instead of finding an escape, I was at her side when she breathed her last breath. I want that feeling of openness and authenticity in other places in my life.”
The Five Stages of Creativity
As part of my work with clients to help them find flow, I usually spend time telling them about the five stages of creativity—incubating, initial idea, diving in, flexible commitment, and flow—and how each requires tolerating unpleasant experiences of doubt, fear, and anxiety. I offer quotes from various artists to introduce each stage, like Degas’ idea: “Only when he no longer knows what he is doing, does the painter do good things.” I play compositions by Keeril Makan, who said, “When fear arises, I’ve reached the threshold between the known and the unknown. If I’m able to continue composing while tolerating the fear, I will be writing music that is new to me.” I talk about writer Anne Lammott’s take on “shitty first drafts” and choreographer Twyla Tharp’s emphasis on “showing up no matter what.”
Pam was able to see the contrast between these artists’ approaches to creativity and her own approach to life. Still, she had doubts about her ability to change. In response, I told her that sitting with doubt was one of the most creative things she could do right now.
Shrugging she said, “I’ll try.”
Don’t Force a Solution. For our subsequent sessions, I asked Pam to bring in current life examples of feeling blocked so we could identify where in the creative process she was getting stuck and practice getting unblocked. She shared that her 12-year-old son had recently thrown a tantrum when she refused to let him visit a friend on a school night. She said, “I know I handled it wrong because I just laid down the law, and I definitely didn’t feel open or connected to my son.”
I asked her to view the situation with her son as if it were a painting, reminding her that to start a painting, an artist must create space and time for the thoughts to come together.
“OK,” she said immediately, “I’ll just stall and won’t give him an answer right away next time.”
“Try it right now,” I suggested. “See what it feels like to sit and generate options. Look at all the perspectives involved. Just sit with my question, sit with your son’s request. Let it incubate and postpone your answer.”
She sighed and sat quietly, then said, “I can see myself being so much more connected to my son when I sit with the feelings he must’ve been having. It feels totally different.”
Embracing Not Knowing. With each real-life example that Pam brought into session, we began to see that she had difficulty not only with incubating, but also with tolerating the discomfort that comes in the second stage of creativity: Pam’s fear of not being good enough and not knowing if she was doing the right thing wouldn’t allow her to experiment with options in the initial idea phase.
I invited Pam to watch some two-minute animated films on YouTube made by artists. When I stopped one of the films after a few moments and asked Pam to predict what was going to appear in the next frames, she realized it was impossible. Then I asked her to imagine writing her own animated film. Closing her eyes, she described herself and her husband at the start of a trailhead where they liked to hike. She then expressed surprise and delight when her imagination changed her and her husband into birds, flying off and landing in a nest of water, where they turned back into people lying hand in hand in a bed. This spur-of-the-moment internal filmmaking gave her an immediate experience of how an artist can create something without being wed to a definitive outcome. Her surprise to see this internal animation unfold so smoothly tickled her. She looked brighter when she said, “I never just let it unfold, do I?”
I said, “Your old pattern dictates that you either know the outcome or just follow the rule. This is a new way of doing things. Is there somewhere in your life you’d like to try out this letting go and unfolding?”
“I think it’d be helpful when I come home from work,” she said. “Maybe I can just back off and try to see our chaotic evenings as a surprising animated film.”
Fear Is Good. When Pam arrived for her next session, she reported that driving home from work, she’d tried to stay committed to the “letting it unfold” idea, but could only imagine bad things happening when she walked in the door. She expressed doubt about the whole “creativity thing.”
“Experiencing doubt is a good sign,” I said. “It means you’re partnering with your creativity.” To illustrate how anxiety is actually part of the creative process, I asked her to make a scribble on a piece of paper. After she made some messy lines, I said, “Good. Now let’s think of things we could turn your scribble into.” We brainstormed options and chatted a bit about the noisy wild roosters outside my studio, then I invited her to get to work.
She froze. “A minute ago, I had an idea, and now I think there’s no way that I can make my scribble look like the idea. I’m not artistic. It’s not going to turn out.” She’d arrived in her familiar place of feeling blocked.
“Just start with a color,” I said, “and see what it wants to do. Don’t worry about what it’ll become, just start.”
Soon her turquoise blended with purples and a peacock’s feather fanned itself from the back of a bird. Pam muttered as she drew, “I don’t know why I came up with a peacock. I have no idea how to draw the beak, but I absolutely love these colors. I’ve never seen a peacock that looks like this. I’m so madly in love with this bird.”
Pam told me afterward, “I get it, I really do. I have to take the plunge and just dive in. When I do, I have to embrace not knowing and just let it unfold, even if it’s scary.”
I related this to her initial expression of fear. “OK, you’re driving home, you’re scared of the chaos that’ll unfold when you get there, you remember that fear is OK. All you need to do is start with something, like the color in your scribble. What do you want to start with?”
“The feeling of love for my family,” she replied. “Yeah, and I can try to let things go from there.”
“Sounds creative—very open and authentic,” I said.
Mistakes Are Opportunities. Since artists are committed to the act of making art no matter what happens, they have to treat mistakes as opportunities to discover something new, and change direction if something leads them down a different path. Although Pam and I had talked often about the importance of allowing flexibility and vulnerability into her life, it was difficult for her to let go of feeling certain in all situations. But one week, she announced, “I told a board member that I had no idea what the right decision was. I felt authentic and honest, and took the risk of looking completely stupid. It turned out great, though, because instead of making a firm decision right away, we decided to elicit more information. So now, the whole organization has been invited to collaborate. It’s like we’re painting a huge mural together.”
Flow: The Artist’s Reward. Over the next few months, Pam loosened up in many ways, even physically. She became noticeably less stiff in her shoulders and made more eye contact when we talked. It was evident that her inner slave driver was letting go. With her 12-year-old son, she signed up for a photography class, and she started having coffee on Sundays with friends. In one of her last sessions, she told me about a memorable Sunday-morning breakfast with her family.
“My youngest was pouring syrup on her pancakes when the dog came up and bumped her elbow,” she said. “The bottle went flying, and syrup poured all over my daughter. I was horrified and told her to get in the bath quickly before more of it dripped on the floor. While I got the sticky-pawed dog outside, she started the bath water. I went to check on her and discovered she’d gotten in the tub with her clothes on. Instead of scolding her, I hugged her and eased myself into the tub, jeans and all. The memory of us giggling uncontrollably has carried me the entire week!”
This experience exemplified Pam’s new ability to partner with her creativity and open herself to being vulnerable and flexible. She said her anxiety was decreasing with each day, and she actually looked forward to being with her family. No longer checking out on her relationship with them, she felt she’d discovered the creative secret of how to keep checking in.
By Jay Efran and Jonah Cohen
Lisa Mitchell’s approach to therapy focuses on cultivating creativity rather than fostering insight. Similar to Acceptance and Commitment Therapy, her methods encourage clients to sit with their distressing thoughts instead of avoiding them or rushing prematurely into action. Specifically, in response to Pam’s request for help with her “inner slave driver,” Mitchell developed a series of creativity exercises designed to increase Pam’s flexibility and self-acceptance. Pam found these methods helpful and reports an increase in spontaneity.
It’s important to keep in mind, however, that there are limits to what creativity training can accomplish. If creativity was truly a mental health panacea, we would see fewer artists, writers, and performers in our practices. Moreover, if it really had a lasting impact on either mental stability or generalized problem-solving ability, it’d be included in required courses at colleges and business schools all across the country. In the current case, it’s difficult to parse how much of Pam’s progress is due to her art therapy exercises and how much is a function of therapy’s nonspecific factors, such as a strong therapeutic alliance and receiving positive reinforcement for taking risks.
Incidentally, personality theorist George Kelly wrote that creativity cycles always involve two phases: loosening and tightening. Without the first, there’s no novelty; without the second, there’s no productivity. Thus, the most crucial skill may be learning to shift easily between these two phases—from open-ended brainstorming to useful synthesis. In this context, Pam’s willingness to solicit information from other members of her organization can only be considered a partial success. A full victory would require that she also be able to collate and make effective use of the feedback she receives.
Instead of endorsing Pam’s metaphor about fighting her inner slave driver, we would have encouraged her to fully embrace her obsessive, perfectionistic style. Such characteristics are legitimate and valuable aspects of her personality—friends to be courted, rather than enemies to be vanquished. After all, without her drive and attention to detail, would Pam have had the same degree of success in business and child rearing? The truth is that each of us falls somewhere on the obsessive-impulsive spectrum, and every position on that continuum brings benefits and headaches. Furthermore, as the developmental research shows, our fundamental temperament traits have large genetic loadings and are likely to remain for life, regardless of how many years we spend in therapy or how many improvisation exercises we complete. Therefore, the trick is to appreciate our characterological quirks and learn how to put them to good use. As we tell our clients, it’s usually easier to ride the horse in the direction it’s going. Of course, Pam needs to remind herself to go off duty once in a while. Yet she should also take time to celebrate the gifts provided by her often ambitious, single-minded nature. This is true self-acceptance.
While artists, writers, and performers may know a great deal about being creative in their chosen art form, they are often not aware of how to apply the creative process to other aspects of their lives. They can benefit greatly from learning to see relationships, emotions, and problem solving in the same way that they see their art. Along the way, they can also learn how to tolerate doubt, uncertainty, and other unpleasant emotions in service of an expanded experience of life.
While it’s difficult to say whether Pam’s single-mindedness was due to genetic loading or other factors, it was clearly taking a toll on her relationships. In the process of learning to tolerate the uncertainties that come with delayed decision-making, she was able to soften in her way of being with others and open herself to more creative risk-taking. Eventually, she discovered that she didn’t need to fight her inner slave driver, just understand that this powerful aspect of herself was blocking her access to her own creativity.
Lisa Mitchell, MFT, ATR, writes and trains on the topic of creativity and therapy. She works with clients and therapists to partner with their creative process in her private practice in Sacramento, California, and blogs at Inner Canvas. Contact: firstname.lastname@example.org.
Jay Efran, PhD, professor emeritus of psychology at Temple University, is the coauthor of Language, Structure and Change: Frameworks of Meaning in Psychotherapy and The Tao of Sobriety. Contact: email@example.com. Jonah Cohen, MA, a doctoral candidate at Temple University, is currently researching social anxiety at the department’s Adult Anxiety Clinic.
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