What follows in this article is an attempt to explore the importance of bringing creativity into clinical practice. To that end, it is my great hope to marry style and content, since it will require some creativity to parse (and then re-braid) the inherent creativity needed for a clinician to inspire productive healing, a client to engage in productive healing, and for either or both to be trained and encouraged to do so.
I use the word creativity advisedly, as the word is often a colloquial synonym for artistic. It is not. I have for a lifetime been deemed a “creative” because from a young age I had a natural proclivity for many of the expressive art forms (painting, poetry, movement, song), and a good deal of cultivation in each. But I would argue that this is not what has enabled me to become the person whom I hope is a creative clinician. Rather, it is a quality that I bring to whatever I undertake, which has enabled me to develop craft in the above forms along with a burning need to give voice to that which I could not otherwise speak. That quality, I would and will argue, was and is curiosity.
Part of my family folklore is that when I was born and the delivering doctor adhered to what was then the accepted custom of swatting my backside to get me reaching for breath, I looked him square in the eyes and asked, “What did you do that for?” This jesting was my mother’s way of saying that I was born a question asker—a habit both endearing and exhausting to her. As exhausting as it may have been to others, it is a habit of mind and being that has served me well in many studies and professions. As a Dean with a background in organizational development, I was able to ask and then answer, “What do these college administrators love and hate about their work?” As a foundation director, I was able to ask and then answer, “What does or does not make this a fund-worthy program?” As a dramaturge/director, I was able to ask and then answer, “What is this play about?” And now, as a clinician, I can ask and ultimately answer, “Where and why is this person stuck?” I was pleased to discover that Warren Berger, an innovation expert and journalist with the Harvard Business Review, has coined the term “questionologist” (Berger, 2014). In his book, A More Beautiful Question, he explores the idea that when we ask questions, and step back from assumptions, we create what he calls a culture of inquiry that leads us to new discoveries. This way of asking questions is true in the consulting room no less than in the boardroom or the classroom: it is the right questions, and not the right answers, that allow people to flourish.
A penchant for inquiry may sound simple, but it is not. In many families, religious traditions, genders, classrooms, consulting rooms, workplaces, and cultures, unbridled curiosity is not welcome and may even be taboo. And it’s hard work to be actively curious—it is, in fact, a kind of mindfulness. It requires active listening and full presence to the response received, the courage and humility to ask and not already know, and the energy and perseverance not to let a word just go by. It requires generosity to fully listen and learn. It is a form of mutual leadership that involves leading with questions and being led with answers. It is Socratic, and in every way antithetical to the way many clinicians are trained. Real curiosity means leaving one’s theories at the door and learning from the expert, the client. It means not assuming what your client means, but making sure you really know what they mean. It entails complete transparency about what you’re hearing and collaboration on the meanings implied. Curiosity is about finding and noting patterns and working together to see what they add up to. Curiosity is a child-like state that entails open hearts, open eyes, and open ears. It is an active exploration in the service of discovering the old learnings that are keeping us stuck, and of co-constructing new possible solutions and the bridges between the two.
It is this natural curiosity that led me to innovations in the growing field of narratology, which synthesizes the work of dramaturgy and therapy. Whatever genetic and environmental conditions led me to this proclivity, they seem to have been shared by my sibling, Dr. Lloyd Noppe, whose doctoral thesis and academic career has been devoted to the study of creative thought (Noppe, 2011), alongside his being a gifted natural musician. In his own words: “Anything can be pursued creatively—plumbing, babysitting, or painting—as long as the process involves seeing things in new ways” (L. Noppe, personal communication, July 23, 2016). To my mind, this is a crucial frame for therapeutic change, as the necessary narrative reframe entailed in symptom release is the very act of “seeing things in new ways”. How could a non-creative clinician hope to lead a client in such an exercise? In order to see things in new ways, one must have the flexibility to think outside of the box—to see things differently than how they have been. Again, in the words of Dr. Noppe: “A poem or a symphony or a painting is a creative product; and thinking flexibly, uniquely, and outside of the box is the person’s strategy to get to that product” (personal communication, July 23, 2016). It is no different when pursuing a creative solution to a client’s well-worn problem: one must understand how the problem came to be and work together to imagine it being otherwise. As Mihaly Csikszentmihalyi, whose seminal work Creativity (1996) I will cite throughout this article, asserted: “Without a good dose of curiosity, wonder, and interest in what things are like and in how they work, it is difficult to recognize an interesting problem” (Csikszentmihalyi, 1996, p. 53). And if the problem cannot be recognized, it certainly cannot be solved.
Until the “interesting problems” that are brought by our clients are recognized through mutual discovery work (as opposed to the application of a generic sticker from the DSM), regarding how and why their symptomatic behaviors were put into place, and what problems these troubling behaviors may have solved, along with the new problems they created (Ecker, Ticic, & Hulley, 2012), we will not be able to transform these old behaviors into new innovations. This discovery work is made of curiosity in the form of asking the right questions, even when these questions involve some degree of discomfort, both for those who ask and those who answer. I would and will argue that “The creative person is one who succeeds in displacing the quest for the forbidden knowledge into a permissible curiosity” (Csikszentmihalyi, 1996, p. 100).
Before I share cases that exemplify the kind of creative inquiry I am endorsing in clinical practice, I want to review the additional qualities besides curiosity that Csikszentmihalyi’s research deemed to be found in all creative people, and then suggest how these qualities are inherently necessary for anyone undertaking the healing art of talk therapy, and how they might be acquired. I have grouped these qualities under two overarching umbrellas: focus and problem-solving...
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