When I reflect on the theme of creativity in therapy, my immediate thought is that the therapeutic process is a creative act in itself. Turning to a dictionary for definitions, to be 鈥榗reative鈥� is to produce or use 鈥榦riginal and unusual ideas鈥�,1, and to 鈥榗reate鈥� is to 鈥榯o make something new.2 Each therapeutic encounter then offers a clean slate and the potential for something new to emerge. And through the vessel of the therapeutic relationship, the possibility for newness 鈥� the forming of new self-concepts to replace old, outworn ones, for example 鈥� results from an act of co-creation, with the unique and ever-evolving interrelationship between therapist and client providing the catalytic converter through which something new can come into being.
When we work, as we do, with what is unconscious (by definition as yet unknown) as much as (if not more than) with what is conscious, it鈥檚 clear the term 鈥榯alking therapy鈥� is a misnomer, because we never use just the language of speech when we converse with clients. We鈥檙e always tuning in to the language of the body, the language of feelings 鈥� for which words frequently prove inadequate 鈥� and the language of what we might call 鈥榮pirit鈥� or 鈥榮oul鈥�; that sense we can all tap into, whatever our religious beliefs or non-beliefs, that connects us to a sense of something greater than our separate, individual selves.
When I think then of the prescriptive, manualised protocols that prevail in statutory mental health provision 鈥� the procedures that therapists are required to follow according to whatever 鈥榗linical鈥� pathway the 鈥榩atient鈥� is deemed to be on 鈥� I fear that something crucial may risk getting lost as we reduce therapy, in a quasi-scientific way, to a series of scripted interventions that terminate with outcome measurements; as if these data can ever be anything other than subjective and empirically unreliable.
That鈥檚 not to say that within the frame of time-limited work, interventions of this sort do not have a validity 鈥� they do 鈥� but this should not be at the expense of providing space and time for something new and听unexpected to happen in the therapy room. Or at the cost of the therapist being free to meet the client where they鈥檙e at; or being able to listen carefully to what they want and need from us (understanding that this involves listening as much to unconscious as conscious communications, and that the unconscious works in its own timeframe), and relating to them from a position of equality rather than power, as a fellow-explorer rather than expert.
I鈥檓 writing this having seen that the draft consultation for NICE guidance on the treatment and management of depression in adults is underway.
Encouragingly, it states that people with depression 鈥樷�hould make the choice on what treatment option is right for them, in discussion with their healthcare professional鈥�, with a focus on 鈥樷�atient choice, and the organisation of, and access to, mental health services鈥�; for example, 鈥樷�ognitive behavioural therapy (CBT), exercise, counselling or psychotherapy鈥�.3
What remains unclear is how the patient鈥檚 choice is to be funded and delivered, should that be to access the full range of therapeutic services on offer, say, by 香港六合彩精准资料 members. To return to the theme of creativity, this issue includes contributions from all the presenters who participated in the 香港六合彩精准资料 Private Practice Conference, 鈥榃hen words are not enough: using creative approaches in therapy鈥�, in September. I hope it might inspire you to reflect on the ways in which you are already working creatively with your clients.
John Daniel, Editor
privatepractice.editorial@bacp.co.uk
