Humour, learning and creativity in therapy. A practical constructivism.

1. Humour, learning and creativity in therapy. A practical constructivism. Peter Stratton Professor of Family Therapy Leeds Family Therapy and Research Centre Inst. of Health Sciences, Leeds University, UK Hello my name is Helen Pote, I am a clinical psychologist with a special interest in working with children and families using ideas and interventions taken from systemic family therapy. I am lecturer for the department of psychology, RHBNC. Today I am going to talk about a research project I undertook whilst based at Leeds. It was an MRC project carried out at the Leeds Family Therapy & Research Centre, which is part of the psychology department there. The project was one year study which aimed to produce a manual for systemic family therapy which could be used as a research tool to standardise systemic therapy interventions in clinical outcome trials of therapy efficacy. We feel we have achieved this and I want to report the process by which we went about this, some of the findings which were of particular interest, and familiarise you with the manual and its clinical applications. The research team for the project consisted of myself and Peter Stratton, Paula Boston & David Cottrell, 3 experienced family therapists all of whom are actively involved in practising and teaching family therapy. Also in the team was David Shapiro who brought extensive research experience in the area of manualised therapies and outcome research. Hello my name is Helen Pote, I am a clinical psychologist with a special interest in working with children and families using ideas and interventions taken from systemic family therapy. I am lecturer for the department of psychology, RHBNC. Today I am going to talk about a research project I undertook whilst based at Leeds. It was an MRC project carried out at the Leeds Family Therapy & Research Centre, which is part of the psychology department there. The project was one year study which aimed to produce a manual for systemic family therapy which could be used as a research tool to standardise systemic therapy interventions in clinical outcome trials of therapy efficacy. We feel we have achieved this and I want to report the process by which we went about this, some of the findings which were of particular interest, and familiarise you with the manual and its clinical applications. The research team for the project consisted of myself and Peter Stratton, Paula Boston & David Cottrell, 3 experienced family therapists all of whom are actively involved in practising and teaching family therapy. Also in the team was David Shapiro who brought extensive research experience in the area of manualised therapies and outcome research.

2. Objectives of the paper You will have a lighter approach to the serious business of humour, and a more serious approach to the funny business of therapy. You will give yourself premission to be creative in therapy and to deliberately foster the creativity of your clients. And you will both enjoy it more.

3. The thesis The main aim of therapy: that the client achieves a new understanding and/or narrative of the familiar events of their lives, is very similar to the main basis of humour. So in defining the conditions that make a joke more likely to succeed we are defining the conditions for creative psychotherapy We may also learn about how to use humour by researching what therapists do.

4. If We can formulate a constructivist position out of our present knowledge of therapeutic practice It should be a platform for a true integration of past, present, and future approaches. I see constructivism as a good base for theories of therapy * Stratton, P. (2003) Human Systems.

5. We have good theories about what humour is for, e.g. Kahn�s (1989) list of 5 primary functions of humour: But much less understanding of the psychological processes involved.

6. Homer Simpson�s spider pig. AKA Harry Plopper

7. Bateson�s pigs Bateson pointed out that there are no pigs in the brain, but there are not usually images of pigs in the brain either. What we do is recognise and interact with pigs in the ways that we find appropriate and effective. Now if you had access to all the ways I have of mentally processing �pig�, you could construct the meanings that I give to pig.

9. Life = potentiating the schemas you might need

10. How many schemas ? When you first came into this room? A small percentage of your complete set Probably not more than 10,000

11. Exploration Samples from the world But also samples within the schemas the theory draws on metaphor and the hermeneutic circle �. Enter the sheep

13. Activated schemas may mobilise you When schemas have implications for action, and the situation is serious, the action is taken. But when mobilised but there is no appropriate action (because you realise the situation does not call for it) you may laugh. The banana skin

14. What is happening here? Two men meet John announces: �my wife is pregnant� David replies: �congratulations�

15. What is happening here? Two men meet John announces: �my wife is pregnant� David replies: �who do you suspect?�

16. A joke: Is achieved through the process of: A. Eliciting of an anticipatory schema B. A recognition that the schema is the wrong one, or inadequate by being too simple C. A resolution through an alternative schema which: requires abrupt activation of a schema with significant positive implications: for relationships/enjoyment/ elaborateness/ connections to other significant schemas/ for major motivations.

17. Therapists have a licence to challenge assumptions and say the unsayable Therapists may act like a priest or a judge, But they are better as court jesters �This fellow is wise enough to play the fool; and to do that well, craves a kind of wit� (Twelfth Night)

21. Critical Thinking, creativity and metaphor.

22. From humour to creativity ... all creative activities - have a basic pattern in common: the shaking together of already existing but previously separate areas of knowledge, frames of perception or universes of discourse ... (Koestler, A., (1975) The Ghost in the Machine, p. 195)

23. �Peter Stratton.Leeds 2003 Creativity is a skill not a miracle Creativity is what psychotherapy is about for clients AND for therapist

24. �Peter Stratton.Leeds 2003 Creativity is one of the prime responsibilities of therapists. So: Not so much what is creativity, but how to go on creatively. Without privileging creativity at the expense of rigour

25. �Peter Stratton.Leeds 2003 Bateson�s dilemma Serious business like therapy implies rigour The dilemma of the tension between rigour and creativity. As Bateson said, too much creativity leads to madness But too much rigour results in death

26. In 2s or 3s have fun inventing metaphors for a therapist that incorporate a role as comedian. Metaphor talk is one way to get free from seriousness. E.g. in the technique of externalising (Churchill�s �black dog�).

27. Humour, and therapy, need to distance from the seriousness In Bateson�s terms, maybe humour allows you to test something out in the map before you have to get into the territory. Flagging something as a joke is a signal that this is map, not territory. �we are going meta� Alternatively: it is the absence of an (amigdaloid) emotional reaction.

28. Conditions for creativity: secure base absence of blocks remembering to

29. �Peter Stratton.Leeds 2003 Motherhood, apple pie and attachment Baby: Hunger cry fed assuaged play General formulation: Stress demand care latitude explore A therapist: New pre-session schema confident creative Family anxiety theory

30. Findings from our research In 10 family therapy sessions there were 183 episodes with an indication of humour. Grounded Theory analysis Both family members and therapists used humour extensively but therapists used a more restricted range. Humour was used with an enabling function by both families and therapists when confronting difficult issues.

31. Types of humour most often used by therapists Were in the group likely to open up alternative attributions. Exposure of censored feelings Introduction of new explanation Comment Task assignment Challenging of beliefs Irreverence

32. Functions of humour common across families

33. A possible conclusionBreeda Gallagher and Peter Stratton while therapists are creators of humour, using the isomorphism of structure of joke and therapeutic intervention to open up possibilities for difference, the families were consumers of humour, using the signals of humour to create space and permissions to say what they want to say, both to the therapist and to each other.

34. For a therapist to help you enjoy jokes about your religion needs: A positive alliance with the therapist creating: - Acceptance that they may offer alternative schemas A reduction in the investment in initial schema which frees you to consider alternatives The building of alternative schemas so that they are constructed in a positive form Potentiating positive alternative schemas so they are readily available for alternative explanations. These are the therapeutic process

35. Applications in therapy Think of the last time you entered a therapy room� What hermeneutic circles started from your prejudices (Milan jargon) But immediately you move on to think about the hermeneutic circles of the family members, then to guessing about their prejudices (dominant societal discourses)

36. Application Think of how your emotional state may have led you to potentiate some schemas rather than others i.e. suppose you had been bored, full of enthusiasm, fed up with adolescents, in love, hungry�. Would different sets of schemas have been potentiated ready for use?

37. A schema take on therapy Therapy is about seeing past actions as due to certain schemas being activated, and negotiating ways in which different schemas could operate. This may be by changing the meanings attached to events, practicing choosing different consequents for common schemas, or changing the setting conditions (e.g. parental criticism) so that the old schemas are not activated, and can gently become less available.

38. You cannot destroy a schema (which is why it is difficult to directly persuade someone to renounce a well rehearsed belief) but you can redirect its connections so that it leads to different consequences. Or you can redirect the setting conditions that until now have activated it. E.g. seeing a vulnerable person to arouse empathy rather than an opportunity for exploitation.

39. Keep exploration going the whole schema system is geared to minimising the exploratory cycle. Creativity is about finding ways to insist on the exploration. What would stop premature closure In a discussion during therapy? In a family at home? Give me some ideas, in schema terms, of hwo to keep the exploratory cycle going. Being less accepting of a fit Attending to ignored aspects that might not fit (e.g. a painter going syncretic) Making novel connections to other schemas Give me some ideas, in schema terms, of hwo to keep the exploratory cycle going. Being less accepting of a fit Attending to ignored aspects that might not fit (e.g. a painter going syncretic) Making novel connections to other schemas

40. In therapy: Look for repetitive cycles with problematic outcomes Negotiate whether to avoid the precipitating conditions or to instate alternative outcomes. This needs irreverence so that the person doesn�t �have� to follow through Including maintaining the exploratory cycle (safety plus curiosity)

41. Further Information Peter�s work-in-progress website: www.psyc.leeds.ac.uk/staff/p.m.stratton/  Stratton, P. (in press 2007) Enhancing Family Therapy�s Relationships with Research, Australian and New Zealand Journal of Family Therapy 28. Stratton, P. (2005) A model to coordinate understanding of active autonomous learning. Journal of Family Therapy. 27(3), 217-236. Stratton, P., (2005). Report on the Evidence Base Of Systemic Family Therapy. London: Association for Family Therapy. At www.aft.org.uk Stratton,�P. (2003) How families and therapists construct meaning through anticipatory schemas. Human Systems, 14, 119-130.