A Controlled Sense Of Crisis: Social-Emotional Learning Through Applied Improvisation In Health Care

Medical and mental health professionals must constantly accommodate the ever-changing, dynamic demands of providing actual care and services. And the stakes are high. Open communication on a medical team, for example, can have life-or-death implications. This kind of creating, interacting and performing all at the same time is what happens on the improv stage but also in more and more professional training that focuses on Emotional Intelligence — which deals with the emotional impact people have on one another, and awareness and management of feelings, particularly in response to change and uncertainty. Improvisation, which occurs through dynamic interaction and the impact that people have on one another moment to moment, is a heightened, artificial version of what medical professionals deal with in real-life, high-stakes circumstances.

Properly designed experiences of Applied Improvisation are ideal for strengthening the mind and skill set necessary to navigate the complex interplay of relationships and systems in health care. The Journal Of Business Research specifically define the current conditions — which require the ability to think, process complex situations and act, often all at once or in a very short period of time — as an ongoing phenomenon in the networked world: “Improvisation is a system’s unplanned but purposeful response at a particular point to a turbulent, fast-changing environment” Learning To Improvise, Improvising To Learn: A Process of Responding To Complex Environments.

Applied Improvisation is uniquely effective for providing a safe environment in which to experience a “controlled sense of crisis” that could easily trigger a range of defensive reactions but is designed to expand the focus to creative, collaborative decision-making. The neocortex of the brain is the seat of planning and organizing actions toward a goal, including emotional ones. If an emotional response is called for, the prefrontal lobes dictate it, working hand-in-hand with the amygdala — which receives information from all the senses as well the emotional brain and is activated by intense emotionally significant events. When a negative heightened emotional reaction is triggered, the prefrontal lobes perform a risk/benefit assessment of possible reactions, e.g. attack, ran placate, persuade, seek sympathy, stonewall, guilt trip, be contemptuous, show of bravado. The cognitive “committee” has a decision to make about how to respond, and creative experiences can expand the field of choices that are available. In this way, a heightened emotional experience in a creative social environment, one that includes other people and takes in their support and understanding, can be transformational. Defenses and beliefs are learned through social situations, so we need direct experiences in healthy social situations to learn new, more useful forms of coping with psychological threats that are adapted to the current need.

The social-emotional connections formed through simple, carefully-designed Applied Improvisation games and exercises provide alternate pathways through the “crisis” of uncertainty and the brain will take those new pathways under the right conditions. These conditions are:

  • A social environment of safety and support
  • Emotional heightening of experience which drives attention to the new information
  • Experiences that trigger the brain’s reward chemistry — experiences of a “win” combined with social interaction are ideal
  • Novelty and creativity, which are associated with the brain chemistry of reward

The February 2007 British Journal of Social Work made the case that the ability to use relationships to address users’ needs is at the core of professional competence. Professionals must call upon their own emotional resources to meet the diverse demands of the job as well as respond to externally-driven stresses and obstacles, often at the same time. The ability to understand one’s own and others’ emotional states, discern the nuances of social-emotional cues and act on them in order to move a situation forward can be continually developed and enhanced through its practice.

The highly interactive nature of improv heightens awareness of others’ thoughts and feelings, strengthens partnerships and enhances social sensitivity, building the skills that reduce stress and allow a team to be more creative and innovative even while under great pressure, as described by Marc Evan Jackson of The Detroit Improv Project, which partnered with the University of Michigan in a study showing that improvisation training strengthened confidence, reduced anxiety, and cultivated essential social skills among the project’s participants.

“The first factor of Emotional Intelligence is the ability to properly determine and express one’s own emotions as well as to be sympathetic, appraise and express emotions of others. Every individual’s ability varies in precisely identifying, appraising and expressing his own emotions as well as the emotions experienced by others. Some people are attentive of their feelings they experience and can express their emotions whereas, some people cannot express their feelings and emotions or they are unaware of their emotions… The research indicated that there is a positive relationship between job performance and team members having high EI because they are highly proficient at appraising and regulating their own emotions which results in a higher level of faith in themselves and have power over them which lead them to make realistic actions resulting in high performance and less supervisory interference.” in Impact Of Emotional Intelligence On Team Performance In Higher Education Institutes

Social-emotional events have a direct impact on our ability to receive, store and use new information. “Event memories are tied to specific emotionally or physically charged events (strong sensory input) because of the emotional intensity of the events to which they are linked,” explains neurologist Judy Willis in Research-Based Strategies To Ignite Student Learning. “Because the ‘dramatic event’ powers its way through the neural pathways of the emotionally preactivated limbic system into memory storage, the associated hitch-hiking academic information gets pulled along with it. Recollection of the academic material occurs when the emotionally significant event comes to mind, unconsciously or consciously. To remember the lesson, students can cue up the dramatic event to which it is linked.” Matthew Lieberman, PhD, Professor of Psychology, Psychiatry, and Biobehavioral Sciences at UCLA whose book Social: Why Our Brains Are Wired to Connect, argues that our need to reach out to and connect with others is a primary driver behind our behavior. Empathy, intuition, and other emotionally-driven social cues are integral to to learning and success, according to his findings.

Improvisation games and exercises are exactly the kind of “dramatic event” that drives new learning. They are social because they involve interaction with other people and emotional because of their meaning. Along with the research showing that creative engagement illuminates, accelerates and integrates new learning, this information should be remaking the way we think about training for any domain in which the acquisition and application of knowledge, skill development and behavior change are the primary objectives.

Improvisation is a direct and engaging way for medical professionals to strengthen the capacity to feel, think and act under pressure. The controlled sense of crisis is the ideal learning state for high-stakes problem-solving and team collaboration.