How The Light Gets In — Creative/Experiential Methods In Addiction Treatment

WORKSHOP HANDOUT

There’s an improv exercise called “Idle Hands” which requires that 2 players begin a scene by acting as if involved in some physical activity— iron a shirt, make a sandwich, wipe down the bar — and interact without ever talking about what it is they are doing. Its like real life in the sense that we usually wash the car or stock shelves while talking about everything but. Through the interaction, a relationship between the characters unfolds. The players continue the activity — fold laundry, deal cards, make coffee — while a dynamic connection develops through their responses to one another. The relationship did not exist before these 2 players began the scene, but it will quickly become clear that there is a history between these characters. They become mother and son, doctor and patient, friends waiting for big news. The interaction creates the relationship and we discover them and what they want from one another at the same time as they do.

This dynamic, unrehearsed quality of improvisation makes it an art form unique in its aliveness and entertainment potential, and also in the potential for the whole thing to go very badly. We all fail, flail, flop and flounder our way through the unfamiliar when dealing with the process of change in life. Without the trust that builds through agreement and moment-to-moment responsiveness, things can easily and painfully go off the rails. The creative experience of improvisation onstage is a model for what works when going through a significant change process. And because of all these parallels, Applied Improvisation provides a mindset and toolkit for therapists to deploy when working with clients having to navigate the thickets of deep and lasting change. As with the “Idle Hands” activity, we need to provide both grounding and freedom. The skills developed through active, ongoing, unrehearsed interaction create the self-awareness and interpersonal relationships that are the foundation of recovery.

The relationship is the thing-that’s what everybody cares about, in improv and in life.

Rules and structures like the ones in this exercise work around the unavoidable self-protective defenses that rise up when we are in situations of emotional discomfort or psychological threat. The unknowable worlds of other peoples’ thoughts, opinions and judgments can shut down even the most courageous creative soul, and the games and exercises deployed in improvisation are a form of relationship and creative thinking skills training for powering through that discomfort.

Improv games and exercises directly engage with the sense of “stranger danger” human beings feel when we are in familiar social territory. So when a group of strangers sit down together to work on a problem — especially if the problem has profound implications to a person’s life and its ripple effect in their social world — a simple game like “Who Said It” functions a bit like “Idle Hands.” The game gives the group a focus, a low-stakes but (ideally) interesting exploration of all possible answers to a quesion. Its how we begin the “Creative/Experiential Methods In Addiction Treatment” training, the success of which turns on the people in this group — unknown to one another — finding not only common ground, but a felt sense of psychological safety. This is central to the success of groups in general but even more essential in addiction treatment. The challenge is to generate enough psychological safety for everyone involved to take some degree of emotional and creative risk, because with risk comes reward, and with reward the group gathers creative momentum.

The “Who Said It” game is this: take a “best guess” at the author of this quote:

“An actor cannot impact another who is not himself impacted upon.” Aristotle

The author is kept secret while each person in turns thinks out loud about what the quote means and who may have originated it. Through this discussion we learn something about each person in the circle, e.g. their unique knowledge, life experience, books read, movies seen. And because there is a correct answer there is likely to be a degree of genuine curiosity piqued and maintained until the answer is revealed.

The Aristotle quote is chosen to focus the group on the central tenet of both creative/experiential methods and of successful recovery: that genuine, supportive human interaction grows out of human beings’ willingness to be impacted by one another. Like the “Idle Hands” exercise, players learn about one another and begin to create some degree of organic connection. Its an open-ended conversation within a clear structure, which fuels a sense of safety. All possible responses are entertained, which fuels freedom. Each response reveals something about the knowledge, life experience and worldview of the person talking, which fuels connnection. A 2nd quote is suggested: “The creation of something new is not accomplished by the intellect, but by the play instinct.” Possible authors? Albert Einstein (great choice since he also famously said “Imagination is more important than knowledge.”) Eric Berne (another great choice, since he developed Transactional Analysis and the concept of the inner adult, parent child). The game carries with it an organic creative tension — everyone contributes to the discussion and wants to know the answer: Carl Jung.

Creative conversations in a game format like this supply 4 of the elements research shows is linked to life satisfaction:

Satisfying work or tasks — to play a game we have to learn how it works and develop the skills needed. Good games are fun because they offer both increasing levels of challenge and rewards for meeting those challenges;
· The experience — or at least the hope — of being successful in small and larger ways;
· Social connections — games are structured, captivating ways to engage with others;
· Meaning — the sense that we are part of something larger than ourselves;

GAME: Harvest and Share

We are always noticing, adapting to or making connections to other people. If we are sighted, visual noticing is the first and most immediate. The brain continually notices visual perceptions about other people and environments without conscious awareness and we adapt or form responses in subtle, and sometimes not-so-subtle ways. When we have a greater sense of “stranger danger” in unfamiliar, high-stakes social situations, this neuroperception can kick into high gear, heightening anxiety and reducing the cognitive thinking process that helps us manage and pilot through it. This exercise takes a fundamental principal of improvisation — noticing and responding to one’s partner moment-to-moment — and adapts it to advance the social-emotional learning goals of a treatment group.

Each player is instructed to take note of something about the the person to his/her right, specifically something visual (not physical), make some kind of personal association to it, what we call “harvesting,” and share it in this way: Player #1 notices a necklace worn by the person sitting to her right, — we’ll call her “Jenny” — which is made of entwined circles, makes a mental association to it and then shares: “I harvest Jenny’s necklace with its design of linked circles and it reminds me of the Olympic rings, which are a symbol of people working together to achieve high goals.” Each player makes a point of noticing, taking in or “harvesting” a detail about the person to the right, and making an association to it. Round 2: After a brief discussion of what everyone is aware of having done the visual noticing, do a round in which players notice and “harvest” something nonvisual about the person, e.g. “I notice Sue’s honesty about how anxious she feels right now and I will harvest it by following her example and talking about my anxiety rather than shutting down.”

Objectives:

  • Make visible and conscious the natural process of neuroperception, of “noticing” that human beings do with one another in social situations, which can to anxiety and subtle defensiveness when it is unconscious in situations of uncertainty or risk;
  • Practice the improvisation technique of receiving and using what others offer- the fundamental improv principle of “yes…and” — just by their presence and what is unique about them;
  • Connect the group to one another by sharing an association;
  • Connection the group to one another by supporting each person’s harvesting and sharing.

Social Connection: Recovery from addiction involves a restructuring of one’s social world that can be extremely challenging. Treatment that provides specific skills training and social-emotional engagement promotes clients’ capacity to make connections to others and to function within a healthy give-and-take exchange of energy and support.

Improvisation occurs through dynamic, unplanned human interaction within a set of agreements or structures that frame the field of choices and is an ideal training ground for these essential social-emotional skills.

The fact that people are coming together to both play with uncertainty and learn something new can heighten the bonding experience. People do not have to open up about deeply personal aspects of their lives to feel connected through improvisation, because everyone is vulnerable, the spirit of improvisation is supportive and collaborative, and the experience itself is a way of revealing self to others. Like fans rooting for a mutually-beloved team, everyone who engages in the process of improvisation has a stake in what develops through the collaboration. But the process is always grounded in structure, and ideally provides ongoing skills in emotional self-management. In addiction treatment it is especially important to consciously connect to the body and breath and remind participants that it is within their grasp to shift out of the anxiety/stress response through physical grounding and use of the breath.

Body Awareness Warm-Up:

Objectives:

  • Heighten awareness of one’s physical/sensory experience;
  • Heighten awareness of internal shifts in thinking and feeling that occur when physical posture changes;
  • Heighten awareness of internal “monologues” that rise up;
  • Identify what happens internally when a physical/emotional experience is identified and put into words;

Participants stand and find a spot in the room where they have limited or no vision of one another, where they can focus on their own internal experience. They should find a spot where their backs are to one another, as close to being alone in the room as possible. Identify their partner as the person to their right.

On a count of 3 -2- 1 strike a pose and hold it. Notice: “what do you see, what do you notice, what do you hear, what do you feel?” Give a name to this pose.

On count of 3 change the pose to something else. Notice “what do you see, what do you notice, what do you hear, what do you feel?” Give a name to this pose.

On count of 3 change to a pose that expresses a heightened positive emotion.

On count of 3 turn to the center of the circle and “offer” this emotion to the entire group.

VARIATION OR ADDITION: Before the exercise begins, demonstrate the “Superman” pose — hands on hips, chest out, head up, feet planted — and the “Victory” pose — arms stretched upward over the head — and describe the physical and psychological benefits of them, according to researcher Amy Cuddy (How Your Body Language Shapes Who You Are TED Talk). Include these in the series of poses participants are doing as they stand alone.

ENCOURAGING WORDS

Objectives:

Focus attention on positive concepts and developing an atmosphere of generosity of spirit;

Demonstrate the mindset of mutual, positive support that improvisation teaches and relies upon to be effective;

Demonstrate the importance of eye contact in interpersonal communication;

Practice simple giving and receiving of energy and ideas, which is central to improvisation and to successful supportive relationships in recovery;

The group stands in a circle. The leader begins by making a “toss” of an encouraging word to someone in the group, e.g. “hope” “support” “strength” to a group member, making sure to establish eye contact so the person knows they are about to receive something. The receiver “catches” the word by repeating it in the same way that it was sent. That member then establishes eye contact with another member and “tosses” another encouraging word.

Toss” an encouraging word to someone in the group, e.g. “hope” “support” “strength.” First be sure to make eye contact so the person knows they are about to receive something, then toss the word. The receiver “catches” the word by repeating it in the same way that it was sent, then “tosses” another encouraging word to someone else.

Suggestions of encouraging words:

Strength, resilience, love, peace, serenity, honesty, playfulness, spirituality, inspiration, grit,

DEBRIEF: What internal monologues came up when striking poses? What self-protective defenses are linked to these monologues — usually “I’m not doing this right” or “I look stupid” or “I picked the wrong pose” or other self-critical voices? The function of these self-protective monologues is to help us get things right and feel safe, and discussing them openly helps to normalize and deconstruct them while generating greater safety in the group.

THREE ICONS

The group identifies 3 iconic figures of recovery, e.g. Bill W., Betty Ford, Robert Downey Jr., A strong identifiable pose is created to represent each one. A team of 3 people is formed. In the style of “rock, paper, scissors” a group member counts out loud “1, 2, 3” and then on the 4th beat the 3 team members assumes one of the postures. The goal is to get one of each icon represented at the same moment. The game repeats until the goal is achieved. OBJECTIVES:

  • Get out of overthinking and jump into a physical experience that connects the players in a shared goal;
  • Experience the “high” of a “win” that can be experienced when the goal is achieved;
  • Observe what happens internally over the course of a few or more attempts to achieve the goial;
  • Identify internal shifts as each turn progresses, which are attempts to achieve the goal as the game proceeds;these individuals.

PROVERBS

Objectives:

  • Practice collaboration with the group/team;
  • Practice yes…and as well as developing an idea one step at a time;
  • Promote the capacity to think on one’s feet and use what is given rather than what is anticipated;

Players sit in a circle. A “proverb” or wise saying is developed by each player adding one word at a time in order around the circle. When the sentence sounds like it is complete the group says “yes yes yes yes yes” and then the next player starts another wise saying.

ASK ME ANYTHING

Same as PROVERBS

Three players stand in a line, arms linked. These players are to play the role of one person who is there to answer questions of other group participants. They will do this by forming an answer one word at a time, as in the Proverbs exercise.

Matthew Lieberman, PhD, Professor of Psychology, Psychiatry, and Biobehavioral Sciences and author of 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. He discusses research which shows, for example, that the parts of the brian that are lit up when we are rejected by other people — even if we hardly know them — is the same part of the brain that is activated when we feel physical pain. Empathy, intuition, and other emotionally-driven social cues are integral to to learning and success, according to his findings. this information should be remaking the way we think about education, health care and any other domain in which the acquisition and application of knowledge or behavior change are the primary objectives. Here is a TED talk by Dr. Lieberman dealing with his research into the social-emotional brain:

MONOLOGUE — song structure

Objectives:

Explore an idea from 2 different perspectives;

Practice putting a point of view into words;

Practice taking a stand on a topic without rehearsal nor editing;

Strengthen confidence in sharing ideas with others;

Process: The structure of each monologue is laid out as similar to the structure of a song. First we establish a “chorus” which is a THESIS STATEMENT about the topic, i.e. “Love always wins out over hate.” A place to stand when delivering the Thesis Statement is established and the Thesis Statement is stated emphatically. Then the participant moves a few steps to the right of that spot is the spot for the articulation of a monologue that supports the Thesis Statement, the “verse” e.g. “Martin Luther King had everything going against him and he kept saying love would win out and he was right. He encouraged people to be nonviolent in the face of violence. And in the end that movement worked.”

The participant steps back to the position of the Thesis Statement and repeats it emphatically, then returns to the position of the Verse and adds another monologue to support the Thesis Statement. After as many verses as the participant can think of, he/she moves to the left of the Thesis Statement position, for the BRIDGE position. Here another perspective is expressed, i.e. “On the other hand, Martin Luther King did not survive to see his movement succeed. There is still so much racism in this country, its hard to see so much hate in the world still playing out…” leading up to a return to the Thesis Statement, e.g. “but who am I kidding, in the big picture Love always wins out over hate.”

The exercise is done first as a skill-builder, using any random topic that the group comes up with. Then it is done with recovery-specific Thesis Statements, e.g. “This feeling of shame will never go away” or “People always let you down.” Any Thesis Statement is okay, the exercise is an opportunity to explore why those beliefs are so strong, but also to look at an alternative viewpoint about the same thing.

VARIATION: Encourage the participants to make a thesis statement that is contrary to therapeutic guidelines, e.g. “I don’t need to go to meetings to recover” or “I can’t deal with this Higher Power talk, it means nothing.” This is a yes…and to the internal struggle that can go on for quite a long time into recovery as a person adapts to a set of principles and behaviors that are radically different from living a life of active addiction. It is a way to give voice to those doubts and conflicts while exploring the new ideas in a creative way.

Jude Treder-Wolff, LCSW, CGP, MT is a consultant/trainer and writer/performer. She is President of Lifestage, Inc and host/creator of (mostly) TRUE THINGS, a show that features true stories — with a twist — told by people from all walks of life, ages and backgrounds.