Book Review: The Creative Process of Psychotherapy

Rothenberg, a leading American psychiatrist, attempts here to further the examination of the essence of creativity that he began in his earlier book The Emerging Goddess, judged best behaviour science book of 1979 by Psychology Today. He defines creativity as a special moment or process during which something both radically new and valuable is brought forth - whether a scientific advance, a consummate work of art or, most relevant to the readers of this journal, a personality shift in psychotherapy.

The equation of scientific endeavour, artistic success and what Rothenberg understands as good Psychotherapeutic practice may initially seem problematic but he develops an engaging and, to some extent, convincing thesis that the best therapists unite scientific and intuitive approaches to arrive at a particular, and particularly creative, form of treatment. Starting from this conception of good therapy as creative act, the writer goes on to attempt to identify the precise components of what he calls "creative sequences" in psychotherapy and attempts to indicate the ways in which we may promote the conditions for such creative sequences in our own practice.

Leaving aside for the moment the analysis of these "creative sequences", Rothenberg's thesis is a simple and relatively unoriginal one: the therapist, he says, experiences the activity of doing therapy with another human being as an especially worthy endeavour. These feelings are communicated to the client (or patient in Rothenberg's world) who then feels himself a worthy participant in this creative activity and, out of a developing sense of worth, begins to experience a sense of his ability to make changes in his life. The therapists creative skill facilitates this process and helps to determine the nature of the outcome. Specific to this argument, though, is an excessively detailed analysis of the mode of transmission of understanding from therapist to client via particular interventions, interpretations and overall approach. This close analysis is fascinating, as is the way in which he teases out the "mode of creative cognition" he terms "homospatial process" and the "creative functions" he calls "janusian process" and"articulation". The sophistication and complexity of these notions is such, though, that the reader may well come, reluctantly, to doubt Rothenberg's claim to offer specific directions for the improvement of psychotherapy in practice.

Other aspects of this text may also give the reader pause for thought. There is something exceedingly odd about the statement, crucial to any understanding of Rothenberg's analysis, that in the creative process of psychotherapy "the patient...chooses new patterns of behaviour just as the creative artist actively chooses to produce new structured content and the creative scientist actively chooses new theoretical formulations". If we follow the logic of this statement we are forced to conclude that the creative process of psychotherapy is fundamentally identical to the creative process of art or science. An existentialist might applaud the way in which this appeal to foreground the importance of active choice in therapy, but this does not seem to be what Rothenberg intends. He writes as though choice (or rather some sort of "correct" choice) is identical to creation. In the loosest sense we might agree that in choosing one course of action from an unquantifiable multitude we do indeed create ourselves. It is difficult, however, to determine what Rothenberg means when he uses the word "choice". He concedes that it is highly unlikely that any therapy of "psychiatric illness" can succeed unless some shift by the patient towards overcoming the illness occurs, but for Rothenberg this shift may obtain in such a variety of situations as to remove any real meaning from the word "choice". He states "I will not go into instances of manifestly directed or forced therapy such as those resulting from psychotic breakdown and institutionalization, suicide attempt, antisocial acts and the like, because any of these may represent indirect requests or decisions for treatment". He also holds that the creative process may occur regardless of the type of therapy - from person-centred to formal psychoanalysis and medicine, or any combination of these.

Rothenberg offers research examples from a number of poets, playwrights, and novelists. We might wonder if he does not share something in common with Henry James, novelist brother of the psychologist William James, who was similarly concerned to strip bare the creative process and who seemed increasingly to deny the possibility of creativity the more precisely he attempted to portray its workings.

Simon Du Plock