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Therapeutic artistry: finding your creative edge with difficult couple and family practice situations

6 April 2016

± minute read

    Therapeutic artistry: finding your creative edge with difficult couple and family practice situations
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be puzzled, or confused in a situation he finds uncertain and unique…a new theory of the unique case…He does not keep means and ends separate but defines them interactively as he frames a problematic situation.----Donald SchonIn each instance, the practitioner allows himself to experience surprise,He is not dependent on categories of established technique, but constructs

My first exposure to therapeutic artistry at its best was in the context of a week-long live supervision training with Salvador Minuchin in 1986. I had brought in one of my toughest families for a live family therapy consultation. The family was comprised of Tim 17-years-old and his father Allen. The mother had abandoned the family when Tim was 10. Tim had had a long outpatient treatment history and two psychiatric hospitalisations for psychotic-like symptoms, hallucinogen abuse, running away, breaking his father’s rules, and school failure. One reoccurring delusion that Tim had was that he was a hippie from the sixties and he could assume the identities of famous personalities from those times, such as: John Lennon, Abbie Hoffman, and so forth. Over the four-session period we had seen one another, the goals were constantly shifting, agreed upon therapeutic experiments were not implemented, and Tim ended up psychiatrically hospitalised. I must say going into this live family therapy case consultation I found it to be quite comforting knowing that one of the master family therapy pioneers was behind the one-way mirror prepared to help me in the best way possible with this highly challenging family. Minuchin did not waste any time like a true artist weaving together a beautiful tapestry of metaphoric hunches, analogies, vivid imagery, humor, surprise, and provocation as the final touches to create a workable reality in one session. After joining with the father and the son, Minuchin had discovered that the father used to wear his hair long and used to have a “wild side” in his younger days before cutting his hair and becoming a businessman.

Minuchin proclaimed that they were “The Yuppie and the Hippie.” Next, Minuchin began to directly challenge the diffused generational boundary problem, their problem-maintaining interactions, and Tim in the role of the symptom-bearer by wondering if when the latter abused acid if he would see images of his father in his hallucinations and that he and his father were like Corsican Twins. Minuchin then challenged Tim by pointing out how he was like Zelig, the lead character in Woody Allen’s movie by the same name. Zelig was like a human chameleon that could transform himself into a woman, an historic figure, a person of colour, and so forth. Finally, making good use of props in the office and humor, Minuchin picked up a palmistry hand and held it up to Tim’s hand and discovered that he lacked the separate line of life and would not be able to ever separate from his father. This last therapeutic move sparked anger in Tim and an outburst from him along the lines of “I’ll show you! You don’t know what you’re talking about!” One week later, when I saw the family the father had reported that Tim had a great week and not only did he come up with some personal goals for himself but he had landed a part-time job. I fell out of my chair out of amazement after hearing about Tim’s tremendous progress. When I had met alone with Tim, he reiterated to me that “Dr. Minuchin did not know what he was talking about!” I said to Tim that he was doing a great job of proving the good doctor wrong and he confidently shared with me that he planned to stay drug-free and do better in school. In our last family therapy session, we celebrated Tim’s high school graduation. Another highlight of this incredible training experience with Minuchin was the short walk we had taken together during a coffee break. He said to me, “Matt, you need to enjoy yourself in there, dance with the family.” These encouraging words really resonated with me and had a profound impact on my becoming more daring, playful, provocative, and bringing more drama into my work with couples and families. Minuchin’s artistry also demonstrated to me the importance of being unconventional, improvisational, and searching for and bringing ideas into our sessions from the worlds of art, drama, and literature, which are rich sources for inspiration, imagination, improvisation, and creative solutions. The latter resource areas take us far beyond the limitations of our choice therapy approaches and lend themselves well for finding creative ideas and constructively managing the dynamics we often face with our toughest couples and families, such as: uncertainty, ambiguity, unexpected crises, and wicked and intractable presenting problems that seem impervious to our change efforts. 

Over the years, I have been developing practice strategies for further cultivating my improvisational style as a therapist and ways to be more inventive for both myself, and the therapists I supervise and train to help them to find their creative edge. Below, I list 19 practice strategies.

  1. Fertilize your brain by reading more science fiction, philosophy, detective mystery books, non-fiction biographies on famous artists, scientists, historic figures and events, and business books.
  2. Dust off and browse through your old Dr. Seuss books, look at cartoons in the newspaper and on TV, watch Comedy Central, Seinfeld, and Woody Allen movies.
  3. Go to jazz concerts of top players to experience improvisation at its best
  4. Go to art museums and pay close attention to the artists that intrigue and inspire you the most
  5. Build mindfulness meditation and related practices into your daily regime
  6. Infuse more rhythm into your sessions and into your daily regime by listening to different types of music, playing an instrument, dancing, engaging in artwork, or exercising
  7. Daily, be on the look out for anomalies, meaningful coincidences, good luck events, and epiphanies to seize both in and out of sessions
  8. View every problem with a beginner’s mind
  9. Think and play with new ideas with the undying curiosity of a child
  10. Think and experiment with opposites
  11. View uncertainty and adversity as opportunities
  12. What would be a song title or newspaper headline that best captures this challenging family?
  13. When faced with a challenging couple or family, hop into your imaginary helicopter to gain an aerial view to see what you may be missing?
  14. Let’s say that Rene Magritte, Dizzy Gillespie, chef Bobby Flay visited you during your intersession break with this challenging family, what recommendations would each of them have for you to try out?
  15. Complete the statement with as many ideas as possible and pursue the ideas that you think have the best shot at working in your next session: “It would be really crazy if I…”
  16. What if your success was completely guaranteed with your toughest family, what would you try and pull off in today’s session?
  17. With a challenging couple, ask yourself, “How can I be even more in competent with them?” Now, get to work!
  18. What if you woke up today with a severe case of amnesia and have completely forgotten your choice therapy approach with your clients. What would you do? How would you manage? What would you do next?
  19. If the Persian poet Rumi were a guest consultant for today’s session, what valuable words of wisdom would he offer you and your clients?

Although this is not the definitive list of practice strategies for cultivating the creative use of self, my hope is that these ideas will inspire you to be more daring, inventive, and improvisational in your clinical work with challenging couples and families. MATTHEW D. SELEKMAN, MSW, LCSW, is the director of Partners for Collaborative Solutions (www.partners4change.net), an international family therapy training and consultation practice in Evanston, IL. He is the author of eight professional practice-oriented books and consults and gives workshops throughout the world. 


Minuchin, S. (1986). Four-day live supervision training in structural family therapy. Gestalt Integrated Family Therapy Institute, Chicago, IL. Selekman, M.D. (2016). Working with high-risk adolescents: An individualized family therapy approach. New York: Guilford, in press. Selekman, M.D. (2010). Collaborative brief therapy with children. New York: Guilford. Selekman, M.D. (2009). The adolescent and young adult self-harming treatment A collaborative strengths-based brief therapy approach. New York: Norton. Selekman, M.D. (2005). Pathways to change: Brief therapy with difficult adolescents, 2nd ed. New York: Guilford. Selekman, M.D. & Beyebach, M. (2013). Changing self-Destructive habits: Pathways to Solutions with Couples and Families. New York: Routledge. Schon, D.A. (1983). The reflective practitioner: How professional think in action. New York: Basic.  

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