Therapists walk into an improv class to learn to better relate to patients

Instructor Lisa Kays, Erin McCarthy, Campbell States and Laurie Emmer-Martin listen to a presentation by a fellow therapist.  Washington Post photo by Linda Davidson

She didn’t want to play naked beach volleyball, but her friend pouted and reminded her that on their girls’ vacation they had promised to do everything the other wanted. So Erin McCarthy methodically procrastinated, first by slowly rubbing on sunscreen. Then she feigned a need to do yoga stretches, then moving into a deep lunge.

And then, before the clothes came off, the scene ended.

McCarthy was not about to strip down at a sunny exotic locale with her girlfriends; she was inside a grungy, second-floor classroom of a District theater with a group of women she had met only a handful of times. They each had a turn having to say “yes” to an unpleasant request: mowing the lawn, changing a diaper, making a drug drop.

It was an exercise in letting go of control and overcoming the reflex to say no. This was Improv 101, and the lesson was character dynamics. But instead of the usual mix of beginners in the Washington Improv Theater class, the students in this Friday morning class were local therapists and social workers.

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At the heart of performing improv is trust, open-mindedness and a willingness to navigate the unknown with another person. The same can be said about therapy.

When Lisa Kays, who leads the class, went back to school in 2009 to become a clinical social worker, she was struck by how familiar the skills were to her. Being present and attuned to others were basic tenets of improv. She discovered there already had been tons of research on how employing improv skills could help therapists better engage with patients.

One of the most important lessons in improv is called, “Yes, and,” which requires performers to go along in whatever direction their scenemates go. If they were to refuse, the scene would end. Likewise, for therapists, it’s crucial that they follow their patients’ line of thinking without judgment, providing support and direction, but not criticism.

“Sometimes you have this desire to fix it with a client – they are having a really difficult emotional state, you just want to fix it, but the improv rules say join them in it,” Kays said. “For depressed people, the hardest thing is when someone tries to make you be undepressed.”

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So on Friday, in the fourth week of their seminar, the six women spent 2 1/2 hours away from their day jobs to learn the art of improv. Some exercises were as simple as screaming “no” or “yes” and seeing how the body responds differently to each, recoiling with the first and standing taller with the second. One had them standing in a circle taking turns in the center, singing a song of their choice (mostly, on this day, by Prince) while the others swayed and sang along. Another required them to pair off and take turns drawing lines or shapes on a piece of paper, adding a mark until there was a complete picture. Then without discussing it first, they had to explain to the rest of the room what they had created.

With improv, the participants must think creatively and be quick on their feet while gauging the intentions of another to then be able to react accordingly. Like a therapy session, nothing is scripted. But if a therapist is really listening to the cues from the patient, they’ll know how to appropriately move the conversation forward like a scene.

Daniel Wiener, a psychologist in New York City, realized this after joining his wife’s improv classes in the 1980s. For the past 25 years, he has trained about 2,500 therapists in improv, and in 1994 wrote “Rehearsals for Growth: Theater Improvisation for Psychotherapists.”

Performing improv “enriches our understanding of social behavior,” he said. Many therapists, especially early in their careers, get stuck in their own interpretations of what they assume is going on with a patient. Improv can help them step back and assess it without those filters, he said.

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It also, he said, is an effective tool to teach patients, particularly in couples therapy where the two people in the relationship might not really be listening to what the other is trying to convey. In improv, much like in a healthy relationship, it’s about validating your partner and wanting to support them.

Jo Sullivan, who just got certified as a counselor for people with addiction, hopes to take the lessons learned in improv and apply the actual exercises in her sessions with patients who are carrying the shame and trauma of substance abuse.

“I have always believed in the power of storytelling. I feel there is remarkable healing in saying your truth out loud, and power in those still suffering and struggling to hear their story reflected in someone else’s experience,” Sullivan said. “What I hope improv will do for me is to allow me to build a program for people in recovery to find freedom to laugh at themselves, participate as equals, show there is no right or wrong and to find joy.”

Before class started, Kays asked the therapists to debrief what happened the week before. Grace Gray, a therapist who specializes in counseling adolescents, said she “felt like she can finally trust the process.”

“There can be a [self-induced] feeling of pressure at times to be able to respond to a client with useful answers or ideas or with an effective technique, when simply being present and very, very aligned with a client might be the most healing thing I could be doing,” Gray said later. “Because improv requires that one become very attuned to what others are doing, practicing improv helps me tune in more deeply to my client.”

In the day’s final exercise, the women, in pairs, imagined they were themselves in a coffee shop having a real conversation. Most, because they’re therapists, talked about work, or human behavior generally. In one scene, McCarthy asked her scene partner why people weren’t more genuine. For several minutes, they discussed why people feel the need to put on pretenses.

Without knowing it, they had tapped into the meaning of that particular exercise. By asking them to play themselves, Kay wanted to show them that as therapists they can be authentic and real with their patients.

“I think they’re sensing that it’s the spontaneity in the relationship, the connection, the conflicts, the rifts and ruptures and repairs, that heal. But all their training says, ‘No, don’t trust that. Don’t listen to yourself. Go to Page 5,'” Kays said. “Improv provides a playground to try on that spontaneity, for therapists to be free and explore their own reactions and get in touch with their own feelings and reactions and to learn how using them can be so valuable.”