creativity articulation and psychotherapy

(1983). Journal of American Academy of Psychoanalysis, 11:55-85Creativity, Articulation, and Psychotherapy

Albert Rothenberg, M.D. Treatment of illness through psychoanalysis and psychotherapy is a

demanding task. All of us who practice these procedures experience seriousdemands and frustrations but, interestingly, we also have the sense ofengaging in an especially worthy endeavor. What is there about theexperience that gives us such a feeling? Surely, we are not merely grandioseprofessionals who have gathered together to carry out practices that feed ourown self-esteem. Nor are we guided by quasireligious or mystical beliefs thatwe try to impart to our patients. Indeed, many of us feel that we practicewithout such beliefs or illusions to any large degree, and even pride ourselveson appraising reality well and avoiding excessive value judgments. Yet, mostof us do have this sense of something especially worthwhile occurring. Ourpatients tell us this — often in an exaggerated way — but even after theseexcesses are analyzed and discounted, the feeling remains. It is theanticipation of experiencing this special worthiness that often carries usthrough the sometimes wearisome and frustrating hours, days, and years ofdifficult therapies.

From a broad scientific perspective, there are indeed reasons to insist thattreatment of mental and emotional illness goes beyond traditional medicalconsiderations of eradicating external or internal physical insults, or ofrepairing defects and malfunctions. Life, on an emotional and mental plane, isso complex and so fraught with risk and insult for everyone, thatpsychotherapy must go beyond simplistically conceived designations of ahealing mark. Persons who have suffered from mental and emotional illnessneed—————————————

Throughout this paper, therefore, I shall refer only to psychotherapy, usingit as a general category that includes psychoanalysis, in order to avoidunnecessary repetition.

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to be better buttressed to deal with life, in some respects, than those who havenot had such difficulties.

I shall not go into the broad scientific and conceptual issues about psychichealth and healing here, because I have discussed them at some lengthelsewhere (Rothenberg, in press a). But I do propose to address the paradoxof a healing procedure based on scientific and objective precepts thatincorporates strong moral and aesthetic values of personal dignity andfreedom, respect for uniqueness and choice, and a certain emphasis onintuition and imagination. It appears that our best therapists have theseparadoxical qualities — they are highly rigorous, consistent and logical, andthey also allow free rein on their intuitiveness and imagination. They arescientific and rely on systematic data and theory, and they are aesthetic intheir appreciation of intensity, narrative, interpretation, and leaps ofunderstanding. To some extent this paradox is the bane of our therapeuticexistences. Because we value the aesthetic and humane side of psychicexperience, and because we value intuitive understanding, we are accused oflacking scientific understanding. Indeed, we are accused of lacking anyscience at all. That this accusation is patently false, in that there need be nocancelling out of science in an aesthetic perspective, and that the aestheticperspective is itself amenable to scientific study, analysis and understanding,is a major point of this paper.

The reason for the paradox, and the answer to the puzzling question aboutthe sense of special worthiness of psychotherapy, is that the process oftherapy is in part a creative process. The creativity involved in thetherapeutic experience is one of the factors that touches on aesthetics and onmatters of value and worth. Creativity was a topic of much interest to SilvanoArieti, and he, in his last major writing on the subject, celebrated a sense ofworth and mystery in his formulation of creativity as a “magic synthesis”(1976). Also, in an article published not long before his death, he focused onthe relationship between creativity and mental illness (Arieti, 1980). Here Ishall be concerned specifically with creativity in relation to the practice ofpsychotherapy. I shall attempt to show that psychotherapy shares many factorsin common with creative processes in other fields such as the arts and thesciences. The relationship is not merely a matter of analogues and analogies;the psychotherapist uses particular creative operations in carrying outeffective treatment.

My topic is the creation of personality attributes and structure

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that occurs in psychotherapy. In previous works, I have discussedrelationships between the process of psychotherapy and the process of poetrycreation (Rothenberg, 1972) and I have also described the therapeutic use ofspecific creative cognitive operations and processes identified in myresearches (Rothenberg, in press a). These researches, it must beemphasized, consist of direct empirical investigations with creative personsin a wide variety of fields. More than 1700 hours of systematic and intensiveresearch interviews have been carried out with outstanding contemporarycreative persons (not patients) in the fields of literature, the visual arts, andthe physical sciences. These interviews have been done in conjunction withongoing creative projects over extended periods of time (Rothenberg,1979b). Reconstructive studies have been done involving qualitative andquantitative analysis of literary manuscripts in conjunction with interviewswith close family relations of noted creative writers of the past (Rothenberg,1969, 1979b). We have carried out controlled psychological experimentswith large numbers of potential and proven creative persons from severalfields (Rothenberg, 1973a, 1973b; Rothenberg, 1982; Rothenberg and Sobel,1980, 1981; Sobel and Rothenberg, 1980). On the basis of these studies, wehave identified specific factors and, I believe, clarified an overall paradigmof the creative process. In applying these factors and paradigms topsychotherapy, I do not employ broad and all-encompassing, and oftenconcomitantly vague, definitions of creativity: a rather strict and limiteddefinition of the term has guided my researches. This definition does notinclude all types of “making,” or of productivity, nor does it merely involvethe novel, unusual, or uncommon. It does not pertain to all artistic andscientific activities nor to all achievements in such fields. Although creativityplays an important role in art and science, much of artistic activity andachievement is imitative or technically skilled, and much of scientific activityand achievement involves systematic repetition, mechanical manipulation, andstraightforward intellectual skills and capacities.

My definition of creativity, briefly, is as follows: to create is to bring forthan entity that is both new and valuable. This is the strict specific definitionthat has achieved the most consensual agreement in scientific research on thematter because it applies best to general usage and general interest. Althoughthe definition could be trimmed down to the lexically accurate meaning, “tobring forth,” it is hard to imagine an interesting or heuristic use of the words“creative,” “create” and “creativity” that does not

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carry a connotation of positive value. Also, it is difficult to think of creatingwithout invoking the idea of something “new,” i.e., bringing forth the new.Psychotherapy is a creative process because, in accord with the definition, itinvolves the bringing forth of entities that are new and valuable. In order toameliorate mental and emotional illness in an effective way, it is necessaryfor the patient and therapist to engage in a process which produces new andvaluable personality attributes and structure for the patient. These personalityfeatures are new for the patient and, because they are unique in thatindividual, they are new to the world as well. Because they serve to improveillness and to enhance function beyond the premorbid state, they are clearlyvaluable to the individual and to society. This paradigm of psychotherapy as acreative process emphasizes issues of worth and value, and points to thecritical role played by active choice on the patient's part. Choice andselection are necessary to produce something new and valuable. The patientmust, at many points along the way, actively choose to adopt a new pattern ofbehavior, just as the creative artist actively chooses to produce new patternsof form and content and the creative scientist actively chooses new theoreticalformulations.

Such active selection and choice is a cardinal feature of a particular factorwhich I have discovered in my creativity researches, one which operatesprominently in all types of creative processes. This is the factor ofarticulation. To show how articulation operates in the creative process ofpsychotherapy, I need first to discuss its general role in creativity and toillustrate its function particularly with examples from literary creativity.Then, I shall return to case examples of psychotherapy and outline somepractical issues and applications.

Articulation and the Creative ProcessIn the process of creation in any field, there is a progression from

emptiness or disarray to the development of tangible order. Every piece ofliterature begins with an empty page, every painting starts with a blankcanvas, music with the absence or profusion of sound, and scientificdiscovery arises from confusion, loose ends, and disorder. A major factor inproducing progression in the creative process is the factor of articulation.Articulation, which technically means simply to join, is a word with a doublesense. The

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articulation or joining one element with another produces both a comingtogether and a separation at the same time. This is demonstrated quite clearlyin the usage sense of the word “articulate” when employed as an adjective. Aperson described as “articulate” or as an “articulate speaker” is a person whois able to present ideas and words clearly and smoothly. Such a personarticulates or joins his or her words and ideas by bringing them together andkeeping them clearly distinct and separate at once. It is in this double sensethat articulation characterizes creative processes. Such processes involve aconstant bringing together and separating, separating and bringing together,throughout their course. This occurs in many different dimensions —conceptual, perceptual, volitional, affectual, and physical. In producing awork of literature or art, as well as in developing a scientific theory, thecreative person separates out critical aspects of the material he works with,and he fuses or brings these separated elements together. For example, in mystudy of Eugene O'Neill's creation of the play, “The Iceman Cometh”(Rothenberg, 1969), the metaphoric title of the play resulted from a processof articulation. Conceived by O'Neill from the idea of Christ as an epiphanicbridegroom coming to the virgins (Matthew: 25:5-6) and from an old bawdyjoke about an adulterous iceman, the “iceman cometh” metaphorsimultaneously brings together and separates out elements of the sacred andthe profane, salvation and icy death, sexuality and chastity, marriage andadultery, and other complex factors. On the basis of evidence frommanuscripts of the play, several of these factors were in O'Neill'sconsciousness when he created the metaphor, and some are immediatelyapparent on both a cognitive and an affective sensing level to a thoughtfulaudience hearing the “iceman cometh” phrase. The fully articulated sense ofnumerous factors brought together and separated out, however, is onlyexperienced by an audience after seeing or reading the entire play.

Articulation in the creative process differs from ordinary problem-solvingby analogic, inductive, and deductive reasoning. All of these types ofreasoning may play a role at some point, but they do not account for theprocess of making, presenting and creating, which is the result of articulation.In scientific fields, the creative thinker uses ordinary problem-solving modesbut he approaches large questions in his field by separating out and bringingtogether key factors underlying controversy and confusion. An example herecomes from evidence I have presented regarding

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Albert Einstein's development of the general theory of relativity(Rothenberg, 1979a). Einstein stated that he strove in his thinking for manyyears to reconcile conflicting interpretations of electromagnetic phenomenaaccording to Faraday's theory and according to the theory of Maxwell andLorentz. A key step in resolving the problem, according to Einstein (1919)himself, was his conceptualization that an observer falling from the roof of ahouse was at the same time in a state of rest during his fall. In thisconceptualization and its elaboration, Einstein separated and brought together,as an articulation, the physical facts and principles of motion and rest. It wasnot a step that resulted from an inductive consideration of a series ofempirical findings, nor was it a direct deduction from theory nor theconsideration of an analogy. Such processes did set the stage for thearticulating conceptualization and also operated later in the working out andelaboration of the fully developed theory of general relativity. In a similarway, the creative physicist Niels Bohr articulated his principle ofcomplementarity, a principle which formed the conceptual underpinning ofquantum physics and has had wide application to other fields of knowledge.For Bohr, a key step in the development of the principle of complementaritywas a conceptualization involving the separating out and bringing together ofthe specific conflicting elements of the wave and particle theories of electronand light behavior (Rothenberg, in press b).

Thus articulation in the creative process serves many functions. Its creativefunction is to produce tangible entities which are new and separate frompreviously existing entities and which, at the same time, are also connected totheir forebears. Creations always bear resemblance to preexisting naturalentities and events, but they are also separate and sharply different in someway. They are separated out and joined to nature rather than being asubmerged part of it. In this way, they are to some extent free of nature andfree of past and preexisting events. This is so in the artistic creative process,and articulation also has direct psychological functions for the artist himself.Through the process of articulating an artwork, the creative artist struggles toarticulate aspects of his own inner world as well. This struggle to articulateon both the aesthetic and psychological levels produces effects that areimportant factors in the emotional appeal of art. A short and concise exampleof such effects of articulation in an artwork is the beginning passage ofHerman Melville's Moby Dick (1930). It is a literary creation manifestingseparating and bringing together in many

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ways. The speaker indicates his own uniqueness and separateness from othermen — he is a strangely erudite sometime sailor who calls himself by thename of the biblical outcast, Ishmael — and at the same time indicates hisconnectedness to all humanity. The language itself is highly articulate — clearand distinct and yet flowing smoothly together, as in “Whenever I find myselfgrowing grim …, whenever it is a damp, drizzly November.” The entirepassage is unified and can be appreciated separately and alone, and at thesame time it strongly connects and leads into the story to come. Here is thepassage:

Call me Ishmael. Some years ago — never mind how long precisely— having little or no money in my purse, and nothing particular tointerest me on shore, I thought I would sail about a little and see thewatery part of the world. It is a way I have of driving off the spleen,and regulating the circulation. Whenever I find myself growing grimabout the mouth; whenever it is a damp, drizzly November in mysoul; whenever I find myself involuntarily pausing before a coffinwarehouse, and bringing up the rear of every funeral I meet; andespecially whenever my hopes get such an upper hand of me, that itrequires a strong moral principle to prevent me from deliberatelystepping into the street, and methodically knocking people's hats off— then, I account it high time to get to sea as soon as I can. This ismy substitute for pistol and ball. With a philosophical flourish,Cato throws himself upon his sword; I quietly take to the ship.There is nothing surprising in this. If they but knew it, almost allmen in their degree, sometime or other, cherish very nearly thesame feelings towards the ocean with me (1930).

Note the explication of the speaker's unique and separate way of dealing withdepressive feelings and his immediate insistence on a similarity andconnection with “almost all men.” How do such passages get created?Obviously, we cannot know precisely how it happened in Melville's case butcan only surmise. In the case of literary creation by my research subjects,however, I have quite detailed information about the process. As a small butcompressed example, there is the case of the creation of a poetic metaphor bya research subject who is a prominent American poet. It is the metaphor, “Amastermind/Kept track above the mantel” in the following two stanzas from apoem entitled “18 West 11th St.”:

The carpet — its days numbered —Hatched another generation

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Of strong-jawed, light besotted saboteurs.A mastermindKept track above the mantel. The cold caught,One birthday in its shallows, racked [The weak frame …].Poetic metaphors are apt exemplars of literary creation because they

contain critical features of larger chunks of literature and of entire literaryworks. An entire novel, play or poem can properly also be considered ametaphor and any successful poetic metaphor possesses the previouslydefined creation attributes of both newness and literary value. In the case of“A mastermind/Kept track above the mantel,” the metaphor is part of a poemabout a house in Greenwich Village where the poet lived as a child and whichthe Weather Underground organization accidentally destroyed in 1971 whilemaking bombs in the basement. It is a pivotal metaphor in the poem in that the“mastermind” is a mirror which allowed a passing through in imagination ofboth the poet's childhood images and the world of the Weather Underground.

The poem took more than two years to create. In articulating this particularmetaphor, the poet wrote at least 33 versions of the lines. The first versioncontained no reference to a mantel, but suggested the reflection of anotherworld in a mirror by a reference to a “magic room,” as follows:

Or is it ChristmasAnd from the first queen mother evergreenStark with unmelting ornamentI am running toward a furtherMagic room. Jamb and lintel of scarred leafTilt benevolently forward. From its depths [A little boy is running…].

The articulation of the final version of the metaphor from this beginninginvolved the dogged and persistent bringing together and separating for thepurpose of making and creating. The phrase “jamb and lintel” was broughttogether several times with the idea of an ideal room in the mirror, then withan idea of a mirror “leaning forward like a matriarch,” and then with an ideaof “an abstract realm,” until the term “mantel” was actually separated out andformulated. It appeared first in this phrase: “The lintel gleams/The magicworld above the mantel.” After that, the poet went on to bring “mantel” andthe areas or realms above the mantel together with 15 different variations,such as, “Above the

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mantel/A realm of infinite shabbiest poverty began,” and “Another realmbegan over the mantel/Its catching cold/Glazed the flowers as with sleet.” Inone of these 15 versions, he returned to the earlier phrase “jamb and lintel”and brought that together with the mantel idea, as follows: “Anotherrealm/Began over the mantel. Jamb and lintel of gilt.” Then, the precursor tothe “mastermind” metaphor was separated out in the following form: “Amental world/Began above the mantel.” After bringing together “mentalworld” and “mantel” in six different ways the poet formulated “A mentalworld/Kept track above the mantel.”

The poet made no further changes in those lines for several months, but hecontinued to work on other portions of the poem. When he hit on the final ideaof using “mastermind” instead of mental world, his verbatim description ofthe process to me was as follows:

Well, I just thought it [“mastermind”] was better than the “mentalworld” and it connected obviously with “saboteurs.” I mean one …one imagines behind any plot there is a mind. And to make it themirror! … I just turned my attention to that line and … and then, thatcame to me. I suppose from the word “mental” it's not so far to getto “mind.” But it seemed to me it was already there, in a way, anembryo in the original phrase. But in a way obscured by thetemptation of rhyme — mental and mantel [my emphasis].

The final step in the articulation, therefore, consisted of a simultaneousseparating of the off-rhymed (i.e., inexactly rhymed) pair “mental” and“mantel” and a bringing together with another idea in the poem, the idea of“saboteurs.” At the same time, this step had connections with earlier versionsin that “mastermind” is related to all of the following: the “abstract” aspect of“abstract realm”; the “magic” of the earlier “magic world”; the idea of the useof a mirror; and in the “master” aspect, to the earlier “matriarch.” The poet'ssense that “mastermind” was already present as an embryo in his originalphrase was an apt and meaningful description. He had indeed articulated itfrom the original phrase and the original idea in several different ways.Through progressive separating and bringing together, he produced ametaphor that joined an aspect of the magic room idea of his childhood to theidea of saboteurs of the Weather Underground organization. Also, although hedid not mention this to me, he, in a final

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step, separated out the initial consonants of the off-rhymed words, “mental”and “mantel,” and joined them into another poetically effective soundsimilarity. In using “mastermind” with “mantel,” he produced both analliteration of “m” sounds and an assonance of “a” sounds together. Onanother level, I have reason to believe — from information I have from myprevious intensive work with this research subject — that he associatedmirrors with his mother (N.B.: the early idea of the mirror leaning forwardlike a matriarch), and that the idea of a mastermind could readily relate to herintelligence and domination. Therefore, in settling on the word “mastermind,”he articulated an underlying unconscious meaning of the original idea focusingon the mirror. This was not a break-through of unconscious material but agradual unearthing and shaping of what the poet indicated to be “alreadythere.”

The final created metaphor, “mastermind keeps track above the mantel,”suggests many of these articulations and, in itself, it is an articulated structure.It is unique and it stands alone at the same time as it connects to other aspectsof the poem. It evokes the ideas of the realms of the inanimate mirror (or afamily portrait) and of an animate mind which are separated but are alsoconnected to each other and interact. In this separateness and interaction liesone of the sources of the aesthetic effectiveness of any good poetic metaphor.A metaphor is a dynamic literary structure which both separates and connectsmany levels of meaning and of word use, all at once.

Another more extensive illustration from the literary process concerns thecreation of an entire novel by a research subject who is a major contemporaryAmerican novelist. It comes from an intensive interview research studycarried out over a period of over one year. The weekly interview seriesbegan shortly after the author had begun the novel and ended at the time of thepublication of the work.

The novel concerns a college student embroiled in a struggle for identityand self-esteem in the America of the 1960s. Caught in a web of rapid valuechanges and a concomitant sense of unbridled impulses and temptations, heloses interest in his classes and school work, and he searches for gratificationin debasement, sex, and drugs. Much of the novel involves the student'srelationship with his parents. Through a series of scenes involving telephonecalls to the parents, a visit home, and an LSD fantasy in which the parentsappear, the novel unfolds a complex intrapsychic and interpersonal son—parent interaction. It is the unfolding and development

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of this interaction that accounts in part for the aesthetic effectiveness of thenovel. It is the son's efforts to cope with his past and to move onward thatcatch us up in the story. These are efforts at what I have described asarticulation. In his movement toward freedom and independence, the sonarticulates his experience and his personality; he attempts to separate himselffrom those elements in his past and in his parents that he finds unacceptable,and to clarify and continue those elements which he accepts. He joins himselfto the past, present, and future both by separating and bringing together.

In my work with the author during the course of his writing the novel, inwhich we systematically discussed the sections as they were written, itappeared that he too was engaged in a process of articulation on both apsychological and an aesthetic level. Thinking about his own sons during theperiod of time the novel was being written, he alternatively shifted hisvantage point between the generations. At various points throughout theprocess, he sometimes felt himself to be more in sympathy with the viewpointof the son, and at other points he felt in sympathy with the parental view,particularly the view of the father. This meant that a process of temporary andshifting identifications was taking place. With particular respect to thefather—son relationship depicted in the novel, the author alternativelyidentified with his own sons in relation to himself as the father, with himselfas father in relation to his sons, and with himself as son in relation to his ownfather. In our discussion of scenes or events in the novel, the author indicatedconnections to his own experience as a father, to his sons' experience withhim, and to his own feelings about his father or a father-figure.

Also, during the course of writing the book, he made a decision to move toa new location involving active daily contact with young adults, and thoughtsrelated to this move connected to various elements and scenes. This does notmean that the characters in the novel were copied from the author's sons, fromhis father, from particular young adults, or even from himself. On the contrary,they were independent, created characters produced in a process ofarticulation in which the author attempted to separate and bring togetherelements from his own past, present, and future relationships. Fueled by hisinvolvement with his sons, by his relationship with his father, and by hisanticipation of his future move, the author juxtaposed a father and a son inorder to separate out and bring together elements in that relationship. At the

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same time that he consciously articulated a story, he was articulating some ofthe unconscious factors in his own relationship with his sons, and in hisrelationship with his own father. It is this struggle to articulate unconsciousfactors in the course of the process that accounts for some of the aestheticpower of this novel. Indeed, such a process seems to relate to this power inany novel. The struggle to articulate is a struggle to become free of the past; itis a struggle to become independent in the sense of being both separated fromthe past and brought together in the meaningful continuity with the past. Anaudience senses this struggle, and participates in it vicariously. Contrary tothe view of many psychoanalytic critics, it is not the successful appearance(symbolic or direct) of unconscious factors in the work of art that is gratifyingto an audience. It is the dynamic process of struggle toward independence andfreedom. I say this for many reasons but will merely point out here that anauthor is never very successful in gaining much insight into his ownunconscious when he is creating. This is not to say that he should be; it ismerely an affirmation that artistic creating is not a form of psychotherapy.

From early on in the conception of the novel, the author had juxtaposed thefather with the son in a significant way. The son is seen as following in thefather's footsteps. He has enrolled in the same college as his father, and he istaking the same history course with the same professor his father had 26 yearsbefore. And the professor still remembers the father and his work! Indeed, itis an incident with this professor that accelerates the young man'santiacademic slide.

In the first actual meeting between son and father in the novel, the son Johnhas brought a young woman home for the weekend, and there is an immediateair of male competition established: “The principal feature of her costume,drawing John's father's eyes ever down, down, down, was a pair of blackpatent-leather knee length boots.” As the scene at home continues, the father isdescribed rather sympathetically and there is a feeling of closeness betweenthe older and the younger man. In the process of the actual writing of the firstdraft of this scene, the author constantly separated them and also brought themtogether. This is seen most—————————————

Arousal and anxiety evoked by artistic works are factors in aestheticappeal (see Berlyne, 1971). It is, however, the modulation of anxiety andthe struggle for psychological freedom from the past and from the effects ofrepressed unconscious elements that constitute a major aspect of positiveaesthetic experience. I discuss these issues at some length in The EmergingGoddess (Rothenberg, 1979b).

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clearly in his initial changes and revisions in this chapter, as follows: Whenthe son says his girlfriend is mature for her age, the author first wrote aseparating phrase as the father's response: “Everything seems to happenearlier these days”; but he crossed that out and wrote a bringing-together oneinstead: “I suppose she is (as if something of the sort hadn't occurred toDaddy-O).” Later in the text, at an important point, he described the father asfeeling he had to be stern in order to give his son something concrete to rebelagainst. He later revised and modulated this sharp separation of father andson by adding that the father was “pretending to be” stern, and he added thephrase, “How out of character!” In the very next sentence, he at firstdescribed the father as talking together “man to man” with his son, but hechanged this to “man to boy” to make it a separating idea.

In the next major change, in the following paragraph, the author at firstdescribed the father as weak and permissive, but then inserted the bringing-together phrase, “until now, John really thought himself wiser than his father.”Finally, he ended this chapter by vacillating between a separation and abringing together of the father and son in these three versions of the son'sleavetaking remark [italics added]: (1) “Excuse me, Pop (he said, going intohis bedroom to dress, leaving the non-king staring at himself in the mirror)”;(2) “Excuse me, Pop (he said, going into his bedroom to dress, leaving hisfriend staring at himself in the mirror)”; and (3) “Excuse me, Pop (he said,going into his bedroom to dress, leaving the old man staring at himself in themirror).” He started with a description of the father as a “non-king,” a phraserelated to an earlier discussion in the chapter of the competitive separationbetween the two. He changed this to a bringing-together phrase, “his friend,”and ended with the separating age reference, “the old man.”

In the chapter following, the son has an argument with his parents andangrily leaves the house without saying goodbye. When the author and Idiscussed these two chapters shortly after he wrote them, he told me that hehad primarily identified with the son while writing them. At the point whenthe young man left in anger, however, the author felt that he had “resumed therole of the father.” He therefore experienced the shifting identificationsinvolved in juxtaposing father and son and articulating their relationship.

In writing of the next direct discussion between the father and sonsomewhat later in the novel, a three-way telephone call including

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the mother, the author experienced a surprising realization. This realizationtook the form of a partial insight and was the result of the progressivearticulation of the unconscious factors in the father—son relationship.Describing the mother as calming down and “gathering her forces” in theconversation, the author then realized that, because of this, the father of thenovel would first have to go to pieces and then the son would break. He wrotethis realization directly into the novel as an insight the son himself had: “ThenJohn had a moment of absolute clarity, and of awful prevision: his fatherwould go to pieces in a minute, and then it would be his turn after that.” Atthis point, therefore, he had clarified that the mother had an important impacton both father and son. He realized too that the father's behavior with themother had an impact on the son, but had not yet clarified the nature of theson's feelings towards the father. Therefore, although father and son wereagain brought together, this relationship was not yet clearly articulated.

Finally, in the midst of a prolonged experience with LSD somewhat afterthis phone call, the son believes himself to be in Vietnam along with hisfather. His father is the commanding officer of the company and a sniper isslowly killing off their “good” compatriots. The following section, beautifullywritten and articulated on a verbal level, had been revised several times inthe course of the first writing:

They were moving again. John's eyes roved through the noblewoods. There! Ten feet off the ground. In the crotch of a twin-trunked giant — was it a species of beech? Fagus grandifolia? Inthe vee, a roundness. A burl? No! Surely a helmetless head; surelythe sniper himself. Word came forward to hold up a minute, thebearers were having it rough. The men stood in fear. John, sayingnothing, stared at the tree crotch. Now he felt the familiar onrush offeelings, the flood of everything at once, in every direction. Withunprecedented force. He spoke to his father:— The whole operation is ridiculous.— We can't help that, son. It's out of our hands.— Is it really? I mean, that idea gives me a real pain in the ass.Aren't you in charge?— Keep your shirt on, fellow.As they talked, John felt that he was maneuvering his father. Therewere some slender saplings between where they stood and the tree-crotch where the ground shape was. Stepping aside little by littlekeeping the talk going so that his father, too, inched sidewise tocatch the

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murmured words, John constantly faced the tree-crotch; his father'sbody, shielding his own, was placed with its back exposed to thedouble tree. Now they were in the open. John, his heart on the run,suddenly became convinced that the odd shape was, after all, aqueer growth, a burl, perhaps a paper-wasp nest. But then a whinecame ridden hard by a snap.As his father fell, with the faintest sign of reproach on his otherwiseempty face, John felt such an exquisite pain in his chest that hethought the bullet must have passed through both generations.

The author's decision to include a scene in which the father was, as he putit, “killed off” was made shortly before he wrote this section. He had notplanned it when he started the novel nor at earlier points along the way. Theclarification of the son's impulse to murder the father as a factor in thefather—son relationship, therefore, resulted from the articulation ofunconscious factors during the course of the writing, the concomitant workingout of the novel's plot, and of the nature of its father—son relationship. I knowit did not come from other sources, such as therapy or any direct explorationby the author of his own feelings toward his father or his sons, because I sawthe author shortly before and shortly after the decision and we explored thecircumstances under which it occurred. By clarifying and articulating thismurderous impulse, the author was also able to describe the psychologicalarticulation between the father and son in a moving and telling way. Hedescribes the idea of the sniper's bullet passing “through both generations.” Inthis way, he indicates that the son is more definitively linked to the father thanhe realizes. And he suggests the nature of the link. Through dropping out ofschool, corrupting himself and taking drugs, the son is trying to destroy hisfather, his internal father, and is thereby destroying himself. Still separatedfrom the father, as indicated by “the faintest sign of reproach on the father'sface,” the son is also brought together with him, and they are articulated.

Psychotherapy as a Process of Creation of PersonalityAttributes and Structure

Unlike the individual literary artist engaged in creating a literary work onhis own, the therapist and patient in psychotherapy are together engaged increating the patient's personality attributes

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and structure. Together, the therapist and patient embark on a process ofarticulation. Together, the patient and therapist separate and bring togetherelements from the patient's past, present, and future. As an end result of thisprocess, the patient achieves an active psychic separation from the past and aconcomitant clarification and acceptance of continuity with factors in the past.In this sense, the patient develops meaningful independence and psychologicalfreedom. Because of the psychic separation of the past and the present, thepatient is freed from the need to repeat the past and the domination ofrepressed material. The patient is freed from the repetition compulsion. Onthe other hand, because there is also an active affirmation of the patient'sconnections with his or her past in the articulation process, there is alsopreservation and affirmation of the patient's unique experience andindividuality. Articulation is the enemy of the repetition compulsion, in thissense, and it is the ally of uniqueness. Therefore, it is one of the prime modesthrough which patient and therapist accomplish the creation of attributes ofpersonality and self.

I must emphasize the difference between this perspective on creativity inthe therapeutic process from traditional ones that focus on inspiratoryexperiences or derive from Kris' formulation of creativity as a “regression inthe service of the ego” (1952). Inspiratory experiences, prototypically, aresudden bursts of understanding and of new ideas which seem to come fromnowhere, and which are usually accompanied by feelings of excitement orgratification. Because these bursts are dramatic and exciting, they have oftenbeen erroneously considered to be the exemplification of creativity. Althoughsuch experiences do sometimes occur in creative processes, they are by nomeans the only, or even the major, factor producing creations. They aredecidedly not a major feature of the creative process involved inpsychotherapy. While inspiratory experiences involve an experience ofunderstanding and illumination, and may therefore seem to be the same as, orsimilar to, attainment of psychological insight, such is not the case. Inspiratoryexperiences are properly related to defensive or abreactive phenomena. Thefeeling of dramatic illumination and certainty, usually accompanied by a gooddeal of affect, results often from a partial defensive repudiation incorporatedin the inspiratory ideas (Rothenberg, 1972). Abreactive discharge of pent-upemotions with a temporary overcoming of repression may also often operateto produce a sense of certainty

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and an affective experience of relief. Psychological insight, however, consistsof both an affective and cognitive apprehension of unconscious andpreconscious contents rather than either discharge or repudiation. Usually farless dramatic than inspiration, insight is psychologically a more productivephenomenon. While an inspiratory experience can serve as a waystation topsychological insight, those therapists who seek constant inspiratory break-throughs or use the inspiratory experience as a therapeutic end point, arepracticing in a spiritual rather than in a scientific mode.

I do not mean to disregard inspiration altogether in creative processes,because it does play a role at certain points. I do mean to indicate thatinspiration is not the sine qua non of creativity, that it is not a proper goal oftherapy, and that it actually is not the usual mode of appearance of new ideas.As seen in the example of the poet's creation of the “mastermind” metaphordescribed earlier, new ideas occur in a nondramatic manner. As he said, “Ijust turned my attention to that line and … and then that came to me” as aresult of a long process of articulation. Because creative ideas appear mostoften in just this way, they are properly included within a discussion of thearticulation process rather than considered as radically separate events.

As for creativity in therapy as a “regression in the service of the ego,”Beres (1957) has presented a model of therapeutic collaboration in which thepatient regresses and characteristically presents primary process material to atherapist who characteristically reacts on a secondary process level until suchtime as the patient can control the regression with his own observing ego. Inother places, I have presented extensive data and observations that challengethe validity of “regression in the service of the ego” as a formulation of thedynamic structure of the creative process in general (Rothenberg, 1979b;Rothenberg and Sobel, 1980, 1981; Sobel and Rothenberg, 1980). Withrespect to the creative process in therapy, the dynamic structure does notconsist of a controlled regression or a “regression in the service of the ego,”as Beres describes it, but is rather a mutual articulation by therapist andpatient on many different psychic levels. Both participants engage in bringingtogether and separating throughout the process. Both may use secondaryprocess, or sometimes primary process, concomitantly, and both articulatematerial from conscious, preconscious, and unconscious levels, and fromcognitive and affective modes at different points along the way.

In order to illustrate this process of articulation in psychoanalytic

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therapy, I shall present two case examples. These are primarily illustrative ofdifferent types: (1) verbal or linguistic articulation; (2) articulation of amother—daughter relationship.

Verbal or Linguistic Articulation in TherapyThe most immediate and straightforward illustration of the process of

articulation in psychotherapy is on the level of verbalization, the use oflanguage. This should come as no surprise, of course, because therapy iscarried out verbally and, therefore, there must be intrinsic connectionsbetween laws of verbal or linguistic interaction and psychological change, aprecept that has been emphasized in varying degrees by radical theorists, suchas Jacques Lacan (1977; see also Muller and Richardson, 1982) and moreconservative analytic theorists as well, such as Edelson (1975), Rosen (1969,1974), and Rycroft (1968). I do not, however, mean to say that therapy is aprocess of helping a patient to speak better in the traditional sense of the term,to articulate. That would be patently absurd and misleading, as the skill ofarticulation in speech has little to do with psychological health except in amost remote way. I am speaking rather of the verbal and language interchangebetween therapist and patient as a process of mutual bringing together andseparating in a concomitant process of psychological and verbal articulation.Much of the actual verbal interaction going on in a therapy hour can beunderstood in just this way.

Presenting the matter schematically, the patient talking in therapy puts fortha series of verbal phrases that manifest varying degrees of organization andconnectedness. As we well know, elements that appear to be consciouslyquite organized and connected may represent severe disorganization anddisconnectedness on a preconscious or unconscious level. Contrariwise,disconnected conscious elements often have both preconscious andunconscious connectedness and organization. As we listen and interact, weattempt to identify numerous factors in the patient's productions, such asanxiety, conflict, affect, nature of object relations, defenses, and so on. In ourattempt to facilitate insight, we are most often interested in identifyingpreconscious and unconscious matters. Also, because we are aware of theneed of persons to have secure ego boundaries and to function effectively asindividuals, we are interested in identifying the qualities of independence,

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separation and uniqueness as well as identifying connections with otherpersons and with society. We help the patient to verbalize and elaborate inorder to accomplish many different psychodynamic goals. Although we maynot have been explicitly aware of it, a major mode of our interaction with thepatient in order to accomplish these goals is to engage in an overall processof articulation, similar to the process in the examples of literary creativity Ihave described.

The following excerpt from a psychotherapy session occurring at midpointin the course of a two-and-a-half-year treatment illustrates the mutualarticulation process. In a manner similar to the poet's articulation of the“mastermind” metaphor, the therapist and patient separate and bring togetherelements of the patient's psychic life. While the poet articulated the metaphorby himself and was concerned with aesthetic effect, the therapist and patientcarry out the articulation together and are directly concerned with psychiceffect. The session begins with the patient focused on his problems withmoney, which he attributes to his upbringing and family background. Thetherapist's first comment, “Is it too late to correct this?” functions to separateout the factor of learning and the patient's apparent stagnation in this area. Atthe same time, it brings together the patient's past with a possible future. Fromthen on, separation and bringing together occur on both sides. The patient'sfear, for instance, is separated out and brought together with other elements inseveral ways.

P: I've been thinking about my problems with handling money[pause]. I've always had money; money has always been given tome but I don't know how or why. Having money that way hasstopped me from learning to do anything.Th: Is it too late to correct this?P: I'm scared shitless of taking responsibility for myself.Th: How does that make you feel afraid?P: I'm afraid I might fail.Th: Are you really afraid of failing?P: Maybe I'm … afraid of doing … well; that's … possible [insaying this, the patient has paused and hesitated repeatedly].Th: You seem also to be afraid of doing well in this session withme — afraid of doing well in therapy.P: I seem to feel that I must punish myself for something.Th: Is it just one thing?P: I'm not sure. I think it's one thing. It has to do with sex, I think[pause]. I always liked climbing trees; did a lot of that in my life.Th: What is the connection?

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P: [Long pause.] There was a tree in front of my house. I climbed itwhen I was three years old … never was able to climb to the top,but later I did a lot of tree climbing. [At this point, the patientlooked very anxious and began staring.]Th: What happened just then?P: I feel vacant.Th: Perhaps that feeling in here has something to do with a feelingthat you are climbing high up and succeeding in something.

The therapist's interpretation, just stated, served to relieve the patient'sanxiety. He then went on to clarify that he had had a sexual sensation whenclimbing the tree. This issue became further clarified in the sessionsthroughout the remaining months of therapy as the patient increasinglyconnected his fear of success to sexual issues with his mother.

Just as the poet earlier brought together and separated ideas of “realms,”“jamb and lintel,” and “mental world” in his several versions leading to thearticulation of the “mastermind” metaphor, in this session the patient andtherapist separate out and bring together several contexts and wordspertaining to the patient's feeling of being afraid. The patient says first that heis afraid of responsibility, then of failure, and then of success. When he faltersat the idea of success — at this point, he pauses repeatedly and literallybecomes verbally inarticulate — the therapist connects his fear of successwith a current fear of success right in the session. Following this bringing-together remark, the patient separates out a new issue, the issue of punishment,and the therapist responds with a question geared directly toward separatingout the factors in the punishment: “Is it just one thing?” When the patientseparates out the sexual issue and the climbing of trees, the therapist thendirectly asks for a connection. Finally, in this particular excerpt, a specificformulation is articulated by means of the therapist's interpretation. Thisinterpretation brings together the elements of the patient's past tree-climbingwith his present fear of success as well as with his symptom of vacancy.

That the therapist's interpretation was psychologically meaningful isindicated by the patient's response of introducing new and important materialwhich thereby separated out yet another factor, sexuality, in his anxiety.Effective interpretations are cardinal examples of articulating interventions ona therapist's part. Indeed, an ideal or prototypical psychoanalyticinterpretation — one that connects a factor in the transference to an ongoingissue in his

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present life, and to his past life as well — is also an ideal articulation, and isa major contribution by the therapist to the ongoing mutual creative process oftherapy. Bringing together and separating may often be temporally distinct,i.e., they may be alternating or sequential, as in this particular session, but theoverall effect is one of joining or articulation. Thus, the therapist'sclarifications, or what Rosen (1974) called “interlocutory interventions,” aswell as confrontations, giving of information, and other interventions, may allserve as part of the articulation process. Taken alone, however, any type ofintervention may serve solely to separate or to connect, and may thereforefunction in many other types of discourse beside an articulating one.

In the therapy excerpt presented, many psychological issues enter into andaffect the course and effectiveness of the articulation process. There is theapparent trust in the therapist, the patient's drive toward improved objectrelations blocked by his fear of growing up and taking responsibility, his guiltabout sexuality, and an apparent yearning for a lost childhood. The therapist'sawareness of, and sensitivity to, such issues plays a critical role in thetherapeutic movement, but his ability to participate in the articulation processis also important. Meaning and psychodynamic significance of the issuesarticulated as well as factors such as timing, defensive state, and level ofpersonality integration are vital factors in the therapeutic effect. So, too,meaning and expressive features of the “mastermind” metaphor presentedearlier were vital aspects of the aesthetic effect. For the poet, as well as forthe therapist and patient, however, articulation is the means for facilitatingrestructuring, integration, and creation.

Articulation of a Mother—Daughter RelationshipAnother example of articulation in therapy will serve to illustrate broader

effects on the total context or content of the patient's life. The previousexample primarily illustrated formal aspects of articulation; the next example,like the earlier description of the novelist's creative process, tracesarticulation on the levels of both form and content together.

A 28-year-old woman executive became severely depressed andexcessively suspicious of friends and coworkers shortly after receiving animportant job promotion. Previously, she had suffered

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from depressive episodes and, at the age of nineteen, she had required a briefpsychiatric hospitalization. Following that hospitalization, she becameenrolled in a business training program which enabled her to get a job with avery large corporation. Starting at the bottom of the clerical ladder, she wasextremely perfectionistic and very highly organized in her work, and so sheexperienced a surprisingly rapid rise through the ranks of the organization toreach a rather high level of administrative responsibility. She could not,however, face the idea of a promotion involving a major change to anotherdepartment and an even more increased amount of responsibility, and she quither job.

The background of these events showed that the patient had been able toaccomplish her rapid rise partly because of very supportive therapy with thesame therapist over the nine-year period, but especially because of theconstant rock-bound support of her mother. Throughout this period of thepatient's life, her mother, just as in the years before, had made virtually alldecisions for her and cared for her hand and foot. Despite having a full-timejob of her own, the mother did all the cooking and cleaning in their sharedapartment. She accompanied the patient on all shopping trips and decided onher clothes; she chose her friends; she wrote all letters and cared for allmoney affairs; she reviewed with the patient on a daily basis every event ofher life in detail. With respect to the patient's therapy, she insisted that thepatient tell her everything that was said, and she provided her ownformulations. When the patient was working on her job, she would call hermother several times a day to ask for support and solace. And on severaloccasions, she called her mother every fifteen minutes throughout the day!

In the course of psychoanalytic psychotherapy within a hospital setting,many aspects of the patient's relationship with her mother were addressed. Atthe beginning, the patient forcefully and flatly asserted: “I have only onefriend in the world — my mother.” Gradually, however, she began to modifythat assertion and to recognize some severely negative feelings toward hermother. Indeed, the ambivalence emerged as so extreme that soon she began toattribute the worst of motives to her mother, believing that her mother wasintensely jealous of her and wanted her always to be sick, or dead. Shedisplayed the characteristic splitting of borderline patients and, as projectiveidentification, she came to believe that the therapist was completelyresponsible for her noxious view of her parent.

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A turning point in the therapy occurred after the development of a peculiarfinancial difficulty. On the basis of an unforeseen technicality, it appeared thather hospitalization insurance coverage would run out much sooner thanexpected. Therefore, she had to make plans to leave the hospital before shefelt she was ready. She believed this to be a disaster for her because she nowfelt that it would be impossible for her to return home and live with hermother, and she could think of no other alternatives. The therapist, however,while well aware of the seriously problematic symbiosis of mother anddaughter, nevertheless decided to challenge this position. Each time shebrought up the impossibility of her living together with her mother, thetherapist, to her surprise and chagrin, questioned why that seemed to be so.Over and over, in session after session, this issue was a central theme. Withrage and anger, the patient talked about her relationship with her mother, andshe spoke of her mother's undue influence on her, her mother's apparent needfor her, and also of her own feelings of attachment and disgust towards hermother.

Out of this therapeutic juxtaposition of herself with her mother, producedprimarily by the therapist's challenge to the patient's splitting defenses and tothe false pretense of separation from her mother, an effective articulationbegan. Together, the patient and therapist were able to designate the continuedlack of separation in the patient's object relations, i.e., the lack of separationbetween daughter and mother as well as between patient and therapist. Bycontinually juxtaposing and bringing herself together with her mother in thetherapy sessions, she began to look for, to specify, and to try out some of herown separate and real attributes. This was the beginning of an ongoingprocess of articulation of her relationship with her mother. In the process ofseparating and bringing together, she, for the first time, came to recognize andacknowledge that she, like her mother, experienced feelings of jealousy. Thisled to a reduction in suspicious and paranoid thinking about other people inher life.

At the same time as she was attempting to articulate her relationship withher mother, the patient was articulating her own personality. She began to takeon increasing responsibility for herself and to feel better. In her mind,however, she reserved many areas of nonseparation and fusion with hermother. One was the working out of her financial responsibility for hertreatment. Telling herself that “this is the last thing I will let my mother do forme,” she took no action whatsoever to work out the insurance

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problem. Instead, her mother made constant calls to the insurance company, toa lawyer, and to the hospital administration. Although it appeared on thesurface that there was little the patient could do, and she received a good dealof sympathy from other patients and from some members of the staff for herdifficulties with finances, the therapist again challenged the patient's position.The therapist raised the question of why the mother, and not the patient, wasworking out the problem. Thus, the mother and daughter were again activelybrought together and separated in the therapy. This led to a severe outburst onthe patient's part; she at first became outraged at the suggestion that she shoulddo more than she was doing. Then, accusing the therapist of not helping herwith the financial problem, she furiously insisted that she was being castaway and thereby being forced again to live with her mother and to be underher mother's domination.

The fury gradually subsided and, in subsequent sessions, the patient andtherapist pursued the articulation of her relationship to her mother. Together,they clarified areas of overlap between some of her own symptomaticbehavior and her mother's behavior to her as a child. They clarified how shewas carrying out in her life her mother's both explicit and implicit wishes.And again they tried to separate out her own goals and wishes. Frequently,during this time, the patient became moody and depressed. As the process ofbringing together and separating continued, she became increasingly aware ofthe possibility of choice and of intention in her life. Although she did notconceptualize it in this way, she became increasingly aware of articulating herown personality. She experienced the challenge of creation of aspects of herself.

In the face of this challenge, sometimes this patient yearned for death andfor self-destruction. In her moodiness and depression, she hovered betweencreation and destruction. It was a very difficult time. In continuing to workand to articulate, she chose the course of creation.

Articulation in the Practice of PsychotherapyIn working towards radical personality change and helping patients to go

beyond themselves, therapy seems an especially worthy endeavor. Althoughpatient and therapist together do not create an entire personality anew in theway that an artist creates

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an entire artwork, or a scientist a complete theory, aspects of the patient'spersonality are distinctly new. These aspects are stamped with the patient'suniqueness, new to the patient him- or herself, but often also related toordinary ways of functioning. The articulation process, taken as a whole,consists of helping the patient to develop his or her uniqueness whilerecognizing and accepting intrinsic connections with others. Because itclarifies and produces connections and separations within the patient'spersonality, it results in a structural personality integration.

While the creative artist's or scientist's struggle to create is often quitedramatic and socially far-reaching, patient and therapist together struggletoward less dramatic but, for the individual, often far-reaching effects. Thecreative artist or scientist develops new ideas and discoveries as a result ofarticulation; they separate and bring together and make what is potential intoactuality. The patient and therapist develop insight and personality structuresby also articulating the patient's potential into actuality. It is the articulation ofinsight specifically that, I believe, Loewald (1980) indicates when he speaksof the patient creating insight as one of the therapeutic actions ofpsychoanalysis.

Psychotherapy is based on scientific knowledge and the creative aspect ofpsychotherapy can be elucidated scientifically. Application of empiricalfindings about the creative process in the arts and in science, as describedhere, contributes to the scientific underpinning of therapeutic practices. Thisapplies both to the form and the content of therapy. In the examples of theliterary creative process and of therapy I have presented, the emphasisalternated in each type between formal verbal factors and more extensiveaesthetic or psychodynamic content. In both the formal verbal examples, i.e.,creation of the “mastermind” metaphor and the excerpt from a therapy session,however, many content psychodynamic factors operated in the choice ofparticular elements articulated. The nature of the poet's relationship with hismother, for instance, entered into the creation of the metaphor. In the therapysession excerpt, there were aggressive transference elements as well asprobable factors of primal scene experience and of masturbation fears. In bothexamples of content articulation, the writing of the novel and thepsychotherapy, formal verbal and interaction factors as well as structuralissues of ego boundaries played a prominent role. Articulation applies both topsychodynamic and aesthetic content and to form. Clarification andelucidation of the articulation process should, however, lead especially

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to a focus on technique and the more structural aspects of psychotherapeuticpractice.

Awareness of the articulation process can serve as a guideline to effectivepractice. While facilitating goals of attainment of insight and understanding,analysis of character and of symptoms, awareness of articulation can help usto listen and to interact directly on the basis of the goal of creation ofpersonality attributes and structure. As I believe I have made clear, insight isattained in the articulation process and analysis of symptoms also occurs, butthe creative process involves making as well as understanding. The constantfocus on bringing together as well as separating in each therapeutic sessionand in the longer sequences of the ongoing therapeutic interaction serves tofacilitate insight and to facilitate the patient's creation and integration ofpersonality.

Focus on the articulation process entails a type of concentration on thetherapist's part that is receptive, wide-ranging, and not persistently evaluativeor judgmental. Keeping in mind the dual goals of separating and bringingtogether, the therapist is interested in encouraging the patient to speak and toelaborate on what he or she says and feels. Within this wealth of material, thetherapist seeks to separate out salient issues and trends, largely by questionsand other clarifying interventions. At the same time, the therapist bears inmind possible analogies and connections between what the patient isimmediately addressing and other areas of the patient's life, past, present orfuture. For example, the therapist may listen for analogies between materialabout a boss or a teacher and issues in the transference. Or, the therapist mayhear connections between hostile feelings toward a spouse and competitivefeelings with a sibling or hostility to a parent. Although he does notnecessarily comment about these connections at any given point, he is activelylistening in this manner. Such listening involves an active concentration on themore formal aspects of the interaction in the therapeutic session. It is similarto the creative artist's concentration on form in art, literature, and music.Concentration on articulation as a formal aspect of therapeutic interactionserves to reduce tendencies to judge, dissect, categorize or compartmentalizein a persistent way the content of the patient's productions.

The principles of neutrality and nonjudgmental acceptance of the content ofa patient's productions are not mechanically or artificially applied in thetherapeutic hour, but arise intrinsically and naturally in conjunction with anactive focus on articulation. Persistent

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judging, categorizing, and compartmentalizing of content have little to do withthe goals of restructuring, making, and creating. Unlike the fluid flow ofarticulation with its alternating or simultaneous separating and bringingtogether, the operations of judging, categorizing, and compartmentalizinginvolve either firm and static separation or else firm and static connectionalone. Moreover, the state of mind associated with intense concentration onarticulation and on the more formal aspects of the interaction involves a senseof broadened awareness. In this state of mind, the therapist is constantlyreceptive to, and is himself developing, new ideas. He is able to hear newmaterial introduced by the patient, and to develop new formulations fromwhat has already been presented. While the process of therapeutic articulationis an ego function, this does not mean that it operates solely on a secondaryprocess level. The therapist is focused on both primary and secondaryprocess cognition in the patient, and he uses both modes himself. He searchesfor separations and connections in the unconscious, preconscious, andconscious in both the patient and himself. Many psychic levels are articulatedconjointly. This is somewhat similar to the state of mind of the creative artist.

The patient also needs to adopt a state of mind that is similar to certainaspects of the state of mind of the creative artist. This was recognized andstated by Freud in an early exposition of the methodology of the therapeuticprocess. In the Interpretation of Dreams (1900), he cites the poet Schiller'sfamous exposition of the mode of facilitating creative thinking as the modelfor dream analysis as follows: “Where there is a creative mind, Reason — soit seems to me — relaxes its watch upon the gates, and the ideas rush in pell-mell, and only then does it look them through and examine them in a mass ….You critics … complain of your unfruitfulness because you reject too soonand discriminate too severely” [emphasis mine]. Although dream analysis issomewhat more specialized and routinized than other aspects of thetherapeutic process, the actions of separating associations and connectingthem to other elements and experiences in the patient's life are prototypes formuch of therapeutic activity and are prototypes of the articulation process.

Analyzing and analysis, in the strict definition of these terms, are only aportion of our activity in psychoanalytic psychotherapy and psychoanalysis.Although we are interested in identifying root causes of psychologicalphenomena, we do not generally carry out a dissection or a breakdown of awhole into constituent parts,

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either in a single session or during the long-term process as well. We do notsystematically carry out detailed discriminations which are to be followed by— or even interrupted by — a synthesis. Along with analyzing, we engage inthe creative activity of articulating. We facilitate separating out in order toproduce joinings and articulations in the personality structure. We are notmerely interested in having a patient lay out all the elements and all thepsychodynamic origins of his behavior and personality, which he then gatherstogether — like so much laundry — into a synthesized new way of being andbehaving. We are, I believe, interested in helping the patient bring togetherthese elements as clearly identified and separated elements into anorganically integrated whole person. As a functional matter, we do this byconstantly separating and bringing together all throughout the process oftherapy. A useful aspect of this dual separating and connecting procedure isthat it also provides us with a means of hypothesis-testing while carrying outa creative making process. On the one hand, when we ask for, or make,connections that are premature or wrong, the patient corrects us fairly quicklyand definitively. On the other hand, when we ask for, or make, connectionsthat are timely and correct, the patient provides some verification of theconnecting intervention or link by spontaneously separating out new materialand new factors.

I am not merely referring to matters of timing, or of avoiding a toointellectual approach to therapy in these comments about the differencebetween articulation and analysis. Both matters do enter into the use of thearticulation process, but the distinction is a more basic one. The creativeaspect of therapy is a process of integrating rather than simply combining, orreconciling. By this I mean that combining and reconciling may involve onlyadding together, submerging, or compromising, i.e., bringing together withoutseparating, various component elements. Integration, on the other hand,involves component elements operating together in an organic whole. Thesecomponent elements of personality remain separate and maintain their identitywhile they are connected and interconnected with each other. They aretherefore related and connected, but may not be added, submerged into oneanother, or combined. Homologous with the structure of the nervous system ofthe physical organism, which is integrated through the joints or articulationsknown as synapses, personality and behavior are integrated througharticulations.

Both therapist and patient engage together in the creative process intherapy and both have some of the same subjective experiences

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as creative artists and scientists engaged in their creative work. There areexperiences of heightened intensity, deep concentration, conflict andfrustration, and sometimes a sense of deep understanding and relief. Suchexperiences relate, of course, to the particular psychodynamic issues in thetherapeutic interchange and some derive directly from the cathectic shifts,anxiety arousal and resolution, and the cognitive effects of engaging in anarticulation process. From the therapist's perspective, the subjectiveexperience of being creative occurs especially when making an unexpected,or a seemingly reverse, joining. An example of this in the first therapy sessionexcerpt presented occurred when the therapist became aware of, and stated,the connection between the patient's general fear of doing well and hisspecific fear of doing well in therapy. In the case of the mother–daughterproblem presented, it occurred when the therapist reversed the issue of themother–daughter symbiosis by raising questions about why the two could notlive together. In the former instance, the therapist experienced a sense ofunexpected understanding, and in the latter instance, he experienced a sense ofreversing or going against his own previous assumptions. However, becausethe creative process in therapy occurs between therapist and patient ratherthan within a single individual working alone, these experiences are similarto but not identical with those of the creative artist or scientist. Whereas theartist or scientist working alone relies on himself to select, shape, connect,and separate such unexpected or reverse ideas and interventions, the therapistand patient carry on these continuations and elaborations together.Nevertheless, the experiences of articulating and creating in therapycontribute to its sense of excitement and worthiness.

Because articulation applies to any type of content material, we can saythat awareness of articulation can help the therapist to apply a consistentprinciple regardless of type of patient or content. Also, awareness ofarticulation focuses the therapist on the structure of personality and of therapy,on making and creating as well as listening, interpreting, and learning. Withrespect to research, designation and description of this particular operationprovides a specific hypothesis about a factor in the therapeutic action ofpsychotherapy that can be empirically tested and assessed. Certainly, inadvocating that a therapist be aware of articulation, I am not suggesting that heor she become self-conscious and operate in a mechanical or formulaicmanner; but I am suggesting that an awareness of the process can serve as awaystation to enhancing the creative skills involved in the therapeutic task.With regard to a fully elaborated description of articulation in

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therapy, several questions remain. What, for instance, is the preciserelationship of articulation to the management of transference? What also isthe full relationship to primary and secondary process and how does itoperate within and between those modes of cognition? Also, issues about thefunction of articulation with respect to particular issues of the psychology ofcreativity involving error, uniqueness, and freedom confront us. These issuesand questions are matters for future explorations.

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Article Citation [Who Cited This?]Rothenberg, A. (1983). Creativity, Articulation, and Psychotherapy. J. Am.

Acad. Psychoanal. Dyn. Psychiatr., 11:55-85


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creativity articulation and psychotherapy

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