Form and structure and their function in psychotherapy

Psychotherapy is a creative process with the same types of effects and determinants as other creative activities in fields such as literature, visual arts, and science. In all of these activities, a focus on form and structure serves to generate new and valuable resultants or creations. As shown in the example of the poet Richard Wilbur's creation of a poem, his focus on rhyme and other formal features generated a new and valuable emotional tension in the poem. In psychotherapy, the creation consists of new and valuable aspects or structural features of personality. This creative result in therapy is produced in part by therapists' focus on form in terms of sequences, style of verbal and non-verbal presentation, and the phases of encounter, growth, and separation. As shown in the psychotherapy session excerpted, the therapist's lack of attention to the critical theme initiated by the patient at the beginning of the session (encounter) as well as to the meanings of connections between sequences in the following interactions (growth) led to a non-creative or destructive suicidal threat at the end (separation). The overall creative result arises also from therapists' attention to patients' approaches to the overall structure of psychotherapy as a regularly occurring timed experience in which the therapist does not directly intervene in the patient's life. This structural organization provides a trial domain for the patient in which creative growth and personal welfare can be facilitated. Both patient and therapist need to focus on any attempts to undermine the structural organization and its meaning. Similarly, in creative activities in other fields, writers, artists, and scientists characteristically focus on form, in a detailed as well as general way, in order to facilitate both aesthetic and social growth and welfare.