To Be Altered

Renowned improv teacher, Keith Johnstone says the following:

Instead of telling actors that they must be good listeners (which is confusing), we should say, ‘Be altered by what’s said.’

Good theatre is like tennis in that the spectators look to see how a statement is received, whereas in bad theatre it won’t be received.[1]

This echoes a dialogue I came across of Carl Rogers and the jewish philospher Martin Buber in 1957 around the topic of dialogic discourse. Rogers pointed out that he was often seeking “to be changed” by what he was learning about a client within the conversation.

As I was connecting the dots between what I’ve learned from Keith Johstone ideas around improv acting and Carl Roger’s approach to relating to another, it came to my recollection that this was something we discovered in our initial research on highly effective therapists in 2014.

Surprised by Clients’ Feedback

One of things we did not expect to find in the supershrinks study was that the amount of time therapists reported being surprised by clients’ feedback was a significant (though small) predictor of client outcomes. “Surprised by feedback” was also negatively correlated to therapists’ ratings of healing involvement (HI; i.e., the degree of how engaged and affirmed they felt they were). More, HI was a negative predictor or client outcomes. In other words, the more effective therapists were a tad more critical of themselves.

Taken together, how do we make sense of such findings?

Here’s what I wrote previously:

“The therapist ratings of the number of times they were surprised by their clients’ feedback infer qualities about the therapist’s openness, receptivity, and willingness to receive negative and positive feedback.”

The Hypercorrection Effect

According to Janet Metcalfe and colleagues, individuals are more likely to correct errors made with initial high confidence than those made with low-confidence, so long as the corrective feedback is given.[2] Metcalfe and colleagues called this the hypercorrection effect.

Self-plagiarism again:

…it appears that therapists in our sub-sample were not only able to elicit “surprising” feedback from their clients, but may have implicitly or explicitly communicated through their on-going interaction with their clients, a sense of openness and willingness to receive and consider their viewpoints, even if it may be contradictory to the therapist existing expectations.

The Flipside of Hypercorrection Effect: Hindsight Bias

If hypercorrection theory might account for why more effective therapists are endorse more accounts of being “surprised” by clients’ feedback, what factors can we consider as plausible explanations regarding the less effective therapists? Why were they “less surprised?”

Perhaps it might be due to hindsight bias.[3] Hindsight bias is defined that “an event is more predictable after it becomes known than it was before it became known.” Perhaps, the less effective cohort, might carry a disposition of “I-knew-it-all-along” train of thought, whereas the more effective therapists experienced more disconfirmation about their prior knowledge about the session; a willingness to be altered.

This is why I believe Keith Johnstone from the realm of improv acting has something to teach us in the practice of therapy.

A willingness to be “altered” can lead to empathy and learning.

1. Empathy

Theologian John S. Dunne describes empathy as “passing over,” where we entry into the thoughts, feelings and imaginations of the other.

“Passing over is never total but is always partial and incomplete. And there is an equal and opposite process of coming back to oneself.”

Douglas Flemons has a beautiful description of hypnosis that is relevant to empathy. He calls the relational phenomena of hypnosis as being “of one mind.” The process of empathy is to result in becoming of one mind with the other.

After all, empathy is not just understanding someone, but it is an active process of helping the other person feel understood.

See Related: To Understand? Easy. To Help Someone Feel Understood? Difficult.

2. Learning

A willingness to be altered, in cognitive science language, simply means to be updating our prior beliefs. This is the process of learning.

This is why psychologist Lisa Fieldman-Barrett says that

Prediction errors = Learning

An Exercise: Rate and Predict Exercise

So how do we take the ideas of empathy and learning, and Johnstone’s notion of “to be altered” into action? Here’s one strategy that can help you called the Rate and Predict Exercise:

1. Rate: At the end of the first session, using an alliance measure (e.g., Session Rating Scale, SRS). Ask your client to RATE how they feel about the level of engagement in the session;

2. Predict: Before you see your client’s score, PREDICT what they would score. It is crucial that you write down scores for each of the sub-scales (for SRS, level of emotional connection, goals, approach/method, overall), and

3. Evaluate: Compare and contrast the scores. See what surprised you. Be willing to be update, change and alter your mind.

Doing this exercise has helped me elicit a much more nuanced feedback from my clients, stuff that I wouldn’t have otherwise have known. It was often in the discrepancy of my view of the alliance compared to that of the client’s, that has led to highly useful feedback that I could feed-forward into the future sessions.

The late Eugene Gendlin, a pioneer of the focusing approach in therapy, said some years ago before he passed away, when he’s asking questions in therapy, he was no longer seeking to be confirmed like he used to. Rather, he’s now intentionally seeking to be disconfirmed by his client. When we are willing to be wrong, our ears open up.

The Symbiosis of Empathy and Learning

One of the ways of learning empathy as a process factor is to be empathically learning by updating your prior knowledge of the person, and willing to be altered by the counterfactuals.

In the act of “passing over,” let us have the courage to be someone else, to be open to be changed in the enterprise of change.

When thinking changes your mind, that’s philosophy. When God changes your mind, that’s faith. When facts changes your mind, that’s science.

– What Have You Changed Your Mind About? (Editor John Brockman)

My addendum: “When you change your own mind, that’s an opinion. When someone changes your mind, that’s love.”

Footnotes

[1] Improv for Storytellers, by Keith Johnstone
[2] Barbie, J. H., & Metcalfe, J. (2012). Making related errors facilitates learning, but learners do not know it. Memory & Cognition, 40(4), 54-527. doi:10.3758/s13421-011-0167-z
Butterfield, B., & Metcalfe, J. (2001). Errors committed with high confidence are hypercorrected. Journal of Experimental Psychology: Learning, Memory, & Cognition November, 27(6), 1491-1494.
Metcalfe, J., & Finn, B. (2011). People’s hypercorrection of high-confidence errors: Did they know it all along? Journal of Experimental Psychology: Learning, Memory, and Cognition, 37(2), 437-448. doi:http://dx.doi.org/10.1037/a0021962
[3] Roese, N. J., & Vohs, K. D. (2012). Hindsight bias. Perspectives on Psychological Science, 7(5), 411-426. doi:10.1177/1745691612454303

Photo by Anna Rye from Pexels