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(117.0112... uliqvifrggffl§§ in. . .i. . full)? 7 uruiflcl . . . .11.... éf!,\.z1{nflfitrkfl.tllrr §IZ‘\ if? )Arl‘lflllfitsif I .5 . -If... .5113}. built! £11551):(bilulr‘fglsftfir§[}l5li.ifvs}.z¢fiflitr 3.1. . r .3 1.5.1.} L frat igblg 61.31.!!! £9; .31..le .31.... "#8300? :).I&.\lgx..(:?(rff.iit. i.‘§1?n)flbfld‘§§f$i ; I» L. .. . . (.51. f».tl. ‘(f’ilili‘lllv v.73. . 1 I I T I) QRHUJE. 1 . . , . m4); . I. . .. . .. .......... . 2...... I. 4 z I, “.17.? w... . WWWWWWW THtms This is to certify that the thesis entitled Training Program For Beginning Therapists In The Production Of Metaphoric Language, Hypothesis And Treatment Plans. presented by Jeana Lynne Dressel has been accepted towards fulfillment of the requirements for PH.D. dpgfimin Dept. of Counseling Personnel Services WA 1% Major professor Date 6 5 79 0-7639 LIBRA R if ' Michigan State University OVERDUE FINES ARE 25¢ PER DAY PER ITEM Return to book drop to remove this checkout from your record. A TRAINING PROGRAM FOR BEGINNING THERAPISTS IN THE PRODUCTION OF METAPHORIC LANGUAGE, HYPOTHESES, AND TREATMENT PLANS By Jeana Lynne Dressel A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Counseling, Personnel Services and Educational Psychology 1979 ABSTRACT A TRAINING PROGRAM FOR BEGINNING THERAPISTS IN THE PRODUCTION OF METAPHORIC LANGUAGE, HYPOTHESES, AND TREATMENT PLANS By Jeana Lynne Dressel The purpose of this study was to assess the effectiveness of a training program in metaphoric language, hypotheses and treat- ment plans in improving beginning therapist's generation of these elements in conceptualizing about a client. Based on ideas in the literature on creativity and scientific thinking, the training pro- gram was designed to use metaphoric language as an initial step in developing hypotheses and treatment plans for clients. An extensive review of the theoretical ideas related to this research is included. Fifteen subjects were randomly assigned to a control or treatment group. Pretesting included three of Guilford's divergent thinking tests (Consequences, Associational Fluency and Alternate Uses) used as a covariate measure and two case studies with ques- tions to be answered by the subjects. All subjects turned in case notes on a current client weekly for five weeks, while the treatment group also completed the training program. The training program con- consisted of five training manuals: Jeana Lynne Dressel Unit I: Similies and Metaphors: Definitions and Identifications Unit II: Generation of Metaphors and Similes Unit III: Metaphors and Similes: Generating Multiple Perspectives Unit IV: Hypothesis Generation Unit V: Generation of Treatment Ideas Posttesting for both control and treatment groups consisted of responses to questions based on two more case studies. Raters then read both case study and case note responses for the occurrence of metaphoric language, hypotheses and treatment plans. Rating con— sidered both the frequency and the quality of the three elements. Hypotheses tested for the effectiveness of the training program to increase the frequency and quality of each of the three elements (metaphoric language, hypotheses and treatment plans) of the treatment group over that of the control group. A fourth hypothesis tested the ability of the divergent thinking tests as a covariate measure to predict performance on the three research elements. The FINN program for multivariate analysis of variance with planned comparisons was used to test for the significance of the dependent and covariate measures. The null hypotheses failed to be rejected in all cases. Reasons for failure to find signifi- cance are explored in the Discussion section. DEDICATION to Howard VanCamp and Susan Guild in your struggles to live you helped me lift my eyes from the daily preoccupations with a dissertation and view the beauty of life even admidst its trials ii ACKNOWLEDGMENTS To William Hinds who helped guide my vague ideas to a project that was finally accomplished. To F. Robert Wilson, a critic,supporter and friend who performed each role as needed. To Anne Heindryckx and Marilyn Lautzenheiser who typed at odd hours so that my manuals were ready when needed. To Lee Erlandson, Sarah Schendel, Chris Riddle and Lucia Palacios who completed rating tasks with good humor and diligence despite the time involved. To Paul Dressel, my father, who in the final stages gave valued criticism when requested and refrained when not. To Sam Plyler, Jeanne Gullahorn, and Joanne Hamachek who made my last doctoral requirement an enjoyable experience. iii LIST OF LIST OF LIST OF Chapter I. TABLE TABLES FIGURES APPENDICES THE PROBLEM Introduction Purpose Need Theory Definition of Terms Hypotheses . . . . Overview OF CONTENTS REVIEW OF THE LITERATURE . Overview Creativity Research Problems of Research on Models of the Thinking P The Creative Process Metaphors as Creative Creativity in Psychother Metaphors and Psychother Creativity in Science: Creativity in Science: Summary . DESIGN OF THE STUDY Introduction Sample Treatment Procedures Instrumentation Rater Sample . . . Rater Reliability Rater's Tasks Creativity . . rocess apy apy Metaphoric Language Hypothesis Generation iv Page vi 14 14 14 l6 18 21 25 27 31 35 37 38 4O 4O 4O 41 44 47 49 Chapter Page Scoring . . . . . . . . . . . . . . . 50 Design over Subjects . . . . . . . . . . . 54 Design over Variables . . . . . . . . . . . 54 Method of Analysis . . . . . . . . . . . . 56 Hypotheses . . . . . . . . . . . . . . 56 Summary . . . . . . . . . . . . . . . 57 IV. ANALYSIS OF DATA . . . . . . . . . . . . 59 Design . . . . . . . . . . . . . . . S9 Hypothesis Tests . . . . . . . . . . . . 6O Covariate . . . . . . . . . . . . . . . 62 Summary . . . . . . . . . . . . . . . 62 V. SUMMARY, CONCLUSIONS AND DISCUSSION . . . . . . 64 Summary . . . . . . . . . . . . . . . 64 Conclusions . . . . . . . . . . . . . . 65 Discussion . . . . . . . . . . . . . . 66 Limitations . . . . . . . . . . . . . . 67 Implications for Further Study . . . . . . . . 71 BIBLIOGRAPHY . . . . . . . . . . . . . . . . 74 APPENDICES . . . . . . . . . . . . . . . . . 82 LIST OF TABLES Reliabilities for Dependent Measures . Matrix for Combined Frequency—Quality Scores for Case Studies . . . . . . . . . . . Matrix for Index of Change Scores Matrix for Combined Frequency—Quality Scores on Case Notes . . . . . . . . . . . . Multivariate Planned Comparisons Contrasting Treatment Group and Educational Level . Regression on Three Covariates . . . . vi Page 48 51 53 53 6O 63 LIST OF FIGURES Figure Page 3.1 Research Design over Variables . . . . . . . . 55 vii Appendix A. B. LIST OF APPENDICES Page Release Form . . . . . . . . . . . . . 83 Case Studies . . . . . . . . . . . . . 85 Instructions and Questions for Case Studies . . . 111 Instructions for Case Notes . . . . . . . . 114 Training Booklets . . . . . . . . . . . . 117 Training Manual I for Raters . . . . . . . . 204 Training Manual 11 for Raters . . . . . . . . 238 Case Study and Case Note Scores . . . . . . . 264 Sample Correlation Matrix . . . . . . . . . 267 viii CHAPTER I THE PROBLEM Introduction The training of beginning therapists demands a great deal of time and energy. Mastering technical skills, including the theoretical foundations of human dynamics and the interpersonal skills upon which therapy is based, is a major part of most contem— porary training programs. However, the competent therapist should be more than a well-trained technician. Technical skills provide only the ground work for an individual's own approach to therapy. Equally important is the prospective therapist's ability to apply these technical skills in a holistic manner that benefits the client. A holistic approach involves applying both theoretical knowledge and technical skills with a flexibility for the unique- ness of each client. Creativity can be a crucial factor in how the therapist integrates the knowledge and skills in therapy sessions with clients. Creativity, however, is a difficult concept to define. In this research, the term creativity is used for discussion purposes and is not a research measure in itself. Yet, it is important to understand the complexity of the term and attempt to clarify its meaning for this research since creativity is the underlying concern. Creativity can refer to the individual, the product, the environment, or the thinking process (Mooney, 1962). Not only can the referents differ, but the type of creativity may differ as well. Taylor (1959) has classified the many varying definitions of creativity into five levels: expressive, productive, inventive, innovative, and emergentive creativity. Each level involves an increasing degree of creativity. The first (expressive) comprises untrained behaviors involved in the spontaneity of the moment; the second (productive) encompasses the discovery and development of skills to master tasks or problems; the third (inventive) emphasizes the perception and revision of relationships between old ideas and tasks; the fourth (innovative) stresses the modification of previous ideas and tasks, going beyond mere revision to new combinations; the fifth, and highest level (emergentive) refers to creatvity involving the evolution of new principles or ideas. In the research literature, all five levels of creativity are found in the definitions, but always using the same word, creativity. A creative/ noncreative dichotomy should not exist in an absolute form, but on a continuum as these levels attest. Purpose The purpose of this study is to construct and test a program to develop the creativity of beginning therapists. The first major step in this process is to define creativity in the context of therapy. The use of verbal language is a primary compo- nent of most psychotherapy (less so in art or dance therapy). There is often a great deal of nonverbal communication as well. Its meaning or intent may also become verbalized in the process of analysis. Therefore language was chosen as the primary focal point for this study. The question that is still unanswered is: What can be considered creative behavior within psychotherapy? In this study the answer lies in the different forms language can take. Taking a "product" approach, language can be structured for form metaphors and Similes (figurative speech), hypotheses, and treatment ideas. These three categories are definable units within language and a natural part of the therapy process. Used creatively, they can combine the technical knowledge of theory with unique insights about the client, and the therapy relationship. This level of creativity, returning to Taylor's categories, would be, minimally, that of inventive creativity, but including the ability to formulate new ideas and perceptions from old patterns of behavior and thought. A creative therapist may go beyond this to developing new insights or perceptions only remotely based on past thinking; this would involve the innovative level. Ideally, though not expected in this research, the therapist could extend his/her thinking to the develop— ment of basic principles of behavior. Freud did this by synthesizing clinical work and introspection. Need As previously noted, training needs to extend beyond the acquisition of technical skills. Kelly (1964) suggested that mastering diagnosis and interpretation is only a beginning. He stressed the need to explore ideas or thoughts that might initially generate confusion, proposing the use of the "language of hyopthesis" in order to face the threat involved in a new revelation. Forming hypothetical statements allows both the client and the therapist to explore the ramifications of a threatening idea without being forced into a rigid acceptance of it. In his examples of how he would do this, Kelly's hypothetical statements are phrased metaphorically: "Supposeiuaregard your feelings as if they were a shield against the hazards of loving someone" [simile]. ". . masks have a way of sticking to our faces when worn too long" [metaphor]. Thesesmatementssupplant simple intellectual conjecture of interpre— tation such as: "You are afraid to let anyone get close to you." "You have been behaving this way for so long it may be a part of you." Kelly takes this interpretive knowledge and applies it through a sensory component. The implications of the metaphoric language are plentiful and limited only by the ability of therapist and client to explore them. Kelly, whose entire discussion of the subject is heavily metaphorical, links the metaphorical process to the formula- tion of hypotheses. The purpose of metaphoric language and hypothe— ses is to explore the unknown and risk unconventional views in a pursuit of understanding. He thus broadens the scope of therapy beyond technical applications. He does not specifically label the process as creative, yet his frequent references to major discoveries by using the process of the language of hypothesis imply such a link. Hammer (1973) is also concerned that therapy be more than an intellectual exercise, or for that matter, an intuitional exercise. He talks specifically about creativity inpsychotherapy, stating that one of the main attributes of a creative therapist is moral courage in the face of new discoveries and their inherent changes. Creative therapists utilize both intuitive and rational abilities. They use intuition to lead to insights about the client. These insights can be evaluated and organized into an overall pattern of behavior in conjunction with rational thought processes that weigh the logic and validity of the ideas. His examples of these creative and intuitive moments are metaphoric: "How nice to get a wound you can lick” [metaphor]. ”It's important not to get so used to tearing away people's masks that you no longer hear the rip" [metaphor]. Hammer reports that these statements had a major impact on the clients; he attributes this to the ability of these images to communicate through the senses, a more basic form of communication. The communication is enhanced by the fundamental directness of the sensory image rather than depending on intellectual statements. They also enhance understanding by the client through the link with the emotional component. The image of tearing off masks is made more graphic by the combination of sight and sound. The symbolism is alive, not merely interpretive. It integrates an understanding of the client's behaviors with a portrayal of their potential impact. Both Kelly and Hammer advocate a process of hypothetical thinking using metaphoric language as a basis for an explorative process. Yet their discussions are at the theoretical level and they do not specifically propose a training method. Little research has been done in this area at all, and there is only a limited discussion of the ideas in the literature. Putting these ideas into the context of a training program is certainly the next step in assessing their value. Since creativity might be a crucial element in the success of good therapy, it is an area worth exploring. m Kelly and Hammer, in their discussions of the need for more creative applications of learning in the therapy situation, utilized metaphoric language and hypothesis. The idea of metaphoric language and hypothesis formation as indicators of creative behaviors within therapy is supported by other authors as well. Shibles (1974) stresses the importance of metaphoric use in therapy. He is not concerned with the creative process per se, but with the influence of langauge on thinking and emotion. Metaphors are often used to express or describe feelings. Since feelings and internal states are difficult to understand and communi- cate, metaphors are constructed. By comparing these feelings to external objects they become more comprehensible to the individual. As Hammer would say, the communication is more direct, being established on a sensory level. In contrast to Kelly and Hammer, Shibles focuses largely on the client's use of metaphors. By constantly thinking of themselves in terms of a few fixed (and usually negative) metaphors, clients experience stress. The process of therapy uncovers these metaphors of self-reference. He notes that schizophrenics often use extreme meta- phorization to the point where it confuses rather than enhances com— munication. The difficulty lies inthe "fixed" natureivifliwhich the metaphors are used bythe clients. The therapistinustloosen this use. Shibles (1971) also considers metaphors as an art form in their own right. He has perhaps devoted more time to an actual review of the use of metaphors within both the arts and sciences than anyone. He traces the basis of music, painting, literature and scientific theories to metaphoric thinking, noting that its ability to lead to new perceptions and insights is crucial to the creative process. Arieti (1976) also became interested in creativity and language through his work with schizophrenics. He noted, as did Shibles, the frequent use of metaphors, puns, and symbols among schizophrenics. He saw a difference between the schizophrenic and artistic use of metaphors. While an artist uses metaphors and symbols to explore universal meanings through comparisons and contrasts, the schizophrenic becomes locked into a world of personal meanings. Schizophrenics react to the metaphors they create as reality. The connotations and denotations of the words become fact, not comparison. For instance, the comparison involved in stating that the human body is a machine is not used for insight by a schizophrenic as a writer might do. Instead, one schizophrenic woman proceeded to oil her entire body stating that machines need oil. Schizophrenics concretize the connotations of words, sometimes in very original ways. Arieti finds humor and originality in many of the conceptions of the schizophrenic, but it is unintentional and unperceived by the schizophrenic. In contrast, he sees the creative use of metaphors as uniting insights and new perceptions developed from seeing the similar in the dissimilar. The creative individual synthesizes perceptions that the schizophrenic and ordinary individual may not even consider. In working with clients, it becomes the task of the thera- pist to ferret out the level of meanings in the client's language. With schizophrenics this involves attending to the patterns of use as well as interpreting the individual symbolism. Forrest (1968) and Lorenz (1968) have devoted their research to discovering the commonalities in schizophrenic language. But, as evidenced by the work of Shibles, this same process of attending to language usage can also be valuable in working with neurotics and normals. Leatherdale (1974) discusses the importance of analogy and metaphor in science at some length. He believes that metaphoric language plays a fundamental role in all states of scientific think- ing from concept formation to high level theorization. Possibly the most famous example of this application is the story of Newton connecting the fall of an apple with the relationship between bodies in space. The juxtapositions created by metaphors and similes are a mixing of contexts that can bring a previously unseen likeness or contrast into perspective. He maintains that analogical or meta— phoric ability is armnnaimportant attribute of great scientists than their mathematic or logical ability. The creation of models initiated from metaphoric language is a key factor in the explora— tion and discovery process in science. However, he also notes that metaphoric language, when it is obscure, incongruous or dead (i.e., a clichE) tends to confuse or mislead thought rather than enhance it. Though he does not relate his ideas to therapy or psychology specifically, his negative attributions repeat the negative aspects already cited with respect to schizophrenics. Schon (1967) also discusses the importance of metaphoric language and hypotheses in science. Metaphors themselves give rise to hypotheses through the implications of their comparison. Metaphors may be suggested from cultural experiences, present situations, or errors in the application of ideas. The scientist works with metaphors by elaborating the contrasts and likenesses of the metaphoric comparison, and exploring the new relationships they reveal. He notes two different modes of inquiry that utilize metaphors and hypotheses: "problematic inquiry: beginning with a problem and searching for a metaphor which will in its elaboration yield a hypothe— sis for a solution." "speculative inquiry: beginning with a metaphor, elaborat- ing it, and developing the hypotheses it yields" (Schon, 1967, p. 87). Black (1962) credits metaphors as a means for uniting the domains of cognitive and affective experience into a single lO relationship. For him, "metaphorical thought is a distinctive mode of achieving insight, not to be construed as an ornamental substi— tue for plain thought" (Black, 1962, p. 237). Metaphors are the first step in developing a model that is the foundation of a theory, and therefore an important factor in scientific thought. Stein (1956), in discussing the difficulty of evaluating creativity, suggests that it can be done by appraising the products of the process: hypothesis formation, hypothesis testing, and the communication of ideas. This is also supported by Bunge (1962). He states that creative imagination in science may be particularly demonstrated in the formation of hypotheses. A second component is the ability involved in choosing the best hypothesis and the work entailed in synthesizing this into a new organization of thoughts or facts. In this study treatment plans were assumed to be a further extension of the views cited above; they are considered to be another potential creative product of the therapy process. This is an assumption made for this study since no research or theory has specifically accounted for treatment plans in this way. Literature on treatment plans makes frequent references to the need for flexibility in the therapist in order to delineate goals and an overall treatment that fits the individual client. Thorne (1961) notes that experience plays an important role in the therapist knowing what to look for, how to look, when to look, how to evaluate the importance of what is seen and then, organizing 11 this information and putting it into a long term perspective. He further stresses that this is a continuing process that requires more than intuitive abilities or random application of methods (1968). The factor of experience is validated by research (Steiper, 1965) and it was further noted from this research that flexibility in style (using questioning, exploring as well as reflective state— ments) seemed to be the predominant difference in styles between experienced and inexperienced therapists. The literature on treatment plans is limited, presumably due to the limitations of writing about plans in a general sense when in practice, they must be specific to the client. However, plans are considered a testing instrument of the therapist's hypotheses (Ingham, 1954; Hadley, 1958) that require a high degree of skill. Here again, creativity can be a factor in integrating the skills of theoretical understanding with the flexibility needed for deter— mining unique goals for each client. Each of the three categories, metaphoric language, hypotheses, and treatment plans, develops in a natural progression in creative thinking. Metaphoric language, which is considered creative in itself, is also capable of initiating further steps of creative thinking through the insights each metaphor provides. Hypotheses are often developed from the insights suggested in metaphoric language. Applying the implications and assumptions of the hypotheses leads to treatment plans. In therapy, this could be Bunge's preliminary step: the organization of hypotheses into a 12 larger framework. The process may end here for the therapist, but the scientist will continue the thought process with the hopes of developing a general theory. Definition of Terms The following terms are crucial aspects of the training program designed for this study and discussed in Chapter III. Metaphoric Language: A generalized phrase referring to the use of metaphors and similes in spoken and written language. Simile: A comparison between one thing/person/concept and another using "like" or "as” to form the comparison. Metaphor: The identification of one thing/person/concept with any other (Brooke—Rose, 1956). The comparison of attributes is implied via using verbs, nouns, adjectives, or adverbs normally connected with one and now applied to another. Hypothesis: A conjectural statement of the relation between two or more variables (Kerlinger, 1964). Treatment Plan: A plan or proposed behavior to be used in conjunction with the therapy of a client. Hypotheses The hypotheses for this study are specifically formulated to assess the impact of the training program on the subjects. I. Subjects who receive training in the use of metaphoric language will receive significantly higher ratings on metaphoric language in the written case materials than the control group. 13 II. Subjects who receive training in the use of metaphoric language will receive significantly higher ratings on hypothesis formation usage in written case materials than the control group. III. Subjects who receive training in the use of metaphoric language will receive significantly higher ratings on treatment plan development in written case materials than the control group. IV. Subjects scoring higher in the pretest measures of divergent thinking will score higher on the measures of metaphoric language, hypothesis formation and treatment plans. Overview In the following chapters the details of this research will be delineated. Chapter II will discuss in greater detail the ideas and theories behind this research. Chapter III will specify the particular sample, measures, and apparatus used in formulating the research. Chapter IV supplies the results of the statistical analysis and in Chapter V these results will be discussed in con— junction with the theoretical ideas upon which the study was based. CHAPTER II REVIEW OF THE LITERATURE Overview In this chapter the theoretical ideas and studies pertaining to creativity will be reviewed. The focus will be initially on the general field of creativity, then narrowing to creativity within psychotherapy. The difficulties of research in creativity will be cited. In addition, some of the primary theoretical models of creative thinking that have guided much of the research will be presented. The exploration of the use of metaphoric language and hypotheses within psychotherapy and the sciences will be the next area of discussion with particular attention to the relationship of these language behaviors to creativity. Creativity Research As mentioned earlier, the topic of creativity became a popular subject of research in the mid-fifties. The relative newness of it as a research area has meant that the procedures and theories so far constructed are still in a preliminary stage, needing further development and validation. An assumption underlying this research, however, has not changed: that creativity is an inherently desirable entity enabling humans to make contributions through their unique symbolic processes. DOppelt (1964) qualifies the predominately l4 15 positive connotations of creativity by noting that creative thought could also be applied for negative purposes. The creative thinker may apply this skill to theft just as s/he may apply it to problem solutions benefiting science. This does not preclude the need for research in creativity nor its value, but merely places a perspective on the value of creativity that is often lost. The four basic areas of creativity research are: the personality, the environment, the product, and the process. Each of these foci has a basic guiding purpose behind its emphasis. Understanding the personality of the creative person can be impor- tant in recognizing and fostering talent early. The creative environment is investigated for much the same purpose. with the hope that structuring an optimum environment will facilitate creative potential and enhance existent ability within individuals (Stein, 1967). The products of the creative process (the third general area cited) undergo continual evaluation, not only by researchers in the laboratory but society as well. They are valued for many reasons: progress, enjoyment, and understanding, among others. While researchers must confine themselves to limited, tangible products developed under controlled conditions, society is concerned with the major products of scientists and artists after many stages of work. A fuller understanding of a creative product can hopefully be used to reflect on the persons and processes needed to implement it. Research on the creative process (the fourth area) ventures into the realm of ascertaining 16 the mental and emotional conditions present as the process evolves. In this area the research relies more on self—report, since outward manifestations of the process are less tangible. Yet its importance in understanding how creativity can be ultimately encouraged in individuals and their environment makes it not less valid. Problems of Research on Creativity The vastness of the area of creativity is one of the primary problems of the research. Within each of the four major categories mentioned above there are still many differences. Studying the creative products of writers can be very different from studying the products of mathematicians, for instance. The complexity is compounded by the reality that creativity is not one thing, but many separate behaviors and attributes. Creativity research is searching for the threads of consistency that weave a recognizable pattern in these differing phenomena. One of the fundamental problems, as implied above, is the definition of creativity. Taylor (1959) tried to bring order to this confusion by his delineation of five basic levels of definitions (cited in Chapter I). However, although his ideas provide a theoretical link for varying definitions, the comparability of operational meanings at the research level still remains a problem. This extension of theoretical concepts to operational definitions is particularly troublesome in the field of creativity. Research studies are often not comparable because a single criterion 17 of creativity does not exist. Therefore, studies tend to be based on ratings, products, and profiles idiosyncratic to the studies (Treffinger, 1971). Furthermore, generalizations from the studies are limited by the predominance of small samples, often with select populations (Dellas, 1970). There are some additional problems as well. For instance, few longitudinal studies have been undertaken, and the short—term studies done are complicated by unrelated, poorly defined criteria. Also, most studies are constructed to evaluate a single product of one or more tasks, overlooking the continuous nature of creativity that encompasses a lifetime (Vinacke, 1952). In addition, the representativeness of creativity based on restricted laboratory tasks remains questionable, especially with the individual character inherent in creativity. Even the separation of creativity from other traits such as intelligence and resourcefulness becomes difficult (Guiselin, 1962; Wallack, 1968). These problems contribute to the costs and complexity of controlled research; nonetheless, they are important for the field to counter whenever possible. The problems of assessment are complex as well. It is difficult to determine a precise criterion for measurement, which remains true to the overall sense of creativity the researcher intends. For example, creativity implies a degree of unusualness, but deciding the exact criteria for unusual can be difficult. Barron (1963b) bases his definition of unusual on a comparison of a subject's response to a normative sample. This generates 18 different results than if the comparison were contained within the research sample. Other researchers have been concerned with credit- ing only appropriate responses. This involves establishing a standard of appropriateness that discounts nonfunctioning, though original, responses (Jackson, 1965; Barron, 1963b). The crucial aspect of whatever procedures are chosen is the relationship they retain to the original conception of creativity and how they consequently operationalize the definition of creativity. Models of the Thinking Process From considerations of the problems involved in creativity, we now move to discussing theoretical models of thinking that have guided creativity research. Mednick (1962) hypothesized that the crucial element was the formation of associations which are then reformulated into new associations. The more remote associations are indicative of greater originality. The greater the number of associations perceived by the individual, the greater the potential for creative solutions. Operationally this hypothesis was assessed by word association tasks (Laughlin, 1967). Graphing his hypothesis, Mednick proposed that noncreative persons would have a steep slope of many initial stereotypic responses to the associative task with a rapid decline as few new associations are constructed. Creative persons, in contrast, would produce a gradual slope starting with a lower number of stereotypic responses and declining more gradually as new and more remote associations are formed (Wallach and Kagan, 1965). 19 From a different perspective, Schroder's theory of informa- tion processing (1966) describes creative persons by their ability to make highly complex integrations of information. The greater the integrative ability the greater the diversity of information an individual assimilates and interrelates. They may do this in one particular area, for instance music, or they may do it with most information they process. The categories by which they organize information will be diverse and abundant. The individual with low integration ability, however, has a few rules by which a limited amount of information is categorized. This type of person will maintain these categories with minimal conflict within or between categories (things are seen as black and white). In contrast to the low-integrative persons, the behavior by high- integrative individuals demonstrates a questioning and searching for additional information regardless of content (Karlins, 1967). Processing information that disagrees with what they've known before is not resisted. A third model of the thinking process, Guilford's structure of intellect model (1959, 1963, 1967) is an attempt to relate his factor-analyzed traits to an overall model of intellect. He conceptualizes five primary types of intellectual processing: cognition, memory, divergent thinking, convergent thinking and evaluation. The types of information processed fall into the categories of figural, symbolic, semantic and behavioral content. Primary to creative thinking are the divergent traits of fluency, 20 originality and flexibility. Divergent thinking is typified by responses that generate new or unusual reconstructions of informa- tion, in contrast to convergent thinking where information is processed with the approach to a single solution or answer. Fluency, for instance, is measured by the multiple generation of words, ideas or associations. Flexibility is the ability to interchange sets and categories so that a variety of ideas or solutions is generated. Originality, the ability to produce uncommon or remotely associated responses, is based on scoring criteria relative to the sample being researched. Theoretically, these three attributes (fluency, flexibility, originality) can be achieved within any of the content areas labeled previously, but tests for these abilities are most predominant in the semantic and symbolic categories. The limitations of considering Guilford's factors separately is stressed by Taylor (1956). For example, with ideational fluency the production of ideas alone is not necessarily creative. An individual producing just a few good ideas, but with good critical judgment, may be actually considered highly creative. Madams (1964) also notes that the low correlation between the tests of divergent thinking suggest that they are not measuring a single domain of behavior as many researchers seem to assume. A further problem is created by other researchers. While Guilford himself recognizes other factors as additional and important contributors to thinking, other researchers sometimes do not. 21 Guilford's system includes creativity as a part of the model but like Schroder's work, attempts to conceptualize the full range of information processing. It tackles a broad purpose, but it does not account for emotional or maturational dimensions (Vinacke, 1952). The Creative Process Models of the thinking process only touch on the process of creative thinking. The conceptualization of the creative process itself largely began with Wallas' delineation of four stages: preparatory, incubation, illumination, and verification (Wallas, 1926). He based these stages on ideas initially developed by Hemholtz. The first stage, that of preparation, is the time of general investigation of a problem, with the generation of questions and the systematic exploration of the questions. Incubation occurs when there is a decline in conscious attention to the problem, be it a matter of months or minutes. Frequently a period of relaxation, physical activity, or attention to a different, unrelated problem may be considered incubation. From this period of disengagement arises the next stage, illumination, which is the experience of insight into the solution, sometimes preceded by an intimation of a solution. The final stage, verification, is a period of conscious systematic activity whereby the ideas or solutions are tested for their validity. These four stages have been elaborated by others: Joseph Rossman 1) observation of a need or difficulty 2) analysis of the need 22 3) survey of the available information 4) formulation of objective solutions 5) critical analysis of the proposed solutions for advantages and disadvantages 6) birth of the new idea or invention 7) experimentation to test out the most promising solution Alex Osborn l) orientation: pointing up the problem 2) preparation: gathering pertinent data 3) analysis: breaking down the relevant material 4) hypothesis: piling up alternatives by way of ideas 5) incubation: letting up 6) synthesis: putting the pieces together 7) verification: judging the resultant ideas (Haefele, 1962, pp. 12—13) Rossman and Osborn further specify those behaviors covered more generally by Wallas' four-stage model. However, the authors have stressed the relativity of the stages; rather than distinct and ordered experiences, these stages may overlap one another and be reordered in a particular instance of problem solving (Haefele, 1962). Bruner (1962) and W. Gordon (1961) formulated psychological conditions present in the creative process in conjunction with the type of intellectual activity described above. Bruner conceptualized five stages: (1) detachment——separate from problem, (2) commitment—- guided by purpose, (3) passion and decorum—~1etting impulses out, but in a controlled manner, (4) freedom to be dominated——seemingly letting problem take over, (5) deferral and immediacy—-sensing of immediate direction but delaying this tendency. Gordon conceived similar stages: (1) detachment—-removed from the problem, (2) involvement——identified with the problems, 23 (3) deferment-—putting off the solutions, (4) speculation—~the consideration of all ideas. These are not ordered categories, but qualities all present during the creative process. The paradox of involvement and detachment are noted by both men, though Gordon's involvement might be considered to encompass 2, 3, and 4 of Bruner's conceptions. The apparent contradiction of intense involvement, yet disciplined detachment, exemplified the balancing of contrasting qualities often attributed to creativity. This is demonstrated by deferring an imminent solution to avoid premature conclusions. W. Gordon (1961) began his work with creativity by looking at the general stages of the creative process by Wallas. He noted the prevalence of analogies and metaphors, and their frequency in creative thinking as a means to make the familiar idea or object strange. By suspending the completion of ideas, the individual uses metaphors to facilitate playing with relationships and meanings. From this, new insights are brought to a problem. This method works conversely in making strange ideas or objects more familiar. Metaphors, as Gordon has studied them, fall into Taylor's inventive level (level 3, Chapter 1). However, beyond just forming new relationships (inventive creativity) metaphors also facilitate the formation of new designs or principles as well, thus evolving the fourth and fifth levels of creativity delineated by Taylor (innovative and emergentive). Gordon differentiated types of metaphors by their idea— content. Initially his categories of metaphors included personal, 24 direct, symbolic and fantasy. The symbolic and fantasy categories were eventually dropped and replaced by compressed conflict. This last category evolved from his own teaching device, a two—word contrast (W. Gordon, 1973). The condensation process of compressed conflict requires selecting two words representing contrasting qualities of a relationship. For instance, "delightful panic" could express the approach-avoidance conflict involved in an event eagerly anticipated yet also feared. Other writers have advocated particular methods for becoming a more creative thinker. De Bono (1967), in describing a method he calls "lateral thinking,‘ proposes that to break out of rigid or routinized thinking it is helpful to transfer the elements of a problem or situation to an analogy. In an analogy, unspecified assumptions or limits unconsciously accepted rarely apply. This increased freedom of thought, along with the concrete images present in analogies, leads to new ideas and the potential for new perspectives. His proposed method is designed to help individuals combine information in novel ways, challenging unquestioned assumptions to arrive at new ideas. From yet another perspective, Wertheimer (1945) in his exploration of creative thought, traces what he considers to be the basic types of thinking. Traditional logic originally focused on the determination of the truth of falsity of propositions and assertions. A formal set of rules guided the determination of this accuracy. The emphasis had been on developing inferences 25 deduced from general propositions. Gradually, however, inductive logic evolved placing empahsis on the methodical gathering of facts, observation of the connections between facts and the reactions to changes imposed. This later method is now most generally practiced in scientific research. However, Wertheimer does not believe these can explain creative thought. Nor can associative thinking account for it. Associative thinking relies on the connections formed between ideas; new ideas would be formed largely by a trial and error method whereby associations become linked as a train of ideas is generated. For Wertheimer, creative thinking or productive thinking as he terms it, is based on seeing relations and seeking the whole in the structure of a problem. The search for complete— ness or a gestalt may encompass some of the methodology of logic, but the creative urge underlying it is the striving for wholeness. Metaphors as Creative The view of metaphors as an element of creativity is indicated by diverse sources. In an oft-quoted statement, Aristotle speaks of metaphor as ”the token ofgfindim¥'(Aristotle, 1932, p. 91). For him, metaphor is above the commonplace since it involves the ability to see relationships between things. In contrast to Gordon's ideas, Aristotle believed the use of metaphoric language could not be taught. Bruner (1962), in speaking of creativity, stresses the element of surprise often involved; metaphors do this through language, unveiling new relationships previously unsuspected. For example, in the statement, 26 "He rolled out so many red carpets for us, I've still got pink lint in my trousers," a touch of humor is combined with a vivid image with which most of us can identify. Rolling out the red carpet has become a cliche, the surprise is added by a new twist. This is not necessarily a spontaneous process; in fact, the best metaphors may be rethought and modified just as any other creative product. In discussing various definitions of the word imaginative, Richards (1925) discusses one aspect of this as applying to persons using figurative language. Figurative language depends heavily on the use of metaphors which combine the concreteness of physical objects with the abstractness of attitudes and psychological states. Metaphors can be an aspect of the creative process in exploring ideas, or a finished product as found in poetry. Rarely, however, will a single metaphor stand by itself except as a device for exploring similarities and contrasts, or as a thought—provoking statement. In Shibles (1971), for instance, five of the first few pages of the book are devoted to quotes about metaphors from famous personages: ”Metaphor was the beginning of wisdom, the earliest scientific method.” C. Day Lewis "To know is merely to work with one's favorite metahpors.” Nietzsche "The whole of nature is a metaphor of the human mind." Emerson Each one of these statements is itself a metaphor, but more importantly they all affirm the element of creativity involved in metaphors. 27 Creativity in Psychotherapy Little theorizing or research has been done on creativity within psychotherapy, and most of what has been done has a general humanistic focus. In this section, the main theorists will be reviewed. Among the humanists, Maslow was one of the first to Show an interest in this area. Maslow (1968) speaks of the importance of self-actualization and of the benefit therapy provides by facilitating this inherent drive. The self—actualized person is described as having such traits as spontaneity, independence, open- ness to experience, and the ability to accept disorder and ambiguity. These are traits similar to ones documented in personality studies of highly creative subjects (Barron, 1962, 1963b; MacKinnon, 1961; Dellas, 1970; Schachtel, 1971). Another trait is the integration of dichotomous behaviors. An example of this is the presence of both childlike and adult behaviors in the self-actualized person. Maslow cites no specifics for psychotherapy in achieving these goals, however, Rogers (1959, 1970) speaks of creativity in relationships and self—growth. He, too, stresses creativity as a form of self—actualization although he differentiates it from artistic creativity. However, he believes the creative process is the same whether the construction is a change in human relation— ships or a painting. For him, self-actualization involves many of the same traits Maslow cites, but he also stresses the ability to maintain an internal locus of evaluation and to toy with unconventional ideas. By experiencing the environment of 28 psychological freedom in therapy through the therapist's unconditional positive regard and empathetic understanding, the individual hastfimzfreedom to discover this creativity within him/ herself. Fromm (1959) speaks of similar attributes but considers this type of creativity as a creative attitude versus the creative ability demonstrated by the artist. Van Kaam (1962), who shares some ideas with Rogers, is concerned with the need for creativity in therapists. Instead of rigidly applying theoretical principles, a creative therapist must demonstrate a flexibility in attitude, feeling and behavior that communicates acceptance of a client apart from any differences in personal values that may exist. This is accomplished through the therapist's acceptance of the client statements and by gentleness and sincerity in response. Other writers emphasize the achievement of wholeness, which is related, if not directly equivalent, to self—actualization. Peavy (1974) notes that creative helping uses various techniques (therapy, personal growth, etc.) to regenerate creativity through strengthening the attributes already mentioned by Rogers (openness, internal locus of control, playfulness). Moustakas (1957) subscribes to the concept of creativity as the expression of the whole person, but he stresses the inability to teach such creativity. This is implied in the concept of self—actualization as the development of inherent abilities. This creativity can be enhanced, but not taught per se. Despite these good intentions, however, Moustakas notes that a great deal of psychotherapy leads the individual to 29 fit the societal norm, rather than developing individual creativity; the theoretical concepts are not always applied in the actual process of therapy. Weigert (1964), while advocating the importance of working within the client's world of values, also notes that not all therapists nor all clients will be creative, i.e., they will not always have the strength to withstand a great deal of anxiety. Rather than solving problems, creative therapy will reconstruct the individual's view and values in the explorative process. R. Gordon (1973) elaborates on the need for tolerance of anxiety. In creative therapy, the old ways of thinking, behaving, and valuing may be challenged with new insights. The client and therapist risk a period of ambiguity created by forsaking the old ways of thinking before the new ways are discovered or understood. In creative therapy, the capacity for wonder, leading to an exploration of the unknown, a trust in the process, and the ability to survive without knowing what lies ahead is essential. Frey (1975) elaborates further on what differentiates creative and noncreative psychotherapy. He asserts that too often the training of therapists stresses knowing the "right" answers rather than developing the answers through the process. Creative therapists and creative individuals must risk failure in generating ideas and attempting their application. In therapy, as in life, this process involves seeking alternate ways of viewing the world, allowing innovation in thinking as well as in behavior. Frey 30 maintains that openness to the primary process, the metaphorical aspects of thought, is a crucial aspect in achieving a creative strategy. But, along with this openness, the creative therapist must understand his/her own values, and when attempting to solve a problem, fully commit him/herself to both the time and energy necessary for its solution. Thus creative therapy must combine the ability for taking risks with an ability for integrating new insights with this self—knowledge and commitment. Psychotherapy goals expressed by these theorists tend to represent attributes found in creative individuals. These include working towards greater openness, integrating insights, increasing the range of the individual's control and gaining greater satisfac— tion and fulfillment (Mooney, 1962). Accepting the clients at face value, and interacting with them, will not only provide an atmosphere for creativity for the client, as Rogers mentioned, but for the therapist as well (Barron, 1963a). Rogers also noted an ability to play with ideas; Alexander (1964) and Patrick (1955) attribute this ability, along with humor, curiosity, and openness as part of the playing with ideas common to creative individuals. One of the difficulties with these theorists is the abstract terms with which they discuss the issue of creativity within psychotherapy. Rogers' terms of genuineness and congruence, for instance, are too broad to define clearly. With this limita- tion on operationalism, the task of facilitating these qualities in prospective therapists and assessing their impact is indeed difficult. 31 Metaphors and Psychotherapy In Chapter I several writers' acknowledgment of the potential value of using metaphors in therapy was discussed. Arieti and Shibles focused primarily on the clients' use of metaphors while Hammer and Kelly used metaphors as a form of intervention by the therapist. These two different uses of metaphoric language are found in the thinking of other practitioners as well. Rohovit (1960) and Perry (1973) both learned to listen to the client's own language. For Rohovit, the client's use of metaphoric language is a key to the client's unconscious. In studying the recurring metaphors used by clients, he found the process comparable to the use of dream interpretation. Perry focused on the psychotics' use of images to uncover their emotions and struggles. He uses drawings and other forms of art therapy to help the client connect these images and extend their expression. Aleksandrowicz (1962) and Cain and Maupin (1961) use metaphoric language as a Specific technique to communicate with their schizophrenic and borderline clients. The client's own metaphoric language is used as the means of communication. Aleksandrowicz notes the positive benefits of this technique: it conveys the therpist's understanding, while accepting the client's need for the protection of indirectness. Such ”inter— pretation within the metaphor" means interpretations build on the client's images and metaphors deemphasizing direct confrontation. Communication at the metaphoric level, while safer for the client, 32 can also allow expression of emotions. Aleksandrowicz, in his work with schizophrenics, has also uncovered some of the problems involved with the technique: (1) the metaphor may be misunderstood by the therapist, (2) too much time and attention may be given to deciphering the metaphor rather than its function, and (3) the therapist may use the metaphor more than is necessary. Cain and Maupin work with borderline children, and have also acknowledged some drawbacks with the technique. They agreed that the therapist may tend to overuse metaphors, not so much within the hour, but over time. Interestingly enough, they attributed the overuse to the fondness that therapists develop for this technique: it expresses the therapist's creative, intuitive abilities. Additionally, they noted that the children sometimes used this metaphoric communication as a way to maintain distance, and would not revert to direct communication. Also, the disguised interpretations implied in metaphors, while intended to be less threatening, sometimes aroused distrust in the child. The authors recommended its use only after some trust had already been established. In a related area, Bandler and Grinder (1975a), writing of the techniques of Milton Erickson, traced his careful use of language which incorporates the client's images and analogies. Erickson used stories and analogies that are predominantly meta- phorical. In fact, Erickson believed the predominant sensory mode of a client could be learned by careful attention to the 33 language. He then used this knowledge in his work with the client. In the following phrases Erickson communicated through visual and tactile metaphors: "lost in a sea of color” "endless vista of color that is soft and gentle and yielding” (Bandler, 1975, p. 75) The focus here, as in Aleksandrowicz and Cain, is in the studied use of metaphoric language and analogy to enhance communication and understanding. In the Structure of Magic, Bandler and Grinder (1975b) specifically delineate a model for the use of language in therapy. They differentiate between the surface and deep structure involved in verbal communication. Based on transformational grammar, the surface structure is defined as the words of the communication as it is presented. The deep structure represents the full model of relationships and meanings underlying it. Those seeking therapy often perceive the world and their role within it in a deficient way. These persons may overgeneralize to the point of making rules that limit their choices. For example, they may generalize that it is wrong to express emotions in any situation, not differentiat— ing appropriate and inappropriate situations. Other individuals limit their model of the world by deleting information (not processing it) or selecting only some portions of the information. Altering facts to fit one's own view or model is distortion, another limiting method. By attending to both the surface and 34 deep structure of a client's language, the therapist can determine his/her model of the world as well as methods used to limit it. The therapist's task is to broaden this model allowing the client to select more appropriate alternatives. This can be done through analogy, psychodrama and other methods; Bandler and Grinder do it through language. Watzlawick (1978) shares similar interests in the use of language, particularly metaphoric language, with the previous authors. Citing recent brain research he attributes figurative language (imagery, metaphor, and symbolism) to right hemisphere ability. The client's view of the world (the world image of Bandler and Grinder) is largely a product of this right hemisphere functioning rather than of the logical, objective abilities attributed to the left hemisphere. In order for change to occur in therapy, Watzlawick belives communication must be established with the right hemisphere. Metaphoric language, stories, and other techniques can be used to circumvent the logical thinking processes and establish this communication with the right hemi- Sphere through imagery. Whiting (1976), a writer in the field of communications, notes that basic research in symbolization has discovered just this: that for people to understand and change their thinking, ideas need to be presented through striking images, analogies, and metaphors. 35 Creativity in Science: Metaphoric Language Some preliminary discussion of this issue was presented in Chapter I, through several writers who stress the importance of metaphoric thinking in scientific insight and discovery. But the topic is more pervasive than one might first suspect. Nash (1963), for instance, has specifically traced the impact of metaphors in psychological theories. Examples of some of the more prevalent metaphors are: the split personality and the persona. At their inception, these metaphors helped communicate an idea in a vivid manner. Developing the metaphors into a theory involves taking this comparison and building a model or analogy based on the similarities and dissimilarities. For example, the metaphor of the heart as a pump evolved into a systematic application of this idea into a theory of circulation. Freud used many different metaphors in his writing; in one, he compares the hysteric's need for punishment and conflicting wish for gratification to frontier posts staffed from both sides (Pederson-Krag, 1956). However, a problem with metaphoric language is the potential confusion generated by differing interpretations; this is a part of the difficulty in Freudian writings. This weakness is countered by the strength metaphors give in expressing emotion and communicating abstract ideas. Nash maintains that confusing theories can be clarified by resolving the inconsistencies in figurative language. He contrasts the problems of Freud's use of many different, unrelated metaphors to McDougall's whose ideas center on a single 36 metaphor. Mehrabian (1968) has applied this idea of tracing the metaphors in theories by specifically writing an analysis of different personality theories using the predominant metaphors as the basis for understanding them. This sometimes involves determining implied metaphors as well as the explicit metaphors used by the theorist. Relating the use of metaphoric language to science in general, Schlanger (1969) cites the innovativeness involved in metaphoric comparisons. Using terminology or methods from another field links the metaphor with models and systems already delineated and provides new associations. For example, early conceptual thinking on gravitation compared the force of gravity to magnetic attraction. This comparison, in turn, suggested further ideas for testing and the refining of theoretical ideas that led to the current theories of gravitation. This capacity for forming analogies and noting similarities and dissimilarities is the basis for creative thinking in science according to Yukawa (1973), himself a prominent scientist. However, Schlanger cites a drawback with this analogical thinking, particularly when the metaphors are used to communicate ideas to laypersons. In communicating with laypersons, the comparisons may be based on concepts only partially understood by the layperson, giving him/her a false sense of understanding. Then, this faulty understanding may be inappropriately extended with serious political or sociological ramifications. In the sciences, the continuing rigorous exploration and testing of ideas limits this danger of false understanding. 37 Creativity in Science: Hypothesis Generation From consideration of metaphoric language as a creative behavior, we now turn to discussing the role of hypothesis genera- tion in the creative process. The scientific method is based on the generation and testing of hypotheses. Hypotheses guide what facts and observations are focused upon. By providing a framework or pattern, hypotheses suggest the relationships or connections between the behaviors under consideration. Using knowledge of past and present behavior in combination with imagined relations, often suggested by analogy, the scientist tries to discover the basic principles involved (Larrabee, 1945). Bruner (1961) talks of using the hypothetical mode of discovery. By searching for the regularity and relatedness in things, this information is organized into a pattern. Seeing the contrasts and learning to discriminate both the negative and positive aspects of these are another important aspect of this hypothetical mode (Bruner, 1966). Larrabee speaks of the hypothesis as a whole-under—construC* tion. This idea is corroborated by Torrance (1962) and Stein (1967). Torrance attributes creative thinking to both the ability and desire to seek out new relationships in formulating patterns. Stein maintains that creative persons are sensitive to imbalance and while tolerating ambiguity, also strive to generate solutions that may reconcile this imbalance. For the scientist, this reconciliation is an intellectual pursuit; for the artist, an emotional one. While there are phases in the process that seem to have little direction, 38 and are therefore consistent with many proposed hypotheses, persistence will lead to elimination, modification, or perhaps, a solution. As can be seen by the ideas cited above, the use of metaphoric language and the generation of hypotheses are often linked in creative thinking. They build one on the other, as ideas are stretched by metaphors and trimmed to fit the patterns of hypotheses. For example, a metaphor may generate yet another metaphor or provide a central idea for a hypothesis. A hypothesis can, in turn, suggest yet another hypothesis or metaphor. The process of discovery and exploration intertwines both of these processes into an intricate network of new ideas and insights. Summary Creativity research is still in its infancy, with many problems in both the theoretical and experimental areas. Yet, clarity can be achieved only by continued searching and exploration. Theorists have tried to account for the creative thinking process in general models of thinking behavior, and through delineating the stages of the intellectual thought in the production of creative products. These attempts have usually ignored the emotional level, because of the difficulty in accounting for these behaviors or attitudes. Narrowing the topic to creativity within psychotherapy or to metaphoric language and hypotheses as creative products does not really simplify the problem. At a theoretical level there seems 39 to be agreement between what different therapists term as creative attributes and what researchers describe as traits of creative persons. But determining how to implement these ideas or to research them is still a difficult task. Just as there is a concurrence at the theoretical level of attributes in creative individuals, there does seem to be a great deal of support for metaphoric language and hypothesis generation as creative behaviors. How metaphoric language and hypotheses are used creatively differs, but this problem typifies the central problem of creativity research, its definition. By definition, a creative product of behavior is unlike most things surrounding it in space or time. Its uniqueness is an assumed part of the definition. Therefore, the theorist and researcher are forced to seek out the commonalities in attributes or processes that are admittedly general and, sometimes, frustratingly nonspecific. This is the major task underlying all creativity research. CHAPTER III DESIGN OF THE STUDY Introduction This chapter describes the design of the research study. The sample population, treatment program, methods of data collec- tion and method of analysis will be specified. The hypotheses will be restated in research form, indicating the criteria for analysis. Sample The sample for this study consisted of 15 volunteers in the disciplines of psychiatric nursing, counseling psychology, clinical psychology, and social work, all attending Michigan State University. Within this sample three different educational levels were repre— sented: baccalaureate, masters, and doctoral. The educational level is utilized as an independent blocking variable in the design to account for potential differences on this dimension. Partici- pants at the Ph.D. level included four subjects in a counseling psychology program and two subjects in a clinical psychology pro— gram. Five subjects at the masters level were in a social work program. The remaining four subjects were members of a psychiatric nursing class and in the final term of a baccalaureate nursing program. 40 41 The subjects were volunteers who responded to a general request for research subjects made during class sessions. The experimenter introduced the study as concerned with client concep— tualization, a purposely vague term chosen in order to avoid stating the study's exact focus. The subjects were advised that their involvement would extend over a five-week period and entail some written work. Out of 100 potential subjects from classes in social work, psychology, and psychiatric nursing, 20 volunteered. Five of the volunteers dropped out of the study, two doing so shortly after the pretesting. The primary reason cited for dropping out of the study was the time commitment involved. Four of the five dropouts had been assigned to the experimental group so reassignments were made on a random basis to the control and experimental groups. This was accomplished within the educational level affected. As required by the study, all subjects were seeing clients on a weekly basis. Treatment Procedures Subjects were scheduled for pretesting at a time of their convenience. Prior to the pretesting subjects read and signed the release form (see Appendix A). Their assignment to control and experimental groups was determined by a randomized draw. Each subject's draw was within their educational level. A second draw was made to randomly assign the four case studies used in the study. There was a possibility of six different pre—post combi- nations of two case studies. This selection was done to ensure 42 randomization of errors due to the potential differences in dif- ficulty of the case studies. Three of Guilford's divergent thinking tests were adminis— tered first, according to the standard directions for the tests. The order of the tests was the same for each subject: Associational Fluency, Alternate Uses, and Consequences. Following the divergent thinking tests the subject was given two case studies (see Appendix B) along with written instructions and questions to be answered and turned in to the experimenter (see Appendix C). Subjects were allowed to take the studies home and turn in their answers later. When all pretesting was finished, each of the control and experimental subjects was given instructions for weekly case notes (see Appendix D). These instructions included specific questions to be answered by all subjects about their clients. Arrangements were made to pick up these answers on a weekly basis. The experimental group was given the case note task, and also a series of training booklets, one each week until five book— lets were completed (see Appendix E). They were to complete one booklet and one week of case notes each time and turn these in. Subjects averaged a week to a week and a half to complete both. The next training booklet was given upon completion of the pre- ceding one. All subjects did the case notes and training booklets on their own, at work or at home. There was no time limit for each section; some attempted to do the work as quickly as possible, 43 others took their time to complete it. The series of five training booklets were as follows: Unit I Similes and Metaphors: Definitions and Identifications Unit 11 Generation of Metaphors and Similes Unit III Metaphors and Similes: Generating Multiple Perspectives Unit IV Hypothesis Generation Unit V Generation of Treatment Ideas Exercises accompanying each training unit required the experimental subjects to apply their learning as they progressed through the program. Several exercises were given to enhance learning by repeated application. The experimenter did not establish any direct relationship between the training booklets and case note writing; they were treated as two separate tasks. Based on conversations with subjects after the research was completed, most experimental subjects assumed the exercises contained in the booklets measured their performance on the training task. It was assumed that con— trol subjects had little knowledge of the treatment tasks since experimental subjects were requested not to discuss their work with their colleagues. Based on conversations with control subjects afterwards, some control subjects were aware of a difference in amount of work being required, but were unaware of the content. Posttesting followed approximately five weeks of case notes for the control group and five weeks of case notes plus training booklets for the experimental group. The posttesting procedure followed the same format as the pretesting except that no divergent 44 thinking tests were administered. The remaining two case studies were given with the same directions and questions. Debriefing con— sisted of informing the subjects of the purpose of the study: specifically to see if there was a difference between the two groups on the generation of metaphoric language, hypotheses, and treatment plans in the case notes and case studies. Some control subjects indicated at this time that they had been unsure whether or not they were in the control group. However, experimental subjects indicated that they were quite sure that they were just that. Instrumentation The case studies were chosen on one basic quality: the ability of the written description to give a sense of involvement. The determination of this as the most crucial attribute was made by the experimenter and was based on the substitution of case studies for actual therapy interactions. The case studies were chosen from studies available through published written works. Case studies that were in the third person or primarily narrative reports were eliminated. Of the four case studies chosen three were verbatim transcripts of therapy sessions, and one was an account of a session by the therapist. The second criterion used for the case study selection was the type of problem presented; the range was somewhat restricted by the small number of cases meeting the first criterion. The ques- tions (Appendix C) accompanying the case studies in the pretesting were formulated from questions developed by Strupp (1960) in a 45 task requiring psychologists to evaluate a client on videotape. The questions were chosen with the three research criteria in mind (metaphoric language, hypotheses, and treatment plans). The purpose of these questions was to give subjects ample opportunity to gener- ate any of the three criteria while discussing the case. The three tests of divergent thinking were used in the pre— testing as a covariate measure. Divergent thinking, as defined by Guilford (1959), is a general thinking ability. It is character- ized by the production of diverse solutions/ideas/thoughts in con— trast to convergent thinking where thinking proceeds to a single solution or idea. This ability is not restricted to language, but for the purposes of this study the three tests chosen are all in the semantic category. Since the three criteria of interest in this study are all recorded through written responses, the semantic attribute of these divergent thinking tests was considered most appropriate. As mentioned in Chapter II, the primary traits of divergent thinking are fluency, flexibility and originality. The frequency of different responses is a measure of fluency. In two of the tests chosen, Consequences and Associational Fluency, the tests require the subjects to produce a number of different ideas (Consequences) or words (Associational Fluency) in response to a given stimulus within a timed period. In the Consequences test the subject lists possible consequences to unusual situations such as "what would be the results if none of us needed food anymore in order to live?" (Consequences, Form A-l, question 1). The 46 Associational Fluency tests give stimulus words to which the subject lists as many words similar in meaning as s/he can. The third test, Alternate Uses, measures spontaneous flexibility. According to Guilford, this trait is the ability to change sets in a situation where the changes in sets are unrestricted. Specifically in the test, the subject lists as many different uses as s/he can for a given object, without listing common uses or repeating ones that have already been listed. The Consequences test has a second score for originality but due to the small sample size it was not used in this study. Each of these tests has a scoring manual providing a general guide for the test raters; examples of the most common answers are included. Keats (1965) reports split-half reliabilities in the 70's for the fluency test; reliabilities for the Consequences test were in the 80's (Gleser, 1965). Validity for the divergent thinking tests is based on construct validity determined by extensive factor analytic studies. Basically, these tests are conceived as research instruments. Gleser recommends them as research instruments "in various decisions where flexibility and originality might be important." As covariates in this study, such predisposing factors were considered potentially influential on subject performance. Rater Sample For the purposes of this study, two separate groups of three raters each were chosen. One group was used to rate the three tests of divergent thinking. All three of these raters were 47 females familiar with the general area of guidance and counseling. None had previously been exposed to the Guilford tests or a similar rating task. They all had masters degrees; in student personnel, social work, and adult education respectively. The second group of raters dealt with the written materials required by the study: case studies and case notes. Two of the raters were female, one male. All had extensive training in counsel— ing and therapy at the Ph.D. level. One rater was a full professor in the university counseling center, while the other two were gradu— ate students. The main criteria for their selection was their use of metaphoric language in everyday speech and their general verbal fluency. This language ability was assessed subjectively by the experimenter based on numerous encounters with these individuals. They frequently punctuated their remarks with graphic metaphors and demonstrated a conscious awareness of language usage by playing with words, and discovering new words. This language ability was assumed by the experimenter to be as important an attribute in their selection as was a background in counseling. The familiarity with the subject matter of the case materials, counseling and therapy, as with the research criteria (metaphoric language, etc.) would make the task of rating less difficult and also more reliable. Rater Reliability Rater reliability was calculated by using Hoyt's (1941) ,analysis of variance procedure for estimating homogeneity of the raters separate from consideration of the test concepts and 48 homogeneity of the test as a whole, the latter accounting for both rater and concept differences. These reliabilities were calculated for each of the three tests of divergent thinking, and separately for frequency and quality on each of the three research criteria. The generally high instrument reliabilities (including rater reli— ability) indicate that the measures were adequately reliable for use in the research design. TABLE 3.1 RELIABILITIES FOR DEPENDENT MEASURES h Rater Instrument H Homogeneity Homogeneity fi— Consequences i .99 .99 1 Alternate Uses .98 .99 Associational Fluency .91 .98 Metaphoric Language—Freq. .87 .91 Hypotheses—Freq. .90 .94 Treatment Plans—Freq. .94 .98 Metaphoric Language-Quality .91 .92 Hypotheses—Quality .91 .91 Treatment Plans-Quality .98 .86 49 Rater's Tasks The three tests of divergent thinking used in the study have a short scoring guide with each test. The guide specifies the general criteria for acceptable (score 1 point) and unacceptable (no points) responses. For the Consequences test there is also a scoring given for obvious and remote responses (originality score); the weighting is the same as for the total score (one point for each acceptable response). In this study only the total score was used; two few subjects were obtained to analyze a more complete breakdown. Guilford also provides lists of examples for each of the categories. In addition, the research provided each rater with sample tests from subjects who dropped out of the study so that s/he could prac- tice before undertaking the task. After reading over the directions for each test and completing one or more sample tests, each rater scored the tests for acceptable and unacceptable responses. Total scores in all three tests were the total number of acceptable responses. The second group of raters had two separate tasks to com- plete. The first task was to read through the written case notes and case studies and identify the occurrence of metaphors, Similies, hypotheses, and treatment plans. The second task, undertaken after all raters had completed Task I, was to rate each of the criteria as poor/below average, average/adequate, and good/above average. This was done by marking each occurrence of the criteria using the symbols (—, /, +) for each of the categories. 50 Task I entailed reading all of the written materials turned in by the subjects and, by means of a color coded marker, identify— ing the criteria. These identifications were then typed individu— ally, grouped by the major categories of metaphoric language, hypotheses, and treatment plans and returned for the final rating. The first task established the frequency score of each subject. The mean of the frequency and quality scores across all three raters was used as the final score for these two categories. For the purposes of training, each of the two rating tasks was accompanied by a training manual. The first manual used a large portion of the Unit I materials developed for the experimental group (see Appendix F). This section defined, discussed and provided practice exercises in identifying metaphors, similes, hypotheses, and treatment plans. The second training manual discussed the general purposes of each of the three criteria (metaphoric language, hypotheses, and treatment plans) followed by a discussion of the positive and negative qualities to be found in them (see Appendix G). Exercises in rating quality were also included. Scoring Due to the small sample size the scores for frequency and quality on the research criteria (metaphoric language, hypotheses, and treatment plans) were combined. The case studies measure was given pre and post, while the case note measure was used only as a posttest measure. Even with the combined frequency—quality scores the number of dependent variables was too large for the degrees of 51 freedom. Therefore a second procedure, combining the pre-post test scores on the case studies into a single index of change for each criterion, was performed. The first step, combining the frequency and quality scores, was determined for the case studies by the following matrix: TABLE 3.2 MATRIX FOR COMBINED FREQUENCY-QUALITY SCORES FOR CASE STUDIES QUALITY HIGH MED. LOW I a; T s :1 9 } i g j +2 [ +1 [ —1 [ :L l I 5 f r‘ t ”t j E z 2 3 ~ C +2 . o -7 ‘ H I , _ 852: g l E i 1 i ' i T l ' l -i [ S 1 +1 I —1 —2 ] 5' i l ~... Each score could fall into one of three levels: high, medium, or low. The level was determined by the division of a frequency dis— tribution of all scores (calculated separately for frequency and quality) into the top, middle, and lower third. Each subject was given a two—letter code representing where his/her scores fell in the two distributions, the first letter of the code representing the frequency score. For instance, a subject scoring in the lower 52 third on the frequency of hypotheses, and in the middle third on quality for this same criterion would be assigned the code, LM. Following the matrix given in Table 3.2, the numerical value of this code would be —1. The second step was to combine the pre— and posttest scores into a single index of change for the case study measures. This was accomplished by following the matrix in Table 3.3. The numbers in the grid indicate the values obtained by subtracting the value of the pretest combined score from the posttest score. For instance, if the same subject who obtained 3 LM code on the pretest were to get a MH code on the posttest the index of change would be +3. This number is obtained by subtracting the pretest value of LM (-1) from the posttest value (+2). This matrix was carefully designed to best approximate the experimenter's theoretical conception of posi- tive and negative change. Slightly more weight was given to the quality dimension since a change in quality was assumed to be more important regardless of its frequency. High frequency of a low quality product was not considered constructive. The case note scores were also combined on the frequency and quality dimensions, but since no pretest existed for this measure there was no need for an index of change. The matrix for the case note scores is given in Table 3.4. 53 TABLE 3.3 MATRIX FOR INDEX OF CHANGE SCORES POST 0 4T] . It’loig [0,! LTD.|1I-[.[I|',|.] H. A. 1. 1. A.L 7. n. 1. 1. no + + + + + + + .11] M 2. 7. no 7. 1. 1. 7. n. 1. + + + + _ + . triall. -i: L 1. no 7. 1. 1. A. no 7. Q. + . + . . _ _ 011.1014 till] [.I "H .4 1. 1. 4. 7. n. R. 1. n. + + + + + + + 'u14v.l.ll,lfi011 iv'.|llll M 7. 1. 1. 7. no 7. 1. 1. 9. + + . + _ + a . _ l 1] TI L n. 1. 2. O. 7. A. I. 3. .4 _ . _ . . . _ ) .[ll'lililliTllllII 41.! [ H 3. 7. n. 3. 1. I. 7. O. .1 + + + + _ + _ .TIJ l] lgllllwl ill. [[11]] -n M I. n. 7. 1. I. 1. no 7. Q. + _ + fi._ . . _ Tall]! fi]!]+]l. -[0 l4 -lluli-.- 1..-] a .l -]._ L O. I. Q.# n. 7. .4 .1 .3 ,4 _ _ fi._ _ _ . a . Fl}. [gv‘lliilllg I] . fi][#.lt x}: .Illlrlafidll L 19.! [I O. L M H I 1 L d H F L D L m m m H E H TABLE 3.4 MATRIX FOR COMBINED FREQUENCY-QUALITY CASE NOTES SCORES ON QUALITY LOW MED. HIGH 2 3 AH . _ _ l O l + _ lléuilée 4 3 2 + + + .I.-!-l-mlll;. 2.: : .52 3.... >oze20mea 54 Design over Subjects This study is an experimental design with a control and treatment group each given pre— and posttest measures as shown below: R O X 0 R O 0 Subjects were randomly assigned to the treatment and control groups as indicated by the R. Design over Variables The variable matrix shows a two-way fully crossed randomized block design (see Figure 3.1). The treatment and control groups were randomly assigned from within each of the educational levels: baccalaureate, masters, and doctoral. This blocking controls for the potential differences involved in the training of each at the different educational levels of the sample. The three tests of divergent thinking were included as a potential covariate due to the similarity between the concept of divergent thinking and the tasks required by the training manuals. Both require a number of ideas to be generated to a single problem; for Guilford this is in response to a word or idea, for this study it is in response to conceptualizing client behavior and therapy treatment. The case studies, which involve the subjects' written answers to questions from four separate case studies, are both a pre- and posttest measure. Two of the four studies are taken pre- and posttreatment. The order of the case studies was randomly assigned within each educational level to limit the effects of particular studies being 55 COVARIATE: Divergent CASE CASE Thinking STUDIES NOTES , EDUCATIONAL TREATMENT LEVEL V1 V2 V3 V4 V5 V6 V7 V8 V9 BACCALAUREATE L EXPERIMENTAL ] MASTERS L i [ E j DOCTORATE e————- i V T l ; 3 BACCALAUREATE [ l i i 4 J— , i f l I l l ; CONTROL ; MASTERS : ] l t l 4 . t— l I [ ; DOCTORATE , i ‘ ; ‘ CODE: Vl—V3: Three tests of Divergent Thinking: Consequences, Alternate Uses and Associational Thinking V -V : Index of Change Scores for Metaphoric Language, 4 6 Hypotheses and Treatment Plans V7-V9: Scores for Metaphoric Language, Hypotheses and Treatment Plans. Figure 3.1 RESEARCH DESIGN OVER VARIABLES more difficult. A second posttest measure was the case notes: the subjects' weekly written responses about one of their clients over a five-week period. The written measures are all assessed for the occurrence of the three research criteria: metaphoric language, hypotheses, and treatment plans. 56 Method of Analysis Multivariate analysis of variance (MANOVA)* was calculated to test for the treatment effects on subsequent case material per— formance. The FINN Multivariate Analysis of Variance program was used to test the 3 x 2 design over nine dependent variables. The purpose of this analysis was to determine if experimental subjects had improved their frequency and/or quality of metaphoric language, hypotheses, or treatment plans after the training program as com- pared to a control group. The significance level was set at p < .05 level. In the case of significance on the multivariate tests, univariate analysis was conducted with p < .05. Hypotheses The following hypotheses were developed to test for the treatment effects of the training program. The null hypotheses are stated as the primary hypothesis for the purpose of research. I. HO: There is no significant difference between the treatment and control group in production of metaphoric language as measured by the case materials. H : There is significant difference between the treat— ment and control group in production of metaphoric language as measured by the case materials. II. H : There is no significant difference between the o . . treatment and control group in production of hypotheses as measured by the case materials. Ha: There is significant difference between the treat- ment and control group in production of hypotheses as measured by the case materials. *FINN Program for Univariate and Multivariate Analysis of Variance, Covariance and Regression, Version 4, June 1968. 57 III. H : There is no significant difference between the treatment and control group in production of treatment plans as measured by the case materials. H : There is significant difference between the treat— ment and control group in production of treatment plans as measured by the case materials. IV. H : There is no significant difference in performance on the measures of metaphoric language, hypothesis formation and treatment plans between those scor- ing significantly higher on the pretest measures of divergent thinking and those who do not. H : There is significant difference in performance on the measures of metaphoric language, hypothesis formation and treatment plans between those scor- ing significantly higher on the pretest measures of divergent thinking and those who do not. Summary A sample of 15 students from baccalaureate, masters and doctoral programs volunteered for this study. They were randomly assigned to either the control or treatment group, with the educa- tional level used as a blocking variable. Both treatment and control groups took three tests of divergent thinking and answered questions referring to case studies and wrote weekly case notes on a personal client. The case mate- rials were rated for the frequency and quality of metaphoric lan- guage, hypotheses, and treatment plans. The FINN program of multi— variate analysis of variance was selected to analyze the data with level of significance p < .05. Two sets of raters were used. The first group rated the three tests of divergent thinking, a potential covariate in the study. The second group read all of the written case materials 58 scoring them separately for frequency and quality on the three research criteria. The multivariate analysis of variance with planned compari— sons tested hypotheses considering the differences between the con- trol and experimental group's performance on each of the three criteria (metaphoric language, hypotheses and treatment plans) and the three tests of divergent thinking. CHAPTER IV ANALYSIS OF DATA Design The design for this study (Figure 3.1) was used to test for the effects of training in metaphoric language on an experimental and control group with educational level used as a blocking variable. Six dependent measures were included in the design: performance in metaphoric language, hypothesis formation and treatment plans on two separate measures, case notes and case studies. Three covariate measures were also incorporated into the design, based on the theo— retical similarity between divergent thinking and the purpose of the treatment. Multivariate analysis of variance* with planned comparisons was used to test for significance of the dependent and covariate measures. Probability of significance was set at p < .05 for the planned comparisons within the multivariate program. The multi- variate tests considered two planned comparisons (Table 4.1). The interaction effect was not found to be significant. Therefore, the planned comparisons of educational level and treat- ment effect were considered. Educational level was used as a 7"‘FINN Program for Univariate and Multivariate Analysis of Variance, Covariance and Regression, Version 4, June 1968. 59 60 TABLE 4.1 MULTIVARIATE PLANNED COMPARISONS CONTRASTING TREATMENT GROUP AND EDUCATIONAL LEVEL Source df F ratio p < S/NS Treatment 6 1.83 .51 NS Ed. Level 12 .45 .85 NS Interaction 12 1.19 .55 NS CODE: Treatment = Experimental and Control Groups Ed. Level Doctoral, Masters, and Baccalaurate NS = Not Significant blocking variable to control for the potential differences on this variable. No significant difference was found between the subjects on this variable. The planned comparison between treatment groups was the crucial test for this study. With a p = .51 the null hypothesis of no significant difference between the treatment and control groups was not rejected. Since the null hypothesis failed to be rejected, no post hoc analysis was conducted. Hypothesis Tests The first three hypotheses were formulated to test differ- ences between the treatment and control groups on the three research criteria (metaphoric language, hypothesis formation, and treatment plans). The three hypotheses will be reviewed in numerical order: 61 I. H : There is no significant difference between the treatment and control group in production of metaphoric language as measured by the case materials. H : There is significant difference between the treat— ment and control groups in production of metaphoric language as measured by the case materials. HO I contrasted the difference in performance of the experimental and control groups on metaphoric language. Since the multivariate planned comparison between experimental and control group was found to be nonsignificant, the null hypothesis may not be rejected. II. H : There is no significant difference between the treatment and control group in production of hypotheses as measured by the case materials. H : There is significant difference between the treat- ment and control group in production of hypotheses as measured by the case materials. Hypothesis II was designed to test for difference between the treat- ment groups on the performance of hypothesis formation. Again, since the null hypothesis of no significant difference between treatment groups on the multivariate planned comparison failed to be rejected, the null hypothesis may not be rejected here as well. III. HO: There is no significant difference between the treatment and control group in production of treatment plans as measured by the case materials. H : There is significant difference between the treat— ment and control group in production of treatment plans as measured by the case materials. The null hypothesis for III was designed to contrast the difference between experimental and control groups on the mean index scores for treatment plans. The null hypothesis of no significant 62 difference cannot be rejected, since the multivariate planned com- parison of treatment groups was found to be nonsignificant. Covariate Hypothesis IV was formulated to test for differences between individuals' mean scores on the three measures of divergent thinking and their resultant performance on the three research criteria. IV. HO: There is no significant difference in performance on the measures of metaphoric language, hypothesis formation and treatment plans between those scor— ing significantly higher on the pretest measures of divergent thinking and those who do not. H : There is significant difference in performance on the meaures of metaphoric language, hypothesis formation and treatment plans between those scor— ing significantly higher on the pretest measures of divergent thinking and those who do not. Table 4.2 shows the regression analysis on the three covariates. None of the three tests of divergent thinking were found to be significant predictors of the task performance of the subjects. Therefore, the null hypothesis of no significant difference failed to be rejected and no further analysis was conducted using the covariate mean scores. Summary Hypotheses were tested to calculate the effects of treat— ment in metaphoric language on the experimental and control groups. Three performance tasks were assessed by two different measures, case studies and case notes. The three performance criteria were: metaphoric language, hypothesis formation, and treatment plans. Multivariate analysis of variance was calculated to determine the 63 TABLE 4.2 REGRESSION ON THREE COVARIATES # of Covariates df F Ratio p< S/NS 3 6, l 5.13 .33 NS 2 6, 2 3.65 .23 NS 1 6, 3 .36 .87 NS CODE: df = Degrees of Freedom NS = Not Significant difference in performance between the experimental and control groups. The probability of significance was set at p < .05. No significant differences were found between the experimental and control. Therefore, the null hypotheses of no significant differ— ence between the experimental and control groups on each of the performance criteria failed to be rejected. The conclusion for this study is that the treatment program resulted in no significant difference in performance for the two groups. In Chapter V these statistical findings will be discussed. The study will be summarized, and the limitations will be noted with suggestions for further research. CHAPTER V SUMMARY, CONCLUSIONS AND DISCUSSION In this chapter, the study is summarized and the conclusions presented. Limitatons in methodology and generalizability are presented, relating them to the implications for future research. Summary The purpose of this study was to measure the effects of training program in metaphoric language on therapists' ability to produce metaphors, similes, hypotheses, and treatment plans. Fifteen volunteers were recruited to participate in the study. Their educational levels (baccalaureate, masters, and doctoral) were used as blocking variables. Within each educational level they were assigned to a treatment or control group. The treatment group received a series of five training booklets developing an approach to conceptualizing ideas by the development of metaphoric language. The control group received no training, but turned in weekly case notes for a five-week period on an actual client they were seeing, as did the treatment group. Both groups were pretested on three tests of divergent thinking and responded to questions about four case studies, two were presented pretest and two posttest. The written responses collected on these case studies, and the case notes previously 64 65 mentioned, were rated by three trained raters on frequency and quality of metaphoric language, hypothesis formation, and treatment plans. The three tests of divergent thinking were also rated by three raters following the standard procedures developed for those tests. Rater reliability (see Table 3.1) was determined by an ANOVA program using homogeneity of the raters and homogeneity of the instrument. The scores for frequency were the mean scores across the three raters for number of metaphors and similes, hypotheses, and treatment plans. The scores for quality were based on a three—level rating system of below average, average, and above average. Due to the small sample size these scores were combined into a frequency-quality combined index for case studies and case notes. A multivariate analysis of variance with planned comparisons was used to test the significance of the treatment effects with p < .05. In case of significance, further analysis would have been conducted using univariate analysis with p < .05. Conclusions This study was designed to test for treatment effects between the experimental and control groups. Educational level, used in the design as a blocking variable, was found to have no significant difference at the p < .05 level. Consequently, separate hypotheses for significant difference between the experimental and control groups on the production of metaphoric 66 language, hypotheses, and treatment plans had to be rejected without separate analysis in accordance with the conditions of the design. Three tests of divergent thinking, included in the design as potential covariates were found to be nonsignificant at the p < .05 level. Based on this finding, they were eliminated from further analysis in the study. Discussion No significant difference was found between the experimental and control groups in this study. Neither group showed appreciable increases in their ratings on the three research criteria (metaphoric language, hypotheses, and treatment plans). The purpose of the study was specifically to test for treatment effects of the training pro- gram in metaphoric language. The group means showed no consistent differences. In some instances an individual subject showed improve— ment in one or more areas, but there was no consistency in perform— ance generally. Improvements by one experimental subject were counteracted by declining performance by another (see Appendix H). It was hypothesized that the training program would increase the experimental subject's score on the frequency and quality of the metaphoric language, hypotheses, and treatment plans they generated in the written materials. Based on this study, no such conclusions can be made. A number of reasons will be explored as to what might have been some methodological factors resulting in a finding of no significance, apart from failure of the training program. 67 Limitations One of the most serious drawbacks to this study is the small sample size; this was reflected in several ways. The small number of subjects necessitates a larger difference in scores in the planned comparisons to detect statistical differences. Possibly some differences may exist in reality, but the power of the statis- tical test is unable to detect this difference with such a small number of cases. The sample would have had to be many times larger for any differences (see Appendix H) to have been statistically significant. The initial loss of five subjects, seemingly crucial for such a small sample, would not have been a large enough number to account fortflmalack of significance. Furthermore, the difference in levels attained may have had limited practical significance, even if it had been statistically significant. For instance, in the few examples of positive change apparent in Appendix H, the change tends to be slight, and therefore probably of limited practical importance, even if it had been statistically significant. Another problem inherent in the small sample size was the manipulation of the scores. In order to limit the number of dependent variables, frequency and quality scores were combined into a single index score. For the case studies these scores were condensed further into an index of change, combining the pre-post scores. Every time raw data is condensed some information is lost, and in this case, possibly potential differences. 68 If statistical significance had been achieved, this study would have also been limited by the representativeness of the sample. The subjects were volunteers who continued participation over a period of seven weeks. This perserverance at a task is a probable distinction between the subjects who completed the study, and the subjects who dropped out. It may also be a differentiation between the subjects who completed the study and the population of therapists in general. However, had significance been achieved it would suggest the possibility of expanding therapist training to include the elements of metaphoric language in teaching the use of hypotheses and treatment plans in therapy. The measures used to assess the change in behavior may be severely limited. The case studies were a substitution for real clients. This required the subjects to respond in writing to a written case study. This may well be different, at least for some therapists, than dealing verbally with a real client. In fact, subjects' comments given in conversations following the research noted that the unfamiliarity of the case study format and the distractions of verbatim comments by an unknown therapist, made the task somewhat difficult. The case notes were perhaps a more accurate measure in terms of the subjects' writing about one of their clients. The sample correlation matrix (see Appendix I) shows that there are, in fact, low correlations between the case studies and case notes within the three research criteria (metaphoric language, hypotheses, and treatement plans) suggesting that theycihinot measure quite the same ability. 69 The question of applicability of the measures is an important one for the purpose of the training program. Therapy is a highly verbal interaction, but both the training program and the research measures were written, and non—interactive. It would seem logical, nonetheless, that increasing sensitivity to verbal factors would be beneficial. Unfortunately, there is no evidence, with regard to this study, to support the hypothesis. Another concern related to the measures used in this study is the lack of any direct testing of the treatment program. The case notes and case studies were designed to measure the application of subjects' learning in a therapy-related situation. However, the ability to produce metaphors, similes, hypotheses, and treatment plans was not tested directly. It is conceivable that some subjects did improve on their production of these elements in either frequency and/or quality, but failed to transfer this learning to the case studies or case notes. Therefore in any further research it would be valuable to access the skill level directly, as well as measuring the subjects' ability to transfer any learning to the desired situation. The complexity of the tasks involved in this study might be considered another limitation. Considering the difficulty of the language skills involved, the five to six weeks of the treat- ment program may have been too brief. Comments from experimental subjects following the completion of the program indicated that the difficulty of the work was a factor in their attitude at the 70 end. For some, the tasks in the training manuals were difficult, and by the time they approached the posttesting their primary interest was to write quickly and finish the task. This contrasts with the pretesting attitudes of curiousity and interest predominant in all subjects. The correction of this problem is more difficult. Lengthening such a program requires even greater commitment from subjects. The difficulty in obtaining subjects for this study was related to the time demands involved. Therefore a lengthening of the training program would probably have to include rewards for participation. Reducing the complexity of the tasks would be another possible change that could be implemented. This would have to be done by restricting the scope of the study; perhaps limiting it to evaluating the abilities involved in producing metaphoric language, hypotheses, and treatment plans. If a successful program at developing these abilities was devised, further research could attempt to assess the transferability of this learning to therapy situations. A serious limitation of this study, shared with many in the field of creativity, is the isolation of the study. This study does not tie directly into any other body of research. The training program and its measures, though based on theoretical ideas of other variables, is totally unique. 71 Implications for Further Study Despite the failure to find significant results in this study, the ideas presented are not necessarily without value. There is a theoretical base for using metaphoric language in developing hypotheses and generating multiple perspectives exploring problems. As noted in the review of the literature, this is a recognized activity by some scientists. Just recently, with the work of Bandler and Grinder (1975), there has been a growth in the conscious use and study of client metaphors in psychotherapy. Though the approach by the latter authors differs in focusing on metaphoric language as a communication tool in itself, the linkage of this with the idea of generating hypotheses and treatment plans may be just a further step. The need is to develop better teaching methods for these skills as well as ways of assessing change. Most of the authors who use metaphoric language in therapy apparently develop it without systematic procedures. They clearly recognize its personal and clinical value and seek to enhance it. The growing interest in developing metaphoric language as a tool in therapy indicates that the idea has face validity. However, the need may first be to design a program that integrates the theoretical ideas into a systematic teaching program. In this study, several subjects in the experimental group in post—research conversations reported frustration that the training program was both written and individualistic. Several of these 72 persons indicated that they would have liked to see the ideas implemented in a group setting with actual cases. They suggested that this procedure would have given more applicability to the production of metaphoric language, hypotheses, and treatment plans, and provided greater stimulation for further development. Many questions remain to be answered by further research. Is there value in a technique to develop metaphoric language ability in therapists? How might this best be taught? Can meta— phoric language be an important factor upon which to build hypotheti- cal thinking or are these distinctly separate abilities? The primary value of this research study may be in the uniting of diverse ideas in an attempt to develop a training program. The program itself attempts to implement these ideas. Whether such a training program can be successful is undetermined here for methodological limitations in the program may account for the lack of significant change. A revision of the training program account— ing for the limitations in written format is perhaps a prerequisite to further study. The ideas are scattered throughout the literature, the time may well be here to try to integrate them and implement them for several fields, psychotherapy included. In addition, a training program incorporating a longer and more intensive period of study would also require subjects whose time and motivation would be adequate to the tasks required. This study has certainly not provided definitive results, but it has indicated that rater and instrument reliability adequate 73 for the problem can be achieved. It has also indicated that issues related to the length and type of training will have to be expanded to adequately research the original hypotheses. BIBLIOGRAPHY 74 BIBLIOGRAPHY Arbib, M. A. The Metaphorical Brain. New York: Wiley-Interscience, 1972. Aleksandrowicz, D. R. The meaning of metaphor. Menninger Clinic Bulletin, 1962, 26, 92-101. Alexander, F. Neurosis and creativity. American Journal of Psycho- analysis, 1964, 23(1), 115-130. Arieti, S. Creativity: The Magic Synthesis. New York: Basic Books, Inc., 1976. Aristotle. The Poetics. New York: G. P. Putnam Sons, 1932. Bandler, R., & Grinder, J. Patterns of the Hypnotic Techniques of Milton H. Erickson. Cupertino, Calif.: Meta Publications, 1975. The Structure of Magic. Palo Alto, Calif.: Science and Behavior Books, Inc., 1975. Barron, F. Creativity and Psychological Health: Origins of Personality and Creative Freedom. Princeton, N.J.: Van Nostrand, 1963. The disposition toward originality. In C. W. Taylor (Ed.), Scientific Creativity: Its Recognition and Develop— ment. New York: John Wiley & Sons, 1963, 139-152. The needs for order and for disorder as motives in creative activity. In C. W. Taylor (Ed.), Scientific Creativity: Its Recggnition and Development. New York: John Wiley & Sons, 1962, 153—160. Black, M. Models and Metaphors Studies in Language and Philosophy. Ithaca, N.Y.: Cornell University Press, 1962. Brooke-Rose, C. A Grammar of Metaphor. London: Secker & Warburg, 1958. Bruner, J. S. The art of discovery. Harvard Educational Review, 1961,.3, 21—32. 76 The conditions of creativity. In H. E. Gruber, G. Terrell, & M. Wertheimar (Eds.), Contemporary Approaches to Creative Thinking. New York: Atherton Press, 1962, 1-30. Some elements of discovery. In L. S. Shulman and E. R. Keislar (Eds.), Learning by Discovery. Chicago: Rand McNally & Co., 1966, 101-113. Bunge, M. Intuition and Science. Englewood Cliffs, N.J.: Prentice—Hall, Inc., 1962. Cain, A. C., & Maupin, B. M. Interpretation within the metaphor. Menninger Clinic Bulletin, 1961, 25, 307-311. de Bono, E. The Use of Lateral Thinking. London: Jonathan Cape, 1967. Dellas, M., & Gaier, E. L. Identification of creativity: the individual. Psychological Bulletin, 1970, 23(1), 55-73. Dollard, J., Auld, F. Jr., & White, A. M. Steps in Psychotherapy. New York: The Macmillan Co., 1953, 128-143. Doppelt, J. E. What is creativity? Transactions New York Academy of Sciences, 1964, 29(7), 788-793. Forrest, D. V. Poiesis and the language of schizophrenia. In H. J. Vetter, Language Behavior in Schizophrenia. Springfield, 111.: Charles C. Thomas, Pub., 1968, 153-181. Frey, D. H. The anatomy of an idea: creativity in counseling. Personnel and Guidance Journal, 1975, 54, 23-27. Fromm, E. The creative attitude. In H. H. Anderson (Ed.), Creativity and Its Cultivation. New York: Harper & Row, 1959, 44-54. Gagne, R. M., & Briggs, L. J. Principles of Instructional Design. New York: Holt, Rinehart & Winston, Inc., 1974. Gleser, G. C. Consequences. In 0. Buros (Ed.), The Sixth Mental Measurements Yearbook. Highland Park, N.Y.: The Gryphon Press, 1965, 851—852. Gordon, R. Reflections on creation, therapy and communication. Art Psychotherapy, 1973,_l, 109-112. Gordon, W. J. J. The Metaphorical Way of Learning and Knowing. Cambridge, Mass.: Porpoise Books, 1973. 77 Synectics. New York: Collier Books, 1961. Guilford, J. P. Intellectual factors in productive thinking. In R. Mooney & T. Razik (Eds.), Explorations in Creativity. New York: Harper & Row, 1967, 95-106. Traits of creativity. In H. H. Anderson (Ed.), Creativity and Its Cultivation. New York: Harper & Row, 1959, 142-161. & Hoepfner, R. Current summary of Structure-of-Intellect Factors and suggested tests. Reports of the Psychological Laboratory. Los Angeles: University of Southern California, No. 30, December 1963. Guiselin, B. Ultimate criteria for two levels of creativity. In C. W. Taylor & F. Barron (Eds.), Scientific Creativipy, Its Recognition and Develppment. New York: John Wiley & Sons, 1962, 30—43. Hadley, J. M. Clinical and Counseling Psychology. New York: Alfred A. Knopf, 1958. Haefele, J. W. Creativity and Innovation. New York: Reinhold Publishing Corporation, 1962. Hammer, E. F. Creativity in the therapy situation. Art Psychotherapy, 1973, 2(1), 1-6. Hoyt, C. Test reliability estimated by analysis of variance. Psychometrika, 1941, p, 153-160. Ingham, H. V. The Process of Psychotherapy. New York: McGraw Hill Book Co., Inc., 1954. Jackson, P. W., & Messick, S. The person, the product, and the response: conceptual problems in the assessment of creativity. Journal of Personality, 1965, 22, 309-329. Karlins, M. Conceptual complexity and remote associative profi- ciency as creativity variables in a complex problem solving task. Journal of Personalipy and Social Psychology, 1967, p, 264-278. Keats, J. A. Christensen-Guilford fluency tests. In 0. Buros (Ed.), The Sixth Mental Measurements Yearbook. Highland Park, N.Y.: The Gryphon Press, 1965, 847. Kelly, G. A. The language of hypothesis: man's psychological instrument. Journal of Individual Psychology. November 1964, 29(2), 137-152. 78 Kerlinger, F. N. Foundations of Behavioral Research. New York: Holt, Rinehart & Winston, Inc., 1964. Larrabee, H. A. Reliable Knowledge. Cambridge, Mass.: Houghton Mifflin Co., 1945. Laughlin, P. R. Incidental concept formation as a function of creativity and intelligence. Journal of Personality and Social Ppychology, 1967, 5) 115-119. Leatherdale, W. H. The Role of Analogy, Model and Metaphor in Science. New York: American Elsevier Publishing Co., 1974. Lorenz, M. Problems posed by schizophrenic language. In H. J. Vetter, Language Behavior in Schizophrenia. Springfield, Ill.: Charles C. Thomas, Pub., 1968, 28-40. MacKinnon, D. W. The study of creativity and creativity in architects. In Conference on the Creative Person. Berkeley: University of California Institute of Personality Assessment and Research, 1961, 1-24. Madams, A. What is creativity? Transactions New York Academy of Science, 1964, 2p(7), 781-787. Maslow, A. Toward a Psychology of Being. New York: Van Nostrand Reinhold Co., 1968. Mednick, S. A. The associative basis of the creative process. Psychological Review, 1962, p2(3), 220-232. Mehrabian, A. An Analysis of Personality Theories. Englewood Cliffs, N.J.: Prentice-Hall, Inc., 1968. Mooney, R. L. A conceptual model for integrating four approaches to the identification of creative talent. In C. W. Taylor & F. Barron (Eds.), Scientific Creativipy: Its Recognition and Deve10pment. New York: John Wiley & Sons, 1962, 331- 340. Moustakas, C. Individual creativity for psychoanalysis. Journal of Individual Psychology, 1957, 22, 159-164. Nash, H. The role of metaphor in psychological theory. Behavioral Science, 1963, 8) 336-345. Patrick, C. What is Creative Thinking? New York: Philosophical Library, 1955. 79 Peavy, R. V. Creative helping. Journal of Creative Behavior, 1974, 8(3), 166-176. Pederson-Krag, G. The use of metaphor in analytic thinking. Psycho-Analytic Quarterly, 1956, 25, 66—71. Perrin, P. G. Writer's Guide and Index to Enggish. New York: Scott, Foresman & Co., 1950. Perry, J. W. The creative element in madness. Art Psychotherapy, 1973, 2, 61-65. Richards, 1. A. Principles of Literary Criticism. New York: Harcourt, Brace & World, Inc., 1925. Rogers, C. Toward a theory of creativity. In H. H. Anderson (Ed.), Creativipy and Its Cultivation. New York: Harper & Row, 1959, 69-82. On Becoming a Person. Boston: Houghton, Mifflin Co., 1970. Rohovit, D. D. Metaphor and mind. American Imago, 1960, 22, 289-309. Schachtel, E. G. On creative experience. Journal of Human Psychology, 1971 (Spring), 2l(1), 26-39. Schlanger, J. E. Metaphor and invention. Diogenes, 1969 (Spring 1970), 12—27. Schon, D. A. Invention and the Evolution of Ideas. London: Social Science Paperbacks, 1967. Schroder, H. M., Driver, M. J., & Streufert, 1. Human Information Processing: Individuals and Groups in Complex Social Situations. New York: Holt, Rinehart & Winston, 1966. Shibles, W. Emotion the Method of Philosophical Therapy. Whitewater, Wis.: The Language Press, 1974. Metaphor: An Annotated Bibliography and History. Whitewater, Wis.: The Language Press, 1971. Snyder, W. V. Dependency in Psychotherapy. New York: Macmillan Co., 1963, 43-51, 237, 320-326. Standal, S. W., & Corsini, R. (Eds.). Critical Incidents in Psycho- therapy. Englewood Cliffs, N.J.: Prentice Hall, Inc., 1959, 64-67. 80 Stein, M. 1. Creativity and culture. In R. Mooney & T. Razik (Eds.), Explorations in Creativity. New York: Harper & Row, 1967, 109-119. A transactional approach to creativity. In C. W. Taylor (Ed.), 1955 University of Utah Research Conference on the Identification of Creative Scientific Talent. Salt Lake City: University of Utah Press, 1956, 171-181. Stieper, D. R., & Wiener, D. N. Dimensions of Psychotherapy. Chicago: Aldine Publishing Co., 1965. Strupp, H. H. Psychotherapists in Action. New York: Grune & Stratton, 1960. Taylor, C. W. Some possible relations between expression abilities and creative abilities. In C. W. Taylor (Ed.), 1955 University of Utah Research Conference on the Identification of Creative Scientific Talent. Salt Lake City: University of Utah Press, 1956. The nature of the creative process. In P. Smith (Ed.), Creativity: An Examination of the Creative Process. New York: Hastings, 1959, 67-98. Thorne, F. C. Clinical Judgment. Brandon, Vermont: Journal of Clinical Psychology, 1961. Psychological Case Handlipg. Brandon, Vermont: Clinical Psychology Publishing Co., 1968. Torrance, P. E. Guiding Creative Talent. Englewood Cliffs, N.J.: Prentice-Hall, Inc., 1962. Treffinger, D. J., Renzulli, J. S., & Feldhusen, J. F. Problems in the assessment of creative thinking. Journal of Creative Van Kaam, A. Counseling from the viewpoint of existential psychology. Harvard Educational Review, 22, 1962, 403—415. Vinacke, W. E. Creative thinking. In W. E. Vinacke (Ed.), The Psychology of Thinking. New York: McGraw Hill, 1952, 353-379. Wallach, M. A. Review of E. P. Torrance Tests of Creative Thinking. American Educational Research Journal, 1968, 2, 272-281. , & Kagan, N. Modes of Thinking in Young Children. New York: Holt, Rinehart & Winston, 1965. 81 Wallas, G. The Art of Thought. New York: Harcourt, Brace & Co., 1926. Watzlawick, P. The Language of Change. New York: Basic Books, Inc., 1978. Weigert, E. The goal of creativity in psychotherapy. American Journal of Psychoanalysis, 1964, 23(1), 4-16. Wertheimer, M. Productive Thinking. New York: Harper & Brothers Publishing, 1945. Whiting, G. C. How does communication interface with change? In E. M. Rogers (Ed.), Communication and Development. Beverly Hills: Sage Publications, 1976, 99-119. Yukawa, H. Creativity and Intuition. New York: Kodansha Inter- national Ltd., 1973. APPENDICES 82 APPENDIX A RELEASE FORM 83 APPENDIX A RELEASE FORM Ph.D. Dissertation Jeana L. Dressel Chairman: William Hinds I understand that this is a research project investigating client conceptualization by therapists. As a participant in this research, I understand that I will be taking several tests as pre- and posttest measures. I will also be asked to provide the researcher with some written materials during the research. This may involve the discussion of one of my current clients, but no identification of the client will be asked for at any time. I understand that the written materials are being collected solely for research purposes, and that my confidentiality will be strictly maintained. I further understand that at the conclusion of the research these materials will be destroyed. I understand that at any time during this study I am free to discontinue my participation totally. SIGNATURE DATE WITNESS By my signature below, I give further permission to the researcher to quote statements I may write as examples of the con- ceptual behaviors being investigated. I understand that no identi- fying information will be associated with the quotes and that my confidentiality will be fully maintained. SIGNATURE DATE WITNESS 84 APPENDIX B CASE STUDIES 85 APPENDIX B CASE STUDY A History When this patient entered psychotherapy, she was overwhelmed with anxiety about the disintegration which she was experiencing subjectively and which was markedly observable in facial tremors, shaking, and a cowering demeanor. Instead of presenting defenses to be interpreted or dealt with, she seemed almost completely undefended and vulnerable. In the first hour, content poured out of her revealing the severely traumatic nature of her early life and premarital years. It was only after several interviews that she was able to slow herself down to a normal speaking rate. Her childhood had combined the deprivations of lower-class poverty with the suffering induced by a brutal, alcoholic, and generally irresponsible father and a negligent and narcissistically manipulative mother. The sordid history provided little to account for the straightforward honesty, self- awareness, and capacity for relatedness which made this woman readily reachable therapeutically. Her capacity for relatedness seemed to derive largely from her childhood closeness to her mother, of whom she had maintained a fantastically idealized picture. In View of this basic defense, the trauma of rejection was intensified when her mother turned her out of the home without a cent to shift for herself at the age of fifteen. She managed to find domestic work, and sought love from a variety of men, who subjected her to devaluating experiences. After rejecting sexual activitv for some months, she found herself pregnant with the conception shrouded in amnesia. With an older sister, she left her home state and delivered the baby. She had planned to give it away but could not. She found work and eventually married a man of fair emotional stability, building a stable life for the first time. The precipitating factors, which occurred more than a year before she entered therapy, were the severe illness of her younger son and the leg injury of her older son, then seven or eight. At that time, she apparently had a psychotic episode, involving the delusion that people were trving to kill her. There was spontaneous remission, followed by development of the anxiety state which brought her to therapy. There has been much somatic preoccupation. There have been two outstanding crises so far during the therapv. The first, which cannot be recalled in detail, occurred after a vear of working through content and reintegrating defenses. Out of what seemed like an impending psychotic break emerged a lost memory or screen memory that, before the death of a younger sister when the patient was four or five, the patient had considered stabbing her in the back with her mother's scissors. Subsequently, there was a complete recovery from a peculiarly nagging back pain she had had for years. However, also subsequently, there was development of arthritis in another back area, a trend toward rejection of dependence on the therapist, and an unrealistic turning to God. The second crisis occurred after another year of work mainly on her relationship with her mother. 86 87 Incident After a period of unusual well-being, the patient telephoned, badly disturbed because medical tests had indicated possible uterine carcinoma. She expressed fear of complete breakdown; but, in light of recent outstanding gains, I felt able to reassure her. Her therapy hour was due next day, and the medical diagnosis the following dav. I gave the support that together we would wait for the test results and together we would face whatever came. When she arrived for therapy, I was shocked bv her appearance. There were no external anxiety symptoms, but there was the pallor of death, and her face and eves were those of a person making the last futile, wild struggle for life. Her body seemed frail and limp with defeat. Instead of going to my chair, I touched her head in a gesture of sympathy, whereupon she put her head against my stomach and clung to me, releasing the sobs that had not been able to come. When she spoke, it was of her fear and of this final, terrible defeat after the long, uphill struggle. I spoke to her of faith and courage, of the fact that she might not have cancer, and of the fact that medical science was often able to deal successfullv with cancer. As I sat down, she moved to a position where she could claso mv hands and lock directlv into mv eves. As I saw the depth of her terror, I felt something that I had felt in my psychotic patients in a mental hosnital. ”Ob, Ur. , I'm so scared," she said; and then as I spoke to her, she became verv calm and began repeating my words in a trance-like voice, "Yes, I nor have faith," she said, and I realized that for her the onlv reality was in my voice and in our hands, and in our eyes. As I felt the completeness of her psychological surrender, I realized with a sudden, internal jolt that she had entered a psychotic state. For just a second of time I felt fear and self-doubt, and then I thought, "Of course I can meet it—-I can't let P. down." Her eyes were still fixed on mine in that unwavering stare, and the upsurge of strength I experienced went out to her, and then she relaxed and her eyelids flickered; and, as I watched her move and speak, I saw that she was not psvchotic, and I felt that I had held her from the abvss of internal isolation on the edge of which she had wavered. She moved back to her chair, stretched out in it, and spoke of the peace she now felt. I, too, felt a deep sense of peace and unity. She said that, for the first time, she was relaxed. mhen, searching the limits of the safety she had found, she asked whether faith in God could keep her from having cancer. Feeling that she needed realistic authority, I told her I believed that God works through natural law; that, if she had cancer, He would not change that; but that He would be with her through the ordeal, if it came to that. She said the conflicts over her mother now seemed so farawav and unimportant. We talked of various realitv considerations; and then, as the hour drew to a close, she again expressed her fear and moved where I could hold her hands. This time the regression was much less severe, and she verbalized our relationship, "I am a little child, and you are my mother." She said also, ”I get completely drained, and I come to you to replenish my supply of strength." 88 The next day, when we had received the negative test results, she spoke of having gained from the experience. She said, "I will never forget how I drew strength from you." She said also, "For the first time I really saw love and kindness in the world, and the bitterness just seemed to melt away" (Standal, 1951 pp. 64—67). CASE STUDY B History Mr. John Jones was a 25—year—old married former graduate student who was teaching in a small college some distance from the therapist's university. However, for the purpose of advancing his therapeutic skill he was conducting several therapy cases under supervision at the university. In his college position he taught several courses, and he also carried a number of counseling cases, some of which occasionally involved work with personal adjustment problems. Mr. Jones requested therapy on his own initiative. Anxiety about homosexual urges and ambivalence about passive versus aggres— sive behavior tendencies constituted his main presenting symptoms. He gave the impression of being a normal young man, but he was experiencingsmronglmmwsexual urges toward friends and colleagues. His passive—dependency needs and his inadequacy feelings proved to be the underlying causes of these urges. He could be moderately agressive toward people but was nevertheless a likeable, "clean—cut," boyish person. He had ambivalent feelings toward his father, a school teacher, who was a passive person. Toward his mother he felt much hostility because she was a very dominating individual. He frankly saw the therapist as a strong father-surrogate, in con— trast to a former adviser whom he saw as the image of his weak father. He had engaged in sexual play with his younger sister as a kid; an experience this interview, the eleventh, makes reference to. 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