On Getting Stuck and Unstuck: Empathy and Improvisation in Psychotherapy

Therapy can feel stuck, stymied and aimless, but fits and starts may be a necessary aspect of transformative therapeutic processes.  

Therapy feels stuck when the domains of choice are too restricted or rigid, when the people involved are unable or unwilling to engage in the options each party invites and attempts.

How does the process of being stuck and unstuck proceed?  This depends partly on how and whether the therapist and client can engage in a co-constructed improvisational activity. Empathy is necessary since its absence may be why the therapy is stuck in the first place. Empathy is required for therapeutic improvisation.

Some of the therapist’s activity might be seen as setting the stage for improvisation to be possible.  A way of thinking about the therapist’s stance of patience, empathy, waiting and toleration is that it serves attempts at getting unstuck.

Improvisation involves an expansion of possibility and requires flexibility. (Your move 1 invites and is incorporated into my move 2, and your move 3 incorporates what has just transpired and so on.) If improvisation is successful both people have done something they have not done before. They have incorporated aspects of the other’s behavior into their own.

In improvisation, a space is created for moves and choices, spontaneous gestures, that neither party has made before.  Winnicott called this the transitional phenomena. Since the improvisation is something already accomplished, it becomes behavior potential, something a person might want to do again.  

I take for granted that we get something of value from improvisational interaction. At the very least, we now have done something we might not have done otherwise.  

Change may involve fundamental, profound or trivial alterations in a person’s powers and dispositions. Usually real change is slight and hardly noticed to the point of being, practically speaking, not much change at all.  But part of the therapist’s job is to notice and accredit these shifts. This doesn’t need to be said out loud but it must find its way into action so that it has a chance of being incorporated into the next set of unfolding acts.

Therapy is difficult since it may require establishing empathy and developing an improvisation with a person one would not ordinarily choose as a companion.  This holds for both participants.  Empathy is easy when the going is easy.  This is often not the case in therapy. Therapy frequently involves difficult people under difficult conditions. This is why people are in therapy rather than successfully working matters out with friends, lovers, parents, and so on.

Therapy brings together people who under other circumstances might not easily understand each other. This is the therapeutic dilemma and opportunity. An empathic relationship requires negotiation, a moral dialogue, for misunderstanding to be corrected. Knowing how to accomplish this reaching out in the service of being understood is a valuable skill.  But this is difficult.

The participants in therapy will be changed when they accomplish something difficult because the players themselves have to overcome the difficulty of getting along. Freud, long ago, knew this and saw it as essential for progress. He called it the “transference neurosis”.  Working it through may require change in values, knowledge and competence for each participant.  Since one or both parties may not yet have what is needed it is no surprise they find themselves, from time to time, stuck.

Getting unstuck has a liberating effect.  We were lost but now are on our way. If this occurs we may have faith and competence not present before.  It is good to know we can weather a storm.



(In weathering the storms of difficult engagement, therapist and client are both transformed: Empathy, Improvisation and the Growth of the Therapist.

For a method of regaining empathy, see April’s Regaining Empathy. 

For the behavioral logic of how improvisation can facilitate each party acquiring strength from the other, see April’s Play and Therapy.)