In case you are not aware, improv is being used in clinical practices such as therapy for anxiety. It may seem odd that a comedic art form is being integrated into therapeutic practices, but when you better understand what improv is and how it works, it will make sense.
People are most familiar with improv as a comedic art form they may have seen on stage or television show, Whose Line Is It Anyway. While people enjoy the spontaneous comedic performances of improv, what people do not see is the process that creates that often hilarious outcome.
Improv is more structured than most people realize. It’s rule of “Yes, and,” as well as other structures form the underlying process of improv that makes it not only a comedic art, but also a clinical tool.
Connections Between Improv and Therapy
While improv is not a substitute for therapy, the basic practices employed in improv do overlap significantly with some practices used in several therapeutic fields. This suggests that improv may help some patients by allowing them to practice needed skills in a safe environment.
Here are just a few ways improv supports some of the same goals and practices used in therapy:
Neurobiologically—The groundbreaking brain research by Dr. Charles Limb revealed that improvisation activates the medial prefrontal cortex of the brain, while quieting the dorsal lateral prefrontal cortex quiets. He describes this as the neural signature of flow state. Daniel J. Siegel, MD, in The Mindful Brain, relates nine specific functions that correlate with integrative neural activity in the middle areas of the prefrontal cortex: body regulation, attuned communication, emotional balance, fear modulation, response flexibility, insight, empathy, morality, and intuition.
It is evident that improv can serve as an experiential therapeutic tool. Moreover, with improv’s 1- to 3- minute games, the rapid and repeated practice of moving into a state of flow can strengthen neural pathways (Siegel, 2002). This means that no matter how someone is feeling or what part of their brain they are in, improv can quickly move them to a better state in which to engage in therapy.
Unconditional Positive Regard—One key tenet of therapy is for the therapist to hold the patient in “unconditional positive regard” at all times and to be completely non-judgmental when working through the patient’s issues. In improv, the rule of “Yes, and…” acts as a social frame guiding all participants to unconditional accept another’s offer without judgement or comment. Following this acceptance, “Yes,” the accepting player than adds on to the offer, giving positive validation to the other participant. There is no rejection or judgment in improv, only unconditional acceptance. Players are fully committed and attuned to each other fostering a trust between players, and within themselves.
Both therapy and improv are thus built on completely trusting someone else, and as a result they both increase trust in others over time. Patients working through trust issues, therefore, can get additional practice in trusting others (and in feeling trusted by others) when improv is added to their therapy regimen (Toohill, 2015).
Developing Mindfulness—Recent research has proven that mindfulness practice such as meditation can lead to a host of benefits such as calming anxiety, reducing stress, and improving impulse control. For patients who obsess over past events or constantly stress about an uncertain future, learning to focus on one’s body or breath in the present moment can be therapeutic. For this reason, many therapists have added mindfulness practice to their approach.
Improv, like mindfulness, focuses on the present moment. To engage in improv, players must accept and add to another player’s offer which may be verbal, physical or emotional. This necessitates that each player be attentively listening and aware of what is going on in every given moment. They must be present. When doing improv correctly, it’s literally impossible to think about the past or the future, which allows patients who have such issues to “get out of their heads” for a period of time to experience what living in the moment can really feel like (Bermant, 2013).
Phobias and Exposure Therapy—One common approach for helping patients overcome phobias of different types is to expose the patient to the feared situation in small doses, which are slowly increased over time. For patients suffering from social anxiety, improv offers a powerful form of exposure therapy because it allows patients to interact with others in a way that is both safe (due to improv’s underlying rules of interaction) and fun. Through repeated practice with improv, patients with social anxiety can thus learn that engaging with people can be an enjoyable experience (Toohill, 2015).
Conditions that May be Improved through Improv Practice
Conditions that May be Improved through Improv PracticeBecause improv overlaps in so many ways with other approaches often used in therapy, it has proven to be helpful for patients suffering from a variety of issues. Here are some of the most common therapeutic uses of improv:
Anxiety
The most common therapeutic use of improv is for relieving anxiety. Because improv creates a safe environment in which to interact, people who often become anxious when around other people can learn to trust that others won’t hurt them and that engaging with others can actually be enjoyable. In fact, Chicago’s famed Second City comedy club has been partnering for several years now with the city’s Panic/Anxiety Recovery Center (PARC) to produce a series of eight-week classes that allow people with social anxiety issues to learn improv and use it to reduce their fears (Fortenbury, 2015).
Depression
One of the problems people suffering from depression experience is that they have a constant stream of negative self-talk running through their heads. Improv, with its high level of engagement, practice of saying “Yes,” and its intense focus on the present moment, can shut off this negative running commentary. And the camaraderie experienced as part of a regular improv ensemble can go a long way toward increasing one’s feelings of self-worth (Konow, 2018).
Post Traumatic Stress Disorder
Many veterans return to civilian life with symptoms of PTSD. Even the ones free from these symptoms deal with a wide range of issues: isolation, a lack of direction, and a feeling of being ostracized. Therapy groups have begun to use improv as a way to give these veterans both a sense of community and some tools for coping with their post-military lives (Merina, 2017).
One such group, run by the Air Force Wounded Warrior Program, offers wounded veterans and their caregivers a variety of training, including optional improv classes, to help them cope with the daily challenges they face. Ali Taylor, the wife of Staff Sgt. Brandon Cipolla, recently participated in the improv classes and found them beneficial. “The concept of ‘Yes, and’ is that you work with what you’ve been given: You carry on and keep going,” says Taylor, whose husband recently took a new job requiring them to relocate to Olympia, Washington. “That’s our marriage” (Lewis, 2019).
Oppositional Defiant Disorder
People who struggle with ODD get caught up in a constant “no” mindset. They challenge every rule or statement, they constantly look for reasons why something or someone is wrong, and they have trouble working with others as a team player. For these people, improv is a challenge. The basic rule of improv—“Yes, and…”—requires that the player agree to any offer made by another player. To get someone who is stuck in a “no” mindset to say “yes” to everything is a major hurdle. But, for those who give it a try, it can break them out of their stuck pattern and get them to practice another way of thinking. Over time, the goal is to reset their thinking patterns more permanently (DeMichele, 2019).
Dementia, Alzheimers, Memory Loss
While Alzheimer’s disease is more of a medical issue than a clinical one, caregivers responsible for working with Alzheimer’s patients can benefit from improv training, and this training ultimately benefits the patients themselves. Actor Karen Stobbe, whose mother and father both suffered from Alzheimer’s, and her husband, Mondy Carter, have developed a training guide and workshop for Alzheimer’s caregivers based on the rules of improvisation. Stobbe and Carter point out that caring for someone with Alzheimer’s and doing improv are alike in several ways. In both situations, you have to listen completely to what someone is saying and accept the reality that’s given you.
In improv, the rule of “Yes, and” requires that you accept the action as it is developing rather than work against it. When caring for someone with Alzheimer’s, it’s also best to work with the reality the patient is living in at the moment rather than to try to impose your own reality on the situation. Alzheimer’s patients hear “no” a lot and going along with them and saying “yes” to the reality they’re engaged in at the moment can make them feel much better. Also, when caring for an Alzheimer’s patient, like in improv, you need to listen completely to what the patient says so that you can converse with them without contradicting them (How improv is helping patients, 2015).
Conclusion
Psychologists and therapists are always on the lookout for new strategies that can be used to supplement more traditional approaches. In recent years, improv games have begun to be used more by therapists as extensions of their therapeutic sessions. Improv is growing in popularity, as its focus on staying in the present moment, trusting others, and positive group dynamics overlaps with the goals therapists have for many of their patients, and ongoing research reveal the neurobiological impact of improv.
For access to improv games to try yourself, pick up a copy of One Rule Improv: The Fast, Easy, No Fear Approach to Teaching, Learning and Applying Improv.
Sources
Bermant, G. (2013, December 10). Working with(out) a net: Improvisational theater and enhanced well-being. Frontiers of Psychology. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyg.2013.00929/full
DeMichele, M. (2019). One rule improv: The fast, easy, no fear approach to teaching, learning and applying improv. Academic Play.
Fortenbury, J. (2015, August 2). Can improv comedy treat social anxiety. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/neuroprogress/201508/can-improv-comedy-treat-social-anxiety
How improv is helping patients with Alzheimer’s disease. (2015, December 8). Retrieved from https://www.ama-assn.org/delivering-care/public-health/how-improv-helping-patients-alzheimers-disease
Konow, D. (2018, January 2). How improv can help people deal with anxiety, depression. The Fix. Retrieved from https://www.thefix.com/how-improv-can-help-people-deal-anxiety-depression
Lewis, L. L. (2019, April 30). Laughter an unlikely medicine for America’s veterans. Nationswell. Retrieved from http://nationswell.com/laughter-americas-veterans/
Lopez-Gonzalez M. and Limb, C. (2012). Musical Creativity and the Brain. Cerebrum. The Dana Foundation. Retrieved from http://dana.org/news/cerebrum/detail.aspx?id=35670
Merina, D. (2017, March 27). Comedy improv class helps veterans deal with civilian life. Retrieved from https://www.scpr.org/news/2017/03/27/70207/a-new-tool-for-vets-transitioning-to-civilian-life/
Siegel, Daniel J. 2007. The mindful brain: reflection and attunement in the cultivation of well-being. New York: W.W. Norton.
Siegel, Daniel J. (2002). The developing mind and the resolution of trauma: Some ideas about information processing and an interpersonal neurobiology of psychotherapy. In F. Shapiro (Ed.), Paradigm Prism (pp. 85-121). Washington, D.C.: APA Press.
Toohill, K. (2015, September 11). So funny, it doesn’t hurt: Can improv be a form of therapy? Some psychologists think so. The Atlantic. Retrieved from https://www.theatlantic.com
Mary DeMichele is a coach, consultant, author and improviser with over 25 years of experience in educational, clinical and professional settings. She is the author of One Rule Improv: The Fast, Easy, No Fear Approach to Teaching, Learning and Applying Improv and Improv ’n Ink: Overcoming “I Don’t Know What to Write! Mary holds a Master’s degree from the Maxwell School of Syracuse University. Visit OneRuleImprov.com for more information.
