How To Get To The Here-And-Now

I always start a session with a patient by asking what is going on with them.  I expect something about how he or she feels that moment, sitting in my office.  I almost never get that. In a typical work day, a simple “Hello, how are you doing?” has been met with such things as:

“I don’t think I am ever going to get better.”

“I still can’t get over what my mother has been doing.”

“I am going to end up on the streets.”

These statements are filled with emotional intensity concerning the past and/or future. Worries about the future. Obsessions about the past. The fastest, easiest, and most effective ways to deal with this kind of emotion are to focus on the moment that you are living in.  Then, it suddenly becomes possible to process logically in your head what is going on. So people who claim they are happy or relieved to see me are actually very distressed when they do not have to be.

Rodney Dangerfield — His act was all about his stressful life.

The notion of living in the “here and now” is a very powerful notion that can help even “normal” people to get through life with considerably less distress. A complete “living in the here and now” is impossible by definition. After all, we are who we are because of our pasts.  If we do not take control of the planning for our future, we are doomed to be controlled by forces outside ourselves.  Good, if we are lucky enough to focus on the positive stuff.  Bad, if the negative thoughts and agendas around us take charge of things.

The author most often cited by the modern “living in the here and now” movement is Eckhart Tolle. I think what he has basically done is to take the principles of ancient mysticism and by presenting them within the context and language of psychotherapy, make them more palatable to a modern audience. I believe that “living in the here and now” is not a notion most people can get from books.  I believe it is experiential.  Not until people have lived the experience, can they really incorporate it into their lives. I cannot help but think of three different patients I have had, who had used Eckhart Tolle’s books as part of their search for peace and meaning in life.  At least one of them and possibly two were people whom I believed were trying to cloak or hide shameful parts of their past which they did not want to think about.

A dramatic reading — even aloud — of Eckhart Tolle, is not the way to get where you want to go.

I can take people to the “here and now” with Emotional Freedom Technique (EFT), if they are willing to bring me the resources to find their true selves, and to spend the time. Similar techniques can work in the same way — clearing the mind of worries of past or future.  People generally have trouble describing how they feel when these veils of thought are lifted.  Words like “clear” and “centered” are frequent. I may have found a more direct way. Theatrical improvisation.

Yes, it works effectively and well. A troupe I practiced with recently told me it was “kindergarten for adults.”

What it is, really, is a series of “acting” exercises so focused, so demanding of alertness and participation in the “here and now” that it is absolutely impossible to worry about either the past or the future while doing them. I do not think that anyone would argue against this assertion: Acting is an altered state of consciousness. When done correctively and effectively, the actor “becomes” another person, either real or imaginary.

Although some people may actually be “talented;” that is, have an easier time projecting externally and effectively something about this other person, I believe anybody can and will profit from the study of acting, especially in improvisational theater. I certainly am, and so is my husband.

Now I am NOT talking about trying to do this as a profession.  I respect those who follow this with a passion, a passion as intense as the one I have for pushing little molecules around people’s brains.  Commitment for them means working in television commercials or community theater and trying out for roles like that of a costumed tomato or something.  It can mean paying the bills by working a day job that fills them with horror, about which they do not speak.

Okay, so I am “lucky.”  Doctors tend to make enough money to be able to do things like acting as a hobby.  Years ago I enjoyed doing stand-up comedy, and my comic colleagues used to tell me I was lucky to have such a great day job.

I didn’t get to be a doctor by luck — I spent years training for it. So whatever it was, luck it is not. At times I spent my days in some temporary assignments at out-of-the-way clinics in rural areas and underserved urban areas trying to help patients who had been given the standard addictive drugs of abuse that were on the medicine formulary, and were back seeking more in larger and more potent dosages.

That goes against everything I have come to stand for in competent and capable medical practice, but I was helpless to change the system when I was only a minor cog and a temporary one, at that.

In addition, there were all the unnecessary and pointless staff meetings, all the administrative paperwork to satisfy the clinical administration and the county and state governments who paid the bills for the indigent patients, as well as the office politics of who had the skills of ducking out of work early and dumping extra patients on the new doctor or the woman doctor.

I reached my dreams and my goals – in medicine, not acting – by working jobs that could kill one’s soul, and saving my money and studying things like marketing and negotiating and business planning.  It’s as difficult to achieve in the medical field as it is in show business.

But I forget all of this the instant I walk into my improvisational workshop.  We immerse ourselves in our activities – “Get out of our own head” as the director says – by doing fast-paced drills.

These really are like the games you would play in adult kindergarten — “passing the sound ball” by making a funny sound while throw an imaginary ball through the air to some unsuspecting person across from you in the circle who “catches” it, repeats the sound,  utters a different sound and “throws” the sound to somebody else.  You need to watch who is throwing and listen to their sound. County prescription paperwork?  What drug? what county?  It is all gone from the moment I start going for the sound ball.  And that is one of the easier exercises you start with.

Maybe you saw, as I did, “Whose Line is it Anyway?” on television and thought all those people were geniuses.  They are not.  They have been trained and they practice, just like my husband and me.

There are lots of exercises that people do to improve and sharpen the improvisational skill.  You can actually find a large amount of them on line:

Each class consists of a progression of exercises, from the simple to the complex, and ending with an easy “warmdown.”

Although I absolutely hate sports (I know I am in a minority here) I also know most of the world does not.   There is an entire genre here, called “theatersports” very similar to “Whose Line Is It, Anyway?” that turns the exercises into a performance piece by putting actors in teams and pitting them against each other. When the games are at their most complex and challenging, there are two different things happening.

First, the actor is developing a character.  Pulling from his or her own life or someone they know.  Real past.  I have channeled one of my aunts.  I have assumed the character of an opera singer.  I have given voice and space to emotions I have certainly felt but could not ever express anywhere else in my life.

Life is structured and if we do not behave in certain ways repeatedly, it does not work.  Who wants a psychiatrist who acts like a petulant child when the patient comes in the room? Nobody, obviously.  It becomes possible to do and be more of yourself in an improv workshop than anywhere.

Second, you have to play off other people.  A monologue is tough enough, but it is a lot easier than working with one or even two other people.  It is like the “sound ball” exercise, but with words.  You have to not only become an altered self, but interact in a meaningful way with others in order for a “scene” to happen. It is easier for me to do a scene with my husband than anyone else. We just know each other better than we do anyone else.  Besides, there is a certain similarity to our styles.  We are both very verbal and we both hate sports, are non-athletic, and would rather do anything than take a pratfall.

Many of the exercises remind me a lot of things I have learned in psychological treatment modalities.  Some exercises of improvisation are a lot like exercises of Neurolinguistic Programming (NLP), for example. Things like “mirroring,” where you copy what another person is doing physically, quite exactly.  I have used different forms of that to connect with patients for many years.

Doing improvisational exercises is like flowing with a pulse of creativity.  It is good for dramatic actors, surely, but I am so much better suited to (and so much enjoy) being a happy buffoon. It is no accident that there is a bit of an overlap between this and psychiatry.

All the stories about the Second City improvisational troop, the famous folks on Saturday NIght Live.  All the reports that somehow, magically and mysteriously, people’s lives seem to “go better” when they do this sort of thing. It could be that nobody besides me really cares that Eugene Levy was a psychiatric orderly before he became, well, Eugene Levy – one of the most in-demand character actors in movies and TV for the past 25 years. I have suggested this sort of training and exercise, far cheaper than the cheapest psychotherapy, to colleagues (one tried once and lasted a half class) and even to patients, who don’t believe me.

Despite all of the things I have read on comedy writing and development, nothing is as powerful as something Mel Brooks said a long time in an interview about running lists through your mind and juxtaposing two things from different lists.  He illustrated by talking about Wilt Chamberlain and Neville Chamberlain, something about writing the Nuremberg Pact (Neville) and following up by sinking a basket (Wilt).  This sort of juxtaposition comes most quickly and easily when someone is “warmed up” into “improv.

There are groups in most cities I’ve been in – from Lawrence, KS to Oklahoma City and San Diego.  Most have a “drop-in” policy so you don’t have to sign up for an expensive course or semester of training, and you certainly do not need to be a pro to try it out.  Most charge a modest fee per class – on the order of $5 or $10 – about what you’d pay to go sit in the audience to watch such entertainment.

During a recent business trip lasting several weeks, my husband and I participated in a weekly class in Ventura, CA

Travis Greer, the director, is a working actor and musician and a sheer delight to work with.  He is patient, supportive and obviously knows what he’s doing. Remember, life is NOT scripted, so you are going to be doing improvisation all your life whether you like it or not. It is great to know that learning improvisation can make life better.