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In this paper we will describe the use of creative techniques, particularly verbal and visual metaphor, as a means to strengthen the ego, lessen the superego, and overcome resistances. We will describe an intricate therapeutic relationship in which the deepest part of the patient's sense of self is tapped. As we see it, the field of the therapist-patient communication is over-determined, replete with inductions and counter-inductions, and overlaid with highly charged transference and countertransference reactions. In many respects the therapeutic session can be compared to a work of art. In both there are a multiplicity of levels and the feelings and communications cannot be readily reduced to words; there is an amalgamation of unconscious, preconscious and conscious material; and past, present and future become concentrated in a delicate balance. There is a sense of excitement when both patient and therapist have experienced an encounter which is healing and growth-producing, and at the close there is a sense of completion and integration.
Every session poses a creative challenge to both therapist and patient since in any one session many parts of a patient's psychic structure need attending. The metaphor, be it visual or verbal, often serves this purpose. One word or image can touch a variety of psychic structures and, at the same time, allow the therapist to cope with the patient's resistances, and to recognize his reality and his need for safety, distance and contact. The metaphor, therefore, reduces inhibition and repression and serves as a frame for complex communications and polarities, allowing them to find form and meaning. Similarly, the image opens up possibilities for exploration and discovery in contrast to more conventional verbal communication which tends to