“The Treasure of Ordinary Psychotherapy,” a series of talks on the most important interpersonal elements in psychotherapy, put on by Silver Hill Academy for Research and Education (SHARE) at Silver Hill Hospital in New Canaan, Connecticut, emphasizes the importance of what’s called “use of self,” i.e., the way in which a therapist brings their own personality and experience into the healing environment. On March 19, 2025, this “extra”ordinary series will feature “The Art of Holding” by Ellenhorn’s own unique personality: CEO and Founder Dr. Ross Ellenhorn. In preparation for the event, Dr. Ellenhorn recently sat down for a bit of an improvisational chat with SHARE Director Dr. Jeff Katzman, who calls upon his 30-year background in improvisational theater to work with psychiatry residents and medical students to develop the capacity for collaboration and spontaneity so vital to the therapeutic alliance. Dr. Katzman’s lifelong work has been to help patients overcome the isolation that informs so many modern lives.

Ross: Jeff, we’ve talked about our shared interest in the improvisational nature of psychotherapy, and how the improvisational arts can inform this work, but I don’t actually know the origin of this for you. Can you tell me about that? 

Jeff: I’ll tell you a story. I was in my first-year of residency at UCLA, and The Second City had just opened a program at a theater in Santa Monica. I went to a show with a fellow resident, and at intermission they announced the opening of their school. I auditioned with about 250 other people and I got in. I was elated. I was in psychiatry school, and yet no one ever saw me with a patient. The door was shut, and I was in the room for 50 minutes, and I thought, “How am I supposed to know what to do in 50 minutes?” I realized, then, that what I was learning in improv was teaching me how to deal with this space of 50 minutes—how to create something together, how to be curious, how to collaborate and how to see each other as equal people. And so, I said to one of my supervisors back then, “You know, I think I’m learning more in improvisational theater about how to be with somebody spontaneously and connect than I am in psychiatry school.” 

Ross: When you think about it now, what was it you were learning? 

Jeff: I was learning how to actually not know something. We would go up on stage with a simple instruction, but then I had to go with whatever was offered by my partner. That’s not so different than being in a therapy room where somebody walks in, they make an offer and you build it together. Improv taught me how to be open, how to be curious and how to say yes to whatever was coming.

Ross: I think a lot about how, in some ways, all of our psychological suffering has to do with uncertainty. And there’s two ways to deal with uncertainty: One is to be certain, and the other is to learn how to bear uncertainty in a creative way. How to withstand it and be brilliant. One of the core foundations of resilience is this capacity called uncertainty tolerance. How do we tolerate uncertainty? There’s a word for the ability to withstand uncertainty and move forward, and that’s hope. 

Jeff: If you don’t have hope, you can’t make a plan. Hope is so fundamental—if you can touch into that experience of hope, then you can start to think again. And don’t you think, Ross, that if you were to live a certain life then your ability to be playful in the world and grow and respond to the world around you would be deadened? Improv is an opportunity to play and bring that spirit of play to your life and to your work. 

Ross: How do you think about improv in response to the loneliness epidemic and how we connect as a community? 

Jeff: Loneliness is not just about being isolated socially. It’s about feeling alone even when you’re with other people. I think improv is a direct experience of connecting with someone. It can be a less lonely world if we actually know how to connect and we agree that that’s okay to do.

Ross: Loneliness is not belonging. You don’t belong just by being part of something. You have to feel like you live in somebody else—and that’s what improv is all about. How do I know what’s going on for you? How do you know what’s going on for me? And how do we take guesses at that? That’s where belonging begins. 

Jeff: It’s hard to belong because we need to put ourselves out there and we need to listen to another. Both components are important and improv can help us develop those. Like, I exist and my ideas are worthy of putting out there so another can catch them. And I also need to catch other people’s ideas. This reciprocity is how we belong.

Ross: I think that’s beautiful. There’s a humility to it, but there’s also the demand for boldness. Improv is a bold thing. Therapy is, too. You’re taking these bold risks in your response to another, not knowing if that’s going to hurt. 

Jeff: Exactly. You have to be not knowing in your boldness. Be bold, but also willing to know that this could be a mistake. That kind of spirit of mistakes or opportunities comes through improv as well.

Ross: That gets me thinking about hope again and how bold it is to be hopeful in the face of uncertainty.

Jeff: You have me thinking about the dilemma we’ve been talking about with psychotherapy training. I think there’s like 440 evidence-based therapies, and students are destined to learn one. And, yes, they’re good and they’re helpful. I know that. But it’s not about just following an algorithm. It’s hard to just recreate yourself independently. To be able to do that with the kind of loving curiosity of another person is really a gift.

Ross: Absolutely. We’re most alive in dialogue, right? It’s about how to deal with problems of living, it’s not about how to remove symptoms. Although if you deal with problems of living, you usually remove the symptoms! 
Jeff: When I moved from Los Angeles, where I was doing improv, to Albuquerque, New Mexico, where there was no improv studio, I realized how much I needed it—so I started one myself. There is something about practicing this creativity—making mistakes, goofing around, getting curious, building something with somebody, taking risks in a regular way—that is really helpful. When I am doing it, I am a way better therapist.