DISCOVER YOUR CLOWN WITHIN
Article published on 7 September 2001 in The GP Journal by Dr.
art of the clown consists of freeing ourselves from all roles except
one: our own.”
(A. Simon: La planete des clowns)
“ The purpose of the doctor is to entertain the patient while the
disease takes its course.” (Voltaire).
Want to revitalize your personal and professional life and have
fun? Like to understand your patients’ bizarre stories and help
them to move on? Then clowning might be for you.
When I was invited to my first clown workshop at the Blackthorn
Centre, Maidstone, I hesitated at the thought of circus clowns and
juggling acts as I am neither extrovert nor exhibitionist. However
the advert said “discover your clown within” which implied a form
of self-discovery that was alternative as well as challenging. I
was feeling inadequate as a doctor dealing with psycho-somatic problems
that obstinately refused to be resolved or slotted into any guidelines.
I had a busy home-life and a lively demanding young daughter. My
workload was increasing and I found myself wanting to avoid patients
altogether. I needed a fresh approach.
The two day workshop was attended by about ten people all of different
occupations (including three doctors). It was led by Vivian Gladwell,
a member of a French group of clowns – Bataclown*. We began each
day with a series of physical
exercises to explore how we could use our own body movements, voice
and the space around us to convey feelings and be receptive to others.
Then we did improvisations. Vivian outlined a scenario or task.
Each person in turn chose a costume and a red nose whilst the rest
of us were the audience. The simplest task for the clown was to
relate to whatever was on stage or simply show what you were thinking
or feeling. Later in the workshop the task became more complex as
two or more clowns appeared on stage together and had to relate
to each other as well as to the audience. After each performance
clowns removed their costumes and received feedback from Vivian
and the audience.
A number of important ideas about clowning emerged during feedback.
It struck me that these ideas mirrored those familiar to teachers
of consultation skills. The clown is a professional empathiser.
He has to listen and respond to others on stage, to his own feelings
and those of the audience. He is an improviser and has no pre-written
script. If a problem arises on stage the clown is advised to “stay
with it” in order to resolve the problem in an imaginative way.
Improvisers on stage together are encouraged not to “block” ideas
and suggestions from each other but to listen and respond to the
other clown. However one clown does not have to give in completely
to the other but express his own character too. He accepts the challenge
posed by the other clown’s suggestion and then transforms it. The
clown responds also to emotion but is not overwhelmed personally
by it. He distances himself from it sufficiently to understand the
drama objectively and to play with it. In so doing he has to be
sensitive to the audience’s response and expectations.
Playing without a script was disconcerting but allowed me to observe
more clearly what was happening around me. So, if I put to one side
my “biomedical scripts”, my concern with disease descriptions, would
I observe better my patient’s own stories? If I
“stayed with” the problem in the way the patient presented
it would I discover new unexplored management options? If I could
accept my patient’s ideas, no matter how odd they appeared, could
I achieve a better, shared understanding of the patient’s problem
and its management? This would mean listening carefully to the patient’s
story and asking questions that clarify that story in preference
to (though not to the complete exclusion of) pursuing ideas in the
doctor’s own mind. If I could respond to my patient’s emotion without
being overwhelmed personally by it then could I help to transform
Of course if, as a doctor, I involve myself in the patient’s
experience of events, I am no longer the “expert” in charge of the
consultation. My patient is regarded as an equal expert. The challenge
in both clowning and doctoring is to listen and respond with no
script or clear guide to follow and to trust that an outcome favourable
to all participants will emerge.
Apart from giving me new insight into my more difficult consultations
I experienced an immediate sense of achievement at being able to
improvise in front of an audience. At work I could see how the rules
of clown behaviour could apply to cooperative team working. Back
home I found the same rules helped me to deal more effectively with
my daughter’s truculent behaviour. I felt stimulated and de-stressed.
I have attended a number of workshops and still discover more about
myself as a clown**.
Of course there is much more to clowning than I have described
here. And, after all, is it not a performing art
- to entertain audiences? So why not entertain people who
are depressed or have chronic ailments? Patch Adams, the American
doctor-clown, does just that and advises all doctors and carers
of sick people to be as “silly” as he is. A group of clowns called
Le Rire Medecin (Laughing Doctors) put on shows for children and
their families in paediatric wards in eight hospitals in France
to help “humanise the care of children” and there are other groups
of clowns across the world performing similar functions. Could clowning
perform that function in the consultation? There have been moments
of spontaneous humour that have transformed a consultation or at
least lightened the prevailing mood, if only for the doctor. I have
more to learn before I would sell myself as an entertainer but I
have wondered if I could use clowning to teach communication skills
to aspiring GPs.
Whatever your view of clowning I recommend the experience of a
clown workshop to anyone who wants to develop skills of intuition.
I certainly recommend it to any doctors who want to improve their
consultation skills or to find out more about themselves. The benefits
spread beyond the individual who “discovers their clown within”
to all those around.