Tuesday, 24 August 2010

The Therapeutic Benefit of Poetry

Poetry Therapy and the Impact of Poetic Dialogue

From the beginning of time, poetry has been a means for people to express their deepest emotions and create healing in ritual and ceremony. In Greek mythology, we know that Asclepius, the God of Healing, was the son of Apollo, god of poetry. Hermes served as messenger between the two worlds to communicate between the gods and humanity. He carried the caduceus, "the winged rod with two serpents intertwined, which has become a symbol of the medical profession" (Poplawski, 75). Poems have also been viewed as carriers of messages from the unconscious to the conscious mind. Wherever people gather to mark a moment, they speak from heart to heart, with poetry.

In the counseling office, perhaps you have read a poem to a client that seemed to capture an issue she/he was struggling with, offering not only understanding, but hope. After the tragedy of 9/11, the airwaves and internet rang with poems of solace. When war in Iraq was imminent, a website developed where people could send poems expressing their feelings: Poets Against the War. Within days, thousands of poems were posted.

Mary Oliver, in her poem, "Wild Geese," says, "Tell me about despair, yours, and I will tell you mine." (Oliver, 110) Joy Harjo, in "Fire" says. "look at me/I am not a separate woman/I am the continuance/ of blue sky/I am the throat of the mountains." (Harjo, 25) The fourteenth century Persian poet Lala speaks about poetry:

I didn't trust it for a moment
but I drank it anyway,
the wine of my own poetry.

It gave me the daring to take hold
of the darkness and tear it down
and cut it into little pieces. (Barks, 11)

These are lines to carry in our hearts, because they open us to beauty, a sense of self, healing, truth, and human connection, and all this in just a few words!

At conception, we are born to the rhythm of the heart, growing in the fluid darkness until one day we stretch our way into light. With our first cry, we make our first poem, a sound that reverberates in our mother's heart, and when she cries in response, we hear our first poem. And so it continues, the voices of those who care for us convey all of the emotions we will come to know as our own, words, that if written down, would be poetry. It's that simple. Poetry is giving sound and rhythm to silence, to darkness, giving it a shape, turning it to light. When we read a poem that speaks to our experience, there is a shift, a click within. Someone has understood our darkness by naming their own. We feel less alone. Therapeutically, the "I" of us gathers energy and insight. Our world expands.

The following poem illustrates the concept of writing a poem to give darkness and suffering a voice. It was written by a participant in Phyllis' poetry therapy group, part of an intensive day treatment program for women addicted to alcohol and drugs. This poem states the truth of the author's experience in a haunting and beautiful way, giving the reader the opportunity to relate to what it feels like to be "broken."

Today I didn't care
whether or not they stared
didn't have time to put on airs.

Yesterday was a different story
wanted to look like a morning glory
fresh and bright couldn't tell
I was up all night.

Sometimes I can hide behind
my colored lines other times
I feel like a stained glass
window that's just been shattered
pretty pieces everywhere. (Klein, 16)

Rather than diminish the excellence of the poet's art, the poetry therapist enhances it. Poet Gregory Orr, in his book Poetry and Survival says "...the elaborative and intense patterns of poetry can...make people feel safe...the enormous disordering power of trauma needs or demands an equally powerful ordering to contain it, and poetry offers such order" (Orr, 92). Poetry structures chaos.

Dr. James W. Pennebaker, one of the most widely published researchers on the benefits of writing, says in his book, Opening Up: The Healing Power of Expressing Emotions, that writing about emotional topics improves the immune system by reducing "stress, anxiety and depression, improves grades in college (and) aids people in securing new jobs." (Pennebaker, 40). "Disclosing secrets beneficially reduces blood pressure, heart rate, and skin conductance." (Pennebaker, 52). Gregory Orr says that when we share secrets "we take a small step from survival to healing; a step analogous to the one a poet makes when he or she shares poems with another reader or an audience." (Orr, 88)

In a therapeutic environment, the trained facilitator addresses the healing elements of poetry: form and shape, metaphor, metamessage, the words chosen, and the sounds of the words together (alliteration and assonance). These elements, in association with each other, carry the weight of many feelings and messages at once, creating a link from the secret internal world to external reality, from the unconscious to the conscious.

Because a poem has a border, a frame, or structure, as opposed to prose, the form itself is a safety net. Strong emotions will not run off the page. A poetry therapist might ask his/her clients to draw a box in the center of the paper and write the words inside. Metamessage implies the ability to carry several messages in one line that "strike at deeper levels of awareness than overt messages" (Murphy, 69). Through the capacity to convey multi-messages, clients are able to experience merging as well as individuation/separation. The poem allows for a trial separation and then a return to the therapist for merging and "refueling" through the therapist's understanding of the poem. If the therapist says he/she appreciates a particular metaphor and how the words flow, the client feels loved and heard. In reading a poem aloud, the client may become caught up in his/her own rhythms and feel caressed.

An important question students of poetry therapy ask is how to find the right poem to bring to a group or individual. The best poems to start with are those that are understandable, with clear language, and a strong theme, as well as emotions that reflect some hope. Another essential element is that the poem must resonate with the mood and/or situation of the group or individual. This is called the isoprinciple, a term also used in music therapy for the same purpose. Dr. Jack Leedy says that "the poem becomes symbolically an understanding- someone/something with whom he/she can share his/her despair" (Leedy, 82)

A woman in Perie's cancer/poetry support group recently published a book of her poems and writings titled, I Can Do This: Living with Cancer-Tracing a Year of Hope. This title contains the critical word hope, for that is what we need in our lives to sustain us and heal. In her poem. "The Uninvited Guest," Beverley Hyman-Fead writes:

I feel fortunate my tumors came to me
in the fall of my life...
I'm grateful for this uninvited wake-up call, ...
Would I have appreciated the beautiful
images the moon makes in the still of the night?
No, I have my tumors to thank for that. (54)

She was able to write this poem in response to a Rumi poem called "The Guest House." This poem, written so long ago, reframes the meaning of suffering saying:

This being human is a guest house,
Every morning a new arrival.

A joy, A depression, a meanness....

Welcome and entertain them all!
Even if they're a crowd of sorrows...

Be grateful for whoever comes,
because each has been sent
as a guide from beyond. (Barks, 1995, 109)

Perie chose this poem to bring to the cancer support group because it might engage the attention of the group members, perhaps to think about how their illness was a "guide," and what they had learned about themselves in the struggle. Another important response might be: "This makes me so angry! How could I ever want to invite in the darkness?" Whatever the emotional reaction, the poem is a catalyst for helping the reader to access and express feelings in a supportive, safe environment. Reading a poem a second time helps the client feel even more deeply the content and emotion. Also, lines spoken spontaneously will often form the first lines of poems.

After a poem is read, the therapist might then ask participants for lines in the poem that speak to them, or to which lines they are most drawn. This might be followed by questions for discussion of an emotional nature. Considering the Rumi poem, the therapist might suggest they discuss: What am I to experience in this life? What am I not inviting in? How can my place of work or home be a Guest House? How is the Guest House like your heart? Comments center around what the poem emotionally means to the reader, not what the poem means intellectually. Through group discussion, time to write and read what was written in the group, both members and facilitator can learn to think differently, perhaps applying newly formed concepts to existing behaviors and attitudes.

For instance, if one has felt like he/she was victimized by illness, through discussion and writing of this or another pertinent poem, she/he might be enabled to begin thinking about how to move toward acceptance. Even writing about rage toward illness is an important step. There is a beginning of some resolution within the poem. Rumi says to be grateful, and in her poem, Beverley, who is far along in her emotional healing process, is able to thank her illness, which gives her hope.

Another kind of healing that poems can provide is illustrated by poems written in response to the other. Here are excerpts from poems that Perie and Phyllis wrote:

Maybe angels are

mistakes
corrected,
old times resurrected, misguided love
back on course to lift the inner flute...
The moon is ripe with hope

but don't look there, angels hover
at elbow bend, between your toes
rows of them, wings of leaves or breeze...
Notice when they arrive
how their wings vary,
some traditional-fully feathered...
others blossomed like heather...

There are those with only goosebumps
not always on the back,
and some no wings at all,
just scratched knees trying to get off the ground.
- Perie Longo

Phyllis responded:

Maybe angels
were with me the day
my sister and husband were run down
on the road in New York, guided my
thoughts to what it would feel like to get hit
as I crossed the street in San Francisco.

Surely angels, familiar with misfortune
and emergency rooms,
watched as my sister and her husband,
almost as big as a small
bear, stepped off the curb, his size what saved them.

Accident angels hovered, caressed, willed them
to survive. Saw the ambulance come.

Did friendship angels, familiar with compassion and coincidence,
know I wouldn't be told for a week?
Did they bring me to the sangha* and the teacher who spoke
about bearing unbearable pain?

Perhaps they remember what it was like to walk,
have shoulders without wings.
Do they know when humans will enter the next life,
and when the unopened tulips
on my table will bloom, die, resurrect?

*sangha-a Buddhist congregation

Gregory Orr talks about "The Two Survivals"-survival of the poet, in that the poet struggles to engage with the disorder to write a poem, and in the act of writing, "bring order to disorder." The other survival is that of the reader, who connects with poems that "enter deeply into" him or her, leading to "sympathetic identification of reader with writer." (Orr, 83-84) This kind of connection can be heightened with direct dialogue because the reader and writer cross back and forth from one role to the other, deepening the possibility for empathy and sympathetic identification.

To illustrate this concept, we return to the two poems we wrote about angels. Perie wrote her poem when her daughter was going through a very difficult period. For Perie, the whole poem is for her daughter whose nickname was "angel-pie." The last three lines of the poem, and some no wings at all /just scratched knees/trying to get off the ground, is a message to encourage and empower her daughter, and more broadly for anyone who is feeling discouraged, traumatized, or troubled. When Phyllis received Perie's poem, she took the theme of angels and wrote her own family story about terrible pain and hope. The poems transcend the theme of angels because there is an even deeper content here-the theme of ordinary people becoming heroes, and the rebirth and reconciliation that can come from tragedy. Also, as is often the case with poetry, there is an unconscious connection as both authors write about family.

In speaking about poetry, it is also important to recognize that it can be an intimidating form of expression, carrying with it a need for perfection or a feeling like "I could never write a poem-my writing isn't good enough." In poetry therapy with groups or individuals, poems are never edited. Editing belongs in a poetry-for-craft setting. The objective of poetry therapy is to use the poem as an entry point for the writer, and it is a helpful way to work with transcendence of the inner editor, that resides in us all. To address a way to think about writing poetry, we turn to the words of our colleague, Robert Carroll, MD, who writes,

Read it aloud
pass it through your ears
enjoy the
ride and
know
the difference between poetry and prose
is that poetry is broken
into lines-
that is all.
(Carroll, 1)

Anyone can write poetry! It is our natural right and human instinct. All we have to do is allow the words to move and inspire us. The National Association for Poetry Therapy (NAPT): Promoting growth and healing through language, symbol, and story (http://www.poetrytherapy.org), has much useful information on its website including more examples of how to use poetry therapy with clients. We, in the Association, are like-minded psychiatrists, psychologists, college professors, social workers, marriage and family therapists, and educators-all of us are also poets, journal writers, and storytellers who have experienced healing through the written and spoken word, and want to share it with other clinicians as a skill they might like to develop. Poetry for self-expression and healing is used with mothers, children, and adolescents; battered women, the elderly, the depressed, the suicidal; those living with terminal illness, the bereaved, those with HIV, the mentally ill, and now hurricane victims and soldiers returning from Iraq who suffer post traumatic stress. We also exchange poems with each other, across the country, that have been effective in helping others heal. This exchange continues the healing rhythm and heart of poetry therapy.

As Jelaluddin Rumi says:

Out Beyond ideas of wrongdoing and right doing there is a field. I'll meet you there. (Barks, 1995, 36 )

Let's find each other along the way.

REFERENCES

Barks, C. (tr.) (1992). Naked Song. Maypop Books.
Barks, C. (tr.) with John Moyne. (1995). The Essential Rumi. NY: Castle Books.
Barks, C. (tr.) and Green, M. (1997). The Illuminated Rumi. NY: Broadway Books.
Carroll, Robert, MD, (2005) "Finding Words to say it: The Healing Power of Poetry" eCam 2005:2(2)161-172.
Harjo, Joy, (2002), How we Became Human, NY: W.W. Norton and Company.
Hyman- Fead, B. (2004) I can do this/ Living with cancer: tracing a year of hope. Santa Barbara Cancer Center: Wellness Program Publishing.
Klein, Phyllis, ed. (2001). Our Words-The Women of Lee Woodward Center Speak Out, SF: Phyllis Klein and Women and Children's Family.
Leedy, J.J. (Ed.). (1985) Poetry as healer: Mending the troubled mind. NY: Vanguard. Orr, G. (2002) Poetry as survival. Athens, GA: The University of Georgia Press.
Murphy, J. M. (1979). The therapeutic use of poetry in Current Psychiatric Therapies, vol. 18. Jules Masserman, ed. NY: Grune & Stratton, Inc., pp. 65-72.
Oliver, M. (1993). Wild geese. New and selected poems. Boston: Beacon Press.
Pennebaker, J. (1990) Opening Up: The healing power of expressing emotions. NY: Guilford Press.
Poplawski, T. (1994) Schizophrenia and the Soul in The Quest, August, 74-79.

"This article appeared in the July/August 2006 issue of The Therapist, the publication of the California Association of Marriage and Family Therapists (CAMFT), headquartered in San Diego, California. This article is copyrighted and been reprinted with the permission of CAMFT. For more information regarding CAMFT, please log on to http://www.camft.org."




Perie Longo, PhD, MFT, is a Registered Poetry Therapist (RPT), poet, poet in the schools, and poetry therapist in Santa Barbara. Perie is the past president of National Association of Poetry Therapy. She can be reached at http://www.perielongo.com
Phyllis Klein, LCSW, CPT, is a psychotherapist, poet, poetry therapist in San Francisco and Palo Alto and was on the Board of National Association of Poetry Therapy. She can be reached at http://www.womenstherapyservices.com

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