Poetry therapy: where art meets the mind

Prolegomenon

The words of the famous American poet, novelist and short story writer Charles Bukowski “Poetry is what happens when nothing else can” echo in my mind as I begin writing this article.

I myself have written poetry since childhood, without ever realising its therapeutic potential when I started. I never considered it as a serious therapeutic tool. Some therapists feel poetry is highly effective in helping patients overcome difficult emotional situations and mental illness. In an article for the Psychiatric Centers Information Network, registered poetry therapist Perie J Longo instructs us that “the word therapy, after all, comes from the Greek word therapeia meaning to nurse or cure through dance, song, poem and drama.” I had no idea about it till I began writing this article.

Poetry and medicine: unfolding of the saga untold

‘Poetry’ is derived from the Greek word ‘poiesis’ with the broad meaning of ‘making.’ Poetry is therefore a form of literary art using aesthetic qualities of language evoking an emotional response. It is known to heal the heart and soul.

Poetry therapy is a process for sufferers to be renewed, rejuvenated and somehow, reborn through the power of poetry.

The word ‘psychology’ is derived from ‘psyche’ meaning soul and ‘logos’ meaning speech or word. In Greek mythology, Oceanus, believed to be the World Ocean, told Prometheus, the one credited with creation of man from clay, that “Words are the physician of the mind diseased.”

Poetry therapy or poetry which is used for healing and personal growth, may be traced back to primitive man, who used religious rites in which shamans and witchdoctors chanted poetry for the well-being of the tribe or individual. It is documented that as far back as the fourth millennium B.C.E. in ancient Egypt, words were written on papyrus and then dissolved into a solution so that the words could be physically ingested by the patient and take effect as quickly as possible. It is also recorded that around 1030 B.C.E., the music of a shepherd boy named David soothed the “savage breast” of King Saul. Ancient Greeks left poems in shrines in remembrance of their healing. The spoken word has always been integral to Native American traditional medicine. In traditional societies, healing was mostly related to the power of the ‘word.’

“How does one happen to write a poem: where does it come from? That is the question asked by psychologists or the geneticists of poetry” - Allen Tate

Poetry has played an important role even in the modern era. Benjamin Rush, the “Father of American Psychiatry” included a library in the hospital he founded in 1810 so patients could read poetry and other literature prescribed by their doctors. Many notable poets throughout history were physicians, including William Carlos Williams, Anton Chekhov, John Keats and Oliver Wendell Holmes.

“Everywhere I go I find that a poet has been there before me” - Sigmund Freud

Sigmund Freud once wrote, “Not I, but the poet discovered the unconscious.” Later on, many other theoreticians such as Adler, Jung, Arieti and Reik wrote of how much science had to gain from the study of poets. Moreno suggested the term “psychopoetry,” as well as the term “psychodrama,” for which he is famous.

Poetry therapy: a form of bibliotherapy

“Bibliotherapy” is a more common term than poetry therapy, which became popular in the 1960’s and 1970’s. It literally means the use of literature to serve or help. Bibliotherapy is an expressive therapy uses an individual’s relationship to the content of books and poetry and other written words as therapy.

Poetry therapy is a specific and powerful form of bibliotherapy, unique in its use of metaphor, imagery, rhythm and other poetic devices. Samuel Crothers first used the term bibliotherapy in 1916. It was adopted by librarians who saw the value of having a special designation for the practice of selecting and using books helpful to psychiatric patients. Early use of the term specified the use of informational books, such as Karl Menninger’s The Human Mind as well as of selected imaginative novels whose characters could serve as models or warnings to the reader. The Menninger doctors of Topeka, Kansas, collaborated closely with hospital librarians because they felt that the librarians knew both the patients and the literature that might draw them out. While librarians kept the use of the term bibliotherapy alive, the services did not include planned discussion of the reader’s personal reactions to materials. This form of the “interactive process” or “interactive dialogue” evolved later with the popularity of group therapy in the 1960’s.

Poetry therapy: healing the mind

Poetry therapy helps an individual to condense his/her experiences and emotions and pen them down on a page which can be easily shared with others. This entire process of collecting one’s emotions and narrating to others in a less painful manner is the most beautiful expression.

“Painting is poetry that is seen rather than felt, and poetry is painting that is felt rather than seen” - Leonardo da Vinci

Truly, creativity meets the human mind during poetry writing. Poetry therapy can include all forms of literature such as short stories, fables, myths, fairy tales, memoirs and journal writing as well. Poetry is the shortest form of a human creative expression. Another dimension of poetry therapy involves reading poems written by others. This is a way by which a patient can find the truth of their own experience recognisably reflected back.

Poetry therapy has been used with a range of psychiatric patients, from those who are psychotic and admitted to acute psychiatric wards to people going through a life crisis or developmental transition such as divorce, job loss or the death of a loved one. Age is no bar for its use. Writing is widely used in children’s hospitals, often in conjunction with art, to help children articulate their fears and experiences with illness. Some physicians invite patients to get creative while waiting for their appointments, supplying crayons and other writing materials, because they have found it to be calming.

A Roman physician named Soranus in the first century A.D. prescribed poetry and drama for his patients. The link between poetry and medicine has not been well documented. It is interesting to note, however, that the first hospital in the American colonies to care for the mentally ill, Pennsylvania Hospital founded in 1751 by Benjamin Franklin, employed several ancillary treatments for their patients including reading, writing and the publishing of their writings in a newspaper they titled ‘The Illuminator.’

In the 1950’s, Eli Greifer, a poet, pharmacist and lawyer began a “poem therapy” group at Creedmore State Hospital in New York City and in 1959 at Cumberland Hospital in Brooklyn, facilitated by psychiatrists Dr Jack J Leedy and Dr Sam Spector. Dr Leedy published the first definitive book on poetry therapy in 1969, Poetry Therapy, which includes essays by many of the early pioneers in the field. About this time more and more people in the helping professions began to use poetry integrated with group process. Among them was Arthur Lerner, PhD of Los Angeles who founded the Poetry Therapy Institute in the 1970’s on the west coast and in 1976 authored Poetry in the Therapeutic Experience. Finally, in 1980, a meeting was called to bring together those active in the field working all over the country to formulate guidelines for training and certification in poetry therapy and form what is now called the National Association for Poetry Therapy (NAPT Guide to Training 1997).

Creative writing has been used in Pennsylvania Hospital in the United States since over 200 years now. Today poetry therapy is widely practiced in a variety of diverse settings with various populations. Efficacy of treatment is enhanced by the use of multimodal approach. NAPT utilises poetry therapy in the United States in the following situations: for adolescents, for the bereaved, for cancer patients, for children, in a day treatment setting, for depressed patients, for the developmentally disabled, in forensic psychiatry, for the frail elderly, in the treatment of HIV/AIDS, in marriage counselling, in the treatment of physical illness, in cases of severe trauma, for the sexually abused and for substance abusers.

“Creativity is great medicine for all, both the creator and the one who experiences it. It prevents disease and promotes wellness. It is not indulgence, it is fundamental to medical practice.” - Patch Adams, MD, as quoted in Illness and the Art of Creative Self-Expression by John Graham-Pole (Oakland, CA: New Harbinger; 2000)

Emotional release writing is associated with improved immune system functioning. This finding points to the significance of writing for physical, as well as emotional health and spiritual well-being. For a patient with mental illness, writing poetry can take on particular importance. According to Longo, there are two major facets to such healing: defining the self, and helping to make connections between the self and others.

Poetry therapy for cancer patients

Cancer is a difficult disease to cope up with especially for teenagers. The use of medical art therapy with children, specifically children living with cancer, is also well established in the literature. There are reports of a teen girl in Minnesota coping up with the diagnosis of leukaemia through art and poetry. Poetry is known to give expression to the challenge an individual faces with the diagnosis of this deadly disease.

The Pediatric Oncology Experimental Therapeutics Investigators’ consortium was founded in 2003 by Dr Lia Gore of Colarado Cancer Centre and Dr Tanya Tripett at the Memorial Sloan Kettering Centre. The mission is to promote early clinical development of promising therapies for the treatment of children, adolescents and young adults suffering from cancer and other related disorders. Particular poetry prompts and writing exercises are extremely valuable for people in finding their words and voices.

Poetry therapy involves reading and writing. No matter which one the patients choose, either of them can reach the best result, the ideal recovery. They are two opposite directions but lead to the same destination in the end. The various steps involved in poetry therapy are: choosing a poem, reciting a poem, summarising a poem, picturing a poem and responding to a poem.

“Poetry therapy helps patients to become more spontaneous and creative… Poetry is one of man’s deepest expressions, and emotions are thereby released. A poem has been described as the shortest emotional distance between two points, the points representing the writer and reader.” - Jack J Leedy, MD, Poetry Therapy: The Use of Poetry Therapy in the Treatment of Emotional Disorders (New York: Lippincott; 1969)

Épilogue

For millions of years, poetry therapy has been a practiced treatment, helping the mentally ill to overcome and ease their suffering. Since then, poetry therapy has become a fast growing career with certified poetry therapists being integrated into all aspects of society, whether it be working in hospitals, asylums, libraries, schools, nursing homes or community support groups. People pursuing poetry therapy as a career must go through the long and rigorous process of certification in order to become poetry therapists, but once they reach certification, they have the ability to reach into the deep depths of the mentally ill’s mind and bring forth the information, which doctors need in order to help them and find cures, that once had been thought to be inaccessible. Through poetry therapy, the mentally ill become aware of the reasons for their problems.

I realise today that every poem I’ve written has given me at least some sense of defining myself. Poems mean different things to different people. A poem that uplifts one patient might depress another. Of course, in poetry therapy, poems aren’t looked at for their value as art, but as a window into the psychology of the poet and, by extension, as a means of healing. When I read some of the poems I have written years ago, I feel happy and healthy – complete.

Suggested reading

Leedy JJ (1969) Poetry therapy: the use of poetry therapy in the treatment of emotional disorders. Philadelphia: JB Lippincott Company

Miller KB, editor (2001) The Cancer Poetry Project: poems by cancer patients and those who love them. Minneapolis, MN: Fairview Press

Mirriam-Goldberg C (2004) Cancer and chronic illness: a brief report. Journal of Poetry Therapy 17:101-7

Nelson D (2001) Making friends with cancer. Findhorn: Findhorn Books

Reiter LS (2000) Creative “righting”: a poetry therapy guidebook for the helping professional. Ann Arbor: Bell & Howell Information and Learning Company

The National Association for Poetry Therpay (2004) [cited 2012 Aug 30]. Available from: http://www.poetrytherapy.org/pdf/IntegrativeMedicinePacket.pdf

Zammit C (2001) The art of healing: a journey through cancer: implications for art therapy. Art Therapy: Journal of the American Art Therapy Association 18:27-36