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Towards An Uncommon Sense: The Practice of Poetry Therapy

Written by: Igor Goldkind

 

Poetry Therapy, or poetry which is used for healing and personal growth, can 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 one 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. 

The first Poetry Therapist of historic record was a Roman physician by the name of Soranus in the first century A.D., who prescribed tragedy for his manic patients and comedy for those who were depressed. It is not surprising that Apollo is the god of poetry, as well as medicine since medicine and the arts were historically entwined.

For many centuries the link between poetry and medicine remained obscure. The Poet John Milton, wrote in 1671:

 

“Apt words have power to swage 

The tumours of a troubled mind 

And are as balm to festered wounds”

In 1751, Pennsylvania Hospital, the first hospital founded  in the United States, by Benjamin Franklin employed many ancillary treatments for their mental patients, including reading, writing and publishing of their writings. Dr. Benjamin Rush, called the "Father of American Psychiatry", introduced music and literature as effective ancillary treatments. Poem writing was an activity of the patients, who published their work in The Illuminator, their own newspaper.  

On the battlefields of the American Civil War, Union field medic Walt Whitman would administer

recitations of verse to fallen soldiers who were well beyond hope long before the use of morphine.  He was later to pen the classic Leaves of Grass, the greatest celebration of humanity in the midst of its own despair.

Pennsylvania Hospital employed this approach as early as the mid-1700s. In the early 1800s, Dr. Benjamin Rush introduced poetry as a form of therapy to those being treated. In 1928, Eli Greifer, an inspired poet who was a lawyer and pharmacist by profession, began a campaign to show that a poem's didactic message has healing power, began offering poems to people filling prescriptions and eventually started “poem-therapy" groups at two different hospitals with the support of psychiatrists Dr. Jack L. Leedy and Dr. Sam Spector. After Griefer's death, Leedy and others continued to incorporate poetry into the therapeutic group process, eventually coming together to form the Association for Poetry Therapy (APT) in 1969. 

Librarians also played a major role in the development of this therapeutic approach. Arleen Hynes was a hospital librarian who began reading stories and poems aloud, facilitating discussions on the material and its relevance to each individual in order to better reach out to those being treated and encourage healing. She eventually began development of a training program for poetry therapy, In 1980, all leaders in the field were invited to a meeting to formalize guidelines for training and certification. At that meeting, the National Association for Poetry Therapy (NAPT)

As interest grew, books and articles were published to guide practitioners in the practice of poetry therapy. Hynes and Mary Hynes-Berry co-authored the 1986 publication Bibliotherapy - The Interactive Process: A Handbook. More recently, Nicholas Mazza outlined a model for effective poetry therapy, also discussing its clinical application, in Poetry Therapy: Theory and Practice. The Journal of Poetry Therapy, established in 1987 by the NAPT, remains the most comprehensive source of information on current theory, practice, and research.

There is also a relationship between psychological healing and incantations; either repeated as a musical chant by the patient or in fact recited by the attending medicine man.  Modern medicine and science of course scoff at the notion of magical incantations having healing or restorative powers as so much superstition.  But this of course begs the question that if recitations and incantations had no evidential resort and no beneficial property then why would have nearly every human culture have adopted the method and repeated it for thousands of years?  

Surely if there was nothing to vibrate the air with the sound of one’s breath rising from the abdomen, pushed upwards by the lungs, shaped by the throat, mouth and tongue adding the stimulation of  associative meanings  being read cognitively by the patient’s mind; we would have given it and its sisters, singing and chanting up aeons ago.   I am not advocating a supernatural or spiritual causation for the effectiveness of poetry as a healing agent but rather the supra-natural mystical cause which is grounded first in human nature and cognition for which there maybe a myriad of imprecise explanations; none of which can fully explain why it works.

Today, poetry therapy is practiced internationally by hundreds of professionals, including poets, psychologists, psychiatrists, counselors, social workers, educators and librarians. The approach has been used successfully in a number of settings—schools, community centers, libraries, hospitals, rehabilitation centers, and correctional institutions, to name a few.

So How Does Poetry Therapy Work?

    Poetry is beneficial to this process of introspection and can be used as a vehicle for the expression of emotions that might otherwise be difficult to express

    Promotion self-reflection and exploration, increasing self-awareness and helping individuals make sense of their world.

    Help individuals redefine their situation by opening up new ways of perceiving reality

    Helps therapists gain deeper insight into those they are treating

In general, poetry therapists are free to choose from any poems they believe offer therapeutic value, but most tend to follow general guidelines. 

Some poems commonly used in therapy are: 

 

"The Journey" by Mary Oliver 

"Talking to Grief" by Denise Levertov 

"The Armful" by Robert Frost 

"I Wandered Lonely as a Cloud" by William Wordsworth 

“Leaves of Grass” by Walt Whitman

“Turtle Island” by Gary Snyder

As well as the poetry of Alan Watts, Allen Ginsberg, Antonin Artaud.


 

Techniques Used in Poetry Therapy

Different models of poetry therapy exist and are being refinined all the time  but one the most popular is the model introduced by Nicholas Mazza.  According to this model, poetry therapy involves three major components:

Receptive/Prescriptive,

Expressive/Creative,

Symbolic/Ceremonial. 

 

I. In the Receptive/Prescriptive component, the poet merely introduces the subject on how to focus on their own issue.  The aim is to establish concentration and cognitive focus on the details of the issue, none which is revealed to the poet.  Only until the poet feels confident that the subject is cognitively attuned to and non verbally focussed on the problem or issue of concern that he or she begins to ask suggestive questions as to how the subject feels not thinks, about their issue.

This provocation of  tangible emotions usually comes in three distinct phases of emotional content.  First is the one of the predicament, then the subject first becomes aware of the existence of the issue.  This is a gateway phase where anticipatory feelings are illicit and registered by the poet.

II. Then there is a further stage when anticipation of the issue has given way to the full experience of all the emotions, anxieties and fears  related to the issue.  This is usually overwhelming (or it wouldn’t be “an issue” in the first place), and it is tantamount that the poet guides the subject through distinct words to describe the layers of emotions experienced by the subject. 

The poet must ground the subject’s emotions in language.  Language and the use of the words is the key here because emotions always come in clusters of complexity that make it difficult for both poet and subject to distinguish and focus on underlying and suppress emotions. 

“What kind of anger do you feel?”  “How would you describe your sadness”  “How much shame do you feel?  What would you compare it to?”  

This is a sophisticated method of word association but rather than creating bridges between seemingly disparate words, the goal is to drill down to the core emotions about the issue by refining the language as led by the subject.  Achieving exactitude of description is the task at hand.  The Poet  makes careful notation of everything the subject says towards describing their emotion.  It is important to keep them focused and not to succumb to intellectual distraction.  Thoughts are illusions and often lies, emotions are facts.  Get the subject to correctly describe the facts of the matter.  All meaning is metaphoric.

III. The final stage is the exit waiting for a strategy.  How  do the feelings commence to recede?  How does the issue recede back into the background?  What are the parting emotions? Is there anxiety about the leaving?  Anticipation of an issue yet unresolved?  Or is the issue impermeable and subject to a rhythmic return?  Again, the subject’s wording, their adjectives, adverbs and phrases are the material of the poem.

At this point there is usually a short break to give time for the subject to recover from the emotional transitions and for the poet to briefly skim their notes and begin to focus on the flow of adjectives.  It is preferable if possible, to compose what amounts to a first draft, a flow of words which the poet can read back to the subject to confirm the accuracy of the flow.

At this first reading stage it is possible to start interjecting logical bridges between the emotional descriptors.  This is the creative factor unleashed.  The Poet must be assisted by the subject to create coherent sequences between the emotional states.  The poet suggests and the subject confirms or vetoes the phraseology, one line at a time.  Now we arrive at a second draft which is the property of the subject.  It is their poem.  The preference is that the subject now read the poem aloud and take ownership of its content.  The subject can redraft the poem a third time or more times in claiming it as their own.

The poet has merely provided poesy prompts, the poem is the creation of the subject.

The expressive/creative component involves the use of creative writing—poetry, letters, and journal entries--for the purpose of assessment and treatment. The process of writing can be both cathartic and empowering, often freeing blocked emotions or buried memories and giving voice to one's concerns and strengths. Some people may doubt their ability to write creatively, but therapists can offer supporting by explaining they do not have to use rhyme or a particular structure. Poets can also provide stem poems from which to work or introduce sense poems for those who struggle with imagery. A Poet might also share a poem with their subject and then ask them to select a line that touched them in some way and then use that line to start their own poem. 

In groups, poems may be written individually or collaboratively. Group members are sometimes given a single word, topic, or sentence stem and asked to respond to it spontaneously. The contributions of group members are compiled to create a single poem which can then be used to stimulate group discussion.

The symbolic/ceremonial component involves the use of metaphors, storytelling, and rituals as tools for effecting change. Metaphors, which are essentially symbols, can help individuals to explain complex emotions and experiences in a concise yet profound manner. Rituals may be particularly effective to help those who have experienced a loss or ending, such as a divorce or death of a loved one, to address their feelings around that event. Writing and then burning a letter to someone who died suddenly, for example, may be a helpful step in the process of accepting and coping with grief.  

How Can Poetry Therapy Help? 

Poetry therapy has been used as part of the treatment approach for a number of concerns, including borderline personality, suicidal ideation, identity issues, perfectionism, and grief. Research shows the method is frequently a beneficial part of the treatment process. Several studies also support poetry therapy as one approach to the treatment of depression, as it has been repeatedly shown to relieve depressive symptoms, improve self-esteem and self-understanding, and encourage the articulation of feelings.  Researchers have also demonstrated poetry therapy's ability to reduce anxiety and stress in people.

Those experiencing post traumatic stress have also reported improved mental and emotional well-being as a result of poetry therapy. Some individuals who have survived trauma or abuse may have difficulty processing the experience cognitively and, as a result, suppress associated memories and emotions. Through poetry therapy, many are able to integrate these feelings, reframe traumatic events, and develop a more positive outlook for the future. 

People experiencing addiction may find poetry therapy can help them explore their feelings regarding the substance abuse, perceive drug use in a new light, and develop or strengthen coping skills. Poetry writing may also be a way for those with substance abuse issues to express their thoughts on treatment and behavior change. 

Some studies have shown poetry therapy can be of benefit to people with schizophrenia despite the linguistic and emotional deficits associated with the condition. Poetry writing may be a helpful method to describe mental experiences and can allow therapists to better understand the thought processes of those they are treating. Poetry therapy has also helped some individuals with schizophrenia to improve social functioning skills and foster more organized thought processes. 

It is important to note in many instances, especially in cases of moderate to severe mental health concerns, poetry therapy is used in combination with another type of therapy, not as the sole approach to treatment. 

Training for Poetry Therapists

Poetry therapists receive literary as well as clinical training to enable them to be able to select literature appropriate for the healing process. While there is no university program in poetry therapy, the International Federation for Biblio-Poetry Therapy (IFBPT), the independent credentialing body for the profession, has developed specific training requirements. Several studies support poetry therapy as one approach to the treatment of depression, as it has been repeatedly shown to relieve depressive symptoms, improve self-esteem and self-understanding, and encourage the expression of feelings.

However, the only qualitative measure of effective poetry therapy is in the poesy and the results.  No accreditation can guarantee or substitute for the quality of cognitive empathy that is achieved during a successful session.  Ultimately, there can be no real separation between the experience of the Poet and the subject.  This methodology provokes a meeting of mind in confrontation with universal truths.  The Poet is there merely to reassure the subject that there is no hocus pocus, no supernatural or alternative reality, that the cognitive associations that ring true are true in the present mind of the subject.  Therapy is really only a factor when arriving  at truths, when descriptive, revealing cognitive associations and their corresponding emotional content become overwhelming for the individual,

The Poet is on hand to reassure, to validate the responses of the subject to radical new perspectives on their own most intimate selves and to relieve and dispel any accompanying trauma as grounded in the normalcy of human experience.

Concerns and Limitations of Poetry Therapy

In spite of its widespread appeal and broad range of application, some concerns have been raised about the use of poetry therapy. 

Some critics have pointed out it is possible for people to analyze a poem on a purely intellectual level, without any emotional involvement. This type of intellectualization may be more likely when complex poems are used, as a person might spend so much time trying to decipher the meaning of the poem that they lose sight of their emotions and spontaneous reactions. Poems that are unoriginal or filled with clichés are unlikely to stimulate individuals on a deep emotional level or challenge them to think in ways promoting growth.

Just always keep in mind that poetry therapy may have little or no value for those individuals who simply do not enjoy poetry.

References:

Chavis, G.G. (2011).  Poetry and story therapy: The healing power of creative expression. Philadelphia, PA: Jessica Kingsley Publishers.

Gooding, L. F. (2008). Finding your inner voice through song: Reaching adolescents with techniques common to poetry therapy and music therapy. Journal of Poetry Therapy, 21(4), 219-229.

International Federation for Biblio/Poetry Therapy. (n.d.). Summary of training requirements. Retrieved from http://ifbpt.org/obtaining-a-credential/getting-trained

Mazza, N. (2003). Poetry therapy: Theory and practice. New York: Brunner-Routledge.

Olsen-McBride, L. (2009). Examining the influence of popular music and poetry therapy on the development of therapeutic factors in groups with at-risk adolescents (Doctoral dissertation). Rossiter, C. (2004). Blessed and delighted: An interview with Arleen Hynes, poetry therapy pioneer. Journal of Poetry Therapy, 17(4), 215-222.       


The following are are poems I have selected from the over 350 Poetry Therapy sessions I have facilitated since 2016.  Each of these poems belongs to an individual attempting to grasp a central issue in their life.  The names have been omitted for the sake of their privacy.

I’ve lost the person locked within the situation 

Like a nut dwells within its hard shell of fearful anger.

Escaping vulnerability

Hiding from the unknown.

Hard shells, hard feelings, hardness itself

 

The excitement of living days in the present

Belonging to the past

I will not let go of what I can recall but not relive

My belonging to that which encompasses myself

Another nut within its shell.

 

To belong is to exist

Without belonging there is Nothing and

I fear nothing most of all because I do not know it

And I fear what I do not know more than

I would remedy the pain of this loss  with trustworthy tools

 

When two liquids are bonded  as one

A single drop of poison poisons the whole glass

And betrayal  is always poison no matter how little or how much

The glass of Narcissus’s tears is now empty

He has blinded himself rather than drink his own poison.

 

Instead he has left me to sip the bitter poison 

Of fading better days.

Like a cat 

Poised in stillness

Distracted by nothing

 

Ready  to pounce

 

I will not surrender the pain.   

I will not surrender the pain.

Because the pain is my memory of the happiness 

We’ve now lost

A sweet nut within a bitter  shell.

 

Snake Heart

This sadness, this hopelessness

Will not be swatted away

Nor drowned by the busy work

Of the day to day.

It persists

Even when I am submerged in my bathtub.

The warm water rising from the bottom of my lungs.

Until I lose the will to breath

And the sadness becomes anger

Rising to the very top of my horns 

 

Of my red-hot raging exhaustion.

How good to be angry!

 

I used to be afraid of snakes but no longer.

I am hissing from the center of my snake-heart

As you try and step over me.

Your eyes fail to see as you  tread on my tail.

On my snake heart.

On my resolution without confrontation, without owning emotion

All that’s left for us is the hissing sound of machinery.

 

Preview Extract from the new work by Igor Goldkind
Take a Deep Breath, A Book of Remedies publishing on November 22, 2020

 

To Preorder or for more information  Go to igorgoldkindthepoet.com.