Poetry therapy and some links to art therapy∗

Art Psychotherapy,

Vat. 1. pp. 145-151.

Pergamon Press, 1973. Rinted

POETRYTHERAPY

ANDSOME

in the U.S.A.

LINKSTOARTTHERAPY'

JACK J. LEEDYt Poetry Therapy Center, New York, New York

and ELAINE RAPP$ Pratt Institute,

Brooklyn,

New York

involves a search for self, not an attempt to express latent art talent. There is no “good work” or “bad work.” There is only what each person creates out of himself for himself. The therapist facilitates awareness of what comes up in the artwork at the moment of spontaneous unprogr~ed self-expression. The catharsis which takes place in releasing suppressed feelings through the act of creating .a poem or a piece of artwork and the processing of whatever emerges from within the patient whether verbal or non-verbal has distinct therapeutic value. As we will see later, there is a link within each of us between the various manifestations of our natural creativeness in writing, art, music and dance. #en expressiveness in any one area surfaces, due to contact with a supportive non-th~atening therapist, the likelihood of other for& of creative expression emerging is enhanced. Our expectation is that important therapuetic breakthroughs will be made when therapists from vatious expressive disciplines supplement one another’s involvement with a particular patient or work directly together in a coordinated therapy program. At this time, there are a number of principal areas in which poetry is finding application as a

POSSESSED of intuitive wisdom, the Greeks recognized the healing power of poetry. They worshipped Apollo, the personification of the sun and the father of Asklepios, as a dual god of medicine and poetry. Poems iike dreams are another royal road to the unconscious. We live in prose, and dream in poetry. Poetry therapy is the use of poetry as an added dimension in treatment. The principles and techniques of poetry therapy are now used in individual and group psychotherapy, and in Poetry Therapy Groups as part of social rehabilitation programs. Poems are written during sessions by the patients about symptoms, fantasies, dreams, daydreams, conflicts, or relationships with relatives, friends or associates. The patients also bring poems written by others to their sessions as these poems remind them of their own symptoms or conflicts. The therapist will also choose verse useful in therapy, however fine or poor it may appear to critics old or new. Some of it may be .of the most inferior quality, some of the most superior quality: for poetry therapy, the standard is not whether it is good or great poetry, but whether it will help heal the ill. Similarly, in art therapy, the use of art materials

*Requests for reprints should be sent to Jack J. Leedy, M.D., 799 Broadway, New York, N. Y. 10003. *Director, Poetry Therapy Center, New York, N. Y. Associate Attending Psychiatrist, Cumberland Hospital, Brooklyn, N. Y. fFifth Avenue Hospital, Fifth Avenue and 9th Street, New York, N.Y. Group Supervisor, Pratt Institute, Brooklyn, N. Y. 145

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therapeutic tool in the medical field. We will take a brief look at each of them and then see how poetry therapy naturally and easily finds itself at home with some of the recent trends in the field of art therapy. POETRY THERAPY AND INSOMNIA Rather than immediately prescribing a sedative to relieve insomnia, the therapist should try to encourage his patients to read one or more of the following poems several times before bedtime, and to give these poems a fair chance to work. (There have been no deaths reported from an overdosage of poetry): Hymn to the Night

A Ballad of Dreamland

To Sleep

Night Oft, in the Stilly Night 7’he Things That Cause of Quiety Life A Good Night

To Steep

Henry Wadsworth Longfeilow Algemon Charfes Swinburne William Wordsworth Paul F. Whitaker Thomas Moore Henry Howard, Earl of Surrey

Francis Quarles John Keats

The hymn Now the Day is Over Care-Charming Sleep, Thou Easer of Ail Woes John Fletcher

There are spelling weaving poems that are also worth trying: La Belle Dame Sans Merci by John Keats; Annabel Lee by Edgar Allan Poe; Tintern Abbey by William Wordsworth. Using poems to induce sleep is similar to the use of sedatives. Some patients respond to one and not to another. Most effective in my patients’ experiences has been A Bailad of Dreamland. Though they may require a sedative, these poems will help relax them and thereby encourage the induction of sleep. POETRY THERAPY AND ANXIETY Rather than rushing to prescribe a tranquilizer for nervousness, the therapist should first consider suggesting one or more of the following poems to his patients: Anxiety I’m Nobody The Road Not Taken Time. You Old Gypsy Man Ode On A Grecian Urn The Day Is Done I Celebrate Myserf She Dwelt Among the Untrodden Ways

Paul F. Whitaker Emily Dickinson Robert Frost Ralph Hodgson John Keats

Henry Wadsworth Longfellow Walt Whitman William Wordsworth

The Luke Isle of lnnisfree William Butler Yeats

In the labor room, the husband or boyfriend (preferably not both simultaneously) is encouraged to read these poems to his beloved. Hospitalized patients, particularly those who are about to be operated upon, are encouraged to write poems about their fears, fantasies and anxieties. Patients will be able to write important things in poetry that they are unable to say face to face to the doctor or nurse. As a result of releasing powerful feelings in their poetry, the patients require fewer preoperative tranquilizers and sedatives. These same principles may be used postoperatively. Through his poetry the patient entices the interest of his therapist. In effect, the patient says: “Here are my sorrows and my joys and my fears. It pleases me to share them with you.” The late Dr. Smiley Blanton told of the power of poetry to help his patients when they felt anxious, overwhelmed, frustrated, defeated, angry, or bereaved. He used poetry with his patients as an ancillary therapy to buoy their flagging spirits . through the use of hopeful examples and he urged his patients to memorize poems to carry them through times of crisis. In 1928 the late Eli Greifer, a poet and pharmacist, began a campaign to show that a poem’s didactic message, its quite explicit moral, has a specific healing power in itself, and can help relieve anxiety. He founded the Messagists Club and the Remedy Rhyme Gallery in Greenwich Village, New York City. As a volunteer he organized a Poetry Group in 1959 in Cumberland Hospital, Brooklyn, N.Y. His ideas have spread to hospitals, nursing homes, rehab~itation centers and to organizations such as the Staten Island Aid for Retarded Children, Inc., where Poetry Groups have become a part of the total treatment plan. He is a marvelous exemplar of the volunteer who, under guidance of the therapist, can be of crucial help to patients. POETRY THERAPY AND FEELINGS OF DEPRESSION When choosing poems for his patients, the therapist should suggest poems that are close in feeling to the mood or mental tempo of the patients. This is the important isoprinciple of poetry therapy. Depressed patients are helped by poems sad and gloomy in tone yet having stanzas that reflect hope and optimism, especially toward their conclusion.

POETRY THERAPY AND SOME LINKS TO ART THERAPY By reading, studying, memorizing, reciting or creating this kind of poem, or interpreting the poem in spontaneous body movements, depressed patients come to feel that they are not alone in their depressions, that others are also depressed, that others have been depressed and recovered from their depressions, and that no disgrace attaches to victims of extreme alterations of mood. For them, crying precipitated by a poem is often therapeutically helpful; the poem becomes symbolically an understanding someone with whom they can share their despair. The therapist should avoid poems that offer no hope or that might increase guilt feelings or that encourage and glorify suicide. Poems that encourage silence and discourage vocalization, particularly feelings of hostility, are contraindicated. For a few days to some weeks before a suicidal attempt, there are prodromal clues or indirect hints of unconscious intentions that may be detected in the patients’ poems. These patients want to be rescued and their deaths prevented. The patient’s internal debate of the Supreme Court of the mind often makes a 5-4 decision for death; five factors that make life intolerable, and four that encourage the patient to go on living. The physician should try to convert this one vote from death to life by counteracting the patient’s feeling of hopelessness. One way is for the therapist and the patient to write a poem together. Without being concerned with spelling, rhythm or rhyme, the patient first writes a line, and then the doctor writes a line. This alternating procedure continues until the poem is complete, and neither has anything further to add. Often this technique relieves tensions and establishes commu~cation. The patient’s ego defenses are reinforced, and his feelings of hope, love and trust are renewed. The patient. wants to live. Many suicidal patients want to contribute a lung or a kidney for a transplant operation. Reports show that if suicidal patients donate a pint of blood, often their suicidal trends are alleviated. If these patients are encouraged to write a poem and donate it to the doctor, the poem symbolically represents an organ or a pint of blood, and is thereby helpful therapeutically. Writing a poem is like converting blood into ink. In the book Poetry Therapy (3, B. Lippincott Co., 1969) which Dr. Leedy edited, there is a List of Poems suitable for use in poetry therapy. For

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depressed patients, poems such as the following are suggested: Todoy Light Shining Out of Darkness The Chambered Nautilus The Doy is Done On His Blindness Ode To The West Wind The Celestial Surgeon In No Strange Land Psalm 23: fie Lord is my Shepherd The Eternal Goodness Tears

Thomas Carlyle William Cowper Oliver Wendell Holmes William Wadsworth Longfellow John Milton Percy Bysshe Shelley Robert Louis Stevenson Francis Thompson fDomin~s reg.t me] John Greenleaf Whittier Paul F. Wkitaker

POETRY THERAPY AND DRUG ADDICTION Poetry therapy is now being used in detoxifkation centers at the Bernstein Institute and in the Odyssey and Samaritan Houses in New York. The poems of Kahlil Gibran as found in The Ropher are helpful to addicts. Isn’t it worthwhile trying to convert drug addicts to poetry addicts? How wonderful it would be (and sometimes is) to progress from Heroin to Herrick, Henley, Holmes, Hopkins, Hughes, Homer, Heywood, Hogg, Hardy, Herbert, Holderlin, von Hoffman~~~, and Hilda Doolittle @-I.D.). The most difficult patients are drug addicts, and now the therapist has a new ally, the metaphors of the poet, which may be more meaningful than technical scientific language with all its precision and clarity. To establish one meaningful relationship with a drug addict through a poem, where two minds may meet for however brief a period, is a thing not to be dismissed lightly. And who is to say that poetry does not release the energy for this first outreach to a more meaningful way of life? POETRY THERAPY AND PSYCHOSOMATIC (PSYCHOPHYSIOLOGICAL) DISORDERS Peptic ulcers and other psychosomatic disorders may be interpreted in part as poems struggling to be born. This is to imply that these patients have emotional conflicts that are precipitating and perpetuating factors of their psychosomatic disorders, and that these conflicts can be defused and sometimes resolved with the use of poetry as an added dimension in the total treatment plan. Unique here is the process whereby poetry therapy contributes to the liberation of the patients’ spooned or

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LEEDY

frozen creativity. As the patients write, talk, and react to their own poetry, the material produced serves as a therapeutic tool, which, when added to the traditional therapeutic measures, enables the patients to accelerate their healing. The poem may touch off a series of psychic events that contribute to the patient’s feeling of well-being in a way similar to what is experienced after having been involved in a creative act. Psychosomatic diseases often start as defenses against the intrusion by outside schedules upon biologic patterns. In attempting to control the unthe counterroutine begins to pleasant routine, control the young protestor. Most mothers know by instinct that rhythmic movements soothe and relax the baby. Dr. Jules Masserman explains this dependency on rhythm as one of the magic UT defenses of man, the miraculous transformation of chaos into pleasurable order. The outside beat is incorporated into a personal beat and order of time. The rhyme and rhythm of poetry often have a much more compelling force than the actual meaning of the words. Through rhythm, old phylogenetic memoiies are aroused, and rhythm helps us memorize what formerly seemed chaotic. Rhythm, in short, is life itself. The tune is the mind. In the rhythm and repetition of themes in poetry, emotional abreaction takes place. Although poetry therapy often is involved with seriously disturbed patients, it also can be a valuable tool for the person who is concerned solely with self-actualization. This is true of art therapy as well. For example, Elaine Rapp’s creative growth wcrkshops are for anyone with an interest in selfdiscovery and a willingness to interact personally with a variety of art materials. There is tissue paper for collage, crayons, water color markers and oil pastels for drawing, metamorphic rocks for stone carving, plastelene and terra cotta clay for modeling, tin foil and armature wire for free-form sculpture. The workshop offers each participant an opportunity to use these materials in a series of experience designed to facilitate self-awareness. How does a person take territory and how does he give it up? How does he use his eyes to take in the world? How does he handle responsibility? How does he make contact with others and how does he withdraw? In these carefully structured exercises each person comes to grips with his own behavior as a member of the group as well as with what emerges

AND RAPP

graphically from within himself in the artwork he produces. Gestalt techniques are used to facilitate the taking of responsibility for what is happening and for owning the parts of the self which become visible in each person’s works. There is an artist and a poet within each of us. As children we experience what it is like to be the artist and to express our perceptions and feelings spontaneously with chalk, crayon and other fun-to-use art materials. All of us remember the child-poet within us who created nonsense verse, thrilled at making words rhyme and created word pictures almost from the day we started to speak. In the non-judgmental workshop atmosphere and in the presence of a knowledgeable art or poetry therapist it is possible for grown men and women to be creative in the same unselfconscious manner as children are and to experience the same kind of satisfaction. The goal of art therapy and creative development workshops is the search for self, not a search for talent. Past art training and technical ability are irrelevant. Many of the participants have never used or even seen some of the art supplies and sculpture tools provided. When instruction is necessary it is given as a natural part of the group experience. Each of us has his own special differences and the spontaneous artwork or poetry you or I produce is as individual as our own thumb prints. The therapist builds trust by seeing and appreciating the specialness of each person’s work. More than a hundred men and women have carved stone sculptures in Elaine Rapp’s creative growth workshops - and every sculpture completed has been entirely different from all the others. Artwork and poetry are simply different forms of communication. Personal growth takes place when that communication emerges spontaneously from within the individual and there is ample opportunity to process these manifestations of the self in a meaningful way. Marston Morse, the mathematician, once said: “It is only as an artist that man knows reality.” To experience oneself in the creative act is to experience your own aliveness. Instead of talking about what can’t be done, the member of a creative growth group or a poetry therapy group sees what can be done. The person learns how easily skills can be mastered with proper instruction offered in a supportive non-competitive environment. One of the special advantages of working with

POETRY

THERAPY

AND SOME LINKS TO ART THERAPY

art materials is the chance they provide to explore alternatives and to change what has been created if it is not what a person wants. Whether working with clay, collage or even stone, there is the opportunity to undo what has been done and to risk the unexpected by exploring new possibilities. A 19-year-old girl in one workshop comes to mind. She had been piling layer upon layer of tissue onto the paper, working compulsively in her fear that any of the underlying white paper might show in the finished work. Later, when the group was sharing the collage experience, she was asked how much of the tissue she would risk taking off her collage. Cautiously, she stripped away one piece at a time in what was for her a slow and painful process. In one spot, she came to the bottom layer and took the risk of lifting the tissue to expose the white, vulnerable part underneath. What she found instead of the expected empty space was an orange pool of color that had bled onto the paper from the tissue and entirely filled the hole. Her experience was that the expectation of frightful emptiness was in her head and that in reality, when she took the risk of facing it, the emptiness did not exist. In the process of working with art materials, the group member can add to a drawing, subtract from a collage, re-shape a piece of clay, take out a negative in stone, explore endless possibilites for change. The participant has the power to fill in the unfinished parts, and to go back and change what has been done before. Over and over again in whatever art materials are used, there is visible expression of the individual’s polarities evident. There is the light side and the dark side, the weak side and the strong side, the death side and the life side, the baby side and the adult side, as the case may be. When a person accepts into awareness the different sides of himself, he can deal with them, take responsibility for them and integrate them into his organism. Creative growth workshops and a variety of recently developed gestalt art therapy experiences are designed to contribute to that process, to take the mystery out of “being creative” and to facilitate whatever personal growth the participant is ready to achieve. A surprising side benefit of the creative growth experience has been the spontaneous triggering of “therapeutic” poems written after the event by program participants. In each instance, the poem has arrived in the mail about a week after the workshop

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as if the non-verbal creative energy released in the art experience had overflowed into the verbal form of poetic expression. The group leader has never suggested an attempt at putting the experience into words. It simply happened once the creative process was unblocked as if the poet and the artist within us shared a’,spe&l&ind of kinship. Here is ho.w one man expressed his feelings at getting in tquch with his own uniqueness in the workshop experience: Until now, the words, I spoke were hollow, and fell on barren ground, so that I doubted I had spoken. From time to time I heard a few others speak with the voice of the sea and the wind, and I quickened my pace to find my voice the words And now I will speak and some will hear, but mostly I will hear my own voice, will sound my own sound a deep bass. And their and will

others will sing notes, the Universe resound

Sometimes the need to verbalize grows out of deep personal pain. A workshop at Tarango in Mexico City closed on a tragic note when Charles Goldberg, who was both director of the growth center and a workshop participant, had a heart attack and died during the Saturday night break. After returning home to New York, Elaine Rapp received the following “tribute to Charlie” written by one of the participants. The original is in Spanish. What follows is a loose translation:’

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I still recall the moment at the start when I heard you say that the miracle happening here is what helps you find your reason for being.

The sun shining, the trees in bloom, the birds singing and all of us together as one, we saw your remains arrive at the crematorium.

Soon, you had made yourself real to us in your collage, your clay birds and the stone sculpture you created.

You do not feel the fire. You are one with the fire, you are one with the dust, you are completely one with the fire, air and dust.

On Saturday night when you finished the carving I said “goodnight” as you talked happily with Irene about your artwork.

You have obtained unity. You have finished your sculpture. You have recognized truth. Your life has given so much beauty, so much truth, so much love.

On Sunday, we continued to work on our pieces, finding in them a part of ourselves. Unaware of your destiny, we approached the time the workshop would end. *************** “What’s wrong?” I asked Andres when I heard Elaine cry out. With sadness I learned how that morning your heart had ceased to beat.

Meditating outside, my eyes were futed on the ground. “See you soon!” I seemed to hear you say as I was encircled by the shadows of the smoke which started to rise from the tall chimney. Diane, George, Sylvia, Andres, Elaine, Anatole and many more said “goodbye” once more. Now, even more united in Tarango, we shall continue to carve our Sculptures.

On Monday, I gave my condolences to your widow and all of us accompanied your brother and your body to the cemetery.

Another example of the need to memorialize a meaningful personal growth experience in words came from a group member who had participated in an age regression exercise. This woman had, with the aid of the art therapist, been able to travel back in time to her own childhood and to reclaim some,

of the “good times” she had known then in drawings expressive of fondly remembered moments. Later she felt a need to put into words her feelings about the experience and wrote the following spontaneous blank verse:

You said to us, “Go back over the years, remembering the good,” - and I started to sweat! I had resolved not to look back, only ahead. A truly sensible decision, since I am much happier now. But I put my hand in yours and reluctantly thought, “Well, I’ll try.” Remembered anguish is a savage, vicious clown. He pranced along beside me over that frost-encrusted rubble, and I was struck old, again and I boiled with grief.

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You said, “no, no! Push away the bad. Remember the little things: a book, B friend, a taste,a sound; z joke> a funny rhyme, a song Your favorite one.” As simple as that . . .

And soit was. f recalled a playmate and a book and a movie hero; egg creams and the sparkling ocean beyond the nasty beach. - Well, 1’11be damned! - The “EREHWON’s” our club! (spell it backwards, please) Presto! Melodious morning, and the rubble sprouting green! My chndhood yearnings had proven themselves to be false as fairy tales and as treacherous as pretty poison, in that world where promises could not be kept. But., ..thereitwas, the first time I stumbled against music or upon beautiful color pictures of exotic places, into which f leaped. - And there was Mama’s soup and her smile and the mad gayety of autumn leaves carpeting the park. f had been and will be merry. And I can celebrate today! You’ve given them back to me L I . those years.

These poems and the others which have happened without any prodding.or suggestion frum the art therapist are added evidence ofthe link between the fields of art and Poetry therapy. Rather than look at these disciplines as separate entities to be employed ~de~uden~y~ it is time to expetient with joint programs designed to treat an individual’s creative energies as a whole. As individuals, we do not merely have a capacity

to express ours&as in either words or pictures, or sounds, or movement - but rather we have the creative potential to express ourselves in any of a dozen different ways. For the therapist, there is the Promise of a fertile new area to explore - application. of the interrelated expressive therapies which can help people to become better aware of who they are and what they may yet become.