The Art of Medicine in Metaphors December 20, 2012

Fellow “healing writer” blogger, James Borton, has just come out with a new book , The Art of Medicine in Metaphors: A Collection of Poems and Narratives.

I met James at the 2011 Examined Life Conference hosted by the University of Iowa Writing Program and the Carver College of Medicine and was riveted by his story.  Like many of us who have experienced a life-changing health crisis, he returned to the world with a mission.  He began the blog, allheartmatters.com, where he generously writes about Medical Humanities and solicits healing narratives.  His anthology is a welcome addition to the growing literature on writing and healing.   He describes his book below:

Poetry and stories about illness address more than just the symptoms of disease. Narratives and poems are the pathways for people to make sense of and discover meaning in life’s difficult events. Three years ago, I learned a painful lesson about how a pa­tient bleeds a story. Following a triple bypass, I emerged after nine dark days from a coma after losing all of my blood from a ruptured coronary artery. It is no wonder that my call to others to learn about their broken health stories met with remarkable responses.

Every patient’s story, whether it be through the admission report, the clinical medical chart, or the arc of an entire life history, translates into a valued healing narrative. The poems and stories presented in this anthology are all written from the heart. They are about losses and they are also about gains. What patients and doctors continue to understand is the power of telling and listening to personal stories.

This anthology includes thematic re­flections on death, diagnoses, fears, humor, joy and transforma­tion—both physical and spiritual. These writers all succeed in telling their story, sharing their brokenness, discovering healing metaphors, and—at unexpected moments—offering grace and renewal.

James Borton teaches in the English Department at Coastal Carolina University and is a faculty associate at the Center for Bioethics and Medical Humanities at the University of South Carolina. He is also a past National Endowment Fellow at Yale University.

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Love is What Carries You December 12, 2012

 

 Love held us. Kindness held us. We were suffering what we were living by.

I began to know my story then. Like everybody’s, it was going to be the story of living in the absence of the dead. What is the thread that holds it all together?…. Love is what carries you, for it is always there, even in the dark, or most in the dark, but shining out at times like gold stitches in a piece of embroidery.

—Wendell Berry, Hannah Coulter

As I flipped through my address book yesterday to make my Christmas card list, I was caught short by all the names of those I have lost this year: my beloved courageous Irish aunt, Sheila; my Jewish godmother, Lily; my dear friend Cecelia.  All of these women have blessed my life, in ways both sweet and profound.  When my birthday passed without my aunt’s card, I felt an orphan.  Her steady support throughout my life has been like a vigil candle. I miss that light now.  I miss Lily’s quirky and affectionate and sometimes outrageous letters, like the one that included an erotic poem that she said she would have loved if she had been my age at the time (46?) instead of her age (80?).  I miss Cecelia’s elegance, fierceness and mystical streak.  I think of how I took them all for granted, as if they would live forever.

Selfishly, I know that part of what I miss is that no one will ever look at me with quite the same indulgent affection as they did, that I am no longer the young woman who drank endless cups of tea and poured out my heart, certain of loving ears.  With their deaths I feel I have stepped into a new phase of my own life, one in which I have a new role to play.  Wendell Berry in his poem “Ripening” speaks to this process of our lives becoming peopled with our beloved dead, even as we give up the pleasant illusions of youth:

 Ripening

 The longer we are together

the larger death grows around us.

How many we know by now

who are dead! We, who were young,

now count the cost of having been.

And yet as we know the dead

we grow familiar with the world….

 What does he mean, that we “grow familiar with the world?”  Perhaps that we know its true dimensions–the cost of living and loving—rather than our fantasies of what it should be. My friend Jane, who suffers from Alzheimers yet still retains sharp memories of her past, said to me recently, after describing her mother’s illness and death at fifty-four and how hard it was for her then, “People are just going to have to get with the fact that life is hard.”  I thought of my post-war generation, of how privileged we have been and how it comes as a shock to us that, indeed, life is hard.

Every Christmas we make a pudding out of persimmons.  We prefer wild ones, but will use “borrowed” persimmons from a neighbor’s tree.  The trick about them is that they have to be touched with frost to make them sweet.  Grief is like that frost, it can soften and sweeten us, as Berry concludes in his poem:

Having come/the bitter way to better prayer, we have/the sweetness of ripening./ How sweet

to know you by the signs of this world!

 

 

 

 

 

 

art: http://dkirkeeide.blogspot.com/2010/10/mysterious-persimmon.html

Incantations October 30, 2010

In our workshop this week, we ended up talking a lot about the sounds of a piece, and how each writer has her own signature sound.  This was most apparent in rhythm.  We noted that one writer’s prose has a “stately” feel to it–understated, elegant, with gentle lifts and falls.  Another writer’s work surges forward in an urgent, emotional tide that builds to a climax, then dissipates, just as a wave does, and ends in a peaceful resolution.  Still another writer’s work could be distinguished by her rhythmic repetitions.  All her work has an incantatory quality, the kind of repetitions you find in witches’ spells, or in prayers.  That is how the work comes to her, she says, she doesn’t choose to write like that.  She just does.

Gregory Orr in his book, Poetry as Survival, writes that incantation is the third “ordering” power of the lyric, “capable of dealing with even more extreme disorderings, catastrophes so powerful that the self is unable to shape them towards the coherence of story or the complex concentration of symbol.  With incantation, the self discovers that it can be sustained, if all else fails, through rhythmic repetition alone.  In these instances, incantation is like a woven raft of sound on which the self floats above the floodwaters of chaos.”

The writer of incantations in our group has been slowly emerging out of such floodwaters.  Her history includes her mother’s early death, life in an orphanage, a raging, mentally ill stepmother, and a traumatic marriage, not to mention cancer and other health issues.  Her writings have always had this incantatory bent.  In addition, they often have been written in third person, which has created a distance between her own traumatic experiences and the emotions and words on paper.  It has only been in the last several months that she has started to use first person.

I think that for some of the other participants her incantatory pieces were perplexing.  So many repetitions!  Where was it all leading? I didn’t always  know.  Yet, I held fast to the principle that the “self”, the healthy ember at her center, was guiding her process.  And slowly but steadily, she has emerged like a butterfly from her chrysalis–an image she often writes about.  She has lost weight.  She reports more and happier interactions with her family.  Other members of the group remark on the positive changes they see.  She now talks about herself more, about her plans, and even her past.

As facilitators, we don’t always know what participants are working through or how their writing helps them move towards wholeness.  I only recently stumbled on the Gregory Orr quote as I was reading Poetry as Survival and  had a real “ah,hah!”  moment.  This is why I think it is so important to respect each person’s process, to give them the space and the tools to find their own rhythms, rather than to too narrowly define therapeutic goals for them.  Sometimes it is only in retrospect that we are able to understand how their writing sustained them.

 

 

 

After a Long Absence October 6, 2010

Dear Readers,

I hope you are still out there.  I guess I needed a long hiatus to swim, relax, just be.  But fall is finally here and I’m half-way through my fall writing class at the cancer center, and as always, I marvel at what a privilege it is to be witness to the richness of so many lives and so much courage.  Because it takes courage to face the empty page, to face, as one of the participants said yesterday, “my demons.”

That particular writer wrote a short, spine-tingling impressionistic piece about spousal abuse, using the image of being put into a rotten, rat and snake infested well, of calling and pleading for help, only to have her husband stand at the top of the well, laughing at her.  The visceral images and strong verbs: rotting, slithering, pleading, had the group by the neck.  We felt the terror, without the word terror needing to be used.  In the reflection she wrote about the act of writing that piece,  she said that even though it was hard to go back to that experience, once she got it on paper she felt better, more at peace.

I am reading another friend’s fascinating and lengthy memoir.  On our morning walks she has described how she had to write this tome, to put the chaos of her young experience into some kind of order.  She has for years gone home after work and written, often times feeling guilt at not being more accessible to her children.  Yet, she maintains, she had to write this to be a whole person, and she feels that she is a more authentic parent for it.

The poet Karl Shapiro has this to say about writing and pathology: “The prevalence of the tragic and the pathological in great works of literature has misled many theorists ino the belief that art is symptomatic of psychic disorder, whereas it is the opposite.  Art is a way of reaching for wholeness by way of the assimilation of the pathic into the joyousness of the unified being….”  (Foreward, Life on the Line: selections on words and healing).

Another writer of breathtaking courage I have the honor of having in our class, wrote a long piece about years of being stuck, of facing the feeling of not making a difference, and yet also of affirming that it has only been

through her suffering that she has become “real.”   She ends her lament about “time  (that) cannot be regained,” though, with the observation that it is “time to change how I see…..time to love.”

For those of us attending to these works, we borrow courage to look at our own demons, to know that we can face them and know that we too can survive.  For the writers sharing their work with us, those demons b

ecome less potent because the writers are no longer alone with them.  It is this sharing which I think brings the process of healing to another level.  We are meant not only to create art, but to share it, for our own good and the good of all.

So here we all are, imperfect, striving for wholeness, facing our demons, becoming, slowly, more “real.”  It is time.

Climbing Above June 16, 2010

I recently received a call from one of the social workers at our cancer center.  She was concerned about a woman in my group who had scored high for depression on our intake forms.  She wondered why I hadn’t referred her for individual counseling.  “She didn’t present as depressed,” I explained.  As a matter of fact, she had been one that I least worried about.  She was engaged, lively, full of humor and right on the mark with new skills and ideas.  I knew the facts of her life; they were dire, and those facts would stand, to everyone’s grief.  But for two hours a week, she was not mired in those facts.  She was free to exercise the other parts of herself that were neither patient nor caregiver.  She was free to think, imagine, communicate, laugh. In the past, I have referred participants to our counselors, or have gently suggested that they might find what they need there instead of in the writing group.  But in this case I saw no reason.  It seemed she was doing what she needed to do to help herself.

Ted Deppe, a splendid poet and psychiatric nurse, often writes about his pediatric charges.  In a poem called “The Japanese Deer,” he describes taking the children on an outing to the Lost Village. On a walk in the countryside, he truly gets lost, then comes upon an “apparition of apple blossoms.” The children break ranks and run towards the trees, climbing the upper branches and adorning themselves with apple blossoms.  Here is a stanza from that poem:

What’s true in this story is that Marisol,

raped repeatedly by her mother’s boyfriend,

and Luis, who watched from the hall as his stepfather

stabbed his mother to death–nothing

can change those facts–climbed for a short time

above the brambled understory, outside history,

discovered a fragrant scent on their hands,

shredded more petals, rubbed the smell deep in their skin.

In the poem, the children are entranced by the apple blossoms and the idea of tiny Japanese deer.  Although they didn’t actually see the deer, the idea of them is so real, some of the children were sure they’d “seen the whole herd.”  I love this poem.  It does not deny the horror of the children’s lives, but it also does not deny them their moment of transcendence.  I love the visual pun of the brambled understory and climbing up above the facts of their histories. Our histories are a part of us, but they do not define us.  I love also how this moment is sensual, how instinctual the children are in rubbing “the fragrant smell into their skins.”  One thinks of all the Biblical stories of anointing by fragrant oil in the presence of the sacred.  This moment was sacred, and Deppe suggests this beautifully.

The social worker and I grieved together over my writer’s  plight.  Yet I have had the privilege of listening to her wonderful stories, full of beauty and drama and pathos and humor.  I think of the last line of Deppe’s poem “….impossible, all of it,/but this is the way he remembers it; this is the truth.”

“The Japanese Deer,” from Cape Clear  New and Selected Poems, by Theodore Deppe, Salmonpoetry,  www.salmonpoetry.com

 

 

On Being a Recluse April 9, 2010

“And then there’s a lecture by Cornell West, and a wonderful Tchaikovsky concert, and how about going to see Spunk at the Morton?”  My friend’s breathless voice reels off the plethora of activities available in our college town this weekend.

I love my irrepressible friend, she of the bubbling enthusiasm and indefatigable energy.  I hedge.  I don’t know how to tell her I’m in no shape to do any of these things. I’ve been active lately, and she’s gotten used to it.

I would have loved to do all these things in my parallel life, the one I live in my imagination.  In my parallel life, I not only volunteer at my son’s school, ride bikes with my son and my husband,  go to concerts and plays, but I also have redecorated my house and give dinner parties “a plein aire”.  I’ve managed to get my novels published and I travel around teaching.  My husband and I vacation in Greece.  I get up early, work out with my personal trainer, and go to bed late after earth-shaking sex with hubby. Well and often.  I collect original art and sing jazz at local dives for fun on weekends. And oh, I just won an international tango contest and my photographs–just a hobby–hang in collections around the world….

In my actual life, I slowly and gingerly make my way into the day. If I’ve “overdone it” in some way–either physically or mentally–the day before, as I did yesterday and the day before, I am in pain and stiff from head to foot.  If I’m lucky, I’m out of bed by eight. Usually not. If I haven’t rested my still recovering broken back, the twinges of pain become adamant sledgehammers by three in the afternoon.  My personal trainer is my dog, Maisie, and on good days we take a half hour walk.  On bad days, like today, I struggle for fifteen minutes, the air in my lungs like knives, and flinging myself on the couch as soon as we return.  I then sort out the tasks that have to be done–teaching preps, doctors visits, the endless filing of claims–from the goals I’d like to get done–work on novel, finish essay–and I try to get the first done so that I can get to the latter.  Some days it is a personal victory to merely get the bed made, the dishes put away, the exercises done and maybe an hour at my desk before brain fog or pain make it impossible. Sometimes my despair at the necessary smallness of my life overwhelms me. On good days I have the energy left over to see friends, to go to a movie, to a party.  And when I’m there, I look and act “normal” and nobody thinks of me as sick.

No one has any idea of the careful husbanding of energy it has taken to have that moment. I even fool myself.  Then, like Cinderella, the clock strikes and I am back in my rags and ashes.

Probably one of the least understood aspects of chronic illness is how it shapes or distorts one’s identity, especially one’s social identity.  We are social animals, after all.  My need to connect with the world, to be part of a social matrix, is just as strong as in a person who is not sick.  But I cannot physically keep up a “normal” level of  interaction.  And I know I confuse people with my popping up and fading-out routines.

So, the question is, how to satisfy the desire to connect with the need to withdraw?

Hillary Mantel, who won this years Booker Prize for “Wolf Hall,”  says she became a writer because of illness.  One thinks of Keats, writing poetry as he is dying of TB, of Virginia Wolf”s essay, “On Being Ill,” of John Donne’s Devotions Upon Emergent Occasions, his meditations on health, illness, and suffering, of D.H. Lawrence.  Forced by their health to withdraw from the active world, they nevertheless were passionately engaged, sounding the depths of  their own experiences and sending the world dispatches. Writing, they refused to be obliterated as personalities by illness, refused to let illness define them, even as they reported, like journalists at the front, on the losses illness entailed.

When I was in sixth grade, I wanted to be Brenda Starr, the star-eyed, red-headed reporter .  I remember how avid my twelve-year-old self was for experience of the world.  We spent a summer in Mexico and I remember thinking that I wanted to travel the world as a journalist or work in the UN.  That girl lives on.  She’s just sending dispatches from a very different place.

Craft and Catharsis May 7, 2009

How important is it to focus on craft when we conduct a healing writing workshop?

As artists in healthcare, I think many of us get to this to question. We, ourselves, are constantly striving to refine our own work, but the aim of facilitating a healing writing workshop is not to create artists, but to create an opportunity for healing. So what is the role of crafting, of refining style and mastering elements of good writing, in the healing writing workshop?

Belleruth Naparstek, in her book, Invisible Heroes:Survivors of Trauma and how they Heal, states “those who wind up finding something useful to do in the midst of a traumatic event, who can take charge and effect some measure of improved outcome, usually wind up without symptoms of trauma or with feewer or lighter symptoms, than those who are frozen in hopelessness.” She goes on to say that through this doing, traumatized persons experience “the joyous self-love that comes from accomplishment.”

Writing something as small as a fable, or a short poem may seem insignificant compared to the overwhelming task of fighting cancer, but that small text represents an act of self-agency, a defiant rejection of hopelessness. To create out of the self, when the sense of self and its symbolic order has been fragmented, is often an opportunity not to be restored to a former wholeness, but to find a different wholeness, one which acknowledges loss, but is not devastated by it.

So, what does all this have to do with craft? According to Mark Robinson, a British researcher and teacher, a lot. Crafting that text, that artifact, seems to be an inherently important part of the process of healing. He states: “To sum up, there were strong indications that writers of all kinds felt thy gained psychological benefits from their writing practice. Only in a few cases was this separate from the normal literary writing and redrafting process necessary for good writing of any genre, form or school. An interest in quality, in producing a text which was more than instant or an outpouring but in some way crafted, was clearly integral to the process of writing enhancing  well-being.”

Many professional writers became writers first driven by a need to find healing, or stumbled upon writing as a way to experience the “joyous self-love that comes from accomplishment.” Through that experience, we took up the discipline of the craft, seeking to increase mastery as well as joy. I think it is not so very different for patient-writers. Although they may have various degrees of committment to their writing, for most of them, learning to craft their texts with as much skill as possible is an important aspect of their healing.

Vibrations of the Spiderweb April 18, 2009

In the novel, Kristin Lavransdatter, set in Medieval Norway, the middle-aged protagonist reflects on her brother’s troubles, which, while they don’t affect her directly, affect her nonetheless, because, she reflects, they are part of each other. She likened it to feeling the vibrations along a spider’s web, how a disturbances in one part affect the whole. This image has stayed with me over many years, not only as an image of how families are connected, but also of how sensitive communities of any sort are to the well-being of their members. Whether we are aware of it or not, we are all a part of a a social matrix which affects our health. I just read a blurb–was it in Oprah?–that if your friend’s friend is happy, that increases your likelihood of being happy, even if you don’t know this person.

We Americans like to think of ourselves as rugged individualists, self-made, self-determined. That belief can provide a lot of pride when the wheel of fortune rises to the top, but it can also crush one when the wheel of fortune rolls to the bottom. Self-reliance is a good trait, up to a point. Past a certain point it creates a lonely society.

I am thinking in particular of the various feelings of failure and guilt that often accompany a chronic or acute illness. Instead of seeing our situation as part of the common lot of humanity, we often focus on our individual failures–if only I had eaten better, gotten more exercise, not gotten divorced…..fill in the blank. And these feelings of guilt and shame only further isolate the sick person, creating more stress, and inhibiting healing.

The healthy don’t want to hear the stories of the sick, and the sick know it, just as the married don’t want to hear stories of the divorced. The mere acknowledgement of the experience of illness, some seem to believe, gives it too much power. And so we isolate the ill and refuse to hear their stories and think thereby we are preserving our own health. We are as superstitious as any Amazonian tribe, and perhaps not as wise.

But the vibrations are still felt on the web. By not giving the ill a chance to express their experience in all its chaos and pain, the chaos and pain remains, affecting the community nevertheless. It inhibits the healing of the individual, but it also inhibits the healing of the community. By not finding ways to express the lived experience of illness, all of us are diminished in our humanity. Ellen Dissanayake, author, professor of music and lecturer on the nature of art, asks, what is art for? in her many articles and books. Her answers have great implications for our understanding of how the arts strengthen community and individual healing. (http://ellendissanayake.com/). The arts can provide that bridge between the country of the ill and the country of the well, increasing all of our capacities for understanding, and also for compassion and joy.

Is Poetry Therapy? February 9, 2009

One of the issues alive in the world of healing and writing today is whether or not writing poetry is therapy.  This issue is a sticky wicket, because in bringing the writing of poetry into the healthcare setting, we are claiming that there are measurable and intangible therapeutic effects, otherwise why would we do it?  How is the use of creative writing in healthcare similar to and also different from traditional therapy?

Therapists, it can be loosely claimed, analyze an individual according to certain categories, depending on whether they are Freudian, Cognitive-Behaviorists, etc.  Then they establish a goal for the individual and work towards that specific goal.  Artists in the healthcare setting, however, do not analyze the patients they work with.  Their purpose is to transmit their craft as vehicle for the individual to begin a dialogue with themselves.  The artist as facilitator cannot know what the deep needs of the individual are to move towards their healing, although there are specific needs which we must always attend to: for safety, acceptance and boundaries.  By using close reading, by attending to the text created by the individual and make observations about the text, not assumptions about the individual, we model a process where individuals can begin to express and observe their own emotions, and draw conclusions from them, in their own language and in their own time.The goals and methods of therapy can be lifesavers, and there are often times when we have individuals whom we need to refer for therapy.  But Thomas Moore, a psychotherapist himself, makes this distinction between poetic language and the language of popular psychology in  his book Dark Nights of the Soul:

The language of popular psychology tends to be both heroic and sentimental.  You conquer your problems and aim at personal growth and wholeness. The alternative is to have a deeper imagination of who you are and what you are going through…The quality of your language is significant.  In your dark night, try speaking in story and image.

I would suggest that in some ways it could be said that psychotherapy is reductive, in that it aims to conform the individual to an already conceived-of-goal, whereas poetry and story are additive, in that while they may summon not only the wounds of the past, they also invite openness to the mystery of the self, to the creation of something new.  To use the language of psychology, when the ego is fractured, the Self breaks in, speaking not only of pain, but also of remembrance of wholeness.

Gregory Orr, in his book, Poetry as Survival, alludes to the same idea of the dominant paradigm of heroism in the face of pain, despair and disorder as Thomas Moore does:

(My cultural training suggest) I should resist disorder and try to dominate it.  According to the mythic models that shape my response, I should take active control and subdue disorder, by heroic force, if necessary.

But the approach recommended by the personal lyric is the opposite of this: to become vulnerable, to open the door and admit the mysterious creatures who wait on our threshold seeking permission to enter.  We must, the personal lyric tells us, become vulnerable to what is out there (or inside us). Not in order to be destroyed or overwhelmed by it, but as a part of a strategy for dealing with it and surviving it.  Lyric poetry tells us that is precisely by letting in disorder that we will gain access to poetry’s ability to help us survive.  It is in the initial act of surrendering to disorder that permits the ordering powers of the imagination to assert themselves.

Artists bring to the work of facilitating this understanding and this experience.  We know that there are many mysterious creatures who wait on the threshold seeking permission to enter. We have entertained them and survived.  We give them names other than dysfunction or repression, although these names too may fit.  We try to open a space for them, in  ourselves and others.

I believe it is important to keep a distinction between poetry as healing and poetry as therapy.  In the best of all worlds, good therapy partakes of the poetic and good poetry partakes of the therapeutic.  But as artists in healthcare need to be clear about what we do, and do not, bring to the table.

Tell It Slant January 29, 2009

I’m about to start a new class, and as always, I have some trepidation. I often work with very ill people, and my intention is to create a safe, nurturing environment. But I am aware that the trauma of cancer creates disorder and destabilizes a sense of self, often triggering memories of earlier traumas. And this is not always a bad thing. In the past, I have seen participants, through the ordering process of language and the stability of a community of witnesses, express emotions that have been locked up inside them for years. For most of them, this has been cathartic. For a few of them, it has been frightening, and they have had to back off from writing from their own experiences. I encourage the use of the third person and fiction or essay writing for these people, respecting that too close an inquiry into their own history can be re-traumatizing to them.

I think that while the lyric poem or memoir can be the most direct route towards healing writing for some people, for others such direct routes can overwhelm them with emotions. Patients are in various stages of treatment, with various prognoses, so that their ability to withstand anything they feel is threatening is variable. They also come with differing personalities: one study shows that for high avoidance women, disclosure actually is more traumatizing , while for low avoidance women disclosure is cathartic.

It was a patient of mine who taught me all this. She had been doing so well, writing poetry and responding to the fairy tales that we worked with. But when we came to memoir, she balked. She couldn’t do it. So I suggested that she write what was “too hard” as a story, which she did. As long as it was in third person, with enough fictional elements, the story she needed to tell could be told. I think the important thing here is that she accessed the emotional truths of her past, without having to go into the particulars of her own history.Jayne Anne Phillips said much the same thing in a recent interview. When asked if her book Motherkind was based on her own life, here is what she answered:

The book seems to be the blow-by-blow account of a real life, and it was my hope that it would seem that way. In truth I didn’t really remember what happened during the time that I was caring for my mother. It’s like the drug they give you during surgery: the drug numbs you and also blocks short-term memory. It keeps you from remembering what happened and that you were scared or confused. We have a kind of psychological counterpart. The book is based on the idea of a woman with her first baby who loses someone who is part of her identity, a parent, slowly and painfully, and being caretaker to that person. And that did happen to me. But I blocked it out. I didn’t write the book until ten years after the experience.

I reentered the experience and made up those details. There were certain things, like the paper she uses to line the baby’s drawers, that were real and certain key moments that I did remember and put into the book. But most of it was reentered and reenvisioned and seen by the character Kate, who is just as much an invention as Lark or Termite. What is it that Wordsworth said, something like, “Poetry is the spontaneous overflow of powerful feelings . . . recollected in tranquility.” Writing is that. Living requires our full attention, as does writing. I, for one, can’t do both. An element of the writer is always held apart. You sit in a chair inside the space of the material, and you’re able to enter experience in a way that is not open to you otherwise.

The goal in healing writing is to access emotions and express them, build a coherent story, impose some order on disorder, and to create something that can be shared, so that the burden of suffering can be lifted. How this is done, through the practice of which genre, matters less than that it is done. As practitioners, I think it is important to be aware of the variable levels of comfort patients have about disclosure, and to offer as many different kinds of writing opportunities as possible.

“Any sorrow can be borne if it can be made into a story, or if a story can be told about it,” wrote Isak Dinesen. In the end, we are simply helping our participants find their story.

Read the full interview with Jayne Anne Phillips about her new book, Lark and Termite, on Narrative, https://narrativemagazine.com/issues/winter-2009/jayne-anne-phillips