What’s Wrong with this Picture??? October 15, 2010

I usually have one, two or more nurses-usually retired, working nurses don’t have time for writing–in my classes.  I’ve heard for years about the crying closet–usually a supply closet a nurse can go into to grieve privately when she/he loses a patient.  I’ve heard the story of a child dying in a young nurse’s arms, and how, as a mature woman, the nurse is still carrying the grief of the death with her.  I’ve known a student nurse who had severe stress after working on an oncology floor, but who had no way to process that stress.  We talk about caring for the caregiver, but when are we going to do something about it?

Yesterday, a working nurse told of how she cared for both her dying parents while a myriad of other disasters  befell her.  She had always, she reported, been known for her skills.  But when she asked her superior to give her some leniency, as she was grieving, she was told that she didn’t have the “luxury” to grieve, and to get back to being the high-functioning performer she had been.

Another retired psychiatric nurse, told of being put in an ICU unit.  Overwhelmed by being in a position she wasn’t trained for, she was later scolded for not–I repeat, not–letting a patient (who was an addict) bleed out.

Both nurses were taken to task for spending too much time with patients.

Hospitals today are under tremendous financial stress which translates into worker stress.  The question is–can overburdened caregivers give quality care to patients?

Arts experiences are one way hospitals can address the stress of caregiving.  Art at the bedside–writing, art, music, even dance, relieves the burden of care for nurses.  And weekly arts sessions held for nurses provide a way for them to help heal themselves, bring themselves into balance, and create more compassion for themselves, their patients, and each other.

One of the best sites to read about arts in healthcare is Marti Hand’s site:http://creativityinhealthcare.com.  A nurse and painter herself, she has done extensive research on how creativity heals.  In her latest post, she quotes David Bohm, “Creativity is fundamental to human experience. ”  We need to bring more humanity back into the healthcare environment, and arts interventions can be an important part of that effort.

Someday, there may not be a need for a crying closet.

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An Abundance of Need January 21, 2010

In The Wounded Storyteller, Arthur Frank quotes Nancy Mairs, poet and essayist, as saying that “all persons have abundances and all have lacks….your abundance may fill someone’s lack, which you are moved to fill….”  I remembered this the other night after my first meeting with my winter class at the cancer center.  I had not taught for almost 6 months.  In those months, my life revolved around therapy for my broken back, and it has been less than a month since I shed my body brace and have been able to drive. In the months of rehabilitation I lived a twilight life of sleep and physical therapy. Slowly the more normal rhythm of life claimed me: church on Sundays, lunch with friends, short forays of shopping, longer walks with my dog.  But I still feel fragile and tired. So when I drove to work Tuesday afternoon, I was more aware of that fragility than my competence.

This class was a mixture of women who had taken the class before and several newbies.  That is always a challenge because I need to bring in new material instead of relying on the tried and true, and perhaps more importantly, I need to make sure that the newbies were made  to feel part of a group that has already forged its own dynamics.

So, the first thing I asked of the group was to tell their stories.  They didn’t need to be coaxed.  A new, lovely, quiet lady opened up with a harrowing tale of  family members felled by breast cancer, gene testing, prophylactic mastectomies, and then finding that she had a rare form of cancer in her abdominal lining.  Another woman told  how she rejected implants and instead had flowers tatooed on her flat chest. Each story was like that, trauma upon trauma, terrifying diagnosis and painful treatments, including stories of loneliness and heartbreak.  By the time they were done, I realized I was the only woman at the table with breasts.  The storytelling, though, had brought the women into a deeper connection with each other, an almost palpable feeling of sisterhood.

Yet fragile myself, I felt in danger of being swamped by the sheer concentration of pain.  I was tired and in pain myself, and stressed by my wish to hide those facts. How could I offer anything to counter the pain of these brave women?

One of the first activities we always do is collaging our journals.  It is a relaxing, fun exercise, allowing for easy exchanges in the group.  More importantly, the images we are drawn to often are potent symbols for healing.  While we were collaging, one of the participants turned to me and said, “I noticed you were moving as if you were in pain. May I do some Reiki on you?”  I told her yes, I was in pain, and I would appreciate her help. Her hands on my back radiated warmth and I could feel my muscles relax.  And that was when I looked around the table and realized that I was not the helper, but that we all helped each other. We all had something to offer, even if it was an abundance of need.

One of the things I love about this work is that I can’t be anything else but what I am at that moment.  Perhaps the main competency is simply that: authenticity.  Driving home that evening, I turned off the radio, and allowed myself to savor the pink clouds in the west, the faces of the people walking in the warm evening air, the new ease of my body.  My own fragility no longer seemed like an obstacle to be overcome, but the very thing which I offered to others.

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.