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A Brief Overview Of Poetry Therapy
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.
Historically, the first Poetry Therapist on 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. It is of interest to note that Pennsylvania Hospital, the first hospital in the United States, which was founded by Benjamin Franklin in 1751, 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. Poemwriting was an activity of the patients, who published their work in The Illuminator, their own newspaper.
Poetry Therapy - A Form of Bibliotherapy
A scholarly literary search will reveal more entries under the term "bibliotherapy" than the term "poetry therapy," which became popular in the 1960's and 1970's. "Bibliotherapy" literally means books, or literature, to serve or help medically. 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.
Modern Medicine Recognizes the Power of Poetry
Meanwhile, great figures in the world of medicine were recognizing the important relationship of the arts to healing. "Not I, but the poet discovered the unconscious," wrote Freud. Other theoreticians, such as Adler, Jung, Arieti and Reik also confirmed that the poets were the first to chart paths that science later followed. Moreno suggested the term "psychopoetry," as well as the term "psychodrama", for which he is famous. By the 1960's, with the progressive evolution of group psychotherapy, therapists were delighted to discover that "poetry therapy" was an effective tool which they felt comfortable incorporating into their work. Poetry Therapy began to flourish in the hands of professionals in various disciplines, including rehabilitation, education, library science, recreation, and the creative arts.
Mental health professionals were exploring the therapeutic value of literary materials, especially of poetry. Their contribution to the emerging discipline was two-fold: 1) emphasis on the evocative value of literature, particularly poetry; and 2) recognition of the beneficial potential of having clients write either their response to poems written by others or original material, drawing on the clients' own experiences and emotions.
The Association for Poetry Therapy
In 1928, Eli Greifer, an inspired poet who was a pharmacist and lawyer by profession, began a campaign to show that a poem's didactic message has healing power. Poetry was Eli's passion, and he gave his time and energy to this life-long interest. He organized the Village Arts Center and the Messagists Club on 8th Street in the Village of New York City, and then he created the "Remedy Rhyme Gallery." He became a volunteer in order to test his theories. In the 1950's he started a "poemtherapy" group at Creedmore State Hospital. In 1959, Greifer facilitated a poetry therapy group at Cumberland Hospital with two supervising psychiatrists, Dr. Jack J. Leedy and Dr. Sam Spector. Although Greifer died in 1966, this remarkable humanitarian played a key role in the development of what we now call "Poetry Therapy". He passed along his love of "poemtherapy" to Dr. Leedy, whose drive and pioneering spirit led to the creation of the Association for Poetry Therapy.
While Dr. Leedy continued to explore the therapeutic benefits of poetry at Cumberland Hospital and the Poetry Therapy Center in New York, Ann White (co-author with Deborah Grayson of Parents and Other Strangers, 1987) was working with the Nassau County Recreation Department and created an experimental project that brought the therapeutic benefits of poetry to hospitals, rehabilitation centers, and schools for special children. Concurrently, Gil Schloss, Ph.D. (author of Psychopoetry, 1976) was conducting "psychotherapy" sessions with individuals and groups at the Institute for Sociotherapy in New York. In 1969, they joined with Dr. Jack Leedy to found the Association for Poetry Therapy. Morris R. Morrison, Ph.D., poet and educator, (author of Poetry as Therapy, 1986) was a great supporter of the Association and drafted the first systematic set of standards for certification in the field. This document was published in the Association of Hospital and Institution Libraries Quarterly in 1973.
Around the country many gifted individuals, who were helping professionals, were using Poetry Therapy. From the first few months of poet Joy Shieman's pioneering research in 1962, within a mental health unit of a hospital in California, her method was termed "thera-poetics." Authentically and naturally, this right hemisphere of the brain approach to the healing action of Poetry Therapy attended to what she has always viewed as a lack within the psychiatric picture - "realignment of the soul". In 1971, Arthur Lerner, Ph.D., poet and psychotherapist, was appointed Poet-in-Residence and Poetry Therapist at a private psychiatric facility, the Calabasas Neuropsychiatric Center in California. Ruth Lisa Schechter, poet (author of Poetry Therapy: A Therapeutic Tool and Healing Force, 1983), became the first official poetry therapist at Odyssey House, in New York City, working with addiction clients and victims of rape and incest in 1971. Librarian Eloise Richardson convinced the Governor of Maryland to hold a Poetry Therapy Day, sponsored by the state of Maryland in 1974. Poet and educator Aaron Kramer, Ph.D. opened new worlds to the deaf and disturbed (see Poetry the Healer, 1973). Poet Art Berger, Ph.D. wrote about poetry as a vehicle for self-discovery for both teachers and youngsters (Poetry the Healer, 1973), and used rock, blues lyrics, and "jazz cinquains" to elicit writing from children. Dr. George Bell (The Self-Discovery Notebook, 1990), a minister from Ohio, was incorporating poetry into his counseling, and developed "the feedback poem," a technique enabling the counselor and counselee to understand each other better. Clearly, Poetry Therapy was being used successfully with many different populations.
The 1970's also saw the development of several groups or training institutes. Arthur Lerner, Ph.D., RPT (Poetry in the Therapeutic Experience, 1976) founded the Poetry Therapy Institute on the west coast. Arleen Hynes (co-author of Bibliotherapy - The Interactive Process: A Handbook, 1986), librarian at St. Elizabeths Hospital in Washington, DC, founded the Bibliotherapy Roundtable. Morris Morrison founded the American Academy of Poetry Therapy in Austin, Texas. Jennifer Groce Bosveld (author of Topics for Getting in Touch, 1982) created the Ohio Poetry Therapy Center and Library in Columbus, Ohio.
Publications reflect the burgeoning of interest in the field. In 1927 R.H. Schauffler published The Poetry Cure: The Medicine Chest of Verse, Music and Picture. Unfortunately almost no record indicating how this precursor of the contemporary creative arts therapies was used. In 1960, the psychiatrist, Smiley Blanton wrote The Healing Power of Poetry, based on several years of practice. Dr. Jack Leedy, ascribes his early enthusiasm for poetry in psychotherapeutic practice to Eli Greifer, who published a pamphlet, Principles of Poetry Therapy in 1963. By 1969, Dr. Leedy had motivated several mental health practitioners to contribute articles about their use of poetry to his historic collection, Poetry Therapy: The Use of Poetry in the Treatment of Emotional Disorders. Molly Harrower, a psychologist, came out with The Therapy of Poetry in 1972. Dr. Leedy, in 1973, provided further evidence of the use of poetry in practice when he edited Poetry the Healer.
In 1978, Rhea Joyce Rubin, a librarian, published two books which contribute to theory and are valuable evidence of the growth of the field, Using Bibliotherapy: A Guide to Theory and Practice, and Bibliotherapy Sourcebook. In the same year, Arthur Lerner, Ph.D., a clinical psychologist, published Poetry in the Therapeutic Experience. Arleen Hynes and Mary Hynes-Berry provided the field in 1986 with the first comprehensive text, Bibliotherapy - The Interactive Process: A Handbook. In 1987, NAPT started the Journal of Poetry Therapy: The Interdisciplinary Journal of Practice, Theory, Research and Education under the editorship of Nicholas Mazza, Ph.D., RPT, a professor of social work.
In the 1980's and 1990's there have been many excellent books and articles published about writing as a therapeutic tool. The Journal of Poetry Therapy is the richest and most comprehensive source of current theory, research and technique.
The Development of Standards in the Field
By 1980, the field was represented by different institutes giving their own training certificates, but uniform requirements for training poetry therapists had not been established. In 1980, Sherry Reiter, as Vice-President of APT, called a Board Meeting which invited leaders in the field to deal with issues which were impeding the profession's growth as a viable, national creative arts therapy group.
The leaders in attendance were: Jack Leedy, M.D., Arthur Lerner, Ph.D., Morris M. Morrison, Ph.D., Akhter Ahsen, Ph.D., Arleen M. Hynes, CPT, Rosalie M. Brown, CPT, RPT, Art Berger, M.Ed., George L. Bell, D.Min., Joy Shieman, CPT, Anthony Pietropinto, M.D., Deborah Sklarew Langosch, MSW, CPT, Gilbert Schloss, Ph.D. and Sherry Reiter, MA, CPT.
Two important developments resulted from this meeting: 1) It was unanimously decided that APT become NAPT, a national non-profit association; and 2) Arleen Hynes chaired a steering committee and became the first president of what developed into the National Federation for Biblio/Poetry Therapy, an organization founded by early activists in NAPT in order to consolidate their concerns for continued excellence in the field. This group has now taken over the function of credentialing Poetry Therapists with designations as a Certified Poetry Therapist (CPT) or Registered Poetry Therapist (RPT).
Kenneth F. Edgar, Ph.D. and Richard Hazley, M.A., who did some of the first research studies of Poetry Therapy in the 1960's, published a curriculum proposal for training poetry therapists (see Poetry Therapy, 1969). The proposal required the establishment of a new curriculum that would embrace training in both psychology and literature. To date, no university has adopted this approach, although individual courses are offered at universities throughout the United States.
The first comprehensive training program was created in 1974, by Arleen Hynes, a librarian at St. Elizabeths Hospital, with the encouragement and support of Kenneth Gorelick, M.D. Standards and criteria for practice were a continuing focus for Hynes and Gorelick, who collaborated with Sherry Reiter, certification chair of APT, to make Morris Morrison's 1973 standards specific to the St. Elizabeths Hospital training program. In 1976, Rosalie Brown was appointed as the first Federal Bibliotherapist, a job title which never existed before. Persistence and high standards helped to make this achievement possible.
The professional standards and requirements were set by the Certification Committee of NAPT, and as of June 2000, the Federation for Biblio/Poetry Therapy is the only organization qualified to grant Certification or Registration in Poetry Therapy. NAPT is the official membership organization representing poetry therapists. It provides information and publications, sponsors a national conference, supports education, research and training, represents the field to other organizations and promotes the growth of the field along with the interests of practitioners and the public. NAPT is also an affiliate of the National Coalition of Arts Therapies Associations (NCATA).
The fact that Poetry Therapy is a "non-traditional" form of therapy and one which is still in its early stages of public acceptance makes high standards a necessity. NAPT is proud to welcome those who choose to enter this field and become fellow pioneers. The future of Poetry Therapy will be written by you.
Adapted and revised with author's permission from Hynes, Arleen M. and Hynes-Berry, Mary (1992) Biblio/Poetry Therapy: A Resource Bibliography. St. Joseph, Minnesota: Bibliotherapy Round Table. A more in-depth overview and history is in the making. There are many individuals whose names have not been mentioned, who have worked steadily and passionately in the field of Poetry Therapy. NAPT wishes to acknowledge their efforts and dedication. This is by no means a definitive history.
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Poetry as Therapy
by Perie J. Longo, PhD., RPT(Registered Poetry Therapist)
It is difficult
to get the news from poems,
yet men die miserably every day
for lack of what is found there.
William Carlos Williams
Since 1991, I have been conducting group poetry reading and writing sessions at Sanctuary Psychiatric Centers. My interest in this field began as far back as I can remember, before I ever knew there was such a thing as poetry therapy. As a child I remember sitting in school daydreaming. My mind would wander out the window, and as it did, my feet would begin to tap a rhythm. The more I would fall into the rhythm, the more complex it would become, and then words and images would swim to mind. Before I could write them down, however, the teacher would call me back to the classroom, where shame would quickly replace ecstasy, having lost one focus for another. Only years later would I understand that entering the space of rhythm was the place where poetry dwelt, and that place resisted the mind of everyone but the individual, the creative Self, the "I."
In the years that I have been writing poetry with many different groups, I have come to respect more and more the indefinable place from which the poem comes (which I like to call "The Secret Place"), the ability of each individual to travel to that source of creativity easily and naturally, and how much the poem has to teach us about ourselves and the world, as form and sound give rise to silence. One of the benefits of poetry reading and writing is not only does it help define the "I", but strengthen it. This is necessary if we are to be a part of the world. The process attaches us to the greater part of ourselves, to all that is whole and good and beautiful. And when we feel ourselves as not alone in the world, but a part of and integrated with all that exists, self-esteem grows. The good news is we discover we are the same heroes and heroines of the old mythology, and in writing ourselves we extend it into the present, and forward, creating new stories to mark us.
Some of the members of the poetry groups at Sanctuary Psychiatric Centers have been coming for two to three years. Each week their poems are typed and added to a notebook. Some of them have several volumes. It seemed important to me to fasten their poems down, so that when they moved from place to place, they could take their poems with them to provide some continuity. When this activity first started I asked a group how it felt to have their creations in this form. One young man, who dictated all his words, clutching his book to his heart said, "I feel like I am somebody, finally."
It is important to mention here that the focus of poetry for healing is self-expression and growth of the individual whereas the focus of poetry as art is the poem itself. But both use the same tools and techniques; language, rhythm, metaphor, sound, and image, to name a few. In the end, the result often is the same. The word therapy, after all, comes from the Greek word therapeia meaning to nurse or cure through dance, song, poem and drama, that is the expressive arts. The Greeks have told us that Asclepius, the god of healing, was the son of Apollo, god of poetry, medicine and the arts historically entwined.
History of Poetry Therapy
Though poetry as therapy is a relatively new development in the expressive arts, it is as old as the first chants sung around the tribal fires of primitive peoples. The chant/ song/poem is what heals the heart and soul. Even the word psychology suggests that, psyche meaning soul and logos speech or word. In mythology Oceanus told Prometheus, "Words are the physician of the mind diseased."
Though it was recorded there was a Roman physician named Soranus in the first century A.D. who 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.
The term "bibliotherapy" is a more common term than poetry therapy, which became popular in the 1960’s and 1970’s, which literally means the use of literature to serve or help. Freud once wrote, "Not I, but the poet discovered the unconscious." Another time he said, "The mind is a poetry-making organ." 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.
In the 1950’s, Eli Greifer, a poet, pharmacist and lawyer began a "poemtherapy" 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, Ph.D. 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). For more information on this organization you may visit their website at http://www.poetrytherapy.org.
Healing Components of Poetry
Poetry is the response of our innermost being to the ecstasy, the agony and the all-embracing mystery of life. It is a song, or a sigh, or a cry, often all of them together.
--Charles Angoff (Lerner, 1994)
Poetry humanizes because it links the individual by its distilled experience, its rhythms, its words to another in a way which no other form of communication can. Poetry also helps to ease the aloneness which we all share in common.
--Myra Cohn Livingston (Lerner, 1994)
I believe that a poem is an emotional-intellectual-physical construct that is meant to touch the heart of the reader, that it is meant to be re reexperienced by the reader. I believe that a poem is a window that hangs between two or more human beings who otherwise live in darkened rooms. I also believe that a poem is a noise and that noise is shaped.
--Stephen Dobyns (Dobyns, 1997)
The above quotations encompass some of the therapeutic aspects of poetry mentioned in the opening of this article. Often those in a therapy group have never written a poem, or if they have, it was unsuccessful and they feel they are "no good" at writing and want to leave the group. It is important to explain they do not have to write, they need only join in the discussion when they are ready. It is also important to mention that this is not a class as in school and there are no grades, no editing unless they want to do so on their own. This is a space not for criticism, but self-expression and exploration. And then we begin.
Each session, a poem is presented. Selection of material is based on the "isoprinciple" also effective in music therapy. This means that the emotion of the poem is one that hopefully captures the mood of the group. If depression is a dominant mood, then a poem about depression is helpful, as long as there are lines that reflect hope and optimism. This principle is very comforting, because it allows the participant to realize they are not the only ones who suffer, that someone understands them because they have experienced it and written about it. They can share in their despair (Leedy, 1985).
The facilitator can present a reason for the poem choice for that day. Or wait until someone reads it, and let the group decide if it has anything to do with them. Often the poem is read twice by one or two of the members so that the rhythm, the music of the poem will enter their minds to help focus, replacing the chaos of thought. Usually there will be a silence after the reading, as members survey the field of words as if it is a lake or meadow or scene to absorb.
The silence gives way to a breeze, as members begin to discuss lines that appeal to them, or images. Maybe only a word will call to them. Or maybe they won’t like it at all. The mystery of the poem is discussed. They love to ask "what does it mean" and we try to respond, not for the correct answer, for there never is one, but for the possibilities that can exist. And the possibility becomes an avenue for seeing things in a new way, even a predicament they can be experiencing. Whatever they have to say, or not say, is heard and accepted, never judged. A poem does not have to rhyme, but it must have rhythm, and does. I find when people speak from their heart, there is usually a rhythm, subtle though it may be.
Rhythm comes in many forms in a poem and often carries with it repressed feelings integrating chaotic inner and outer events into one’s own experience. (Meerloo, 1985) A change in rhythm can often help move a participant from one place to another, or help them be aware of the feelings that are causing pain or fatigue or withdrawal. Often rhythm will release the tension in the beginning of a group. The rhythm is carried in the beat of the words, the repetition of certain sounds. And it is that repetition that has its hypnotic quality that helps create "the secret place," the bridge to the unconscious, from which the poem springs. As participants respond to the gentle suggestions of what they see in the poem, they see more and begin to speak to each other. Isolation is broken. The poem brings them not only in touch with their own music, but each other’s.
Poet Donald Hall describes the primitive pleasures of rhythm in poetry as "Goatfoot, Milktongue, and Twinbird" (Hall,1980) saying they are the ancestors, the psychic origins of poetic form. The infant kicks rhythmically, without thought; experiments with sound, babbling vowels and consonants, plays with its hands, seeks nourishment from the mother, bonding in repetitive motions. There is the pleasure of appearance-disappearance as in the peek-a-boo play, words appearing and disappearing again. The ability to be poetic is natural in our system of survival, and it is the facilitator’s task to ease participants into this birthright to catch their thoughts and write them down, or have someone write them down, in a form that unlocks the mind.
Form is an important component of the therapeutic value of poetry. Sometimes, if the issue at hand is too frightening, we can actually draw a box in the middle of the page and limit words to that space. Emotion will not run amok in this way, but be protected in the frame natural to the order of poetry. In free verse, the constraints of couplets and quatrains no longer exist, with rhyme removed, but still we know poetry has shape and form, and we can impose that naturally with the workings of our mind and the natural rhythms and images that come forth. "Form makes arrangement out of derangement, harmony out of disharmony, and order out of chaos." (Heninger, 1994) When strong emotions can be expressed in an acceptable, safe manner, these feelings can subside. There is great release, and enjoyment in sharing with others, who identify. Balance is restored.
Shapes can also be invented as in concrete poetry. Children often love dancing the words on the page in circles and spirals, drawing arrows where one word leads to another in a sort of map. There is great feeling and release in that playfulness. Poetry does not have to be the serious business we were once taught. Rules can fly out the window and we can make up our own as we go along.
Often I will take a phrase from a poem and repeat it for each group member to orally fill in their thoughts, before they write their own poem. One day I began with such a phrase, "I have the right." As we went around the circle seated in the living room, most touching lines were being spoken: I have the right to get a cup of milk in the middle of the night; I have the right to breathe; I have the right to play my guitar; I have the right to comb my hair, etc. Suddenly one young man who was suicidal said, "I have the right to get a gun to shoot myself." A woman, who had sat quite silently lost in herself each time she came to group, which was not often, spoke up. Turning to him she said softly but firmly, "And I have the right to take it from you." In that moment the silence was stunning. Everyone felt the impact of these simple words: certainly a poem. A sound and shape that still resonates with all of us.
The sounds of words themselves are healing not only in and of themselves but in conjunction and juxtaposition with each other. Constantine Stanislavski, founder of the method school of acting once wrote "Vowels are the rivers of the soul and consonants are the banks." Poetry is language and language is what humans do with air, I once heard from a Native American speaking the Cherokee language which sounded like a woodpecker to me with its repetitive k sounds. How we define words, defines us. How we use them also defines us and when we realize they are notes like drops of rain we can have a little storm or a big one, make a composition of our interior life.
As we speak our emotion, sadness may roll out in long o sounds as in "The Negro Speaks of Rivers" by Langston Hughes: "I’ve known rivers ancient as the world and older than/the flow of human blood in human veins./My soul has grown deep like the rivers."
In the same poem, the line "I built my hut near the Congo and it lulled me to sleep" uses sharper sounds. These allow the soul to flow. They also give tension to the sound, conveying stress, anger, struggle. And so a woman can write of losing her baby in a poem expressing her pain and grief through the sound of vowels, and her anger through the firmness of consonants. Poetry has the ability to carry many emotions at once, and hold them intact. Often that is exactly what is needed in the therapeutic environment.
One of the most often quoted poems in American literature in conjunction with literary genius and word sounds is Robert Frost’s "Stopping by Woods on a Snowy Evening". It is also used often in poetry for healing, focusing on the intent to keep going with the journey, no matter how rough it gets, how cold the weather, or how enticing the moment of wanting to linger in the woods, "lovely, dark and deep." Mary Oliver in her Poetry Handbook discusses the beauty and repetition of the sounds of the poem, the repetition of w’s and th’s, the double ll’s. The sounds set the quietness of the tone in the first stanza ("Whose woods these are I think I know./His house is in the village though;") In the second and third stanza the horse is the focus of the poem: "He gives his harness bells a shake/To ask if there is some mistake." The k sounds give the snap, the tension, carrying the conflict of hesitation. (Oliver, 1994) This is how sound works in writing, but often it is subconscious.
In as essay "Sing It Rough" poet Tess Gallagher says in writing poetry, nothing is more important than the heart, for there is the passion and the struggle. Often this comes about by hitting the "wrong notes", not just making pretty music. She quotes a poem by Cahil McConnel:
You can sing sweet
and get the song sung
but to get to the third
dimension you have to sing it
rough, hurt the tune a little. Put
enough strength to it
that the notes slip. Then
something else happens. The song
gets large. (Gallagher, 1986)
Each time I come away from poetry groups for healing, I carry the immense songs sung by the members, spoken or written, with what has happened. They have the courage that Gallagher describes, maybe because the focus is on the emotion rather than craft, and artifice is never stressed. There is a natural drive to survive and the language, the sounds of the words help achieve that.
A client I had a few years ago in private practice started coming to me because she had things to say and wanted me to help her get them down. She loved poetry, and wanted to participate more freely in it. For five months we saw each other almost on a weekly basis. As a child of seven, she had contracted equine encephalitis in Mexico from mosquito bites and gone into a coma for six weeks after complete cardiac arrest following wild convulsions. That she recovered was a miracle. That she could talk and walk again took years of work. When I started seeing her, she was almost thirty, though her brain had suffered severe damage so that her thought processes were still as a young child. Because she could barely write, her right arm and hand with limited motion, I would write down what she spoke. One day she had a massive convulsion and left without warning. But she left a legacy of poems that portray how words can lift someone from despair to hope. One of her poems, engraved on her grave site reads: "I cry not/For if I die, I go as one/The body, spirit, mind and soul/Connected now/Set free." (Longo, 1996) Perhaps that is the main therapeutic benefit of poetry; words remain forever for they are sound waves. Wherever we go, they follow us, from room to room, unconsciousness to consciousness, denial to acceptance, sorrow to joy. And hopefully to health.
Dobyns, Stephen. (1997) Best Words, Best Order: Essays on Poetry. New York: St. Martins Griffin, xii.
Gallagher, Tess. (1986). A Concert of Tenses: Essays on Poetry. Ann Arbor: The University of Michigan Press, 88.
Hall, Donald. (1980). Goatfoot, Milktongue, Twinbird: the psychic origins of poetic form. In Stuart Friebert and David Young, (Eds).A Field Guide to Contemporary Poetry and Poetics. New York: Longman, 26-36.
Heninger, Owen E., MD. (1994). Poetry therapy in private practice: An odyssey into the healing power of poetry. In Arthur Lerner, Ph.D., (Ed.). Poetry in the Therapeutic Experience, 2nd edition. St. Louis: MMB Music, Inc., 57.
Leedy, Jack J., M.D. ed. (1985) Poetry As Healer: Mending the Troubled Mind. New York: Vanguard Press, 82.
Lerner, Arthur,Ph.D. ed. (1994) Poetry in the Therapeutic Experience, 2nd edition. St. Louis: MMB Music, Inc., xi.
Longo, Perie J., Ph.D. (1996). If I had my life to live over - Stephanie’s story: A case study in poetry therapy. Journal of Poetry Therapy ,10, 55-67.
Meerloo, Joost, M.D. (1985). The Universal Language of Rhythm. In J.J. Leedy, ed., Poetry As Healer: Mending the Troubled Mind. New York: Vanguard Press, 15.
Oliver, Mary. (1994). A Poetry Handbook: A prose guide to understanding and writing poetry. New York: A Harvest Original, 24.
The National Association for Poetry Therapy Guide to Training. New York: NAPT, 1997.
HOW DO I BECOME A POETRY THERAPIST?
The National Association for Poetry Therapy encourages the professional growth of the field and persons in it by facilitating training and encouraging pursuit of the designations of Certified Poetry Therapist (CPT) and Registered Poetry Therapist (RPT). As of June 2000, these designations are awarded by the Federation for Biblio/Poetry Therapy, an independent credentialing organization, to fully qualified applicants who have duly applied and been approved by the Federation. Prior to June 2000, credentialing was handled through the Certification Committee of NAPT.
Please note that the only persons authorized to call themselves poetry therapists are those who have fulfilled the training requirements and been awarded, or who are eligible to be awarded, the designation by the Federation for Biblio/Poetry Therapy (formerly NAPT, through its Certification Committee).
The requirements for certification summarized here are effective as of May 1, 1997. Those who began training before that date are entitled to complete their training under the requirements which were in effect when they submitted their letter of intent and training plan to the NAPT Certification Committee. Those who submit letters of intent after May 1, 1997 must complete their training under these requirements.
SUMMARY OF REQUIREMENTS FOR CERTIFICATION/REGISTRATION AS A POETRY THERAPIST
Thousands of professionals use poetry and other forms of literature to foster personal growth and help achieve therapeutic goals with clients. However,
The only persons authorized to call themselves poetry therapists are those who have fulfilled the training requirements and have been awarded or who are eligible to be awarded the designation of either Certified Poetry Therapist (CPT) or Registered Poetry Therapist (RPT) by the Federation for Biblio/Poetry Therapy (formerly NAPT, through its Certification Committee).
The CPT is trained to facilitate groups and work with individuals in developmental settings such as schools, libraries, recreational facilities and similar growth and development oriented organizations. The CPT may also work in a mental health setting as an adjunct therapist in cooperation with a primary therapist. In clinical settings, the CPT works under the clinical supervision of an RPT or other qualified mental health professionals.
The CPT brings a unique background, blending love of literature and creative writing with an understanding of basic psychology and group dynamics. Although the CPT's training is geared to working in developmental settings with healthy populations, the CPT must be able to recognize the difference between "normalcy" and pathology, and must be able to determine when a distressed individual needs to be referred to another mental health professional.
The RPT has trained more extensively and in greater depth than the CPT and works with more difficult and troubled populations. Because the RPT has previously earned an advanced clinical degree in psychotherapy, counseling, psychiatry or social work, the RPT is qualified to work with clients of all types in settings such as clinics, hospitals, prisons and similar institutions, as well as with mentally healthy populations. RPTs also work with individuals having adjustment problems brought about by developmental or life crises or disabilities.
TRAINING REQUIREMENTS FOR CERTIFIED POETRY THERAPIST (CPT)
Bachelor's Degree and appropriate knowledge of psychology and literature
1. Facilitating Group, Individual or
Family Sessions of Poetry Therapy 120 hours
2. Supervision 60 hours
3. Didactic Study of Poetry Therapy 200 hours
4. Peer Experience in Poetry Therapy 60 hours
TOTAL: 440 hours
In addition to fulfilling these hours of training with appropriate supervision by a Mentor/Supervisor, the applicant must also meet personal qualifications.
TRAINING REQUIREMENTS FOR REGISTERED POETRY THERAPIST (RPT)
Master's Degree or higher in a Clinical Field and appropriate knowledge of psychology and literature
1. Facilitating Group, Individual or
Family Sessions of Poetry Therapy 300 hours
2. Supervision 100 hours
3. Didactic Study of Poetry Therapy 250 hours
4. Peer Experience in Poetry Therapy 60 hours
5. Institutional Experience 165 hours**
6. Other Meritorious Learning 100 hours**
TOTAL: 975 hours
** Requirement waived for applicants with a Ph.D. in a clinical field or a medical degree.
In addition to fulfilling these hours of training with appropriate supervision by a Mentor/Supervisor, the applicant must also meet personal qualifications.
REQUIRED BACKGROUND KNOWLEDGE FOR BOTH CPTs & RPTs
Psychology: Both CPTs and RPTs must demonstrate knowledge in areas of psychology including: personality; human development; abnormal psychology; methods of psychotherapy; group process. "Knowledge" is demonstrated by successful completion of a course, or an equivalent, in at least 3 core areas:
Counseling Strategies (Methods of Psychotherapy)
Literature: CPTs and RPTs must also demonstrate knowledge in areas of literature including: creative writing; poetic devices; literature of various genres appropriate for use in Poetry Therapy. A minimum of 3 courses are required in the core areas of literature; e.g.,
Literature of Various Genres Appropriate for Use in Poetry Therapy
Possible Additional Courses (e.g.):
Nineteenth Century U.S. Poetry
For programs that guide you through the CPT/RPT training process, click here.
FOR MORE INFORMATION
Order the CPT/RPT Guidebook on-line or by sending $25 to:
ATTN: CPT/RPT Guidebook
5505 Connecticut Ave. NW #280
Washington, D.C. 20015
CPT/RPT Training Guide $25
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Copyright 2000-2002 The National Association For Poetry Therapy
All rights reserved.
Revised: Saturday, February 02, 2002 ]
Journal of Poetry Therapy, Vol. 10, No. 3, 1997
Poetry Therapy: Testimony on Capitol Hill
Sherry Reiter, C.S.W., RPT, RDT
This report on poetry therapy was originally submitted to the National Coalition of Arts Therapies (NCATA) for testimony on Capitol Hill. The report presents an overview of the field of poetry therapy.
Poetry therapy and bibliotherapy are terms used synonymously to describe the intentional use of poetry and other forms of literature for healing and personal growth. The term "biblio" means "books" and by extension, literature. "Therapy" is derived from the Greek word "therapeia," meaning "to serve or help medically," and suggests the concept of healing. Basically then, bibliotherapy is the use of literature to promote mental health (Hynes & Hynes-Berry, 1994). The poetic elements play a central role in heightening the emotional impact of the literature with the potential for katharsis-cleansing through the release of emotion.
The concept of katharsis was conceived by Aristotle who believed that poetry was a form of knowledge, having a positive moral effect on the psyche. The process of katharsis involved both a controlling and directing of emotions, reminiscent of William Wordsworth's lines in "Intimations of Immortality":
* This testimony was written and respectfully submitted by Sherry Reiter, President of the National Association for Poetry Therapy ('93-95), and the following members of the Advisory Committee: Samuel Gladding, Ph.D., C.P.T., Marion Goldstein, M.A., R.P.T., Kenneth Gorelick, M.D., R.P.T., Owen Heninger, M.D., R.P.T., Arleen Hynes OSB, R.P.T., Jack J. Leedy, M.D., C.P.T., Arthur Lerner, Ph.D., R.P.T., Hirsch Lazaar Silverman, Ph.D. More information about the National Association for Poetry Therapy may be attained from NAPT's Central Office, P.O. Box 551, Port Washington, NY 11050. Phone (516) 944-9791.
© 1997 Human Sciences Press, Inc.
To me alone, there came a thought of grief:
A timely utterance gave that thought relief,
And I again am strong.
Imaginative literary material books; articles; stories; songs; poems; films or videos may be chosen to elicit both thoughts and feelings. The therapeutic experience is facilitated by a therapist, poet, or other professional trained in biblio/poetry therapy and may involve a one-to-one relationship, a couple, a family, or group process.
Developmental interactive bibliotherapy refers to the use of literature and creative writing with children, adults, and older persons to promote growth and development when working with healthy populations in environments such as schools, recreation centers, libraries, and nursing homes.
Clinical interactive bibliotherapy refers to the use of literature and creative writing to promote healing and growth in psychiatric units, community mental health centers, and in chemical dependency units.
Creative writing is a specific activity in which the participant's own creative writing is viewed as another avenue toward self-discovery. Different genres lend themselves to specific needs. For example, preschool and older children benefit from a technique called "mutual storytelling," in which the client and bibliotherapist tell a story together (Gardner, 1971). Junior high school kids read, write, and react enthusiastically to soap opera scenarios. Teens are especially responsive to song lyrics and may choose to write their own (Mazza, 1988). Journal writing is an excellent way to discover what has been learned over time through reflecting on personal experiences (Adams, 1990).
Life review and reminiscence have been particularly effective in helping the elderly (Reiter, 1994). A life review involves a person writing his or her autobiography using albums, letters, memoirs, and interviews in order to gather and integrate a person's life experience into a meaningful whole. Telling one's story through poems, songs, journals, or other expressions of the written word provides vital material for the therapeutic process. Finding one's own voice is a self-affirming process, often followed by greater self-understanding and new insight.
The basic goal of therapy is to promote change, resulting in increased coping skills and adaptive functions to work through underlying conflicts. The specific goals of poetry therapy may be identified as follows:
a. to improve the capacity to respond to vivid images and concepts,
and the feelings aroused by them;
Testimony on Capitol Hill
b. to enhance self-understanding and accuracy in self-perception;
c. to increase awareness of interpersonal relationships;
d. to heighten reality orientation;
e. to develop creativity, self-expression and greater self-esteem;
f. to encourage positive thinking and creative problem-solving;
h. to strengthen communication, particularly listening and speaking skills;
i. to integrate the different aspects of the self for psychological wholeness;
j. to ventilate overpowering emotions and release tension;
k. to find new meaning through new ideas, insights, and/or information;
1. to help participants experience the liberating and nourishing qualities of beauty.
Bibliotherapy has a broad range of application with people of all ages and is used for health, maintenance, and populations requiring treatment for a variety of illnesses and conditions. Examples of these are: those suffering from the addictions of drugs, alcohol, and eating disorders; families with problems; the frail elderly; adolescents; survivors of violence, abuse and incest; the homeless; the learning disabled; and veterans. The literature and case studies provide supporting evidence that poetry therapy is an effective and powerful tool with many different populations.
Poetry therapy is an interactive process with three essential components: the literature, the trained facilitator, and the client(s). A trained biblio/poetry therapist selects a poem or other form of written or spoken media to serve as a catalyst and evoke feeling responses for discussion. The interactive process helps the individual develop on emotional, cognitive, and social levels. The focus is on the person's reaction to the literature, never losing sight of the primary objective-the psychological health and well-being of the client. The great poet Byron once said, "Poetry is the lava of the imagination whose eruptions prevent the earthquake." When emotions such as anger and depression cannot be expressed, they may lead to symptom formation. The process of reading and writing poetry can be seen as providing an acceptable outlet for venting potentially explosive psy-
chic forces and restoring psychological and physiological balance (Heninger, 1978). William Blake's poem reminds us of the importance of expressing feelings directly and honestly.
I was angry with my friend:
I told my wrath,
my wrath did end.
I was angry with my foe: I told it not,
My wrath did grow.
Poetry enables people to express what they may be unable to say in any other way. A bibliotherapy session may provide the first step in speaking about what is shameful or "unspeakable." The bibliotherapist draws upon a wide range of literature to address the "existential" concerns of individuals (i.e., mortality, loss, loneliness) (Yalom, 1985). These subjects, which are ordinarily "taboo," can be approached and examined in a bibliotherapy session.
The power of literature is derived largely from imagery or seeing with the mind's eye. Research has shown that imagery is linked with learning, relaxation techniques, life meaning and life enjoyment (Gladding, 1992). Imagery is the language of dreams and the unconscious, and as such, serves as a catalyst for bringing unconscious material into conscious awareness. Freud called the poet "the professional daydreamer," and noted the similarities between poetry and dreams (Leedy & Reiter, 1981). Dreams and poetry utilize the same psychological mechanisms-imagery, displacement and condensation. The single most powerful poetic device, in dreams as well as literature, is symbolic representation through metaphor. Dramatic plays and short stories may be chosen to help people gain control over their life situation; the reader identifies with the characters, and seeks solutions that are unique and universal (Lerner & Mahlendorf, 1991). Symbolic representation and imagery are poetic qualities that can be found in fiction, myths, fairy tales and dramatic plays, but its richest source is poetry.
Imagery teaches people how to use their creative imagination, and taps into hidden resources that can break dysfunctional patterns and promote change. The cultural authority attributed to the poem is a factor that may influence individuals to surrender some control of their thinking to the organized experience portrayed in the literature. Constricted thinking and resistance give way to involvement, sharing, and the resolution of conflict (Stainbrook, 1978). Literature is also infused with the energy of its creator, and the words of great men and women through the ages empower the reader.
Testimony on Capitol Hill
The poetry that is written or used in poetry therapy is not chosen for its literary merit, but as a tool for awareness and self-discovery. Since an essential part of self is experienced through sense perception, poetry with vivid imagery is most effective. Poetry opens the senses and their associated feelings to receiving clearer, more intense impressions and images from both the outer and the inner world (Gorelick, 1989). With the help of the facilitator and group, the participant can examine and adjust these impressions for a clearer focus.
The universal component is essential to helping people connect with others who are "in the same boat." Often the poem is experienced as "an understanding other" or a "friend" (Leedy, 1985). "I suffer," said the man. "Not you alone," said the poem.
When participants externalize feelings through writing, the literature is a black and white testament to feelings and thoughts previously without form. The externalization gives participants a sense of mastery and also allows individuals to view their feelings from an different perspective. Often people who are experiencing loss or stress are comforted by a poem or affirming thought that they can carry with them.
In addition, poetry may have layers of meaning, and its ability to conceal as well as reveal, gives participants the freedom to express themselves without being judged. The subtlety of poetry is part of its gentle appeal. By introducing a poem, the therapist suggests an agenda for the session. If the group is not ready for it, they will evade it, but because the suggestion is gentle, the resistance is also gentle. As a result, poetry therapy may be experienced as less confrontational and less threatening than other therapies, and some people in clinical settings who refuse to participate in more traditional therapies, willingly attend poetry therapy (Rossiter, 1989).
Poetry can be subtle, hold multiple messages, and at the same time be emotionally direct (Murphy, 1979). Its honesty helps people to explore difficult issues. When participants hear a group member or poet speak from the heart, they become more willing to do so themselves.
How I miss my father.
I wish he had not been
when I was born.
Poetry has the unique capacity to allow the varied and even paradoxical aspects of self to be integrated into a unified expression of the heart, mind, and spirit. Contradiction is exemplified in these words by poet James Kavanaugh:
I laugh and cry with the same eyes,
Love and hate with the same heart
I feel my rage and my gentleness.
A typical session would consist of the following steps:
The poetry therapist creates a gentle, non-threatening atmosphere where people feel safe and are able to share feelings openly and honestly. The group agrees to respect any confidential issues that are brought up. A warm-up consisting of a word game, word associations, a song, or other verbal introduction is used to "break the ice" so everyone feels comfortable.
II. The Body of the Session
The facilitator suggests a creative writing theme, or uses creative writing that has already been published to help participants to explore feelings, thoughts, ideas and personal issues. Choosing literature that will be effective therapeutically requires forethought and sensitivity. Although there are no fixed rules regarding the method for selecting material, there are some basic guidelines:
1) The facilitator uses universal material to foster identification. Psychiatrist Dr. Jack Leedy suggests that the catalyst poem be chosen according to the isoprinciple, matching the feeling tone of the poem to the client's mood to aid in the identification process.
2) The facilitator avoids confusing, hopeless, and depressing material that offers no resolution or insights into coping with negative feelings. Even if a poem's last few lines are uplifting, if the bulk of material is negative, the mood of the client may plummet with counter-therapeutic results.
3) The facilitator chooses poems in which the metaphoric content
builds upon and integrates images clearly and consistently. This leads to clear, cohesive thinking on the part of the listener (Goldstein, 1992).
Testimony on Capitol Hill
4) The facilitator avoids literary material that glorifies homicide, suicide, or that denigrates parental figures or G-d (Leedy, 1985).
In addition to choosing the genre or form of literature, the poetry therapist will pay special attention to the content of the material and its relevance to the participants. The developmental level, cultural make-up, literacy level, circumstance and emotional fragility of the participants will be assessed prior to making a literary selection. If the bibliotherapist is working in a clinical or institutional setting, it is important to know the personal history and diagnosis of each participant. This familiarity will alert the bibliotherapist to sensitive issues and the individual goals in the participant's treatment plan.
Ideally, each participant is given a copy of the chosen literature, so that the words can be taken in visually while being heard. Reading the material silently is not enough; a poem must be read word for word in order that rhythm, rhyme, assonance and alliteration be appreciated (Silverman, 1988). Poetry therapy can be used effectively with any population regardless of formal education or reading ability. Because the literature is read aloud, participation is not hampered by illiteracy or physical disabilities.
Reading poetry aloud builds group cohesion, is ego-boosting, and enables patients to respond to the rhythm of the poem. The closer the rhythm of the poem is to the human heartbeat, the more calming its effect. Therefore, the rhythm of a poem is a factor that should not be overlooked.
Four stages can be identified in the interactive process (Hynes & Wedl, 1990):
To begin with, participants must be able to recognize and identify with the selection.
During this phase, participants explore specific details with the assistance of a bibliotherapist. Through questions and open dialogue, the group explores the significance of their reactions.
This is a process that explores the significant interplay between contrasts and comparisons. For example, Robert Frost's poem "The Road Not Taken" is about coming to a fork in the road and the difficult dilemma of having to make a choice. In juxtaposition, two reactions are placed side by side.
Reaction #1: "If I had to choose between two roads, I'd take a road I've been down before. At least then I'd know what to expect. Security is important to me."
Reaction #2: "If I had to choose a road, I'd just flip a coin and take my chances. Adventure is important to me."
Looking at an experience from a directly opposite view can provide an awareness that may become the basis for wise choices in attitude and behavior.
d) Application to the Self
The bibliotherapist encourages feelings to emerge and become integrated with cognitive concepts and deeper self-understanding. "Now I understand why I was able to leave home and succeed; my parents believed in me," or "Now I understand why I have difficulty making decisions; I lack confidence." It is important for the client to see the connection between the individual and the literature, and to apply the new knowledge to his/her own self in the real world.
At the end of the session, the facilitator will help provide closure. Factors to consider include: the length of the session, the degree of self-disclosure and group unity, and the degree of tension encountered during the workshop. Closure provides a time for "winding down" and "tying up loose ends." The facilitator can use closure to:
1. Ask the group what relevancy the workshop had to everyday life;
2. Summarize some of the key points;
3. Take care of "unfinished business;"
4. Help participants reestablish defenses;
5. Conclude in a positive and mutually affirming way.
Psychotherapist Irwin Yalom has defined eleven therapeutic factors that clients relate to a successful outcome in group therapy, all of which are evident in a bibliotherapy group (Goldstein, 1989). These factors include cohesion, universality, addressing existential fears, developing social skills, altruism and imparting information. All factors combine to achieve the goals of interpersonal learning, catharsis, and perhaps most important of all-the instillation of hope. Bibliotherapy builds community and offers opportunities for what Yalom calls the "corrective recapitulation of the primary family group."
The process of reading and writing, encouraged by the sensitive guidance of professionals trained in bibliotherapy, acts as a significant catalyst
Testimony on Capitol Hill
for self-integration. Poetry joins the realms of sensation, feeling, thought and spirit. The different aspects of self meet in a place where all things gather as one. This integration becomes possible by language that is particular and specific (Fox, 1992). The words of a sixth century Japanese poet, Izumi Shikibu, express this beautifully:
Watching the moon
I knew myself completely;
no part left out.
Although bibliotherapy in the United States may be traced back to the 1840's when Benjamin Rush introduced reading and writing into a Pennsylvania hospital, the practice of bibliotherapy is very different today. Whereas then the reading and writing was primarily a self-directed, recreational task, today the National Association for Poetry Therapy (NAPT) confers professional credentials to bibliopoetry therapists who have met its rigorous standards. The poetry therapist today is a professional who is wellgrounded in both psychology and literature, as well as group dynamics. NAPT maintains a registry of biblio/poetry therapy practitioners in educational, medical, geriatric, therapeutic and community settings. The poetry therapist of the 1990's is a valuable professional whose work is applicable to many different and difficult-to-treat persons who do not always respond to conventional therapy.
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