(347) 506-1612 DrWolkin@BrainCurves.com
POETRY THERAPY: POETRY AS Rx 

POETRY THERAPY: POETRY AS Rx 

There is research that those experiencing PTSD reported improved well-being in response to poetry therapy. This might be the case because a hallmark of having experienced trauma is the subsequent difficulty processing the experience, which results in avoiding and suppressing associated emotions/memories.

Poetry therapy has provided an outlet for those suffering with PTSD to start to integrate many of these feelings, and even more so, to start to reframe the traumatic experience.

Poetry therapy itself is a bit abstract to describe, but there are a few ways to engage with it. Here is a multi-model poetry therapy practice developed by Nicholas Mazza, the founding and continuing editor of the Journal of Poetry Therapy.

According to Mazza’s model, poetry therapy involves three main components:

  1. Receptive/prescriptive: This part of therapy involves the clinician/therapist reading a poem out loud, and then subsequently encouraging the client to react to it, either verbally, non-verbally, or both. The therapist might even prompt: “Is there a particular line in the poem that resonated with you?”, or “I noticed you started to become teary-eyed when I read this line…”
  2. Expressive/creative: This entails actual creative writing. The therapist promotes stream of consciousness writing that might aid in discovering blocked emotions, parsing felt emotions, or retrieving memories that are difficult to articulate. The therapist might offer a prompt to help someone get started.
  3. Symbolic/ceremonial: This includes working with metaphor/simile to help further explain emotions that are hard to describe in a more literal sense. The ceremonial part may consist of writing a letter to someone they may have lost and then burning it.

 

The efficacy of poetry therapy is still being studied. Most of the empirical evidence for its effectiveness comes through James Pennebaker’s (a pioneer in the field of Positive Psychology) work in the therapeutic use of expressive writing. His studies have indicated that the use of expressive writing, even for as little as 15 minutes over the course of 4 days, resulted in positive health effects. In addition, his initial work dealt with the use of expressive writing to heal wounds from traumatic stressful events.

One case in point is that in the aftermath of 9/11, poetry was utilized as a healing mechanism. According to a New York Times article on October 1, 2001:

“In the weeks since the terrorist attacks, people have been consoling themselves—and one another—with poetry in an almost unprecedented way … Improvised memorials often conceived around poems sprang up all over the city, in store windows, at bus stops, in Washington Square Park, Brooklyn Heights, and elsewhere. …”

In some ways poetry gives us the way to speak about the unspeakable. It is more and more common for those suffering with medical challenges to write their story, many times in poetic form, to aid in their own healing. As always, it is crucial to note that just like with mindfulness approaches to trauma, poetry therapy is most often used in conjunction with other therapies.

On a personal note, I’m particularly drawn to this type of therapy and recently started studying for my MFA at Queens College. I am touched by the profound pain that is both individually and collectively felt, how this pain can displace someone from others and their selves, and yet, the profound capacity for resilience, healing, and growth. Aside from writing my own work, I hope to employ poetry as a technique to help my clients say what they couldn’t otherwise say.

Here’s an example of a poem that I recently published in the British Journal of Medical Practice in this vein:

This is part 3 of a 4-part series of excerpts from the latest 2018 edition of Dr. Wolkin’s PTSD Packet

TRAUMA IN THE CONTEXT OF MASS SHOOTINGS

TRAUMA IN THE CONTEXT OF MASS SHOOTINGS

By way of full-disclosure, I’m tearing up as I write this. In the last few years alone, we have seen a rise in mass school shootings; that is, the death of innocent children, adolescents, and their adult mentors/teachers in cold blood.

I too, continue to grapple with the snuffing out of so many lives, and the lack of response to these deaths that somehow don’t seem to create change. Actually, most school shootings aren’t even talked about.

According to a non-profit that tracks gun violence in America, as of April 20th  2018, there have been 17 shootings since the February shooting at the Marjory Stoneman Douglas High School in Parkland, Florida which launched the Never Again movement. You read that number correctly. 

I don’t want to get too political here, but as a mental health practitioner and staunch advocate, I want to go on record saying that gun violence is not a mental health issue. Is mental health sometimes a component in these shootings? Sure. Yet, let’s be clear. The rise of school shootings is not attributable to a national mental health crisis. It is far too easy for someone to get a gun in this country. No matter which side of the gun control debate you are on, it is insulting with those who suffer with mental health to be accountable for this.

Here’s some info taken straight from MentalHealth.gov to keep in mind:

Myth: People with mental health problems are violent and unpredictable.

Fact: The vast majority of people with mental health problems are no more likely to be violent than anyone else. Most people with mental illness are not violent and only 3%–5% of violent acts can be attributed to individuals living with a serious mental illness.

Now that I made that clear, I want to discuss PTSD in the context of these shootings.

Undoubtedly, these shootings will impact the victim’s families, friends and communities forever – some might even develop PTSD, as they are certainly at risk, especially those who survived and witnessed the events.

Of course, what we have seen come out of the Parkland shooting is no less than a post-traumatic growth response (learn more in my PTSD packet); while this doesn’t mean the survivors aren’t deeply suffering, many have been able to utilize this suffering as fuel to advocate for gun control in a way it seems that no other organization or group of individuals has been able to before. Their efforts have affected real change, and I pray the change continues.

What I want to address is the idea of virtual trauma. We, as a nation, are privy to these events either in real time, or moments after. Sometimes, the media coverage is more gruesome and detailed than at others. Regardless, we, as a nation, are at risk for PTSD even if we were not directly affected. Whether we were involved or not, these accounts bring up a real sense of danger and deep concern about our and our loved one’s safety.

According to research in the early 2000’s, approximately 15 to 36 percent of the population that did not experience violence directly, will still develop post-traumatic stress disorder (PTSD) symptoms. 

The impact of trauma has a wide range. Even just hearing about the event can shatter our assumptions about our world. You see, tragedies like these reverberate in the hearts and minds of much of humanity, as it rips through the basic foundation that we lay our trust upon. That is, we don’t expect people to just shoot other human beings in cold blood. So, it seems that trauma’s effect surpasses the psycho-neurobiological impact of experiencing a direct threat to one’s own life.

According to psychologist Janoff-Bullman, what a mass trauma like this does is challenge our assumptions and brings them into question.

These assumptions may include:

  • “the world and people are intrinsically good”
  • “good people experience good things”
  • “the world is safe”
  • “the world is just”

 

Undoubtedly, these assumptions aren’t necessarily true, but can be healthy and adaptive.  For many of us, these very assumptions help us get out of bed in the morning and actually go about our lives and are necessary for meaningful experiences and interpersonal relationships.

The figurative ground we walk on becomes shakier and shakier with each shooting. If you notice that after an event you start feeling more irritable, anxious, like you have lost control, depressed, have trouble sleeping and anything else that is not your baseline and does not seem to be going away, please reach out for help.

This is part 2 of a 4-part series of excerpts from the latest 2018 edition of Dr. Wolkin’s PTSD Packet

Repost: April Showers Bring Poetry Pitter Patters: My Favorite Poems and Why They Resonate

Repost: April Showers Bring Poetry Pitter Patters: My Favorite Poems and Why They Resonate

This blog post originally appeared on The Huffington Post

It’s April, and while that means more rain showers, it also means it’s time to recognize a literary style “in which special intensity is given to the expression of feelings and ideas by the use of distinctive style and rhythm”. Or, simply put, poetry!

In honor of National Poetry Month, I would like to present these 4 poems that not only resonate deeply with me, but have also helped to inform my work with my clients.

One of the beauties of poetry, I think, is that there is no single meaning to any one poem. The poet pens a narrative in verse that can be interpreted in all ways; I would even go so far as to say that a reader of poetry projects upon a poem what he/she needs in that given moment. The interpretation is never static, and likely the reader will experience something different with each reading or recitation. So, if it stirs something within you right now – and moves you to greater awareness of self, others, and the world – then honor those things!

Vulnerable alert: These works have seen me through difficult times. As my post-doc and a romantic relationship were both simultaneously coming to an end in 2010, the feeling of loss led me to these poems. I recited them every time I needed a reminder that not only was it was okay to feel every iteration of my feelings, but that those feelings were also healthy, and important – serving as a springboard for new endeavors and a greater openness to identifying, and then saying yes to, those things I desired that were beyond my comfort zone.

Reciting the poems, as I power-walked around the Charles River, comforted me, and also allowed me to notice and feel the pain of confronting the changes in my life. The more I recited, the more I let myself feel, and the more facile it became to just put one foot in front of another, trusting that those small steps would lead me to my somewhere new. The words reverberated over and over until I found my way towards healing.

There is much to be learned from a poetic journey inward. I hope that one, or more, of these poems bring you some of the peace that they have brought me.

 

1. The Journey

by Mary Oliver

One day you finally knew

what you had to do, and began,

though the voices around you

kept shouting

their bad advice—

though the whole house

began to tremble

and you felt the old tug

at your ankles.

“Mend my life!”

each voice cried.

But you didn’t stop.

You knew what you had to do,

though the wind pried

with its stiff fingers

at the very foundations,

though their melancholy

was terrible.

It was already late

enough, and a wild night,

and the road full of fallen

branches and stones.

But little by little,

as you left their voices behind,

the stars began to burn

through the sheets of clouds,

and there was a new voice

which you slowly

recognized as your own,

that kept you company

as you strode deeper and deeper

into the world,

determined to do

the only thing you could do—

determined to save

the only life you could save.

Why it resonates:

The Journey resonates with me because it speaks to the idea of individuation and separation.

It is hard for most of us to leave our family of origin, mentally speaking. It’s a challenge to go out into the world, without the protection and grounded-ness that our primary attachment figures provided (if we were lucky enough) when we were younger. It is also just as hard, because despite wanting to “become ourselves” as individual entities, we often stay enmeshed in the maladaptive patterns of our ancestry. Their traumas, and subsequent triggers, sometimes become ours, and though we want to shed those layers from our own psyches, it is what we know – the familiarity is resoundingly comforting.

My clients and I have learned that we sometimes make unconscious agreements with ourselves to hold on to the pain, until we realize we can’t breathe from the bearing of it, and we need to let go of it in order to save ourselves.

2. Autobiography in Five Chapters

by Portia Nelson

I

I walk down the street.

There is a deep hole in the sidewalk

I fall in.

I am lost…

I am hopeless.

It isn’t my fault.

It takes forever to find a way out.

II

I walk down the same street.

There is a deep hole in the sidewalk.

I pretend I don’t see it.

I fall in again.

I can’t believe I’m in the same place.

But it isn’t my fault.

It still takes a long time to get out.

III

I walk down the same street.

There is a deep hole in the sidewalk.

I see it is there.

I still fall in…it’s a habit

My eyes are open; I know where I am;

It is my fault.

I get out immediately.

IV

I walk down the same street.

There is a deep hole in the sidewalk.

I walk around it.

V

I walk down another street.

Why it resonates:

Both personally and professionally I know so well that change is hard. Actually, that’s the understatement of the day! When we have engaged with certain unhealthy thoughts, feelings, and behaviors for a long time, the path towards wellness takes extra patience, perseverance, time, and trust. This poem resonates for me because it reflects a sequence of change that is authentic.

Portia beings by speaking to the deeply painful reckoning with bumps in the road. Then, she begins to recognize patterns that might be holding her back, but does so with a gentle nudge and compassion for herself. She continues by putting just one step in front of the other, supporting herself through each step, not blind to the challenges, but not beating herself up either for the slow progress, which includes literally falling into the same old maladaptive patterns.

She recognizes that patterns are like habits, accumulations of ways of being and showing up in a world that used to work for us, and that most likely previously protected us from our pain. Ultimately, she finds a new path. This doesn’t mean her journey is over. In fact, in some ways, it has just begun.

3. The Guest House

by Rumi

This being human is a guest house.

Every morning a new arrival.

A joy, a depression, a meanness,

some momentary awareness comes

As an unexpected visitor.

Welcome and entertain them all!

Even if they’re a crowd of sorrows,

who violently sweep your house

empty of its furniture,

still treat each guest honorably.

He may be clearing you out

for some new delight.

The dark thought, the shame, the malice,

meet them at the door laughing,

and invite them in.

Be grateful for whoever comes,

because each has been sent

as a guide from beyond.

Why it resonates:

Rumi, the Sufi poet, waxed poetic in his ‘The Guest House’ a long time ago about how we should treat every emotion as a visitor, without looking to get rid of any of them, but rather to understand their message and purpose.

Emotions are neither inherently good nor bad, and to think of them in such dichotomous terms is to do oneself a disservice. Emotions just are. In fact, every emotion tells us something about our inner experience that might be informing our outer experience.

What Rumi alluded to in his writing was also recently confirmed by research (https://www.scientificamerican.com/article/negative-emotions-key-well-being/) – which indicated that well-being is actually predicated on having a wider range of emotions, including the negative ones! Yes, that’s correct, the more you can feel, in all of feeling’s iterations, the better off you are.

While relaxation is a beneficial byproduct of mindfulness practice, its salutary effects are associated with the ability to help us expose ourselves to our emotions, to truly feel them, with compassion and as little judgment as possible. That’s why techniques like mindfulness have gained anecdotal significance, and their effectiveness is being confirmed through rigorous research.

4. Wild Geese

by Mary Oliver

You do not have to be good.

You do not have to walk on your knees

For a hundred miles through the desert, repenting.

You only have to let the soft animal of your body

love what it loves.

Tell me about your despair, yours, and I will tell you mine.

Meanwhile the world goes on.

Meanwhile the sun and the clear pebbles of the rain

are moving across the landscapes,

over the prairies and the deep trees,

the mountains and the rivers.

Meanwhile the wild geese, high in the clean blue air,

are heading home again.

Whoever you are, no matter how lonely,

the world offers itself to your imagination,

calls to you like the wild geese, harsh and exciting —

over and over announcing your place

in the family of things.

Why it resonates:

We are socialized from a young age to think that being “good” means that we will be rewarded. What does “good” really mean though? The need to “be good” for the sake of approval, or the idea that one needs to repent to be redeemed, is immediately refuted here. How do we differentiate our own moral compass, and being a “good” person versus a “bad” person, from how other people interpret “good” and “bad”? When we try to base our actions on other people’s definitions, it can often lead to stifling expectations and guilt, which leads to deep suffering.

This poem, perhaps, then, speaks to a freedom that defies the need to be “good” as a way out of punishment or scorn by others. In this poem, Mary Oliver invites us to shed the shackles we so often place upon ourselves for the sake of pleasing others. She makes room for us to let go of that, to fully embrace our essence, without judging it, without labeling it good or bad or right or wrong.

There is a chance for catharsis here, as we let ourselves connect to the “soft animals of our body”. Beyond the layers of somatic tension, clenching, and a protective posturing, is softness. The soft part of ourselves doesn’t need to hide. We shouldn’t deny what we love or whom we love or how we love.

To me, the most poignant part of this poem is the invitation to shed those limiting layers, and to look at the bigger and grander picture; that is, all of us, every living creature, are immortally bound by our smallness and bigness all at once. Perhaps, this collective truth is the most healing of them all.

You may have noticed that two of the poems I shared are from Mary Oliver’s oeuvre. I tried to be more diverse in my choices, but Mary has become a role model and mentor (read-she doesn’t know who I am!) for me in my own journey as a poet. A few years ago I attended one of Mary Oliver’s rare readings and signings at the 92nd Street Y and scored this!

Buy more of Mary Oliver’s poetry here

~

Sometimes the only way out of a trying situation or time in our life, is to journey inward, and a great place to start is by peering into a poet’s own journey. I hope that one, or more, of these poems bring you some of the peace that they have brought me.

Repost: 3 Ways Mindfulness Can Improve Your Relationships

Repost: 3 Ways Mindfulness Can Improve Your Relationships

This blog post originally appeared on About Meditation.

Do you ever struggle to connect or communicate with your partner? I mean, who doesn’t?

But what a lot of people don’t know is that brain science shows that practicing mindfulness can help you in this area of life.

You see, mindfulness is much more than meditation. It’s more like a fundamental approach to life.

Mindfulness Improves Relationships

It starts with choosing to become more aware of how we show up in life and making conscious choices about what our presence looks and feels like in each moment.

All of this can inform the way we are as individuals in our relationships.

How is that?

Because mindfulness can help you cultivate healthier relationships through stress reduction, enhanced emotion-regulation abilities, and honed communication skills (Among other ways I am sure)!

1. Stress reduction

We’ve all experienced that moment when we are so stressed that the little things start to bother us. Stress increases our irritability levels, and then inconsequential things start to elicit reactivity.

I know you know what I’m talking about…

Mindfulness meditation can help reduce stress, and consequently, make each individual in a relationship less likely to argue about the little things that—oftentimes unnecessarily—blow up into big things.

Here’s one quick mindfulness exercise to help you in moments like that. Try this stress-busting breathing with your partner.

2. Enhanced Emotion Regulation

It’s becoming clearer to researchers that practicing mindfulness meditation can help us regulate our emotions, and lash out less at one another!

How does that work?

Studies show that practicing mindfulness meditation decreases the grey-matter volume of the amygdala—the fear center of the brain—and increases the grey-matter volume of our pre-frontal cortex.

That’s the part of the brain responsible for forethought, and what we call “higher order” functions.

But it doesn’t stop there. Mindfulness meditation is also associated with increased connection between the amygdala and pre-frontal cortex. This leads to greater integration of our emotions and intellect.

How This Can Help Your Relationship

But you might be wondering, how does this help us? Here’s an example.

When our partner says something we don’t like, it’s plausible that instead of thinking it through, we feel threatened. That activates the amygdala that readies us to attack back.

In truth, much of the time when our partner “acts out” it’s from a place of their own insecurity, and their own deep-rooted pain.

So instead of impulsively trying to attack back from one’s own “wounded place,” try responding with compassion for all of the pain both of you are experiencing by truly listening and then responding from a place that is less fear-based.

Slowly, but steadily, we can work together with our partner to decrease our amygdala volume!

3. Honed Communication Skills

Now, imagine that instead of immediately reacting based on fear, we take a moment to pause and reflect on why we feel threatened and then proceed to respond with more kindness.

We can then start to imagine that our significant other also has their own insecurities and hot-button issues. It’s hard, but imagine if each individual in a partnership practiced taking a few breaths before lashing out and attacking in return and instead responded with a calmer and less defensive demeanor.

We’d actually give one another the space to be heard, and the opportunity to communicate without our armor. WOW.

But how do we do this?

Each partner works on becoming more attuned to their own emotional landscape by starting to understand what triggers them most, and why.

For example, someone might immediately be on the attack if her significant other calls to say that they will be late to dinner. It’s important to understand why that call felt so threatening that it resulted in anger and lashing out.

Perhaps, and this is just an example, it taps into someone’s deeper fear of being abandoned by their partner. If possible, cultivate compassion for oneself for experiencing such deep pain, and even needing to be on the defensive.

This takes time, and it’s a process…one that is often worked upon in therapy.

A Mindful Listening Exercise

Then, maybe try THIS:

Mindful listening is a core element of healthy communication.

Really taking the time to listen to how the other feels, without immediately and sometimes impulsively reacting, creates the space for both parties to feel heard and then to show up in kind with a more mindful ear.

I recommend you set a timer for five minutes. Then one partner begins to speak about whatever they would like (this isn’t the time to attack the other, this is just about practicing uninterrupted listening), which can include how they feel about the relationship or about anything at all.

Non-verbal responses are permitted from the listening part, but no verbal response of any kind.

Then, when the timer goes off switch roles so that the speaker now becomes the listener. Each time you practice the exercise, switch off who starts being the initial listener and vice versa.