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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: Love Was Love That Night…Until Hate Walked In: Mindful Grieving After Tragedy

Repost: Love Was Love That Night…Until Hate Walked In: Mindful Grieving After Tragedy

This blog post originally appeared in The Huffington Post.

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I feel extraordinary heartbroken at the news of the shooting death of at least 49 human beings who came together in a place they felt safe; a place whose four walls bore witness to love without its shackles.  The Pulse nightclub in Orlando, Florida was a place in which lovers could hold hands and kiss, to revel in a feeling of belonging without the still all-to-common threats of discrimination, alienation, and condescension. Inside those doors love was love, until hate walked in.

Hate walked in and obliterated this sanctuary, tearing apart lives that he thought were less worthwhile than his own, and infiltrated the heart and soul of a community and greater world who has had to fight for its birthright; to love and be loved.  This is what hate does. He is at once insidious and blatantly hostile, unrelenting, unforgiving, and lacks a conscience. He is heartless and mindless, self-serving and sadistic to the core.

As I grapple with the way hate snuffed the life out of so many vibrant beings this past Sunday, I grieve.  I am at once angry, anxious, sad, and shocked. 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 because of who they are and whom they love.

I am struggling with how to grieve along side you. My own journey of grief includes humbly offering all of us some words about grief from a psychological perspective, and providing five ways to grieve mindfully.

What Grief Is and Isn’t

Psychologically speaking, according to Dr. Kubler-Ross (1969), “Grief is an emotional response to loss.”

This emotional response is conceptualized as a non-linear expression of different stages of feeling states including Denial, Anger, Bargaining, Depression, and Acceptance (aka: “DABDA”).

Biologically speaking, grief is a homeostatic process, a journey that our mind, brain, and body need to engage in, to best recover from the trauma of a loss. This is an evolutionary need, since attachment and connection to others is embedded within our limbic circuitry. Yes, whether we are conscious of it or not, or like it or not, relationships deeply imprint upon our neural circuitry.

Grief is not, by any means, a one-size-fits-all kind of process. In fact, it is a uniquely individual process that often feels amorphous and difficult to capture with words. When it comes to grief, there is no “normal” or typical way to go through it, and despite what some believe, in my opinion, there is no “normal” time period allotted for grief.

It takes a boat-load of self-compassion to allow oneself to feel whatever it is you are feeling at any given time, without judgment, without comparison to another’s explicit portrayal of their own process. In this way, to grieve is to be mindful of our own thoughts and feelings.

While there is no one “right” way to grieve, to actually grieve is essential for our ability to employ our human capacity to find a renewed sense of meaning. Grief elicits resilience and the capacity to continue to hold this tragedy in our hearts and minds, while still forging forward with purpose and direction.

Five ways to Grieve Mindfully

  1. Accept your feelings: Allow yourself to feel what you feel at any given moment, with a sense of self-compassion, and without judgment.
  2. Express your feelings: Just as important as accepting your feelings, is expressing them in a way that is helpful to you. Journaling, talking about the experience, scrapbooking, or dancing, for example, are helpful ways to process grief instead of allowing the feelings to stay stuck.
  3. Reach out: During this time, it is important to reach out in multiple ways. Reach out for guidance from a spiritual counselor or a psychologist. Reach out to share stories of your loved one with others. Reach out to offer support to other grievers. Find a balance between being with yourself, and being with others, but ultimately, reach out – don’t isolate.
  4. Continue to take care of yourself and others. Living life while grieving often feels like scaling a mountain. Grieving takes energy and can often feel draining. As much as possible during this tough time, continue to eat well, exercise, and maintain wellness practices.
  5. Celebrate life: It is important through the grief process to keep the memory of the tragic incident alive in some way that inspires healing, but also reflects and honors your mourning process. This can include donating to a charity, meditating on behalf of a loved one or a community, and even planting a tree in honor of the tragedy.

 

At times like this, many of us are also challenged in our own grieving process to try to explain the unexplainable to others in our life. I, therefore, invite you to also read my post: Five Strategies to Help Us Help Our Children And Ourselves In Times of Trauma.

Today, together as one world and one nation, we are grieving. Here are some resources so that we may process this horrific tragedy together. You are not alone.

Orlando:

  • Victim Service Center of Central Florida

https://www.victimservicecenter.org/

  •  APG Health Behavioral Healthcare

http://www.apghealth.com/

  •  Psychology Today List of Support and Grief Groups for Victims and Families

https://groups.psychologytoday.com/rms/prof_results.php?city=Orlando&spec=14

NYC:

  • Center for Bereavement

http://www.centerforbereavement.com/

  • NYC Innovations in Mental Health List of Bereavement Groups

http://newyorkcity.ny.networkofcare.org/mh/services/subcategory.aspx?tax=PN-8100.1000

  • Psychology Today List of Support and Grief Groups for Victims and Families

https://groups.psychologytoday.com/rms/prof_results.php?state=NY&spec=14

 

If you don’t see what you are looking for, and need a referral to a psychologist or a support network during this time, please directly reach out to me with your name and a brief paragraph regarding the type of help you are seeking.  I will help you find a safe space to grieve. Please contact me at DrWolkin@BrainCurves.com.

With pure love for all my fellow mourners,

Jennifer Wolkin, PhD

Remembering Jamie Zimmerman, ABC’s Meditation Doctor

Remembering Jamie Zimmerman, ABC’s Meditation Doctor

This post originally appeared on Mindful.org

The other week, I lost a dear friend and colleague, Jamie Zimmerman. A physician, meditation teacher, and author, Jamie lectured internationally on “meditation medicine” and living your calling. She was passionate about global health and believed that healing happens from the inside out. A medical journalist at ABC News, she loved spending time in nature, exploring museums, yoga classes, cafes, and live music. She died as she lived—taking the time to connect to nature and herself in Hawaii, where she was taking a few days for vacation before she was going to speak at a conference.

Jamie’s death is a profound loss to so many people, and many of us grapple with understanding how to grieve. Her death was sudden and shocking, and in trying to make sense of something so seemingly senseless, I found myself remembering one of our last conversations. Jamie and I spoke about the vast potential of maintaining a beginner’s mind and that the essence of mindfulness is remembering this idea when we are faced with something we think we already know. Dear Jamie, all of us who were, and continue to be, touched by your work are forever mindful of you. As we struggle with grief, we will try to do what you would have sought to do with grace and wisdom—bring a mindful perspective to all we are now experiencing.

I offer here five ways to grieve mindfully, but first, I want to touch upon a question I’m asked often as a psychologist. What IS grief? Psychologically speaking, according to Dr. Kubler-Ross (1969), grief is an emotional response to loss. This emotional response is conceptualized as a non-linear expression of different stages of feeling states including denial, anger, bargaining, depression, and acceptance (aka: “dabda”). Biologically speaking, grief is a homeostatic process, a journey that our mind, brain, and body need to engage in to best recover from the trauma of a loss. This is an evolutionary need, since attachment and connection is embedded within our limbic circuitry. Yes, whether we are conscious of it or not, or like it or not, relationships deeply imprint upon our neuronal selves.

Grief is not, by any means, a one-size-fits-all kind of process.

Second, I want to note what grief is not. Grief is not, by any means, a one-size-fits-all kind of process. In fact, it is a uniquely individual process that often feels amorphous and difficult to capture with words. When it comes to grief, there is no “normal” or typical way to “do it.” Despite what some believe, in my opinion, there is no “normal” time period allotted for grief.

It takes a boat load of self-compassion to allow oneself to feel whatever it is you are feeling at any given time, without judgment, without comparison relative to another’s explicit portrayal of their own process. In this way, to grieve is to be mindful of our thoughts and feelings.

Finally, while there is no one “right” way to grieve, to actually grieve is essential for our ability to employ our human capacity to find a renewed sense of meaning. Grief elicits resilience. The capacity to continue to hold a loved one in our heart/mind while still forging forward with purpose and direction.

Five ways to Grieve Mindfully

  1. Accept your feelings: Allow yourself to feel what you feel at any given moment, with a sense of self-compassion, and without judgment.
  2. Express your feelings: Just as important as accepting your feelings is expressing them in a way that is helpful to you. Journaling, talking about the experience, scrapbooking, or dancing, for example, are helpful ways to process grief instead of allowing the feelings to stay stuck.
  3. Reach out: During this time, it is important to reach out in multiple ways. Reach out for guidance from a spiritual counselor or a psychologist. Reach out to share stories of your loved one with others. Reach out to offer support to other grievers. Find a balance between sitting with yourself, and being with others, but ultimately, reach out—don’t isolate.
  4. Continue to take care of yourself and others. Living life while grieving often feels like scaling a mountain. Grieving takes energy and can often feel draining. As much as possible during this tough time, continue to eat well, exercise, and maintain wellness practices.
  5. Celebrate your loved one’s life: It is important through the grief process to keep the memory of your loved one alive in some way that both inspires growth, and reflects and honors your unique relationship. This can include donating to a charity, meditating in their honor, and even planting a tree.