Using Poetry to Discover and Share Significant Meanings in Child and Adolescent Mental Health Nursing

Journal of Child and Adolescent Psychiatric Nursing, Jan-Mar 2004 by Raingruber, Bonnie

TOPIC. Does writing and reading poetry help nurse-therapists, students, and clients reflect on significant meanings and gain a greater understanding of intense clinical situations?

PURPOSE. To describe the use of poetry in managing intense feelings, discuss the relevant literature, articulate how students and clients responded to the use of poetry, and address the limitations of such an approach.

SOURCES. Published literature, clinical expertise, and poems written by the author.

CONCLUSIONS. Writing and reading poetry helps clinicians, students, and clients give voice to situations that touch their hearts. Poetry and literature should be used more extensively in clinical and educational settings.

Search terms: Empathy, compassion fatigue, poetry, therapeutic use of self

The poet David Whyte asserts that poetry is phenomenology, a way of making sense of the lived experience of human beings, a conversation with one's environment, a way of giving voice to feelings individuals are not easily able to articulate (Reece, 2000). Poetry helps us reflect on and remember what is most important within life and within one's profession (Linney, 2000). Writing and reading poetry brings greater knowledge about one's self, others, and external events.

Akhtar (2000) posits that poetry bears witness to pain and allows for the sharing of otherwise private anguish. The repetition inherent in rhymes and metaphors within a poem reinforces a multitude of meanings. In poetry, sense and thought merge as the message is conveyed in "a multilayered, figure-ground sort of architecture" (p. 235). In its fluidity, poetry allows individuals to simultaneously mourn and master challenges. In poetry, passive suffering is changed to a creative act. Poetry allows individuals to vent unarticulated emotions by writing, reading, and co-creating the poem as it is shared. Akhtar reminds us that no two individuals hearing a poem interpret it in exactly the same way or with the same precise emphasis. Meanings within a poem are understood in part based on the listener's background. Moreover, poets frequently discover what they were writing about only after having completed a poem. By familiarizing the reader and writer with new worlds of experience, poetry increases one's capacity to tolerate pain, understand oneself, and other people.

Poetry helps us discover and reflect on other's feelings while developing empathy (Akhtar, 2000). Donald Hall (1994), himself a poet, has commented that the poem is a journey of connecting the one to the many. Poetry is "dialogical: it seeks in the listener an ally whose empathy will take the form of sharing the survivor's anguish and struggle" (Kaminsky, 1998, p. 408). Poetry allows one to share a residue of another's experience. It renders the impersonal intimate. Berger (1984) explains that poetry engages the listener and engenders caring. he wrote, "Poetry can repair no loss but it defies the space which separates" (p. 96). The words spoken and received in dialogue bring the writer, subject, and listener into closer contact.

The complexity, power, and beauty of language within poetry allow the expression of intense human experiences. Poetry is replete with shifts in meaning, multivalent impressions, juxtaposed images woven together. New meanings emerge from the free play of images, signifiers, and analogies within each poem (Kaminsky, 1998). Rowe (2000) suggested that poetry "strikes the reader" from the beginning and is more often retained afterward than is prose.

It is precisely because poetry is poignant, memorable, and allows both the writer and listener to familiarize with an emotional climate (Ogden, 1999) that it is effective when used in clinical situations with families, adolescents, and children. In highlighting the point just made, this article describes how poems written by the author were used with clients and students to create dialogue about events that occurred in clinical settings in mental health. The ways that writing the poems assisted the author to let go of impressions and feelings that remained on her mind are discussed. In the following section, the clinical situations described by the author in which poetry was used are presented in the first person to maintain their storied nature.

Using Poetry in Clinical Situations

Prior to writing the poem titled "Unasked For Hands," I kept getting the feeling I should discuss the importance of recognizing child abuse with one of my clinical students who was completing her mental health rotation. After feeling prompted to talk to her on several occasions, I asked myself if there was anything that she had said to me to trigger my impression. I concluded it wasn't anything she had said but rather something about her demeanor, a distant quality and a listless mood that surrounded her. As is often my practice when preoccupied, I decided I would write a poem that attempted to capture the mood I felt, and as is typically the case, by the time I finished the poem my distress had lifted.