Rapport and group dynamics
I believe the success of small group therapeutic creative writing sessions is greatly influenced by how comfortable and supported participants feel in the group, and on the development of confidence to share writing, thoughts and feelings with each other. Writing itself is therapeutic, but writing and sharing writing in a supportive group adds another dimension. For example, some people who had probably never written creatively before, gained confidence within the space of one session, and over several sessions, in response to the heartfelt and supportive feedback they received on their writing from the group.
Rapport between facilitator and participants is vital for creating a relaxed, supportive group. Rapport and good group dynamics can be fostered in many ways, e.g., by being friendly and approachable and using only first names in the group. I try to speak to participants not as their group leader but just as one person to another. I make it a rule to write and read aloud with the group. Sometimes someone is unable or unwilling to write for all sorts of different reasons, e.g., not having learned to read and write, reading glasses left at home, arthritis. Everyone is welcome in my groups and if they don’t or can’t write on the day in question we find ways of working around it, e.g., when it comes time to read our writing aloud they speak instead, they draw instead, or I write for them. One person wasn’t able to write on paper but he was able to compose poems on his phone and read them to us. Everyone needs to feel welcome and valued, which means giving effective reassurances, and encouraging and supportive feedback.
Rationale for selection of writing activities
Writing exercises in mental health wards need to be quite short for two reasons: (i) many of the people who come to the group do not have the concentration needed for a long period of writing while they are ill in hospital, and (ii) some patients arrive late or leave early for all sorts of reasons and having short exercises makes managing this easier. Starting with short bursts of writing, such as freewriting for 2 minutes per word for 4 words, is an easy and calming start and a good ‘warm up’ for writing.
I select, develop and/or adapt writing activities on the basis of anticipated wellbeing benefits for the participants and suitability for writers of mixed ability and experience. Because there can be new people each week, and the abilities and level of concentration of participants vary, I plan each session as if it were the first session, rather than building on what has gone before. At the same time I need to ensure variety from session to session for the sake of those patients who do attend week on week. A high priority for the selection of writing exercises is always for the sessions to be enjoyable – if people enjoy writing in the session they will hopefully do more writing after the session, both in the unit and after they go home.
Freewriting (see Chapter 1) is a powerful technique for therapeutic creative writing that can draw out unexpected thoughts and feelings. When working in a mental health unit I feel it is helpful to use word prompts or other stimuli for freewriting for these reasons:
(i) Writing completely freely whatever comes into the mind, with no prompt of any kind, could emphasise any negative thoughts that are in the person’s mind at the time of writing, cause distress and make the negative thoughts worse;
(ii) Writing in small chunks, i.e, 2 minutes per word for 4 words, is an easily manageable start to writing sessions, even for people with a low level of concentration, and avoids a long silence early in the session;
(iii) Writing from prompt words is less likely to be deeply personal, so the participants are more likely to be willing to read aloud some of what they have written. Reading aloud, sharing thoughts and discussing our writing, seems to contribute to the effects of the writing sessions.
I choose freewriting stimulus words on the basis of (i) avoiding directing participants’ thoughts or leading their writing; and (ii) encouraging new thoughts to appear and flow without constraint. For example when the word pool is used one person may write about pool balls rolling around a table while another writes about the moon reflected in a pool of water. Word ‘sets’ that allow these differences to appear in participants’ writing make for interesting group discussions. An alternative approach, with a confident group, is to ask each person, during the introductions at the start of the session, for a word that they associate with wellbeing, and then use those words as freewriting prompts later in the session.
The 15- to 20-minute writing exercises I use include: writing following guided visualizations; journal-writing techniques, and exercises based on weather, places, people, amusing stories, or playing with words. These longer writing exercises are chosen to achieve a balance between opportunities to write in a fun and imaginative way and encouraging writing that is grounded in the here and now, the real world. I take care not to use exercises that will lead participants to write about painful memories and generally do not lead people to write about anything very specific or in a prescribed creative form such as a poem. In this way, participants are free to write what they need or want to write at that moment in time. In one session five people all wrote very differently in a writing exercise about boxes, for example, two of the group wrote rhymed poems while the other three wrote prose.
Next time I’ll cover the things I use as inspiration for writing in my therapeutic creative writing groups.