This has been an inspiring week for me in respect of my therapeutic writing groups. Which has got me thinking about the relationship between the therapeutic benefit of my groups (for patients), and inspiration (theirs and mine). Does it happen that when I feel personally inspired about writing, I become more effective both at providing inspiration to others, and at managing groups? Or, alternatively, do I become more inspired about writing during sessions where I feel that the patients present are really engaging with the writing exercises and therefore (I believe) benefiting from attending the session? Or is what happens more like a mixture of the two, i.e., I start out a bit more inspired than usual and so better able to inspire the patients, who then engage better with the writing exercises, which I notice, and which feeds my inspiration, and so on. Whichever of these possibilities is true, it is clear to me that something different happens when therapeutic writing is facilitated in a group rather than being done as a solitary self-help exercise. On a good day, the whole becomes much more than the sum of its parts.
After having three weeks off over Christmas and New Year for annual leave and sickness, it has taken several weeks to re-build patient interest in my psychiatric ward writing groups (at Carleton Clinic, Carlisle, UK). This lag tends to happen after each time I take a long break – even though new patients are being admitted to the wards every week. I think the explanation for the lag is that the ward staff take two or three weeks to get used to my groups running regularly again, at which point they start actively encouraging patients to participate. During this lag period I tend to feel less inspired about doing the groups, until I gradually get back into the swing of doing them, and the interest from patients picks up.
Two of my regular writing groups happened this week: a one-hour session in an adult mental health unit (Hadrian) and a half-hour session in psychiatric intensive care (Rowanwood). The term ‘group’ is somewhat misleading here, because in Rowanwood sessions are very often one-to-one. This is partly because there are fewer patients in Rowanwood than in Hadrian, and they are more unwell, resulting in fewer patients attending the sessions; and partly because patients who are more unwell generally prefer not to participate in company with other patients. Having said that, this week’s session in Rowanwood was a group of two patients participating simultaneously (although not really together). In Hadrian, I generally work with a group of between two and seven patients, but the patients in the group change from week to week. This week four patients participated in the Hadrian session.
In both sessions I used a door-themed poem and photograph as writing inspiration. In Hadrian, as the session was longer, I also used a photograph of a complex wooden box as inspiration for a second writing exercise. The poem was ‘The Door’ by Miroslav Holub. We read the poem aloud and briefly discussed it. Then I showed them a colour photograph of a wooden door, which looks like the door of a cottage. I suggested they might use either the poem or the photograph as writing inspiration, for example, they might write about what they would want to find on the other side of the door depicted in the photograph. As always, I stressed that spelling, grammar, punctuation and handwriting do not matter and that participants do not have to follow my writing suggestions – that they are always free to write whatever they wish. For the second exercise inspired by the photograph of the wooden box I suggested they might write about what is inside the box, what they might keep in the box, or perhaps imagine that the box is magic in some way.
I hope you will see from this post that, if the writing practitioner takes a flexible approach, one writing exercise can work very differently for different individuals.
The patients and their writing
Angela is a middle-aged woman who has been in Rowanwood psychiatric intensive care for some time. Whenever I have encountered her she has seemed confused and restless. She wrote with me a few weeks ago, but then she stayed at the table for only ten minutes and wrote about four or five lines. This week she stayed half an hour and wrote almost a page of A4. She said she was inspired by the lovely golden colour of the door in the photograph I’d brought. Angela’s writing on this occasion, although not entirely grammatically correct, was nevertheless understandable. She wrote partly descriptively about what she could see in the photograph – the door, the steps, and the plants in pots on the steps; and partly interpretatively, for example, she wrote that the slate steps suggest strength, that the plants suggest a welcome for invited guests, and that the closed door suggests that uninvited people will not be made welcome.
Although Bob (Rowanwood) seemed quite distracted by his own thoughts, he stayed at the writing table for about twenty minutes. He is about thirty. He said that he liked the poem very much, and he spontaneously read it aloud after I’d read it. He wrote very little, and nothing at all about the photograph or the poem. He wrote only that that he would like to be given the opportunity for a new start in life. I suggested that Bob could tell the doctor that when he met him later.
In Hadrian, the door theme started forty-year-old Colin talking about how he would not want to let strangers in through his door. What he wrote was about his relationship with his family and about the family house that he used to live in by himself. He read his writing to the group, and then elaborated on his written words by telling us about the police coming to his house and taking him off to hospital, about his relationships with family members, about his wife being abusive to him, cheating on him and then leaving him, and about the house he used to live in. It seemed as though the ten minutes of writing he did had helped Colin to express his feelings. Colin does not understand why he is in hospital and he wants to leave. We were supportive to Colin but we did not encourage him to continue talking about his feelings. Instead, we suggested that Colin request a one-to-one talk with his named nurse, tell him/her how he feels and ask any questions he wants to ask. Colin left before the session ended.
Twenty-year-old Diane (Hadrian) arrived as we were finishing the doors exercise. She was restless and talkative and (I guessed) probably going through a manic episode. She came in and out of the activities room several times during the session. Nevertheless she managed to write at least a page and read her writing aloud to the group. She wrote imaginatively about a magic box. When she read her writing aloud I found it difficult to follow the meaning. I asked her to read it again. The second time she read more slowly, and corrected some mistakes, so the meaning was easier to follow – although still not entirely clear. She said that she enjoyed doing the writing and interpreting her own writing.
Elspeth (Hadrian), another young woman of about twenty, appeared to be on the verge of tears in the early part of the session. Her writing was fairly emotional, for example, she wrote about a door that might have good things beyond but that she was too afraid to open. However, she said that she had enjoyed the session, especially listening to the rest of us read our writing aloud. She no longer looked tearful by the end of the session.
Fay (Hadrian) is a middle-aged woman who enjoys arts and crafts as well as writing. She produced two pieces of creative, enjoyable and quite poetic prose in response to the two writing exercises. In the door-themed exercise she wrote about a door holding back a bursting flow of burning lava. She said it was a metaphorical account of what had happened the previous day. Her piece about the wooden box was very imaginative – she wrote about the box having magic powers that enabled her to fly. Fay said she enjoyed the session, and she found it helpful to be able to stop thinking about her problems and allow her mind to be creative for a time.
And as for me, inspired by the photograph of the door I wrote the start of a short story about a woman who rents a cottage having never seen it, receives the front door key by post, and moves in to start a new life there. During the wooden box exercise I wrote some more toward the same story, the box being a wrapped gift left by the previous occupier for the incoming tenant.
I love it when a week like this one happens and I feel inspired all over again both for my own writing and for my therapeutic writing practice. I’m still unsure where the inspiration started – whether with me as an individual or in the group process – but whatever its source, I’m glad it’s here.
Note: participants’ names have been changed to protect their identities.