NURSING AT McLEAN

Creative Writing at MSE: Another Tool for the Healing Journey

By Bella Doumbia, M.Ed
Mental Health Specialist

On a Wednesday afternoon at MSE, an announcement rings out over the intercom. “Good afternoon, ladies and gentlemen. At 4:00 pm, there will be a creative writing session in the group room. See you there. Thank you.” Some patients are already waiting in the room, while the staff encourages others to join the group. A few walk in slowly, with apparent apprehension; still others peer in, waiting to be coaxed. “Writing is not for me,” some say, while others comment that they haven’t written since high school. A few patients seem enthusiastic: “Oh boy, what? Writing?”

When the group has gathered, I introduce myself as leader, and I describe the therapeutic characteristics of creative writing during a brief psycho-education presentation. Mindfulness, the awareness of oneself in the present moment, is the primary use of creative writing in the therapeutic milieu.

To begin, I coach patients to check in using the weather, flowers, or animals as metaphors to describe how they feel in the moment. This helps patients to see their thoughts in a different light. The next step is a mindfulness exercise, like breathing or stretching, to help patients release muscular and emotional tension. The goal is to bring each patient’s consciousness back into the present.

Next, I give a writing prompt, often using a story. Patients may or may not find personal meaning in a story, and some may even want to engage exclusively in a dialogue about what a particular story was intended to mean. The therapeutic value, however, lies in each person’s response to the story. During a fifteen-minute period, each patient writes down thoughts and feelings about the prompt or anything else that arises from his or her inner voice.

“Where should I begin?” some ask.

“Right here, right now,” I say. “In this very moment, write about your experience.”

”Who would think that a simple pen lying on a table and begging to be picked-up could be part of my moment right here?” one patient comments.

Today’s prompt is a story about a child’s search for treasure. She wanders into nature and experiences euphoria, serenity, and wholeness, as nature opens up its beauty to her. The patients are moved by the story. It provokes all their senses, and stirs a wide range of emotions. Some write about feeling a connection with the child. Two patients discover a parallel with their own experiences. One is reminded of things she used to enjoy. Others want to detach from the story, expressing discontentment. “How can I see beauty in the world when all I see in my world is darkness?”

My role is to coach and guide patients as they write what needs to be written in their own voices: their feelings, thoughts, hopes, and dreams in the moment. Natalie Goldberg, in her book Writing Down the Bones, suggests that “we do not ignore suffering, we acknowledge it, and writing is the aim. It is an opportunity to take the emotions we felt many times and give them light, color and a story.” In that moment, Goldberg adds, “you can finally align how you feel inside with the words you write, at that moment, you are free because you are not fighting those things inside.”

Patients find writing therapeutic. “I have to remember about the things I used to cherish while I am here,” one patient writes. Another comments that “I’ve been stuck all morning, and it feels good to write about it.“

“This exercise has been a good outlet to observe my feelings,” interjected another. Patients share their writings and give each other feedback. They find themselves laughing, crying, applauding, and “ready to face the storm,” as one patient expresses it. 

Creative writing encourages patients to deal with their own worlds and their own pain. With the coaching of the group leader, patients learn skills that enable them to come to terms with their feelings and identify healthy coping mechanisms. The writing process gives the patient and the group leader a common reference as they engage in a healing journey. It inspires patients to explore their feelings, while offering each other support as a community with shared interests.

One of the treatment approaches at MSE is patient education to improve understanding of illness and to strengthen coping skills. As an educational tool, the creative writing group at MSE has provided many benefits in multiple diagnoses centers. I love to use this tool to initiate change from unhealthy behaviors to healthy ones in the everyday lives of patients. That is the strength of the creative writing group. So let’s start writing.

Acknowledgments: Joan Kovach, MS, Nursing Director at MSE, who suggested that I write this article, and Lois Choi-Kain, MD, Gunderson Residence at Mclean Hospital, encouraged me to use my passion for creative writing as a skills coaching tool in their respective departments. Thank you!

09.2011