Cathartic Poetry: Healing Through Narrative



 

Richard Bruce Hovey, MA, PhD; Valerie Curro Khayat, MA; Eugene Feig

Perm J 2018;22:17-196 [Full Citation]

https://doi.org/10.7812/TPP/17-196
E-pub: 06/25/2018


Most people are perfectly afraid of silence. —EE Cummings

Abstract

This article explores the efficacy of writing and reading poetry as a means to help people living with chronic pain to explore and express their narratives in their own unique way. Throughout our narrative we have interwoven poems from Eugene Feig, one of the authors of this article. His poetry is sent out almost weekly to the members of our pain support group as a method of sharing his own experiences of living with pain, as well as to support and to inspire hope in others. The style of poetry we are presenting is that of a person who is not knowledgeable about poetry in a formal sense but who has an understanding of how it has helped him learn to live with his own chronic pain and suffering. These poems are the author’s expression of the meaning of living with chronic pain for over 20 years. This article is a philosophical hermeneutic conversation about pain and poetry.

Poetry

Hermeneutic scholar HG Gadamer wrote, “It seems incontrovertible to me that poetic language enjoys a particular and unique relationship to truth,”1p105 helping us to acknowledge and understand the role that poetic recollection plays in the reflectivity of our own truth, and not just in the poetic freedom one might be permitted and encouraged in the telling of our stories of living with chronic pain. Gadamer adds, “… the task of poetry to instruct as well as to please has maintained its absolute validity in classical aesthetics and still remains valid for modern scientific thought—at least in a more reflected and indirect form … .”1p105 In this way, we can consider poetry as a relevant resource, within a scientific and academic context, for the exploration of the chronic pain experience. The cathartic poem is an attempt at self-healing through self-empathy. The poem and the person endeavor to make sense of chaotic thinking, restoring a feeling of balance and of wholeness in oneself through words. By better understanding their own experience of their pain, and of the internal chaos that inhabits them, people may begin to open up to learning to accept their lives with pain.

The cathartic narrative or poem, when offered by the suffering person, is an invitation with encouragement to say, to write, or to artistically represent an interpretation of their suffering.2 It is clear that this process is one that is not guided by a templated rubric about how someone should tell their story, but rather is freely given, often from personal, chaotic reflections from a precise place and time, such as in the poem “Pain Journey” by Feig (see Sidebar: Pain Journey). Gadamer wrote that “Reflection [is] the free process of turning in on oneself”3p50 and that our minds are thus enabled to examine their own content about what we understand and why. Reflection can give us distance from ourselves: “[The] ability to stand back from oneself is a fundamental prerequisite for linguistic orientation in the world, and in this sense all reflection is in fact freedom.”3p51 It is during these times of reflection that we are open to possibilities of the expression of self beyond merely a chronic pain patient. With the help of others, we express ourselves openly while creating conversations that both provoke and promote transformation of oneself. Poetry is one way we can open up these conversations. This article offers an example of the poetic narrative, from chaos to cathartic.

17 196

Poetic Narratives

It is essentially the narratives people keep about themselves regarding why they are doing what they are doing, what their goals are, and what their views of their past are—all components of ongoing stories people maintain about how they see themselves as distinct persons, whether rightly or wrongly.4p61

The act of reflection allows for an interpretation of our narratives, especially the ones we keep suppressed and often take for granted or dismiss as unimportant. Finding a means to express these internal thoughts and interpretations, such as transposing them into poetry, provides a novel form of expression. This transposing process moves our internal thoughts onto the written page, creating a space for our inner thoughts to be in the world in a tangible way as if we were pulling the narratives out of ourselves and laying them down before us. We now can hear and see them differently. We could say that our written reflections allow for a ritual of being honest with ourselves. The written page is our truth written out at that moment and time. Gadamer goes on to say that poetic language experiences a particular and distinctive relationship with truth.1

Gadamer continues,

First, this is shown by the fact that poetic language is not equally appropriate at all times to any content whatsoever, and second, by the fact that when such content is given poetic form in language, it thereby acquires a certain legitimization. It is the art of language that not only decides upon the success or failure of poetry, but also upon its claim to truth.1p105

Cathartic narratives through poetry illustrate Gadamer’s supposition that language gives us an expressed description of our experiences through our particular and unique relationship to a personal truth. The person living in pain may not look ill because that chronic pain is lived inside of the person. Their truth of living with pain cannot be seen externally as with other traumas. No wound is exposed, no cast is setting a broken bone, and there are no visible signs that a person is living with serious, persistent chronic pain, other than the grimaces on their faces.

The invisibility of chronic pain requires a deeper kind of expression about our pained lives, one that disrupts the brevity of medical narratives and allows us to “negotiate and act on our own purposes, values, feelings, and meanings rather than those we have uncritically assimilated from others … .”5p8 Whereas the biomedical narrative works to anesthetize the person’s pain and to reach an objectively determined single truth, the poetic narrative serves as an expression for the person’s claim to their truths. The poetic narrative provides an intimate, detailed representation of the person’s pain.

Feig’s poem “Confronting Fear” (see Sidebar: Confronting Fear) becomes an invitation for others who share an interest in this topic. We must be ready to hear something that we did not notice before. This readiness is the only way the word becomes binding, because the poem has the potential to connect one human being to another and to help a person become open to being struck by something written, read, and reread. Unlike telling a story in its entirety, we write poems to express an intensity of emotion; we bring it out into the world with intensity of feeling.

This article explores the relationship between the cathartic poem and healing in the context of chronic pain. Through an understanding of how poetry can provide an access to a different experience of healing, cathartic expression of our personal narratives suggests that the act of recounting one’s new narrative (re-storying) leads to restoring and learning to live with pain. The sharing of cathartic poetry also opens up a space for dialogue, for exchange (the hermeneutical), which is central to healing. We recognize the distinction between curing and healing. Pain in the context of a theory can be thought of as a “primarily neurological phenomenon (‘nociception’), not a spiritual phenomenon, whereas a great deal of suffering is of a properly spiritual or ‘existential’ nature, ‘psychic pain.’”6p8 The goal of health care is to cure the patient of their pain, whereas poetry offers a means to heal the person’s suffering.

The Cathartic Poem: Healing Suffering

Gadamer1 says that there is a fundamental difference between a genuine poem—one that is articulated within a specific structure and form—and the well-intentioned poetic communications, which are less structured and without literary constraints, that people compose to express their experiences. When someone writes a healing poem, there is an abundance of sincerity and emotional influence in it, and as such these verses are best understood from the motivation behind them. Structure, technicality, and poetic tradition become secondary to the process of expressing one’s experience and emotions for a primarily cathartic purpose. For example, Gadamer3 notes that while in extreme pain, Rilke wrote in one of his last verses: “‘Oh life, life, remaining always on the outside.’ So powerfully does pain cause us to withdraw from all external experience of the world and turn us back upon ourselves.”3p75 As pain incarcerates the person from their previous lifeworld into one with a profound sense of loss and despair, an inward spiraling of self occurs through suffering and the endurance of pain. The cathartic poem promotes movement from the inside to the outside, moving a person to open up to a new reality, releasing words onto the page; it is an act of unburdening instead of coiling in on oneself.

Regardless of form, any poem such as Feig’s “Chaotic Thinking” (see Sidebar: Chaotic Thinking) is worthy of being called a poem and is clearly different from other forms of emotional speech, even as it helps to sort out our chaotic thoughts. When we read a poem that touches us deeply, it may not occur to us to ask who the author is and why they wrote the poem the way they did; it just speaks to us and captivates our attention. We are moved on an emotional level rather than stimulated intellectually by the words. We are only aware of those words, as though they were written specifically for us. The poem becomes our interpretation of the interpretation of another’s profound experience, which is in that moment independent of both reader and poet; it is now in the world.1 The author’s interpretation, presented through the act of writing the poem, makes it available for others to interpret because of its surplus of possible meanings. Our ability to interpret poems differently to find individual meaning, which may not have been the intention of the author, makes poems uniquely available to many different readers. As with all thoughtful works of art, each time we see a picture or read a poem we may find something new that grasps our attention. There is an intrinsic motivation among humans to try to find meaning in our day-to-day living. We learn that there are no persistent truths, and that change is continuous. Even with our planning, wanting, and needing, we cannot always be confident of what we think we know or believe.

The cathartic poem is one that arises from within the poet in an attempt to make sense of chaotic thinking. Actually writing the cathartic poem is not a process in which the writer sits down and beautifully crafts a poem, stanza by stanza, but rather it is created to relieve the dialectic tension of thoughts that have become too overwhelming, confusing, and painful to make sense of. “The Fight” by Feig presents an example of this type of poem (see Sidebar: The Fight).

Humanizing pain, which returns the meaning of pain to the person living with it through reflection, writing, and accepting, becomes a way to learn to live with pain with the goal of more than merely managing it, but rather learning to live well with it. Pain for the person living with it exists within the experiential realm, where “learning to tolerate pain brings us closer to an understanding of the pain.”7 This means overcoming our resistance to change. Life consists of continuous movement through various emotional states. We can neither hold onto the comfortable ones with apprehension of what might one day change nor can we remain paralyzed by the grip of nostalgia for a past (painless) existence. We must embrace what is, right now, in this moment, and breathe, imagine, and learn. This approach strongly echoes the mindfulness school of thought, which has been increasingly valued over the years by many health care practitioners such as Jon Kabat-Zinn, who said, “When we can actually be where we are, not trying to find another state of mind, we discover deep internal resources we can make use of. Coming to terms with things as they are is my definition of healing.”8 Just as breath is the vehicle through which one brings oneself back to the present in mindful practices like yoga or meditation, cathartic poetry becomes an instrument through which the mind can be trained to live moment to moment once again.

Healing through re-storying

The cathartic poem, like Feig’s “Pain Relief” (see Sidebar: Pain Relief), calls for renewal through an exploration of what it means, in our own life, to live with chronic pain. It allows us to take a step back and observe our experience from a different perspective in order to find new meaning. It is an approach that requires us to involve every part of ourselves while we acknowledge not only the pain, but also our emotions, our shifting sense of identity, and how we can grow from the experience. The pain becomes our teacher, adding a richer dimension to our story instead of robbing us of what we once had.

Rediscovering or reclaiming our story through poetry is a holistic process and a form of care toward ourselves that can improve healing. It moves us to prepare for and fulfill the inevitable task of continuously re-storying ourselves as we learn to live with chronic pain. Perhaps the process of writing poetry becomes an approach to take our chaotic, pained thinking and to turn it into cathartic narratives, ones that may confront our suffering. Perhaps it can be an approach to become whole again in a different sense than before pain. The world of the person living with pain can only be expressed through their personal narrative. How this narrative comes into the world is through many potential expressions of text. The silence of speech (spoken words) is replaced by the written text. Where text is any form of expression (eg, art, photography, sculpture, or poetry, as in this case), it helps to let the person living with pain heal cathartically.

Coda

Rather than naming this section of the article the Conclusion, we decided to use the term coda to say something about the ongoing possibilities of expression to help people living with chronic pain to heal. Coda is a musical term, originating from the Latin word cauda, which means the tail, the end. However, chronic pain does not end, so we adopted another interpretation of the word: coda, “used in a more complex sense, as in a movement in music that echoes and replays the basic structure and motifs of the work as a whole, and, in doing so, reminds us of how a story has unfolded in both what was amplified and perhaps what is still hidden in the silences.”9p131 This is where the possibilities of poetry reveal themselves over and over by breaking through the silence of our hidden thoughts and lived experiences of pain. To write cathartic poetry means bringing into presence our inner reflective thinking, emotions, and self-empathy to help ourselves and others who suffer alongside us. In the spirit of the coda we offer the poem “Hope” by Feig (see Sidebar: Hope). We invite you to take this opportunity to pause, read, and reflect.

Disclosure Statement

The author(s) have no conflicts of interest to disclose.

Acknowledgments

Kathleen Louden, ELS, of Louden Health Communications provided editorial assistance.

How to Cite this Article

Hovey RB, Khayat VC, Feig E. Cathartic poetry: Healing through narrative. Perm J 2018;22:17-196. DOI: https://doi.org/10.7812/TPP/17-196

References
1.    Gadamer HG. Bernasconi R, editor. The relevance of the beautiful and other essays. Cambridge, UK: Cambridge University Press; 1998.
    2.    Hovey RB. Cathartic narratives for chaotic thinking. CMAJ 2016 Dec 6;188(17-18):E543-4. DOI: https://doi.org/10.1503/cmaj.160831.
    3.    Gadamer HG. Gaiger J, Walker N, translators. The enigma of health: The art of healing in a scientific age. Stanford, CA: Stanford University Press; 1996.
    4.    Davis JB. Person-centered health care: Capabilities and identity. Am J Bioeth 2013;13(8):61-2. DOI: https://doi.org/10.1080/15265161.2013.804336.
    5.    Mezirow J & Associates. Learning as transformation: Critical perspectives on a theory in progress. San Francisco, CA: Jossey-Bass; 2000.
    6.    Madison GB. On suffering: Philosophical reflections on what it means to be human. Hamilton, Ontario, Canada: Les Érables Publishing; 2013.
    7.    Ferrini M; Centro Studi Bhaktivedanta. [Tollerare per comprendere il dolore] [Internet]. [Video in Italian]. San Bruno, CA: YouTube; 2009 Dec 15 [cited 2016 Aug 30]. Available from: www.youtube.com/watch?v=g7Jk0vI3gxE.
    8.    Boyce B. The healing power of mindfulness [Internet]. New York, NY: Foundation for a Mindful Society; 2011 Feb 28 [cited 2017 Aug 24]. Available from: www.mindful.org/the-healing-power-of-mindfulness/.
    9.    Lund DE, Panayotidis EL, Smits H, Towers J. Provoking conversations on inquiry in teacher education. New York, NY: Peter Lang, Inc; 2012.

The Permanente Journal

Sponsored by the eight Permanente Medical Groups, The Permanente Journal advances knowledge in scientific research, clinical medicine, and innovative health care delivery.

Reprint Permissions

The Permanente Journal welcomes requests for reprints and reproduction. Use of any and all material published in The Permanente Journal is copyrighted and protected.

The Permanente Press

The Permanente Press publishes The Permanente Journal and books related to healthcare. Journal subscriptions are entered for the calendar year. Advance payment in US dollars is required.


ISSN 1552-5775 Copyright © 2018 thepermanentejournal.org.

The Permanente Press. All Rights Reserved.