Gillie Bolton

Apollo is god of both poetry and healing. Writers have probably always known the deeply healing power of writing, certainly since Sappho. But it has been a secret well kept from western official healers until recently. Now it is increasingly used in mainstream and complementary healthcare, medicine, and in therapy.

Writing is powerful communication: perhaps even more powerful than speech, as it does not disappear on the breath. Every utterance is a communication between interlocutors. But no-one initially listens to a written utterance except the quiet accepting page. The writer is their own first reader, their own primary interlocutor. So writing is, in the first instance, a private communication with the self.

These initial writing processes can be intensely absorbing - almost trancelike; the scribbling can be intuitive and unreasoned, the hand being allowed to write with no conscious mental direction: 'That willing suspension of disbelief for the moment, which constitutes poetic faith.' (Coleridge 1817). Keats' opinion was that: 'If poetry comes not as naturally as the leaves of a tree it had better not come at all.' Winnie the Pooh clearly read Keats: '"It is the best way to write poetry, letting things come," explained Pooh.' (AAMilne) He'd also read Wordsworth: 'Poetry is the spontaneous overflow of powerful feelings; it takes its origin from emotion recollected in tranquillity; the emotion is contemplated till by a species of reaction the tranquillity gradually disappears.'

Ted Hughes likened it to silent, still night watching for foxes: 'Till, with a sudden sharp hot stink of fox / It enters the dark hole of the head.' ( The Thought Fox ) These are passive approaches which suggest that the writer has to be in a specific state of mind, and the inspiration will arrive.

Seamus Heaney used more active metaphors: 'Between my finger and my thumb / The squat pen rests. / I'll dig with it.' ( Digging ) And:

Usually you begin by dropping the bucket half way down the shaft and winding up a taking of air. You are missing the real thing until one day the chain draws unexpectedly tight and you have dipped into water that will continue to entice you back. You'll have broken the skin of the pool of yourself. (selected prose)

Helene Cixous similarly searches: 'These pearls, these diamonds, these signifiers that flash with a thousand meanings, I admit it, I have often filched them from my unconscious. The jewellery box. . Furtively, I arrive, a little break-in, just once, I rummage, ah! The secrets!' ( Coming to Writing )

The writer does not know what the treasure hunt, bucket or spade will yield. But it's well worth working for that magical sighting of young reddish furry creatures tumbling on grass together, the vixen watching over.

Writing as listening

The metaphor I use is of deep searching listening to some of the many multiple voices in the self which are habitually blanketed during our waking lives. Some of those voices we ignore at our peril. This is why people who write for the first time with a trusted facilitator say such as: 'it unlocked something I didn't know was there' (a general practice patient working with a poet-in-residence in a Gloucestershire GP surgery). Someone I worked with said: 'Hell, did I write that? Was that really me? You can't pick something safe with writing, like you can with role-play. I suppose it's because you're not listening to yourself as you write. Writing takes you out of control.'

'You're not listening to yourself AS you write'. No, you listen to yourself AFTER you write. And this is the key. The interlocution is delayed until the writer chooses to reread their own writing. WHILE they write, the page offers no judgement at all.

So often we want, but don't really know what. People who overeat (or drink). know they want, but don't know what, and so they reach for an available comfort - food or alcohol. It isn't what they really want or need, so they carry on overeating or drinking, in an effort to stop that terrible crying want.

In a gilt frame above me as I write, is a William Blake picture of someone climbing a ladder leant against the moon. The caption reads: 'I want! I want!' We all have an innate right to want - not quite the moon, but then the person who feels they want the moon has not had their most basic and ordinary needs satisfied. We are born wanting and we die wanting. That's what we're like, and it's OK. What isn't ok is a constant denial of want, or re-channelling of it into something which will inevitably be inappropriate or unsatisfactory.

I suspect my framing of this Blake in gilt is an unconscious irony. There is so much guilt associated with wanting. And it's the cause of a lot of problems.

If we can listen to ourselves coherently, lovingly and without guilt then we can begin to understand, begin to communicate with those desperately wanting selves, as well as those loving and wise selves. We can then begin to sort out how to relate to the world in a way which might reasonably bring us a measure of control over our own lives.

Derek Walcott doesn't mention the process of writing when he says 'You will love again the stranger who was your self. / . who knows you by heart.', but this is what writing can help you to do. It's a funny thing: we are the greatest authorities on ourselves, yet we are extraordinarily deaf to the 'still small voices' inside, which can give the keys to understandings. Nobody can know me like I can know myself. Yet I don't, and I make little effort to try. Who's going to if I don't?

What's the difference?

In what way is therapeutic writing different from creative writing . Therapeutic writing is intended for a tiny audience - occasionally none at all - as a writer might choose not even to read their writing themselves, but therapeutically destroy it unread. This tiny audience might include - apart from the writer - family, friends or a healing person.

Almost every creative writer does therapeutic writing; traces of it can be detected clearly in so many novels and poetry. But when they come to think of publication, literature writers take their own bleeding heart, anguished mind, or tortured body off the page. Because literature readers are not interested in the writer, they are interested in what the writer has to say. Exploring material with therapeutic writers is a deep privilege; but reading this kind of material off a printed page with no relationship with the writer would be boring, and seem self-indulgent in the writer. Published literature writers might well go through the deeply therapeutic initial stages of intuitive writing and sharing material with family, friends or therapist, but they then move onto the rigorous redrafting, crafting and editing stages required for publication.

The redrafting stages can also be deeply therapeutic, as vital images become sharper, clearer and more meaningful, as the experience, emotion, or memory is captured as accurately as possible in apt succinct words and images. Writing can be worked on in a way neither speech nor thought can, as it remains unchanged on the page. The etymological roots of the word 'record' are: re- meaning again, and -cord meaning heart (OED). Redrafting is re-recording, getting closer to what is in the heart each time.

Most therapeutic writers can't be bothered with these stages - they do not want to be writers, and the cathartic first stage of writing has brought them a great deal. That's fine - but for those with deep-seated problems these later stages are veritable jewellery boxes of discovery (though I recommend only trained personnel do writing work with people thought to be psychotic). The distancing involved in the redrafting and crafting stages can also be therapeutic; Anne Sexton's poetry for example is deeply crafted; her therapist thought she staved off her eventual suicide by this writing.

Many writers cannot bear the thought of writing being used instrumentally: writing for them is an art, not a personal development process. Similarly some therapists and healthworkers feel writers shouldn't work with patients as they have no therapeutic training. But I believe in these boundaries being permeable, and all of us in this uncertain world making as much use of these powers as we can. As Nelson Mandela is supposed to have said, it's not our powerlessness we are afraid of, but our power. Some are afraid of what might be unleashed by the writing hand. I think we need not be afraid to listen, and to extend a helping hand to those who are listening by writing.

Where and how is therapeutic writing used?

Therapeutic writing is increasingly being used within therapy and counselling: often journaling or poetry. It is mushrooming on the internet and email. The Samaritans run a very popular email service, and Interapy is offered on the internet in the Netherlands , and soon will be here. It is offered in general practices, hospices, hospitals, prisons, in substance abuse treatment centres, and so on. Courses are run, such as Write by the Sea , with Ann Kelley in Cornwall . We have a vibrant association for writing for personal development in Britain (Lapidus), and an immensely resourceful National Network for Arts and Health.

My research at King's College London University is into the ways therapeutic writing benefits dying patients; I have practised and done research previously with dying as well as general practice patients who are depressed and anxious. I train counsellors, therapists, clinical psychologists, doctors, and nurses to use it within their practice. I am also involved in developing medical humanities - the use of literature, creative writing, and other arts and humanities within medical education (pre- and post-experience). This field is opening up dynamically.

Prescriptions

So for whom would I prescribe writing? For the depressed and anxious, post-traumatic stress sufferers, dying, bereaved or chronically ill, new and old parents, anorexia and bulimia and substance abuse recoverers, and the worried well. A surgeon once snapped at me: 'how can writing mend a broken leg?' Well of course it can't, but anyone who knows about the relationship of mind, body and spirit knows that happy or contented people don't get so ill, they experience less severe symptoms when they do, and they recover more quickly. And what makes for more contented people? Understanding what they need, not being terrified of what's going in inside them, being able to ask for what they want, and accepting where they are in life.

Where do you start? Writing is pretty cheap. All you need is pencil and paper. I suggest you choose both carefully - I like 2b pencils with rubbers, and loose-leaf paper. Others like beautiful bound blank books and fountain pens. Though some like writing like this on the computer, it can give too official and printed a look: scribbling can be better. And you can scribble anywhere and at any time - in odd places like bed or moor-tops, and at odd times like the middle of the night or immediately on waking, when your internal policemen might be napping (as Ted Hughes said).

There are loads of ideas in Mslexia for starting writing, and in books like the ones listed below. Write about an object which was important to you sometime in your life, about a person who was vital in your personal development, or about a recurring dream, or write a letter to that dreadful person who made your life hell years ago (but don't send it), make lists of things which mean a great deal to you, or things you can't stand. Write dialogues with the part of your body which is troubling you, or with an arresting dream character, write as if you were Little Red Riding Hood, or Penelope. Finally, and endlessly play with metaphors: if your loved one were a piece of furniture, what piece would they be, if they were a colour, a drink, a food, a season or weather - what would they BE, not what do they like. If the person who so troubled (or troubles) you were an animal what animal would they be? Experiment. Play!

Dannie Abse, poet, physician, and writing facilitator said in The Lancet: poems 'profoundly alter the man or woman who wrote them'. There is a thirst for this profound altering, for this deepening of self-understanding and expression. The rash of poems which followed the death of Princess Diana, and 9:11 demonstrate that people have something to express and explore. They need permission to do this with their own angsts, griefs, anxieties, or memories, not just about an unknown icon such as a princess. We all need this permission, though writing is not the best route for everyone. But it is for many. Get to know the person 'who knows you by heart' better.