Various forms of structured language, and especially what we recognize as poetry, have been important and even principal means of healing throughout history and in many different cultures, even after the advent of a more sophisticated understanding of the human body’s anatomy and pathophysiology. During the modern era, poetry flourished in an important sense as a response to the alienation and fear engendered by once inconceivable scientific advancement. (“Make it new, make it real” was the battle cry as poets like William Carlos Williams, himself a physician, sought to reinvent a more genuinely democratic, organic, New World idiom for their craft). If any mode of affliction with illness, as many before me have attested, it is poetry.
Incantation and poetry were the primary means of healing in Native American culture for many millennia. Cabeza de Vaca, a written record of the healing practices of indigenous people in his Relacion, published in Spain in 1557. He himself adopted the techniques of the Capoque Indians, who inhabited for about two thousand years the Gulf Coast of present-day Texas; he describes, in language notable for its lyricism, how he grew to be highly esteemed among them by curing abdominal pain and puncture wounds, and even reviving the dead by blowing breath into afflicted person’s mouth and praying over the body, thereby casting out the illness. The Navajo “night chant,” a centuries-old poem passed down orally through countless generations, integrate the human body into the larger natural world and addresses the Spiritual implications of physical illness. Calling upon the stars, the moon, the sky, the sun, the corn, and the land, all in the context of the sufferer’s community, it relies for its therapeutic effect upon the belief in what literary scholars have termed “the magical instrumentality of the voice.” The Iroquois “condolence ritual” made use of similar tenets of Native American belief systems; its ceremonial incantation led by a medicine man or shaman dealt specifically with grieving and depression in the wake of the loss of a loved one. These and many other Native American traditions of healing in the holistic sense, and communal realms. Many compelling accounts exist of dramatic cures affected by these practices.
The Egyptians of the pharamoic age expressed their belief in the connection between language and healing by giving their dead a hook. a kind of guidebook to the afterlife, without which survival of the spirit was unimaginable. The Book of the Dead, as it is known, was inscribed with charms and spells to serve various purposes in the hereafter. It also contains beautiful hymns In honor of the great gods Ra and Osiris. .Though little is known about its use in the ancient burial ritual itself. It is clear that this advanced civilization believed that a written text was necessary to guide the deceased in their perilous journey to eternal life by helping them to overcome the various tests and obstacles on their way.
The ancient Greeks, whose highly evolved culture perhaps more than any other forms the foundation of our own, also believed poetry and healing to be inextricably interrelated. The crucial important of this relationship was unmistakably represented in their theology. Apollo, the most revered and awesome deity in the Greek pantheon, was god of both poetry and healing; amoung his symbols were the lyre (the harplike instrument whose music often accompanied the declaiming of poetry) and the staff, which retains to this day its identification with medicine. Apollo’s son Aesculapius was the god associated with physicians and was believed to have invented the art of medicine; the Muses, the seven goddesses responsible for inspiring poets, musicians, and artists in their crafts, were his daughters. The shrine of Aesculapius at the ancient site of Epiduarus, said to be among the most beautiful in all of Greece, demonstrates in its physical construction the inseparability of poetry and medicine: the abaton, where supplicants slept in anticipation of a cure which would come to them in the form of a dream, was immediately adjacent to the tholos, or theatre, where the great dramatic poems of Greek culture were performed. According to Aristotle, the catharsis, or emotional turning point in these tragedies, was often linked either to physical healing or to physical affliction, and delivered an intentional and expected effect upon the audience.
Much in the Judeo-Christian tradition also joins poetic utterance and healing. Biblical poetry such as that in Psalms and the Song of Solomon makes frequent reference to the physical body and contains many prayers for the healing of conditions as varied as depression and infertility. Some of these traditions continue to have expression in the current day, where for example, faith healing thrives in many revivalist and fundamentalist churches across our country, or in the formal teachings of Christian Scientists, who rely strictly upon prayer for the treatment of illness. Christ himself, who some theologians and scholars believe bears a distinct resemblance to the Greeks’ Apollo, is often shown in the Bible to have healed with only words; most dramatically, he revives Lazarus with the simple, divinely iambic pronouncement; “Come forth!” Gerard Manley Hopkins, an important religious poet of the 1800s, repeatedly imagines Christ as both a poet and a healer, and Christ acts often as a powerful muse not only for him but also for many other devotional poets.
During the Middle Ages, the body itself was “read” or interpreted as a text, and manuscripts meditatively produced by monks contained such “prescriptions” as exhortations against the sinfulness that was thought to cause disease, and specifically linked prayers for healing. After the revolutionary development of the printing press, and as medicine concomitantly evolved into more of a rigorous science – and as scientific disciplines in general began to lay greater claim to the human imagination – the relationship between words and healing changed but did not disappear. Books only began to be used more formally in medical contexts. By the 1700s in Europe, for example, reading was often prescribed as “moral treatment for the instance,” as one physician of the time wrote, updating the medieval practice. Books went on to become perhaps the most important antidote to the dehumanizing effects of the Industrial Revolution, which with its new technologies ushered in both centralized hospitals and terrible new diseases. Even the renowned visionary physician Benjamin Rush, in planning his Pennsylvania Hospital of 1810 established a library so that inpatients could read up on subjects prescribed by their physicians. (Rush’s Pennsylvania Hospital, most will recall, is considered the precursor of the modern American “medical centre,” like the one I work in today.)
This practice of prescribing literature to patients as a form of therapy continues today in what is called bibliotherapy. In a recent review of bibliotherapy that appeared in the Canadian Journal of Psychiatry, Katz and Watt define modern bibliotherapy as the “guided use of reading, usually as an adjunct to psychotherapy in mental health care settings, for learning about and developing insights into illness, and for stimulating catharsis, to aid in the healing process.” These authors describe a number of conditions in the treatment of which bibliotherapy has proved successful, from social phobias to depression. (Least surprising of these, perhaps, is sexual dysfunction, which supports the age-old romantic belief that poetry is especially effective in wooing and inspiring potential lovers.) There even exists in the literature a report of a randomized controlled trial of bibliotherapy in chronic schizophrenic patients which purports to show that chronic schizophrenics who were randomly assigned thrice-weekly reading sessions which included poetry exhibited fewer behavioral problems than those who received the usual care. While the author does not explain in detail the nature of the improvement in patient attitudes, the results are intriguing nonetheless, particularly in light of some of the long-standing theories regarding the therapeutic effect of psychoanalysis. Among analysts, one school of thought holds that the efficacy of psychotherapy lies in its ability to provide critical structure – something like poetic form, one might say – to disturbed though processes, thereby helping to develop the insight and sense of reality so useful to the mentally ill patient.
Other scientific work has begun to investigate the effect of poetry more directly on basic human physiology. With data published in the International Journal of Cardiology, German researchers have shown that metrical poetry, when read aloud for thirty minutes, slowed their subjects pulse rates, as compared to those who engaged in normal conversation for the same period of time. They hypothesize a “harmonic interaction” between heart rate and respiratory rate, perhaps mediated through neural connections between the language centres in the cerebral cortex and the lower brain structures that govern autonomic nervous system responses, that tends to synchronize these cardiopulmonary functions; as a consequence blood pressure may drop, allowing tense muscles to relax. Such “proof” only bears out what any of us knows from the familiar experiences of singing hymns in church or calling out cheers at baseball games or chanting slogans at politics) rallies or meditation in stress management classes; rhythmic language helps us breathe more deeply, makes our hearts pound more steadily, and reminds us that our heads are joined to ecstatic, flesh-and-blood bodies.
An indirect therapeutic benefit of poetry can be imagined in the impact it can have as an instructive tool upon aspiring physicians (and other care providers). Surely the flourishing interest in medical education circles over the last decide in the “medical humanities” is a renaissance that bodes well for the future of medicine. August medical journals such as The Lancet and Annals of Internal Medicine have begun to publish poetry by physicians and people living with illness; one can find medicine and literature courses springing up in the curricula of medical schools across the country. More and more care providers are following in the footsteps of such literary luminaries as Anton Chekhov, Walt Whitman and William Carlos Williams; several literary journals specialize in publishing doctor-writers, and there is even a weekly E-zine that circulates physician-poets work on the Internet. Anecdotally, from my experiences of meeting medical students and residents, and their mentors who are beginning to teach humanistic materials alongside of cardiac electrophysiology and renal tubular acidosis, it appears that a resurgent movement is indeed afoot – one that harkens back to the monitoring that once was at the heart of the apprenticeship of an aspiring physician, and which may someday reclaim medicine as the art it truly remains.
Perhaps more immediately relevant to general medical practice, just within the last few years another randomized controlled trial appeared in the prestigious Journal of the American Medical Association that showed – and the significance of these findings cannot be overstated – that among patients with chronic and debilitating medical conditions such as asthma and rheumatoid arthritis, those who wrote creatively about their illness experiences reported fewer symptoms and exhibited less disability than those receiving usual care alone. This result is shocking not solely because modern-day physicians actually thought to investigate a hypothesis as humane as one that posited a relationship between creative self-expression and healing but also because the “emotional” or “subjective” (usually so stridently dismissed as impossible to quantify) was quantifiable in these terms. Not just calming the pulse rate, or providing reassuring insight into what it might mean to be sick, but modifying the course of disease: the act of writing here seems to heal, as the relentless deterioration caused by two very different and yet equally complex illnesses was stalled with nothing more than paper and pen, language and imagination. So vaunted is the biomedical understanding of illness today that patients themselves often demand tests or diagnostic procedures to explain their symptoms, and then the medication or surgery they presume will cure them; the allure of technology itself seems to motivate them as much as the articles they read in health magazines or on the Internet that rightly empower them to take charge of their health. It is inspiring to see amidst such pressures that the subjects of this study remained open to the possibility of the healing power of their own narratives, a low-tech way to be “proactive” that might afford even greater benefits.
Such research begs further questions, one perhaps most acutely: Why might poetry be therapeutic? Though the breadth of historical examples of the marriage between poetry and healing is intriguing, and the continued successful use of literature in psychiatric and some medical settings is suggestive, precious little “scientific data” exists to support its effectiveness. As David Morris notes, mysterious phenomena such as the placebo effect which he defines as “the power of belief to initiate physiological processes,” have been demonstrated in countless similar studies and yet remain largely ignored, or taken for granted, or scoffed at; less familiar, equally disregarded data, generated by prominent physicist at Princeton University and also cited by Morris, contends that human consciousness can influence otherwise randomly mechanized sequences of information from an isolate, tamperproof machine. Even prayer, which undoubtedly shares its roots with poetry, even in this nation of diminishing secularism, is viewed with skepticism despite preliminary clinical studies that show its therapeutic effectiveness.
After all, one might be tempted also to ask the usual variation of this question, one that has been kicked about in many quintessentially postmodern settings of late, from highbrow literary magazines to community college departments of creative writing): What use is poetry at all these days? Is it even remotely possible that any study, carried out by epidemiologist or poet could be devised that might accurately gauge the indispensability of the poem? For the answers to these questions, let us pull ourselves away (if we can) from validating science, and open our minds to the music of the poets themselves.
- What purpose does reading and writing creatively serve in your personal life? Has it ever been healing for you? If it has, why do you think it was therapeutic for you?
- Do you think there is negative or positive association with the word “poetry” in our society? How do you think this association affects the way that people interact with it?