Poetry and Narrative in Therapy

When I was in NYU’s film program about 45 years ago, I read and studied poetry. But it wasn’t until I began pursuing a career as a psychologist that I decided to revisit it. During my doctoral training, we examined the intergenerational transmission of trauma—how our home environment and parents and their histories impact us consciously, unconsciously, and epigenetically. As a father of two adult children I thought, My god, how is this manifesting in my own life with my own kids? This haunted me for a while. One day while I was driving home, I stopped at a red light. A phrase was going through my head about the branches of a family tree and blood connections. I reached over and grabbed an old napkin off the passenger seat and wrote it down—my first real poem:

Flaw
My tree branch leaf veins’
Sweet and spoiled brine passed to you
Pray the pain is tamped

After graduating, I was providing psychotherapy in a setting where the material was pretty heavy, and soon I realized I needed to metabolize all the trauma I’d been working with and absorbing. A poem began to formulate in my mind. I wrote it. Then I wrote another one. I started writing more and more until it became a recurring practice that continues today, years into my career.

I often wake up before everyone else in my house, find a quiet space, let words and phrases drop into my mind, and write them down. Sometimes I’ll find poems taking shape around material I’ve been working on with clients, or around what’s happening in society or politics. Other times something personal comes up, like my relationship with my mother, who passed away in 2019. As the writing accelerated over the years, I became more confident. I never thought about publishing a book, but the material piled up, and eventually, I began compiling The Alchemy of Blood, which was published earlier this year.

When I began organizing the poems, I noticed there was a deep, implicit tonality if I arranged them a certain way. Some were very dark and heavy, and others seemed to communicate light and movement forward. I thought of Carl Jung and his take on alchemical change. This was my process, which led to the structure of the book.

Poets and songwriters often say a word or phrase will drop into their mind unexpectedly, which can spark a piece of work. I’m most vulnerable and open to my emotions in the morning, over coffee and granola, so I’ll just allow myself to feel whatever feelings are coming up, whether it’s happiness or sadness or amusement or a strong feeling sparked by a newspaper headline. To use an analytic term, there’s usually something cathectic happening—something that creates a spark in me. Sometimes I’ll only come up with a single line, and I’ll let it go and come back to it later. Other times the trance brings a flow and a whole piece forms. Often, I find that the tonality, themes, or mutual resonances in my work as a psychotherapist drive a poem.

Over time, poetry became a more direct part of my work with a handful of clients. Many therapists have clients who stumble across old creations like a journal. And when mine do, I say “Oh, bring it in!” Sometimes they discover their own little narratives like poetry or songs. And as someone who’s been a film writer and editor, it’s very natural for me to dig into these things in session, assuming the client is open to it. One of my older clients had published a chapbook of poetry and decided to bring it in. When she handed me the book, I asked which poem she’d like me to read. She chose one related to her childhood trauma, and my emotional reaction to it was powerful. She appreciated my feedback and praise so much that we went on to read practically every poem in her book. She told me she wanted to continue writing but had stopped because of significant turmoil in her life, so part of our work together became encouraging her to get back to it.

I’ve long believed that writing poetry can be deeply therapeutic. Some of my clients have discovered that the metaphorical symbolism of poetry allows them to access dissociated or defended emotions they wouldn’t have been able to access had we gone directly at the narrative. They could tell me the straight story, but it would be more verbal and cognitive. One of my clients recently told me, “poems are a sneaky way around my defenses, and writing a poem fools the internal programming I have to avoid telling something so horrible.” Another client found that rereading her poems with me finally allowed her to cry, to feel feelings she hadn’t been able to feel before. It was as if she’d been playing two roles: the writer when she was writing it, and the reader when she was reading it.

For some of my clients, I’m taking on a sort of parental role: they’re sharing something personal and getting praise and input from me, and they aspire to keep working on the craft. The client who brought me her book of poems is extraordinarily talented, and there was one poem of hers that I kept coming back to. I eventually asked her whether I could print it and hang it in our office hallway, leaving her name off for confidentiality. “Oh yes, you can print it,” she replied, “and please put my name on it!” Nobody in the practice knows she’s my client; it’s just a poem on the wall. But people stop and read it. I like to see that. And she’s repeatedly told me how honored she feels, that this whole process has helped her rebuild some much-needed self-esteem after her early childhood traumas. Now, she’s working on a complex, epic poem that talks about trauma and survival.

At one point in our work, this same client asked me if I’d written any poetry. I told her I had, and we went into a kind of reciprocal analysis of both of our writing—which actually made me start writing much more. Disclosing my work was a clinical decision I wouldn’t have made with just anyone. Even though I have about 30 clients, only a few resonate in a narrative or poetic way, so it feels right to share with them. The rest of my caseload knows nothing about my poetry and doesn’t need to because it won’t resonate with them, or because it isn’t clinically appropriate.

Writing poetry helps me metabolize the heaviness that often accompanies our work. In the preface of my book, I write about how the world has been through a kind of hell over the past decade, and whenever I write—on any topic—I immediately find myself in a better mood. It’s not always a direct metabolizing of all the difficulties of doing therapy, but we are absorbing the world through our clients, so it does help. Plus, a part of me needs to do something creative and artistic. I think if I didn’t have to make a living, that’s all I would do—make music and write poetry and create things.

If you’re thinking about incorporating poetry or other creative modes in your clinical work, I’ll say this: don’t impose it. And when it comes to ethical competency, trust your gut. Some clients use the therapy space for completely different things and have no interest in sharing their creative work or hearing about the therapist’s. Next, ask yourself whether you have enough facility and language for whatever artistic medium you’re dealing with—as well as the therapeutic style to smoothly blend the two. If you don’t, then don’t do it. It has to be useful. Last, if you’re thinking about sharing your own creations, just know that that’s part of a very advanced relational approach. You have to be careful; it’s a very delicate process.

But if you’re working with a client who seems to resonate with narrative—whether it’s their own or something else—then you can start by saying something like, “You seem to have a very good story sense” or, “You seem to have a good sense of metaphor and symbol.” Then you can ask, “How do you use that in your life?” If the client says they read or write a lot, then ask what they read or write. If you feel they’re engaged in this exchange, you can say, “Wow, well I’d love to see some of that!” or, “Do you want to work together in exploring that part of you?” If a client brings in a journal and reads something that has symbolic weight about their therapeutic journey or goals, you can say ,“Wow, that’s really impactful!” or, “That clarifies something.” Then you can ask whether they’d like to do more of that writing.

Whether you’re a creative, a fan, or a knowledgeable consumer of art, you and certain clients may find utility and depth in using poetry or other mediums in the therapy room. Whether you decide to share your own creations or keep them to yourself, I hope you’ll find the experience as powerful as I have. It’s extremely rewarding to hear clients say how productive and healing these approaches have been for them. In closing, I’ll leave you with one of the poems I’m most proud of, in honor of my mother:

Faded Color Scan, In Memoriam

My mother’s gentle knock-kneed stance
Heartbreaks me every time
Young, with a hat
Her humble smile at Aunt Helen’s pool
The only honeymoon they could afford

So new, you, a step above poor
 and carrying, growing a life

Why do I paw at that muted simplicity
 when it’s possible now, here?
Not possible.

You showed me acorns and a squirrel at a cold park
Your beige belted coat a plan against the rain
You were learning. You were good.

Twenty-one and another coming
Maybe our last outing alone?
You worked so hard and did so well

Why do I long so deeply if you fed
 so lovingly into my trench of murky needs?

Much later I saw you staring off
Calm and more serious than you showed us
 at backyard barbecues
Please come back and tell me