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<h1>Narrative-Poetic Medicine for Student Veterans in Higher Ed (and Everyone)</h1>

<div id="MainImg" style="margin-bottom:20px;margin-top:5px;"><img src="https://images.higheredjobs.com/images/articles/article_3684_1.jpg" alt="Woman outside creative writing" class="" style="" /><div class="ArticleCaption">LinkedIn Sales Navigator/Pexels</div></div>

<div id="article-byline">by Rosemarie Dombrowski</div>

<div id="article-content"><strong>Wednesday, October 18, 2023</strong> -
<p>In <a rel="noopener" href="https://www.besselvanderkolk.com/resources/the-body-keeps-the-score" target="_blank">Bessel Van Der Kolk's</a> seminal VA clinic "basement groups" with Vietnam veterans, which predated the APA's inclusion of PTSD as a psychiatric diagnosis, he made several crucial discoveries: That after trauma, the world becomes sharply divided between those who know [trauma] and those who don't know; [that] the act of telling the story doesn't necessarily alter the automatic physical and hormonal responses of bodies that remain hypervigilant.</p>

 <p>Years later, Van Der Kolk would discover that reciprocal social support, i.e. being truly seen and heard by those outside one's own "narrowly defined victim group" is key to recovery.</p>

 <p>Additionally, helping people who have experienced trauma "live fully and securely in the present", aka what some deem mindfulness, is another integral part of the process.</p>

 <p>This idea of presence, as well as the concept of being seen and heard, is at the heart of a not-so-new practice called narrative medicine, one that arguably dates back to antiquity<sup>1</sup> and more recently has experienced a resurgence, in part due to the trauma inflicted on healthcare providers and patients (and patients' families) during the Covid pandemic. In response to unprecedented levels of burnout and retirement among practitioners, as well as the ongoing depersonalization of healthcare, many medical schools have bolstered/grown their narrative medicine programs.</p>

 <p>Rita Charon, MD, PhD, a faculty member at Columbia University College of Physicians and Surgeons and author of "<a rel="noopener" href="https://www.amazon.com/Narrative-Medicine-Honoring-Stories-Illness/dp/0195340221" target="_blank">Narrative Medicine</a>" (2006), "[Narrative medicine] is a commitment to understanding patients' lives, caring for the caregivers, and giving voice to the suffering." Charon, known as the mother of narrative medicine, also calls it a practice of "radical listening." In non-medical spaces, this can be translated into "the art of holding space," something every human, and especially those struggling with grief, illness, and trauma, need and deserve.</p>

 <p><b>Using Narrative Medicine with Veterans</b></p>

 <p>As a poetry scholar and professor, I've been using poetry as portal to discovering socio-historical truths, especially the narratives of marginalized and underrepresented populations for decades. As a poet and caregiver to my disabled adult son, I've used poetry as a means of survival, a tool for navigating both depression and PTSD. Eventually, I came to understand the relationship between these two seemingly divergent potentialities, thus, re-envisioning myself as a medical humanist and practitioner of narrative medicine. As a medical humanist, I've facilitated "poetic medicine" workshops at reentry centers, prisons, dementia care centers, assisted living facilities, medical schools, and most pertinently, veterans' programs and centers. Accordingly, in the past several years, my students and I have applied poetic medicine widely in the community, thereby discovering the ubiquitous therapeutic value of reading and discussing poetry.</p>

 <p>For instance, I teach a class for Barrett, the Honors College at Arizona State University entitled Poetry & Medicine. It's a course that's predominately populated with future medical practitioners as well as those pursing degrees in social support fields.In Poetry & Medicine, we explore the evolving relationship between poetry and medicine, primarily from the mid-19<sup>th</sup> C to the present, through the lens of both poet-practitioners and poet-patients. The poetic texts cover a range of illnesses, with some focusing on diagnosis and treatment, thereby showcasing both the importance of patient agency and empathy-centered care. The final eight weeks of the course are dedicated to the practice (or praxis) of narrative medicine, i.e. the clinical/communal applications of poetry as a complementary therapeutic intervention. Thus, we study the modalities and methodologies of poetic medicine in order to curate and facilitate workshops for our community partners, thereby allowing students to experience firsthand the efficacy of reflective-poetic writing as a means to navigating illness and promoting compassion, wellness, and healing.</p>

 <p>A second course offered through our veterans studies degree program speaks less to methodologies and simply embarks on the reading and discussion of "war poetry," i.e. poems penned by members of the infantry to the medical corps, poems that traverse the major American-involved conflicts from the Civil War to the war in Afghanistan. This course, entitled Brutality & Beauty: The Poetry of Witness, is primarily concerned with exploring firsthand accounts of war written in poetic form-what's come to be known as "the poetry of witness." Unlike its less creative cousin - war reportage - the poetry of witness gets at the heart of the issue-the toll of war on the human psyche, body, and spirit, the trauma that remains, and finally, the healing that can come from the re-casting/rewriting of war stories by those who have experienced them firsthand. Though not advertised as a course in narrative medicine, our discussions beg for both poetic analysis and personal reflection, making it more of a course in narrative/poetic medicine praxis with a caveat-rather than applying narrative/poetic medicine to other populations, the students in this course focus on applying it to themselves.</p>

 <p>Accordingly, some recent studies that tout the benefits of narrative medicine for veterans have concluded that both the discussion of poetic texts - specifically texts about service, aka the poetry of witness - as well as expressive writing about service, not only promote authorial agency, but are both qualitatively and quantitatively beneficial for veterans (Tracey 109).</p>

 <p>Additionally, The Journal of Poetry Therapy has published research that showcases the efficacy of creative writing for veteran populations, especially the use of "poetry writing for Veterans with posttraumatic stress disorder (PTSD)…and [the] <a rel="noopener" href="https://jmvfh.utpjournals.press/doi/pdf/10.3138/jmvfh-2020-0005" target="_blank">therapeutic implications</a> of the metaphors Veterans use in interviews to describe experiences of PTSD." <a target="_blank">According to</a> <a rel="noopener" href="https://starr.org/wp-content/uploads/recon_mission_healing_vets_with_poetry.pdf" target="_blank">Anjana Deshpande</a>, author of "Recon Mission: Familiarizing veterans with their changed emotional landscape through poetry therapy," "Expressive writing is fast emerging as an invaluable tool to assist in the rehabilitation of trauma survivors."</p>

 <p>For example, Brian Turner, an Iraq War veteran, scholar, and award-winning poet, has been cited as an exemplar of "discovery through writing" as opposed to a mere "re-teller" of war stories, the latter of which can lead to a "stuck-loop" of trauma for veterans. According to Tracey,</p>

 <p>Turner's poetry [from <i>Here, Bullett</i> (2005)] does not preach about what he is already carrying but instead functions as a vehicle that brings him to discovery about the world. Attention to such discovery counters an impulse in the discourse around trauma in creative expression to foreground evidentiary testimony (the bare facts of experience) to the exclusion of authorial agency (the ability to choose how to engage and tell those facts) (109-10).</p>

 <p>Despite the relatively small number of veteran-focused studies, the value of poetry/narrative as a complementary therapy has been substantiated for decades. Generally speaking, studies involving a wide range of populations and published across a pantheon of peer-reviewed journals have concluded that poetry can increase resilience and hope, promote a sense of self and greater understanding of "other," and decrease stress and depressive symptoms.</p>

 <p>Perhaps most notably, a study published in <a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/30712734/" target="_blank">Complementary Therapies in Clinical Practice</a>(2019) found that participants who were suffering from trauma showed increased resilience and decreased stress and depression after six weeks of intensive poetic writing.</p>

 <p>Given the efficacy of narrative medicine within healthcare and across vulnerable populations, as well as the availability of creative writers in higher education who already write as a means to re-envisioning, processing and healing, it seems like poetry/poetic medicine (courses) could be the missing prescription for veterans in higher education as well.</p>

<div class="article-footer"><small><p><sup>1</sup>According to the National Association for Poetry Therapy (NAPT), Barbara Trainin Blank's "Poetry Therapy: Using Words to Heal" (published in The New Social Worker) and several other sources, the 1 <sup>st</sup>/2nd century Greek physician, Soranus of Ephesus, is considered the first bibliotherapist and poetry therapist, suggesting that he was an ancient proponent of reading and writing as a means of addressing mental health conditions.</p> <p><strong>Disclaimer:</strong> HigherEdMilitary encourages free discourse and expression of issues while striving for accurate presentation to our audience. A guest opinion serves as an avenue to address and explore important topics, for authors to impart their expertise to our higher education audience and to challenge readers to consider points of view that could be outside of their comfort zone. The viewpoints, beliefs, or opinions expressed in the above piece are those of the author(s) and don't imply endorsement by HigherEdMilitary.</p></small></div>
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