Carol Gregory And Elizabeth Wilde McCormick, 2019. Poetry and Cognitive Analytic Therapy. Reformulation, Summer, pp.33-35.
Poetry and recovery
Liz McCormick and I both read Rachel Kelly’s autobiography Black Rainbow (Kelly, 2017) in preparation for her opening keynote address at the Annual ACAT conference in 2018. Listening to her, and reflecting on the role of poetry in her recovery from severe depression has encouraged us to consider the many ways in which poetry may be helpful in times of emotional distress, and to consider this through the relational lens of CAT. Liz and I outline some of our thoughts here and hope that you will enjoy reading them.
Poetry does not speak to everyone; for each person who enjoys or is moved by poetry, others may find solace in nature, gardening, exercise, sport, art and a host of other activities. But it is poetry that we would like to focus on because over the years it has become increasingly important to both of us.
Rachel, when sufficiently unwell with depression and anxiety to necessitate an admission to hospital, and at her absolute nadir, described in her key note address, the physicality of her depression, manifested at its worse as a terrible fear of falling, during which she needed, literally, to clutch at and hold onto something or someone. While holding her hand in hospital Rachel’s mother reminded her of a passage from the bible: Corinthians 12:9 My grace is sufficient for thee: my strength is made perfect in weakness. ‘Chanting’ this ‘held’ Rachel during this time of crisis and these words gradually reawakened her interest in poetry, abandoned since her school studies. When her concentration was poor she was only able to read short poems, but later, as she began to recover, she was able to read longer poems and learn some by heart, which she shared with us at the conference. We ponder on how to describe what happens in the relationship between a person – the reader – and a poem, written by the poet. What happens in the particularity of this space, and this relationship?
The gift of words: expanding our understanding
An important task of the poet, is to give words to something that has the capacity to touch and awaken several of our senses: seeing, hearing, feeling, thinking, imagining; and to combine singular, personal, and universal themes. Poems offer us a moment in time, a heartfelt longing, or a way of being, in a way that invites a ‘dropping down’ experience from thinking about, to engaging with. We are then in a ‘new’ place within ourselves, and need time to reflect on what the poem may be bringing us, and its meaning for us.
Whatever the subject, right at the beginning, each poem arrives as a gift – to the reader, by the poet, through the medium of language. We are invited to join with the poet in reflecting on a subject offering the potential for new words, metaphors and an expansion of understanding. The reading and experiencing of the poem connects and clarifies something for both the poet and reader, between meaning and affect; a ‘thought unknown’ becomes an ‘unthought known’ (Bollas, 1987) Dannie Abse (Abse, 2013, reflecting on his father’s death, and speaking powerfully to me after the death of my father – ‘your nerveless hand in mind,’ tunes into the universality of grief and the loss of the fantasy of immortality – ‘men become mortal the night their fathers die.’ Perhaps in CAT terms this might be understood as feeling connected to another and held in relation to ‘reaching out’ or ‘reaching in’ or ‘validated’ and understood in relation to clarifying, making meaning and making sense.
Feel connected & held
Clarifying, making meaning
Sense made of, validated and understood
It appears to us that there is something even more important when the poem is literally a gift, given by a person who cares for you, who wishes you well, who sought this poem out for you. This is reminiscent of the qualities of a secure base, of being noticed and held in response to being held in mind; feeling cared for in relation to generously giving. Rachel was tangibly reminded of this when she was ‘gifted’ the passage from Corinthians by her mother. And, when the words are experienced as ‘absolutely right’, speaking and connecting powerfully to us, a sense of being understood in relation to an attentive attuned other may be experienced, with associated changes in affect, with the possibility of developing a space for thinking again.
Being held in mind
& generously giving
Noticed & more secure
Attentive and attuned to
Matching words to feelings
When Rachel’s mother was holding her hand the combination of physical touch and familiar comforting sounds allowed her to step into something new that bypassed her painful experience of depression. There were reminders of being absolutely understood, accepted and noticed that went beyond ordinary everyday conversation. The vessel of the relationship within which the work of psychotherapy takes place, is imbued with this intention as the above reciprocal roles suggest. This therapeutic space allows for something new – a possible opening into which the ‘unthought known’ may arise, through words, feelings, sounds, or images.
Words are the business of psychotherapy and particularly in CAT. Using the patient’s own words is the core of our understanding. Experimenting with words is also part of what we do, matching words to feelings and to experience.
When lines from a poem are read aloud by a significant person it can feel as if the gift is in the understanding that there is more within us than is perhaps at first seen. It is as if we are being shown the way to a treasure within us, and we are being invited to join with the songs and lines of the many poets who have written about life experience who have gone before us. There is a combination of sound, feeling, intention, attachment, of feeling seen and understood. Wendell Berry’s beautiful poem ‘I go among trees’ (Berry, 1987) describes the moment of quietude that arrives, ‘ as sitting still’, his tasks done, and ’asleep like cattle’; then fear arises, and through his writing helps us learn how to stay with our fears whilst stilling our minds.
Poetry helps still the busy mind from thinking repetitively and to drop down into feeling and into the body so that a different, often wise voice can be heard. Matching words to feelings is the central theme of ‘focusing’ research undertaken by Eugene Gendlin (Gendlin, 1996). Patients are invited to concentrate on a feeling within the body, to place their hand upon it if possible, and are then invited to find a word, or words that match the feeling, what Gendlin called a felt sense. This often takes time, experimenting with different words until finding a match. ‘Matching’ leads to what Gendlin called a felt shift, when voicing the right word facilitates a release of energy. This matching of words to feelings is the task of poetry. Helping patients explore feelings by joining them in a dialogue about feelings and by using the body to deepen contact with feelings can change understanding – such as when what is thought of as anger, can in fact be sadness. And so a completely different dialogue begins.
Rhythm, musicality creating, a space to think and imagine again.
Perhaps too there is also something in the experience of the reading of a poem, which is different to the experience of reading a novel or other literature. Poetry is meant to be read aloud (Barry, 2013), or if read in our minds, to be done slowly, internally mouthing and shaping each word, with each word’s sound and physicality experienced and given our full attention, savoured and considered; allowing the rhythm that the poet has carefully crafted through sounds and meter to permeate us, if we are open to it and allow it. This rhythm and physicality may be calming, soothed in response to a soothing other; may be energizing and empowering. It may induce a lightening or lifting of the spirits, a feeling of coming alive again in ‘relation to the rhythm and energy of my voice’ (Ogden, 1999). It may re-ignite curiosity….what depends on a ‘red wheel barrow’ that is so important? (Williams 2000). It may directly awaken one’s senses, just as Vicki Feaver’s sensual and physical poem, (which is and is not about the mundane task of ironing) does when she conjures up the particular ‘sweet-heated smell’ of an iron as it noses ‘into sleeves and around buttons’ and, when the blouse is ironed, creates an ‘airy shape’, which she can push ‘my arms, breasts and lungs into,’ (Feaver, 1994).
Calmed & soothed
Calmly aware of one’s body
Energised in body and mind
The task of CAT: Unmasking the healthy self
CAT theory names the myriad ways in which human beings learn to survive an often difficult early life that masks the ‘healthy self’. Working with intention to reveal and nourish this healthy self is the business of psychotherapy. Some poems do speak to the potential for a healthy self within each of us. In R S Thomas’ poem ‘The Bright Field’ (Thomas, 1990) he writes about seeing the sun break out over a field one day, but he ‘goes on his way’ and forgets it. Later he knows that he must give his all to remember and connect with that precious moment. ‘For that is the Pearl of Great Price.’ My reading of his poem is that the poet is inviting us to notice and nourish those moments of real connection, inner and outer, that help begin the process of healing. A process Rachel Kelly describes so beautifully in her book.
Often, the learned problematic procedures that are being revised arise again once the ending of the therapy has been named. This offers a potential ‘breakthrough’ experience, where the aims of the collaborative work can be tried out, within the safety of the therapeutic relationship, and a conscious ending is possible.
In Slouching toward Bethlehem (Coltart,1993), Dr Nina Coltart writes of times within therapy when darkness (as in depression or ending) appears to close in. ‘But it is a darkness having that special quality of the unknown which is moving toward being known.’ In East Coker TS Eliot (Eliot, 1941) writes about the love, the hope and the faith that are all in the waiting. It is the ‘active’ waiting supported by poetry that helps us navigate new passages when mental health has been compromised.
Abse, D. (2013) Moonbright. Speak Oold Parrot. Hutchinson Press.
Barry, P. (2013) Reading Poetry. Manchester University Press.
Berry, E. (1987) I go among trees. Sabbath Poems. Counterpoint.
Bollas, C. (1987) The shadow of the object. Free Association Books.
Coltart, N. (1993) Slouching towards Bethlehem. Other Press.
Corinthians 12 -9. Holy Bible, King James Version. Thomas Nelson.
Elliot, TS. (1941) East Coker, Four Quartets. Faber and Faber.
Kelly, R. (2017) Black Rainbow. Yellow Kite Books.
Ogden, TH. (1999) The music of what happens in poetry and psychoanalysis. The International Journal of Psychoanalysis, 80, 979-994.
Feaver, V. (1994) Ironing. The handless Maiden. Jonathan Cape.
Gendlin, E. (1996) Focusing –Orientated Psychotherapy. Guilford Press.
Thomas, RS. (1990) The bright field. Sabbath Poems. Counterpoint Press.
Williams, WC. (2000) The red wheelbarrow. Collected poems Volume 1. New Directions.
Carol Gregory is a psychiatrist, CAT practitioner and supervisor working at Addenbrookes Hospitial, Liaison Psychiatry Department, Cambridge and in independent practice. She recently became a tutor on the South London CAT practitioner training course.
Elizabeth Wilde McCormick is a CAT psychotherapist, supervisor and trainer, now mainly retired, and also writer. She is the author or a number of psychological self help books including Change For The better, the CAT self help book now in its fifth edition. She is a founder member of ACAT and currently a Trustee.
Effectiveness of Group Cognitive Analytic Therapy (CAT) for Severe Mental Illness
Dr Laura Brummer & Olivia Partridge, 2019. Effectiveness of Group Cognitive Analytic Therapy (CAT) for Severe Mental Illness. Reformulation, Summer, pp.29-31.
Paper 1. ‘Infamy, Infamy, they’ve all got it in for me.’ 1 Exits in Organisationally Informed CAT Supervision
Sue Walsh, 2019. Paper 1. ‘Infamy, Infamy, they’ve all got it in for me.’ 1 Exits in Organisationally Informed CAT Supervision. Reformulation, Summer, pp.6-8.
Paper 2. Applying the Ideas into Practice: Narrative CAT Exits in Organisational Supervision
Sue Walsh, 2019. Paper 2. Applying the Ideas into Practice: Narrative CAT Exits in Organisational Supervision. Reformulation, Summer, pp.8-12.
Play & Creativity in Psychotherapy. (Eds) Marks-Tarlow, T., Solomon,M., Seigel D. W.W Norton
Review by Dr Carol Gregory, 2019. Play & Creativity in Psychotherapy. (Eds) Marks-Tarlow, T., Solomon,M., Seigel D. W.W Norton. Reformulation, Summer, p.47.
Reflecting on working with palliative cancer patients through a CAT ‘lens’ with a focus on reciprocal roles
Leonie Lalayiannis, 2019. Reflecting on working with palliative cancer patients through a CAT ‘lens’ with a focus on reciprocal roles. Reformulation, Summer, pp.17-22.
Split-Egg Fantasies: Incorporating Fantasy into a Developmental Model of CAT
Dr Lawrence Howells, 2019. Split-Egg Fantasies: Incorporating Fantasy into a Developmental Model of CAT. Reformulation, Summer, pp.36-40.
The Idealised Care Smokescreen: How the Tools we Share can be Used to Attack
Julia Coleby and Kate Freshwater, 2019. The Idealised Care Smokescreen: How the Tools we Share can be Used to Attack. Reformulation, Summer, pp.13-16.
Trauma, Trauma and More Trauma: CAT and Trauma in Learning Disability
Julie Lloyd, 2019. Trauma, Trauma and More Trauma: CAT and Trauma in Learning Disability. Reformulation, Summer, pp.44-46.
‘The Sense of an Ending’ – Death and Endings in CAT
Claire Moran, 2019. ‘The Sense of an Ending’ – Death and Endings in CAT. Reformulation, Summer, pp.23-25.
This site has recently been updated to be Mobile Friendly. We are working through the pages to check everything is working properly. If you spot a problem please email firstname.lastname@example.org and we'll look into it. Thank you.