a bibliotherapy toolkit
by Rosie Alexander
Recently I have been working with a group of adults with mental health difficulties who meet at a local mental health charity. The group comprised of four to five participants, and although the group was small, the range of abilities, mental health issues and other issues was large – alcohol, depression, psychosis, disability, cancer. My work involved running a four-week course, and the exercise that I wish to discuss here took place in week two of the course.
The exercise started with one of the group reading the poem ‘Handbag’ by Ruth Fainlight1. The poem describes ‘my mother’s old leather handbag’ and the items within it, including letters from her mother’s husband sent during the war. Through the poem, themes of relationships, womanliness, love and grief are explored.
As a group we then discussed the poem. I started by asking an open question – ‘what do you think?’ and then let the group discuss. There were some technical questions, like ‘what is Coty powder?’ but there was also some wider discussion about how the writer felt about her parents, and how the parents felt about each other. Facilitating the conversation, I brought the conversation round to some features of the poem itself – such as the use of the senses to describe the bag.
Once we had discussed the poem I introduced the second part of the exercise – writing a poem about our own bags. As a way of warming up, though, we started with two short exercises. The first was to write a list of things that were actually in our handbags / bags at the moment, I gave the group about two minutes for writing this list. The second exercise was to write a list of things that could be in our bags – encouraging them to think as wild as they liked, anything could be in there, emotions, sounds, sights, animals, things, places. I gave them a little longer to write this list. I then asked them to look back at what they had written, and using some of the things from their lists to try writing a poem about their bag. In all these exercises I took part too, writing my own lists and writing my own poem as a result.
After fifteen minutes or so, I invited the group to read out their pieces or to say something about what they had written. The poems that were produced ranged from the relatively literal to the quite fantastical. The items that they chose to put in their bag for the poem, inevitably said some quite profound things about themselves. So, for example, one participant put in a ticket to visit family abroad, one participant put in sunshine and a desert island so that they had somewhere nice to escape to. One young participant put in imaginary elephants and tigers, telling us that these represented her ‘reality’ that was so often discounted by mental health professionals.
The power of this exercise is in the choice of what to put in the bag. By choosing certain items, the participants gave value and recognition to parts of themselves and their experiences (including parts that may be discounted by others, such as the elephant and the tiger). After reading their work, the group discussed aspects of their poems and what they meant to them and even if they weren’t sure why they had included certain things, they speculated about possible reasons – finding meaning in and through their writing.
Reflections on the Exercise
The exercise I have just described demonstrates a number of important features that are helpful in therapeutic reading and writing:
1. Reading a poem or a prose extract as a starting point for a writing exercise can be a very helpful way of introducing key themes for the session – in this case how a bag of objects can say a great deal about a person and their history. Poems like Fainlight’s can also be extremely useful with groups of adults with mental health issues, to show them that they don’t necessarily need to write directly about their illness and their suffering, they can write ‘therapeutically’ through exploring objects, places, ideas. Through reading it is also possible to discuss how writing ‘works’ and to explore techniques such as metaphor or repetition. This can help participants to think about their own writing and encourage them to try out different styles.
2. Using short warm-up exercises is a good way of getting people started with writing, especially those who haven’t written very much before. The important thing with warm-ups is the permission to write whatever comes to mind, and not to worry about whether it is ‘good’ or not. After that writing a poem or a prose piece feels much easier.
3. Taking part in all the activities as a facilitator is a useful way for me to establish a sense of mutuality in the group. It can be challenging because I may end up reading pieces of work that I am not sure about, that are half written. However, this too can be a strength, it shows that I, like any other member of the group, will find certain exercises easier or more difficult.
4. After writing, I always encourage everyone in the group to either read what they have written or to say something about what they have written. This is a good way to encourage everyone to speak, but not to feel pressurised to share what they don’t want to. Metaphorically speaking, allowing everyone to ‘find their voice’ in a workshop can be a very powerful way to overcome some of the isolation and lack of confidence that is characteristic of some kinds of mental illness.
A final comment
Through discussing a particular exercise used with a particular group, I have explored some important themes in the way that reading and writing can be used with groups of adults suffering from mental illness. However, underpinning all of this is one key theme – paying attention to the development of the group and developing an atmosphere of support and respect. Many of the themes I have explored can be helpful – for example exploring a poem together, taking part as a facilitator in the exercises, encouraging everyone to read out. However, much of the development of a strong group dynamic comes down to more basic things – making sure the room is set up and the session is well introduced can help participants to feel secure; using open questions and encouraging group members to respond to each other can encourage a sense of cooperation; and in the first sessions, setting out ground rules and expectations as well as giving time to ‘getting to know each other’ exercises can help a group to settle. Giving time and space to this background work is essential to establishing a supportive and safe environment for participants to fully engage with the exercises that are presented.
a bibliotherapy toolkit