Literature and Therapy

A Systemic View

Liz Burns

• Publisher: Routledge
• Year: 2020
• eBook ISBN: 9780429915727
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Literature and Therapy: A Systemic View is an invitation to the world of literature, drawing us into the creative and imaginative spaces which lie between readers and their choice of novels, plays and poems. In this world, the fundamental importance of emotion and intuition is recognised, as is the power of literature to promote transformations of meaning in every day life and in therapeutic practice. Its potential to contribute depth and diversity to therapists' personal/professional development is explored via literary reflections and qualitative research findings. The author defines the terms literature and therapy broadly, emphasising their mutual relevance in contemporary and historical contexts, acknowledging the richness of literary resources and signposting accessible routes to their use in clinical practice. A systemic view, highlighting relationships, calls to the reader to explore both therapy and literature with fresh eyes, newly motivated thoughts and a lightening heart.

Part I
Starting Out

Chapter One

Starting out with literature

“Where shall I begin, please your Majesty?” he asked. “Begin at the beginning,” the King said, gravely, “and go on until you come to the end: then stop.”

(Lewis Carroll, Alice’s Adventures in Wonderland, 1865)

“That reminds me of a story.”

(Gregory Bateson, Mind and Nature: A Necessary Unity, 1988)

A scene: “In the waiting room”

Three families sit waiting to be seen one afternoon in a Child and Adolescent Mental Health Service. One of the mothers wears elegant casual clothes and her blonde hair is neatly styled. Nevertheless she looks tired, haggard and ten years older than her 37 years. Her husband is sleek in a dark suit. Occasionally they converse briefly, in low voices. With them is a silent girl, about fourteen. She is wearing baggy trousers and top, but despite this she is noticeably thin. Next to them sits a young black woman flanked by two sad looking boys. They both lean against her, one about six, the other a little older. She is reading quietly to the younger child. Occasionally and unobtrusively her eyes fill with tears. Opposite them sits a large untidy woman, the buttons of her cardigan straining across an ample midriff. Beside her a pallid teenage girl is flicking through the pages of a magazine. At her feet is a push-chair containing a sleeping toddler whilst two other children, five and six, play noisily with the waiting room toys. A further boy occupies himself by sliding across the floor on his knees. He can make it nearly all the way across the room if he takes a run from somewhere over by the entrance door. Every so often his mother calls to him to pack it in because he will make holes in his trousers.

Each family is made up of individuals, subtle blends of thought and sensation, spirit and body, emotion and intellect, poised in their particular stages of physical and social development. Every individual’s existence is embedded in complex inner and outer worlds, simultaneously creating, and caught in, webs of meaning. Each family is one of these webs, patterned and constantly evolving in time and space. When systemic psychotherapists are required to achieve engagements with them, these engagements are at once individual and collective. Their intervention is both a dramatic performance and a private experience. For those involved, therapy is private, public and political, all at the same time.

Meaning-making is central to the therapeutic enterprise. New understandings and feelings are needed to carry participants through problematic life situations and challenges. Each family, each person in the waiting room will encounter the therapist in a different way, and it is the practitioner’s skill to facilitate the creation of new and healing meanings with and between each and all. For these reasons, working with families is a tough and demanding task, requiring complex blends of observational and communication skills. Head and heart have to work together, what we know being held within the context of what we feel, whilst emotional realities are recognised and addressed within the framework of knowledge. The necessary transformations of therapy can only take place in this multi-level, holistic matrix.

The people in our fictional waiting room may or may not be interested in literature; may or may not, in fact, have the necessary skills or motivation to read more than the front page of their favourite newspaper. Possibly the therapists who meet with them will not have read any imaginative literature for many years, and may not have got much out of it when they did. There may be no one who feels that anything beyond everyday humdrum experience has any personal relevance, yet all of them are preparing, in one way or another, to join in an enterprise of great subtlety and complexity. They cannot help it—this is what therapy is about. It is necessary to find a way to span the gap between the preoccupations of everyday life and the vision of what may be possible. Literature typically fulfils this role, and a literary bridge may offer a path for even the most unlikely of feet.

Carrying on from Bateson

Back in 1967, Gregory Bateson attempted to map a theory of cultural connectedness and the non-verbal arts in his essay “Style, Grace, and Information in Primitive Art” (1972, p. 128). Bateson’s thoughts and writings have permeated the development of family therapy, and have appeared and reappeared in theory and practice developments throughout my acquaintance with the field. I would like to focus for a moment on his remarks about poetry. My purpose is to interest fellow therapists in stepping into the domain of literature, in order to facilitate and extend their abilities in just the sort of complex engagement proposed above and needed by our families in the waiting room. Bateson’s view is that art is a conscious communication about the nature of underlying unconsciousness and “a sort of play behaviour whose function is … to practise and make more perfect communication of this kind”. Art works are not so much messages from the unconscious as indications of, or comments upon, the relationship of levels of mental process. Poets, he says later in “Form, Substance and Difference” (1972, p. 464), are specifically concerned with the relationship of intellect and emotions, which he defines as levels of mental process. They also build bridges between internal and external aspects of mind, and these are the bridges we use when we engage with arts in general and poetic literature in particular.

At the beginning of the 2000s, theoretical developments in many fields, including that of systemic therapy, have helped us to feel confident in rejecting unhelpful binary distinctions. We now prefer “both … and” to “either … or”. This leads us to seek ways of engaging more holistically with our clients, with colleagues, and with aspects of our own lives. We have absorbed Maturana’s assertion (1978) that there can be no “instructive interaction” or real power to influence except by a process of co-evolution, and we have accepted that therapists cannot consider themselves separate from the people they work with. The notion of objectivity has been largely banished from the therapy room and from the thought processes of the social sciences researcher. We attempt to co-create realities with our fellow humans, looking for healing narratives and solutions, and we pursue collaborative ways of working. We only feel comfortable when we are not being “expert”, and we continue to puzzle over the need to “not know”. The “self” of the therapist has moved to centre stage (even if this is a de-centred therapist) and “self-reflexivity” must be shown in all activities. Much of the therapeutic task is performed in the head and through talking, but therapists, clients and service commissioners also desire behavioural change and evidence that interventions are effective.

Narratives

The move to a narrative mode has been one of the major shifts visible in the world of family therapy and systemic practice. Many therapists now operate within a metaphor which enables them to use the imaginative power of personal and shared stories. This therapy addresses the relationship between people and the narratives which surround and shape the ways in which they, and we, see and are seen. The importance of narrative forms in making sense of experience can hardly be overestimated. Narratives are seen as the means to “plot our passage across time and enable us to offer to ourselves and to others some explanation of how we have become who we are” (Dallos, 1997, p. 64). They are excellent and, it might be said, our dominant examples of “patterns which connect” (Bateson, 1988, p. 11). Lives, and events in them, may be simultaneously composed of an infinite multiplicity of such narratives, some of them harmonious but many of them contradictory and conflicting. They are social constructions, and as such are dependent on both authors and audiences for their generation and interpretation (see Chapter Six).

Much has been written about the implications of the narrative metaphor in such disciplines as psychology (Bruner, 1986, 1990; Dallos, 1997), qualitative research (Shotter & Gergen, 1993; Lieblich et al, 1998), psychotherapy (McLeod, 1997), medicine (Greenhalgh & Hurwitz, 1998; Charon, 2006), narrative therapy (White & Epston, 1990; White, 2007), and work with children and families (Vetere & Dowling, 2005) and in the area of attachment narratives (Dallos, 2007). It is a rich and extensive field, of which this is just a taster and an opportunity to “signpost” some useful texts.

From a more literary point of view, the narrative may be seen as but one manifestation of what we might find between the covers of a book. It is the “telling of an event”, and in most cases the putting of events in an order and timescale which makes sense of them. As we shall see later (Chapter Four), literary narratives and their narrators are not always what they seem, and can mislead and manipulate. This ensures that the reader has to work quite hard to find a position for him- or herself in relation to what is presented. In this way, literary narratives are distillations of the flawed and indeterminate stories of “real life”. Many other aspects of literary texts impact upon the reader: the choice and ordering of words; the evocation of associations and emotional responses; physical and mental images; states of arousal which are stimulated by the sound and the forms of language. Sometimes, as in a poem like Ezra Pound’s “In a Station of the Metro” (Chapter Three), the image is foremost and the narrative, if there is one, must be generated by the reader or readers from a combination of their own resources and the suggestions which come from the poem itself.

Novels usually tell a story of some sort, so a narrative thread usually weaves through the fabric. In his book Aspects of the Novel, E.M. Forster (the man who exhorted us to “only connect” in his novel Howards End) emphasises the importance of the relationship between the narrative and the stuff of everyday life. The story on its own “is the lowest and simplest of literary organisms”. When it succeeds in connecting what he calls “the life in time and the life by values” (Forster, 1927, pp. 42–43), and also keeps the reader wondering what happens next, the result is the rich and complicated organism we call the novel. This description is not so different from what we would expect narrative thinkers and practitioners to give today. If we want to look more carefully at how written narratives can interrelate with lived narratives (and readers who have got thus far probably do want to), we need to consider the metaphorical capacity of literary readings to interact with everyday lived experience (see Chapter Three) to make meaning. We may also want to look at emerging relationships between the “literary mind” and others which may feel more familiar: the “scientific”, the “practical” and the “rational” mind (Turner, 1996).

However “real” any of the narratives we encounter seem to be, either in the consulting room or between the covers of a book, we need to remain sceptical about their capacity to pin down meaning. We live in language and are empowered by it, but we are also its prisoners. American novelist Toni Morrison said in her 1993 Nobel Prize lecture: “The vitality of language lies in its ability to limn the actual, imagined and possible lives of its speakers, readers, writers. Although its poise is sometimes in displacing experience it is not a substitute for it. It arcs toward the place where meaning may lie.”

A range of resources

Using literary resources includes an interest in and valuing of narratives both great and small, but it does not imply either a method of therapy or a limitation of literary matters to narrative alone. The lad in the waiting room who is intent on polishing the floor with his knees may be prepared to be engaged therapeutically in a great variety of ways, but the suggestion here is that a liaison with the adventurousness of Treasure Island’s Jim Hawkins, the magic of Harry Potter or the worldly wisdom of Bart Simpson may encourage him towards transforming his accustomed realities into something preferred. A therapist whose consciousness has also been stretched may engage with him in a particularly apposite manner.

Let’s look for a moment into the therapy room of the service we visited in our initial vignette:

The therapist is a woman, elegantly dressed, with a slight reminiscence for a hippy youth in the long earrings she is wearing. She has worked with families for more years than she cares to remember. She welcomes the family into the room and ensures that they are comfortable. This is the second session. Mrs X, the lady with the tight cardigan, barely touches the chair before she starts to complain about her eldest son. Her daughter picks listlessly at a couple of threads which are hanging off the bottom of her jacket and stares out of the window. The five- and six-year-olds continue to occupy themselves. Everyone ignores the little person in the pushchair, who is still asleep. The son in question sits slumped in his chair. His jacket is zipped up to conceal the lower part of his face and his hood covers the rest.

Several starts on the conversation fail to interrupt Mrs X effectively. Something in the demeanour of our lad sparks the curiosity of the therapist.

“Tell me, (boy’s name), what do you like to do when you have the choice?”

Fortunately he does not reply with the name of a computer game, of which the therapist knows little (although she would improvise). He likes to watch TV and prefers horror films. Does he ever read anything? “No.” His sister now falls about laughing and his mother begins to look interested.

The therapist searches her store of horror movies—what particularly has he enjoyed recently? He recently saw Dream-catcher and watched it with his mum.

The therapist wonders which was his favourite bit—she knew there was a lot of rather deadly farting, but what else? He liked the bit where one of the characters escaped in the snow. What was good about that? Did he (the hero) make it? What was it like for the others left behind? How did they deal with their fear and their disgust? etc. The therapist is reluctant to settle for a “dunno” answer, and actually she receives few of them now that her young client is talking about something which interests him and he has chosen to speak about. Furthermore, he is now engaged in talking about a film, which opens another world of possibilities, albeit rather gorily expressed. There is in this fiction a horrible situation which requires desperate measures. There is a friendship system which enables some characters to survive against all the odds, and when others succumb, there is the option to reflect on their predicament. There are monsters and conspiracies—all easily translatable into the world of an unhappy adolescent. Above all there is a world which is different from normal, an imaginative landscape in which escapes and solutions are possible.

This fiction also engages his mother and gives them a common focus of attention. The sister has something she can join in with or reject—perhaps naming something else in its place.

We will leave them to finish the session with a new set of concerns and an emotional connection to the problem at hand. The therapist does not need to spell out the connection—it will be obvious from the way the talk has developed, and can be left inexplicit for the time being.

Poets, therapists, poetry and prose

Few psychotherapists have been attracted into their profession because they crave clarity and simplicity. If only others would let them, like John Keats (1817) describing his notion of “Negative Capability”, most would relish “being in uncertainties, mysteries, doubts”. They would happily forego “irritable reaching after fact and reason” in the interests of profounder understanding. It is no coincidence that this poet’s definition of a state of openness and readiness fits for many psychotherapists. Both poets and psychotherapists are pursuing the transformation of complex human experience through the operations of language. Like the wedding guest who is compelled to attend to the story of Coleridge’s Ancient Mariner, the psychotherapist is drawn to witnessing unknown tales of terror, fury and misery in the hope of discerning and nurturing some potential for transcendence in the depth of the mystery. There will be those, of course, who do not subscribe to this view, but they are probably not reading this book.

Bateson argued that both poetry and prose reflect “the complex layering of consciousness and unconsciousness” which make up what he, after Pascal, calls “the reasons of the heart” (Bateson, 1972, p. 138). Poetry is not, he maintains, “a sort of distorted and decorated prose” but rather prose is “poetry which has been stripped down and pinned to a Procrustean bed of logic” (ibid., pp. 134–136). Like Robert Frost, who says: “Poetry is what is lost in translation. It is also what is lost in interpretation” (Frost, 1964), he maintains that this multi-layeredness, and the close relationship with the “reasoning of the heart”, makes it impossible to translate art works, including literary texts, into forms other than those in which they were originally presented. The changes inherent in interpretation and translation would destroy both the content and the quality of the “information” they embody. In “Style, Grace, and Information in Primitive Art”, Bateson recalls Isadora Duncan’s famous saying “If I could tell you what it meant, there would be no point in dancing it” (1972, p. 137). For our purposes this means that the text itself, particular words in a particular order, and also, perhaps, in a particular type or binding (see Chapter Five), conveys something fundamental that is inexpressible in another form or through interpretation.

Reading—engaging with the “other”

T.S. Eliot suggests that literary writing represents an es...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Dedication
• CONTENTS
• ACKNOWLEDGEMENTS
• ABOUT THE AUTHOR
• INTRODUCTION A journey of discovery
• PART I: STARTING OUT
• PART II: TRAVELLING ON
• PART III: ARE WE NEARLY THERE?
• REFERENCES
• APPENDIX 1 List of literary works mentioned in the text and not included in the references
• APPENDIX 2 Literary texts brought by research participants
• APPENDIX 3 Literary resources and how to find them
• APPENDIX 4 Exercises
• INDEX