ࡱ> UWTa Gjbjb,, $bNN2~~~8<448888      , R"n6888886Xv@48K888rrjr8 #Q~ a0G#G#Catharsis and the Creation of Order Through Writing E. J. Green FORD FORUM Dr. Johnston The universe is made of stories, not atoms. Muriel Rukeyser (1913-1980, poet) The Speed of Darkness Fishing trip, 1990: One day my father rented a small boat and took me fishing. He fished and I (just short of turning five) toyed with a snack-sized box of sugar cereal he had promised I could have if I tried to be quiet. I watched the water, a few shades grayer than the sky, and the waves chopping at the side of our little boat. I wondered if I had been quiet enough to get to eat my snack. Even now, as I write this story, I can hear it as though I am there, the sound that washed around my ears, the rushing of water into the back of the boat where the anchor hung. I can feel the words forming in my throat, nervous, Is the water supposed to be in the boat? And then the gaps come, and my memories bob as though in waves. Head below water. Head above. Bobbing in the choppy gray sea and watching the boat stand up on its head with the motor high in the air, and then watching it sink with the sound of a suction cup and the sea licking its own lips. And I remember my father swimming after me as I floated along in my life preserver. He told me to hold onto his arm, and I did. He told me to kick, and I did. And I remember the pumice seawall we climbed and how red the blood on my fathers skinned knees looked against the grayness of the sea and sky. Numb, I dont remember how long we walked before we found help or if I even cried, though I do know I never let go of the box of cereal. A week later he took my mother and me out on a pontoon boat. I screamed and begged to dock, though I wasnt sure why. My mother told me to think of how the story had gone the week before. The boat had sunk, but I hadnt. I stopped screaming and remembered the story: The current was stronger then, the boat was smaller, and anyway, it ended all right. We had swum to safety. I have told the boat wreck story many times. In each incarnation, the story gets a little clearer. The necessary details become sharper, and the unnecessary details fade. It has been over a decade since the experience became a part of my personal narrative, or life-story, and over the course of the years Ive come to terms with the event as a source of personal growth rather than the horror story it was when I was five. As one of my earliest memories, it was also one of the first times I thought about memory in the form of story as a means of keeping track of important events. Memory-stories help to make sense not only of what had happened, but to provide guidance in future situations. As the memory of the event became a story it provided me with an opportunity to find closure and gain coping skills for the future. When I revisit the boat-wreck story now, I see it not only as a story of surviving a dangerous accident, but also as an illustration of how stories help us make sense of and cope with the world around us. As a student of psychology and of creative writing I have a particular affection for narrative. Narrative, or story, is one of the most useful creations of the human mind. It is perhaps our best survival skill. Through narrative we synthesize otherwise chaotic events into cohesive sequences. We learn causal relationships from these organized structures that not only help us to infer why something happened, but also to equip us with new tools to employ in the future. We tell stories about ourselves to define who we are, and as personality psychologist, Dan McAdams, asserts in his book The Person, many scholars dedicated to the study of personality have recently argued that modern lives are meaningful to the extent that they conform or express culturally meaningful stories. Writing gives you the illusion of control David Sedaris Recent research has shown that writing about traumatic or emotionally difficult events leads to improvements in psychological and physical health. A pioneer in the writing paradigm, James W. Pennebaker has published a huge amount of literature on his experiments with participants from a variety of cultural and socio-economic backgrounds. In many of his studies, Pennebaker had participants write for a short period of time (15 minutes a day 4 times a week) on either a superficial topic or on a certain traumatic memory. The general instructions for the trauma group were as follows: For the next three days, I would like for you to write about your very deepest thoughts and feeling about the most traumatic experience of your entire life. In your writing, I'd like you to really let go and explore your very deepest emotions and thoughts. You might tie this trauma to your childhood, your relationships with others, including parents, lovers, friends, or relatives. You may also link this event to your past, your present, or your future, or to who you have been, who you would like to be, or who you are now. You may write about the same general issues or experiences on all days of writing or on different topics each day. Not everyone has had a single trauma but all of us have had major conflicts or stressors and you can write about these as well. All of your writing will be completely confidential. Don't worry about spelling, sentence structure, or grammar. The only rule is that once you begin writing, continue to do so until your time is up. Participants in the trauma-related writing group later reported a decrease in visits to the doctor and an increase in positive feelings in follow-up evaluations. Other related studies revealed similar favorable results. Participants who wrote expressively on an experience of traumathough often reporting as sense of extreme sadness in the moments immediately after writinglater showed an increase in emotional wellbeing and physical health, such as an improvement in immune function and a decrease in doctor visits. A variety of reasons for such improvements have been a topic of scholarly discussion. Perhaps turning an experience into a story with a beginning, middle, and end facilitates a sense of resolution or the sort of closure that might help an individual to let go of the painful memory. Evidence from many studies highlights the importance of the writing process as well. A content analysis of writings from Pennebakers studies revealed that participants whose narrative became more cohesive over time and included more words that signaled negative emotions experienced the most health benefits from the process. The first half of this finding suggests that the writing process is not only about catharsis, or expression, but rather that the cathartic moment is contingent on the ability to distillmake sense ofthe event in coherent terms. This finding opens up a variety of questions for discussion and future research. For instance, do a higher level of language skills result in the ability to cope better with traumatic events? If an individual is an exceptional writer or storyteller, does that mean he or she will be more resilient if forced to cope with trauma? It is vital that we take into account individual differences, and also investigate the nature of trauma outside the frame of the writing paradigm. I return the topic of resilience at the end of my discussion. While Pennebakers findings are inspiring, they are not yet applicable to all manifestations of traumatic experience. In fact, the definition of traumatic experience in Pennebakers studies suggests that traumatic experience does not always lead to trauma-related illnesses. When the word trauma is used, one might be tempted to think of it in psychoanalytic (Freudian) terms such as: A psychic injury, esp. one caused by emotional shock the memory of which is repressed and remains unhealed; an internal injury, esp. to the brain, which may result in a behavioral disorder of organic origin. Also, the state or condition so caused.  None of the participants in Pennebakers initial writing paradigm studies suffered from any known form of mental illness. They had experienced traumatic events, but they did not suffer from posttraumatic illness. It is likewise important to make the distinction that to experience a traumatic event does not necessarily lead to trauma in the psychoanalytic use of the word. The APA recently cited that roughly 9% of individuals exposed to traumatic events actually develop posttraumatic stress disorder (though it doesnt discuss what percentage suffer PSIs as a result). About 15% of war veterans suffer from PTSD. Traumatic Memory vs. Narrative Fall 2003: In bed. In the dark. The phone is ringing. It rings on the bed stand and it rings throughout the whole house. I can tell no one is home by how loudly the ring echoes up the hall of the split-level I share with my father. The digital clock on the corner wall is the only light. 4 AM in bright red. The phone wont stop ringing. Im sure its one of my fathers crazy girlfriends, or one of his clients. Maybe it will stop. It doesnt. Someone is at the door. He is banging, and the sound vibrates the house with the ringing phone. I hide under the covers. It doesnt stop. I hear my name called. Elizabeth Green this is the Columbus Police. Can I go on with this story? It isnt mine to tell. I was a bystander. I dont know how it felt from the inside. In certain traumatic instances people on the inside dont even know how it felt on the inside. So how can I construct this story to make sense of an experience I never had? How can he? I was there to watch forensics peel the duct tape off his eyelids, from his wrists, and from everywhere the robbers had bound him. To watch the skin come off raw. His eyes looked pink and dry and dazed and I heard them say guns were involved. They asked him what he remembered. Could he remember? A challenge that victims of trauma face is the inability to deal consciously with the memories of a traumatic event. Often a victim of trauma experiences memory loss, as a result of disassociation during the traumatic event. Recovery of the repressed memory may be painful. The traumatic memory is fragmented. If the goal of the writing paradigm is to construct a cohesive narrative, then the person remembering faces a challenge. While this is possibly one of the reasons the writing paradigm is not applicable to individuals with PTSD, it is most likely not the only one. The symptoms of PTSD include a variety of psychological problems that may be best worked through using a combination of therapeutic techniques, including medical approaches. Resilience (Fall seven times, stand up eight - Japanese Proverb) The ability to synthesize cohesive stories out of traumatic events allows one to make connections, see the cause and effect of certain events, occasionally experience a catharsis, and find closure. Having a repertoire of storiesor well- synthesized experiencesalso prepares us for the future. Not only do we learn from our own stories, we learn vicariously through others stories. Reading or hearing that another individual survived horrible events and lived to testify may enhance our ability to cope with trauma. This ability is also known as resilience. The term resilience refers to our ability to bounce back after life-altering or traumatic events. Having resilience means having both the internal and external resources to receive the support necessary for recovery. There are a variety of strategies available for individuals to develop resilience. The APA suggests strategies such as making connections, keeping a perspective on the problem (that a crisis is not insurmountable), accepting change as a part of life, and looking for opportunities for self-discovery. While there is no prescribed method best for building resilience, I see the use of expressive writing as not only as a palliative measure (i.e. as used in a therapeutic setting) but also as a measure conducive to the development of personal resilience. Conclusions The use of narrative is an essential aspect of human experience. Through narrative structure we are often able to discover meaning in seemingly random events. In the wake of extremely stressful and traumatic events, the use of narrative helps us cope. However there are certain limitations to the benefits of writing for individuals more severely affected by trauma. While the act of expressive writing may not be able to alleviate the suffering of victims of traumatic related illness (e.g. PTSD), the presence of a trauma-related narrative adds to our collective cultural repertoire of experience. Lastly, writing and reading about traumatic events allows us to process the potentially incomprehensible in ways that are conducive to enhancing our sense of resilience. It is my hope that through the creation and study of these narratives we might prepare future generations with better abilities to cope in a drastically changing world. Green  PAGE 1 Notes  James W. Pennebaker and Jane D. Seagal, Forming a Story: The Health Benefits of Narrative, Journal of Clinical Psychology 55 no. 10 (199): 1243-1254.  Dan P. McAdams The Person (United States: John Wiley & Sons, Inc., 2006) 389.  James W. Pennebaker, Writing About Emotional Experiences as a Therapeutic Process, Psychological Science 8, no.3 (1997): 162-166.  Ibid., 162. Note that the trauma group delineates the condition write about a traumathat is, participants were not selected based on a previous traumatic experience. In Pennebakers studies, participants do not suffer from trauma related illnesses as defined by the DSM.  Pennebaker, Writing About Emotional Experiences, 162.  James W. Pennebaker, Janice K. Kiecolt-Glaser, and Ronald Glaser, Disclosure of Traumas and Immune Function: Health Implications for Psychotherapy, Journal of Consulting and Clinical Psychology 56, no.2 (1988): 244.  Pennebaker and Seagal, Forming a Story, 1243.  Ibid., 1248.  Oxford English Dictionary Online, trauma. 10 Posttraumatic Stress Disorder (PTSD) is a relatively new addition to the DSM (1980). PTSD is one of several post-traumatic illnesses (PTIs). L. Stephen O Brien, Traumatic Events and Mental Health, writes how people react to trauma is influenced by a whole range of factors including the nature, severity and meaning of the traumatic event, and factors in the individual such as his or her personality, previous history, experience, support and subsequent experience. Not only is PTSD not a universal response to trauma, but it is not the only response.  APA Online, Facts and Statistics, APA Help Center, http://www.apahelpcenter.org/articles/topic.php?id=6#Post-Traumatic%20Stress%20Disorder.  John Briere, Ph.D. and Catherine Scott, M.D. Principles of Trauma Therapy (London: Sage Publications, 2006), 55.  Scott Russell Sanders, Top Ten Reasons: Why Well Always Need a Good Story, Georgia Review (Spring 1997)  APA online, The Road to Resilience Brochure. APA Help Center, http://www.apahelpcenter.org/featuredtopics/feature.php?id=6. Bibliography APA Online, Facts and Statistics, APA Help Center, http://www.apahelpcenter.org/articles/topic.php?id=6#Post-Traumatic%20Stress%20Disorder. APA online, The Road to Resilience Brochure. APA Help Center, http://www.apahelpcenter.org/featuredtopics/feature.php?id=6. Briere, John, and Catherine Scott. Principles of Trauma Therapy. London: Sage Publications, 2006. Caruth, Cathy, ed., Trauma: Explorations in Memory. Baltimore: The Johns Hopkins University Press, 1995. Graybeal, Anna, Janel D. Sexton, and James W. Pennebaker. The Role of Story-Making in Disclosure Writing: The Psychometrics of Narrative. Psychology and Health 17, no. 17 (2002): 571-581. Laub, Dori, and Daniel Podell. Art and Trauma. The International Journal of Psycho-Analysis 76, part 5 (1995): 991-1005. McAdams, Dan P. The Person. United States: John Wiley and Sons, Inc., 2006. OBrien, L. Stephen. Traumatic Events and Mental Health. Cambridge: Cambridge University Press, 1998. Pennebaker, James W. Writing About Emotional Experiences as a Therapeutic Process. Psychological Science 8, no. 3 (1997): 162-166. Pennebaker, James w., and Jane D. Seagal. Forming a Story: The Health Benefits of Narrative. Journal of Clinical Psychology 55 no. 10 (199): 1243-1254. Pennebaker, James W., Janice K. Kiecolt-Glaser, and Ronald Glaser. Disclosure of Traumas and Immune Function: Health Implications for Psychotherapy. Journal of Consulting and Clinical Psychology 56, no.2 (1988): 239-245. Sanders, Scott Russell. Top Ten Reasons: Why Well Always Need a Good Story. 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