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Carers often need to protect their own well-being and to express pent-up emotion, frustration and stress. Practical permissions to ease your daily round can help. Journal-keeping can help. But journal-keeping can involve permissions directly-related to self-care – all of its own!

When – at 2am – the local hospital’s A&E department tell you to remove your next of kin from their charge, what do you do next?

This happened to Jane and Jane was still noted on someone’s form as next of kin to her schizophrenic ex-husband. As a result, A&E would not take ‘No!’ for an answer over the telephone. So off she had to go.

But – when Jane arrived – no-one would hand over the case notes or make suggestions as to where she could get help. And there was nothing Jane could do. She had to take her ex-husband home – even though he was threatening her with jealous violence at the time.

However, there is another way. If you find this kind of situation arising – as carer/parent/child/sibling/friend – remember to ask your ‘caree’ in a calm moment to sign a permissions letter to the GP and others. Produce this letter and they’ll discuss your caree’s case with you.

This is a simple solution but prevents you being kept out of the loop of discussions about case plan and management. Among other considerations, to have a say in this is crucial for your well-being

But the concept of ‘permissions’ is more wide-ranging than this.

Permission is not just a practical management tool for the daily situation of a carer. Permission can also be an effective safeguard for people like ‘Jane’ who keep a journal as part of a self-care strategy.

Jane keeps a journal to give herself a voice – when people such as health professionals just don’t listen. But also, she keeps a journal to explore feelings that – when she starts writing – she doesn’t know she has. This can be powerful and frightening, too.

Let me explain. As a journal-keeper, you are responsible for managing your own safety and you can do this in several ways – by, for example, building in the principles of ‘structure’; ‘pacing’; and ‘containment’.

If you are new to journalling, for example, you may find the blank page daunting and structured prompts can help get you started. These may include such beginnings as ‘Today, I . . . ‘ or ‘I am . . .’ or questions such as ‘Who am I?’ or ‘What weather am I today?’

But the structure of these sentence stems, as well as getting you over the blankness of the page, will also ground you. They will keep you in the present and not allow you to return to an unhappy past. This will keep you safe.

Writing without pause, editing or reflection is another form of journalling. Triggered by simple prompts – such as a single word pulled randomly from your dictionary – and expand in unthought of directions. Known as free-writing, this is worthwhile for the truly surprising insights you gain!

But in some vulnerable people, this freedom can be dangerous. Some suffer severe distress. Some – rare examples – have even been known to hallucinate. So, when tempted by free-writing, try these safety measures:

 

  1. Set a time-limit and – when the timer pings – stop even if you are half-way through a word. (This provides structure, pace and containment.)

 

  1. Make sure you have your support network in place – family, friends, counsellors & therapists, the dog! (More containment.)

 

  1. Give yourself permission to stop! Yes, permission to stop is the most effective ‘containment’ measure of them all. And it is in your power.
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Unsent letters are a great place to vent pent-up anger and frustration – simply because we write them as if we will never send them and with brutal honesty about what we feel and what we think. People suffering from brain-injury and their carers are no different from the rest of us in this. And, recently, at a journal-writing session at Wirral Headway, having written the letters, we then brainstormed the next steps. Here are some of the ideas we came up with:

  1. Send the letter to the person addressed anyway – options included a range of people from the kind/unkind to healthcare professionals (understanding/unsympathetic) and so on . . . 
  2. With due regard for Health & Safety, burn the letter and throw the ashes on the sea or use them round the roses
  3. Commit the letter to the unknown – such as the God in our lives – by putting it in a bottle and throwing it off a ship or attaching it to a balloon
  4. Or make it part of our future so that we can see what progress we have made. We can do this by putting the letter in a time capsule to be opened this time next year or we can leave it in a stamped, self-addressed envelope with a friend who will post it when we least expect it.

 

If you can think of any other ways to handle the unsent letter, we’d be grateful if you’d let us know.

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The First Word!

Short of time? Just quickly write down three words that describe how you feel in body, mind, or spirit at this very moment. First into your head. Go!

Three words that describe how I feel right now are:

_____________      ______________    _____________________

 

The Last Word!

Write down three words that describe how you feel at this moment – first into your head. Go!

Three words that describe how I feel right now are:

_____________      ______________    _____________________

Do you notice any change from the three feelings you wrote down earlier? More self-awareness?  Anything different?

You can use this exercise any time of day – but you may also find it helpful at the beginning and end of the day for checking in with yourself!

 

I’m very grateful to Barbara Stahura (www.barbarastahura.com) for suggesting this exercise!

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King Peter and Millie (from Armenia)

Re-told by Lizzie Gates

Once upon a time . . .

King Peter of Armenia had a beautiful daughter, Millie. When she was born, he wanted to care and guard her so she would know nothing of the world and never love anyone but himself.  For her sole use – with only female servants and a woman teacher – he had a lovely palace built on a lonely island in the middle of a dark forbidding lake.  This palace had no windows looking outwards and only the king had a key to the outer door.  He visited her once a week, for three hours, on Sundays.

 

But Millie grew up.  And, when she was 18, she began to think for herself.  She knew she had learned about life but only from books. And she knew she was a woman.  But, she wondered, what did that make her father? Fear had kept her servants silent. But, pitying her, her woman teacher brought her a book. And Millie realised she was in prison.

 

So, copying the images in the book, she made a young man out of flour, eggs and butter and milk. And, weeping, she prayed to God for a soul to fill the beautiful young man with Life. The image was given a soul and Millie called him Michael. The woman teacher brought him clothes. Apart from Millie – only she knew of his existence. And the two young people fell in love.

 

Then, one Sunday, they slept over long in the morning, and King Peter arrived.  Millie’s father came upon his daughter with a young man sleeping by her side and was enraged.He had been to so much trouble and expense to prevent precisely this.  In a rage, he ordered their executions.

 

As Millie stood on the block, about to die, she said:  “I made the young man standing beside me – he has no family and no ties. I made him by myself. And it was my wish – to have loved and been loved. If you kill me, father, I have no regrets.”

 

King Peter on the other hand would lose everything he valued. Furthermore he could find no evidence that the young man was human. Relieved, he relented because he truly loved his daughter. In reparation, he gave the young couple a new home and his blessing.  And they all lived happily ever after.

 Writing Interventions

  1. Which character do you favour/empathise with? Why? Write the story from this person’s point of view?
  2. Which character do you like least? Why? Write the story from this person’s point of view.
  3. Do you like the ending? If not, why? Write your own ending.

 

 

Group Discussion (In pairs and then full group)

  1. Whose visions are represented here?
  2. Where is the conflict?
  3. Who changes their vision? Why?
  4. Whose vision is most powerful? Why? Could this be changed?
  5. What are the problems in this story which reflect/resonate with issues your clients face?
  6. What solutions could you offer in your professional practice?

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Little Red Riding Hood

I used this traditional tale to give a network of carers – who had never thought of themselves as creative writers – the opportunity to  reflect on character and consequences. They were empowered but the opportunities to listen, discuss, select and develop their own versions. This story opens up the possibilities of having choices, a voice and the means to express it.

The Story

Once upon a time, there was a lovely young woman named Little Red Riding Hood.  She lived with her mother in a cottage on the edge of a Forest. Her grandmother lived at the other side of the Forest but close enough to visit often with lots of lovely treats for her lovely granddaughter.

 

Then one very sad day, her mother told Little Red Riding Hood, “Your grandmother is not feeling very well today. Take these treats over to her – for a change! It will make her happy and she’ll feel better.”

 

Little Red Riding Hood set off carrying all the delicacies that her grandmother could wish for in her basket. The sun was shining and she knew her grandmother would enjoy the treats. She felt today would be a good day.

 

Then, on the forest path, she met a tall, strong stranger.

 

“Where are you going, my lovely?” asked the tall, strong stranger.

 

“To my grandmother’s cottage,” Little Red Riding Hood replied and explained how ill her grandmother was feeling.

 

“Oh, the poor dear old lady!” said the tall, strong stranger. “Why don’t you pick some flowers for her, too?”

 

“Now that would be a very good idea,” said Little Red Riding Hood – always willing to do that little bit extra.

 

So she spent the next few hours looking for all the most beautiful wild flowers of the Forest. And, although she grew very tired, she kept on looking – because she loved her grandmother very much.

 

Then she noticed the sun was almost completely gone. And, although the moon shone and the stars were out in the night sky – she could no longer see anything very well. The trees arched over her and the darkness frightened her.  So she ran to her grandmother’s cottage, hoping her grandmother would have a good fire lit and candles burning – as she usually did.

 

But, when she arrived, all was dark and strange. If anything, the cottage was even darker and colder than the Forest.

 

“Of course,” the young girl remembered, “grandmother is ill.”

 

So she crept around the kitchen. She wanted to make the old woman a warm drink, light the fire and set the flowers in a vase where she could see them. Her poor sick grandmother could then have all the treats she had carried through the Forest especially for her.

 

 But – before she could arrange all this – Little Red Riding Hood heard a movement from the bed. And, candle in hand, she turned round.

 

What she saw terrified her!

 

“This illness – it’s so changed you, grandmother!” she cried. “What big eyes you have?”

“All the better to see you with?”

“What big hands you have?”

“All the better to grab you with!”

“What big teeth you have!”

“All the better to eat you with.”

 

And the much-changed grandmother leapt from the bed, seizing hold of the girl so tightly it hurt. Only then did she recognise the tall, strong stranger of the Forest.

 

“You are not Grandmother. You are the Wolf! What have you done with Grandmother?”

 

But the Wolf didn’t bother with explanations. He just swallowed Little Red Riding Hood whole.

 

However, inside the Wolf, she found her grandmother and the two women – the old and the very young – wept together. But tired, worn out by misery, neither had any idea what to do next.

 

Then, a hunter appeared  . . .

To empower the listeners, I stopped the story at this point and offered them a number of endings to choose from and the opportunity to develop their own.The rest of the session followed these lines.

A Happy Ending? Really?

Which of these endings do you think most likely?

Ending 1) but the hunter was too late.

 

Ending 2) The hunter drew out his hunting knife and fought with the Wolf. Then, when the Wolf was dead, the hunter heard the women cry out in his stomach. And the hunter cut open the Wolf and released them. He was glad he had done so when he saw how beautiful Little Red Riding Hood was. He married LRRH. And the grandmother and the mother then lived happily to the end of their days with Little Red Riding Hood and her hunter.

 

Ending 3) After such a heavy meal, the Wolf fell asleep and the hunter – hearing the women weeping inside the animal – cut open his stomach and released Little Red Riding Hood and her grandmother. Little Red Riding Hood then placed stones in the Wolf’s stomach. When the Wolf woke up, he tried to chase the old woman and her young grandaughter but the stones weighed him down and killed him.

Ending 4) What else could anyone have done to change the ending? James Thurber, in The Little Girl and the Wolf took out a gun from her basket and shot the predator. Do you have your own ideas how to end this story? Discuss in pairs.

After this, I invited members of the group to share what had come up for them – both in relation to the story and on a personal level. Any group enduring any distressing situation could benefit from the opportunities presented by this sort of story session.

 

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Hello, Everyone!

 

Using creative writing to improve life quality for the long-term ill and distressed – and that of their family, friends and professional advisers – is a subject dear to my heart. And since I went to an Arts and Dementia Conference in Liverpool at the beginning of November, I’ve been thinking about this a lot.

 

As organisers Collective Encounters  explained, the conference aimed ‘to explore the possibilities in the use of arts in dementia care, celebrate excellence in the artistic work created by artists working with people with dementia and their carers, and look at the potential impact of Live and Learn [a new project] will have on the health and social care and creative sectors locally.’

 

It did and I found it difficult to process so many stunning insights all at once. But one story particularly impressed. David Clegg – a sculptor by profession – had volunteered to visit an old lady with dementia. When, after fifteen minutes, she found her front door, she was stark naked apart from ski-boots and oven gloves. She told him later, she was dressed this way because someone had stolen her clothes and replaced them with the clothes of an old woman. A stunning insight – indeed.

 

David now spends his time, when not sculpting, helping people with dementia record their stories and make sense of their lives. Which is what we all – as humans – want to do. And what creative writing is all about.

 

So, I have two pieces of news for you. Firstly, I now offer e-courses in Therapeutic Creative Writing – fiction, life-writing and journaling – for anyone dealing professionally or personally with relationship issues and emotional health problems. These e-courses each contain six units full of advice and writing games to explore the unit topic. Each unit may be completed at your own pace and in your own time with 24/7 support and – when appropriate – professional critique.

 

Secondly, November is packed with Lonely Furrow Company’s Out of the Box Workshops. These are designed to be useful for those – including writers – who deal with relationships and communication issues professionally. Group interaction is a crucial aspect of this form of communication training and the workshops provide a basis for further work.

 

November Workshops:

 

All will take place at The Conservatory, 28 Park West, Heswall, Wirral, CH60 9JF. (Tel: 0151 342 3877)

 

Communication Series

November 23rd 2011 (1pm-3.30pm) ‘Body Language – the silent story’  (£25)

November 30th 2011 (1pm-3.30pm)  ‘Story-telling – the techniques’ (£25)

 

Creative Writing Technique Series

November 26th 2011 (10am – 12.30pm) ‘Memorable Characters – how to write them.’ (£20)

 

To find out more or book your place, contact me initially via Elizabeth@lonelyfurrowcompany.com or telephone 0151 342 3877.

 

And, for a no-charge, no-obligation chat about any Lonely Furrow Company services, contact me initially via the Lonely Furrow Company brochure website www.lonelyfurrowcompany.com .

 

 

I hope you find the concept of Arts in Health as inspirational as I do. If you’d like to know more about this kind of work, please also see www.lapidus.org.uk. Lapidus is a professional organization which promotes the use of creative words for health and well-being, has established an ethical code for this work and maintains a directory of creative writing practitioners (of which I am one).

 

With very best wishes

Lizzie

 

 

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Creative Writing comes from our ability to day-dream.  Through it we can practice our narrative competence – making sense of our own lives, our own fears, our own anxieties.  We can generate meaning and find re-assuring resolution.

As writers, as Freud said in his paper on Creative Writers and Day-dreaming (1907) we can make up imaginary worlds, take them seriously, invest them with huge emotion, enliven them with material from the world’ around us and keep these worlds separate from our own reality.

So what’s in it for doctors?  Why should they bother writing – creatively?

By developing an alternative world, you can process emotions you experience in the real world.  You can give your characters your own insecurities, your own feelings of powerlessness, your own sense of burnout.  You can express how these emotions act out in imagined situations based on the reality you live with – how bad news is broken, how guilt and fatigue feel.  You can put yourself in other people’s shoes.  And, from your own creative resources – as a humane and caring person – you can work out some better ways of handling matters, trying for the ‘happy ending’ – whatever that may entail.

The benefits are real if difficult to measure quantitatively.

You’ll be more easily able to see your patients as people, not medical cases, recognising and understanding their re-actions.  You’ll develop curiosity about what it’s like for them, for example, to hear the bad news you have to tell them.  And – because you understand them better – you may be able to adapt the way you tell them.

You’ll become a better communicator – even a better doctor – as a result.

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