Counseling work oftentimes takes unexpected turns. We find ourselves venturing down emotional journeys with clients, uncovering suppressed traumas and unaddressed feelings. Trauma may be best conceptualized as an event so overwhelming that it results in a wound of separation and violation (van der Kolk, 2014). Core beliefs regarding self, others, and the world are violated, leaving the person navigating a world that is now insufficient for a new lived reality characterized by ongoing distress (Gan et al., 2013; Park et al., 2016). To protect itself from fully confronting the pain associated with the trauma, it is common for the mind to separate the different facets of lived experience (emotional, cognitive, and somatic), a feat that has been observed in brain imagery. Through this lens, the overarching (and aspirational) goal of the therapist is not just to reintegrate these components of existence but also to create new post-trauma meaning and guide the client through the processing of the trauma narrative (van der Kolk, 2014).
Meaning-making is the crucial process involving the inner and outer selves and centers on acceptance and transformation, resulting in integration and reconstruction of identity. Survivors of trauma often pursue new meaning in their lives to be able to navigate in society (Wright et al., 2007). This new meaning may be both self-serving and self-destructive. However, when survivors successfully reframe their painful events, there are a multitude of mental health benefits, both understood and experienced (Zeligman et al., 2019). New meanings can serve as a source of coping in tough times and as a tool for growth in times of peace, so counselors are most effective when their interventions guide the client to create meanings that are flexible and able to weather life’s storms (Joseph & Linley, 2006; Park, 2010).
Poetry Therapy in Practice
Poetry therapy, by its very nature, lends itself to meaning-making. When a client constructs a poem as an intervention, they are asked to express an emotion in a condensed, verbal manner. As emotions are often accompanied by somatic experiences, too, both of these facets of existence are activated and then channeled using the cognitive, verbal consciousness to construct the poem. This results in bilateral brain activation and reintegration that sets the stage for the client to answer the question, “What does this traumatic event mean for me?”
Poetry therapy excels in its ability to create integration of experience and open the door for conversations of meaning; however, counselors may find themselves challenged to integrate this modality because it tasks the client with constructing a narrative of their trauma, an “enormously difficult” process (van der Kolk, 2014). Before you start, reflect on the purpose for the intervention. What are you, the counselor, trying to do? To process, provide coping, raise awareness, or something else? It is also helpful to consider the client’s position in therapy, in their healing journey, and toward poetry. For example, if a client is not ready to process their trauma, it may be more helpful to start with introducing poetry as a form of coping before using it as a tool for processing.
An accessible first step may be to raise familiarity around poetry by reading pre-existing works. You should have representation of the client in the works provided, keeping in mind the client’s cognitive developmental and reading level. Another intervention that could be helpful as a first step could be to use significant statements from the session to construct a poem, either with the counselor’s assistance or for homework. Again, keep in mind the client’s stage of healing when choosing significant statements. Only after building a sense of comfort with poetry should the client be tasked with independently constructing a work. Likewise, processing through poetry should only proceed when clinically indicated. This will not happen with every client. The nature of trauma is such that confronting the event through deep poetic processing may be too threatening. Clients may decide that being able to cope with their symptoms is the most they can do during your time together.
Another important consideration to make is a client’s connection to this modality through their cultural identities. Expressive storytelling and poetry have always been a significant factor in African culture; however, there are certain considerations that should be made by a therapist working with Black American clients. For example, some Black clients may connect with Christian lyrical work (such as psalms or hymns) or traditional African works. A counselor using poetry therapy with clients should assess for strong connections to existing lyrical traditions to use for coping. There may also be a gendered effect with poetry therapy. It would be helpful for the therapist to have exploratory conversations with their male-identifying Black clients about expressive interests, Black masculinity, and gender schemas. Conversely, female-identifying Black clients do not typically have the same type of cultural restrictions on expression through the written word.
Consider the following case study of work with a Black-identifying client:
Izzy is a 25-year-old Caribbean American woman who is self-employed as an online sex worker. Izzy is both a survivor of sexual abuse and domestic violence. Izzy’s initial goal was to process her trauma so it would no longer affect her work. After psychoeducation about trauma and survival mechanisms, Izzy agreed to weave expressive modalities into her healing journey. Izzy’s first expressive work was in reading affirming African proverbs to create historical meaning-making; this was important for Izzy as she wanted to create historical and transcendent meaning. She would begin each session with a proverb and close with a reading from female Black poets. The reading of existing work that focused on sexual trauma and healing helped Izzy to gain awareness of how this trauma has impacted her. After gaining familiarity with poetry, Izzy was asked to create mini-proverb flipbooks for herself. She would often do this poetic work after her online shifts as a sex worker. These books tracked her symptoms, became a coping mechanism, and transitioned into songs, which were used for processing. Each song or proverb represented aspects of her trauma narrative and worked as a prologue into each processing session. After processing, Izzy had a flipbook and journal of her songs; this was one of the many coping mechanisms she built during her time in counseling.
Poetry is meaning in its purest form, so weaving this modality into a client’s healing journey in any intentional way promotes meaning-making. Outside of processing, poetry also lends itself well to coping and raising awareness. Although integration into the healing journey may require more thought by the clinician, poetry therapy is unique in its ability to reintegrate experience and generate lasting change in clients.
If you would like to contribute a story or share a unique approach in your sessions for consideration, we want to hear from you! Email firstname.lastname@example.org.
Gan, Y., Guo, M., & Tong, J. (2013). Scale Development of Meaning-Focused Coping. Journal of Loss & Trauma, 18(1), 10–26.
Joseph, S., & Linley, P. A. (2006). Growth following adversity: Theoretical perspectives and implications for clinical practice. Clinical Psychology Review, 26(8), 1041–1053. https://doi.org/10.1016/j.cpr.2005.12.006
Park, C. L. (2010). Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136(2), 257–301. https://doi.org/10.1037/a0018301
Park, C. L., Riley, K. E., George, L. S., Gutierrez, I. A., Hale, A. E., Cho, D., & Braun, T. D. (2016). Assessing disruptions in meaning: Development of the Global Meaning Violation Scale. Cognitive Therapy and Research, 40(6), 831–846. https://doi.org/10.1007/s10608-016-9794-9
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
Wright, M. O., Crawford, E., & Sebastian, K. (2007). Positive resolution of childhood sexual abuse experiences: The role of coping, benefit-finding and meaning-making. Journal of Family Violence, 22, 597–608.
Zeligman, M., McElroy-Heltzel, S. E., Davis, E. B., Dispenza, F., Davis, D. E., & DeBlaere, C. (2019). Posttraumatic growth and trauma in flood survivors: Contributions of attitudes toward God. Journal of Mental Health Counseling, 41(2), 127–143. https://doi.org/10.17744/mehc.41.2.03
Jasmaine Ataga, NCC, LPC, is a doctoral student at the University of Florida in the counseling and counselor education program. Her research agenda focuses on sexual trauma and utilizing expressive arts to promote meaning-making and post-traumatic growth. As a sexual assault counselor, Ms. Ataga created sand tray interventions, art-based techniques, and expressive art teen retreats for underserved individuals impacted by sexual trauma.
Zachary McNiece is a doctoral student at the University of Florida in the counseling and counselor education program. He has worked in day treatment and private practice settings with clients with a variety of presenting concerns. He is a registered mental health intern in the state of Florida. Mr. McNiece’s research interests center on intergenerational trauma and culturally responsive interventions.
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