This discussion seeks to highlight the ability of poetry to combat loneliness, a growing public health problem with significant negative health outcomes that potentially impact millions of Americans. We argue that poetry can play a very relevant role and have an impact in medicine. Through a brief literature review of previous studies on poetry in medicine, we demonstrate that poetry can not only combat loneliness but can also play important roles in helping patients, physicians, and other healthcare professionals/providers. Because of the COVID-19 pandemic, we believe now is the perfect opportunity to utilize poetry because the benefits can be experienced even in solitude, which is why this is such a timely and pertinent issue today.
“Healing is a matter of time, but it is also a matter of opportunity.”
During this pandemic, the dangers of loneliness and social isolation cannot be ignored. Loneliness is associated with a 26% increase in risk of premature mortality, can have a negative impact on cardiovascular, immune, and nervous systems, and affects about a third of people in most industrialized countries (Cacioppo and Cacioppo 2018). Reducing social interactions is a well-documented risk factor for several mental disorders including schizophrenia and major depression, as well as generating increased feelings of fear and anxiety (Miller 2011). Moreover, with acute stress generated during the COVID-19 pandemic, reported symptoms of psychological stress, including loneliness, among American adults have increased since 2018 (McGinty et al. 2020).
With the disruption of regular networks of trusted individuals and groups, that means we must confront these pertinent mental health issues ourselves. Yet without meaningful methods or practical tools to do so, many have nowhere to turn to, and no solution seems to be in sight. Lack of access to mental health resources is exacerbated by this pandemic, and improving mental health services is needed (Moreno et al. 2020). After all, loneliness is becoming an incredibly pressing public health problem, and must be addressed with proper engagement and full support from the medical community.
In this paper, we hope to show that poetry can be a powerful, practical, and accessible tool to combat loneliness directly, and that poetry can provide a new avenue for healing. Since the nineteenth century, poetry has been used formally and informally for healing purposes in the United States, and now, in our current day, we believe the opportunity for poetry’s significance and applications to be recognized is crucial (Mazza and Hayton 2013). During this COVID-19 pandemic, the opportunity for poetry to provide healing can be immediately effective and applied widely.
Poetry in medicine
Poetry, as a healing tool applicable and accessible to anyone, can have a concrete impact in all areas of medicine, specifically in providing innovative methods for healing to occur individually and holistically.
Several scientific studies and reviews have previously demonstrated that poetry has a beneficial impact on patients in terms of managing pain, coping with stressors, and improving personal well-being (Lepore and Smyth 2002). Moreover, listening, writing, and reading poetry is associated with a reported improvement in pain following a surgical procedure and improves a patient's ability to deal with chronic illness (Arruda, Garcia, and Garcia 2016; Naidu and Shabangu 2015; Eum and Yim 2015; Hovey, Khayat, and Feig 2018). Additionally, poetry provides patients with further methods of coping with unexpected or stress-inducing situations. A previous study demonstrated that reading and writing poetry temporarily increases working memory capacity, which can increase an individual’s ability to proactively cope with stressful events. Moreover, this improvement in working memory is associated with greater recall of medication instructions and scheduled health appointments, which improves health outcomes (Klein 2002).
In directly addressing mental health, poetry has been shown to have positive short and long-term mood changes as well as behavioral effects in school and work performance (Lepore 1997). Expressive writing can decrease physiological stress indicators such as lower muscle tension, reduce perspiration level, and lower blood pressure and heart rate levels (Smyth et al. 1999). Furthermore, the introspective writing that poetry fosters also offers patients an opportunity to reflect on their lives, enabling them to accept their situation with poise and peace (Heimes 2011). This aspect of poetry is often highlighted in palliative care, as there has been a growing recognition within the field to recognize how poetry can develop person-centered organizations, better train health professionals, and support a patient’s overall well-being (Davies 2018; Coulehan and Clary 2005). Previous literature review on poetry therapy for patients in palliative and end-of-life care show that poetry facilitates meaningful shared experiences and significantly improves relationships between healthcare providers and patients (Gilmour, Riccobono, and Haraldsdottir 2019).
In health professions education, specifically, in nursing, poetry has been frequently employed as a teaching platform to teach values such as empathy, to develop greater emotional awareness, to reduce anxiety and stress, and to assess communication skills (Mood 2018; Jack 2015). The benefits that poetry can have in fostering empathy and greater self-awareness for those in the nursing profession have been well-documented and provide a different approach that can greatly enhance knowledge of complex and ambiguous situations often experienced in nursing practice (Clancy and Jack 2016).
For the caregiver, physician, or healthcare professional, poetry can provide a different lens with which to view the field of medicine. Poetry offers an innovative approach to further humanizing medicine through promoting empathy, emotional sensitivity, cultivating a compassionate presence, and ultimately, providing an accessible platform to acquire and develop skills that are difficult to otherwise teach. Furthermore, these are traits crucial in healing and can significantly increase one’s own effectiveness, further helping and facilitating the patient experience.
For patients, poetry provides a space to vent, to reflect, and to come to terms with their respective situation. It provides an organizational structure with which to tackle new perceptions and deal with negative thoughts. Healing can take place within individuals, at a pace determined by them. Whether it is coping with pain, dealing with stressful situations, or coming to terms with uncertainty, poetry can benefit a patient’s well-being, confidence, emotional stability, and quality of life (Heimes 2011). Poetry restores agency, allowing one’s voice to be heard and represented the way he or she wishes it to be. Moreover, when writing, the poems that patients generate can serve as valuable repositories of past knowledge and experience and can comfort relatives or affected parties, which oftentimes strengthens relations with loved ones. Poetry has immediate benefits for not just the individual but also for the immediate family members, and the larger community as a whole.
The benefits of poetry in medicine and public health today
One of the key tools to combat loneliness is a strong social relationship with others. A genuine connection with others can effectively help those who are suffering from loneliness. As a matter of fact, the presence of strong social relationships is associated with a 50% increased likelihood of survival, and surprisingly, both actual and perceived social isolation are both associated with increased risk for early mortality (Holt-Lunstad, Smith, and Layton 2010). A 2015 study found no differences in increased likelihood of mortality between measures of objective and subjective social isolation, suggesting that both perceived and actual social isolation can have similar detrimental effects on individuals (Holt-Lunstad et al. 2015).
That is where the three aspects of poetry—reading, writing, and sharing—become so incredibly relevant and applicable. To paraphrase poet Paul Celan, a poem is like a handshake: it creates bonds between people. Poetry, and the creative introspection it fosters, can help individuals feel more connected to themselves, to those around them, and to the external world as a whole. Even when practiced in isolation, as many individuals currently are during this pandemic, poetry can increase self and interpersonal awareness, encourage the ownership of voicing your own ideas and emotions, and increase one’s ability to reflect upon significant memories or current-day situations. This can directly address both actual and perceived social isolation and can be a powerful step in helping individuals combat loneliness.
When reading poetry, one is able to challenge his or her own perspectives, to become more tolerant of different points of view, and to appreciate the nuances of various opinions. Reading poetry can also help individuals feel connected to others; oftentimes, reading a poem can remind the individual of a similar experience or emotion, creating a sense of belonging. Poems have real emotional power and serve as a testament to all of us that we are never alone, that amongst these collective voices we can find those that ring at the same frequency as ours (Wassiliwizky et al. 2017). Reading poetry can provide solace and great hope to us, as it reaffirms our place in the world and, in those moments when we come across a poem or certain lines that strongly resonate with us, it is as if we are jolted with electricity at the sheer joy of knowing we can share a bond with someone who we may have never met.
In writing poetry, the mind is forced to slow down and to revisit memories, often bringing to life past emotions and experiences. The process itself is a dynamic one in which writers often learn many new things about themselves that they did not previously think about. Writing poetry also allows one to strengthen an individual’s sense of identity and voice. Poems function as fragments of ourselves, and when writing, we are able to represent ourselves the way we want to be represented, in the most honest and effective light. Poetry allows us to bear witness to who we are and to put into words what often cannot be expressed easily otherwise. Poetry creates avenues for self-expression that cannot be felt through other means of communication. This in itself can be a healing and restorative process, a self-guided therapy that allows us to strengthen our mental health and connection to ourselves, and to those around us.
And when provided a space to share poetry with others, as one is listening to others’ lived experiences and emotions, social bonds can be formed, and safe spaces can be generated where vulnerability and tolerance are actively encouraged. In sharing favorite lines or discussing experiences and emotions with strangers, poetry can bring people together, from all backgrounds, with subtle ease. Unexpected commonalities are frequently found, which spur conversation and a further willingness to create new social relationships. Poetry can create genuine community and an atmosphere of welcome and warmth.
We experienced this firsthand through the Hope Storytelling Project, a series of virtual poetry workshops that we co-led and taught through our local library systems in Cambridge and Las Vegas. We had developed our program with discussion and connection in mind, as we wanted both to teach poetry and to allow our participants to form meaningful social relationships with each other. Quickly, we realized that the sense of community we were able to generate through poetry was incredibly valuable. Over the course of the summer, we consistently had participants remark on the sense of belonging and community that the workshops provided, and how encouraged they were to speak and share their hopes and fears, their worries and joys, and to feel a real connection to others, while learning and immersing themselves in poetry. They shared how the space absorbed them in heartfelt sharing, how the workshops felt like a gentle cleansing, how people’s willingness to share was truly touching, and how poetry enabled them to continue their journey of self-discovery and healing.
Our experiences with teaching and leading these poetry workshops reaffirmed our belief that poetry can serve as an effective antidote to loneliness and the health complications that social isolation brings. During this pandemic, this project provides a model for coping with the uncertainty and chaos of life: as we were reminded of each other's stories, we were able to find similarities in seemingly different lives, finding connection through those similarities. In the moments of interaction and dialogue with each other, we saw genuine relationships being cultivated.
Most importantly, the accessible nature of poetry makes it an incredibly relevant and applicable tool, especially now, when genuine connections are a scarce commodity. Poetry is particularly powerful because it is so easily accessible, as its benefits can be experienced from the comfort of one’s own home. Simply by reading a poem once a week, sharing a poem with a friend, or spending five to ten minutes to free write about a favorite memory, a current idea, a worry or hope, can all be effective first steps in experiencing the benefits of poetry. It is imperative that we bring such experiences into more communities, where other methods and tactics to combat loneliness may not be as accessible. The opportunity is now to recognize the healing potential of poetry.
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Xiang, D.H., Yi, A.M. A Look Back and a Path Forward: Poetry's Healing Power during the Pandemic. J Med Humanit 41, 603–608 (2020). https://doi.org/10.1007/s10912-020-09657-z
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