Living Stories of Hope and
Change
Meeting the challenge of change through the arts in medicine
Keynote:
The Alberta Psychiatric Association Conference, Banff, Alberta
March 28, 2014
Cheryl L. McLean, CherylMcLean@ijcaip.com
______________________________________________________________
This article features a few very brief excerpts from
my recent keynote presentation, Living Stories of Hope and Change.
"The business of art is rather to understand Nature and
to reveal her meanings to those unable to understand. It is to convey the soul
of a tree rather than to produce a fruitful likeness of a tree. It is to reveal
the conscience of the sea, not to portray so many foaming waves or so much blue
water. The mission of art is to bring
out the unfamiliar from the most familiar."
Kahlil Gibran
Kahlil Gibran
This is a
presentation about meeting the challenges
of change through the arts in medicine.
In this
talk, I want to show how living stories, or personal stories,
stories of lived experience,
particularly those written and performed for public witness, might lead
to hope and change for the practitioner and the patient. There are two key questions I will address: The
first question, How can the creative arts be used for my own personal wellness? I will
share with you research as well as personal
stories and performed illustrations of
the work (that I will weave in and through this presentation) to show how living
stories have been healing in my own life and in the lives of others and to
suggest how they might be healing for you.
The second question, How do
the creative arts in medicine help practitioners, (especially psychiatrists)
enhance clinical and relational skills? I will share with you topical
research and evidence and relate performance
examples to skills in psychiatry and offer other specific ways the work links
to skills in practice.
I understand many
psychiatrists (the healers of the soul)
enter psychiatry as a profession because they are interested in helping those
who suffer and are in need of healing, opening the door to human
understanding. You want to know why
people behave the way they do, you want to use your considerable education and
skills to help people be well, you want to restore balance and quality of life
to those you care for. Among you today
will be those who commonly deal with
issues around depression, anxiety, paranoia, and /sex abuse...
Many psychiatrists have themselves seen what it is to live on
the other side of the door, they may know, through lived experience, through their
fathers, their mothers, their aunts and uncles what abuse and alcoholism is,
some have suffered devastating personal losses of those closest to them, many have grown up with
family members who have lived with depression and other mental illnesses.
Research shows that doctors, in general, are at greater risk for
depression, mood disorders and suicide and psychiatrists, according to The
American Psychiatric Association, commit suicide at rates at about twice that
of other physicians. Dr. Michael Myers,
Professor of Clinical Psychiatry and a leader in physician health and wellbeing
also stresses deeply depressed
physicians still feel the effects of the stigma of mental illness.
Meeting this challenge of change for your patients and your profession,for
your health and your wellbeing, I believe can be achieved through
sharing your stories and the stories of others to help counter stigma and break
the silence with your voices in creative communities of love, support and
common connection. This is where hope
can be found and where the change can
begin.
EVIDENCE
"In the US, a
recent study found that over half of all US medical schools involved the arts
in learning activities (Rodenhauser, Strickland, & Gambala,2004). This
survey found that the arts are used to foster student well-being,enhance
teaching and learning, and improve clinical and relational skills, for example,
observation and reflection and
insight."
There are many illustrative examples of the arts in research and in medicine in the book "Creative Arts in Humane Medicine" . Among the topics; teaching empathy through role play and fabric art, visual arts in dental education, drama for patient communication, reader's theatre and sharing experiences of caregiving, music for practitioner self care and narrative as a reflective process in the illness experience among others.
There are many illustrative examples of the arts in research and in medicine in the book "Creative Arts in Humane Medicine" . Among the topics; teaching empathy through role play and fabric art, visual arts in dental education, drama for patient communication, reader's theatre and sharing experiences of caregiving, music for practitioner self care and narrative as a reflective process in the illness experience among others.
Dr. Rita Charon at Columbia University, New York, a pioneer in the field of narrative
medicine and founder of the Narrative Medicine program at Columbia has long
advocated for the value of sharing stories of medical practice, of reading and writing stories, of attentive listening,
reflective writing, and bearing witness to suffering.
Dr. Arthur Frank has
written extensively about illness narratives.
He encourages people to tell
stories to reflect and help make sense of their suffering. He believes when illness can be transformed
into story this can be deeply healing. Other medical
educators like Dr. Johanna
Shapiro, Medical Education, University of California School of Medicine, who does
qualitative research on patient narrative and the doctor-patient relationship
with a focus on communication skills,
literature and medicine, believes theatre performance, as well, can provide
opportunities for medical students to identify with imagined roles and
situations as viewers or participants.
I have
special research interests in narrative and
ethnodrama which is a form of performance based qualitative research. While
doing graduate work at Concordia University in Montreal I also worked as a
drama therapist associated with an Over 60 mental health programme. I
wrote and acted in the ethnodrama "Remember Me for Birds" based on
this research and client stories. Ethnodramas have been written about
communication between physicians and cancer patients, nursing and home care, stigma and
HIV/AIDS, alcohol and drug abuse, schizophrenia, death and loss and eating
disorders, for example.
How can such work
be healing for the practitioner?
I have personally found
that writing and embodying the stories was a transformative and visceral form
of learning and healing, a deeply transformative process of self discovery whereby
one can explore and re-experience the personal
links between self and family history and the common connections between themes
that arise in client/character stories
and themes in one's own life. For
example, it was through my own work in the creative arts and living story that I discovered survival
was an important theme in my personal life, as it had been for family members
and the many characters in my
performances.
How might the creative arts in medicine help practitioners
enhance clinical and relational skills?
Empathy is a key relational skill in
clinical practice. The arts can help
foster empathy.
A study
through Thomas Jefferson University has been able to quantify a relationship
between physicians' empathy and their patients' positive clinical outcomes,
suggesting that a physician's empathy is an important factor associated with
clinical competence.
Jodi Halpern, a
psychiatrist and professor of Bioethics and Medical Humanities at The
University of California, Berkeley, claims that empathy requires experiential
not just theoretical knowing. The arts and drama are particularly effective,
she reports, as a means of active and
embodied learning and knowing.
Embodying the living story through an experience with
the arts can foster a sense of having
being there, to see as another sees,
bringing about the miracle of
empathic connection that Henry David Thoreau refers to in the quote; "Could a greater miracle take place than
for us to look through each other's eyes for an instant?"
Empathy is good for practitioner wellness and important in the physician patient relationship. The processes we are referring to, the
capacity to read, write and share complex, fully embodied stories, foster great
empathy for the patient or client as well as ourselves as we connect closely on
an embodied and emotional level while becoming increasingly attuned to our own
corresponding issues and themes.
There is a transformative learning process taking place for practitioners in writing
such narratives and performing living stories. As well, the audience may learn more about
human experience as they witness historical or past events and the present within
a performed context. As an audience member witnessing a living story we can see
the NOW more contextually and observe
the WHYS in action.
I
have presented numerous examples of narrative, story, poetry and monologue in
this presentation that have shown how
these creative forms of self expression have been healing for the
practitioner. Sharing your personal story for witness can be a validating act of self compassion and love. Self-compassion that can help protect against
anxiety and promote psychological resiliency. We can meet the challenge. Countering
stigma through sharing our living
stories we can break the silence and open the way for others to share their
stories.
Cheryl McLean is an educator, publisher, author and speaker. She is publisher of "The International Journal of the Creative Arts in Interdisciplinary Practice" IJCAIP Editor, Creative Arts in Humane Medicine, published by Brush Education (dist. University of Toronto Press) and
the books Creative Arts in Interdisciplinary Practice, Inquiries for Hope and Change, Creative Arts in Research for Community and Cultural Change.
Cheryl McLean is an educator, publisher, author and speaker. She is publisher of "The International Journal of the Creative Arts in Interdisciplinary Practice" IJCAIP Editor, Creative Arts in Humane Medicine, published by Brush Education (dist. University of Toronto Press) and
the books Creative Arts in Interdisciplinary Practice, Inquiries for Hope and Change, Creative Arts in Research for Community and Cultural Change.
For more information: website: http://www.cherylmclean.com (please email to this address from your own email this link does not work directly from this site.)
More info: http:/www.cherylmclean.com
More info: http:/www.cherylmclean.com