Expressive Writing : Support for Front Line Health Care Workers during and after the COVID-19 Outbreak

 

This month I thought I would be researching and preparing for my various talks on Expressive Life Writing and Trauma Recovery at venues in Cyprus, Finland and France.

Instead I am in the midst of researching and developing (alongside my research partner Dr Siobhan Campbell of the Open University) a participatory research project designed to use digitised forms of Expressive Life Writing specifically adapted for the use of front line health care workers across the world, helping to support their well-being in the face of the COVID-19 epidemic. The project has generously been sponsored by Viaro Investments Ltd and will be completed within six months or sooner.

https://www.viaroinvestment.com/about

Campbell and I are currently gathering information on the forms of support already available to these workers, and understanding the findings of some very recent studies of the effectiveness of such interventions on Front line health care workers in China. Next we will draw upon this information and our past expertise with Expressive Writing training to create bespoke Expressive Writing materials for supporting the wellbeing of those workers.

These materials, all of which will be made freely available to those workers in English, Italian and Arabic, will include: The Expressive Writing for Front Line Health Care Workers Handbook and accompanying Expressive Writing Film;  The Expressive Writing for Front Line Health Care Workers Exercises;  and The Expressive Writing for Front Line Health Care Workers website, which will contain FAQs; further exercises and a space for Front Line Health Care Workers to share their own stories in confidence. At the same time, the proposed research project will also develop and test the efficacy of an innovative multilingual, freely accessible digital model for the successful dissemination of Expressive Writing training and exercises, gathering feedback via online surveys.

A secondary project, currently in development will seek to create a user friendly app with shorter exercises and mediations targeted specifically at front line health care workers across the world.

What is Expressive Writing?

For those of you unfamiliar with my previous work in this area and with Expressive Writing, Expressive Writing is a form of imaginative writing that places emotional expression at the centre of supporting well-being and post-trauma recovery. Through previous Expressive Writing projects collaboratively developed with local and international stakeholders in the UK, Iraq and Lebanon since 2015,  including the United Nations Development Program, the researchers Jensen and Campbell have trained palliative care staff, human rights advocates and social workers in the use of EW and overseen the deployment of their Expressive Writing methodology to support health and social care workers and the vulnerable populations with whom they work. https://www.kingston.ac.uk/research/research-showcase/research-case-studies/expressive-writing-workshops-in-iraq/

As Director of Kingston’s Life Narrative Research Group (since 2007), I have spent over a decade collaborating with inspirational colleagues from across the world who work at the interface of life writing, narratives of traumatic experience, and the advancement of human rights.https://www.kingston.ac.uk/faculties/kingston-school-of-art/research-and-innovation/life-narratives/

My recent monograph The Art and Science of Trauma and The Autobiographical: Negotiated Truths, draws on the latest research on the clinical, behavioural, evolutionary psychologies and the neuroscience of trauma in order to categorise and elucidate the complex relations between life stories and traumatic disorders. Art and Science of Trauma and the Autobiographical

Siobhan Campbell’s research explores ways in which narrative, expressive writing and creative writing interventions address and interact with forms of activism and participation in post conflict environments while her creative practice enables the provision of workshop approaches and story gathering protocols for use in contested or recovering environments.Campbell

In 2015, we began to develop and adapt the Expressive Writing methodology, first developed by Professor James Pennebaker in the 1980s, for use in the rights-building context. https://journals.sagepub.com/doi/10.1177/1745691617707315

Expressive writing has been shown to support well-being and recovery for people during and after facing very difficult life experiences such as combat, sexual violence, and the death of loved ones. Siobhan and I have overseen several research projects that have trained social workers in conflict and post conflict regions, refugee camps and palliative care settings, teaching them how to use Expressive Writing to support some of the most vulnerable people in the world. Our current aim is to adapt this same material to support Front Line Health Care Workers in the current crisis, and to test the effectiveness of online access to Expressive Writing Material specifically aimed at those workers and freely available to them in three languages (English, Italian and Arabic).

Women, Peace and Security, Part 1

 

The Language of Human Rights

In That the World May Know (2007), James Dawes documents the complex organizational dynamics and communicative practices of some of the world’s most recognizable “humanitarian inquisitors”: the UNHCR, the International Committee of the Red Cross (ICRC), and the Human Rights Association (HRA). Dawes observes that these organizations aim to “eliminate physical suffering by using words,” relying on interviews, investigations and campaigning to “perform certain types of speech acts,” such as the UNHCR announcing “This person is a refugee” or the ICRC stating “You are guilty of violating international norms” (77). As Dawes explains, such interventions on behalf of rights advancement are linguistic acts within a discourse of activism, judgement and storytelling, and however well-intentioned cannot be value-neutral. The rights-testimonial context calls for semantic choices on the part of the interviewee in the act of telling, while the cultural and historical frames through which activists, bureaucrats and policy-makers listen to that testimony powerfully informs their ability to act upon that information.

The language of human rights activism from grass roots campaigns to state-mediated peace agreements thus describes and delimits the parameters and character of the spaces in which human experiences are spoken and heard. In a series of blogs, I will explore the workings of some of these discursive processes and practices by examining the development and later impact of a well-intentioned set of resolutions devised to increase women’s participation in International peace and security missions. These include the United Nations Security Council Resolution 1325 (2000) and later resolutions devised to support the aims of 1325, the International Protocol for the Documentation and Investigation of Sexual Violence in Conflict (2014) and the greatly revised second edition of the Protocol (2017). As we shall see, while all of these international resolutions seek to advance the rights of women in conflict and post-conflict regions and enable safe spaces for them to share their concerns and experiences, the conceptual frames through which those aims are articulated  are increasingly understood as posing obstacles to achieving those goals.

UNSCR 1325 (2000)

For the United Nations Security Council at the start of the 21^st century, the political and economic status of women became “a matter for the most serious consideration” as its members generally agreed that “addressing chronic gender inequality could indeed lay the foundations for sustainable peace” (Kirby and Shepherd [a] 250). The tangible result was the passing of UN Security Council Resolution (UNSCR) 1325 “Women, Peace and Security” in 2000. 1325 reaffirms the role of women in the prevention and resolution of conflict, in peacebuilding negotiations, peacekeeping, humanitarian interventions and responses, post-conflict reconstruction and sustainable peace initiatives.

In addition to calling for more widespread consideration of the needs of women in conflict and post-conflict settings, the resolution also calls for greater representation and participation of women in decision and policy making at national, regional and international levels; for an increase in their involvement in conflict negotiation and resolution, field operations, and consultancy on missions; greater funding and support measures for gender-based work; states’ increased commitment to upholding the rights and protection of women and girls under international law; and the creation of deterrents and other special measures to prevent sexual violence in armed conflict. At international institutional levels, the resolution has led to the appointment of a Special Representative of The Secretary-General on Sexual Violence and to the formation of an Inter-Agency Taskforce on Women, Peace and Security to facilitate its implementation.

Arguably, the passage of UNSCR 1325 is largely responsible for stimulating feminist interest in the work of the UN Security Council. Soumita Basu notes for example that the Council’s “procedures, practices and ideological leanings” feature prominently in scholarly research on the ‘adoption story’ of the resolution,” (255) much of which focusses on the seemingly new public/political spaces it carved out by listening to so-called women’s concerns. More recent scholarship from the field of feminist security studies, however, challenges the earlier consensus on the unalloyed benefits to women of 1325. As Maria Jansson and Maud Eduards contend, for example, the resolution can best be understood as “the outcome of political negotiations in a setting characterized by power relations” through which a “specific understanding of gender and security has been generated” (591-2). Critics like these argue that 1325 and later resolutions aimed at advancing the WPS agenda, uphold problematic traditional patriarchal divisions of the roles of men and women in war and peace. In the next blog I will be exploring the Background and context of the adoption of 1325 in 2000 and the impact that has had on Women, Peace and Security. For further information right now – have a look at the following videos, the first from the Inter parliamentary Union, and the second from UN Women.

WomenPeaceandSecurity

UNWomen

Testimony

Around this time last year, I was asked to contribute a chapter to on Testimony to The Routledge Companion to Literature and Trauma, edited by Colin Davis and Hanna Meretoja. https://www.routledge.com/The-Routledge-Companion-to-Literature-and-Trauma-1st-Edition/Davis-Meretoja/p/book/9781138494923

It was rather late in the day to be asked, but it seems that the editors has just been reading my recent book  (https://www.palgrave.com/gp/book/9783030061050) and realised that their volume needed a chapter on Testimony and that I was the person they should ask to write it.

 

I was in the midst of researching and writing two other articles at the time (part of a list of things I saved to do ‘when I finish my book’ but when I saw the list of contributors and topics that Hanna and Colin had assembled for this collection (Stef Craps, Michael Rothberg, Roseanne Kennedy and Cathy Caruth among them) I said “count me in.” I didn’t get much sleep between March and June, but I am delighted I was able to contribute. The book will be out in the next month or so and my chapter explores the relationship between “testimony” and literature, particularly in the context of traumatic discourse.

“Testimony” as both mode and genre is frequently identified as the emblematic literary and discursive mode of the past fifty years and counting. But to what precisely does this term refer in relation to literature and discourse? And how might those definitions be challenged in the context of witnessing that testifies to traumatic events? Testimonial forms that attest to traumatic experience are as old as humanity itself. From ancient myths, legends and folk tales in all cultures, to songs of war, conquest and revenge, both the power and the vulnerability of what it means to be human has been expressed through narratives with varying degrees of adherence to actual events. Moreover, testimony is often generated by marginalised populations in which it frequently constitutes a dangerous act.

In my forthcoming chapter, therefore, I consider various forms of eye-witness narrative offered as evidence of suffering – including Holocaust and Soviet Gulag testimonies, the testimonio of oppressed indigenous peoples in Latin America, African-American slave narratives, rights campaigning materials produced by former Cambodian child prostitutes, and the thousands of disclosures generated by the #metoo movement. In doing so I hope to identify and problematize the complex social, biological, rhetorical, psychological and cultural networks along which such narratives must travel in order to generate and disseminate meaning, and, potentially, new forms of knowledge.

A Description of the volume follows below:

Literary trauma studies is a rapidly developing field which examines how literature deals with the personal and cultural aspects of trauma and engages with such historical and current phenomena as the Holocaust and other genocides, 9/11, climate catastrophe or the still unsettled legacy of colonialism.

The Routledge Companion to Literature and Trauma includes a comprehensive guide to the history and theory of trauma studies, including key concepts, consideration of critical perspectives and discussion of future developments. It also explores different genres and media, such as poetry, life writing, graphic narratives, photography and post-apocalyptic fiction, and analyses how literature engages with particular traumatic situations and events, such as the Holocaust, the Occupation of France, the Rwandan genocide, Hurricane Katrina and transgenerational nuclear trauma.

40 essays from top thinkers in the field demonstrate the range and vitality of trauma studies as it has been used to further the understanding of literature and other cultural forms across the world. Routledge Companion to Literature and Trauma

 

 

The Expressive Writing and Telling Project

Expressive writing is a supportive narrative therapeutic methodology which serves as a type of coping strategy often used for survivors of trauma. In Expressive Writing workshops, participants  write out their thoughts and feelings about many of their past experiences, from the quotidian to the joyous to the stressful or traumatic experience in various, imaginative ways. Research with victims of traumatic experience in non-conflict settings and with combat veterans has demonstrated that the process of writing down these reflections helps survivors ‘detach’ from negative experiences by turning them into tangible, shareable stories, thus increasing their sense of well-being.

Since 2015, Dr Siobhan Campbell of the Open University and I have been working with NGOs and other charitable organisations to develop and deploy expressive writing and telling workshops with UK combat veterans, hospice patients, carers and their families, and with international partners across Iraq and Lebanon. We have been supported in the work by funding from the UNDP Siri Project in Baghdad, the AHRC Global Challenge Research Fund, and the UK and Foreign and Commonwealth Office Human Rights Fund. For further information on some of these projects look here: https://www.kingston.ac.uk/research/research-showcase/research-case-studies/expressive-writing-workshops-in-iraq/

And here: https://www.kingston.ac.uk/faculties/kingston-school-of-art/research-and-innovation/life-narratives/

This month, in another GCRF funded project, Dr Campbell and I are working once again with the Akkar Network for Development, Lebanon, https://arab.org/directory/akkar-network-for-development/ looking at ways to digitise and expand the reach of the Expressive Writing and Telling Methodology, making it at the same time suitable for younger children and families. I will keep you updated on how that work all proceeds!

 

Happy New Year!

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Sorry to have been away so long – last year flew by with both the launch of the book, presentations on my research at the Ohio State University “Conflict, Disaster, Trauma and the Autobiographical: Healing stories for individuals and communities“  and two talks at the International Auto/biographical Association (Europe) conference at the Universidad Complutense de Madrid “Beyond ‘Do No Harm’: Women, Peace and Security: The Language of Human Rights” and, with Siobhan Campbell,  “Writing-based interventions and Knowledge Communities: Building Communities of Practice through Life Story Telling ”  https://eventos.ucm.es/26045/section/15175/iaba-conference-2019.-knowing-the-self_-autobiographical-narratives-and-the-history-of-knowledge.html

For fun, at the Crickhowell Literary Festival in October, https://cricklitfest.co.uk/ I continued my yearly lecture series offering my iconoclastic take on classic literature written by women.  Previous Talks at the Festival have included “Don’t be Afraid of Virginia Woolf” in 2016; “Wuthering Heights: We need to talk about Heathcliff” and this year’s talk was entitled “Jane Eyre- so many questions.” I have been invited back next year to talk about Jane Austen, and am playing around with the title “Jane Austen hated everyone.” One day, I hope to pull these general readership talks together into a book.

I first began to research the complex relationship between literature and suffering as I studied towards my PhD. Reading the letters, diaries and journals of both Katherine Mansfield and Virginia Woolf, I was struck by how each of them had, like me, lost a brother. Now many decades later, I have been asked to edit and introduce a new anthology of Katherine Mansfield’s stories for Macmillan, and I am absolutely thrilled. I will be writing more on this delightful task in a future blog, but in the meantime I am awaiting the publication of two chapters in edited collections that supplement the work in The Art and Science of Trauma and The Autobiographical: Negotiated Truths (https://www.palgrave.com/gb/book/9783030061050). The first of these to appear will be my chapter “ Speaking Trauma and History: The Collective Voice of Testimonial Literature   “ in Andrew Hammond’s edited collection The Palgrave Handbook of Cold War (Spring 2020) https://www.palgrave.com/gb/book/9783030389727#aboutBookand the second a chapter on “Testimony” in the forthcoming Routledge Companion to Literature and Trauma, edited by Colin Davis, Hanna Meretoja (Spring 2020) https://www.palgrave.com/gb/book/9783030389727#aboutBook

In the meantime I am in preparing for forthcoming talks on the relationship between trauma, memory and human rights. I have been invited to participate in a symposium for Narrative Research Centre Directors at the Paris Centre for Narrative Matters in June (https://cerilac.u-paris.fr/paris-centre-narrative-matters) and later that month to a workshop on “Political Narratives” at The Collegium for Advanced Studies, Helsinki https://www.helsinki.fi/en/helsinki-collegium-for-advanced-studies. Shortly afterwards I will take up another invitation to travel to Turkku Finland and deliver a paper on “Time, Body, Memory: The Staged Moment in the Posttraumatic Autobiographical“ as part of the IABA International Conference https://iabaturku2020.net/, where I will also be running an information and discussion session on my applied research – the Expressive Writing Project. For the latest information on this project, see my blog next month and for an introduction to the project and previous work in this area see also: https://www.kingston.ac.uk/faculties/kingston-school-of-art/research-and-innovation/life-narratives/

More to come in February!

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Chapter 7. The Art and Science of Therapeutic Innovation: Hope for PTSD sufferers today and tomorrow

Drawing on the most recent findings in the fields of clinical, behavioral and evolutionary psychology, neuroscience, transcultural psychiatry, “alternative therapy,” and her personal  experiences, Jensen provides a jargon-free overview of key developments in the treatment of traumatic disorders. Highlighting the emergence of new psycho-pharmaceuticals designed to target and interfere with pathological neural processes, to new age and holistic approaches aimed at “supporting well-being,” to technologically-enhanced interventions using Virtual Reality visors, brain-activated telecommunications and the like, Jensen compares the evidence base for these interventions and considers their potential future value in the PTSD treatment.  Finally, Jensen explores the implications and the therapeutic efficacy of life narratives methodologies of various kinds for treating PTSD, including those that endeavour to make the neural circuitry of the brain “speak out. ” These life-telling interventions, Jensen concludes, can enable sufferers to interpret the processes of their traumatized brains and produce a new, resilient mind-story.

Chapter 6. Annihilation and Integration in Collective Posttraumatic Monuments, Testimonies and Literary Texts

Chapter 6. Annihilation and Integration in Collective Posttraumatic Monuments, Testimonies and Literary Texts

Jensen offers a unique comparison of collaborative memory projects: contemporary expressions of public suffering (such as the Monument Against Fascism in Hamburg, Germany) and collective literary and testimonial representations of group or generational traumatic history (like those generated by the Truth and Reconciliation Commission in South Africa). Such forms of witness arise, Jensen demonstrates, from identifiable biological and psychological conditions in posttraumatic communities, which elicit specific cognitive affects. Examining memorial projects such as the Vietnam Veterans’ Memorial and the National Memorial for Peace and Justice, alongside collective testimonies from survivors of the Rwandan genocide, the Holocaust, the repression of indigenous peoples in Guatemala among others, Jensen highlights the ways that each these memorial projects, whether verbal or material create interactive, aesthetically interesting, interrogative and performative spaces in which stories can be shared through a rhetorically-distanced witness that enables the development of collective traumatic identity while simultaneously supporting traumatized communities.

 

Chapter 5: Speaking In and Speaking Out: Posttraumatic Poetry and Autography

Chapter 5. Speaking In and Speaking Out: Posttraumatic Poetry and Autography

 

Jensen analyses the complex strategies used to communicate posttraumatic autobiographical experience through the limiting frames of autography and poetry. Outlining the latest neuroscientific understandings of the relations between mental illness and the creative drive, Jensen demonstrates how both poetry and autography have arisen alongside traumatic historical contexts: while poetry traditionally communicated the horrors of war and imprisonment, autography has been used to tell stories of genocide, rape, incest, anorexia, and pedophilia.  Jensen argues that often in posttraumatic autobiographical works in these strict forms a remembered, intrusive scene of violent incursion upon the mind and body is “spoken out” verbally or visually in a manner similar to ekphrástic poetic renderings of a painting or sculpture. Drawing attention to this form of ekphrásis as the business of posttraumatic poetry and autography, Jensen concludes that in both forms, metaphor is used to reread powerful images and provide a rhetorical bridge between affective realms.

You can read a preview of Chapter 5: HERE

Chapter 4: What It Is Like: Fiction, Fear, and Narratives of Feeling in Posttraumatic Autobiographical Novels

Chapter 4. What it is like: Fiction, Fear and Narratives of Feeling in Posttraumatic Autobiographical Novels

Jensen provides a unique comparison of serial autobiographical fictions written by Virginia Woolf, Vladimir Nabokov, Jack Kerouac and Julia Alvarez, reflecting on their use of both reality and the imagination in posttraumatic life-story telling. Focussing on the repetition of key autobiographical moments in their novels, Jensen, provides an analysis of the often conflicting viewpoints on those events presented by numerous narrating “bodies” in each of these texts: this point-of-view narrative strategy, Jensen argues, may be linked to the limbic phenomenon called “Event memory” in which a scene is constructed in memory from a particular point of view.  By similarly constructing a figurative witness who plausibly evokes the qualia of “what it was like” through a public incarnation of private suffering, these texts can be understood as counter narratives in which imaginative narration redresses old wounds, proposing an alternative story about subjectivity in the aftermath of trauma: narratives of feeling.

You can read a preview of Chapter 4: HERE 

Chapter 3: Time, Body, Memory

Chapter 3. Time, Body, Memory: The Staged Moment in Posttraumatic Letters, Journals, Essays and Memoirs

 

Jensen offers a detailed examination of the temporal narrative swerves that appear in much autobiographical literary non-fiction composed in the aftermath of traumatic experience: memoirs, letters, diaries and essays. Uniquely in the case of post-traumatic stress disorder, one can not only recall a past event but also re-experience it fully in both mind and body. Flashbacks bring the past viscerally into the present. Drawing on the latest neuroscientific findings on the interactions of “time cells” and memory in posttraumatic brains, Jensen demonstrates how an analysis of non-fiction works by Vladimir Nabokov, JG Ballard, Virginia Woolf, Jack Kerouac and Julia Alvarez alongside these scientific findings adds to and complicates our understanding of the temporal narrative dynamics through which painful experience can be negotiated in the aftermath of trauma. Moreover, it will posit one possible origin for each writer’s emblematic representations of a complex trope: the body in time.

You can read a preview of Chapter 3: HERE