BIBLIOTHERAPY IN BEREAVEMENT –
THE USE OF STORY AND METAPHOR
Haifa University 1997
Denial of death in contemporary society
There is a amazing paradox in contemporary attitudes toward death. On the one hand we witness a growing fascination towards death related activities and images. One example of this current attraction is the high rating these issues get on the electronic media across the world and across the ages. On the other hand – the flight from facing death and the fear of death of self and that of meaningful others is reflected in avoidance of open and candid discourse of death issues and their ramifications.
Our society seems insulated from and uncomfortable with the subject of death to the degree of casting a taboo over it (Bertman, 1991). The taboo on open and candid discussion of death is more common in the Western technological culture than in traditional societies which foster the belief that death is a doorway to another life (Rowe, 1989). This taboo breeds and nurtures the psychological defense mechanism of denial. In spite of daily evidence of prevailing mortality there is still a persisting attempt not to allow contemplation of death to enter our life. Denial functions mainly to protect us from the agony brought by the awareness of human mortality, as if by refusing to accept and acknowledge death – it will go away. However, the curtain of denial seldom provides a perfect protection. Shattered pieces of reality penetrate into awareness, forcing us to confront unavoidable loss and bereavement. Even when attempts to deny the objective aspects of death may fail, personal implications are often avoided, by warding off such mortal hazards implied in ecological neglect, substance abuse, careless driving, unprotected sex, to mention but a few examples. The preallotted attitude holds on to the comforting self-deception: ” If I don’t think of it – it won’t happen to me. “
‘Denial’ in itself is no longer considered ‘sick’ or ‘pathological’ by experts on stress but as a legitimate way of coping (Lazarus, 1983). Yet the arduous reluctance to confront death may provide only a limited relief, since it demands a constant struggle to turn a blind eye to the prevalence of death both in nature and in society. To avoid direct confrontation we disguise the subject in a reach array of euphemisms such as “passed away”, “gone”, “fallen”, “deceased”, “departed”, “sleeps eternally”, “flies with angels”, “lies with ancestors” , to mention but a few. As a therapist I have been painfully aware of the psychological price people pay for the denial of death, namely unconsummated grieving processes, fear of life, avoidance of intimacy, curtailed creativity and looming depressions. When denial obstructs the process of grieving it blocks the ways to heal from the wounds of loss.
Traumatic and non traumatic Death
Death of a meaningful person causes an enormous deprivation, as intimate relations, physical and/or sexual contacts, security, comfort and affection suddenly vanish. By calling the complex task of parting from the deceased ‘grief work’ Freud (1959) emphasized the need for an active investment in this process. Incomplete ‘grief work’ may cause psychological obstructions that distort one’s reintegration in the family and in society. The steps toward recuperation seem forever stormy and painful (Kubler-Ross, 1982), entailing shock and numbness, causing temporary regression and resignation, triggering anger and protest on the long way to reach acceptance and re-adaptation. The path of grief cannot be plotted in advance, as it is an ongoing dialogue between the person and the environment, affected by the circumstances of death, intensity of bonding, internal resources and availability of a social support system.
Confronting traumatic death has become a very pressing issue in our time. The global exposure to the enormity of man-made violence and the constant threat of nuclear and ecological disasters imprint the images of traumatic death on contemporary consciousness.
We cannot prepare ourselves for trauma, because by definition ‘trauma’ is an unexpected event, though it is not “outside the usual human experience”, as proposed with some undue optimism by the DSM (APA 1980; 1994). Traumatic threat to life by solicited and unsolicited violence has almost become a norm in many parts of the world, leaving indelible marks on the bereaved and the survivors.
Research bears witness to the fact that people who were targeted for extinction but had not died – live the rest of their lives imprinted by this traumatic experience. Lifton (1967) describes the survivors of Japan’s nuclear destruction as the ‘living dead’. “For them and for many other survivors, death is reality, whereas life seems allusive and non-real”. Wardi (1990) witnesses Holocaust survivors shaping their identity and their offsprings as ‘memorial candles’ for those who perished in the Nazi genocide. Metaphoric expressions such as ׂliving dead׃ and ׂMemorial Candles׃ convey the death imprint wrought upon the living.
Detrimental effects of traumatic death on behavior and on health result in post-traumatic sequelae, which can interfere with grieving . Intrusive recollections of the trauma may block the need of the bereaved to dwell upon and cherish the image of the deceased person. Witnessing violent death creates helplessness, numbing of emotional response and avoidance of any reminder of the event. “The mutilated image prevents reminiscence in tranquillity” (Hendriks et al, 1993). The hyper-vigilance, which occurs after trauma, leads to a pervasive fearful anxiety, which curtails the normal grief process.
Incomplete ‘grief work’ may increase emotional disruption triggered by memorial days and by encounters with objects or places associated with the dead. Unabated sorrow and yearning for the deceased lead to depletion of energy and vitality. In some cases it may even elicit suicidal ideations and behavior. ( Ayalon.1983, Ayalon & Lahad, 1992).
When death becomes ‘unthinkable’ and the pain of loss is ‘undiscussable’, coping with personal bereavement may be replaced by over-reaction, anxiety, shame and guilt. The lack of traditional mourning ceremonies in our society is another factor which may leave some people stuck in an unrelenting grief process (Van der Hart, 1987). As bereavement therapists we need special tools to help our clients overcome these barriers.
When is therapy needed?
The purpose of therapy is to acknowledge the pain and despair of the bereaved, while helping them to recreate the damaged whole and re-enkindle future-orientation (Ayalon, 1983). Mapping the expected response patterns of the individual’s mourning process can assist in distinguishing between ‘active coping’ and ‘pathological grief’, suggesting therapeutic help when the later occurs. By transmitting positive expectations for the gradual performance of ‘grief tasks’ (Worden, 1982) therapy increases the chances for coping and healing.
Therapeutic intervention is appropriate and even necessary when the bereaved seem to remain stuck in a transient stage between ‘what had been’ and ‘what might have been’. Being stuck between two worlds is analogous to the experience of refugees in a ‘transition camp’: The doors of the country they have been forced to leave are shut behind them, yet they don’t have access to their final destination. They are doomed to exist in some sort of ‘twilight zone’, in which they become listless and numbed in relation to the ‘here and now.’ This often breeds symptoms of depression and dissociation from familiar life patterns and social relations. It may also decrease ability to respond to family and friends, cause guilt and self-punishment, compulsive preoccupation with and idealization of the past, loathing of the present and loss of an orientation towards the future. Psychological guidance in the ‘twilight zone’ is like holding a torch in the dark. Such guidance may be found in the rich cultural arsenal of myth, folk-tales, poetry and fiction. The therapist must be well versed in this richness to be able to offer the appropriate metaphor that will trigger both identification and hope.
The significant role of bibliotherapy is to help create an optimal emotional distance between the severed emotional commitment toward the deceased, and the preservation of their memory. The ensuing release creates a space in which memory can be preserved in a story, be it the personal narrated story of the client (White & Epston, 1990), or a story told by the therapist Erickson & Rossi (1979)
Encountering death in narratives and metaphors
The process of secularization in western society, the loss of tradition and rituals and the dominance of ‘scientific’ thinking caused us to lose an appropriate and helpful way of dealing with death and death anxiety (Palgi, 1987). In response to these cultural deprivations, new ‘parting rituals’ are introduced into bereavement therapy. These are adapting healing and transitional rituals from non-western cultures for therapeutic interventions. (Van der Hart, 1988). Exposure to a large number of literary sources, ancient myths, traditional folk-tales, poetry, stories and metaphors provides us with a broad range of alternative mechanisms of coping in times of stress.
Narratives over generations centered on the two existential themes of love and death. These two eternal motifs are forever intertwined. Kubler-Ross (1981) coined this linkage by stating: “A grief over a loss is the price we pay for having the right to love and be loved.” Shakespeare preceded this by teaching us the “it’s better to have loved and lost, than not to have loved at all ” (King Lear), Love and death are presented in literature in endless forms, from the realistic to the imaginary and mythological, and even in all of these together. The Story transcends the boundaries of time and space (Campbell, 1988). It is especially true regarding myth and folk-tales, where death is a regular visitor, appearing countless times in many guises, with special emphasis on the life-cycle of birth-decay-rebirth & renewal. The unnatural elements featured in such myths capture the imagination and contribute to the metaphorical design of the unrealistic and experiential in the most convincing manner (Shenhar Alroi, 1984). Levi-Strauss (1969) discovered that myth, using symbolic language as coded messages, carries a healing potential for coping with life’s foreboding mysteries. Mastering these symbols grants us a kind of magical mastery over issues of life and death.
According to existential philosophy the existence of death enhances the importance of life (Yalom 1980). This point of view is well reflected in the following verses:
“If you strongly desire to penetrate the spirit of death
open your heart to know life
Because life and death are one
Even as the river and the sea are one”.
The anthropological point of view argues that one can grasp the continual flow of life-death-life by combining personal symbols and collective images (Estes, 1994). Such images created in historical and cultural context bestow meaning to life and comfort at a time of loss.
The metaphor – a bridge between internal and external realities
When direct confrontation seems impossible, therapeutic metaphors are welcome. Metaphors, being indirect symbolic communication one step removed from stark reality, create a kind of symbolic shield to protect us from the fear and pain involved in death. They provide a ‘safe zone’ for confronting the new bewildering experience of loss. The following story is an illustration of how a metaphor can serve as such a ‘shield.
Greek mythology tells us of Medusa, a monster who defeated all the Greek heroes who confronted her, turning to stone those who dared look her in the eye (Newman 1954).The horrible Medusa inflicted fear on people, who avoided facing her. This changed with the arrival of young Perseus, who devised a
special strategy to confront the mortal danger. Removing his shield, he examined the monster’s image reflected in its shiny surface, and without directly facing the creature – struck it to death with his sword.
Perseus, trying to avoid the lethal ‘eye to eye’ contact, replaced direct confrontation by a ‘reflected image’. Overtime Perseus’ model of dealing with dangers through their reflections was taken up by certain members of society such as the king’s fool, the prophet, the storyteller and the poet. They found their ‘bibliotherapeutic way’ , which enabled them to defy social taboos and express the inexpressible without getting punished, by using stories, jokes, fables and metaphors as a protective device. The ‘fool’ in Shakespeare’s plays, for example, confronts the mighty king with painful and unpalatable truths disguised as pranks. The Biblical prophet of gloom and doom is often saved from the king’s punishment or from the people’s wrath by clothing his messages in fables. Creative authors such as traditional storytellers and modern fiction writers are all protected by ‘licencia poetica’, e.g., ‘artist’s immunity’, which allows them to touch on taboo subjects. Equipped with the ‘shiny shield’ of symbolism, metaphor and fable they dare to reflect the various faces of death and at the same time escape punishment for breaking the taboo. Once people look at the various faces of death in the guise of a metaphor, they may be ready to deal with it candidly and courageously.
The word ‘metaphor’ is of Greek origin, meaning transfer from one container to another. Functioning as a liaison, the metaphor bridges between logical-conscious strategies of data processing associated with the left hemisphere of the brain and emotional-experiential-unconscious processing associated with the right hemisphere (Watzlawick 1978). By connecting various perceptions that are normally unconnected, metaphoric images create transformation of meanings and spur creativity and innovation in our dealings with taboos. When grief is overwhelming and blocks communication with the helpers, a carefully chosen metaphoric story can bridge between inner and outer reality. It can open doors for discovery and insight. Many therapists, among them Barker (1985), Erickson & Rossi (1979), Kopp (1972), Lankton & Lankton (1989), Miles & Crawly (1986), Van der Hart (1987-1988), to mention but a few, have already discovered the use of stories and metaphors as effective tools for changing self-perception and enhancing the chances of recovery.
The therapeutic use of metaphor shifts the figure-background relationships between the rational and irrational mental processes (Wiztum & Van der Hart 1988). Metaphors enable us to penetrate through worn-out phrases , old labels and stereotypical roles, to discover a hidden dimension of internal resources. An appropriate metaphor will make the familiar look strange and exciting. It elicits curiosity and yet helps maintain a safe distance from the feelings of personal vulnerability. By this virtue it will ‘fool’ our reluctance to touch upon painful issues. At the same time the metaphor makes the strange seem familiar. It creates a feeling of intimacy which allows us to identify with a hero, a theme or a problem presented in the story. Audience of metaphoric stories feels safe and enriched, because the metaphor bypasses their ‘inner critic’. One is exempt from rationalizing inner feelings like fear, fury, helplessness or misunderstanding. By dealing with the imaginary representations of these processes and their solutions on an imaginary level, the metaphoric story conveys a message effectively. In other words, the metaphor bridges between internal and external realities. It reconciliates the contradictions aroused by conflicting feelings and contains the tensions between the familiar level of reality and unmapped internal pressures. According to Rilke (1967), “in a world reflected through metaphor, the wall dividing life and death disintegrates”.
Which story to choose for therapy?
The story most suitable for therapy is the one that simultaneously transmits on many levels. It relates to the person’s internal world and dreams, and legitimizes his or her ambivalent emotions. The effective story transcends the boundaries of the rational and creates a direct link to the internal world of the reader or the listener. The therapeutic story, gleaned either from traditional oral stories, from religious and ritual myths or from children’s tales in modern literature, appeals to various layers of the personality. It carries both hidden and explicit implications, which register without the listener’s awareness. A good story is can directly and indirectly influencing moods and states of minds, attitudes and conducts. One can apply personal significance to the story, depending on his/her situation and needs. The therapeutic value lies in the fact that clients may find a solution in a story that seems to them tailored for them and their unique internal struggles. This applies to the story’s external aspects, where it is possible to find comfort in the images of the explicit context as well as to deeper implicit layers. It is in the more subtle dynamics of the story that the listener can find an echo to his or her perturbing internal concerns. Those concerns such as facing our own death, loss of loved ones, traumatic massive death such as in disaster and massacre, and facing the Killer within may otherwise seem misunderstood or unresolved.
The search for the meaning of life and death may lead us to explore old wisdom stored in myth, in poetry or stories. We may even find in a story some explicit or implicit answers (Frankl, 1988). Even those who are caught up by unrelenting grief may receive mental and spiritual support from reading or hearing a story that touches the roots of their sorrow from the safe distance of the metaphor.
A healing process may occur when the expressive means, the plot, the characters and the symbols of the story match the internal needs of the reader. Such a match may prompt the bereaved to confront their withdrawal from the world and revalidate their bonds with others. This healing process often requires active guidance of the biblio-therapist, who can transform the metaphoric power of the story into active learning and bring about a change of attitudes.
Using stories and metaphors as biblio-therapeutic treatment of pathological grief enables us to break the blockage of fear and denial and help the client call things by their real name. Naming is a powerful symbolic act which helps regain control over one’s own world. in this way the first created person, Adam, gained control over his new and unfamiliar world by naming all the animals in the Garden of Eden.
Text and Task / a multidimensional method
Bibliotherapy is coping-oriented, interactive and creative. It combines a chosen text ( oral or written story, poem, non-fiction etc.) and a prescribed task (Ayalon 1979; 1992; Gersie & King, 1990). While the text is carefully chosen to metaphorically reflect the different faces of death, the complementary therapeutic tasks, performed by the listeners either individually or in groups, mirror the psychological coping mechanisms employed in the various stages of grief and bereavement.
There is a richness of death metaphors to be found in orally transmitted ancient healing stories and myths (Gersie,1991), in modern fiction (Naveh, 1993; Fleman & Laub, 1990), in poetry (Leedy, 1980 ) and in children’s literature (Cohen, 1992).
The storyteller-therapist, using a backdrop of familiar scenes and images, is building a semblance of a stable and secure ‘transitional space’ (Winnicot, 1971), into which elements of conflict can be safely introduced and handled. The story, which metaphorically represents the ‘core’ issue, must be anchored in a certain cultural and ethical context. It becomes a ‘joint space’ for both therapist and client have to enter the ‘magic world’ of the story and its symbols.
The therapeutic process supported by the story follows the story’s structure. The tasks chosen by the therapist draw attention to such explicit and implicit motifs as are deemed essential for the clients’ issues. Thus, although people may have a heavy load to carry they find opportunities to explore, re-arrange and discard that which is no longer needed and re-narrate their story through symbols, images, drawing, moving enacting and writing.
Therefore there is always a threefold therapeutic interaction involving the following elements,
which affect and transform each other.
The therapy follows the story-structure step by step (Gersie & King, 1990):
- A problem is presented – e.g. encountering death .
- The distress or the challenge are formulated, such as mortal fear, grief,
- Various solutions are attempted, via verbal and non-verbal modes ofexpression, guided imagery, cognitive problem solving, sharing with othersor ceremoniesand rituals.
- A symbolic or metaphoric solution is found.
- Some level of integration is achieved.
- The entire process is reflected upon.
The choice of tasks:
The audience, whether a group, a family or an individual, participate in performing the prescribed tasks, thus composing parallel stories to the one which is told. The sequential introduction of tasks by the therapist creates a ‘structured but open-ended’ process. This structure provides a context of security and trust, allowing participants to fill in the gaps with their own images, projections and experience. The tasks ‘paraphrase’ the developmental processes and solutions of the problems hinted in the story. They are designed to facilitate the personal expression and trigger memories, knowledge, wishes, and expectations for the future. The tasks create a ‘potential space’ (Winnicot, 1971) within which new alternatives can be negotiated. They also encourage a dialogue on two levels: interpersonal dialogue (between the therapist and patient or among members in the therapy group), and intrapsychic dialogue (between the different inner voices of each member). The bibliotherapeutic process invites the listener to actively participate in weaving the story-plot, while maintaining a protective distance from personal unresolved painful issues.
Various bibliotherapeutic methods use different types of metaphors to access the prime sensory experiences of touch, sight, hearing, thinking and behavior. Therapeutic communication is based not only on verbal metaphors but on concrete metaphors as well, such as objects and actions. We use physical metaphors in body position and movement, visual metaphors in painting, sculpture and guided fantasy, as well as verbal metaphors in play, drama, and storytelling.
The story as a journey
The therapeutic process starts as a reconstruction of the ‘journey’ imprinted in the story’s structure, paralleling the listener’s inner journey from the familiar and conscious awareness into the unknown depth of the soul. Events and encounters in the story represent life’s turning points and crises. Along the metaphoric journey participants may seek answers to personal queries, such as arise in the encounter with death, loss and grief:
- a) The protest queries: ‘why?’ or ‘why me?’, ‘why now?’ represent the inability to accept a loss. It may have been the initial reason for embarking on this journey. It may have been a desperate attempt to bring back what was lost, as represented in the myth of Orpheus, who descends to hell in a futile attempt to retrieve his dead Euridice.
- b) The disappointment: “I didn’t have a chance to say good bye”. Sudden and violent death caught us unprepared, severing relationships, leaving numerous things unsaid, undone.
- c) The ambivalence: it is hard to contain and reconcile conflicting emotions toward the deceased, such as yearning and anger, guilt and blame. Quite often the negative feelings will be stifled by social taboos which don’t allow blatant expression of negative emotions towards the deceased, or by social norms that regard the spontaneous expression of agony as a sign of weakness. But, as the story triggers emotional release of pent-up feelings, it creates an opportunity to transform the negative images to positive ones. Only when these conflicting emotions receive legitimacy and support from the protective guise of a story, can the ‘journey’ evolve into a healing experience.
- d) The search for meaning: A story which accounts for the circumstances of a loss or tells us how a disaster occurred, may bring a symbolic order into the chaos, some kind of intentionality and meaning to the arbitrariness of the personal crisis.
When the story-therapy creates a symbolic transformation or reorganization in the perception of the bereaved, it may also affect changes in the reality of existing social and family ties, since “the changes in our subjective experience are the source of our responses in reality” (Rowe, 1987).
Surprise, security and shared experience as therapeutic elements in bibliotherapy.
Surprise , which is embedded in the story and in the tasks, makes it impossible to foresee the next step of the process, thus preventing repetitive and rigid defeating behavior patterns and helps bypass resistance to change. Security derives from the clear structure of the story, from it’s authoritative implication and trusting the ‘storyteller’ who probably knows what he or she is doing. In order to enhance this trust the therapist guides the listeners to create a metaphoric ‘security symbol’, which is often non-verbal, signifying their coping resources by painting, modelling or sculpturing. This painting or model become a ‘transitional object’ and acquires a protective role in times of stress. Since the symbol is representation of subjective experiences and consciousness state, therefore any change and evolvement in the symbol effects a change in the client’s experience (Van der hart , 1988).
Sharing experience with other members of the therapeutic group or the family group is embedded in the process.. The group of ‘shared fate’ serves as a micro-cosmos for reality testing, giving and receiving credibility to each story, reflecting the emerging images in a variety of ‘mirrors’.
Putting it all together:
engaging in a metaphoric story-work to deal with death
“Structured” process vs. “open” process:
The ‘parting ritual’ conducted in the storytelling must be structured, and yet suitable to the internal world of each one. The bridging over contrasts between objective structure and subjective openness is created by the special technique of the ‘open structure’. The structured elements are composed of clear directions for the bibliotherapeutic process, such as presentation of story segment, imposing tasks (writing, painting, motion, drama, role-play, interpersonal communication and sharing with others). The open elements are represented by the freedom granted to the participant to listen to his/her feeling and express them. In this way idiosyncratic processing of the story is made possible and adapts to personal needs. There is no attempt to create a common denominator for an ‘objective’ comprehension of the story.
Six stages of story/task method
The following is a step by step description of the bibliotherapeutic process.
A). The primary stage – ‘invitation’
This serves as a metaphoric ‘therapeutic contract’, by which the therapist invites the ‘inner child’ to join the magical journey of the story. The listeners’ consent depends upon their trust in the storyteller-healer, and their willingness to be directed. In the therapeutic metaphor the therapist may appear as a guide for a journey (man or beast), as a detective, an archeologist etc. The therapy is symbolized by an adventurous journey, pilgrimage, mountain climbing, deep water diving, prisoner’s release, searching for hidden treasure or embarking on a difficult mission to bring the light, fire, water or any other vital element. At this stage the metaphor remains untouched, without any commentary.
B). Preparatory stage
It summons the brain’s right hemisphere to take over by introducing semi-hypnotic suggestions called ‘set induction’ (Gersei & King, 1990). Their purpose is to encourage (or facilitate) the transition from logical rational, skeptical, linear and dogmatic thinking to eliciting images, visual representation and verbal associations. This way it may reduce somewhat the rational control and self-consciousness. At this stage, the clients are summoned to respond to ‘key words’ chosen by the therapist, high lightening chosen motifs in the impending story. Nonverbal associations are produced in various ways: by using line, shape or colour, painting and doodling in the non-dominant hand, movement with or without music, relaxation and guided fantasy.
C). The absorption stage
Now comes the ‘story’, listened to in a state of consciousness which is ‘trance’-like. Relaxation reduces the impact of external stimuli and opens up the inner ear for listening to inner responses, without too much fear of internal or external censorship (Erickson and Rossi, 1979).
D). The contact stage – the interaction
At this stage the therapist introduces the various tasks, assisting the listener to take an active role in the story. The tasks activate the listeners in various ways by inviting them to step in to the shoes of one of the characters or the objects ( may it be a tree, a beast, an objector a person) and give it a voice by playing a role, write a letter to or from this chosen character, creating a dialogue with the characters and re-narrate the story-plot. As the participants fill the gaps in the story with their own images and life experiences they come in contact with their blocked emotions and other inhibitions. This activity triggers internal coping mechanisms, such as identification, projection and introjection. By interacting on various levels of consciousness with the story’s character, participants may have a corrective experience that transforms old obstructive attitudes, responses and emotions. As they achieve comprehension of the dynamics moving the story characters, they may gain better self- awareness.
During all this, the therapist serves the role of a mediator or a guide, providing road signs for reorientation of one’s problems and supporting participants to overcome obstacles and hindrances.
The accepting atmosphere created by the therapist frees the participants
from adherence to imposed norms. They can operate in a ‘transitional space’
in which old emotional prohibitions are permeated. This space bridges between the fantasy world to the real world (Lumsden, 1995). The participants are free to express true emotions disguised in the role of the fictional character (Jennings, 1990). At this stage we can expect an eruption of suppressed emotions and outburst of tears that are saturating and purifying. This abreaction, the direct expression of pain, that has been equally recommended by old sages and modern healers, is echoed by Shakespeare (1925):
“Give sorrow words
the grief that does not speak
whispers overfraught heart,
and bids it break”.
(“Macbeth” IV act scene III)
We thus receive ‘permission to cry’ by the reassurance of the poet-therapist that the expression of emotions does not discredit one’s normal standards of coping and endurance.
Illumination follows by discovering new meanings of the authentic story, as each participant unfolds his or her new narrative,
The final stage anchors the new (healing) story in reality, connecting the physical, cognitive and emotional channels, the images and the beliefs, through active sharing and reflecting of the support group. The magic is fading away, and the therapist provides reality based reinforcements.
The therapeutic use of stories for confronting separation, loss and
death has become our trademark in treating individuals, families and groups. The special needs of the target population determines the process, while the structure remains stable.
A story about leave-taking:
This lengthy discussion leads us directly to the demonstrated encounter with a story, most appropriate for dealing with death, whether one’s own or another’s.
The following story demonstrates the therapeutic use of story-work in confronting separation from dear ones. The therapeutic purpose is dictated by the needs of the group or the individual in therapy. It can serve young people studying the life cycle, divorced families, bereaved parents, children who were exposed to death in their close surrounding, the elderly or the terminally ill. Likewise we have found this particular story suitable for training therapists working in emergency situations and dealing with survivors of death trauma.
Parallel story-line & therapeutic process:
The therapeutic process starts with warming-up set-induction, as an invitation to join in, suspend criticism, participate and share. This introduction creates the therapeutic contract. Participants ae asked to respond to three to five ‘key words’ suggested by the therapist, using color, line and shape. These ‘key words’, chosen very carefully by the therapist, grant the story an invisible direction. In the following example five words were chosen as most conducive for a ‘set induction’, leading from the external perception to the internal experience:
fall ; unknown; ending; parting; alone.
The associations, which serve as a set-induction for the ‘story-trance’, are shared in pairs. This sharing is intended to enhance mutual trust, enhanced by relaxation.
The story is told in a soft and quiet voice, to assure absorption in a ‘trance’ like state of mind.
The following story by Felix Saltan (from “Bambi”,1931) touches indirectly and metaphorically on the questions of life and death. In summing up, the therapist delineates the process by repeating key sentences like those that are emphasized in the story. The therapist can choose to leave the process within the metaphor, and let the implications sink down.
The story begins…..
The leaves were falling from the great oak at the meadow’s edge. They were falling from all the trees. One branch of the oak reached high above the others and stretched far out over the meadow. Two leaves clung to its very tip.
“It isn’t the way it used to be”, said one leaf to the other.
“No”, the other leaf answered. “So many of us have fallen off tonight . We’re almost only ones left on our branch”.
“You never know who’s going to go next”, said the first leaf. “Even when it was warm and the sun shone, a storm or a cloudburst would come sometimes, and many leaves were torn off, tough they were and still young. You never know who’s going to go next”.
“The sun seldom shines now”, sighed he second leaf, “and when it does it gives no warmth. We must have warmth again”.
“Can it be true”, said the first leaf, “Can it really be true, that others come to take our places when we’re gone, and after them still others, and more and more?”
“It is really true”, whispered the second leaf. “We can’t even begin to imagine it, its beyond our powers”.
“It makes me very sad”, added the first leaf.
They were silent a while.. Then the first leaf said quietly to herself, “Why must we fall?..”
The second leaf asked, “What happens to us, when we have fallen?”
“We sink down…”
“What is under us?”
The first leaf answered, “I don’t know, some say one thing, some another, but nobody knows”.
The second leaf asked, “Do we feel anything, do we know anything about ourselves when we’re down there?”
The second leaf answered, “Who knows? Not one of all those down there has ever come back to tell us about it”.
They were silent again. Then the first leaf said tenderly to the other, “Don’t worry so much about it. You’re trembling”.
“That’s noting”, the second leaf answered, “I tremble at the least thing now. I don’t feel so sure of my hold as I used to”.
“Let’s not talk any more about such things”, said the first leaf. The other replied, “No, we’ll let be. But what else shall we talk about?” She was silent.
Night fell. The leaf felt that there was so much left to say. There was a lot she wanted to say to the tree. But the tree was asleep and she hesitated to wake it up so she decided to write a letter to the tree.
Presented are asked to write the leaf’s letter to the tree. The letters are collected and redivided randomly. Each participant receives a letter, opens and reads it. After reading, each participant is requested to change roles and write a reply from the “tree” to his /her ” particular “leaf”. The letters are collected again and redivided, so each “leaf” receives the reply of his/her “tree”, reading it in silence. The storytelling then continues:
“Which of us will go first?”
“There’s still plenty of time to worry about that”, the other leaf assured her. “Let’s remember how beautiful it was., how wonderful, when the sun came out and shone so warmly that we thought we’d burst with life. Do you remember? And the morning dew, and the mild and splendid nights…”
“Now the nights are dreadful”, the second leaf complained, “and there is no end to them”.
“We shouldn’t complain”, said the first leaf gently. “We’ve out-lived many, many others”.
“Have I changed much?” Asked the second leaf shyly but determinedly.
“Not in the least”, the first leaf assured her. You only think so because I’ve got to be so yellow and ugly. But it’s different in your case”.
“You’re fooling me”, the second leaf said.
“No, really”, the first leaf exclaimed eagerly, “believe me, you’re as lovely as the day you were born. Here and there may be a little yellow spot , but it’s hardly noticeable and only makes you more handsome, believe me”.
“Thanks”, whispered the second leaf, quite touched. “I don’t believe you, not altogether, but I thank you because you’re so kind, you’re always been so kind to me. I’m just beginning
to understand how kind you are”.
“Hush”, said the other leaf, and kept silent her-self for she was too troubled to talk any more. Then they were both silent.
Participants are asked to write an ending to the story, then share in the group their personal narratives. In the sharing.
In lieu of an epilogue, we will bring a dialogue between the ‘leaf’ and the ‘tree’ as written by two participants. (The dialogue is quoted with the writers’ consent).
I wanted to tell you that it’s not worth it to spend the time left to us in thoughts and deliberations about the unknown world down there. Maybe it’s better to use the moments left to stay here together, to try and enjoy as much as we can, to observe the wonderful universe. There are so many views that I wanted to see and things that I wanted to experience, and this gives me the power to hold you tight when a strong wind is blowing.
I would be very glad to know that you will remember one special leaf that has been here and is no here no more, and that leaf is me. Now I believe that you really won’t forget me and I can fall feeling much better.
I understand from the tone of your words that you are leaving me with a light heart and a good spirit. Well, it is a blessing, and I will send you away in the same good feeling. A leaf goes and a leaf comes , a tree goes and a tree comes, and blessed be the one who has used his time well and with satisfaction, because than the sadness of the separation is sweet and it does not necessarily depress but can be uplifting.
With friendly feeling
Bibliotherapy as a leave-taking ritual
The ‘therapy though story’ process described here has much in common with symbolic ‘parting rituals’ . Van der Hart (1988) points this out by saying that “as-if” imaginary parting’ is as effective in the grief process as a real parting experience, because both raise similar mental responses. Both enable the working trough of mourning and the starting of the rehabilitation stage, if we actively take part in it, not only as spectators.
The mediating concept of ‘symbolic identification’ is the key to the bibliotherapy process. The act of writing the letters moves the audience from being passive listeners into being active participants. Letter-writing is often used for completing an interrupted ‘parting’ ( e.g. to say the final “good-bye”), to settle ‘unresolved matters’ or to change the writer’s attitude towards the deceased. The fact that the letter is not meant to be sent relieves the writer from possible apprehension. To quote Bergman & Viztum (1987): “For many people it is much easier to express in writing emotions of pain, anger and disappointment rather than express them in other ways. In these cases the writing transforms into a corrective experience for the patient.
letter writing in bibliotherapy has yet another dimension. The letter and the reply are written under the ‘protective shield’ of the metaphor. Writing in the ‘role’ of the narrative character diffuses the defenses and reduces anxiety. The letter-exchange triggers two parallel communicative processes: an interpersonal empathic dialogue and an intrapsychic soul searching dialogue. In this process, attention and adherence to internal voices occur, promoting the discovery of hidden coping resources.
The therapeutic process os ‘story text & task’ is an illustration of the broad package of bibliotherapy for facing death and bereavement “On life and Death (Lahad & Ayalon, 1994). This package contains guidelines for the appropriate choice of metaphoric stories according the client’s needs, their developmental age and presenting problems. Stories are suggested as a preventive preparation for encountering death in the life-cycle, specified as non traumatic death. This is particularly valuable for children and adolescents, whose perception of death is limited due to age and life experience. The issue of denial is dealt by presenting stories that deal with one’s own death indirectly and metaphorically. Issues of traumatic death such as suicide (Ayalon & Lahad, 1992) war and terror victimization (Ayalon & Lahad, 1990; Ayalon & Horowitz, 1996), domestic violence and separation (Ayalon & Flasher,1993) emerge in ancient stories and new tales and are reflected in the specific tasks, which present a potential for positive, projective coping courage and hope.