Can poetry be good for our health?

Rime of the modern medicine man

Can poetry be beneficial for human health, or is the idea just literary snake oil? In this article written for one of his earlier blogs, Mark Cantrell explored the idea of its positives

POETRY might be food for the soul, but it is also a therapy that can help people's health and well-being, according to American poet, therapist and teacher John Fox.

In September [2005], Fox will be coming to Yorkshire to share his thinking and his techniques into this esoteric art. As with most things poetic, it is rooted in the personal. When he was 18, Fox lost a leg below the knee and he says it was poetry that gave him a 'life line'. Since then, he has deepened his exploration of poetry and creative arts as a mechanism for assisting the healing process - both physically and mentally.

Today, he is the president of the US National Association of Poetry Therapists and a certified poetry therapist. He also teaches and has authored many books on the subject.

"Poems show us that our sensitivities are of great value," he says. "Writing allows us to discover how vulnerabilities and strengths can co-exist even thrive together and be recognised as one. At times, poems can reveal deep understanding and compassion. Poems can guide us through rough times and sometimes transform us at profound levels.

"There is magic in language that poets, children, mystics, lovers, revolutionaries, [and] indigenous peoples in particular have had access to for aeons. And their lasting words have inspired others... There is more to what poetic language does for you. When you write with feeling and expression, it is a way to bolster your health."

There is something almost 'shamanistic' to the expression of such sentiments, so little wonder then that he has been called a 'medicine man' by a Navajo friend. But writers are a colourful breed, and there is no reason why those who work in healthcare should be any different. After all, anyone who has spent time around writers will hear the inevitable anecdotes about writing as a kind of personal therapy. Fox is taking it to a deeper conclusion.

 In September, he will present a seminar and workshop at the recently established Centre for Citizenship and Community Mental Health, part of the School of Health Studies at the University of Bradford. It is aimed at both experienced and beginning poets and writers, as well as people involved in healthcare, and those involved in spiritual and educational professions.

The Centre joins a growing list of organisations and groups that have desired to explore the possibility of using poetry as an added means of instilling well-being. He has conducted workshops for such institutions as the Harvard Medical Institute at the Mind/Body Institute, Stanford Medical School, Shands Hospital at the University of Florida and the Royal Free Hospital in London.

Additionally, he is an adjunct professor at the California Institute of Integral Studies in San Francisco, and teaches at the Graduate School of Psychology at John F Kennedy University, Berkeley, California and at the Institute for Transpersonal Psychology in Palo Alto, California. His books on the subject include such works as Poetic Medicine: The Healing Art of Poem Making.

The event in Bradford was organised by Lapidus (North Yorkshire), with the assistance of Phil Thomas, who has worked for 25 years as a psychiatrist before becoming the senior research fellow at the Centre. 

"There has always been a tradition of medicine and the humanities," he said. " To be a doctor of medicine is to exist in a twilight between the dazzling light of science and the dark mysterious world of the human heart. There is for example a journal called Humanities and Medicine. There are departments of literature and medicine [such as at] Durham University. The John Fox event is important because it will draw attention to academic staff the value of creative writing in a way that will, I hope, mean that they will want to include it in the courses taught here for nurses and other professionals."

The Lapidus group is concerned with exploring the use of literary arts in personal development and healthcare. Many of the members are themselves healthcare professionals who work with creative writers, or are themselves creative writers.

Regional co-ordinator Kate Evans said: "Lapidus has strong links with the US National Association of Poetry Therapists (NAPT) and as an organisation we welcome their speakers and workshop leaders. John Fox was coming to the UK and he offered to come and do events with local Lapidus groups. We were very quick to take him up on his offer, because of all the work he has done in developing the field of poetry therapy.

"We felt we had a lot to gain from working with someone like Mr Fox, who is both a practitioner and an academic looking at how poetry and writing poetry can assist people to a greater sense of mental well-being and self-awareness.

"Of course there are many people in the UK who have expertise in this field, but there is nothing as yet in the UK to compare to the NAPT and the training that it gives. Se we felt we had much to learn from the NAPT president. This is an evolving field, and we are always interested in learning from the experience of others and in drawing on examples of best practice."

Thomas added: "These days, medicine and psychiatry are dominated by science and technology. This means that more basic human values are overlooked. Of course people want the benefit of science when they are ill or distressed, but they need much more than that if they are to be healed. In general, health professionals today are not encouraged to reflect on themselves, their lives and their experiences in relation to their work. There is no better way, in my experience, of becoming able to reflect on your own life experiences than through creative writing. Edward Albee, the American playwright [has] said that he couldn't write about his characters unless he cared about them. The act of writing creatively, or for that matter reading serious literature and poetry, is fundamentally an ethical process because it encourages one person to step into the world of another person. This is something we all need to do more."

A greater need for empathy between people is indeed something that can benefit people beyond healthcare, and it is one of the many factors that those involved in the event - and the field - are hoping to promote during Fox's visit and beyond.

At the time of writing, the workshop is fully booked, but places remain available for the seminar. It takes place 24th September 2005 between 11 am and 3 pm and is promised to be in interesting and inspiring event.

The final word goes to Fox: "Poems stir us to wake up. There is aliveness and emotional honesty in poetic language. There are messages and clues in poems about where we have been, where we are and where we might go - not only individually but in our humanity."



This article was originally written for - and published on - one of the author's earlier blog sites. It appeared circa August 2005.

Remembering eco-towns

The ego has landed

Back in 2008, eco-towns were presented as something of a recipe for a national green makeover, but as this article by Mark Cantrell from a 2008 edition of Northern Housing suggested, maybe it was more a case of an egotist's red herring

EGO is a major driving force in politics, so it was richly ironic when communities secretary Hazel Blears suggested to the Fabian Society that the Poundbury model village in Dorset was the creation of a royal ego-trip. Only the day before, her ministerial minion Caroline Flint had announced the Government’s shortlist for 10 entire eco-towns.

By any measure, eco-towns up the ante. Not only must developers and planners, architects and builders, housing associations and local authorities work together to create sustainable communities where people want to live and work, they must also create the very model of environmental living.

The buzzwords are many and familiar: ‘sustainable’, ‘zero carbon’, ‘affordable housing’, ‘innovative’ and so on. Flint’s shortlist contained 15 locations, which will compete to put the most flesh on the eco-buzzwords, in the hope of winning through to become one of the 10 finalists. Before that decision arrives, however, they will need to run a hurdle of public consultation, local authority planning scrutiny, and the stern appraisal of Flint’s panel of experts.

Between them, the eco-towns will provide around 100,000 new homes, with 30 per cent of those labelled ‘affordable’ for people on lower incomes. Each settlement will consist of between 5,000 and 20,000 homes and go towards reaching the national jackpot of three million new homes by 2020, including infrastructure to make them real settlements and not just barren dormitories. Or so the theory goes.

None of this is about ego - no, really - but a concerted drive to meet the twin challenges of climate change while ensuring an adequate supply of houses. These will be the first new towns built from scratch since the 1960s, which in a roundabout way brings us to Blears’ jibe at the Prince of Wales and his Poundbury development.

Presenting a speech to the Fabian Society, she lauded the garden-suburb movement of old: “I personally have more time for this ideal for urban living than I do for the utopias built for the workers by industrialists such as Saltaire, Bourneville, or Port Sunlight, which I have always felt owed more to paternalism and the aggrandisement of the benefactor, than real concern for residents. And you couldn’t get a drink!”

It’s worth noting, of course, that over the last 10 years, the Government has gained something of a reputation for a paternalistic streak of its own. Certainly, it has come in for such criticism in the past over aspects of its housing policy, as Blears’ predecessor Ruth Kelly once acknowledged in a speech to the Fabians.

“If I were being cheeky, I might add Poundbury to the list,” Blears added. In an equally cheeky vein, it might be said that prime minister Brown is himself famously austere on the matter of drink, as middle class wine drinkers and the brewing industry are learning to their cost. While not a temperance advocate as was the textile baron Titus Salt, Brown’s concern over the moral well-being of modern Britons does appear to echo that of the 19th century industrialist’s views on the well-being of his workforce.

By the standards of the day, he was a philanthropist, building the model village of Saltaire to rescue them from the slums that typified the era, but there was nothing utopian about the community he built for his mill workers. Quite the opposite, one might say, given that by today’s standards it was also something of a personal fiefdom-come-tyranny where practically every aspect of the workers’ lives was controlled.

Famously, there were no pubs in the village. Salt wanted to protect his employees from the evils of drink for both their physical and spiritual well-being - and doubtless ensure they worked more efficiently “down t’ mill”. This was one of a raft of rules, postered across the village and the mill, in a manner almost reminiscent of 20th Century totalitarian systems, though he forewent the portraiture.

By the same measure, he clearly wanted to protect his workforce from the ‘evils’ of socialism and trade unionism, for there were limits placed on the number of people who could gather. Perhaps in modern parlance, this could be regarded as a measure to protect against anti-social behaviour; others might perceive an infringement of the right to free assembly. Well, this was the 19th Century - the rights of freeborn Englishmen hadn’t quite trickled down to the working classes.

So where does all of this fit in with the Government’s eco-town proposals? Hopefully nowhere. However, the increasing use of new local authority powers to levy on the spot fines for, say, littering, points to the potential for life in eco-towns to be hideously regulated from on high. It has already been mooted that the new towns will be built to discourage car-use. Furthermore, cars will be limited to 15mph speed limits.

High standards of design, planning and construction are expected of these new urban enclaves to achieve the desired outcomes. So, can the lofty goals of these brave new eco-towns be realised on the basis of physical environment alone, or must the future inhabitants be corralled by regulation and by-law - to protect themselves and the environment from human fallibility? The utopia of the few is often the dystopia of the many.

Though the eco-towns were warmly welcomed by the TCPA, and in a qualified manner by the CPRE, overall the welcome has been somewhat lukewarm, where they haven’t provoked outright hostility such as among the residents living nearby.

The Royal Town Planning Institute (RTPI) has warned of the dangers of creating “soulless Stepford Wives suburbia” if the new eco-towns aren’t linked up effectively with existing communities. Less colourfully, but in the same vein, this concern was echoed by RICS which warned there was a risk of creating ‘isolated pockets of housing’ that will undermine any environmental benefits by forcing a reliance on cars.

“The Government’s eco-town proposals may well provide an environment where new technology and designs can be road-tested on a large scale, however we must keep our eye on the bigger picture,” said Stewart Baseley, chairman of the Home Builders Federation (HBF). “Even if all the shortlisted locations were developed, the homes built would only comprise less than five per cent of the three million homes we need to build by 2020. Local planning authorities and central government must avoid the danger of eco-towns becoming an expensive distraction from the core need to provide the right number of homes in the right places.”

The Federation of Master Builders went further, calling the whole eco-town premise a “red herring”. “Building brand new eco-towns outside existing settlements is a really bad idea when there are over 650,000 empty homes in England alone, all ripe for re-fitting with green technologies,” said spokesman Brian Berry. “If the Government is really serious about sustainable settlements the better solution would be to develop a patchwork of hundreds of smaller eco-projects, but the Government seems to think it always knows best.”

Knowing best is a hallmark of the kind of nineteenth century philanthropy Blears derided in her Fabian speech, which rather brings things back full circle. She might have decried utopianism, but on the scales of self-aggrandisement then old man Salt, or Prince Charles for that matter, are surely both dwarfed by the scale of the Government’s own self-aggrandising ‘ego-towns’.

First published in Northern Housing magazine, circa April 2008. It was subsequently re-published on the Housing Excellence website, 20 May 2008.

Nationalisation, privatisation and the future of social housing

Rock and Orr

Labour's Caroline Flint started her brief term as housing minister by making herself popular, writes Mark Cantrell

First published in the February 2008 edition of Northern Housing

Caroline Flint MP

THE word was nationalisation – cue the shudders of horror and the howls of outrage, for this is the bright and bountiful 21st Century, not the shabby and fashion-challenged 1970s, so how can it be that this Jurassic Policy can be heard a thundering across the landscape? Something has gone horribly wrong.

No, this isn’t the saga of troubled Northern Rock, the Newcastle-based bank that has, so to speak, metaphorically defaulted on its mortgage and has been expecting the Government to pay off its debts and leave it in possession of the keys and the deeds.

It was in the arena of social housing that this particular invocation of the ‘N’ word caused paused for thought and the consideration that something is afoot.

David Orr, chief executive of the NHF, shot the word across the Government’s bows in the course of the argument raging over the Housing & Regeneration Bill that is slowly being crunched through the Parliamentary legislative procedure.

The word nationalisation, with the strength of feeling it invokes, is clearly a testament to the outrage and the deep felt concerns of the social housing sector to proposals drafted in the Bill – that it is alleged will effectively curtail the independence of housing associations and turn them into de facto agencies of state.

It’s not just the sector’s independence that is under threat, the organisation believes, but also the Government’s own targets for the delivery of millions of new homes by 2020. In short, the strategy to solve the housing crisis is in danger of becoming unravelled, according to these concerns.

“We are very supportive of the Government’s commitment to tackle the nation’s housing crisis and housing associations are keen to do whatever they can to respond. However, we are shocked that the Housing Bill, as it is currently drafted, would create a real danger of associations effectively being nationalised,” Orr said.

Some of the NHF’s key concerns are that the Bill, if passed as is, will grant the secretary of state the power to direct the regulator to set standards for housing associations; the new regulator may regulate non-housing activity, leading to the stifling of innovation and flexibility; and the regulator may then intervene because standards have not been met rather than because there is mismanagement or misconduct.

In that view, then, regulation will become an effective mechanism of direction, leading to central Government to have a more direct and intimate involvement in people’s everyday lives in their own communities – dare one suggest not merely nationalising housing associations but nationalisation of neighbourhoods too?

Whispering mouths of conspiracy have inevitably suggested that the amendments are deliberate, but the NHF says that many of its member organisations have received private assurances that the problems are the source of badly written draft clauses and are therefore unintentional. However, the organisation remains concerned that this ‘poor wording’ has been left to carry. Conspiracy by cock-up?

“Whether or not poor drafting is to blame, the fact is that we have yet to see action to correct the problem,” said the NHF’s assistant director of neighbourhoods, Helen Williams.

“Hundreds of Government amendments have been tabled so far, but none seek to seriously check the level of state control. We are delighted that committee members have pressed the minister Iain Wright to look again at whether the Bill pushes housing associations into the public sector, but the regulator still retains a vast amount of control over the activities and constitutions of independent organisations.”

The Bill has completed its House of Commons committee stage; the next key stage will be the Commons report and Third Reading, expected early next month. The lobbying and the future over this issue is set to continue.

Housing associations are not the only ones to be disgruntled over the Housing & Regeneration Bill.

The NHF’s longstanding thorn, the Defend Council Housing (DCH) campaign has also taken a stance against the Bill, although from an entirely difference angle. Calling for tenants and trade unionists to lobby Parliament earlier this year,Austin Mitchell MP, a vocal supporter of the campaign, said: “The Bill, as it stands, continues the discrimination against council housing. Profit making landlords can apply for Social Housing Grant. But councils cannot unless they set up arms length companies. Why? Councils are being cajoled and bribed to put public land into public/private partnerships (Local Housing Companies) that will build private – not council – housing...This all falls a long way short of the ‘warm words’ for council housing we heard [last] summer from Ministers, would-be Deputy Leaders of the Labour Party and the Prime Minister himself.”

The NHF and DCH have, of course, long been sparring partners. The DCH campaign has campaigned against LSVT to create new housing associations, and has railed against what it says is privatization. This is something that has been vociferously denied by the NHF. There’s an inherent irony, then, to Orr’s invocation of the spectre of nationalisation.

So, just to stir the conspiracy pot a little more, do the controls inherent in the Bill represent not a stand for ‘nationalision’ of the housing association sector, but a driving force intended to push the larger associations into the private sector?

To some of its critics, after all, Brown and Company and not so much unreconstructed socialists, as Neo-Liberal privateers, so is this a plot to force the sector’s hand into making DCH’s fears and accusations come true?

There’s nothing like a good conspiracy theory to raise a smile, especially given the tales of lost data disks, stolen laptops, and the new housing minister’s less-than-endearing introductory gaffe; it more suggests a plot unravelling than a plot fulfilled.

Campaign donations, of course, led to the departure of Peter Hain, head of the DWP, which meant an impromptu reshuffle and a change of face on the housing front. Out to the Treasury went Yvette Cooper, and in came Caroline Flint. It didn’t take her long to start living up to her name and shed a few sparks into the tinder.

In her speech to the Fabians, to cut a long story short, she suggested a stern turning of the screw for social, and especially council, housing tenants – ‘work or lose your home’. The notion of turfing out a claimant onto the streets caused howls of outrage at DCH, Shelter and the NHF too.

“It would mean a return to the workhouse, the destruction of families and communities and would add to the thousands who are already homeless,” said Shelter’s Adam Sampson. Still, one could say that Flint has certainly made an impression. A great start to a new job and a new year. The year ahead is certainly looking interesting.



This article was first published in the February 2008 edition of Northern Housing magazine. It was subsequently re-published on the Housing Excellence website, 6 March 2008

None of us are getting any younger

Creating the cities of the seventh age

Building more sheltered housing units is not enough in itself to solve the problems of an ageing population, according to a growing body of opinion. The future demands the creation of not just homes but ‘age friendly cities’, writes Mark Cantrell

 This article first appeared in Northern Housing

THE world is getting older. Now, while Mother Earth forever ages with eternal grace, for the human passengers hitching a ride through time, the ageing process is a little more problematic – the elders are gathering and our urban world just isn’t built to accommodate them.

Life in the 21st Century, then, is certainly hinting at ‘interesting times’ ahead, what with the supposed threats of global warming and climate change, various alleged dates of peak oil production, concerns over a housing market crash, sundry wars, and, according to one Russian doomsday cult, the End of the World by May 2008. So maybe we don’t need to worry anyway, unless one has pencilled in that carbon-belching foreign holiday for June.

On the other hand, while some of the woes alluded to above might go some way towards solving the demographic time bomb of an ageing population, hiding away in a cave certainly won’t. That’s why there is a growing body of opinion pushing for not just homes but cities to be made fit for all the Seven Ages of Man (and women too, of course).

In the UK, we’re used to understanding the context of a growing elderly population (post-60 for a general guide) in terms of pension support and provision, or in terms of healthcare, but outside of the appropriate professional circles there is less awareness of how ageing affects everything around us. Or at least potentially: for the most part our urban civilisation is not built for the convenience of the elderly and infirm but the hale and hearty – and above all young.

Historically, there’s a very good reason for this: the young outnumbered the old, who didn’t tend to linger long before the Reaper took them beyond the need for suitable housing provision. That’s changing. Fast. Not only are people living longer, they are living healthier for longer even if ultimately the morbidity of age catches up with us all. Even globally, fertility rates are down and older people are expected to outnumber children by 2047. In the developed world that has already happened, according to the World Health Organisation (WHO) – back in 1998.

So, the world faces the need for a major restructuring of its urban and social environments. This touches upon a host of issues, from housing to planning, to infrastructure, to retail, leisure, health and a wide variety of amenities and services. There is much to consider, a bewilderingly complex menu of food for thought to chew on – with or without the false teeth.

The issue is as local as it is global, with agencies at both the national and international level pushing for greater awareness of the myriad interlocking issues that need addressing to make the world more elder-friendly. Indeed, WHO published a guide to ‘Global age-friendly cities’ in October as part of a global initiative.

“Older people are concentrated in cities and will become even more so,” said Dr Alex Kalache, director of WHO’s Ageing and Life Course Programme. “Today around 75 per cent of all older people living in the developed world are urban dwellers – expected to increase to 80 per cent in 2015. More spectacularly, in developing countries the number of older people in cities will increase from 56 million in 2000 to over 908 million in 2050.”

In the UK, to bring matters to the more appropriate parochial level, the campaigning charity Help The Aged (HTA) together with Kings College London (KCL), launched their supporting report ‘What makes a city age friendly?’

Demographics are making it a pertinent and pressing question: older people need somewhere to live, just like their younger counterparts, to make life meaningful. They also need access to the wider community and beyond. As we get older, of course, the greater our needs become as regards health and support, but there is also need for the older end to remain connected to life. As HTA has said, some 1.4 million older people in the UK feel socially isolated. The reasons are legion, but in part relate to many familiar themes already underway in the housing world – to tackle poverty and both financial and social exclusion to name but a couple.

Professor Simon Biggs, the director of the Institute of Gerontology at KCL, said: “Age-friendly communities benefit people of all ages and taking an age-friendly perspective of any city shows up how it works well and where it works badly. Transportation, buildings and streets that are safe and reliable, and allow spaces for different generations to share in their communities should be a hallmark of any 21st Century environment.”

Clearly one can see how it fits into the already crowded housing agenda for the current century, and in theory at least, it involves ‘merely’ an added consideration to factor into designs and plans – such as building houses that can be readily adapted to suit people throughout the ‘seven ages’ of our lives. But what is an ‘age-friendly city’?

The WHO guide, which was aimed primarily at urban planners but nevertheless can be used as a resource for other interested bodies, suggests an environment with sufficient benches that are well-placed, well-maintained and safe; sufficient public toilets that are clean, secure and accessible for people with disabilities and well-indicated (something the younger generations will appreciate too). Other key features include well-maintained and well-lit pavements; housing integrated in the community that “accommodates changing needs and abilities as people grow older”; and public and commercial services and shops in neighbourhoods close to where people live, rather than concentrated outside the city.

In other words, to re-use the now-clichéd phrase, it’s the drive to create a ‘sustainable community’.

Obviously, this requires greater investment in specialist supported housing – such as Extra Care schemes, or the Government’s recent announcement of an extra £25 million to help people gain adaptations to their homes such as stairlifts and ramps, but it also requires so much more. Housing needs to be designed accordingly, and integrated into mainstream housing provision, complete with a diversity of affordable housing options for the older age ranges, as HTA has pointed out.

“We need a more robust approach to the future supply of affordable housing that is relevant to all of us at different stages in our lives. The consequences of not acting now will be an increase in numbers of older people trapped in poor, cramped and inaccessible housing – impacting on both their physical and mental well-being,” HTA stated in its response to the DCLG’s Green Paper ‘Homes for the future’ back in October.

“We live in an ageing population so we must now make sure our attitudes to ageing are positive,” said HTA’s director general Michael Lake. “Being age friendly is up to all of us – it starts in our own backyard and has a knock-on effect to other parts of the community. Having a guide for cities to be age-friendly is the first step towards creating a world where older people can live in a safe and welcoming environment. The evidence is there – the next stage is for cities and local authorities to take action.”

Obviously, we can’t afford to wait – none of us are getting any younger.

This article first appeared in Northern Housing magazine, December 2007. It was subsequently re-published on the Housing Excellence website, 16 January 2008.