The Psychological Role of Expressive and Literary Writing - A Case Study on Kuwaiti Women

by Haifa Al Sanousi, Ph.D.

May 28, 2004


abstract

Expressive and literary writing is a way of putting thoughts and feelings into words as a therapeutic tool. This technique is based on the belief that writing about memories, problems, feelings and concerns can help to relieve stress and heal psychological wounds. It also promotes health, well being and personal growth and restores psychological balance.
There are several different types of expressive and literary writing. A popular one is journal therapy, which focuses on expressing hidden emotions and exploring the self. Other examples are letter writing therapy, story writing and poetry therapy. The experience of expressive writing encourages people to put their emotions and memories into words, which in some way provides therapeutic release.
I became aware that expressive and literary writing as a way of healing was neglected in clinics in the Arabic world in general, and in Kuwait in particular. I began to think seriously about conducting a study of the attitudes of Kuwaiti woman towards writing therapy, with a focus on its therapeutic effects. This is the first study its kind in the Arabic world.
In this article I have tried to concentrate on the therapeutic effects of expressive and Literary writing through workshop and writing exercises for Kuwaiti women. I have also studied the role of creative writing in the life of a famous Kuwaiti story writer, who suffered from her society’s misunderstanding of her thoughts and beliefs. One of the difficulties with the research was that some women did not accept this type of therapy because they were used to talking about their feelings and problems. They wanted someone to listen to them and focus on their need. It was difficult to persuade them to let their pens go on paper.

article
The psychology of storytelling 
Stories possess the ability to tap into our deepest needs and desires, to hold us in their grasp. We are all storytellers, as we relate our histories, our daily experiences, our hopes and dreams, in ways that inspire or weaken us. Our stories have the potential to empower and guide us. Since stories are created in the brain and are heard, read, or viewed by the brain, it is possible that there are biological 'laws' for how they are organized and expressed. Exciting psychological research has provided insights into our universal and unique ways of creating characters and plots. This body of work explores the biological, psychological, and spiritual origins of storytelling and provides the writer and non-writer alike with powerful tools for living life with passion and compassion. 

Michael White & David Epston
White & Epston start with the assumption that people experience problems when the stories of their lives, as they or others have invented them, do not sufficiently represent their lived experience. Therapy then becomes a process of storytelling or re-storying the lives and experiences of these people. In this way narrative comes to play a central role in therapy. Narrative therapy, as introduced by White & Epston, is based on the idea that problems are manufactured in social, cultural, and political contexts. Each person produces the meaning of his or her own life from the stories that are available in these contexts. White & Epston draw upon the work of Foucault , in observing that development of capitalism has been associated with a trend for human experience to become increasingly shaped and controlled by discourses that reflect an externalised, unitary, global knowledge. The technique of externalization used by White and Epston relies on the use of certain types of questions on the part of therapist. This is known as relative influence questioning and participants are first invited to map the influence of the problem in their lives and relationships. They are then asked to map their own influence in the life of the problem. 

Externalization is an approach to therapy that encourages the client to objectify and, at times, to personify a problem that is experienced as oppressive. In this process, the problem becomes a separate entity and thus external to the person or relationship that was ascribed as the problem. Those problems that are considered to be inherent, as well as those relatively fixed qualities that are attributed to persons and to relationships, are rendered less fixed and less restricting. (Michael White & David Epston, p.3)

White began his first systematic attempts at encouraging people to externalize their problems approximately ten years ago. These attempts took place predominantly within the context of work with families that presented for therapy with problems identified in their children.  
Epston often invites people to record their own stories. Customarily, the avowed purpose is to render the story in a form that could be available to others. He has employed a wide range of media: videotape, audiotape, testimonial letters, stories in various genres, personal letters, and the telephone. The narrative structure of these recordings is conventionally that of a success story rather than the sad tale format of many psychotherapy narratives.  

White and Epston in their book invite us through their theories to ask ourselves: how can we enable the writing of personal and collective stories that liberate and heal when the dominant stories are so problem-saturated? They both believe that people are rich in lived experience, only a fraction of which can be storied and expressed at any one time, and that a great deal of experience inevitably falls outside the dominant stories about lives and relationships. Those aspects of life experience that fall outside the dominant story provide a rich and fertile source for generation, or re-generation of alternative stories. (Michael White & David Epston, p.15 ).

When alternative stories become available to be performed, the neglected aspects of the person's experience can be expressed and circulated. 

When we invite people to be an audience to their own performance of the alternative stories, the survival of these stories and the sense of personal agency is enhanced. People can be encouraged to identify expressions of aspects of life experience that would have passed unnoticed and to review the real effects of these expressions in their lives and relationships. Stories are full of gaps which the person must fill in order for the story to be performed. These gaps recruit the lived experience and the imagination of that person with every performance; they re-author and enter into the story, taking it over and making it their own. ( Michael White & David Epston. P.13 ).  

John McLeod and Martin Payne  
John McLeod, a professor of counselling at the University of Abertay, Dundee, took representative examples of the uses of narrative in therapy theory and practice and described these in a manner that allows the distinction between foundationalist and constructionist approaches. He believed that while the therapy session provides a unique arena for telling stories, these are not usually responded to as stories, but are treated as a source of evidence in relation to the supposed underlying personality structures expressed through the story. 

A story is an account of a specific event. Much of the time, however, stories are linked together, so that between separate stories are linking passages that reflect on the stories, categorise them, comment on their veracity and so on. The term 'narrative' then, is more loosely defined than the term 'story'. A narrative is a story-based account of happenings, but contains within it other forms of communication in addition to stories. The word 'story' is much more widely employed in common usage than the word 'narrative', because a story is a more accessible, immediately graspable entity that people deal with at an every day level. The idea of narrative is more often found in academic discourse. However, the ordinary-language notion of narrator captures some of the meaning of narrative. A narrator tells a story, but in doing so offers something over and above the bare story, for example asides, or by announcing the end (John McLeod p.31-32). 

There are several examples of narrative being used to generate clinical data through assessment tools. One of these is the practice of asking the client to invent imaginative stories in response to given pictures; these protocols can then be analysed in terms of constructs. 

When encouraging a client to expand her initial narrative, the therapist invites her to give a specific name or names to the problem, perhaps a single word or short phrase. If the person cannot think of a name the therapist floats possibilities, such as depression, stress, marriage, abuse and so on, until a name is provisionally agreed. ('Martyn Payne, p.11) .

Martin and Payne have occasionally, in workshops for counsellors, invited people to write their autobiographies in ten minutes. They attempt this, but of course they need more time to write about themselves. Payne believes that we can only, even in telling the most detailed stories of our lives or parts of our lives, create partial representations, maps of our experiences, not fully accurate all inclusive representations. So partial maps are all we have, and they do not represent the entirety of the experience. Payne invites the client to talk about what brings him to therapy and waits if he is hesitant. Once the person has come to a natural pause and indicates that his initial account of his problem or problems is complete, he encourages him to stay with the problem description and to extend it.  

Alida Gersie  
Alida Gersie, Director of Studies of Graduate Art Therapies Programmes at the University of Hertfordshire, has written several books on the uses of stories in healing. She specialises in the therapeutic use of stories with people who have experienced trauma or problematic bereavements. She pioneered this 'story making' method for educational and therapeutic settings in various contexts and countries. She now works as an organisational consultant and writer/researcher and has published several successful books in her specialist field. Extending her earlier work on the use of stories to bring about healing change, she develops both the theory and practice of storymaking with a focus on group settings. Using examples from her work in many different countries, Gersie reflects on the dynamics of the storytelling process and explores the experiences and attitudes most frequently brought to story work. She looks at the impact of race and class on both group leader and members of the group, and clarifies how these affect the group's functioning. She explores, amongst other topics, the various types of narrative and their uses, mutuality and reciprocity, the need to promote systematically the clients' tolerance for the _expression of emotional range, and the empowerment that can result from the group storytelling process.(look at Alida Gersie , Reflection on Therapeutic Storymaking)  

Expressive Writing as a Therapy 
Expressive writing therapy is a way of using writing to gain insight into personal struggles and to heal emotional wounds. It relies on carefully planned co-operation between the client and the therapist. Writing can also be a self- healing therapy when we rely on ourselves to develop personally, heal our psychological wounds, understand our needs and explore our creativity. Writing can take many different forms such as autobiography, letters, poetry, self-confession and day and night dreams. In expressive writing, thoughts and feelings are put into words. It is a means of self- exploration and discovery in an attempt to become a whole person. 


Writing, like painting, reaches mostly into the back part of the brain, the visual cortex, where images are made. As we visualise an image, we tap into the parietal lobe where images are stored. We are all made up of a jumble of thoughts and sensations, habits and hauntings, dreams and uncertainties. We may not even know how we feel at any one moment of our lives, we just live. And in living, we often fall victim to repetitive habits and attitudes that don't really express who we are, or what we want to become. Writing separates the strands, gives voice to the confusions, gradually pulls together the disparate fragments into an intelligible whole. We gain greater clarity of purpose, greater freedom of choice. And above all through the writing we discover and absorb the key recognition that we are each responsible for our own lives. 


The writing process is structured in such a way that self-discovery is at the core of the experience and Art is the result. We begin talking to ourselves on the page, perhaps in a group or even online. This private dialogue with the self gradually reveals material that we were not aware of: patterns of behaviour that compel us, inner imagery that haunts us, fears and uncertainties that hold us back from being able to hear our own voice. When we start to write, our store of emotions and thoughts is opened, so it is an excellent tool for self-exploration. 


We might wonder what to write about: it could be something that we are thinking or worrying about too much, something that we are dreaming about, or something that we feel is affecting our lives in an unhealthy way. We should have the feeling that this writing is a mirror reflecting our thoughts, emotions, dreams, ambitions and fears. We could, for example, write letters to people who have hurt us, or to those we love who have died, whom we need to be with psychologically. This kind of writing comes under the heading of self - reflective writing. 


Other types of expressive writing may be forms of Literary writing such as stories, autobiography, poetry, plays and glimpse. It is very important to ensure that we are safe when we write - writing can help us to heal but we must proceed slowly and cautiously. Whenever we feel we are at risk, for example of losing control or acting on dangerous thoughts, we should consult a qualified, professional therapist. We can explore ourselves through writing later, when we feel that we have re-gained psychological balance. I should make it very clear here, that writing therapy is not recommended for people who have been diagnosed as psychotic, and those people should be supervised by psychiatrists.  


The benefits of expressive writing 
Whether those who use writing are grade school students, medical students, nursing home residents or prisoners, the results are the same: writing works. According to Pennebaker blood tests show that subjects have more robust immune systems several weeks after completing particular writing exercises. They also tend to make fewer visits to the doctor, report lower levels of pain, use fewer medications, function better in day- to day situations, and score higher on tests of psychological well-being. The value of writing goes beyond mood disorders. A groundbreaking study published in the Journal of the American Medical Association (April 14, 1999) shows that writing about past traumas can even ease the symptoms of asthma and rheumatoid arthritis. 


Nobody knows the answer to this, but it probably lies in the strong connections between stress and disease. Putting memories on paper can help defuse the danger, says Pennebaker. Writing forces a person to confront the past one word at a time, and trauma doesn't seem so overwhelming when broken into small increments. It also gives a person the perfect opportunity to explore and gain new insight into his or her feelings. In fact, studies show that people who use words such as 'understand' and 'realize' in their writing enjoy the greatest improvement in physical and psychological health.  


Susan M. Bauer, assistant professor at the Graduate School of Nursing at the University of Massachusetts Medical School is the first and only nurse scientist to receive a Komen Breast Cancer Foundation grant. Her research on expressive writing therapy is significant because of its approach to the quality of life of breast cancer patients. Oral and written storytelling is advocated as a method of therapy by Ailda Gersie , who draws on myths, folk tales and fairy stories to facilitate clients' creative story-making as a means of getting in touch with inner imagery, which leads to a deeper awareness of self.  


Research done by Kitty Klein, an Associate Professor in the Department of Psychology at North Carolina State University, noted that writing can also improve attention, or the ability to concentrate, which cognitive psychologists call working memory. Two experiments were carried out: the first step was to measure participants' working memory capacity using a standard laboratory task. Next, the research team randomly assigned these participants to write about different topics. In the first experiment, they asked one group of first semester freshmen to explore their deepest thoughts and feelings about coming to college (the expressive writing group).  


The other group was asked to write about how they had spent the previous day (the control group). Everyone wrote for 20 minutes, at three different sessions, spread over a two-week period. After the third writing session WM was measured again. Six weeks later, everyone returned to the laboratory for a final measurement of their WM. When changes in the WM scores were examined, the data indicated that the freshmen asked to write about coming to college experienced a 6% gain in WM while the group who wrote about their day had an average gain of 3%. When a text analysis program was used to analyse the essays, as in previous research in which health benefits were of interest, compared to the control group the expressive writers showed increases in the use of words related to understanding and reasoning across the essays.  


The greater these increases, the greater the increases in their ability to focus their attention. Finally the researchers looked at the grade point averages for the students for the semester of the experiment, which was their first, and those of the following spring semester. People who showed the greatest increases in WM capacity on the laboratory test had better grades for the semester of the experiment and even better grades the next spring.  


In the second experiment, the research team used similar procedures for measuring WM and timing the experimental sessions, but they used three different writing groups. At the first session, everyone gave a brief description of a negative personal event and a positive personal event and recorded how often they had unwanted thoughts about these events. They were then assigned to a topic, either the negative personal event they had described, the positive personal event, or how they spent their day. The results from this experiment were more striking than those in the first study. People who wrote about a negative event showed an average 11% increase in WM capacity. Those who wrote about a positive experience had an average 4% improvement in their WM test scores and people who wrote about their daily activities had an average 2.5% improvement. Again, the greater the increase in WM capacity, the greater the improvement in grade point averages. The research team also found that the greater the decrease in unwanted thoughts about the negative experience, the greater the improvements in attentional capacity.  


Klein, in her two experiments described above, noted that people who wrote about a stressful experience showed improvements in their ability to concentrate, measured by a standard test of working memory capacity. Her explanation for this finding is that our memories for negative or traumatic experiences are often fragmented and disorganized, like pieces of a nightmare. When we write about these experiences, our memories gradually become more coherent and story-like, allowing us to understand what happened and better deal with the emotions surrounding the experience. 
Once we are able to 're-package' our stressful memories into a story, isolated fragments of these memories are less likely to come unbidden to our conscious minds. We do not forget traumatic experiences but expressive writing can transform our memories so that we are not continually upset by unwanted thoughts about traumatic or stressful events.(Stephen J. Lepore , The Writing Cure). David Huddle in his book ' The Writing Habit ' confirms that expressive writing can increase working memory capacity.

Ira Progoff (1921-1998) 
After completing his Ph.D. at the New School of Social Research in the A.S.A ,Ira Progoff was invited in the early 1950s to study in Switzerland as a Bollingen fellow with C.G. Jung. Based upon his research on the founding fathers of depth psychology (Sigmund Freud, Carl Jung, Otto Rank, and Alfred Adler), he had concluded that individuals need to have meaning in life to be whole persons. He also realized that people needed to work from their inner levels to develop their potential in life. He was attracted to Jung's work because he held a similar point of view versus the more accepted framework that focused upon pathology and diagnosis.  


Since the 1950's, Progoff has devoted his life to the exploration of new ways to encourage creativity and to enhance individual growth. He is a leading authority on C.G. Jung, depth psychology and transpersonal psychology as well as journal writing. Progoff conducted research on the dynamic process by which individuals develop more fulfilling lives. As a psychotherapist, he found that the clients who wrote in some form of a journal were able to work through issues more rapidly. In the 1960s he developed the Intensive Journal Program, and journal writing became a popular therapeutic technique. Progoff's journaling techniques allow us in our writing to reach under the daily problems to find the deeper issues lying below. As participants journal they discover parts of themselves long neglected. In the unfolding process of discovery, Progoff's holistic depth psychology can be healing in itself or can be added to therapy sessions already in progress. In 1966, he founded Dialogue House to make the Intensive Journal method available to the public. Over the years, he conducted many workshops and further refined and developed the method. In 1975, he published the basic text for the program, 'At a Journal Workshop'.  
 
The Intensive Journal workbook contains both 'log' sections and feedback sections. In the log sections, we record the factual data of our lives. The feedback sections are used to carry out the active exercises that generate the energy and momentum to propel us forward to develop our lives further. The workbook is further divided into four main parts or dimensions that each have their own realm of human experience, content, and characteristic ways of _expression. These are: 'Life/ Time', 'Dialogue', 'Depth', and 'Meaning'. Each of these dimensions in turn, is divided into subsections or 'mini processes'.  


According to Progoff's theory, in the Life/Time Dimension, we deal with the other level of experiences, our personal life history. This dimension includes the major periods or phases (Steppingstones) of our lives, important choices made a vehicle for reviewing these periods to gain a perspective on the continuity of our lives. 


Through these exercises, we explore in detail new possibilities and interests not yet developed, as a way to broaden our range of opportunities in life. When working in the Dialogue Dimension, we enter into a dialogue relationship with each of the major facets of our lives: personal relationships, work and special projects, body and health, events and society. By 'walking in the shoes' of the other person or object, individuals deepen their relationship with that aspect of their lives, avoid blockages and preconceived notions and gain insights that otherwise would not be possible. In the course of these dialogues, we often find that we write things that we were not aware of knowing.  


In the Depth Dimension, we explore our symbolic messages in the form of dreams and imagery. The exercises provide a way for individuals to bring these elusive images up to the surface to be developed further through various non-analytical techniques. By developing our sensitivity to these messages, our intuitive capacities are strengthened to provide new energy and leads for our work in other dimensions of the workbook. The fourth dimension, the Meaning Dimension, focuses on the fundamentals of life: values, priorities, and the ultimate concerns that motivate people. We focus extensively on connecting to the wider aspects of society whether through symbols or experiences.  


When people become connected, they are strengthened inside. Individuals also utilize the dialogue techniques to learn from another person, whether from the past or present, who can teach us something about life. This dimension also includes Entrance Meditation techniques which are used throughout the Journal work, providing a neutral way to enter our depths and tap into these symbolic feelings. The Meaning Dimension is helpful to people because they can only be fulfilled when they have meaning in life. Meaning also produces a great energy that can have very positive effects on their lives. Progoff has created workshops for prisons, social service agencies and health care facilities. It is part of his commitment and dedication to provide a tool for individuals of limited economic means to develop themselves. He has devoted his life to the exploration of new ways to encourage creativity and to enhance individual growth. The goals of Progoff's work are to: 
 
 
 
•Use an integrated system of writing exercises. This is much more than a diary; 
•Gain insights about many different areas including personal relationships, career and special interests, body and health, dreams and imagery, and meaning in life; 
•Apply fresh approaches to access your creative capacities and untapped possibilities; 
•Work in total privacy. Neither you nor anyone else will judge or analyse your life; 
•Use a method that is without dogma. The Intensive Journal method is a process that can be used by people of all different backgrounds, interests and faiths.  


From these goals we can say that journal writing is the most popular type of expressive writing. It can be a tool for exploring the self more deeply and a way to share feelings, thoughts and experiences with others. Maybe it is useful here to touch on Ira Progoff's own words: "When our attention is focused inwardly at the depth of our inner being, in the context of the wholeness of our life, resources for a profound knowledge of life become accessible to us."  


Progoff believed that people who are facing these various challenges can benefit from using Intensive Journalling, but several important principles about the method should be kept in mind as they proceed. Before seeking to find answers to specific situations or challenges, the Intensive Journal exercises must be done to gain a perspective on the continuity of their life. This will provide a grounding from which to develop other specific areas of interest; without this sustaining basis their journal work could miss possibilities and interconnections between aspects of their lives.  


Progoff's belief in the principle that the darkest moments are before the dawn should be kept in mind. Often, new developments cannot occur until there is an emptying out of feelings about earlier experiences. Times of struggle or emptiness provide an important vehicle for self-development and this process of emptying out does not occur easily. Progoff believed that the Intensive Journal method provided a way for individuals to maintain a perspective as they moved through periods of anxiety before reaching the upward phase of the cycle. Patience is essential. There are no simple answers and each person must find those, that are right for him/her.  


Progroff stressed that people must be honest with themselves in their journal work, as self-deceit would lead to the therapist attaining false results. This may not be easy. However, through the Intensive Journal process, we can work through experiences that are painful to us, so that we see them in a new light and discover that they were not negative after all. By working through these situations, individuals learn important lessons about life, become empowered and strengthened through the process and gain energy and momentum to carry their lives forward.  


Progoff's conception of how change occurs in a person is not in terms of pathology and diagnosis.Change is brought about by deepening the level at which we experience our lives. We experience our lives from an inner perspective and not an intellectual point of view. The Journal allows us to take this perspective, evoking the potentials within us as we work with our life as a whole. Progoff's theory does not require anyone to hold a particular belief system; an individual working seriously on his or her life, is moving towards the most profound recognition of meaning that can be achieved. He should be able to do this because he is a human being who needs to make new decisions and take new steps. He has potential that he may not be able to find entirely on his own. He needs to come in contact with someone who has experienced and is familiar with people's inner process. This process can lead to a creative experience, a new awareness, a new potentiality, or greater spiritual knowledge.

 
We can see from the work of Progoff that the written word has the potential to reflect our thoughts and feelings on paper and to show us the larger picture of our lives and the depth of our inner feeling and thoughts. It gives us the chance to stand as critics, so we can understand everything correctly. Writing is a good way to get rid of guilt feelings and to clear and organise thoughts. Some people might be afraid to put down everything they need to write about, feeling that some secrets should be hidden. We can avoid this hurdle by using password language. Our feelings towards certain people in our lives can be reflected by the use of passwords to disguise their identities. It is very difficult for us to contain all our stress in our bodies, and it is hard for us to live with our pain. Expressive writing is a very clear path for releasing pains and unlocking the psychological wounds.  


Freud and other psychiatrists have all learnt from the poet's insight into the subconscious and its inner working. Most people heal themselves by using expressive writing. We know that writing will help us to feel better emotionally, and in time our writing will be a means of solving problems. It focuses on the use of the subconscious to heighten awareness of events and the feelings we experience. We may notice this particularly when we write about our dreams. Writing is a peaceful, safe and supportive way to explore and express your feelings and thoughts.  

Progoff's work is interesting for several reasons. 


1) Firstly it is based on Carl Jung's ideas, which gives Progoff a stature rather different from the more common 'positive thinking' approach to creative development. 
2) Secondly, his work uses a structured method of personal writing that anyone can do by themselves; group workshops are valuable but not essential. 
3) Thirdly, with the online journal or web log becoming increasingly popular - thousands of new sites appear every week - Progoff's ideas provide a critical framework for understanding personal diary writing. 
4) Most importantly, Progoff's journal method is based on creative process. It is a self-development approach to creative development, underpinned by the Jungian outlook. Progoff passed away in 1977. His son John, now the executive director of Dialogue House, believes that the practice of journaling is a very helpful technique for getting a perspective on our life: where it's been, where it's going.  
 
 
 
 
 
 
James Pennebaker  
James Pennebaker is a professor of Psychology at the University of Texas at Austin. He and his students are exploring the links between traumatic experiences and physical and mental health. A recent study in the Journal of The American Medical Association found that people who wrote about their stressful situations had less health problems and overall better health. This is confirmed by Pennebaker's study, which found that people who wrote about their deepest thoughts and the feelings surrounding traumatic experiences evidenced heightened immune function compared with those who wrote about superficial topics. 


Over four consecutive days, 50 healthy undergraduates were randomly assigned to write about either the most upsetting events of their lives or about superficial topics. Blood samples were drawn from the participants before the first day of writing, the last day of writing, and a third time 6 weeks later. Two particular results emerged from the immune study. First, individuals who wrote about traumas exhibited improved immune function from the final day of the experiment to the 6 week follow up. Second, a high level of disclosure showed significantly greater immune improvement than low disclosure from before to after the writing phase of the study.  


Pennebaker believes that disclosure of trauma is cognitively beneficial because it promotes the assimilation of the events. In his view, it translates the images of the events into language, and provides a sense of detachment from the experiences. Pennebaker compared a group of college students who wrote about trauma with a group who wrote about trivial things. Before the study, the 46 students visited the campus health clinic at similar rates. But after the exercise, the trauma writers' visits were cut in half relative to the others. In another study, published in 1988, researchers found direct physiological evidence that writing increased the level of disease fighting lymphocytes circulating in the blood stream. Preliminary research showed that writing can cause modest declines in blood pressure.  


Pennebaker investigated the impact of expressive writing among worksite wellness programme participants. He found 28.6 % reduction in absentee rates from work relative to the eight month period before, compared to a 48.5% increase in the absentee rate of participants who wrote about trivial events. The degree to which writing or talking about basic thoughts and feelings can produce profound physical or psychological changes is nothing short of amazing.  


Dozens of writing experiments have been conducted by researchers in laboratories around the world. Writing about emotional upheavals has been found to improve the physical and mental health of grade- school children and nursing home residents, arthritis sufferers, medical school students, maximum security prisoners, new mothers, and rape victims. Not only are their benefits to health, but writing about emotional topics has been found to reduce anxiety and to aid people in securing new jobs.  
 
At the beginning of his research journey Pennebaker thought that the primary value of writing was that it reduced the work of inhibition. From his own experience however, it was clear to him that writing accomplished much more. He believed that writing about upsetting events would bring a new understanding of the emotional events themselves. Pennebaker talked about his own experience in writing as a self- therapy. He and his wife had married right out of college and 3 years later, were questioning many of the basic assumptions of their relationship. This was a very dark period of their life. He had never been depressed before, but at that time he felt an overwhelmimg pressure on his heart every morning.  


Pennebaker did not know how to cope with this depression. He stopped eating, began drinking more alcohol, and began smoking. And, because he was embarrassed by what he considered to be emotional weakness, he avoided friends. Even though he was a graduate student in psychology, he refused to go to a therapist. After a month of emotional isolation e started writing about his deepest thoughts and feelings. He was drawn to his typewriter each afternoon for about a week, where he spent from 10 minutes to an hour pounding on the keys. He wrote about his marriage but soon turned to his feelings about his parents, career etc.; he felt fatigued but freer each day after writing. By the end of the week he noticed his depression lifting. He understood his deep love for his wife. 


Pennebaker's early studies received criticism because people didn't believe in the effect he described. When many other laboratories around the world found the same effects, however, those criticisms stopped. The biggest debate now concerns how and why this works (personal communication with Pennebaker).  


Dozens of studies have now demonstrated that writing about emotional upheavals can affect people physically. Those asked to write about emotional topics, compared with those writing on superficial topics, go to the doctor less for a variety of health problems in the next 2-6 months. Beneficial changes in immune function, blood pressure, days in the hospital following surgery, liver enzyme levels, and other biological markers have been reported in the medical and psychological literature. These effects hold up across culture, education, language, and sex. According to Pennebaker the benefits of writing are that it can: ' Help integrate and organize our complicated lives in a variety of ways; . Clear the mind;

 
•Help resolve traumas that stand in the way of important task.  
•Help in acquiring and remembering new information;  
•Foster problem solving.. It forces people to sustain their attention on a given topic for a longer period of time;  
•Lower the blood pressure and heart rate, and benefit the immune system;  
•Improve lung function in asthmatics;  
•Improve joint mobility in rheumatoid arthritis. 


Pennebaker believes that narrative expression, whether spoken or written, has a controlling and structuring effect. He suggested that a chaotic, cathartic splurge of writing is not enough. People need to carry on writing until they understand what their writing means for their own personal development. A piece of writing created with an emotional charge about an event in the past is very often therapeutic and creative. 

Gillie Bolton 
Gillie Bolton, who is a poet and teacher of writing, is a research fellow in Medical Humanities at Kings College, London. Bolton believes that writing is fun, stimulating and exciting; it helps us to explore and express important things. It also enables us to create something beautiful, like a poem. A diary, in her view, is written for its own sake, for the joy, the painful release, the discovery, the ordering and making sense, and the creation. This kind of writing can be a comforting process. According to Bolton, writing has been offered in some surgeries, hospitals, hospices and other health centres, supported either by the doctors, nurses and social workers, a writer in residence or a therapeutic writing specialist.  


A therapeutic writing group exists to support the writers in their own personal explorations and experiences. A group can bring writers to understand the import of their own writing more clearly; to think of fresh writing avenues; enable them to discuss issues with involved and caring others who are on similar voyages themselves. Certain principles need to be considered in this group work. These are: respect, shared responsibility, confidence and confidentiality. Bolton thinks of a group as being like a warm island in a stormy sea. The members arrive out of the wind and dark, clutching their precious papers.  


We can see the difference between the work of Progoff, Pennebaker and Bolton. Progoff focused on Journal writing, while Pennebaker focused on the physical effects of emotional disclosure, his theory being a combination of cognitive, social and biological ideas. Finally Bolton have focused on the effects of creative writing, especially poetry. We can see that all these theories are related. We can combine them in one theory that says expressive writing - Journal writing, emotional disclosure, creative writing and all other types of writing - seems to be effective and the benefits are different from one person to another. I am trying to reach a combinative theory that can be used in Kuwait, which focuses on the word expressive, and in which the client can choose the way he feels it should benefit him.  

Types of Expressive Writing  
There are different types of expressive writing. We will focus on these types starting with writing the self-story.

Autobiography 
The humanities are traditionally the most accepting of autobiography as a data source, because they are focused on the totality of human beings. The humanities span the study of history, literature, philosophy, theology, and the arts. Autobiography has also been used in the search for understanding of those motivations and influences that form the perspective of the artist. Rich demonstrated how the creative process of writing and revising a novel could reveal key aspects of an author's life history. Stout(1987) traced one author's use of biography as part of a search for self- presence. Autobiography can be shared with a small group. Birren and Deutchman summarised the positive outcomes of studies on autobiography as follows:  


• A sense of increased personal power and importance;  
•Recognition of past adaptive strategies and application to current needs and problems; 
•Reconciliation with the past and resolution of past resentments and negative feelings; 
•Resurgence of interest in past activities or hobbies; 
•Development of friendships with other group members; 
•A greater sense of meaning in life;  
•The ability to face the approaching end of life with a feeling that one has contributed to the world.  

Someone might wonder 'who am I to write my autobiography? I am not a popular person, autobiography is only for the famous'. That point might be relevant if we thought seriously of publishing it, but here we are writing primarily for self -exploration and healing. 


The story of anyone's life is not only the story of one person. It would have to include our parents, friends and colleagues. The autobiographer should let his pen go to identify himself and others. This is an attempt to identify those things which lie behind the outward events. It would be an account of one's dream life as well as waking events. 


Most of us achieve a personal balance between inner and outer, which works for us positively. In our writing we can focus on our childhood and ask ourselves important questions such as: what were our feelings? Were they joyful, fearful, sad, or something else? How has our childhood experience affected our life today? 


In April 1999, an article appeared in the Journal of the American Medical Association supporting other studies by Pennebaker, which demonstrated the healing power of writing. Journal writers have long known the benefits of writing, but now scientific research is providing proof, and the medical profession is listening. Writing a structured narrative ' 'what happened' integrated with feelings - has long-term effects on such diseases as asthma, chronic fatigue syndrome, post-traumatic stress, and arthritis. It also has a preventative effect, as studies found that a group writing true and deeply emotional stories had fewer visits to the clinic than who wrote superstitious events. These studies are very important for the therapeutic profession and healers. To heal ourselves, we need to write the truth, spilling the story in complete detail. Studies have found that the writer would feel more emotional during and just after the writing, but much better following the writing session. Writing our own story gives us perspective, and is emotionally satisfying. When people allow the pen to take them where they need to go, surprising insights emerge.  


There is a sense of relief, as when a musical phrase comes to a close. We can share our work in a group, and this group is focused on the meaning and depth of the story, as well as how the piece was created. The purpose of group work is to explore through writing those things, which have formed our identity, our life's journey, and us. What we do with our writing is up to us. We might rewrite it to publish, or share it with our family. Or we might choose to keep it private. When writing our life-story, we may underline key words throughout the text. This can be very therapeutic to any unhealed emotional wounds, which may be causing us to feel uncomfortable or inadequate.  


Writing our stories is a journey towards realizing who we are and what we are truly capable of becoming. In this kind of writing, we can describe ourselves, our behaviour, our dreams, our ambitions, our tastes in everything, our problems, etc. Some people write their life-stories just for pleasure, while others use it as a self- therapy. It acts as the container for inner feelings and psychological needs; it is the gateway, opened wide to dreams and future ambitions. We call recall our lives through writing it. We might wonder sometimes who we are, and what is the nature of our identity? What do we want? What annoys us? What do we feel and why? We came to life peacefully, and we have to survive and succeed and refuse to give up.  


Some of us have been through bouts of feeling like a victim. Writing urges us to underline everything we see and feel. It makes us believe that life will be better one day and we will experience the power of having a vision to aim for; we will go through changes, which will improve our lives. If we look closely at ourselves, we might find something in our own personalities that make us feel uncomfortable. Through our writing we might discover things which don't meet our approval.  


Writing about our lives gives us the opportunity to be more in touch with ourselves and to express what we want. Examining our own lives when writing provides us with a road map to sift through our emotions in relation to different issues. Writing our life story gives us the chance to pay ourselves proper attention; it helps us to focus on positive solutions for a better life. It can confirm directions to our relationship with other people and give us a better understanding of their personalities. Writing a self-story takes us to the world of our inner self; childhood, unforgettable characters and scenes, incidents, which have affected us. 


Many people say, 'My life is dull. I'm just an ordinary person, so why write my autobiography?' But we have all listened to thousands of life histories and have never heard an uninteresting one if the person is willing to honestly share his/her soul--the details and depth, the joy and the pain, of the self.  
 
Letter Writing 
Writing letters is a helpful technique, which can lead us to face problems in a deeper way. It is not commonly thought of as a therapeutic writing method, as people think of it as imaginative writing which doesn't give any solution to problems we may be facing in our lives. Writing letters to people or to ourselves can be a way of relieving stress. We might imagine that we are writing to explain why we are angry for example. In this letter we would focus on our feeling of anger and express it in detail. This technique will allow us to hold off a purely emotional reaction in order to think through a cognitive response. Later we can destroy this letter once we have regained our balance and feel calm. 


We could write a letter to ourselves asking a few questions, which touch our inner feelings, reaching sensitive, upsetting emotions. We will find our mood swings towards the positive side of the balance scale as we ask why? how? and focus on the answers which come into our mind. This will bring a sense of unburdening and relief. 


Therapeutic letter writing is a technique for communicating with the self. It offers some advantages in therapeutic outcome. It allows us to expand on specific thoughts and feelings. When we write to ourselves or to others, we frame the ideas in as positive a way as possible. Reading these letters and reading between the lines as critics do can help us to highlight many bad habits or attitudes which we need to get rid of.  


Sometimes people feel regret for things they have said or done to someone who is now dead, so that there is no longer an opportunity to meet them and say sorry. Feelings of guilt can destroy lives. This can be resolved by writing a letter to the dead person, after strengthening the belief of god's forgiveness through prayer. In the letter we can satisfy our conscience by saying sorry and asking for forgiveness. 


If we feel mistreated or misunderstood by our colleagues, we can let our pen go in a letter, expressing our inner feelings and attempting to reveal the true situation considered from our point of view. These letters can be written with the intention of actually sending them to people. We can write letters to loved ones who have died, who played an important role in our lives. 


For some time it has been apparent that counseling by letter is a powerful tool that can readily be adapted by helpers from a variety of theoretical backgrounds. France, Cadieux and Allen researchers in Canada, developed a model for letter therapy after extensive trials with a number of clients. It should be remembered that letter therapy is not necessarily more valuable or effective than any other counseling method, but it has worked well for therapists with clients who are introspective or unable to schedule regular counseling sessions. They made it clear to all clients, however, that their counselor is always available in person or by telephone contact if the need arises.  


The letters from the counselor (regardless of the stage or progress in the therapy) were structured in the following manner: (a) a summary of the contents of the previous letter; (b) exploration of feelings and thoughts; (c) positive reinforcement of the client's progress; and (d) homework assignments and advice on activities or thoughts. The letter therapy process is essentially one of focusing and refocusing the client's feelings, thoughts, and actions. The purpose is to allow the client an opportunity to reassess strengths, to focus on the positive, and to take responsibility for his or her actions. The process allows the client to reflect, experiment, and take action to solve his or her problem. 


The counselor-client interactions with a 35-year-old female client experiencing undefined stress is presented and discussed as an example of letter therapy. The decision to use letter writing was made with this client when she was unable to make regular office visits. She stated that it suited her perfectly, as she was an aspiring writer and felt that she did her best thinking when writing. The process is described in a series of steps; however, this does not necessarily imply that the process is linear. 


The counseling interaction occurred over a 5-month period and consisted of the following: (a) an initial face-to-face encounter that outlined the letter therapy process; (b) discussion of confidentiality and trust; (c) seven letters from the client and eight letters from the counselor; and (d) a follow-up face-to-face encounter. The client was told that she could meet in person with the counselor or terminate the letter therapy at any time. Upon receiving the letters, the counselor responded immediately, but the client preferred to take more time (from 1 to 3 weeks). The use of systemized letter writing in therapy offers counselors another option for providing help that goes beyond the confines of face-to-face interaction. The client-counselor interaction described illustrates the potential of letter therapy for those who enjoy writing and receiving letters. Clients who have opted for this strategy have responded positively about the process. The number of letters included in the interaction depends on the client's issue (and the amount of time the counselor needs). 


Not all clients may benefit from this strategy. Although there is little doubt that important interpersonal elements such as eye contact, nonverbal cues, and body language enhance counseling relationships, the letter therapy strategy can provide a viable, if not optimum, alternative when these face-to-face details cannot be actualized due to physical constraints (e.g., resistance or personal reluctance to verbalize face-to-face).The most crucial factor for choosing this method of counseling is the client's willingness to write letters and communicate thoughts and feelings to writing in a therapeutic context. At present, the letter therapy model is being used successfully with a number of clients who do not have regular physical access to a counselor and as a follow-up with other clients who have requested the letter therapy strategy. I used to ask my students at Kuwait University to write a letter to some authors and poets whose addresses we knew. Writing a letter to an author or a poet is a way to practice expressing in writing how the literary work affected their lives. I gave them 15-20 minutes to write this letter, in up to 1000 words and including what they especially liked about the work and how it changed the way they thought about themselves and the world around them. If the work was fiction, I urged them to make a connection between themselves and any character or event. At the end of the session I asked them to include any questions that came to mind in the letter to the author/poet. 

Short message writing 
We should also consider writing short messages to the people we love, through e-mails, mobile messages and postcards. We can write such messages to friends or relatives on different occasions; when they are sick, for example, the words we write really heal them and support them psychologically. Even a few words on a nice postcard can be very powerful. For example: Get well soon, I really miss you. 
I feel so awful because you are sick. 
Please listen to your doctor's instructions, as I really need you. 

Writing about Day and Night Dreams Day Dreaming 
For this type of writing pens and paper are needed everywhere so that they are to hand when the thoughts come and you need to write them down. First let us talk about the day- dreams which all of us have. Actually we can't live without having these dreams: they are the source of our energy. They motivate us and push us towards building our future and making the right decisions. It is very important to write down these dreams as they reflect our ambitions, wishes, desires and life goals. If we write them down we will focus on them and they will come true.  
The theory that says 'write it down - make it happen' has been proved through people's experience to be a very efficient theory that helps us in building a good future and in being very focused in our lives. Day dreaming is one way of opening the right - intuitive - creative side of the brain when we have spent too much time in logical left brain activities and need to balance both sides. It can be a form of visualization, wherein a person 'sees' an image then creates whatever they want that image to do. It can help us plan our future as we imagine the various ways in which events could unfold in our life - then decide which path best suits the lessons we need to learn at that particular moment in time.  
Day dreaming can often be useful in decision making for important issues. It is a form of meditation that allows us to be adventurous. In day dreaming we can control events ' which makes it a good, safe place for those who do not have control of their lives - and play out various roles. Whereas in meditation, we must watch and wait for answers, in day dreams we create the illusion. but that is how we manifest in the first place. In meditation and night dreaming we generally get the information once - and have little control over it, whereas in day dreaming we can replay the scenario over and over again - as needed. 
Day dreaming can be good for healing as it allows us to deal with issues we have no physical way of releasing. For example some people hate their boss, but they need the job! In their daydreams they zap him with a phaser! The problem with this is we are merging into higher frequencies and with that comes manifestation of whatever we create in our minds. So do be careful - and keep the phaser locked in the bottom drawer.  

Night Dreaming  
There are many theories, which explain the meanings and symbols of night dreams. I will focus here on one theory, which we have in the Arabic world, which was written more than a thousand years ago. It gives a remarkable analysis of night dreams.  

Most of us bury our emotions for one reason or another. Feelings that seem to be very powerful might be anger, sensual desire, or perhaps our need for consideration or closeness. These emotions and feelings will interact in our brain through messages received during sleeping. Our dreams offer us an opportunity to complete or to integrate these emotions. Sometimes we anticipate future events in our dreams. Perhaps our subconscious is warning us of all the things that could go wrong. While dreams are expressions of our wishes, they are not always wishes. For example

a dream of someone's death does not reflect a wish, though it could do. The dream could just as easily express a fear of loss of this person. Or it might be a symbol of something, which only the dreamer knows.  

Another function of dreams is their ability to give us clarity, perhaps by problem- solving ability or giving us a more honest picture of who we are. Dreams will often find the discrepancies between our self-image and our behavior. This painful aspect of our dreams makes us hesitate to remember or to analyse them because we are anxious that we will find out something about ourselves, which we may not want to know. If we write our dreams down, we will realise what valuable information they give us.  

We might wonder whether the function of dreaming in to warn us about the future. The answer to this question is yes, some dreams do prophesy because we are at a deeper level of being, in what we call the subconscious, and so may be led by our heart and soul to a particular course of action. The most important thing is that we are the only audience. We might discover during our dreams that there are answers to our questions. Dreams are symbols and code messages.  

We might find it difficult to write down our dreams when we wake up, as we often forget them, but if we follow a few basic steps for improving dream recall we will remember most of them. The first step is to keep a notebook and a pen by the bedside every night. On waking, lie for a few minutes and think 'where was I?'; 'what was happening to me?'; 'who did I meet?' Finally write whatever comes into your mind, however senseless it sounds. It may be necessary to go over the dream several times in our mind to memorize the events. Getting plenty of sleep is important for good dream recall as we can focus more easily if we are rested and won't mind so much taking the time during the night to record our dreams. Another benefit of getting plenty of sleep is that dream periods get longer and closer together as the night proceeds.  

It can be useful while developing the technique of dream recall to keep a complete dream journal. Keep the journal handy by the bed and record every dream you remember, not just the complete, coherent, or interesting ones - even fragments such as a face or a room, should be written down. When you wake in the night and recall a dream, record it right away.  


If you don't, by the morning you may remember nothing about the dream, and will certainly have forgotten many interesting details. We seem to have built-in dream erasers in our minds, which make dream experiences more difficult to recall than waking ones. So, whenever we remember a dream, we have to write it down. Possibly, all we will need to do to increase our dream recall is to remind ourselves as we are falling asleep that we wish to awaken fully from our dreams and remember them. This works in a similar manner to remembering to awaken at a certain time in the morning. Additionally, it may help to tell ourselves to have interesting, meaningful dreams.  


A major cause of dream forgetting is interference from other thoughts competing for our attention. Therefore, our first thought upon awakening must be, 'What was I just dreaming?' Before attempting to write the dream down, we should go over it in our mind, re-telling the dream story to ourselves. We should not move from the position in which we awaken, or think about the day's concerns. When we recall a scene, we should try to recall what happened before that, and before that, reliving the dream in reverse. If after a few minutes, all we remember is a mood, then we should describe that in the journal. If we can recall nothing, we should try imagining a dream we might have had - note our present feelings, list our current concerns, and ask ourselves, "Did I dream about that?".  


Even if we can't recall anything in bed, events or scenes during the day may remind us of something we dreamed the night before. We have to be ready to notice this when it happens, and record whatever we remember. It is very useful to focus on these dreams because they mostly reflect us. We can then analyse the remembered dreams by asking such questions as; what action does the dream call for? What other possible meaning does the dream hold?

When Literature and Psychology meet Poetry and stories as a way of healing  
Creative literary writing is now an important component in the therapeutic programme of many mental health professionals. There are a number of recognised clinical and practical benefits that can derive from the practice of creative writing. Deborah Philips, Liz Linington and Debra Penman worked with writing groups at St Charles Acute Adult Day Hospital. From their experience there they concluded that writing: -Provides an opportunity to externalise feelings; 


•Promotes trust and a sense of community; 
•Can prompt reminiscence;  
•Can help to develop concentration and orientation in time;  
•Can promote awareness of others and of the environment;  
•Can help to develop a sense of self- esteem.

Poetry is the spontaneous flow of our powerful feelings. It is an exploration of our deepest and most intimate experiences, feelings, ideas and thoughts. The basic thing in poetry is the use of image, which opens a gate to our inner feelings. Sometimes we read poems written by famous poets and do not understand them ' we need to discover the meanings, which are hidden behind the lines. Poetry therapy is the most developed of the therapies which uses creative writing, particularly in the United States , where it has been well established for some twenty years. There is a National Association for Poetry Therapy, which has standards and procedures in place for Certified Poetry Therapy and Registered Poetry Therapists.  


Techniques of poetry therapy include: reading poems as sparking- off points for individual, family, or group discussion; the writing of poems by individuals, couples, families or groups; the analysis of metaphors and imagery arising from this writing.  
When we write a poem as a way of expressing our inner feelings and thoughts towards ourselves and others, or as a way of healing our wounds, we don't need to form it in the same way that a famous poet might write. It is just a window, which is opened to touch something deep inside us. When we study the case history of some poets we can see how their poems were a source of self- healing. Some people like to write stories from their imagination mixed with real scenes and characters.  


'Hugging the heart and letting the pen flew' is a very valuable step towards healing psychological wounds. It is the most sensible thing we can do. Writing should follow not the rules of a theory but the instructions of each heart. I believe that expressive writing is a means of gaining psychological balance for both optimistic and pessimistic individuals. People who write about their problems and possible solutions can gain control over those problems. As mentioned already, Pennebaker discovered in one of his research studies that writing for 15 to 20 minutes for four consecutive days, about emotionally challenging topics and experiences, increases immune system functioning. The point is not to craft a perfect essay, but to dig deeply into one's emotional baggage, then translate the experience into language on the page. 


This positive change remained for up to six weeks after the end of the four- day writing experiment. Writing about emotional upheavals has been found to improve the physical and mental health of grade school children, medical students, new mothers, nursing home residents and victims of crime. 
The goal of writing therapy is not to win a prize or to publish a best selling book, but rather to use writing as a way of accessing our subconscious feelings. Anyone can do this. Good writing is charged by our true emotions. Writing therapy adheres to this affirmation: ' Write from the heart and act as a judge'.  


Joshua Smyth and colleagues studied the effects of journalising in individuals experiencing asthma and rheumatoid arthritis. Their study is believed to be the first using standardized, quantitative outcome measures to examine how writing about stressful events affect specific illness. The study included 112 patients, 61 asthmatic, and 51 rheumatoid arthritics. 58 asthmatics and 49 arthritics completed the study. Patients were assigned to write either about the most stressful event of their lives or emotionally neutral events for only three days, 20 minutes each day. 


Four moths later, nearly half of those who wrote about stressful events such as car accidents, abuse, divorce, or sexuality, had improved significantly. Asthma patients improved lung function by 19% and patients with rheumatoid arthritis had a 28% improvement of symptoms.  


Although many approaches to narrative/ writing therapy have been developed, none of them have been tried out in Kuwait and other Arabic and Muslim countries. There is a need for further research in this area. 

Motivating the students of Kuwait University to write 

I felt from my experience in teaching at Kuwait University that my students needed someone to motivate them to express their feelings and thoughts through writing. It was also a way to encourage their creativity.  

For some reason I always feel responsible for others, and the people with whom I share my life feel part of me. That was the basic principle which led my students to write freely. It was a good opportunity for them to reflect their own voices in writing, with someone who really cares reading their writing and commenting on it. 

I encouraged them to use reflective and expressive writing for five minutes each day before the lecture started. The purpose of this exercise was very clear to the students; they all knew that they were writing for better understanding and to explore their creativity, and the idea was well accepted. I always asked them just to write, without considering language errors or stopping to think of what to write about ' just whatever came into their minds regardless of any rules or cautions. Most of them would show me their writing and ask me to comment on it. 

I discovered many talented students who might be famous authors in the future.

I also found that they were attending my lecture enthusiastically, because they felt that someone was concerned to help them understand their needs and explore their creativity. A few of them kept their writing secret; hiding it was a way of protecting confidentiality. Others told me that they tore their papers up or burnt them when they got home, so that no one could invade their privacy; this was their way of keeping their reflections in a safe place.  

Some of the students learnt how to give their characters and narrators a life of their own, while others developed more flexible relationships with the different parts of themselves, and managed to open up the possibility of a greater level of inner freedom. This project, which I later developed into a workshop, was taken seriously by my students especially when they were stressed during test time, or when they had emotional difficulties.  

I believe that expressive writing and reflective writing raised my awareness of my students and helped them to resolve the personal issues exposed in their writing. They found a way to explore many issues, which helped them to heal themselves. Some of them were encouraged by me to publish their literary work, such as poems and short stories, in Al Bayan Magazine, a monthly literary magazine published by the Kuwaiti Writers' Association.  

I also suggested that my students read autobiographies of people who held high principles and values, or who are symbols of bravery. I asked them to write down their feelings and the benefits they had gained, when they finished reading the book.  

Students fear of tests (a comparative study)  
I asked 35 undergraduate students, who were studying my Literature of the Arabic Gulf Area course (group A), on the day of their final exams to write down the feelings they were experiencing. They were given only three minutes to do this. When they had finished I asked them to write the following two sentences and read them out loud together three times:  

I am relaxed  

It is a very easy test 

What did the students write?
The students wrote between 50 and 300 words. Their writing focused on the following: 

  • being afraid that the test would be difficult;
  • being afraid of getting a low mark;
  • being confused and unfocused;
  • being stressed because they had another test on the same day;
  • being exhausted because of sleep disturbance the night before the test.
 

On the same day another 37 students who were studying Practical Criticism: Story Writing (group B) did their test without any prior intervention.  

The ensuing test results for group A were better than those for group B. We can conclude from this that the group A students were encouraged to release their stresses, tensions and fears by writing them down, so they became more balanced and focused. Group B did not have the opportunity to let go in this way, so their stresses, tensions and fears affected them.  

Watch it, write it down, then discuss it  
Since the school year 1999-2000 I have been taking the students on my Practical Criticism; Story Writing and Literature of the Arabic Gulf Area courses to the show room at the University where they can watch popular dramatic films based on famous novels and autobiographies. Throughout these three years nearly 450 students have experienced this psycho-literary cycle twice per term. 

When each film finishes I ask them to write in 10 minutes only the feelings and thoughts they have experienced while watching it. When they have finished writing, we have a free discussion and they read what they have written. The amazing thing here is that most of them write an excellent piece of work, expressed with depth and sincerity. They succeed in opening up their creativity and manage to use some reflective phrases. 

By comparison, when I asked my students to read a novel or an autobiography and give me their comments and critical views orally in class, I discovered that they found it difficult to express their feelings and thoughts about the book. However, when they were asked to write down their comments in 10-15 minutes they wrote very well. It seems that writing really can reach deeply into the mind and heart. 

Written words which come from the heart - a personal experience 

I would like here to shed a little light on my own experience of writing, which started when I was ten years old. I was aware of having the right to tailor my own life in the way that I wanted. This principle led me to devize a plan, and I wrote down some important questions that needed to be answered. I was also able to write down my ambitions, dreams and fears, and write about difficult events and unwanted people in my life who annoyed me in one way or another. I believe that when I started writing I already knew what I needed. I kept on writing from the heart and making lists of the things I wanted to accomplish. I was always expecting things to happen and would watch for signs of of my dreams and ambitions coming to fruition between my written words. 

My writing gave me permission to dream and to work on making those dreams come true. I learnt through my writing experience that when I wrote down goals, which were nurtured by good faith and surrounded by strong will to bring them to realisation, my brain reacted positively by inspiring me with bright ideas. Through this writing, which started at a very early age, I discovered my talent for writing short stories and novels. It was a wonderful opportunity for me to explore my creativity and do my best to develop it. I was able to delve into my inner feelings and emotions and to build up my confidence and self-esteem.  

The subconscious speaks to us in different ways, for example: night dreams, a moment of peace and silence, writing a creative piece of work or reflecting inner feelings under difficult circumstances. 

Through our writing, our subconscious is letting us know what we need and what we want. Between 1995 and 1999 I suffered a lot at Kuwait University, after arriving from Scotland carrying my Ph.D. certificate in Modern Arabic Literature. I came full of ambitions and dreams to develop the use of creative literary writing in my own culture by starting a new way of teaching and training students. Some of my colleagues in the department were antagonistic towards me simply because I came with new ideas ' an ambitious and hard working person wanting to change some old fashioned techniques in teaching and pave the way for new research strengthening the link between Literature and Psychology. 

I was strongly opposed during these years, but managed to write down many goals, and do my best to realise them. During the struggle for my rights, I published five articles in five academic Journals in different countries. I also wrote my first short story collection in English and managed to publish a booklet on reducing stress using natural methods. The greatest thing was translating Kuwaiti literary poems and short stories into English and succeeding in having them published in two books by the Centre of Kuwaiti Researches.  

During these years I ran many workshops in creative writing and thinking, developing conversational skills and using writing for self- healing. I gained

a reputation as a successful workshop leader.  

I wondered why my creativity was not stifled during those stressful times and the answer came to mind immediately: it was because of my reflective and expressive writing. While I was writing I used to speak to myself out loud, expressing my emotions, feelings and thoughts towards those hurtful people and difficult events. I believe that my writing has made me a strong and practical woman who knows what she wants.

The difficulties, which I experienced forced me to write and to use very strong and powerful words. Those words affected my brain and proved to me that I can do everything I need to do. And I can face opposition from those who want to prevent me from taking my rights and making my dreams reality. 

Maybe this is a good moment to go back to an old scene, which I still remember. I was a student in the first year of the secondary school. During the English class, the teacher had asked us to write a composition. I was the first to finish this and while I was waiting for the other students to finish I was drawing using a pencil. I thought of writing my name on it and decided to create a nice signature using my first and surname. As I practised, filling the paper with my name, suddenly I noticed that my surname Al-Sanousi, contained two great symbols. The two words jumped into my mind: SUN and SEA. When I went home I started writing in my journal. What do SUN and SEA mean to me? I wrote two sentences; SUN is the strength, the warmth and the clearness. SEA is the huge thing, the purity and treasure. (Kuwaiti people used to dive for pearls before discovering oil). Writing my name opened my mind to some deep thoughts that hadn't occurred to me before. From that time on I have written down everything that comes into my mind. Writing can lead us to powerful ideas and help us to find ways of building up our future.  

Writing autobiography  
From my own experience in teaching creative writing at the university, I can see the spark in my students' eyes when they hear the inner voice. As a creative writer myself, I know the joy of letting go when I write about myself or some particular events of the day. It is a good feeling to be talking to myself about myself - the facts, which I've put on paper are very important to me. This warm sort of writing gives me the understanding, which I need in my life, and a kind of confidence. It does not matter what other people think of me, what I think of myself is more important. I believe that the words are mine; they reflect my own emotions, which mean a lot to me. 

My course Autobiography and well- being was specifically designed to help women to learn how to find their inner voice. Over the eight weeks course, the participants engage in life events writing such as: childhood, school memories etc. They get in touch with spontaneous imagery arising from the subconscious and through their writing explore the world of the inner self.  

Through early memories and sensory imagery they try to find appropriate voices for themselves at different ages; they write the names of people they have known, focusing in particular on their feelings about them, and about places they have lived in or visited. They also write about their feelings from different points of view, placing themselves as narrators and dramatising moments from their lives through the eyes of other characters. Significant moments, people and places in their lives are identified, which can be used as themes in their autobiographical writing.  

The course has proved successful in helping women to develop a deeper relationship with their writing and to energise it with their own rich source material. Because of the deep involvement in their inner feelings, they reach a strong sense of their own identity. 

Psychology and Literature 
The study of Psychology & Literature concerns a careful examination of the similarities and differences between literary and psychological treatments of various major human motivations and conditions. Topics include such phenomena as intimacy, fear, psychosis, self-actualization, death, memory, and social processes.  

In my course on this subject, a wide variety of short fictional writings are considered, as well as readings from psychology, philosophy, and literary criticism. There is an emphasis on original analysis and ideas, and students are expected to be comfortable giving oral presentations and writing clear, concise essays. 

Psychology and literature are both windows onto human behavior. However, their methods may seem to differ: psychology is a science, literature is an art. Scientists must take great pains to pinpoint the objective truth, whereas authors, by one definition, are liars. How are these two methods of exploring the human condition really similar and how do they differ? Can one method describe or explain aspects of human behavior that the other cannot? Which method is the most accurate? Which method is the most satisfying to our current sensibilities? 

I used to teach a course to the Arabic Literature students at Kuwait University entitled A Practical Criticism: Story and Novel. The goal of this course was to foster critical and creative analysis of such questions through the reading of a number of works of short fiction and novels, as well as through research on pertinent psychological findings about the authors and the contents of their literary works.  

I always tell my students that reading writers' stories and their real life experiences helps us to discover our own solutions in similar situations. All literature styles have

a rich psychological dimension. This operates on many levels: not only the imaginary characters and their problems, hopes and interactions, but also as an _expression of the writer's psyche. 

When writers and artist's talk about their work, they often refer to unplanned discoveries and unforeseen developments, as if the work 'takes them over'. This might sound implausible and indulgent, but it could be a reasonable way of describing subconscious process. Writing is a psychological matter: at once a conscious activity and an subconscious one. Reconciling and balancing the two - making the subconscious conscious, and making the conscious tap the elements that are less than conscious - is an essential part not just of the process of writing, but becoming a writer in the first place. 

Most people read literature more than they write it. We enjoy the experience of having the imagination shaped by a skilful author. In the modern computer age, the term 'interaction' has become a widespread goal whether it is in digital games, web sites, or sophisticated television. Yet reading a novel is interactive; walking though a gallery and gazing at traditional paintings is interactive. This term does not only apply to technological wizardry. Reading is interactive because we make interior pictures and interpretations as rich and varied as any multi-media experience - probably more so. 

Progoff's journal method is based on the psychology of literature, and he reverses the more common situation where you explore someone else's work. This is significant. Art of all kinds is not automatically or necessarily creative; much of it is imitative. Creative work means you become the author of something yourself. Progoff begins his book by referring to religious Bibles, which are written by other people. Reading them is imitative, because you are not generating insight yourself. 

If we focus on the active imagination as an important factor in creative literature, we should first mention the names of Freud who used free association and Jung who used what he called active imagination. Active imagination is a psychological state between everyday awareness and the dream world. It occurs naturally in circumstances like listening to stories, watching the flames in a fireplace, and listening to the sea. 

Progoff uses active imagination, but calls it 'twilight imagery'. It is the central method for working intuitively with diary entries. Thus, the book tells you to 'sit in stillness' and move into 'twilight imaging'. The key to twilight imaging lies in the fact that it takes place in the twilight state between waking and sleeping. We find that by working actively in that intermediate state of consciousness, we are able to reach depths of ourselves with which it is very difficult to make contact by any other means.

Story Writing and Healing 
There are two major challenges in writing about extreme trauma caused by natural disasters, sexual and physical abuse, rape, torture, or wartime experiences. The first, and the most important surely, is emotional. We must not use our work to re-traumatize ourselves or put ourselves in danger. The second is artistic and, ultimately, moral. We must find a way to convey an experience that essentially seems beyond language and form.  

DeSalvo offers a way of helping us put our pain down on paper in a deeper more creative way. This process helps us sort out feelings and anxieties and allow us to live a fuller life. The author of several books, she is professor of English at Hunter College in the U.S. She points out that a healing narrative is a balanced narrative. It uses negative words to describe emotions and feeling in moderation; but uses positive words too.

Lived stories are those real-life, actual stories that are happening in the real world all around us all the time. The actual unfolding events relating to any one actual entity or subject comprise that entity or subject's lived story. Everything that exists has, embodies and participates in many lived stories. 

The way to co-intelligently engage in story-reality is to become sensitive to lived stories, to learn about the lived stories of people, places, things, to share our own lived stories and to discover how all these stories intersect, who or what is in the foreground and background of each other's stories. Ultimately, this provides the guidance we need to find our own most meaningful place in the universal story. 

The Therapeutic Effects of Creative literary Writing
Story Writing - A case study 

In this section I would like to shed some light on a famous Kuwaiti story -writer who imprinted her name in the minds of Kuwaiti people and Arabs. Her name is

Laila Al-Othman. She started writing as a teenager, and the deep personal pain she experienced as a girl prompted her to become a writer. The aim of this section is to use a single case history to explore how expressive writing in general, and writing stories in particular, can be used as a therapeutic tool. 

Laila Al Othman  
Laila Othman is a Kuwaiti woman who was born in 1945. She did not finish her studies at secondary school but in 1965 began to publish articles concerning literary and social cases and issues in a Kuwaiti daily newspaper. She published her first book in 1970 and her first short story collection in 1976. 

Laila's first attempts at story writing were published in the local Al-Watan newspaper; later she published many stories in the Arab literary magazines. She is the first Kuwaiti to attract people around the world to her stories. Her writings and works have been translated into English, Chinese, French and Russian. Some of her stories have been translated in Yugoslavia. 

The translated stories were published in specialist magazines in Britain and America. A Polish researcher called Barbara Metalich, submitted her Ph.D. on the literature of Laila Al Othman. Laila now has a definite job but has dedicated herself to her literary work. She is a member of the Writers' Guild in Kuwait and has been on the board of directors since 1993/94. She is a member of the public union of Palestinian Writers and Journalists, the Kuwaiti Society of Journalists and the Kuwait Writers' Association, and takes part in many symposia, and Arab and local conferences. Several of her short story collections, three novels and one diary book were written about her experience during the Iraqi invasion: 

Short story collections 

1. A woman in a pot, 1976

2. Departure, 1979

3. At night, the eyes come, 1980

4. Love has pictures, 1982

5. Fatehiyyah chooses her death, 1987

6. Crazy love case, 1989

7. 55 short stories, 1992

8. Black barriers, 1994

9. Zahrah enters her neighborhood. (Selective stories) 1997

10. It happens every night, 1998 

Novels 

1. The woman and the cat, 1985

2. Wasmiyyah gets out of the sea, 1986

3. The tail, 2002 

Diary Book 

    From the diary of better patience 

Laila Al Othman as a striking example 
For the psychologist, Laila is a striking example of a creative writer who rebuilt her life after years of suppressed grief, and the ongoing violence of her father towards her. Hers is a case, which proves that writing about the traumatic events we have experienced is an extremely helpful way of integrating them into our lives, of helping us feel happier and improving our psychic and physical well-being. 

In my view Laila used her story writing as a way to transform herself from victim to survivor. In the beginning she wrote to comfort herself, but later she could fashion an entire novel in her head before putting pen to paper. Some of her stories were written when she was extremely depressed, feeling lonely and without hope. 

Laila suffered a lot during her childhood. Her parents divorced when she was young and both made new lives, forgetting all about her. She was raised in a rich family with everything she needed. However she was not happy because stealing her psychologically damaged her will to live the way she wanted. Her life was always organised by others - she didn't have the right to say yes or no. She spent her childhood between stepmother, stepfather and sisters in law where she was psychologically abused. She breathed her inner self when she started writing short stories and flash stories. 

Laila retreated into her own world as she discovered that since no one else was paying attention to her, she could focus on herself. She found herself in her expressive writing. Laila was concerned that, being a woman, she was neglected in her family.  

She had the impression that men in her society made demands on women which she refused to accept. Laila had a dream of changing the image of women in Arabic society. When we look at her childhood we can see how much she was hurt by her family and by society, especially when she wrote stories and novels that reflected women in an unaccepted way. She was up against strict tradition and rules but was brave enough to say everything she wanted to. The suffering is reflected in many of her stories. Most of her characters are women in different situations holding their troubles in their heart and trying their best to survive.  

Many people in Kuwaiti society did not accept Laila because she wrote in a way that challenged their customs and traditions. It was a kind of revolution in which she fought for her rights. If we study her stories we can see her personality with all its ambitions, dreams and psychological wounds.  

When I met Laila Al Othman I asked her many questions. From her answers I discovered that she and her stories are very closed. We can see that she is living out her thoughts and inner feelings in her expressive writing. For her, the world of stories is the true world, which can bring her reality and overcome her psychological wounds.  

The sea and the cat  
The sea and the cat were two of Laila's symbols, which reflected her personality, thoughts and feelings. The sea was a symbol of clarity and purity with its blue colour, similar to the ink of the pen, which reflected her soul, her thoughts and her feelings with a clear vision. There is a union between the sea and her pen. In our interview, Laila told me: 

I love the sea, it is part of me. Whenever I write a story I remember it, everyone notices that it's a basic theme in my stories. When I was a child my grandmother used to tell me stories when we were sitting on the beach, looking at the sea and enjoying the sound of the waves and the blue colour of the water.  

We can feel her love for the sea in many of the stories and in her novel entitled Wasmiyyah gets out of the sea. This is the story of Wasmiyyah, a beautiful and kind girl from a high class family who falls in love with a poor boy from a low class family. She tries to oppose the strict rules and way of life in the old Kuwaiti society before oil was discovered, by meeting her close childhood friend at the beach. As they gaze at the sea, which they both love, the guards arrive to investigate what Abdullah, her boyfriend, is doing there in the middle of the night. Scared to death, she hides between some big rocks in the sea, but because the interchange between Abdullah and the guards takes a long time, she drowns.  

The story finishes with a description of Abdullah's life - in love with the sea, which reminds him of Wasmiyyah, the girl he loved. 

The cat in Laila's view looks like a woman - both of them are beautiful but they are under someone's control, the cat under her owner's control and the woman under the man's. There is a chapter entitled Me and the cats in her book Without chains Let me talk. 

She explains her experience with cats saying;

'I have many stories about cats. My relationship with them started with fear when

we lived in mud houses at the sea, before oil was discovered. We used to sleep on the roof and I remember seeing cats walking on the roof edges. We could see their shadows on the wall and I was so scared because they were big and I can't forget the sound of them fighting with each other. I used to put cotton in my ears so I wouldn't hear it. I was scared of them because we have a belief that evil souls live in black cats. I never tried to hurt them because I thought they might take revenge. So I grew up hating cats until I saw a picture of the famous Universal actress Pergete Pardo in the newspaper. She was called the cat P.P. Since that moment I've loved cats because I always believed that I looked like P.P. and used to imitate her. Cats were everywhere in my childhood and youth, and after I became a mother, because my daughter adored cats. For that reason cats have never been hidden in my life as a writer, they entered the world of my stories as symbols, similes, sometimes playing an important role'.(Laila Al Othman , Without chain let me talk , p.56-57)  

Laila's first novel was entitled The Woman and the Cat. Danah was a cat, which played a important role in Salem's life. His cruel aunt, who interfered in his life and abused him during his childhood, killed Danah. In her short story entitled ' The Miaow ' we meet an older, single woman who has suffered a very tough childhood. She is an orphan and lives with her brother and his wife who is cruel to her, depriving her of the joys of life, often even food. She says at one point, 'I eat until I am more than full, not because I want to eat, but because I am filling my stomach for the coming period when I may not find a bite to eat, if my brother's wife gets mad at me. She is awful when she gets angry. She wants to take revenge on me for my childhood and she does this by depriving me of food.' ( Laila AlOthman , Women in a pot , p.22) 

The story continues with a scene between the woman and a cat lying on the grass outside the house. Laila creates a dialogue between them in which she finds a way to describe her misery. At the end of it, a comparison is drawn between the two. 'I have tried to find out all the differences between me and her and all the cats in the world. I do not see differences as much as similarities.'(Laila AlOthman , Women in a Pot , p.23) 'This cat is a female like me and she has a moustache. Why then do women not have moustaches?.'(Laila AlOthman , Women in a Pot , p.22)  

Laila is very much concerned with the grievances of women in Eastern Society where the moustache is a symbol of male power and domination over women. The protagonist's dream vanishes when she realises that the moustache is only for men and she wishes that women could have them. When I interviewed her she mentioned that she was the little girl who suffered that miserable life with her brother's wife. 

Love and women are the recurring themes in Laila's stories. Through her, the Kuwaiti short story argues for women to have the same liberty as men in their lives, and she works very hard to challenge mens' authority.

The woman in her stories cheats as the man does, falls in love as men do and makes love if she wants to with her lover. However, behind this liberation, Laila has her characters acknowledge their psychological make-up and feelings of inferiority; most show cracks from the hard environment around them. 

This combines with their inability to accommodate their social needs because of the old, restraining traditions that rule oriental society. In the story entitled Curiosity a lively, woman seeks the love that she craves. Her curiosity and intense feeling of emptiness is clear in a scene where she is shown discovering a love letter to one of her friends from a neighbour. She blackmails her friend into providing her with a letter as well, from her brother. She says, 'Since when were we not curious?' Sometimes I think that God created us only to uncover things, and after working hard to reveal them, we either find wonder or shock.'(Laila AlOthman , Women in a Pot , p.13)  

The protagonist's unorthodoxy is clear when she gets a chance to meet a man who loves her and wants to marry her. He changes his mind for no other reason than her pre-occupation with curiosity. 

If Laila understands the enfeebling of women as a result of male dominance, she still wishes to reject this as empty power, as shown in her story entitled The Coming Season. She portrays the situation of Kawthar and her daughter Hanan after the death of her husband. Kawthar cannot look for a new love through another marriage because of her brother in-law's domination. He controls her life and threatens that he will take her daughter away from her if she refuses his advances. Kawthar's problem eases when a man proposes to Hanan. With Hanan's marriage she can extricate herself from the chains of imprisonment imposed on her by her brother-in-law and his selfish pursuit of her mind and body. 

The writer's rebellion against the position of women in Eastern society is clear, especially when she has Kawthar say, 'Today women are hastening to leave men's barns. '(Laila Al Othman , Women in a Pt , p.31) At the end of the story the author gives Kawthar freedom from her brother-in-law's control. 

In another story The Other Dress we meet a woman immersing herself in dishonour and vice, by selling her body to other men, to satisfy her husband's desire for large amounts of money. She is not happy about this, as she shows when he asks her to accompany him to one of his night parties. 'I went mad' she says, -and pulled out my hair with desperation. I felt as defeated and subdued as ever. I am torn and the darkness of night, which I had hoped would ease my suffering has become like a giant hovering over me. I am moved from one chasm to another even more daunting. What am I going to do'' 

Here Laila is reflecting the emotions of a woman who feels that she is lost, and feels great pressure from the situation she is living under. Her suffering is caused by a man who, even though he is her husband, treats her and makes her behave as if she were a prostitute. All he wants is to use her to gain money and the favour of rich and famous people. 

We can feel a sense of love in the life of women in Eastern society in Laila's story The Heart and the Smell of Burned Bread. This is a love story that takes place in old Kuwait between Fahd, eighteen years old, and Sara. It has the two of them not only meeting during Fahd's mother's absence, but making love in her bed. Unfortunately, the mother arrives home, catches them, and starts beating Sara, who in the end loses everything. Fahd's mother represents the hard, stubborn mentality which has no understanding of love. Fahd and Sara hurl themselves into love and it leads to their moral undoing. However, the writer thinks that this is going to be inevitable in such a repressed society as hers. It would have been natural, she thinks, for Sara to tell her mother frankly about her love for Fahd, and for Fahd to do the same with his mother. The illicitness of the relationship obstructs such openess, and the consequences are dire. 

In the story entitled The Picture we read of another aspect of women's suffering. The protagonist lives a restricted life and this pushes her to behave abnormally and display a breakdown in dignity. She is a woman aged 45, looking for a frivolous adventure which will involve being unfaithful to her husband. The feeling that she is getting older pushes her to look for another man to satisfy her vanity and make her feel young and desirable again. This feeling intensifies when she looks into the mirror on her birthday. 'In this big mirror, with its glittering, golden frame, I saw reflected my face and upper body. I came closer and closer until it was filled with my face only. I looked at it attentively - that was the moment I decided to be unfaithful to my husband. My face is not that bad but of course it is not as well- preserved as my husband's. It is wrinkled around the eyes, more so than his even though he is over 53 years of age. This is my face and this is a fact, and it arouses real rebellion inside me against him. I stick with my decision; I am going to be unfaithful to him.'(Laila AlOthman , At Night , the Eyes come , p.96) 

Laila Al Othman found herself through writing 
In all her stories Laila managed to reflect her own suffering along with that of other women. She herself managed to marry a man not chosen by her father. Laila also refuses to accept the belief that it is permitted for a man to feel love, but for a woman it is illicit. So when a woman admits that she loves someone this means that she is jumping in where jumping is forbidden. Laila was brave enough to talk about sexual relations between men and women; she gave the women in her stories the right to smoke, drink alcohol and make love with different men. This was a big mistake, which many people in her society will never forgive. 

Bad memories were the background to most of her stories. She tried her best to let her pen go in order to gain psychological balance. Laila didn't have the chance to continue her studies; she was shocked by her father's strict decision. She tried her best to pursue her ambition to become a famous writer by reading her father's books and writing poems and stories.  

Laila was married at an early age. It was her own choice to marry the family doctor who was her father's age. After his death she married another man, so she took on the responsibility of being a mother to children from both husbands.  

Her dream eventually came true and she is now one of the most popular names in the Arabic world. It seems she found a successful way to become a new person with a new life embracing her ambitions, principles and values. 

She is no longer a person who can be easily directed or controlled. She has had enough orders and now doesn't allow anybody to say no when she wants to say yes.

I had many interviews with her and found her to be a strong woman who can fight for anything she needs. She found it very interesting to talk about her own life experience, which is reflected in her stories. When I invited her to talk to the literature students of Kuwait University they asked her to talk about her personal life and memories of her childhood. She told them: 'I lived a hard life when as a child my life was organised by others. I didn't have the chance to make decisions for my self, however I don't have difficulty talking about it. Memories of distant events haven't been buried in my mind all these years - they re-surfaced in my stories. Those memories of suffering were a significant challenge, and it was them that gave value to my stories. 

The level of emotion which I reached in that one stage of my life in some way acted positively when I discovered that I could find myself and heal my wounds by putting my heart on paper. It was an opportunity for me to arrive at a level of self -understanding.'Laila then focused on the reasons she loved her stories and novels by saying: 'I have struggled enough in my life so I believe that I had the right to discover myself by exploring my own world and concentrating on certain events and people. My stories opened the door to a peaceful room where I could rest. I managed to shed a heavy load, which was making me exhausted. I can honestly say that writing saved my life.' 

Laila was interested in what it means to be human, and the process of becoming a good person who can contribute to society and the world. She wanted desperately to tell her society what it meant to be a female.

In total Laila has written eight short story collections and two novels. Some of her stories have been adapted for television.  

It was her ambition to be a strong woman, able to make her own decisions. She felt that all women in her world need to live life the way they want to.

If we focus on her stories and novels, her work is a mirror in which we see her psychological reflection - her thoughts and emotions towards herself and others. A part of her life was reflected in the story entitled Fathiyyah chooses her death . In this story Laila drew on a memory from her childhood when she was totally abused by her stepmother and sister in law. Her personality was spilt in an unfairly. She could not help feeling that as a human being, she had the right to protest about her ordeals. Her stories were told with her own voice. 

She kept finding herself in a situation in which her efforts to do the right thing which is finding a place for herself in her world. Laila stored bad memories for the future in an attempt to find a defensive tool against the abusive reactions of those she was trying to please. These tracks of the events led back to serious of abusive experiences, She was a confused and terrified child who needed support from someone. People's anger made her feel she was failing to live the normal life which everyone dreams of. Laila was able to build a new life based on making herself and others happy through reading short stories and novels. She created most of her stories from the events of her own life. She used the reality of her emotions and feelings to bring the stories to life. She responded to her past life at different levels; one of these was revenge and realizing her inner voice in an attempt to reveal the hidden abused emotions, which never breathe their right. Through story writing she was able to take what she wants, she became increasingly confident asks for her own choices. 

Her first book was entitled Hamasat which means whispers, and was based on short poems which reflected her heart beat. This first experience in expressive writing brought her to a new stage of self healing. It was like a wake up call. She discovered that a lot of things could be brought from her heart. When she started writing stories she experienced different feelings which were hidden in her heart and conflicted thoughts which printed in her mind. She managed to find the right path when she started exploring her own world in an attempt to find her stolen identity. Her writing was her rescuer, it was based on her own feelings and thought, no one has ever the right to be involved in. 

Laila was the author of her own life mixed with those of others in the universal human action of multiple authorship. However she could delete any character she wished to and reveal the personality of many cruel people who had played an important role in her life using different names. 

She gave her literary pen the right to write and publish everything she wanted people to know about, and on the whole this action has led to relief.

She always likes to start any talk or conversation by shedding light on her childhood memories, and is keen to talk about painful events. She believes that if she hadn't suffered these events and written them down, she wouldn't have become a famous writer. 

Laila wrote down her experiences for me. The following paragraphs are from her own personally written words, which have never been published.

It was my fate to be a child hated by everyone; my father divorced my mother when I was three years old. I lived a horrible life but held three dreams in my heart: to be loved, to be a writer and a mother with a great family. I lived between a step- father, a step- mother and my brother's wife. They all abused me and destroyed my childhood. My step-father used to torture me by burning my skin and I would put myself to bed bleeding physically and psychologically. I still remember him screaming at my face while my mother could not defend me or even kiss my cheek. I dreamt of escaping from my mother's house, thinking I could go back to my fathers house where I thought he might give me the affection I needed. When the big door was opened I didn't know that it was the door of hell. The dreams started when my blond hair was cut and thrown in the fire. I received every type of punishment just because I was an unwanted person in that big house. I used to ask myself 'why do they hate me? why do they torture me'? My father was very rich, but I often went to sleep starving. Between the harsh details of that life I lived, there was one kind face among all the other faces. It was our neighbor Om Khalid , whose stories I loved to listen to. The stories of Om Khalid are the best thing I can remember. I feel that those stories were the source of my inspiration. I was a child experiencing a tough childhood, but I found myself in my imagination. The old neighborhood and its people are printed in my mind. The sea and all the stories about Kuwaiti sailors who left on pearl diving journies, also inspired me. I loved the sea with its salty smell, it was the place where

I could breathe my dreams and my ambitions for the future. So the sea became the master of my stories. 

Laila then talks about her childhoods suffering:

' Everything was printed on my mind. The only lovely things in my world were found in my imagination and writing. I discovered that I could have a bright future and was dying to plan for that future. I don't know why, but I can't forget the people who tortured me for no reason. I haven't been able to forgive them till this moment, but I have to admit that they helped me to express myself through writing. This helped me to avoid becoming a woman filled with defects, and a cruel mother who might have tortured her own children.] I believe it was my writing, which made me a strong woman who managed to bring her dreams of becoming a famous author to reality.

I was surrounded by people who abused me and didn't give me the chance to control my own life - that made me so sad. My father was one of the people who controlled my life. I was not allowed to go to cinemas or theatre like my friends and it was very difficult for a child to be in a house like a prison. All I heard was orders and shouting, this was my fate. I have to admit that I hated my father, because he was very tough and my life was like a soldier's life. He wanted my friends at school to see that I was from a rich family, so I was forced to wear jewellery and they all thought that I was a lucky child with a happy life. But it wasn't happy. I was so sad because I was an ignored child with no identity - an orphan although both my parents were alive.  
 

Moments of happiness disappear quickly while sadness remains in our heart and mind for a long time. I can't forget my father's decision that it was time for me to leave school, which came as a big shock. I was an excellent student, but unfortunately wasn't given the chance to continue my studies. The good thing that I remember from my childhood was that he did give me the chance to read his books. 

When we focus on Laila's stories we can feel those memories which built her strength and ambitions. She found in her expressive writing as a child a means of reflecting all the hidden emotions that she was not able or allowed to express. If we read her story 'Fatehiyyah choose her death' we can see Laila in amongst the other characters in the story. Laila was Fatehiyyah, the little girl who suffered a lot as a child for no real reason. She struggled in a life filled with violence, where she was mistreated by her mother in law, her step-mother and her brother's wife. In her story collections, Laila proves that a woman is more able than a man would be, to highlight the issues of the women's world. She managed to focus on the inner feelings of different women in different situations. 

Laila Al Othman and the reflection of woman's image 
In her writing Laila explored her own feelings and thoughts. She was able to create a world of women's suffering in a special way. However, although she was reflecting women's suffering in the eastern world, she also shed some light on a few strong women who stood up against the strict rules imposed on women. 

We can see both kinds in her two novels Wasmiyyah get out of the sea and The Woman and the Cat. We can see womans suffering in her novel Wasmiyyah got of the sea where Wasmiyyah the main character lost her life because of the strict rules in Kuwait Society during 1940s. 

When we read Laila's stories, we can see that women play a key role and scream for help in a symbolic way. Women in her stories and novels are asking for a fair situation and reflecting their desire for a world, which gives weak women the right to say NO to men. 

Women and stress 
Stress is a word to describe a complex series of biochemical changes that occur in the body when the brain or central nervous system perceives a threat to its well-being. The body sets up the alarm response, a primitive response designed to help the organism protect itself. In the distant past, the primitives were affected by episodic stressors such as natural disasters, thunderstorms or encounters with wild animals. The primitive's alarm response, which includes increased adrenaline flow, heart rate, muscular strength and other related physiological adjustments, helped her gather the physical strength to fight or run from the danger.  

Modern woman also has her share of episodic stressors. However, she rarely fights or runs. Instead, her body adapts. Worry, guilt, long-term time pressures, confronting the problems of being a woman in the business environment, questioning her role in society, running a home and a career - these are all stressors. These also cause similar adaptive biochemical changes in the body. Over a period of time, the body runs out of adaptive energy, and stress-related illness occurs. Many women don't recognize stress until it gets out of hand, but we do have plenty of warning. 

The following are some of the common symptoms of stress: headache, stiff neck, back pains, muscle tension, tics, nervous habits, digestive problems, appetite change, sleeplessness, loss of interest in sex, teeth grinding, colds, minor illnesses, mood swings, low self-esteem, irritability, isolation, anxiety, depression, fatigue, distrust, attributing blame, crying. 

Women so Vulnerable 
While it is true that men may face more immediate life-threatening occupational hazards, women appear to be more vulnerable to stress-induced illnesses, for a variety of reasons. First, they are socialized to being caretakers, and as such they almost automatically take on responsibilities that men might not even consider. 

This alone adds to the stress loads they carry. Second, women as a whole are less likely to be in positions of power and are not as able to control what's going on in their environment as most men. If you can't say no, the stress you feel can be doubly disastrous because you don't see any escape. The less power you have over the circumstances of your everyday existence, the heavier the stress load. It may be obvious that what complicates a woman's stress is work. Men who are stretched to their limits at their work places often go home to relax. Women, on the other hand, go home and keep on working. In spite of the increasing number of women with careers and jobs, traditional roles in their homes still take precedence for many women. They can expect to be in charge of everything from childcare to laundry, food preparation, social calendars, and runny noses.  

Delegating these duties to others in their households helps, but in the long run most women are still in charge. Given this situation, their minds as well as their bodies work overtime. When they become angry about too much to do in too little time with too little help, the anger only adds to their overstressed physical condition. Even women who sense their own need to slow down are programmed toward over-commitment because they feel guilty about not being able to be everything to everyone in their lives. Time spent alone or nurturing their own mental and physical well-being might be construed as selfish, so they push even harder on all fronts - home, work, and social life. Sociologists speculate that many women today may be disadvantaged because they have incorporated a male standard for achievement in the work place with an old-fashioned female standard for perfection at home. 

Women can cope better
Interestingly, a recent study by Professor Shelley Taylor of the University of California has shown that women cope with stress better than men because of their female hormone. He believes that in history women often didn't have the option to fight or to flee - for the simple reason that they were frequently pregnant or encumbered by small children. So he concludes that women developed a more suitable strategy for them, which was to 'tend and befriend'. In other words a woman would look after children or other dependants close by - and do what she could to keep them safe - but she would also enlist help from a female friend. The key to this behavior was, and is, a female hormone called oxytocin: and Professor Taylor and his team believe that it is this difference between men and women that accounts for women frequently seeking out other women to talk to when the going gets tough. 

Kuwaiti Women and Expressive Writing  
Expressive Writing is a blending of techniques that release the inner meaning, feelings, and ideas of the writer. It gives shape and form to the energies and growth

of the inner Self. The Expressive Writing process itself is growth and positive development. I carried out a questionnaire survey of 150 Kuwaiti women. It covered the use of expressive writing for self- discovery, self -development and as a way of healing. The women were between 18-42 years old. A copy of the questionnaire is included in this research can be found in Appendix. The results were as follows: 

Stress:

23% were deeply stressed;

41% suffered from stress sometimes;

36% had no stress in their lives. 

Understanding themselves and knowing their own needs:

45 % understood their inner selves;

13% knew something about themselves;

42% didn't know anything about themselves. 

Hiding feelings, emotions and worries:

41% always hid their feelings, emotions and worries;

40% sometimes hide their feelings, emotions and worries;

19% revealed feelings, emotions and worries. 

Use of expressive writing for emotional disclosure, self -discovery and self-healing:

Writing letters

12% always wrote letters

13% wrote letters sometimes

75% never wrote letters 

Writing reflective glimpse

22% always wrote

19% wrote sometimes

59% never wrote 

Writing about important events

19% always wrote

21% wrote sometimes

60% never wrote 

Writing diaries

6% always wrote.

22% sometimes wrote.

72% never wrote. 

Express yourself - A Workshop in Expressive Writing 
This workshop was designed for 18 married women who had some social and psychological problems and were aged between 28 and 50 years old. They completed a stress questionnaire before the first meeting. A copy of the questionnaire is included in this research can be found in Appendix. They were asked also to write down the sources of their stress and their goals for joining this workshop.  

The following sources of stress were cited:  

Being unhappy at work, having differences with their colleagues and their boss.

Being mothers of between two to five children with an overload of responsibilities of following up their homework and their needs in life. [for keeping up with their housework and their needs in life].

Being wives of irresponsible men who relied on their wives for everything.

Being lost in a mean of misunderstanding their social and psychological needs in life.

We can see that the sources of their stress were social but over time it affected their psychological balance. They felt the need to regain that balance in order to continue their lives. 

This workshop included a workbook and some instructions to be followed. The technique they started with was ' Hug your heart, Let you pen flow'. The workshop took place for two weeks only, three hours per session twice a week. (Saturday and Wednesday).

The 'Hug Your Heart and Let Your Pen Flew ' Technique  
The workshop was a journey of hugging the heart through expressive writing. In it the logic of the heart is very sensitive and focused. Participants learned to trust the sensitivity and focus of their hearts, in order to recognise their emotions and feelings. 

They should follow the signs of their hearts and never resist any emotion which may come by Following their hearts, and not resisting any emotion which was experienced, they asked themselves honestly 'what do I feel and why?' Finally they wrote this down without any restrictions. 

In the first session I tried to explain the theory of Writing as a therapy and shed some light on the most important goals which my students could reach when they wrote about their emotions and feelings towards everything in their lives. I gave them some examples of expressive writing and talked about how this technique can release stresses and develop the personality. I opened a discussion circle and gave them the chance to ask any questions about writing for healing. The following questions were asked: 

* What if I don't like writing?

* What if I don't know how to express myself?

* I am not good at writing, so this technique will not work for me. Shall I continue with the workshop?

* I can't write about the details of my life. I need to but there are some secrets which must be hidden. How can I protect my privacy?

* Is this method successful' Can I really heal myself by myself?

* Can I share my experience with others?

* Do I have to write about everything that made me stressed?

* Can I support myself by myself at the end of the workshop' 

* You have mentioned that some researchers have proved that by writing down our emotions and feelings we will increase the function of our immune system. I have high blood pressure. Can I expect to find a way to lower it?

Before asking the group to write anything I tried to create a comfortable environment. I gave them some suggestions for ways of relaxing while writing - a stretching exercise and a breathing exercise. 

I asked them then to close their eyes for a minute, take a deep breath and think of nothing. 

I lit a big Lavender candle and I put few drops of lavender oil on the candle burner. 

Then I wrote down the following question on the board: 

Who are you? What do you need?

I asked them to open their eyes and to focus on the question which was written on the board, then start writing one page only. I said: 'Please be really focused and write from the heart'. I gave them only 10 minutes to write. Watching their faces as they wrote I noticed that they were very excited. This was a new experience for them and a serious step, nothing like writing compositions in school lessons. When ten minutes had passed I asked them to stop writing, to take a deep breath and then exhale all their stresses. I also suggested drinking a glass of cold water, which can be very good at this time. I gave them a big smile and asked this question: What do you feel now? And why' ?

Then I listened to them as they expressed their feelings. I ended our meeting by asking them to spend 15-30 minutes each day for the next three days, on one of the following exercises:

The Exploring Exercise 

* Relax on the bed and take a deep breath.

* Bring a recorder and a tape.

* Close your eyes and talk to yourself about yourself.

* Stop when you feel you want to stop.

* Listen to your voice and explore yourself.

* Transfer your self- exploring to paper.

* Smile and drink a glass of water when you've finished. 

The discovering exercise 

* Sit in a room where no one will come and disturb you.

* Light a lavender candle or any relaxing aromatic candle.

* Take a deep breath and smile.

* Hug your heart by writing down every event that has caused you

stress.

* Discover the pleasure of writing about yourself and your needs.

* Blow the candle out.

* Smile and drink a glass of water. 

Touch your wound exercises 

* Take a sheet of paper and listen to the hidden voice that you know you

    need to listen to.

* Release all the stresses and touch all your psychological wounds.

* Don't hide secrets or emotional difficulty.

* Protect the privacy of your writing by using a password language.

* Read what you have written.

* Focus on people who have annoyed you and write them a letter which, they won't read.

* Focus on the difficult emotions that are stored inside you.

* Let everything go.

* You can either tear the paper up or burn it.

* Drink a glass of water or fresh lemon juice mixed with fresh mint. 

When I met the group again on Wednesday, which was the second session I wrote this question on the board: What do you feel after three days of writing. I was very glad when they happily expressed their feelings towards this new experience.  

I asked whether they could write about their feelings towards their psychological needs in life. This was a very important question and I saw the concern in their eyes. I gave them 15 minutes to write and then asked if we could swap the papers, so no one knew who had written them. 

On the last day of the workshop the women asked if they could have another chance to meet me and I agreed, but only after one month. I gave them a workbook and asked them to try their best to consider the suggestions in it. I gave them my e-mail address and fax number and asked them to write to me if they needed to ask about anything. I then put four sentences on the board for them to write down in their diaries: Trust yourself. Hug your heart. Listen to your voice. Let your pen flow.  

The Kuwaiti Women express their feeling towards Expressive Writing 

I asked the group to send me their experience of expressive writing after one month. This is what they said: 

* This workshop was a very nurturing supportive experience for me. It helped

me to know who I am and what I really need. 

* I loved writing about my inner feelings and I was very connected with my soul. 

* It was an amazing experience. I am addicted now to exploring through expressive writing. 

* I believe that I found the expressive writing workshop a perfect technique for self development and self exploring. The feeling of writing was a little bit scary but now I enjoy it, even when I write about my bad memories. 

* Expressive writing improved my personality and creativity and increased my self awareness. It has healed some of my emotional wounds. 

* It encouraged clarity for successful self examination and concentration. 

* Through writing I developed an effective method to not only recognise feelings such as anger and pain but also to define and manage those feelings. 

* Writing to me is a way of learning to achieve emotional stability which is often a balancing act. 

* I was stuck with my interview issue from the past and fears about the future but I am now a different woman. 

* The workshop was a place where I learned not only what I want to be but also what I will be. 

* The workshop gave me the feeling of gaining power to direct my life. 

* I discovered that I am the only one who is in charge of my life and no one has the right to ruin it. 

* It was a great journey into the darkness of the soul. I was not feeling secure when I joined the workshop as I thought some of my secrets might be revealed, but it worked. 
 

* In this workshop I was drawing myself, painting my emotions in a very special way. 

* Writing about me seems to be very difficult. It was like holding a torch in a dark tunnel where you can't see anything. I was afraid of falling over suddenly. I was searching for a light to make everything clear to me. the scary feeling ended when I managed to write about myself. 

* In this workshop I opened myself to the hidden possibilities of my life. It was a way to listen to my deepest self. 

* The most important goal, which I reached in this workshop was putting my pain in the background. 

* Only now I know what I was really searching for. I collected the part, which was lost for ages. 
 

References 
 

Al Sanousi , Haifa .The Kuwaiti Short Story: 1947-1985 An Analytical Study of Its Social and Political Aspects, Univesrity of Glasgow, U.K. 1995 

Al Othman , Lalia . At Night, the Eyes come in, Kuwait 1984 

Al Othman , Laila . Without chain let me talk , Dar Al Robia'an , Kuwait 19993 

Al Othman , Laila .Women in Pot, Al Robai'aan Press, Kuwait 1993 

Bolton , Gillie.The Therapeutic Potential of Creative Writing p.128

Jessica Kingsley Publsihers, London 1999 

DeSalvo , Louise .Writing as a Way of Healing: How Telling Our Stories Transforms Our Lives, Beacon Press, Boston, USA 2000 

Fox, John . Poetic Medicine, Jessica Akingsley , London 1998 

France, Honore. Letter Therapy: A Model for Enhancing Counseling Intervention , Jan Cadieux and G. Edward Allen . Journal of Counseling & Development Published by the American Counseling Association Volume 73 Number 3 January/February 1995. 

Gersie ,Alida. Reflections on Therapeutic Storymaking: The Use of Stories in Groups.

Jessica Kingsley Publishers , London 1997 

Huddle, David. Have a look at the book entitled 'The Writing Habit'

University of Vermont Hanover and England1991 

Lepore , Stephen. J and Joshua M.Smyth. The Writing Cure , American Psychological Association Washington USA 2002 

McLeod , John .Narrative and psychotherapy p.31-32 ,SAGE Publications, London 1997 

Parry , Alan and Robert E.Doan. Have a look at the Book entitled ' Story Re- visions'

The Guilford Press, New York USA 1994  

Payne , Martin .Narrative Therapy p.11. SAGE Publication , London 2000 

Pennebaker, James. Opening Up, p. 40, The Guilford Press, New York USA 1990 

Philip, Deborah , Liz Linington and Debra Penman. Writing Well- Creative Writing and Mental Health. 

White, Michael and David Epston. Have a look at the book entitled 'Narrative Means To Therapeutic Ends'. A Norton Professional Books, USA 1990 

To cite this article, use this bibliographical entry: Haifa Al Sanousi, Ph.D. "The Psychological Role of Expressive and Literary Writing - A Case Study on Kuwaiti Women". PSYART: A Hyperlink Journal for the Psychological Study of the Arts. December 15, 2009. Available http://www.psyartjournal.com/article/show/al_sanousi_phd-the_psychological_role_of_expressive_and. May 28, 2004 [or whatever date you accessed the article].
Received: May 5, 2004, Published: May 28, 2004. Copyright © 2004 Haifa Al Sanousi, Ph.D.