Art Ps.vchotherup~, Vol. 5 pp. 211-215, Pergamon Press, 1978. Printed in the U.S.

A
ASSESSMENT OF MOOD CHANGE AS A FUNCTION OF POETRY THERAPY*
RAYMOND F. LUBER, M.DIV.
University of Pittsburgh
School of Medicine
INTRODUCTION.
The use of poetry as a therapeutic technique
has expanded to a variety of settings including
correctional institutions, drug abuse programs,
inpatient psychiatric hospitals, partial hospitali-
zation programs, individual psychotherapy, and
multiple family therapy groups (Hersen & Luber,
1977; Leedy, 1969a, 1973; Lemer, 1973; Luber &
Wells, 1976; Luber, 1978). This expansion has
led to increased speculation regarding both the
utility and effectiveness of the technique. Prac-
titioners have hypothesized that poetry can be
utilized effectively as a cathartic agent (Luber,
1973), as an aid in the achievement of emotional
insight (Berger, 1969), and as a means of facilitat-
ing communication between individuals in
group psychotherapy settings (Buck & Kraemer,
1974). However, with the exception of one in-
vestigation which demonstrated some positive
changes in patients participating in poetry ther-
apy (Edgar & Hazley, 1%9), little empirical in-
vestigation has been conducted. Indeed, only
minimal research results are available in the
entire field of poetry therapy including the
theoretical/conceptual and clinical areas (Berry,
1978).
One of the basic issues facing therapists utiliz-
ing poetry therapy has been the choice of mate-
rial to be used with clients/patients. This issue
has been raised by several authors (Edgar & Haz-
ley, 1969; Luber, 1976; Tedford & Synott, 1972).
Generally, poems have been chosen largely on an
intuitive or subjective basis (i.e., the individual
therapists feelings regarding the utility of a
given poem), on the basis of trial and error over a
duration of time with a variety of subjects, or
simply because the poem is widely known.
However, on a more theoretical level,
therapists have generally appropriated the so-
called iso-principle from the area of music
therapy as a guideline for the choice of poems
and as a rationale for the effectiveness of poetry
therapy. Alvin (1966) explains this theory as it
applies to music therapy by stating that the
magic iso-principle is fundamental in the induc-
tion of moods, meeting the patient first in his
actual emotional climate. To establish a basic
rapport between the patient and the music, the
latter must be chosen to fit his frame and speed of
mind.
This rationale has been extended to the selec-
tion of material utilized in poetry therapy. For
example, Murphy (1973), in discussing the con-
ditions by which poetry becomes therapeutically
valuable states that the third condition
the iso-principle, which means that the
Leiingof the poem must be the same as the feel-
ing of the person hearing the poem. In addition,
Leedy (1%9b) utilizes the same principle in rec-
ommending the use of sad and gloomy poems
(with positive endings) with depressed patients
on the assumption that this will lessen the
patients depression by decreasing his/her sense
of alienation.
As has been pointed out elsewhere (Luber,
*Requests for reprints should be sent to Raymond F. Luber, M. Div. Assistant Professor of Clinical Psychiatry, Western
Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pa. 15261.
0090-9092/78/040211-05$02.00/O
Copyright o 1978 Pergamon Press, Ltd
212 RAYMOND F. LUBER
1976), the utilization of the iso-principle as a cri-
terion for the selection of poems rests on the dual
assumption that both the mood of patients and
the mood of poems can be reliably identified and
labeled so that they can be matched in the
therapeutic situation.
Two studies have offered preliminary findings
indicating that poetic mood can be identified to
some degree. Tedford and Synott (1972) iden-
tified the mood evoked by four types of poetic
feet; they concluded that meter or structure de-
termines a portion of the mood evoked by a poem
and should be considered in selecting material for
use in therapy. Secondly, Luber (1976) demon-
strated that poems can be classified by general
mood (positive or negative) and that the identifi-
cation of specific poetic moods such as anxiety,
depression, etc. is a complex and difficult task
which is not consistently identifiable across
readers. This paper reports on a study designed
to investigate the interaction between poetic
mood and the mood or emotional state of partici-
pants in a poetry therapy group.
METHOD
Subjects
Ten subjects who were patients in the Partial
Hospitalization Service at Western Psychiatric
Institute and Clinic, University of Pittsburgh
participated in the study. Each participant served
as his/her own control by attending five experi-
mental and five control groups during a three
week period. Demographic characteristics of
participants are summarized in Table 1.
Procedure
A series of five experimental (Poetry Therapy)
and five control (Current Events) groups were
held over a three week period; all subjects par-
ticipated in both experimental and control
groups. The same therapist conducted all group
sessions. Poems and current events material
used in each session were independently rated
using 7 semantic differential scales (Osgood, Suci
& Tannenbaum, 1957) to identify their positive or
negative mood. The criterion for the classification
of a poem or current events material by mood
was one standard deviation above or below the
midpoint on all seven scales (see Luber, 1976, for
a more detailed description). Table 2 presents the
affect or mood rating of poems and current
events material utilized in the session; current
events material consisted of articles taken from
newspapers or magazines.
Rated poems and current events material were
placed in random order and presented in alter-
nate sessions during the study. In addition, in
order to assess the degree to which participants
comprehended the content or meaning of the
poetic material (misunderstanding could theoret-
ically create an unintended mood in subjects), a
multiple choice question was included at the end
of each poem; participants were instructed to
check the statement which best reflected the
meaning of the poem. The degree of comprehen-
sion for each poem is included in Table 2.
Testing Procedure
In order to assess the effect of experimental
Table 1. Demograohic Characteristics of Participants
Number of Number of Days
Sex
Age IQ
Previous in Program Diagnosis
Hospitalizations Prior to Study
Males=3 Mean = Mean= Mean= Mean= Schizophrenia 4
Females=4 32.4 104 4 38.7 Bipolar
depression 1
-
Median = Median = Median= Median = Schizoaffective 1
Total=7* 34 99 4 39 Deferred 1
(16-57) (80-134) (O-8) (9-W
*Complete data were available on 7 of 10 participants. Only those subjects are included in the data
analysis.
MOOD CHANGE AND POETRY THERAPY 213
Table 2. Affect Rating of Poems and Current Events Material
Percent
Mean Affect/Mood Identifying
Rating Rating Poem Meaning
Current Events #1
Current Events #2
Current Events #3
Current Events #4
Current Events #5
3.62 Neutral
4.83 Neutral*
4.94 Neutral*
3.52 Neutral
4.70 Neutral*
Man Who Chose 5.66
I Can See A New Day 1.90
Malleable As You Are 5.61
Youve Got A Friend 1.98
The Hammers 5.21
Negative
Positive
Negative
Positive
Negative
86%
71%
100%
100%
71%
*Did not meet classification criterion on all rating scales.
and control material on the mood of subjects, the
same rating scales used to classify poems and
current events material were administered at
three points during each group session: 1) at the
beginning of each session, but prior to the distri-
bution of the experimental or control mate.rial; 2)
immediately following the distribution and read-
ing of the material; 3) at the end of each session
following the discussion of the poem or current
events material.
To determine the sensitivity of rating scales to
mood change and to instruct participants in the
use of the scales a pilot session was conducted.
In this session, imagination techniques were used
in which subjects were asked to recall the most
disturbing and the happiest events in their lives.
Following the recall of each event subjects were
requested to rate their mood using the seven
semantic differential scales. An analysis of vari-
ance yielded a significant difference (F
1,7=12.05, pc.025) between the two ratings
confirming the ability of the scales to measure
mood or affect changes.
RESULTS
An analysis of variance was performed on the
scores obtained at the testing points described
above. This analysis yielded no significant
differences between the first and second mood
ratings (pre-reading and post-reading) for any
groups in either the experimental or control
condition. In addition, only one significant
difference was discovered between pre-reading
arid post-session mood ratings and that was in
one of the control (current events) sessions (F
1,6=6.07; pc.05).
DISCUSSION
It has been hypothesized that in poetry
therapy the so-called iso-principle should be
utilized in selecting appropriate material for use
in treatment. This principle calls for the matching
of poetic mood with the mood of the individual
hearing the poem. The iso-principle rests on the
supposition that poetic mood affects the mood of
those participating in poetry therapy. More spe-
cifically, Murphy (1973) indicates that poetic
mood has the ability to induce moods in partici-
pants; and Leedy (1%9b) implies that poetic
mood can be influential in changing the mood of
participants.
The results of this study fail to support this
hypothesis. No interactive effects were found be-
tween poetic and participant mood. There was no
evidence that poetry per se was a tool for either
the induction or the changing of patient mood.
Indeed, the only mood change evidenced
throughout the study was produced in one of the
control (current events) groups and occurred
only after the discussion portion of the group. It
must be recognized, of course, that the small N
in this study does not permit wide generalization
RAYMOND F. LUBER
of results. Nevertheless, in light of the total ab-
sence of empirical support for the inclusion of the
iso-principle in the rationale of poetry therapy,
these results do suggest the necessity for further
investigation.
Finally, the results of this study suggest that a
rationale for the use of poetry therapy must be
sought in an area other than that of its effect on
affect or mood. Previous investigations have
indicated the difficulty of accurately and consis-
tently identifying specific poetic mood; further,
when utilized in a group therapy setting the task
appears more complex since it would then be
theoretically necessary to identify a group mood
as well.
Other areas in which poetry may be useful
have been suggested. Buck and Kraemer (1974)
propose that poetry may serve as a means of
facilitating interpersonal interaction in the group
setting. In addition, it has been hypothesized that
poetry may serve as a method for assessing cog-
nitive functioning, as a thematic focus for group
interaction or as a tool in cognitive restructuring
and problem solving approaches (Luber, 1975).
Similarly, Heninger (1977) suggests that poetry
may serve as a catalytic agent in the stimulation
of new perspectives and the ordering and re-
ordering of thoughts when patients write
poems. And, finally, Lemer (1973) suggests that
poetry can open vistas of feelings which, if
properly synthesized, may lead to positive kinds
of behavior. These uses have yet to be investi-
gated and remain largely conceptual and theoret-
ical in nature.
However, some empirically based investiga-
tions have recently appeared which may be use-
ful in specifying the function of poetry in the
therapeutic setting. Most notably, Berry (1978)
has reported studies related to the reading-in-
crisis and/or writing-in-crisis behavior of indi-
viduals and the effort to place poem selection on
a more objective basis. Several suggestions of
interest to the poetry therapist have been pro-
posed as a result of these studies, including the
following:
1. Previous writing behavior is predictive of
whether or not an individual will utilize
literature in times of crises;
2. Individuals with high operant literature-
reading or literature-writing levels are
likely to use therapy based on such behav-
iors;
3.
4.
5.
Groups using literature should be struc-
tured so that there are some members who
already read or wrote literature prior to
therapy to serve as models for other group
members;
An entire poem (rather than some smaller
portion) is of most importance in generat-
ing interpretations and evoking feelings in
readers;
A poems subjective value to the reader is
related to the frequency with which it
evoked feelings in the reader.
These studies offer at least preliminary data
regarding the function of poetry therapy as well
as the population which might most benefit from
the utilization of the approach. It may be, indeed,
as Berry suggests, that further refinements will
make it possible to accurately describe the
feeling-evocation properties of a poem. There
remains, however, a question regarding the use
of this ability. Several techniques are currently
available which appear quite effective in evoking
(or provoking) feelings in patients. What advan-
tage(s) poetry might have over these techniques
(is it more effective with certain populations,
under certain treatment conditions, etc .?) has not
been demonstrated, nor has evidence clarified
the role which the feeling-evocation properties of
poetry might serve in the therapeutic situation.
The study reported in this paper indicates that
this role, in all probability, does not lie in the
realm of effecting patient mood, either in the in-
duction or the changing of mood. Future investi-
gations might, therefore, profitably consider this
question in greater detail.
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