Mila Daskalova reflects on the importance of poetry to psychiatry, both in the nineteenth-century and the present day.
Walking across the grounds of St Nicholas’ Hospital in Newcastle, I cannot help but look up with awe at the tall clock tower sticking above the surrounding buildings. Built in the late 1890s, the clock tower has given rhythm to the operations of the institution for decades. The hospital itself, known locally as St Nick’s, was established as Newcastle upon Tyne Borough Lunatic Asylum in 1869. As I approach the entrance to the main building, I realise the symbolic meaning of the watchful clock above me on this Friday afternoon in late August 2025. The reason I am here today has everything to do with time. I am about to teach people how to stop it. Or at least how to slow it down through poetry.
This is the first time I am running my ‘Back to Poetry’ workshop for psychiatry trainees and professionals.* Dr Caroline Hayes, psychiatrist and member of the Royal College of Psychiatrist’s ‘History of Psychiatry Special Interest Group’, has kindly invited me to test out my idea at St Nick’s. The four-hour workshop aims at drawing attention to the important role of poetry in nineteenth-century psychiatry amongst contemporary practitioners. Through engagement with poetry, it also shows them how poetic thought can help with confronting the challenges of their work—by promoting introspection, empathy, and accommodating ambiguity and otherness.
Poetry and Nineteenth-Century Explorations of the Mind
When it comes to explorations of the mind, poetry was there before psychiatry became a distinct discipline. The Romantic poets laid the foundations of psychoanalysis around the turn of the nineteenth century—around a hundred years before Freud (Falflak, 2008, 7). As madness entered the domain of medicine in the late-eighteenth century, physicians too wrote poetry to examine and share advice on the preservation of a healthy mind (Faubert, 2009, 1-2). Some nineteenth-century asylum superintendents (or alienists) encouraged patients to compose poetry and other kinds of writing as a means to restoring them to ‘sanity’. The literary work of patients soon appeared in asylum periodicals and newly emerging professional journals (Reiss 2008, 24; Daskalova 2025, 56–57; Blumenthal 1995, 8). In medical publications, physicians scrutinised the works of Shakespeare, Lord Byron, Samuel Taylor Coleridge and other prominent poets to study the relationship between the imagination, genius, and madness (Whitehead, 2017, 88).
As the nineteenth-century progressed, psychiatrists showed preference for more ‘scientific’ language and became less willing to engage with literary criticism. For instance, in his review of Alfred Lord Tennysons’ poem Maud in the Asylum Journal of Mental Science (now the British Journal of Psychiatry), John Charles Bucknill (1817–1897) anxiously observed that engaging with poetry was ‘debarred by the custom and opinion of his profession’ (Bucknill, 1855, 95). Yet, recognising the connection between psychiatry and poetry, he praised Maud for being ‘wonderfully true to nature,’ and urged poets and doctors to join forces and become ‘fellow-students’ of the human mind (Ibid. 1855, 102, 104).
Bucknill’s call was not enthusiastically answered by his British medical colleagues. Caught in the schism between science and art, psychiatrists were starting to prioritise the pursuit of objectivity through clinical research and the collection of empirical data (Blumenthal, 1995, 27). Keen to establish themselves as medical experts, psychiatrists became less willing to engage with literature and creative writing which were associated with the subjective, artistic self. Time was also an obstacle. In the prospectus of the Asylum Journal, Bucknill reflects on the difficulties of establishing a professional periodical for alienists, since ‘their occupations … are greatly antagonistic to literary habits’ (Bucknill, 1853, 2). Managing large institutions left little time for focused writing, be it of scientific or literary nature.
The Value of Poetry to Psychiatry Now
Time continues to be in shortage in contemporary psychiatric practice. In response, at the St Nick’s hospital workshop, I keep my historical presentation brief, following it by an outline of the benefits of poetry to modern-day psychiatry. ‘Something is lost, as medical students move through their training,’ writes psychologist Victoria Tischler (Tischler, 2010, 19). The focus on medical categories, positivist data, and efficiency, limit consideration of the patient as a human and of the contexts in which illness and distress are experienced (Charon 2001, 1897; Butchart and Parsa 2024, 160). Creative writing, close reading, and group discussion of literature, have consequently been incorporated into Narrative Medicine and Medical Humanities curricula in the US and the UK.
Reflecting on his experience of teaching poetry to medical students at Columbia University, poet and professor of psychiatry Owen Lewis identifies its various positive outcomes: improved observation skills, recognition of the role of intuition and creativity in clinical encounters, and an ability to relate to and empathise with others (Lewis, 2023). Relying less on clear narrative than on metaphor and images, poetry is especially well-aligned with the fragmentary but intense nature of encounters in the psychiatric clinic: ‘lyric language could build a bridge to others that would allow authentic communication while respecting difference’(Kirmayer, 2007, 22). Recently, there have been proposals for the use of poetry in interactions between psychiatrists and service users, to assist with writing clinical formulations, or to entirely reimagine the meaning of medicine and psychiatry (Kalkat 2023; Kumar 2024; Bleakley and Neilson 2024).
Reading or writing poetry forces us to stop and focus. It teaches us patience and flexibility of thinking, as figurative language challenges us to look beyond what’s immediately available and explore the intellectual and emotional responses inspired. Poetry’s rhythm, interruptions, and leaps between words and meaning is what leads us to the most surprising discoveries. It allows us to leave aside our theories and logic for a moment, follow our intuition and connect with other minds. Finally, poetry offers comfort: it reminds us that uncertainty is okay. We can give it another go, read the lines once again, or cherish the questions with which a poem has left us.
Back to Poetry
I am aware that the pressures on the time of practitioners poses a challenge, if not an impossibility, to engagement with poetry. But accessing the resource of poetic thought doesn’t have to take long and gets easier with practice.
After a basic introduction to the main literary devices used in poetry, participants in the workshop are given their first full poem. Together we read Mary Oliver’s ‘Breakage’, which takes us on a trip to a beach, where ‘everything shines in the morning light’ (Oliver, 2003). With every line, however, the poem reveals the chaos and destruction beneath the shining surfaces: ‘the broken cupboard of the clam’, the ‘barnacle scarred’, ‘nothing at all whole or shut’ (Ibid). After reading it out loud, we spend a few minutes in silence, alone with the poem. Then we share our impressions. Some love it, some are not sure, some have concluded it is not their cup of tea. We dig deeper. What do we like? What confuses us? Different meanings emerge, complement each other, and clash. During the conversation, many of those who were originally put off by the poem begin to find enjoyment in it.
One of the participants views the poem as about the process of understanding the chaos and pain of life. The beach is described as a ‘schoolhouse’; its pieces are ‘thousands of words’ (Oliver, 2003). Perhaps these refer to the hidden lessons we find in the suffering of ourselves and others? Or maybe it’s about the need for meaning, our attempts to ‘read’ the world, to make sense of the seemingly incomprehensible. We then talk about the ways in which facing the disjointedness, the discomfort, the mystery of poetry compares to interacting with living human beings, who can be equally fragmented, discomforting, and perplexing. But while one can stop reading a poem halfway through, there is a different kind of responsibility when ‘reading’ people—especially those in a position that demands understanding, care, and support. Spending time with poetry teaches us curiosity and perseverance, while knowing that there might not be a fully satisfying ‘click’ of meaning. Sometimes ambiguity is part of the message.
The time comes for writing our own lines. I have prepared a small collection of objects for inspiration and a series of questions to guide us. By the end of the exercises, many are surprised by how easy they found it, the insight they gained from their pen, or simply the pleasure of finding the right words and sharing them with caring listeners.
Can this newly discovered power be applied to the professional and personal lives of psychiatrists? Potentially. It can be a tool for self-reflection, for processing difficult experiences, or for seeking new perspectives on situations encountered. Writing and reading poetry can also serve as an invitation to conversation between practitioner and person, a new way to build trust and mutual understanding, a collaborative project, a shared adventure.
As I leave St Nick’s, the clock is still there, but it seems less intimidating. I am hopeful that, despite the demands on their time and attention, participants will return to the pleasant slowness of this afternoon and seek new ways of connecting with themselves and others. I know I will.
* The ‘Back to Poetry’ workshop is a part of my British Academy funded research project on the literary origins of nineteenth-century British and American psychiatry. It is a collaboration with the History of Psychiatry Special Interest Group at the Royal College of Psychiatrists.
About the author
Mila Daskalova is a British Academy Postdoctoral Fellow at the University of Glasgow, associated with the Medical Humanities Research Centre. Her research explores the early development of psychiatry in conversation with literary culture. Her first book, The Nineteenth-Century Asylum Periodical, will be published by Cambridge University Press.
References
Bleakley, Alan and Shane Neilson. 2024. Routledge Handbook of Medicine and Poetry. London: Routledge.
Blumenthal, Susanna. 1995. “‘The Tempest in My Mind:’ Cultural Interfaces between Psychiatry and Literature, 1844-1900.” Journal of the History of the Behavioral Sciences XXXI, no. 1: 3–34.
Bucknill, John Charles. 1855. “Maud and Other Poems, by Alfred Tennyson, D. C. L.” Asylum Journal of Mental Science 1, no. 2: 95-104.
—- 1853. “Prospectus.” Asylum Journal of Mental Science 1, no. 1: 1–7.
Butchart, Liam, and Shabnam Parsa. 2024. “Narrative Medicine Theory and Practice: The Double Helix Model.” Medical Humanities 50, no. 1: 153–61. https://doi.org/10.1136/medhum-2023-012648.
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Faubert, Michelle. 2009. Rhyming Reason: The Poetry of Romantic-Era Psychologists. London: Pickering&Chatto.
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Kirmayer, Laurence J. 2007. “Celan’s Poetics of Alterity: Lyric and the Understanding of Illness Experience in Medical Ethics.” Monash Bioethics Review 26, no. 4: 21–35.
Kumar, Varun. 2024. “Medical Education and Creative Writing: Poetry and How It Can Assist Trainees in Developing Psychiatric Formulation Skills.” Australasian Psychiatry 32, no. 4: 365–69. https://doi.org/10.1177/10398562241246638.
Lewis, Owen. 2023. “Reflections on Teaching Poetry to Medical Students”. Medical Humanities Blog, October 12, 2023. https://blogs.bmj.com/medical-humanities/2023/10/12/reflections-on-teaching-poetry-to-medical-students/.
Oliver, Mary. August 2003. ‘Breakage.’ Poetry. https://www.poetryfoundation.org/poetrymagazine/poems/41917/breakage
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Tischler, Victoria. 2010. Mental Health, Psychiatry and the Arts: A Teaching Handbook. Oxford: Radcliffe Publishing.
Whitehead, James. 2017. Madness and the Romantic Poet: A Critical History. Oxford: Oxford University Press.
