Reflections on the integration of poetry therapy and psychodynamic practice based on an analysis of the book Tribute to Freud by the poet H.D.

ABSTRACT

This paper concerns the book Tribute to Freud, by Hilda Doolittle (H.D.) (1886–1961). In the book, H.D. – an important person in the modernist poetry scene – presents her psychoanalysis with Sigmund Freud (1856–1939). She describes how literature, sculptures, mythology, and symbols were central to their dialogues. I have analysed these dialogues with respect to the three components of poetry therapy, the receptive, the expressive, and the symbolic. Based on the analysis, I discuss how poetry therapy and psychodynamic practice can be integrated and how practitioners from the two orientations can learn from and inspire each other. I reflect on the presence of symbols and mythology in the book and suggest that the symbolic component, which has received the least attention, could be strengthened by the psychodynamic tradition’s acknowledgement of symbols and mythology. I also discuss how poetry therapy could inspire psychodynamic practitioners to acknowledge the expressive component.

KEYWORDS:

• H.D
• integration
• mythology
• poetry therapy
• psychoanalysis
• psychodynamic
• Sigmund Freud
• symbolic

In 1933, the poet Hilda Doolittle (penname H.D.) (1886–1961) went to Vienna to undergo psychoanalysis with Sigmund Freud (1856–1939). In 1934 she returned for additional analysis. She became fond of Freud and his family, and the feelings were mutual. In the book Tribute to Freud (1956), written during the last years of World War II, she describes her analysis and tender relationship with Freud (Appignanesi & Forrester, 1992).

H.D. was born in Bethlehem, Pennsylvania, USA, in 1886. Her mother belonged to the Moravian church and engaged in a variety of creative activities. Her father was a professor of astronomy, and she grew up in a well-to-do environment (H.D., 1982). As a teenager, she was engaged to Ezra Pound. They became life-long friends, and she wrote about him in End to torment. A memoir of Ezra Pound (1979). Nevertheless, she always took a clear stand against the fascist and anti-Semitic positions he expressed before and during World War II. H.D.’s daughter, Perdita Schaffner (1919–2001), and Pound’s daughter, Mary de Rachewiltz (born 1925), became friends. Unfortunately, Pound and H.D. never met after the war, despite living close to each other; H.D. in Switzerland, Pound in Merano in Northern Italy (Mary de Rachewilts, personal communication, 2019-06-01).

H.D. moved to Europe in 1911 and became an established person on the modernist scene, engaged in poetry and avant-garde cinematography. She was openly bisexual, had polyamorous relationships, and embraced the lifestyle of modernity. Her life companion was another writer, Annie Winfred Ellerman, called Bryher, who came from a tremendously wealthy family and supported writers and literary journals. She also took part in rescuing psychoanalysts from Nazi persecution and supported psychoanalytic organizations financially (Appignanesi & Forrester, 1992; Friedman, 2002).

H.D. challenged patriarchal perceptions of female identity and sexuality. Her works have been analyzed from feminist perspectives, examining how H.D. contested Freud and patriarchal assumptions (i.e. Friedman, 1982, 1990). While acknowledging this, it should be noted that H.D. and Freud could reflect on differences and disagreements and yet remain fond of each other (Friedman, 2002). Some disagreements between H.D. and Freud, not least concerning mysticism, can be understood with respect to their different cultural and religious backgrounds, Freud being Jewish and H.D. belonging to the Moravian church (Johansson & Punzi, 2019). Tribute to Freud is a rich text. H.D and Freud spoke about mythology, religions, mysticism, dreams, art, and literature. The therapeutic process was open and eclectic and involved mythological objects from Freuds’ collection (Martin, 2008).

Since the dialogues between H.D. and Freud involved arts, sculpture, literature, mythology, and symbols, there are similarities to poetry therapy. Therefore, I have analysed Tribute to Freud (1956) with respect to the three components of poetry therapy (i.e. Baker & Mazza, 2004; Mazza, 2017a). Based on H.D.’s poetic description of her therapeutic contact with Freud, the aim of this paper is to understand similarities and differences between poetry therapy and psychodynamic practice, what the two orientations can learn from each other and how the two may be integrated. Before I describe methods and results, I provide an overview of Tribute to Freud and give a brief overview of poetry therapy and psychodynamic practice.

Tribute to Freud

When H.D. initiated psychoanalysis, she suffered from writers’ block, had experienced serious traumas and mental breakdowns, and feared that world war and breakdowns would be repeated (Appignanesi & Forrester, 1992). She had published relatively few texts in the years before the analysis. During World War I, she had lived through relational difficulties, the birth of a stillborn child, severe physical illness, and her brother and father passed away. These experiences became overwhelming. Fortunately, she was supported by Bryher, also in raising her daughter. Freud encouraged H.D. to write about these experiences, which she did, in Bid me to live (Zilboorg, 2011). Freud admired creative writers (Freud, 1917/1955, 1908/1959) and to him, creative processes and products are connected with overcoming and dealing with distress and suffering. Their therapeutic contact indeed dissolved H.D.’s writer’s block and restored her self-confidence (Zilboorg, 2011).

Through reading Tribute to Freud (1956) we can, as researchers and practitioners, understand the therapeutic process. From H.D.’s poetic presentation, we can reflect on therapeutic processes in general and develop our capacity to encounter clients and provide client-centred care. H.D. describes a therapeutic process that is open and creative, involving continuous dialogues about literature, mythology, symbols, and various artistic expressions.

In Tribute to Freud, some themes are recurring. They seem deeply meaningful for H.D. and for the therapeutic process, not only because they contribute to healing, but because they initiate new thoughts, meandering of memories and meanings, and new understandings of difficulties, relationships, personal experiences, and herself. Some of these recurring themes concern dreams, objects from Freud’s collection, childhood memories, and spiritual experiences she had been through. Neither her experiences, traumas and memories, nor the therapeutic process or her insights and healing, are presented in straightforward, chronological manners but rather presented in enigmatic and indirect ways. Topics conflate and dissolve, just like in dreams. It is a poet’s presentation, simultaneously dense and airy. Shaddock (2020) proposes that psychodynamic treatment may be improved if it is understood through the lens of poetry. Poetry, just like psychodynamic practice, involves metaphors, form, silences, imagination, and creativity (Bayley, 2016; Rasmussen, 2000; Shaddock, 2020). These phenomena are also central to poetry therapy. In the following section, I will reflect on the similarities and differences between poetry therapy and psychodynamic practice.

Poetry therapy and psychodynamic practice

Contemporary psychodynamic practice includes narrative, neuroscientific and psychiatric perspectives, flexible and manualized treatments, intensive psychoanalysis and brief interventions, and much more. In this paper, I refer to the pragmatic psychodynamic practice, a form of practice that acknowledges inner conflicts and defense mechanisms and supports emotional experience, reflection, and increased understanding of self and of painful experiences, while being open to the needs and narratives of the unique client (Summers & Barber, 2012). Psychodynamic practitioners pay attention to childhood development and context, qualities of relationships, unconscious dynamics, that we all struggle with ambivalence, and that no one moves through life without suffering and occasional or continuous symptoms (Athanasiadou-Lewis, 2016; Summers & Barber, 2012). It is also acknowledged that clients may engage in “enactment,” which means that they act out difficulties instead of handling them in the therapeutic process (Athanasiadou-Lewis, 2016; McLaughlin, 1987).

Clients and treatment relationships are unique and shaped by each practitioner and each client (Shaddock, 2020). Psychodynamic practitioners, therefore, need to be creative and able to handle insecurity and provide client-centred care that simultaneously is predictable and reliable (Stadter, 2012). Psychodynamic practice is, just like poetry writing, an art and a craft (Shaddock, 2020). In current health care systems and social services, classifications, pharmacological treatments, and structured interventions are however prioritized (Stadter, 2012). The goal is cost-effective care, but the consequences are excessive measurement, exclusion of human complexity, and underestimation of meaning-making and social context (Hammarström, 2016). Open psychodynamic practice, and other flexible interventions, do not fit this model and, therefore, may become less available (Hammarström, 2016). Some psychodynamic practitioners respond by developing psychodynamic short-term interventions aimed at symptom reduction or manualized methods that may support clients (i.e. Ajilchi et al., 2020; Vinnars et al., 2005). Other researchers show that long-term, flexible psychodynamic interventions are effective and argue that they therefore should be provided (Leuzinger-Bohleber et al., 2019). Accordingly, psychodynamic practitioners need to acknowledge evidence-based interventions and simultaneously be flexible towards the needs of each unique client.

The same holds true for poetry therapists who need to choose the appropriate intervention for each client and simultaneously acknowledge the growing body of research concerning how poetry, bibliotherapy, narrative perspectives, symbols and rituals can be used in various client populations (Heimes, 2011; Mazza, 2017a). There are practitioners who integrate poetry therapy and psychodynamic approaches (i.e. Johnson, 2017; Schwietert, 2004). Just like psychodynamic practice, poetry therapy is multi-faceted, and the therapeutic use of words and symbols is adapted to the client concerned, and to the prerequisites of the treatment unit. It may be performed in medical settings (Johnson, 2017), crisis intervention (Schwietert, 2004) and community work aimed at social justice and empowerment (Mazza, 2018), just to mention a few areas.

Poetry therapy and psychodynamic practice both appreciate the importance of narrative understanding. Poetry therapy is however more flexible, action-oriented, and integrative, with roots in medicine, psychoanalysis, social work, and counseling, to name a few disciplines (i.e. Johnson, 2017; Schwietert, 2004). The aim is to support meaning-making, agency, healing, and cognitive, emotional, and relational functioning and strength (Mazza, 2018). Poetry therapy is structured around three components; (1) the receptive, in which literature, poetry, stories, and song lyrics are introduced, (2), the expressive, in which the client(s) engages in writing journals letters, poetry etc., (3), the symbolic, in which metaphors, rituals, ceremonies and storytelling are integrated into the therapeutic process (Mazza & Hayton, 2013). Poetry therapy thereby permits clients and practitioners to develop the therapeutic process in ways they find relevant and use modes of expression that meet the needs of the client concerned. Even though poetry therapy is centered on language and symbols, language and its symbolic content are not idealized or canonized as I perceive it to be in some psychodynamic traditions. Pictures, dance, drama, and other forms of non-verbal expressions may be integrated (Mazza, 2017b).

Yet, both poetry therapy and psychodynamic practice appreciate human creativity and artistic expressions and acknowledge that clients and practitioners together form a unique therapeutic process in which language, metaphors, silences, and non-verbal forms of communication create a shared space in which something new may grow (Mazza, 2017a; Rasmussen, 2000; Schwietert, 2004; Shaddock, 2020; Summers & Barber, 2012). The healing power of poetry and other creative expressions is increasingly recognized in society and in the helping professions, and interdisciplinary interests and findings, therefore, need to be integrated (Mazza, 2017b), I, therefore, suggest the bridges between poetry therapy and psychodynamic practice should be established. The therapeutic process described by H.D in Tribute to Freud (1956) could be a starting point for building such bridges.

Materials and methods

This paper is based on close and repeated readings of Tribute to Freud (1956), including the letters H.D. and Freud sent to each other, which are included in the book. After the close readings, all parts of the book that concerned literature, creativity, symbols, rituals, etc. were labeled with codes that reflected the content. Codes with similar content were grouped into thirteen preliminary themes. After examining these preliminary themes, some merged, others were excluded, and some remained. Thereby, nine themes were identified. In the final step of the analysis, the nine themes were related to the three components of poetry therapy. In Table 1, the themes and their relevance for the three components of poetry therapy are presented.

Table 1. Themes and their relevance for the three components of poetry therapy.

Themes	Relevance for receptive/expressive and/or symbolic components
Literature, poetry	Receptive, symbolic
The Bible	Receptive, symbolic
Religious themes	Receptive, symbolic
H.D.’s writings	Expressive
Visual arts, interiors	Receptive, symbolic
Statues/figures	Recpetive, symbolic
Mythology	Receptive, symbolic
Mysticism/spiritualism	Symbolic
Rituals	Symbolic

In the results sections, the findings are presented under the subheadings Receptive components, Expressive components, and Symbolic components. Examples and quotes from the book are included. Under each subheading the findings are related to theoretical concepts and prior research. In the discussion section, the findings are related to each other, and I reflect on how poetry therapy and psychodynamic practice can learn from each other and be integrated.

The analysis is influenced by my position as a clinical psychologist, educated in the psychodynamic and humanistic traditions, as well as by my position as a social work researcher, interested in recovery, meaningful activities, and relationships, and how to establish person-centred care that integrates poetry, creative writing, and other creative expressions.

Results

Receptive components

H.D. continuously describes how literature and various forms of artwork are incorporated into her dialogues with Freud. One example is when she talks about a dream, which she calls The princess dream. In this dream, she sees a beautiful Egyptian princess walking down a marble staircase, toward a river where there is a child in a basket or a boat. Together, H.D. and Freud associate the dream to Moses in the bulrushes, an illustration in the Doré bible. This specific artwork becomes a starting point for reflections on H.D.’s position as a woman and a daughter and also on the therapeutic process and her interest in psychoanalysis. The painting can hence be seen as a receptive component.

H.D.’s and Freud’s reflections on Moses in the Bulrushes resemble Mazza and Hayton’s (2013) descriptions of how practitioners of various orientations integrate language arts as well as visual art and other creative expressions in their clinical practice to promote self-disclosure, express feelings, and deal with difficult experiences. Freud seemed to be open to using literature, visual arts, and sculpture as starting points for putting words to inner experiences. Another example from Tribute to Freud (1956) is when H.D., in chapter three, describes their dialogues about the beautiful fountain in the Neuer Markt, Vienna, created by Raphael Donner. They spoke about the mythological characters portrayed by Donner. Yet, they did not lose track of the therapeutic aim of their dialogues and Freud rounded off the topic. H.D. writes “It was in any case our Professor’s charming way to fall in with an idea, to do it justice but not to overstress unimportant details.”

Martin (2008) describes that Freud never explicitly mentioned sculptures as part of his clinical practice, but nevertheless, the antique objects from his collection were part of the clinical setting. The use of antique objects is described in detail by H.D. and under the heading Symbolic component, I will reflect on how a specific sculpture, and what it symbolized, became important for the therapeutic process.

In Tribute to Freud (1956), receptive components are often intertwined with symbolic components. This is not surprising, since there are no clear-cut boundaries between creative expressions and their symbolic content, or the cultural narratives and mythologies that surround them. This reminds us that the three components of poetry therapy should not be treated as prescriptions for providing poetry therapy but rather as points of reference for flexible, action-oriented, and integrative interventions (i.e. Johnson, 2017; Schwietert, 2004).

Expressive components

Before H.D. and Freud encountered each other, Freud read some of H.D.’s writings. In a letter to her, written in December 1932, he expressed that through reading her texts, he wanted to get a glimpse of her personality. This resembles the expressive component in poetry therapy. The poet Bruno Goetz, who consulted Freud in 1904/1905, likewise related that Freud read his poems in order to get to know him (Goetz, 1975). This indicates that Freud acknowledged that emotions and psychic processes could be understood from texts and accordingly might be important for the therapeutic process.

Nevertheless, dialogues about H.D.’s writing, what writing meant to her, and what she expresses in her texts are not portrayed in Tribute to Freud (1956). This seems somewhat surprising since Freud encouraged H.D. to write about her experiences from World War I (Zilboorg, 2011), expressed admiration for creative writers in general (Freud, 1908/1959), and appreciated H.D.’s writing (H.D., 1956). Instead of encouraging writing as part of the therapeutic process, Freud instructed her to refrain from writing. Luckily, H.D. did not follow the instruction. During her analysis in 1933, she wrote about the therapeutic process. Part of her notes was published as Advent, together with Tribute to Freud (1956). She also had an intense correspondence with Bryher, both during 1933 and 1934 (Friedman, 2002). Thanks to Advent and the correspondence, we can understand the therapeutic process and what it meant to H.D.

Freud has been depicted as austere and prone to rationalistic thinking. H.D. (1956) and the poet Bruno Goetz (1975), however, portray him as someone who communicates kindness, trust, wisdom, generousness, and warmth. When it comes to writing as part of the therapeutic process, Freud, however, seemed somewhat rigid. His rejection of writing as part of the therapeutic process may also represent the respect for boundaries that is central to psychodynamic practice (Bridges, 1999). Boundaries create predictability and trust, support the therapist’s capacity to contain the client’s symptoms, and the capacity to handle transference and countertransference. Boundaries also protect clients from harmful interventions (Summers & Barber, 2012). In the history of psychodynamic practice, boundaries have sometimes been exceeded and sometimes become rigid and perceived as laws (Bruch, 1974). Rigidness may include an insistence that clients should pay for sessions even if they, well in advance, have declared that they are unable to attend on a particular day and that practitioners never should accepts gifts from clients. Accordingly, Freud’s rejection of writing could be seen as an example of rigid boundaries. It may also represent a rigid focus on spoken language, which is emphasized in psychodynamic practice (McLaughlin, 1987). From a psychodynamic perspective, practitioners need to acknowledge that clients’ activities outside the therapeutic setting, including writing, may represent enactment that hinders or obstructs the therapeutic process (Athanasiadou-Lewis, 2016; McLaughlin, 1987). Also in poetry therapy, boundaries are respected (i.e. Bowman, 2004; Schwietert, 2004). However, poetry therapy is more flexible, and the spoken word is not considered superior to the written, and accordingly, several forms of expression are integrated into the therapeutic process.

Symbolic components

Symbolic components are the most frequently described in Tribute to Freud (1956). One example is when Freud and H.D. discuss statues from his collection. The collection was situated in another room than the famous couch and the statues stimulated reflections on symbols, mythology, metaphors, and their meanings. H.D. writes;

I did not always know if the Professor’s excursions with me into the other room were by way of distraction, actual social occasion, or part of his plan. Did he want to find out how I would react to certain ideas embodied in these little statues … .

Two pages later, she describes how Freud shows her a small statue, saying, “This is my favourite.” It was a statue of Pallas Athena. H.D. continues; “He knew that I loved Greece.” The statue stimulated reflections on Pallas Athena as a symbol of victory and of a woman leading an army. This was important for H.D. whose writings concerned woman’s mysterious powers and her life and position as a modern woman with an unconventional lifestyle (DuPlessis & Friedman, 1981).

Within the field of poetry therapy, the symbolic component has received the least attention (Rosenfield, 2007). H.D., however, shows the importance if symbols, and how they may be integrated into therapeutic processes. She also shows how time and place provide therapeutic boundaries and, therefore, can be seen as forms of rituals. The sessions are predictable; the same time, the same room, which even looks the same. When something changes, for example, the time of the session, or when sessions occasionally take place in a summer house the Freuds’ rented, H.D. notes that things are not the same. Time, place, and symbolic objects constitute rituals that are meaningful for her, and the symbolic component of poetry therapy indeed includes rituals (Mazza, 2017b).

In chapter eleven, H.D. describes a porcelain stove beside the couch, and how it reminds her of a book her mother had liked, The Nurnberg stove. This becomes another example of the importance of rituals, captured in the symbolic component. The book makes her think that despite the stove, it might be a little chilly in the room. She writes, “There was the stove, but there were moments when one felt a little chilly. I smoothed the folds of the rug, I glanced surreptitiously at my wristwatch.” A few lines later, she places her hands under the rug and continues;

I always found the rug carefully folded at the foot of the couch when I came in. Did the little maid Paula come in from the hall and fold the rug or did the preceding analysand fold it, as I carefully did before leaving?

McLaughlin (1987) describes that even though psychoanalysis traditionally has focused on speaking and listening, behaviors are integral to the therapeutic process; clients may, for example, develop personal rituals when they lay down on the couch. When H.D. reflects on the rug, how others may approach it, and how she carefully folds it, she shows us how much there is to understand in a seemingly colloquial ritual. Through her poetic, dreamlike language, she illustrates how behaviors, rituals, and other parts of the symbolic component become central to the unique therapeutic process.

Discussion

It has been argued that poets can stimulate practitioners of various orientations to integrate poetic writing into their therapeutic practice and thereby promote understanding of overwhelming emotions and experiences, as well as meaning-making and a sense of creative joy (Daniels, 2021; Pohl et al., 2018; Shaddock, 2020). In line with this, I suggest that there is much to learn from H.D. Based on my analysis of Tribute to Freud (1956), I propose that practitioners of various orientations could learn not only from poets but also from each other. The similarities between poetry therapy and psychodynamic practice come forth when reading Tribute to Freud (1956). Narrative understanding, symbols, literature, and mythology, as well as H.D.’s unique needs, ways of expressing herself, and her personal values and interests, became central to the therapeutic process. The book gives an example of how poetry therapy and psychodynamic practice can be integrated, and how interventions that are appropriate for the needs and wishes of each unique client can be developed.

Therapeutic boundaries is a field that could inspire poetry therapists and psychodynamic practitioners to learn from each other. Psychodynamic practitioners who work from an integrative perspective, respect boundaries, and simultaneously encourage flexible and creative interventions (Bridges, 1999; Summers & Barber, 2012). Boundaries should neither be too flexible, nor too rigid. Rigid therapeutic boundaries may indeed be the therapist‘s way to handle own anxiety (Bridges, 1999). It is impossible to state whether Freud was too rigid when he did not integrate H.D.’s writing in the therapeutic process, or whether the exclusion of writing was relevant for this particular process with this particular client. I, however, suggest that current psychodynamic practitioners should not take Freud’s exclusion of writing as a reason for them to exclude creative writing from treatment. On the contrary, they could be inspired by the therapeutic process described in Tribute to Freud (1956) and be open to integrating various creative expressions as well as mythology, symbols, and rituals in their clinical practice. In other words, they could integrate the expressive component from poetry therapy. It seems as if Freud was flexible, personal, and caring when he encountered clients (Goetz, 1975; H.D., 1956). This could be inspiring for psychodynamic practitioners who value complexity, meaning-making, creative expressions, and social context and who strive to provide client-centered care in a system that prioritize classifications, pharmacological treatments, and structured interventions (Hammarström, 2016; Stadter, 2012).

Both poetry therapists and psychodynamic practitioners perceive narrative understanding as central to healing (Mazza, 2018; Summers & Barber, 2012). Writing may indeed support narrative understanding and enhance healing (Croom, 2015; Niederhoffer & Pennebaker, 2009). When Freud engaged in self-analysis and interpreted his own dreams, he engaged in writing (Freud, 1900/1953). Integration of writing is in line with Freud’s admiration of poetry, literature, and creative writers (Freud, 1908/1959, 1917/1955), an admiration he shares with many succeeding and current psychodynamic practitioners (i.e. Bayley, 2016; Rasmussen, 2000; Shaddock, 2020).

Simultaneously, psychodynamic practitioners could inspire poetry therapist to acknowledge therapeutic boundaries and the need to consider that writing sometimes might represent avoidance of a topic that should be verbally reflected on together with the therapist (Pohl et al., 2018). Moreover, it should be noted that metaphors might open up for understanding and exploration, but they may also be misunderstood or serve defensive functions (Rasmussen, 2000). Bowman (2004) warned that excitement over the components of poetry therapy may cause harmful consequences. Even though one benefit with poetry therapy is that it only takes a pen and a piece of paper and that it is possible to practice it anywhere, the meaning of the place in which writing, and therapy occur, and the meaning of predictable environments, need to be reflected on. In line with Bowman’s appeal for prudence, Rojcewicz (2020) reminds us that Pegasus, the logotype of the National Association of Poetry Therapy, and a symbol of poetic inspiration, needs to be tamed. The taming involves Athena, the goddess of wisdom (Rojcewicz, 2020). Freud and H.D. were both highly knowledgeable in mythology and history and their reflections on the statue portraying Pallas Athena may have multiple meanings which could further be explored.

While the symbolic component is prevalent in the dialogues between H.D. and Freud, it is the least developed and acknowledged of the three poetry therapy components (Rosenfield, 2007). This is somewhat surprising, since symbols, mythological characters, and metaphors might be sources of inspiration and wisdom (Rosenfield, 2007). I, therefore, suggest that poetry therapy can be inspired by the psychodynamic tradition and its acknowledgement of mythology, mythological characters, symbols, and metaphors, to develop the symbolic component. In practice, this could be achieved by inviting clients to talk about symbols, stories, mythology, and existential themes. Mythology and metaphors open our eyes to human existence, our personal and collective struggles, and what it means to be human. Existential themes do not need to concern Greek mythology or high culture. While some clients might appreciate this, others may be more drawn to current creative expressions and the mythologies and symbols they are embedded in or to mythologies from other cultural and religious traditions.

Finally, I would like to mention that there are limitations to this analysis. There is no perfect fit between the three components of poetry therapy and the therapeutic process H.D. and Freud was involved. After all, H.D. and Freud did not engage in poetry therapy, they engaged in psychoanalysis. I, however, sense that both poetry therapists and psychodynamic practitioners could be inspired by H.D. and Freud, learn from each other, and integrate elements from the two orientations. The book is rich and enigmatic in many ways. The examples I have chosen cannot illuminate its complexity. Hopefully, other scholars and practitioners will analyse the book from varying perspectives, thereby exploring the many ways in which creative expressions, rituals, mythology, and symbols, support therapeutic processes.

Disclosure statement

No potential conflict of interest was reported by the author(s).