Creative reminiscence

Type of Psychology: Clinical; Counseling; Developmental; Psychotherapy

Creative reminiscence is a technique of psychotherapy that uses the psychology of memory to help explore, reflect, and construct the narratives that make us who we are. The technique is used primarily in written and oral psychotherapeutic discourse. Creative reminiscence can also employ various forms of artistic expression (e.g., dance, painting, music) that foster and portray memories. When memories are revealed, it is suggested, we can gain insight into patterns of thought and feeling that create our narratives.

Introduction

Robert Butler, former Director of the Institute on Aging, was one of the first researchers to recognize the important role of reminiscence in human development. In his work with healthy older adults in the 1950s and 60s, he became aware of their reports of an internal process of reviewing and coming to terms with the past. Butler wrote what has become a classic in reminiscence psychology, "The Life Review: An Interpretation of Reminiscence in the Aged" (1963). He describes life review as a spontaneous personal process of recalling and evaluating one's life and making sense of the life one has lived. Butler theorizes that retellings represent a deep psychic urging toward a final reckoning. He goes on to note that life review is similar to the psychotherapeutic process in that a person reviews the past in order to understand the present. Useful in the process of creating a life review are such memorabilia as scrapbooks, family photo albums, letters, possessions, genealogies, and music.

While there is no clear consensus regarding the difference between reminiscence and life review, Butler and others conceptualize reminiscence as thinking and telling about the past, either as a solitary or communal act, thought out, written, or spoken, resulting most often in an improved sense of well-being. Life review is a similar process, but is more systematic and evaluative, a deliberate undertaking for the specific purpose of gaining insight and feeling better. More recent theorists have an openness to inconsistencies in recall and an acceptance of the narrative metaphor of self not as a static entity that can be objectively perceived but as one that evolves only as it is narrated. Thus, the memories generated in creative reminiscence not only reflect one's perception of a past self, but they help create change as the self evolves. Scholarly discussion, studies, and methods have surged since Butler's early work, with numerous applications of reminiscence to psychotherapy such as structured life review therapy, guided autobiography, integration of reminiscence with cognitive behavior therapy (CBT) by examining history of cognitive distortions, reminiscence as a component of self-efficacy theory to fortify coping strategies with chronic illness, life review and evolving systems approach groups in prison, and coming to terms perspective in nursing homes.

Reminiscence is also prominent in the fringes of psychotherapeutic treatment. For example, Shaping Voices is an organization in Sussex, England, that provides cultural programs for people to recall shared memories and stories, often incorporating dance, music, photography, poetry, and drama with particular reference to reminiscence. The UK Alzheimer's Society has shown that packaging from past decades can be a powerful trigger to recall past experience in people with dementia, and Nestle UK & Ireland, who said they were inundated with requests from caregivers, introduced a "reminiscence pack" of items from their archive to create a nostalgic sensory experience. The pack consists of a board game, old photos, and labels and wrappers and can be downloaded free from the Internet. In the United States the late John Kunz, psychotherapist and author, founded the International Institute for Reminiscence and Life Review in 1995, which promotes research and practice of reminiscence and life review and helps preserve life reviews through videography and other media.

Creative reminiscence and psychotherapy

All psychodynamic psychotherapies involve some type of reminiscence with the goal of helping people become aware of their histories and how they have learned particular thought or behavioral patterns that may contribute to present unhappiness. Sometimes people get stuck in the past and are burdened with such emotions as regret, grief, or unfulfilled dreams. Traditional therapies tend to focus on problematic experience and pathology, defining people in terms of illness and then attempting to "cure" them. In contrast, narrative therapy, usually associated with the work of Michael White and David Epston, is an approach to healing mental distress that emphasizes strengths and competencies, showing clients how to provide their own solutions. Rather than focusing on individual pathology or interpersonal troubles, narrative therapists help people review their life stories and see how the details of their lives are social and personal constructions that are not rigid but evolve as stories change.

The technique of creative reminiscence is compatible with the narrative approach to psychotherapy, with the emphasis on competence and mastery and revisioning one's history. The past provides one with a general sense of identity and guides one in imagining the future. Character evolves, and one can be part of that evolution by coming to terms with the past and paying attention to present purposes. With this understanding, reminiscence can be therapeutically future-oriented.

Sally Chandler and Ruth Ray conducted life-writing groups for an adult community in Detroit. They make the differentiation between fixed and dynamic reminiscence. Fixed reminiscence refers to the stories that tend not to change with each retelling. They sound well-rehearsed, as if the narrator has told them countless times, and the core meaning remains unchanged. Repetition in fixed reminiscence appears to set the stories in stone. Chandler and Ray refer to such reminiscences as frozen anecdotes. Fixed reminiscence can become ruminative and painful, particularly when what is remembered is traumatic.

Dynamic reminiscence, on the other hand, is change-oriented. With reflection, the fixed can become dynamic, especially in the context of a group session in which others help in a shared reconstruction of the past. The function of the group is to help one tell a story, to evoke different remembered and remembering selves. Studies in reminiscence show that listeners shape what tellers tell. What one reminisces about one's life depends in part on who is listening and the relationship one has with the listener. A group of college alumna, for instance, who meet decades after graduation, may describe a shared experience, each in different ways from the other. Emotions one attributes to the past may sometimes arise from the way she or he feels in the present. It is also true that some memories may have vanished permanently, or perhaps one may be motivated by memories that are inaccurate. Through retelling the experience, some parts may be deemphasized and some highlighted, creating a dynamic landscape, depending on the listener. Thus, dynamic reminiscence is more like a painting than a photograph. This post-modern view does not claim a solipsistic existence in which there is no objective reality. Rather, it gives credence to the social construction of thought, consistent with what psychologist Jerome Bruner calls the narrative mode of thinking, with an openness to particulars rather than constructs about variables and classes.

How creative reminiscence works

The first step in creative reminiscence is becoming aware of life stories through memories. Soon after a psychotherapist meets a client, the two will construct a psychosocial history (i.e., factual information about the client's past, including date and place of birth, and information about past and present home life, e.g., family members, family structure, school performance, hobbies, significant illnesses, mood or thought problems, religious beliefs, substance abuse issues, sexual development, trauma, eating and sleeping). Creative reminiscence is the technique of therapeutic conversations that follows this history, the interpretations in which the client reflects on the past. In this sense, creative reminiscence seems synonymous with dynamic reminiscence. The former refers specifically to a therapeutic technique and the latter to a thought process. Creative reminiscence stirs up memory and creates new attempts to interpret the past.

Creative reminiscence starts with the facts of a psychosocial history, and much more develops from that. What is important to the client's well-being and construction of a better life is not what exactly happened, but what exactly it means that something happened. The client's perception will be full of rich experience of everything he or she knew before and after what happened. While this distinction may seem obvious, it has far reaching therapeutic implications. For instance, a client may report a history of behavioral issues in childhood or mood instability in early adulthood. An unexplored categorization such as "oppositional defiant" or "borderline personality disorder" does little to advance psychotherapeutic outcome.

Once stories are evident, metaphors can be created. For example, a young biracial man (BK) in a prison study had labeled himself as an "obese oddball" in childhood. His white father was absent, and with freckles and lighter skin than his dark mother and half siblings, BK felt different from the rest of his extended family. A narrative metaphor he found helpful was life is a battlefield. BK grew to have an adolescent preoccupation with mosh pit dancing as a way of making fierce physical contact while intoxicated in a socially accepted venue. Body slamming, or moshing, is the activity of aggressively hitting one's upper body against another person in a pit during a concert. BK felt the mosh pit provided a place for him to express his rage about feeling inadequate. He could go to the pit by himself and dance in the dark. At one concert, BK met drug dealers and decided to experiment. He began getting high on speed and cocaine and was pleased to see that he lost weight. With a slimmer body he wanted to try the rave scene. BK chose life is a playground as the metaphor for this part of his life. He recalled that his mother had described to him the disco scene from her youth. He thought the rave might be similar: a large community of youth getting together late at night and dancing to a continuous mix of loud electronic music and colorful strobes and laser lights. BK sold candy and sparkly jewelry at the raves and began to see how easy it was to sell drugs, too. He made large amounts of money quickly. One morning BK was caught by the police as he was driving home after a rave with an array of drugs in his car. He received a four-year-sentence. Life as a battle for BK was a metaphor he thought he outgrew, but he came to realize, in a creative reminiscence group in prison, that he was in a losing battle, and that the playground metaphor was an escape for him and equally as destructive.

Recreating old stories loosens the hold they have. BK asked, repeatedly, in a therapeutic group setting of peers: Why am I an outcast because my missing father was irresponsible and left me looking like a stranger in my own home? Who defined my life as a battle? What makes escape into illegal physical pleasures a solution to my depression? Have my old stories outgrown their usefulness? Creative reminiscence of biographical knowledge helps one discover a self different from the one based on old stories. It is not a process of fact finding but of finding the context of the facts of one's life.

How does creative reminiscence work with trauma? Responses to trauma can include obsessive thinking, nightmares, flashbacks, and often seemingly random startle responses. Numerous researchers, including James Pennebaker at the University of Texas, have shown the therapeutic benefits of writing about trauma and that such writing can result in a significant decrease in the negative effects it caused. Writers are instructed to write freely and disregard grammar, punctuation, and spelling. The focus becomes not the traumatic event itself (fixed reminiscence) but one's feelings about the event (dynamic reminiscence).

Unlike ordinary memories, traumatic memories tend to be stored as a disordered array of sensory perceptions and negative affect (emotion). Emotional expression, and writing in particular, appears to reduce negative affect by converting the chaotic thoughts and feelings into an organized, logical, and linguistic understanding of the traumatic event. Improvement has been noted on physiological measures, including immune system function. In the context of talk therapy, reminiscence of a bad experience can be validated by a therapist or group. When feelings about traumatic memories are validated and understood, they are less likely to become fixed in memory and less likely to generate obsessive rumination. In trauma work, the process of guiding creative reminiscence involves recognizing the initial damage and making the memories dynamic and open to change. This requires attention to and respect of a client's denial or non-reflection as a defense mechanism. The clinician must be more than well-meaning and understand the importance of timing of insight, not rushing clients to review events that may overwhelm them and recognizing that denial may be adaptive in early bereavement.

Back to the future of reminiscence

In an article in the International Journal of Reminiscence and Life Review, Jeffrey Webster asks, "Is it time to reminisce about the future?" He discusses the perception of past and future intertwining and that both are infinite while the present is delimited. Moreover, both remembering the past and imagining the future have strong cognitive constructionist elements. For instance, recall of the past is sometimes distorted by needs, desires, and cognitive limitations, and memories are constructed within those distortions. This occurs with the future too which may be distorted by schemas, scripts, and prior knowledge. Furthermore, empirical findings show a common neurological network that is triggered by both recalling autobiographical memories as well as imagining future self scenarios. Webster describes the intimate links between memory of one's personal past and anticipated future. For example, reminiscing about a past dating experience may bring up thoughts about future similar activities such as meeting someone on an online dating site. Or while preparing for a blind date, one may conjure up a barrage of prior experiences: How anxious was I about meeting someone new? What did I do to prepare? How much time did I spend on that first date? Webster notes the advantage of mentally travelling in time from past experience to anticipated future. By constantly writing, revising, editing, and recounting our life stories as we age, evolving self narratives keep our experiences fresh and new.

Bibliography

Chandler, S. & Ray, R. "New Meanings For Old Tales: A Discourse-Based Study of Reminiscence and Development in Late Life." Critical Advances in Reminiscence Work: From Theory to Application. Ed. J. Webster & B. Haight. New York: Springer, 2002. Print.

Creative Horizons Cumbria. CreativeHorizonsCumbria.co.uk, 2011. Web. 27 Jun. 2016.

Freeman, M. Hindsight. New York: Oxford UP, 2009. Print.

Haber, D. "Life Review: Implementation, Theory, Research, and Therapy." International Journal of Aging and Human Development 63.2 (2006): 153–171. Print.

Haight, B., & Haight, B. The Handbook of Structured Life Review. Baltimore: Health Professions, 2007. Print.

Lee, Hilary, and Trevor Adams. Creative Approaches in Dementia Care. New York: Palgrave, 2011. Print.

McAdams, D. The Redemptive Self. New York: Oxford UP, 2005. Print.

Tahir, L. "The Evolving Systems Approach and Narrative Therapy for Incarcerated Male Youth." Education, Arts, and Morality. Ed. D. B. Wallace. (85–101). New York: Kluwer Academic, 2005. Print.

White, M. & Epston, D. Narrative Means To Therapeutic Ends. New York: Norton. 1990. Print.