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Write to Learn

     NOT
 Learn to Write
    www.gilliebolton.com   1
Why Reflective Practice Writing?



‘The life without examination

           is no life’
                                    Plato

             www.gilliebolton.com       2
Why Reflective Practice Writing?



‘The unexamined fact is like a
  rattlesnake. It’s going to
       come after you.’

                                    Joan Didion
             www.gilliebolton.com             3
Why Writing?

  ‘The progress of any writer
is marked by those moments
 when he manages to outwit
his own inner police system.’

                                Ted Hughes


         www.gilliebolton.com            4
Why Writing?




          We write
before knowing what to say
     and how to say it,
  and in order to find out,
        if possible.

      Jean-Francois Lyotard 1992
                                 Philosopher
          www.gilliebolton.com                 5
‘Things come out
          because the story lets them out’
                                         Physician-writer




‘Stories are a form of everyday theorising’
                                         Max Van Manen




                  www.gilliebolton.com                 6
A Family Doctor’s Story
The family asked to meet me. Their daughter
had recovered from meningococcal
septicaemia, and they wanted to know why I
hadn’t diagnosed it when they saw me that
morning six weeks ago at the GP surgery. … My
stomach wrenched with anger and frustration.
Can’t they see? … There was nothing that
morning to indicate meningitis or septicaemia.
… As the date for our meeting drew closer, that
black churning bitterness was still there, and I
realised I had to do something. … .

         A. Munno, British Medical Journal 2006
                   www.gilliebolton.com        7
…I decided to write the story of the family’s
complaint from the point of view of the parents.
The first line came easily: “She nearly died you
know. Our daughter nearly died”. At that point
my perspective on the complaint changed. I felt
the parents’ fear, and I understood their terror. …
The complaint wasn’t about diagnostic skills or
statistical probabilities but about a family trying
to make sense of the horror of nearly being
ripped apart forever.
By thinking about the complaint from the
family’s point of view, I understood that my role
in the meeting wasn’t to defend but to listen.

          A. Munno, British Medical Journal 2006
                  www.gilliebolton.com                8
Ethics and Values

If Munno’s patient’s parents found out about his writing, they’d
probably feel profoundly grateful as it enabled him to approach
them ethically and empathetically,
with espoused values consonant with his values-in-practice.

Munno was exploring his own understanding and perceptions,
doing it carefully and respectfully.

Reflective writing work is undertaken privately, and discussed
only with carefully chosen confidential peers or tutors.


                         www.gilliebolton.com                9
A story is an attempt to create order and security out
                  of a chaotic world.

  But for our experiences to develop us - socially,
 psychologically and spiritually - our world must be
              made to appear strange.

    We, and our students, must be encouraged to
    examine our story making processes critically:
  to create and recreate fresh accounts of our lives
from different perspectives, different points of view.

   Exploration of experience, knowledge, values,
              identity is what matters,
    not any attempt to arrive at a 'true' account.
                   www.gilliebolton.com                  10
Why Fiction?


‘It’s under the mask of fiction
         that you can
         tell the truth’

                                  Gao Xingjian

           www.gilliebolton.com            11
Privacy

‘Having a private space in which to record
things as you go along is helpful.
I have found that I understand things better
by writing them down.’

 ‘You don’t have to worry that you have used
the right words or spelt something incorrectly
you can build up to a more formal statement
later.’
                             student midwives
                 University of Wolverhampton
                www.gilliebolton.com             12
Community
‘An online group quickly develops a sense of
collegiality, especially if the tutor is a participant, and
when a climate of respect has been created,
learners become able even to challenge each other
and the tutor. They begin to see themselves and
others differently.
…
An e-portfolio provides a critical thinking space which
can move users out of their comfort zone. They can
be encouraged to take risks and so progress further.
That also applies to tutors!’

                  Julie Hughes, e-portfolio practitioner
                     www.gilliebolton.com                     13
‘Poems…
    profoundly alter the man or woman
        who wrote them.’

                               Dannie Abse 1998
                                      Physician Poet



               www.gilliebolton.com              14
‘I like poetry because
                it has to do what it wants.

I can’t make it do what I want.’

                                         Physician-writer

                  www.gilliebolton.com                15
The Death of Simon                        Mark Purvis MD

The grown-ups stand around watching.
Grown-ups know what to do.
The grown-ups stand around watching.

Is that Simon lying on the pavement?
He has got blondie hair like Simon's.
The grown-ups stand around watching.
A boy has been run over, another kid says.

Is that Simon lying on the pavement? He was walking in front of me.
The grown-ups stand around watching.
Mrs Bailey puts a blanket over him - but I can still see his blondie hair.

She looks at me but before she can turn quickly to the other grown-ups,
I can see she's scared.
`Send Mark away.'
What have I done wrong?

The grown-ups know what to do.
They send me away.
                                  www.gilliebolton.com                       16
I run ahead alone.
Trying to find Simon.
I might not recognise him.
Pulling kids by their shoulders - no that's not him.
I speed up when I hear the ambulance siren.

`Simon's been run over.' Pete Williams said.
I run away, trying hard not to believe him.

How can Pete Williams tell who is lying there,
anyhow I saw him looking for his brother too.
Surely I would have recognised my own brother.

My teacher says `Simon will be in his classroom'
But he isn't, so she smiles and cuddles me, warm and soft.
`It's alright Mark, they call ambulances for sprained ankles these days.'

When he came into the classroom everyone stopped and looked.
He didn't have to tell me.
I said `Simon's dead', and he nodded, unable to speak.
                                                     Mark Purvis MD
                           www.gilliebolton.com                             17
I had never before in detail talked about what I was
feeling at the time when Simon died.

Now I have written, I can and do talk about it…. .

The writing has made me feel completely different
about Simon's death, has made me deal with it in a
different way. I can now see I wasn't responsible.

The time was right for me to write.

I didn't know I was carrying so much guilt. Now I
know I don't need to carry it. I will cope differently
now when a child patient dies.
                                        Mark Purvis MD
                    www.gilliebolton.com                 18
‘This writing allows you to touch things you
             otherwise couldn’t.’


‘It is an opportunity to inhabit the unknown.


                               Reflective practitioners

                 www.gilliebolton.com                19
Dr Brendan Boyle
      My First Writing Course

I found myself terrified, empathising
with my phobic/ anxiety patients.
   What had possessed me to enrol?

      It was incredibly reassuring to
discover you need no writing skills. By
 what seems to be simplicity itself we
    are led into unlocking memories,
   thoughts, reactions, experiences.
              www.gilliebolton.com        20
Dr Brendan Boyle
  I was haunted by the prospect of
the blank page staying blank, but the
  almost mystical unlocking process
    created by those simple words:
 “Write anything that comes into your
          head for 6 minutes”
  was, and indeed remains, baffling.

  Hard to believe, but that acts as the
 key to access parts of our thinking
    that most of us seldom use.
              www.gilliebolton.com        21
What is Free Writing?

                      For 6 minutes
            Write whatever is in your head
                  Do not stop writing
                  Do not think about it
 Grammar, form, spelling, handwriting do not matter
      It might be a list or jump all over the place
               (our minds do skip about)
                 Or it might be brilliant
If you get stuck write ‘I am stuck’ until you’re unstuck
     YOU WILL NOT BE ASKED TO SHARE IT
                       It’s private!
                     www.gilliebolton.com            22
‘I found
the reflective writing process itself
was where the bounties lay,

and NO amount
of teaching about reflection
could help me.’

                                A Reflective Practitioner
                www.gilliebolton.com                 23
www.gilliebolton.com   24
www.gilliebolton.com   25
How to Write Reflectively

Grammar, form, spelling, handwriting do not matter
           (You can always correct them later if you need)
It’s the content which is significant

Write what is in your heart, thoughts and memory

Write what you know already
    (though you might not know you know it)
                 without planning or forethought

                      www.gilliebolton.com              26
Reflective writing is a conversation with the self

You are not listening to yourself as you write.

While writing, the page offers no head-nodding, smiling,
  frowning, grimacing, no immediate response of questions,
      affirmation, shouts or screams.

You listen to yourself after you write, on rereading.

Writing creates tangible footprints to be followed,

              but this interlocution is beneficially postponed.
                          www.gilliebolton.com                    27
What is Reflective Writing?
When you trust writing to take you where you need
to go

When you value yourself to explore and express

When you take responsibility for your writing
          (your tutor or boss aren’t responsible)

When you give generous time to yourself to write

When you have positive regard for patients and
               colleagues you write about
                     www.gilliebolton.com           28
Writing – Reflective or Therapeutic?

           Writing works

            for anyone

     professional
              patient
                   student
                       client
             www.gilliebolton.com      29
Self Confidence
Our deepest fear is not that we are inadequate. Our
deepest fear is that we are powerful beyond measure. It is
our light, not our darkness, that most frightens us. We
ask ourselves, Who am I to be brilliant, gorgeous,
talented, fabulous? Actually, who are you not to be? …
Your playing small doesn’t serve the world…. . We are all
meant to shine… . And as we let our own light shine, we
unconsciously give other people permission to do the
same. … Our self perception determines our behaviour.
If we think we're magnificent creatures with an infinite
abundance of love and power to give, then we tend to
behave that way, and the energy we radiate reflects those
thoughts no matter what we do.
                                      Marianne Williamson
                       www.gilliebolton.com            30
www.gilliebolton.com   31
Take Care
     You are about to enter a danger zone
   Wear protective clothing around your heart
              Take off your shoes

  Writing can seriously damage your sadness
 Writing can seriously damage your nightmares
  You are in danger of achieving your dreams

     Once started you won’t be able to stop
              Nor will you want to
         And others might catch it too

You are in serious danger of learning you’re alive
 You are in serious danger of laughing out loud
  You are in serious danger of loving yourself

 If it gets in your eyes, consult your loved ones
   If it gets in your mind, cancel your therapist
         If it gets in your heart, hold on tight
                                                     Gillie Bolton
                 www.gilliebolton.com                         32

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Write to Learn — not Learn to Write

  • 1. Write to Learn NOT Learn to Write www.gilliebolton.com 1
  • 2. Why Reflective Practice Writing? ‘The life without examination is no life’ Plato www.gilliebolton.com 2
  • 3. Why Reflective Practice Writing? ‘The unexamined fact is like a rattlesnake. It’s going to come after you.’ Joan Didion www.gilliebolton.com 3
  • 4. Why Writing? ‘The progress of any writer is marked by those moments when he manages to outwit his own inner police system.’ Ted Hughes www.gilliebolton.com 4
  • 5. Why Writing? We write before knowing what to say and how to say it, and in order to find out, if possible. Jean-Francois Lyotard 1992 Philosopher www.gilliebolton.com 5
  • 6. ‘Things come out because the story lets them out’ Physician-writer ‘Stories are a form of everyday theorising’ Max Van Manen www.gilliebolton.com 6
  • 7. A Family Doctor’s Story The family asked to meet me. Their daughter had recovered from meningococcal septicaemia, and they wanted to know why I hadn’t diagnosed it when they saw me that morning six weeks ago at the GP surgery. … My stomach wrenched with anger and frustration. Can’t they see? … There was nothing that morning to indicate meningitis or septicaemia. … As the date for our meeting drew closer, that black churning bitterness was still there, and I realised I had to do something. … . A. Munno, British Medical Journal 2006 www.gilliebolton.com 7
  • 8. …I decided to write the story of the family’s complaint from the point of view of the parents. The first line came easily: “She nearly died you know. Our daughter nearly died”. At that point my perspective on the complaint changed. I felt the parents’ fear, and I understood their terror. … The complaint wasn’t about diagnostic skills or statistical probabilities but about a family trying to make sense of the horror of nearly being ripped apart forever. By thinking about the complaint from the family’s point of view, I understood that my role in the meeting wasn’t to defend but to listen. A. Munno, British Medical Journal 2006 www.gilliebolton.com 8
  • 9. Ethics and Values If Munno’s patient’s parents found out about his writing, they’d probably feel profoundly grateful as it enabled him to approach them ethically and empathetically, with espoused values consonant with his values-in-practice. Munno was exploring his own understanding and perceptions, doing it carefully and respectfully. Reflective writing work is undertaken privately, and discussed only with carefully chosen confidential peers or tutors. www.gilliebolton.com 9
  • 10. A story is an attempt to create order and security out of a chaotic world. But for our experiences to develop us - socially, psychologically and spiritually - our world must be made to appear strange. We, and our students, must be encouraged to examine our story making processes critically: to create and recreate fresh accounts of our lives from different perspectives, different points of view. Exploration of experience, knowledge, values, identity is what matters, not any attempt to arrive at a 'true' account. www.gilliebolton.com 10
  • 11. Why Fiction? ‘It’s under the mask of fiction that you can tell the truth’ Gao Xingjian www.gilliebolton.com 11
  • 12. Privacy ‘Having a private space in which to record things as you go along is helpful. I have found that I understand things better by writing them down.’ ‘You don’t have to worry that you have used the right words or spelt something incorrectly you can build up to a more formal statement later.’ student midwives University of Wolverhampton www.gilliebolton.com 12
  • 13. Community ‘An online group quickly develops a sense of collegiality, especially if the tutor is a participant, and when a climate of respect has been created, learners become able even to challenge each other and the tutor. They begin to see themselves and others differently. … An e-portfolio provides a critical thinking space which can move users out of their comfort zone. They can be encouraged to take risks and so progress further. That also applies to tutors!’ Julie Hughes, e-portfolio practitioner www.gilliebolton.com 13
  • 14. ‘Poems… profoundly alter the man or woman who wrote them.’ Dannie Abse 1998 Physician Poet www.gilliebolton.com 14
  • 15. ‘I like poetry because it has to do what it wants. I can’t make it do what I want.’ Physician-writer www.gilliebolton.com 15
  • 16. The Death of Simon Mark Purvis MD The grown-ups stand around watching. Grown-ups know what to do. The grown-ups stand around watching. Is that Simon lying on the pavement? He has got blondie hair like Simon's. The grown-ups stand around watching. A boy has been run over, another kid says. Is that Simon lying on the pavement? He was walking in front of me. The grown-ups stand around watching. Mrs Bailey puts a blanket over him - but I can still see his blondie hair. She looks at me but before she can turn quickly to the other grown-ups, I can see she's scared. `Send Mark away.' What have I done wrong? The grown-ups know what to do. They send me away. www.gilliebolton.com 16
  • 17. I run ahead alone. Trying to find Simon. I might not recognise him. Pulling kids by their shoulders - no that's not him. I speed up when I hear the ambulance siren. `Simon's been run over.' Pete Williams said. I run away, trying hard not to believe him. How can Pete Williams tell who is lying there, anyhow I saw him looking for his brother too. Surely I would have recognised my own brother. My teacher says `Simon will be in his classroom' But he isn't, so she smiles and cuddles me, warm and soft. `It's alright Mark, they call ambulances for sprained ankles these days.' When he came into the classroom everyone stopped and looked. He didn't have to tell me. I said `Simon's dead', and he nodded, unable to speak. Mark Purvis MD www.gilliebolton.com 17
  • 18. I had never before in detail talked about what I was feeling at the time when Simon died. Now I have written, I can and do talk about it…. . The writing has made me feel completely different about Simon's death, has made me deal with it in a different way. I can now see I wasn't responsible. The time was right for me to write. I didn't know I was carrying so much guilt. Now I know I don't need to carry it. I will cope differently now when a child patient dies. Mark Purvis MD www.gilliebolton.com 18
  • 19. ‘This writing allows you to touch things you otherwise couldn’t.’ ‘It is an opportunity to inhabit the unknown. Reflective practitioners www.gilliebolton.com 19
  • 20. Dr Brendan Boyle My First Writing Course I found myself terrified, empathising with my phobic/ anxiety patients. What had possessed me to enrol? It was incredibly reassuring to discover you need no writing skills. By what seems to be simplicity itself we are led into unlocking memories, thoughts, reactions, experiences. www.gilliebolton.com 20
  • 21. Dr Brendan Boyle I was haunted by the prospect of the blank page staying blank, but the almost mystical unlocking process created by those simple words: “Write anything that comes into your head for 6 minutes” was, and indeed remains, baffling. Hard to believe, but that acts as the key to access parts of our thinking that most of us seldom use. www.gilliebolton.com 21
  • 22. What is Free Writing? For 6 minutes Write whatever is in your head Do not stop writing Do not think about it Grammar, form, spelling, handwriting do not matter It might be a list or jump all over the place (our minds do skip about) Or it might be brilliant If you get stuck write ‘I am stuck’ until you’re unstuck YOU WILL NOT BE ASKED TO SHARE IT It’s private! www.gilliebolton.com 22
  • 23. ‘I found the reflective writing process itself was where the bounties lay, and NO amount of teaching about reflection could help me.’ A Reflective Practitioner www.gilliebolton.com 23
  • 26. How to Write Reflectively Grammar, form, spelling, handwriting do not matter (You can always correct them later if you need) It’s the content which is significant Write what is in your heart, thoughts and memory Write what you know already (though you might not know you know it) without planning or forethought www.gilliebolton.com 26
  • 27. Reflective writing is a conversation with the self You are not listening to yourself as you write. While writing, the page offers no head-nodding, smiling, frowning, grimacing, no immediate response of questions, affirmation, shouts or screams. You listen to yourself after you write, on rereading. Writing creates tangible footprints to be followed, but this interlocution is beneficially postponed. www.gilliebolton.com 27
  • 28. What is Reflective Writing? When you trust writing to take you where you need to go When you value yourself to explore and express When you take responsibility for your writing (your tutor or boss aren’t responsible) When you give generous time to yourself to write When you have positive regard for patients and colleagues you write about www.gilliebolton.com 28
  • 29. Writing – Reflective or Therapeutic? Writing works for anyone professional patient student client www.gilliebolton.com 29
  • 30. Self Confidence Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? … Your playing small doesn’t serve the world…. . We are all meant to shine… . And as we let our own light shine, we unconsciously give other people permission to do the same. … Our self perception determines our behaviour. If we think we're magnificent creatures with an infinite abundance of love and power to give, then we tend to behave that way, and the energy we radiate reflects those thoughts no matter what we do. Marianne Williamson www.gilliebolton.com 30
  • 32. Take Care You are about to enter a danger zone Wear protective clothing around your heart Take off your shoes Writing can seriously damage your sadness Writing can seriously damage your nightmares You are in danger of achieving your dreams Once started you won’t be able to stop Nor will you want to And others might catch it too You are in serious danger of learning you’re alive You are in serious danger of laughing out loud You are in serious danger of loving yourself If it gets in your eyes, consult your loved ones If it gets in your mind, cancel your therapist If it gets in your heart, hold on tight Gillie Bolton www.gilliebolton.com 32