A qualitative study of letters to President Kennedy from persons with mental illness and their families: using the research poem in policy oriented research.
Keywords: research poem, mental health policy, John F. Kennedy
While it is true that statistical representations of social problems do influence policy development, it is equally true that affective data and more humanistic presentations may be as influential as "facts" (Smit, 2003). Prevailing social perceptions regarding a problem have been shown to be essential to how social policy decisions are shaped (Appelbaum, 2001). Policy decisions are also based heavily upon personal and socially constructed values. Values lie at the heart of differing political and social ideologies, and often underlie differences between political parties and social movements. Policy makers often make decisions based upon their own personal, moral and religious values (Caputo, 2005).
Emotions are heavily implicated in the formations of values (Gordon, 1965; Linzer, 1992). Emotional pleas from key constituents often do have an effect on various levels of the policy development process. Yet, too often policy research is disconnected from the voices of vulnerable populations that are affected by social policies. Giving voice to those without the power and/or privilege to express their experiences in public or professional forums is a growing objective of social research, and represents an important practice domain of social work advocates and researchers.
Numerous researchers have commented on the importance of presenting the lived experience of clients as fully and powerfully as possible (Reason, 1988; Richardson, 1992). However, studies that use thick, narrative descriptions to present these voices may often be too dense or long for easy consumption by key policy constituents. In order to have increased emotional impact on social policy formation, it is important that researchers develop methods that present the experiences of key constituents in a concise, consumable, and emotionally expressive manner.
Fortunately, post-modern researchers working on the boundary between the social sciences and the humanities have developed just such a tool: the research poem. Through various social science and literary tools, researchers have used the research poem to faithfully and consistently present data on international development (Furman, 2004a), the impact of cancer (Furman, 2004b), the experience of HW care providers (Poindexter, 2002), oppression and discrimination (Langer and Furman, 2004) and many other topics.
Using the research poem as a tool of data representation, this paper presents an analysis of letters sent to President John F. Kennedy regarding the formulation of mental health policy during the early 1960s. The article seeks to present the experiences of mental health consumers and their families--shapers and receivers of mental health services that are infrequently given voice. It should be noted that this article is less about social policy than it is about the presentation of the lived experience of those who are the targets and beneficiaries of social policy. It is the hope of this researcher that others will be encouraged to use similar methods in current social policy research.
Several key areas will be addressed. First, the research poem as a tool in qualitative social research will be explored. Second, the method used in this study will be explicated. Third, data will be presented in the form of three types of research poems: free verse, the pantoum, and tanka. Finally, implications for social and policy research will be presented.
The Research Poem
In order to present the voices of various constituencies, research methods must be adopted that preserve their lived experiences. Traditional research guided by a positivist epistemology attempts to quantify and categorize the opinions and beliefs of those being researched. Contrasted to the positivist approach is the research tradition developed by various post-modern scholars in multiple disciplines (Freedman & Combs, 1996; Gilgun, 1994). These scholars observed that reducing human experience to numerical representation often strips the meaning from these experiences (Janesick, 1994: Lincoln & Guba, 1985). For instance, one can say that a certain percentage of people support one policy over another. Yet numerical presentations lose the important affective and contextual data that can help policy analysts and human service practitioners understand the interplay of human value and desire in the policy making process. Also, numerical data may not stimulate the type of empathic reactions that more evocative methods may produce in the consumers of research.
As a means of preserving the fullness of human experience, various researchers have drawn upon the expressive and creative arts in the research process (Allen 1995; Blumenfeld-Jones 1995; Barone & Eisner 1997; Eisner 1981 & 1991; Finley & Knowles 1995; McNiff 1998; Prosser 1998; Stein 2003; Willis, Smith & Collins 2000; Wong 1999). Creative and expressive arts research methods may be used throughout the research process. They can be integrated with well-articulated methodologies that help researchers to become increasingly engaged with their data, thereby allowing them to "transfer cognitive and affective knowledge from artist/researcher to reader" (Prendergast, 2004, p. 75). Willis (2002) explores how arts and humanities-based research is congruent with the expressive research agenda. This approach is contrasted with the analytical tradition of research, in which human phenomena are reduced into statistical forms, which often strip the life and practical utility from data. Expressive research:
does not grasp an object to analyze and subdue it. It attempts to hold it in consciousness, to allow its reality and texture to become etched on the mind. It holds back from closure and returns again and again to behold the object, allowing words and images to emerge from the contemplative engagement (Willis, 2002, p. 4).
This notion is congruent with Denzin's (1997) advocacy for the use of alternative forms of data to evoke intense and meaningful emotional reactions in the consumer of research.
Poetry is one of the creative/expressive arts that has been applied increasingly in the research endeavor. Using poetry allows researchers to preserve the richness and complexity found within data sources, yet encourages compression and data reduction that allows consumers of research to more fully grasp the essence of text. When applied as a method of data reduction, it helps researchers move from "thick descriptions" (Geertz, 1973), to data that is powerful yet easy to consume (Szto, Furman, & Langer, 2005).
Research poetry has been used in studies of a variety of social problems from multiple research paradigms. Many scholars integrate traditional social science methods in the process of creating research poems. Richardson (1992, 1993) has been an important voice in the development of poetry as a tool in presenting qualitative research. She notes that compressing qualitative data into poetic forms helps convey the complexities of paradoxical and often conflicting emotions. Her research powerfully describes the complexity of marital relationships, yet does so in a more concise manner than traditional qualitative narratives. Langer and Furman (2004) used research poetry as a means of presenting data regarding the identity formation of a bi-racial Native woman. In their research, they crafted research poems from passages taken directly from ethnographic interviews. They utilized traditional thematic analysis as a means of explicating salient themes, and crafted research poems as a means of reducing the data into a consumable form. They also sought to maintain the depth and integrity of the original data.
Furman (2006) used a similar methodology to represent data about his experience as a patient in an emergency room. In this work, the researcher analyzed his data through thematic analysis, and then re-mined data for passages that represent the discovered themes. The researcher then used three poetic forms to condense, contain and focus the data. The new research poems demonstrate how different methods of data representation can impact the emotional tone and quality of the data. For instance, he found that the French/Malaysian poetic form of the pantoum was particularly useful in portraying intense, powerful emotions.
Poindexter (2002) used methods from narrative and linguistical analysis to preserve the vocal patterns that are often lost in the translation between oral and written form. Her research poems use symbols and signs to designate various changes in speech patterns in order to "honor the strengths and uniqueness of each individual and to preserve their inspirational stories" (Poindexter, 1998, p. 22).
Other studies have relied even less upon methods of social science research and have developed techniques more in adherence with the humanities. Purto (2002) showed how poetry originally written for expressive purposes can also serve as research text. She presents poems written from journals and field notes in various states of aesthetic development to explore education in India and racism in Georgia. By writing aesthetically-based poems from empirically-based notes, she deviates from research poems and delves into the realm of the literary and the interpretative. Prendergast (2004) created what she refers to as literature-voiced poetry as a means to "help me synthesize, process and make meaning" (p. 75) of a literary text. For her, the literature-voiced poem is both a means and an end--a process of coming to grips with the nature of text, as well as a means of data representation.
Data were collected for this study at the John E Kennedy Library in Boston, Massachusetts. For five days, the researcher explored numerous files containing thousands of pages of documents relevant to mental health policy from 1960-1963. Some of the most powerful qualitative materials consisted of letters written to the president. These letters were written in response to proposed mental health legislation, many of which were discussed in newspapers and in the media.
Sample and Sampling Issues
Files consisted of one hundred and seventeen letters to President Kennedy. Of these letters, over fifty percent were written by family members dealing with mental illness. Nearly thirty percent were written by persons with mental illness themselves, and twenty percent were from citizens who did not identify either their mental health status or their relationship to persons with mental illness. However, it appears that the majority of these were written by mental health service consumers themselves. About half of the letters were hand written, the other half were typed. Many letters expressed anger at a lack of services, and some were personal appeals for specific services. Some letters included brochures from programs that people wished received more funding. Some were notes of thanks.
Letters were chosen if they met the following criteria: 1) they were legible; 2) they contained the authors' perspective about mental illness vis-a-vis social policy 3) they were written by a mental health consumer or a family member of a consumer; 4) the documents contained enough material to be suitable for the creation of a research poem; and 5) they contained enough affective materials to present the lived experience of the author. A total of 20 letters met these criteria. From these letters, a subset of six was chosen to be analyzed and presented via poetic re-representation.
The following methods were used in the creation of research poems. The author analyzed the data for themes using traditional open and axial coding methods. A five step method was used in the data analysis phase. During the first round of coding, the researcher read the letters without the intent to develop codes or themes. The goal was to familiarize himself with the text. During the second round, general impressions were noted and written in the margins of the text. The third round of coding consisted of a line-by-line analysis of the text. During the fourth round of coding, general themes were induced from the identified codes. A fifth round of coding was conducted two weeks later, using the same method with the intent to discover any uncovered themes and to insure accurate and adequate representation of the themes.
Once themes were identified, the researcher undertook the process of representing some of the observed themes in different poetic forms. No hard and fast rules were strictly followed in deciding how to present a letter in one form versus another; the researcher relied upon his sense of the data and the media. Yet, several principles have guided this researcher in his work. First, letters that followed a more narrative or historical structure lent themselves well to being presented in free verse. For letters in which a narrative or story was less evident, yet were characterized by powerful emotions and evocative language, the pantoum seemed to be the best means of data presentation. Tankas were used to represent letters and themes that were less dense and complex, and lent themselves to compression and parsimony.
With origins tracing back to eighth-century Japan, the tanka is one of the oldest forms of poetry still widely being used (Waley, 1976). The tanka is far older and, in many ways, of more historical significance than its cousin the haiku. Traditionally, the tanka was written in one long line of 31'onji', or sound units (Ueda, 1996). The rhythmic pattern of onji consisted of units of 5-7-5-7-7 sound and meaning units (Strand & Boland, 2000). The onji in Japanese is a different unit of sound than is the English syllable, yet the American tanka has come to use the same pattern, corresponding to syllables instead of onji. In writing American tankas, it is considered permissible to use syllabic counts as a guide; strict adherence to the form itself is less important than conveying the meaning that the researcher intends. The following tankas were crafted mostly using lines from the original letter, with some minor restructuring to help the poem fit close to the traditional form of the American tanka.
The pantoum is a powerful form that can create a haunting effect through the repetition of lines throughout the poem. The pantoum is a French poem based on an ancient Malaysian form of poetry (Unst, 2002). It was introduced to the West by the French poet Victor Hugo and gained popularity in the United States throughout the 20th century (Blackmore & Blackmore, 2004). Colorado poet Jack Martin (personal communication, 2003) referred to the pantoum as the poetry machine, in that the repetition of lines and energy of the poem can be almost contagious. It should be noted that because each of the following research poems are of a condensed nature, all of the identified themes are not contained in each poem.
Free verse poems are those that do not follow structured syllabic patterns or other traditional literary conventions. Free verse originated in the early part of the twentieth century as poets attempted to break the free of the rules and constants of formal verse (Kirby-Smith, 1996). However, free verse does not imply that anything can be a poem. In free verse poetry, compression, cadence, tone, metaphor, line breaks, and other literary devices are used to create a sense of music and meaning. The exact nature of free verse poetry can be extensively debated; such debates are beyond the scope of this paper. For the purposes of this discussion, research free verse poems follow the basic structure of the letters, yet are far more condensed, and use line breaks to focus the data. These poems are presented first.
Free Verse Poem One On behalf of the forgotten people A personal thanks and tribute For your legislation for the mentally ill. After World War II I spent months in the VA hospital Depressed. Since, I have worked in mental hospitals And what you have done I assure you A place at the hand of God. Free Verse Poem Two The house committee cut more than half the money To the mentally ill, a surprising and stunning blow But then I read, of 8.2 billion in "Pork" Why so upset? We have a twenty year old son A patient in a private mental hospital And unless we put him in A state institution We will slowly go broke We always drew comfort from your efforts President Kennedy. I admire so much Your mental Health Program I am writing my congressmen and senators Can you suggest to me What else I might do? Pantoum One We have twenty years of heartache A sister who is mentally defective The institution tries hard, but with eighty in each cottage? She was placed there permanently. A sister who is mentally defective She gave birth to a boy we idolize. She was placed there permanently. He too turned out to be emotionally disturbed. She gave birth to a boy we idolize Thanks you Mr. President, for your proposed bill. He too, turned out to be emotionally disturbed. At the Kennedy Child Center, the right path to a better future. Thanks you Mr. President, for your proposed bill. The institution tries hard, but with eighty in each cottage? At the Kennedy Child Center, the right path to a better future. We have twenty years of heartache. Pantoum Two I see heartaches and suffering from our mentally ill a human mind, meant to inspire now unable to muster the wit and true vision and we used to throw them away. a human mind, meant to inspire they were locked behind walls, how tragic and we used to throw them away and now, your plea to the nation, for change. they were locked behind walls, how tragic You stated: "We have neglected to meet our mentally ill" and now, your plea to the nation, for change. you are ready, and ask us, to sacrifice. You stated: "We have neglected to meet our mentally ill" now unable to muster the wit and true vision you are ready, and ask us, to sacrifice. I see heartaches and suffering from our mentally ill Tanka One my children, no mother, we pray she comes home, to live, not for rare weekends. I pray congress hears your plea community care, for Sarah. Tanka Two Normal children? Tough. Raising the mentally ill? Help? We need more support. Must fund mental health centers to bring my child back home.
A reading of the poems shows that each form leads to different effects. The free verse poems, being more open in structure, allow for the presentation of data that are congruent with the original form, style and narrative flow of the original letter. In writing the free verse poems, the researcher was able to pay attention to the original narrative flow of each letter, and was able to take advantage of this as a guiding structure. Placing the data in this form allows for a compression whereby redundant or non-essential words are removed. The free verse poems are perhaps the less "cooked" and analyzed data, as they are closest to the original letter.
The pantoums were less effective in presenting narrative flow. Linear data are not best presented in this form. However, through the use of repeating lines, affective intensity is achieved. Similarly, creating new alignments of sentences creates exciting new contrasting meanings between different aspects of the data. The juxtapositioning created by these new alignments forces the researcher to understand the intricacies of the data, and to pay careful attention to the order in which data are presented. Similarly, the tanka forces the researcher to seek the essence of the data, yet perhaps leave out a great deal of information as well.
The inquiry presented here is situated at the boundary between the humanities and the social sciences. Methods such as these encourage researchers to experiment with different means of data presentation, ranging from those informed mostly by the humanities, to those informed by the social and behavioral sciences, to many methods in between. These experiments may be valuable not only for researchers who seek to present their work in creative forms, but as a mechanism to help researchers understand and analyze their data.
How should these poetic forms be used in qualitative research? First, even for researchers who will not use these methods of data presentation, experimenting with data reduction techniques such as these helps researchers become more familiar with the tone, shape and nuances of their data. The decision making that goes into creating the research poems necessitates an intimate familiarity with one's data. These methods may be particularly useful to those who have typically relied upon computer software for analyzing data; these methods may present new insights that reliance on computer programs may not provide.
Second, experiments with data representation applying poetic forms stress the importance of data presentation in qualitative research. Too often, this important step is seen as an afterthought to the research endeavor. Researchers may consider various means of presenting data, based upon the data itself, and the reason for dissemination.
Perhaps most importantly, these methods should be considered on their own merits. Poetic forms and structures are highly consumable means of presenting the lived experiences of research participants. These forms may help research consumers achieve the goal of an affective response to research.
It may be difficult for policy advocates to imagine themselves reading poetry in front of congress or other legislative bodies. However, there exists a tradition of using emotionally evocative data as testimony in support of policy aims (Dror, 1988; Miller, 1979; Poets Against War, 2007). Whether or not poetry, research or otherwise, is utilized, policy researchers and advocates may be encouraged to include direct expressions of individuals who have been affected by social policies in their testimonies. Including this type of data can bring a human presence to policy debates, allowing policy makers to understand the real impact of their decisions.
Policy makers are inundated with statistics that may have very little impact upon them. Such data are often quickly forgotten. A poem, however, may ring in someone's mind for many years after they hear or read it, and may influence their views for many years to come.
* This research was conducted with the support of a grant from the Kennedy Library Foundation. The author is grateful to the wonderful librarians who made this research possible.
Allen, P. (1995). Art is a way of knowing. Boston: Shambala Press.
Appelbaum, L. D. (2001). The influence of perceived deservingness on policy decisions regarding aid to the poor. Political Psychology, 22(3), 419-442.
Barone, T., & Eisner, E. (1997). Arts-based educational research, In R. M. Jaeger (ed.), Contemporary methods for research in education (pp. 225-245). Washington, DC: American Education Research Association.
Blackmore, E. H., & Blackmore, A. M. (2004). The essential Victor Hugo. New York: Oxford University Press.
Blumenfeld-Jones, D. (1995). Dance as a mode of research representation. Qualitative Inquiry, 1(4), 391-401.
Caputo, R. K. (2005). What's morality got to do with it? An essay on the politics of moral values in light of the Presidential election of 2004. Families in Society, 86(2), 171-179.
Denzin, N. K. (1997). Interpretive ethnography: Ethnographic practices in the 21St century. Thousand Oaks, CA: Sage.
Dror, Y. (1988). Visionary political leadership: On improving a risky requisite. International Political Science Review, 9(1), 7-22.
Eisner, E. W. (1981). On the differences between scientific and artistic approaches to qualitative research. Educational Researcher, 10(4), 5-9.
Eisner, E. W. (1991). The enlightened eye: Qualitative inquiry and the enhancement of educational practice. New York: Macmillan.
Finley, S., & Knowles, J. G. (1995). Researcher as artist/artist as researcher. Qualitative Inquiry, 1(1), 110-142.
Freedman, J. & Combs, G. (1996). Narrative therapy: The social construction of preferred realities. New York: Norton.
Furman, R. (2004a). Poetry as qualitative data for exploring social development and human experience in Latin America. Journal of Latino-Latin American Studies, 1(3), 81-103.
Furman, R. (2004b). Using poetry and narrative as qualitative data: Exploring a father's cancer through poetry. Family, Systems & Health, 22(2), 162-170.
Furman, R. (2006). Poetic forms and structures in qualitative health research. Qualitative Health Research, 16(4), 560-566.
Geertz, C. (1973). The interpretation of cultures. New York: Basic Books.
Gilgun, J. (1994). Hand into glove. The grounded theory approach and social work practice research. In E. Sherman & W. J. Reid (Eds.), Qualitative Research in Social Work (pp.115-125). NY: Columbia University Press.
Gordon, W. E. (1965). Knowledge and value: Their distinction and relationship in clarifying social work practice. Social Work, 10(3), 32-39.
Janesick, V. J. (1994). The dance of qualitative research design: Metaphor, methodolatry, and meaning. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of Qualitative Research (pp. 209-219). Thousand Oaks, CA: Sage Publications.
Kirby-Smith, H. T. (1996). The origins of free verse. Ann Arbor, MI: University of Michigan.
Langer, C., & Furman, R. (2004). Exploring identity and assimilation. Research and interpretative poems. Forum: Qualitative Social Research, 5(2), http://www.qualitative-research.net/fqs-texte/2-04/2-04langerfurman-e.htm
Lincoln, Y. S. & Guba, E. G. (1985). Naturalistic Inquiry. Beverly Hills, CA: Sage Publications.
Linzer, N. (1992). The role of values in determining agency policy. Families in Society: The Journal of Contemporary Human Services. November, 553-558.
Martin, J. (2003). Personal communication. Fort Collins, Co.
McNiff, S. (1998). Arts-based research. Philadelphia: Jessica Kingsley Publishers.
Miller, E. F. (1979). Metaphor and political knowledge. Political Science Review, 73 (2) 155-170.
Piirto, J. (2002). The question of quality and qualifications: Writing inferior poems as qualitative research. Qualitative Studies in Education, 15(4), 431-445.
Prosser, J. (Ed.). (1998). Image-based research: A sourcebook for qualitative research. London: Falmer.
Poets Against War (2007). Poetry matters. Retrieved February 11, 2007 from http://www.poetsagainstthewar.org/poetry_matters.asp
Poindexter, C. C. (1998). Poetry as data analysis: Honoring the words of research participants. Reflections, Summer, 22-27.
Poindexter, C. C. (2002). Meaning from methods: Re-presenting narratives of an HIV-affected caregiver. Qualitative Social Work, 1(1), 59-78.
Prendergast, M. (2004). Shaped like a question mark: Found poetry from Herbert Blau's The Audience, Research in Drama Education, 9(1), 73-92.
Reason, P. (1988). Human inquiry in action: Developments in new paradigm research. London: Sage.
Richardson, L. (1992). The consequences of poetic representation. In. C. Ellis & M. G. Flaherty (Eds.), Investigating subjectivity: Research on lived experience (pp.125-173). Newbury Park: Sage Publications.
Richardson, L. (1993). Poetics, dramatics, and transgressive validity: The case of the skipped line. The Sociological Quarterly, 34(4), 695-710.
Smit, B. (2003). Can qualitative research inform policy implementation? Evidence and arguments from a developing country context. Forum: Qualitative Social Research, 4(3), http://www.qualitative-reserach.net/fgs-texte/3-03/3-03smit-e.htm.
Stein, H. F. (2003).The inner world of workplaces: Accessing this world through poetry, narrative, literature, music and visual art. Consulting Psychology Journal: Practice and Research 55(2), 84-93.
Strand, M., & Boland, E. (2000). The making of a poem: A Norton anthology of poetic form. New York: W. W. Norton.
Szto, P., Furman, R., & Langer, C. (2005). Poetry and photography: An exploration into collaborative research processes. Qualitative Social Work: Research and Practice, 4(2), 135-156.
Ueda, M. (1996). Modern Japanese Tanka. New York: Columbia University Press.
Unst, Q. (2002). The Pantoum verse form. Retrieved February 14, 2005, from http://baymoon.com/~ariadne/form/Pantoum.htm
Waley, A. (1976). Japanese poetry. Honolulu: University of Hawaii Press.
Willis, P., Smith, R. and Collins, E. (2000). Being seeking telling: Expressive approaches to qualitative adult education research. Flaxton, Australia: Post Pressed.
Willis, P. (2002). Poetry and poetics in phenomenological research. Indo-Pacific Journal of Phenomenology, 3(1), 1-19.
Wong, L. (1999). (ed.). Shootback: Photos by kids in the Nairobi Slums. London: Booth-Clibborn.
University of North Carolina Charlotte
Department of Social Work
|Printer friendly Cite/link Email Feedback|
|Title Annotation:||John F. Kennedy|
|Author:||Furman, Rich; Shukraft, Allison|
|Publication:||Journal of Sociology & Social Welfare|
|Date:||Dec 1, 2007|
|Previous Article:||A critique of the global trafficking discourse and U.S. policy.|
|Next Article:||The research practices and needs of non-profit organizations in an urban center.|
|The Mad Among Us: A History of the Care of America's Mentally Ill.|
|NBER Profile: James R. Hines, Jr.|
|NBER profile: Jeffrey R. Brown.|