The Writer’s License

Foreword by the Editor of the Psychotherapy Matters Blog:

Dr. Bernard contributed this post after writing it for a course that he took at the University of Toronto School of Continuing Studies on Creative Non-Fiction taught by Shaughnessy Bishop-Stall.  Psychiatrists rarely–if ever–admit to psychiatric or psychological issues in themselves.  It is courageous of Dr. Bernard to allow us to post his writing.  I hope that the posting of his writing exercise further erodes the stigma surrounding mental illness.

I need to tell you that the problem has already started as I begin to write this short story. I’m perspiring and my heart is racing a bit. If I could measure it, I’m pretty sure my blood pressure is increased, my adrenals are releasing catecholamines, and my amygdalae are lighting up the neural pathways for fight, flight or freeze. Now I’m looking for a way to avoid writing. I think I need to do much more research on creative non-fiction writing or check my e-mail. Maybe get something to drink. I started this paragraph with the words, “I need to tell you …” but who are “you” and why do I care so much about what you think?

I was really looking forward to the School of Continuing Studies course on “Creative Non-Fiction.” I’m a psychiatrist taking a sabbatical leave from my usual clinical work, and one of my goals for this year is to improve my writing. When I woke up the morning of the class (the class started in the evening), the optimism and excitement was replaced by the familiar sick feeling of anxiety. Then my mind began to range over some escape paths. During our breakfast of oatmeal, filled with fresh fruits and almond milk, I reminded my wife of how wonderfully she writes and told her that she would get more out of this course than I ever could. I told her that it wouldn’t be a problem switching who attends. She swallowed the blueberries but not my line.

My irrational fear of writing started in childhood. We psychiatrists usually state that such problems are “overdetermined”, meaning that there are multiple reasons for the development of a psychological disorder (this also allows us to make up lots of different explanations and to one-up our colleagues). I will tell you about one contributing cause, Miss Campbell, my grade 3 teacher back in 1964.

In grade 3, I was taught how to write in cursive. Before we were allowed to make the transition from printing to joined-up writing, we had to write in cursive on the blackboard, in front of the entire class. Miss Campbell would award you a “Writer’s License” if you passed the blackboard test. Only then, would you receive your license, a very official looking document which would be posted prominently on the classroom wall. I’m left handed and my writing was (and still is) very messy. I was the last child in the class to get my license and it was probably only awarded to me because the school year was ending. The other children in my class started to tease me and that was the beginning of my feelings of shame and anxiety when writing in front of others. This fear of public writing was one of the precursors to my anxiety over the entire process of writing.

My writing phobia meets the usual clinical definition: a persistent irrational fear cued by an object or situation (writing) that triggers avoidance, anxious anticipation and distress sufficient to interfere with life. I’m far from alone with this type of problem. About 10 percent of people have a specific phobia and up to 25 percent of the entire population will suffer from some type of anxiety disorder in their lifetime.

In alphabetical lists of specific phobias (usually created by word game enthusiasts and not psychiatrists), graphophobia, fear of writing, is found somewhere between glossophobia, fear of public speaking, and gymnophobia, fear of nudity. It’s an interesting coincidence that writing can feel like public speaking in the nude.

Over the years, it was relatively easy to avoid writing in front of others. In the days before powerpoint, if I had to make a presentation, I would ask someone with good penmanship to copy my writing in advance onto overhead transparencies, or on paper that I would photocopy and distribute. In group work, there were times when it was very difficult to avoid going up to the board to write things down in front of others but I would find some excuse or explanation. I continued to suffer until I embarked on a program of self-treatment.

The treatment for phobia involves “avoiding avoidance.” This wonderfully wise mantra is much easier to say than to do. As a sufferer, avoidance works so well (temporarily) even though it actually perpetuates the phobia. In my last year of training as a psychiatrist, I was the chief resident in a large general hospital. One of my responsibilities was to conduct teaching sessions and patient reviews with medical students and other trainees every morning at 7:00 am. For 6 months, every morning, I would stand up at the whiteboard and write down important details of the cases presented and any of the teaching material for that day. After just a few weeks of sweating and fumbling, I started to feel comfortable writing in front of others and, as a bonus, I learned that my writing was somewhat legible if I printed in block letters.

Unfortunately, even after I stopped feeling anxious about writing in front of others, I continued to experience excessive anxiety when confronted by most writing tasks. Academic papers and clinical reports are still sources of great distress. I procrastinate terribly and this makes the whole process exhausting and painful. When there is absolutely no alternative, I finally do the writing and I’m usually shocked by how little time it takes. Why can’t I just write with a little bit of ease and a lot less procrastination, avoidance and anxiety?

It’s the day after my first writing class and I’m sitting at the The Rex on Queen Street, a Toronto bar “where Jazz lives” (and sometimes dies). Sitting across from me is my best friend from childhood. Amongst his many accomplishments, my friend became a successful Blues harmonica player in his fifties. We can barely hear each other above a Trumpet solo that has me tapping the table. He asks me how the class went and I tell him that I foolishly agreed to write about my fear of writing and that I really don’t want to self-disclose. I’m thinking about the special risks and complications of self-disclosure for a psychiatrist.

He tries to encourage me: “You should definitely write about yourself. One of the most interesting things about you is that you knew that you wanted to be a psychiatrist in Grade 3. I love to tell people that you used to interpret my dreams when we were 9 years old! Anyway, if it’s so difficult for you, why do you want to write?”

“Oh, for the usual reasons …” I answered.

“Like what?”

“Maybe I have an exaggerated need to be admired and I want to leave something behind after I die. Maybe I imagine that my writing will live on after me. Doesn’t everyone feel that way?”

He shook his head.

“No, that doesn’t interest me. I never would have done my music with that sort of motivation.”

So now it comes back to “you”, dear reader, and why do I care so much about what you think? Somehow I’ve turned you into a licensing authority and I don’t even know who you are.

It occurs to me that writing, for better or for worse, is an unlicensed creative activity. Unlike medicine (which includes a license to write messily, “Oh, you’re a doctor. Of course your writing is illegible!”) or driving a motor vehicle, we regularly allow unlicensed writers to run rampant. The risks are largely reputational for the writer and rarely fatal for the reader.

I’m going to need courage, wisdom, practice and lots of helpful feedback to develop and improve my writing skills. I’m hoping that the writing course will be another program of self-treatment, a form of exposure therapy, an effort to avoid avoidance and an opportunity for self-compassion.

Now I’m waiting for a class of fellow students and an instructor to criticize this story, my first assignment. Hit me with your best stuff. It’s bound to be therapeutic.

This time, I’m giving myself a Writer’s License.

The views expressed in these blogs are the author’s own and not necessarily reflective of those of Psychotherapy Matters.  Copyright © 2015

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