The healing environment: without and within

Here is a treasure trove for you. Three books to read in your deckchair on the lawn with your feet on the spaniel. Offering a range of views and experience, they're that friendly, and that fascinating, informative, and inspirational. Gwyneth Lewis' Sunbathing in the Rain is an autobiographical study of surviving severe clinical depression with the use of artistic understandings and practices. The other two (Kirklin and Richardson, and Sampson) cover the broad fields of medical humanities and arts and health — fields which go hand in hand, ducking and diving.

Medical humanities is the development of arts and humanities within medical and healthcare education, and the development of the academic disciplines of medicine and health care: extending the human side of medicine. A study of literature or history, philosophy or ethics can hugely broaden understandings of the human condition in all its social and psychological complexities, for example.

Arts and health is the provision of arts — writing, painting, music, and so on, in health. Art can be provided in two ways, a) as appreciation of product — pictures and poems on practice walls and concerts in wards, and b) as a practice — with people writing, painting and playing instruments. This latter can either have a therapeutic or a more purely creative aim. The arts forms are usually provided by artists in particular fields, rather than health or therapeutically trained people.

The arts have healing power, whether through creative practice or by appreciation. This is hardly a new insight: the arts have been used in this way for thousands of years. A study of the humanities on its own, does not of course, ensure more compassionate, understanding doctors with improved listening skills. Doctors are not suddenly to be educated as philosophers or literary critics, but to be able to draw upon the insights, knowledge and experience within arts and humanities disciplines — fruitfully and practically.

These books are not textbooks. Rather than telling you how to do things, they offer a patchwork of experience and interdisciplinary knowledge and skill.

Sunbathing in the Rain is Gwyneth Lewis' personal experience of deep clinical depression. The reader travels with her, learning what helped and what didn't, what she could do and what she couldn't. What helped the most? Writing poetry. Like Gwyneth, I too would have gone under if it hadn't been for the self-illuminating, searingly uncompromisingly, honest power of journal and poetry writing to face one with oneself. A hard road to psychological healing, but a true one. And you don't have to be clinically depressed or traumatised for it to help you. Writing can be illuminative for anyone.

I recommend a reading of Gwyneth's brave exposure of her own experience, both for you — to help with understanding depression — and for your patients to read. I also recommend her poetry collection (Keeping Mum, Bloodaxe 2003), but you'll have to wait for a further review for that.

You can learn more about how to use poetry for healing from John Fox, president of the American National Association for Poetry Therapy. His chapter in The Healing Environment: without and within, eloquently and elegantly describes the use of writing personal poetry, and reading published works. In the same book, Claire Elliott writes fascinatingly about using the cult text Trainspotting to enable medical undergraduates to understand the junky's point of view much more clearly in the treatment of drug abuse. Michele Petrone, cancer sufferer and artist extraordinaire, tells us fascinatingly how a dream helped him to understand his condition (first published in Opening the Hoard, my literature and medicine section in the journal Medical Humanities. If you don't know it then subscribe now.) Ruth Richardson paints a graphic picture of what hospitals used to be like in the bad old days in her historical chapter.

The Healing Environment: without and within culminates in a superb chapter by Roger Higgs (a professor of general practice and a medical ethicist). An autobiographical reflection on medicine and general practice, beginning with a memory of tonsillectomy in 1949, he calls it a ‘brief and personal study of the change of the emotional and moral landscape’ of health care and medicine. I recommend this book for this chapter, and to appreciate the illustrations throughout. I hope you'll read the other chapters too; your practice will benefit.

Creative Writing in Health and Social Care is full of experience of working with patients with dementia, hospital, hospice and occupational therapy patients, and those in primary care. This is innovative work — deeply helpful to the patients, illuminatively described. It also includes an excellent chapter by Robin Downie, a professor of moral philosophy. Robin writes very persuasively, pragmatically and unemotionally about medical humanities in medical education.

I've run out of space, and I've run out of time. You'll have to read the books for yourself. Please do.

• © British Journal of General Practice, 2004.