The Write to Heal: Resilience is a Muscle (Episode 5)

Interview with Captain Moira G. McGuire, former Chief of the Arts in Health Program at the National Intrepid Center of Excellence, and Sarah Moore, Community Specialist for Arts and Health at Walter Reed National Military Medical Center.

[00:00:00] Tamara Kissane: Welcome to The Write to Heal: Soldiers Deep Dive into Storytelling. Are you compelled to write, whether it be journaling, poetry, or stories to help make sense of your life and the world? I'm Tamara Kissane, the founder of Artist Soapbox. In this limited audio series writer and teacher June Guralnick and I speak with life changers - people who champion creative writing as a catalyst for healing and soldiers whose lives have been radically transformed through story.

In this episode, you'll hear from two remarkable individuals: Retired Captain Moira McGuire, former Chief of the Arts and Health Program at Walter Reed National Military Medical Center and Nurse Officer with the U.S. Public Health Service and Sarah Moore, Dance Movement Therapist and current Community Specialist for the Arts and Health Program at Walter Reed.

Check out our show notes for more information about their backgrounds as well as relevant links. We hope you enjoy this conversation about the power of storytelling to inspire connection and healing. And do stay to the end because we have a provocative writing prompt we're inviting you, our listener, to sink your teeth into.

[00:01:13] June Guralnick: Good morning, Moira. Good morning, Sarah. We are so honored to have you both here to talk about the wonderful Arts and Health Program that both of you have been so dedicated to; it's such an important seminal program in the country and indeed, actually in the world. I'd like to begin with Captain McGuire and thank you Captain McGuire for permitting me to call you Moira.

I'd like to get your reflections on how the Arts and Health Program actually started at Walter Reed Hospital, because let's be frank, when people think about a military hospital, they're not typically linking that with the arts.

[00:01:58] Moira McGuire: You are absolutely correct that most people do not link the two. Although interestingly, the D.O.D. is the single largest employer of musicians in the world, and music therapy as a profession actually started in veteran hospitals after the war.

The program officially started in 2019, and yet the pieces of it had been in place for a long time, mostly through a lot of individuals who were very aware, very passionate, very dedicated to making sure that these things were happening. Dr. Micah Sickel, who's a pediatric psychiatrist who worked there for a long time, started the performing art series called Stages of Healing.

I myself started the art show in 2003, which actually initially was just for breast cancer patients, and then eventually became for the entire hospital. So the good news is in 2019, all of the pieces were already there, and we also happened to have a director, Captain Mark Kobelja who was very moved by his observations of staff and patients’ responses to people playing pianos in the Medical Center.

We have a few pianos placed around, particularly in our outpatient pavilion in the America Building. And so he pulled a group of people together, including our Chief of Staff at the time, and said, we need more of this, make it happen. I think this was perhaps impeccable timing in many ways. And unbeknownst to us at the time, of course, we were about to enter into a global pandemic. But I said to him, you know, if you really want piano playing to be sustainable in the hospital, then it has to be part of a program.

It can't just be one or two people who are passionately, you know, shepherding this through. And fortunately, you know, some of the people at the table included senior leaders at the National Intrepid Center of Excellence. And they already had a healing arts program with creative arts therapists, and they were willing to help contribute staff positions.

So it was a wonderful kind of perfect storm in a very positive way that brought the program together.

[00:04:11] June Guralnick: Moira, I wanna make sure it’s stated for the record that the program would not exist without you.

[00:04:20] Moira McGuire: That is very generous and kind of you, June. I don't know if I get that award because I'm the most stubborn, the most hardheaded, the one who beat the drum the longest, but yes, thank you.

[00:04:35] Tamara Kissane: Sarah, who does the Arts and Health program serve at Walter Reed? And how is the program different from other arts programs in non-military hospitals?

[00:04:46] Sarah Moore: So the Arts and Health Program at Walter Reed serves the entire Walter Reed community. And when I say the entire community, I'm referring to patients and staff members, active duty and civilian, family members, volunteers, medical students. It's really our goal to invite everybody that comes through the doors with an opportunity to engage with the arts, to support their health and well being.

[00:05:12] Tamara Kissane: What is the difference between arts and health and creative arts therapy?

[00:05:18] Sarah Moore: I think the biggest difference is that creative arts therapists focus on clinical treatment the same as any other psychotherapist might. So they're working towards specific treatment goals, whereas arts and health professionals come from more of a wellness model and really focus more on prevention, on building resiliency, on building skills that people can integrate into everyday routines, connecting with the arts for their well being, and then also continuity of care.

[00:05:53] June Guralnick: I think it would be wonderful to give folks an idea or a sense of your own background and what drew you to this work. So Moira, when did you first fall in love with the arts?

[00:06:05] Moira McGuire: I would say probably in utero. My dad was a Marine who, when he got out, took his GI bill and went to William and Mary and studied voice. He was an opera singer and then taught voice at Catholic University for about 45 years. And then my mother, her first two degrees are in speech and drama, so she is a playwright. She's also a pianist and a painter. So, I mean, the arts were always a part of every single thing we did. I always knew how magical these experiences were.

And so then when I went to nursing school and started working, I think that was really my first introduction to the fact that, oh, wait a minute, people actually don't, they don't understand this. And I thought, we need to do something about this. So that's how I got involved. I had no intention, and my first 11 years in nursing was actually in Inpatient Psych.

So again there, right, we all had art therapists, dance movement therapists, music therapists, drama therapists. I mean, it was just part of the menu. As I became more aware of the lack of appreciating the power that these tools have for individuals, that's what really kind of brought me to this work.

[00:07:21] June Guralnick: Sarah, I wanna ask you the same question. How did you first connect with the arts?

[00:07:27] Sarah Moore: So I come from a long line of military service and then also artists. My grandfather was in the Army. All the boys on my dad's side of the family served, my cousin served, and my grandfather was also a stained glass artist. And I think music was very much around my dad's household growing up.

Everybody played a different instrument and my dad ended up serving in the Air Force, but he's also a clarinetist at the Atlanta Philharmonic. I went to an art school in high school and I danced from a young age. I started dancing around age four, and I think that arts and health or healing through the arts or sort of this connection with ourselves through the arts started for me at a young age.

I remember saying to my mom over a Christmas break when I was probably 10 or 11 years old, we had only been away from dance for two weeks or something, and I told her my body misses dancing, like I don't feel good. And I got older and really realized that you could replace that with my soul misses creating, or my voice misses singing, my hands miss painting, whatever form of expression really connects with people individually. And then I eventually found my way to the mental health field. I also worked in Inpatient Psych. We have that in common, and I think there I started to see just how necessary it is, how intrinsic it is to human nature to be creative.

I think humanity wouldn't have gotten far at all without creativity. I found the counseling framework that really resonated with me was relational cultural theory, which posits that all healing happens in connection in human relationship, and all trauma also happens in human relationship, and so I think that's where arts and health is like a perfect fit. In addition to that, being in touch with oneself, being able to connect with a deeper part of ourselves.

[00:09:44] Tamara Kissane: What has been one of the most impactful experiences for you at Walter Reed?

[00:09:49] Sarah Moore: I think what's most impactful about working in arts and health at Walter Reed is really seeing the vitality of the human spirit come alive in a place that can feel sterile at times, anxiety provoking at times.

So one memory that comes to mind is we had a performance happening in the main hospital lobby and a father walked up with his daughter. She was probably about four years old, and she was really enjoying the music. This was what we imagine stereotypically a soldier to look like. He had really big muscles and he had a buzzed haircut. But they stopped and they were listening to the music and she started dancing around and he picked her up and started waltzing around with her.

And you could just see the joy on their faces of this connection - a moment that they got to have as father and daughter. Again, there's a lot of power in community and so I saw other people's faces also soften because they got to see what was happening. And so that definitely stands out to me as some of the magic of what arts and health is.

[00:11:04] June Guralnick: Beautiful story. Moira, what about you?

[00:11:07] Moira McGuire: If I had to pick out one, I would probably pick out one that's a little more recent. So interestingly, in 2019, another thing that happened was that Walter Reed was awarded the Lennon Ono Peace Prize. And so the director at the time, Captain Kobelja, decided he wanted to use the money to purchase player pianos.

So that again, we could have music throughout the command regardless of whether you had a human being sitting there playing it. And so we had a little ribbon-cutting when we got our first piano there, and at the end of the ceremony, a gentleman sat down and just started playing. And anytime someone sitting at a piano is playing, I am more than happy to be their audience.

So I sat down to listen. And afterwards he explained to me that he was actually an organ transplant patient and had received an organ a number of years ago. And that the piano that he was playing, which by the way had been retrofitted to be a player piano, he considered saved his life. And I thought, you know, one of the other amazing things about our patient population is that it's really filled with people who are so humble and they do these things quietly in secret without any need for fanfare or saying, look at me.

And I think this is really what we need more of as a society when we consider the relationship between the arts and healing.

[00:12:34] Tamara Kissane: How do the arts help with healing for soldiers and veterans?

[00:12:39] Sarah Moore: From a scientific standpoint, something that happened in the brain in trauma is a disconnection of the brokus area. That's the sort of area for speech. And we no longer, when we've experienced something unmanageable, have the ability to access the brokus area in the same way as before a particular event. And this is very specific, I think, to post-traumatic stress disorder, but the arts give us that opportunity to dive into expression beyond words neurobiologically.

It makes a lot of sense to start what neurobiologists say from the bottom up. So from expression and then towards speech and cognitive processing. And the arts are a fantastic way to do that because they really cause individuals to drop in to the present moment and also stay present, which is really important in the process of healing.

[00:13:45] Moira McGuire: Well, certainly from an integrative health and wellness perspective, studies have shown that when we have positive interactions with people who are not known to us, it elevates our mood. And when we do meaningful work with our hands, it releases oxytocin, which is a bonding hormone.

So, you know, we do know that there's all kinds of wonderful, magical things going on in our bodies, but I think the other part of arts and health that I love is that it reminds people that whatever you need to be healthy and well, you already have, it already exists inside of you. So from a healthcare perspective, whether this is intentional or not, sometimes the message is that you can't really fix what's going on unless you come to us from an integrative health and wellness perspective.. It's actually just the opposite, right?

We want to know what are you doing well. Where are your strengths? Let's maximize those. When we talked about naming our program, we were very intentional to not use the word heal. Not that it's not very important, but heal kind of denotes injury pr illness. This is about health. This is about prevention. This is about doing these things, not when something happens, but all of the time. And in doing them, it will enhance your sense of well being. It will make you more flexible, resilient, better prepared to manage whatever might happen. Right?

And when you talk about how healthcare is supposed to be person-centered, and I think nothing is more person-centered than arts and health because it truly starts with that person acknowledging that that person is a work of art. You're already coming to us as this amazing Rembrandt, and how can we help you as this amazing work of art achieve your health goals?

[00:15:29] Sarah Moore: So I offered an explanation that was quite clinical, but I also just want to piggyback on resilience and that really the focus of arts and health is building resilience.

Like that metaphor that resilience is a muscle, it's something that we can exercise so that when big, traumatic or stressful life events do come up, we have already this buoyancy of well being to fall back on.

[00:15:56] June Guralnick: Sarah, I've been so blessed to work with you for the past few years, and I've watched you bring this magical combination of movement, breath and narrative together, and I think it would be wonderful if we could just take the next two or three minutes and demonstrate a little bit of how extraordinary you really are in the type of work you do.

[00:16:25] Sarah Moore: I like the prompt of visualization and body and breath. For folks who are listening, I would invite you just to kind of clear your space and if there's anything in front of you, just kind of move it to the side. Bring both of your feet flat on the ground. You can relax your arms. You don't have to close your eyes. Just kind of softening your gaze to not strain, to look at anything.

Just start by connecting with your breath, taking a breath in through the nose, and sighing out through your mouth. And then tapping into our visualization, I'll invite you to just bring to your mind's eye the image of a snow globe. Like a glass globe filled with those magical little representations of snow.

And imagine just this morning, just getting into your day, if this snow globe sort of represented your body. How did it start its day? Was the snow calm? Maybe your day started really frantically and it was all shaken up. And staying with your breath again, just staying with a consistent breath, breathing in, finding a steady exhale, you can bring to mind anything that might have shaken up that snow globe this morning.

And as you exhale, just allow the snow in this image in your mind's eye to just begin to slowly fall and find rest and calm, and stay with that sense of peace that might be in that image. And then just hear this truth that you always have the ability inside of you. When things get shaken up, when things are chaotic, to find that calm, and as we start to come back together, I'll invite you to just bring a little movement into your fingers and toes.

Notice if anywhere in your body you might need to stretch. And if your eyes were closed, you can blink your eyes open and we'll just take one more of those cleansing breaths, in through the nose and really sigh it out. Awesome. Thank you.

[00:19:00] June Guralnick: It was so wonderful and renewing.

[00:19:05] Tamara Kissane: Captain McGuire, this question is for you. If you could share with other military-run health facilities the most important thing to know about implementing an arts and health program, what would that be?

[00:19:19] Moira McGuire: Well, I would say number one, don't give up. Number two, find partners Very, very important. You don't want to be solitary ever, but particularly in this work. And believe that there are partners out there, that there are a lot of people who want to do this work, a lot of people who are already doing this work, and that by choosing to continue to pursue creativity and expression in your life, it actually just makes you better at everything that you do.

[00:19:53] June Guralnick: Both of you are leaders in the arts and health field. How do you handle the stress of what you do? The emotional drain? How do you take care of you?

[00:20:04] Sarah Moore: I guess it's a predictable answer. For me, it's engaging in the arts. For example, I was at a concert last night that was really inspiring. It really filled me up.

I think it's a balance between things that we're taking care of our physical body, also taking care of our spiritual selves, and that can be hard just based on the time constraints, but I think it's really important to do it in a balanced way, not let that kind of stuff slip.

[00:20:36] Moira McGuire: I definitely find self-care through engaging in the arts, and so the short answer is I'm going to be exploring a lot of that in my newly-found retirement. You know, I'm a founding member of the United States Public Health Service Music Ensemble, and I will say for the Choral Ensemble, we stopped practicing and performing during the pandemic.

And I know for a lot of people it was very, very, very difficult. So, you know, just looking forward to returning to some of the modalities I engaged in on a regular basis and adding a few more. I want to start weaving, painting, throwing pots. I don't know. I'm going to be doing all kinds of stuff.

[00:21:19] June Guralnick: Sarah, let me ask a follow up question then.I recently had the pleasure of watching a streaming version of Our Country's Keepers. Could you talk a little bit about what that was and its impact?

[00:21:36] Sarah Moore: Yeah. Our Country's Keepers was the product of a three week artist residency that we had at Walter Reed with a dance and theater company called Stuart Pimsler.

They received a National Endowment for the Arts grant to do this project, and they went about it in such a beautifully organic way. By asking individuals who were not dancers necessarily, not performers, to share their stories and really artistically and creatively and organically pulling this whole performance out of those stories.

So there was singing involved, there were monologues and speech, and also dance. And it was just a beautiful night and a tapestry of different people's experiences.

[00:22:25] Tamara Kissane: Let's listen now to an excerpt from Our Country's Keepers.

[00:22:39] Stuart Pimsler Dance & Theater: The flight line at 3:00 AM in the desert is a cryptic place. Bones of aircraft sit waiting to be brought to life. To have jet fuel coursing through their veins and lights glowing in their gauges. To vibrate with radio traffic frequency hopping to protect grid coordinates and takeoff times. These aircraft sitting so still and lifeless will soon make ghosts of people.

[00:23:36] Tamara Kissane: That's powerful stuff.

[00:23:38] Moira McGuire: Interestingly, I think one of the most phenomenal aspects of this project was that it opened our minds to the possibility of doing other residencies. So after Stuart Pimsler came, we had a Marine veteran ceramic artist who came and was in residence for a week, and it was wonderful in the product it created and the people it brought together, but also in the ideas it sparked.

[00:24:06] Tamara Kissane: How did the creative writing workshops that June taught fit into your arts model?

[00:24:11] Moira McGuire: I would like to briefly touch on how unique and special June has been to our program. Again, you know, doing things virtually, this was new to so many of us. It was absolutely new to Walter Reed, right? The pandemic is definitely what pushed us in very new ways.

Some of the telehealth was going on, but in a more limited capacity, so it really pushed us into these new domains you know, and it's no small feat to create trust and establish even intimacy in an online setting with people who are coming to you from a variety of backgrounds; you have no idea what they're bringing with them.

And I have just been so in awe of June's ability to make people feel safe, to make people feel heard. I think that very, very few people could do what she does, and I will be eternally grateful that we found her and that she was there for us. Because I cannot begin to describe the impact that she has had for our patients and staff.

[00:25:17] Sarah Moore: I agree with all of that. I'm very determined to keep up our writing classes and we're trying to figure out the best way to fund that. Thank you June, for being part of our community. You absolutely are.

[00:25:32] June Guralnick: Thank you both so much. It was life changing, working with both of you and having the opportunity to work with Walter Reed and the population it serves. I just want to tell you both how much I admire and respect you. What amazing leaders you are in the arts and health field. See, notice - I didn't use the word healing.

[00:25:55] Sarah Moore: Good job. I used health because people aren't broken. So that's right.

[00:26:01] June Guralnick: Because when I look at healing, I look at it in the largest sense of that word in that we're all healing, aren't we? Yes, we're constantly embracing a better vision for ourselves and in that sense, that's how I use that word. I'm grateful to both of you for spending this time with us today, and I look forward to seeing more of the wonderful things that you're doing.

[00:26:29] Tamara Kissane: We heard a lot today about the healing power of telling your own story. What did you hear? What did you take away from this conversation that's still turning in your mind? In the spirit of this series, The Write to Heal, we invite you to respond to this prompt: Describe an experience in your life where you found joy when you least expected it. Take a moment to jot down whatever comes to mind. No need to edit yourself. Just let it flow. And if you're willing, we'd love to hear your thoughts and writings. You can share them by sending to artistsoapbox@gmail.com with the subject heading The Write to Heal.

The Write to Heal: Soldiers Deep Dive into Storytelling is a production of Artist Soapbox in partnership with June Guralnick. This series is dedicated in memory of David Brave Heart, who's inspiring music graces our introduction and closing sections with additional music by Louis Wilkinson. The intro montage is sound engineered by Royce Froehlich with post-production by Jasmine Hunjan and Tamara Kissane.

For more information, including the list of writers who contributed to our opening montage, please see the show notes. Catch us on social media, or visit our websites: artistsoapbox.org and juneguralnick.com.