Therapists every day work to help those traumatized by events like a sexual assault.

But where to start when the pain runs deep?

Poetry might be one way to begin the healing process, according to local author Cynthia Gustavson. She's written a textbook chapter for a recently published book, Expressive Therapies for Sexual Issues: A Social Work Perspective, which outlines techniques for using poetry to help others.

"We all have such different personalities, but a piece of paper is not scary. And a person can be scary, because that person, you see it in the judgment on their face, even if they don't say a word," Gustavson said.

Gustavson said she hopes to turn poetry into a more commonly used tool for therapists.

With the textbook chapter, "I've actually made my own model for them to use ... no matter if they've never written a poem," said Gustavson.

She acknowledged that only a minority of people embrace the idea of being a poet. But that doesn't mean there aren't ways to help them with poetry therapy, Gustavson said.

One poetry therapy exercise commonly used by Gustavson calls for a person to fill in the blanks: "I used to be 'something,' but now I am 'something else,'" Gustavson said.

It's a simple and basic approach to begin to understand what has changed in a person's life.

What others call poetry can also be aptly described as metaphor, she said.

"It helps us describe the indescribable," Gustavson said.

For Gustavson, poetry has been almost a lifelong comfort.

"My father died when I was 13," Gustavson said. "And I remember writing a poem for my mother because I didn't know what else to do. I just absolutely did not know what to do with my feelings."

Even at that young age, she said she had already developed a love for the form "because I loved the sound," describing her early appreciation for the "music in the words" -- noting that her father was a musician.

The simple act of writing a poem while grieving his death "was probably the first time that I realized I could use it for a purpose," said Gustavson, 65.

She continued on with poetry while trying other jobs, eventually settling on becoming a therapist.

Gustavson didn't think of herself as a poetry therapist until after her first book of poetry was published -- and her clients took notice.

"They saw in the newspaper that I was a poet, so then my clients -- who hadn't known that before -- came in with pieces of paper in their pockets. And they'd unfold them and say, 'Can I show this to you, does this mean anything?'" recalled Gustavson. "So they'd bring their poetry in to me, and I would say to them, 'Of course it means something. But I'm not going to tell you what it means, you have to tell me what it means.' And that's the difference between an English teacher and a poetry therapist."

It was the start of a career blending her passion for poetry and her desire to help others. She came to Tulsa in 1997, working with a diverse population in her counseling practice before retiring last year to focus on her writing. In the past three years, she's written an award-winning children's book, Ballad of the Rag Man with a message about empathy, and also a workbook for youth last year called Bully! The Big Book About Bullies and the Bullied.

These latest works come after a series of workbooks Gustavson wrote on poetry therapy.

She has been an innovator in a field that has deep roots but still struggles for wider visibility. The National Association for Poetry Therapy traces the movement's roots in America to Dr. Benjamin Rush, who signed the Declaration of Independence while serving as a leading physician known as the "Father of American Psychiatry." Rush called for patients in mental hospitals to receive a steady dose of music and literature, and to have their poems published in a patient newspaper.

The association formed 30 years ago, but poetry therapy has not become widespread -- at least not by that name.

"There's a lot of room to grow," Gustavson said. She couldn't name any therapists in Tulsa who specialize in poetry therapy. However, "I think there are thousands of people out there doing what I do, because people naturally write the poetry and they bring it in and somebody looks at it. And maybe they're not trained in it, but you know they say, 'Sure this is important; let's look at this.' So I think it's happening without being named a lot." She added that anyone seeing a therapist shouldn't hesitate to share poems with a counselor.

Poetry therapists also have the ability to pick poems out for clients, however. Gustavson said she often wrote original poems specifically for her clients as a way to convince them she had some insight into what they were feeling.

"You give them something that's in writing and they relate to it, and they might as well tell you the rest of the story," Gustavson said.

It's true that men rarely choose poetry therapy, but Gustavson offered one simple exercise that might benefit anyone. If feelings of unease seem to be taking some joy out of life, Gustavson said people might try writing a word vertically, then use the letters of the word to inspire a poem -- or at least a group of words -- associated with their feelings.

"You can do that for Christmas, survivor, guilt, for your own name -- whatever," Gustavson said. If done "at least twice, you're going to get some hints about what's going on with you and what's not right."

She added: "In a sense, I think it draws from your subconscious, the things that it's very hard to get in touch with. Poetry can just go right through everything else and grab it and pull it out."

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